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OBJECTIVE: Because villoglandular adenocarcinoma (VGA) of the uterine cervix has favorable features and outcomes, patients receive less radical surgery and young women preserve their ovaries. We aimed to evaluate the clinicopathological features and outcomes of VGA and to see if the ovarian preservation is safe in young women with VGA. METHODS: We retrospectively reviewed medical records and identified patients with VGA, who had been treated and followed from January 2004 to December 2015. RESULTS: This study consisted of 17 patients with VGA, including 9 premenopausal women. International Federation of Gynecology and Obstetrics (FIGO) stage IB1 disease was found in 12 patients (70.6%), IA1 in 2, IA2 in 1, IB2 in 1, and IIA1 in 1. Of the 12 women diagnosed with stage IB1 disease, a young woman received only conization and she has not showed a recurrence. During a median follow-up of 58 months (range: 12-116), 4 patients, who had undergone radical surgery for stage IB1 disease, had a recurrence and one of them died due to disease progression. Among patients with stages IB-IIA disease, 2 premenopausal women did not receive simultaneous oophorectomy or chemoradiation therapy. Both of them had a recurrent tumor at adnexa. CONCLUSION: This study revealed favorable features and outcomes of VGA. However, the appropriate treatment for young women with early-stage VGA must be cautiously selected. Ovarian preservation might not be safe when young women with stages IB-IIA VGA undergo surgical procedures.
Coagulation involves the regulated sequence of proteolytic activation of a series of proteins to achieve appropriate and timely hemostasis in an injured vessel. In the non-pathological state, the inciting event involves exposure of circulating factor VIIa to extravascularly expressed tissue factor, which brings into motion the series of steps which results in cell based model of coagulation. In the new concepts of coagulation system, initiation, amplification and propagation steps are involved to converse of fibrinogen to fibrin. The precisely synchronized cascade of events is counter-balanced by a system of anticoagulant mechanisms. Developmental hemostasis refers to the age-related changes in the coagulation system that are most marked during neonate and childhood. An understanding of these changes in crucial to the accurate diagnosis of hemostatic abnormalities in neonate and children. This review aims to elucidate the main events within the coagulation cascade as it is currently understood to operate in vivo, and also a short review of the anticoagulants as they relate to this model. Also this paper describes the common pitfalls observed in the clinical data related to the coagulation system in neonate to children.
Purpose: Vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) are associated with increased angiogenesis, growth, and metastasis in solid tumors. But, until today, the importance of theses factors on leukemia, especially childhood acute lymphocytic leukemia (ALL) has received limited attention. Therefore, this study examined the bone marrow plasma VEGF and bFGF levels in ALL patients and normal controls. Patients and Methods: Bone marrow plasmas at diagnosis from 33 ALL patients (median age 5.9 years; range 1.8-13.9 years) were used for analysis. The bone marrow levels of bFGF and VEGF were determined by enzyme-linked immunosorbent assay (R & D Systems) and compared with the bone marrow levels of 7 healthy control subjects (median age 11.98 years; 6 months -13.6 years). Results: Average VEGF was higher in relapse ALL (N=7, 216.6±79.9pg/mL) compared to standard (N=9, 36.8±12.1pg/mL) (p=0.013) or high risk ALL (N=17, 80.0±12.2pg/mL) (p=0.023). bFGF levels were also significantly higher in relapse than standard-, or high-risk ALL patients (relapse ALL; 48.6±15.4pg/mL, standard risk ALL; 18.9±5.5pg/mL, high risk ALL; 19.0±3.5pg/mL, normal control; 18.6±4.0pg/mL) (p=0.003). Three patients with refractory relapse and death had much higher VEGF and bFGF values (VEGF; 420.0±81.6pg/ mL, bFGF; 85.6±3.2pg/mL). Conclusion: Our data suggest that the increased levels of VEGF and bFGF in bone marrow may play an important role in prognosis of childhood ALL.
소아암은 18~20세 이하에서 생기는 악성 종양으로, 우리나라에서 한 해에 약 1,200명 정도의 환자가 새로 진단되고 있다. 소아암은 성인에서 생기는 암과 비교하여, 종류와 치료 결과에 차이가 많다. 소아에서 가장 많이 생기는 암은 백혈병이며, 소아암의 약 1/3 정도를 차지하고 있다. 이외에 뇌종양, 악성 림프종, 신경모세포종, 윌름스종양 등이 있다. 소아암의 치료로는 수술, 항암제 투여, 방사선치료를 하게 된다. 소아암은 완치율이 높아 60~70% 정도의 완치율을 보인다. 완치율이 높아지면서, 치료 중 혹은 치료 후에 나타날 수 있는 합병증을 되도록 감소시키기 위한 노력이 중요시 되고 있다. 최근 소아암의 완치율이 많이 향상되었으나, 치료 과정은 아이 뿐 아니라 부모와 가족 등 주위 사람에게 상당한 고통을 안겨주게 되고, 어려운 상황들을 자주 접하게 된다. 이러한 어려운 치료과정을 잘 이겨내도록 최근에는 미술치료, 놀이치료, 음악치료 등 다양한 분야의 도움이 제공되고 있으며, 소아암 치료의 중요한 한 분야로 인식되어지고 있다. 본 논문은 소아암의 일반적 개요와 종류 및 빈도, 각 질환에 대한 소개, 치료에 대하여 기술하였다. (임상미술치료학연구 2007;2(2):104-108) Over the past several decades, great strides have been made in diagnosis, treatment, and survival of childhood cancer. In the 1960s the probability of survival for a child with cancer was less than 25%, whereas today it may exceed 70%. This dramatic change has occurred through significant and steady progress in our understanding of tumor biology, creation of specialized multidisciplinary care teams, incremental improvements in therapy. Also, recent progress in the understanding of psychological and social factors related to cancer is important because cancer is the most common fatal disease of childhood and adolescence. Research interest in children and adolescents who have survived cancer also has increased over the past several years. Attention has focused on the long-term socal outcomes of these children and adolescents. As health-related research on children shift from seeking information about children to seeking information directly form them, researchers recognize the need for developmentally appropriate methods such as drawing, playing, and music to help children communicate their experiences. (Journal of The Korean Academy of Clinical Art Therapy 2007;2(2):104-108)
Background: Intrachromosomal amplification of chromosome 21 (iAMP21) is known to be associated with poor prognosis in B-cell ALL (B-ALL). To determine the frequency and clinical characteristics of iAMP21 in Korean B-ALL patients, we performed FISH and multiplex ligation-dependent probe amplification (MLPA) analyses. Methods: A total of 102 childhood B-ALL patients were screened with ETV6-RUNX1 FISH probes (Abbott Molecular, USA). The presence of an iAMP21 was confirmed by using MLPA P327 iAMP21-ERG probemix (MRC Holland, The Netherlands). Results: iAMP21 was detected in one of the screened B-ALL patients (1/102 patients, 1.0%) who presented the ALL immunophenotype and complex karyotype at initial diagnosis. The patient relapsed twice after bone marrow transplantation. MLPA showed 12.5-Mb and 4.28-Mb regions of amplification and deletion, respectively. Conclusions: The frequency of iAMP21 is considerable in Korean pediatric patients. Our report suggests that iAMP21 in childhood B-ALL has very unfavorable impact on patient’s prognosis. Additional methods such as MLPA analysis is essential to rule out patients with equivocal interphase FISH results.
Purpose: Children and adolescents diagnosed with cancer experience emotional distress, such as sadness, worrying, and irritability. However, there is little information about the psychological well-being of parents at the time of their child’s diagnosis. We sought to identify factors that were associated with emotional distress in cancer patients as a basis for developing innovative psychologicalinterventions. Materials and Methods: A retrospective chart review was performed on patients newly diagnosed with cancer at a single center in Korea from 2014 to 2016. Eighty-five patients and their mothers completed psychological inventories. To determine factors associatedwith emotional distress in patients, we assessed the psychological inventory results using multiple linear regression after performing correlation analysis. Results: The maternal Beck Depression Inventory-II (BDI-II) score was positively correlated with total problem scores and externalizingscores in patients aged less than 7 years. In patients aged 7–12 years, there was no significant association between the patient’semotional distress and other variables. In contrast, the maternal BDI-II score was the strongest factor associated with patientdepression in adolescents. Conclusion: We suggest that the most important factor affecting emotional distress in children and adolescents with cancer is maternal depression, especially in patients aged 1–6 years and aged 13–17 years. Understanding the factors associated with emotionaldistress of cancer patients allows us to develop early psychiatric interventions for patients and their parents at the initial psychological crisis.