Background/Aims: We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). Methods: We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. Results: The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. Conclusions Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.

PURPOSE: This study evaluated the usefulness of ultrasonography for a diagnosis of acetabular labral tear in femoroacetabular impingement (FAI). MATERIALS AND METHODS: From March 2010 to October 2011, an ultrasonographic examination was performed in 58 patients(58 hips: 26 men and 32 women) with acetabular labral tear. The sensitivity and positive predictive value of ultrasonography were evaluated for 58 cases with acetabular labral tear confirmed by hip arthroscopy. RESULTS: The sensitivity and positive predictive value for an acetabular labral tear using ultrasonography was 89.6% and 100%, respectively. The concordance rate of an acetabular labral tear between arthroscopy and ultrasonography was 84.6%. CONCLUSION: Hip ultrasonography can make a significant contribution to a pathologic diagnosis and isa useful diagnostic tool for acetabular labral tears.
Arthroscopy ; Femoracetabular Impingement ; Hip ; Humans ; Male

PURPOSE: Gemcitabine and 5-fluorouracil (5-FU) are two compounds with reproducible activity against advanced pancreatic carcinomas. To evaluate the activity and feasibility of this combination chemotherapy, a multi-institutional phase II study was performed. MATERIALS AND METHODS: Twenty patients (male: female 15: 5, median age: 60.5 years), with histologically verified locally advanced or metastatic pancreatic carcinomas, were enrolled between April 2000 and March 2002. Gemcitabine was administered by intravenous injection at the doses of 1, 000 mg/m2 on days 1, 8 and 15, and 5-FU 800 mg/m2/day, was given by continuous intravenous infusion on days 1~5. The treatment was repeated every 4 weeks. The clinical benefit response (CBR) was a composite of the pain, Karnofsky performance status and body weight change measurement. RESULTS: Nineteen of the twenty patients were assessable for response. The median follow-up duration was 4.6 months (0.4~15.2 months). Five patients achieved a partial response and eight a stable disease. The overall response rate was 25.0%. The CBR was assessable in 12 patients. The overall CBR was 41.7% (5/12). The median survival of all the patients was 8.0 months. Grade 3~4 toxicities included neutropenia (9.3%) and thrombocytopenia (5.3%). CONCLUSION: This study suggested that gemcitabine, combined with infusional 5-FU, was well tolerated, and produced modest antitumor activity and symptomatic relief in advanced pancreatic cancer patients.
Body Weight Changes ; Drug Therapy, Combination ; Female ; Fluorouracil* ; Follow-Up Studies ; Humans ; Infusions, Intravenous ; Injections, Intravenous ; Karnofsky Performance Status ; Neutropenia ; Pancreatic Neoplasms* ; Thrombocytopenia

PURPOSE: The outcomes of infants weighing less than 1,500 gm(very low birth weight infant : VLBWI) reflect recent progress in neonatal intensive care. In this study, we analyzed changes over time in survival rate and morbidity of VLBWIs during the past seven years. METHODS: A retrospective review of medical records was analyzed for VLBWIs admitted to the neonatal intensive care unit of Samsung Medical Center within three days from birth. We compared the outcomes of previous corresponding data(period I : Oct. 1994 to Sept. 1996), with the outcomes of period II(Oct. 1996 to Dec. 1998) and period III(Jan. 1999 to Dec. 2000). RESULTS: As shown in Tables 1 and 3, the distribution of birth weight, gestational age(GA), gender, and inborn admissions did not change during the 7-year study. The overall survival rate of VLBWI increased significantly over time(period I : 72% vs period III : 88.3%, P<0.05). Between period I and period II, the birth weight-specific survival rate increased by 23.6%(75% vs 92.7%, P<0.05) for infants 1,000 to 1,249 gm. Between period II and period III, the birth weight-specific survival rate increased three times(20% vs 66.7%, P<0.05) for infants <750 gm. The survivors of lowest birth weight included infants at 624 gm(GA : 26(+5) weeks), 667 gm(GA : 25(+6) weeks) and 480 gm(GA : 26(+2) weeks) in each period. The gestational age-specific survival rate in period III increased significantly in GA 25-26 weeks and 29-30 weeks(vs period I and period II, P<0.05). The survivors of lowest gestational age included infants at GA 26 weeks(970 gm), GA 23(+5) weeks(791 gm) and GA 24(+1) weeks(740 gm) in each period. The incidence of severe IVH(grade III, IV) and the early death rate( Birth Weight ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Critical Care ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Retrospective Studies ; Survival Rate ; Survivors

PURPOSE: Within a clinically acceptable time frame, we obtained the high resolution MR images of the human brain, knee, foot and wrist from 3T whole-body MRI system which was equipped with the world first 3T active shield magnet. MATERIALS AND METHODS: Spin echo (SE) and Fast Spin Echo (FSE) images were obtained from the human brain, knee, foot and wrist of normal subjects using a homemade birdcage and transverse electromagnetic (TEM) resonators operating in quadrature and tuned to 128 MHz. For acquisition of MR images of knee, foot and wrist, we employed a homemade saddle shaped RF coil. Typical common acquisition parameters were as follows: matrix= 512x512, field of view (FOV) = 20 cm, slice thickness = 3 mm, number of excitations (NEX) = 1. For T1-weighted MR images, we used TR= 500 ms, TE = 10 or 17.4 ms. For T2-weighted MR images, we used TR=4000 ms, TE = 108 ms. RESULTS: Signal to noise ratio (SNR) of 3T system was measured 2.7 times greater than that of prevalent 1.5T system. MR images obtained from 3T system revealed numerous small venous structures throughout the image plane and provided reasonable delineation between gray and white matter. CONCLUSION: The present results demonstrate that the MR images from 3T system could provide better diagnostic quality of resolution and sensitivity than those of 1.5T system. The elevated SNR observed in the 3T high field magnetic resonance imaging can be utilized to acquire images with a level of resolution approaching the microscopic structural level under in vivo conditions. These images represent a significant advance in our ability to examine small anatomical features with noninvasive imaging methods.
Brain ; Foot ; Humans ; Knee ; Magnetic Resonance Imaging* ; Magnets ; Signal-To-Noise Ratio ; Wrist

This study is aimed at preparing basic data required for establishment of a cancer screening program by examining the status of cancer screenings performed by residents in a community and the factors that have an effect on determination for a cancer screening by residents. Cervix, breast and stomach cancers were chosen as target cancers of the study due to the fact that merits of screening for these cancers have been proved by studies done in different countries. In order to find out the status of cancer screening and the factors having an effect on the determination for a cancer screening, 10 Dongs and a total of 1988 people were selected as study area and subjects by a random cluster sampling method, and the subjects were questioned on different aspects by questionnaires. Additionally, in order to find out how cancer screening is performed at medical facilities and how cancer screening is recommended by doctors, medical facilities doing cancer screening were also questioned. The results of the study are as follows: 1. In the case of the screening of the stomach cancer, 16.1% of male subjects and 25.6% of female subjects turned out to have had one or more screening for the cancer. In the cases of the breast and the cervical cancers, 21.6% and 62.6% of the subjects turned out to have had one or more screenings respectively. 2. As to the screening for the stomach cancer, there was a tendency that more of the subjects with lower level education, excepting those without education, had themselves screened for the cancer. Higher screening rates were shown by the subjects in higher ages, those who visited doctors regularly. 3. As to the screening rate by education levels, a high rate of screening was shown by the subjects with above-university education level and there was not a big difference between the screenings done for high school graduates and for those with lower education levels. Regarding the rates of screening by age groups the screening rate turned out to be higher with the higher ages. Screening rates, checked on the basis of the income levels, did not show a big differences between income levels. 4. The highest rate of screening for the breast cancer was shown by the subjects with postgraduate level of education and regarding the rate by income level, a slightly higher level was shown by the subjects with the monthly income of the 2,010,000 won, but the difference between the rates of screening by subjects at different income levels was overall not significant. 5. The rates for selecting the health screening facilities were higher in orders of the reasons that 1) they were close: 2) service was excellent and 3) equipment and facilities were good. Based on the above-mentioned results obtained by the study, it is anticipated that this study will play a vital role as basic data for the development and execution of cancer screening program for a community, and the analysis, done on the basis of the status of the cancer screening, of the factors related to the determination for the cancer screening showed that for the development of a cancer screening program, factors like income levels, education levels, whether people consult doctors regularly and the local government' care for health in a community should be considered, and in addition to which active participation of doctors in the program is also requested.
Breast ; Breast Neoplasms ; Early Detection of Cancer* ; Education ; Female ; Humans ; Male ; Mass Screening ; Stomach Neoplasms ; Uterine Cervical Neoplasms ; Surveys and Questionnaires

PURPOSE: Recent progress in neonatal intensive care has led to increased survival of infants weighing less than 1500 gm. Many studies to declining sequelae of intensive care, addition to increasing survival, were made. So, we investigated particulary the relationship between survival and birth weight, gestational age, and factors associated with morbidities. METHOD: The retrospecitve review of medical records was analyzed for 92 VLBW infants(birth weight <1,500gm) who were admitted to the neonatal intensive care unit of Samsung seoul hosptial from 1994 to 1996. We compared the outcomes of 32 VLBW infants between October 1994 and September 1995 (period I), with the outcomes of 60 VLBW infants between October 1995 and September 1996 (period II). RESULTS: 1) The incidence of VLBW infants was 1.01% in period I and 1.55% in period II. The overall survival rate increased to 76.7% in period II, compared with 71.9% in period I. 2) By birth weight, the highest survival rate was 100% at 750gm in peeriod I, and 86.4% at 1000 to 1249gm in period II. The survival rate at birth weight 1000 to 1249 gm increased significantly in period II. According to gestational age, the highest was at 31-32 weeks(85.7%) in period I, and at 29-30 weeks(88.9%) in period II. 3) The male : female ratio was 1:1 in period I versus 1:1.07 in period II. There was no significant difference in sex and mode of delivery. 4) The most common major morbidity occurred in VLBW infants was respiratory distress syndrome (65.6% in period I, 53.3% in period II). 5) There was no difference of neonatal death rate during period I, while 2-3 days after birth was the highest(30.0%) during period II. Major causes of death, during both periods, were infection and respiratory distress syndrome and/or its sequelae. CONCLUSION: This report demonstrates marked increased survival rate than previous other reports and especially during period II. With increasing survival, more attention to neonatal sequelae, including chronic lung disease and neurodevelopmental delay, is required.
Birth Weight ; Cause of Death ; Female ; Gestational Age ; Humans ; Incidence ; Infant* ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Critical Care* ; Intensive Care, Neonatal ; Lung Diseases ; Male ; Medical Records ; Mortality ; Parturition ; Seoul ; Survival Rate

Tracheal bronchus is an aberrant bronchus that arises most often from the right tracheal bronchial wall above the carina and is the result of an additional tracheal outgrowth early in embryonic life. Its incidence ranges from 0.1 to 5%. This anomaly is usually diagnosed incidentally during bronchoscopy or bronchography in patients with various respiratory problems. Tracheal bronchus may be associated with other bronchopulmonary anomalies such as tracheal stenosis, pulmonary agenesis, pulmonary sequestration, abnormal lobulation, and Down's syndrome. In patients without specific clinical symptoms, a incidentally diagnosed tracheal bronchus does not require any treatment. We report a case of 59-year-old man incidentally detected accessory tracheal bronchus associated with bronchial asthma with review of literatures.
Asthma* ; Bronchi* ; Bronchography ; Bronchopulmonary Sequestration ; Bronchoscopy ; Down Syndrome ; Humans ; Incidence ; Middle Aged ; Tracheal Stenosis

PURPOSE: In the Spring 1995, there was an outbreak of adenoviral infection, which caused four death out of ten patients with adenoviral pneumonia in our hospital. Clinical courses of ten patients with severe pneumonia were similar each other, and two were confirmed as adenoviral pneumonia by postmortem autopsy. Although not proven, we believe eight patients had adenoviral pneumonia. Therefore, we report clinical features in ten cases of severe adenoviral pneumonia. METHODS: Two cases with adenoviral pneumonia and eight cases with presumed adenoviral pneumonia were admitted in this hospital from March to June, 1995. Age and sex distribution, clinical manifestations, laboratory data, chest X-ray findings were reviewed. RESULTS: They were young children between 4 to 25 months of age(mean 12.7+/-6.1 months), and male to female ratio was 9:1. They presented with abrupt fever, cough, tachypnea, and dyspnea. Mean duration of fever were 12.7+/-6.1 days. Crackles on auscultation were heard in all patients. Studies for Mycoplasma and Tuberculosis were all negative. Cultures of bacteria and fungi were negative, and they did not respond to the antibiotics. The chest X-ray revealed the diffuse lobar consolidation with varying amount of pleural effusions. The findings of pleural fluid showed characteristics of transudate with predominant monocyte. Eight of our severe adenoviral pneumonia patients were enjoying normal health previously. Only two patients had previous medical problems, one with chronic cytomegalovirus pneumonia and the other with neutropenia induced by phenobarbital. The course of illness suggests that the infection was hospital acquired and the final outcome was fatal. Three of them developed seizure with fever, five change of consciousness, four conjunctivitis, three otitis media, and two gastro-intestinal symptoms. Autopsy was done in two of four patients. Grossly, the lungs were heavy and dark- red in color. There were bilateral pneumonic consolidation with patchy areas of hemorrhage. Microscopically, severe necrotizing bronchitis and bronchiolitis with numerous intranuclear inclusion of Cowdry type A and B were found. Alveoli were edematous and filled with fibrinous exudate, and covered with hyaline membrane. Ultrastructurally, typical adenoviral particles showing hexagonal shape in paracrystalline array symmetry were found in the nucleus of aleveolar lining cells. CONCLUSIONS: Yet, occasionally, adenoviral infection becomes most aggressive form of pneumonia. We should consider adenoviral pneumonia when clinical findings of pneumonia are very similar with baterial pneumonia except poor response to broad spectrum antibiotics. There is no specific treatment for adenoviral infection. So, for prevention of adenoviral pneumonia, we recommend isolation in suspicious adenoviral infection.
Adenoviridae ; Anti-Bacterial Agents ; Auscultation ; Autopsy ; Bacteria ; Bronchiolitis ; Bronchitis ; Child ; Conjunctivitis ; Consciousness ; Cough ; Cytomegalovirus ; Dyspnea ; Exudates and Transudates ; Female ; Fever ; Fibrin ; Fungi ; Hemorrhage ; Humans ; Hyalin ; Intranuclear Inclusion Bodies ; Lung ; Male ; Membranes ; Monocytes ; Mycoplasma ; Neutropenia ; Otitis Media ; Phenobarbital ; Pleural Effusion ; Pneumonia* ; Respiratory Sounds ; Seizures ; Sex Distribution ; Tachypnea ; Thorax ; Tuberculosis

We experience coronary artery aneurysm and coronary artery stenosis in an adult as complications of Kawasaki disease. The patient suffered from ischemic heart disease due to coronary artery aneurysm and stenosis, We carried out PTCA and stenting at stenotic coronary artery successfully. A brief review of related literature was made.
Adult* ; Aneurysm ; Angioplasty, Balloon, Coronary* ; Constriction, Pathologic ; Coronary Aneurysm* ; Coronary Stenosis* ; Coronary Vessels* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia ; Stents