18F-FDG PET/CT Prognostic Role in Diffuse Large B-cell Lymphoma Following Chemotherapy / 中山大学学报(医学科学版)

ObjectiveTo assess the prognostic value of 18F-FDG PET/CT parameters for predicting therapeutic response in diffuse large B-cell lymphoma （DLBCL）. MethodsWe retrospectively analyzed the clinical data and 18F-FDG PET/CT radiomics features of 81 DLBCL patients enrolled between June 2015 and October 2020. Multivariate logistic regression analysis was used to identify the predictive factors for therapeutic response of DLBCL， based on which a predictive model was developed accordingly. The performance of the model was evaluated by receiver operating characteristic （ROC） curves and calibration plots. ResultsDuring the two years after first chemotherapy， 23 patients （28.3%） developed relapse and 58 patients （71.7%） had progression-free survival （PFS）. The analysis for the predictive capability of the binary logistic regression model incorporating the PET/CT features revealed that the imaging features of 18F-FDG PET/CT after chemotherapy were independent prognostic factors for PFS. Among them， SUVTHR-mean2 was the most important factor for predicting therapeutic response in DLBCL patients after chemotherapy， with a cutoff value of 2.00 （AUC=0.81）. Conclusions18F-FDG PET/CT showed a valuable prognostic performance for PFS in DLBCL patients after chemotherapy， with the imaging feature after chemotherapy SUVTLR-mean2 being the optimal independent predictor. Our predictive model of imaging features might have an important prognostic value in assessing the risk of disease progression， guiding the treatment and follow-up protocol， improving therapeutic efficiency and cutting down the medical cost.

Prise en charge des hémopathies malignes au centre national d'oncologie médicale et de radiothérapie Alassane Ouattara d'Abidjan / Managem ent of hem atologic neoplasm sat the Centre National d'Oncologie Médicale et de Radiothérapie Alassane Ouattara ofAbidjan

Introduction. Les hémopathies malignes sont des proliférations anormales et anarchiques de cellules hématopoïétiques à point de départ médullaire ou périphérique. Notre étude qui avait pour objectif de faire le bilan de la prise en charge des hémopathies malignes au Centre national d'oncologie médical et de radiothérapie Alassane Ouattara. Méthodes. Il s'agissait d'une étude rétrospective descriptive d'une durée de 2 ans 3 mois allant du 1er janvier 2018 au 31 Mars 2020 portant sur 80 dossiers de malades porteurs d'hémopathies malignes et prise en charge dans le centre. Résultats. Notre étude a permis de recenser 2,2% d'hémopathies malignes sur les 3650 cas de pathologies cancéreuses recensées au CNRAO, soit une incidence 26,66 cas/an avec un sex-ratio 1,2. Les syndromes lymphoprolifératifs (SLP) sont les plus fréquents (96,25 %), sous trois principales formes: lymphomes malins non hodgkiniens (LMNH) non Burkitt (51,25%), leucémie myéloïde chronique (20%) et le myélome multiple (16,25%). Les LMNH représentent 51,25% des HM recensées avec 41,46 % de lymphomes de haut grade de malignité. La chimiothérapie était de mise chez tous nos patients. Ainsi sur 41 cas de LMNH, seulement 12 (29,27%) ont bénéficié du protocole R-CHOP. On notait 46,34% de réponse complète. Dans notre étude, le LH représentait 8,75% il était traité à 71,43% avec le protocole ABVD avec une réponse complète chez 6 patients. 37,5% des patients porteurs de leucémie myéloïde chronique ont reçu le Rituximab; ils ont été traités par les protocoles COP (31,25%), CHOP (31,25%), RCVP (12,5%) et R-CHOP (25%). La réponse thérapeutique était complète à 68,75%. Le protocole utilisé dans le traitement du myélome multiple a été le VMCD-REV à 76,92% avec pour réponse thérapeutique complète chez 6 patients, 3 réponses partielles et 4 en cours de traitement. Conclusion. Les SLP qui sont les plus fréquents des HM avec trois principales formes: LMNH non Burkitt, leucémie myéloïde chronique et myélome multiple. Nous avons cependant des difficultés quant à la mise en route de la chimiothérapie.

Introduction. Hematologic neoplasms are abnormal and anarchic proliferations of hematopoietic cells with a medullary or peripheral starting point. Our study aimed to report the management of hematological malignancies at the Centre National d'Oncologie Médicale et de Radiothérapie Alassane Ouattara (CNRAO). Methods. This was a descriptive retrospective study lasting 2 years 3 months from January 1st, 2018 to March 31st, 2020 concerning 80 patients with hematologic neoplasms who were managed in the CNRAO. Results. Hematologic neoplasms represented 2.2% of cancers (80/3650) at CNRAO, giving an annual incidence of 26.66 cases. The sex ratio was 1.2. Lymphoproliferative syndromes were the most common subgroups (96.25%). These were mainly non-Burkitt non Hodgkin lymphoma (51.25%), high grade lymphomas (41.46%), chronic lymphocytic lymphoma (20%) and multiple myeloma (16.25%). Chemotherapy was administered to all patients. Among 41 cases of non-Hodgkin lymphoma, 12 (29.27%) benefited from the R-CHOP protocol and full response was observed in 46.34% of them. We found 7 patients with Hodgkin lymphoma (8.75%) and the ABVD protocol was used for 6 cases (71.43%). Six out of these seven patients were in complete response. Among the 16 patients with chronic lymphocytic leukemia, 6 (37.5%) received Rituximab. The distribution of the patients with chronic lymphocytic leukemia was as follows: COP 31.25%, CHOP 31.25%, RCVP 12.5% and R-CHOP 25% and 68.75% had full response. The most common treatment protocol for multiple myeloma was VMCD-REV (76.92%). Six patients had complete response, 3 had partial response and 4 were in the course of treatment. Conclusion. In our practice, hematologic neoplasms are mainly lymphoproliferative syndromes and the most common varieties are non-Burkitt non Hodgkin lymphoma, high grade lymphomas, chronic lymphocytic lymphoma and multiple myeloma. We have difficulties in getting chemotherapy started.

Argón plasma: respuesta terapéutica y calidad de vida en pacientes con proctitis actínica crónica hemorrágica / Impact of exclusive breastfeeding withdrawal on the health of babies

Introducción: La proctitis actínica crónica hemorrágica (PACH) se presenta secundaria a la radioterapia pélvica. La coagulación con argón plasma (APC) es una terapéutica eficaz, segura, de fácil uso y relativo bajo costo. Objetivo: Describir la respuesta terapéutica a corto y largo plazo del APC en pacientes con PACH, así como evaluar la calidad de vida antes y después de la intervención. Material y Métodos: Estudio observacional, prospectivo de serie de casos en 46 pacientes con PACH, atendidos en el Centro Nacional de Cirugía de Mínimo Acceso entre 2017 y 2020. Se emplearon medidas de resumen y comparación de medias (t de Student pareada) para la hemoglobina inicial y final, así como para los puntajes de calidad de vida aplicados antes y después de la intervención. Para determinar el tiempo libre de resangrado se utilizó l Método de Kaplan-Meier. Se estimó una significación menor a 0.05 para un intervalo de confianza de 95 por . Resultados: Se necesitó una media de 3,6 ± 2,394 sesiones de APC. La media de hemoglobina se incrementó 1,9 g/L. La respuesta terapéutica a corto plazo se observó en 100 por ciento de los pacientes y a largo plazo en 91,3 . La media de puntaje para la calidad de vida descendió en 12,065 puntos (p˂ 0,00), La percepción global percibida se incrementó en una media de 7.326 puntos (p˂ 0,00). Conclusiones: El APC tiene buena respuesta terapéutica a corto y largo plazo con pocas sesiones y bajo número de complicaciones, con mejoría de la calidad de vida de los pacientes(AU)

Introduction: Chronic hemorrhagic radiation proctitis (CHRP) appears secondary to pelvic radiotherapy. Argon plasma coagulation (APC) is an effective, safe, easy-to-use, and relatively inexpensive therapy. Objective: To describe the short- and long-term therapeutic response of APC in patients with CHRP, as well as to evaluate the quality of life before and after the intervention. Material and Methods: Observational, prospective case series study of 46 patients with CHRP, treated at the National Center for Minimally Access Surgery between 2017 and 2020. Summary measures and comparison of means (paired Student's t-test) were used for baseline and final hemoglobin, as well as for the quality of life scores applied before and after the intervention. The Kaplan-Meier method was used to determine the recurrence free time. A level of significance less than 0.05 was estimated for a 95 por ciento confidence interval. Results: A mean of 3,6 ± 2,394 APC sessions was required. The mean hemoglobin increased 1,9 g / L. Short-term therapeutic response was observed in 100 % of patients, and long-term in 91,3 por ciento. The mean score for quality of life decreased by 12,065 points (p˂ 0,00). The perceived global perception increased by a mean of 7,326 points (p˂ 0,00). Conclusions: APC has a good therapeutic response in the short and long term with few sessions and a low number of complications, with an improvement in the quality of life of the patients(AU)

Role of Imaging in Early Therapeutic Response Assessment for Neuroendocrine Neoplasm with Liver Metastasis:from Anatomical to Functional View / 中国医学科学院学报

Liver metastasis is not rare during the course of neuroendocrine neoplasms.The methods for treating neuroendocrine neoplasm with liver metastasis(NENLM)are diversifying,which exposes the limitations of the early therapeutic response assessment based on only morphological changes.The emerging imaging biomarkers can sensitively describe changes in response to treatment from the functional level,providing new ideas for the therapeutic response evaluation of NENLM.In this paper,we reviewed the status quo and the latest research progress of imaging assessment for early therapeutic response of NENLM,aiming to provide reference for assessing the response and further exploring the treatment-related biomarkers.

Development of a novel chemokine signaling-based multigene signature to predict prognosis and therapeutic response in colorectal cancer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Colorectal cancer (CRC) is the most lethal gastrointestinal cancer in both males and females worldwide (Sung et al., 2021). Because of the high heterogeneity of tumors, robust prognostic biomarkers are urgently needed in CRC management (Koncina et al., 2020). Chemokine signaling is a well-known pivotal player in immunity, inflammation, and cancer metastasis (Lacalle et al., 2017; Poeta et al., 2019; Do et al., 2020), and multiple genes involved in chemokine signaling have been demonstrated as potential prognostic biomarkers for CRC (Cabrero-De Las Heras and Martínez-Balibrea, 2018; Ottaiano et al., 2020; Yu et al., 2020). Therefore, the aim of our study was to develop a chemokine signaling-based multigene signature (CSbMgSig) that could effectively predict overall survival (OS) and therapeutic response for patients with CRC.

Formulation And Evaluation Of Metformin Hydrochloride Loaded Floating Microspheres

Objective: The main objective of this study was to develop and evaluate the eudragit and HPMC coated metformin hydrochloride floating microspheres, in which HPMC helps in floating and eudragit as a coating material for a site-specific drug release in a controlled manner and the active moiety metformin used as anti-hyperglycemic agent. Methods: The floating microsphere was prepared by the solvent evaporation method incorporating metformin as a model drug. The prepared floating microsphere were characterized for particle size, %yield, drug loading and entrapment efficiency, compatibility study, %buoyancy, surface morphology and In vitro drug release and release kinetics. Results: The result metformin loaded floating microsphere was successfully prepared and the particle size range from 397±23.22 to 595±15.82 µm, the entrapment efficiency range from 83.49±1.33 to 60.02±1.65% and drug loading capacity range from 14.3±0.54 to 13.31±0.47% and %buoyancy range from 85.67±0.58 to 80.67±1.15%. The FT-IR and X-RD analysis confirmed that no any interaction between drug and excipient, and surface morphology confirmed those particles are sphere. The floating microsphere show maximum 96% drug release in pH 0.1N HCL and follow the Korsmeyer peppas model of the super case-2 transport mechanism. Conclusion: These results suggest that metformin loaded floating microspheres could be retain in stomach for long time and give site specific drug release in controlled manner.

FLI1 gene influences lesion size and skin test may predict therapeutic response in cutaneous leishmaniasis

Genes associated with wound healing have been shown to be risk factors for cutaneous leishmaniasis (CL) which is caused by Leishmania braziliensis. In this study, we examined whether the genes previously associated with CL influenced the clinical outcome. Patients were genotyped and retrospectively classified as responders, who were cured with a single course of pentavalent antimony (Sbv), or as refractories, who did not respond to Sbv. Patients characterised as responders showed a stronger response to the leishmanin skin test (LST) when compared to the refractory subjects (p = 0.0003). Furthermore, we observed an association between the FLI1 CC genotype and an increased size of ulcers (p = 0.0170). We suggest that the leishmanin skin test may be a predictive tool for therapeutic outcome and reinforce FLI1 as a potential influencer of susceptibility and lesion size in CL.

Response Prediction of Altered Thyroglobulin Levels After Radioactive Iodine Therapy Aided by Recombinant Human Thyrotropin in Patients with Differentiated Thyroid Cancer / 대한핵의학회잡지

PURPOSE: Thyroglobulin (Tg) may be released from damaged residual thyroid tissues after radioactive iodine (RAI) therapy in patients with differentiated thyroid carcinoma (DTC). We investigated whether altered levels of serum Tg after recombinant human thyrotropin (rhTSH)-aided RAI therapy could be a prognostic marker in patients with DTC.METHODS: We evaluated 68 patients who underwent RAI therapy after total thyroidectomy. Serum Tg levels were measured just before RAI administration (D0Tg) and 7 days after RAI therapy (D7Tg). Patients with a D0Tg level greater than 2.0 ng/mL were excluded to more precisely evaluate the injury effect of RAI in small remnant tissues. The ratioTg was defined as the D7Tg level divided by that on D0Tg. The therapeutic responses were classified as acceptable or non-acceptable. Finally, we investigated which clinicopathologic parameters were associated with therapeutic response.RESULTS: At the follow-up examination, an acceptable response was observed in 50 patients (73.5%). Univariate analysis revealed significant differences in N stage (P = 0.003) and ratioTg (acceptable vs. non-acceptable responses, 21.9 ± 33.6 vs. 3.8 ± 6.5; P = 0.006). In multivariate analysis, only ratioTg significantly predicted an acceptable response (odds ratio 1.104; 95% confidence interval 1.005–1.213; P = 0.040). A ratioTg above 3.5 predicted an acceptable response with a sensitivity of 66.0%, specificity of 83.3%, and accuracy of 70.6% (area under the curve = 0.718; P = 0.006).CONCLUSIONS: Altered levels of serum Tg after RAI therapy, calculated as the ratioTg (D7Tg/D0Tg), significantly predicted an acceptable response in patients with DTC.

Prediction of the therapeutic response after target-combined chemotherapy treatment for patients with liver metastasis from colorectal cancer using computed tomography texture analysis / 生物医学工程学杂志

This study aims to investigate the value of pre-treatment computed tomography (CT) texture analysis in predicting therapeutic response of liver metastasis from colorectal cancer after combined targeting chemotherapy. A total of 82 patients with colorectal cancer liver metastases who underwent chemotherapy combined with targeted therapy (cetuximab) between March 2011 and October 2017 comprised this retrospective study population. According to the RECIST1.1, the best curative effect evaluation of patients was recorded. Complete response (CR) and partial response (PR) were assigned to the response group, and the stable disease (SD) and progressive disease (PD) were assigned to the non-response group. The CT texture analysis was based on the Omini-Kinetics software, and the three-dimensional (3D) texture analysis was performed on the marked lesion on portal phase. The differences of texture parameters between the response group and the non-response group were compared. The receiver operating characteristic (ROC) curves were depicted on the parameters which with statistically difference, to characterize value in predicting the response to target-combined chemotherapy. The differences of Entropy, Energy, Variance, std. Deviation, Quantile95 and sumEntropy between the two groups in pre-treatment lesions were significant ( 0.867, good diagnostic efficiency could be obtained, with sensitivity of 60.5% and specificity of 79.5%, respectively. In conclusion, texture parameters derived from baseline CT images of colorectal cancer liver metastasis have the potential value acting as imaging biomarkers in predicting tumor response to combined target chemotherapy.

Diversidade clínica e tratamento da leishmaniose visceral / Clinical diversity and treatment of visceral leishmaniasis

A leishmaniose visceral (LV) é causada por protozoários do gênero Leishmania, sendo as duas principais espécies: Leismania (Leishmania) donovani e Leishmania (Leishmania) infantum, as quais tem ocorrência geográfica diversa e estão relacionadas com diversidade de manifestações clinicas e de resposta terapêutica. Notadamente, a LV que ocorre, principalmente, na Índia Sudão, Sudão do Sul, Bangladesh e Etiópia é causada pela espécie L. donovani, enquanto nas Américas e em algumas regiões da África e Europa, a espécie causadora é a L. infantum. A LV causada pela L. (L.) donovani tem um espectro clínico variando de comprometimento visceral à lesão cutânea que ocorre após um episódio de LV, que é a leishmaniose dérmica póskalazar (PKDL), manifestações esta que não é muito frequente na LV causada pela L. infantum. Ademais, a resposta terapêutica é divergente entre essas espécies, visto que na LV causada por L. donovani há pobre resposta ao antimonial pentavalente, configurando um padrão de resistência elevado, enquanto que na LV causada pela L. infantum essa informação não é muito clara. Neste artigo abordamos a diversidade clínica e a resposta terapêutica da LV causada principalmente por L. infantum, que é de ocorrência nas Américas.

Visceral leishmaniasis (VL) is caused by protozoa of the genus Leishmania, of the species Leismania (Leishmania) donovani and Leishmania (Leishmania) infantum, which occur in different geographic regions and are related to the diversity of clinical manifestations and therapeutic response. Notably, VL occurring mainly in India, Sudan, South Sudan, Bangladesh and Ethiopia is caused by L. donovani, while in the Americas and in some regions of Africa and Europe is caused by L. infantum. Visceral leishmaniasis caused by L. donovani has a clinical spectrum ranging from visceral involvement to cutaneous lesion that occurs after a VL episode, which is post-kala-azar-dermal-leishmaniasis (PKDL), which is not very frequent in the VL caused by L. infantum. In addition, the therapeutic response is divergent among these species, since in VL caused by L. donovani there is poor response to pentavalent antimony, setting a high resistance pattern, whereas in VL caused by L. infantum this information is not very clear. In this article, we discuss the clinical diversity and therapeutic response of VL caused mainly by L. infantum, which is occurring in the Americas.

In vitro and in vivo antileishmanial activity of Artemisia annua L. leaf powder and its potential usefulness in the treatment of uncomplicated cutaneous leishmaniasis in humans

ABSTRACT INTRODUCTION: Cutaneous leishmaniasis (CL) is a tropical disease that affects millions of individuals worldwide. The current drugs for CL may be effective but have serious side effects; hence, alternatives are urgently needed. Although plant-derived materials are used for the treatment of various diseases in 80% of the global population, the validation of these products is essential. Gelatin capsules containing dried Artemisia annua leaf powder were recently developed as a new herbal formulation (totum) for the oral treatment of malaria and other parasitic diseases. Here, we aimed to determine the usefulness of A. annua gel capsules in CL. METHODS: The antileishmanial activity and cytotoxicity of A. annua L. capsules was determined via in vitro and in vivo studies. Moreover, a preliminary evaluation of its therapeutic potential as antileishmanial treatment in humans was conducted in 2 patients with uncomplicated CL. RESULTS: Artemisia annua capsules showed moderate in vitro activity in amastigotes of Leishmania (Viannia) panamensis; no cytotoxicity in U-937 macrophages or genotoxicity in human lymphocytes was observed. Five of 6 (83.3%) hamsters treated with A. annua capsules (500mg/kg/day) for 30 days were cured, and the 2 examined patients were cured 45 days after initiation of treatment with 30g of A. annua capsules, without any adverse reactions. Both patients remained disease-free 26 and 24 months after treatment completion. CONCLUSION: Capsules of A. annua L. represent an effective treatment for uncomplicated CL, although further randomized controlled trials are needed to validate its efficacy and safety.

Association of Therapeutic Response and Change of Mismatch Negativity in Schizophrenia Patients

OBJECTIVES: Schizophrenia is characterized by disturbances in perception and cognition. Attenuated mismatch negativity (MMN) reflects central auditory dysfunction in schizophrenia. The aim of this study is to compare MMN changes before and after treatment in schizophrenia patients and to assess their association with treatment response. METHODS: Twenty-three schizophrenia patients underwent an oddball paradigm. MMN was calculated by the difference waveforms of the event-related potentials (ERPs) elicited by subtracting standard from deviant stimulus. The clinical symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), the Psychotic Symptom Rating Scale (PSYRATS). Follow-up evaluation was conducted when the PANSS total score decreased by 30% or more (treatment response group) or before discharge (non-response group). RESULTS: The treatment response group showed significantly larger MMN amplitude improvement and latency reduction than the non-response group after treatment (Fz ; mean amplitude p = 0.035, FCz ; p = 0.041). The auditory hallucination group showed shorter latency than that of the group without hallucinations. Additionally, auditory hallucination was associated with prolonged MMN latency and shortened after treatment in the auditory hallucination response group (Fz ; p = 0.048). CONCLUSIONS: These results suggest that the attenuated MMN amplitude reflects the progression of the disease. The increment of MMN amplitude and shortening of latency after treatment may reflect cognitive functional recovery of central auditory sensory processing.

A prospective study predicting the outcome of chronic low back pain and physical therapy: the role of fear-avoidance beliefs and extraspinal pain / Estudo prospectivo de fatores prognósticos em lombalgia crônica tratados com fisioterapia: papel do medo-evitação e dor extraespinal

ABSTRACT Objective: To identify the prognostic factors for conventional physical therapy in patients with chronic low back pain (CLBP). Methods: Prospective observational study. Participants: One hundred thirteen patients with CLBP selected at the Spinal Disease Outpatient Clinic. Main outcome measures: Pain intensity was scored using the Numeric Rating Scale (NRS), and function was measured using the Roland-Morris Disability Questionnaire (RMDQ). Results: The Fear-Avoidance Beliefs Questionnaire work subscale results (FABQ-work; odds ratio [OR] = 0.27, 95% confidence interval [CI] 0.13–0.56, p < 0.001) and extraspinal pain (OR = 0.35, 95% CI 0.17–0.74, p = 0.006) were independently associated with a decreased response to conventional physical therapy for CLBP. Conclusion: We identified high FABQ-work and extraspinal pain scores as key determinants of a worse response to physical therapy among CLBP patients, supporting the need for a special rehabilitation program for this subgroup.

RESUMO Objetivo: Identificar os fatores prognósticos para a fisioterapia convencional em pacientes com lombalgia mecânica comum crônica (LMC). Métodos: Estudo prospectivo observacional. Participantes: Foram selecionados pelo Ambulatório de Doenças da Coluna Vertebral 113 pacientes com lombalgia mecânica comum crônica. Medidas de desfecho principais: A intensidade da dor foi pontuada utilizando a Escala Numérica de Dor (END) e a função foi medida usando o Questionário Roland-Morris de Incapacidade (RMDQ). Resultados: Os resultados da subescala trabalho do Fear-Avoidance Beliefs Questionnaire (FABQ-trabalho; odds ratio [OR] = 0,27, intervalo de confiança de 95% [IC 95%] 0,13–0,56, p < 0,001) e da dor extraespinal (OR = 0,35, IC 0,17–0,74, p = 0,006) estiveram independentemente associados a uma diminuição na resposta à fisioterapia convencional para a lombalgia crônica. Conclusão: Foram identificados escores elevados na FABQ-trabalho e dor extraespinal como determinantes-chave para uma pior resposta à fisioterapia em pacientes com LMC o que apoia a necessidade de um programa de reabilitação especial para este subgrupo.

Biomarkers of therapeutic responses in chronic Chagas disease: state of the art and future perspectives

The definition of a biomarker provided by the World Health Organization is any substance, structure, or process that can be measured in the body, or its products and influence, or predict the incidence or outcome of disease. Currently, the lack of prognosis and progression markers for chronic Chagas disease has posed limitations for testing new drugs to treat this neglected disease. Several molecules and techniques to detect biomarkers in Trypanosoma cruzi-infected patients have been proposed to assess whether specific treatment with benznidazole or nifurtimox is effective. Isolated proteins or protein groups from different T. cruzi stages and parasite-derived glycoproteins and synthetic neoglycoconjugates have been demonstrated to be useful for this purpose, as have nucleic acid amplification techniques. The amplification of T. cruzi DNA using the real-time polymerase chain reaction method is the leading test for assessing responses to treatment in a short period of time. Biochemical biomarkers have been tested early after specific treatment. Cytokines and surface markers represent promising molecules for the characterisation of host cellular responses, but need to be further assessed.

Therapeutic Response and Adverse Effects of Methotrexate in Korean Patients with Dermatological Diseases / 대한피부과학회지

BACKGROUND: Methotrexate (MTX) is a synthetic folic acid analogue with anti-proliferative and anti-inflammatory properties, and is prescribed for a variety of dermatological disorders. OBJECTIVE: The aim of this study was to investigate the therapeutic responses, adverse effects, and risk factors of MTX for dermatological use. METHODS: We retrospectively evaluated age, gender, underlying diseases, initial and cumulative doses of MTX, treatment duration, physician's global assessment (PGA) scores, and adverse effects in 200 dermatological patients treated with MTX. RESULTS: Various dermatoses responded to MTX in the following order of effectiveness: psoriasis vulgaris, pustular psoriasis, pityriasis lichenoides, atopic dermatitis, mycosis fungoides, and morphea. Adverse effects of MTX were observed in 64 of the 200 patients (32%) as follows: elevated liver function tests (LFTs) in 36 (18%), nausea or vomiting in 22 (11%), complete blood count abnormalities in 5 (2.5%), and a burning sensation over the lesion in 4 (2%). All patients who showed abnormal LFTs were normalized after reducing or stopping MTX, and the mean time to normalization was 5.76 weeks. Liver fibrosis was not found. Risk factors for MTX-related adverse effects were old age (p=0.028), skin disease (p=0.018), high initial dose of MTX (p=0.023), and high cumulative dose of MTX (p=0.044). CONCLUSION: Among various dermatoses, psoriasis showed an excellent response to MTX with relatively acceptable safety in Koreans, but regular monitoring of MTX-related adverse effects is important. The risk factors for MTX-related adverse effects were old age, psoriasis, high initial dose, and high cumulative dose.

Biological characteristics and primary therapeutic response of acute erythroid leukemia / 白血病·淋巴瘤

Objective To observe the biological characteristics and analyse primary therapeutic response of acute erythroid leukemia.Methods The data of 28 patients primarily diagnosed as acute erythroid leukemia were analyzed.The patients were divided into with muhilineage dysplasia group and without muhilineage dysplasia group,and the morphology,immunology,cytogenetics and molecular biology characteristics and the complete remission rate of the first induction therapy were compared.Results There were 14 cases(50％)with muhilineage dysplasia,which involved in two lineage or trilineage.In 6 cases by flow cytometry,the myeloid blast immunophenotypes were common expressed.In 8 cases detected by karyotype analysis,5 cases were chromosomal abnormal,including 4 cases were complex chromosomal abnormal,1 case was trisomy 8.In 4 cases underwent WT1 detection,all of them were positive.The complete remission rate of the first induction therapy was 39.29％(11/28),the ratein the multilineage dysplasia group was 35.71％(5/14),and the ratein without multilineage dysplasia group was 42.86％(6/14),the difference had no statistical significance(P＞0.05).The complete remission rate of the complex chromosome group was 25.00％(1/4),the intermediate prognostic group was 50.00％(2/4).Conclusions Acute erythroid leukemia had special biological features different from other subtype AML:accompanyed with high frequency of multilineage dysplasia.The abnormality of karyotype were high,and it was often complex karyotype involved with chromosome 5 and/or chromosome 7,which had a low complete remission rate.The complete remission rate of chemotherapy was low,treatment effect was poor.

CREB-Phosphorylation as a Predictor of Therapeutic Response to Antidepressants

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.

CREB-Phosphorylation as a Predictor of Therapeutic Response to Antidepressants

OBJECTIVES: CREB (c-AMP response element binding protein) is known as a key mediator of the therapeutic response to antidepressants. We investigated the change of CREB-phosphorylation (pCREB) at the early point of the fluoxetine treatment to find out it can be a predictor for antidepressant response. METHODS: We evaluated the pCREB of T - lymphocyte nuclear extracts from 18 depressed patients at 0 and 1th week during fluoxetine treatment (20 mg/day). Responders were defined as the > or = 50% reduction of HAM-D score in 4 weeks. We compared the changes of pCREB at 0 and 1th week between responders and non-responders. RESULTS: The responders showed a significant increase of pCREB at week 1 compared with week 0. The HAM-D difference between week 0 and 4 was positively correlated with the change of pCREB response. CONCLUSION: These results suggest that the early change of pCREB in peripheral lymphocyte can predict the later response of antidepressant. The correlation showed pCREB directly reflects a response status to the antidepressant fluoxetine and clinical improvement.

A Study on the Association Between Cholineacetyltransferase(ChAT) Polymorphism and Treatment Responses of Galantamine in Alzheimer's Disease Patients

Cholineacetyltrasnferase (ChAT) is a key enzyme that facilitates synthesis of acetylcholine affecting the memory, learning, awakening and sleep process of the cerebrum. The object of this study was to test the hypothesis that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with Alzheimer's disease (AD) susceptibility, and galantamine response. To elucidate a genetic predisposition of AD, we studied ChAT-gene 2384G>A (rs3810950) polymorphism in 52 AD patients in 93 normal controls. We also examined the association of this polymorphism and galantamine therapeutic response in 52 AD patients who received a 24-week galantamine treatment. There were no significant differences in the genotype or allele frequency of the ChAT polymorphism between the AD and control groups. However, we found that the allele-carrier distributions, allele frequency for the ChAT polymorphism differed significantly between responders and non-responders. The frequency of A-allele carriers (GA+AA) was higher in responders than in non-responders (chi-square=4.282, df=1, p=0.039), as was the A-allele frequency (chi-square=5.216, df=1, p=0.022). These results suggest that the ChAT-gene 2384G>A (rs3810950) polymorphism is associated with galantamine therapeutic response.

The Clinical Role of FDG PET in Malignant Lymphoma / 한양의대학술지

FDG PET is a functional and metabolic imaging modality to detect lesions with altered glycolytic activity. Conventional imaging modalities, such as CT or MRI, provide tissue information based on anatomical and physiological changes. In most cases of malignant lymphoma, malignant cells have up-regulated glycolytic activity and increased uptake of FDG, an analogue of glucose. FDG PET can detect change in FDG uptake in lesions of malignant lymphoma and may be advantageous to differentiate malignant lesions from other non-malignant tissues over the conventional methods. For these reasons, FDG PET has become popular as a new imaging modality to diagnose many kinds of malignant tumors. FDG PET has a major impact on management of patients with malignant lymphoma in the differentiation of malignant lesions, monitoring the therapeutic response, and identifying the non-responders who could benefit from a different therapeutic strategy. At present, FDG PET appears to be one of the promising imaging modalities in the management of patients with ymphoma.