PURPOSE: This study was conducted to evaluate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical outcomes in patients with stage III non-squamous cell lung cancer treated with definitive concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: From January 2008 to December 2013, the medical records of 197 patients with stage III non- squamous non-small cell lung cancer treated with definitive CCRT were analyzed to determine progression-free survival (PFS) and overall survival (OS) according to EGFR mutation status. RESULTS: Among 197 eligible patients, 81 patients were EGFR wild type, 36 patients had an EGFR mutation (exon 19 Del, n=18; L858R, n=9, uncommon [G719X, L868, T790M], n=9), and 80 patients had unknown EGFR status. The median age was 59 years (range, 28 to 80 years) and 136 patients (69.0%) were male. The median follow-up duration was 66.5 months (range, 1.9 to 114.5 months). One hundred sixty-four patients (83.2%) experienced disease progression. Median PFS was 8.9 months for the EGFR mutation group, 11.8 months for EGFR wild type, and 10.5 months for the unknown EGFR group (p=0.013 and p=0.042, respectively). The most common site of metastasis in the EGFR mutant group was the brain. However, there was no significant difference in OS among the three groups (34.6 months for EGFR mutant group vs. 31.9 months for EGFR wild type vs. 22.6 months for EGFR unknown group; p=0.792 and p=0.284). A total of 29 patients (80.6%) with EGFR mutation were treated with EGFR tyrosine kinase inhibitor (gefitinib, n=24; erlotinib, n=3; afatinib, n=2) upon progression. CONCLUSION: EGFR mutation is associatedwith short PFS and the brain is the most common site of distant metastasis in patients with stage III non- squamous cell lung cancer treated with CCRT.
Brain ; Carcinoma, Non-Small-Cell Lung ; Chemoradiotherapy ; Disease Progression ; Disease-Free Survival ; Epithelial Cells ; Erlotinib Hydrochloride ; Follow-Up Studies ; Humans ; Lung Neoplasms ; Lung ; Male ; Medical Records ; Neoplasm Metastasis ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor

Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.
Adult ; Carcinoid Tumor* ; Frameshift Mutation ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary* ; Incidental Findings ; Multiple Endocrine Neoplasia Type 1 ; Pancreas ; Recurrence ; Siblings ; Thorax ; Thymectomy

Tinea incognito (TI) is a dermatophytic infection which has lost its typical clinical appearance because of improper use of steroids or calcineurin inhibitors. The incidence of TI is increasing nowadays. We conducted retrospective review on 283 patients with TI from 25 dermatology training hospitals in Korea from 2002-2010 to investigate the demographical, clinical, and mycological characteristics of TI, and to determine the associated risk factors. More than half (59.3%) patients were previously treated by non-dermatologists or self-treated. The mean duration of TI was 15.0 +/- 25.3 months. The most common clinical manifestations were eczema-like lesion, psoriasis-like, and lupus erythematosus-like lesion. The trunk and face were frequently involved, and 91 patients (32.2%) also had coexisting fungal infections. Among 67 isolated strains, Trichophyton rubrum was the most frequently detected (73.1%). This is the largest study of TI reported to date and the first investigational report concerning TI in Korea. We suggest that doctors should consider TI when a patient has intractable eczema-like lesions accompanied by tinea pedis/unguium. Furthermore, there should be a policy change, which would make over-the-counter high-potency topical steroids less accessible in some countries, including Korea.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Demography ; Eczema/pathology ; Face/pathology ; Female ; Humans ; Lupus Erythematosus, Cutaneous/pathology ; Male ; Middle Aged ; Psoriasis/pathology ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Tinea/*diagnosis/microbiology ; Trichophyton/isolation & purification ; Young Adult

BACKGROUND: Fibroblasts produce many components of the extracellular matrix (ECM) and so they contribute to the maintenance of connective tissue integrity. OBJECTIVE: The aim of this study is to evaluate the effect of velvet antler extract (VAE) on the ECM production of dermal fibroblasts cultured in vitro. METHODS: Primary cultured human dermal fibroblasts were treated with VAE, and then the ECM production was determined by RT-PCR, ELISA and Western blot analysis. Furthermore, the change of gene expression according to VAE treatment was evaluated by cDNA microarray. RESULTS: VAE accelerated the growth of fibroblasts in a dose-dependent manner. VAE increased the production of several ECM components, including type 1 collagen, fibronectin and elastin. In line with these results, the phosphorylations of p42/44 ERK and p38 mitogen-activated protein kinase were markedly increased by VAE, suggesting that the enhancement of ECM production may be linked to the activation of intracellular signaling cascades. VAE also significantly increased cell migration on an in vitro scratch wound test. In cDNA microarray, many genes related with connective tissue integrity were identified to be up-regulated by VAE. CONCLUSION: These results suggest that VAE has a potential to stimulate ECM production, and VAE may be applicable for maintaining the skin's texture.
Animals ; Antlers ; Blotting, Western ; Cell Movement ; Collagen Type I ; Connective Tissue ; Elastin ; Enzyme-Linked Immunosorbent Assay ; Extracellular Matrix ; Fibroblasts ; Fibronectins ; Gene Expression ; Humans ; Oligonucleotide Array Sequence Analysis ; Phosphorylation ; Protein Kinases

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

PURPOSE: Painful plantar callosities under the second, third or fourth metatarsal head have been controverted about its treatment mordalities. We performed the vertical chevron osteotomy in patients with painful callosities on the second and third metatarsal head, and evaluated the outcome clinically. MATERIALS AND METHODS: Fourteen cases from 10 patients who had plantar keratosis were operated by vertical chevron osteotomy from March 2005 to October 2008. We used K-wire fixation for all cases. We evaluated the clinical results by the patients' satisfaction and disappearance of plantar lesion. RESULTS: The plantar keratosis was completely disappeared in 8 cases and partially in 5 cases. In 2 cases, patients expresses their pain caused by constant metatarsalgia that was suspected to be dorsal incisional pain and joint capsulitis. Transmetatarsalgia was not appeared. CONCLUSION: We consider vertical chevron osteotomy as a good surgical method for treatment of plantar keratosis.
Callosities ; Head ; Humans ; Joints ; Keratosis ; Metatarsal Bones ; Metatarsalgia ; Osteotomy

Granulocytic sarcoma is a localized tumor that's composed of immature granulocytic cells and this is more common in patient with 8;21 translocation. We present here a case in a 64-year-old man who was diagnosed with acute myelogenous leukemia (erythroleukemia) that had a complex hyperdiploid karyotype. While he underwent chemotherapy, he developed nausea, vomiting, headache and dysarthria. After several diagnostic work-ups, granulocytic sarcoma in the cerebellum and leptomeningeal metastasis of his leukemia were found on the magnetic resonance imaging and the cerebrospinal fluid cytology.
Brain ; Cerebellum ; Dysarthria ; Headache ; Humans ; Karyotype ; Leukemia ; Leukemia, Erythroblastic, Acute ; Leukemia, Myeloid, Acute ; Magnetic Resonance Imaging ; Middle Aged ; Nausea ; Neoplasm Metastasis ; Sarcoma ; Sarcoma, Myeloid ; Vomiting

The esophagus is a rate site for rarely involved site of tuberculosis. The most common cause of esophageal tuberculosis is secondary involvement from adjacent tuberculous lymphadenitis. Esophago-nodal or esophagobronchial fistulas may be formed when tuberculous lymph nodes erode the adjacent esophageal or bronchial wall. We report a patient diagnosed with esophageal tuberculosis, which was complicated by an esophago-mediastinal fistula, by endoscopy, sputum acid fast bacilli (AFB) stain, chest computed tomography (CT), and an esophagogram. The patient was treated with antituberculous agents and chest CT and endoscopy showed that the fistula had closed completely.
Cytochrome P-450 CYP1A1 ; Endoscopy ; Esophagus ; Fistula* ; Humans ; Lymph Nodes ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis* ; Tuberculosis, Lymph Node

OBJECTIVES: The purpose of this study was to investigate the prevalence of erectile dysfunction (ED) in a rural area of Korea and to examine the relationship between the prevalence and correlates of subjects. METHOD: This study was done as a part of the chronic disease survey of rural area by the Asan Foundation. Among 30 years or older population from Jung Eup, a rural area of Korea, 711 male subjects were sampled using a cluster probability sampling method. Trained interviewers visited and interviewed subjects aged 30 years or older with a structured interview. ED was categorized as 'none', 'mild', 'moderate', or 'severe' according to the ability to 'attain and/or maintain an erection satisfactory for sexual intercourse'. Response rate was 54.3% (N=386). RESULTS: The age weighted prevalence of ED was 27.2% (minimal 14.1%, moderate 7.6%, severe 5.5%). Prevalence and severity increased with age. Liver disease and underweight were significantly (p<0.05) associated with ED. Smoking seemed to be correlated with ED, but did not reach statistically significant level. CONCLUSION: ED was highly prevalent in the rural community of Korea. Medical, sociodemographic, and lifestyle variables associated with ED may alert physicians to patients at risk for ED and offer insight to its etiology.
Chronic Disease ; Chungcheongnam-do ; Epidemiology* ; Erectile Dysfunction* ; Humans ; Korea ; Life Style ; Liver Diseases ; Male ; Prevalence ; Risk Factors ; Rural Population* ; Smoke ; Smoking ; Thinness

Kimura's disease is an uncommon, chronic inflammatory disorder of unknown etiology that is seen in an endemic form in the Orient. It usually presents as a mass in the subcutaneous tissue of the head and neck region or the major salivary glands, and is often associated with a regional lymphadenopathy. The patients have peripheral blood eosinophilia and elevated IgE levels but are otherwise usually healthy. We encountered the case of a 33-year-old man who had a soft tissue mass in his left distal arm which was diagnosed as being Kimura's disease.
Adult ; Arm* ; Eosinophilia ; Head ; Humans ; Immunoglobulin E ; Lymphatic Diseases ; Neck ; Salivary Glands ; Subcutaneous Tissue