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

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

Angiosarcoma is a very rare neoplasm, and even more so in the gastrointestinal tract where its distinction from adenocarcinoma may be extremely difficult. We report a case of multifocal epithelioid angiosarcoma of the stomach in a 65-year-old woman. Histologically, the tumor foci were composed of haphazard, anastomosing channels lined by malignant endothelial cells with epithelioid features. Those neoplastic cells stained positive for CD31, CD34, and factor VIII-related antigen.
Adenocarcinoma ; Aged ; Endothelial Cells ; Female ; Gastrointestinal Tract ; Hemangiosarcoma* ; Humans ; Stomach* ; von Willebrand Factor

Hantavirus is known to a causative agent of hemorrhagic fever with renal syndrome and it can cause hantavirus pulmonary syndrome, a rare disease in Korea. Hantavirus pulmonary syndrome is usually associated with pulmonary hemorrhage and fever. The common hematologic features of this syndrome are elevated hematocrit level, leukocytosis and thrombocytopenia. We report a case of hantavirus pulmonary syndrome with pancytopenia. This patient with severe neutropenia with pulmonary infiltration mimicked aplastic anemia with invasive aspergillosis.
Anemia ; Anemia, Aplastic ; Aspergillosis ; Fever ; Hantavirus ; Hantavirus Pulmonary Syndrome ; Hematocrit ; Hemorrhage ; Hemorrhagic Fever with Renal Syndrome ; Humans ; Korea ; Leukocytosis ; Neutropenia ; Pancytopenia ; Rare Diseases ; Thrombocytopenia

Thymomas are one of the most common neoplasms of the mediastinum derived from thymic epithelium. It is common that invasive thymoma invades the lung, pericardium, and great vessels. Airway compression by mass effect also occurs, but direct polypoid tumor growth into the airway is extremely rare. Only 20 cases of invasive thymoma with endobronchial polypoid growth have previously been reported globally. However, there is no case report of invasive thymoma with endotracheal growth. Herein, we report a rare case of invasive thymoma with endotracheal polypoid growth in a 28-year-old woman.
Bronchoscopy ; Epithelium ; Female ; Humans ; Lung ; Mediastinum ; Pericardium ; Thymoma

Acquired amegakaryocytic thrombocytopenia (AAMT) is an unusual disease characterized by severe thrombocytopenia resulting from a marked decrease in bone marrow megakaryocytes. Various pathogenic mechanisms have been suggested, and several treatments have been tried, with varying outcomes. In some case reports, cyclosporine and anti-thymocyte globulin have had good clinical results in the treat of AAMT. There are few reports on the treatment of relapsed AAMT with cyclosporine. We report a patient with relapsed AAMT who was treated successfully with an additional course of cyclosporine. The initial remission was achieved with cyclosporine 4 years earlier and a second remission was induced by cyclosporine. Cyclosporine may be effective for relapsed AAMT that previously responded to cyclosporine.
Antilymphocyte Serum ; Bone Marrow ; Cyclosporine* ; Humans ; Megakaryocytes ; Thrombocytopenia*

OBJECTIVE: Impaired processing of working memory is one of the cognitive deficits seen in patients with schizophrenia. This aimed at corroborating the differences in the brain activities involved in the process of working memory between patients with schizophrenia and the control subjects. METHOD: Fourteen patients with schizophrenia and 12 healthy volunteers were recruited in this study. Functional magnetic resonance imaging(fMRI) was used to assess cortical activities during the performance of a 2-back visual working memory paradigm using the Korean alphabet as mnemonic content. RESULTS: Group analysis revealed that left lateral prefrontal cortex and right parietal lobule showed decreased cortical activities in the patient group. On the other hand, an increased activation in left superior and middle frontal gyrus, left middle temporal gyrus, right cuneus, both occipital lobes, right fusiform gyrus and right cingulate gyrus. The activation in left anterior lobe and both declive of cerebellum was also increased. CONCLUSIONS: This study showed a decreased activation in left lateral prefrontal and right parietal neural networks from the patient group and confirmed the earlier findings on the impaired working memory of patients with schizophrenia using fMRI investigation. The regions implicated in our study suggest an abnormal functioning of the fronto-parietal cortical areas that are critical to the information processing stream, which might be correspondent to common pathophysiology rather than a common etiology in schizophrenia.
Automatic Data Processing ; Brain ; Cerebellum ; Gyrus Cinguli ; Hand ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Memory, Short-Term* ; Occipital Lobe ; Prefrontal Cortex ; Rabeprazole ; Rivers ; Schizophrenia*

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*

PURPOSE: We performed this study to evaluate the efficacy and the safety of EAP regimen as a second line therapy for the recurred or metastatic gastric cancer unresponsive to 5-fluorouracil based chemotherapy. MATERIALS AND METHODS: Recurred or metastatic gastric cancer patients unresponsive to 5- fluorouracil based regimen were entered into this trial. They were treated by EAP chemotherpy which consisted of etoposide 40 mg/m2, doxorubicin 15 mg/m2 and cisplatin 25 mg/m2 IV during 3 days each every 3 weeks. RESULTS: From December 1994 to March 1998, Eighteen patients were enrolled in this protdegrees Col. Fourteen patients were evaluable for response. The overall response rate was 28.6% (95% CI: 11.7~56.7%). The median response duration was 21 weeks. The median survival for all enrolled patients was 28 weeks. The major toxicity was myelosuppression. Among total of 69 cycle che motherapy, WHO grade 3 or 4 granuldegrees Cytopenia and thrombdegrees Cytopenia were observed in 71.0% and 27.5%, respectively. CONCLUSION: Second line therapy with EAP regimen was active for gastric cancer. Chemotherapy induced toxicities were moderate to severe.
Cisplatin* ; Doxorubicin* ; Drug Therapy ; Drug Therapy, Combination* ; Etoposide* ; Fluorouracil ; Humans ; Stomach Neoplasms