• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7975-7979
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• 2015

Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a lower IHC4 score was associated with an increased probability of pCR (low; 52.9% vs. High; 21.6%, OR=4.1, 95% CI=1.28-13.16, p=0.018) and a lower pathological stage (OR=3.9, 95% CI=1.34-11.33, p=0.012). When the IHC4 score was treated as a continuous variable, a lower score was again associated with an increased probability of pCR (OR=1.010, 95% CI=1.001-1.018, p=0.025) and lower pathological stage (OR=1.009, 95% CI=1.002-1.017, P=0.008). Lower clinical stage was associated with a better pCR rate that was of borderline significance (P=0.056). When clinical stage and IHC4 score were incorporated together in a logistic model, the likelihood ratio test gave a P-value of 0.004 after removal of the IHC4 score and 0.011 after removal of the stage, indicating a more significant predictive value of the IHC4 score for pCR. Conclusions: This study suggests that the IHC4 score can predict pathological response to neoadjuvant chemotherapy in HR-positive BC patients. This finding now needs to be validated in a larger cohort of patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.464-476
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• 1999

This study was conducted between October 1, 1998, and December 31, 1998, in order to provide basic data to develop better self-management educational programs for systemic lupus erythematosus (lupus) patients. In the study, the extent of each patients knowledge on the disease and their learning needs about it were examined for 100 lupus inpatients and outpatients at the Kangnam St. Marys Hospital. Data were collected by using questionnaires to those patients. Frequencies, percentage, average, standard deviation, t-test, ANOVA, and Duncans multiple range test were examined through the SAS program. The result of study follows : 1) The average score of patients knowledge on the disease was 15.7 (range, 7-20; standard deviation, 2.74). Subjects scored higher as far as the extent of their knowledge in the following categories : management of daily life, diet, characteristics of the disease, risk factors, and medication. Two categories shared the highest percentage of correct answers : 99% of subjects correctly identified that fatigue and stress aggravate symptoms of lupus and symptoms of lupus vary among individuals in range and type. However, when subjects were asked if patients should get a regular examination by an ophthalmologist every 4-6 months while they are on medication to treat rashes, lupus can be completely cured, and contraceptives that include a female hormone (estrogen) are good as contraceptive methods, the percentages of correct answers were low (32%, 31%, and 20%, respectively). In terms of subjects knowledge about the disease by their general characteristics, single subjects had more knowledge about the disease than married subjects did (t=2.14, p=0.0353). The extent of knowledge also varied by monthly income (F=4.96. p=0.0097). Those with more formal education had more knowledge about lupus than those who had less formation education did (t=2.95, 0.0039). Additionally, those who were satisfied with their education about the disease had better knowledge about it than those who were dissatisfied with their education did (t=2.71, p=0.0090). 2) The extent to which lupus patients wanted to be educated about the disease was, on average, 64.5 (range, 46-75; standard deviation, 7.91). Areas for which patients requested education are listed here in order : risk factors, sexual lives and patients associations. Patients who had been hospitalized demonstrated wanting more education than those who had not been did(t=3.73, p=0.0003). The extent to which they wanted the information was different by the number of educational sessions they had (F=3.98, p=0.0249). In conclusion, the results above would be considered when the education programme is planned for SLE patients.

• Asian-Australasian Journal of Animal Sciences
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• v.26 no.4
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• pp.488-500
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• 2013

The objective of this study was to compare the effectiveness of the protocols for superstimulation of follicular growth in Thai native heifers. Heifers (n = 20) were randomly divided into four groups of five heifers/group. Heifers were given a single dose by i.m. administration of 100 mg Follicle Stimulating Hormone dissolved in polyvinylpyrrolidone (FSHp) at 24 h. Ovum pick up (OPU) occurred at 72 h ($F_{24}O_{72}$ protocol; Group 1) or 96 h ($F_{24}O_{96}$ protocol; Group 2), and at 36 h and OPU at 72 h ($F_{36}O_{72}$ protocol; Group 3) or 96 h ($F_{36}O_{96}$ protocol; Group 4) after follicular ablation. The dynamics of ovarian follicular growth were monitored by twice-daily ultrasonographic examinations. Blood sample collections were performed every 12 h after initiation of treatment for assessment of FSH, E2 and P4 profiles. All heifers were subjected to eight repeated sequential sessions of OPU. The follicular deviation commenced $24{\pm}5.32$ h after follicular ablation in all groups. The circulatory FSH surged quickly from 24 to 36 h (>0.8 ng/ml) after follicular ablation and circulatory estrogen levels steadily increased from 36 h until OPU in all groups. At the end of the OPU sessions, the mean number of aspirated follicles/heifer/session in $F_{36}O_{72}$ protocol (Group 3) and $F_{36}O_{96}$ protocol (Group 4) were higher than in the two other groups (p<0.05). The number of cumulus-oocyte complexes (COCs), cleaved and day 8 blastocysts rates in the $F_{36}O_{72}$ protocol (Group 3) were higher than in the other groups (p<0.05). It can be concluded that a single dose i.m. administration of 100 mg FSHp at 36 h and OPU at 72 h after follicular ablation ($F_{36}O_{72}$ protocol; Group 3) was the most effective protocol for superstimulation of follicular growth for repeated OPU and subsequent in vitro embryo production in Thai native heifers.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.6055-6059
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• 2015

Background: Medication policy development in Thailand is continually promoting rational drug use. Letrozole, an endocrine therapy drug, is usually prescribed for post-menopausal status early and advanced stage breast cancer. After Ministry of Public Health announced Letrozole as compulsory licensed drug in 2009, more breast cancer patients can access to this drug at low cost especially those within universal coverage schemes. To ensure that Letrozole is rationally prescribed, the drug utilization study was conducted. Objectives: The aim of this study was to describe the appropriate use of Letrozole in breast cancer and the relationship between appropriate use and health benefit schemes. Materials and Methods: A retrospective study to evaluate use of Letrozole in breast cancer patients was performed for six months between January - June 2010 in seven regional cancer hospitals, Thailand. All prescriptions of Letrozole were identified from pharmacy dispensing databases and prescription papers. A medical record review was also performed to evaluate appropriate use referring to the drug use evaluation criteria. The approved criterion of this study was referred from the guideline of Thai National Formulary version 2010. Results: There were 681 prescriptions of Letrozole for 254 breast cancer patients with an average age of $58.6{\pm}10.0years$. The patients in universal coverage scheme (UCS), civil servant medication benefit scheme (CSMBS) and social security scheme (SSS) were 77.7%, 18.5% and 8.7% respectively. 10.6% were prescribed Letrozole for the first time. Letrozole were prescribed by oncologists (82.8%). The average number of tablets per prescription was $58{\pm}10$. Calcium supplements were prescribed concomitant with Letrozole for 19.4%. To assess drug use evaluation criteria, 45 prescriptions were excluded because of uncompleted clinical data, 636 prescriptions were evaluated. The study showed 86 prescriptions (13.5%) with inappropriate use including 6 (0.9%) not prescribed for estrogen receptor (ER) and/or progesterone receptor (PR) positive, 31 (4.9%) not prescribed for post-menopausal and 49 (7.7%) not prescribed for an appropriate duration. Appropriate use percentages in different health benefit schemes were similar, 85.7% of CSMBS, 86.4% of SSS and 86.7% of UCS. The relationship between health benefit scheme and appropriate use of Letrozole was not significantly different, ${\chi}^2$ (2, N = 636) = 0.081, p > 0.05. Conclusions: The study showed inappropriate use in breast cancer patients because of non-compliance with duration, menopausal status and hormone receptor requirements. To prescribe appropriate indication did not referred to the appropriate practice along the treatment. Drug use evaluation proved very useful for detecting the sign of inappropriate use and allows immediate feedback to the stakeholder for developing medication policy in the future. Importantly, there was no significantly difference in appropriate use of Letrozole across health benefit schemes.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3233-3238
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• 2014

Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was $64.3{\pm}10.5$ years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ${\leq}2cm$, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3595-3600
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• 2016

Background: To investigate the association between preoperative pathological Ki-67 labeling index and serum tumor marker cancer antigen 15-3 (CA 15-3) with clinic-pathological parameters and treatment outcomes in early breast cancer. Materials and Methods: A retrospective study at 4 cancer centers in Saudi Arabia and Egypt was performed. Data were collected for female patients diagnosed with unilateral early breast cancer between March 2010 and October 2013. Cases treated with neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy were included. NACT included 6-8 cycles of anthracycline and taxane based regimens. Trastuzumab and hormonal treatments were added according to HER2 and hormone receptor status. Baseline serum CA15.3 and pathological Ki67 levels were evaluated and correlated with disease free survival (DFS) and overall survival (OS). Results: A total of 280 pts was included. The median age was 49 years (38-66 y) and median overall survival was 35 (20-38) months (mo). Estrogen receptors (ER), progesterone receptors (PR) and HER 2 receptors were positive in 233 (83.2%), 198 (70%) and 65 cases (23.2%), respectively. High preoperative Ki67 and CA15.3 were noted in 177 (63.2%) and 131 (46.8%). A total of 45 (16%) patients had distal or local recurrence and 24 (8.6%) died of their disease. Most of the relapsed cases had high preoperative Ki-67 (n=41, 91%) and CA15.3 (n=28, 62%) values. All of the patients who died had a high Ki-67 but CA15.3 was high in 9 (37%) only. Mean DFS/OS in patients with high preoperative Ki-67 was 32 months /32 months as compared to 37 months/35 months in those with normal Ki-67 (p<0.001). Correlation of preoperative CA15.3 and survival was statistically not significant. Conclusions:Preoperative Ki-67 can be a predictive and prognostic marker. Higher levels are associated with poor DFS and OS in patients with early BC.

• Journal of Life Science
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• v.19 no.12
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• pp.1841-1846
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• 2009

Menopause is often associated with the incidence of several chronic diseases including osteoporosis, cardiovascular disease, and obesity. Hormone replacement therapy (HRT) is an effective regimen that has been found to prevent these diseases in postmenopausal women. However, HRT is accompanied by an increased risk of unfavorable outcomes. Therefore, this study was conducted to evaluate the effects of Ecklonia cava, a kind of seaweed, extract on bone turnover markers in symptomatic menopausal women. For this study, the following four groups of 9-week-old Sprague-Dawley rats were evaluated over 6 weeks: normal rats (SHAM), ovariectomized rats (OVX-CON) and ovariectomized rats that were treated with Ecklonia cava extracts. The optimum extraction temperature and solvent of Ecklonia cava were found to be $80^{\circ}C$ and 80% ethanol. We measured the osteocalcin and CTx content, enzyme ALP activity in serum and collagen content in the cartilage, bone, skin and lungs. We found that the levels of indicators of bone metabolism such as ALP, osteocalcin and CTx were lower in rats in the Ecklonia cava extract group than the OVX-CON group. In addition, the collagen contents in the bone, cartilage, skin and lungs decreased in response to ovariectomy, but the levels of collagen were greater in the bone of rats that were treated with Ecklonia cava extract than in the bone of rats in the OVX-CON group. According to these results, we were able to know the effects of Ecklonia cava extract on bone aging in ovariectomized rats. Consequently, we expect Ecklonia cava extract to have an effect on bone aging in postmenopausal women.

• Journal of Aquaculture
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• v.6 no.2
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• pp.125-132
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• 1993

To determine the effective dose of $17\beta-estradiol$ on the production of all female populations of Nile tilapia, Oreochromis niloticus, the first feeding-stage larvae were fed 0, 60, 120, 240 and 480 ppm of $17\beta-estradiol$ in the diet for 30 days. Rates of sex reversal, survival and growth of each treated group were analyzed. Effects of 3 different treatment durations, 10, 20 and 30 days, treated with 480 ppm $17\beta-estradiol$ in the diet to produce all females, were also evaluated. The incidence of female fish were clearly dose and time dependent. The female induction rate of 0, 60, 120, 240 and 480 ppm were 47.5, 86.4, 91.3, 97.0 and $100\%$, respectively. Female induction rates of 480 ppm treated for 10, 20 and 30 days were 64.2, 84.3 and $100\%$ respectively. The survival rate of each treated group was not different from the control, and the growth rates of the treatment groups decreased as the treatment duration and the concentration of the estrogen hormone increased.

• Clinical and Experimental Reproductive Medicine
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• v.33 no.2
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• pp.133-138
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• 2006

Female phenotype of a 46,XY male may originates from male pseudohermaphroditism due to $17{\alpha}$-hydroxylase deficiency. Lack of cortisol increases adrenocorticotropic hormone (ACTH) and mineralocorticoid production, leading to low renin hypertention and hypokalemia. A 41-year-old phenotypic female presented primary amenorrhea and hypertension. In the hormonal profile, the levels of serum estradiol, testosterone, rennin, and cortisol were decreased and ACTH and deoxycorticosterone were increased. Laparoscopic bilateral gonadectomy was performed, and corticosteroid, antihypertensive drugs, and estrogen were administered. We report this case with a brief review of the literatures.

• Clinical and Experimental Reproductive Medicine
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• v.35 no.3
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• pp.181-191
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• 2008

Objective: Environmental chemicals alter reproduction, growth, and survival by changing the normal function of the endocrine system. Bisphenol A (BPA), one of the endocrine disruptors, is known to be an estrogen receptor agonist. Therefore, we hypothesized that BPA may affect male reproduction including spermatogenesis in the mouse testis. Methods: We used 7-week-old ICR mice. The first experiment group received BPA in sesame oil (vehicle, 1 mg/kg, 10 mg/kg, and 100 mg/kg) by i.p. injection and mice were sacrificed 24 hr later. The second experiment group received BPA (vehicle, 10 ${\mu}g/kg$, 1 mg/kg, and 100 mg/kg) daily for 14 days by subcutaneous injection. Expression of cell type-specific marker genes in the testis was evaluated by RT-PCR. Histological analysis, immunofluorescence staining, and TUNEL staining were also performed. Results: RT-PCR analyses showed that expression of luteinizing hormone receptor (LHR), a marker gene for the Leydig cell, was notably decreased in the testes of high dose-exposed mice. No obvious difference in the histology of testes was noted among treatment groups. Immunostaining of LHR in the first experiment group did not show noticeable difference in LHR protein expression in Leydig cells. Immunohistochemistry also revealed heightened expression of the immunoreactive Bax in the treatment group, and this was accompanied by positive TUNEL staining in the interstitial area within testis where Leydig cells reside. Conclusions: Our result suggests that BPA affects Leydig cell functions by altering gene expression and by increasing apoptosis in the mouse testis.