The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.
Objective: This study was performed to compare the clinical outcomes of GnRH antagonist (Cetrorelix) single dose and multiple dose protocols for controlled ovarian hyperstimulation with GnRH agonist long protocol. Materials and Method: From September 2001 to March 2002, 48 patients (55 cycles) were performed controlled ovarian hyperstimulation for ART using by either GnRH antagonist and GnRH agonist. Single dose of 3 mg GnRH antagonist was administered in 15 patients (17 cycles, single dose group) at MCD #8 and multiple dose of 0.25 mg of GnRH antagonist was administered in 15 patients (18 cycles, multiple dose group) from MCD #7 to hCG injection day. GnRH agonist was administered in 18 patients (20 cycles, control group) by conventional GnRH agonist long protocol. We compared the implantation rate, number of embryos, and clinical pregnancy rate among three groups. Student-t test and Chi-square were used to determine statistical significance. Statistical significance was defined as p<0.05. Results: There were no significant differences in ampules of used gonadotropins, number of mature oocytes, obtained embryos between single and multiple dose group, but compared with control group, ampules of used gonadotropins, number of mature oocytes, obtained embryos were decreased significantly in both groups. Clinical pregnancy rate and implantation rate were not different in three groups. There were no premature LH surge and ovarian hyperstimulation syndrome in three groups. Multiple pregnancy were occurred 1 case in multiple dose group and 2 case in control group. Conclusions: GnRH antagonist is a safe, effective, and alternative method in the controlled ovarian hyperstimulation compared with GnRH agonist. Clinical outcomes and efficacy of both single and multiple dose protocol are similar between two groups.
International Journal of Vascular Biomedical Engineering
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제3권1호
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pp.6-13
/
2005
Individual clinical significance of each layer of CCA (common carotid artery) has not been well studied. We intended to measure the intima thickness (IT), media thickness (MT), and intima-media thickness (IMT) of CCA separately and tried to analyze the clinical significance. One hundred fifty one consecutive patients (mean age: $57{\pm}15$ years; 77 males, 74 females) underwent CCA scanning using high-resolution ultrasound. The images were off-line analyzed using B-mode ultrasound image processing, devised for individual measurement of IT and MT as well as IMT. The mean coefficients of variation of new method measuring IT, MT, and IMT separately were 0.16% for IMT and 0.21% for both IT and MT. The IT (p < 0.01), MT (p < 0.01) as well as IMT (p < 0.001) of patients with atherosclerotic disease were significantly thicker than that of the patients without atherosclerotic disease. Patients with hypertension showed significantly thicker IT (p < 0.01), MT (p < 0.001), and IMT (p < 0.001) than that of the patients without hypertension. However, only IT was thicker in patients with smoking (p<0.01) than that of the patients without smoking.
Malak, Camelia A Abdel;Elghanam, Doaa M;Elbossaty, Walaa Fikry
Asian Pacific Journal of Cancer Prevention
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제16권18호
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pp.8197-8201
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2016
Background: To investigate the expression of the fragile histidine triad (FHIT) gene in acute lymphoblastic leukemia and its clinical significance. Materials and Methods: The level of expressed FHIT mRNA in peripheral blood from 50 patients with acute lymphoblastic leukemia (ALL) and in 50 peripheral blood samples from healthy volunteers was measured via RT-PCR. Correlation analyses between FHIT gene expression and clinical characteristics (gender, age, white blood count, immunophenotype of acute lymphoblastic leukemia and percentage of blast cells) of the patients were performed. Results: The FHIT gene was expressed at $2.49{\pm}7.37$ of ALL patients against $14.4{\pm}17.9$ in the healthy volunteers. The difference in the expression levels between ALL patients and healthy volunteers was statistically significant. The rate of gene expression did not significantly vary with immunophenotype subtypes. Gene expression was also found to be correlated with increase of total leukocyte and decrease in platelets, but not with age, gender, immunophenotyping or percentage of blast cells. Conclusions: FHIT gene expression is low in acute lymphoblastic leukemia and could be a useful marker to monitor minimal residual disease. This gene is also a candidate target for the immunotherapy of acute lymphoblastic leukemia.
Many previous studies have proved that human allergic disease resulted from the formation of antibodies belonging to a unique immunoglobulin isotype termed immunoglobulin E (IgE). Most of IgE-producing plasma cells are found in the lymphoid tissue associated with the gastrointestinal and respiratory tracts. IgE may be found free in the mucosal secretions of these tissues, bound to local mast cells, or distributed by the systemic circulation to mast cells and basophils throughout the body. Total serum IgE concentrations tend to be higher in allergic adults and children compared with non-allergic individuals, but the value of total serum IgE as a screening test for allergic disease is limited. Total serum IgE levels are related to the probability of an individual having detectable allergen-specific IgE. Allergen-specific IgE concentrations vary with a person's age, the degree and duration of the recent allergen or cross-reactive allergen exposure. The value of quantitative assays for allergen-specific IgE has been suggested in recent studies. Serum IgE increases in many non-allergic diseases, including infectious and parasitic diseases. The IgE changes appear to be specific to the infectious agents, whereas non-specific in other diseases. The increased serum IgE in some of these conditions probably results from alterations in immune function. This review summarizes the clinical significance of total and allergen-specific IgE examinations in allergic diseases.
Objective : The purpose of this clinical research is the investigation of the effects between acupuncture group(control group) and NURIEYE-1 group (experimental group) in myopia Methods : Comparison clinical study was conducted with the randomly arranged 32 patients for acupuncture group(control group) and NURIEYE-1 group(experimental group). For effectiveness evaluation, eye sight test, MQOL and DITI were tested three times with visits for every 4 weeks. With SAS, Statistical analysis was performed by using paired t-test and two sample t-test. Statistical significance was achieved with less than 5% probability (p<0.05). Result : 1. There was no significant effect from the eye sight comparison between the two group. We had improved results in average with MQOL, however, there was no statistical significance. Though there was also no significant result with DITI average comparison between two group, we witnessed significant effect in some part of MQOL. 2. Nevertheless Periodical comparison test showed weak significance with eye sight and DITI, significant effect was found in some part of MQOL. 3. With periodical comparison tests, there were significant effects in eye sight, MQOL and DITI with the experimental groups and control groups, respectively. Conclusion : There was no significant eye sight improvement. However, with acupuncture point stimulation, we think there are some positive effects for the relaxation of excessive stress in eyes.
Hur, Junseok W.;Hur, Junho K.;Kwon, Taek-Hyun;Park, Youn Kwan;Chung, Hung Seob;Kim, Joo Han
Journal of Korean Neurosurgical Society
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제52권3호
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pp.215-220
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2012
Objective : There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods : Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results : RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion : RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.
Kim, Tae-Ho;Lee, Hyun-Koo;Rhee, Jong-Joo;Lee, Seung-Jun;Lee, Chae-Heuck;Kim, Myoung-Soo
Journal of Korean Neurosurgical Society
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제40권2호
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pp.74-78
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2006
Objective : We examined the incidence of fenestration in the proximal segment of the anterior cerebral artery[ACA] and reviewed its clinical significance. Methods : Cerebral angiography was performed in 843 patients and magnetic resonance angiography[MRA] in 1,787; all patients had, or were suspected to have, cerebrovascular disease. We subsequently reviewed the angiography and MRA data. Results : Fourteen patients [six men and eight women, $35{\sim}81$ years of age, median age = 67 years] had proximal ACA fenestrations. Three of the 843 patients [0.36%] undergoing cerebral angiography had fenestrations of proximal ACA as did eleven of the 1,787 MRA patients [0.62%]. Seven fenestrations were located on the right side and seven fenestrations were located on the left side. The fenestrated ACA in one patient was associated with a saccular aneurysm at its proximal end. None of the 120 patients who underwent both conventional cerebral angiography and cranial MRA showed fenestration of proximal ACA. Conclusion : Although fenestration of ACA has little clinical significance, knowledge and recognition of this condition is important in the interpretation of cerebral images, especially during neurosurgical procedures.
Background: To explore mRNA expression and clinical significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in tumor tissue of postoperative patients with non-small cell lung cancer (NSCLC). Materials and Methods: Sixty NSCLC patients undergoing radical operation in our hospital from Nov., 2011 to Jun., 2012 were selected. Plasmid standards of ERCC1, BRCA1, RRM1, TYMS and TUBB3 were established and standard curves were prepared by SYBR fluorescent real-time quantitative PCR analysis. Samples from tumor centers were taken to detect mRNA expression of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in cancerous tissue during operation. The total mRNA expression quantities were compared according to different clinical characteristics. Results: The total expression quantities of 5 genotypes from high to low were ERCC1>RRM1>TUBB3>TYMS>BRCA1 in turn. By pairwise comparisons, other differences showed statistical significance (p<0.05 or p<0.01) except for TYMS and TUBB3 (p>0.05); the low expression rates from high to low were ERCC1>TYMS>TUBB3>TUBB3>RRM1>BRCA1 in turn. The expression quantities of BRCA1, RRM1 and TYMS in males, smokers and patients without adenocarcinoma were all significantly higher than that in females, non-smokers and patients with adenocarcinoma, and significant differences were present (p<0.05 or p<0.01). In terms of pathological staging, the expression quantities of BRCA1, RRM1 and TYMS in phases IIa~IIb and IIIa~IIIb had a tendency to be greater than in phases I and IV. Conclusions: Resistance to chemotherapy and sensitivity to targeted therapy differ among patients with NSCLC. Differences in gene expression in different individuals were also revealed. Only according to personalized detection results can individualized therapeutic regimens be worked out, which is a new direction for oncotherapy.
Purpose: This study aims to get the fundamental data which is necessary to the development direction of implant surface treatment hereafter, based on the understanding the surface structure and properties of titanium which is suitable for the absorption of initial tissue fluid by researching effects of additional surface treatments fir sandblasted with large git and acid-etched(SLA) titanium on surface micro-roughness, static wettability, fibronectin adsorption Materials and Method: In the Control groups, the commercial pure titanium disks which is 10mm in diameter and 2mm in thickness were treated with HCI after sandblasting with 50$\mu$m $Al_2O_3$. The experiment groups were made an experiment each by being treated with 1) 22.5% nitric acid according to SLA+ASTM F86 protocol, 2) SLA+30% peroxide, 3) SLA+NaOH, 4) SLA+ Oxalic acid, and 5) SLA+600$^{\circ}C$ heating. In each group, the value of Ra and RMS which are the gauges of surface roughness was measured, surface wettability was measured by analyzing with Sessile drop method, and fibronectin adsorption was measured with immunological assay. The significance of each group was verified by (SPSS, ver.10.0 SPSS Inc.) Kruskal-Wallis Test. (α=0.05) And the correlation significance between Surface micro-roughness and surface wettability. surface roughness and fibronectin adsorption, and surface wettability and fibronectin adsorption was tested by Spearman's correlation analysis. Result: All measure groups showed the significant differences in surface micro-roughness, surface wettability, and fibronectin adsorption. (p<0.05) There was no significance in correlation among the surface micro-roughness, surface wettability, and fibronectin adsorption. (p>0.05) Conclusion: Surface micro-roughness and surface wettability rarely affected the absorption of initial tissue fluid on the surface of titanium.
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