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Case Reports : Hand-Foot Syndrome with Scleroderma-Like Change Induced by the Oral Capecitabine
Sehe Dong Lee,Hye Jeong Kim,Seung Jae Hwang,Yoon Jung Kim,Seung Hyun Nam,Bong Seog Kim 대한내과학회 2007 The Korean Journal of Internal Medicine Vol.22 No.2
Hand-foot syndrome (HFS) is a well-known adverse event associated with capecitabine, a prodrug of 5-Fluorouracil (5-FU). HFS manifests as acral erythema, with swelling and dysesthesia of the palms and plantar aspects of the feet, which in the absence of dosage reduction or drug cessation, progresses to moist desquamation and ulceration, resulting in serious infections and loss of function. We report a case of HFS, with scleroderma-like changes, apparently induced by capecitabine. In our case, capecitabine, given in the recommended dosage was observed to lead to hyperpigmentation of the palms and soles, followed by a distinct keratoderma-like thickening unfamiliar to usual cases of HFS. This case may provide important clues for revising the definition of HFS, and allow the formation of effective preventive strategies for this side effect of chemotherapy.
Gastroesophageal Reflux Disease in Type 2 Diabetes Mellitus With or Without Peripheral Neuropathy
( Sehe Dong Lee ),( Bo Ra Keum ),( Hoon Jai Chun ),( Young Tae Bak ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.3
Background/Aims Patients with type II diabetes mellitus (DM) were known to have higher prevalence of gastroesophageal reflux disease (GERD). Recent studies have shown that neuropathy has positive role on the development of GERD in type II DM, although its pathogenesis has not been fully understood yet. The aim of this study was to investigate whether neuropathy really contribute to the development of GERD and typical GERD symptoms in patients with type II DM in Korea. Methods One hundred and nineteen patients with type II DM who had given informed consents were enrolled. All patients underwent electromyography to check the presence of peripheral neuropathy, face-to-face interview to evaluate their typical GERD symptoms and esophagogastroduodenoscopy to look for the presence of erosive esophagitis. Ninety-five patients were finally included for this study and they were divided according to the presence or absence of the peripheral neuropathy. Results The mean age of 95 patients was 59.3 ± 9.1 years and the mean disease duration of DM was 9.3 ± 5.9 years. Typical GERD symptoms were similarly found in both groups with and without peripheral neuropathy (23.6% vs 22.8%, P = 0.921). Erosive esophagitis was more prevalent in patients with neuropathy than in those without neuropathy (31.5% vs 10.5%, P = 0.022). Conclusions In patients with type II DM, peripheral neuropathy is an independent risk factor for the erosive esophagitis. However, peripheral neuropathy did not contribute to the presence of the typical GERD symptoms.
Sinking Skin Flap Syndrome or Syndrome of the Trephined: A Report of Two Cases
Hae-Yeon Park,Sehee Kim,Joon-Sung Kim,Seong Hoon Lim,Young Il Kim,Dong Hoon Lee,Bo Young Hong 대한재활의학회 2019 Annals of Rehabilitation Medicine Vol.43 No.1
Decompressive craniectomy (DC) is commonly performed in patients with intracranial hypertension or brain edema due to traumatic brain injury. Infrequently, neurologic deteriorations accompanied by sunken scalp may occur after DC. We report two patients with traumatic subdural hemorrhage who had neurologic deteriorations accompanied by sunken scalp after DC. Neurologic function improved dramatically in both patients after cranioplasty. Monitoring for neurologic deterioration after craniectomy is advised. For patients showing neurologic deficit with a sunken scalp, early cranioplasty should be considered.
Identical twin with discordant classification of pituitary adenoma, and different GNAS gene sequence
( Seunghee Han ),( Hye-sun Park ),( Ji-yeon Lee ),( Sehee Park ),( Cheol Ryong Ku ),( Dong Yeob Shin ),( Young Suk Jo ),( Sun Ho Kim ),( Eun Jig Lee ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1
The majority of pituitary adenomas are sporadic tumors with recognized genetic mutations seldom being found. And familial pituitary tumors account for about 5%, carrying germline mutations in predisposition genes, including MEN1, PRKAR1A, and AIP. But, about 85% of familial pituitary adenoma kindred have unknown genetic cause. Meanwhile, the concordant occurrence of pituitary adenoma in identical twins is extremely rare. This case which report different subtypes of pituitary adenoma occurred in identical twins could contribute to elucidate the tumorogenesis of pituitary adenoma. A 26-year-old woman visited hospital with amenorrhea for 1.5 years. Her initial serum prolactin level was 141.0 ng/mL. Sella magnetic resonance imaging (MRI) showed a 0.6 cm sized right pituitary adenoma. After transsphenoidal surgery, serum prolactin level normalized and her menstruation returned regularly. Her twin sister had acromegalic features, such as enlarged face, hands and feet. Basal serum insulin-like growth factor (IGF-1) levelwas 770.9 ng/mL. Sella MRI showed a 1.5 cm sized left pituitary adenoma.. Serum growth hormone (GH) level was not suppressed by 75g oral glucose tolerance test (OGTT). After tumor removal, serum GH level was suppressed by OGTT. Their pathologic results consisted with prolactinoma andgrowth hormone secreting tumor, respectively. In evaluating family history, their father’s brother had pituitary adenoma. Short tandem repeat (STR)analysis results consisted with identical twins. Because of their family history and early onset of pituitary adenoma, genetic test was done for determining familial pituitary adenoma. And, genetic alterations in sporadic pituitary tumor also evaluated, because different subtypes of pituitary tumor was occurred in identical twins. We found GNAS gene mutation only in acromegaly patient. But the primary oncogenic potential of GNAS mutations remains a matter of debate. Thus, a better understanding of the causative genes and the pathogenic mechanisms of pituitary tumorogenesis is needed to improve the diagnosis and management of pituitary tumor patients.
Seung Jae Hwang,Jong Won Park,Sehe Dong Lee,Gyong Jung Kim,Cheol Ho Sin,Seung Hyun Nam,Bong Seog Kim 대한내과학회 2006 The Korean Journal of Internal Medicine Vol.21 No.4
Gastric cancer patients with severe liver dysfunction secondary to hepatic metastases have limited treatment options. Most cytotoxic drugs have a narrow therapeutic index. Although both capecitabine and oxaliplatin have been well tolerated as single agents for patients with severe hepatic dysfunction, the combination of these drugs has not been investigated. We report here on a case of successful treatment of a patient suffering with severe liver dysfunction and metastatic gastric cancer; the patient was treated with a combination of capecitabine and oxaliplatin (XELOX). The initial bilirubin level of the patient was 10.9 mg/dL. After two cycles of treatment, his bilirubin level decreased to 2.1 mg/dL. He has experienced an excellent radiological response and he has received six cycles of XELOX chemotherapy. XELOX chemotherapy is feasible and it can be associated with positive outcomes for the patients suffering with metastatic gastric cancer and severe liver dysfunction.
진행성 위암에 대한 1차 요법으로 Docetaxel과 Cisplatin 복합화학요법의 효과와 안정성에 대한 연구
김경중 ( Gyung Jung Kim ),이세동 ( Sehe Dong Lee ),박종원 ( Jong Won Park ),신철호 ( Cheol Ho Sin ),황승재 ( Seung Jae Hwang ),남승현 ( Seung Hyun Nam ),김봉석 ( Bong Seog Kim ) 대한내과학회 2007 대한내과학회지 Vol.72 No.6
본 연구에서는 수술 후 재발한 진행성 또는 절제 불가능한 전이성 위암을 가진 42명의 환자를 대상으로 1차 항암요법으로 docetaxel과 cisplatin을 투여하여 높은 반응률과 감내할만한 부작용을 확인할 수 있었다. 향후 많은 환자를 대상으로 한 전향적 연구와 표적치료제를 포함한 병용치료에 대한 연구가 필요할 것으로 판단된다. Background: To evaluate the activity and safety of docetaxel and cisplatin for advanced gastric cancer as a first-line chemotherapy treatment. Methods: Between December 2001 and February 2006, forty-two patients with recurrent or metastatic gastric cancer were enrolled. Docetaxel (75 mg/m2) was administered as a 1-hour intravenous infusion on day 1 and cisplatin (60 mg/m2) was also administered as a 30-minute intravenous infusion on day 1 every three weeks until disease progression or severe toxicity was detected. The response was assessed every 2 cycles. The toxicities were evaluated for every course of chemotherapy according to NCI toxicity criteria. Results: The median age of the patients was 66 (range, 33~77) years. Among the forty-two patients, 38 were male. Twenty-seven patients had an Eastern Cooperative Oncology Group performance score of 0 or 1 and fifteen patients had a score of 2. All patients had adenocarcinoma. Thirty-three of the forty-two patients were assessable for response. Partial responses were observed in 14 patients. The overall response rate was 42.4% (95% C.I., 25.259.6%) and the median response duration was 5.7 (range, 1.4~17.2) months. The median overall survival of all patients was 8.1 (range, 1.2~47.0) months. During a total of 170 cycles, granulocytopenia worse than National Cancer Institute toxicity grade 3 occurred in 7.6% of the patients, thrombocytopenia in 0.6% and anemia in 3.5%, respectively. No deaths resulting from toxicity were observed. Non-hematologic toxicities were minor and were easily controlled. Conclusion: Combination chemotherapy with docetaxel and cisplatin has a tolerable efficacy with acceptable toxicities in patients with advanced gastric cancer as a first-line treatment. (Korean J Med 72:593-599, 2007)
( Ji Hyun Kim ),( Jin Ki Hwang ),( Ju Hyung Kim ),( Sehe Dong Lee ),( Beom Jae Lee ),( Jae Seon Kim ),( Young Tae Bak ) 대한내과학회 2008 The Korean Journal of Internal Medicine Vol.23 No.3
Background/Aims: Important lesions related to gastroesophageal reflux disease (GERD) are located around the gastroesophageal junction (GEJ). This study examined the distribution of endoscopic findings around the GEJ and elucidated their relationship to each other and esophageal manometric features. Methods: Endoscopic data were collected prospectively from 2,450 consecutive diagnostic upper gastrointestinal endoscopies. The presence and degree of hiatal hernia (HH), columnar-lined esophagus (CLE), and reflux esophagitis (RE) were recorded. Esophageal manometric data were collected from 181 patients. Results: The prevalence of HH, CLE, and RE was 9.8, 18.8, and 9.9%, respectively. Of all HH and CLE cases, 62.8 and 98.9%, respectively, were of the short-segment variety. Of all RE cases, 95.0% were mild. Younger age, male gender, the presence of HH, and a higher gastroesophageal flap valve (GEFV) grades were associated with the presence of RE. Increased ZAP grades were associated with increased prevalence and grades of HH, CLE, and RE. Higher GEFV grades were associated with increased prevalence and grades of HH, CLE, and RE. Lower esophageal sphincter pressure (LESP) decreased in patients with HH or RE compared to those without HH or RE. Conclusions: Endoscopic findings around the GEJ revealed that a substantial proportion of our patients showed features potentially related to GERD. In combination with other recent reports, our study implies that Korea is no longer a very-low-prevalence area of GERD, although it may predominate in silent or milder forms.