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JYMS : Journal of Yeungnam Medical Science

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Volume 23(2); December 2006
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Reviews
Target Therapy for Colorectal Cancer.
Kyung Hee Lee
Yeungnam Univ J Med. 2006;23(2):143-151.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.143
  • 1,493 View
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AbstractAbstract PDF
In the past decade, the median duration of survival among patients with advanced colorectal cancer has increased from 12 months to about 18 months, primarily as a results of the introduction of irinotecan and oxaliplatin. Advances in the understanding of the molecular mechanisms underlying the development and progression of cancer have resulted in the discovery of new therapeutic interventions that target specific molecular abnormalities. Their specificity, and therefore their potential to bind preferentially and modify tumor-specific targets, sparing normal tissues and causing fewer side-effects compared to conventional cytotoxic agents, makes them an attractive therapeutic option. The future of this approach for the treatment of solid tumors is promising
Premalignant Lesions of Gallbladder Carcinoma and Treatment.
Sung Su Yun
Yeungnam Univ J Med. 2006;23(2):152-161.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.152
  • 1,533 View
  • 16 Download
AbstractAbstract PDF
Carcinoma of the gallbladder is an uncommon but highly malignant tumor with a poor five year survival rate. Early detection is very important for successful treatment because this tumor is very hard to cure in cases where it has advanced beyond the reach of surgical treatment. The purpose of this review was to evaluate risk factors for carcinoma of the gallbladder and determine the best management approach.. Solitary polys, more than one cm are considered to be predisposing factors for gallbladder carcinoma when they are found to be echopenic, sessile, and with a high cell density. Anomalous union of the pacreato-biliary duct(AUPBD) without a choledochal cyst is also considered to increase risk for gallbladder carcinoma. A polyps size of more than one cm and an AUPBD are indications for prophylactic cholecystectomy. The presence of gallstones is a well-established risk factor for the development of gallbladder carcinoma; risk appears to correlate with the stone size and the duration of chronic cholecystitis. Metaplastic changes of the gallbladder epithelium present with chronic cholecystitis and may indicate a premalignant lesion. Abnormal forms of cholecystitis such as xanthogranulomatous or a porcelain gallbladder also have malignant potential; cholecystoenteric fistula as well as bacterial infection of the gallbladder(typhoid, helicobacter species) also has malignant potential. In this review, the risk factors associated with carcinoma of the gallbladder are summarized with special attention to gallstones, polyps,AUPBD, and chronic inflammation.
Original Articles
Docetaxel and Cisplatin Combination Chemotherapy in Patients with Advanced Head and Neck Cancer.
Sung Won Choi, Young Ho Choi, Chang Hoon Bai, Yong Dae Kim, Si Youn Song
Yeungnam Univ J Med. 2006;23(2):162-170.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.162
  • 1,443 View
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AbstractAbstract PDF
BACKGROUND
Head and neck cancer is curable at early stages with local-regional therapy. However, most patients are diagnosed with advanced stage disease that requires combination therapy. The aim of this study was to determine the efficacy of docetaxel and cisplatin combination chemotherapy, in patients with advanced head and neck cancer by evaluating the response, survival and organ preservation rates. MATERIALS AND METHODS: We reviewed retrospectively the medical records of 39 patients with advanced head and neck cancer who received docetaxel and cisplatin combination chemotherapy from March 2000 to July 2004. RESULTS: The average age of the 39 patients was 53.4 (range 30 to 73 years) years and the most common primary site was the hypopharynx (23.0%). There were 36 patients who had stage IV disease and three patients with stage III disease. The overall response rate was 76.9% (30/39), including 12 complete responses (30.8%) and 18 partial responses (46.1%). The response rate based on the primary cancer and neck metastasis was 74.4% and 69.3%; the differences were not significant. Among 16 patients with laryngeal and hypopharyngeal cancer, 13 (81.2%) had their larynx preserved after chemotherapy followed by radiotherapy and a survival rate of 61.5%; three patients (18.8%) received a total laryngectomy and had a survival rate of 66.7%. The overall survival rate from the start of chemotherapy was 56.4% with a median survival of 30 months. The common toxicities observed were alopecia, vomiting, diarrhea, hepatotoxicity and anemia but they were all generally manageable. CONCLUSION: Docetaxel and cisplatin combination chemotherapy is an effective regimen with a relatively high response rate and acceptable toxicity
Clinical Features of Clonorchiasis.
Kook Hyun Kim, Byung Ik Jang, Tae Nyeun Kim
Yeungnam Univ J Med. 2006;23(2):171-181.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.171
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  • 2 Crossref
AbstractAbstract PDF
BACKGROUND
Clonorchis sinensis is an important human parasite that is usually found in the biliary tract. It is widely distributed in East Asia in Taiwan, Japan, China and Korea. About 2 million people are estimated to be infected with C. sinensis in Korea. This study was conducted to evaluate the state of infestation and clinical aspects of C. sinensis. MATERIAL AND METHODS: We evaluate 1,063 patients with clonorchiasis retrospectively at Yeungnam University Hospital and Health Promotion Center from January 2001 to December 2003. All patients were diagnosed by a positive stool test for C. sinensis eggs. Clinical features, laboratory data and imaging studies were evaluated. RESULTS: The ratio between affected males and females was 3.6 : 1. The highest infection rate was noted in the 40-60 age groups regardless of sex. The infection rate of C. sinensis among the residents of urban areas was higher than in rural areas. There were 813 (76.5%) patients who were asymptomatic. Common symptoms included right upper abdominal pain in 7.6% and epigastric pain in 7.2%. For the laboratory studies, serum ALP and GGT levels were within normal limits in 85.2% and 56.0% respectively. Peripheral eosinophilia was noted in 66.1% of cases. Of the 83 cases undergoing ERCP, 27 cases (32.5%) showed peripheral dilatation of the intrahepatic duct. CONCLUSION: This study suggests that C. sinensis infection is still endemic even in rural areas of Korea and that asymptomatic infections are common. Further work should be focused on the early diagnosis and treatment of patients with subclinical infection.

Citations

Citations to this article as recorded by  
  • Prevalence and Related Factors of Clonorchiasis among Five Major Riverside Residents in South Korea
    Chunmi Kim, Kyung Ja June, Shin Hyeong Cho, Kyung Soon Park, Hung Sa Lee, Ji Yeon Park
    Journal of Korean Academy of Community Health Nursing.2016; 27(4): 346.     CrossRef
  • A Study on the Prevalence of Clonorchis Sinensis and the Effects of Educational Program among Residents in the Basin of the Youngsan River, Korea
    Chunmi Kim, Aeyoung So, Kyung-Ja June, Hee Young Jung
    Journal of Korean Academy of Community Health Nursing.2011; 22(1): 56.     CrossRef
Isolation of Endothelial Cells and Smooth Muscle Cells from Rat Aort.
Young Eun Yun, In Hwan Song, Eon Ki Sung, Joo Young Kim
Yeungnam Univ J Med. 2006;23(2):182-192.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.182
  • 1,641 View
  • 11 Download
AbstractAbstract PDF
BACKGROUND
Atherosclerosis has emerged as the leading cause of death in developed countries. At present, human umbilical vein endothelial cells (HUVEC) are most commonly used for the investigation of Endothelial cells (EC). However, HUVEC are not found in arteries but only in veins. Currently there are many reports on methods used to isolate EC;, most of these methods require special equipment to remove contaminating smooth muscle cells (SMC). MATERIALS AND METHODS: The method described here may be used to isolate not only ECs but also SMCs;,the approach presented here did not require special equipment. Rat aorta was treated with 2 mg/ml of type II collagenase solution for 45 minutes. The isolated cells from the aorta were incubated in medium G for a week;, only ECs could be separated. After the collagenase treatment, the rest of aorta was cut lengthwise, and left undisturbed to obtain SMCs in the culture dish for 10 days. To verify the purity of the isolated cells, we performed immunofluorescence and evaluated the results with transmission electron microscopy analysis. RESULTS: The immunofluorescence study demonstrated specific expression of CD31 and alpha-smooth muscle actin in the isolated ECs and SMCs, respectively. Cultured ECs and SMCs showed their own fine structure characteristics. CONCLUSION: These results suggest that this method for isolating ECs and SMCs may be especially useful for the study of atherosclerosis.
The Comparison of Survival Rates of Postoperative Adjuvant Chemotherapies in The Stage III Gastric Cancer Patients.
Eun Mi Kim, Se Won Kim, Sang Woon Kim, Sun Kyo Song
Yeungnam Univ J Med. 2006;23(2):193-204.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.193
  • 1,477 View
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AbstractAbstract PDF
PURPOSE: Various postoperative adjuvant chemotherapy regimens have been proposed for the patients with advanced gastric cancer. The majority of clinical trials have shown no significant difference in the survival benefit. The aim of this study was to compare the survival rates of postoperative adjuvant chemotherapies used in stage III gastric cancer patients who received curative gastrectomy. MATERIALS AND METHODS: Between 1990 and 1999, a survival analysis was performed in 260 patients who received curative gastric resection and postoperative adjuvant chemotherapy. The patients were divided into four groups according to the chemotherapeutic regimens received. The groups were: the F group: furtulon alone, FM group: furtulon and mitomycin, FAM group: 5-FU, adriamycin and mitomycin, FLEP group: 5-FU, leucovorin, etoposide and cisplatin. The survival rates were analyzed using the Kaplan-Meier method and the Cox proportional hazards model. RESULTS: There were no differences among the groups of patients with regard to tumor characteristics except for lymph node metastasis and the ratio of metastasis to lymph nodes. In the FLEP group, the ratio of metastasis to lymph nodes was higher than in the other groups. The five and ten year survival rates of F, FM, FAM and FLEP were 51.9%, 28.9%, 59.5%, 49.8%, 66.1%, 57.4% and 30.0%, 27.5%, respectively. The univariate analysis showed that age, Borrmann type, lymph node metastasis, ratio of metastasis to lymph nodes, postoperative adjuvant chemotherapy and recurrence were significant factors for survival. For the multivariate analysis, recurrence, age, Borrmann type, ratio of lymph node metastasis and lymph node dissection were independent prognostic factors; however, the postoperative adjuvant chemotherapy was not an independent prognostic factor. CONCLUSION: The FAM regimen was the most beneficial postoperative adjuvant chemotherapy for improved survival rates; the FM regimen was the second and the FLEP regimen was the last. In order to determine the effectiveness of postoperative adjuvant chemotherapy in stage III gastric cancer, well designed prospective studies including a surgery only group will be needed.
The Usefulness of Integrated PET/CT to Distinguish between Benignancy and Malignancy in Solitary Pulmonary Nodule.
Won Jong Park, Dong Hee Kim, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Kyung Ah Chun, Ihn Ho Cho
Yeungnam Univ J Med. 2006;23(2):205-212.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.205
  • 1,540 View
  • 1 Download
AbstractAbstract PDF
BACKGROUND
Malignant pulmonary nodules account for about 30 to 40 percent of solitary pulmonary nodules (SPN). Therefore, tissue characterization of SPNs is very important. Recently, PET/CT has been widely used for tissue characterization, and has become of importance. The purpose of this study was to compare and to assess multiple factors in PET/CT comparing benign and malignant nodules. MATERIALS AND METHOD: Nineteen patients with SPN underwent PET/CT and biopsy. The difference of standardized uptake value 1 (SUV1), standardized uptake value 2 (SUV2) and retention index in PET/CT between malignancy and benignancy were compared by Levene's test. RESULT: There were twelve malignant and seven benign nodules. SUV1 and SUV2 were significantly different between malignant nodule and benign nodule (p=0.006 and 0.022), but retention index was not significantly different between malignant nodule and benign nodule (p=0.526). By receiver-operating-characteristic (ROC) analysis, the sensitivity was 66.7% and the specificity was 71.4% at a cut off value of 5.40 in SUV1. The sensitivity was 75% and the specificity was 71.4% at cut off value of 7.45 in SUV2. CONCLUSION: There was a statistically significant difference in SUV1 and SUV2 between benign and malignant nodules. However, the cut off value of SUV1 and SUV2 by receiver-operating-characteristic (ROC) analysis was 5.40 and 7.45 which is different from previous studies. Therefore, studies on a larger sample of patients are required for confirmation.
Case Reports
Two Cases of Intravenous Leiomyomatosis of the Uterus.
Jin Hee Kim, Min Whan Koh
Yeungnam Univ J Med. 2006;23(2):213-220.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.213
  • 1,703 View
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AbstractAbstract PDF
Intravenous leiomyomatosis of the uterus is a rare tumor that presents with benign histological features. It is characterized by intravenous proliferation of smooth muscle cells originating from the uterus that sometimes extends to the inferior vena cava and the right heart. It may spread elsewhere, usually to the lung. The first case of intravenous leiomyomatosis was described in 1896 by Birsh-Hirshfeld,1) and only a few cases have been reported since then. Its pathogenesis and optimal treatment have not yet been established. We report a case of metastasizing leiomyomatosis found to have multiple nodular densities in both lower lung fields seven months after myomectomy. In another case the leiomyomatosis was confined to the pelvis after a laparoscopy assisted vaginal hysterectomy, the patient is alive without evidence of disease. Here we provide a detailed report of two cases of intravenous leiomyomatosis of the uterus with a brief review of the literature.
A Case of Gefitinib (Iressa(R))-associated Tumor Lysis Syndrome in Adenocarcinoma of the Lung.
Kyu Jin Kim, Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Myung Soo Hyun, Kwan Ho Lee
Yeungnam Univ J Med. 2006;23(2):221-226.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.221
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AbstractAbstract PDF
The tumor lysis syndrome has been described as biochemical disturbances associated with rapid destruction of tumor cells and subsequent synchronized massive release of cellular breakdown products sufficient to overwhelm excretory mechanisms and the body's normal reutilization capacity. The cardinal signs of the tumor lysis syndrome are hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. Gefitinib (Iressa) is an oral, selective epidermal growth factor receptor (EGFR) inhibitor that has activity in female, non-smoker and non-small cell lung cancer with an EGFR mutation. Gefitinib is a well tolerated drug with few side effects. It has been associated with skin rash, diarrhea, nausea, a decrease in liver function and interstitial lung disease. However, there is no prior report of the tumor lysis syndrome associated with gefitinib. We report a case of a 54 year-old woman who developed tumor lysis syndrome that might have been induced by gefitinib after the treatment of adenocarcinoma of lung with an EGFR mutation.
A Case of Valsalva Retinopathy Associated with Straining at Stool.
Tae Yoon Lee, Woo Hyok Chang
Yeungnam Univ J Med. 2006;23(2):227-231.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.227
  • 1,677 View
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AbstractAbstract PDF
The Valsalva maneuver is described as an expiratory effort against a closed glottis or airway. It leads to elevation of retinal venous pressure and may result in retinal hemorrhage. A fifty two-year-old man presented with an acute reduction of central visual acuity in his right eye which occurred after considerable straining at stool. Detailed past medical history revealed that he suffered from chronic constipation and hypertension. There were one disc sized subhyaloid hemorrhage and three small intraretinal hemorrhages around the fovea at the dilated fundus examination. After three months of follow-up without any treatment, the retinal hemorrhages resolved without any sequelae. Here we report a patient with sudden visual loss and retinal hemorrhage.
Two Cases of Alopecia Totalis treated with Diphenylcyclopropenone (DPCP) Immunotherapy.
Seok Ki Moon, Young Min Shin, Chan Woo Kim, Dong Hoon Shin, Jong Soo Choi, Ki Hong Kim
Yeungnam Univ J Med. 2006;23(2):232-239.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.232
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AbstractAbstract PDF
Treatments for alopecia areata include topical corticosteroid treatment, corticosteroid intralesional injection, systemic corticosteroid treatment, PUVA(psoralen-UVA) and topical immunotherapy. The therapeutic effects are variable. Alopecia totalis is hard to treat completely. Topical immunotherapy with dinitrochlorobenzene (DNCB), squaric acid dibutyl ester (SADBE) or diphenylcyclopropenone (diphencyprone, DPCP) represents the most accepted therapeutic modality for the treatment of extensive alopecia areata. We report two cases of alopecia totalis treated with DPCP. After DPCP treatment, total scalp hair was completely recovered.
Injury of the Medial Rectus Muscle by Using a Microdebrider During Endoscopic Sinus Surgery : A Case Report.
Yoon Seok Choi, Chang Hoon Bai, Si Youn Song, Yong Dae Kim
Yeungnam Univ J Med. 2006;23(2):240-246.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.240
  • 1,495 View
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AbstractAbstract PDF
A microdebrider is increasingly used in endoscopic sinus surgery. Although it has many advantages over conventional instruments, it has been associated with severe complications. We treated a case of rupture of the left medial rectus muscle after use of a microdebrider during endoscopic sinus surgery in a 50 year-old female patient who complained of binocular diplopia and exotropia. The patient showed marked limitation on adduction and about 40 prism diopters of left exodeviation. The orbital computed tomography showed a bony defect at the left medial orbital wall, and injury of the medial rectus muscle. The exodeviation was corrected after ophthalmologic surgery. We report a case of the rupture of the medial rectus muscle after use of a microdebrider during endoscopic sinus surgery and review the medical literature.
Gastric Phytobezoar Treated by Oral Intake and Endoscopic Injection of Coca-Cola.
Hee Jung Moon, Sang Hoon Lee, Jun Young Lee, Dong Hee Kim, Ji Eun Lee, Chang Hun Yang, Jong Ryul Eun, Tae Nyeun Kim, Heon Ju Lee, Byung Ik Jang
Yeungnam Univ J Med. 2006;23(2):247-251.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.247
  • 1,738 View
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  • 1 Crossref
AbstractAbstract PDF
Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the 11th day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.

Citations

Citations to this article as recorded by  
  • Systematic review: Coca‐Cola can effectively dissolve gastric phytobezoars as a first‐line treatment
    S. D. Ladas, D. Kamberoglou, G. Karamanolis, J. Vlachogiannakos, I. Zouboulis‐Vafiadis
    Alimentary Pharmacology & Therapeutics.2013; 37(2): 169.     CrossRef
A Case of Glycogen Storage Disease with Hypertrophic Cardiomyopathy.
Dong Hee Kim, Sang Wook Kang, Won Jong Park, Kyoung Ae Jang, Joon Hyuk Choi, Woong Kim, Sang Hee LEE, Geu Ru Hong
Yeungnam Univ J Med. 2006;23(2):252-257.   Published online December 31, 2006
DOI: https://doi.org/10.12701/yujm.2006.23.2.252
  • 1,699 View
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AbstractAbstract PDF
Glycogen storage diseases are a heterogeneous group of metabolic disorder affecting multiple organ system: liver, skeletal muscle, heart and brain. Clinical features include: short status, hepatomegaly, hypoglycemia, dyslipidemia and rare involvement of the myocardium except in the case of type III, glycogen storage diseases with hypertrophic cardiomyopathy in adult, which is extremely rare. We treated a case of hypertrophic cardiomyopathy with hepatomegaly that was unknown etiology. The patient was diagnosed as having glycogen storage disease. This 46-year old women was transferred with dyspnea on exertion and abnormal LFTs. She was diagnosed with hypertrophic cardiomyopathy by echocardiography but there was no specific cause for hypertrophic cardiomyopathy. A liver biopsy was performed. The result showed glycogen storage disease possible type III, IV or IX. In conclusion, patients with hypertrophic cardiomyopathy of unknown etiology and abnormal LFTs should be evaluated for glycogen storage disease.

JYMS : Journal of Yeungnam Medical Science