Membranous glomerulonephropathy is the most common cause of nephrotic syndrome in adults and idiopathic autoimmune thrombocytopenic purpura is autoimmune disease caused by autoantibody to platelet membrane glycoprotein. Although there are some pathologic similarity between two diseases that 'membrane attack complex' play a role in pathologic process, but only 3 cases worldwide are reported about membranous glomerulonephropathy associated with idiopathic autoimmune thrombocytopenic purpura. So we report a case of sixty eight years of woman who had symptoms of generalized edema, foamy urine, anorexia and thrombocytopenia on admission and developed more severe symptomatic thrombocytopenia there after. She was diagnosed membranous glomeulonephropathy on renal biopsy and also diagnosed idiopathic autoimmune thrombocytopenic purpra on bone marrow biopsy and on the basis of exclusion.
Adult ; Anorexia ; Autoimmune Diseases ; Biopsy ; Blood Platelets ; Bone Marrow ; Edema ; Female ; Glomerulonephritis, Membranous* ; Humans ; Membrane Glycoproteins ; Nephrotic Syndrome ; Purpura, Thrombocytopenic, Idiopathic* ; Thrombocytopenia

BACKGROUND: Most patients with gastric cancer have metastatic disease at first diagnosis and need palliative chemotherapy. Unfortunately, the response duration of the first line chemotherapy is usually short and most patients need the second line therapy during their disease process. The action mechanism of continuous infusion of 5-FU is different from bolus 5-FU and we can expect that among patients who failed on bolus 5-FU, some patients will achieve response to infusional 5-FU. So, we planned to evaluate the efficacy and safety of leucovorin and infusional 5-FU as a second line regimen for the metastatic gastric cancer refractory to regimen containing bolus 5-FU. METHODS: Patients with recurred or metastatic gastric cancer unresponsive to regimen containing bolus 5-FU were entered into this study. The mixture of 5-FU 1,000 mg/m2/day and leucovorin 50 mg/m2/day was infused continuously for four days and this treatment was repeated by every three weeks. RESULTS: From March, 1996 to July 2001, 25 patients were enrolled in this study. One patient showed a partial remission, 9 stable disease and 15 progressive disease. The overall response rate was 4%. The median time to progression was 73 days and the median duration of overall survival was 140 days. Among total of 92 cycle chemotherapy, leukopenia, granulocytopenia and thrombocytopena of WHO grade 3 or 4 were observed in 7.6%, 12.0% and 14.1%, respectively. Stomatitis, nausea or vomiting of WHO grade 3 or 4 were 13.1%, 5.4%, respectively. Neutropenic infection occurred in two patients. CONCLUSION: The LF regimen was well tolerated with minimal toxicities and showed low effect as the second line chemotherapy for the patients with gastric cancer.
Agranulocytosis ; Diagnosis ; Drug Therapy ; Fluorouracil* ; Humans ; Leucovorin* ; Leukopenia ; Nausea ; Stomach ; Stomach Neoplasms* ; Stomatitis ; Vomiting

The damage which radiation produces in tissues such as the lungs can be discussed at the molecular, biophysical, cellular, and organ levels. The cellular effects of irradiating the lungs are related to the histologic and clinical sequelae. In the present study the right lung of rabbits were exposed to single dose of 20 Gy of X-irradiation. Animals from each group were sacrificed monthly for 6 months postexposure. Sections of lung were examined by light microscopy(LM) and by transmission electron microscopy(TEM). Multiple exudative lesions were seen at 2 months after the 20Gy irradiation, and they progressed to a proliferative and then reparative fibrotic lesion by 6 months. Changes in epithelial lining of lung components, particulary the presence of type II pneumocytes were found by both LM and TEM. Capillary endothelial damages were less pronounced. The possible implication of cellular components in radiation pneumonitis and fibrosis is discussed.
Animals ; Capillaries ; Fibrosis ; Lung* ; Pneumocytes ; Rabbits ; Radiation Pneumonitis

BACKGROUND: As a tumor marker, lactate dehydrogenase is widely used as a prognostic factor in malignant lymphomas and a therapeutic monitor in ovarian dysgerminoma. But in other tumors, the clinical role of lactate dehydrogenase is not clear yet. To investigate the role of LD as a tumor marker, we analyzed patients with various cancers and high LD level. METHODS: The serum LD level was assayed in the cancer patients who visited our hospital. For the patients with high LD level, isoenzyme was also assayed. The response of chemotherapy was classified according to the WHO criteria into remission, which covers complete and partial remission, stable disease and progressive disease. The relationship between the tumor response and the LD response was examined in terms of sensitivity, specificity and positive predictive value. RESULTS: A total of 100 cancer patients were found to have high LD level; among them, 76 patients underwent chemotherapy. There were 38 patients with LD increased and 38 patients with LD decreased after chemotherapy. No patient was in remission, 6 patients in stable disease, and 32 patients in progressive disease among 38 patients with increased LD level; 18 patients in remission, 10 patients in stable disease, and 10 patients in progressive disease among 38 patients with decreased LD level. The sensitivity of LD increase in the patients with tumor progression is 76.2%, the specificity 73.7%, and the positive predictive value 84.2%(71.4%, 25.0% and 76.9% respectively in stomach cancer patients). The sensitivity of LD decrease in the responsive patients is 100%, the specificity 65.5% and the positive predictive value 47.4%.(100%, 64.7% and 14.3% in stomach cancer patients respectively). The LD isoenzyme pattern was not specific in this study. CONCLUSION: Serum LD measurement may be helpful in monitoring tumor response, especially for stomach cancer, after chemotherapy.
Drug Therapy ; Dysgerminoma ; Humans ; L-Lactate Dehydrogenase ; Lactic Acid* ; Lymphoma ; Sensitivity and Specificity ; Stomach Neoplasms

A 76 year-old female who was diagnosed with multiple myeloma (IgG, lambda) had received bortezomib, melphalan and prednisolone as first-line treatment. After completing six cycles of chemotherapy, her serum monoclonal protein level decreased from 7.28 g/dL to 0.65 g/dL, indicating a partial response. However, at the next scheduled visit she complained of slowly progressing dyspnea. On chest X-ray, newly developed pleural effusion was found, and rapidly progressing extramedullary plasmacytoma was detected in the anterior mediastinum on chest computerized tomography. However, there was no change in her serum monoclonal protein level. In Korea, extramedullary involvement is encountered in 5% of patients with multiple myeloma. However, evaluation of treatment response using solely the serum monoclonal protein level may not accurately reflect disease status in these patients.
Drug Therapy ; Dyspnea ; Female ; Humans ; Korea ; Mediastinum ; Melphalan ; Multiple Myeloma* ; Plasmacytoma* ; Pleural Effusion ; Prednisolone ; Thorax ; Bortezomib

OBJECTIVES: The purpose of this study was to describe the status of mental activity participation in community-dwelling elderly and to evaluate the association between mental activity and cognitive function after adjustment for depression and anxiety. METHODS: This study was based on the Suwon Project, which was a cohort comprising of nonrandom convenience samples of ethnic Koreans aged 60 years and above. All the subjects completed the study questionnaire including their demographic characteristics, current and past illnesses history, drug history, Korean version-Mini Mental State Examination (K-MMSE), Korean version of Short Form Geriatric Depression Scale (SGDS-K), Beck Anxiety Inventory (BAI). We checked how many hours per day are used for each items of 11 mental activities through the checklist. RESULTS: Total time spent in 11 mental activities was 237.4+/-152.4 minutes per day. On multiple regression analysis, total time spent in 11 mental activities (MA-total), and time spent by watching television and reading book/newspaper showed statistically significant association with K-MMSE score after adjustment with age, sex, education, chronic medical illness, depression and anxiety. CONCLUSION: Our result suggested that mental activity may be associated with cognitive function in the elderly without cognitive impairment in the community after adjusting age, sex, education, chronic medical illness, depression and anxiety.
Aged ; Anxiety ; Cognition ; Cohort Studies ; Depression ; Humans ; Surveys and Questionnaires ; Television ; Periodicals

Lymphoid malignancies have been reported in association with chronic myelogenous leukemia, but the development of chronic myelogenous leukemia and T-cell lymphoma in the same patients is rare. We experienced a case of peripheral T-cell lymphoma developed in the course of chronic myelogenous leukemia. In December 1993, a diagnosis of chronic myelogenous leukemia was made. The patient was treated with hydroxyurea and busulphan. In June 1999, the patient was admitted because of a swelling in right submandibular area and throat pain. He underwent right tonsilectomy. The histologic and immunologic examination of tonsil revealed a peripheral T-cell lymphoma. This case is additional one to a few previously reported cases of concurrence of chronic myelogenous leukemia and T-cell lymphoma.
Busulfan ; Diagnosis ; Humans ; Hydroxyurea ; Leukemia ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Lymphoma ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral* ; Palatine Tonsil ; Pharynx ; T-Lymphocytes

Myeloid sarcoma is a rare tumor mass consisting of immature granulocytic cells occurring in an extramedullary site or in a bone. It has often been observed during the course of an acute leukemia, myelodysplastic syndrome or myeloproliferative neoplasms, and it can involve any site of the body. However, it rarely present in the absence of bone marrow infiltration, especially for the isolated spinal myeloid sarcoma. In this report, we describe a case of isolated myeloid sarcoma that showed spinal compression. A 66-year-old male, with no underlying disease or medication history, presented with a progressive back pain and numbness in bilateral lower extremities that had begun two weeks before. He was diagnosed with myeloid sarcoma with no evidence of bone marrow involvement. Tumor cells were positive for CD34, c-KIT, and Bcl-2 on the immunohistochemical stain. He was treated with systemic chemotherapy with daunorubicin plus cytosine arabinoside and achieved a partial response.
Aged ; Back Pain ; Bone Marrow ; Cytarabine ; Daunorubicin ; Drug Therapy ; Humans ; Hypesthesia ; Leukemia ; Lower Extremity ; Male ; Myelodysplastic Syndromes ; Sarcoma, Myeloid* ; Spinal Cord Compression

BACKGROUND: Mad1 protein is known to repress Myc target genes and antagonize Myc function. We underwent this study to investigate the clinical implication of Mad1 expression in human breast cancer. MATERIALS AND METHODS: We performed immunohistochemical assay for Mad1 protein together with Myc in human brest cancer, along with tissues from normal and benign diseases. The data from protein assay were merged with clinical and biologic parameters of the patients. RESULTS: Of 66 patients with invasive ductal cancer, Mad1 expression was detected in 22(33.3%). Intensity and area of Mad1 expression significantly decreased in DCIS and invasive cancers while high levels of Mad1 expression were persistent in benign breast lesions. Mad1 expression was significantly reduced in poorly differentiated tumors(P<0.001). Expression of Mad1 was not associated with tumor size, lymph node status, and stage of the disease. We could not observe any correlation between S-phase and expression status of Myc or Mad1. Mad1 expression was closely linked to differentiation of the cancer cells and inversely correlated with Myc expression(P=0.042). In survival analysis, Mad1 possessed a prognostic significance to predict recurrence of the disease but not overall survival after CMF chemotherapy. CONCLUSIONS: In human breast cancer cells, expression of Mad1 seems to be downregulated while expression of Myc is amplified. Altered expression of Mad1 may play a role in malignant transformation of human mammary epithelial cells and represent an aggressive phenotype in human breast cancer.
Breast Neoplasms* ; Breast* ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Epithelial Cells ; Humans* ; Lymph Nodes ; Phenotype ; Prognosis ; Recurrence

BACKGROUND: Cyclin D1 expression is closely related with ER in breast cancer. We conducted this study to evaluate whether therapeutic response to tamoxifen is varied with levels of cyclin D1 expression in ER positive breast cancer patients. MATERIALS AND METHODS: Immunohistochemical assay for cyclin D1 protein was performed in 66 patients tasted with tamoxifen for more than 2years. Patient survival and correlation between cyclin D1 expression and biologic data of the patients were analyzed RESULTS: Cyclin D1 expression was detected in 46 (69.7%) and significantly reduced in poorly differentiated cancer (p=0.023). Cyclin D1 expression was high in the tumors expressing Myc (15/15 vs 31/51; p=0.002), and was markedly increased in the tumors in which p27Kip1 expression was repressed (30/38, 78.9%). However, the difference was not statistically significant (p=0.051). There was no significant relationship between cyclin D1 expression and S-phase. Patients with tumors expressing cyclinD1 showed better disease free survival and overall survival but the difference was not statistically significant. CONCLUSIONS: Cyclin D1 expression was associated with cell differentiation but not useful in discriminating high risk group with tamoxifem treatment. Cyclin D1 may have a role in process other than cell cycle regulator in ER positive breast cancer, such as differentiation signal.
Breast Neoplasms ; Cell Cycle ; Cell Differentiation ; Cyclin D1* ; Cyclins* ; Disease-Free Survival ; Estrogens* ; Humans ; Prognosis ; Tamoxifen*