Purpose: Triple-negative breast cancer (TNBC) is a particularly challenging subtype of breast cancer, with a poorer prognosis compared to other subtypes. Unfortunately, unlike luminal-type cancers, there is no validated biomarker to predict the prognosis of patients with early-stage TNBC. Accurate biomarkers are needed to establish effective therapeutic strategies. Materials and Methods: In this study, we analyzed gene expression profiles of tumor samples from 184 TNBC patients (training cohort, n=76; validation cohort, n=108) using RNA sequencing. Results: By combining weighted gene expression, we identified a 10-gene signature (DGKH, GADD45B, KLF7, LYST, NR6A1, PYCARD, ROBO1, SLC22A20P, SLC24A3, and SLC45A4) that stratified patients by risk score with high sensitivity (92.31%), specificity (92.06%), and accuracy (92.11%) for invasive disease-free survival. The 10-gene signature was validated in a separate institution cohort and supported by meta-analysis for biological relevance to well-known driving pathways in TNBC. Furthermore, the 10-gene signature was the only independent factor for invasive disease-free survival in multivariate analysis when compared to other potential biomarkers of TNBC molecular subtypes and T-cell receptor β diversity. 10-gene signature also further categorized patients classified as molecular subtypes according to risk scores. Conclusion Our novel findings may help address the prognostic challenges in TNBC and the 10-gene signature could serve as a novel biomarker for risk-based patient care.

Purpose: This study evaluated the impact of auricular acupressure on depression among nurses. Methods: This study used a randomized control group pretest-posttest design. Shift-work nurses with the Patient Health Questionnaire-9 (PHQ-9) score over 5 points were randomized to the experimental group(n=20) or the control group(n=20). For the experimental group, auricular acupressure was conducted at the corresponding points of depression (TGI, AH1) weekly for seven days as well as for two weeks. The PHQ-9 was completed before intervention, as well as two weeks after intervention. Results: The mean difference in the PHQ-9 score before and after auricular acupressure in the experimental group (-4.11±2.27), was more significant than in the control group (-1.72±3.82) (t=2.28, p=.03). Conclusion Result showed that nurses who received auricular acupressure had a decrease in depression, compared to those who did not receive auricular acupressure. Further research is required, to apply the other auricular acupressure points, to evaluate the impact on depressive symptoms.

BACKGROUND: To identify potential molecular prognostic markers in core binding factor (CBF) AML, we analyzed incidences and prognostic impacts of mutations in c-KIT, WT1, CEBPA, CBL, and a number of epigenetic genes in CBF AML. METHODS: Seventy one and 21 AML patients with t(8;21) and inv(16) were enrolled in this study, respectively. NPM1, CEBPA, c-KIT, IDH1/2, DNMT3A, EZH2, WT1, and CBL mutations were analyzed by direct sequencing. Patients were categorized with respect to c-KIT and WT1 mutation status, and both clinical features and prognoses were compared. RESULTS: The incidences of FLT3 internal tandem duplication (ITD), NPM1, CEBPA, IDH1/2, DNMT3A, EZH2, and CBL mutations were low (< or =5%) in CBF AML patients. However, c-KIT and WT1 mutations occurred frequently (10.9% and 13.8%, respectively). t(8;21) patients with c-KIT mutations showed significantly shorter overall survival (OS) and disease free survival (DFS) periods than those without mutations (P<0.001, for both); however, although the limited number of t(8;21) patients were analyzed, WT1 mutation status did not affect prognosis significantly. Relapse or death during follow-up occurred more frequently in t(8;21) patients carrying c-KIT mutations than in those without the mutation, although the difference was significant only in a specific patient subgroup with no WT1 mutations (P=0.014). CONCLUSIONS: The incidences of mutations in epigenetic genes are very low in CBF AML; however, c-KIT and WT1 mutations occur more frequently than others. The poor prognostic impact of c-KIT mutation in t(8;21) AML patients only applies in a specific patient subgroup without WT1 mutations. The prognostic impact of WT1 mutation in CBF AML is not evident and further investigation is required.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group/*genetics ; CCAAT-Enhancer-Binding Proteins/*genetics ; Child ; Core Binding Factors/genetics ; Disease-Free Survival ; Epigenesis, Genetic ; Female ; Humans ; Incidence ; Leukemia, Myeloid, Acute/*diagnosis/epidemiology/genetics ; Male ; Middle Aged ; Mutation ; Prognosis ; Proto-Oncogene Proteins c-cbl/*genetics ; Proto-Oncogene Proteins c-kit/*genetics ; Republic of Korea/epidemiology ; Survival Rate ; Translocation, Genetic ; WT1 Proteins/*genetics ; Young Adult

BACKGROUND: The automated hematologic analyzer has increased the precision and accuracy for platelet counting. However, spurious elevations of automated platelet counts occur occasionally in patients receiving chemotherapy or radiotherapy for solid organ tumors, leukemia, and other lymphomas. The CELL-DYN Sapphire analyzer (Abbott, USA) detects platelets with a CD61 monoclonal antibody and uses both impedance and optical technologies; thus, it is expected to present more accurate platelet counts. METHODS: We evaluated platelet counts obtained with the CELL-DYN Sapphire impedance, optical, and CD61 methods and compared them with the results obtained with the XE-2100 analyzer (Sysmex, Japan). We analyzed 111 samples from hospitalized patients with various hematologic diseases, who were receiving chemotherapy or radiotherapy. RESULTS: The results from the impedance, optical, and CD61 methods of CELL-DYN Sapphire and those from XE-2100 showed significant linearity, with correlation coefficients greater than 0.99. Three cases had significantly different platelet counts among the different methods used. Microscopic examination of these three cases showed very low platelet counts that corresponded with the low counts from the CD61 methods. It should be noted that because the automated blood counter assesses cell populations by their dimensions, many cellular fragments that were of the same size or smaller than platelets were thus counted as platelets. CONCLUSIONS: The CELL-DYN Sapphire analyzer has good precision, linearity and performance, comparable with the XE-2100 analyzer. As the CD61 methods of CELL-DYN Sapphire is specific for platelet, this method may reduce the interference from other blood components and count the exact platelet numbers.
Aluminum Oxide* ; Blood Platelets ; Drug Therapy* ; Electric Impedance ; Hematologic Diseases* ; Humans ; Leukemia ; Lymphoma ; Platelet Count* ; Radiotherapy

Chromosome 13q deletion syndrome, which is relatively rare, is characterized by a wide spectrum of phenotypes resulting from a partial deletion of the long arm of the chromosome 13. The main clinical features are mental retardation, developmental delay, craniofacial dysmorphism, and various congenital defects. Here, we report a de novo interstitial deletion in chromosome 13 (q21.3q31) in a neonate with congenital megacolon (Hirschsprung disease) confirmed by biopsy. A short tandem repeat analysis (D13S317) was used to compare the loci on the chromosomes of the patient and the parents, the latter representing the normal karyotype, to determine how the features of the profile peaks relate to the deletion. The clinical data were also compared with those of similar cases in previously published reports.
Arm ; Biopsy ; Chromosome Deletion ; Chromosome Disorders ; Chromosomes, Human, Pair 13 ; Congenital Abnormalities ; Hirschsprung Disease ; Humans ; Infant, Newborn ; Intellectual Disability ; Karyotype ; Megacolon ; Microsatellite Repeats ; Parents ; Phenotype ; Polymethacrylic Acids

Clostridium difficile, an anaerobic, spore-forming, gram-positive, rod-shaped bacterium, is the most common nosocomial pathogen causing pseudomembranous colitis. C. difficile is not intrinsically invasive and rarely infects extraintestinal sites. The bacterium, therefore, is not commonly detected in blood cultures. Here, we report a case of C. difficile bacteremia in a patient who had underwent loop ileostomy because of rectal obstruction following metastatic colon cancer originated from prostate cancer.
Anti-Bacterial Agents/*therapeutic use ; Bacteremia/*drug therapy ; Clostridium difficile/genetics/*isolation & purification ; Colonic Neoplasms/pathology/secondary ; Enterocolitis, Pseudomembranous/drug therapy/microbiology ; Humans ; Ileostomy ; Male ; Middle Aged ; Prostatic Neoplasms/pathology ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA

Clostridium difficile, an anaerobic, spore-forming, gram-positive, rod-shaped bacterium, is the most common nosocomial pathogen causing pseudomembranous colitis. C. difficile is not intrinsically invasive and rarely infects extraintestinal sites. The bacterium, therefore, is not commonly detected in blood cultures. Here, we report a case of C. difficile bacteremia in a patient who had underwent loop ileostomy because of rectal obstruction following metastatic colon cancer originated from prostate cancer.
Anti-Bacterial Agents/*therapeutic use ; Bacteremia/*drug therapy ; Clostridium difficile/genetics/*isolation & purification ; Colonic Neoplasms/pathology/secondary ; Enterocolitis, Pseudomembranous/drug therapy/microbiology ; Humans ; Ileostomy ; Male ; Middle Aged ; Prostatic Neoplasms/pathology ; RNA, Ribosomal, 16S/chemistry/genetics ; Sequence Analysis, RNA

Pregnancy associated osteoporosis (PAO) is a rare condition. It may affect women during pregnancy or after the delivery and it can induce severe back pain. Physicians can find multiple compression fractures on the plain images of these patients. However, little is known about PAO, including the prevalence, the cause, the risk factors and the prognosis. Herein we report on a case of PAO in a 38-year-old female who suffered from severe back pain induced by multiple vertebral compression fractures. After excluding the possibility of unknown malignancy, the patient underwent vertebroplasty to improve the clinical symptom. The bone biopsy results confirmed multiple benign acute compression fractures. The patient was treated with oral bisphosphonate, calcium and vitamin D. She showed clinical improvement without developing any additional vertebral fracture. When young women during pregnancy or just after the delivery complain of persistent back pain, PAO should be considered in the differential diagnosis, and early recognition and treatment are needed for PAO.
Adult ; Back Pain ; Biopsy ; Calcium ; Diagnosis, Differential ; Female ; Fractures, Compression ; Humans ; Osteoporosis ; Pregnancy ; Prevalence ; Prognosis ; Risk Factors ; Vertebroplasty ; Vitamin D

PURPOSE: The purpose of this study was to assess the current therapeutic status of attention deficit-hyperactivity disorder (ADHD) in children with epilepsy. METHODS: A cross-sectional survey of 178 patients aged 4-20 years from ten pediatric neurology clinics in eight cities in South Korea from January 2005 to July 2010 was used to assess clinical characteristics of ADHD patients with epilepsy and risk factors associated with ADHD. RESULTS: A total of 178 pediatric epileptic patients were recruited for this study. One hundred seventy-four subjects' (M:F=4:1, mean age: 12.2+/-3.3 yrs old) records were evaluated excluding four patients due to incomplete data. One hundred twenty-five of 174 patients (71.8%) had partial epilepsy and 45 had generalized epilepsy. Eighty of 112 patients showed ADHD combined type from the DSM IV. The mean prevalence rate of ADHD treatment among the epileptic patients was 1.9%. Over 45% of patients showed complete or persistent symptoms without difficulties in school life with CNS stimulants. Adverse reactions were reported in 19.8% of patients who received ADHD medication, and 18 patients discontinued ADHD medication due to severe adverse effects such as aggravated seizures (5.6%) or ADHD symptoms (3.7%). About 60% of children with ADHD and epilepsy had psychiatric comorbid disorders. CONCLUSION: The results indicate that ADHD treatment in epilepsy patients is safe and effective. However, these data also show that ADHD in pediatric epilepsy patients in Korea is under-diagnosed and under-treated.
Aged ; Attention Deficit Disorder with Hyperactivity ; Child ; Cross-Sectional Studies ; Epilepsies, Partial ; Epilepsy ; Epilepsy, Generalized ; Humans ; Korea ; Neurology ; Prevalence ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Seizures

Rituximab is a chimeric monoclonal antibody that specifically targets the CD20 molecule on the B cell surface. Although rituximab was originally introduced for the treatment of lymphoid neoplasms such as non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukemia (CLL), it is now emerging as an effective and relatively safe therapeutic option for the patients with refractory immune thrombocytopenic purpura (ITP). We report here on a case of life-threatening toxic epidermal necrolysis (TEN) that was related with the use of rituximab in a patient with refractory ITP. The patient developed extensive erythematous papules and bullous lesions on his whole body associated with fever and visual disturbance during the second cycle of rituximab. The rituximab was discontinued and high dose intravenous immunoglobuline and steroid were administrated. Four weeks later, he fully recovered without any sequelae. A review of the literature reveals this to be the first reported case of TEN associated with rituximab injection in Korea.
Antibodies, Monoclonal, Murine-Derived ; Blister ; Epidermal Necrolysis, Toxic ; Fever ; Humans ; Immunoglobulins ; Korea ; Leukemia, Lymphocytic, Chronic, B-Cell ; Lymphoma, Non-Hodgkin ; Purpura, Thrombocytopenic, Idiopathic ; Rituximab