Purpose: Despite the recent success of Bruton’s tyrosine kinase (BTK) inhibitors for the treatment of Waldenstrom macroglobulinemia (WM), their indefinite treatment duration ultimately tantamount to substantial financial and emotional burden. On the other hand, fixed duration of proteasome inhibitors (PI) have shown rapid and reasonable response in WM treatment. Despite the well-known synergism between PI and immunomodulatory drugs (IMiD), there is no trials evaluating such combination in WM. Materials and Methods: Based on above, we designed this phase II study to investigate the efficacy and safety of 6 cycles of 28-day bortezomib-thalidomide-dexamethasone (VTD) regimen for treatment-naïve WM. Results: A total of 15 patients were enrolled: major response rate was 64.3%, and overall response rate was 78.6%. During the median follow-up of 41 months, median progression-free survival (PFS) was 13 months and overall survival 40 months. For responders, median duration of response was 13 months and median PFS 19 months. The most common adverse event (AE) of any grade was constipation (57.1%). The most common grade ≥ 3 AE was anemia (21.4%). Conclusion All in all, we hereby provide proof-of-concept that PI + IMiD may be an attractive backbone for fixed duration treatment. It should be noted that granting the same level of access to newer drugs globally is virtually impossible. Thus efforts to develop regimens using readily available drugs to yield similar or adequate treatment outcomes should not be disregarded. In this sense, we believe our study holds its place for its novelty and eloquently addresses achieving the daunting societal quest of health equity.

Background: and Purpose: The main difficulty when diagnosing leptomeningeal metastases (LMSs) is the low sensitivity of cytology. Cancer cells release cell-free DNA (cfDNA) during proliferation and apoptosis, and so we analyzed the cfDNA level as a biomarker for LMSs in hematologic malignancy. Methods: This study prospectively enrolled 20 patients with hematologic malignancy who underwent cerebrospinal fluid (CSF) analysis. LMS was diagnosed based on both CSF cytology and clinical findings. Results: The CSF level of cfDNA was higher in patients with LMSs (108.17±84.84 ng/mL, mean±standard deviation) than in non-LMS patients (14.23±2.78 ng/mL). The sensitivity of cfDNA was higher than that of cytology (100% vs. 87%). Conclusions The cfDNA level in the CSF can be used as a supplemental marker for diagnosing LMS in hematologic malignancy patients.

OBJECTIVES: This study estimated the magnitude of malignant mesothelioma and its epidemiologic features in Korea. We collected data on 160 cases for the 5-year period from 2001 to 2005. METHODS: We established a surveillance system for malignant mesothelioma in 2001. The important participants were pathologists, and respiratory and occupational physicians. We reclassified these cases according to the date of diagnosis and calculated fatality by comparing National Mortality Data. We actively surveyed 18 cases which were diagnosed in 2004 and 2005 to evaluate their work-relatedness. RESULTS: Among 160 cases, 18 were initially diagnosed before 1995, 57 from 1996 to 2000, 11 in 2001, 18 in 2002, 11 in 2003, 29 in 2004 and 16 in 2005. After 2001, 17cases were reported annually. Among the 86 cases which were diagnosed before 2003, 60 cases (69.8%) had died and 46(53.5%) had died within 1 year. Among the 18 cases which we surveyed, 5 were related with the construction industry, 2 with asbestos textile manufacturing industries and 1 with asbestos painting. There was no evident work relatedness in the other 10 cases, but 6 were related to environmental exposure. CONCLUSIONS: Although this surveillance system revealed the magnitude of malignant mesothelioma in Korea, it needs to be supplemented by an active surveillance system using death certificate data and cancer registry data etc.
Asbestos ; Construction Industry ; Death Certificates ; Diagnosis ; Environmental Exposure ; Korea* ; Mesothelioma* ; Mortality ; Paint ; Paintings ; Textiles

OBJECTIVE: The objective of this study was to elucidate the relationship between job stress and pulse wave velocity (PWV) as a cardiovascular risk factor. METHOD: The study design was cross-sectional, and a total of 234 industrial workers were recruited. A structured-questionnaire was used to assess the general characteristics and job characteristics (work demand, decision latitude) using a modified Karasek model. Cuffs were applied to the extremities and a microphone for phonocardiography was placed at the second intercostal space at the margin of the sternum. The subjects rested in a supine position for 5 min, and PWV was measured using a VP-1000(Colin Waveform analyzer). RESULTS: There were significant correlations between blood pressure, glucose, total cholesterol, coagulation factor and PWV. The group with low decision latitude and high decision latitude showed higher levels of PWV, but the differences were not significan. The PWV (left) was significantly higher in the high strain group than in the lower strain group. After adjustment for age and cardiovascular risk factors, job strain was still associated with PWV. CONCLUSION: These result suggest that the high strain group among workers is related to an increased risk of PWV as a marker of atherosclerosis.
Atherosclerosis ; Blood Coagulation Factors ; Blood Pressure ; Cholesterol ; Extremities ; Glucose ; Phonocardiography ; Pulse Wave Analysis* ; Risk Factors* ; Sternum ; Supine Position

BACKGROUND: The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea are limited. OBJECTIVE: The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. METHODS: The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. The relative frequency of the major diagnostic group according to WHO classification was as follows: mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone lymphoma, 1%; angioimmunoblastic lymphadenopathy, 1%. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma.
Academies and Institutes ; Classification ; Continental Population Groups ; Geography ; Humans ; Immunoblastic Lymphadenopathy ; Korea* ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, Follicular ; Lymphoma, Large-Cell, Anaplastic ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Pathology ; Retrospective Studies

BACKGROUND: Malignant melanoma in Korea has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. OBJECTIVE: The aim of this study was to document the clinical and histopathological features of cutaneous melanoma in Korea. METHODS: The Dermatopathology Research Group conducted a review of nationwide collection of 109 primary cutaneous melanomas, diagnosed at 23 institutes over a recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. RESULTS AND CONCLUSION: The peak age was the 7th decade with the mean age of 58.1 years. Korea has a higher rate of acral melanoma and much lower rate of lentigo maligna melanoma. .Major component tumor cell was spindle cell type. Clark level of tumor was III or more and Breslow depth was 2mm or more at the time of the first diagnosis in many cases (62%). Pre-existing melanocytic nevus was present in a few cases (3 cases). All these features suggest that the racial difference between the Korean and the Caucasian is evident. We also suggest that an early detection program is very important to cure this malignant tumor.
Academies and Institutes ; Diagnosis ; Humans ; Hutchinson's Melanotic Freckle ; Korea* ; Melanoma* ; Nevus, Pigmented ; Pathology ; Retrospective Studies

The subjects in this study were the directors in charge of article inspection from 127 academies that are registered with the Korea Academy of Medical Science. After a questionnaire was prepared covering the examination process, judging committee organization, problems with examination and possible reform measures, a survey was conducted by e-mail and facsimile from October 4 through 20, 2001. The responses from 79 academies were gathered, a response rate of 62.2%, and the collected data were analyzed with SAS. The most common examination process was C type, which convenes publishing committees, employed by 59 academies_(74.6%), and these institutes found it satisfactory. Thirty-four academies_(43.0%) had 10 to 19 judges, and these judges were separately in charge of different fields, whereas 79 academies_(77.3%) allocated five or less judges to each field. Thirty_(38.0%) academies had their judges comply with related official directions or guidelines, and 50 academies_(63.3%) conducted investigation just twice. Fifty-four academies_(68.4%) weren't satisfied with their examination process. As for the problems with the examination process, many_(41.8%) pointed out that it's time-consuming work and that a lot of procedures were repeated. Concerning the benefit of the online examination program, 41 academies_(51.9%) thought that it was more efficient and less time-consuming. Forty-one academies_(51.9%) were aware of the online examination program, but only 23 academies_(29.1%) were willing to use it. In order to realize an online paper review, there should be appropriate criteria and guidelines for the construction of an online paper review system that suits various types of paper review process employed by the academies. The usability of online information and technology for more efficient and higher-quality judgment should be widely be publicized, and consideration should be given for the types of paper review system that might be suitable for those who are neither aware of the use of the internet nor willing to utilize.
Academies and Institutes ; Electronic Mail ; Internet ; Judgment ; Korea ; Surveys and Questionnaires ; Societies, Medical*

BACKGROUND: Data on the clinicopathologic features of hair follicle tumors in Korea are limited. OBJECTIVE: The purpose was to investigate the clinical and histopathologic characteristics of hair follicle tumors in Korea. METHODS: Two hundred sixty four cases of hair follicle tumors seen from 1999 to 2001 in Korea were analyzed clinically and histopathologically. RESULTS AND CONCLUSION: The most common hair follicle tumor in Korea was pilomatricoma(81.0%), followed by trichoepithelioma(6.4%), dilated pore of Winer(3.8%), and proliferating trichilemmal tumor(2.2%). Hair follicle tumors usually occurred as a solitary skin-colored nodule. The most commonly involved site was the face, and the peak age of presentation was 10 to 19. Pilomatricoma usually occurred as a solitary skin-colored nodule. The most commonly involved site was the arm, and more than 50% of tumors occurred before the age of 20. Histopathologically, the tumor was often surrounded by fibrous capsule and was composed of basophilic and shadow cells. It was usually located in the dermis and extended into the subcutis. Retraction spaces between tumor nests and stroma were frequently observed. Trichoepithelioma usually occurred as multiple skin-colored papules on the face. Histopathologically, the tumor was usually located in the dermis with sometimes connected to the epidermis. It frequently showed peripheral palisading. Dilated pore of Winer usually occurred as a solitary brownish to pigmented papule on the face in middle-aged persons. Proliferating trichilemmal tumor occurred as a solitary or multiple tumors. Histopathologically, the tumor was usually surrounded by incomplete fibrous capsule. Tumor cells frequently showed clear cell formation, nuclear atypia, mitosis, peripheral palisading, trichilemmal keratinization, and individual keratinization.
Arm ; Basophils ; Dermis ; Epidermis ; Hair Follicle* ; Hair* ; Humans ; Korea ; Mitosis ; Pilomatrixoma

OBJECTIVES: Parents of child neuropsychiatic patients may have many stresses due to their children's illness. Characteristics and severity of diseases will influence to the stresses of parents. The authors investigated various factors and parents' social support having an effect on the parenting stress. METHODS: Children and parents in outpatients interviewed and completed measures assessing children's problem behaviors, parenting stress, general social support, and support related to parenting by Child Behavior Checklist, Parenting Stress Index, Medical Outcomes Study's Social Support Scale, and Parenting Support Scale. RESULTS: We could not find the differences in the total scores of CBCL, Social Support Scale, and Parenting Stress Index among major diagnostic groups. In the same diagnosis, no difference of parenting stress was found according to general social support. Parenting stress highly correlated with severity of problem behaviors measured by CBCL. CONCLUSION: Severity of problem behaviors perceived by parents most predicted parenting stress. Parenting stress correlated with support to parenting, but not with general social support. Managing of children's problem behaviors is the most immediate and effective method to diminish the parental stress of child neuropsychiatric patients.
Checklist ; Child Behavior ; Child* ; Diagnosis ; Humans ; Outpatients* ; Parenting* ; Parents*

This study was designed to analyze the research methodology and the key concepts used in articles published in each nursing journal of seven branches of the Korean Academy of Nursing. The purpose of this study was for reflecting the trends of nursing research and suggesting the direction of future nursing research in Korea. One thousand three hundred seventy two articles published in seven nursing journals from the beginning year of 2000 were analyzed. The prevailing research designs for these journals were the non-experimental design ranging from 54.3% to 75.7%, the experimental design ranging from 6.2% to 30.4%, and qualitative research design ranging from 3.7% to 10.6%. Research subjects were 10.0% to 46.0% for clients with health problems, 2.1% to 42.4% for generally healthy persons, 1.4% to 43.9% for primary care-givers, 7.0% to 53.5% for nurses or nursing students, and 3.1% to 7.3% for health organizations or nursing organizations. The data collection method used most often self-report questionnaires using psychosocial measures. Interviewing methods and physiologic measures were used relatively few times. The domains of the key concepts that prevailed was personal domain and health domain. This study has the limitation of focusing on only the superficial structural analysis rather than in-depth content analysis of each article. However, this study is the first study for reflecting the trends of nursing research based on each journal of seven branches of the Korean Academy of Nursing.
Data Collection ; Humans ; Korea ; Nursing Research* ; Nursing* ; Qualitative Research ; Surveys and Questionnaires ; Research Design ; Research Subjects ; Students, Nursing