Favorable response of hepatocellular carcinoma with portal vein tumor thrombosis after radiotherapy combined with atezolizumab plus bevacizumab

Recently, the superiority of atezolizumab plus bevacizumab (AteBeva) over sorafenib was proven in the IMbrave150 trial, and AteBeva became the first-line systemic treatment for untreated, unresectable hepatocellular carcinoma (HCC). While the results are encouraging, more than half of patients with advanced HCC are still being treated in a palliative setting. Radiotherapy (RT) is known to induce immunogenic effects that may enhance the therapeutic efficacy of immune checkpoint inhibitors. Herein, we report the case of a patient with advanced HCC with massive portal vein tumor thrombosis treated with a combination of RT and AteBeva, who showed near complete response in tumor thrombosis and favorable response to HCC. Although this is a rare case, it shows the importance of reducing the tumor burden via RT to combination immunotherapy in patients with advanced HCC.

Treatment outcome of anaplastic ependymoma under the age of 3 treated by intensity-modulated radiotherapy

Purpose@#Intensity-modulated radiotherapy (IMRT) allows for more precise treatment, reducing unwanted radiation to nearby structures. We investigated the safety and feasibility of IMRT for anaplastic ependymoma patients below 3 years of age. @*Materials and Methods@#A total of 9 anaplastic ependymoma patients below 3 years of age, who received IMRT between October 2011 and December 2017 were retrospectively reviewed. The median equivalent dose in 2 Gy fractions was 52.0 Gy (range, 48.0 to 60.0 Gy). Treatment outcomes and neurologic morbidities were reviewed in detail. @*Results@#The median patient age was 20.9 months (range, 12.1 to 31.2 months). All patients underwent surgery. The rates of 5-year overall survival, freedom from local recurrence, and progression-free survival were 40.6%, 53.3%, and 26.7%, respectively. Of the 9 patients, 5 experienced recurrences (3 had local recurrence, 1 had both local recurrence and cerebrospinal fluid [CSF] seeding, and 1 had CSF seeding alone). Five patients died because of disease progression. Assessment of neurologic morbidity revealed motor dysfunction in 3 patients, all of whom presented with hydrocephalus at initial diagnosis because of the location of the tumor and already had neurologic deficits before radiotherapy (RT). @*Conclusion@#Neurologic morbidity is not caused by RT alone but may result from mass effects of the tumor and surgical sequelae. Administration of IMRT to anaplastic ependymoma patients below 3 years of age yielded encouraging local control and tolerable morbidities. High-precision modern RT such as IMRT can be considered for very young patients with anaplastic ependymoma.

Association between Cardiometabolic Risk Factors and Decreased Glomerular Filtration Rate in Korean Women

Background@#Decreased glomerular filtration rate (GFR) was associated with increased mortality and decreased quality of life in previous studies. In Korean adults, the prevalence rates of cardiometabolic risk factors are higher in women than in men after middle age. We evaluated the association between cardiometabolic risk factors and decreased GFR in Korean women. @*Methods@#We evaluated 2,339 subjects using data from the Korea National Health and Nutrition Examination Survey VII-1 (2016) after excluding participants with GFRs of <15 mL/min/1.73 m2. Normal GFR was ≥60 mL/min/1.73 m2, and decreased GFR was 15–59 mL/min/1.73 m2. Socioeconomic status, lifestyle factors, body mass index, waist circumference, and comorbidities were evaluated to analyze the association between cardiometabolic risk factors and decreased GFR. The odds ratio (OR) and 95% confidence interval (CI) were calculated using multivariate logistic regression analyses. @*Results@#As age increased, the OR for decreased GFR increased. In comparison with women with waist circumferences of <85 cm, the women with waist circumferences of ≥85 cm (OR, 1.94; 95% CI, 1.22–3.10) had a significant increase in the OR for decreased GFR. In women with diabetes mellitus, the OR for decreased GFR significantly increased (OR, 3.14; 95% CI, 1.70–5.81). @*Conclusion@#Decreased GFR was associated with age, abdominal obesity, and diabetes mellitus in Korean women. Control of abdominal obesity and appropriate management of diabetes mellitus are needed to prevent chronic kidney disease in Korean women.

Radiotherapy for initial clinically positive internal mammary nodes in breast cancer

PURPOSE: Internal mammary lymph node (IMN) involvement is associated with poor prognosis in breast cancer. This study investigated the treatment outcomes of initial clinically IMN-positive breast cancer patients who received adjuvant radiotherapy (RT), including IMN irradiation, following primary breast surgery. MATERIALS AND METHODS: We retrospectively reviewed data of 95 breast cancer patients with clinically detected IMNs at diagnosis treated with surgery and RT between June 2009 and December 2015. Patients received adjuvant RT to the whole breast/chest wall and regional lymph node (axillary, internal mammary, and supraclavicular) areas. Twelve patients received an additional boost to the IMN area. RESULTS: The median follow-up was 43.2 months (range, 4.5 to 100.5 months). Among 77 patients who received neoadjuvant chemotherapy, 52 (67.5%) showed IMN normalization and 19 (24.6%) showed a partial response to IMN. There were 3 and 24 cases of IMN failure and any recurrence, respectively. The 5-year IMN failure-free survival, disease-free survival (DFS), and overall survival (OS) were 96%, 70%, and 84%, respectively. IMN failure-free survival was significantly affected by resection margin status (97.7% if negative, 87.5% for close or positive margins; p = 0.009). All three patients with IMN failure had initial IMN size ≥1 cm and did not receive IMN boost irradiation. The median age of the three patients was 31 years, and all had hormone receptor-negative tumors. CONCLUSION: RT provides excellent IMN control without the support of IMN surgery. Intensity-modulated radiotherapy, including IMN boost for breast cancer patients, is a safe and effective technique for regional lymph node irradiation.

Dosimetric comparison between modulated arc therapy and static intensity modulated radiotherapy in thoracic esophageal cancer: a single institutional experience

PURPOSE: The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose. MATERIALS AND METHODS: We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed. RESULTS: Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart V30 (p = 0.039), V40 (p = 0.040), and V50 (p = 0.032). CONCLUSION: Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung V10, V20, and V30 than in 3D-CRT, but could not be proven superior in lung V5. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.

Classficiation of Bupleuri Radix according to Geographical Origins using Near Infrared Spectroscopy (NIRS) Combined with Supervised Pattern Recognition

Rapid geographical classification of Bupleuri Radix is important in quality control. In this study, near infrared spectroscopy (NIRS) combined with supervised pattern recognition was attempted to classify Bupleuri Radix according to geographical origins. Three supervised pattern recognitions methods, partial least square discriminant analysis (PLS-DA), quadratic discriminant analysis (QDA) and radial basis function support vector machine (RBF-SVM), were performed to establish the classification models. The QDA and RBF-SVM models were performed based on principal component analysis (PCA). The number of principal components (PCs) was optimized by cross-validation in the model. The results showed that the performance of the QDA model is the optimum among the three models. The optimized QDA model was obtained when 7 PCs were used; the classification rates of the QDA model in the training and test sets are 97.8% and 95.2% respectively. The overall results showed that NIRS combined with supervised pattern recognition could be applied to classify Bupleuri Radix according to geographical origin.

Comparison of Speech Audiometry Using KS Word List and Hahm's List in Hearing Impaired Adults / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare speech audiometry test results of the conventional Hahm's list with those of Korean standard word lists for adults (KS-WL-A) using both live voice and compact disc (CD) speech presentation modes. SUBJECTS AND METHOD: Eighty patients with sensorineural hearing loss and 23 control subjects with normal hearing participated in the study. Each hearing loss group comprised 20 subjects (mild, moderate, moderately severe, and severe hearing loss groups). Speech audiometry was performed to measure the speech recognition threshold (SRT) and word recognition score. KS-WL-A was presented either through a live voice mode or recorded CD materials. Test words from Hahm's list were presented using the live voice mode only. Pure tone audiometry was also conducted for all subjects. RESULTS: Differences between the SRT and pure tone average were within 6 dB in all subgroups in all three stimulation methods, indicating high reliability of the SRT in both the conventional and Korean standard methods. The moderate, moderately severe, and severe hearing loss groups showed lower word recognition scores in the CD mode with KS-WL-A than with the two live voice modes. CONCLUSION: Both the live voice mode and CD mode showed reliable speech audiometry test results in normal and hearing-impaired subjects. Although the CD mode is recommended to standardize test methods and reduce test errors, the live voice mode might be more effective for patients with moderate to severe hearing loss.

Efficiency to Discovery Transgenic Loci in GM Rice Using Next Generation Sequencing Whole Genome Re-sequencing

Molecular characterization technology in genetically modified organisms, in addition to how transgenic biotechnologies are developed now require full transparency to assess the risk to living modified and non-modified organisms. Next generation sequencing (NGS) methodology is suggested as an effective means in genome characterization and detection of transgenic insertion locations. In the present study, we applied NGS to insert transgenic loci, specifically the epidermal growth factor (EGF) in genetically modified rice cells. A total of 29.3 Gb (~72x coverage) was sequenced with a 2 x 150 bp paired end method by Illumina HiSeq2500, which was consecutively mapped to the rice genome and T-vector sequence. The compatible pairs of reads were successfully mapped to 10 loci on the rice chromosome and vector sequences were validated to the insertion location by polymerase chain reaction (PCR) amplification. The EGF transgenic site was confirmed only on chromosome 4 by PCR. Results of this study demonstrated the success of NGS data to characterize the rice genome. Bioinformatics analyses must be developed in association with NGS data to identify highly accurate transgenic sites.

Reliability of Speech Recognition Threshold Test Using the Korean Standard Bisyllabic Word List for Adults in Comparison with Conventional Hahm's List / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare a newly developed Korean standard bisyllabic word list for adults (KS-BWL-A) against the conventional Hahm's List based on the reliability in speech recognition threshold (SRT) test. SUBJECTS AND METHOD: Twelve adults with normal hearing and 11 hearing-impaired patients participated in this study. After excluding 10 words that are common in both lists, 26 bisyllabic words from each list were used for comparison in this study. SRTs were obtained using the modified ascending method. RESULTS: The mean SRTs measured by KS-BWL-A were 1.9 dB lower for the normal hearing group and 2.7 dB lower for the hearing-impaired group than those measured by the conventional Hahm's list with statistical significance (p=0.025 and p=0.045). In both groups, the pure tone averages (PTAs) were highly correlated (correlation coefficient >0.7, p<0.001) with SRTs measured using old and new lists, and the differences between PTA and SRT were within 3 dB for both lists. CONCLUSION: These results suggest that both KS-BWL-A and the conventional list are reliable methods as adult SRT tests and that two lists are not considerably different. However, speech recognition was slightly easier by the new list than it was by the conventional list. Authors propose the KS-BWL-A as a standard word list for SRT measurement in Korea.

Identification of Anthocyanin from The Extract of Soybean Seedcoat

Anthocyanins are naturally occuring phytochemicals and the main components of the coloring of plants, flowers and fruits. They are known to elicit antioxidative, anti-inflammatory and cancer preventive activity. In this study, we investigated anthocyanins in black / yellow soybean seedcoats using different methods of detection - thin layer chromatography (TLC), capillary zone electrophoresis (CZE) and HPLC analysis. The anthocyanins in soybean seedcoats were extracted by five independent methods of extraction and the aglycons (anthocyanidins) of the corresponding anthocyanins were prepared by acid mediated hydrolysis. The anthocyanin / anthocyanidin in black soybean seedcoat showed characteristic TLC mobility, CZE electrophoretic retention and HPLC migration time while little of anthocyanins were detected from yellow soybean seedcoat. The extracted anthocyanins showed pH dependent retention time in CZE and spectral change in UV-Vis spectrum. HPLC analysis of the hydrolyzed extract of black soybean seedcoat identified the presence of four anthocyanidins. The major anthocyanin in black soybean seedcoat was cyanin (cyanidin-3-O-glucoside), with the relative order of anthocyanidin in cyanidin > delphinidin > petunidin > pelargonidin.