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Objective@#The purpose of this study was to examine whether there is a causal link between rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and autism spectrum disorder (ASD). @*Methods@#We used inverse variance weighted (IVW), weighted median, and MR-Egger regression methods to perform two-sample Mendelian randomization (MR) study using publicly available summary statistics datasets. In addition, we employed genome-wide association studies (GWASs) for RA and SLE as exposure and an ASD GWAS as an outcome. @*Results@#Thirty-three and 28 single-nucleotide polymorphisms from RA and SLE GWASs were selected as instrumental variables for ASD. The IVW method revealed no evidence supporting a causal association between RA and SLE and risk for ASD (beta=−0.077, standard error [SE]=0.041, p=0.062; beta=0.014, SE=0.021, p=0.493). The weighted median approach yielded no evidence of any causal association between RA and SLE and risk for ASD (beta=−0.071, SE=0.058, p=0.223; beta=0.045, SE=0.030, p=0.130). MR-Egger analysis demonstrated no causal association between RA and SLE and risk for ASD (beta=−0.062, SE=0.079, p=0.434; beta=0.048, SE=0.043, p=0.273). The MR results calculated using IVW, the median weighted and the MR-Egger regression approaches were consistent. @*Conclusion@#The findings of the MR analysis did not support a causal relationship between RA or SLE and the risk of ASD.
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Background@#Sebocytes are the main cells involved in the pathogenesis of acne by producing lipids and inflammatory cytokines. Although palmitic acid (PA) has been suggested to induce an inflammatory reaction, its effect on sebocytes remains to be elucidated. @*Objective@#In the present study, we investigated whether PA promotes inflammasome-mediated inflammation of sebocytes both in vivo and in vitro. @*Methods@#We intradermally injected PA into the mice ears. And, we treated cultured human sebocytes with PA. Inflammasome-mediated inflammation was verified by immunohistochemistry, Western blot and ELISA. @*Results@#PA-treated mice developed an inflammatory response associated with increased interleukin (IL)-1β expression in the sebaceous glands. When PA was added to cultured human sebocytes, caspase-1 activation and IL-1β secretion were significantly enhanced. In addition, NLRP3 knockdown attenuated IL-1β production by sebocytes stimulated with PA. PA-mediated inflammasome activation required reactive oxygen species. @*Conclusion@#These findings indicate that PA activates the NLRP3 inflammasome before induction of an inflammatory response in sebocytes. Thus, PA may play a role in the inflammation of acne
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Background@#Open reduction and internal fixation is the standard treatment for a displaced medial malleolus fracture (MMFx), achieving ankle stability and bony union to prevent post-traumatic arthritis. Previous fixation techniques including tension band wiring and unicortical screw fixation are not optimal for fixation of small fragments in MMFx due to their small size and poor manipulability. Here, we describe a novel surgical method using mini-screws only for fixation of small fragments in MMFx. @*Methods@#We conducted a retrospective consecutive study of patients who underwent surgery using mini-screws for small fragment MMFx between April 2013 and March 2018. We reviewed the patients’ clinical characteristics and assessed the fracture features radiographically. Clinical outcomes were assessed by measuring the range of motion of both ankle joints and investigating symptomatic implants. We reviewed the radiographic outcomes of the medial malleolus and the functional outcomes using the Foot and Ankle Outcome Score (FAOS) at the last follow-up. @*Results@#Nine patients were included in the study. The minimal follow-up period was 27 months. There was no incidental bone breakage during the procedure. All MMFx healed without reduction loss, nonunion, or implant failure at the last follow-up. Two patients had mild osteoarthritic changes of the ankle joint. The mean FAOS score of the patients was 80.99 (range, 65.44–98.42). No patients required removal of the hardware. @*Conclusions@#Fixation of comminuted fractures of the medial malleolus using mini-screws for young adult patients is a straightforward and simple technique. Safe fixation of the anterior and posterior colliculi reduces the risk of implant irritation symptoms that necessitate implant removal.
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Background@#Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. @*Objective@#The purpose of this study is to uncover possible roles of MDA5 in psoriasis. @*Methods@#Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. @*Results@#As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. @*Conclusion@#These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.
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Background@#Open reduction and internal fixation is the standard treatment for a displaced medial malleolus fracture (MMFx), achieving ankle stability and bony union to prevent post-traumatic arthritis. Previous fixation techniques including tension band wiring and unicortical screw fixation are not optimal for fixation of small fragments in MMFx due to their small size and poor manipulability. Here, we describe a novel surgical method using mini-screws only for fixation of small fragments in MMFx. @*Methods@#We conducted a retrospective consecutive study of patients who underwent surgery using mini-screws for small fragment MMFx between April 2013 and March 2018. We reviewed the patients’ clinical characteristics and assessed the fracture features radiographically. Clinical outcomes were assessed by measuring the range of motion of both ankle joints and investigating symptomatic implants. We reviewed the radiographic outcomes of the medial malleolus and the functional outcomes using the Foot and Ankle Outcome Score (FAOS) at the last follow-up. @*Results@#Nine patients were included in the study. The minimal follow-up period was 27 months. There was no incidental bone breakage during the procedure. All MMFx healed without reduction loss, nonunion, or implant failure at the last follow-up. Two patients had mild osteoarthritic changes of the ankle joint. The mean FAOS score of the patients was 80.99 (range, 65.44–98.42). No patients required removal of the hardware. @*Conclusions@#Fixation of comminuted fractures of the medial malleolus using mini-screws for young adult patients is a straightforward and simple technique. Safe fixation of the anterior and posterior colliculi reduces the risk of implant irritation symptoms that necessitate implant removal.
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Background@#Psoriasis is a chronic inflammatory skin disease. The etiology of psoriasis is not fully understood, but the genetic background is considered to be the most important factor. To date, many psoriasis-related genes have been discovered, but the role of many important genes has not been well understood. @*Objective@#The purpose of this study is to uncover possible roles of MDA5 in psoriasis. @*Methods@#Expression of MDA5 was investigated using immunohistochemistry. Then, MDA5 was overexpressed in keratinocytes using a recombinant adenovirus. @*Results@#As a result of immunohistochemical staining, the expression of MDA5 was significantly increased in the epidermis of psoriasis compared to normal skin. Similarly, the expression of MDA5 was increased in imiquimod-induced psoriasiform dermatitis model. In cultured keratinocytes, toll-like receptor 3 agonist poly(I:C) induced expression of MDA5 at both mRNA and protein levels. When MDA5 was overexpressed using a recombinant adenovirus, poly(I:C)-induced cytokine expression was significantly increased. Finally, MDA5 overexpression significantly inhibited calcium-induced differentiation of keratinocytes. @*Conclusion@#These results suggest that MDA5 increases in psoriasis and negatively regulates keratinocyte differentiation.
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Objective@#The aim of this study was to examine if the intestinal microbiome is causally correlated with osteoarthritis (OA) incidence. @*Methods@#A two-sample Mendelian randomization (MR) study was conducted using inverse variance weighting (IVW), weighted median, and MR-Egger regression techniques. Publicly accessible summary statistics dataset of intestinal microbiomes of European descent from genome-wide association studies (GWASs) (a total with 3,326 individuals) was used as an exposure. As an outcome, summary data from the GWAS include 3,498 patients with OA of the knee and hip from the arcOGEN sample and 11,009 controls of European descent. @*Results@#We identified 29 single-nucleotide polymorphisms from GWAS of intestinal microbiomes as instrumental variables. The IVW approach found no evidence to suggest a causal relationship between the intestinal microbiota and OA (beta=−0.001, standard error [SE]=0.004, p=0.748). The regression test of MR-Egger showed that the directional pleiotropy was unlikely to be a bias (intercept=0.002, SE=0.007, p=0.697) and the MR-Egger study showed no causal relation between the intestinal microbiota and the OA (beta=−0.002, SE=0.005, p=0.630). The weighted median analysis also did not have indications of a causal relationship between the intestinal microbiota and OA (beta=−0.002, SE=0.005, p=0.630). The MR results calculated using IVW, the median weighted and the MR-Egger regression approaches were consistent. @*Conclusion@#The findings of the MR analysis did not support a causal relationship between intestinal microbiome and OA risk.
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he inference of causality from observational evidence may be problematic, as observational studies frequently include confounding factors or reverse causation for the identification of associations between exposure and outcome. Thus, in observational studies, the association between a risk factor and a disease of interest may not be causal. A randomized controlled trial (RCT) is considered the gold standard, because it has the best possibility to establish a relationship between a risk factor and an outcome. However, RCTs cannot always be performed, because they can be costly, impractical, or even unethical. One of the alternatives is to perform Mendelian randomization (MR) experiments that are similar to RCTs in terms of study design.The MR technique uses genetic variants related to modifiable traits/exposures as tools to detect causal associations with outcomes. MR can provide more credible estimates of the causal effect of a risk factor on an outcome than those obtained in observational studies by overcoming the limitations of observational studies. Therefore, MR can make a substantial contribution to our understanding of complex disease etiology. MR approaches are increasingly being used to evaluate the causality of associations with risk factors, because well-performed MR studies can be a powerful method for exploring causality in complex diseases. However, there are some limitations in MR analyses, and an awareness of these limitations is essential to interpret the results. The validity of results from MR studies depends on three assumptions that should be carefully checked and interpreted in the context of prior biological information.
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. The purpose of this study was to determine whether the rs7574865 polymorphism of signal transducers and transcription 4 activators (STAT4) in multiple ethnic populations is associated with susceptibility to systemic lupus erythematosus (SLE). Methods. A meta-analysis on the STAT4 T allele rs7574865 polymorphism was performed in all subjects of study as well as in each ethnic population. Results. It included twenty-four manuscripts with 36 comparative studies of 22,898 SLE patients and 24,838 controls. The mean frequency of the STAT4 rs7574865 T allele was 28.5%, ranging from 14.3% to 35.7%, among the controls. T allele rates were 14.3%, 22.8%, 31.9%, 32.4%, and 35.7%, respectively in African American, European, Arab, Asian, and Latin American populations. Meta-analysis revealed a substantial correlation in all subjects between STAT4rs7574865 and SLE (odds ratio=1.549, 95% confidence interval=1.459∼1.644, p＜0.001). Analysis after stratification of race showed a strong association between the STAT4 rs7574865 T allele and SLE in Europeans, Asians, Latin Americans, African Americans, and Arabs. Conclusion. This meta-analysis demonstrated that the STAT4 rs7574865 polymorphism in different ethnic groups was correlated with SLE susceptibility, and that its prevalence depended on ethnicity.
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Objective@#. To assess the circulating levels of interleukin (IL)-37 in rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and determine a correlation between plasma/serum IL-37 levels and disease activity. @*Methods@#. We performed a meta-analysis comparing plasma/serum IL-37 level between patients with RA or SLE and controls, and examined correlation coefficients between circulating IL-37 levels and disease activity. @*Results@#. A total of 14 publications included 711 patients with RA and 394 controls, 522 patients with SLE and 259 controls. In the RA group, the IL-37 level was significantly higher than in the control group (standardized mean difference [SMD]=1.222, 95% confidence interval [CI]=0.722∼1.711, p＜0.001). Subgroup analysis by sample size showed a significantly higher IL-37 level in RA group of large (n＞90) and small sample numbers (n≤90) (SMD=0.994, 95% CI=0.323∼1.666, p＜0.001; SMD=1.617, 95% CI=1.328∼1.906, p＜0.001). In addition, IL-37 level in SLE group was significantly higher than in control group (SMD=1.096, 95% CI=0.635∼1.558, p＜0.001). A strong association between circulating IL-37-level and RA activity based on Disease activity Score 28 was shown (correlation coefficients=0.547, 95% CI=0.355∼0.695, p＜0.001). Meta-analysis of the coefficients for correlation indicated a positive correlation between the circulating level of IL-37 and SLE activity based on Systemic Lupus Erythematosus Disease Activity Index (coefficients for correlation＜0.588, 95 % CI=0.270∼0.806, p=0.003). @*Conclusion@#. Our meta-analysis showed that circulating IL-37 levels are higher in RA and SLE patients, and there is a positive correlation between IL-37 and disease activity in RA and SLE.
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Purpose@#Gastric delta cells (D-cells), which are somatostatin-secreting cells, are the main paracrine inhibitor of acid secretion. The number of D-cells was studied in children presenting with upper gastrointestinal (UGI) disease. @*Methods@#We retrospectively investigated the number of D-cells in the gastric body and antrum through immunofluorescence examinations according to symptoms, endoscopic findings, and Helicobacter pylori infection in 75 children who visited Hanyang University Hospital Pediatrics. @*Results@#The mean patient age was 12.2±3.3 years. The male-to-female ratio was 1:1.4. The mean D-cell number per high-power field in the antrum and body was 20.5 and 12 in children with substernal pain, 18.3 and 10.3 in vomiting, 22.3 and 6 in diarrhea, and 9.3 and 6 in abdominal pain, respectively (p>0.05). According to endoscopic findings, the mean D-cell number in the antrum and body was 14.3 and 6 with gastritis, 14 and 9.3 with reflux esophagitis, 16.7 and 8.7 with duodeno-gastric reflux, 19.3 and 12.7 with gastric ulcer, 16 and 13.7 with duodenitis, and 12.3 and 4 with duodenal ulcer, respectively (p>0.05). The D-cell number in the gastric body was 2.7 and 8.7 in children with current H. pylori infection and non-infected children, respectively (p=0.01), while those in the antrum were 15.5 and 14, respectively, with no statistical significance. @*Conclusion@#The D-cell number was lower in the gastric body of children with current H. pylori infection. Further studies concerning peptide-secreting cells with a control group would provide information about the pathogenic pathways of UGI disorder.
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Background@#Hereditary hemolytic anemia (HHA) is a rare disease characterized by premature red blood cell (RBC) destruction due to intrinsic RBC defects. The RBC Disorder Working Party of the Korean Society of Hematology established and updated the standard operating procedure for making an accurate diagnosis of HHA since 2007. The aim of this study was to investigate a nationwide epidemiology of Korean HHA. @*Methods@#We collected the data of a newly diagnosed pediatric HHA cohort (2007–2016) and compared this cohort's characteristics with those of a previously surveyed pediatric HHA cohort (1997–2006) in Korea. Each participant's information was retrospectively collected by a questionnaire survey. @*Results@#A total of 369 children with HHA from 38 hospitals distributed in 16 of 17 districts of Korea were investigated. RBC membranopathies, hemoglobinopathies, RBC enzymopathies, and unknown etiologies accounted for 263 (71.3%), 59 (16.0%), 23 (6.2%), and 24 (6.5%) of the cases, respectively. Compared to the cohort from the previous decade, the proportions of hemoglobinopathies and RBC enzymopathies significantly increased (P < 0.001 and P = 0.008, respectively). Twenty-three of the 59 hemoglobinopathy patients had immigrant mothers, mostly from South-East Asia. @*Conclusion@#In Korea, thalassemia traits have increased over the past 10 years, reflecting both increased awareness of this disease and increased international marriages. The enhanced recognition of RBC enzymopathies is due to advances in diagnostic technique; however, 6.5% of HHA patients still do not have a clear diagnosis. It is necessary to improve accessibility of diagnosing HHA.
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Meissner’s corpuscles are generally considered to be located in the dermal papilla of hairless skin on the fingers, toes, palms, soles, lips, eyelids, nipples, and genital organs. We used hematoxylin and eosin staining to examine the distribution of Meissner’s corpuscles in skin tissues of the fingertips, palms, lips, nipples, and labia majora and minora obtained from cadavers. Many Meissner’s corpuscles were observed in the dermal papilla of the fingertips, whereas the palms had only 20% as many. Meissner’s corpuscles were rare in the lips, nipples, and external genital organs, which have relatively high two-point discrimination. Because Meissner’s corpuscles are rapidly adapting mechanoreceptors, they may quickly detect changes in tactile sensation, including two-point discrimination, in the movable glabrous skin. In conclusion, Meissner’s corpuscles might be rare in non-movable glabrous skin compared to the fingertips and palms.
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Meissner’s corpuscles are generally considered to be located in the dermal papilla of hairless skin on the fingers, toes, palms, soles, lips, eyelids, nipples, and genital organs. We used hematoxylin and eosin staining to examine the distribution of Meissner’s corpuscles in skin tissues of the fingertips, palms, lips, nipples, and labia majora and minora obtained from cadavers. Many Meissner’s corpuscles were observed in the dermal papilla of the fingertips, whereas the palms had only 20% as many. Meissner’s corpuscles were rare in the lips, nipples, and external genital organs, which have relatively high two-point discrimination. Because Meissner’s corpuscles are rapidly adapting mechanoreceptors, they may quickly detect changes in tactile sensation, including two-point discrimination, in the movable glabrous skin. In conclusion, Meissner’s corpuscles might be rare in non-movable glabrous skin compared to the fingertips and palms.
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OBJECTIVE: To examine whether uric acid level or gout is causally associated with the risk of osteoarthritis.METHODS: We performed a two-sample Mendelian randomization (MR) analysis using inverse-variance weighted (IVW), MR-Egger regression, and weighted median methods. We used the publicly available summary statistics datasets of uric acid level or gout genome-wide association studies (GWASs) as the exposure, and a GWAS in 3,498 patients with osteoarthritis in the arcOGEN study and 11,009 controls of European ancestry as the outcome.RESULTS: Six single nucleotide polymorphisms (SNPs) from the GWAS data on uric acid level and 12 SNPs from the GWAS data on gout were selected as instrumental variables (IVs). The IVW analysis did not support a causal association between uric acid level or gout and risk of osteoarthritis (beta=−0.026, standard error [SE]=0.096, p=0.789; beta=−0.018, SE=0.025, p=0.482). MR-Egger regression revealed no causal association between uric acid level or gout and risk of osteoarthritis (beta=0.028, SE=0.142, p=0.852; beta=−0.056, SE=0.090, p=0.548). Similarly, no evidence of a casual association was provided by the weighted median approach (beta=0.004, SE=0.064, p=0.946; beta=−0.005, SE=0.025, p=0.843).CONCLUSION: The results of MR analysis demonstrates that uric acid level and gout may be not causally associated with the increased risk of osteoarthritis. Considering MR study is not susceptible to bias from unmeasured confounders or reverse causation, the epidemiological evidence for an association between uric acid level or gout and a higher risk of osteoarthritis may be due to residual confounding or reverse causation rather than direct causality.
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OBJECTIVE: This study aimed to evaluate the relationship between circulating interleukin (IL)-18 levels and systemic lupus erythematosus (SLE) and establish a correlation between plasma/serum IL-18 levels and SLE activity.METHODS: We performed a meta-analysis comparing plasma/serum IL-18 levels in patients with SLE to controls by using fixed or random effects model based on the heterogeneity.RESULTS: Sixteen studies with 659 SLE patients and 502 controls were included in this meta-analysis. Meta-analysis showed that IL-18 levels were significantly higher in the SLE group (standardized mean difference=1.556, 95% confidence interval=1.087~2.024, p<0.001). Stratifying by ethnicity showed that IL-18 levels were significantly elevated in the SLE groups of European, Asian, and Arab populations. Stratification by adjustment for age and/or sex revealed a significantly higher IL-18 level in the SLE group, independently of the adjustment. Subgroup analysis by sample size showed significantly higher IL-18 levels in the SLE group for both large sample (n≥50) and small sample (n<50) subgroups. Subgroup analysis by data type showed significantly higher IL-18 levels in the SLE group for both original and calculated data populations.CONCLUSION: This meta-analysis demonstrated that circulating IL-18 levels are higher in patients with SLE.
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OBJECTIVE: To systematically investigate the relationship between circulating interleukin-17 (IL-17) levels and systemic lupus erythematosus (SLE) and associations between polymorphisms in IL17 genes and SLE susceptibility.METHODS: We performed a meta-analysis of serum/plasma IL-17 levels in patients with SLE and controls and evaluated the associations between the IL17A rs2275913, IL17F rs763780, and IL17F rs2397084 polymorphisms and IL17F copy number variations (CNVs) and risk of SLE.RESULTS: Thirteen studies focusing on 2,096 patients with SLE and 2,587 controls were included. Our meta-analysis revealed that IL-17 levels were significantly higher in the SLE group than the control group (standardized mean difference=1.045, 95% confidence interval [95% CI]=0.521~1.568, p < 0.001). Subgroup analysis using sample size showed increased IL-17 levels in samples from large (n>100) but not small (n < 90) SLE groups. We found no evidence of associations between SLE and the IL17A rs2275913, IL17F rs763780, and IL17F rs2397084 polymorphisms. However, a significant association was found between SLE and IL17F CNVs in a pooled cohort of affected individuals compared to that in pooled controls (odd ratio=3.663, 95% CI=2.466~5.221, p < 0.001).CONCLUSION: This meta-analysis revealed significantly higher circulating IL-17 levels in patients with SLE and showed evidence of associations between IL17F CNVs and SLE.
Subject(s)
Cohort Studies , Disease Susceptibility , Humans , Interleukin-17 , Lupus Erythematosus, Systemic , Sample SizeABSTRACT
Distal humerus fractures require stable fixation and early joint motion, similar to other intra-articular fractures, but are difficult to treat adequately because of the anatomical complexity, severe comminution, and accompanying osteoporosis. In most cases, surgical treatment is performed using two supporting plates. Plate fixation can be divided into right angle plate fixation and parallel plate fixation. In addition, depending on the type of fracture, surgical procedures can be performed differently, and autologous bone grafting can be required in the case of severe bone loss. The elbow joint is vulnerable to stiffness, so it is important to start joint movement early after surgery. Postoperative complications, such as nonunion, ulnar nerve compression, and heterotopic ossification, can occur. Therefore, accurate and rigid fixation and meticulous manipulation of soft tissues are required during surgery.
Subject(s)
Bone Transplantation , Elbow Joint , Humerus , Intra-Articular Fractures , Joints , Ossification, Heterotopic , Osteoporosis , Postoperative Complications , Rehabilitation , Ulnar Nerve , Ulnar Nerve Compression SyndromesABSTRACT
OBJECTIVE: To evaluate the fate of abstracts presented at scientific meetings of the Korean College of Rheumatology (KCR). METHODS: This study examined the abstracts presented at annual meetings of the KCR from 2005 to 2014. Only original studies were selected, excluding case reports. A manual search was conducted using PubMed, KoreaMed, Cochrane Library, and Embase to track the published articles. The abstracts were considered to have been published if the authors, title, study design, and results were the same for a published article. In addition, they were considered published if the author and the study design matched, even if the results of the abstract and the results of the published articles were not identical. RESULTS: A total of 928 abstracts from 2005 to 2014 were analyzed. Of the 928 abstracts, 468 (50.43%) abstracts were published in a peer-reviewed journal and the mean time to publication was 19 months. Of the 468 abstracts, 414 were published in a science citation index extended (SCI[E]) journal, and 54 were published in non-SCI(E) journals. The proportion of SCI(E) articles increased annually. The average impact factor for the SCI(E) journals was 2.93. In subgroup analysis, the abstracts that were awarded the best oral or best poster presentation were more likely to be published as full-length articles with a higher impact factor than the abstracts not awarded. CONCLUSION: Half of the abstracts presented in the KCR annual meetings were published in a peer-reviewed journal. Approximately 90% of the articles were published in a SCI(E) journal.
Subject(s)
Awards and Prizes , Korea , Publications , RheumatologyABSTRACT
PURPOSE: Dexrazoxane has been used as an effective cardioprotector against anthracycline cardiotoxicity. This study intended to analyze cardioprotective efficacy and secondary malignancy development, and elucidate risk factors for secondary malignancies in dexrazoxane-treated pediatric patients. MATERIALS AND METHODS: Data was collected from 15 hospitals in Korea. Patients who received any anthracyclines, and completed treatment without stem cell transplantation were included. For efficacy evaluation, the incidence of cardiac events and cardiac event-free survival rates were compared. Data about risk factors of secondary malignancies were collected. RESULTS: Data of total 1,453 cases were analyzed; dexrazoxane with every anthracyclines group (D group, 1,035 patients) and no dexrazoxane group (non-D group, 418 patients). Incidence of the reported cardiac events was not statistically different between two groups; however, the cardiac event-free survival rate of patients with more than 400 mg/m2 of anthracyclines was significantly higher in D group (91.2% vs. 80.1%, p=0.04). The 6-year cumulative incidence of secondary malignancy was not different between both groups after considering follow-up duration difference (non-D, 0.52%±0.37%; D, 0.60%±0.28%; p=0.55). The most influential risk factor for secondary malignancy was the duration of anthracycline administration according to multivariate analysis. CONCLUSION: Dexrazoxane had an efficacy in lowering cardiac event-free survival rates in patients with higher cumulative anthracyclines. As a result of multivariate analysis for assessing risk factors of secondary malignancy, the occurrence of secondary malignancy was not related to dexrazoxane administration.