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 aim of this study was to investigate the gender differences of direct aggression and relational aggression in Korean elementary and middle school students. METHODS: Parents of 946 elementary school students(age 9.54±1.72 years, 485 boys, 461 girls) completed the Child Behavior Checklist(CBCL). Six-hundred-and-three middle school students(age 13.98±0.93 years, 301 boys, 302 girls) completed the Youth Self-Report(YSR). Independent t-test, chi-square test, and Fisher's exact test were used. RESULTS: Boys had significantly higher direct aggression scores than girls in elementary school students(p<0.001). There was no significance gender difference of relational aggression in elementary school students(p=0.235). In middle school students, boys had significantly higher direct aggression than girls(p=0.017), and girls had significantly higher relational aggression compared to the boys(p<0.001). CONCLUSION: Our results suggest the presence of gender differences in manifestation of aggression subtypes in Korean elementary and middle school students. These gender differences should be taken into account in prevention and intervention approaches of aggression in children and adolescents.
Adolescent* ; Aggression* ; Child Behavior ; Child* ; Female ; Humans ; Parents

PURPOSE: The aim of this study was to investigate the effect of perinatal risk factors on brain maturation and the relationship of brain maturation and neurodevelopmental outcomes with brain maturation scoring system in brain MRI. METHODS: ELBWI infants born at the Seoul National University Children's Hospital from January 2006 to December 2010 were included. A retrospective analysis was performed with their medical record and brain MR images acquired at near full term. We read brain MRI and measured maturity with total maturation score (TMS). TMS is a previously developed anatomic scoring system to assess brain maturity. The total maturation score was used to evaluate the four parameters of maturity: (1) myelination, (2) cortical infolding, (3) involution of glial cell migration bands, and (4) presence of germinal matrix tissue. RESULTS: Images from 124 infants were evaluated. Their mean gestational age at birth was 27.1+/-2.1 weeks, and mean birth weight was 781.5+/-143.9 g. The mean TMS was 10.8+/-2.0. TMS was significantly related to the postmenstrual age (PMA) of the infant, increasing with advancing postmenstrual age (P<0.001). TMS showed no significance with neurodevelopmental delay, and with brain injury, respectively. CONCLUSION: TMS was developed for evaluating brain maturation in conventional brain MRI. The results of this study suggest that TMS was not useful for predicting neurodevelopmental delay, but further studies are needed to make standard score for each PMA and to re-evaluate the relationship between brain maturation and neurodevelopmental delay.
Birth Weight ; Brain ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Magnetic Resonance Imaging ; Magnetic Resonance Spectroscopy ; Magnetics ; Magnets ; Medical Records ; Myelin Sheath ; Neuroglia ; Parturition ; Premature Birth ; Retrospective Studies ; Risk Factors

BACKGROUND: An important metabolic feature of acromegaly is a reduced action of insulin on hepatic gluconeogenesis and peripheral glucose disposal which mediated by growth hormone hypersecretion. Octreotide, a synthetic octapeptide somatostatin analogue exerts complex effects on hormonal and metabolic regulations affecting glucose homeostasis. This study was designed to ascertain the shorterm effect of octreotide on glucose tolerance in acromegaly. METHODS: 10 patients (five men and five women, age 47.9+/-11.8) were injected subcutaneously with octreotide, 100 micrograms for 24 hours. Patients were assessed with respect to growth hormone, glucose, and insulin response to a standard 100 g oral glucose tolerance test (OGTT) before and during the last 2 hour of octreotide infusion. RESULTS: During the therapy, there was significant decrease in mean blood glucose response to OGTT (678.4+/-51.9 vs 581.9+/-47.3 mg/dL/2hr: mean areas under the glucose curve, p=0.01) and mean serum insulin response to oral glucose load was significantly reduced in all patients (339.2+/-106.2 vs 256.7+/-111.3 U/mL/2hr: mean areas under the insulin curve, p=0.01). Using glucose tolerance test criteria three patients of 10 had normal glucose tolerance, four and three had impaired glucose tolerance and diabetes, respectively, at base line. While on octreotide these composition was changed to six patients of NGT, three of IGT and one diabetes. CONCLUSION: We conclude that insulin resistance mediated by GH hypersecretion was improved by shorterm octreotide treatment.
Acromegaly* ; Blood Glucose ; Female ; Gluconeogenesis ; Glucose Tolerance Test ; Glucose* ; Growth Hormone ; Homeostasis ; Humans ; Infusions, Subcutaneous* ; Insulin ; Insulin Resistance ; Male ; Octreotide* ; Social Control, Formal ; Somatostatin

PURPOSE: To understand the morphologic and molecular changes in carcinogen-induced breast tissues, DMBA (10-dimethy1-1,2 benzanthracene) was administrated in Sprague- Dawley female rats. MATERIALS AND METHODS: At 50 days of age, all experimental rats were given 20 mg DMBA by gastric intubation. Until the seventh week after DMBA administration, six rats were sacrificed every week, thereafter all tumors found during 20 weeks were removed every week. The morphologic changes were evaluated in routinely processed sections stained with H-E and with anti-smooth muscle actin antibody. Mutation of Ha-ras codons 12 and 61 was examined by ARMS (amplification refractory mutation system) method in frozen tissues. RESULTS: The epithelial cell proliferation of terminal end buds began 2 weeks after DMBA treatment and progressed to the 6th week, resulting in microscopic malignant tumor in one of the 7th weeks rats. The tumors were developed in 43 of 62 rats (69.4%); 8 benign lesions in 4 rats and 72 malignant tumors in 39 rats. Mutations in the 12th and 61th codon of Ha-ras gene were respectively found in 29.7% and 2.7% of preneoplastic breasts, 25% in benign lesions, 2.6% and 31.6% of malignant tumors. CONCLUSION: DMBA treatment in rats induced epithelial proliferation, then benign and malignant tumors through Ha-ras gene mutation, especially in codon 61 leading to cancer.
9,10-Dimethyl-1,2-benzanthracene* ; Actins ; Animals ; Arm ; Breast ; Codon ; Epithelial Cells ; Female ; Genes, ras ; Humans ; Intubation ; Rats*

The purpose of this study is to introduce the patients with bilateral cleft lip nose have lots of distinctive anatomical features such as short columella, inferior displacement of the medial crura of alar cartilage, lowering of the alar dome, flattened tip of the nose, widened nostril sill and prominent vestibular skin web. Although millard, Kaplan and Wray have introduced columellar lengthening by fork flap, it was difficult to achieve satisfying results without reconstructing the nasal skeletal framework of the cleft lip nose deformity for their anatomical distinctiveness. We have performed rhinoplasty on 7 patients with bilateral cleft lip nose from January. 1995 to August. 1997, using onlay calvarial bone graft and suture suspension technique. Operation was performed on basic anatomical structure, skeletal framework using outer table of calvarial bone pushed into the nasal tip area and suspension suture was applied to the framework with anteroinferior projection of nasal tip projection vector by cantilever effect of the calvarial bone which carried out nearly normal anatomical nasal structure. We have obtained satisfying results without complication in all seven cases. In conclusion the method which authors have used shows several advantages. First, it was possible to obtain the substantial skin lengthening in anterior and inferior direction by "Tent-Pole effect" in which creating bony structure projected into nasal tip and traction suturing of the deformed alar cartilages. Secondly, columellar lengthening and close to normal nostril shape was obtained and thirdly, re-deformation of corrected structure was prevented. An expected problem in above method is resorption of grafted calvarial bone which expected to maintain its position under influence of alternation and reformation by reaction between chondroblast and chondroclast results in fibrous tissue replacement, yet long term follow up is necessary for futher evaluation.
Cartilage ; Chondrocytes ; Cleft Lip* ; Congenital Abnormalities* ; Follow-Up Studies ; Humans ; Inlays ; Nose* ; Rhinoplasty ; Skin ; Sutures* ; Traction ; Transplants*

No abstract available.

This study was executed to measure the shear bond strength of Panavia EX and Panavia 21 when the Ni-Cr-Be alloy castings were cemented to the enamel surfaces with these cements. The cast metsl plates of Ni-Cr-Be alloy were sandblasted and cemented to acid etched enamel surface with Panavia EX or Panavia 21. Their shear bond strength were measured with Instron Universal Testing machine. Within the limits of this study, following conclusions were withgdrawn. 1. The mean shear bond strength were 26.85.7Mpa, in Panavia EX and 28.35.2Mpa, in Panavia 21. 2. t-Test revealed no statistical significance between two groups(.05 level) 3. Macroscopically, bond failures were revealed compound fracture at metal and enamel interfaces, in cases of both cements, as the cement attached partly on both metal and enamel surface.
Adhesives* ; Alloys* ; Dental Enamel* ; Fractures, Open

We analyzed 20 cases of traumatic carotid cavernous fistula(CCF) during the recent 10 years The results are summarized as follows: 1) In 18 cases(90%), the clinical symptoms & signs of CCF occurred within 2 months after trauma. 2) The sites of fistulae were common in horizontal segment(40%) and at the junction(30%) between horizontal segment and posterior ascending segment of cavernous portion of internal carotid artery. 3) The main draining veins of CCF were the superior ophthalmic vein(90%) and the inferior petrosal sinus(70%). 4) The methods of treatment were occlusion of fistula with balloon(9 cases), occlusion of cavernous ICA with balloon(2 cases), ligation of cervical ICA with Poppen's clamp(4 cases) and trapping(2 cases). Two patients were not treated and another patient was healed spontaneously. 5) The frequency and severity of complication was significantly decreased in cases treated by detachable balloon occlusion than by direct cervical ICA ligation or trapping procedures. 6) The procedure using the self-sealed goldvalve balloon was simple, but had a risk of premature separation and premature deflation.
Balloon Occlusion ; Carotid Artery, Internal ; Fistula* ; Humans ; Ligation ; Veins

Meningioma is the most common primary intracranial neoplasm that originates from the meningothelial cells. It occurs mainly in adults, and has a female preponderance. It is classically classified into three main types: meningotheliomatous or syncytial type, fibrous or fibroblastic type, and transitional type. Transforming growth factor alpha(TGF-alpha) was known as a neoplastic transformer found in the neoplastic tissue of the brain rather than in normal tissue in the neoplastic tissue, the expression of the TGF-alpha was more intense in the malignant rather than benign tumor, but the expression of the TGF-alpha on the meningioma was not reported. Transforming growth factor-beta (TGF-beta) was known as a peptide which is involved in the proliferation of the mesenchymal cells and the other many physiologic processes. Tumor necrosis factor(TNF) has a selective necrotic action of the neoplastic cells without influence on normal tissues. Epidermal growth factor (EGF) and epidermal growth factor receptor(EGR) have a control effect on cellular proliferation and differentiation and the expression of the EGR in breast cancer has a reverse correlation to the expression of the estrogen receptor(ER). The meningioma is the most common host tumor of breast cancer among the intracranial neoplasm, so, presence of some estrogen receptors in the meningioma is suspected. The correlation of the estrogen receptor expression to EGR expression in the meningioma is the concern of this study. Therefore, the authors have observed the meningioma on the basis of the expression of the ER, TGF-alpha, TGF-beta, TNF-beta, EGF and EGR according to the immunohistochemical stain and polymerase chain reaction(PCR), and the results obtained were as follows. The expressions of the TGF-alpha, TGF-beta were weakly positive in 4 out of 25 examined cases, and the expressions of the EGF and EGR, were more intensely positive in 2 out of 25 examined cases, especially in the vascular wall and perivascular area. TNF-beta expression was weakly positive to focal area only in one case of the meningotheliomatous type. The ER expression was weakly positive to focal areas. The subtypes of meningioma expressing positivity were meningotheliomatous and transitional type, which wer not related to tumor aggressiveness or poor prognosis. In conclusion, ER,EGF-alpha, TGF-beta, TNF-beta, EGF and EGR were experssed in the meningionma, and it is suspected that these factors may be involved in the tumorigenesis or "host" tumor action rather than in tumor aggressiveness.
Adult ; Brain ; Brain Neoplasms ; Breast Neoplasms ; Carcinogenesis ; Cell Proliferation ; Epidermal Growth Factor ; Estrogens ; Female ; Fibroblasts ; Humans ; Lymphotoxin-alpha ; Meningioma* ; Necrosis ; Polymerase Chain Reaction* ; Prognosis ; Receptors, Estrogen ; Transforming Growth Factor alpha ; Transforming Growth Factor beta ; Transforming Growth Factors