BACKGROUND: Nm23 gene was identified by the hybridization between two murine melanoma cell lines which had low or high metastatic potential and was located in chromosome 17q22. A number of tumor cohort studies have shown an inverse relationship between the levels of expression of nm23 protein and disease aggressiveness and tumor metastatic potential. METHODS: In order to determine the significance of overexpression of the antimetastatic gene nm23 protein in human-lymph node-negative breast cancer and to compare it with established clinicopathologic prognostic factors such as the tumor size, histologic grades, TNM stages, and hormonal receptor status, we analyzed the nm23 protein expressions by immunohistochemical staining in 53 lymph-node-negative breast-cancer tissue specimens. RESULTS: The nm23 protein expression was positive in 35 cases (66%). There was no relationship between nm23 protein overexpression and menopause status, tumor size, histologic grade, and hormonal receptor status, but tumor stage correlated with nm23 protein overexpression. Also, overexpression of the nm23 protein was significantly correlated with a longer disease-free survival rate. CONCLUSION: Expression of nm23 protein may be of value for predicting the long-term disease-free survival rate in lymph-node-negative breast-cancer patients.
Breast Neoplasms ; Breast* ; Cell Line ; Cohort Studies ; Disease-Free Survival ; Female ; Humans ; Lymph Nodes* ; Melanoma ; Menopause ; Staphylococcal Protein A*

BACKGROUND: In korea, tsutsugamushi disease is one of the common diseases which occurs in more than 40% among acute febrile diseases during Autumn. The diagnosis is confirmed with Rickettsia tsutsugamushi antibody, and is characterised by fever, chill, headache, myalgia, skin rash, escha and lymphadenopathy. METHODS: We have conducted a survey on 16 clinically and serologically confirmed cases of Tsutsugamushi disease occurring during the period of October -November, 2000. RESULTS: Of 16 cases,7 were males and 9 were females with an average age of 67.76. Most patients had fever, chill, headache, myalgia, sore throat, cojunctival injection, cough, abdominal, pain, nausea, vomiting, hematuria in order of frequency. The physical findings were eachar (81.257) and skin rash (62.77) . Serologically 7 cases (43.75%) of 16 cases were confirmed positively R.tsutsugamushi antibody. General hematologic findings were decreased platelet count (37.57) , increased or decreased WBC (31.25% and 25% each other) , and anemia (25%) , Test for liver function included elevated AST, ALT (68.76%) , alkaline phosphatase (62.6%) , hypoalbuminemia (12.6%) , and hyperbilirubinemia(6.25) . Urinalysis showed hematuria (50%) , proteinuria (50%) , and pyuria (12.67) . Doxyrcycline therapy decreased fever in 2.85 days and after 5-6 days patients were discharged with improvement of almost all symptoms. CONCLUSION: Primary care physician in a community should always consider tsutsugamushi disease when he encounters patients with acute febrile disease in late Autumn and early winter and expect good prognosis with early diagnosis and treatment.
Alkaline Phosphatase ; Anemia ; Cough ; Diagnosis ; Early Diagnosis ; Exanthema ; Female ; Fever ; Headache ; Hematuria ; Humans ; Hypoalbuminemia ; Jeollabuk-do* ; Korea ; Liver ; Lymphatic Diseases ; Male ; Myalgia ; Nausea ; Orientia tsutsugamushi ; Pharyngitis ; Physicians, Primary Care ; Platelet Count ; Prognosis ; Proteinuria ; Pyuria ; Scrub Typhus* ; Urinalysis ; Vomiting

BACKGROUND: The bcr-abl gene rearrangement is a very important genetic marker in at least 95% of cases of chronic myeloid leukemia (CML). The technique that allows the detection of bcr-abl gene rearrangement seem to be the testing for the diagnoses and the detection of minimal residual disease (MRD) and may help in monitoring patients. Recent introduction of real-time quantitative PCR should eventually allow actual quantification of the target gene during amplification. In the present study, we investigated bcr-abl chimeric mRNA quantification in CML after bone marrow transplantation (BMT) by real-time RT-PCR and its clinical applicability to the decision of therapeutic intervention. METHODS: The subjects were a consecutive series of 9 CML patients with serial quantification of bcr-abl chimeric mRNA by real-time RT-PCR in peripheral blood or bone marrow aspirates. The sensitivity of real-time RT-PCR was compared to conventional RT-PCR and then the correlation with FISH results was analyzed. RESULTS: Seventeen bone marrow samples and 40 peripheral bloods were obtained from patients. The sensitivity of real-time RT-PCR was 10(-6) and positive signals were detected in negative cases by conventional RT-PCR. A significant correlation between the bcr-abl/G6PDH ratio by real-time RT-PCR and the proportion of positive cells for bcr-abl gene rearrangement by FISH was obtained (r=0.64). In the serial blood and bone marrow specimens, we found a progressive decrease in the bcr-abl/G6PDH ratio in all the patients. CONCLUSIONS: Our findings indicated that quantitative analysis of bcr-abl chimeric mRNA by real-time RT-PCR might be a useful tool for the monitoring of minimal residual disease in bcr-abl positive leukemic patients.
Bone Marrow ; Bone Marrow Transplantation* ; Diagnosis ; Gene Rearrangement ; Genetic Markers ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Neoplasm, Residual ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction* ; RNA, Messenger

BACKGROUND: Total T lymphocytes can be measured by CD3-fluorescein isothiocyanate (FITC)/CD4-phycoerythrin (PE) and CD3-FITC/CD8-PE. The difference in the CD3 percentages between these two determinations was evaluated. And, we characterized the CD3(+)CD4(-)CD8(-) T lymphocytes subset using the monoclonal antibody that detects gamma delta T lymphocytes receptors. METHODS: The T lymphocyte subset assay was performed on 221 samples. A two-color direct immunofluorescence flow cytometric assay was done using a Simultest IMK-Lymphocyte kit (Bec-ton- Dickinson, San Jose, CA, USA). If the difference between the CD3 determinations were greater than 3%, the entire procedure was reviewed and the flow cytograms were reanalyzed. In 71 among 221 samples the proportion of gamma delta T lymphocytes was determined. RESULTS: The difference between the CD3-FITC/CD4-PE tube and CD3-FITC/CD8-PE tube was 3.0%, 3.6%, 3.0%, 3.4%, and 2.4% in normal subjects, patients with chronic liver disease, patients with cancer, patients with other diseases, and children, respectively. The between-tube differences for CD3 exceeding 3% were found in 69 samples (31.2%). The proportion of gamma delta T lymphocytes was 0.81%, 2.46%, 2.50%, and 0.85% in normal controls, patients with chronic liver disease, patients with cancer and patients with other diseases, respectively. No correlation between gamma delta T lymphocytes and CD3(+)CD4(-)CD8(-) T lymphocytes was observed. CONCLUSIONS: The reproducibility of the total T lymphocytes should be improved because of the between-tube difference exceeding 3% in about one third of the cases. Additionally, CD3(+)CD4(-)CD8(-) T lymphocytes were composed of heterogeneous subsets including gamma delta T lymphocytes and their proportion might be considered to be related to individual variation.
Child ; Fluorescent Antibody Technique, Direct ; Humans ; Liver Diseases ; Lymphocyte Subsets* ; Lymphocytes* ; T-Lymphocytes

BACKGROUND: The CD34+ cell dose and infused number of committed progenitor cells in transplantation are important factors in hematologic engraftment. However, the relationship between expansion potential of progenitor cells and hematologic engraftment remains controversial. We evaluated whether expansion potential of progenitor cells is a predictive factor of post-transplantation hematologic engraftment. METHODS: Mononuclear cells isolated from mobilized peripheral blood and bone marrow were cultured with cytokine cocktail for 7 days. Progenitor cells and committed progenitors were analyzed using stem cell markers (CD34 and CD133) and lineage specific markers. Hematologic engraftment was defined as neutrophil counts over 500/microliter and platelet counts over 20,000/microliter without transfusion. Acute and chronic graft-versus-host disease (GVHD) were investigated. RESULTS: There was inverse tendency between the number and fold expansion of progenitor cells or committed (granulocytic or megakaryocytic) progenitors and time to engraftment. Especially, fold expansion of CD34(+)/CD33(+) cells was significantly correlated with time to neutrophil engraftment in bone marrow transplantation (r=-0.56, P=0.04). The infused number and fold expansion of lymphoid progenitors were not related to the occurrence of acute or chronic GVHD. CONCLUSIONS: We could not prove that expansion potential of progenitor cells and committed progenitor cells is correlated to hematologic engraftment although there is a correlation between CD34(+)/ CD33(+) cells and time to neutrophil engraftment. But, a further study on the value of expansion potential is required because there is an inverse tendency.
Bone Marrow ; Bone Marrow Transplantation ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Neutrophils ; Platelet Count ; Stem Cells

OBJECTIVES: This study was performed in order to investigate the frequency of the TNF2 allele in patients with coal workers pneumoconiosis (CWP). METHODS: We compared the genotype distribution of TNFalpha gene promoter polymorphism between 80 CWP patients and 54 healthy controls. RESULTS: The results were as follows : 1. The rare allele TNF2 was significantly more frequent in CWP patients (20.6 %) than in controls (10.2 %). 2. The spontaneous or LPS-induced release of TNFalpha from the peripheral monocytes was slightly increased in the TNF2 group, but these values were not significantly different between groups. 3. In the CWP TNF2 group, the increase of LPS-induced TNFalpha release was significant in comparison with that of the controls. CONCLUSIONS: From the above results, we suggest that the TNF2 allele is strongly associated with susceptibility to CWP development.
Alleles ; Anthracosis ; Coal* ; Genotype ; Humans ; Monocytes ; Pneumoconiosis* ; Tumor Necrosis Factor-alpha*

BACKGROUND: AML with myelodysplasia related changes (AML MRC) is known to show a poor prognosis compared with de novo AML, but controversies exist about the prognostic impact of multilineage dysplasia (MLD) among MRC. We investigated the prognostic impact of MLD in AML MRC. METHODS: A total of 357 patients newly diagnosed as AML at Asan Medical Center from January 2001 to December 2005 were analyzed. They were diagnosed and classified as AML with recurrent genetic abnormalities, AML MRC, and AML not otherwise specified (AML NOS). Prognostic markers including overall survival (OS) and event free survival (EFS) were obtained through retrospective analysis of electronic medical records. RESULTS: AML MRC patients showed a lower complete remission (CR) rate (44.7% vs. 64.9%, P=0.002) and shorter OS (297 vs. 561 days, P=0.004) and EFS (229 vs. 374 days, P=0.004) than AML NOS patients. Patients with MLD among AML MRC also showed a lower CR rate (37.7%, P=0.001) and shorter OS (351 days, P=0.036) and EFS (242 days, P=0.076) than AML NOS patients. However, among AML MRC patients, there were no differences in OS, EFS and CR between patients with and without MLD. CONCLUSIONS: AML MRC patients showed a lower CR rate and shorter OS and EFS than AML NOS patients. AML MRC patients with MLD showed similar results and their prognosis was not different from those without MLD. MLD findings among AML MRC could be an independent poor prognostic factor in de novo AML.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cell Lineage ; Child ; Child, Preschool ; Data Interpretation, Statistical ; Disease-Free Survival ; Female ; Humans ; Infant ; Leukemia, Myeloid, Acute/complications/diagnosis/*mortality ; Male ; Middle Aged ; Myelodysplastic Syndromes/complications/*diagnosis ; Prognosis ; Retrospective Studies ; Survival Analysis

PURPOSE: Since fine needle localization biopsy has been introduced, surgeons can have performed biopsies for nonpalpable microcalcified breast lesions, but there are many controversies in determining the disease characteristics and guideline for biopsy with only the findings on mammography. This study was designed to determine the breast cancers according to microcalcification type. MATERIALS AND METHODS: We reviewed 91 cases with only microcalcifications on mammography and with performing localization biopsies from January 1995 to June 1998 at department of surgery, Korea University Hospitals. We subdivided the type of microcalcifications into casting-type, crushed stone like-type and amorphous-type. RESULTS: The mean age was 49 years old (25-82 years). 16 patients (17.6%) among the 91 patients were diagnosed as the breast cancer. Four (22.2%) of 18 patients with casting type, eight (21.6%) of 37 patients with crushed stone-like type, and four (11.1%) of 36 patients with amorphous type microcalcifications were detected in the breast cancer. The incidence of breast cancers by mammographic microcalcificated breast lesions was more prevalent in casting and crushed stone-like types than amorphous types. The mean size of the benign and malignant lesions was 13.11+/-10.89mm, 13.13+/-.51mm, and there was no difference in the size of microcalcifiations between benign and malignant lesions. CONCLUSIONS: Patients who have had clustered microcalcifications of more than 5 within 1 cm circle in diameter on mammography should be undergone biopsies especially in case of casting or crushed stone-like type to detect early breast cancers.
Biopsy ; Breast Neoplasms* ; Breast* ; Classification* ; Hospitals, University ; Humans ; Incidence* ; Korea ; Mammography* ; Middle Aged ; Needles

The p16 is a cyclin-dependent kinase inhibitor(CDKI) that inhibits cell cycle progression. In recent studies, homozygous deletions of p16 gene have been noted in some cancer cell lines, which implies the deletion or mutation of p16 gene may contribute to the malignant progression of cells in some ways. This study was to investigate the frequency of p16 gene mutation in breast cancer patients by using polymerase chain reaction-single stranded confromational polymorphysm(PCR-SSCP) analysis. Examination of 24 blood samples and corresponding 16 tissue samples from 24 breast cancer patients were performed by PCR-SSCP method. Four from 24 blood samples(16.7%) disclosed 3 abnormal bands and one band shifting. Among 13 tissue samples revealed three conformational changes(23.1%). In two cases, there were abnormal bands in both blood samples and cancer tissues. One case with no products by PCR in the tissue sample showed a band shifting in the blood sample. Three cases with no PCR products in tissue samples may considered as total allelic deletion of the p16. The cases of abnormal PCR-SSCP results show some abnormalities on direct sequencing by Sanger method as T base insertion, C/T and A/G bases substitution. The results may suggest some of breast cancer patients have germline mutations of the p16 gene and some have somatic mutations. In the carcinogenesis of some breast cancers, p16 gene mutation may dysregulates the cell cycle, that may play an important role in the unlimited tumor cell proliferations.
Breast Neoplasms* ; Breast* ; Carcinogenesis ; Cell Cycle ; Cell Line ; Genes, p16 ; Germ-Line Mutation ; Humans* ; Phosphotransferases ; Polymerase Chain Reaction

PURPOSE: The purpose of this study was to investigate the welfare status of nurses and the status of fixed night shifts and flexible work arrangements in both general hospitals and advanced general hospitals in Korea. METHODS: A total of 167 hospitals participated in this study, done from April to October 2018. RESULTS: There were 103 hospitals utilizing the fixed night shift system, 22 in the two-shift system, 3 in the fixed holiday shift, 79 in the fixed shift system, and 39 in the short-time working system. The average welfare benefits for nurses increased to 33.02 million won on average. However, welfare services for the nurses were poor: 41.8% of the respondents had a nurses' lounge, 81.7% were given dormitory space at their place of employment, 41.8% had access to welfare facilities, and 56.4% were provided with welfare support countermeasures. CONCLUSION: The results show an increasing trend of hospitals to utilize fixed night shift and flexible work arrangements. An institutional strategy at the national policy level should be established to implement flexible work arrangements including the fixed night shift system, which has a poor level of welfare.
Employment ; Holidays ; Hospitals, General ; Korea ; Surveys and Questionnaires