PURPOSE: We evaluated the effect of early chemoradiotherapy on the treatment of patients with limited stage small cell lung cancer (LS-SCLC). MATERIALS AND METHODS: Between January 2006 and December 2011, thirty-one patients with histologically proven LS-SCLC who were treated with two cycles of chemotherapy followed by concurrent chemoradiotherapy and consolidation chemotherapy were retrospectively analyzed. The chemotherapy regimen was composed of etoposide and cisplatin. Thoracic radiotherapy consisted of 50 to 60 Gy (median, 54 Gy) given in 5 to 6.5 weeks. RESULTS: The follow-up period ranged from 5 to 53 months (median, 22 months). After chemoradiotherapy, 35.5% of the patients (11 patients) showed complete response, 61.3% (19 patients) showed partial response, 3.2% (one patient) showed progressive disease, resulting in an overall response rate of 96.8% (30 patients). The 1-, 2-, and 3-year overall survival (OS) rates were 66.5%, 41.0%, and 28.1%, respectively, with a median OS of 21.3 months. The 1-, 2-, and 3-year progression free survival (PFS) rates were 49.8%, 22.8%, and 13.7%, respectively, with median PFS of 12 months. The patterns of failure were: locoregional recurrences in 29.0% (nine patients), distant metastasis in 9.7% (three patients), and both locoregional and distant metastasis in 9.7% (three patients). Grade 3 or 4 toxicities of leukopenia, anemia, and thrombocytopenia were observed in 32.2%, 29.0%, and 25.8%, respectively. Grade 3 radiation esophagitis and radiation pneumonitis were shown in 12.9% and 6.4%, respectively. CONCLUSION: We conclude that early chemoradiotherapy for LS-SCLC provides feasible and acceptable local control and safety.
Anemia ; Chemoradiotherapy* ; Cisplatin ; Consolidation Chemotherapy ; Disease-Free Survival ; Drug Therapy ; Esophagitis ; Etoposide ; Follow-Up Studies ; Humans ; Leukopenia ; Neoplasm Metastasis ; Radiation Pneumonitis ; Radiotherapy ; Recurrence ; Retrospective Studies ; Small Cell Lung Carcinoma* ; Thrombocytopenia

Dietary intake of whole grains reduces the incidence of chronic diseases such as obesity, diabetes, cardiovascular disease, and cancer. In an earlier study, we showed that Panicum miliaceum L. extract (PME) exhibited the highest anti-lipogenic activity in 3T3-L1 cells among extracts of nine different cereal grains tested. In this study, we hypothesized that PME in the diet would lead to weight loss and augmentation of hyperlipidemia by regulating fatty acid metabolism. PME was fed to ob/ob mice at 0%, 0.5%, or 1% (w/w) for 4 weeks. After the experimental period, body weight changes, blood serum and lipid profiles, hepatic fatty acid metabolism-related gene expression, and white adipose tissue (WAT) fatty acid composition were determined. We found that the 1% PME diet, but not the 0.5%, effectively decreased body weight, liver weight, and blood triglyceride and total cholesterol levels (P < 0.05) compared to obese ob/ob mice on a normal diet. Hepatic lipogenic-related gene (PPARalpha, L-FABP, FAS, and SCD1) expression decreased, whereas lipolysis-related gene (CPT1) expression increased in animals fed the 1% PME diet (P < 0.05). Long chain fatty acid content and the ratio of C18:1/C18:0 fatty acids decreased significantly in adipose tissue of animals fed the 1% PME diet (P < 0.05). Serum inflammatory mediators also decreased significantly in animals fed the 1% PME diet compared to those of the ob/ob control group (P < 0.05). These results suggest that PME is useful in the chemoprevention or treatment of obesity and obesity-related disorders.
3T3-L1 Cells ; Adipose Tissue ; Adipose Tissue, White ; Animals ; Body Weight ; Body Weight Changes ; Cardiovascular Diseases ; Edible Grain ; Chemoprevention ; Cholesterol ; Chronic Disease ; Diet ; Fatty Acids ; Gene Expression ; Hyperlipidemias ; Incidence ; Liver ; Mice ; Obesity ; Panicum ; Serum ; Weight Loss

BACKGROUND/AIMS: In Korea, few studies have examined primary cardiac tumors, which have a reported incidence of 0.0017~0.19% in autopsy series. This study surveyed the status of primary cardiac tumors over the past 7 years in one region. METHODS: A retrospective review examined all patients with primary cardiac tumors, except for confirmed thrombus, using hospital medical records from 2000 to 2006 at six community hospitals. Identified cases undergoing biopsy and surgery were selected for the study. RESULTS: The operative mortality was 7.7%. Of the 71 patients (26 males) with identified primary cardiac tumors, 65 (91.5%) tumors were benign and 6 (8.5%) were malignant. The benign tumors were myxoma (78.9%), rhabdomyoma (4.2%), fibroelastoma (2.8%), fibroma (1.4%), and leiomyoma (1.4%). Two of the myxomas were present at multiple locations. The malignant tumors included sarcomas (67%) and lymphomas (33%). Most of the tumors were located in the left atrium (76%). The majority of patients presented with chest pain and dyspnea. During follow-up for an average of 26.8+/-21.3 months, all but one patient with benign tumors was alive; one myxoma patient died perioperatively (1.5%). Four of the patients with malignant tumors (67%) died. CONCLUSIONS: Cardiac myxomas and sarcomas were the most common primary benign and malignant tumors, respectively. Benign tumors had excellent postoperative survival rates, while malignant tumors had high mortality.
Autopsy ; Biopsy ; Chest Pain ; Dyspnea ; Fibroma ; Follow-Up Studies ; Heart Atria ; Heart Neoplasms ; Hospitals, Community ; Humans ; Incidence ; Korea ; Leiomyoma ; Lymphoma ; Medical Records ; Myxoma ; Retrospective Studies ; Rhabdomyoma ; Sarcoma ; Survival Rate ; Thrombosis

Gymnopilus spectabilis, a hallucinogenic mushroom belonging to the family Cortinariaceae, is found growing in dense clusters on stumps and logs of hardwoods and conifers. It contains the hallucinogenic alkaloid psilocybin and its strongly bitter taste makes it undesirable as an edible. In an effort to identify chemical constituents of Korean native wild mushrooms, 4,6-decadiyne-1,3,8-triol (1), ergosta-4,6,8(14), 22-tetraen-3-one (2), bisnoryangonin (3), and hispidin (4) were isolated from the methanolic extract of the fruiting bodies of G. spectabilis. Their structures were assigned on the basis of various spectroscopic studies. Compounds 3 and 4 displayed significant scavenging activity against the ABTS radical cation, DPPH radical, and superoxide radical anion, while 1 and 2 exhibited no antioxidant activity.
Agaricales ; Benzothiazoles ; Coniferophyta ; Fruit ; Humans ; Methanol ; Pyrones ; Sulfonic Acids ; Superoxides

BACKGROUND AND OBJECTIVES: Compared to bare metal stent, drug-eluting stent has improved the clinical and angiographic outcomes for de novo, simple lesions. In real world clinical practice, we often encounter more complex, long lesions, which increase the rate of restenosis and cardiovascular events. The aim of this study was to evaluate the clinical and angiographic outcome of sirolimus-eluting stent (SES) for the treatment of very long lesions in real world clinical practice. SUBJECTS AND METHODS: We implanted multiple SESs (>40 mm in total length) in 113 de novo lesions in 113 patients. The average length of the implanted stents was 58+/-14 mm (range: 41-112 mm) and a mean of 2.2 stents were implanted in each lesion and the average stent diameter was 3.0+/-0.3 mm. RESULTS: Procedural and angiographic success were achieved in all the patients without death or coronary artery bypass surgery. Non-Q wave MI (CK-MB > or = 3 times the normal value) developed in 13 patients (11.5%). Two patients experienced late stent thrombosis after discharge (1.8%). The major adverse cardiac events (MACE)-free survival was 94% at 12 months. There were two sudden cardiac deaths. Six months follow up angiography was performed on 76 patients (67%) and angiographic binary restenosis developed in 7 patients (9.2%). All of them were the focal type in-stent restenosis and these were found to be located at the distal stents. CONCLUSIONS: In conclusion, long lesion coverage with SESs is feasible with a favorable mid-term outcome in real world clinical practice.
Angiography ; Coronary Artery Bypass ; Death, Sudden, Cardiac ; Drug-Eluting Stents ; Follow-Up Studies ; Humans ; Stents* ; Thrombosis

PURPOSE: We determine the Korean antibody titer and positive rate of tetanus by using a with qualitative test (ELISA) and a quantitative test (TQS(R)). METHODS: This study was prospective collecting study with uncontolled patients who were admitted in 21 Emergency Departments during 3 months in South Korea. We measured TQS(R) and collected the serum with a centrifuge for 5 groups, which was classified with age: 2~10 years (I), 11~20 years (II), 21~30 years (III), 31~40 years (IV), 41~60 years (V), in each hospital. The freezed serum and the protocol with TQS(R) results were taken at the Soonchunhyang University Bucheon hospital to be analyzed. RESULTS: The number of enrolled patients was 1816 (male 58%). The positive rate of TQS(R) was 835 patients (46%), and there was no relation with region or sex. In sex and age, there was a definitive decline in the group III fort males and females. The results of ELISA was showed that 62.8% (> 0.15 IU/ml) and 52.2% (> 0.2 IU/ml) had protective levels of tetanus antibody. The proportion decreased to approximately 43% and 18% among persons 40~60 years of age at each level of antibody titers. By region and population, there was no statistical relationship with TQS(R) and ELISA, but previous military service was associated with a higher prevalence of protective antibodies to tetanus (p<0.001). CONCLUSIONS: A substantial portion of adults in South Korea do not have antibody levels that are protective against tetanus. Also, the mean level of tetanus antibody titers was definitively lower than those of other developed conturies and consistently decreased with aging. Therefore, an adult formulation diphteria and tetanus toxoid every 5 or 10 years is recommended for all adults between 20 and 60 years of age after being tested with TQS(R) in South Korea.
Adult ; Aging ; Antibodies ; Emergency Service, Hospital ; Enzyme-Linked Immunosorbent Assay ; Epidemiology ; Female ; Gyeonggi-do ; Humans ; Korea ; Male ; Military Personnel ; Prevalence ; Prospective Studies ; Tetanus ; Tetanus Toxoid

PURPOSE: High resolution ultrasonography has made it possible to detect many non-palpable small nodules in thyroid gland. We investigated the prevalence and clinical features of non-palpable thyroid nodule and carcinoma discovered incidentally at screening ultrasonography in healthy women. METHODS: A retrospective review was undertaken on the previous healthy asymptomatic 1, 714 women where selected to undergo screening ultrasonography for the detection of the presence of non-palpable thyroid nodules from January 2004 to December 2004. The aims of study were to define the prevalence of thyroid nodule and carcinoma in healthy asymptomatic women and to access the extent of disease in patients with malignant nodule by surgery. RESULTS: Of the 1, 714 subject, thyroid nodule were detected in 822 (48.0%) women with their prevalence increasing with the increasing age of patients. The malignant detection rate based on the USG-guided fine-needle aspiration (USGFNA) results, including both suspicious and malignant groups, was 2.8% (48/1, 714) of all subjects. 38 of 50 patients with malignant, suspicious or indeterminate cytology underwent surgery and all of them were confirmed to have papillary carcinoma on histological results. In 38 patients with papillary thyroid carcinoma, the average size of tumors was 0.87+/-0.33 cm, a range of 0.3 to 1.5 cm, multifocal tumors were found in 50% (19/38), bilaterality was found in 44.7% (17/38), extrathyroidal extension was observed in 50.0% (19/38), and regional lymph node metastasis was found in 29.4% (5/17). CONCLUSION: High resolution ultrasonography detected a high percentage (48%) of nonpalpable thyroid nodules. Characteristics of thyroid nodules on ultrasonography can be used to decision of optimal management strategies. Total thyroidectomy with lymph node dissection may be suitable in patients with non-palpable papillary thyroid carcinoma due to its high incidence of extrathyroidal extension, bilaterality and regional lymph node metastasis.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Female ; Humans ; Incidence ; Lymph Node Excision ; Lymph Nodes ; Mass Screening* ; Neoplasm Metastasis ; Prevalence* ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography*

The histological distinction between benign and malignant phyllodes tumors (PT) is often difficult and arbitrary. We analyzed clinical, histological features and expressions of Ki-67 and p53 using immunohistochemistry and estimate its significance in assessing the grade of malignancy and in predicting the clinical behavior of these tumors on 20 cases of PT of the breast (11 benign, 3 low-grade malignancy and 6 high-grade malignancy). Statistically significant differences between benign, low-grade malignant, and high-grade malignant PT by size of tumor, cellular atypism, stromal cellularity, margin of tumor, and number of mitotic figures. The mean labeling index (LI) of Ki-67 in high-grade malignant PT (9.6+/-9.6) was three-fold higher than that in benign PT (2.7+/-2.2), but this difference was not statistically significant (P=0.074). None of the benign PT were positive for p53, whereas 2 of 3 low-grade malignant and 3 of 6 high-grade malignant PT were positive for p53. Statistically significant differences in the pattern of p53 expression existed among the benign, low-grade malignant, and high-grade malignant lesions (P=0.018). Ki-67 LI and p53 expression were associated with numbers of mitotic figure, but were not associated with metastasis (P=0.546 and 0.216). Increased p53 immunoreactivity is present in high-grade and low-grade malignant PTs in contrast to benign PTs, and malignant PT had a higher Ki-67 LI than benign PT. Thus, p53 and Ki-67 expression may assist in distinguishing benign from malignant PT in diagnostically difficult cases.
Breast* ; Immunohistochemistry ; Neoplasm Metastasis ; Phyllodes Tumor* ; Prognosis

PURPOSE: Multiple clinical, biological, and pathologic factors correlate with the outcomes in patients with invasive breast cancer. The utility of a peritumoral vascular invasion (PVI) as an additional prognostic indicator has been poorly defined. The aim of this study was to determine if the presence or absence of PVI can be used to help assess the survival and recurrence. METHODS: An invasion of the vascular space (lymphatic and/or blood vessel) by a tumor, as assessed on routine hematoxylin and eosin sections, was investigated in a 146 women with primary operable invasive breast carcinoma. The presence of PVI was compared with the established prognostic factors such as age, tumor size, axillary lymph node involvement, histological grade, hormonal receptor status, and expression of c-erb B2, Ki-67 and p53. Survival analysis was performed using Kaplan-Meier method and log-rank test. RESULTS: PVI was found in 35.6% of cases and was significantly associated with an increasing tumor size (P=0.033) and metastatic axillary lymph nodes (P=0.012). The 5 year disease free survival (DFS) and overall survival (OS) were significantly lower in the patients with PVI than without PVI (P=0.0431 and 0.0445, respectively). In multivariate analysis, the axillary lymph node status (P=0.001), the tumor size (P=0.044) and PVI (P=0.050) were significant independent prognostic factors for the DFS. In the node- negative breast cancer group and in the node-positive breast cancer group, the 5 year DFS and OS were lower in the patients with PVI than in those without, but this did not show significant difference. CONCLUSION: Cox multivariate analysis showed that PVI is a strong prognostic factor for patients with operable invasive breast cancer and an independent prognostic factor for a recurrence. A histological assessment of PVI can provide prognostic information on primary operable invasive breast carcinoma and might be helpful in making a clinical decision.
Breast Neoplasms* ; Breast* ; Disease-Free Survival ; Eosine Yellowish-(YS) ; Female ; Hematoxylin ; Humans ; Lymph Nodes ; Multivariate Analysis ; Prognosis ; Recurrence

PURPOSE: Worldwide data shows that there is an increasing resistance among urinary tract pathogens to the first-line antimicrobial agents used in domestic areas. The objective of this study was to obtain data on the susceptibility patterns of the pathogens responsible for acute uncomplicated cystitis to currently used antimicrobial agents. MATERIALS AND METHODS: This study was carried out with the participation of fifteen hospitals in South Korea. A total of 239 isolates were obtained from female outpatients with acute uncomplicated cystitis. The antimicrobial susceptibilities to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, trimethoprim/sulfamethoxazole(TMP/SMX) and tobramycin were determined by Vitek(R) antimicrobial susceptibility test systems. RESULTS: The most prevalent causative organism was Escherichia coli(79.9%), followed by coagulase negative Staphylococcus(4.2%), and a combination of other species of Enterobacteriaceae(8.2%). The mean rates of susceptibility were 35.5, 45.0, 85.7, 81.5, 62.1 and 85.3% to ampicillin, ampicillin/sulbactam, ciprofloxacin, gentamicin, TMP/ SMX and tobramycin, respectively. No significant differences were detected in the resistance rates between the results from 4 regional groups. CONCLUSIONS: The high prevalence of resistance to ampicillin, ampicillin/sulbactam, and TMP/SMX suggest these drugs would not provide adequate initial therapy, and therapies other than TMP/SMX may need to be considered. The relatively high prevalence of resistance to ciprofloxacin, compared with other countries, also requires on going surveillance to identify further changes among urinary tract isolates.
Ampicillin ; Anti-Infective Agents ; Ciprofloxacin ; Coagulase ; Cystitis* ; Disease Susceptibility ; Escherichia ; Female ; Gentamicins ; Humans ; Korea ; Outpatients ; Prevalence ; Tobramycin ; Urinary Tract