The usefulness of fluorodeoxyglucose-PET/CT for preoperative evaluation of ductal carcinoma in situ

PURPOSE: PET/CT is useful in preoperative evaluation of invasive breast cancer (IBC) to predict axillary metastasis and staging workup. The usefulness is unclear in cases of ductal carcinoma in situ (DCIS) diagnosed at biopsy before surgery, which sometimes is upgraded to IBC after definitive surgery. The aim of this study is to find out the usefulness of PET/CT on DCIS as a preoperative evaluation tool. METHODS: We investigated 102 patients preoperatively diagnosed with DCIS who subsequently underwent definitive surgery between 2010 and 2015. The uptake of 18F-fluorodeoxyglucose was graded by visual and semiquantitative methods. We analyzed the maximum standardized uptake value (SUVmax) of each patient with clinicopathologic variables. We determined optimal cutoff values for SUVmax by receiver operating characteristic curve analysis. RESULTS: Fifteen cases out of 102 cases (14.7%) were upgraded to IBC after surgery. The SUVmax was higher in patients upgraded to IBC (mean: 2.56 vs. 1.36) (P = 0.007). The SUVmax was significantly higher in patients who had symptoms, palpable masses, lesions over 2 cm in size and BI-RAD category 5. Both visual and semiquantitative analysis were significant predictors of IBC underestimation. SUVmax of 2.65 was the theoretical cutoff value in ROC curve analysis in predicting the underestimation of IBC. The underestimation rate was significantly higher in patients with SUVmax >2.65 (P < 0.001), over the moderate enhanced uptake on visual analysis (P < 0.001). CONCLUSION: PET/CT can be used as a complementary evaluation tool to predict the underestimation of DCIS combined with the lesion size, palpable mass, symptomatic lesion, and BI-RAD category.

Kinetin Improves Barrier Function of the Skin by Modulating Keratinocyte Differentiation Markers

BACKGROUND: Kinetin is a plant hormone that regulates growth and differentiation. Keratinocytes, the basic building blocks of the epidermis, function in maintaining the skin barrier. OBJECTIVE: We examined whether kinetin induces skin barrier functions in vitro and in vivo. METHODS: To evaluate the efficacy of kinetin at the cellular level, expression of keratinocyte differentiation markers was assessed. Moreover, we examined the clinical efficacy of kinetin by evaluating skin moisture, transepidermal water loss (TEWL), and skin surface roughness in patients who used kinetin-containing cream. We performed quantitative real-time polymerase chain reaction to measure the expression of keratinocyte differentiation markers in HaCaT cells following treatment. A clinical trial was performed to assess skin moisture, TEWL, and evenness of skin texture in subjects who used kinetin-containing cream for 4 weeks. RESULTS: Kinetin increased involucrin, and keratin 1 mRNA in HaCaT cells. Moreover, use of a kinetin-containing cream improved skin moisture and TEWL while decreasing roughness of skin texture. CONCLUSION: Kinetin induced the expression of keratinocyte differentiation markers, suggesting that it may affect differentiation to improve skin moisture content, TEWL, and other signs of skin aging. Therefore, kinetin is a potential new component for use in cosmetics as an anti-aging agent that improves the barrier function of skin.

Review on Fabrication and Manipulation of Scaffold and Ciliary Microrobots / 한양의대학술지

Various microrobots are being studied for potential biomedical applications including targeted cell transportation, precise drug delivery, opening blocked blood vessels, micro-surgery, sensing, and scaffolding. Precise magnetic field control system is a coil system for wireless control of those microrobots for personalized and minimally invasive treatments. The microrobots for possible biomedical applications are fabricated by micro-electro-mechanical systems (MEMS) and nano-electro-mechanical systems (NEMS) technologies. In this review, fabrication technologies for scaffold and ciliary microrobots will be introduced and their control methods will be discussed. Various materials are being used for the fabrication of the microrobot such as SU-8, IP-Dip, IP-L, silicon, etc. The scaffold and ciliary microrobots are fabricated by SU-8, IP-Dip, and IP-L because these materials showed the maximum performance for three-dimensional (3D) microrobots using a 3D laser lithography system. All or part of the structures are coated with nickel and titanium layers after fabrication of the structures for magnetic control and biocompatibility, respectively, of the microrobots.

Review on Fabrication and Manipulation of Scaffold and Ciliary Microrobots / 한양의대학술지

Various microrobots are being studied for potential biomedical applications including targeted cell transportation, precise drug delivery, opening blocked blood vessels, micro-surgery, sensing, and scaffolding. Precise magnetic field control system is a coil system for wireless control of those microrobots for personalized and minimally invasive treatments. The microrobots for possible biomedical applications are fabricated by micro-electro-mechanical systems (MEMS) and nano-electro-mechanical systems (NEMS) technologies. In this review, fabrication technologies for scaffold and ciliary microrobots will be introduced and their control methods will be discussed. Various materials are being used for the fabrication of the microrobot such as SU-8, IP-Dip, IP-L, silicon, etc. The scaffold and ciliary microrobots are fabricated by SU-8, IP-Dip, and IP-L because these materials showed the maximum performance for three-dimensional (3D) microrobots using a 3D laser lithography system. All or part of the structures are coated with nickel and titanium layers after fabrication of the structures for magnetic control and biocompatibility, respectively, of the microrobots.

The Independent Effects of Cigarette Smoking, Alcohol Consumption, and Serum Aspartate Aminotransferase on the Alanine Aminotransferase Ratio in Korean Men for the Risk for Esophageal Cancer

PURPOSE: The goal of this study is to assess the interactions among alcohol consumption, cigarette smoking, and aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratios on esophageal cancer. MATERIALS AND METHODS: Alcohol and the risk of incidence and death from esophageal cancer were examined in a 14-year prospective cohort study of 782,632 Korean men, 30 to 93 years of age, who received health insurance from the National Health Insurance Corporation and had a medical evaluation from 1992 to 1995. RESULTS: Smoking, alcohol intake, and AST/ALT ratios were associated with the increased risk of esophageal cancer in a dose-dependent manner independent of each other. Smoking was associated with an increased risk of incidence [Hazard ratio (HR) = 2.2, 95% CI = 1.8 to 2.5] and mortality (HR = 2.5, 2.0 to 3.1). Combined HR of incidence for alcohol consumption (> 25 g/day) and smoking was 4.5 (3.8-5.5); for alcohol (> 25 g/day) and the AST/ALT ratio (> or = 2.0), it was 5.8 (4.6-7.2); for smoking and the AST/ALT ratio (> or = 2.0), it was 6.3 (5.1-7.5). Similar results were seen for mortality from esophageal cancer. Subjects who drank > or = 25 g/day with an AST/ALT ratio > or = 2 had a higher risk of esophageal cancer incidence (HR = 6.5, 4.8 to 8.7) compared with those who drank > or = 25 g/day with an AST/ALT ratio < 2 (HR = 2.2, 1.9 to 2.6). CONCLUSION: Alcohol, smoking, and the AST/ALT ratio are independently associated with increased risk of esophageal cancer but did not interact synergistically. The combination of the AST/ALT ratio with a questionnaire for alcohol consumption may increase the effectiveness for determining the risk of esophageal cancer.

The Independent Effects of Cigarette Smoking, Alcohol Consumption, and Serum Aspartate Aminotransferase on the Alanine Aminotransferase Ratio in Korean Men for the Risk for Esophageal Cancer

PURPOSE: The goal of this study is to assess the interactions among alcohol consumption, cigarette smoking, and aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratios on esophageal cancer. MATERIALS AND METHODS: Alcohol and the risk of incidence and death from esophageal cancer were examined in a 14-year prospective cohort study of 782,632 Korean men, 30 to 93 years of age, who received health insurance from the National Health Insurance Corporation and had a medical evaluation from 1992 to 1995. RESULTS: Smoking, alcohol intake, and AST/ALT ratios were associated with the increased risk of esophageal cancer in a dose-dependent manner independent of each other. Smoking was associated with an increased risk of incidence [Hazard ratio (HR) = 2.2, 95% CI = 1.8 to 2.5] and mortality (HR = 2.5, 2.0 to 3.1). Combined HR of incidence for alcohol consumption (> 25 g/day) and smoking was 4.5 (3.8-5.5); for alcohol (> 25 g/day) and the AST/ALT ratio (> or = 2.0), it was 5.8 (4.6-7.2); for smoking and the AST/ALT ratio (> or = 2.0), it was 6.3 (5.1-7.5). Similar results were seen for mortality from esophageal cancer. Subjects who drank > or = 25 g/day with an AST/ALT ratio > or = 2 had a higher risk of esophageal cancer incidence (HR = 6.5, 4.8 to 8.7) compared with those who drank > or = 25 g/day with an AST/ALT ratio < 2 (HR = 2.2, 1.9 to 2.6). CONCLUSION: Alcohol, smoking, and the AST/ALT ratio are independently associated with increased risk of esophageal cancer but did not interact synergistically. The combination of the AST/ALT ratio with a questionnaire for alcohol consumption may increase the effectiveness for determining the risk of esophageal cancer.

Changing Patterns of Low Birth Weight and Associated Risk Factors in Korea, 1995-2007 / 대한주산의학회잡지

OBJECTIVE: Low birth weight (LBW) infants are known to be at the risk of increased morbidity and mortality, and also of developing adult or metabolic diseases later in their life. Recently, the number of LBW infants has increased in Korea. Therefore, we examined the changing patterns of LBW infants and associated risk factors. METHODS: Data from the Korean National Statistical Office during 13 years (1995-2007) were used. We analyzed the changing mean gestational age, mean birth weight, mean maternal age, and the changing incidence of premature infant, LBW infant, multiple births, the proportion of first baby, and sex of the baby. Also, we analyzed the incidence of unmarried mother, old aged mother (>35 years), young aged mother (<20 years), high school graduated mother. In addition, we analyzed the relationship between LBW infants and risk factors. RESULTS: The incidence of LBW infants was 2.99% in 1995, and 4.66% in 2007. The proportion of premature infant, multiple birth, first baby, unmarried mother, old aged mother, female baby increased. The increase in premature infant, multiple birth, old aged mother, unmarried mother, and female infant were found to be the important factors regarding increase in LBW infants in Korea. CONCLUSION: In Korea, an increase in the prevalence of LBW infants and prematurity from 1995 to 2007 was observed. The increase in premature infants, multiple birth, old aged mother, unmarried mother, and female infant are associated with the increase in LBW infants.

Double Intussusception in a Preterm Infant / 대한주산의학회잡지

Intussusception is a common surgical disorder in infancy. Intussusception in preterm infant is very rare and about 40 cases have been reported. Furthermore, double intussusception is extremely rare in children and there seems to be no such a case reported in preterm infant. We report a case of idiopathic double intussusception in the preterm infant, who was born at 25 weeks' gestation, underwent an explolaparotomy for bowel perforation on 39 days of life, and during the operation, an ileo-ileo-colic intussusception was found without a leading point.

The Safety and Cosmetic Effect of Immediate Latissimus Dorsi Flap Reconstruction after Breast Conserving Surgery / 한국유방암학회지

PURPOSE: Oncoplastic breast conserving surgery is a new concept in breast cancer surgery. We performed immediate latissimus dorsi flap reconstruction after breast conserving surgery (BCS) to get an adequate resection margin and a good cosmetic results. The aim of this study is to evaluate the effect of immediate latissimus dorsi flap reconstruction after BCS. METHODS: From January to December, 2007, we performed BCS and immediate latissimus dosi myocutaneous flap reconstruction for 44 breast cancer patients. We evaluated the status of the post operative resection margin, the complications and the cosmetic results. The cosmetic results were evaluated with paying particular attention to the symmetry of the breasts, the breast shape, the location of the nipple and the post-operative scar by a three person panel that consisted of one doctor and two nurses. RESULTS: Reoperation was performed in 3 patients out of 44 (6.8%) because of positive resection margin. Flap complications didn't occurred and donor-site complications such as seroma occurred in only 3 cases. The mean score for the overall cosmetic outcome by the panel was 7.03 (SD=1.36) out of 10 and the cosmesis was deemed to be fair for 52% and, good for 48%. The mean subjective score by the patients was 6.5 (SD=2.29) out of 10 and the cosmesis was deemed to be poor for 14%, fair for 46% and, good for 40%. The most influential factors for the overall cosmetic results were breast symmetry and shape, and the breast scar in descending order (p<0.05). CONCLUSION: BCS with immediate latissimus dorsi flap reconstruction allows an adequate resection margin and good cosmetic results without serious complications.

Bone Metastasis from Primary Hepatocellular Carcinoma: Characteristics of Soft Tissue Formation / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: To assess the characteristics of bone metastasis from hepatocellular carcinoma and the radiation field arrangement based on imaging studies. MATERIALS AND METHODS: Fifty-three patients (84 lesions) with bone metastasis from a primary hepatocellular carcinoma completed palliative radiation therapy. All patients underwent one of following imaging studies prior to the initiation of radiation therapy: a bone scan, computed tomography or magnetic resonance imaging. The median radiation dose was 30 Gy (7~40 Gy). We evaluated retrospectively the presence of soft tissue formation and the adjustment of the radiation field based on the imaging studies. RESULTS: Soft tissue formation at the site of bony disease was identified from either a CT/MRI scan (41 lesions) or from a symptomatic palpable mass (5 lesions). The adjustment of the radiation field size based on a bone scan was necessary for 31 of 41 soft tissue forming lesions (75.6%), after a review of the CT/MRI scan. The median survival from the initial indication of a hepatoma diagnosis was 8 months (2 to 71 months), with a 2-year survival rate of 38.6%. The median survival from the detection of a bone metastasis was 5 months (1 to 38 months) and the 1-year overall survival rate was 8.7%. CONCLUSION: It was again identified that bone metastasis from a primary hepatocellular carcinoma is accompanied by soft tissue formation. From this finding, an adjustment of the radiation field size based on imaging studies is required. It is advisable to obtain a CT or MRI scan of suspected bone metastasis for better tumor volume coverage prior to the initiation of radiation therapy.