• Annals of Clinical Neurophysiology
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• v.25 no.2
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• pp.84-92
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• 2023

Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

• Clinical and Experimental Vaccine Research
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• v.12 no.4
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• pp.319-327
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• 2023

Purpose: Patients with hematological malignancies are at an increased risk of severe infection with coronavirus disease 2019 (COVID-19). However, developing an adequate immune response after vaccination is difficult, especially in patients with lymphoid neoplasms. Since the long-term effects of the BNT162b2 vaccine are unclear, the humoral immune response 5 months after the two vaccinations in patients with hematological disorders was analyzed. Materials and Methods: Samples were collected from 96 patients vaccinated twice with BNT162b2 and treated with at least one line of an antitumor or immunosuppressive drug in our hospital from November 2021 to February 2022. Serum anti-severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2) spike (S) antibody titers were analyzed. Patients were age- and sex-matched using propensity matching and compared with a healthy control group. Patients with serum anti-SARS-CoV-2 S antibodies were defined as 'responder' if >50 U/mL. The patients had B-cell non-Hodgkin lymphoma (B-NHL), multiple myeloma, chronic myeloid leukemia, etc. Results: Patients had significantly low antibody levels (median, 55.3 U/mL vs. 809.8 U/mL; p<0.001) and a significantly low response rate (p<0.001). Multivariate analysis showed that patients with B-NHL, aged >72 years, were associated with a low response to vaccination. There were no significant differences between patients with chronic myeloid leukemia and healthy controls. Conclusion: Our study shows that patients with hematological disorders are at risk of developing severe COVID-19 infections because of low responsiveness to vaccination. Moreover, the rate of antibody positivity differed between the disease groups. Further studies are warranted to determine an appropriate preventive method for these patients, especially those with B-NHL.

• Journal of the Korean Society of Radiology
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• v.85 no.4
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• pp.807-812
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• 2024

Breast lymphomas are rare, malignant breast neoplasms with a heterogeneous pattern of clinical symptoms. Burkitt's lymphoma is a rare, highly aggressive, and rapidly growing B-cell non-Hodgkin lymphoma. We report about a 27-year-old woman diagnosed as having secondary breast Burkitt's lymphoma, probably originating from the stomach, with multiple distant metastases. Breast ultrasonography revealed multiple, variable sized, heterogeneous masses with posterior acoustic enhancement and echogenic rims. These imaging findings may sometimes overlap with those of other breast malignancies. However, unlike other breast malignancies, lymphoma can be diagnosed by biopsy and does not require surgical excision. To avoid unnecessary treatment, radiologists and clinicians should be aware of the characteristic imaging features of breast lymphomas.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.7-14
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• 1992

Between August 1988 and December 1991, 24 patients with intracranial tumors were treated with stereotactic radiosurgery(RS) using a 10 MV linear accelerator at Severance Hospital, Yonsei University College of Medicine. There were 5 meningiomas, 3 craniopharyngiomas, 9 glial tumors, 2 solitary metastases, 2 acoustic neurinomas, 2 pineal tumors, and 1 non-Hodgkin's lymphoma. Ten patients were treated as primary treatment after diagnosis with stereotactic biopsy or neuroimaging study. Nine patients underwent RS for post-op. residual tumors and three patients as a salvage treatment for recurrence after external irradiation. Two patients received RS as a boost followed by fractionated conventional radiotherapy. Among sixteen patients who were followed more than 6 months with neuroimage, seven patients (2 meningiomas, 4 benign glial tumors, one non-Hodgkin's lymphoma) showed complete response on neuroimage after RS and nine patients showed decreased tumor size. There was no acute treatment related side reaction. Late complications include three patients with symptomatic peritumoral brain edema and one craniopharyngioma with optic chiasmal injury. Through this early experience, we conclude that stereotactically directed single high doses of irradiation to the small intracranial tumors is effective for tumor control. However, in order to define the role of radiosurgery in the management of intracraniai tumors, we should get the long-term results available to demonstrate the benefits versus potential complications of this therapeutic modality.

• The Journal of Korean Society for Radiation Therapy
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• v.15 no.1
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• pp.19-27
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• 2003

I. Purpose In special cases of Total Body Irradiation(TBI), Half Body Irradiation(HBI), Non-Hodgkin's lymphoma, E-Wing's sarcoma, lymphosarcoma and neuroblastoma a large field can be used clinically. The dose distribution of a large field can use the measurement result which gets from dose distribution of a small field (standard SSD 100cm, size of field under $40{\times}40cm2$) in the substitution which always measures in practice and it will be able to calibrate. With only the method of simple calculation, it is difficult to know the dose and its uniformity of actual body region by various factor of scatter radiation. II. Method & Materials In this study, using Multidata Water Phantom from standard SSD 100cm according to the size change of field, it measures the basic parameter (PDD,TMR,Output,Sc,Sp) From SSD 180cm (phantom is to the bottom vertically) according to increasing of a field, it measures a basic parameter. From SSD 350cm (phantom is to the surface of a wall, using small water phantom. which includes mylar capable of horizontal beam's measurement) it measured with the same method and compared with each other. III. Results & Conclusion In comparison with the standard dose data, parameter which measures between SSD 180cm and 350cm, it turned out there was little difference. The error range is not up to extent of the experimental error. In order to get the accurate data, it dose measures from anthropomorphous phantom or for this objective the dose measurement which is the possibility of getting the absolute value which uses the unlimited phantom that is devised especially is demanded. Additionally, it needs to consider ionization chamber use of small volume and stem effect of cable by a large field.

• Journal of Life Science
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• v.32 no.7
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• pp.532-541
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• 2022

Obesity induced by high-fat diet (HFD) is verified as a strong risk factor and negative prognostic factor for prostate cancer in several genetically engineered mice although it was not examined in the normal mice. To investigate whether HFD-induced obesity can affect the development and progression of cancer in the prostate of normal mice, alterations in the weight and histological structure of the prostate as well as the expression of cancer-related proteins were analyzed in obese C57BL/6N mice fed with 60% HFD for 16 weeks. First, HFD-induced obesity, including an increase in organ weight, body weight, fat accumulation, and serum lipid profile, was successfully induced in C57BL/6N mice after HFD treatment. The total weight of the prostate significantly increased HFD-induced obesity in the model mice compared with the control group. Among the four lobes of the prostate, the weight of the ventral prostate (VP) and anterior prostate (AP) were higher in HFD-induced obesity model mice than in the control group, although the weights of the lateral prostate (DLP) and seminal vesicle (SV) were constantly maintained. In addition, the incidences of hyperplasia and non-hodgkin's lymphoma (NHL) in the histological structure were remarkably increased in HFD-induced obesity model mice, while the epithelial thickness was higher in the same group. A significant increase in the phosphorylation levels of key proteins in the AKT (protein kinase B) signaling pathway was detected in HFD-induced obesity model mice. Therefore, these results suggest that HFD-induced obesity can promote hyperplasia and NHL in the prostates of C57BL/6N mice through the activation of the AKT signaling pathway.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.26-31
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• 2001

Background: Primary malignant lymphoma of the parotid gland is a rare disease and defined as any malignant lymphoma that first manifests in the parotid gland, regardless of the subsequent stage of the diseases, whether it arises in the parenchyma or intraglandular lymph nodes. This study was performed to review the clinicopathological characteristics of primary parotid lymphoma and identify its optimal treatment modality. Materials and Methods: Six cases with parotid mass as first presentation of malignant lymphoma between 1988 and 2000, were studied on the basis of clinical features, diagnostic tools, treatment modality, treatment outcomes, and clinical stage by Ann Arbor Criteria. All were microscopically reevaluated and classified by NCI working formulation. Results: All patients were males and mean age was 36.7 years (2-66 years). Rapid growing non-tender mass was presented in all the cases and cervical lymphnodes were palpated in 4 cases. However, there was not any evidence of concurrent autoimmune disease such as Sjogren's syndrom or Rheumatoid arthritis. One case was confirmed by surgical specimen after superficial parotidectomy, 2 by excisional biopsy, and 3 by incisional biopsy. The stage of disease by NCI working formulation was IE in 1 patient, IIE in 4 and IV in 1. All were classified into non-Hodgkin' lymphoma, of which there were 5 cases of B-cell type and 1 case of T-cell type. There were 3 diffuse large cell lymphomas, 1 Burkitt lymphoma, 1 MALT lymphoma and 1 T-lymphoblastic lymphoma. Three cases were treated by chemotherapy only, 2 by radiotherapy only and 1 by chemo-radiotherapy. One case with Burkitt lymphoma was died from the disease and one case was lost to follow-up. The others are alive with no evidence of recurrence. Conclusions: Although primary parotid lymphoma is rare and difficult to diagnose preoperatively, most were detected in early stage and showed a relatively good response to the chemotherapy or radiotherapy like other types of extranodal malignant lymphoma.

• Journal of Preventive Medicine and Public Health
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• v.27 no.4 s.48
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• pp.711-734
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• 1994

Among chemical agents in herbicides, dioxin (2, 3, 7, 8-tetrachloro dibenzo-$\rho$-dioxin : TCDD), a chemical contaminant in herbicides sprayed during the Vietnam War has been known to be the major agent causing toxic effects. Approximately 320,000 korean soldiers participated the Vietnam War from 1964 to 1974. Although the potential hazards of the herbicides among Korean veterans exposed were implicated, the problem had not been a public issue until 1991 when Korean veterans were informed U.S. companies, the herbicides manufacturer payed fund, from which a trust fund for New Zealand and Australian Class members were established in 1985. After a series of appeals and demonstration by the Korean Veterans demanding medical care and compensation for their serious health damages, a bill of medical care and compensation for herbicides victims was promulgated in March 1993 and become effective from May 1993, This study was carried out with two major objectives : the first to understand the health problems caused from the herbicides by reviewing literatures published, and the second to examine the nature and extent of health impacts among Korean veterans exposed and to develop valid study methods for the major study by interviewing and reviewing records on a part of veterans (638 persons) registered and completed medical examination in Seoul Veterans Administration Hospital from June to October 1993. The results obtained are as followings: 1. The literature review of 107 papers revealed that 1) Dioxin is teratogenic, carcinogenic and affects almost all organs including nervous, endocrine, and reproductive systems in animal experiments. 2) The diseases showing evidence of causal association were Hodgkin's disease, non-Hodgkin's disease, lung cancer, lymphoma, soft tissue sarcoma, chloroacne and polyneuropathy when judged on the basis of consistency in study results and biological plausibility. 2. Interview and medical record review study on 638 veterans, though limited validity owing to lack of control group, crude estimates of dioxin exposure levels (no biomarkers measurable), and uncertainty of diagnosis, showed that: 1) Most of the study subject's were in their 40's of age and had been dispatched to Vietnam during the period from $1965{\sim}1970$ around one year. 2) Most frequently complained symptoms in medical examination were motor weakness (32%), sensory abnormalities in extremities (23%), skin diseases (22%), and pain in extremities (20%) whereas in Interview they were more frequent in order of skin problem (44%), motor weakness (38%), sensory abnormalities and pain in extremities(17% and 19% each). Kappa indices on the same category of complaints between two sources of information were variable and relatively low. 3) On medical examination, only a part of the 638 subjects had initial impression (442 pts) and final diagnosis (218 pts) suggesting decision making on diagnosis appeared to be difficult even with all available modern medical technologies: in initial impression disorders from peripheral and central neuropathy were predominant whereas in final diagnosis various types of skin disorder were most frequent 4) When dose-response relationship between several conditions (from questionnaire) and arbitrary exposure scores were examined by CMH linear trend test, spontaneous abortion, sexual problems and health problem of offsprings showed statistically significant linear trends. However, pregnancy, accident and suicidal attempts did not show any relationship in this study capacity. 5) Among complaints, psychosis and neurosis (anxiety, phobia) in interview study, and memory disorder and psychosis in medical record study revealed linear trend. 6) Skin disorder was the only condition showing linear trend in initial impression and none in final diagnosis on medical examination. Even though objective to select out dioxin-related disease or group of diseases from this study was not achieved the research experiences provided firm basis for developing various methodological approaches. 3. From this preliminary study we concluded that a larger scale major epidemiologic study on health impacts of herbicides among Korean veterans exposed is not only Indispensible but also well designed study with more valid exposure information and diagnosis may be able to establish causal relationship between certain groups of diseases and exposure to the herbicides among Korean veterans.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.107-115
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• 2002

Purpose: Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. Materials and Methods: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin's lymphoma and others were Hodgkin's lymphoma. Results: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. Conclusion: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.

• Radiation Oncology Journal
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• v.34 no.4
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• pp.273-279
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• 2016

Purpose: Although each Waldeyer's ring sub-site is considered an independent prognostic factor, few studies have assessed the prognosis and treatment of tonsillar lymphoma. Treatment outcomes were analyzed in patients with primary tonsillar lymphoma who were treated with chemotherapy and radiotherapy (RT). Materials and Methods: Nineteen patients with diffuse large B-cell lymphoma were evaluated, with a median follow-up of 53 months. Age, sex, and histology, amongst other factors, were reviewed. Progression-free survival (PFS) and overall survival (OS) rates were analyzed. Results: Most patients had Ann Arbor stage I-II (94.7%), IPI score of 0 (89.5%), and complete remission after chemotherapy (89.5%). The 5-year PFS and OS rates were 74.6% and 80%, respectively. In univariate analysis, the rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen resulted in a better PFS than the cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) regimen (88.9% vs. 50.0%; p = 0.053). RT dose was related to the survival outcome (p = 0.010 for PFS, p = 0.044 for OS). Patients were classified into the CHOP + RT (>40 Gy) group and R-CHOP + RT (${\leq}40Gy$) group. The 5-year PFS rates were 50% in the CHOP + RT group, and 100 % in the R-CHOP + RT group (p = 0.018). The 5-year OS rates were 66.7% and 100%, respectively (p = 0.087). Conclusion: Primary tonsillar lymphoma patients typically have favorable outcomes. Chemotherapy (R-CHOP) combined with relatively lower dose consolidative RT may be safe and effective for primary tonsillar lymphoma.