Purpose: The purpose of this study was to determine if there were prognostic differences between BRCA related and BRCA non-related Korean patients with early-onset breast carcinomas. Materials and Methods: Sixty women who had developed breast cancers before the age of 40, and who were treated at the Soonchunhyang University Hospital, were studied independently of their family histories. The age range was 18 to 40 with a median of 34.5 years. Lymphocyte specimens from peripheral blood were studied for the heterozygous mutations of BRCA1 and BRCA2 using direct sequencing methods. Immunohistochemistry was peformed on the paraffin-embedded tissue blocks that were available. Results: Eleven deleterious mutations (18.3%, 6 in BRCA1 and 5 in BRCA2) and 7 missense mutations of unknown significance (11.7%), were found among the 60 patients. More than half of the mutation were novel, and were not reported in the database. Most of the BRCA-associated patients had no history of breast cancer. No treatment related failures were observed in the BRCA carriers, with the exception of one patient that had experienced a new primary tumor of the contralateral breast. The seven year relapse free survival rate were 50 and 79% In the BRCA carrier and BRCA negative patients, respectively. Although the expression of estrogen and progesterone receptors were less common, and histological features more aggressive, in the BRCA associated tumors, the outcome of the patients with BRCA mutations was not poorer than that on the patients without deleterious mutations. Conclusion.: Despite the BRCA mutation carriers having adverse prognostic features, the recurrence rate was relatively lower than that in the BRCA non-carrying Korean patients wi4h early-onset breast carcinomas. In addition, although the prevalence of the BRCA mutation in Korean patients was higher than that in white patients, the penetrance of the cancer seemed to be relatively low in Korean women carrying BRCA mutations. A large population based study of the BRCA mutation, with a long-term follow-up of the study patients will be required to confirm these results.
In an attempt to investigate the effect of Hymenolepis dana infection on immunological responses to sRBC in ICR strain of mice, cellular and humoral immune responses were chronologically monitored after sensitization with sRBC. Mice weighing about 20 g were allocated into artificial and natural infection groups. The shell-free eggs of H. dana were inoculated into mice on the day 0 (initial) and day 10 in the former group, and praziquantel (25 mg/kg/day) was administered for 3 days to the one half of the mice at the 15th day after the first inoculation and to all of the mice in natural infection group. In artificial infection group, the delayed-type hypersensitivity (DTH) to sRBC was considerably decreased on the day 10 after the first inoculation, and then elevated gradually to normal. Eosinophils in the peripheral blood increased slightly. The hemagglutinin (HA) and hemolysin (HE) titers during the early stage were shown to be more or less higher than those of control. Thereafter, the titers were returned to normal, followed by a transient decrease on the day 15 post-infection. The sRBC rosette and antibody-treated rosette-forming capacities on the day 15 post.infection were temporarily lowered but became higher thereafter. The mucosal mast cells (MMC) in the small intestine were gradually increased to make a peak on the day 10 post-infection and then maintained more or less at lower level. After praziquantel treatment, the DTH and the number of eosinophils were decreased slightly and the MMC number and sRBC rosette-forming capacity were considerably decreased. The titers of HA and HE and antibody-treated rosette-forming capacity, however, were elevated in general. In natural infection group, the DTH, the number of eosinophils, and MMC which were elevated due to H. dana infection were gradually returned to normal after prasiquantel treatment. The titers of HA and HE which were decreased by parasite infection were increased to normal after the treatment. However, the capacities of sRBC rosette or antibody-treated rosette formation were maintained at low levels in spite of the treatment. These results revealed that the immune responses to sRBC were significantly activated during H. dana infection, although they were transiently decreased during the days 10~15 post-infection.
Amrinone is a non-glycosidic, non-adrenergic positive inotropic agent with peripheral and coronary vasodilator effect. It inhibits phosphodiesterase F-III, the cardiac cyclic-AMP specific phosphodiesterase, selectively and potently. In this study, the effects of IV administered amrinone and dopamine were compared in 40 patients who had open heart surgery. Amrinone was administered as a bolus of 1 5~2mglkg for several minutes, followed by continuous infusion at 5~1 Oug/kg/min. The hemodynamic measurements including heart rate, systolic and diastolic pressure, cardiac index, pulmonary wedge pressure, and systemic vascular resistance were recorded immediately for 12~24 hours awl 7th day following operation. In amrinone group, cardiac index increased from 3.73$\pm$1.39 L/min/m2 to 5.44$\pm$2.65 L/min/m2 at the time of posterative 48 hours (n=20, p< 0.05). The decrease in systemic vascular resistance from 1237.5 $\pm$ 637.7 dyne/sec/cm2 to 1000.8 $\pm$ 608.5 dyne/sec/cm2(p<0.05). In Dopamine group, the heart rate increased from 92.1 $\pm$ 13.0/min to 101.0 $\pm$ 13.1/min and the cardiac index decreased from 3.40 $\pm$ 0.50 L/min/m2 to 2.53 $\pm$ 1.15 L/min/m2 at the time of postoperative 12 hours(p<0.05). Systemic vascular resistance increased from 1058.5 $\pm$ 234.6 dyne/sec/cm2 to 1979.7 $\pm$ 759.2 dynelsec/cm2 The comparison of the hemodynamic effects of amrinone and dopamine, both drugs improved cardiac performance. But the administration of amrinone results in a higher cardiac index, diastolic blood pressure and lower systemic vascular resistance than those achieved with dopamine (p<0.05). The uniqueness of the action of amrinone on the heart and its sustained hemodynamic effect suggest it has clinical promise, pos operative care of cardiac surgery
Background : Isolated leukopenia is rare, but it has important clinical implications during antituberculosis treatment. Inadvertent discontinuation of short-course regimen drugs for fear of leukopenia inevitably will extend the duration of treatment, and the completion of treatment will be delayed. However no guidelines concerning proper management for leukopenia during antituberculosis treatment have been presented. Therefore, this study was performed to evaluate the possibility of continuing the same short-course regimen if a mild-to-moderate degree of isolated leukopenia was to develop during antituberculosis treatment. Method : Thirty-six patients who had been prescribed a short-course antituberculosis regimen between January 1997 and August 1999, had newly developed, mild-to-moderate degree, isolated leukopenia during medication, and had continued the same drug regimen despite leukopenia were enrolled. One patient was not available for the follow-up, so the remaining thirty-five (twenty-five prospectively and ten retrospectively) patients were analyzed. Patients who had other known causes of leukopenia were excluded. A mild-to-moderate degree of isolated leukopenia was arbitrarily defined as having a peripheral blood leukocyte count between 2,000 and $3,499/mm^3$ and no evidence of coexisting hematologic abnormalities. Results : 1) All thirty-five patients were able to complete short-course anti-tuberculosis treatment without complication or further decrease of leukocytes count to less than $2,000/mm^3$ despite continuous treatment with the same regimen. 2) The mean duration from start of antitituberculosis medication to detection of leukopenia was $64{\pm}65$ days. 3) The mean leukocyte count was $5,035{\pm}1,583/mm^3$ before treatment, and the its lowest count was $2,908{\pm}390/mm^3$ during treatment. Leukopenia recovered after completion of treatment ($4,283{\pm}1,269/mm^3$). 4) The main component of leukopenia was the decrease in neutrophil count ($3,361{\pm}1,732$ vs. $1,512{\pm}423/mm^3$, p<0.05). Conclusion : For mild-to-moderate degree of isolated leukopenia ($2,000/mm^3{\leq}$ WBC < $3,500/mm^3$), developing during short-course antituberculosis treatment, the short-course antituberculosis regimen may be continued without complications.
Purpose : To evaluate the changes of differential counts and lymphocyte subsets in cancer patients' leukocyte before and after radiotherapy. Materials and Methods : From Dec. 1994 to Mar 1995, the changes of leukocyte and its subsets in 16 patients who received radiotherapy in the Dept. of Radiation Oncology of Dong-A University Hospital were investigated. Radiation was delivered from 2700 cGy to 6660 cGy with median dose of 5400 cGy. The results of pre- and Post-radiotherapy were analyzed by paired T-test. The results of patients Who received < 50 Gy and $\geq$ 50 Gy were analyzed by Wilcoxon test. Results : Before and after radiotherapy, there was not any significant differences in the counts of leukocyte, granulocyte and monocyte. A remarkable decrease was noted in lymphocyte counts after radiotherapy(p=0.015). T cells, B cells and natural killer cells were also decreased in number after radiotherapy but it was not significant statistically. 1 helper cells and T suppressor cells were also decreased in number(p>0.05). The ratio of T helper/suppressor cell was decreased from 1.52 to 1, 11 and it was significant statistically(p=0.016). The portion of T suppressor cell among all T cells was increased after radiotherapy (p=0.0195). No significant difference was observed in the analysis of leukocyte and its subsets between patients who received < 50 Gy and $\geq$ 50 Gy, Conclusion : Radiotherapy caused remarkable decrease in lymphocyte count and its subsets. Among all lymphocyte subsets, T helper cell might be the most vulnerable to radiation, considering decreased ratio of T helper/suppressor cell count after radiotherapy.
Lee, Seung Min;Oh, Yoon Jung;Jun, Yong Hoon;Hong, Young Jin;Son, Byong Kwan;Kim, Soon Ki;Han, Jee Young;Chu, Young Chae
Clinical and Experimental Pediatrics
/
v.49
no.2
/
pp.167-172
/
2006
Purpose : Palpable lymph nodes are common in the pediatric population, and most of them are either inflammatory or congenital. As the diagnostic evaluation, fine needle aspiration cytology (FNAC) is known to be more convenient and economical than tissue biopsy. We evaluated the usefulness of FNAC in children and adolescents. Methods : Four hundred and thirteen FNAC samples(M : F=1 : 1.15) were retrospectively analyzed in patients who were brought to Inha University Hospital, from August 1999 to August 2004. Results : The most common age group was 16-20 years of age(N=148, 35.8 percent). The cervical area was the most frequently involved site(N=310, 75 percent). Non-specific lymphadenitis was the most common(N=227, 54.9 percent), followed by the benign neoplasm(N=59, 14.2 percent). Malignant tumors were 18 cases(4.3 percent), and congenital diseases were found in 10 cases(2.4 percent). In inflammatory lesions, tuberculous lymphadenitis(N=22, 5.3 percent) was the most common with a histologic sensitivity of 90.9 percent. The peripheral blood and serologic studies were non-specific. Fifty nine percent(N=244) of lymphadenitis improved without specific management. Antibiotics were prescribed in 15.2 percent of lymphadenitis and lymphadenectomy was performed in 12.6 percent. Conclusion : Most of the enlarged lymph nodes in children and adolescents were benign. These results show FNAC is a safe, rapid and reliable diagnostic procedure for the appropriate differential diagnosis of enlarged lymph nodes in children and adolescents.
Journal of the Korean Academy of Child and Adolescent Psychiatry
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v.5
no.1
/
pp.108-117
/
1994
Twenty nine children with autism and thirty children with mental retardation were examined for association between autism and chromosomal disorders including fragile X. The peripheral blood was cultured in Medium 199 with methotrexate and without methorexate for 70 hours. Thirty metaphase cells in each case were karyotyped in all samples. Chromosomal abnormalities were found in 11 cases(37.9%) of autistic disorder and 10 cases (33.3%) of mental retardation, but in none of fragile(X)(q27.3) from all cases. Chromosomal abnormalities were present on group A, C, D and X in autistic disorder and on group A, B, C, D, E and X in mental retardation. No specific chromosomal region was found in both autistic disorder and mental retardation. Types of chromosomal disorders were only fragile and/or gap but no numerical abnormality was present in all cases. Number of cells which revealed fragile sites were 31 cells(3.6%) out of 870 cells in autistic disorder and 29 cells(3.2%) out of 900 cells in mental retardation Number of cells which revealed gaps were 43 cells(4.9%) out of 870 cells in autistic disorder and 35 cells(3.9%) out of 900 cells in mental retardation. Autistic disorder may not be directly correlated with fragile X but with nonspecific chromosomal breakages from these data.
GRP was known as the modulator of Pain transmission in central nervous system and local effector to peripheral tissue causing vasodilation, increased blood flow, modulation of immune sysem, stimulation of endothelial cell proliferation, and stimulation of bone formation. Numerous study, therefore, were done to elucidate involvement of CGRP to tooth movement. To investgate the response of CGRP immunoreactive nerve cells according to cell size in trigeminal ganglion during tooth movement, immunohistochemical study was performed using rat. Experimental rats(9 weeks old, 210 gm) were divided as six groups(normal(n=6), 3 hour group(n=5), 12 hour group(n=4), 1 day group(n=5), 3 day group(n=5), 7 day group(n=5)), and were applied orthodontic force (approximately 30 gm) to upper right maxillary molar. After frozen sections of trigeminal ganglions were immunostained using rabbit antisera, the changes of CGRP immunoreactive cells in regard to cell size distribution(small cell(upto $20{\mu}m$), medium cell($20-35{\mu}m$), large cell(above $35{\mu}m$)) were observed. The results were as follows 1. The percentage of CGRP immunoreactive cells to all nerve cells in trigeminal ganglion was 33.0% in normal control group, was decreased to 24.5% in 1 day group, and was increased to 41.8% in 7 day group. 2. The percentage of small, medium, and large cells expressing CGRP immunoreactivity in normal trigeminal ganglion to all CGRP immunoreactive cells were 51.3%, 44.0%, 4.7%, respectively. 3. The percentage of small cells with CGRP immunoreactivity to all CGRP immunopositive cells was increased in 3 hour and 12 hour groups. 4. The percentage of medium cells with CGRP immunoreactivity was increaed in 3 day and 7 day groups. 5. The percentage of large cells with CGRP immunoreactivity was increaed in 7 day group. Conclusively, the small cells with CGRP immunoreactivity in trigeminal ganglion respond to orthodontic force during initial phase of tooth movement, and later the medium and large cells with CGRP immunoreactivity respond
Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.
The purposes of this research were to evaluate the relationships of between characteristics of noise and annoyance of dental hygienist by noise in dental clinic. To investigate the dental clinic workers' reactions to noise when occurred in dental clinic, the noise level test in dental clinic and questionnaire were taken. As a result of noise evaluation, It shows that the range of noise level was 67.7~78.3dB(A) and frequency was very high (more than 4KHz). It's seem to be begins occurrence of stamina-loss, contraction of peripheral blood vessel, decrease of adrenocortical hormones. Most of respondents were affected by noise: 67% of respondents were nervous about noise and the rest of respondents were bearable. Analysis by NR-curve showed that it was exceed the noise permit level in working space. As a result of correlation - test, the more exposed dental hygienist to noise, the more felt the unpleasantness and fatigue. It's hard to sufficient explanation to patients about the dental treatment. So it's thoughts that insufficient explanation will negative impact on the patients' satisfaction and increase competitiveness in dental clinics. To remedy a unpleasantness and fatigue of noise in dental hygienist, it's considered that making an offer the ear protection and choosing the low noise-vib. equipment and using the masking effect. Therefore, It can be provide a pleasant working environment with dental hygienist and It will have a great advantage to dental clinics to improve their competitiveness.
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