Objective: We aimed to revalidate the chemotherapy response score (CRS) system as a prognostic factor for ovarian cancer patients with breast cancer gene (BRCA) mutations or those receiving frontline poly-ADP ribose polymerase (PARP) inhibitors or bevacizumab as maintenance therapy. Methods: A retrospective analysis was performed using medical records of patients with high-grade serous carcinoma who received neoadjuvant chemotherapy followed by interval debulking surgery between January 2007 and December 2021 at 5 tertiary medical institutions in South Korea. At each hospital, pathologists independently assessed each slide of omental tissues obtained from surgery using the CRS system. Progression-free survival (PFS) and overall survival (OS) values were obtained using Kaplan-Meier analysis to evaluate the effect of BRCA mutation, maintenance therapy, and CRS on survival time. Results: Of 466 patients, BRCA mutations were detected in 156 (33.5%) and 131 (28.1%) were treated with maintenance therapy; 98 (21.0%) and 42 (9.0%) were treated with PARP inhibitors or bevacizumab, respectively. Patients with CRS3 had significantly longer PFS than those with CRS1 or 2 (24.7 vs. 16.8 months, p<0.001). However, there was no significant difference in PFS improvement between CRS3 patients and those with CRS1 or 2 with BRCA mutation (22.0 vs. 19.3 months, p=0.193). Moreover, no significant PFS prolongation was observed in CRS3 patients compared to CRS1 or 2 patients treated with PARP inhibitors or bevacizumab (24.3 vs. 22.4 months, p=0.851; 27.5 vs. 15.7 months, p=0.347, respectively). Conclusion CRS may not be a prognostic factor in patients with BRCA mutations and those receiving frontline maintenance therapy.

Objective: We aimed to revalidate the chemotherapy response score (CRS) system as a prognostic factor for ovarian cancer patients with breast cancer gene (BRCA) mutations or those receiving frontline poly-ADP ribose polymerase (PARP) inhibitors or bevacizumab as maintenance therapy. Methods: A retrospective analysis was performed using medical records of patients with high-grade serous carcinoma who received neoadjuvant chemotherapy followed by interval debulking surgery between January 2007 and December 2021 at 5 tertiary medical institutions in South Korea. At each hospital, pathologists independently assessed each slide of omental tissues obtained from surgery using the CRS system. Progression-free survival (PFS) and overall survival (OS) values were obtained using Kaplan-Meier analysis to evaluate the effect of BRCA mutation, maintenance therapy, and CRS on survival time. Results: Of 466 patients, BRCA mutations were detected in 156 (33.5%) and 131 (28.1%) were treated with maintenance therapy; 98 (21.0%) and 42 (9.0%) were treated with PARP inhibitors or bevacizumab, respectively. Patients with CRS3 had significantly longer PFS than those with CRS1 or 2 (24.7 vs. 16.8 months, p<0.001). However, there was no significant difference in PFS improvement between CRS3 patients and those with CRS1 or 2 with BRCA mutation (22.0 vs. 19.3 months, p=0.193). Moreover, no significant PFS prolongation was observed in CRS3 patients compared to CRS1 or 2 patients treated with PARP inhibitors or bevacizumab (24.3 vs. 22.4 months, p=0.851; 27.5 vs. 15.7 months, p=0.347, respectively). Conclusion CRS may not be a prognostic factor in patients with BRCA mutations and those receiving frontline maintenance therapy.

Objective: We aimed to revalidate the chemotherapy response score (CRS) system as a prognostic factor for ovarian cancer patients with breast cancer gene (BRCA) mutations or those receiving frontline poly-ADP ribose polymerase (PARP) inhibitors or bevacizumab as maintenance therapy. Methods: A retrospective analysis was performed using medical records of patients with high-grade serous carcinoma who received neoadjuvant chemotherapy followed by interval debulking surgery between January 2007 and December 2021 at 5 tertiary medical institutions in South Korea. At each hospital, pathologists independently assessed each slide of omental tissues obtained from surgery using the CRS system. Progression-free survival (PFS) and overall survival (OS) values were obtained using Kaplan-Meier analysis to evaluate the effect of BRCA mutation, maintenance therapy, and CRS on survival time. Results: Of 466 patients, BRCA mutations were detected in 156 (33.5%) and 131 (28.1%) were treated with maintenance therapy; 98 (21.0%) and 42 (9.0%) were treated with PARP inhibitors or bevacizumab, respectively. Patients with CRS3 had significantly longer PFS than those with CRS1 or 2 (24.7 vs. 16.8 months, p<0.001). However, there was no significant difference in PFS improvement between CRS3 patients and those with CRS1 or 2 with BRCA mutation (22.0 vs. 19.3 months, p=0.193). Moreover, no significant PFS prolongation was observed in CRS3 patients compared to CRS1 or 2 patients treated with PARP inhibitors or bevacizumab (24.3 vs. 22.4 months, p=0.851; 27.5 vs. 15.7 months, p=0.347, respectively). Conclusion CRS may not be a prognostic factor in patients with BRCA mutations and those receiving frontline maintenance therapy.

PURPOSE: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. METHODS: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild (100×10⁹/L≤platelet < 150×10⁹/L), moderate (50×10⁹/L≤platelet < 100×10⁹/L), or severe (platelet < 50×10⁹/L). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. RESULTS: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. CONCLUSION: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.
Academic Medical Centers ; C-Reactive Protein ; Classification ; Critical Care ; Gestational Age ; Hematocrit ; Hematologic Tests ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care, Neonatal ; Leukocytes ; Mortality ; Neutrophils ; Platelet Count ; Reproductive History ; Retrospective Studies ; Sepsis ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune

Although central catheter-related complications are frequently reported and are inevitable in the neonatal care unit, the incidence of pericardiac tamponade is low but may be fatal. Index of suspicion, prompt diagnosis, and urgent pericardiocentesis are crucial for lifesaving. We encountered two premature cases of central venous catheter-related pericardial tamponade. The first case was a 4-day-old male premature infant (gestational age [GA], 33(+5) weeks; birth weight [BW], 1,864 g), and the second case was a 4-day-old female premature infant (GA, 28(+6) week; BW, 1,050 g). Each infant had an indwelling central venous catheter since birth and at the third day of hospitalization. The conditions of the babies suddenly deteriorated, but both babies were successfully resuscitated with urgent echocardiography and prompt pericardiocentesis.
Birth Weight ; Cardiac Tamponade* ; Central Venous Catheters ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Incidence ; Infant ; Infant, Newborn ; Infant, Premature* ; Male ; Parturition ; Pericardiocentesis

OBJECTIVE: To evaluate uterine and ovarian cancer mortality trends in East Asian countries. METHODS: For three Asian countries and one region (Japan, Korea, Singapore, and Hong Kong), we extracted number of deaths for each year from the World Health Organization (WHO) mortality database, focusing on women > or =20 years old. The WHO population data were used to estimate person-years at risk for women. The annual age-standardized, truncated rates were evaluated for four age groups. We also compared age-specific mortality rates during three calendar periods (1979 to 1988, 1989 to 1998, and 1999 to 2010). Joinpoint regression was used to determine secular trends in mortality. To obtain cervical and uterine corpus cancer mortality rates in Korea, we re-allocated the cases with uterine cancer of unspecified subsite according to the proportion in the National Cancer Incidence Databases. RESULTS: Overall, uterine cancer mortality has decreased in each of the Asian regions. In Korea, corrected cervical cancer mortality has declined since 1993, at an annual percentage change (APC) of -4.8% (95% confidence interval [CI], -5.3 to -4.4). On the other hand, corrected uterine corpus cancer mortality has abruptly increased since 1995 (APC, 6.7; 95% CI, 5.4 to 8.0). Ovarian cancer mortality was stable, except in Korea, where mortality rates steadily increased at an APC of 6.2% (95% CI, 3.4 to 9.0) during 1995 to 2000, and subsequently stabilized. CONCLUSION: Although uterine cancer mortality rates are declining in East Asia, additional effort is warranted to reduce the burden of gynecologic cancer in the future, through the implementation of early detection programs and the use of optimal therapeutic strategies.
Adult ; Age Distribution ; Aged ; Databases, Factual ; Far East/epidemiology ; Female ; Genital Neoplasms, Female/*mortality ; Humans ; Middle Aged ; Mortality/trends ; Ovarian Neoplasms/mortality ; Uterine Neoplasms/mortality ; Young Adult

PURPOSE: The objective of this study was to identify differences in the clinical manifestations and allergic indices between monosensitized and polysensitized children. METHODS: We reviewed retrospective data from the medical records of patients who had chronic or recurrent respiratory symptoms and visited the pediatric clinic at Chung-Ang University Hospital for an evaluation of allergic diseases from January 2003 to January 2011. The patients were categorized into nonsensitized (n=111), monosensitized (n=149), and polysensitized (n=205) groups according to skin prick tests (as classified by five allergen groups). We compared gender, age, family history, admission history, food sensitization, total immunoglobulin E (IgE), peripheral eosinophil counts, eosinophil cationic protein (ECP) levels, forced expiratory volume in 1 second (FEV1), and methacholine provocation tests among the three groups. RESULTS: The frequency of food sensitivity was highest in the polysensitized group (n=101, 49.3%), followed by the monosensitized (n=8, 5.4%) and nonsensitized groups (n=0) (P<0.001). The FEV1 was significantly lower in the polysensitized group than that in the monosensitized and nonsensitized groups (79.4+/-20.2% vs. 87.2+/-16.0% vs. 87.6+/-17.1%, respectively) (P=0.013). The total IgE and ECP levels were significantly higher in the polysensitized patients than those in the other patients (P<0.001 and <0.001, respectively). Differences in gender, age, peripheral eosinophil count, and bronchial hyper-responsiveness were not identified between the monosensitized and polysensitized groups. CONCLUSION: The polysensitized group showed more frequent food hypersensitivity, lower FEV1 values, and higher allergic indices such as total IgE and ECP, suggesting a different atopic phenotype compared with those in the monosensitized group.
Eosinophil Cationic Protein ; Eosinophils ; Food Hypersensitivity ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Immunoglobulin E ; Immunoglobulins ; Medical Records ; Methacholine Chloride ; Phenotype ; Respiratory Function Tests ; Retrospective Studies ; Skin

BACKGROUND/AIMS: Hypoxia-inducible factor-1alpha (HIF-1alpha) is a central transcriptional factor involved in the cellular responses related to various aspects of cancer biology, including proliferation, survival, and angiogenesis, and the metabolism of the extracellular matrix in hypoxia. This study evaluated whether adenovirus-mediated small hairpin RNA (shRNA) against HIF-1alpha (shHIF-1alpha) inhibits cell proliferation and angiogenesis in hepatocellular carcinoma (HCC) cell lines. METHODS: Knockdown of HIF-1alpha expression was constructed by adenovirus-mediated RNA interference tools, and HCC cell lines infected with shHIF-1alpha coding virus were cultured under a hypoxia condition (1% O2) for 24 hours. Following infection, the expression levels of HIF-1alpha, angiogenesis factors, and matrix metalloproteinase (MMP) were examined using Western blotting. Cell proliferation and angiogenesis were measured by a cell proliferation assay (MTT assay) and an angiogenesis-related assay (invasion and tube-formation assay), respectively. RESULTS: Adenovirus mediated inhibition of HIF-1alpha induced suppression of tumor growth in HCC cell lines. It also down-regulated the expression of angiogenesis factor and MMP proteins. Angiogenesis as well as mobility of vascular cells to tumor was suppressed by adenovirus-mediated shHIF-1alpha-infected groups in human umbilical vein endothelial cells (HUVECs). CONCLUSIONS: These data suggest that adenovirus-mediated inhibition of HIF-1alpha inhibits the invasion, tube formation, and cell growth in HUVECs and HCC cells.
Adenoviridae/genetics ; Carcinoma, Hepatocellular/*blood supply/metabolism/therapy ; Cell Line, Tumor ; Cell Proliferation ; Endothelial Cells/metabolism ; Gene Knockdown Techniques ; Genetic Vectors ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit/*antagonists & ; Liver Neoplasms/*blood supply/metabolism/therapy ; Matrix Metalloproteinases/metabolism ; Neovascularization, Pathologic/genetics/metabolism/*therapy ; RNA Interference ; RNA, Small Interfering/metabolism

PURPOSE: The study aimed to explore the health consequences that women experienced after miscarriage and the factors related to them. METHODS: A convenience sample consisting of 102 women who had miscarried within 2 years was used. Women were recruited from hospitals and enterprises in Seoul and Gyeong-Gi Province. Participants completed a self-administered questionnaire containing a physical and psychological symptoms checklist developed for this study. RESULTS: More than 40% of the miscarriages occurred after 9 weeks of pregnancy and 35% of women were found to have had a previous miscarriage prior to this study. Psychological symptoms were more prevalent and prolonged than the physical symptoms, furthermore, the frequencies of the symptoms experiencedwere not consistent with the duration of symptoms. Employed women and women with early miscarriages complained of more physical symptoms; however, psychological symptoms were not different according to women's characteristics. Employment was a significant factor affecting physical symptoms. CONCLUSION: Health care professionals need to inform and educate women and the family of the potential health changes during the recovery after the miscarriage. Health consequences due to miscarriages also need to be incorporated in women's reproductive health care. Nursing care should consider factors of maternal age, employment status, and obstetrical conditions upon the apparent social changes.
Abortion, Spontaneous ; Checklist ; Delivery of Health Care ; Employment ; Female ; Humans ; Maternal Age ; Nursing Care ; Pregnancy ; Surveys and Questionnaires ; Reproductive Health ; Social Change

PURPOSE: We wanted to evaluate the clinical and radiological results after performing arthroplasty for an intertrochanteric fracture in patients 70 years of age or older, and we used a new fixation technique of the greater trochanter. MATERIAL AND METHODS: From January, 2004 to August 2007, we treated 21 cases (M/F: 3/18) of intertrochanteric fracture with hemiarthroplasty with modified double tension band wiring. All the cases were above type 2 (AO/OTA A1.3) according to the Jensen modification of the Evans classification, and all the patients were elderly. The fractures were evaluated for the fracture pattern by using simple radiography and 3D computed tomography. We analyzed the clinical and radiological results at a minimum of 12 months (range: 12~36 months). RESULTS: We performed hemiarthroplasty with modified double tension band wiring. Two cases (9.5%) among the 21 cases developed loss of reduction due to an additional injury and one of them underwent reoperation using a greater trochanter reattachment device (GTRD). The greater trochanters were well maintained without displacement and excellent union was seen at the fracture site of 19 cases. CONCLUSION: The modified double tension band wiring technique, along with several other fixation methods, should be considered to easily obtain rigid fixation in an unstable intertrochanteric fracture.
Aged ; Arthroplasty ; Displacement (Psychology) ; Femur ; Hemiarthroplasty ; Humans ; Reoperation