• Title/Summary/Keyword: q-difference

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The aesthetics of irony in repetition and the difference of Oh! Soojung (<오! 수정>의 아이러니 미학 - 반복과 차이의 구조를 중심으로)

  • Suh, MyungSoo
    • 기호학연구
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    • no.57
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    • pp.121-153
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    • 2018
  • In terms of the story told, we see that Oh! Soojung(Virgin Stripped Bare by Her Bachelors) is a film of the ideololgy of masculinity. However, from the point of view of the manner of presenting story, Oh! Soojung is a film that aims to devalue this ideology. How will it be possible? This is the principle of the irony that the speaker, by saying P, wants to make Q listen that devalues and contradicts P. Our study is tempted to explain the process of interpreting the irony in the film. The ideology of the film occurs when the presupposed contents have become the subject. For example Cendrion who tells a story of a girl married to a prince presupposes that the girl, Cendrion, is obedient. The subject of this story is that the presupposition: /the girls who want to be happy must be obedient/, which represents the ideology of masculinity. Presupposed content thus imposes on the public a collective and conservative value, as its enunciator belongs to the collective voice. Since ironisation occurs when the utterance itself is annulled, one must also deny or cancel the story told of Oh! Soojng: /Jeahun who is rich and Soojung who is obedient and virgin have become lovers/. Since there is no semantic mark within the utterance, irony is a voice that comes from without; this is how we understand irony in a purely pragmatic way. The outer voices are two things: the way to build the story: question of focusing, ocularization and auricularization, and the way to present the story: question the order, the frequency or the plot. Our study is focused on the question of frequency at Oh! Soojung which has a repetition structure in which the memory of Jeahun and that of Soojung are represented one after the other. Since the memories of two characters are not identical, the repetition is accompanied by differences. The differences at first allow the public to build their own story from the di?g?se of the film and then make the audience fall into confusion where we can not be certain of what we see and know in the di?g?se of the film, and finally make their knowledge questionable. About repetition, so that it can have validity in terms of the informativeness of the utterance, it must deny the existence of the previous repetition. This is how repetition cancels itself and consequently the utterance. We see that the irony of Oh! Soojung occurs by repetition with differences that cancels the story of the film.

Quantitative Electroencephalogram Markers for Predicting Cerebral Amyloid Pathology in Non-Demented Older Individuals With Depression: A Preliminary Study (비치매 노인 우울증 환자에서 대뇌 아밀로이드 병리 예측을 위한 정량화 뇌파 지표: 예비연구)

  • Park, Seon Young;Chae, Soohyun;Park, Jinsick;Lee, Dong Young;Park, Jee Eun
    • Sleep Medicine and Psychophysiology
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    • v.28 no.2
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    • pp.78-85
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    • 2021
  • Objectives: When elderly patients show depressive symptoms, discrimination between depressive disorder and prodromal phase of Alzheimer's disease is important. We tested whether a quantitative electroencephalogram (qEEG) marker was associated with cerebral amyloid-β (Aβ) deposition in older adults with depression. Methods: Non-demented older individuals (≥ 55years) diagnosed with depression were included in the analyses (n = 63; 76.2% female; mean age ± standard deviation 73.7 ± 6.87 years). The participants were divided into Aβ+ (n = 32) and Aβ- (n = 31) groups based on amyloid PET assessment. EEG was recorded during the 7min eye-closed (EC) phase and 3min eye-open (EO) phase, and all EEG data were analyzed using Fourier transform spectral analysis. We tested interaction effects among Aβ positivity, condition (EC vs. EO), laterality (left, midline, or right), and polarity (frontal, central, or posterior) for EEG alpha band power. Then, the EC-to-EO alpha reactivity index (ARI) was examined as a neurophysiological marker for predicting Aβ+ in depressed older adults. Results: The mean power spectral density of the alpha band in EO phase showed a significant difference between the Aβ+ and Aβ- groups (F = 6.258, p = 0.015). A significant 3-way interaction was observed among Aβ positivity, condition, and laterality on alpha-band power after adjusting for age, sex, educational years, global cognitive function, medication use, and white matter hyperintensities on MRI (F = 3.720, p = 0.030). However, post-hoc analyses showed no significant difference in ARI according to Aβ status in any regions of interest. Conclusion: Among older adults with depression, increased power in EO phase alpha band was associated with Aβ positivity. However, EC-to-EO ARI was not confirmed as a predictor for Aβ+ in depressed older individuals. Future studies with larger samples are needed to confirm our results.

Anatomical Studies on Root Formation in Hypocotyl and Epicotyl Cuttings of Woody Plants (임목(林木)의 배축(胚軸) 및 유경삽수발근(幼茎揷穗発根)의 해부학적(解剖学的) 연구(研究))

  • Choi, Man Bong
    • Journal of Korean Society of Forest Science
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    • v.52 no.1
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    • pp.1-30
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    • 1981
  • The origin and development of adventitious roots was studied using hypocotyl and epicotyl cuttings of 34 species, 24 genus of woody plants. These cuttings obtained from young seedlings cultured in vials containing distilled water only. The several characteristics of cuttings materials studied are shown in Table 1. The results are summerized as follows: 1. The circumference shapes of cross-sections of hypocotyl and epicotyl cuttings can be divided into six categories, namely, round, irregular round, ellipse, irregular ellipse, square, and triangle. Species differences within a genus did not show any difference of hypocotyl and epicotyl cross-sections shape, however, a noticeable variation among genus or higher taxa. 2. The arrangements of vascular bundles in the cross-sections of hypocotyls or epicotyls were almost all collateral types and generally showed generic characteristics differing one to the other. However, there were some variations between species within the genus. Six models of vascular bundle arrangement were proposed for all the above speices. 3. The rooting portions of hypocotyl and epicotyl cuttings in this experimental materials can be grouped as follows: (1) Interfascicular parenchyma; (Thuja orientalis. T. orientalis for. sieboldii, Acer microsieboldianum, A. palmatum, A. saccharinum, Cercis chinensis, Lespedeza bicolor, Magnolia obovata, M. sieboldii, Mallotus japonicus, Staphylea bumalda) (2) Cambial and phloem parenchyma: (Chamaecyparis obtusa, C. pisifera, Albizzia julibrissin, Buxus microphylla var. Koreana, Cereis chinensis, Euonymus japonica, Firmiana platanifolia, Lagerstroemia indica, Ligustrum salicinum, L. obtusifolium, Magnolia kobus, M. obovata, Mallotus japonicus, Morus alba, Poncirus trifoliata, Quercus myrsinaefolia, Rosa polyantha, Styrax japonica, Styrax obassia) (3) Primary ray tissues; (Euonymus japonica, Styrax japonica) (4) Leaf traces; (Quercus acutissima, Q. aliena) (5) Cortex parenchyma; (Ailanthus altissima) (6) Callus tissues; (Castanea crenata, Quercus aliena, Q. myrsinaefolia, Q. serrata) 4. As a general tendency throughout the species studied, in hypocotyl cuttings, the adventitious root primordia were originated from the interfascicular parenchyma tissue, however, leaf traces and callus tissues were contributed to the root primordia formation in epicotyl cuttings. The hypocotyl cuttings of Ailanthus altissima exhibited a special performance in the root primordia formation, this means that cortex parenchyma was participated to the origin tissue. And in Firmiana platanifolia, differening from the other most species, the root primordia were formed at the phloem parenchyma adjacent outwardly to xylem tissue of vascular bundle system as shown photo. 48. 5. All the easy-to, or difficult-to root species developed adventitious roots in vials filled with distilled water. In the difficult-to-root species, however, root formations seemed to be delayed because they almost all had selerenchyma or phloem fiber which gave some mechanical hindrance to protrusion of root primordia. On the other hand, in the easy-to-root species they seemed to form them more easily because they did not have the said tissues. The rooting portions between easy-to-root and difficult-to-root species have not clearly been distinguished, and they have multitudinous variations. 6. The species structured with the more vascular bundles in number compared with the less vascular bundles exhibited delayed rooting. In the cuttings preparation, the proximal end of cuttings was closer to root-to-stem transition region, the adventitious root formation showed easier. 7. A different case occured however with the mature stem cuttings, in both the needle-leaved and the broad-leaved species. In the hypocotyl cuttings, parenchymatous tissues sited near the vascular bundles become the most frequent root forming portions in general and relevant distinctions between both species were hardly recognizable. 8. In the epicotyl cuttings, root primordia originated mainly in leaf traces in connection with cambial and phloems or callus tissues itself. In the hypocotyl cuttings, interfascicular parenchyma was the most frequent portion of the root primordia formation. The portions of root primordia had more connection with vascular cambium system, as the tissues were continuing to be developed.

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A study of the plan dosimetic evaluation on the rectal cancer treatment (직장암 치료 시 치료계획에 따른 선량평가 연구)

  • Jeong, Hyun Hak;An, Beom Seok;Kim, Dae Il;Lee, Yang Hoon;Lee, Je hee
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.2
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    • pp.171-178
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    • 2016
  • Purpose : In order to minimize the dose of femoral head as an appropriate treatment plan for rectal cancer radiation therapy, we compare and evaluate the usefulness of 3-field 3D conformal radiation therapy(below 3fCRT), which is a universal treatment method, and 5-field 3D conformal radiation therapy(below 5fCRT), and Volumetric Modulated Arc Therapy (VMAT). Materials and Methods : The 10 cases of rectal cancer that treated with 21EX were enrolled. Those cases were planned by Eclipse(Ver. 10.0.42, Varian, USA), PRO3(Progressive Resolution Optimizer 10.0.28) and AAA(Anisotropic Analytic Algorithm Ver. 10.0.28). 3fCRT and 5fCRT plan has $0^{\circ}$, $270^{\circ}$, $90^{\circ}$ and $0^{\circ}$, $95^{\circ}$, $45^{\circ}$, $315^{\circ}$, $265^{\circ}$ gantry angle, respectively. VMAT plan parameters consisted of 15MV coplanar $360^{\circ}$ 1 arac. Treatment prescription was employed delivering 54Gy to recum in 30 fractions. To minimize the dose difference that shows up randomly on optimizing, VMAT plans were optimized and calculated twice, and normalized to the target V100%=95%. The indexes of evaluation are D of Both femoral head and aceta fossa, total MU, H.I.(Homogeneity index) and C.I.(Conformity index) of the PTV. All VMAT plans were verified by gamma test with portal dosimetry using EPID. Results : D of Rt. femoral head was 53.08 Gy, 50.27 Gy, and 30.92 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. D of Rt. aceta fossa was 54.86 Gy, 52.40 Gy, 30.37 Gy, respectively, in the order of 3fCRT, 5fCRT, and VMAT treatment plan. Likewise, Lt. Femoral head showed average 53.68 Gy, 51.01 Gy and 29.23 Gy in the same order. The maximum dose of both femoral head and aceta fossa was higher in the order of 3fCRT, 5fCRT, and VMAT treatment plan. C.I. showed the lowest VMAT treatment plan with an average of 1.64, 1.48, and 0.99 in the order of 3fCRT, 5fCRT, and VMAT treatment plan. There was no significant difference on H.I. of the PTV among three plans. Total MU showed that the VMAT treatment plan used 124.4MU and 299MU more than the 3fCRT and 5fCRT treatment plan, respectively. IMRT verification gamma test results for the VMAT plan passed over 90.0% at 2mm/2%. Conclusion : In rectal cancer treatment, the VMAT plan was shown to be advantageous in most of the evaluation indexes compared to the 3D plan, and the dose of the femoral head was greatly reduced. However, because of practical limitations there may be a case where it is difficult to select a VMAT treatment plan. 5fCRT has the advantage of reducing the dose of the femoral head as compared to the existing 3fCRT, without regard to additional problems. Therefore, not only would it extend survival time but the quality of life in general, if hospitals improved radiation therapy efficiency by selecting the treatment plan in accordance with the hospital's situation.

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Comparison of Naphthalene Degradation Efficiency and OH Radical Production by the Change of Frequency and Reaction Conditions of Ultrasound (초음파 주파수 및 반응조건 변화에 따른 나프탈렌 분해효율과 OH 라디칼의 발생량 비교)

  • Park, Jong-Sung;Park, So-Young;Oh, Je-Ill;Jeong, Sang-Jo;Lee, Min-Ju;Her, Nam-Guk
    • Journal of Korean Society of Environmental Engineers
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    • v.31 no.2
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    • pp.79-89
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    • 2009
  • Naphthalene is a volatile, hydrophobic, and possibly carcinogenic compound that is known to have a severe detrimental effect to aquatic ecosystem. Our research examined the effects of various operating conditions (temperature, pH, initial concentration, and frequency and type of ultrasound) on the sonochemical degradation of naphthalene and OH radical production. The MDL (Method detection limit) determined by LC/FLD (1200 series, Agilient) using C-18 reversed column is measured up to 0.01 ppm. Naphthalene vapor produced from ultrasound irradiation was detected under 0.05 ppm. Comparison of naphthalene sonodegradion efficiency tested under open and closed reactor cover fell within less than 1% of difference. Increasing the reaction temperature from $15^{\circ}C$ to $40^{\circ}C$ resulted in reduction of naphthalene degradation efficiency ($15^{\circ}C$: 95% ${\rightarrow}$ $40^{\circ}C$: 85%), and altering pH from 12 to 3 increased the effect (pH 12: 84% ${\rightarrow}$pH 3: 95.6%). Pseudo first-order constants ($k_1$) of sonodegradation of naphthalene decreased as initial concentration of naphthalene increased (2.5 ppm: $27.3{\times}10^{-3}\;min^{-3}\;{\rightarrow}$ 10 ppm : $19.3{\times}10^{-3}\;min^{-3}$). Degradation efficiency of 2.5 ppm of naphthalene subjected to 28 kHz of ultrasonic irradiation was found to be 1.46 times as much as when exposed under 132 kHz (132 kHz: 56%, 28 kHz: 82.7%). Additionally, its $k_1$ constant was increased by 2.3 times (132 kHz: $2.4{\times}10^{-3}\;min^{-1}$, 28 kHz: $5.0{\times}10^{-3}\;min^{-1}$). $H_2O_2$ concentration measured 10 minutes after the exposure to 132 kHz of ultrasound, when compared with the measurement under frequency of 28 kHz, was 7.2 times as much. The concentration measured after 90 minutes, however, showed the difference of only 10%. (concentration of $H_2O_2$ under 28 kHz being 1.1 times greater than that under 132 kHz.) The $H_2O_2$ concentration resulting from 2.5 ppm naphthalene after 90 minutes of sonication at 24 kHz and 132 kHz were lower by 0.05 and 0.1 ppm, respectively, than the concentration measured from the irradiated M.Q. water (no naphthalene added.) Degradation efficiency of horn type (24 kHz) and bath type (28 kHz) ultrasound was found to be 87% and 82.7%, respectively, and $k_1$ was calculated into $22.8{\times}10^{-3}\;min^{-1}$ and $18.7{\times}10^{-3}\;min^{-1}$ respectively. Using the multi- frequency and mixed type of ultrasound system (28 kHz bath type + 24 kHz horn type) simultaneously resulted in combined efficiency of 88.1%, while $H_2O_2$ concentration increased 3.5 times (28 kHz + 24 kHz: 2.37 ppm, 24 kHz: 0.7 ppm.) Therefore, the multi-frequency and mixed type of ultrasound system procedure might be most effectively used for removing the substances that are easily oxidized by the OH radical.

Advantage of Selective Release of Lateral Patellar Retinaculum (선택적 외측 슬개 지지대 이완술의 장점)

  • Son, Jung-Hwan;SaGong, Eun-Seong;Kwon, Young-Ho;Jang, Jae-Ho;Kim, Jae-Do
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.61-69
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    • 2006
  • Purpose: Open lateral release and complete lateral release have been conducted as a surgical method in patients with patellofemoral malalignment. But authors sought to find out the best method by conducting selective release, with minimal excision of the involved lesion, and comparative analyzing the result, as postoperative satisfaction and complication. Materials and Methods: Over the 68 patients of 90 cases who underwent arthroscopic release, among 94 patients of 129 cases who underwent lateral retinacular release, from January 1993 to June 1998 were followed up prospectively. A radiological evaluation of patellar inclination, patellar tilt, congruence angle, and Q-angle and a clinical evaluation of HSS-Knee score and modified patellar score were used for analysis data before operation and data at 1 year and 5 year after operation. Results: According to the radiologic evaluation, the patellar tilt and translation revealed improvement of the results, from $13.4^{\circ}$ and 12.1mm to $3.6^{\circ}$ and 3.8mm with arthroscopic lateral complete release, and from $12.3^{\circ}$ and 11.2mm to $4.8^{\circ}$ and 5.2mm with selective release, and from $13.6^{\circ}$ and 12.3mm to $3.3^{\circ}$ and 3mm with open release. But they were not significantly related to the clinical results. HSS-Knee score was 84.2%(48/57), 81.8%(27/33), 82.1%(32/39) and modified patellar score was 82.5%(47/57), 81.8%(27/33), 82.1%(32/39) respectively, which revealed satisfactory results. And no significant difference among the operative methods were shown. Conclusion: Arthroscopic lateral retinacular release which is one of the surgical method for patellofemoral malalignment enhances rehabilitation and satisfaction of the patient, by releasing the involved retinaculum within lesser surgical extent, compared to open and complete lateral release without complications such as adhesion.

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Effects of Iron from an Amino Acid Complex on the Iron Status of Neonatal and Suckling Piglets

  • Wei, K.Q.;Xu, Z.R.;Luo, X.G.;Zeng, L.L.;Chen, W.R.;Timothy, M.F.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.10
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    • pp.1485-1491
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    • 2005
  • This experiment was conducted to investigate the effects of iron from an amino acid complex (Availa-$Fe^{\circledR}$) on the iron status of neonatal and suckling piglets. A total of 24 gestating sows (Landrace${\times}$Large White) were randomly allocated to three dietary treatments. The control diet contained 80 mg $kg^{-1}$ Fe from ferrous sulfate heptahydrate ($FeSO_4$.$7H_2O$), while the two experimental diets were supplemented with an additional 120 mg $kg^{-1}$ Fe from Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$, respectively. The lactating sows remained the same iron treatments as gestating sows, while neonatal piglets of 24 litters born from the above sows were allotted to another three treatments. Piglets from the sows of the control treatment were fed basal diet with no supplemental Fe as control treatment, but were injected with 100 mg Fe as Fe dextran at birth. Piglets from the sows of Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$ treatments were supplemented with 120 mg $kg^{-1}$ iron from Availa-$Fe^{(R)}$ or $FeSO_4$.$7H_2O$, respectively. The total born alive and weaned, and the average piglets weight at birth and at weaning were not significantly affected by the sow' dietary treatments (p>0.05). Iron from Availa-$Fe^{(R)}$ did not demonstrate a statistically significant improvement in hemoglobin concentration, hematocrit and plasma iron of sows on day 90 and 105 of pregnancy and the milk iron of sows during lactation (p>0.05). Neonatal piglets in the Availa-$Fe^{(R)}$ treatment had a significantly higher hemoglobin concentration (p<0.05) and higher hematocrit and plasma iron (p>0.05) than those in the other two treatments, respectively. The hemoglobin of suckling piglets in the Availa-$Fe^{(R)}$ treatment was higher than that of piglets in $FeSO_4$.$7H_2O$ treatment on day 28 (p<0.05). The total iron binding capacity of piglets in Availa-$Fe^{(R)}$ treatment was lower than that of piglets in the control and $FeSO_4$.$7H_2O$ treatment on day 14 (p<0.05), but there was not a statistically significant difference among three treatments on day 28 (p>0.05). However, the hemoglobin and hematocrit of suckling piglets injected with Fe were higher than those of piglets in the other two treatments (p<0.05). This study indicated that the addition of 120 mg $kg^{-1}$ iron from amino acid complex into the diets improved iron status of neonatal and nursing piglets more effectively than the addition of 120 mg $kg^{-1}$ iron from $FeSO_4$.$7H_2O$, however, this improvement of the organic Fe was not sufficient to replace the Fe injection for prevention of iron-deficiency anemia.

The relationship between catechol-O-methyltransferase gene polymorphism and coronary artery abnormality in Kawasaki disease (가와사키병의 관상동맥 이상과 catechol-O-methyltransferase 유전자의 단일염기다형성)

  • Lee, Hyo Jin;Lee, Myung Sook;Kim, Ji Sook;Kim, Eun Ryoung;Kang, Sung Wook;Kim, Soo Kang;Chung, Joo Ho;Yoon, Kyung Lim;Han, Mi Young;Cha, Seong Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.87-92
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    • 2009
  • Purpose : Many gene polymorphisms are associated with coronary artery abnormalities in Kawasaki disease. Catechol-O- methyltransferase (COMT) plays an important role in the metabolism of catecholamines, catechol estrogen, and catechol drugs. Polymorphisms of the COMT gene are reported to be associated with myocardial infarction and coronary artery abnormalities. The aim of this study was to evaluate the relationship between COMT gene polymorphisms and coronary artery abnormalities in Kawasaki disease patients. Methods : One hundred and one Korean children with Kawasaki disease and 306 healthy Korean control subjects were enrolled in this study. The polymorphisms of the COMT gene were analyzed by direct sequencing. Results : There were no differences in the genotype and allelic frequency of the rs4680 and rs769224 polymorphic sites between Kawasaki disease and control subjects. Further, no significant difference was found in the rs4680 polymorphism between patients with coronary artery abnormalities and patients without coronary artery abnormalities (codominant P=0.32, dominant P=0.74, recessive P=0.13). However, the distribution of the rs769224 polymorphism was significantly different between patients with coronary artery abnormalities and patients without coronary artery abnormalities (codominant P= 0.0077, dominant P=0.0021, recessive P=0.16). Conclusion : Our results indicate that the polymorphisms of the rs769224 gene might be related to the development of coronary artery abnormalities in Kawasaki disease.

A Study on the Production of Artificial Seed and Intermediate culture for Attached Spats of the Chinese Stock of a Scallop, Patinopecten yessoensis (중국산 참가리비, Patinopecten yessoensis의 인공종묘 생산 및 부착치패 중간양성에 관한 연구)

  • Oh, Bong-Se;Lee, Jeong-Yong;Park, Se-Ku;Lee, Chu;Jo, Q-Tae
    • The Korean Journal of Malacology
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    • v.24 no.2
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    • pp.153-159
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    • 2008
  • We investigated artificial mass seed production of a Chinese scallop, Patinopecten yessoensis, in 2004. The GSI(gonad somatic index) of the Chinese scallop, P yessoensis was 17.2 on mid-February, 20.2 on mid-March, while that of Korean scallop, P yessoensis was 6.9 on mid-February, 10.8 on mid-March. Matured 120 females and 350 males were selected for artificial mass production. They were exposed in air for 1 hr at over $20^{\circ}C$, and placed into a spawning tank(20 ton) containing sea water treated with UV radiation at $12^{\circ}C$. We gained a total of 228,000 thousand scallop embryos between March 10th and 15th, and reared larvae at the indoor tank during 25 days. When the mean shell length of larvae reached 250 ${\mu}m$ and they have eye-spots, the number of pre-settling larvae was 47,500 thousand. We gained 1,850 thousand attached scallop spats from two kinds of collectors. Attached spats were reared in indoor tank for different periods from 5 days to 60 days. They were divided into 5 groups according to the length of reared days. Each group of attached spats was moved to intermediate rearing sites at Yangyang fishing port in Gangreung-city for acclimation to ocean environments. The highest survival rate of attached spats was 13.0% shown at the group reared for 12 days, but the significant difference in their growth was not found between the groups. The shell length of artificial attached spats increased from 0.9 ${\mu}m$ on July 10th to 24.7 ${\mu}m$ on December 16th with the survival rate of 85.0% while that of natural attached spats increased from 0.6 ${\mu}m$ on July 10th to 23.9 ${\mu}m$ on December 16th with the survival rate of 85.7%.

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Decitabine in the Treatment of Acute Myeloid Leukemia and Myelodysplastic Syndromes, Which Combined with Complex Karyotype Respectively

  • Gao, Su;Li, Zheng;Fu, Jian-Hong;Hu, Xiao-Hui;Xu, Yang;Jin, Zheng-Ming;Tang, Xiao-Wen;Han, Yue;Chen, Su-Ning;Sun, Ai-Ning;Wu, De-Pei;Qiu, Hui-Ying
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6627-6632
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    • 2015
  • Background: We conducted a study exploring the clinical safety and efficacy of decitabine in patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS), combined with a complex karyotype. Materials and Methods: From April 2009 to September 2013, a total of 35 patients with AML/MDS combined with a complex karyotype diagnosed in the First Affiliated Hospital of Soochow University were included for retrospective analysis. All patients were treated with decitabine alone ($20mg/m^2$ daily for 5 days) or combination AAG chemotherapy (Acla 20mg qod*4d, Ara-C $10mg/m^2$ q12h*7d, G-CSF $300{\mu}g$ qd, the dose of G-CSF adjusted to the amount in blood routinely). Results: In 35 patients, 15 exhibited a complete response (CR), and 6 a partial response (PR), the overall response rate (CR+PR) being 60% (21 of 35). Median disease-free survival was 18 months and overall survival was 14 months. In the 15 MDS patients with a complex karyotype, the CR rate was 53.3% (8 of 15); in 20 AML patients with complex karyotype, the overall response rate was 65% (13 of 20). The response rate of decitabine alone (22 cases) was 56.5% (13 of 22), while in the combination chemotherapy group (13 cases), the effective rate was 61.5% (8 of 13)(P>0.05). There are 15 patients with chromosome 7 aberration, after treatment with decitabine, 7 CR, 3 PR, overall response rate was 66.7% (10 of 15). Of 18 patients with 3 to 5 kinds of chromosomal abnormalities, 66.7% demonstrated a response; of 17 with more than 5 chromosomal abnormalities, 52.9% had a response. In the total of 35 patients, with one course (23 patients) and ${\geq}$two courses (12 patients), the overall response rate was 40.9% and 92.3% (P<0.05). Grade III to IV hematological toxicity was observed in 27 cases (75%). Grade III to IV infections were clinically documented in 7 (20%). Grades I to II non-hematological toxicity were infections (18 patients), haematuria (2 patients), and bleeding (3 patients). With follow-up until September 2013, 7 patients were surviving, 18 had died and 10 were lost to follow-up. In the 6 cases who underwent allogeneic hematopoietic stem cell transplantation (HSCT) all were still relapse-free survivors. Conclusions: Decitabine alone or combination with AAG can improve outcome of AML/MDS with a complex karyotype, there being no significant difference decitabine in inducing remission rates in patients with different karyotype. Increasing the number of courses can improve efficiency. This approach with fewer treatment side effects in patients with a better tolerance should be employed in order to create an improved subsequent chance for HSCT.