Secondary acute leukemia is a rare and fatal complication after the treatment of breast cancer. Recently, we experienced 2 cases of acute leukemia that had developed during the follow-up period after adjuvant therapy of breast cancer. In addition, retrospective analysis of medical records of St. Mary's hospital, the Catholic University of Korea, revealed another 5 cases of secondary leukemia following the treatment of breast cancer. Total 7 cases of secondary acute leukemia of breast cancer were reviewed and summarized according to their clinical characteristics. The mean age at diagnosis of primary breast cancer was 38.9 years (range, 16-49), and the average period from the completion of chemotherapy to the diagnosis of acute leukemia was 30.9 months (range, 11-40). The mean survival period of the 7 patients after diagnosis of leukemia was 4.6 months. Based on these findings, the risk of secondary leukemia following the treatment of breast should be considered in choosing chemotherapy and radiotherapy for the treatment of breast cancer especially in the young patients.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Korea ; Leukemia ; Medical Records ; Retrospective Studies

Secondary acute leukemia is a rare and fatal complication after the treatment of breast cancer. Recently, we experienced 2 cases of acute leukemia that had developed during the follow-up period after adjuvant therapy of breast cancer. In addition, retrospective analysis of medical records of St. Mary's hospital, the Catholic University of Korea, revealed another 5 cases of secondary leukemia following the treatment of breast cancer. Total 7 cases of secondary acute leukemia of breast cancer were reviewed and summarized according to their clinical characteristics. The mean age at diagnosis of primary breast cancer was 38.9 years (range, 16-49), and the average period from the completion of chemotherapy to the diagnosis of acute leukemia was 30.9 months (range, 11-40). The mean survival period of the 7 patients after diagnosis of leukemia was 4.6 months. Based on these findings, the risk of secondary leukemia following the treatment of breast should be considered in choosing chemotherapy and radiotherapy for the treatment of breast cancer especially in the young patients.
Breast ; Breast Neoplasms ; Follow-Up Studies ; Humans ; Korea ; Leukemia ; Medical Records ; Retrospective Studies

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.
Acidosis ; Acidosis, Lactic* ; Amylases ; Diabetes Mellitus ; Diabetic Nephropathies ; Female ; Humans ; Hypertension ; Insulin ; Lactic Acid ; Lipase ; Metformin* ; Middle Aged ; Nausea ; Pancreatitis* ; Renal Dialysis* ; Sitagliptin Phosphate ; Vomiting

Histone modifications are key epigenetic regulatory features that have important roles in many cellular events. Lysine methylations mark various sites on the tail and globular domains of histones and their levels are precisely balanced by the action of methyltransferases (‘writers’) and demethylases (‘erasers’). In addition, distinct effector proteins (‘readers’) recognize specific methyl-lysines in a manner that depends on the neighboring amino-acid sequence and methylation state. Misregulation of histone lysine methylation has been implicated in several cancers and developmental defects. Therefore, histone lysine methylation has been considered a potential therapeutic target, and clinical trials of several inhibitors of this process have shown promising results. A more detailed understanding of histone lysine methylation is necessary for elucidating complex biological processes and, ultimately, for developing and improving disease treatments. This review summarizes enzymes responsible for histone lysine methylation and demethylation and how histone lysine methylation contributes to various biological processes.
Biological Processes ; Epigenomics ; Histone Code ; Histones* ; Lysine* ; Methylation* ; Methyltransferases ; Tail ; Writing*

To verify the spectrum of CD99-expressing lymphoid malignancy, an immunohistochemical study for CD99 was carried out in 182 cases of non-Hodgkin's lymphoma, including 21 lymphoblastic lymphomas, 11 small lymphocytic lymphomas, 9 mantle cell lymphomas, 12 follicular lymphomas, 37 diffuse large B cell lymphomas, 18 Burkitt's lymphomas, 28 NK/T-cell lymphomas, 8 angioimmunoblastic T-cell lymphomas, 23 peripheral T-cell lymphomas, unspecified, and 15 systemic anaplastic large cell lymphomas. CD99 was positive in all T-lymphoblastic lymphomas and in 60% of B-lymphoblastic lymphomas. Majority of T and NK cell lymphomas were negative for CD99, except anaplastic large cell lymphomas (ALCLs). Eight of 15 cases (54%) of ALCLs reacted with anti CD99 antibody. Seven of 10 (70%) ALK positive ALCLs expressed CD99, whereas only 1 of 5 (20%) ALK negative ALCLs were positive. Of the mature B-cell lymphomas, 5.4% (2/37) of diffuse large B cell lymphomas and 11.1% (2/18) of Burkitt's lymphomas expressed CD99. In conclusion, CD99 is infrequently expressed in mature B and T cell lymphomas, except ALK-positive ALCL. High expression of CD99 in ALK-positive ALCL is unexpected finding and its biologic and clinical significances have yet to be clarified.
Antigens, CD/*metabolism ; Blotting, Western ; Cell Adhesion Molecules/*metabolism ; Humans ; Immunohistochemistry ; Lymphoma, Large-Cell/enzymology/*immunology/pathology ; Lymphoma, Non-Hodgkin/enzymology/*immunology/pathology ; Protein-Tyrosine Kinase/immunology/*metabolism

BACKGROUND: The quality of sexuality is significantly affected by physical changes following hematopoietic stem cell transplantation (HSCT) and the dissatisfied and/or dysfunctional sexuality may cause deterioration in the quality of life (QOL). METHODS: With two models of questionnaires, we interviewed thirty-eight patients who remained in the disease-free status after HSCT and had sex partners, to assess: 1) the changes in sexuality, 2) QOL in physical, psychological, social and spiritual domains and 3) the correlation between sexuality and QOL. RESULTS: The common physical changes that may affect sexuality in women were secondary amenorrhea (69.2%), loss of sexual interest (53.8%), diminished vaginal secretion (50%), menopausal syndrome (34.6%), dyspareunia (30.8%) and failure to orgasm (23.1%), while men complained of impotence (41.7%) and difficulty in ejaculation (16.7%). For sexuality, satisfaction of sexual activity, attainment of orgasm and frequency of intercourse decreased significantly after HSCT as compared with the pre-transplant levels. A score measuring QOL after HSCT marked 5.91 on a full score of 10; social domain ranked the lowest (5.01) while physical domain the highest (6.70). Among the items of sexuality, only sexual desire was significantly correlated with QOL; satisfaction, orgasm and frequency were not significantly correlated with QOL. CONCLUSION: Although sexuality is affected by the physical changes following HSCT, we should not overlook the psychological and social effects on the sexuality of post-transplant patients. Therefore, educational and counseling programs are very important to restore and improve their sexuality.
Adult ; Female ; Hematopoietic Stem Cell Transplantation/*adverse effects/psychology ; Human ; Male ; Middle Age ; Quality of Life ; Questionnaires ; Sex Disorders/*etiology ; *Sexuality

BACKGROUND: Invasive aspergillosis is an important cause of morbidity and mortality in neutropenic patients after chemotherapy in hematologic malignancies. HEPA filtration was known as an effective preventive measure for invasive aspergillosis, but the role of chemoprophylaxis has not been established yet. Itraconazole has been considered to be an effective antifungal agent for invasive aspergillosis. We evaluated the effect of itraconazole chemoprophylaxis in the prevention of invasive aspergillosis for neutropenic patients after chemotherapy in hematologic malignancies, who were treated in general ward without HEPA filtration. METHODS: A total of 89 patients with hematologic malignancies were enrolled in the two groups between January, 1995 and December, 1997 at Samsung medical center. Itraconazole, 200 mg po twice daily, was given to the patients as their neutrophil count decreased below 1,000/microliter following chemotherapy, and continued until it recovered over 1,000/microliter. Incidence of invasive aspergillosis was prospectively compared between the itraconazole prophylaxis group and the control group. RESULTS: Itraconazole prophyaxis was done in 34 patients on a total 59 episodes of severe neutropenia (absolute neutrophil count <500/microliter) after chemotherapy. Two out of 34 patients were histologically diagnosed as invasive aspergillosis. Control group included 55 patients with 103 episodes of severe neutropenia. Five out of 55 patients were diagnosed as invasive aspergillosis. No statistically significant differences were observed between two groups, because 2 of 59 (3.4%) and 5 of 103 (4.9%) were found to have invasive aspergillosis proven histologically (P=1.00). CONCLUSION: Itraconazole chemoprophylaxis for invasive aspergillosis was not effective, and the prognosis was closely related to the recovery of neutrophils. But we cannot exclude thepossibility that the drug has been failed in achieving effective plasma concentration by oral administration, as reported in several studies. Randomized prospective study, including measurement of plasma drug concentration, is warranted to evaluate the efficacy of itraconazole for the prevention of invasive aspergillosis.
Administration, Oral ; Aspergillosis* ; Chemoprevention ; Drug Therapy ; Filtration ; Hematologic Neoplasms ; Humans ; Incidence ; Itraconazole* ; Mortality ; Neutropenia ; Neutrophils ; Patients' Rooms ; Plasma ; Prognosis ; Prospective Studies

Polycystic kidney disease (PCKD) is the most common life-threatening genetic disease that causes kidney failure worldwide. Patients with autosomal dominant PCKD notice an increase in abdominal size as the kidney cysts grow and present with gastrointestinal and pulmonary symptoms. Surgical therapy, percutaneous drainage, sclerotherapy, cyst decompression, and laparoscopic fenestration have been used to treat the symptoms, but the results are often unsatisfactory. We recruited five patients with PCKD. Each patient complained of severe abdominal discomfort, and had a poor quality of life. In these patients, we performed renal artery embolization. After the procedure, all of the patients were discharged without severe complications. Follow-up abdominal computed tomography was performed 3-6 months after the procedure, and we were able to confirm a reduction in the size of both kidneys. In addition, the clinical symptoms improved in all five patients.
Decompression ; Drainage ; Follow-Up Studies ; Humans ; Kidney ; Polycystic Kidney Diseases* ; Quality of Life ; Renal Artery* ; Renal Insufficiency ; Sclerotherapy

OBJECTIVES: Art and culture education might play a good role in children's emotions ; however, few studies to verify this have been conducted. The objective of this study was to examine the effect of an art and culture education program on behavior and social skills in children aged 7-10 years. METHODS: Fifteen children (mean age 7.31+/-0.95 years) were recruited from a community center and participated in an art and culture education program. The participants received a once a week program for 17 sessions, and we compared scores on the Child Behavior Checklist (CBCL) and Social Skills Improvement System-Rating Scales (SSIS-RS) before and after intervention. RESULTS: The participants' subscale scores of CBCL-aggressive behavior, social immaturity, internalizing behavior, externalizing behavior, total behavior problems and social skill scores on the SSIS-RS showed improvement (p<.05) after 15-weeks of the art and culture education program. CONCLUSION: These results suggest a positive effect of an art and culture education program on the reduction of externalizing and internalizing behaviors and improvement of social skills in children. Further prospective, controlled studies in large samples are needed in order to confirm our findings.
Checklist ; Child Behavior ; Child* ; Education* ; Humans ; Social Behavior ; Weights and Measures

Gene therapy holds a great promise and has been extensively investigated to improve bone formation and regeneration therapies in bone tissue engineering. A variety of osteogenic genes can be delivered by combining different vectors (viral or non-viral), scaffolds and delivery methodologies. Ex vivo & in vivo gene enhanced tissue engineering approaches have led to successful osteogenic differentiation and bone formation. In this article, we review recent advances of gene therapy-based bone tissue engineering discussing strengths and weaknesses of various strategies as well as general overview of gene therapy.
Bone and Bones* ; Bone Morphogenetic Proteins ; Genetic Therapy* ; Osteogenesis ; Regeneration ; Tissue Engineering