• Title/Summary/Keyword: HER2 positive

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Benefit of Post-mastectomy Radiotherapy of the Supra-/infraclavicular Lymphatic Drainage Area in Breast Cancer Patients

  • He, Zhen-Yu;Wu, San-Gang;Zhou, Juan;Sun, Jia-Yuan;Li, Feng-Yan;Lin, Qin;Guo, Ling;Lin, Huan-Xin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5557-5563
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    • 2014
  • Background: This study investigated the survival benefit of radiotherapy (RT) of the supra- and infraclavicular lymphatic drainage area in Chinese women with T1-2N1M0 breast cancer receiving mastectomy. Methods: A total of 593 cases were retrospectively reviewed from 1998 to 2007. The relationship between supra- or infraclavicular fossa relapse (SCFR) and post-operative RT at the supra-/infraclavicular lymphatic drainage area was evaluated. Results: The majority of patients (532/593; 89. 8%) received no RT while 61 patients received RT. The median follow-up was 85 months. Among patients without RT, 54 (10. 2%) developed recurrence in the chest wall or ipsilateral SCFR. However, none of the 61 patients who underwent RT demonstrated SCFR. One patient who received RT (1. 6%) experienced recurrence in the chest wall. Univariate analysis revealed that age and molecular subtype (both P < 0. 05) were two prognostic factors related to supraclavicular and infraclavicular fossa relapse-free survival (SFRFS). Multivariate analysis revealed that only Her-2 positive status (P = 0. 011) was an independent predictor of SFRFS. RT had no influence on distant metastasis (P = 0. 328) or overall survival (P = 0. 541). SCFR significantly affected probability of distant metastasis (P < 0. 001) and overall survival (P < 0. 001). Conclusion: Although RT was not significantly associated with SFRFS, postoperative RT was significantly associated with a lower locoregional (i. e., supraclavicular/infraclavicular and chest wall) recurrence rate. SCFR significantly influenced distant metastasis-free survival, which significantly influenced the overall survival of T1-2N1M0 breast cancer patients after mastectomy. Thus, prophylactic RT is recommended in T1-2N1M0 breast cancer patients, especially those who have Her-2 positive lesions.

Cutaneous Gnathostomiasis with Recurrent Migratory Nodule and Persistent Eosinophilia: a Case Report from China

  • Cui, Jing;Wang, Ye;Wang, Zhong Quan
    • Parasites, Hosts and Diseases
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    • v.51 no.4
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    • pp.467-470
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    • 2013
  • The present study reports a human case of cutaneous gnathostomiasis with recurrent migratory nodule and persistent eosinophilia in China. A 52-year-old woman from Henan Province, central China, presented with recurrent migratory reddish swelling and subcutaneous nodule in the left upper arm and on the back for 3 months. Blood examination showed eosinophila (21.2%), and anti-sparganum antibodies were positive. Skin biopsy of the lesion and histopathological examinations revealed dermal infiltrates of eosinophils but did not show any parasites. Thus, the patient was first diagnosed as sparganosis; however, new migratory swellings occurred after treatment with praziquantel for 3 days. On further inquiring, she recalled having eaten undercooked eels and specific antibodies to the larvae of Gnathostoma spinigerum were detected. The patient was definitely diagnosed as cutaneous gnathostomiasis caused by Gnathostoma sp. and treated with albendazole (1,000 mg/day) for 15 days, and the subsequent papule and blister developed after the treatment. After 1 month, laboratory findings indicated a reduced eosinophil count (3.3%). At her final follow-up 18 months later, the patient had no further symptoms and anti-Gnathostoma antibodies became negative. Conclusively, the present study is the first report on a human case of cutaneous gnathostomiasis in Henan Province, China, based on the past history (eating undercooked eels), clinical manifestations (migratory subcutaneous nodule and persistent eosinophilia), and a serological finding (positive for specific anti-Gnathostoma antibodies).

A Study on Women's Level of Educational Need & Knowledge about Routine Episiotomy and the Degree of Discomforts and Pain after Episiotomy (일상화된 회음절개술에 대한 여성의 지식, 교육요구, 불편감 및 통증정도에 관한 일 연구)

  • Yoo, Eun-Kwang;Kim, Jin-Hee
    • Women's Health Nursing
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    • v.7 no.3
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    • pp.393-406
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    • 2001
  • The purpose of this study was to find out women's need and level of knowledge about episiotomy, pain and discomfort related to episiotomy on a cross-sectional survey design. The subjects were 102 postpartal women agreed on oral consent. 34 postpartal women admitted at obstetric ward of H university hospital, 34 postpartal women admitted at 2 Sanhujoriwons, and 34 women within one year afterbirth. They were selected in Seoul, Korea. Data were collected from July, 1 to September 30, 2000, by a structured questionnaire. The instrument used for this study was a questionaire consisted of 5 items of general characteristics, 12 items of obstetric characteristics, 10 items of level of knowledge (Chronbach $\alpha$ .8176), 8 items of need of education(Chronbach $\alpha$ .8836), 3 items of pain (Chronbach $\alpha$ .9252), and 3 items of discomfort (Chronbach $\alpha$ .8092). The data were analyzed by the SPSS/PC+ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows; 1. 63.2% of respondents had right answer on 6-8 items among 10 items. Only 4.4% of women got right answer on 10 items all. 2. The need of education was high(4.45%) on all items and the range of score was $4.25{\sim}4.64$. 3. The strength of pain was the highest within one week afterbirth(5.93/10) and became lower in 8-14 days afterbirth(2.55). And after 15days of postpartum, the pain level became to the lowest level(1.08). However, pain was delayed until more than one month afterbirth. 4. The level of discomfort was the highest one week afterbirth(6.88/10) and became lower in 8-14 days afterbirth(4.20). And after 15days of postpartum, the discomfort level became to the lowest level(2.47). Universally, the degree of discomfort was higher than pain. 5. There was a strong positive correlation between discomforts and pain ($r=.752^{**}$) and weak positive correlation between discomforts and the level of educational need($r=.308^*$). In conclusion, women have a right to choose whether she will have episiotomy or not according to her decision making based on the comprehensive knowledge of episiotomy before they get episiotomy with consent process and explanation in detail. Women health care providers like nurses have a responsibility to do conscious raising and empowerment for women so that they could lead themselves to choose given medical treatments for women's health and wellbeing and the quality of life in her life cycle.

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The Prognostic Impact of Synchronous Ipsilateral Multiple Breast Cancer: Survival Outcomes according to the Eighth American Joint Committee on Cancer Staging and Molecular Subtype

  • Chu, Jinah;Bae, Hyunsik;Seo, Youjeong;Cho, Soo Youn;Kim, Seok-Hyung;Cho, Eun Yoon
    • Journal of Pathology and Translational Medicine
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    • v.52 no.6
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    • pp.396-403
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    • 2018
  • Background: In the current American Joint Committee on Cancer staging system of breast cancer, only tumor size determines T-category regardless of whether the tumor is single or multiple. This study evaluated if tumor multiplicity has prognostic value and can be used to subclassify breast cancer. Methods: We included 5,758 patients with invasive breast cancer who underwent surgery at Samsung Medical Center, Seoul, Korea, from 1995 to 2012. Results: Patients were divided into two groups according to multiplicity (single, n=4,744; multiple, n=1,014). Statistically significant differences in lymph node involvement and lymphatic invasion were found between the two groups (p<.001). Patients with multiple masses tended to have luminal A molecular subtype (p<.001). On Kaplan-Meier survival analysis, patients with multiple masses had significantly poorer disease-free survival (DFS) (p=.016). The prognostic significance of multiplicity was seen in patients with anatomic staging group I and prognostic staging group IA (p=.019 and p=.032, respectively). When targeting patients with T1-2 N0 M0, hormone receptor-positive, and human epidermal growth factor receptor 2 (HER2)-negative cancer, Kaplan-Meier survival analysis also revealed significantly reduced DFS with multiple cancer (p=.031). The multivariate analysis indicated that multiplicity was independently correlated with worse DFS (hazard ratio, 1.23; 95% confidence interval, 1.03 to 1.47; p=.025). The results of this study indicate that tumor multiplicity is frequently found in luminal A subtype, is associated with frequent lymph node metastasis, and is correlated with worse DFS. Conclusions: Tumor multiplicity has prognostic value and could be used to subclassify invasive breast cancer at early stages. Adjuvant chemotherapy would be necessary for multiple masses of T1-2 N0 M0, hormone-receptor-positive, and HER2-negative cancer.

A Case of Chronic Hepatitis C Acquired through Ear Piercing and Acupuncture (침술과 피어싱으로 발생한 만성 C형 간염 1예)

  • Rim, Jee-Yeon;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.88-92
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    • 2009
  • Although transfusion of blood and plasma products are accepted as the principle means of transmission of HCV, other parenteral methods, such as acupuncture, tattooing needles, piercing, and surgery are possible methods of transmission of HCV. We managed a case of chronic hepatitis C acquired through ear piercing and acupuncture. A 10-year old girl presented with nausea, abdominal pain, and anorexia for 1 month. Her laboratory finding showed the following: AST/ALT, 865/1,290 IU/L; positive anti-HCV Ab; and HCV RNA. One year previously, she was treated with acupuncture for an ankle sprain and 2 years previously, she had her ears pierced. Laboratory findings of family members showed AST/ALT in the normal ranges, and negative anti-HCV Ab and HCV RNA. The pathologic findings of a liver biopsy revealed chronic hepatitis with mild lobular activity, moderate porto-periportal activity, and portal fibrosis. She was treated with pegylated interferon ${\alpha}$-2a and oral ribavirin for 6 months, after which the clinical symptoms and laboratory findings improved.

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A Study on Janvenile Delinquents' View of Parental Attitudes (비행 청소년의 부모관 인식에 관한 일 연구)

  • 장선경
    • Journal of the Korean Home Economics Association
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    • v.27 no.4
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    • pp.123-137
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    • 1989
  • The purpose of this study is to examine parental attitudes perceived by juvenile delinquents and to provide the basic material on the problem of juvenile delinquency. For this purpose, this study examines 1) the relation-ship between the juvenile delinquents' social demographic characteristics and the juvenile delinquents' view of parental attitudes 2) the correlation between the juvenile delinquents' social demographic characteristics and the content and the motive of delinquency, 3) the content and the motive of delinquency in accordance with the juvenile delinquents' view of parental attitudes. For the subject of this study, 318 juvenile delinquents who were in the custody of the institution in An-Yang were selected, and questionnaire sheets were used. Of 318 questionnaire sheets, 221 sheets were analyzed by statistical methods, and the data were analyzed by frequency, percentage, average, t-test, x-test, and F-test; 1. There is a significant difference in the juvenile delinquents' view of their fathers in accordance with their fathers' age. Namely, the younger the father is, the more the juvenile delinquent wants his father to be less negative. There is a significant difference in the juvenile delinquents' view of their mothers according to the existence of step-sibling. Juveniles with step-siblings deny their mothers' inconsistent attitude more than the juveniles without a step-sibling. 2. The social demographic characteristics influencing the content of juvenile delinquency are juvenile's age, the degree of education, the father's age, the style of possessing house and the region of a dwelling. The motive of delinquency show a significant difference according to the juvenile's age. 3. According to the results of studying the correlation between the view of parental attitudes and the content and the motive of delinquency, there is a significant difference in the father's protective attitude, and the content of delinquency as well as in the mother's positive denial, her rigid control, her inconsistent attitude and the content of delinquency. The subordinate domains are opposite to the traditional conception that the father is stern and the mother is peronssive. Today our society encourages the parents' equal and democratic attitude toward their children and the juvenile's view of parental attitudes is discordant with the reality. The juvenile delinquents' view of parental attitudes reflects the equalitariansim of the contemporary society but is influenced by the traditional view of the parents.

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A Case of Pulmonary Paragonimiasis with Involvement of the Abdominal Muscle in a 9-Year-Old Girl

  • Cho, Ah-Rum;Lee, Hae-Ran;Lee, Kwan-Sub;Lee, Sang-Eun;Lee, So-Yeon
    • Parasites, Hosts and Diseases
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    • v.49 no.4
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    • pp.409-412
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    • 2011
  • In Korea. many people enjoy eating raw or underkooked freshwater crayfish and crabs which unfortunately may cause paragonimiasis. Here, we describe a case of pulmonary and abdominal paragonimiasis in a 9-year-old girl, who presented with a 1-month history of abdominal pain, especially in the right flank and the right inguinal area, with anorexia. A chest radiograph revealed pleural effusion in both lungs, and her abdominal sonography indicated an inflammatory lesion in the right psoas muscle. Peripheral blood analysis of the patient showed hypereosinophilia (66.0%) and an elevated total serum lgE level (>2,500 IU/ml). The pleural effusion tested by ELISA were also positive for antibodies against paragonimiasis. Her dietary history stated that she had ingested raw freshwater crab, 4 months previously. The diagnosis was pulmonary paragonimiasis accompanied by abdominal muscle involvement. She was improved after 5 cycles of praziquantel treatment and 2 times of pleural effusion drainage. In conclusion, herein, we report a case of pulmonary and abdominal paragonimiasis in a girl who presented with abdominal pain and tenderness in the inguinal area.

Could the Breast Prognostic Biomarker Status Change During Disease Progression? An Immunohistochemical Comparison between Primary Tumors and Synchronous Nodal Metastasis

  • El Nemr Esmail, Reham Shehab;El Farouk Abdel-Salam, Lubna Omer;Abd El Ellah, Mohammed M
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4317-4321
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    • 2015
  • Background: Prognostic biomarkers in breast cancer are routinely investigated in the primary tumors to guide further management. However, it is proposed that the expression may change during the disease progression, and may result in a different immune profile in the metastatic nodes. This work aimed to investigate the expression of breast prognostic biomarkers in primary tumors and in its axillary nodal metastasis, to estimate the possible discordant expression. Materials and Methods: 60 paired primary and axillary nodal metastasis samples were collected from patients with primary breast cancer with positive nodal deposits, diagnosed at the Maadi Military Hospital, Cairo, Egypt, during the year 2013. ER, PR and HER2 expression was assessed by immunohistochemistry in all samples Results: 48.3% of the included cases showed concordant results for both ER and PR receptors between the primary tumor and its nodal metastasis while 51.7% showed discordant results and the discordance level was statistically significant. On the other hand, 70% of the cases showed concordant Her2 results between the primary tumors and the nodal deposits, 30% showed discordant results and the difference was significant. Conclusions: The study indicated that the discordance in ER and PR receptor expression between the primary breast tumor and their nodal metastasis may be significant. The possible switch in the biomarker status during the disease progression is worth noting and may change the patient therapeutic planning. So, whether the treatment selection should be based on biomarkers in the lymph node is a topic for further studies and future clinical trials.

Identifying Differentially Expressed Genes and Screening Small Molecule Drugs for Lapatinib-resistance of Breast Cancer by a Bioinformatics Strategy

  • Zhuo, Wen-Lei;Zhang, Liang;Xie, Qi-Chao;Zhu, Bo;Chen, Zheng-Tang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10847-10853
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    • 2015
  • Background: Lapatinib, a dual tyrosine kinase inhibitor that interrupts the epidermal growth factor receptor (EGFR) and HER2/neu pathways, has been indicated to have significant efficacy in treating HER2-positive breast cancer. However, acquired drug resistance has become a very serious clinical problem that hampers the use of this agent. In this study, we aimed to screen small molecule drugs that might reverse lapatinib-resistance of breast cancer by exploring differentially expressed genes (DEGs) via a bioinformatics method. Materials and Methods: We downloaded the gene expression profile of BT474-J4 (acquired lapatinib-resistant) and BT474 (lapatinib-sensitive) cell lines from the Gene Expression Omnibus (GEO) database and selected differentially expressed genes (DEGs) using dChip software. Then, gene ontology and pathway enrichment analyses were performed with the DAVID database. Finally, a connectivity map was utilized for predicting potential chemicals that reverse lapatinib-resistance. Results: A total of 1, 657 DEGs were obtained. These DEGs were enriched in 10 pathways, including cell cycling, regulation of actin cytoskeleton and focal adhesion associate examples. In addition, several small molecules were screened as the potential therapeutic agents capable of overcoming lapatinib-resistance. Conclusions: The results of our analysis provided a novel strategy for investigating the mechanism of lapatinib-resistance and identifying potential small molecule drugs for breast cancer treatment.

A Case of Microscopic Polyangiitis Initially Suspected with Henoch-Sch$\ddot{o}$nlein Purpura Nephritis (Henoch-Sch$\ddot{o}$nlein 자반병 신염으로 의심했던 현미경적 다발혈관염 1례)

  • Im, Jong Geun;Moon, Kyung Chul;Koo, Ja Wook
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.132-137
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    • 2012
  • Microscopic polyangiitis (MPA) is systemic small vessel vasculitis that is very rare in childhood. MPA is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. Approximately 90% of patients have glomerulonephritis that is accompanied by a variety of other organ involvement. A 10-year-old girl visited our clinic with clinical manifestations suggestive Henoch-Sch$\ddot{o}$nlein purpura nephritis such as purpuric skin rash, abdominal pain, arthralgia on both knees, massive proteinuria and microscopic hematuria. So initially we suspected Henoch-Sch$\ddot{o}$nlein purpura nephritis. However, later her perinuclear-antineutrophil cytoplasmic antibodies(p-ANCA) test was positive, and her renal biopsy was consistent with microscopic polyangiitis. We began steroid therapy, combined with cyclophosphamide, ACE inhibitor. Currently she is a 12-year old, and until now she has been regularly examined in the outpatient. We report a case of microscopic polyangiitis initially suspected with Henoch-Sch$\ddot{o}$nlein purpura nephritis.