Long-term follow-up results of cytarabine-containing chemotherapy for acute promyelocytic leukemia

Background/Aims@#We evaluated the feasibility and long-term efficacy of the combination of cytarabine, idarubicin, and all-trans retinoic acid (ATRA) for treating patients with newly diagnosed acute promyelocytic leukemia (APL). @*Methods@#We included 87 patients with newly diagnosed acute myeloid leukemia and a t(15;17) or promyelocytic leukemia/retinoic acid receptor alpha (PML-RARα) mutation. Patients received 12 mg/m2/day idarubicin intravenously for 3 days and 100 mg/m2/day cytarabine for 7 days, plus 45 mg/m2/day ATRA. Clinical outcomes included complete remission (CR), relapse-free survival (RFS), overall survival (OS), and the secondary malignancy incidence during a 20-year follow-up. @*Results@#The CR, 10-year RFS, and 10-year OS rates were 89.7%, 94.1%, and 73.8%, respectively, for all patients. The 10-year OS rate was 100% for patients that achieved CR. Subjects were classified according to the white blood cell (WBC) count in peripheral blood at diagnosis (low-risk, WBC < 10,000/mm3; high-risk, WBC ≥ 10,000/mm3). The low-risk group had significantly higher RFS and OS rates than the high-risk group, but the outcomes were not superior to the current standard treatment (arsenic trioxide plus ATRA). Toxicities were similar to those observed with anthracycline plus ATRA, and higher than those observed with arsenic trioxide plus ATRA. The secondary malignancy incidence after APL treatment was 2.7%, among the 75 patients that achieved CR, and 5.0% among the 40 patients that survived more than 5 years after the APL diagnosis. @*Conclusions@#Adding cytarabine to anthracycline plus ATRA was not inferior to anthracycline plus ATRA alone, but it was not comparable to arsenic trioxide plus ATRA. The probability of secondary malignancy was low.

Test–Retest Reliability of Attention Network Test Scores in Schizophrenia / 정신신체의학

OBJECTIVES: Although the Attention Network Test(ANT) has been widely used to assess selective attention including alerting, orienting, and conflict processing, data on its test-retest reliability are lacking for clinical population. The objective of the current study was to investigate test-retest reliability of the ANT in healthy controls and patients with schizophrenia. METHODS: Fourteen patients with schizophrenia and 23 healthy controls participated in the study. They are tested with ANT twice with 1 week interval. Test–retest reliability was analyzed with Pearson and Intra-class correlations. RESULTS: Patients with schizophrenia showed high test–retest correlations for mean reaction time, orienting effect, and conflict effect. Also, they showed moderate to high test-retest correlations for mean accuracy and moderate test-retest correlations for alerting effect and conflict error rate. On the other hand, healthy controls revealed high test–retest correlations for mean reaction time and moderate to high test-retest correlations for conflict error rate. In addition, they revealed moderate test-retest correlations for alert effect, orienting effect, and conflict effect. CONCLUSIONS: The mean reaction time, alerting effect, orienting effect, conflict effect, and conflict error rate of ANT showed acceptable test–retest reliabilities in healthy controls as well as patient with schizophrenia. Therefore, the analyses of these reliable measures of ANT are recommended for case-control studies in patients with schizophrenia.

Repolarization Heterogeneity of Magnetocardiography Predicts Long-Term Prognosis in Patients with Acute Myocardial Infarction

PURPOSE: Magnetocardiography (MCG) has been proposed as a noninvasive, diagnostic tool for risk-stratifying patients with acute myocardial infarction (AMI). This study evaluated whether MCG predicts long-term prognosis in AMI. MATERIALS AND METHODS: In 124 AMI patients (95 males, mean age 60±11 years), including 39 with ST-elevation myocardial infarction, a 64-channel MCG was performed within 2 days after AMI. During a mean follow-up period of 6.1 years, major adverse cardiac events (MACE) were evaluated. RESULTS: MACE occurred in 31 (25%) patients, including 20 revascularizations, 8 deaths, and 3 re-infarctions. Non-dipole patterns were observed at the end of the T wave in every patients. However, they were observed at T-peak in 77% (24/31) and 54% (50/93) of patients with and without MACE, respectively (p=0.03). Maximum current, field map angles, and distance dynamics were not different between groups. In the multivariate analysis, patients with non-dipole patterns at T-peak had increased age- and gender-adjusted hazard ratios for MACE (hazard ratio 2.89, 95% confidence interval 1.20–6.97, p=0.02) and lower cumulative MACE-free survival than those with dipole patterns (p=0.02). CONCLUSION: Non-dipole patterns at T-peak were more frequently observed in patients with MACE and were related to poor long-term prognosis. Thus, repolarization heterogeneity measured by MCG may be a useful predictor for AMI prognosis.

The Effect of Bilateral Eye Movements on Face Recognition in Patients with Schizophrenia / 정신신체의학

OBJECTIVES: The deficit of recognition memory has been found as one of the common neurocognitive impairments in patients with schizophrenia. In addition, they were reported to fail to enhance the memory about emotional stimuli. Previous studies have shown that bilateral eye movements enhance the memory retrieval. Therefore, this study was conducted in order to investigate the memory enhancement of bilaterally alternating eye movements in schizophrenic patients. METHODS: Twenty one patients with schizophrenia participated in this study. The participants learned faces (angry or neutral faces), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analysed. Two-way repeated measure analysis of variance was performed for statistical analysis. RESULTS: There was a significant effect of bilateral eye movements condition in mean response time(F=5.812, p<0.05) and response bias(F=10.366, p<0.01). Statistically significant interaction effects were not observed between eye movement condition and face emotion type. CONCLUSIONS: Irrespective of the emotional difference of facial stimuli, recognition memory processing was more enhanced after bilateral eye movements in patients with schizophrenia. Further study will be needed to investigate the underlying neural mechanism of bilateral eye movements-induced memory enhancement in patients with schizophrenia.

EEG Source Imaging in Partial Epilepsy in Comparison with Presurgical Evaluation and Magnetoencephalography

BACKGROUND AND PURPOSE: The aim of this study was to determine the usefulness of three-dimensional (3D) scalp EEG source imaging (ESI) in partial epilepsy in comparison with the results of presurgical evaluation, magnetoencephalography (MEG), and electrocorticography (ECoG). METHODS: The epilepsy syndrome of 27 partial epilepsy patients was determined by presurgical evaluations. EEG recordings were made using 70 scalp electrodes, and the 3D coordinates of the electrodes were digitized. ESI images of individual and averaged spikes were analyzed by Curry software with a boundary element method. MEG and ECoG were performed in 23 and 9 patients, respectively. RESULTS: ESI and MEG source imaging (MSI) results were well concordant with the results of presurgical evaluations (in 96.3% and 100% cases for ESI and MSI, respectively) at the lobar level. However, there were no spikes in the MEG recordings of three patients. The ESI results were well concordant with MSI results in 90.0% of cases. Compared to ECoG, the ESI results tended to be localized deeper than the cortex, whereas the MSI results were generally localized on the cortical surface. ESI was well concordant with ECoG in 8 of 9 (88.9%) cases, and MSI was also well concordant with ECoG in 4 of 5 (80.0%) cases. The EEG single dipoles in one patient with mesial temporal lobe epilepsy were tightly clustered with the averaged dipole when a 3 Hz high-pass filter was used. CONCLUSIONS: The ESI results were well concordant with the results of the presurgical evaluation, MSI, and ECoG. The ESI analysis was found to be useful for localizing the seizure focus and is recommended for the presurgical evaluation of intractable epilepsy patients.

The Effect of Bilateral Eye Movements on Emotional Face Recognition Memory Task / 신경정신의학

OBJECTIVES: Previous studies have shown that bilateral eye movements enhance episodic memory retrieval. However, few studies on the effect of bilateral eye movements on emotional memory have been reported. Therefore, this study was conducted in order to investigate the differences in memory retrieval between neutral and angry stimuli after bilaterally alternating eye movements. METHODS: Twenty seven healthy right-handed subjects participated in this study. The participants learned faces (angry or neutral face), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analyzed. Two-way repeated measure analysis of variance was performed for statistical analysis. RESULTS: There was a significant effect of bilateral eye movement conditions in recognition accuracy (F=13.833, p<0.01). Statistically significant interaction effects were observed between eye movement condition and face emotion type (F=6.253, p=0.02). CONCLUSION: In this study, recognition memory for angry faces was more enhanced than that for neutral faces after bilateral eye movements. This finding suggests that bilateral eye movements can improve recognition memory for emotional stimuli more than that for neutral stimuli.

The Effect of Bilateral Eye Movements on Emotional Face Recognition Memory Task / 신경정신의학

OBJECTIVES: Previous studies have shown that bilateral eye movements enhance episodic memory retrieval. However, few studies on the effect of bilateral eye movements on emotional memory have been reported. Therefore, this study was conducted in order to investigate the differences in memory retrieval between neutral and angry stimuli after bilaterally alternating eye movements. METHODS: Twenty seven healthy right-handed subjects participated in this study. The participants learned faces (angry or neutral face), and then performed a recognition memory task in relation to the faces after bilateral eye movements and central fixation. Recognition accuracy, response bias, and mean response time to hits were compared and analyzed. Two-way repeated measure analysis of variance was performed for statistical analysis. RESULTS: There was a significant effect of bilateral eye movement conditions in recognition accuracy (F=13.833, p<0.01). Statistically significant interaction effects were observed between eye movement condition and face emotion type (F=6.253, p=0.02). CONCLUSION: In this study, recognition memory for angry faces was more enhanced than that for neutral faces after bilateral eye movements. This finding suggests that bilateral eye movements can improve recognition memory for emotional stimuli more than that for neutral stimuli.

Establishment and Magnetocardiographic Changes of Pressure Overload Left Ventricular Hypertrophy and Its Regression in Rats

BACKGROUND AND OBJECTIVES: Regression of left ventricular hypertrophy (LVH) is important because development of myocardial ischemia, heart failure or arrhythmias may be reduced. However, an animal model for LVH regression is not well established and there are no useful parameters to predict LVH regression. Magnetocardiogram (MCG), magnetic signal generated from the heart, has recently been investigated for the detection of electrical current changes of the heart. This study was undertaken to establish rat models of LVH-regression and to assess MCG changes during LVH induction and regression. MATERIALS AND METHODS: Rat models of pressure overload LVH were established by transverse aortic constriction (TAC) and LVH regression was generated by untying 2 weeks after TAC. Hemodynamic, echocardiographic and biochemical evaluation were performed in order to confirm this model. Magnetic fields were recorded with a SQUID gradiometer before and after TAC, and also recorded at 1, 3, 7, and 14 days after untying, respectively. RESULTS: Rat models of LVH-regression were established successfully by TAC and untying. The pressure gradient across TAC disappeared within 10 minutes after untying. LV weight, LV weight/body weight ratio, LV mass and expression level of atrial natriuretic factor were significantly increased following TAC and decreased to baseline value after pressure unloading. Deeper S waves and strain patterns were observed after LVH induction and gradually returned to basal levels over the 2 weeks after untying. CONCLUSION: MCG changes in the rat models of LVH-regression indicate that MCG can be a helpful modality for the diagnosis and evaluation of LVH as well as follow-up after treatment of LVH.

Sequential changes of magnetocardiogram in rat models of experimental myocardial infarction / 대한내과학회지

BACKGROUND: Magnetocardiogram (MCG), which records the changes of magnetic fields generated by the heart's electrical activity, theoritically can provide unique data for clinical application. To date, MCG has been investigated only at a single time point after myocardial infarction (MI) with severe left ventricular dysfunction in rats. The purpose of the present study was to investigate sequential changes of MCG after MI and to evaluate effects of infarct size on MCG. METHODS: Acute MI were induced by the permanent ligation of left coronary artery in 22 rats. Magnetic fields were recorded just above a rat with Nb Superconducting Quantum Interference Device (SQUID) gradiometer inside a magnetically shielded room. MCG was measured before and immediately after surgery and it was subsequently recorded at the time points of 1, 4 and 6 hours postoperatively. MCG was also measured at 1, 3, 7 and 21 days after surgery. RESULTS: Elevation of ST segment and appearance of pathological Q wave on the MCG were evident immediately after the ligation of coronary artery and persisted to 6 hours after MI. On MCG, ST segment was depressed and T wave was inverted from 1 day after MI. In rats with small- and moderate-sized MI (infarct size or = 30%). CONCLUSION: Evolutional changes of MCG were well-recognized up to 21 days after MI. Furthermore, the infarct size can be expressed by the extent of Q wave and ST segment depression on MCG. Taken together, these data indicate that MCG is a helpful modality for the diagnosis, evaluation of infarct size and follow up after MI.