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2.  Detection of RUNX1-MECOM Fusion Gene and t(3;21) in a Very Elderly Patient Having Acute Myeloid Leukemia with Myelodysplasia-Related Changes 
Annals of Laboratory Medicine  2012;32(5):362-365.
An 87-yr-old woman was diagnosed with AML with myelodysplasia-related changes (AML-MRC). The initial complete blood count showed Hb level of 5.9 g/dL, platelet counts of 27×109/L, and white blood cell counts of 85.33×109/L with 55% blasts. Peripheral blood samples were used in all the tests, as bone marrow examination could not be performed because of the patient's extremely advanced age and poor general health condition. Flow cytometric analysis, chromosome analysis, FISH, and reverse transcriptase-PCR (RT-PCR) results indicated AML-MRC resulting from t(3;21) with the RUNX1-MECOM fusion gene. To our knowledge, this is the second most elderly de novo AML patient associated with t(3;21) to be reported.
doi:10.3343/alm.2012.32.5.362
PMCID: PMC3427825  PMID: 22950073
RUNX1; MECOM; t(3;21); Acute myeloid leukemia; Myelodysplasia-related changes
4.  Korean Patients with Superwarfarin Intoxication and Their Outcome 
Journal of Korean Medical Science  2010;25(12):1754-1758.
This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. Ten patients were diagnosed as or highly suspicious for superwarfarin intoxication. Case report forms described by attending hematologists of the patients were collected and analyzed. Bleeding symptoms were varied among the patients. Patients uniformly showed prolonged prothrombin time (PT) and activated thromboplastin time (aPTT) with decreased activity of vitamin K dependent coagulation factors. Positive serum brodifacoum test results in 4 of 5 requested patients contributed to confirmatory diagnosis. Psychiatric interview revealed an attempted ingestion in one patient. High dose vitamin K1 therapy promptly corrected prolonged PT and aPTT, but hasty discontinuation caused repeated bleeding diathesis in 6 patients. Route of intoxication was unknown or not definite among 8 of 10 patients. Three patients had a possibility of environmental exposure considering their occupations: there might be intoxication by transdermal absorption or inhalation. Therefore, high dose and prolonged use of vitamin K1 therapy is necessary for effective detoxification. Further detailed investigation on environmental exposure and efforts to improve availability of the blood level test in clinic are requested.
doi:10.3346/jkms.2010.25.12.1754
PMCID: PMC2995229  PMID: 21165290
Superwarfarin; Brodifacoum; Vitamin K; Rodenticides
5.  Korean Guidelines for the Prevention of Venous Thromboembolism 
Journal of Korean Medical Science  2010;25(11):1553-1559.
This guideline focuses on the primary prevention of venous thromboembolism (VTE) in Korea. The guidelines should be individualized and aim at patients scheduled for major surgery, as well as patients with a history of trauma, high-risk pregnancy, cancer, or other severe medical illnesses. Currently, no nation-wide data on the incidence of VTE exist, and randomized controlled trials aiming at the prevention of VTE in Korea have yielded few results. Therefore, these guidelines were based on the second edition of the Japanese Guidelines for the Prevention of VTE and the eighth edition of the American College of Chest Physicians (ACCP) Evidenced-Based Clinical Practice Guidelines. These guidelines establish low-, moderate-, and high-risk groups, and recommend appropriate thromboprophylaxis for each group.
doi:10.3346/jkms.2010.25.11.1553
PMCID: PMC2966990  PMID: 21060742
Guideline; Prevention; Venous Thromboembolism
6.  Long-term outcomes of a 5-year follow up of patients with immune thrombocytopenic purpura after splenectomy 
The Korean Journal of Hematology  2010;45(3):197-204.
Background
The long-term outcomes of adult patients with immune thrombocytopenic purpura (ITP) after splenectomy are not clear.
Methods
We retrospectively analyzed 31 patients who underwent splenectomy after diagnosis of ITP at our institution between 1990 and 2009. Long-term follow-up was defined as a follow-up that lasted 1 year or more from splenectomy to the last follow-up.
Results
The overall response rate to splenectomy was 84%. However, the response rate at 6 and 12 months decreased to 77% and 68%, respectively. During the 6 years of median follow-up after splenectomy, 11 patients (35%) relapsed. The long-term response rate was 55%. The long-term follow-up of 26 patients after responding to splenectomy showed that the median time from splenectomy to relapse was 19 months in the partial response (PR) group; however, there was no relapse after 9 months in the complete response (CR) group. Variables, including age, were not predictive of the long-term response after splenectomy. Additional treatment in patients who did not respond or relapsed after splenectomy was mostly effective. After a median follow-up of 7 years (range: 1-25 years) from the diagnosis, there were 2 deaths, including one due to spontaneous bleeding after repair of duodenal ulcer perforation.
Conclusion
Although splenectomy is safe and effective, the response rate after splenectomy continuously decreases over time. The duration of response is different between the patients that achieved CR and those that achieved PR. Factors, including age, were not predictors of a response to splenectomy.
doi:10.5045/kjh.2010.45.3.197
PMCID: PMC2983037  PMID: 21120210
Adult; Immune thrombocytopenic purpura; Long term; Splenectomy; Thrombocytopenia
7.  Effects of the Expression of Leptin and Leptin Receptor (OBR) on the Prognosis of Early-stage Breast Cancers 
Purpose
Obesity-related leptin and leptin receptor (OBR) have a relation to the development of cancer and metastasis and also the low survival rate for breast cancer patients. Leptin has been associated with increased aromatase activity and it displays functional cross-talk with estrogen. This study was designed to determine the relationship between the expression of leptin and OBR in breast cancer tissue and the prognosis of early-stage breast cancer patients, and especially for the tamoxifen-treated patients.
Materials and Methods
Ninety-five patients with early-stage breast cancer and who had undergone surgical treatment at Kyung Hee University Hospital between January 1994 and June 2004 were analyzed. The surgical specimens underwent immunohistochemical analysis for leptin and OBR. The patients' survival and clinical characteristics were obtained from the medical records.
Results
Of the 95 patients, 79 (83%) and 32 (33.7%) showed the expression of leptin and OBR in breast cancer tissue, respectively. The expression of leptin and OBR in breast cancer tissue was not significantly related to the clinicopathological characteristics, including obesity, the expression of hormonal receptor, the HER-2/neu expression, menopause, stage and the nuclear grade. The expression of leptin and OBR was not significantly related to the overall disease-free survival (DFS). For the tamoxifen-treated postmenopausal obese patients, the DFS of the leptin-positive group was higher than that of the leptin-negative group (p=0.017).
Conclusion
The expression of leptin and OBR in breast cancer tissue may be not a prognostic factor for disease-free survival of breast cancer patients. In the future, further studies are needed to determine whether leptin expression could be a predictive factor for tamoxifen therapy in the postmenopausal obese subgroup among the early breast cancer patients.
doi:10.4143/crt.2006.38.3.126
PMCID: PMC2741678  PMID: 19771272
Leptin; OBR; Early breast cancer; Obesity; Postmenopause; Tamoxifen
8.  Increased ERCC Expression Correlates with Improved Outcome of Patients Treated with Cisplatin as an Adjuvant Therapy for Curatively Resected Gastric Cancer 
Purpose
It has been reported that the overexpression of the excision repair cross-complementing 1 (ERCC1) gene, which is essential for the repair of cisplatin (CDDP)-DNA adducts, negatively influences the effectiveness of CDDP-based therapy for primary gastric cancer. We investigated whether the ERCC1 expression was associated with survival for gastric cancer patients in an adjuvant setting.
Materials and Methods
We retrospectively analyzed 44 patients who were diagnosed with stage II or higher disease after undergoing curative resection and they had also received cisplatin-based chemotherapy. The ERCC1 expression was examined by performing immunohistochemical (IHC) staining, and this was divided into two groups according to the percentage of IHC staining of the tumor cell nuclei (negative: 10% or less, positive: more than 10%).
Results
Among the 44 patients (ERCC1-negative/ERCC1-positive group=16/28), 32 patients were male and their median age was 52 years. There was no difference for the baseline characteristics of the two groups. The median follow-up duration was 41 months. The median disease-free survival (DFS) and the overall survival (OS) for the ERCC1-positive group were significant higher than those of the ERCC1-negative group (DFS: 40.4 vs. 14.6 months, p=0.02, OS: undefined vs. 20.4 months, p=0.008).
Conclusion
The overall survival in gastric cancer patients who received cisplatin-based adjuvant chemotherapy after a curative resection is higher in those patients showing the overexpression of the ERCC1 gene. However, prospective studies using the ERCC1 gene expression as a prognostic marker for the DNA repair activity are needed.
doi:10.4143/crt.2006.38.1.19
PMCID: PMC2741659  PMID: 19771254
Adjuvant therapy; Cisplatin; ERCC1; Stomach neoplasms; Survival
9.  The Efficacy of a Modified Chronomodulated Infusion of Oxaliplatin, 5-Fluorouracil and Leucovorin in Advanced Colorectal Cancer (Preliminary Data) 
Purpose
To determine the efficacy and tolerability of a modified chronomodulated infusion of oxaliplatin, 5-fluorouracil (5-FU) and leucovorin in the treatment of advanced colorectal cancer.
Materials and Methods
Sixteen patients with relapsed or metastatic colorectal cancer were treated with an intravenous infusion of oxaliplatin 25 mg/m2, 5-FU 700 mg/m2 and leucovorin 20 mg/m2 on days 1 to 5. The infusion of oxaliplatin was chronomodulated with a peak delivery rate at 16:00 p.m., with 5-FU infused constantly overnight. Each course was repeated every 21 days.
Results
The response rate was 38.5% (95% confidence interval [CI], 13.9% to 68.4%) in the 13 measurable patients, including 1 complete response (7.7%) and 4 partial responses (30.8%). Five patients (38.5%) had a stable disease and 3 (23.0%) a progressive disease. Three patients without a measurable lesion had improved status. The median time to progression and overall survival were 29 weeks and 85 weeks, respectively. Grade 3 thrombocytopenia occurred in 2.5% (2 cycles) and grade 3 vomiting in 12.5% (2 patients). Anorexia, stomatitis, diarrhea, pruritus, alopecia and peripheral neuropathy were mild and tolerable.
Conclusion
The modified chronomodulated infusion of oxaliplatin, 5-FU and leucovorin is effective and tolerable, but the number of patients was too small. Further study will be needed to confirm the efficacy of this regimen with a larger population of patients.
doi:10.4143/crt.2004.36.3.199
PMCID: PMC2855084  PMID: 20396545
Colorectal neoplasm; Chemotherapy; Chronotherapy; Oxaliplatin; 5-fluorouracil; Leucovorin
10.  Randomized Phase III Trial of Cisplatin, Epirubicin, Leucovorin, 5-Fluorouracil (PELF) Combination versus 5-fluorouracil Alone as Adjuvant Chemotherapy in Curative Resected Stage III Gastric Cancer 
Purpose
The combination of cisplatin, epirubicin, leucovorin and 5-fluorouracil (PELF) administration, as adjuvant chemotherapy after curative resection for gastirc cancer, was compared with 5-fluorouracil (5-FU) administration alone. This paper reports the results of a prospective randomized comparison of the two regimens, PELF and 5-FU.
Methods
From August 1996 to July 1999, 54 patients were selected subsequent to being diagnosed with stage III cancer after a curative resection for gastric cancer. The patients were stratified according to stage IIIA/IIIB and subtotal/total gastrectomy, and then they were randomized into each treatment group, i.e. the PELF or 5-FU alone groups.
Results
54 assessable patients were enrolled in this study: 28 received PELF and 26 received 5-FU alone. 12 patients relapsed in each group and the median follow-up duration was 42 months (range: 10~77 months). The overall survival rate and disease-free survival rate (DFS) were not significantly different between two groups, (5-year survival of PELF vs. 5-FU: 57% vs. 64%, 5-year DFS: 54% vs. 51%). The PELF combination was more toxic in terms of anemia, anorexia, nausea and diarrhea than the 5-FU.
Conclusions
This study showed that the PELF combination, as an adjuvant therapy for gastric cancer after a curative resection, was a less effective treatment, and it had more toxic effects than the 5-FU.
doi:10.4143/crt.2004.36.2.140
PMCID: PMC2855100  PMID: 20396554
Adjuvant chemotherapy; 5-Fluorouracil; Stomach neoplasm; Cisplatin; Epirubicin; Leucovorin; Phase III trial
11.  Lotus japonicus SUNERGOS1 encodes a predicted subunit A of a DNA topoisomerase VI that is required for nodule differentiation and accommodation of rhizobial infection 
The Plant Journal  2014;78(5):811-821.
A symbiotic mutant of Lotus japonicus, called sunergos1-1 (suner1-1), originated from a har1-1 suppressor screen. suner1-1 supports epidermal infection by Mesorhizobium loti and initiates cell divisions for organogenesis of nodule primordia. However, these processes appear to be temporarily stalled early during symbiotic interaction, leading to a low nodule number phenotype. This defect is ephemeral and near wild-type nodule numbers are reached by suner1-1 at a later point after infection. Using an approach that combined map-based cloning and next-generation sequencing we have identified the causative mutation and show that the suner1-1 phenotype is determined by a weak recessive allele, with the corresponding wild-type SUNER1 locus encoding a predicted subunit A of a DNA topoisomerase VI. Our data suggest that at least one function of SUNER1 during symbiosis is to participate in endoreduplication, which is an essential step during normal differentiation of functional, nitrogen-fixing nodules.
doi:10.1111/tpj.12520
PMCID: PMC4282747  PMID: 24661810
legumes; Lotus japonicus; symbiosis; topoisomerase; endocycle

Results 1-11 (11)