Influence of NK cell count on the survival of patients with diffuse large B-cell lymphoma treated with R-CHOP

BACKGROUND: Although adding rituximab to the chemotherapy regimen of cyclophosphamide, vincristine, doxorubicin, and prednisone (R-CHOP) has improved clinical outcomes of patients with diffuse large B-cell lymphoma (DLBCL), several recent studies have shown that the effect of rituximab is dominantly in the non-germinal center (non-GC) subtype compared to the germinal center (GC) subtype. Natural killer (NK) cell count, a surrogate marker of immune status, is associated with clinical outcomes in DLBCL patients in the rituximab era. We investigated whether the impact of NK cells on clinical outcomes differed according to the immunophenotype of DLBCL. METHODS: This study analyzed 72 DLBCL patients treated with R-CHOP between January 2010 and January 2014. RESULTS: Low NK cell counts (<100/microL) were associated with poor progression-free survival (PFS) and overall survival (OS) compared to high NK cell counts. In multivariate analysis, low NK cell count was an independent prognostic factor for PFS and OS. However, survival did not significantly differ between the GC and non-GC subtypes. We examined the clinical influence of NK cells according to the immunophenotype and found that low NK cell counts were significantly associated with poor PFS and OS in non-GC cases, but not in GC cases. CONCLUSION: Low NK cell counts at diagnosis are associated with poor clinical outcomes in DLBCL patients treated with R-CHOP therapy. However, the impact is significant only in non-GC subtype DLBCL, not in the GC subtype.

Successful Treatment by Chemotherapy of Pineal Parenchymal Tumor with Intermediate Differentiation: A Case Report / Journal of the Korean Cancer Association, 대한암학회지

A 37-year-old male presented with a mass measuring 2.5 cm in size in the midbrain and obstructive hydrocephalus, which had manifested as a headache and dizziness. Magnetic resonance (MR) imaging of the brain showed intermediate enhancement on T1-weighted MR imaging and a high intensity of enhancement on T2-weighted MR. Neurosurgeons performed an occipital craniotomy with partial removal of the tumor and the postoperative diagnosis was a pineal parenchymal tumor with intermediate differentiation. He had undergone irradiation with 54 Gy of radiation on 27 fractions for removal of the remaining tumor approximately one month after surgery. However, in follow-up imaging performed four months after radiotherapy, a remnant mass in the superoposterior aspect of the midbrain was found to have extended to the hypothalamus and the third ventricle. He was treated with six cycles of procarbazine, lomustine, vincristine chemotherapy. At five months since the completion of chemotherapy, the brain MR imaging showed no evidence of any remaining tumor and he no longer displayed any of his initial symptoms.

A Case Report of Pancreatic Arteriovenous Malformation Diagnosed by Endoscopic Ultrasonography / 대한내과학회지

Pancreatic arteriovenous malformations (AVMs) are rare, and most cases occur as congenital anomalies. Many patients with AVM are asymptomatic, but occasionally present with abdominal pain or gastrointestinal bleeding. The increased portal vein flow that forms these malformations can lead to portal hypertension and gastrointestinal bleeding in the absence of primary liver pathology. Early diagnosis can lead to successful surgical resection or percutaneous transarterial embolization. We report a case of a patient with pancreatic AVM in the tail of the pancreas, in which endoscopic ultrasonography was helpful. This patient presented with abdominal pain and was subsequently treated with distal pancreatectomy.

Is the frequency of metabolic syndrome higher in South Korean women with rheumatoid arthritis than in healthy subjects?

BACKGROUND/AIMS: To compare the frequency of metabolic syndrome (MetS) and magnitude of insulin resistance, measured by the homeostatic model assessment of insulin resistance (HOMA-IR), between South Korean women with rheumatoid arthritis (RA) and healthy subjects, and to evaluate risk factors for MetS and increased HOMA-IR in patients with RA. METHODS: In a cross-sectional setting, 84 female patients with RA and 109 age-matched healthy female subjects were consecutively recruited at a university-affiliated rheumatology center in South Korea. MetS was defined according to the Third Report of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP III) 2004 criteria. RESULTS: The frequency of MetS did not differ significantly between patients with RA (19%) and healthy subjects (15.6%, p = 0.566), although patients with RA had a higher HOMA-IR compared with healthy subjects (p < 0.001). Patients with RA met the NCEP-ATP III 2004 criteria for high blood pressure more often than healthy subjects (44% vs. 19.3%, p < 0.001), and low high density lipoprotein cholesterol was more prevalent in healthy subjects (33%) than in patients with RA (14.3%, p = 0.004). Although no obvious risk factors for the presence of MetS were identified in patients with RA, higher serum C-reactive protein and disease activity score assessed using the 28-joint count for swelling and tenderness-erythrocyte sedimentation rate significantly contributed to a higher HOMA-IR. CONCLUSIONS: Despite their increased insulin resistance, South Korean women with RA did not have a significantly higher frequency of MetS compared with that in healthy subjects.

Apoptotic Change in Placenta of Pregnancy-induced Hypertension / 대한산부인과학회잡지

The mechanism of apoptosis was first discovered at the end of the 19th century, but it was only recently that its importance was recognized. Not only in a pathologic environment but also in a normal environment, apoptosis has an important role in homeostasis. The number of cells is restricted by apoptosis which is controlled by several SlgBS lll VlVO. In pregnancy, the placenta regulates the maternal-fetal exchange of molecules and functions as a barrier for the protection of the fetus. As the pregnancy proceeds, changes occur in the number and components of placental cells. Observing the placental tissues, apoptosis was found in the syncytiotrophoblasts of early and late pregnancy. In particular, the fact that apoptosis observed in the placenta of late pregnancy supports the hypothesis that pmgrammed cell death is a normal sequence. Pregnancy-induced hypertension is usually accompanied by abnormal placenta and intrauterine growth restriction. In this study, using the TdT-FragEL DNA fragmentation detection kit, the changes in the nucleus by apoptosis in the placental tissues of 23 to 40 gestational weeks in preeclampsia and eclampsia were compared with normal placenta. Apoptosis was observed in the normal term placenta and in pregnancy-induced hypertension patients, regardless of whether vasculopathy was observed in Doppler ultrasound or confirmed by pathology, more apoptoses were observed aside from the number of gestational weeks.

A Cases of Impetigo Herpetiformis During Pregnancy / 대한산부인과학회잡지

No abstract available.

Prognostic Value of Day 3 Inhibin-B on Assisted Reproductive Technology Outcome / 대한불임학회지

This study was performed to determine if women with day 3 serum inhibin-B concentrations or = 45pg/ml, independant of day 3 FSH, E2 and patient age. From Jan 1996 to Dec 1996, 16 volunteers patients who underwent 25 IVF cycles with luteal phase GnRH agonist suppression and HMG stimulation were allocated to the study group. We evaluated day 3 serum inhibits-B, FSH, E2, peak E2, cancellation rate per initiated cycle (%) and clinical pregnancy rate per initiated cycle (%) according to the above two groups and independent of patient age, day 3 FSH, day 3 E2 and all of above combined. Women with day 3 serum inhibin-B > or =45pg/m1 demonstrated higher average day 3 inhibits-B level, clinical pregnancy rate per initiated cycle (20.3+/-2.5 pg/ml vs 80.9+/- 5.0pg/ml, p or =45pg/ml and age or =45pg/ml and day 3 FSH or =45pg/ml and day 3 E2 or =45pg/ml, age<40 year, day 3 FSH<15mIU/ml and day 3 E2<50pg/m1 demonstrated higher pregnancy rate per initiated cycle (30.0% vs 10.8%, p<0.05) and lower day 3 FSH level, cancellation rate per initiated cycle (6.8+/-0.6 mIU/ml vs 8.4+/-0.9 mIU/ml, p<0.05; 1.5% vs 7.8%, p<0.05). Therefore women with low day 3 serum inhibits-B concentrations demonstrate a poorer response to ovulation induction and are less likely to conceive a clinical pregnancy though ART relative to women with high day 3 inhibits-B and day 3 serum inhibin-B, in addition to a day 3 FSH, E2 and patient age, appears helpful in prediction in IVF-ET outcome.