Purpose: Effectiveness and safety of clofarabine (one of the treatment mainstays in pediatric patients with relapsed/refractory acute lymphoblastic leukemia [ALL]) was assessed in Korean pediatric patients with ALL to facilitate conditional coverage with evidence development. Materials and Methods: In this multicenter, prospective, observational study, patients receiving clofarabine as mono/combination therapy were followed up every 4-6 weeks for 6 months or until hematopoietic stem cell transplantation (HSCT). Response rates, survival outcomes, and adverse events were assessed. Results: Sixty patients (2-26 years old; 65% B-cell ALL, received prior ≥ 2 regimen, 68.3% refractory to previous regimen) were enrolled and treated with at least one dose of clofarabine; of whom 26 (43.3%) completed 6 months of follow-up after the last dose of clofarabine. Fifty-eight patients (96.7%) received clofarabine combination therapy. Overall remission rate (complete remission [CR] or CR without platelet recovery [CRp]) was 45.0% (27/60; 95% confidence interval [CI], 32.4 to 57.6) and the overall response rate (CR, CRp, or partial remission [PR]) was 46.7% (28/60; 95% CI, 34.0 to 59.3), with 11 (18.3%), 16 (26.7%), and one (1.7%) patients achieving CR, CRp, and PR, respectively. The median time to remission was 5.1 weeks (95% CI, 4.7 to 6.1). Median duration of remission was 16.6 weeks (range, 2.0 to 167.6 weeks). Sixteen patients (26.7%) proceeded to HSCT. There were 24 deaths; 14 due to treatment-emergent adverse events. Conclusion Remission with clofarabine was observed in approximately half of the study patients who had overall expected safety profile; however, there was no favorable long-term survival outcome in this study.

During mid-life, women experienced not only physical but also neurological transition. Because of this, many women suffer from physiological and/or psychological menopausal symptoms. Although hormone therapy (HT) was broadly used to alleviate menopausal symptoms, HT showed inconsistent effects in case of psychological symptoms. Moreover, mid-life women’s brains have distinct characteristics than in other periods of life, it is needed to study psychological symptoms in shifted brain network of mid-life women. As an alternative, inhalation of fragrances may alleviate psychological menopausal symptoms. To characterize the alleviation mechanism by fragrances, we tested the effect of fragrances on menopausal symptoms using electroencephalographic (EEG) methods. We hypothesized that fragrance could restore mid-life women’s brain response to stressful situations. We tested six fragrance conditions, including no-odor condition (solvent only) in twenty-eight mid-life women (49.75 years±3.49).Our results showed that fragrances increased alpha power and decreased β/α ratio depending on the severity of menopausal symptoms in a stressful situation. Our study would be helpful in psychological menopausal symptom alleviation as well as fragrance screening for well-being in mid-life.

BACKGROUND: Heat shock proteins (HSPs) induced by variable kinds of stress produce tolerance to a variety of adverse conditions. However, the protective effect of HSP on ischemia/reperfusion injury (I/R injury) of kidney in vivo remains unclear. The present study was designed to evaluate whether HSP70 induced by hyperthermic preconditioning had renoprotective effect on I/R injury of the kidney in vivo. METHODS: 82 Sprague-Dawley male rats were used. Animals in control group (n=24) were subjected to bilateral occlusion of renal pedicles for 30 or 60 minutes followed by 24-hour reperfusion. In amphetamine (Amp, n=18) and quercetin (Q, n=16) group, amphetamine sulfate, a sympathomimetic drug which can elevate the body temperature as a result of enhanced endogenous lipolysis, and quercetin, a biflavonoid which inhibit the expression of HSP, were injected 4 hours prior to renal ischemia, respectively. In quercetin-amphetamine (QAmp, n=7) group, quercetin was injected 1 hour before administration of amphetamine. AA (n=8) or QQ (n=9) group was identical to Amp or Q group except that sham operation was performed instead of ischemic insult. In all groups, animals were sacrificed prior to or 24 hours after I/R injury. HSP70 induction was confirmed by immunohistochemistry. To assess the I/R injury of kidney, BUN, Cr, histopathologic change of tubular cell and HSP70 expression were evaluated. RESULTS: In Amp group, an increase of BUN and Cr were significantly lower than other groups and less severe renal tubular injury was also observed. In addition, HSP70 was strongly expressed in Amp group, whereas HSP70 was weakly expressed in control group and not expressed in QAmp and Q group. There were no differences in the functional and histologic injuries of kidney after I/R injury between AA, QQ and control group. CONCLUSION: These data demonstrate that the renoprotective effect by amphetamine preconditioning to I/R injury is linked with the expression of HSP70.
Amphetamine* ; Animals ; Body Temperature ; Heat-Shock Proteins ; Humans ; Immunohistochemistry ; Ischemia ; Kidney ; Lipolysis ; Male ; Quercetin ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Solitary rectal ulcer syndrome (SRUS) is a rare disorder characterized by rectal ulceration associated with typical histological features and disturbed defecatory behaviour from the passage of blood and mucus. While the cause of SRUS is yet unknown, the rectal prolapse and the paradoxical contraction of pelvic floor muscles have been considered the most important factors. The diagnosis is made usually on the basis of clinical symptoms, endoscopic appearance, and histology. Despite the terminology of SRUS, patients often show multiple lesions instead of just a single lesion or polypoid lesions instead of ulcerative lesions. Polypoid lesions, especially when combined with histologic findings of colitis cystica profunda, may sometimes be mis-interpreted as cancer. We report the case of one female patient with SRUS with out-growing polypoid lesion, which was misdiagnosed as invasive cancer on endoscopic biopsy.
Biopsy ; Colitis ; Diagnosis ; Female ; Humans ; Mucus ; Muscles ; Pelvic Floor ; Rectal Prolapse ; Ulcer*

Thyroid tuberculosis is rare. We experienced case of a 50-year-old woman with tuberculosis of the thyroid associated with miliary tuberculosis. She complained of chronic cough and weight loss. She was clinically and biochemically euthyroid. Thyroid sonogram demonstrated 3 2 cm sized heterogenous echogenic mass on upper pole of the left lobe of thyroid with calcification. Fine needle aspiration biopsy showed epithelioid granuloma in the caseous necrosis and acid-fast bacilli. She took antituberculous agents. One month later, radiologic finding improved and thyroid mass decreased also.
Biopsy ; Biopsy, Fine-Needle ; Cough ; Diagnosis* ; Female ; Granuloma ; Humans ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Tuberculosis, Miliary* ; Weight Loss

Thyroid tuberculosis is rare. We experienced case of a 50-year-old woman with tuberculosis of the thyroid associated with miliary tuberculosis. She complained of chronic cough and weight loss. She was clinically and biochemically euthyroid. Thyroid sonogram demonstrated 3 2 cm sized heterogenous echogenic mass on upper pole of the left lobe of thyroid with calcification. Fine needle aspiration biopsy showed epithelioid granuloma in the caseous necrosis and acid-fast bacilli. She took antituberculous agents. One month later, radiologic finding improved and thyroid mass decreased also.
Biopsy ; Biopsy, Fine-Needle ; Cough ; Diagnosis* ; Female ; Granuloma ; Humans ; Middle Aged ; Necrosis ; Thyroid Gland* ; Tuberculosis* ; Tuberculosis, Miliary* ; Weight Loss

PURPOSE: Recently, it has been reported that the disease with secondary surfactant deficiency such as pneumonia and adult respiratory distress syndrome (ARDS) improved in arterial blood gas analysis and pulmonary mechanics by surfactant treatment. In this study, we investigated the effect of surfactant in the experimentally induced E. coli pneumonia in rats. METHODS: 0.25 mL (0.5x109) E. coli suspension was injected intratracheally to the rats. After ventilating rats for 1 minute, 0.25 mL Surfactant TA (60 mg/mL phospholipid) was administered to the study group and normal saline to the control group. In about 12 hours, pneumonia symptoms developed, and the arterial blood gas analysis was performed with the blood obtained from abdominal aorta accessed by laparotomy. And then, bronchial lavage fluid (BAL) was obtained to perform cell count with differentials and E. coli culture, and to measure protein concentrations. The lungs were fixed in formalin for histological examination to compare the degree of inflammation. RESULTS: There were no significant differences in PaO2, cell count, differential count, E. coli culture between the study group and the control group. The protein concentrations of BALs in the surfactant-treated group were significantly lower than those in the control group (277+/-164 mg/dL vs 1,030+/-410 mg/dL). The inflammatory changes were found in E. coli-infected lung tissues from both groups, but less prominent in the surfactant-treated group than in control. CONCLUSION: Surfactant treatment decreased both the protein concentration of BALs and the inflammatory changes of lung tissue in an experimental model of E. coli pneumonia in rats.
Animals ; Aorta, Abdominal ; Blood Gas Analysis ; Bronchoalveolar Lavage Fluid ; Cell Count ; Formaldehyde ; Inflammation ; Laparotomy ; Lung ; Mechanics ; Models, Theoretical ; Pneumonia* ; Rats* ; Respiratory Distress Syndrome, Adult

Pleomorphic adenoma in nasal cavity is rare and mainly occurs in the major salivary gland. We have experienced a case of a 25 years old woman complaining recurrent nasal bleeding and nasal obstruction. She showed a tumor in the left nasal cavity. We treated the nasal cavity tumor by endoscopic sinus surgery. The tumor was 4.5X3.0X2.5 cm in size and firm, parenchymatous and pale in contour. The pathologic diagnosis was pleomorphic adenoma. We report in this case of pleomorphic adenoma in the nasal septum.
Adenoma, Pleomorphic* ; Adult ; Diagnosis ; Epistaxis ; Female ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum* ; Salivary Glands

PURPOSE: This study was carried out to clarify significance of types of intestinal metaplasia and roles of bcl-2, p53 and c-erbB-2 protein in the development of gastric carcinoma. MATERIALS AND METHODS: Total one hundred fifty nine cases of surgically resected stomachs with benign ulcer (n=21), dysplasia (n=18) and gastric carcinoma (n=120) were studied histologically, histochemically and immunohistochemically. RESULTS: Type III intestinal metaplasia was significantly more common in the carcinoma patients in older age group. Bcl-2 expression was found in 94.4% cases of dysplasia and 75.0% cases of carcinoma. Positivity for bcl-2 protein was significantly higher in intestinal type carcinomas than in diffuse type carcinomas (p=0.000). The expression of p53 protein showed 50.0% cases of dysplasia and 49.2% cases of carcinoma. The expression of p53 protein was significantly correlated with depth of invasion (p=0.000), regional lymph node metastasis (p=0.001), and tumor size (p=0.001). C-erbB-2 protein was only expressed in 15.0% cases of carcinoma. The expression of c-erbB-2 protein was found more often in advanced carcinomas (p=0.001) and carcinomas with regional lymph node metastasis (p=0.003). CONCLUSION: Type III intestinal metaplasia was associated with age, but not with types of gastric carcinoma. Bcl-2 protein is probably involved in dysplastic lesion of gastric carcinogenic sequence and associated with intestinal type carcinoma, and p53 protein is also involved in dysplasia. p53 protein and c-erbB-2 protein may have a role of tumor invasion and nodal metastasis as poor prognostic factors.
Humans ; Lymph Nodes ; Metaplasia* ; Mucous Membrane* ; Neoplasm Metastasis ; Receptor, erbB-2 ; Stomach ; Ulcer

This study was designed to identify expression of calcium-binding proteins and synaptic reorganizations of dentate mossy fibers in hippocampal sclerosis of human temporal lobe epilepsy. Hippocampal neuronal density was quantitively analyzed in temporal lobe epilepsy group (n=50) to investigate the degree of hippocampal sclerosis and it was compared with that of autopsy control (n=3). To verify the distribution of calcium-binding proteins in neurons of epileptic hippocampi, the parvalbumin (PV)-immunoreactive and calbindin-D28K (CB)-immunoreactive neurons were quantitively analyzed in each area of Ammon's horn by immunohistochemical stain. Also, to clarify synaptic reorganizations of the dentate mossy fibers, a part of each hippocampus was examined under light microscopy and transmission electron microscopy using Timm sulphide silver method. In epileptic hippocampi, severity of hippocampal sclerosis (HS) was graded four, which consisted of 3 cases with no HS, 6 mild HS, 12 moderate HS, and 29 severe HS. The hippocampal neuronal loss was most prominent in CA1, followed by CA4 and CA2. Expression of calcium-binding proteins was more prevalent in CA2 of all groups. The proportion of PV-immunoreactive neurons in CA1 and CA4 significantly increased in the moderate and severe HS group, whereas the proportion of CB-immunoreactive neurons did not correlated with the severity of HS. Timm granules were noted in inner molecular supragranular layer of dentate gyrus of epileptic hippocampi and they tended to increase in proportion along with the severity of hippocampal sclerosis. Transmission electron microscopy showed that supragranular Timm granules corresponded to synaptic terminals of mossy fibers. These results suggest that parvalbumin appears to have more protective effect against neuronal loss and that mossy fiber synaptic reorganization seems to play a major role in pathogenesis of hippocampal sclerosis of human temporal lobe epilepsy.
Autopsy ; Calbindin 1 ; Calcium* ; Calcium-Binding Proteins* ; Dentate Gyrus ; Epilepsy, Temporal Lobe* ; Hippocampus ; Humans ; Microscopy ; Microscopy, Electron, Transmission ; Nerve Fibers, Myelinated ; Neurons ; Presynaptic Terminals ; Sclerosis* ; Silver ; Temporal Lobe*