• Asian Pacific Journal of Cancer Prevention
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• v.15 no.1
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• pp.117-122
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• 2014

Background: Breast cancer is the most common malignancy and the second leading cause of cancer-related death among women in the developed countries. Despite advances in screening, improved local therapies and adjuvant systemic treatments, median survival of metastatic breast cancer patients (MBC) is in the range of 2-3 years at most. We aimed to investigate whether the prognostic factors and therapeutic responses of our Turkish patients are similar to those in the literature. Materials and Methods: We reviewed the medical records of MBC patients who had been treated in our institution between 1999-2009 and analyzed their clinicopathological features and survival outcomes retrospectively Results: A hundred and sixty patients were included. Median age was 47 (23-82), median follow up was 24 (2-186) months. At the time of diagnosis 59% of patients were under the age of 50 and 46% were postmenopausal. The majority (37%) had multiple sites of metastases. Forty percent received endocrine therapy and 40% chemotherapy as first line metastatic treatment. Thirty (20%) patients were treated with molecular targeting agents like trastuzumab, lapatinib and sunitinib, frequently combined with a chemotherapy agent. Five-year overall survival (OS) was 32% and median OS was 38 months for the whole group. Five year progression free survival (PFS) was 10% and median PFS was 10 months. Menopausal status, hormone receptor expression and disease free status had a significant impact on overall survival in the multivariate analysis (p 0.018, p 0.018 and p:0.003, respectively). Conclusions: All our patients were treated with the modern oncologic therapies recommended by the international guidelines. From our data, MBC patients live up to 3-4 years, indicating that further improvement beyond that requires development of new treatment modalities. The survival outcomes of our patients were consistent with the data reported in the literature.

• Biomedical Science Letters
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• v.12 no.3
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• pp.171-176
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• 2006

Sodium iodide symporter (NIS) plays a key role in thyroid hormone production by efficiently accumulating iodide from the circulating blood into the thyocytes, and this is done against an electrochemical gradient. Thyroid transcription factor-l (TTF-l) is a homeodomain-containing protein expressed in embryonic diencephalons, thyroid, and lung and has been found to bind to thyroid specific promoters and to activate their transcriptional activity. TTF-l may be one of the factors capable of activating NIS gene expression in the thyroid gland, thus it accounts for the lower levels of NIS gene expression that are seen in the extrathyroidal tissues. However, a high frequency of TTF-l expression has been observed, especially in primary lung adenocarcinoma. The present study was undertaken in order to elucidate the relationship between the expression of NIS and TTF-l in primary lung adenocarcinoma. Immunohistochemical studies for NIS and TTF-l were performed in 64 primary lung adenocarcinomas. Immunoreactivities for NIS and TTF-l were found in 49 (76.6%) and 45 (70.3%) out of 64 cases, respectively. Forty-one (83.7%) of the 49 cases with positive NIS immunoreactivity showed positive TTF-l expression, whereas 11 (73.3%) of the 15 cases with negative NIS immunoreactivity showed negative TTF-l expression (P<0.05). So the NIS expression was significantly associated with the TTF-l expression. These findings suggest that TTF-l may be one of the factors capable of activating NIS gene expression in primary lung adenocarcinoma. Further studies are needed to define the relation between NIS and TTF-l for examining the mechanisms of tissue-specific NIS expression.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.149-152
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• 2014

Purpose: At our hospital blood is collected from a patient before an imaging test, with the concern of any effect possible when a nuclear medicine imaging test and an in-vitro test are carried out at the same time. However, occasionally, the blood collection is performed after an imaging test, with the reasons that the patient is not properly guided or the patient doesn't follow the guide correctly. In that case, we prefer to gather blood again after a few days. The purpose of this study is not only to see whether there is any effect of an imaging test on the result of the in-vitro test performed with the blood collected after the imaging test, but also to study how many days waiting after each test is appropriate to take a blood sample, if the effect exists. Materials and Methods: From September to October 2013, blood were collected from 13 patients in our hospital regardless of age and sex each time before and after the injection of the radioactive isotope from the tests : PET-CT, Gated Myocardial SPECT, and DTPA GFR Scan. Considering a half-life, AFP, CA19-9, CEA, TSH, and T3 were carried out right after the blood collection. In case of an iodine therapy, blood were taken each time before and after taking radioactive iodine, and, after AFP, CA19-9, and CEA, the difference between them in consistency and in cpm were compared. Results: With 10 patients after the imaging tests and 3 patients after the iodine therapy, their serum cpm was over 10,000. Over time, the cpm decreased in accordance with the half-life ($^{18}F$ 110minutes, $^{99}mTc$ 6hours, $^{201}Tl$ 72hours, $^{131}I$ 7days). Between the two cases, one before and the other after the injection of the radioactive isotope, the cpm and the results of AFP, CA19-9, CEA, TSH, and T3 from three patients each test, PET-CT, Gated Myocardial SPECT, and DTPA GFR Scan, were very similar. In addition, in case of an iodine therapy, there was also not a meaningful difference in the cpm and the results of AFP, CA19-9, and CEA, from three patients in an iodine therapy, between the two cases, one before and the other after taking the radioactive iodine. Conclusion: In case a blood collection was performed after the imaging test which required a radioactive isotope injection, the cpm increased, differently according to the kind of the radioactive isotope. However, the results of the in-vitro tests like AFP, CA19-9, CEA, TSH, T3, etc were nearly not affected. As the result, it's considered that there will not be any significant effect also from other tests, as the result from the performed seven tests.

• Childhood Kidney Diseases
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• v.8 no.1
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• pp.43-50
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• 2004

Background : Steroid-induced osteoporosis(SIO) is one of the serious complications of long-term steroid therapy, especially in growing children. Recently bisphosphonates have been used to treat or prevent SIO in adult, which is rare in children with glomerular diseases. We studied the effect of pamidronate on SIO using dual energy X-ray absorptiometry and biochemical markers of bone turnover. Methods : Forty four children receiving moderate-to-high doses of steroids were enrolled. They had no history of bone, liver, or endocrine disease. Patients were stratified by their baseline bone mineral density(BMD) findings. All patients received corticosteroids for 3 month and oral calcium supplementation(500 mg/day) daily. Among them, 28 patients were treated with placebo and 16 were treated with pamidronate(125 mg) for 3 months. Blood chemistry and bone mineral density(BMD) were measured at baseline, and 3months. In addition, parathyroid hormone(PTH), serum osteocalcin, and urinary dipyridinoline levels were evaluated. Results : In overall population, the mean lumbar spine BMD decreased from $0.754{\pm}0.211(g/cm^2)$ to $0.728{\pm}0.208(g/cm^2)$ in the placebo group(P<0.05) and increased from $0.652{\pm}0.194(g/cm^2)$ to $0.658{\pm}0.226(g/cm^2)$ in the pamidronate group(P>0.05). Conclusion : Pamidronate appears to be effective in preventing SIO in children with glomerular diseases requiring long-term steroids therapy. Further careful observation and follow-up might be needed for children receiving bisphosphonates such as pamidronate.

• Journal of Life Science
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• v.29 no.6
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• pp.747-753
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• 2019

Cognitive decline is characterized by reduced long-/short-term memory and attention span, and increased depression and anxiety. Such decline is associated with various degenerative brain disorders, especially Alzheimer's disease (AD) and Parkinson's disease (PD). The increases in elderly populations suffering from cognitive decline create social problems and impose economic burdens, and also pose safety threats; all of these problems have been extensively researched over the past several decades. Possible causes of cognitive decline include metabolic and hormone imbalance, infection, medication abuse, and neuronal changes associated with aging. However, no treatment for cognitive decline is available. In neurodegenerative diseases, changes in the gut microbiota and gut metabolites can alter molecular expression and neurobehavioral symptoms. Changes in the gut microbiota affect memory loss in AD via the downregulation of NMDA receptor expression and increased glutamate levels. Furthermore, the use of probiotics resulted in neurological improvement in an AD model. PD and gut microbiota dysbiosis are linked directly. This interrelationship affected the development of constipation, a secondary symptom in PD. In a PD model, the administration of probiotics prevented neuron death by increasing butyrate levels. Dysfunction of the blood-brain barrier (BBB) has been identified in AD and PD. Increased BBB permeability is also associated with gut microbiota dysbiosis, which led to the destruction of microtubules via systemic inflammation. Notably, metabolites of the gut microbiota may trigger either the development or attenuation of neurodegenerative disease. Here, we discuss the correlation between cognitive decline and the gut microbiota.

• Journal of Veterinary Clinics
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• v.28 no.2
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• pp.244-248
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• 2011

Hypoadrenocorticism results from the deficient adrenal gland production of glucocorticoids or mineralocorticoids. Fludrocortisone have been used for the management of hypoadrenocorticism in dogs. But desoxycorticosterone pivalate (DOCP) have been administered for management of hypoadrenocorticism in dogs since several years because of the equivalent effect of fludrocortisone, and lessening of owner and patient's effort. The therapy of DOCP was evaluated in 14 dogs diagnosed with hypoadrenocorticism based on clinical signs, an electrolyte imbalance, and the results of an adrenocorticotropic hormone stimulation test. DOCP was administered at 25-day intervals at an initial dose of 2.2 mg/kg. The dogs were monitored for clinical signs and serum electrolyte, blood urea nitrogen, and creatinine concentrations every 25 days. Fludrocortisone was an effective treatment in dogs overall; however, a change to DOCP was necessary in 7 dogs because of adverse effects or poor responses. Another 7 dogs were treated with DOCP from the first time. A total of 14 dogs were treated with DOCP. Clinical signs and electrolyte imbalance resolved completely in 12 dogs. However, mild clinical signs, such as shivering, remained in 2 dogs, and 4 dogs required regular supplementation with prednisone. Improvements in clinical signs and electrolyte imbalance were significantly better after treatment with DOCP than with fludrocortisone. The results suggest that DOCP may be a better choice than fludrocortisone for the management of hypoadrenocorticism in dogs.

• Childhood Kidney Diseases
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• v.16 no.2
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• pp.89-94
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• 2012

Purpose: The option of selecting isotonic rather than hypotonic fluids for maintenance fluid in children has been advocated by some authors. Pneumonia and CNS infections are frequent clinical settings for acute hyponatremia because of nonosmotic anti-diuretic hormone stimuli in children. We conducted the present study to identify the incidence of hyponatremia in pneumonia and CNS infection of children and to determine the importance of maintenance intravenous fluid therapy regimen and other related factors. Methods: The study included 1,992 patients admitted to the Department of Pediatrics at Pusan National University Children's Hospital between November 2008 and August 2011, who were diagnosed with pneumonia or CNS infections and checked for serum sodium concentration. Their clinical data including laboratory findings were reviewed retrospectively. Results: During the study period, 218 patients were identified to have acute hyponatremia among 1,992 patients. The overall incidence of hyponatremia was 10.9%. The incidence of hyponatremia in encephalitis (37.3%) was highest and the incidence in bacterial meningitis (27.4%), viral meningitis (20.0%), bacterial pneumonia (11.1%), mycoplasma pneumonia (9.2%), and viral pneumonia (6.8%) were in descending order. The mean age was higher in hyponatremic patients than in isonatremic patients. The incidence of hyponatremia was higher in who had 0.18% NaCl in 5% dextrose (D5 0.18% NS) than 0.45% NaCl in 5% dextrose infusion (D5 1/2NS) (9.0% vs. 2.2%). SIADH was identified in 20.5% among hospital acquired hyponatremic patients after adequate evaluation for SIADH. Conclusion: We recommend D5 1/2NS rather than D5 0.18% NS as the maintenance fluid given to children with pneumonia or infectious CNS diseases.

• Clinical and Experimental Reproductive Medicine
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• v.17 no.1
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• pp.29-44
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• 1990

In 105 patients with the past history of poor response to the previous controlled ovarian hyperstimulation(COH) due to poor follicular growth or premature LH surge, the effectiveness of pituitary suppression with gonadotropin-releasing hormone agonist(GnRH agonist) in IVF/GIFT program was evaluated in 112 cycles of COH using a combination regimen of Leuprolide acetate (Lupron TAP Pharmaceuticals, USA) and FSH/hMG or pure FSH from May to December, 1989 at SNUH. Starting on day 21 of the menstrual cycle(MCD #21, Day 1), Lupron (1.0mg/day, subcutaneous) was administered once a day till next MCD #3(suppression phase). After the confirmation of pituitary suppression, ovarian follicular growth was stimulated with FSH/hMG or pure FSH from MCD #3(Day + 1), and Lupron was continued with hMG or FSH until hCG administration (D 0) (stimulation phase). After suppression phase, serum E2 level decreased from 183.7${\pm}$95.1(Day 1) to 17.4${\pm}$12.3pg/ml (Day +1), and serum progesterone level from 19.17${\pm}$8.67 to 0.12${\pm}$0.05ng/ml. But there was no decresas in serum LH and FSH levels; LH from 12.74${\pm}$6.21 to 15.49${\pm}$4.93mIU/ml,FSH from 7.60${\pm}$3.84 to 8.58${\pm}$3.15 rnlU/ml. There was no occurrence of premature LH surge during COH. Eleven cycles(9.8%) were cancelled due to poor follicular growth during stimulation phase, and 3 cycles (3.0%) failed in the transvaginal oocytes fretrieval. Serum E2 level was 1366.8${\pm}$642.4 on D 0 and 1492.3${\pm}$906.9pg/ml on D+1. 7.00${\pm}$3.32 follicles(FD${\geq}$12mm) were observed on D 0, and 6.11${\pm}$4.15 oocytes were retrieved, with the oocyte retrieval rate per follicle of 95.0%. 3.59${\pm}$2.57 oocytes were fertilized and cleaved with the oocyte cleavage rate of 55.7%. In 83 IVF patients, 4.08${\pm}$2.39 embryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET 2.39 mebryos were transferred, and 16 pregnancies were obtained with the pregnancy rate per ET of 19.3%. In 6 GIFT patients, 7.83${\pm}$3.31 oocytes were retrieved and transferred with maximum number of 6, but no pregnancy was obtained. When compared with the previous 108 cycles of COH using FSH/hMG or pure FSH regimen, the cancellation rate during COH was significantly decreased, and all the parameters of the outcome of COH including the pregnancy rate were increased. These data suggest that GnRH agonist therapy for pituitary suppression is an effective adjunct to the current gonadotropin regimens for COH in IVF/GIFT and can increase the probability of oocytes retrieval and pregnancy, especially in the previous poor responders.

• Korean Journal of Psychosomatic Medicine
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• v.19 no.2
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• pp.109-114
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• 2011

The abnormalities in Hypothalamic-pituitary-adrenal(HPA) axis are associated with many psychiatric symptoms including depression. We present a report of a 71 year old man who was admitted to the psychiatric department presenting symptoms of headache, avolition, loss of energy, psychomotor retardation, poor appetite, insomnia, anxiety resulting from adrenal insufficiency and hypopituitarism. Hypothyroidism and electrolyte disturbance were managed and headache, insomnia, anxiety, GI symptoms were improved. But he remained in anergic state. After discharge, he was readmitted to infection department with high fever and drowsy mentality. Adrenal insufficiency was recognized and he was treated with corticosteroid replacement therapy. Finally his diagnosis was made as panhypopituitarism and overall symptoms were resolved. In this case, we showed how the atypical symptoms resulting from hypopituitarism develop and progress. Hypothyroidism, adrenal insufficiency, and growth hormone deficiency resulting secondarily from panhypopituitarism were associated with various nonspecific symptoms such as loss of energy, fatigue, insomnia, weight loss, decreased appetite etc. In clinical situation, differential diagnosis with depression is needed when clinicians were met a patient with these nonspecific symptoms. It is important that laboratory tests and differential diagnosis with endocrine diseases should be conducted, especially in geriatric patients with nonspecific symptoms like anergia, fatigue, poor appetite and so on.

• Journal of Korean Academy of Nursing
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• v.29 no.2
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• pp.225-237
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• 1999

The purpose of this study was to analyze the relationship among the health promoting behaviors, self-reported climacteric symptoms and depression on a cross-sectional survey desist The subjects were 108 middle-aged women who were nonhystrectomized and ranged in age from 40 to 60. They were selected in Seoul and Kyoung-ki province. Korea. Data were collected from Oct. 25 to Nov. 10, 1997 by a structured Questionnaire. The instrument used for this study was the revised Health Promotion Lifestyle Profile(HPLP) developed by Walker, Sechrist and Pender, revised Climacteric Symptoms Scale developed by Chi, Sung Ai, and the Beck's Depression Inventory(BID). The data were analyzed by the SPSS /PC$^{＋}$ program using t-test, ANOVA and Scheffe test as a post hoc and Pearson Correlation Coefficient. The results of the study were as follows ; 1. The mean score of health promoting behaviors was low(2.42$\pm$0.35). There were statistically significant difference in the score of health promoting behaviors according to the educational background. family income, marital satisfaction, and whether or not taking a restoraitve food(t ＝－2.07, F＝2.60~7.57, p＜0.05). 2. The mean score of self-reported climacteric symptoms was 1.69 ; 99% of middle-aged women had symptoms. There were statistically significant difference in the score of middle-aged women's self-reported climacteric symptoms according to the age, number of children, educational background, occupation, family income, marital satisfaction, whether or not receiving hormone replacement therapy(HRT) or consultation experience with a professional, and perceived health status(t＝－2.04~3.69. F＝2.87~11.63, p＜0.05). 3. The mean score of depression was 10.84. There were statistically significant differences in the score of the depression according to the age, number of children, educational background, occupation, marital satisfaction, whether or not receiving menopausal treatment or consultation by a professional, and perceived health status(t ＝－2.25~3.00, F＝3.50~9.24, p＜0.05). 4. Women's degree of health promoting behaviors was a negative correlation with the degree of climacteric symptoms(r＝－0.19, p＝0.03) and the degree of depression(r＝－0.23, p＝0.01). The degree of climacteric stmptoms was a positive correlation with the degree of depression(r＝0.64 p＝0.01). In conclusion. health promoting behavior should be considered when developing nursing strategies for middle-aged women. especially when dealing with climacteric symptoms and depression.