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Biomedical subjects

C Y Chon

Publications and source records attributed to C Y Chon.

At least 19 recordsLinked to original sources
PubMed1999

Combined transcatheter arterial chemoembolization and local radiotherapy of unresectable hepatocellular carcinoma.

PURPOSE: The best prognosis in hepatocellular carcinoma (HCC) can be achieved with surgical resection; however, the number of resected cases are limited due to advanced lesions or associated liver disease. The purpose of this study was to investigate the efficacy and toxicity of a prospective trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) in unresectable HCC. METHODS AND MATERIALS: Patients with histologically proven unresectable HCC due to either advanced lesions or associated cirrhosis were eligible. From March 1992 to August 1994, 30 patients were entered into this study. TACE was performed with Lipiodol (5 ml) and doxorubicin (Adriamycin ; 50 mg), followed by gelatin sponge particle (Gelfoam) embolization. Local RT was started within 7-10 days following TACE. Mean tumor dose was 44.0+/-9.3 Gy in daily 1.8 Gy fractions. Response was assessed by computerized tomography (CT) scan 4-6 weeks following completion of the treatment and then at 1-3-month intervals. Survival was calculated from the start of TACE using the Kaplan-Meier method. RESULTS: An objective response was observed in 19 patients, giving a response rate of 63.3%. Distant metastasis occurred in 10 patients, with 8 in the lung only and 2 in both lung and bone. Survival rates at 1, 2, and 3 years were 67%, 33.3%, and 22.2%, respectively. Median survival was 17 months. There were 6 patients surviving more than 3 years. Toxicity included transient elevation of liver function tests in all patients, fever in 20, thrombocytopenia in 4, and nausea and vomiting in 1. There was no treatment-related death. CONCLUSION: Combined TACE and local RT is feasible and tolerable. It gives a 63.3% response rate with median survival of 17 months. We feel that this regimen would be a new promising modality in unresectable HCC. Further study is required to compare the therapeutic efficacy of this regimen to TACE alone.

Adult↗
PubMed1998

Membranoproliferative glomerulonephritis associated with HCV infection in native kidneys and renal allograft.

Hepatitis C viral infection occurs relatively low in Korea compared to hepatitis B. However, it progresses into chronic hepatitis and cirrhosis more frequently than HBV. It may be associated with cryoglobulinemia and glomerulonephritis, both in native and transplanted kidneys. We report three cases of membrano-proliferative glomerulonephritis type I in anti-HCV positive, but cryoglobulin-negative patients, presenting massive proteinuria, two in native kidneys and one in an allograft. HCV-RNA was positive in sera of two patients. Two were cirrhotic and ALT was mildly elevated in two. In addition to the characteristic membranoproliferative feature, two native kidneys overlapped with features of diabetic nephropathy. Immunofluorescence demonstrated mainly IgM and C3 deposits along the peripheral capillary walls. Subendothelial electron dense deposits were present in the glomeruli of all three cases with subepithelial and intramembranous deposits in two. HCV-RNA was associated not only with a greater amount of immune deposits but also with subepithelial and intramembranous deposits, indicating the role of active infection.

Adult↗
PubMed1997

Nitinol self-expanding stents: when severe twisting occurs, self-expansion may ensue after a waiting period.

One of the major disadvantages of nitinol endocoil stents is said to be incomplete deployment leading to twisting and stent dysfunction. We report a patient with irresectable pancreatic head cancer where severe twisting of the nitinol stent occurred which resolved on the day after stent insertion; the stent took its normal shape ten days later, whereafter the patient lived without stent-related problems for one year until his death. This shows that prospective management rather than immediate stent extraction may be warranted in such cases of stent dysfunction.

Aged↗
PubMed1996

Anorectal dysfunction in systemic sclerosis.

This study was aimed to evaluate the anorectal dysfunction in systemic sclerosis (SSc) and propose the clinical significance of anorectal manometry in patients with SSc. Seven patients with SSc were evaluated with manometry for anorectal function and an additional 11 normal subjects were collected as a control group. The study group underwent esophageal manometry as well and the correlation between the degree of anorectal and esophageal dysfunction was evaluated. Patients showed a lower tolerance for balloon distention of the rectum than controls (minimal sensory volume and urgency volume, P < 0.05). The resting and squeezing pressure of the anal sphincter and the functional length of the anal canal showed no significant difference in these two groups. Rectoanal inhibitory reflex was absent in one (14%) and diminished in two (29%) of seven patients with SSc. SSc patients also showed abnormal esophageal manometry findings, notably decreased LES pressure and body amplitude of distal 2/3 esophagus. The comparison between manometric profiles of anorectum and esophagus showed no significant correlation by statistical analysis. In conclusion, our data could suggest that anorectal function may be impaired in patients with SSc which could reflect the involvement of the anorectum by the disease, and that anorectal manometric studies can be useful to detect such dysfunction in patients with SSc, even before clinical symptoms.

Adult↗
PubMed1996

Sebaceous glands in the esophagus.

We report a case of sebaceous glands in the esophagus diagnosed by endoscopic biopsy. The patient was a 47-year-old Korean man presented with postprandial pain of several months duration. An endoscopic examination disclosed an early gastric carcinoma in the gastric antrum and a 0.4 x 0.4 cm sized irregular lobulated nodule in the middle esophagus. Microscopically, the lobule was proven to be sebaceous glands in the submucosa. Possible histogenesis of this lesion is discussed.

Choristoma↗
PubMed1996

A case of paraesophageal hernia repaired by laparoscopic approach.

Paraesophageal hernia comprises only 2 approximately 5% of all hiatal hernias but is prone to incarceration and strangulation. For this reason they must be recognized and repaired as expeditiously as possible. The laparoscopic approach has already been successfully applied to the repair of the more common sliding hiatal hernia and it seems reasonable to propose that the paraesophageal hernia, provided it is not complicated, might also be repaired by the laparoscopic technique. We present here a case of paraesophageal hernia which has been successfully repaired by the laparoscopic approach. A 73-year-old female suffering from postprandial fullness in the retrosternal area was diagnosed preoperatively with paraesophageal hiatal hernia with gastroesophageal acid reflux and was submitted for laparoscopic repair. The procedure entailed reduction of the hernia, mobilization of the esophagogastric junction with crural repair and partial fundoplication. At the 9th-month follow-up, the patient had remained asymptomatic and follow-up studies revealed no evidence of hernia or acid reflux. As a result of this favorable experience with minimal morbidity, early hospital discharge, and effective control of symptoms without adverse sequalae, laparoscopic repair can be considered as the curative and minimal invasive method in the management of paraesophageal hernia.

Aged↗
PubMed1996

Spontaneous bowel perforation during the course of acute pancreatitis--a case report.

We recently experienced a case of spontaneous perforation of infected necrosis into the colon and duodenum during the course of acute pancreatitis in a 63 year-old male patient. Enteric perforations or fistulas in the setting of acute pancreatitis implicate severe underlying pathology and have substantial morbidity and mortality. In the meantime it has generally been accepted that infected pancreatic or peripancreatic necrosis should be managed surgically as soon as possible. Enteric perforations in the present case contributed to transient improvement of the patient's infection sign and condition, and thus an early operation was able to be avoided. Delayed surgical management resulted in complete recovery of the patient without postoperative morbidity. Herein we report an unusual complication of acute pancreatitis.

Acute Disease↗
PubMed1996

A case of flutamide-induced acute cholestatic hepatitis--a case report.

Flutamide, an oral nonsteroidal, antiandrogenic, anilid compound which inhibits the uptake and binding of androgens to nuclear receptors in the prostate, is used with or without LH-RH analogues for treatment of patients with metastatic carcinoma of the prostate. Clinically significant hepatotoxicities such as toxic hepatitis, cholestatic hepatitis, hepatic failure, and even death have rarely been reported in the English literature, but no case has been reported in Korea. A 75-year-old man with metastatic carcinoma of the prostate had taken flutamide (750 mg/day) for 7 months and suddenly developed jaundice and general weakness. The findings of blood chemistries were compatible with cholestatic hepatitis, but ultrasonography, viral marker and auto-antibody studies did not reveal any attributable causes. Histologic examination of a sono-guided liver biopsy only disclosed centrilobular cholestasis, nuclear glycogenosis and mild sinusoidal lymphocytic infiltration. Discontinuation of flutamide resulted in an almost full recovery of the patient's liver function in 2 months. We, herein, report a case of flutamide-induced acute choestatic hepatitis with a brief review of the literature.

Acute Disease↗
PubMed1996

Peritoneoscopic liver biopsy findings in asymptomatic chronic HBsAg carriers with normal liver function tests and no hepatomegaly.

Asymptomatic chronic HBsAg carriers with normal liver function tests are, in general regarded as having no liver pathology. Most of the histologic findings in asymptomatic chronic carriers have been reported from areas with low incidence of Hepatitis B virus (HBV) infection, such as North America and Western Europe. It is well known that there are many differences in HBV infection between low and high endemic areas, but there have been few reports on the histologic findings of asymptomatic chronic HBsAg carriers from endemic areas. The present study was undertaken in Korea which is one of the endemic areas for HBV infection and was designed to assess the prevalence of chronic liver disease by peritoneoscopic liver biopsy among asymptomatic chronic HBsAg carriers and to make a basis for the follow-up of asymptomatic chronic HBsAg carriers according to the results obtained. One hundred and ten asymptomatic HBsAg-positive carriers with normal liver function tests and no hepatomegaly were included in the study. Final diagnosis by peritoneoscopic liver biopsy revealed that of the 110 asymptomatic carriers only 27 (24.5%) had a histologically normal liver, while 51 (46.4%) had chronic liver diseases, and the remaining 32 (29.1%) had nonspecific histologic abnormalities (nonspecific reactive changes in 18 cases, cholestasis in 6 cases, and fatty change in 8 cases). Of the 51 patients with chronic liver diseases, 3 had liver cirrhosis, 4 chronic active hepatitis with cirrhosis, 11 chronic active hepatitis and 33 chronic persistent hepatitis. The frequency of liver cirrhosis and chronic active hepatitis with cirrhosis was significantly high in the over 30 years of age group (12.1%) than in the under 30 years of age group (0%; p = 0.011 by Fisher's exact test). In conclusion, 46.4% of the Korean asymptomatic chronic HBsAg carriers with normal liver function tests and no hepatomegaly had chronic liver disease. This finding contrasted with reports from low incidence areas of HBV infection. Our results suggest that in endemic areas, a liver biopsy should be considered to assess the status of liver disease in asymptomatic chronic HBsAg carriers even if liver function tests are normal and hepatomegaly is absent, and the result can be used as a basis for the follow-up of each asymptomatic chronic HBsAg carriers.

Adolescent↗
PubMed1996

Extrahepatic bile duct hepatocellular carcinoma without primary hepatic parenchymal lesions--a case report.

Obstructive jaundice is rarely a presenting symptom of hepatocellular carcinoma (HCC). Most of the cases in the literature describing obstructive jaundice by HCC have a major hepatic component. Extrahepatic HCCs without primary hepatic parenchymal lesions are extremely rare. We encountered a case of extrahepatic HCC without primary hepatic parenchymal lesions in a 36-year-old man who presented with jaundice. We extensively sought primary hepatic parenchymal lesions preparatively and postoperatively with hepatic angiography and combined computed tomography (CT) studies, such as CT arterioportography and lipiodol-CT. The patient has been followed up for 1 year without definite evidence of recurrence. We herein report an unusual manifestation of HCC.

Adult↗
PubMed1995

Adjuvant effect of polyadenylic.polyuridylic acid on antibody production of recombinant hepatitis B surface antigen in mice.

The adjuvant effect of polyadenylic.polyuridylic acid [poly(A).poly(U)] on antibody production against recombinant hepatitis B surface antigen (rHBsAg) was investigated. Immunization of adult Balb/c mice with rHBsAg plus poly(A).poly(U) elicited significantly higher antibody responses than immunization of mice immunized with rHBsAg alone. Such an adjuvant effect was evident even in mice sensitized with subimmunogenic doses of the antigen.

Adjuvants, Immunologic↗
PubMed1995

A case of abdominal cocoon.

Abdominal cocoon is a rare disease of the peritoneum and almost invariably presents as an acute or subacute intestinal obstruction with or without a mass. The etiology of this disease is largely unknown and abdominal cocoon of unknown etiology has been limited to the tropical and subtropical zones and primarily affects young adolescent females. In the temperate zone, only one case has been reported from the United Kingdom, but the patient was also born in Pakistan. No case of abdominal cocoon purely developed in the temperate zone has been reported. Recently, we experienced a case of abdominal cocoon in a 34-year-old female patient(Korean) who had never been abroad. The diagnosis was made postoperatively by reviewing the literature. We herein report this rare condition developed in an unusual geographical location with a brief review of the literature.

Adolescent↗
PubMed1995

A large common bile duct stone migrated from the gallbladder through a cholecystohepaticodochal fistula: an unusual complication of Mirizzi syndrome type II.

Mirizzi syndrome with a biliobiliary fistula (Mirizzi syndrome type II) is a rare complication of a long-standing gallbladder stone disease. It is even rarer for a gallbladder stone to migrate through a biliobiliary fistula into the common duct. We encountered this interesting complication of Mirizzi syndrome type II in an 86 year-old female patient. A large gallbladder stone migrated into, and impacted into the distal common bile duct through a cholecystohepaticodochal fistula. The stone was resistant to mechanical lithotripsy and was treated with biliary endoprosthesis and oral bile acids.

Aged↗
PubMed1995

Dysphagia due to mediastinal tuberculous lymphadenitis presenting as an esophageal submucosal tumor: a case report.

Mediastinal tuberculous lymphadenitis is rare in adults, and it is even rarer for dysphagia to be the presenting symptom of mediastinal tuberculous lymphadenitis. Mediastinal tuberculous lymphadenitis with esophageal symptoms has been presented as esophageal ulceration, mucosal or submucosal mass with ulceration, fistula or sinus formation, extrinsic compression, or displacement of the esophagus. An exaggerated form of extrinsic compression may be presented as a submucosal tumor, radiologically or endoscopically. A barium esophagography of a 34 year-old woman with painful dysphagia revealed a large submucosal tumor-like mass on the mid-esophagus. The symptom was spontaneously improved over a 3-week period together with reduction of the mass size. A computed tomography of the chest disclosed an enlarged subcarinal lymph node and histologic examination of the specimen obtained by thoracoscopic biopsy brought about a diagnosis of tuberculosis. We herein report a case of mediastinal tuberculosis with unusual manifestations.

Adult↗
PubMed1994

Efficacy of polyadenylic.polyuridylic acid in the treatment of chronic active hepatitis B.

In order to assess whether polyadenylic.polyuridylic acid [poly(A).poly(U)] can be used as a new therapeutic agent for the treatment of chronic hepatitis B, 19 patients with histologically proven chronic active hepatitis B were injected intravenously with 100-150 mg of poly(A).poly(U) weekly for six weeks. Changes in alanine aminotransferase (ALT) levels, 2',5'-oligoadenylate synthetase (2'.5'-AS) activities and HBV markers were sequentially checked during and after treatments. Serum ALT levels were decreased gradually and 2'.5'-AS activities were significantly increased after initiation of poly(A).poly(U) injections. At the end of this trial (24th week) we have observed the normalizations of elevated ALT levels in 14 (73.7%), negative conversion of HBeAg in 11 (57.9%) and loss of HBV-DNA in 12 out of 19 patients (63.1%). Complete responses which had both normalization of ALT levels and negative conversion of HBeAg were noted in 11 patients (57.9%) and partial responses showing either normalization of ALT levels or negative conversion of HBeAg alone were in four out of 19 patients (21.1%). No notable adverse effects were observed during the treatments and follow-up period. It can be concluded that poly(A).poly(U) seems to be effective in the treatment of chronic active hepatitis B and has an advantage of being free of significant side effects.

2',5'-Oligoadenylate Synthetase↗
PubMed1994

Combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma.

Eighty-four patients with unresectable primary hepatocellular carcinoma due either to locally advanced lesion or to association with liver cirrhosis were treated with combined radiotherapy and hyperthermia from April 1988 to January 1991. Purpose of this study was to assess thermometry, response rate, toxicity, and survival in those patients. External radiotherapy was given with a total of 30.6 Gy/3.5 wks. Hyperthermia was given twice a week with a total of 6 treatment sessions using an 8 MHz radiofrequency capacitive type heating machine. Each hyperthermia session was started within 30 min following radiotherapy and continued for 30-60 min. Thermal data were analysed with maximum, minimum, and average temperatures of the tumors. Thermal mapping was also done. In thermometry results, maximum, minimum, and average temperatures of the tumors were 41.9 +/- 1.3 degrees C, 39.9 +/- 1.0 degrees C, and 40.8 +/- 0.9 degrees C, respectively. The fraction over 40 degrees C was 73 +/- 32% with a wide variation from 15% to 100%. Among 67 assessable patients, 27 patients showed tumor regression of more than 50% of the original tumor volume (40.3% response rate). Symptomatic improvement was observed in 78.6% of the patients. Acute toxicities during the treatment were mostly acceptable local pain (51.2%) and local fat necrosis (13.1%). The actuarial 1-year, 2-year, and 3-year survival rates were 44.8%, 19.7%, and 15.6%, respectively. Median survival was 6 months. In view of acceptable toxicities and the current rate of survival, further evaluation of combined treatment of radiotherapy and hyperthermia for unresectable hepatocellular carcinoma is warranted.

Carcinoma, Hepatocellular↗
PubMed1993

Effect of anticancer drugs and desferrioxamine in combination with radiation on hepatoma cell lines.

Several anticancer chemotherapeutic agents (5-fluorouracil, adriamycin and cisplatinum) and desferrioxamine, an iron chelator, were tested with regard to cytotoxicity and to the combined effect on radiation induced cell killing using two human hepatoma cell lines (HepG2 and PLC/PRF/5). Survival fractions were measured by quantitative colorimetric assay (MTT assay) and dose-response curves were plotted. MTT assay could be successfully used in the assessment of radiosensitivity in addition to chemosensitivity, because a good linear relationship between optical densities and cell numbers was observed and cells approached exponential growth for the first 7 days of culture when 5 x 10(3) or less cells were inoculated per well in our study. Steepness of the final slope (D0), width of the shoulder (D0) and the extrapolation number (n) of radiation survival curves were 1061.72 rad, 226.43 rad and 1.25 respectively in HepG2 and 1091.38 rad, 268.42 rad and 1.29 respectively in PLC/PRF/5. After combining anticancer chemotherapeutic agents and desferrioxamine with radiation, the widths of the shoulders were decreased whereas sensitizer enhancement ratios were increased as the concentration of drugs increased in both cell lines. These results suggest that neither anticancer chemotherapeutic agents nor desferrioxamine enhance cell killing induced by radiation alone, but suggested the possibility that they inhibit the repair of radiation damage.

Antineoplastic Agents↗