• Title/Summary/Keyword: Node negative

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Temperature-dependency of $Ca^{2+}$ Effect on the Electrical Activity of Rabbit SA Node (동방결절 전기적 특성에 대한 $Ca^{2+}$ 효과의 온도에 따른 변화)

  • Ho, Won-Kyung;Kim, Ki-Whan;Hwang, Sang-Ik
    • The Korean Journal of Physiology
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    • v.21 no.1
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    • pp.1-12
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    • 1987
  • There is evidence that the effect of extracellular $Ca^{2+}$ on heart rate is temperature-dependent: at $38^{\circ}C$ excess $Ca^{2+}$ induces positive chronotropic response, whereas at $30^{\circ}C$ there is no significant chronotropic effect of $Ca^{2+}$. The cause of this temperature-dependency, however, remains still unclear. Therefore, this study was undertaken to investigate the chronotropic effect of external $Ca^{2+}$ at different temperature in the isolated rabbit atria and in the small strips of SA node cut perpendicularly to crista terminalis. In the isolated atria, the $Ca^{2+}$ effect was temperature-dependent: at $35^{\circ}C$ excess $Ca^{2+}$ evoked positive chronotropic response, while at $30^{\circ}C$ there was no significant changes in sinus rate. On the contrary, in the small SA strips external $Ca^{2+}$ induced negative chronotropic effect. At $35^{\circ}C$ changes in $Ca^{2+}$ concentration from 2 to 4, 6, and 10 mM decreased the sinus rate by $2.7{\pm}1.6%$, $11.2{\pm}3.7%$ and $23.2{\pm}8.1%$ respectively. Lowering the temperature to $30^{\circ}C$, the negative chronotropic effect of $Ca^{2+}$ became greater. With intracellular microelectrodes transmembrane potential was recorded in the small SA strips at $30^{\circ}C$, $35^{\circ}C$ and $38^{\circ}C$. As temperature increased from 30 to $38^{\circ}C$, sinus rate was accelerated by $13/min/^{\circ}C$, $APD_{50}$(action ptential duration from peak to 50% repolarization) decreased by $5\;msec/^{\circ}C$, and amplitude of action potential was slightly decreased. With an increase in $Ca^{2+}$ concentrations from 0.5 to 6 mM, overshoot increased and MDP decreased. These $Ca^{2+}$ effects on the overshoot and MDP of action potentials were not altered by temperature. But the $Ca^{2+}$ effects on the rates of diastolic depolarization, systolic depolarization and repolarization were modified by temperature. Discrpancy of the chronotropic effects of $Ca^{2+}$ between isolated atria and small SA strips was discussed.

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ACCURACY OF PREOPERATIVE ASSESSMENTS FOR CERVICAL LYMPH NODE METASTASIS IN ORAL CANCER (구강암 경부임파절 전이에 대한 술전 평가의 정확성)

  • Lee, Jae-Jun;Nam, Woong;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.151-156
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    • 2006
  • Purpose : The aim of this study was to determine the accuracy of clinical and radiologic assessments in detecting positive cervical lymph nodes in oral cancer. Materials and Methods : We had reviewed the preoperative clinical, radiologic and postoperative histopathologic reports of 46 patients who had been diagnosed as oral cancer and underwent surgical excision combined with neck dissection (52 sides of neck) in the Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University from the July 1, 1992 to the April 30, 1999. Results : The results were as follows 1. The male to female ratio was 4.38 : 1 and the mean age was 57. 2. Sensitivity values for the preoperative assessment of cervical lymph node metastasis in oral cancer were 62.5 % in clinical examination and 50.0 % in radiologic assessments. Specificity values were 77.8 % in clinical examination and 94.4 % in radiologic assessments. 3. False positive values were 44.4 % in clinical examination and 20.0 % in radiologic assessments. False negative values were 17.6 % in clinical and 19.0% in radiologic assessments. 4. Overall efficiency values were 73.1 % in clinical examination and 80.8 % in radiologic assessments. Summary : There were some limits on the accuracy of clinical and radiologic assessments in the preoperative detection of the cervical lymph nodes in oral cancer. To improve the accuracy, it is important to communicate between clinician and radiologist, and adjunctive diagnostic measures, ultrasound and fine needle aspiration cytology, were helpful increasing the overall efficiency. In the high risk sites (oral tongue and floor of the mouth) the false negative value is higher and the overall efficiency in radiologic evaluation is lower than those of the low risk sites (gingiva and alveolar ridge, retromolar trigone and buccal mucosa ). The elective neck dissection should be considered in the high risk sites.

Immunohistochemical Profile of Breast Cancer Patients at a Tertiary Care Hospital in New Delhi, India

  • Doval, Dinesh Chandra;Sharma, Anila;Sinha, Rupal;Kumar, Kapil;Dewan, Ajay Kumar;Chaturvedi, Harit;Batra, Ullas;Talwar, Vineet;Gupta, Sunil Kumar;Singh, Shailendra;Bhole, Vidula;Mehta, Anurag
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4959-4964
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    • 2015
  • Background: To assess the immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) neu receptor in breast cancer and their associations with various clinicopathological characteristics. Materials and Methods: This is a retrospective analysis of women who presented with primary, unilateral breast cancer in the Department of Medical Oncology at Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India during the period from January 2008 to December 2011. Data were retrieved from the medical records of the hospital including both early and locally advanced cancer cases. ER, PgR and HER2neu expression in these patients was assessed and triple negative patients were identified. Associations of triple negative and non-triple negative groups with clinicopathological characteristics were also evaluated. Results: A total of 1,284 women (mean age 52.1 years, 41.9% premenopausal) were included in the analysis. Hormone receptor positivity (ER and/or PgR) was seen in 63.4% patients, while 23.8% of tumors were triple negative. Only 23.0% were HER2 positive. Around 10.0% of tumors were both ER and HER2 positive. ER and PgR positivity was significantly associated with negative HER2 status (p-value <0.0001). Younger age, premenopausal status, higher tumor grade, lymph node negativity, advanced cancer stage, and type of tumor were strongly associated with triple negativity. Significantly, a smaller proportion of women had ductal carcinoma in situ in the triple negative group compared with the non-triple negative group (35.6% versus 60.8%, p-value<0.01). Conclusions: The present analysis is one of the largest studies from India. The majority of the Indian breast cancer patients seen in our hospital present with ER and PgR positive tumors. The triple negative patients tended to be younger, premenopausal, and were associated with higher tumor grades, negative lymph nodes status and lower frequency of ductal carcinoma in situ.

Expression of Matrix Metalloproteinase-2, Cathepsin D and E-cadherin in Human Gastric Adenocarcinomas (위선암에서 Matrix Metalloproteinase-2, Cathepsin D 및 E-cadherin의 발현)

  • Lee Sang Kuon;Park Seung Cheol;Kim Won Woo;Kim Wook;Lee Kyo Young;Jeon Hae Myung;Kim Eung Kook;Koh Yong Bok
    • Journal of Gastric Cancer
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    • v.2 no.3
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    • pp.151-156
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    • 2002
  • Purpose: The prognosis of gastric cancer depends on the depth of invasion, lymph-node metastasis, invasion to adjacent tissues, and distant metastasis. Recently, it is known that tumor-associated proteases and adhesion molecules have been shown to play a relevant role in the process of progression and metastasis. The purpose of our study was to demonstrate the value of MMP-2 (matrix metalloproteinase), cathepsin D and E-cadherin as prognostic factors. Materials and Methods: In this study, formalin-fixed, paraffin-embedded tissue blocks from 69 patients with gastric cancer were immunohistochemically studied using antibodies to MMP-2, cathepsin D, and E-cadherin, and their expressions were analyzed according to the pathologic stage, lymph-node metastasis, histological differentiation, and patient survival. The medical records of these patients were retrospectively reviewed. Results: Increased expression of MMP-2 significantly correlated with advanced pathologic stage (P=0.026). Patients with lymph-node metastasis also had increased expression of MMP-2. Those patients with increased expression of MMP-2 showed a poorer survival; nevertheless, it was not statistically significant. Increased expression of cathepsin D significantly correlated with advanced pathologic stage (p=0.029). However, no correlation was observed between advanced pathologic stage and either lymph-node status or histological differentiation. Patients with increased expression of cathepsin D had a poorer survival, but that result was not statistically significant. No association was found between reduced expression of E-cadherin and pathologic stage, lymph-node status, or histological differentiation. Also, no correlation was found between the expression of E-cadherin and survival. In addition, when a combination of MMP-2 and cathepsin D expressions was analyzed, if both were negative, the survival seems to be longer, but it was not statistically significant. Conclusions: In patients with gastric cancer, expressions of MMP-2 and cathepsin D correlated with tumor stage; therefore, they may be considered as prognostic factors.

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Efficacy of Dose Dense Doxorubicin and Cyclophosphamide Followed by Paclitaxel versus Conventional Dose Doxorubicin, Cyclophosphamide Followed by Paclitaxel or Docetaxel in Patients with Node-Positive Breast Cancer

  • Yazilitas, Dogan;Sendur, Mehmet Ali Nahit;Karaca, Halit;Ozdemir, Nuriye;Aksoy, Sercan;Berk, Veli;Yazici, Ozan;Ozturk, Banu;Ozkan, Metin;Zengin, Nurullah;Altundag, Kadri
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1471-1477
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    • 2015
  • Background: Adding taxanes to adjuvant antracycline and cyclophosphamide (AC) in combination may provide significant improvement in node-positive and high risk node-negative breast cancer (BC) patients. However, the optimal dose and the role of dose-dense (DD) chemotherapy have yet to be determined. The aim of this study was to compare the efficacy of a DD paclitaxel (P)-AC combination with conventional weekly P-AC or docetaxel D-AC combinations in patients with node-positive breast cancer. Materials and Methods: Newly diagnosed 280 node-positive BC patients diagnosed from 1998 to 2013 in three clinics were retrospectively analyzed. Demographic and medical data were collected from the medical charts. Patients were categorized to 3 groups according to treatment arms: arm A, ddAC-P; arm B, weekly P and AC combination; and arm C; T and AC combination. Adjuvant trastuzumab was added for HER2-positive patients. Kaplan-Meier survival analysis was carried out for disease free survival (DFS) and overall survival (OS). The log-rank test was used to examine the statistical significance of the differences observed between the groups. Two-sided P values <0.05 were considered statistically significant. Results: Of the total of 280 patients, 101 were in arm A, 114 in arm B and 65 in arm C.The median ages were 49, 50 and 46, respectively (p=0.11). Median follow-up was 39 (3-193) months. Stage, lymphovascular and perineural invasion, receptor patern, and menopausal status were similar in the 3 treatment arms, but HER2 positivity was significantly lower in arm A, compared to arms B and C (25.7%, 53.1%, 41.5% in arms A, B and C, respectively; p<0.001). Also grade 3 tumors were significantly less frequent in treatment arm A compared to arm B and C (27.3%, 56.8% and 49.2%, respectively, p=0.01). Afterunivariate and multivariate analysis were performed, 3-year DFS rates were 89%, 81%, and 75%, respectively (p=0.12) and three year OS rates were 96.6%, 89%, and 75% (p=0.62). Conclusions: In this study, no significant difference was found between adjuvant dose dense and conventional taxane treatment regimens.

Clinicopathologic and Demographic Evaluation of Triple-Negative Breast Cancer Patients among a Turkish Patient Population: a Single Center Experience

  • Somali, Isil;Ustaoglu, Bahar Yakut;Tarhan, Mustafa Oktay;Yigit, Seyran Ceri;Demir, Lutfiye;Ellidokuz, Hulya;Erten, Cigdem;Alacacioglu, Ahmet
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6013-6017
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    • 2013
  • Background: To evaluate the clinicopathologic and demographic characteristics of triple-negative breast cancer (TNBC) patients and to determine differences from non-triple-negative cases. Materials and Methods: A detailed review of the medical records of 882 breast cancer (BC) patients was conducted to obtain information regarding age, menopausal status, height and weight at the time of diagnosis, presence of diabetes or hypertension, and pathologic characteristics of the tumor (tumor size, lymph node status, histologic grade, ER status, PR status, HER2 status, p53 mutation). Body mass index (BMI) was calculated and a value of ${\geq}30$ was considered as indicative of obesity. Results: 14.9% (n=132) of the patients had TNBC. There was no difference among the patients in terms of median age, comorbid conditions and menopausal status. The proportion of medullary, tubular and mucinous carcinomas was significantly higher (15.9%) in the triple-negative (TN) group, while invasive lobular histology was more frequent (8.2%) among non-triple negative (NTN) cases (p<0.001). Grade 3 (G3) tumors were more frequent in the triple-negative group (p<0.001). The rate of p53 mutation was 44.3% in TN tumors versus 28.2% in the NTN group (p<0.001). The two groups were similar in terms of LN metastasis. In the NTN group, the rate of patients with BMI ${\geq}30$ was 53% among postmenopausal patients, while it was 36% among premenopausal women, and the difference was statistically significant (p<0.001). No significant difference was observed in terms of BMI between postmenopausal and premenopausal patients in the TN group (p=0.08). Conclusions: TNBC rates and clinicopathologic characteristics of the Turkish patient population were consistent with the data from Europe and America. However, no relationship between obesity and TNBC was observed in our study. The association between TNBC and obesity needs to be evaluated in a larger patient population.

The Relationship Between Expression of Matrix Metalloproteinases(MMPs)-2, 9 and Tissue Inhibitors of Metalloproteinase(TIMPs)-1, 2 and Survival Time in Resected Non-Small Cell Lung Cancer (비소세포폐암에서 Matrix Metalloproteinase(MMPs)-2, 9와 Tissue Inhibitor of Metalloproteinase(TIMPs)-1, 2의 발현과 생존율과의 관계)

  • Kim, Hak-Ryul;Yang, Sei-Hoon;Jeong, Eun-Taik
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.5
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    • pp.453-462
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    • 2002
  • Background : Matrix metalloproteinases(MMPs) are a large family of proteolytic enzymes, which are involved in the degradation of many different components of the extracellular matrix. There is increasing evidence indicating that individual MMPs have important roles in tumor invasion by inactivating the MMPs. In this study, the correlation between MMPs and TIMPs expression, and the clinical outcome was investigated. Materials and Methods : Immunohistochemical staining of MMP-2, 9 and TIMP-1,2 were performed on paraffin-embedded tumor sections from 74 resected primary non-small cell lung cancers. Results : In 74 patients, MMP-2, MMP-9, TIMP-1, and TIMP-2 immunoreactivity was demonstrated in 24(34%), 19(26%) and 32(43%) of the paraffin-embedded tumors, respectively. The median survival of the MMP-2 positive cases was significantly shorter than that of the negative cases(20 vs 34 months). The median survival of the TIMP-2 positive cases was also was significantly longer than that of the negative cases (34 vs 18 months). The MMP-2, and MMP-9 expression level had a positively correlation with a more advanced stage and lymph node metastasis. There was inverse correlation between TIMP-2 expression and tumor invasion. The median survival of the MMP-2 negative/TIMP-2 positive cases was higher than that of the other cases. Conclusion : These results suggest that tumor invasion and lymph node metastasis are closely related to MMP-2 and MMP-9 expression. There was an inverse correlation between TIMP-2 and MMP-9 expression, and tumor invasion.

Characteristics of Invasive Breast Ductal Carcinoma, NOS, Diagnosed in a Tertiary Institution in the East Coast of Malaysia with a Focus on Tumor Angiogenesis

  • Ch'ng, Ewe Seng;Sharif, Sharifah Emilia Tuan;Jaafar, Hasnan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4445-4452
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    • 2012
  • Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.

Physiological effects of magnesium in the guinea pig hearts (기니픽 심장에서 magnesium의 생리학적 영향)

  • Chang, Sung-eun;Kim, Shang-jin;Kang, Hyung-sub;Kim, Jin-shang
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.311-317
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    • 2001
  • In this work we have investigated the physiological effects of $MgCl_2$ in isolated atrium, papillary muscle, perfused heart and anesthesized guinea pig, The addition or infusion of $MgCl_2$ (0~20 mM or mg/kg) to perfused hearts and to anesthesized guinea pigs induced a marked and dose-dependent negative chronotropic effect. The sinoatrial node automaticity could also be reduced by $MgCl_2$. The addition of $MgCl_2$to isolated atria and to papillary muscles induced a marked and dose-dependent negative inotropic effect. The threshold voltage could be increased by $MgCl_2$in papillary muscle. Increasing $MgCl_2$ shortened the action potential duration (APD) in dose-dependent manner at 30% ($APD_{30}$) and 90% repolarization ($APD_{90}$) measured with conventional microelectrode technique in papillary muscle. In anesthesized guinea pig, the magnesium infusion resulted in a dose-dependent drop in blood pressure. These results suggested that magnesium is closely associated with cardiac physiological condition and exerts antiarrhythmic activities.

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A Clinical Evaluation of Mediastinoscopy (종격동경 검사의 임상적 의의)

  • Go, Yeong-Sang;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.26 no.9
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    • pp.705-709
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    • 1993
  • The mediastinoscopy was a well known useful diagnostic tool for detection of certain mediastinal tumors ,mediastinal lymph nodes invasion by bronchogenic carcinoma and metastatic cancer. A total of 33 cases of mediastinoscopies were reviewed, which were experienced at Chon Buk National University Hospital from August,1980 to October 1991. Mediastinoscopy was performed through anterior or parasternal approach in 18 cases, cervical approach in 14 cases and both in 1 case. In 12 cases which were used for preoperative stagig of lung cancer, 10 cases[83.3%] had the positive biopsy results at mediastinal nodes. In 11 cases for diagnosis of lymph nodes and masses with unknown lung lesion, small cell carcinoma revealed in 3 cases,squamous cell carcinoma in 2 , adenocarcinoma in 1 case and the others were had the negative biopsy results. In 10 cases for diagnosis of mediastinal tumors, lymphoma revealed in 2 cases, malignant thymoma in 2, sarcoidosis in 2, tuberculous granuloma in 1, mesothelioma in 1, metastatic cancer with unknown origin in 1 case. Thoracotomy was performed in 3 cases of lung cancers, 2 patients with negative biopsy results in preoperative staging and 1 patient with subcarinal lymph node involvement only. Bleeding complications during mediastinoscopy were developed in 2 cases, managed by anterior mini-thoracotomy.

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