About 5% of patients with SCLC have the ectopic production of ACTH. Ectopic ACTH production of SCLC is suspected when patients of SCLC have unexplained metabolic alkalosis and hypokalemia. Most patients lack the classic feature of Cushing's syndrome. According to the recent report, they have poor prognosis, which median survival is less than 4 months and associated with a high rate of complication during chemotherapy. Also a case of paraneoplastic CRH production with SCLC can mimic the ectopic ACTH syndrome hut it can be distinguished by immunohistochemistry or direct measurement of serum CRH level. We report here a case of small cell lung cancer associated with Cushing's syndrome of ectopic ACTH production. That is immunohistochemically provened by staining with ACTH.
ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone* ; Alkalosis ; Cushing Syndrome* ; Drug Therapy ; Humans ; Hypokalemia ; Immunohistochemistry ; Lung Neoplasms* ; Lung* ; Prognosis ; Small Cell Lung Carcinoma

PURPOSE: Advanced gastric cancer, the most common malignancy in Korea is a kind of systemic disease. At dignosis, 50~80% of patients have systemic cancer. Therefore, the most patients require systemic chemotherapy. Cisplatin and 5-FU have been suggested to be active in the treatment of gastric cancer, a high response rate was observered with a combination of 5-FU infusion and cisplatin, and the biochemical modulation of 5-FU by leucovorin has been demonstrated to enhance the activity of 5-FU in gastrointestinal tract cancer. MATERIALS AND METHODS: The patients with advanced gastric cancer whose disease had relapsed or unresectable were treated with 5-FU(800 mg/m2 12 hr IV infusion, D 1~5), leucovorin(20 mg/m2 IV, D 1~5, max. 30 mg), cisplatin(100 mg/m2 15min IV dripping, D1). The cycles of treatment were repeated at 3-weeks intervals. RESULTS: Between Sep. 1994 and Aug. 1996, previously untreated 44 patients(39 eligible patients) were admitted to this study, the median age was 55 years(range 17~73) and male to female ratio was 20:19. The rate of complete remission was 5%(2/39), the rate of partial remission was 21%(8/39). The median-response duration was 26 weeks(5+~38+ ). The median-time to progression was 25 weeks(4+~62+). The range of overall survival time was from 4 to 62+ weeks. 24 weeks survival rate was 71.5% but the median survival time was not reached. The leukopenia and anemia were the main hematologic toxicities. Non-hematologic side effects were nausea, vomiting, diarrhea, stomatitis, peripheral neuropathy. These toxicities were observed commnonly, but tolerable. Two treatment-related deaths were associated with sepsis. CONCLUSION: Based on these results, FLP combination chemotherapy seems to be a moderate efficacy for advanced gastric cancer with tolerable toxicities. To confirm the efficacy further, the long-term follow up and a large scale of clinical studies are needed.
Anemia ; Cisplatin* ; Diarrhea ; Drug Therapy ; Drug Therapy, Combination* ; Female ; Fluorouracil* ; Follow-Up Studies ; Gastrointestinal Neoplasms ; Humans ; Korea ; Leucovorin* ; Leukopenia ; Male ; Nausea ; Peripheral Nervous System Diseases ; Sepsis ; Stomach Neoplasms* ; Stomatitis ; Survival Rate ; Vomiting

No abstract available.
Cisplatin* ; Etoposide* ; Ovarian Neoplasms*

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of mental nerve (the distal trigeminal nerve). This uncommon neuropathy may be associated with neoplastic disease and usually appeared as a late manifestation of systemic malignancy, and it is an important sign for early diagnosis and prediction of clinical course and prognosis of hematologic malignancy. The numb chin syndrome is usually associated with a poor prognosis although various therapeutic strategies led to resolution of this syndrome. We report 2 cases of numb chin syndrome ; one in acute leukemia in early course of disease before diagnosis of leukemia and the other in leptomeningeal seeding of malignant lymphoma. The therapeutic response and prognosis were poor, a patient of malignant lymphoma expired in two months and a patient of acute leukemia is alive at present but the disease was relapsed in 5 months after complete remission.
Chin* ; Diagnosis ; Early Diagnosis ; Hematologic Neoplasms ; Humans ; Hypesthesia ; Leukemia ; Lip ; Lymphoma ; Prognosis

The association between aplastic crisis and human parvovirus (HPV) B19 infection is well described in patients with sickle cell anemia. This association has also been described, although much less frequently, in patients with hereditary spherocytosis (HS). However, most cases of aplastic crises in patients with HS and induced by HPV B19 have been reported in children or adolescents. In this paper, we describe an aplastic crisis induced by HPV B19 in an adult with HS. A 34-year-old female presented with presyncope, febrile sensation, and myalgia. The complete blood counts showed severe anemia. The peripheral blood smear revealed spherocytosis with reticulocytopenia and pancytopenia. The direct Coombs' test was negative; the osmotic fragility test was positive. In the bone marrow aspirates, a few giant pronormoblasts with deep blue cytoplasm, pseudopods, and intracellular inclusion bodies were observed. The patient was given eight units of packed red blood cells. HPV B19 infection was proven by the presence of IgM antibodies to HPV B19 and the detection of viral DNA using the PCR technique. To the best of our knowledge, this is the first report in Korea that describes an adult with aplastic crisis presenting initially with HS.
Adult ; Anemia, Aplastic/*etiology ; Female ; Humans ; Parvoviridae Infections/*complications/diagnosis ; Parvovirus B19, Human ; Spherocytosis, Hereditary/*diagnosis

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*

Carcinoid tumor is the most commen tumor of appendix. Metastases from the appendecial carcinoid tumor is rare, and the prognosis of metastatic appendecial carcinoid tumors are closely related to the histologic findings. Atypical, aggressive metastatic carcinoid tumors shows poor prognosis. We experienced a case of atypical aggressive carcinoid tumor of appendix with metastasis. We treated her with combination chemotherapy, etoposide and cisplatin, and achieved partial remission. The duration of remission was 5 months, and survival duration was 19 months. To the best of our knowledge, this is the first case of atypical appendiceal carcinoid tumor with distant metastasis in Korea, so we report this case and the result of chemotherapy.
Appendix* ; Carcinoid Tumor* ; Cisplatin ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide ; Korea ; Neoplasm Metastasis ; Prognosis

PURPOSE : We conducted a phase II trial of the addition of a paclitaxel and cisplatin regimen as induction chemotherapy to concurrent thoracic radiation therapy and weekly paclitaxel and cisplatin in locally advanced unresectable stage III non-small cell lung cancer. The endpoints were to determine the applicability, safety, response rate and survival statistics. MATERIALS AND METHODS : The induction chemotherapy consisted of paclitaxel 175 mg/m2 given 3 hours on day 1 and cisplatin 75 mg/m2 given over 1 hour on day 2 repeated 3 weeks for two cycles. Thoracic radiation therapy 63 Gy/35 fractions in daily 1.8 Gy fractions along with paclitaxel 45 mg/m2/1 hr and cisplatin 20 mg/m2/1 hr given 2~4 hours before irradiation repeated every week for 6 cycles. To minimize the toxicities of a concurrent portion of treatment, the treatment planning for thoracic radiation therapy was done throughly with the assistance of a planning CT scans and computerized radiation treatment planning system. RESULTS : Twenty-nine patients were enrolled between Sep 1999 to Sep 2002. The overall response rate after the induction chemotherapy was 79.3%. Due to the refusal of further treatment, 1 patient left the trial. Twenty-three (79.3%) of the 29 patients received the concurrent portion of treatment. Five (17.2%) patients received the radiation therapy alone, two due to refusal, two for decreased performance stati, one due to pulmonary abscess. After completion of the entire course of treatment, 5 (17.2%) patients gained the complete remission and the overall response rate of 79.3%. With a median follow-up of 22 months, the 1-, 2- and 3-year overall survival rates were 75.7, 53.4 and 41.6%. The progression free survival rates were 52.5 and 20.5% at 1- and 2-year, respectively. Induction chemotherapy was well tolerated. Among 23 patients who completed the entire course of treatment including the concurrent portion, 6 (34.8%) suffered hematologic toxicities more than grade 3, 2 (8.7%) had esophagitis greater than grade 3 and 3 (13.3%) had radiation pneumonitis greater than grade 3. CONCLUSION : We concluded that weekly Paclitaxel+ Cisplatin with concurrent radiotherapy following 2 cycles of induction chemotherapy with Paclitaxel+Cisplatin repeated 3 weeks is effective and welltolerated, should be further evaluated in a randomized phase III trial
Carcinoma, Non-Small-Cell Lung* ; Chemoradiotherapy* ; Cisplatin ; Disease-Free Survival ; Disulfiram ; Esophagitis ; Follow-Up Studies ; Humans ; Induction Chemotherapy* ; Lung Abscess ; Paclitaxel ; Radiation Pneumonitis ; Radiotherapy ; Survival Rate ; Tomography, X-Ray Computed

Neuropeptide Y (NPY) was a 36-amino acid peptide that biochemical structure to be resemble the pancreatic polypeptide in mammalian and it was first isolated from porcine brain by Tatemoto et al. (1982). It is now known to neurotransmitter or neuromodulator as well as it has important effects to sexual precocity, regulation of feeding behavior and function of pituitary gland in avians. The distribution and morphological study of NPY-immunoreactive neurons (NPY-IR) is studied in many experimental animal but in developing chick brain have been not studied. The present study provided the distribution and morphological study of NPY-IR in developing chick brain. The developing brain of Korean native chicks embryos at E8, E10, E12, E14, E16, E18, and E20 days of incubation were used. Experimental animals were perfused with 4% paraformaldehyde through the left ventricle and aorta. The brains were removed and transferred 30% sucrose, and then cut on a cryostat into 60 mm-thick. The tissue immunostained with free-floating and avidin-biotin complex (ABC) method. The results obtained in this study are that followings. The numerous of NPY-IR first observed at E8 days in the telencephalon of neostriatum, ectostriatum, archistriatum intermedium pars ventralis, nucleus taeniae and paleostriatum agumentatum, at E12 days in telencephalon of hippocampus, at E14 days in telencephalon of hyperstriatum. In the telencephalon, NPY-IR distributed predominantly in neostriatum and ectostriatum. shape of neuron's that E8 days of incubation were oval shape neurons and increased days of chicks was sphere, oval and many multigonal shapes. Their processes were also omnidirectional. The process of neuron's that E8 days of incubation was observed a few and weak immunity and increased days of chicks was numerous and strong immunity. According to increasing the days the morphology of NPY-IR showed the tendency to increase their sizes and numbers. We suggest that the regional differences in the distribution of NPY-containing neuron types may reflect adaptations of local neuronal circuits for specialized functions.
Animals ; Aorta ; Brain ; Embryonic Structures ; Feeding Behavior ; Globus Pallidus ; Heart Ventricles ; Hippocampus ; Neostriatum ; Neurons* ; Neuropeptide Y* ; Neuropeptides* ; Neurotransmitter Agents ; Pancreatic Polypeptide ; Pituitary Gland ; Sucrose ; Taenia ; Telencephalon*

Neuroendocrine tumors originate from neuroendocrine cell, so called APUD (amine precursor uptake and decarboxylation). Most neuroendocrine tumors have typical histopathology, immunohistochemical findings, and can be diagnosed by specific electromicroscopic feature of dense core granules. Neuroendocrine tumors are a diverse group of neoplasms that include carcinoid tumors, islet cell tumors, neuroblastoma, and small cell carcinoma. Neuroendocrine carcinoma of thymus bears similarities to neuroendocrine carcinoma in other organs, but it is clinicopathologically distinct from other tumors of thymus. Rare reports have been seen about thymus neuroendocrine carcinoma. Authors experienced a case of neuroendocrine carcinoma of thymus which cannot be classified as carcinoid, atypical carcinoid, or small cell carcinoma. Herein, we report this case with a review of the literatures.
Adenoma, Islet Cell ; Carcinoid Tumor ; Carcinoma, Neuroendocrine* ; Carcinoma, Small Cell ; Neuroblastoma ; Neuroendocrine Cells ; Neuroendocrine Tumors ; Thymus Gland*