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1983년 한해동안 한양대학병원에 내원한 환자의 총 대변검사 8,561례중에서 187례의 간흡충환자를 찾을 수 있었다. 연령별로는 40대, 50대가 51.3%로써 가장 많았으며 성별비는 5.7 : 1로 남자가 월등히 많았다. 경 또는 중등도 감염이 전체 간흡충증 환자의 87.5%로 대부분이었고 감염정도와 말초혈액의 호산구증다간에는 상관성이 있었다. 입원환자의 주된 동반 질병은 소화기질환이었으며 간흡충증환자에 대한 치료시행이나 치료후 추적연구가 불충분하였다. Total 187 cases of Clonorchiasis were detected out of 8,561 samples which were examined by the formalin-ether concentration method and Stoll's egg counting method, among the patients visiting Hanyang University hospital, from January to December, 1983 in Seoul. This study was undertaken to reveal the change of clinical pattern of Clonorchiasis, comparing with the previous reports. 1. The highest prevalence of Clonorchiasis was found in the 40 - 49 years group. And sex ratio of male vs female was 5.7:1. 2. Light and moderate infection cases, less than 9,999 in E.P.G., were detected 87.1% out of total cases tested. 3. There was a good correlation between the degree of peripheral blood eosinophilia and E.P.G. (coefficient 0.65) 4. Among the associated diseases of inpatients, gastrointestinal diseases were frequently involved. 5. Follow-up study after anthelminthic treatment was carried out unsatisfactorily.
Surgeon have been peeking through tubes into the thoracic cavity since 1910, when described thoracoscopy for the division of tuberculous adhesions. The applications of this technique remained necessarily limited because of visualization problems, however, and no really significant advances were recorded until video-assisted technology was added to the procedure. A vital new technical branch of our specialty, video-assisted thoracic surgery(VATS), has developed rapidly. These advances have helped foster the evolution of minimally invasive thoracic surgical techniques. We are now able to diagnose and treat thoracic diseases using thoracoscopic techniques that require smaller and fewer incisions, reduce morbidity, and allow patients to return home and back to work earlier.
During the last 30 years, research and therapeutic progress has been very slow with multiple myeloma. Using standard chemotherapy, reponse rate has been 40% to 50%, but complete remission(ie, normal bone marrow and absence of monoclonal protein in blood and/or urine) rate has been below 5%. The median survival is 30 to 36 months and no more than 5% live longer than 10 years, and these patients ultimately die of the disease. A dose-response effect for alkylating agent has been demonstrated in multiple myeloma. especially of melphalan. With more and more experience in transplantation and with the help of cytokines, escalation up to 200㎎/m2 of melphalan is possible with improved complete remission rate to 40-50% and prolongation of overall survival. Currently, peripheral stem cell transplantation after standard induction chemotherapy of 3-4 cycles is considered standard therapy for newly diagnosed multiple myeloma. Allogeneic transplantation although still with high transplantation mortality and relapse, can cure myeloma with documented molecular remission. Further research effort should be directed to the finding of new drugs or drug combination with over 50% complete remission which is essential for prolonging survival and ideal postttransplant chemoimmunotherapy protocol.
Patients with malignant lymphoma can be induced into a complete remission with chemotherapy. But stem cell transplantation has become widespread in the treatment of patients with refractory or relapsd NHL. High-dose therapy and autologous BMT are superior to conventional therapy in relapsed patients while the majority of patients undergoing BMT have intermediate and high-grade NHL. High-dose chemotherapy with autologous BMT has been widely employed as cytoreductive treatment for low-grade lymphoma. High-dose chemotherapy and autologous BMT has resulted in improved cure rates for patients with recurrent, chemotherapy-sensitive, large cell lymphoma compared to continuing salvage chemotherapy alone. The use of high-dose therapy by autologous hematopoietic cell transplantation has become accepted for patients with relapsed and refractory Hodgkin's disease.
Hematologic malignancies and some solid tumors have been effectively treated by conventional doses of chemotherapy. However, those patients are confronted by relapse due to minimal residual disease. Therefore, more effective treatment stratege is needed for cure or increase of survival. Hematopoietic stem cell transplantation(HSCT) is a kind of organ transplantation and can be used as a curable treatment stratege in some malignant patients. HSCT can be classifed into bone marrow transplantation and peripheral blood stem cell transplantation according to the source of hematopoietic stem cells. If donor of hematopoietic stem cell is the healthy person, we call it allogeneic HSCT, and if donor of hematopoietic stem cell is the patient himself, that is autologous HSCT. In this article, HSCT is briefly introduced for the easy access to clinicians.
Pituitary gland metastasis is a rare clinical diagnosis, usually made in the setting of known primary systemic cancer with widespread metastasis to other organs. But visual loss as a presenting symptom of metastasis to the pituitary gland is unusal. We report here a case of 45-year-old woman who had been diagnosed as having metastatic breast cancer involving bone and liver 2 years ago, and received high dose chemotherapy with peripheral blood stem cell transplantation, developed sudden bilateral complete visual loss. At initial presentation, the patient had no light perception and no pupillary response to light in both eyes, but without evidence of panhypopituitarism, or diabetes insipidus. Brain MRI showed a large enhanced mass invasion to the cavernous sinus and extension to the suprasella portion without dura or base-of-skull metastasis. Pathologic examination showed metastatic breast cancer. Despite the transsphenoidal decompression surgery of metastatic tumor, the visual loss was not improved.
Aggressive non-Hodgkin's lymphoma by REAL classification is a heterogenous group of disease. With recent advances in combination chemotherapy, the long-term survival is improved to 40-65%. We investigated twenty-one aggressive non-Hodgkin's lymphoma patients treated with pro-MACE-cytaBOM (prednisone, adriamycin, cyclophosphamide, etoposide, cytosine arabinoside, bleomycin, vincristine and methotrexated) to determine the efficacy and toxicites. There were seven patients older than 60 years. Histologic types by REAL classification were as follows : diffuse large B cell (12/21), peripheral T cell (6/21), anaplastic large cell (2/21) and angiocentric T cell (1/21). Most of patients were classified in Stage Ⅱ-Ⅳ (20/21). According to IPI (international prognostic index) score, seven patients were included in low risk, five were low-intermediate risk, three were high-intermediated risk and six were high risk group. seventeen complete responses (85%) and two partial responses (10%) were achieved. The overall response rate was 95%. The mena disease free survival was 30 months, the mean overall survival was 29 months (range:21-36), and the median overall survival was not reached. WHO grade Ⅲ/Ⅳ neutropenia or thrombocytopenia was observed in 16.7% and 2.8%, respectively. There was no treatment-related death. These results suggest that proMACE-cytaBOM combination chemotherapy is very effective and has low toxicity in the treatment of aggressive non-Hodgkin's lymphoma even treated in elderly patients.
To investigate epithelial cell proliferation and oncoprotein expression of the adenomas and adenocarcinomas of the colorectum, immunohistochemical staining using monoclonal antibodies against Ki-67 and p53 was performed and the results were compared with those of hyperplastic and retention polyps. The study groups consisted of 18 adenomatous polyps, 7 villoglandular polyps, and 13 adenocarcinomas. Seven cases of hyperplastic polyps and five cases of retention polyps were included as a control group. The Ki-67 positive reaction was present in 66% of 18 adenomatous polyps, seven villoglandular polyps and 13 adenocarcinomas. The Ki-67 positive cells among the neoplastic cells were distributed throughout crypt levels in contrast to those in the normal colonic mucosa and hyperplastic polyps, in which the positive cells were limited to the lower zone of the crypts. p53 protein expression was present in 6 out of 18 adenomatous polyps (33%) with focal, mild degree of positivity. Positive foci for p53 expression of the adenomatous polyps corresponded to those of dysplasia. Villoglandular polyps and adenocarcinomas were reactive for p53 protein in similar distribution and intensity. The normal colonic mucosal epithelium, hyperplastic polyps and retention polyps were all negative for p53 protein expression. These results suggest that the adenomatous polyps are committed to independent growth with cloncal expansion. The villoglandular polyps are thought to be premalignant prone to transition to adenocarcinoma.