Hepatic resection for isolated breast cancer liver metastasis: A single-center experience

PURPOSE: The objective of this study was to investigate the outcomes of selected patients with breast cancer liver metastases (BCLM) without extrahepatic metastases after hepatic resection.METHODS: Patients whose imaging findings did not show extrahepatic disease were selected for hepatic resection. If R0 resection was available and the operative risk was low in preoperative tests, the patients underwent surgery.RESULTS: Between 2011 and 2014, six patients underwent hepatic resection for BCLM. All patients received hepatic resection to achieve an R0 resection. The time interval between initial detection of breast cancer and that of liver metastases in the patients, excluding one patient with synchronous metastases, was 55.2 months. Major liver resection was performed in four patients. Differences were observed in the hormone receptor status between the primary breast tumor and liver metastases; however, no difference was observed in the human epidermal growth factor receptor 2 status. The 1-year and 3-year overall survival rates after hepatic resection were 100% and 83.3%, respectively. The 1-year and 3-year disease free survival rates after hepatic resection were 66.7% and 50.0%, respectively.CONCLUSION: Curative resection may be considered as one of the multimodality treatments for BCLM. It shows benefit in selected patients; its selection criteria needs to be investigated.

Wear Properties of Surface Modified Ultra-high Molecular Weight Polyethylene / 대한정형외과연구학회지

The wear debris of ultra-high molecular weight polyethylene (UHMWPE) used as a bearing material in total joint arthroplasty evokes a serious adverse biological reaction (osteolysis). In this study, therefore, the wear resistance of UHMWPE is enhanced by attaching a hydrophilic graft on the UHMWPE surface and by improving surface hardness without deteriorating the mechanical properties, which may result in the formation of lubrication film and the increased resistance to penetration, scratching or deformation during articulation. This was done by ion-implantation technique. The results showed that the wettability and the surface hardness of the modified UHMWPE by the above treatments increased due to the increased cross-linking density and hydrophilic graft attachment on the surface. The wear test was performed by a wear testing machine of pin-on-disk type. The modified UHMWPE revealed about 30~50% less volumetric wear than the control specimen. It was also shown that the volumetric wear depended not only on the optimal treatment condition but on the applied load and the sliding speed.

The Effect of Controlled Elastic Dynamization on Regenerate Bone Healing in Distraction Osteogenesis of Canine Tibia / 대한정형외과학회잡지

In order to investigate wheter or not elastic dynamization by axial micromotion enhanced regenerate bone healing in distraction osteogenesis(callotasis), a unilateral external fixator, with which the magnitude of dynamization could be controlled, was applied to the tibiae of 12 Korean adult mongrel dogs, weighting approximately 35kg. Tibiae and fibulae of both sides were osteotomized at the proximal metaphysio-diaphyseal junction and fixed with unilateral external fixators. Distraction was started from the third postoperative day until 2 cm (10% of tibial length) of length gian was achived, at the rate of 0. mm twice a day. When 1 cm (5%) of lengthening was achieved, controlled elastic dynamization of 1 mm (group I), 2 mm (group II), and 3 mm (group III) in magnitude was allowed on left tibia. Right tibia was not dynamized until sacrifice, and served as a control for each group. Plain anteroposterior radiographs and measurements of bone mineral density(BMD) by dual x-ray absorptiometry(DXA) were obtained pre- and post-operatively. Relative ratio of BMD was calculated, dividing the BMD value measured in each period by the BMD value measured at the beginning of dynamization. Mechanical test was performed in uniaxial compression on an Instron machine. Following observations were made: 1. Plain anteroposterior radiography showed that at mid-consolidation phase (postoperative 50th day) the width of callus in the distraction gap increased significantly in all dynamization groups, as compared to their control groups(p 0.05). 3. Axial Compression test revealed that the dynamization group had significantly increased stiffness, maximal load, elastic modulus, and strength, as compared to those of the control group(p < 0.05). In conclusion, controlled elastic dynamization effectively enhances regenerate bone healing in distraction osteogenesis of canine tibia, at 1 mm to 3 mm of magnitude.