No abstract available.
Child* ; Humans ; Visual Acuity*

BACKGROUND: Overexpression of bcl-2 protein is observed both in follicular lymphoma, in which bcl-2 has usually undergone a translocation t (14;18). The experimental findings that transfection of bcl-2 in to murine lymphoid cells confers resistance to nitrogen mustard and camptothecin by inhibiting apoptosis suggests that bcl-2 overexpression may confer clinical drug resistance in lymphomas. In contrast to bcl-2, p53 arrests cells exposed to DNA-damaging agents in G1 to allow DNA repair or if essential repairs are not possible, promotes apoptosis. Experimentally, loss of p53 function produces cellular resistance to alkylating and topoisomerase-II drug classes, suggesting that loss of p53 function in lymphomas may cause drug resistance. These observations led to the hypothesis that bcl-2 and p53 play a role in the development of drug resistance in lymphoma. Although several studies assessed the association between bcl-2 expression and disease-free survival, they reached conflicting conclusions. METHODS: We analyzed tumor tissue from 42 patients with advanced NHL for p53 and bcl-2 expression and correlation with multiple clinical characteristics, response to therapy and overall survival. Among 42 tumors, 8 (19.0%) tumors had bcl-2 expression and 19 (45.2%) had a p53 overexpression. RESULTS: A significant correlation was found between bcl-2 expression and poor performance, advanced stage (stage III and IV) at diagnosis, and bone marrow involvement in a univariate analysis (P<0.05). A multivariate analysis showed that tumors with bcl-2 expression (>50%) were more likely to be poor prognosis than tumors with negative or week expression (<50%) and to have a shorter long-term survival (28.6% vs 75.5%; P<0.05). However, the expression of p53 did not correlate with any clinical characteristics and overall survival was not influenced by p53 protein expression. CONCLUSION: These results suggest that bcl-2 protein expression in patients with malignant lymphoma appears to be predictive of shorter long-term survival and it might be considered as a strong independent prognostic factor.
Apoptosis ; Bone Marrow ; Camptothecin ; Diagnosis ; Disease-Free Survival ; DNA Repair ; Drug Resistance ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, Follicular ; Lymphoma, Non-Hodgkin ; Mechlorethamine ; Multivariate Analysis ; Prognosis ; Transfection

Posttransplant lymphoproliferative disorder (PTLD) is a group of heterogeneous lymphoid diseases that cause serious complications after organ or stem cell transplantation. The onset of PTLD is mostly due to EBV infection-induced B-cell proliferation and a defect in cytotoxic T cell function that occurs with immunosuppression. The usual treatment strategy for PTLD is reduction or withdrawal of immunosuppressive drugs with or without the administration of antiviral agents. Recently, various studies on the efficacy of rituximab or chemotherapy have been reported. We report two cases of rapidly progressing and complicated PTLDs after kidney transplantation that were successfully treated with a combination regimen consisting of rituximab, cyclophosphamide, adriamycin, vincristine and prednisolone (R-CHOP).
Antibodies, Monoclonal, Murine-Derived ; Antiviral Agents ; B-Lymphocytes ; Cyclophosphamide ; Doxorubicin ; Herpesvirus 4, Human ; Immunosuppression ; Kidney Transplantation ; Korea ; Lymphoproliferative Disorders ; Prednisolone ; Stem Cell Transplantation ; Vincristine ; Rituximab

BACKGROUND: Notch is a gene family encoding receptors to transduce intercellular signals involved in cell-fate determination. Although several lines of evidence indicate that abnormal Notch signaling may contribute to neoplastic transformation, little is known regarding the role of Notch in the pathogenesis of leukemia. METHODS: To explore the functional significance of Notch1 in acute myeloid leukemia (AML), the expression of Notch1 and its association with survivin and p27Kip1 expression was examined in 50 patients with de novo AML. RESULTS: Notch1 transcripts were expressed in 40 (80%) cases with a variable degree of expression, and the fraction of AML cells in the G0/G1 phase was higher in Notch1-positive cases than in Notch1-negative cases. Survivin was shown to be present in 38 (76.0%) cases, and Notch1 expression highly correlated with survivin mRNA expression (r=0.7170, P<0.001). p27Kip1 was present in 40 (80.0%) cases of AML and p27Kip1 expression was significantly associated with Notch1 expression (r=0.8770, P<0.001). Except for one case, the simultaneous expression of survivin and p27Kip1 was not seen in all cases that were negative for Notch1 expression. There were no differences in clinical outcomes according to Notch1 expression. CONCLUSION: Notch1 expression was a frequent event and has functional significance in the alteration of the cell cycle in AML cells. Notch1 expression was also significantly associated with survivin and p27kip1 expression in AML cells. To evaluate the clinical significanceand functional role of Notch1 expression in the aberrant regulation of survivin and p27Kip1 expression in de novo AML, a further study with a larger number of patients is necessary.
Cell Cycle ; Genes, vif ; Humans ; Leukemia ; Leukemia, Myeloid, Acute ; RNA, Messenger

BACKGROUND: To evaluate the diagnostic accuracy of EBT(Electron Beam Tomography) in the diagnosis of conotruncal anomaly and to determine whether it can be used as a substitute for cardiac angiography. MATERIAL AND METHOD: 20 patients(11M & 9F) with TOF(n=7, pulmonary atresia 2), DORV(n=7), complete TGV(n=4), & corrected TGV(n=2) were included. The age ranged from 7 days to 26 years(median 60 days). We analyzed the sequential chamber localization, the main surgical concenrn in each disease category (PA size, LVED volume and coronary artery pattern for TOF& pulmonary atresia, the LV mass, LVOT obstruction, coronary artery pattern for complete TGV, and type of VSD and TV-PV distance for DORV, etc) and other associated anomalies(e.g., VSD, arch anomalies, tracheal stenosis, etc). Those were compared with the results of echocardiography(n=19), angiography (n=9), and surgery(n=11). The interval between EBT and echocardiography/angiography was within 20/11 days, respectively except for an angiography in a patient with corrected TGV (48 days). RESULT: EBT correctly diagnosed the basic components of conotruncal anomalies in all subjects, compared to echocardiography, angiography or surgery. These included the presence, type and size of VSD(n=20), pulmonic/LV outflow tract stenosis(n=15/2), relation of great arteries and the pattern of the proximal epicardial coronary arteries(16 out of 20). EBT proved to be accurate in quantitation of the intrapericardial and hilar pulmonary arterial dimension and showed high correlation and no difference compared with echocardiography, angiography, or surgery(p>0.05) except for left pulmonary arterial & ascending arterial dimension by echocardiography. LVED volume in seven TOF(no difference: p>0.05 & high correlation: r=0.996 with echocardiography), and LV mass in 4 complete TGV were obtained. Additionally, EBT enabled the cdiagnosis of subjlottic tracheal stenosis and tracheal bronchus in 1 respectively. Some peripheral PA stenosis were not detected by echocardiography, while echocardiography appeared to be slightly more accurate than EBT in detecing ASD or PDA. CONCLUSIONS: EBT can be a non-invasive and accurate modality of for the evaluation of most anatomical alteration including peripheral PS or interruption in patients with conotruncal anomalies. Combined with echocardiography, EBT study provides sufficient information for the palliative or total repair of anomalies.
Angiography ; Arteries ; Bronchi ; Constriction, Pathologic ; Coronary Vessels ; Diagnosis ; Echocardiography ; Heart Defects, Congenital ; Humans ; Pulmonary Atresia ; Tomography, X-Ray Computed* ; Tracheal Stenosis

A healthy 55-year-old man was referred for investigation of palpitations. During an episode of palpitation, the ECG documented two types of tachycardia with differing morphologies. One was a narrow QRS complex tachycardia with a heart rate of 140 beats/min. The other was wide QRS complex tachycardia with a heart rate of 210 beats/min. Transformation from one tachycardia to the other occurred spontaneously. Electrophysiological studies revealed two inducible tachycardia, which were shown to represent atrioventricular nodal reentrant tachycardia (AVNRT) and idiopathic left ventricular tachycardia. Radiofrequency catheter ablation of the slow atrioventricular nodal pathway resulted in alleviation of AVNRT. Following the ablation of AVNRT, the wide QRS complex tachycardia was induced during ventricular pacing. The mapping showed that the origin of the ventricular tachycardia was the mid-inferior wall of the left ventricle. Radiofrequency catheter ablation of the ventricular tachycardia resulted in mitigation cure of the idioventricular left ventricular tachycardia.
Catheter Ablation* ; Coronary Artery Disease ; Electrocardiography ; Heart Rate ; Heart Ventricles ; Humans ; Middle Aged ; Stents ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Ventricular