• Title/Summary/Keyword: 소아암 환아

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Clinical significance of loss of p16 protein by immunohistochemical staining in acute lymphoblastic leukemia (급성림프구성백혈병에서 면역조직화학염색에 의한 p16 단백질 소실의 의의)

  • Jin, Hye Young;Kang, Kyoung In;Kim, Sun Young;Youn, You Sook;Kang, Joon Won;Jo, Deog Yeon;Kwon, Kye Chul;Park, Kyung Duk
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.73-77
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    • 2008
  • Purpose : p16 gene, mapped to the 9p21 chromosomal region, has emerged as a candidate tumor suppressor gene in human neoplasm. It is an inhibitor of cyclin-dependent kinase and inhibits Rb phosphorylation. In a variety of tumors including childhood acute lymphoblastic leukemia (ALL), deletion and/or mutation of the p16 gene has been found. Despite their high frequency, the prognostic importance of p16 alterations is still controversial in ALL and has been reported to be either unfavorable or similar to that of other patients. We studied the correlation between loss of p16 protein confirmed by immunohistochemical staining and clinical outcomes of patients diagnosed as ALL. Methods : We performed an immunohistochemical staining for p16 protein in 74 cases of bone marrow biopsy slide initially diagnosed as ALL between January 1998 and December 2006. We reviewed the clinical manifestations, laboratory findings, treatment outcomes retrospectively. Results : Of 74 slides, 12 were negative for p16 protein. Seven were males and 5 were females with a median age at diagnosis was 5.8 (1.3-18.8) years. Initial WBC were 17,225 $(500-403,300)/{\mu}L$. By immunologic surface marker analysis, 7 patients were early pre-B CALLA (+) and 5 patients were T-cell ALL. Two patients of intermediate risk group had relapsed and died. Three patients had family history of breast cancer. Four patients died and overall survival rates were $53.5{\pm}18.7%$. Conclusion : Loss of p16 protein is supposed to be an independent risk factor of childhood ALL associated with poor outcomes. In clinical setting, the clinician must take into account p16 status, not only at the genomic but also at the protein level. Further clinical experience on thoroughly investigated cases will help a better understanding between p16 status and clinical outcomes.

Hand-Foot syndrome induced by sorafenib, a multitargeted tyrosine kinase inhibitor, in a patient with advanced renal cell carcinoma (진행된 신세포암 환아에게 sorafenib 투여시 발생한 Hand-Foot syndrome 1예)

  • Lee, Seung Hyun;Noh, Sung Hun;Kim, Sun Young;Jang, Kyu Yun;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.119-123
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    • 2009
  • Renal cell carcinoma (RCC) arising from epithelial cells of the renal tubules is a highly aggressive and malignant tumor in all ages; however, it rarely occurs in children. the standard treatment for RCC is radical nephrectomy with lymph node dissection when the tumor is localized and can be completely resected. Adjuvant chemotherapy, radiotherapy, and immunotherapy are used for pediatric patients with advanced RCC involving lymph nodes or metastatic lesions. Sorafenib is an oral, multikinase inhibitor that has recently been approved for use in metastatic RCC. Common toxicities that have been reported include dermatologic changes such as rash or desquamation and hand-foot skin reaction, diarrhea, fatigue, alopecia, and hypertension. In particular, hand-foot syndrome (HFS) an erythematous skin lesion of the palms and solesis most often caused by cytostatic chemotherapeutic agents. In this report, we have studied a 14-year-old female patient with hand-foot syndrome that occurred in association with sorafenib for the treatment of metastatic RCC. Furthermore, this case demonstrates that reversal of complications can be achieved by discontinuing the drug and intervention with topical steroids, vitamin E, and high-dose pyridoxine.

NECROSIS OF ALVEOLAR BONE BY FORMOCRESOL : CASE REPORT (Formocresol에 의한 치조골 괴사의 치험례)

  • Park, Cheol-Hong;Lee, Chang-Seop;Lee, Sang-Ho;Lee, Nan-Young
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.657-661
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    • 2005
  • Various chemotherapeutic agents have been recommended for pulpotomy of primary teeth, and there are formocresol, ferric sulfate, and calcium hydroxide. Of those, formocresol has fixation effect of pulp tissue and high clinical success rate, so it is most commonly used agent. But formocresol has strong cytotoxic effects, thus many articles reported displacement and loss of permanent successor, amelogenesis imperfecta, mutation by general absorption, possibility of cancer induction. Recently, it has been reported that leakage by imperfect temporary sealing when FC-soaked cotton was inserted into the root canal caused necrosis of surrounding tissues. and that necrosis of alveolar bone related to the use of excessive formocresol. In this case, 2nd primary molar of upper left jaw was treated using formocresol in local clinic, but extracted because of lasting pain. Furthermore, symptoms didn't disappear so patient was refered to us. The patient was 8-year-old male, had foul odor from oral cavity and circular alveolar bone necrosis around the permanent successor' crown. Thus sequestrectomy was operated and observed through 19 months after operation, we found normal root development of permanent successor but no complete regeneration of alveolar bone defect and attached gingiva. Lesion of periodontal tissues by formocresol is irreversible, so we have to confirm the indication in using formocresol and pay attention to complete temporary sealing.

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Iron chelating agent, deferoxamine, induced apoptosis in Saos-2 osteosarcoma cancer cells (Saos-2 골육종 세포에서 iron chelating agent, deferoxamine에 의한 apoptosis 유도)

  • Park, Eun Hye;Lee, Hyo Jung;Lee, Soo Yeon;Kim, Sun Young;Yi, Ho Keun;Lee, Dae Yeol;Hwang, Pyoung Han
    • Clinical and Experimental Pediatrics
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    • v.52 no.2
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    • pp.213-219
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    • 2009
  • Purpose:Iron is a critical nutritional element that is essential for a variety of important biological processes, including cell growth and differentiation, electron transfer reactions, and oxygen transport, activation, and detoxification. Iron is also required for neoplastic cell growth due to its catalytic effects on the formation of hydroxyl radicals, suppression of host defense cell activities, and promotion of cancer cell multiplication. Chronic transfusion-dependent patients receiving chemotherapy may have iron overload, which requires iron-chelating therapy. We performed this study to demonstrate whether the iron chelating agent deferoxamine induces apoptosis in Saos-2 osteosarcoma cells, and to investigate the underlying apoptotic mechanism. Methods:To analyze the apoptotic effects of an iron chelator, cultured Saos-2 cells were treated with deferoxamine. We analyzed cell survival by trypan blue and crystal violet analysis, apoptosis by nuclear condensation, DNA fragmentation, and cell cycle analysis, and the expression of apoptotic related proteins by Western immunoblot analysis. Results:Deferoxamine inhibited the growth of Saos-2 cell in a time- and dose-dependent manner. The major mechanism for growth inhibition with the deferoxamine treatment was by the induction of apoptosis, which was supported by nuclear staining, DNA fragmentation analysis, and flow cytometric analysis. Furthermore, bcl-2 expression decreased, while bax, caspase-3, caspase-9, and PARP expression increased in Saos-2 cells treated with deferoxamine. Conclusion:These results demonstrated that the iron chelating agent deferoxamine induced growth inhibition and mitochondrial-dependent apoptosis in osteosarcoma Saos-2 cells, suggesting that iron chelating agents used in controlling neoplastic cell fate can be potentially developed as an adjuvant agent enhancing the anti-tumor effect for the treatment of osteosarcoma.

Assessment of Left Ventricular Function with Echocardiography in Patients Treated with Adriamycin : A Load-Independent Index of Myocardial Contractility and Comparisons between Rest and Exercise (Adriamycin을 사용한 환아에서 심초음파를 이용한 좌심실 기능의 평가 : 심근 수축력의 부하 비의존족 지표 및 휴식시와 운동시의 비교)

  • Park, Pyoung Soo;Park, Hye Young;Lee, Hae Yong
    • Clinical and Experimental Pediatrics
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    • v.45 no.2
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    • pp.214-222
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    • 2002
  • Purpose : The aim of this study was to evaluate myocardial injury in children treated with adriamycin by echocardiography, which is non-invasive and safe measurement for children. Methods : Left ventricular dimensions, wall stress, and contractile function were determined by echocardiographic methods in 17 patient recepients with adriamycin chemotherapy at rest(group 1) and during stress(group 2). Twenty age-matched normal subjects were established as control group. Results : End-diastolic dimension was decreased in both groups(group 1; $92{\pm}7%$ of normal, group 2; $87{\pm}8%$ of normal, P<0.05). Left ventricular end diastolic volume and wall mass were also decreased in both groups(group 1; $96{\pm}12mL/m^2$ and $145{\pm}18g/m^2$, group 2; $87{\pm}8mL/m^2$ and $137{\pm}16g/m^2$, respectively, P<0.05 and P<0.05) and group 2 showed lower values than group 1. Meridional end systolic stress(ESSm) was increased in both groups but there was no significant difference between the two groups(group 1; $52.6{\pm}6.2g/cm^2$, group 2; $63.5{\pm}8.5g/cm^2$, P<0.05, normal value $45.7{\pm}3.5g/cm^2$). The load-independent relation of rate-corrected circumferential fiber shortening velocity(Vcfc) to ESSm has a significant abnormal change in 7 out of 17(41%) in group 1 and 12 out of 17(71%) in group 2. Conclusion : The load-dependent systolic index, such as fractional shortening, may fail to show abnormality because of the compensatory changes in preload and afterload which can mask the impaired contractility. Therefore, systolic performance also should be monitored by a load-indepedent contractility index such as slope value of the end-systolic pressure-dimension relation and the position of the left ventricular stress-fiber shortening velocity after exercise.

Effects of enucleation and chemotherapy in advanced intraocular and intraorbital retinoblastoma with or without radiotherapy (진행된 안구내 및 안와내 망막모세포종에서 안구적출술과 항암화학치료 및 방사선조사 유무에 따른 효과)

  • Lee, Jae Min;Lee, Hyun Dong;Hah, Jeong Ok
    • Clinical and Experimental Pediatrics
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    • v.51 no.1
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    • pp.84-88
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    • 2008
  • Purpose : Radiotherapy is effective in local treatment for retinoblastoma. However, asymmetric facial hypoplasia after radiation is a serious late effect. This study was performed to investigate the effects of enucleation and chemotherapy with or without radiotherapy in advanced intraocular and intraorbital retinoblastoma. Methods : Between 1985 October and 2006 December, the records of thirty five patients who were diagnosed as retinoblastoma at Yeungnam University Hospital were reviewed. Advanced intraocular and intraorbital retinoblastoma patients classified as Reese-Ellsworth group III, IV, and V and Grabowski- Abramson class II were selected for the study. Results : Eighteen patients were enrolled in this study. All patients were enucleated and had received chemotherapy. Nine patients received radiotherapy and nine patients didn't receive radiotherapy. Tumor cells were found on resection margin of optic nerve in five of nine patients who received radiotherapy, but none of nine who didn't receive radiotherapy. Chemotherapy included vincristine, adriamycin, cyclophosphamide, VM-26, cisplatin before 2001, and vincristine, etoposide, and carboplatin after 2001. There were no recurrences or metastases in nine patients who didn't receive radiotherapy. But two of nine patients who received radiotherapy had metastases to brain. However, all survivors who received radiotherapy had significant facial asymmetry. Conclusion : In advanced intraocular and intraorbital retinoblastoma without tumor cell on resection margin of optic nerve, enucleation and chemotherapy without local radiotherapy appears to be safe for long-term survival. However, in those with tumor cells on resection margin of optic nerve, enucleation and chemotherapy with local radiotherapy seems to be necessary to improve survival.

An Empirical Review of the Relationship between Schooling and Demand for Children on the Basis of Quantity-Quality Interaction Model (자녀교육과 수요간의 상관관계에 관한 실증적 고찰)

  • Chang-Jin Moon
    • Korea journal of population studies
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    • v.11 no.1
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    • pp.197-203
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    • 1988
  • In order to examine cause-specific mortality in Korea by comparing mortality of Japan, various mortality indicators are calculated using 1995 of ficial statistics of twonations. The mortality measures are cause-specific mortality rate by sex, age, andmarital status, cause-specific age-standardized death rate and potential years of lifelost, and their ratios by sex and nation. Items of major causes of death include allcauses (total deaths),tuberculosis, malignant neoplasm, diabetes mellitushypertensive diseases, heart diseases, cerebrovascular diseases, liver diseasestransport accidents, and suicide. Major characteristics of mortality in Korea are asfollows . (1) Death rates from most causes except suicide are higher in Korea thanJapan and especially death rates from tuberculosis, hypertensive diseases, liverdiseases, and transport accidents are higher for economically active Koreans : (2)Death rates from tuberculosis, liver diseases, transport accidents, and malignantneoplasm are salient for Korean children (3) Sex-differentials in mortality fromliver diseases, tuberculosis , and transport accidents are large for economically activeKoreans, because male mortality is higher than female mortality : (4) Suicide ratesare lower for economically active males, and higher for females aged 10s and 20s inKorea than Japan : (5) Death rates are highest f3r divorced or widowed under 45years of age depending on causes, but death rates from all causes are highest fornever-married of the age 45 and over in Korea : and (6) Sex-differentials inmortality are greatest for widowed in Korea and for divorced in Japan.

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Transmission Dose Estimation Algorithm for Tissue Deficit (조직 결손에 대한 투과선량 계산 알고리즘 보정)

  • Yun Hyong Geun;Chie Eui Kyu;Huh Soon Nyung;Lee Hyoung Koo;Woo Hong Gyun;Shin Kyo Chul;Ha Sung Whan
    • Radiation Oncology Journal
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    • v.20 no.2
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    • pp.186-192
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    • 2002
  • Purpose : Measurement of transmission dose is useful for in vivo dosimetry. In this study, previous algorithm for estimation of transmission dose was modified for use in cases with tissue deficit. Materials and Methods : The beam data was measured with flat solid phantom in various conditions of tissue deficit. New algorithm for correction of transmission dose for tissue deficit was developed by physical reasoning. The algorithm was tested in experimental settings with irregular contours mimicking breast cancer patients using multiple sheets of solid phantoms. Results : The correction algorithm for tissue deficit could accurately reflect the effect of tissue deficit with errors within ${\pm}1.0\%$ in most situations and within ${\pm}3.0\%$ in experimental settings with irregular contours mimicking breast cancer treatment set-up. Conclusion : Developed algorithm could accurately reflect the effect of tissue deficit and irregularly shaped body contour on transmission dosimetry.

An Improved Online Algorithm to Minimize Total Error of the Imprecise Tasks with 0/1 Constraint (0/1 제약조건을 갖는 부정확한 태스크들의 총오류를 최소화시키기 위한 개선된 온라인 알고리즘)

  • Song, Gi-Hyeon
    • Journal of KIISE:Computer Systems and Theory
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    • v.34 no.10
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    • pp.493-501
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    • 2007
  • The imprecise real-time system provides flexibility in scheduling time-critical tasks. Most scheduling problems of satisfying both 0/1 constraint and timing constraints, while the total error is minimized, are NP-complete when the optional tasks have arbitrary processing times. Liu suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on uniprocessors for minimizing the total error. Song et at suggested a reasonable strategy of scheduling tasks with the 0/1 constraint on multiprocessors for minimizing the total error. But, these algorithms are all off-line algorithms. In the online scheduling, the NORA algorithm can find a schedule with the minimum total error for the imprecise online task system. In NORA algorithm, EDF strategy is adopted in the optional scheduling. On the other hand, for the task system with 0/1 constraint, EDF_Scheduling may not be optimal in the sense that the total error is minimized. Furthermore, when the optional tasks are scheduled in the ascending order of their required processing times, NORA algorithm which EDF strategy is adopted may not produce minimum total error. Therefore, in this paper, an online algorithm is proposed to minimize total error for the imprecise task system with 0/1 constraint. Then, to compare the performance between the proposed algorithm and NORA algorithm, a series of experiments are performed. As a conseqence of the performance comparison between two algorithms, it has been concluded that the proposed algorithm can produce similar total error to NORA algorithm when the optional tasks are scheduled in the random order of their required processing times but, the proposed algorithm can produce less total error than NORA algorithm especially when the optional tasks are scheduled in the ascending order of their required processing times.