Purpose: The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications. Methods: We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis. Results: According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months). Conclusion The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.

Purpose: The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications. Methods: We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis. Results: According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months). Conclusion The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.

Purpose: The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. In this study, patients were reclassified according to the revised classification and their prognoses were analyzed to confirm the clinical utility of the new classifications. Methods: We included 101 adult patients, 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified the patients according to the revised criteria, examined the differences, and analyzed the prognosis using survival analysis. Results: According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than that of patients in other AML groups; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months). Conclusion The revised classifications allow for a more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown a high prognostic significance in a small number of cases.

Chromosome 4q deletion syndrome is a rare disease caused by partial deletion of the long arm of chromosome 4. Phenotypic severity and expressivity vary among patients with chromosome 4q deletions, depending on the size and region of the deletion of the affected chromosome. Although there have been many reports of proximal 4q deletion cases, very few have been confirmed by high-resolution array comparative genomic hybridization (aCGH). In the current study, we presented a new case of 4q proximal deletion, with detailed genetic and clinical characteristics, and compared these characteristics to those of six previous cases with available aCGH data. According to our review, several genes known to be associated with specific phenotypes of 4q12q21.1 deletion cannot sufficiently explain the variable phenotypes observed among the cases. These phenotypes include mental retardation, microcephaly, ocular anomalies, dental anomaly, and piebaldism. Consequently, we recommend further detailed investigations into the genes associated with 4q12q21.1 deletion to assist in identifying genotype-phenotype associations more clearly.

OBJECTIVES: This study aimed at assessing the quality of dental services, as perceived by the disabled, and analyzing the factors identified to be of both high importance and low performance, as identified by IPA. METHODS: The data were collected from June 8 to November 2, 2016, after approval by the institutional review board. Questionnaires were distributed to 1466 disabled dental service consumers, of which 349 cases were included. The data were analyzed by frequency analysis, multi-regression analysis for implicit importance, and IPA matrix for marketing strategy. RESULTS: The performance results revealed that cost level, reduction of the fee, and waiting time for treatments were the sources of greatest dissatisfaction. The IPA matrix results categorized the next appointment, explanation of the fee, waiting time for treatment, professionalism of the staff, and convenient facilities as high-importance, low-performance factors. Meanwhile, the results of the IPA matrix for consumer segmentation, according to recently used dental institutions were different. The dental clinic users evaluated professionalism of the staff, convenience of the facility, explanation of the fee, and cost level as high-importance, low-performance attributes. The dental hospital users indicated that waiting time for treatment and next appointment were high-importance, low-performance attributes. Finally, the public health center users indicated that convenience of booking, waiting time for treatment, convenience of facilities, reduction of the fee, and next appointment as high-importance, low-performance attributes. CONCLUSIONS: To improve the quality of dental service, we need to understand the needs of the dental patients with disability. All attributes that were categorized as high-importance, low-performance must be improved first and should accordingly be used as strategic factors to increase satisfaction with oral medical institutions.
Dental Clinics ; Ethics Committees, Research ; Fees and Charges ; Humans ; Marketing ; Professionalism ; Public Health

A 50-year-old woman was admitted to our hospital due to multiple lung nodules detected incidentally on a chest X-ray. A video-assisted thoracoscopic lung biopsy revealed low-grade endometrial stromal sarcoma (LG-ESS). She had undergone a simple hysterectomy 1 year earlier owing to a diagnosis of adenomyosis. A review of her previous hysterectomy specimen showed not endometriosis but LG-ESS. According to the patient's levels of serum follicle stimulating hormone and estradiol, she was in the premenopausal state with retained and normally functioning ovaries. She then underwent ovarian ablation by radiotherapy, after which she was administered 2.5 mg of letrozole once per day. Three months later, the size of the metastatic nodules in both lungs had decreased. The patient was followed up for 24 months while continuing on letrozole, and maintained a partial remission. We report herein on a case of metastatic LG-ESS treated with letrozole after ovarian ablation by radiotherapy.
Adenomyosis ; Biopsy ; Diagnosis ; Endometrial Stromal Tumors ; Endometriosis ; Estradiol ; Female ; Follicle Stimulating Hormone ; Humans ; Hysterectomy ; Lung ; Middle Aged ; Ovary ; Radiotherapy* ; Sarcoma, Endometrial Stromal* ; Thorax

OBJECTIVES: The aim of this study was to evaluate the oral health beliefs and cultural specificity of multicultural families. METHODS: Subjects were 179 adults from multicultural families living in Gwangjin-gu, Seoul. The surveys and interviews were performed between June and November 2014 in the subjects' native languages (English, Chinese, Vietnamese, and Korean). The surveys were conducted using a self-administration method and a face-to-face interviewing method with the assistance of translators. RESULTS: Perceived barrier of oral health belief scores were higher in Vietnamese and Korean spouses than those from other countries (P<0.05). Cultural specificity scores were highest among the Japanese and lowest among the Vietnamese (P<0.01). CONCLUSIONS: Multicultural families showed different oral health beliefs and cultural specificities. Therefore, future oral health care programs for multicultural families should consider cultural differences and adaptations.
Adult ; Asian Continental Ancestry Group ; Humans ; Oral Health* ; Sensitivity and Specificity* ; Seoul ; Spouses

BACKGROUND: The XN-series (Sysmex, Japan) is the new hematology analyzer from Sysmex, with new channels to improve the accuracy of differential leukocyte count and platelet count in the low cell count range. We evaluated the analytical performance and low white blood cell (WBC) mode of the XN-2000. METHODS: Precision, linearity, and carryover were evaluated for the analyzer. We analyzed the accordance of complete blood count (CBC), reticulocyte count, and differential leukocyte count between the XN-2000 and XE-2100 (Sysmex), using 200 samples from normal controls and patients. For 80 samples with a WBC count <1.5x10(9) cells/L, the low WBC mode was evaluated by comparing the automated count with a manual differential count as the reference. RESULTS: The coefficients of variation of precision were <5% for most CBC parameters and <10% for differential leukocyte count. All results obtained with the XN-2000 showed good correlation with those obtained with the XE-2100. The correlation coefficients (r) were >0.9800 for all CBC parameters except mean corpuscular hemoglobin concentration, mean platelet volume, and platelet distribution width, and >0.9900 for differential leukocyte count except monocytes and basophils. The low WBC mode provided accurate counts for neutrophils and lymphocytes, with r>0.9300 for samples with a WBC count of 0.1-1.5x10(9) cells/L. CONCLUSIONS: The XN-2000 showed good analytical performance and correlation with the existing model, the XE-2100. The XN-2000 provided accurate results for differential leukocyte count in samples with a WBC count of 0.1-1.5x10(9) cells/L, and reduced manual slide reviews.
Basophils ; Blood Cell Count ; Blood Platelets ; Cell Count ; Erythrocyte Indices ; Hematology* ; Humans ; Leukocyte Count* ; Leukocytes ; Lymphocytes ; Mean Platelet Volume ; Monocytes ; Neutrophils ; Platelet Count ; Reticulocyte Count

We report four cases of Ganoderma lucidum-induced aplastic anemia involving members of the same family. A 33-year-old man and three family members were admitted to the hospital due to fever and pancytopenia. The illness arose after ingesting herbal wine containing G. lucidum 2 weeks earlier. A bone-marrow biopsy showed hypocellularity in three of the four family members (the exception was the one who died). They were treated with supportive management, including transfusions, granulocyte colony stimulating factor, and empirical antibiotics for neutropenic fever. The pancytopenia improved 4-5 weeks after the symptoms first appeared.
Adult ; Anemia, Aplastic* ; Anti-Bacterial Agents ; Biopsy ; Colony-Stimulating Factors ; Fever ; Ganoderma ; Granulocytes ; Humans ; Pancytopenia ; Plants, Medicinal ; Reishi* ; Wine

BACKGROUND: In the early stages of non-Hodgkin lymphoma (NHL), it can be difficult to recognize minimal morphological changes in the bone marrow (BM). In particular, when the quality of the BM biopsy is poor, determining BM involvement is limited to microscopic findings on BM aspiration. In this study, we compared the results of clonal immunoglobulin (IG) gene rearrangements with BM morphology results in B-cell NHL patients who underwent BM analysis as a staging workup and evaluated the usefulness of the clonal IG gene rearrangements for staging. METHODS: Forty two B-cell NHL patients were analyzed. Clonal rearrangements of the IG heavy chain (IGH), kappa light chain (IGK) and lambda light chain (IGL) genes were detected using the IdentiClone(TM) Clonality assay (InVivoScribe Technologies, USA). Clinical characteristics and outcomes were evaluated based on the detection of monoclonal IG gene rearrangements. RESULTS: Monoclonal IG gene rearrangements were found in 9 of 42 patients (21.4%). Microscopic BM involvement was found in only 2 of 42 patients (4.8%). The monoclonality rate of IG genes in BM was correlated with clinical stage and the international prognostic index (P<0.01). Patients with monoclonal IG gene rearrangements in BM had a significantly higher relapse rate (P=0.014) and poorer overall survival at 2 yr (P<0.01). CONCLUSIONS: Clonality analysis of BM in B-cell NHL can contribute to identification of patients with occult BM involvement with a significantly poorer overall survival despite normal BM histology.
B-Lymphocytes* ; Biopsy ; Bone Marrow* ; Gene Rearrangement ; Genes, Immunoglobulin* ; Humans ; Immunoglobulins ; Lymphoma, Non-Hodgkin* ; Recurrence