Comparison of survival outcomes according of patients with metastatic gastric cancer receiving trastuzumab with systemic chemotherapy

Purpose@#Currently, trastuzumab plus chemotherapy is the standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic gastric cancer (mGC) or esophagogastric junction cancer. However, it is not clear whether the prognosis of HER2-positive mGC treated with trastuzumab plus chemotherapy is better than that of HER2-negative mGC treated with chemotherapy as the first-line therapy. @*Methods@#We performed a retrospective study comparing the prognosis of mGC according to first-line treatment with trastuzumab plus chemotherapy or chemotherapy only, at the Korea Cancer Center Hospital from 2011 to 2018. The Kaplan-Meier method and Cox proportional hazards model were used for univariate and multivariate survival analyses. @*Results@#The median overall survival of trastuzumab group was 26.1 months and that of chemotherapy group was 14.8 months (P=0.047). Trastuzumab group had a longer median progression-free survival than chemotherapy group (23.4 vs. 9.2 months, P=0.026). By univariate analysis, sex, age, World Health Organization (WHO) histology, HER2 status, primary tumor site, extent of disease, number of lesions, number of metastatic, measurability of disease, prior gastrectomy, and chemotherapy group are statistically significant. Using multivariate analysis, number of lesions, number of metastatic, prior gastrectomy, and trastuzumab group (hazard ratio, 0.594; 95% confidence interval, 0.384–0.921; P=0.020) were found to be independent prognostic factors of overall survival. @*Conclusion@#The result suggests prognosis of HER2-positive mGC treated by trastuzumab plus chemotherapy could be better than that of HER2-negative mGC treated by chemotherapy only. Well-designed prospective cohort studies are needed to confirm the results of this study. HER2 testing should be performed routinely in all patients newly diagnosed with mGC.

Effects of health-related behaviors and oral health behaviors on oral disease symptoms in adolescents / 대한구강보건학회지

Objectives@#The purpose of this study was to provide basic data for the improvement of healthrelated behaviors, oral health behaviors and develop an oral health promotion program for adolescents. Therefore, this study investigated health-related behaviors of adolescents and their oral disease symptoms. @*Methods@#Data of 62,276 adolescents were derived from the 13th Korea youth risk behavior webbased survey. Chi-square tests and logistic regression analyses were performed using complex sampling to determine the effects of health-related behaviors and oral health behaviors on the experience of oral disease symptoms among the adolescents. @*Results@#In total, 52.9% had developed oral symptoms in the previous year. The sample population consisted of 55.1% females, 53.4% third grade high school students, and 51.1% academic achievers. Among the adolescents, 57.6% of those categorized as having low economic status showed high oral disease experience (P<0.001). The increased intake of sweet drinks and snacks due to a higher subjective depression and perception of stress, increased the experience of oral symptoms (P<0.05). Fewer times of toothbrushing per day was correlated to an increase in oral disease symptoms (P<0.001). @*Conclusions@#As health-related behaviors and oral health behaviors formed during adolescence affect adulthood, a systematic oral health education program should be developed and implemented for proper health-related behaviors and oral health management in adolescents.

Comparison of survival outcomes according of patients with metastatic gastric cancer receiving trastuzumab with systemic chemotherapy

Purpose@#Currently, trastuzumab plus chemotherapy is the standard first-line therapy for human epidermal growth factor receptor 2 (HER2)-positive advanced or metastatic gastric cancer (mGC) or esophagogastric junction cancer. However, it is not clear whether the prognosis of HER2-positive mGC treated with trastuzumab plus chemotherapy is better than that of HER2-negative mGC treated with chemotherapy as the first-line therapy. @*Methods@#We performed a retrospective study comparing the prognosis of mGC according to first-line treatment with trastuzumab plus chemotherapy or chemotherapy only, at the Korea Cancer Center Hospital from 2011 to 2018. The Kaplan-Meier method and Cox proportional hazards model were used for univariate and multivariate survival analyses. @*Results@#The median overall survival of trastuzumab group was 26.1 months and that of chemotherapy group was 14.8 months (P=0.047). Trastuzumab group had a longer median progression-free survival than chemotherapy group (23.4 vs. 9.2 months, P=0.026). By univariate analysis, sex, age, World Health Organization (WHO) histology, HER2 status, primary tumor site, extent of disease, number of lesions, number of metastatic, measurability of disease, prior gastrectomy, and chemotherapy group are statistically significant. Using multivariate analysis, number of lesions, number of metastatic, prior gastrectomy, and trastuzumab group (hazard ratio, 0.594; 95% confidence interval, 0.384–0.921; P=0.020) were found to be independent prognostic factors of overall survival. @*Conclusion@#The result suggests prognosis of HER2-positive mGC treated by trastuzumab plus chemotherapy could be better than that of HER2-negative mGC treated by chemotherapy only. Well-designed prospective cohort studies are needed to confirm the results of this study. HER2 testing should be performed routinely in all patients newly diagnosed with mGC.

Erratum: Effects of plaque control according to professional toothbrushing and oral health education of orthodontic patients / 대한구강보건학회지

The authors confirm that the author name and the title were incorrect in the last isuse of the journal.

Effects of plaque control according to professional toothbrushing and oral health education of orthodontic patients / 대한구강보건학회지

OBJECTIVES: This study aimed to contribute to the development of an oral health education program on organized professional toothbrushing by determining its effects on plaque control in patients undergoing orthodontic treatment. METHODS: The subjects in the experimental group participated in the professional toothbrushing and oral health education weekly for 4 weeks, and those in the control group participated in the same program without professional toothbrushing education. RESULTS: The difference in knowledge, attitude, and behaviors on oral health was higher among the experimental group who underwent professional toothbrushing and oral health education program than those in the control group. The effects of toothbrushing time on the plaque index were significantly lower in experimental group than those in the control group. CONCLUSIONS: It is suggested that adequate oral health and professional toothbrushing education program should be implemented to improve oral health.

Interobserver agreement on the interpretation of automated whole breast ultrasonography

PURPOSE: The purpose of this study was to prospectively evaluate the interobserver agreement on lesion characterization and the final assessment of automated whole breast ultrasonography (ABUS) images. METHODS: Between March and August 2012, 172 women underwent bilateral ABUS before biopsy guided by handheld ultrasonography (HHUS) and mammography. A total of 206 breast lesions were confirmed histopathologically by biopsy. Three-dimensional volume data from ABUS scans were analyzed by two radiologists without the knowledge of HHUS results or patient clinical information. The two readers described the type, shape, orientation, margin, echogenicity, posterior acoustic features, and categorization of the final assessment of detected breast lesions. Kappa statistics were used to analyze the described characteristics of the breast lesions detected by both of the two readers. RESULTS: Of the 206 histopathologically confirmed lesions, reader 1 detected 166 lesions and reader 2 detected 150 lesions. A total of 145 lesions were detected by both readers using ABUS images. There was substantial agreement on shape (kappa=0.707), and moderate agreement on type, margin, mass orientation, echogenicity, and posterior acoustic features (kappa=0.592, 0.438, 0.472, 0.524, and 0.541, respectively). Breast Imaging Reporting and Data System final assessment values yielded a kappa value of 0.3971 when category subdivisions 4A, 4B, and 4C were included. With respect to the C2, C3, C4, and C5 categories, the interobserver agreement was moderate (kappa=0.505). CONCLUSION: ABUS is a promising diagnostic tool with a good interobserver agreement, comparable to that of HHUS.

Readout-Segmented Echo-Planar Imaging in Diffusion-Weighted MR Imaging in Breast Cancer: Comparison with Single-Shot Echo-Planar Imaging in Image Quality

OBJECTIVE: The purpose of this study was to compare the image quality of standard single-shot echo-planar imaging (ss-EPI) and that of readout-segmented EPI (rs-EPI) in patients with breast cancer. MATERIALS AND METHODS: Seventy-one patients with 74 breast cancers underwent both ss-EPI and rs-EPI. For qualitative comparison of image quality, three readers independently assessed the two sets of diffusion-weighted (DW) images. To evaluate geometric distortion, a comparison was made between lesion lengths derived from contrast enhanced MR (CE-MR) images and those obtained from the corresponding DW images. For assessment of image parameters, signal-to-noise ratio (SNR), lesion contrast, and contrast-to-noise ratio (CNR) were calculated. RESULTS: The rs-EPI was superior to ss-EPI in most criteria regarding the qualitative image quality. Anatomical structure distinction, delineation of the lesion, ghosting artifact, and overall image quality were significantly better in rs-EPI. Regarding the geometric distortion, lesion length on ss-EPI was significantly different from that of CE-MR, whereas there were no significant differences between CE-MR and rs-EPI. The rs-EPI was superior to ss-EPI in SNR and CNR. CONCLUSION: Readout-segmented EPI is superior to ss-EPI in the aspect of image quality in DW MR imaging of the breast.

Polymerization of dual cured composites by different thickness / 대한치과보존학회지

The purpose of this study was to evaluate the effect of thickness, filling methods and curing methods on the polymerization of dual cured core materials by means of microhardness test. Two dual cured core materials, MultiCore Flow (Ivoclar Vivadent AG, Schaan, Liechtenstein) and Bis-Core (Bisco Inc., Schaumburg, IL, USA) were used in this study. 2 mm (bulky filled), 4 mm (bulky filled), 6 mm (bulky and incrementally filled) and 8 mm (bulky and incrementally filled)-thickness specimens were prepared with light cure or self cure mode. After storage at 37degrees C for 24 hours, the Knoop hardness values (KHN) of top and bottom surfaces were measured and the microhardness ratio of top and bottom surfaces was calculated. The data were analyzed using one-way ANOVA and Scheffe multiple comparison test, with alpha = 0.05. The effect of thickness on the polymerization of dual cured composites showed material specific results. In 2, 4 and 6 mm groups, the KHN of two materials were not affected by thickness. However, in 8 mm group of MultiCore Flow, the KHN of the bottom surface was lower than those of other groups (p < 0.05). The effect of filling methods on the polymerization of dual cured composites was different by their thickness or materials. In 6 mm thickness, there was no significant difference between bulk and incremental filling groups. In 8 mm thickness, Bis-Core showed no significant difference between groups. However, in MultiCore Flow, the microhardness ratio of bulk filling group was lower than that of incremental filling group (p < 0.05). The effect of curing methods on the polymerization of dual cured composites showed material specific results. In Bis-Core, the KHN of dual cured group were higher than those of self cured group at both surfaces (p < 0.05). However, in MultiCore Flow, the results were not similar at both surfaces. At the top surface, dual cured group showed higher KHN than that of self cured group (p < 0.05). However, in the bottom surface, dual cured group showed lower value than that of self cured group (p < 0.05).

Ring Lesions in MR Imaging of the Liver

PURPOSE: The purpose of this study is to find some points that may help the differential diagnosis of ring lesions in magnetic resonance (MR) imaging of the liver through recognition of the characteristics of the morphology and the signal intensities of the ring lesions. MATERIALS AND METHODS: T1- and T2-weighted axial spin-echo images and gadolinium-enhanced Tl-weighted images were obtained with a 1.0 T superconducting MR imager. We reviewed the MR findings of 23 hepatic ring lesions which were confirmed as hepatocellular carcinomas (13), metastases (4), liver abscesses (4), hydatid cyst (1), and hematoma (1). RESULTS: There were 19 single rings and 4 double rings (all the cases were liver abscesses) on Tl-weighted images, and 8 single rings and 14 double rings on T2-weighted images. The signal intensity of the ring was low in hepatocellular carcinoma on Tl-weighted images and in hydatid cyst on T2-weighted images. It was high on Tl-weighted images in subacute hemaroma. Target lesion as an inner high-signal-intensity ring surrounded by a high-signal-intensity ring on T2-weighted images was seen in metatasis, liver abscess, and hepatocellular carcinoma. CONCLUSION: It is helpful to recognize the chracteristics of morphology and signal intensities of the ring lesions in the differential diagnosis of hepatic focal lesions.

MRI of the temporomandibular joint using flip back spin echo technique

The authors introduced flip back spin echo (FBSE) technique for MR imaging of the temporomandibular joint (TMJ) instead of conventional spin echo (SE) technique, and evaluated whether FBSE technique in MRI of TMJ is adequate for the diagnosis of the disorders or not. FBSE T1 parasagittal images in closed mouth state and sequential opening and closing mouth states using patient's own finger(s) were obtained and then FBSE T1 paracoronal image in closed mouth state and STAGE(short tip angle gradient echo) parasagittal T2WI were followed. All 30 images of the symptomatic TMJs using FBSE technique were excellent in the visualization of articular and their displacement, and we could easily diagnose the internal derangement. FBSE technique was adequate for the diagnosis of internal derangement of the TMJ, and the modified cine display from images using FBSE technique was advantageous in the diagnosis of the disorders by visualization of the dynamic motion of the TMJ.

High signal intensity lesion in basal ganglia on MR imaging: Correlation with portal-systemic encephalopathy in liver cirrhosis

To evaluate of the relationship between basal ganglia lesion and portal-systemic encephalopathy, eleven patients who had clinically proved liver cirrhosis with superior mesenteric vein larger than 10mm in diameter on ultrasonogram underwent brain MR imaging. No evidence of clinical or neuropsychiatric disturbance was observed in any patient at the time of the MR examination. Brain MR imaging revealed basal ganglia lesion characterized by bilateral, symmetric, high signal intensity without edema or mass effect on spin echo T1-weighted images in nine patients which included three patients with the past history of portal-systemic encephalopathy. It was concluded that excepted in the circumstances of other causes of the high signal intensity in basal ganglia on T1-weighted images such as fat, methemoglobin, melanin, neurofibromatosis, dense calcification, and parenteral nutrition, bilateral and symmetric high signal intensity lesion, in basal ganglia would be a useful MR finding of subclinical portal-systemic encephalopathy in liver cirrhosis patients with no clinical or neuropsychiatric symptoms and larger than 10mm diameter of superior mesenteric vein in ultrasonography.