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Eight Year Survival Analysis of Patients with Triple Negative Breast Cancer in India

  • Doval, Dinesh Chandra;Suresh, P;Sinha, Rupal;Azam, Saud;Batra, Ullas;Talwar, Vineet;Kumar, Kapil;Mehta, Anurag
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2995-2999
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    • 2016
  • Background: Triple-negative breast cancer (TNBC) often presents as an interval cancer with short survival upon metastasis and thus represents an important clinical challenge. The present study investigated the clinicopathologic characteristics and long term survival outcome of early and locally advanced TNBC. Materials and Methods: Medical records were reviewed retrospectively for 148 consecutive confirmed cases of TNBC treated in a single unit at our centre. Demographic profile, tumor type, histopathology details, treatment and follow-up information was recorded and immunohistochemistry was performed. Results: Age group >50 years was associated with tumors of clinical stage 3 (53.8%), pathological stage 3 (46.2%), pathological grade 3 (45.7%), presence of extracapsular extension (ECE, 48.5%) and lymphovascular invasion (LVI, 64.9%). Locally advanced breast cancers (LABCs) were characterized by pathological stage 3 (96.2%), presence of ECE (100%) and absence of LVI (46.7%) as compared to early breast cancers (EBCs) which had higher incidence of lower stage tumors (100%), absence of ECE (82%) and presence of LVI (91.9%; p-value <0.001. Better relapse free survival was observed in patients with no axillary involvement (69%; p-value <0.001) and absence of ECE (64%; p-value <0.001). Improved overall survival was seen in patients with EBC (90%; p-value 0.008), clear axilla (86%; p-value <0.001), absence of ECE (87%; p-value <0.001) and negative lymph nodes (90%; p-value 0.006). Conclusions: TNBCs are aggressive tumors which show poor long term survival. Patients with TNBC benefit from chemotherapy, thus better and less toxic treatment options are needed. Identification of newer targets and development of targeted therapies are the need of the hour.

A Case of Congenital Lacrimal Ductule Fistula on Lateral Skin to the Right Upper Eyelid (우측 윗눈꺼풀 외측 피부에서 발견된 선천 눈물샘소관 샛길 1예)

  • Han, Ga Hee;Chung, In Kwon;Lee, Do Hyung;Kim, Jin Hyoung;Seo, Ji Won
    • Journal of The Korean Ophthalmological Society
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    • v.59 no.12
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    • pp.1181-1184
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    • 2018
  • Purpose: To present a rare case of tear drainage since birth from a lacrimal ductule fistula, which is the first report in the Republic of Korea. Case summary: A 3-month-old female who presented with discharge of clear fluid from a small skin opening lateral to the right upper eyelid since birth visited the outpatient clinic. The patient was healthy and was receiving no medication. She was born on gestation age 35 weeks and 3 days. No other specific history or other ophthalmic abnormality was found. On examination, a small skin orifice approximately 2 mm diameter and no sign of infection or discoloration was observed. To relieve this symptom, the patient underwent a fistulectomy under general anesthesia. Histopathological examination of the surgical specimen was performed. The patient's symptom subsided postoperatively without recurrence. Conclusions: This is the first report in the Republic of Korea of tears draining from a lacrimal ductule fistula since birth and the subsequent clinical treatment procedures.

Pollen analysis of alpine wetlands on Mt. Jeombong in Gangwon-do, South Korea and climate change during the late Holocene (점봉산 고산습지의 화분분석과 홀로세 후기 기후변화)

  • Yoon, Soon-Ock;Kim, Minji;Hwang, Sangill
    • Journal of The Geomorphological Association of Korea
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    • v.20 no.4
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    • pp.101-115
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    • 2013
  • 11 alpine wetlands at the upper reaches of Bangtae River on a high flat summit around Mt. Jeombong were found. Two core samples(JB-1 and JB-2) among them were collected in order to reconstruct paleovegetation history and climate change using pollen analysis. Pinus and Quercus dominated at the wetland of JB-2 with a deep water depth were developed from 1,700 yr BP to 1,000 yr BP of the pollen zone I. Subsequently Quercus dominated in the pollen zone II from 1,000 to 400 yr BP, and it is supposed that warm weather prevailed with oak climax forest corresponding to the Medieval Warm Period. Moreover, sphagnum grew densely in the alpine wetlands and the wetlands were extended widely on the summit around Mt. Jeombong with the beginning of subzoneIIc at JB-2. The pollen zone III from 400 yr BP to the present with an increase in Pinus and a decrease in Quercus suggests cold climates under the Little Ice Age. Moreover, human disturbances at JB-2 were more significant than those at JB-1, based on the increase in Pinus.

Health Inequalities among the Elderly : Mediation Effect of Social Participation Between Educational Level Inequalities and Self-rated Health·Depression (노인의 건강불평등 : 교육불평등에 따른 건강불평등에 대한 사회참여의 매개효과)

  • Kim, Dongbae;Yoo, Byungsun;Lee, Jeongeun
    • Korean Journal of Social Welfare Studies
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    • v.43 no.1
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    • pp.117-142
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    • 2012
  • This research attempts to explain the influence of educational level inequalities on self-rated health and depression of the elderly. Also, we are focusing whether there is a mediating effect of social support between educational level inequalities and self-rated health depression of the elderly. The data was collected from July, 30 to August, 15, 2009. 631 persons who live in Gangnam-Gu area over 60 years of age were recruited. Frequency, percentage, mean, standard deviation and multiple regression were employed using SPSS 12.0. The result of this study shows that educational level inequalities have a influence on the self-rated health and depression. It is also verified that social participation variable has a partial mediating effect between educational level inequalities and mental health(self-rated health and depression). This study carried out a positive linear relationship between educational level and health: the higher education, the better the health. And also, the results present the importance of developing adequate intervention programs for the elderly having low educational level to improve social participation and to enhance mental health(self-rated health and depression).

Review on Marine Terraces of the East Sea Coast, South Korea : Gangreung - Busan (강릉-부산 간 동해안 해안단구 검토)

  • Choi, Sung-Ja
    • Economic and Environmental Geology
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    • v.52 no.5
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    • pp.409-425
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    • 2019
  • Marine terraces, a step-like landform, are important geologic markers that provide tectonic information during the Quaternary Period. Marine terraces are well developed along all coastlines(East, West, and South) of the Korean Peninsula, those along the East coastline are the most distinctive. The marine terraces of the East coastline are classified into 4-6 flights that are several meters or several tens of meters above the present sea level. It is believed that these terraces, except for the lowest one, were formed in the middle Pleistocene. In the base of the OSL age dating results and Blake excursion events of magnetostratigraphy, the $2^{nd}$ and $3^{rd}$ terraces are correlated to the last interglacial stage. Considering the marine terraces linked to a sea-level curve of the Pleistocene, it is thought that regional tectonic movements have uplifted the East coastal area since the middle Pleistocene. Besides, former shorelines of each terrace have varied elevations from Gangreung to Busan bay, which can be divided into four regions, namely, Gangreung-Yonghanri(I), Homikot-Najung(II), Najung-Bangeojin(III), and Waesung-Busan Bay(IV). The former shorelines of each terrace at both Gangreung-Yonghanri(I) and Najung-Bangeojin(III) are higher than those in the other two regions, due to block movements by regional faults such as the Ocheon Fault or its subsidiaries, the Gampo Lineament and Ulsan Fault. Uplift rate of the East coast ranges from 0.2 m/ky to 0.3 m/ky, but each region shows different uplift rate.

Effectiveness of Intravenous Immunoglobulin Therapy in Women with Recurrent Spontaneous Abortions and Elevated Pre-conceptional Peripheral Blood CD56+ Natural Killer Cell Percentage (말초 혈액 CD56+Natural Killer Cell 증가에 기인한 습관성 유산 환자에서 정맥 내 면역글로블린 치료의 효과에 관한 연구)

  • Cha, Sun Hwa;Park, Chan Woo;Kim, Hae Suk;Cho, Dong Hee;Kim, Jin Young;Kang, Inn Soo;Koong, Mi Kyoung;Yang, Kwang Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.2
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    • pp.165-170
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    • 2005
  • Objective: The aim of present study was to evaluate the effectiveness of low-dose intravenous immunoglobulin (IVIg) therapy in women with recurrent spontaneous abortions (RSA) and elevated pre-conceptional peripheral blood CD56+Natural Killer (NK) cell percentage. Study Design: Retrospective case control study. Materials and Methods: Thirty three women with RSA and elevated pre-conceptional peripheral blood CD56+NK cell percentage who had received low-dose IVIg therapy (400 mg/kg per day, every 4 week, until 20 gestational weeks) were included in this study. Controls were nine women with RSA and elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage who had not received IVIg therapy were included in this study. Medical records of study and control groups were retrospectively analyzed and we compared the successful pregnancy outcomes between two groups. Successful pregnancy outcome was defined as pregnancy ongoing beyond 25 gestational weeks. Results: Age, number of previous abortions, pre-conceptional CD56+NK cell percentage and type of RSA were not statistically different between two groups. Otherwise, twenty-five women who received IVIg therapy (25/33, 75.8%) but, only three women who had not received (3/9, 33.3%) had a successful pregnancy outcome and the rate difference between two groups was statistically significant. Conclusion: Based on our study, low-dose IVIg therapy have a effective role in treatment of RSA patients with elevated pre-conceptional peripheral blood CD56+ Natural Killer (NK) cell percentage, but more larger scaled prospective study is needed for available of conclusive evidence.

Bioequivalence Test of Gabapentin 400 mg Capsules (가바펜틴 400밀리그람 캡슐의 생물학적동등성시험)

  • Kim, Se-Mi;Kang, Hyun-Ah;Cho, Hea-Young;Shin, Sae-Byeok;Yoo, Hee-Doo;Yoon, Hwa;Lee, Yong-Bok
    • YAKHAK HOEJI
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    • v.52 no.3
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    • pp.195-200
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    • 2008
  • Gabapentin, [1-(aminomethyl) cyclohexaneacetic acid], a structural analog of $\gamma$-aminobutyric acid (GABA), is being developed for the treatment of epilepsy. Unlike GABA, gabapentin crosses the blood-brain barrier after systemic administration. Gabapentin is an effective antiepileptic drug in patients with partial and secondarily generalized seizures who are uncontrolled with use of existing anticonvulsant drug therapy. The purpose of the present study was to evaluate the bioequivalence of two gabapentin 400 mg capsules, $Neurontin^{(R)}$ capsule 400 mg (Pfizer Inc.) and Gabatin capsule 400 mg (Korean Drug Co. Ltd), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of gabapentin from the two gabapentin formulations in vitro was tested using KP VIII Apparatus II method with various dissolution media (pH 1.2, 4.0, 6.8 buffer solution and water). Twenty six healthy male subjects, 23.58$\pm$1.50 years in age and 66.74$\pm$8.31 kg in body weight, were divided into two groups and a randomized 2$\times$2 cross-over study was employed. After one capsule containing 400 mg as gabapentin were orally administered, blood was taken at predetermined time intervals and the concentrations of gabapentin in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar at all dissolution media. In addition, the pharmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Neurontin^{(R)}$ capsule 400 mg, were 2.04, -3.68 and 16.79% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.91$\sim$log 1.16 and log 0.87$\sim$log 1.11 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Gabatin capsule 400 mg was bioequivalent to $Neurontin^{(R)}$ capsule 400 mg.

Bioequivalence Test of Fexofenadine Hydrochloride 120 mg Tablets (염산펙소페나딘 120밀리그람 정제의 생물학적동등성시험)

  • Cho, Hea-Young;Kang, Hyun-Ah;Kim, Se-Mi;Lee, Yong-Bok
    • YAKHAK HOEJI
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    • v.52 no.3
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    • pp.188-194
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    • 2008
  • Fexofenadine, ($\pm$)-4-1-hydroxy-4-{4-(hydroxydiphenylmethyl)-1-piperidinyl}-butyl-a,a-dimethyl benzeneacetic acid, is a selective histamine $H_1$ receptor antagonist, and is clinically effective in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria as a first-line therapeutic agent. The purpose of the present study was to evaluate the bioequivalence of two fexofenadine hydrochloride tablets, $Allegra^{(R)}$ (Handok Pharmaceuticals Co., Ltd.) and Alecort (Samchundang Pharmaceutical Co., Ltd.), according to the guidelines of the Korea Food and Drug Administration (KFDA). The release of fexofenadine from the two fexofenadine hydrochloride formulations in vitro was tested using KP VIII Apparatus II method with various dissolution media. Twenty six healthy male subjects, 25.62$\pm$3.35 years in age and 70.05$\pm$11.71 kg in body weight, were divided into two groups and a randomized 2$\times$2 cross-over study was employed. After a single tablet containing 120 mg as fexofenadine hydrochloride was orally administered, blood samples were taken at predetermined time intervals and the concentrations of fexofenadine in serum were determined using HPLC with fluorescence detector. The dissolution profiles of two formulations were similar in all tested dissolution media. The harmacokinetic parameters such as $AUC_t$, $C_{max}$ and $T_{max}$ were calculated, and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed $AUC_t$, $C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the reference drug, $Allegra^{(R)}$, were -1.37, 5.22 and 16.50% for $AUC_t$, $C_{max}$ and $T_{max}$, respectively. There were no sequence effects between two formulations in these parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log 0.8 to log 1.25 (e.g., log 0.83$\sim$log 1.08 and log 0.81$\sim$log 1.03 for $AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA bioequivalence guideline were satisfied, indicating Alecort tablet was bioequivalent to $Allegra^{(R)}$ tablet.

Sudden Deafness (돌발적난청)

  • 조중환;류태현
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1976.06a
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    • pp.85.3-86
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    • 1976
  • Sudden deafness requires immediate investigation and treat if there is to be any prospect of salvaging the hearing. It present an otological emergency and a diagnostic challenge. Sn Sudden sensorineural deafness can be caused by a wide variety of pathologies. A battery of tests and investigations must be performed forthwith if treatment is to be started without further delay. The concept that nothing can be done for the patient with sensori-neural deafness must be abandoned. Some pathologies causing sudden deafness are not amenable to therapy or can show only partial reversibility. But there are several causes, showing little or no spontaneous recovery, which do responed to appropriate treatment. It is important to identify them and concentrate on their management. The age and sex ratios and the unilaterral or bilateral nature of the lesion are related to the etiology and depend upon which type of case is included in the series. Though individually rare, collecting for about 2.5 per cent of new otoloical patients. Some 70 per cent of cases are unilateral. Viral, bacterial and treponemal infections accounted for about 30 per cent of the cases. Some 16 per cent were due to vascular lesions of the cochlea. In almost 22 per cent there was no obvious cause (idiopathic), they occurred in young adult and were either sensory or neural. About 12 per cent were traumatic and 9 per cent were ototoxic in origin. The remaining 11 per cent were due to a group of rarities. The two vital factors are the site of the lesion and the duration of the hearing loss. The earlier these are diagnosed and treated the better the response. The etiology, pathology and treatment are reviewed.

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A Study on Middle and High School Girl Students' Menstruation Characteristics and their Menstruation Dysmenorrhea (중.고등학교 여학생의 월경 특성과 월경곤란증에 관한 연구)

  • Park, Young-Soo;Hong, Sun-Sim
    • The Journal of Korean Society for School & Community Health Education
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    • v.4
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    • pp.97-115
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    • 2003
  • Middle and high school girl students' menstruation characteristics, appearance of menstruation dysmenorrhea, and coping with the menstruation dysmenorrhea were examined in order to give information in instructing girl students about menstruation dysmenorrhea, in delivering health education in the school, and establishing health policy. 970 girl students in middle and high schools in Cheju-do were selected and surveyed using the questionnaire the author developed based on the previous studies. The findings are as follows. First, the age of first menstruation was average $12.9{\pm}1.22$ years. The younger they were, the earlier their first menstruation came. The most common menstrual cycle was such one that continuously irregular from the beginning or that regular and irregular cycle run together. The first irregular menstrual cycle changed regular one within 1 or 2 years. Most of the respondents had normal menstrual cycle of $21{\sim}35$ days and menstruation period of $3{\sim}8$ days. Second, symptom of menstruation dysmenorrhea was orderly; hurt in the underbelly, tired, hurt in the waist, and headache. It was higher with high school students than middle school students. For the most part, time of heavy menstruation dysmenorrhea was the 2nd day after menstruation starts and period of menstruation dysmenorrhea was 2 days. More than the half of the respondents felt that the present menstruation dysmenorrhea was similar with the first one and they felt not comport in daily life due to menstruation dysmenorrhea, and 'hard to live a normal life' was higher with the high school girl students than with the middle school students. Third, how to cope with menstruation dysmenorrhea was enough sleep, relax and rest, taking a hot water shower, listening to music or watching a movie, taking medicine, and doing excercise. Few of the respondents have ever visited a doctor due to menstruation dysmenorrhea, and the reason was mostly irregular menstruation and heavy dysmenorrhea. Forth, when they took medicine due to menstruation dysmenorrhea, they gathered information on the medicine from family members and friends, while extremely low from a pharmacist or a doctor. The most of them have ever took medicine during menstruation once and took standard dose. While excess dosage was higher with high school students than with middle school students. From these findings, a good many girls are experiencing menstruation dysmenorrhea since their first menstruation. To discover early the severely abnormal findings and to treat, more interest from home and school, counseling and sexual education on time, and expert's diagnosis are necessary. Rather than unconditionally taking pain-relievers which can plainly solve the pain, continuous health education at home and in the school should be carried on for the girls to practice proper measures one think effective or an expert recommends.

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