The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

The initial molecular cytogenetic characteristics of blasts plays a significant role in determining the treatment course of B-cell acute lymphoblastic leukemia (B-ALL).B-ALL with intrachromosomal amplification of chromosome 21 (iAMP21) has been well known to have unfavorable prognosis. Also, there are previously recognized germline mutations that increase the risk of ALL, such as trisomy 21, Down syndrome. This case report is about a 16-year-old girl who presented with lymphadenitis, purpura, and fever followed by initial lab of elevated white blood cell with blasts.She had some notable facial features, but no typical Down syndrome related one.Bone marrow biopsy and fluorescence in situ hybridization finalized the diagnosis as B-ALL with iAMP21, high-risk group. The minimal residual disease-negative complete remission was achieved after the induction chemotherapy with Korean multicenter high-risk protocol. However, abnormal karyotype was sustained in bone marrow. Microarrays with her buccal swab raised the possibility that the abnormal karyotype was not from the leukemic blasts but rather from the germline. Although she underwent scheduled chemotherapy uneventfully as slow early responder type, thrombocytopenia and abnormal karyotype persisted, leading to the diagnosis of acute myeloid leukemia. Additional chemotherapy and peripheral blood stem cell transplantation was performed which resulted in engraftment. This case highlights the discovery of a constitutional genetic aberration, which played like a silent yet critical background factor for B-ALL with iAMP21. As the number of reported cases are limited, the role of germline chromosome 21 mutation as the indicator for prognosis of B-ALL should be studied further.

Background: s/Aims: Reported incidence of extrahepatic bile duct cancer is higher in Asians than in Western populations. Korea, in particular, is one of the countries with the highest incidence rates of extrahepatic bile duct cancer in the world. Although research and innovative therapeutic modalities for extrahepatic bile duct cancer are emerging, clinical guidelines are currently unavailable in Korea. The Korean Society of Hepato-Biliary-Pancreatic Surgery in collaboration with related societies (Korean Pancreatic and Biliary Surgery Society, Korean Society of Abdominal Radiology, Korean Society of Medical Oncology, Korean Society of Radiation Oncology, Korean Society of Pathologists, and Korean Society of Nuclear Medicine) decided to establish clinical guideline for extrahepatic bile duct cancer in June 2021. Methods: Contents of the guidelines were developed through subgroup meetings for each key question and a preliminary draft was finalized through a Clinical Guidelines Committee workshop. Results: In November 2021, the finalized draft was presented for public scrutiny during a formal hearing. Conclusions The extrahepatic guideline committee believed that this guideline could be helpful in the treatment of patients.

Objectives: This study aimed to compare each strain’s number of microorganisms found in oral samples collected using various collection methods. Methods: Twenty-two adults aged 40 and above participated in the study. Oral samples were collected from subjects using three different methods (stimulated saliva, oral biofilm, and calculus), and the collected samples were analyzed using the multiplex real-time Polymerase chain reaction (PCR) method. Results: The study included 22 subjects (2 men, 20 women) with an age range of 40-75 years.Healthy oral condition was observed in 10 subjects, while the remaining 12 had periodontitis. The saliva and biofilm collection methods for oral microorganisms detected Porphyromonas gingivalis (Pg), Tannerella forsynthesis (Tf), and Fusobacterium nucleatum (Fn), which are the causative bacteria of periodontal disease, more effectively compared with the calculus group. In addition, the saliva group showed a better ability to detect Streptococcus mutans (Sm) which causes dental caries, compared with the biofilm and calculus groups. Comparisons based on the presence or absence of periodontitis and the collection method revealed a statistically significant difference in the number of oral microorganisms only in case of Sm strain. Conclusions The frequency of expression of certain strains varies according to the method of collection of oral microorganisms. Further, the saliva and biofilm methods of collecting oral microorganisms are more suitable for quantitative analysis of bacteria causing periodontal disease.

OBJECTIVES: The purpose of this study was to evaluate the association between the distribution of periodontopathic bacteria and oral conditions. METHODS: Stimulated saliva was collected from 162 adults aged 60 years and above. The prevalence and amount of periodontopathic bacteria in the saliva were analyzed using real-time PCR. Pocket depth and clinical attachment loss were examined to evaluate the oral conditions of the subjects. Patients who had at least one tooth surface involved, with a pocket depth ≥4 mm or clinical attachment loss ≥5 mm were classified as having periodontal disease. RESULTS: The detection rates of most bacteria in the orange and green complexes were more than 90%, while those of P. gingivalis and T. forsythia in the red complex were 58.6% and 61.7%, respectively. The number of bacteria in the red complex positively correlated with each other. There were no significant differences in the number of types of red complex bacteria in the saliva and the distribution of residual number of teeth and periodontal disease (P>0.05). On the other hand, the number of remaining teeth in subjects with higher bacterial density were more than those with lesser bacterial density. In addition, the occurrence of dental disease differed significantly depending on the number of P. gingivalis and T. forsythia. CONCLUSIONS The relative amount of periodontopathic bacteria is important in the occurrence of periodontal disease, and the number of these bacteria positively correlated with each other.

Purpose: The introduction of immune checkpoint inhibitors represents a major advance in the treatment of lung cancer, allowing sustained recovery in a significant proportion of patients. Nivolumab is a monoclonal anti–programmed death cell protein 1 antibody licensed for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after prior chemotherapy. In this study, we describe the demographic and clinical outcomes of patients with advanced NSCLC treated with nivolumab in the Korean expanded access program. Materials and Methods: Previously treated patients with advanced non-squamous and squamous NSCLC patients received nivolumab at 3 mg/kg every 2 weeks up to 36 months. Efficacy data including investigator-assessed tumor response, progression data, survival, and safety data were collected. Results: Two hundred ninety-nine patients were treated across 36 Korean centers. The objective response rate and disease control rate were 18% and 49%, respectively; the median progression-free survival was 2.1 months (95% confidence interval [CI], 1.87 to 3.45), and the overall survival (OS) was 13.2 months (95% CI, 10.6 to 18.9). Patients with smoking history and patients who experienced immune-related adverse events showed a prolonged OS. Cox regression analysis identified smoking history, presence of immune-related adverse events as positive factors associated with OS, while liver metastasis was a negative factor associated with OS. The safety profile was generally comparable to previously reported data. Conclusion This real-world analysis supports the use of nivolumab for pretreated NSCLC patients, including those with an older age.

OBJECTIVES: The purpose of this study is to determine methods of dental caries prevention by investigating the use of compounds of Diospyros kaki (D. kaki) peel, Momordica charantia (M. charantia), and Canavalia gladiata (C. gladiata) extracts to limit the cariogenic traits of Streptococcus mutans (S. mutans), such as their ability to proliferate and adhere to the tooth surface. METHODS: Broth microdilution and the agar spreading assay were used to determine the antimicrobial effect and minimum inhibitory concentration (MIC) of S. mutans extracts. In order to identify the adhesive ability of S. mutans at varying concentrations, culture plates were first stained with 1 ml of 0.01% crystal violet for 15 minutes at room temperature, and then eluted with 1 ml of EtOH:Acetone (8:2) solution for 15 minutes in a 37℃ incubator. Eluted solutions were then evaluated by use of a spectrophotometer at 575 nm. RESULTS: Experiments were conducted in order to investigate the effectiveness of D. kaki peel, M. charantia, and C. gladiata extracts on limiting the proliferation of S. mutans. The MIC was measured as an indication of whether the antibacterial activity of D. kaki peel, M. charantia, and C. gladiata extracts had a significant bacteriostatic effect on S. mutans. M. charantia extract was effective for growth inhibition on S. mutans at a minimum concentration of 0.25%. From the adhesion ability assay, M. charantia extract had an anti-adhesive effect. CONCLUSIONS: These results indicate that M. charantia extract demonstrates antibacterial activity and has an anti-adhesive effect on S. mutans. Due to these properties, M. charantia extract may be used to prevent dental caries.
Adhesives ; Agar ; Canavalia ; Dental Caries ; Diospyros ; Gentian Violet ; Incubators ; Microbial Sensitivity Tests ; Momordica charantia ; Momordica ; Streptococcus mutans ; Streptococcus ; Thiram ; Tooth

OBJECTIVES: The purpose of this study was to evaluate the efficacy of a 2.9% hydrogen peroxide (HP) whitening strip with a desensitizing agent as a primer. METHODS: This study was approved by the Institutional Review Board of Kyungpook National University Hospital. A total of 144 subjects (mean age: 21.7 years) were recruited after they provided informed consent for participation in the study. All participants used the whitening strip and primer for 1.5 h a day for 14 days. ShadeEye-NCC and Vita classical shade guide were used to determine the color changes, with respect to baseline, after 1, 3, 5, 7, and 14 days. A self-administered questionnaire was used to collect data on satisfaction after bleaching and irritating symptoms during the 14 days. All collected data were analyzed with repeated measures ANOVA and one-way ANOVA using SPSS 20.0 for windows. RESULTS: Brightness (ΔL*) was significantly higher in groups 2 and 3 than in the control group after 3 days of the experiment. Chroma (Δb*) started to decrease in groups 2 and 3, compared to control, after 1 day. Perceived symptoms of irritation were significantly lower in groups using the strip combined with the desensitizing primer than in the control group. Satisfaction after bleaching was higher in the experimental groups than in control. CONCLUSIONS: The HP whitening strip with a desensitizing agent as a primer is clinically effective in bleaching human enamel after 3 days of use. It also reduces the prevalence of gingival irritation.
Dental Enamel ; Ethics Committees, Research ; Gyeongsangbuk-do ; Humans ; Hydrogen Peroxide ; Informed Consent ; Prevalence ; Tooth*