Objective To analyze the incidence of general complication and methods of prevention and treatment in extremely low birth weight infants (ELBW). Methods The complication of neonatal respiratory distress syndrome(NRDS), bronchopulmonary dys-plysia( BPD), patent ductus arteriosus(PDA),intracranial hemorrhage (IVH), periventricular leukomalacia (PVL) and retinopathy of prematurity (ROP) were analysed in 16 cases of ELBW and 26 cases of very low birth weight(VLBW) infants. Results The incidences of NRDS,BPD,PDA,IVH,PVL,ROP were 81 %,81 %,25 %,50 %,13 %,63 % respectively in ELBW group. The incidences of NRDS, BPD.PDA, IVH.PVL.ROP were 88 % ,42 % ,42 % ,50 % , 12 % ,54 % respectively in VLBW group. The incidence of BPD in ELBW infants was significantly higher than that of VLBW infants (P

PURPOSE: microRNAs (miRNAs) are non-coding RNAs composed of 20 to 22 nucleotides that regulate development and differentiation in various organs by silencing specific RNAs and regulating gene expression. In the present study, we show that the microRNA (miR)-183 cluster is upregulated during hair cell regeneration and that its inhibition reduces hair cell regeneration following neomycin-induced ototoxicity in zebrafish. MATERIALS AND METHODS: miRNA expression patterns after neomycin exposure were analyzed using microarray chips. Quantitative polymerase chain reaction was performed to validate miR-183 cluster expression patterns following neomycin exposure (500 µM for 2 h). After injection of an antisense morpholino (MO) to miR-183 (MO-183) immediately after fertilization, hair cell regeneration after neomycin exposure in neuromast cells was evaluated by fluorescent staining (YO-PRO1). The MO-183 effect also was assessed in transgenic zebrafish larvae expressing green fluorescent protein (GFP) in inner ear hair cells. RESULTS: Microarray analysis clearly showed that the miR-183 cluster (miR-96, miR-182, and miR-183) was upregulated after neomycin treatment. We also confirmed upregulated expression of the miR-183 cluster during hair cell regeneration after neomycin-induced ototoxicity. miR-183 inhibition using MO-183 reduced hair cell regeneration in both wild-type and GFP transgenic zebrafish larvae. CONCLUSION: Our work demonstrates that the miR-183 cluster is essential for the regeneration of hair cells following ototoxic injury in zebrafish larvae. Therefore, regulation of the miR-183 cluster can be a novel target for stimulation of hair cell regeneration.
Animals ; Animals, Genetically Modified ; Cell Count ; Gene Expression Profiling ; Gene Expression Regulation/drug effects ; Gene Knockdown Techniques ; Green Fluorescent Proteins/metabolism ; Hair Cells, Auditory/drug effects ; Hair Cells, Auditory/physiology ; Larva/drug effects ; Larva/genetics ; MicroRNAs/genetics ; MicroRNAs/metabolism ; Morpholinos/pharmacology ; Neomycin/toxicity ; Regeneration/drug effects ; Regeneration/genetics ; Zebrafish/genetics

Bilateral pneumothorax is very rare in primary spontaneous pneumothorax patients. This condition can cause chest pain, dyspnea, and even lead to tension pneumothorax. Spontaneous hemopneumothorax can be lethal due to massive bleeding and hypovolemic shock. This condition requires precise decision making and emergency management. We report on a case of simultaneous bilateral spontaneous pneumothorax combined with hemopneumothorax in a healthy 21-year-old male patient with chest discomfort. In the emergency department, closed thoracostomy was performed for decompression of hemopneumothorax, with drainage of 850 mL of blood. Then bilateral video-assisted thoracoscopic surgery was performed successfully.
Chest Pain ; Decision Making ; Decompression ; Drainage ; Dyspnea ; Emergencies ; Emergency Service, Hospital ; Hemopneumothorax* ; Hemorrhage ; Humans ; Male ; Pneumothorax* ; Shock ; Thoracic Surgery, Video-Assisted ; Thoracostomy ; Thorax ; Young Adult

The authors report below a clinical study of 23 patients bearing 31 primary central nervous system lymphomas diagnosed between January 1985 and December 1994. The cohort included 13 men and 10 women whose mean age was 46 years, ranging from 28 to 61 years. No patient had antecedent of human immunodeficiency virus positivity but one had a past history of rheumatoid arthritis. The duration of symptom was less than 8 weeks in 52% of the patients. Symptom groups included increased intracranial pressure(78%), focal neurological decificit(52%), neuropsychiatric symptoms(43%), and seizures(13%). The histopathologcal diagnosies were done in 19 cases(10 cases by resective surgery, 9 cases by open or stereotactic biopsy). The others were diagnosed by the typical clinical course such as rapid disappearance of lesions after steroid therapy, and/or radiological findings. Histological subtypes(National Cancer Institute Working Formulation) was confirmed in 8 patients including 3 cases of diffuse larger cell type. Phenotype was determined in 7 patients: 4 were B-cell type and 3 were T-cell type. One patient committed suicide during the radiation therapy and was therefore excluded from the survival analysis. All but two patients received radiation therapy. Five patients received chemotherapy. The over-all Kaplan-Meier survival rate was 46% at 2 years and 15.5% at 5 years. On univariate analysis, statistically significant prognostic factor associated with survival was not found but the higher Karnofsky score and single lesion were found to be favorable to the long-term survival. In the statistical analysis of the patients who received radiation therapy, surgical resection did not significantly influence the survival.
Arthritis, Rheumatoid ; B-Lymphocytes ; Brain Neoplasms ; Central Nervous System* ; Cohort Studies ; Drug Therapy ; Female ; HIV ; Humans ; Lymphoma ; Male ; Phenotype ; Suicide ; Survival Rate ; T-Lymphocytes

PURPOSE: The hepatocyte growth factor, (HGF)/c-Met, pathway may play various roles in the carcinogenesis of various organs. HGF, a ligand for c-Met, is a pleiotrophic factor that was originally identified as a polypeptide growth factor for hepatocytes. Met protein, known as the HGF receptor, is a transmembrane 190 kDa heterodimer with tyrosine kinase activity, which is encoded by the c-met oncogene. The HGF/ c-Met signalling pathway has been shown to demonstrate various cellular responses including mitogenic, proliferative, morphogenic and angiogenic activities. Although the c-met gene is known to be expressed in a variety of tissues and play important roles in signal transduction, studies of its expression in thyroid tumors are rare. Our objectives were to evaluate the c-met gene expression in benign and malignant thyroid tumors and to correlate this with various clinicopathological facors. METHODS: In this study, the mRNA expression of the c-met was examined by means of a RT-PCR method and the from immunohistochemical expression of c-Met protein in 100 cases of thyroid tumors cases, including 50 papillary carcinomas (pc), 10 follicular carcinomas (fc), and 20 follicular adenomas (fa), 20 nodular hyperplasia (nh). RESULTS: c-met mRNA expression was detected in 10, 20, 40 and 86% of the nh, fa, fc and pc, respectively. Also, c-Met protein expression was detected in 5, 15, 20 and 88% of the nh, fa, fc and pc, respectively. Especially, the c-Met protein expression was higher in well differentiated papillary carcinomas than those that were poorly differentiated, and was statistically significant. Correlation between c-met mRNA and protein expression was recognized in papillary carcinomas. CONCLUSION: These results suggest that the expression of c-met gene expression may be associated with the development of papillary carcinomas of the thyroid. Also, both c-met mRNA and protein expressions may contribute to the morphogenesis of well differentiated papillary carcinomas.
Adenoma ; Carcinogenesis ; Carcinoma, Papillary ; Gene Expression ; Hepatocyte Growth Factor ; Hepatocytes ; Hyperplasia ; Morphogenesis ; Oncogenes ; Protein-Tyrosine Kinases ; Proto-Oncogene Proteins c-met ; RNA, Messenger ; Signal Transduction ; Thyroid Gland*

PURPOSE: To evaluate the outcomes and prognostic factors of postoperative radiotherapy (PORT) for patients with pathological stage III non-small-cell lung cancer (NSCLC) at a single institution. MATERIALS AND METHODS: From 2000 to 2007, 88 patients diagnosed as having pathologic stage III NSCLC after curative resection were treated with PORT. There were 80 patients with pathologic stage IIIA and eight patients with pathologic stage IIIB in the AJCC 6th staging system. The majority of patients (n=83) had pathologic N2 disease, and 56 patients had single station mediastinal LN metastasis. PORT was administered using conventional technique (n=76) or three-dimensional conformal technique (n=12). The median radiation dose was 54 Gy (range, 30.6 to 63 Gy). Thirty-six patients received chemotherapy. Radiation pneumonitis was graded by the Radiation Therapy Oncology Group system, and other treatment-related toxicities were assessed by CTCAE v 3.0. RESULTS: Median survival was 54 months (range, 26 to 77 months). The 5-year overall survival (OS) and disease free survival (DFS) rates were 45% and 38%, respectively. The number of metastatic lymph nodes was associated with overall survival (hazard ratio, 1.037; p-value=0.040). The 5-year locoregional recurrence free survival (LRFS) and distant metastasis free survival (DMFS) rates were 88% and 48%, respectively. Multiple stations of mediastinal lymph node metastasis was associated with decreased DFS and DMFS rates (p-value=0.0014 and 0.0044, respectively). Fifty-one relapses occurred at the following sites: 10 loco-regional, 41 distant metastasis. Grade 2 radiation pneumonitis was seen in three patients, and symptoms were well tolerated with anti-tussive medication. Grade 2 radiation esophagitis was seen in 11 patients. There were no grade 3 or more severe complications associated with PORT. CONCLUSION: Our retrospective data show that PORT for pathological stage III NSCLC is a safe and feasible treatment and could improve loco-regional control. The number of metastatic lymph nodes and stations of mediastinal lymph node metastasis were analyzed as prognostic factors. Furthermore, efforts are needed to reduce distant metastasis, which is a major failure pattern of advanced stage NSCLC.
Disease-Free Survival ; Esophagitis ; Humans ; Lung ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Radiation Pneumonitis ; Recurrence ; Retrospective Studies

PURPOSE: The impact of postoperative ipsilateral neck radiotherapy (INRT) versus bilateral neck radiotherapy (BNRT) on the clinical outcomes of patients with tonsillar squamous cell carcinoma was analyzed retrospectively. MATERIALS AND METHODS: Between October 2001 and June 2012, 241 patients with T1-2 and N0-N2b tonsillar carcinoma from 16 institutes underwent postoperative INRT (n=84) or BNRT (n=157) following a tonsillectomy. Seventy patients were identified from each group by propensity score matching and compared in terms of the overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates calculated using the Kaplan-Meier method with a log-rank test. RESULTS: The median follow-up was 55 months (range, 3 to 133 months). The survival outcomes in the INRT and BNRT groups were similar: 5-year OS (92.8% vs. 94.0%, p=0.985), DFS (80.5% vs. 94.2%. p=0.085), LRRFS (88.1% vs. 97.1%, p=0.083), and DMFS (92.7% vs. 97.0%, p=0.370). Subgroup analysis revealed no contralateral neck recurrence in 61 patients with T1-2N0-2a regardless of the treatment groups. For 79 patients with N2b, contralateral neck recurrence was more common in the INRT group than in the BNRT group (7.9% vs. 0.0%), but the difference was not significant (p=0.107). The overall grade ≥ 2 toxicities were lower in the INRT group: acute (45.7% vs. 74.3%, p=0.001) and late (4.3% vs. 31.4%, p < 0.001), respectively. CONCLUSION: INRT is an attractive strategy for patients with T1-2N0-2a tonsillar carcinoma compared to BNRT. For patients with N2b, there was a small risk of contralateral neck recurrence when treated with INRT, but its impact on the OS was limited with successful salvage treatment.
Academies and Institutes ; Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epithelial Cells* ; Follow-Up Studies ; Humans ; Methods ; Neck* ; Palatine Tonsil* ; Propensity Score* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Salvage Therapy ; Tonsillar Neoplasms ; Tonsillectomy

PURPOSE: We compared the treatment results and toxicity in nasopharyngeal carcinoma (NPC) patients treated with concurrent chemotherapy (CCRT) alone (the CRT arm) or neoadjuvant chemotherapy followed by CCRT (the NCT arm). MATERIALS AND METHODS: A multi-institutional retrospective study was conducted to review NPC patterns of care and treatment outcome. Data of 568 NPC patients treated by CCRT alone or by neoadjuvant chemotherapy followed by CCRT were collected from 15 institutions. Patients in both treatment arms were matched using the propensity score matching method, and the clinical outcomes were analyzed. RESULTS: After matching, 300 patients (150 patients in each group) were selected for analysis. Higher 5-year locoregional failure-free survival was observed in the CRT arm (85% vs. 72%, p=0.014). No significant differences in distant failure-free survival (DFFS), disease-free survival (DFS), and overall survival were observed between groups. In subgroup analysis, the NCT arm showed superior DFFS and DFS in stage IV patients younger than 60 years. No significant difference in compliance and toxicity was observed between groups, except the radiation therapy duration was slightly shorter in the CRT arm (50.0 days vs. 53.9 days, p=0.018). CONCLUSION: This study did not show the superiority of NCT followed by CCRT over CCRT alone. Because NCT could increase the risk of locoregional recurrences, it can only be considered in selected young patients with advanced stage IV disease. The role of NCT remains to be defined and should not be viewed as the standard of care.
Arm ; Chemoradiotherapy ; Compliance ; Disease-Free Survival ; Drug Therapy* ; Humans ; Induction Chemotherapy ; Methods ; Nasopharyngeal Neoplasms ; Propensity Score* ; Radiotherapy ; Recurrence ; Republic of Korea ; Retrospective Studies* ; Standard of Care ; Treatment Outcome

PURPOSE: To define the role of neoadjuvant and concurrent chemotherapy in stage II nasopharyngeal carcinoma, we compared the treatment outcomes of patients treated with curative radiotherapy with or without chemotherapy. MATERIALS AND METHODS: From 2004 to 2011, 138 patients with American Joint Committee on Cancer (AJCC) 2002 stage II nasopharyngeal carcinoma were treated with curative radiotherapy in 12 hospitals in South Korea. Treatment methods included radiotherapy alone in 34 patients, neoadjuvant chemotherapy followed by radiotherapy alone in seven, concurrent chemoradiotherapy in 80, and neoadjuvant chemotherapy followed by concurrent chemoradiotherapy in 17. Adjuvant chemotherapy was used in 42 patients. Total radiation dose ranged from 64 Gy to 74.2 Gy (median, 70 Gy). RESULTS: Median follow-up was 48 months (range, 7 to 97 months) for all patients. At the last follow-up, 13 patients had died and 32 had experienced treatment failure; locoregional failure occurred in 14, distant failure in 16, and both in two. Five-year locoregional relapse-free survival, distant metastasis-free survival, progression-free survival, and overall survival were 86.2%, 85.5%, 74.4%, and 88.2%, respectively. Multivariate analyses showed that the significant prognostic factors were concurrent chemotherapy and N stage for locoregional relapse-free survival, concurrent chemotherapy for progression-free survival, and age and N stage for overall survival. Neither neoadjuvant nor concurrent chemotherapy improved distant metastasis-free survival. CONCLUSION: Concurrent chemotherapy significantly improved 5-year locoregional relapse-free survival and progression-free survival in stage II nasopharyngeal carcinoma. However, neoadjuvant chemotherapy failed to improve either.
Chemoradiotherapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy* ; Follow-Up Studies ; Humans ; Joints ; Korea ; Multivariate Analysis ; Radiotherapy* ; Treatment Failure

PURPOSE: To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea. MATERIALS AND METHODS: A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions. RESULTS: Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose. CONCLUSION: Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.
Appointments and Schedules ; Chemotherapy, Adjuvant ; Cisplatin ; Diagnostic Imaging ; Drug Therapy ; Electrons ; Humans ; Korea* ; Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms ; Radiation Oncology ; Radiotherapy ; Retrospective Studies