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Burnt-out Metastatic Prostate Cancer

  • Shin, Dong Suk;Koo, Dong Hoe;Yoo, Suhyeon;Ju, Deok Yun;Jang, Cheol Min;Joo, Kwan Joong;Shin, Hyun Chul;Chae, Seoung Wan
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.116-119
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    • 2013
  • A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

Reproductive Cycle of the Abalone, Haliotis discus hannai Collected from Jindo of Korea (한국 진도에서 채집된 북방전복, Haliotis discus hannai의 생식주기)

  • Park, Min Woo;Kim, Hyejin;Kim, Byeong Hak;Son, Maeng Hyun;Choi, Ji Sung;Lee, Jung Sick
    • The Korean Journal of Malacology
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    • v.30 no.3
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    • pp.243-248
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    • 2014
  • This study histologically describes the gonadal development and reproductive cycle of the abalone, Haliotis discus hannai inhabiting Jindo on the southern seashores of Korea. Gonads displayed histologically definitive seasonal changes. The female ratio (F/F + M) was 57% (n = 154/271). The gonad index (GI) of both males and females was the highest (3.3 and 3.9) in June and was the lowest (1.1 and 1.1) in December. The condition index (CI) and meat weight rate (MWR) were highest in May and lowest in October. The pattern of changes in the GI, CI and MWR were similar to the pattern of seasonal changes in gonadal tissues. The reproductive cycle was divided into an inactive stage (November-December), early active stage (January-March), late active stage (March-April), ripe stage (May-June) and spent and degenerative stage (July-October). The main spawning period of Haliotis discus hannai was July to August at Jindo in 2013.

Multiple Primary Malignant Tumor (다발성 원발성 악성종양)

  • Lee, Su-Jung;Chung, Yun-Woong;Kim, Hong-Jin;Suh, Bo-Yang;Kwun, Koing-Bo
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.221-230
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    • 1988
  • Though the occurrence of multiple primary malignant tumor is a rare finding but the reported cases of it has increased in recent years. We collected multiple primary cancer of different organ, tissue and the multicentric origin of bilaterally paired organs. This paper reports 6 cases of multiple primary malignant tumors which were experienced at Yeungnam university hospital in Taegu during the past 2 years with review of journals. The results were as follows. 1. The incidence of multiple primary cancer was 0.31% for 2 years(1987-1988). 2. The ratio between male and female was 1:1 and mean age of incidence was 54.1 years. 3. The ratio between synchronous and metachronous(interval more than 6 months) was 1:1. 4. The time interval between first and second cancer was average 2.7 years in metachronous cases. 5. The most frequent involved organ was stomach, breast and colon in order of frequency. 6. The incidence of familial cancer associations was found in one out of 6 cases. 7. The test of DNCB, multi test CMI and ratio of T4 to T8 were performed in 4 cases but there was no definitive evidence of abnormality. We concluded that every effort should be made to discover the presence of synchronous malignancies in the patients who are being treated for a known tumor, and also special care should be given to detect new metachronous lesions is required.

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Arthroscopic Treatment for Localized Pigmented Villonodular Synovitis of the Knee (슬관절의 국소적 색소 융모 결절성 활액막염에 대한 관절경적 치료)

  • Kim, Sung-Jae;Shin, Sang-Jin;Choi, Nam-Hong;Joo, Eui-Tak;Kim, Hyung-Chan
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.2
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    • pp.121-126
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    • 1999
  • Diagnosis of localized pigmented villonodular synovitis (PVNS) is difficult because of its rarity and indistinctive symptoms. This study presented 11 cases of localized PVNS of the knees, which were diagnosed and treated by arthroscopic technique. There were 6 males and 5 females between the age of 15 and 59 years (mean 34.6 years). The interval from the onset of symptoms to treatment ranged from 2 months to 3 years (average 29.9 months). All patients complained knee pain and 7 patients complained palpable mass. Four of the 11 patients had trauma history. The most common involved site was anteromedial synovium near the anterior horn of medial meniscus (5 patients). The remaining cases were identified on anterior fat pad (2 cases), suprapatellar pouch, posteromedial compartment, medial gutter and the anterior horn of the lateral meniscus, respectively. Nine cases had 1 mass and the remaining cases each had 2 or 3 masses. There was no evidence of recurrence during the follow-up period (average 29.9 months). Arthroseopy is effective in the diagnosis of localized PVNS with minimal morbidity and in the definitive treatment for PVNS.

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Historian Samuel Eliot Morison and Writing History of United States Naval Operations in World War II (해양사가 새뮤얼 엘리엇 모리슨(Samuel Eliot Morison)의 해전사 서술과 그 현대적 의미 - 『제2차 세계대전기 미국 해군 작전사』를 중심으로 -)

  • Kim, Hyun-Seung
    • Strategy21
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    • s.42
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    • pp.53-82
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    • 2017
  • Samuel Eliot Morison (1887-1976) was one of the pre-eminent historians of his generation. He was not only a famous historian at that time, but also was promoted to the rank of Admiral in U.S. Navy Reserve. Fifteen volume History of United States Naval Operations in World War II was published between 1947 and 1962, was not only a comprehensive report on the Navy's projection of power over two oceans, but a classic of historical literature that stands as the definitive treatment of it subject. Although he was fifty-five when war come to America in December 1941. Samuel Eliot Morison was determined to play a role. A professor at Harvard at the time, he joined volunteering for duty in the Navy. An experienced sailor, Professor Morison had earlier sailed that same routes taken by Christopher Columbus while researching his biography, Admiral of the Ocean Sea, which appeared in January 1942 th much acclaim and later got a Pulitzer Prize. Thus Morison plunged into the war, crossing the Atlantic aboard a destroyer. He assumed himself as "Parkman on the sea", tried to follow Parkman's historiographic method, not only participatory history but also literary style. And during writing History of United States Naval Operations in World War II, He emphasized two principles, publicity and objectivity. In terms of publicity, he always worried about who read history and why. In his pamphlet, "History as a Literary Art", he asserted it is useless if readers do not read a history which historians wrote. So he thought historians have forgotten that there is an art of writing of history. Therefore, he built his narratives around brightly rendered visuals and used the present tense to describe actions he witnessed firsthand, he wrote of the U.S. combat in very vividly. But strongly driven by publicity, he sometimes lost his balance in writing the naval history. For instance, the naval history became the focus of criticism for its prejudiced comments about the commanders. Also some reviewers asserted he did not secure the objectivity on writing the naval history. Although he sometimes deliberately torpedoed the objectivity of his work for strengthening publicity, by writing an extensive U.S. naval history, he introduced maritime history and naval history to the public widely. Until in early twentieth century, U.S. historians usually had been focusing their effort to the traditional areas, for example politic, economy, and etc. His intensive effort on the operations of U.S. Navy in World War II aroused a public interest in maritime and naval history. In conclusion, through using literary style and realistic narratives, historian Morison wrote a naval history for all the people which could appealed to the public.

Definitive Surgical Management for Deep-Seated Mediastinitis and Sternal Osteomyelitis Following Tracheal Reconstruction -Sternectomy, Free or In-Situ Omental Transfer, Myocutaneous Flap- (기관재건술 후 발생한 심부 종격염 -흉골 절제, 위망 이식, 근피성형을 병합한 근치술-)

  • Lee, Seo-Won;Kim, Jung-Taek;Kim, Kwang-Ho;Lee, Choong-Jae;Kim, Young-Mo;Lim, Hyun-Kyoung;Sun, Kyung
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.206-210
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    • 1999
  • We report here 2 cases of deep-seated mediastinitis combined with sternal osteomyelitis after tracheal reconstruction which were successfully treated with sternectomy, in-situ or free omental transfer, and pectoralis major myocutaneous flap. In case I, an 8 year-old boy with deep seated mediastinitis and sternal osteomyelitis that developed after anterior tracheoplasty through a standard midline sternotomy. In case II, a 50 year-old female patient with mediastinal abcess and sternal osteomyelitis that developed after resection and end-to-end anastomosis of the trachea through an upper midline sternotomy. Treatments consisted of drainage and irrigation followed by wide resection of the infected sternum, placement of the viable omentum into the anterior mediastinal space, and chest wall reconstruction with a pectoralis major myocutaneous flap. The omentum was transferred as an in-situ pedicled graft in case I and a free graft in case II. Both patients have recovered smoothly wit out any events and have been doing well postoperatively.

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Prognostic implications of tumor volume response and COX-2 expression change during radiotherapy in cervical cancer patients

  • Noh, Jae Myoung;Park, Won;Huh, Seung Jae;Cho, Eun Yoon;Choi, Yoon-La;Bae, Duk Soo;Kim, Byoung-Gie
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.218-225
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    • 2012
  • Purpose: The relationship between treatment outcomes, alteration of the expression of biological markers, and tumor volume response during radiotherapy (RT) in patients with uterine cervical cancer was analyzed. Materials and Methods: Twenty patients with cervical squamous cell carcinoma received definitive RT with (n = 17) or without (n = 3) concurrent chemotherapy. Tumor volumes were measured by three serial magnetic resonance imaging scans at pre-, mid-, and post-RT. Two serial punch biopsies were performed at pre- and mid-RT, and immunohistochemical staining for cyclooxygenase (COX)-2 and epidermal growth factor receptor was performed. The median follow-up duration was 60 months. Results: The median tumor volume response at mid-RT (V2R) was 0.396 (range, 0.136 to 0.983). At mid-RT, an interval increase in the distribution of immunoreactivity for COX-2 was observed in 8 patients, and 6 of them showed poor mid-RT tumor volume response ($V2R{\geq}0.4$). Four (20%) patients experienced disease progression after 10 to 12 months (median, 11 months). All 4 patients had poor mid-RT tumor volume response (p = 0.0867) and 3 of them had an interval increase in COX-2 expression. Overall survival (OS) and progression-free survival (PFS) decreased in patients with $V2R{\geq}0.4$ (p = 0.0291 for both). An interval increase in COX-2 expression at mid-RT was also associated with a decreased survival (p = 0.1878 and 0.1845 for OS and PFS, respectively). Conclusion: Poor tumor volume response and an interval increase in COX-2 expression at mid-RT decreased survival outcomes in patients with uterine cervical cancer.

Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases

  • Zhang, Bai-Hua;Cheng, Gui-Yu;Xue, Qi;Gao, Shu-Geng;Sun, Ke-Lin;Wang, Yong-Gang;Mu, Ju-Wei;He, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1889-1894
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    • 2013
  • Background: Basaloid squamous cell carcinoma of the esophagus (BSCCE) is a rare and distinctive tumor with no standard treatment. This study aimed to explore treatment in relation to prognosis of the disease. Methods: A total of 142 patients with BSCCE that underwent treatment in our hospital from March 1999 to July 2010 were retrospectively analyzed. All patients received surgery, 42 postoperative radiotherapy and 28 patients chemotherapy. Results: There were 26 patients included in stage I, 60 in stage II, 53 in stage III and 3 in stage IV. The clinical symptoms and macroscopic performances of BSCCE did not differ from those of typical esophageal squamous cell carcinoma. Among 118 patients receiving endoscopic biopsy, only 12 were diagnosed with BSCCE. The median survival time (MST) of the entire group was 32 months, with 1-, 3- and 5-year overall survival (OS) of 81.4%, 46.8% and 31.0%, respectively. The 5-year OS of stage I and II patients was significantly longer than that of stages III/IV, at 60.3%, 36.1% and 10.9%, respectively (p<0.001, p=0.001). The MST and 5-year OS were 59.0 months and 47.4% in patients with tumors located in the lower thoracic esophagus, and 27.0 months and 18.1% in those with lesions in the upper/middle esophagus (p=0.002). However, the survival was not significantly improved in patients undegoing adjunctive therapy. Multivariate analysis showed TNM stage and tumor location to be independent prognostic factors. Furthermore, distant metastasis was the most frequent failure pattern, with a median recurrence time of 10 months. Conclusion: BSCCE is an aggressive disease with rapid progression and a propensity for distant metastasis. It is difficult to make a definitive diagnosis via preoperative biopsy. Multidisciplinary therapy including radical esophagectomy with extended lymphadenectomy should be recommended, while the effectiveness of radiochemotherapy requires further validation for BSCCE.

Hyperhidrosis Treated by Thoracoscopic Sympathicotomy (다한증 환자에서의 T2 Sympathicotomy의 효과)

  • 윤용한;이두연;김해균;이교준;신화균;강정신
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.171-174
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    • 1999
  • Background: Hyperhidrosis of the palms, axillae and face has a strong negative impact on social and professional life. The present existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. A definitive cure can be obtained by upper thoracic sympathectomy. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating. Material and Method: From Sep. 1997 to Feb. 1998, 89 cases of the needle(2 mm) thoracoscopic thoracic sympathicotomy were performed. The second thoracic ganglion was resected by cutting with a endoscissors. Result: A bilateral procedure takes less than 25 min and requires just one night in hospital. There have been no mortality or life-threatening complications. One patient(<2%) required intercostal drainage because of pneumothorax. Primary failure occurred in one cases(<2%) and recurrent hyperhidrosis occurred in no cases. The patients with failure was successfully re-sympathicotomy. At the end of postoperative follow-up(median 3 months), 96.6% of the patients were satisfied. Compensatory sweating occurred in 57 cases(64.0%) with fourteen of those cases classified as either embarrassing in 10 cases(11.2%) or disabling in 4 cases(4.5%). Conclusion: Endoscopic transthoracic sympathicotomy is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis.

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THE USE OF REMOVABLE APPLIANCE FOR THE CORRECTION OF MINOR IRREGULARITIES IN ANTERIOR SEGMENT (전치부의 경미한 공간부조화 개선을 위한 가철성 장치의 적용 예)

  • Kwak, Ah-Ram;Choi, Yeong-Chul;Park, Jae-Hong;Choi, Seong-Chul;Kim, Gwang-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.4
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    • pp.685-693
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    • 2007
  • Class I malocclusion without skeletal problem results from tooth size/arch-size discrepancies, either evidenced by crowding, or spacing problems. Treatment method can be chosen according to dentition, the amount of arch discrepancy, patient compliance, or patient demands. We report of clear aligner and spring aligner that can be applicated in cases of permanent dentition with minimal arch discrepancy in anterior segment. There are some limits of application, but these are very useful appliances in the selective case. When crowding exists, definitive analysis and diagnosis should be made before starting treatment because certain amount of space must be obtained somewhere in the dentition to resolve the crowding. Therefore, appliance should be applied when lacking space is small. Also, in cases with spacing arch circumference is reduced after alignment so no problem in intermaxilla occlusal relationship must be confirmed. In case with crowding, judicious removal of interproximal enamel is indicated.

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