• Journal of Chest Surgery
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• 제6권1호
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• pp.41-46
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• 1973

This is a report on four cases of atelectasis which were implicated as one case of mucoid impaction and three cases of blood clots in main bronchus. The 1st case was found to be massive atelectasis on Lt. entire lung due to mucoid impaction with pulmonary tuberculosis. This case was performed the Lt. pneumonectomy. There are contain-ing impacted yellowish-gray jelly like thick materials on the Lt. whole bronchial trees and pathologic findings were consistent with tuberculosis including caseation necrosis and multinucleated giant cell on whole left lung thoroughly in microscopic findings. The 2nd and 3rd case [25 years old female and 30 years old female] were diagnosed as one sided entire lung ateletasis which were led by accumulation of old blood clots on bronchus following incomplete expectoration of sudden massive hemoptysis from pulmonary tuberculosis lesion. These two cases were recovered by removal of blood clots and bronchial irrigation under bronchoscopy. Follow up chest film revealed well aeration. The 4th case [45 years old] was taken the removal of old blood clots and tissue debris under the bronchoscopy as bronchial obstruction following massive hemoptysis. The cytologic findings revealed the class III in fresh sputum and class 1V in bronchial irrigation which may suggest of malignancy. However, we could not found the causative lesions suggestive malignancy by the bronchography and other diagnostic measurements.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1411-1414
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• 2016

Background: Eosinophilic pleural effusion (EPE) is an eosinophil count more than 10% on cytology of pleural samples. Recently, it was reported that malignancy had been the most prevalent cause inducing EPE. Therefore, we conducted an analysis on the prevalence and etiology of EPE and investigated the relationship between EPE and malignancy. Materials and Methods: Data for pleural cell differential count from patients receiving thoracentesis during the period from January 2008 to December 2013 were compared with clinical data and established diagnosis of patients obtained via electronic chart review. Results: A total of 6,801 requests of pleural cytology from 3,942 patients with pleural effusion who had received thoracentesis were available at Far Eastern Memorial Hospital from 2008 to 2013, and of these subjects, 115 (2.9%) were found to have EPE. The most frequent cause of EPE was malignancy (33.0%, n=38), followed by parapneumonic effusions (27.8%, n=32), tuberculosis pleuritis (13.9%, n=16), transudate effusions (12.2%, n=14) and the presence of blood or air in pleural space (10.4%, n=12). Additionally, an inverse relationship of eosinophilia in pleural fluid was identified in patients with malignancy and EPE. The cut-off eosinophil count in pleural fluid was 15% for the most accurate discrimination between malignancy and benign disorders in patients with EPE. At the cut-off level, the sensitivity and specificity were 65.8% and 67.5%, respectively. Conclusions: Pleural fluid eosinophilia was a speculative negative predictor for malignancy, despite the fact that cancers, including lung cancers and metastatic cancers to lung, were the most leading cause of pleural fluid eosinophilia. An inverse correlation was observed between the pleural eosinophil percentage and the likelihood of malignancy in patients with EPE.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.172-182
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• 1988

혈중 셀레늄 농도와 위장질환과의 관련성을 밝히기 위해, 1986년 7월에서 9월 사이에 대구시내 2개 대학병원 외래를 방문하여 위내시경검사를 받은 사람들 중에서 간장질환, 신장질환, 식도정맥류 및 십이지장질환을 제외한 175명을 대상으로 일반적 특성을 조사하고, 정맥혈 5ml를 채취하여 flameless atomic absorption spectrophotometry를 이용하여 혈중 셀레늄농도를 측정하였다. 평균 혈중 셀레늄농도는 위염($155.5{\pm}14.0{\mu}g/{\ell}$), 위궤양($154.8{\pm}29.3{\mu}g/{\ell}$) 그리고 위암($133.0{\pm}8.4{\mu}g/{\ell}$)으로 모두가 위내시경 음성군($173.3{\pm}33.6{\mu}g/{\ell}$) 보다 통계적으로 유의하게 낮았다(p<0.05). 남성에서도 위염, 위궤양 그리고 위암 모두는 통계적으로 유의하게 낮았지만(p<05), 여성에서는 위염과 위암이 음성군 보다 유의하게 낮았고(p<0.05), 위궤양은 평균 혈중 셀레늄농도가 $177.7{\mu}g/{\ell}$로 음성군($169.7{\mu}g/{\ell}$)보다 높았지만 통계적으로 유의하지는 않았다. McGee의 LOGRESS Program에 의한 logistic분석에 있어 혈중 셀레늄농도의 계수는 위염과 -0.0436(p<0.05 ; odds ratio 0.957), 위궤양과 -0.0197(p=0.17 ; 0.981), 위암과 -0.4876(p<0.05 : 0.614) 그리고 위장질환 전체와는 -0.0411(p<0.05 ; 0.960)이었다. 이상의 성적은 비록 그 검사예수가 적지만 위염, 위궤양 특히 위암에 있어서 혈중 셀레늄농도가 위내시경 정상 소견을 보인 예에 비하여 낮았다는 사실은 혈중 셀레늄과 몇가지 위장질환과는 어떠한 관련성을 시사하는 자료가 된다고 하겠으며 추후 많은 추적검사가 필요할 것으로 보인다. (본 논문의 자료 수집을 위해 협조해 주신 경북의대와 계명의대 내과학교실 및 임상병리학교실 여러 선생님께 깊은 감사를 드립니다. 또한 셀레늄 분석과 원고 교정을 도와준 장봉기 선생과 자료의 통계처리를 도와준 천병렬선생께도 뜨거운 감사를 드립니다.)

• Childhood Kidney Diseases
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• 제21권1호
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• pp.31-34
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• 2017

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin's lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10307-10311
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• 2015

Background: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p=0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p=0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.1053-1056
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• 2013

Background: Leukemia and lymphoma demonstrate significantly incidence rates throughout the world and particularly in Iran they cause serious mortality and diagnosis and treatment expenditures for both families and the health system. Combined they account for about 11 percent of cancers in Mazandaran province, ranking number 2 in prevalent cancers. The purpose of this study was to provide a first general and specific description of leukemia and lymphoma in Mazandaran province. Materials and Methods: In this descriptive retrospective study, entire patient's data were reviewed which had confirmed diagnosis of leukemia and lymphoma with valid laboratory or pathology reports in the period 2001-2008. The data were collected by Babol health research site related to Tehran University of Medical Science. Incidence rates based on age groups, gender, city of residence and type of malignancy were calculated and analyzed. Results: In Mazandaran province, 1,146 cases of leukemia and lymphoma were encountered, 5.9 in 100,000 persons on average annually. The highest incidence rates were obtained at age of 70 or above (26.4) and the lowest at age of 0-9 (2.3).The incidence rates in males and females were 7.1 and 4.8 respectively with a ratio of 1.5. The highest incidence rate was in Babol (7.3) and the lowest was calculated in Neka and Tonekabon equally (1.5). According to the type of malignancy, non Hodgkin lymphoma, with 2.5/100,000 have the most incidence rate and myeloid leukemia with 1.8 had the lowest. Conclusions: The obtained findings indicate clear differences in incidence rates based on age, gender, residence, and type of malignancy. Therefore it's suggested that in addition to promote data collecting programs, research projects should be programmed to define leukemia and lymphoma risk factors in this province.

• Childhood Kidney Diseases
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• 제21권1호
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• pp.21-25
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• 2017

Severe hypercalcemia is rarely encountered in children, even though serum calcium concentrations above 15-16 mg/dL could be life-threatening. We present a patient having severe hypercalcemia and azotemia. A 14-year-old boy with no significant past medical history was referred to our hospital with hypercalcemia and azotemia. Laboratory and imaging studies excluded hyperparathyroidism and solid tumor. Other laboratory findings including a peripheral blood profile were unremarkable. His hypercalcemia was not improved with massive hydration, diuretics, or even hemodialysis, but noticeably reversed with administration of calcitonin. A bone marrow biopsy performed to rule out the possibility of hematological malignancy revealed acute lymphoblastic leukemia. His hypercalcemia and azotemia resolved shortly after initiation of induction chemotherapy. Results in this patient indicate that a hematological malignancy could present with severe hypercalcemia even though blast cells have not appeared in the peripheral blood. Therefore, extensive evaluation to determine the cause of hypercalcemia is necessary. Additionally, appropriate treatment, viz., hydration or administration of calcitonin is important to prevent complications of severe hypercalcemia, including renal failure and nephrocalcinosis.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.4009-4011
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• 2016

Background: Classical Hodgkin's lymphoma (cHL) is a B-cell lymphoid neoplasm characterized by a distinctive biological behavior with potentially curable disease characteristics. It is an uncommon hematological malignancy which primarily affects younger individuals. The rationale of this study was to determine its clinico-hematological profile along with stage stratification in Pakistani patients. Materials and Methods: In this descriptive study, adult patients with Hodgkin's lymphoma were enrolled from January 2010 to December 2014. Results: Sixty two histopathologically confirmed cases of cHL were identified. There were 42 males and 20 females, with a male to female ratio of 2: 1. The mean age was $29.7{\pm}13.8$ years with the median age of 30 years. B symptoms were present in 72.5% of patients. Histopathologically, the mixed cellularity type constituted 62.9% of cases, followed by nodular sclerosis in 25.8%, lymphocyte predominant in 9.6% and lymphocyte depleted in 1.6%. Stages I and II were present in 43.5% of patients at disease presentation, with 56.4% in stages III and IV. Conclusions: Our analysis shows that clinico-pathological features of Hodgkin's lymphoma in Pakistan are comparable to published data. Mixed cellularity is the commonest histological variant and advanced stage at presentation are common findings in our patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.793-796
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• 2015

Background: Chronic lymphoid leukemia (CLL) is not an uncommon hematological malignancy which primarily affects elderly individuals. It is more common in developed world than in developing countries. The rational of this study was to determine the clinico-hematological profile in Pakistan. Materials and Methods: In this prospective cross sectional study, sixty patients with CLL were enrolled from January 2011 to June 2013. Data were analyzed with SPSS version 21. Results: The mean age was $59.0{\pm}9.2years$ (range 40-82) and the male to female ratio was 2.1:1. Peak age group was 60-70 years (38.3%) and 18.3% were under 50 years old. Major complaints were weakness (51.7%), fever (18.3%) and abdominal discomfort (13.3%). Main clinical findings were splenomegaly (46.6%), lymphadenopathy (36.6%) and pallor (26.7%). Some 16.7% were diagnosed incidentally. The mean hemoglobin was $10.8{\pm}2.4g/dl$, with a total leukocyte count of $91.5{\pm}87.8{\times}10^9/l$ and platelets $197.8{\pm}103.2{\times}10^9/l$. Anemia and thrombocytopenia were seen in 26.7% and 21.7% of cases, respectively. High LDH and hyperuricemia were detected in 15% each and elevated serum creatinine was seen in 11.6%. According to Rai staging 11.6% were in stage 0, 13.3% stage 1, 26.7% each for stage II and stage III while 21.7% patients were in stage IV. Conclusions: CLL in our patients in Pakistan, unlike in the West, is seen in a relatively young population with male predominance. Primarily disease is of B-cell origin and about 2/3 of the patients present at advanced stage.

• Journal of Yeungnam Medical Science
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• 제16권1호
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• pp.76-84
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• 1999

악성 복수와 비악성 복수의 감별 진단은 진단과 치료 과정에서 매우 중요한 역할을 한다. 많은 계측치들이 감별을 위하여 사용되어져 왔는데 어느 것도 단독 사용시 두 군을 완벽히 구분짓지는 못한다. 이에 본 연구자들은 악성복수와 비악성 복수의 감별에 있어서 여러 계측치들을 비교하여 민감도와 특이도가 높은 계측치를 찾고 이 결과를 토대로 악성복수와 비악성 복수의 구분에서 간단하면서도 효과적인 진단방법을 찾고자 하였다. 1995년 1월부터 1997년 12월까지 영남대학교 의과대학 부속병원 내과에 복수를 주소로 내원하여 복수 천자를 시행한 80명을 대상으로 이들 환자들을 악성 복수 환자군과 비악성 복수 환자군으로 나누어 조사하였다. 악성 복수군은 다시 암종증이 동반된 21명의 환자와 암종증의 증거가 없는 6명의 환자로 구분하였고 비악성 복수군은 다시 52명의 간경변증 환자군과, 1명의 간경변증이 없는 군으로 구분하였다. 모든 환자에게서 복수와 혈액에서 동시에 검체가 얻어졌고 계측치로 복수액의 콜레스테롤, CEA, LDH, 단백치, 세포진 검사, 복수액과 혈청의 LDH 비, 단백비, 혈청-복수액 알부민 차를 구하였고, 각 계측치의 평균을 구하여 두 군을 비교하였는데, 모든 계측치가 통계적으로 유의한 차이를 보여 주었다. 저자는 각 계측치마다 각 측정치를 적용하여 가장 높은 민감도와 특이도를 보이는, 즉 가장 높은 진단 능력을 나타내는 측정치를 절단치로 정한 후각 계측치에 적용하여 진 양성, 진 음성, 가 양성, 가 음성으로 분류한 후 민감도, 특이도, 양성 기대도, 음성 기대도, 진단 능력을 산출하였고, 연구된 계측치 중 민감도가 높은 계측치인 복수액의 콜레스테롤을 선별검사의 단계에 적용하고, 특이도가 높은 계측치인 세포진 검사와 복수와 혈청의 단백비를 악성 복수로 분류된 군에 적용하여 악성 복수를 확진하는 2단계 진단 과정을 80명의 환자들에게 적용하여 다음 결과를 얻었다. 1) 복수액 분석 결과 복수액의 콜레스테롤치가(절단치: 30 mg/dl) 93%의 가장 높은 민감도를 보였고, 복수액의 세포진 검사와 복수액과 혈청의 단백비가(절단치: 0.5) 100%, 98%의 가장 높은 특이도를 나타내었다. 2) 2단계의 진단 과정을 통하여 복강내 암종 전이가 확인된 21명 모두 악성 복수군으로 분류되었다. 3) 광범위한 간전이가 있는 악성 복수 모두 비악성군으로 분류되었다. 4) 간 경변증으로 인한 52례에서 모두 비악성군으로 분류되었다. 5) 전체 진단 과정을 통해 총 27명의 악성 복수 중 81.5%인 22명이 악성 복수군으로 진단되었다. 이상의 결과를 토대로 본 연구자들이 제시한 진단 과정은 악성 복수와 비악성 복수의 감별 진단에 효과적인 방법으로 생각되며 더욱 정확한 진단을 위해서는 임상 양상, 방사선학적 검사, 기타 검사 등을 토대로 종합적인 판단이 필요하리라 생각된다.