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Case Reports : Pulmonary Nodular Lymphoid Hyperplasia Associated with Sjogren`s Syndrome
Moo Kon Song,Young Mi Seol,Young Eun Park,Yun Seong Kim,Min Ki Lee,Chang Hun Lee,Yeon Ju Jeong 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.3
Pulmonary nodular lymphoid hyperplasia (NLH) is a term first suggested by Kradin and Mark to describe one or more pulmonary nodules or localized lung infiltrates consisting of reactive lymphoid proliferation. To date, there have been only a few cases of pulmonary NLH reported associated with autoimmune disorders. There is no case of NLH associated with Sjogren`s syndrome from Korea in the medical literature. A 56-year-old woman was referred to our hospital with cough productive of sputum and chest tightness. The Computed tomography scans of the chest revealed multiple and well-defined peribronchiolar nodular opacities. A video assisted thoracoscopic surgery (VATS) biopsy was performed and the nodular opacity in the lung parenchyma was pathologically confirmed as NLH. Through meticulous review of patient`s record, we found that she had been suffering from dry eye and dry mouth. The symptoms suggested Sjogren`s syndrome, which was confirmed by specific laboratory tests including the Schirmer test, anti-nuclear antibody and anti-Ro/La antibody. The patient is followed regularly and has no further progression of symptoms.
Song, Moo-Kon,Chung, Joo-Seop,Shin, Ho-Jin,Choi, Young-Jin,Cho, Goon-Jae The Korean Academy of Medical Sciences 2008 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.23 No.3
<P>We initiated this study to investigate whether combining <I>Helicobacter pylori</I> eradication with immunosuppressive therapy provides an additional benefit to patients with idiopathic thrombocytopenic purpura (ITP) that has relapsed or has not responded to steroid and/or danazol therapy in patients who have <I>H. pylori</I> infection. Thirty-four patients with chronic ITP that had relapsed or failed to steroid and/or danazol therapy were assessed for <I>H. pylori</I> infection. Of the 21 confirmed cases, 12 patients were given <I>H. pylori</I> eradication therapy alone (EA), while 9 patients received eradication therapy combined with immunosuppressive therapy (EI). The response rate was not significantly different between patients in the EA and those in the EI group (41.7% in the EA group vs. 66.7% in the EI group, <I>p</I>=0.345). The median platelet count at 6 months after therapy was higher in the EI group patients (75×10<SUP>9</SUP>/L in the EI group patients vs. 18×10<SUP>9</SUP>/L in the EA group patients, <I>p</I>=0.028). The median response duration was also longer in the EI group patients (9 months in the EI group patients vs. 3 months in the EA group patients, <I>p</I>=0.049). These results show that a significant benefit is gained by the use of <I>H. pylori</I> eradication combined with immunosuppressive therapy over the use of eradication therapy alone for patients with chronic ITP.</P>
( Moo Kon Song ),( Joo Seop Chung ),( Young Mi Seol ),( Ho Jin Shin ),( Young Jin Choi ),( Goon Jae Cho ) 대한내과학회 2009 The Korean Journal of Internal Medicine Vol.24 No.4
Background/Aims: Serum ferritin is a marker of acute phase reactions and iron storage. In addition, hematologic malignancies are associated with elevated serum ferritin levels. Other studies have suggested that ferritin is a surrogate for advanced disease and has an impact on relapse, because elevated serum ferritin predicts overall survival (OS) and relapse-free survival following autologous stem cell transplantation for lymphomas. Methods: We studied 89 consecutive patients with newly diagnosed multiple myeloma to determine the value of serum ferritin in comparison with known prognostic factors. Results: The OS in the elevated serum ferritin group (≥300 ng/mL) was shorter than that in the normal serum ferritin group (<300 ng/mL, p<0.001) after a median follow-up of 25 months. In univariate analysis, elevated ferritin was correlated with poor survival in the patients (relative risk [RR], 2.588; 95% confidence interval [CI], 1.536 to 4.358; p<0.001). Furthermore, multivariate analysis showed that elevated serum ferritin was an independent predictor of mortality in patients with multiple myeloma (RR, 2.594; 95% CI, 1.403 to 4.797; p=0.002). Conclusions: The serum ferritin can a prognostic parameter of survival as well as disease activity in patients with multiple myeloma. (Korean J Intern Med 2009;24:368-373)
( Moo Kon Song ),( Joo Seop Chung ),( Deok Hwan Yang ),( Jeong Ok Lee ),( Jun Shik Hong ),( Su Hee Cho ) 대한내과학회 2013 대한내과학회 추계학술대회 Vol.2013 No.1
Few clinical data have been investigated which prognostic factor would affect clinical outcomes for patient with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who is ineligible for autologous stem cell transplantation (ASCT) after immunochemotherapy. A total 161 patients with relapsed or refractory DLBCL were enrolled. All patients received positron emission tomography/computed tomography (PET/CT) before and after salvage therapy, and the patients` pathologic samples were analyzed by immunohistochemistry (IHC) such as CD10, Bcl-6, MUM-1, and Bcl-2. Ninety-three patients had been treated with ESHAP (etoposide, methylprednisone, cytarabine, and cisplatin) therapy, and 68 patients had been treated with ICE (ifosfamide, carboplatin, and etoposide) therapy. Clinical outcomes were compared according to several factors (low age-adjusted international prognostic index [aaIPI], SUVmax<6.5 by PET/CT, time to relapse ≥12 months, complete response [CR] after salvage therapy, and bcl-2 expression combined with germinal center [GC] type by IHC stain). In the EHSAP group, low aaIPI, SUVmax <6.5, and Bcl-2 negative GC type were independent prognostic factors for survivals. In the ICE group, low aaIPI, SUVmax<6.5 and time to relapse ≥ 12 months after the therapy were independent factors for survivals. The aaIPI and initial SUVmax were powerful prognostic factors in patients with relapsed or refractory DLBCL ineligible ASCT. Interestingly, Bcl-2 negative GC type was available to predict the clinical outcomes in ESHAP setting.
Moo Kon Song,정주섭,신호진,최영진,Goon Jae Cho 대한의학회 2008 Journal of Korean medical science Vol.23 No.3
We initiated this study to investigate whether combining Helicobacter pylori eradication with immunosuppressive therapy provides an additional benefit to patients with idiopathic thrombocytopenic purpura (ITP) that has relapsed or has not responded to steroid and/or danazol therapy in patients who have H. pylori infection. Thirty- four patients with chronic ITP that had relapsed or failed to steroid and/or danazol therapy were assessed for H. pylori infection. Of the 21 confirmed cases, 12 patients were given H. pylori eradication therapy alone (EA), while 9 patients received eradication therapy combined with immunosuppressive therapy (EI). The response rate was not significantly different between patients in the EA and those in the EI group (41.7% in the EA group vs. 66.7% in the EI group, p=0.345). The median platelet count at 6 months after therapy was higher in the EI group patients (75× 109/L in the EI group patients vs. 18×109/L in the EA group patients, p=0.028). The median response duration was also longer in the EI group patients (9 months in the EI group patients vs. 3 months in the EA group patients, p=0.049). These results show that a significant benefit is gained by the use of H. pylori eradication combined with immunosuppressive therapy over the use of eradication therapy alone for patients with chronic ITP.
Song, Moo-Kon,Chung, Joo-Seop,Joo, Young-Don,Kim, Yang-Soo,Kim, Sung-Hyun,Seol, Young-Mi,Shin, Ho-Jin,Choi, Young-Jin,Cho, Goon-Jae Blackwell Publishing Ltd 2009 European journal of haematology Vol.83 No.1
<P>Abstract</P><P>Immunosuppressive therapy (IST) has provided an alternative treatment option for cure of aplastic anemia patients who cannot receive bone marrow transplantation. Although there have been many recent studies on the efficacy of antithymoglobulin (ATG) combined with cyclosporine A (CsA), there is no data on the correlation between the variability of CsA levels and the response to IST. Therefore, we retrospectively assessed the factors associated with IST efficacy in patients with acquired severe aplastic anemia (SAA). Sixty-six patients were treated with ATG combined with CsA for 6 months. In the response group, the CsA levels were increased rapidly to more than 200 ng/mL within the first 2 wk after starting the IST. However, the non-response group had a pattern of slower increase of the CsA levels. The CsA levels, during the first and second week of treatment with IST, were significantly different in the responders and non-responders. The factors predictive of response to IST and survival were analyzed. The univariate analysis showed that a younger age at the initiation of IST, a high absolute neutrophil count prior to starting IST, a short interval between the diagnosis and initiation of IST, and high CsA levels during the first and second week of IST treatment were positively associated with the response rate and overall survival. The multivariate analysis showed that these four factors were independent factors associated with a longer patient survival. A high response rate was associated with a short interval between diagnosis and initiation of IST as well as high CsA levels during the first and second week of IST. Therefore, early intensification of CsA levels might improve patient outcome.</P>
Song, Moo-Kon,Chung, Joo-Seop,Shin, Dong-Hoon,Seol, Young-Mi,Shin, Ho-Jin,Choi, Young-Jin,Cho, Goon-Jae Informa UK (TaylorFrancis) 2009 Leukemia & lymphoma Vol.50 No.1
<P>The classification of germinal centre (GC) and non-GC is an important prognostic immunophenotype for patients with diffuse large B cell lymphoma (DLBCL) following anthracycline-based chemotherapy. The expression of the anti-apoptotic protein, Bcl-2, has been associated with an unfavourable prognosis in patients with DLBCL. Immunohistochemistry was performed using antibodies against CD10, Bcl-6, MUM-1 and Bcl-2. To establish the combined prognosis of the immunophenotype and Bcl-2 overexpression, patients were separated into four subgroups based on their gene expression profile: the Bcl-2 positive GC subgroup, Bcl-2 negative GC subgroup, Bcl-2 positive non-GC subgroup, and the Bcl-2 negative non-GC subgroup. The clinical characteristics and survival outcomes of the four patient subgroups were compared. Ninety-six patients with de novo DLBCL received R-CHOP (rituximab, cyclophosphamide, vincristine, adriamycin and prednisone) therapy. The baseline characteristics of the patient subgroups were similar. The Bcl-2 negative GC subgroup had a favourable progression-free and overall survival (OS) compared with the other three subgroups (p = 0.042, 0.043). Multivariate analysis confirmed that the Bcl-2 negative GC group was independently associated with progression-free survival and OS. The results of this study showed that the Bcl-2 negative GC patients had the most favourable prognosis among patients with DLBCL that received R-CHOP.</P>