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  • S. Karger AG  (26)
  • 1
    Online Resource
    Online Resource
    An Extragastrointestinal Stromal Tumor Originating from the Pancreas
    S. Karger AG ; 2018
    In:  Case Reports in Gastroenterology Vol. 12, No. 3 ( 2018-11-22), p. 671-678
    Details
    In: Case Reports in Gastroenterology, S. Karger AG, Vol. 12, No. 3 ( 2018-11-22), p. 671-678
    Abstract: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract (GIT). In fewer than 5% of cases, GIST originates primarily from outside the GIT. The occurrence of GIST originating from the pancreas is rare. Sometimes, neuroendocrine tumors should be differentiated from GISTs because of their hyperenhancing nature in radiologic images. We report a case of GIST arising in the pancreas that was confirmed by surgical resection.
    Type of Medium: Online Resource
    ISSN: 1662-0631
    URL: Article
    DOI: 10.1159/000494553
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 2440540-1
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  • 2
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    Clinical Significance of Chronic Kidney Disease and Atrial Fibrillation on Morbidity and Mortality in Patients with Acute Myocardial Infarction
    S. Karger AG ; 2014
    In:  American Journal of Nephrology Vol. 40, No. 4 ( 2014), p. 345-352
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 40, No. 4 ( 2014), p. 345-352
    Abstract: 〈 b 〉 〈 i 〉 Background/Aims: 〈 /i 〉 〈 /b 〉 Atrial fibrillation (AF) often coexists with acute myocardial infarction (AMI), and chronic kidney disease (CKD) is a major risk for AMI. However, the combined impact of CKD and AF on the mortality and morbidity in AMI population has not been determined. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Between January 2004 and December 2009, a total of 4,738 AMI patients were enrolled prospectively. Patients were divided into four groups according to the combined status of CKD and AF. The primary endpoint was a combination of 5-year major adverse cardiac and cerebrovascular events (MACCE). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The prevalence of AF was significantly higher in CKD patients than in non-CKD patients (6.76 vs. 3.31%, p 〈 0.001). The highest cumulative event rate of MACCE and death was observed in patients with both CKD and AF (68.5 and 64.0%), respectively. In multivariable analyses, compared with patients with neither AF nor CKD, hazard ratios (HR) for composite of MACCE were 1.66 (95% CI, 1.14-2.41), 1.24 (95% CI, 1.06-1.46), and 2.10 (95% CI, 1.42-3.13) for patients with AF only, those with CKD only, and those with both CKD and AF, respectively (p for interaction = 0.935). Patients with both CKD and AF had a greatest risk for all-cause mortality (HR 2.54; 95% CI, 1.60-4.53), and the significant synergistic interaction was observed between CKD and AF (p for interaction = 0.015). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The combined effect of AF and CKD on the risk of MACCE after an AMI is stronger than any separate condition, and it confers a synergistic effect on the all-cause mortality risk.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000368422
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1468523-1
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  • 3
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    Equivalent Outcome of Autologous Stem Cell Transplantation and Reduced Intensity Conditioning Stem Cell Transplantation in Acute Myeloid Leukemia Patients with t(8;21)
    S. Karger AG ; 2015
    In:  Acta Haematologica Vol. 133, No. 3 ( 2015), p. 266-276
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 133, No. 3 ( 2015), p. 266-276
    Abstract: We analyzed the outcome of stem cell transplantation (SCT) for 59 acute myeloid leukemia (AML) patients with t(8;21). The 5-year overall and disease-free survival (OS and DFS) were 70.2 and 68.4%, respectively. The 5-year cumulative incidence of relapse (CIR) and nonrelapse mortality were 16.9 and 13.6%, respectively. OS and DFS in the reduced-intensity conditioning (RIC)-SCT group (70.4%) were not different from in the autologous SCT (ASCT) group (72.4 and 69.0%, respectively). Age was a factor affecting OS (p = 0.007) and DFS (p = 0.008) in the ASCT group, but not in the RIC-SCT group. In the ASCT group, lack of the X chromosome (-X) and an age of 〉 50 years were associated with inferior survival; however, these differences disappeared in the RIC-SCT group. CIR was significantly higher in patients with -X than in those without -X only in the ASCT group (p = 0.038), i.e. not in the RIC-SCT group. ASCT and RIC-SCT are equally effective for the intensification of postremission treatment of AML patients with t(8;21). The subgroups with advanced age or -X should be preferentially considered for RIC-SCT, rather than ASCT. Further investigations with randomized prospective trials of a sizeable study population are warranted. © 2014 S. Karger AG, Basel
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000366261
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2015
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 4
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    Reduced-Intensity Conditioning Regimen Combined with Low-Dose Total Body Irradiation in the Treatment of Myelodysplastic Syndrome
    S. Karger AG ; 2011
    In:  Acta Haematologica Vol. 126, No. 1 ( 2011), p. 21-29
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 126, No. 1 ( 2011), p. 21-29
    Abstract: Although reduced-intensity conditioning (RIC) has been increasingly used in patients with myelodysplastic syndrome (MDS) to reduce transplant-related mortality, a high relapse rate in RIC remains an unresolved problem. Considering the additive antileukemic effect of low-dose total body irradiation (TBI), we evaluated the feasibility of combining RIC regimens with low-dose TBI in de novo MDS. The RIC regimen combined with low-dose TBI in this study consisted of fludarabine (150 mg/m 〈 sup 〉 2 〈 /sup 〉 ), intravenous busulfan (6.4 mg/kg), and TBI (400 cGy). Antithymocyte globulin was used to overcome HLA mismatching. A total of 31 subjects were recruited with a median age of 39 years (range 19–63). The patients received transplants from siblings (n = 20) or unrelated donors (n = 11). All patients rapidly achieved full-donor chimerism. At a median follow-up for survivors of 35 months (range 6.0–54.9), the 3-year overall survival, event-free survival, transplantation-related mortality, and relapse rates were 67.6, 63.2, 20.5 and 11.4%, respectively. The 3-year cumulative incidence of acute (grades II–IV) and chronic extensive graft-versus-host disease in patients who survived at least 100 days was 39.2 and 44.6%, respectively. These results suggest that an RIC combined with low-dose TBI may be a feasible therapeutic approach for treating de novo MDS.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000323717
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1481888-7
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  • 5
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    Improvement in Hematopoiesis after Iron Chelation Therapy with Deferasirox in Patients with Aplastic Anemia
    S. Karger AG ; 2013
    In:  Acta Haematologica Vol. 129, No. 2 ( 2013), p. 72-77
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 129, No. 2 ( 2013), p. 72-77
    Abstract: Iron overload due to regular transfusions of packed red cells can cause multiple organ damage. Iron chelation therapy (ICT) is important in patients with aplastic anemia (AA) who require blood transfusions as supportive management. With the introduction of the oral iron chelator deferasirox, ICT has become more widely available and feasible. We studied 4 adult AA patients who had transfusion-induced iron overload and showed hematological improvement after ICT with oral deferasirox. Following deferasirox treatment, hemoglobin increased and serum ferritin levels decreased, and the patients subsequently became transfusion independent. Our experience raises the possibility of the potential benefit of ICT on hematopoiesis. Further long-term studies in larger patient cohorts are needed to clarify the effect of the restoration of hematopoiesis after iron chelation therapy.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000342772
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2013
    detail.hit.zdb_id: 1481888-7
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  • 6
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    Splenectomy Outcomes in Relapsed or Refractory Immune Thrombocytopenia according to First-Line Intravenous Immunoglobulin Response
    S. Karger AG ; 2022
    In:  Acta Haematologica Vol. 145, No. 5 ( 2022), p. 465-475
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 145, No. 5 ( 2022), p. 465-475
    Abstract: 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 Although splenectomy has long been second-line option for immune thrombocytopenia (ITP) patients, an indicator that reliably predicts the efficacy of splenectomy is still being explored. We investigated the treatment outcomes of splenectomy as a second-line therapy for relapsed/refractory ITP according to first-line intravenous immunoglobulin (IVIG) responses. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Fifty-two adult patients treated with splenectomy as second-line therapy for ITP between 2009 and 2019 were included, and they were classified according to first-line IVIG responses (no response to IVIG: nonresponders; only transient IVIG response shorter than 4 weeks: poor responders; IVIG response for a longer period; stable responders). The efficacy of splenectomy was analyzed in the three subgroups. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Of the 52 patients, 10 were IVIG nonresponders, 34 were poor responders, and the remaining 8 were stable responders. Response to splenectomy was observed in 50.0% of IVIG nonresponders, 94.1% of poor responders, and 100% of stable responders ( 〈 i 〉 p 〈 /i 〉 = 0.0030). Among the 45 patients who responded to splenectomy, 51.1% relapsed subsequently, and a significantly lower relapse rate was noted in the stable IVIG responders (12.5%, 〈 i 〉 p 〈 /i 〉 = 0.0220) than in nonresponders (60.0%) and poor responders (59.4%). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 First-line IVIG response is indicated as a useful predictive factor for response to splenectomy.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000521912
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1481888-7
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  • 7
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    Clusters of Severe Eosinophilic Asthma in a Korean Asthma Cohort
    S. Karger AG ; 2022
    In:  Respiration Vol. 101, No. 5 ( 2022), p. 465-475
    Details
    In: Respiration, S. Karger AG, Vol. 101, No. 5 ( 2022), p. 465-475
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Targeted therapies have broadened the available treatment options for patients with severe eosinophilic asthma (SEA). However, differences in the magnitude of treatment responses among patients indicate the presence of various underlying pathophysiological processes and patient subgroups. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We aimed to describe the characteristics of SEA and identify its patient subgroups. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Clinical data from the Cohort for Reality and Evolution of Adult Asthma in Korea were analyzed. Cluster analysis was performed among those with SEA using 5 variables, namely, prebronchodilator forced expiratory volume in 1 s, body mass index, age at symptom onset, smoking amount, and blood eosinophil counts. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Patients with SEA showed prevalent sensitization to aeroallergens, decreased lung function, and poor asthma control status. Cluster analysis revealed 3 distinctive subgroups among patients with SEA. Cluster 1 ( 〈 i 〉 n 〈 /i 〉 = 177) consisted of patients reporting the lowest blood eosinophils (median, 346.8 cells/μL) and modest severe asthma with preserved lung function during the 12-month treatment period. Cluster 2 ( 〈 i 〉 n 〈 /i 〉 = 42) predominantly included smoking males with severe persistent airway obstruction and moderate eosinophilia (median, 451.8 cells/μL). Lastly, cluster 3 ( 〈 i 〉 n 〈 /i 〉 = 95) included patients with the most severe asthma, the highest eosinophil levels (median, 817.5 cells/μL), and good treatment response in terms of improved lung function and control status. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Three subgroups were identified in SEA through the cluster analysis. The distinctive features of each cluster may help physicians predict patients who will respond to biologics with greater magnitude of clinical improvement. Further research regarding the underlying pathophysiology and clinical importance of each subgroup is warranted.
    Type of Medium: Online Resource
    ISSN: 0025-7931 , 1423-0356
    URL: Article
    DOI: 10.1159/000520492
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1464419-8
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  • 8
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    The Derived Neutrophil-to-Lymphocyte Ratio Is an Independent Prognostic Factor in Transplantation Ineligible Patients with Multiple Myeloma
    S. Karger AG ; 2018
    In:  Acta Haematologica Vol. 140, No. 3 ( 2018), p. 146-156
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 140, No. 3 ( 2018), p. 146-156
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 The neutrophil-to-lymphocyte ratio (NLR) is an independent prognostic marker in solid and hematological cancers. While the derived NLR (dNLR) was shown to be non-inferior to the NLR in large cohorts of patients with different cancer types, it has not been validated as a prognostic marker for multiple myeloma (MM) to date. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 Between May 22, 2011 and May 29, 2014, 176 patients with MM from 38 centers who were ineligible for autologous stem cell transplantation were analyzed. The dNLR was calculated using complete blood count differential data. The optimal dNLR cut-off value according to receiver operating characteristic analysis of overall survival (OS) was 1.51. All patients were treated with melphalan and prednisone combined with bortezomib. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The complete response rate was lower in the high dNLR group compared to the low dNLR group (7 vs. 26.1%, respectively; 〈 i 〉 p 〈 /i 〉  = 0.0148); the corresponding 2-year OS rates were 72.2 and 84.7%, respectively ( 〈 i 〉 p 〈 /i 〉  = 0.0354). A high dNLR was an independent poor prognostic factor for OS (hazard ratio 2.217, 95% CI 1.015–4.842; 〈 i 〉 p 〈 /i 〉  = 0.0458). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The dNLR is a readily available and cheaply obtained parameter in clinical studies, and shows considerable potential as a new prognostic marker for transplantation-ineligible patients with MM.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000490488
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2018
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 9
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    Vitamin B〈sub〉12〈/sub〉-Responsive Pancytopenia Mimicking Myelodysplastic Syndrome
    S. Karger AG ; 2011
    In:  Acta Haematologica Vol. 125, No. 4 ( 2011), p. 198-201
    Details
    In: Acta Haematologica, S. Karger AG, Vol. 125, No. 4 ( 2011), p. 198-201
    Abstract: This study presents 12 patients (7 women and 5 men) with vitamin B 〈 sub 〉 12 〈 /sub 〉 -responsive pancytopenia who had discordant laboratory findings and were misdiagnosed as having myelodysplastic syndrome (MDS). The median hemoglobin level was 6.5 g/dl, and the leukocyte and platelet counts were 2.85 × 10 〈 sup 〉 9 〈 /sup 〉 /l and 55.5 × 10 〈 sup 〉 9 〈 /sup 〉 /l, respectively. The median serum lactate dehydrogenase level was high (3,204.5 IU/l). The serum vitamin B 〈 sub 〉 12 〈 /sub 〉 levels were within normal limits at the initial evaluation, but a serial follow-up of the vitamin B 〈 sub 〉 12 〈 /sub 〉 levels revealed either fluctuations or a gradual decrease. The patients were initially diagnosed with MDS and responded rapidly to a 7-day parenteral B 〈 sub 〉 12 〈 /sub 〉 treatment with normal complete blood counts (CBCs). We propose that patients suspected to have MDS may suffer from vitamin B 〈 sub 〉 12 〈 /sub 〉 deficiency and that this can be revealed by a normalization of CBCs following 7 days of treatment with parental vitamin B 〈 sub 〉 12 〈 /sub 〉 .
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    URL: Article
    DOI: 10.1159/000322941
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2011
    detail.hit.zdb_id: 1481888-7
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  • 10
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    Association between Rapid Ventricular Response and Stroke Outcomes in Atrial Fibrillation-Related Cardiac Embolic Stroke
    S. Karger AG ; 2023
    In:  Cerebrovascular Diseases
    Details
    In: Cerebrovascular Diseases, S. Karger AG
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Patients with atrial fibrillation-related stroke (AF-stroke) are prone to developing rapid ventricular response (RVR). We investigated whether RVR is associated with initial stroke severity, early neurological deterioration (END) and poor outcome at 3 months. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We reviewed patients who had AF-stroke between January 2017 and March 2022. RVR was defined as having heart rate & gt;100 beats per minute on initial electrocardiogram. Neurological deficit was evaluated with National Institutes of Health Stroke Scale (NIHSS) score at admission. END was defined as increase of ≥2 in total NIHSS score or ≥1 in motor NIHSS score within first 72 h. Functional outcome was score on modified Rankin Scale at 3 months. Mediation analysis was performed to examine potential causal chain in which initial stroke severity may mediate relationship between RVR and functional outcome. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We studied 568 AF-stroke patients, among whom 86 (15.1%) had RVR. Patients with RVR had higher initial NIHSS score ( 〈 i 〉 p 〈 /i 〉 & lt; 0.001) and poor outcome at 3 months ( 〈 i 〉 p 〈 /i 〉 = 0.004) than those without RVR. The presence of RVR [adjusted odds ratio (aOR) = 2.13; 〈 i 〉 p 〈 /i 〉 = 0.013] was associated with initial stroke severity, but not with END and functional outcome. Otherwise, initial stroke severity [aOR = 1.27; 〈 i 〉 p 〈 /i 〉 = & lt;0.001] was significantly associated with functional outcome. Initial stroke severity as a mediator explained 58% of relationship between RVR and poor outcome at 3 months. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 In patients with AF-stroke, RVR was independently associated with initial stroke severity but not with END and functional outcome. Initial stroke severity mediated considerable proportion of association between RVR and functional outcome.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000531386
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482069-9
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