Status and Perception of Risk Management in Radiation Therapy: Survey Among Korean Medical Physicists.

This study was conducted as part of an endeavor to improve the risk management system of radiation therapy departments in the Republic of Korea. An online survey on the status and perception of Korea's medical physicists on risk management in radiation therapy was carried out. A total of 40 domestic radiation oncology departments participated. This survey is divided into three categories: (1) work environment; (2) risk management status; and (3) opinions on how to improve risk management. Based on the results of the survey, the conclusions that can be derived are (1) the majority of respondents have a high interest in the risk management of radiation therapy; (2) the lack of staffing is one cause of risk management difficulties; (3) a risk-related terminology and classification system at the national or professional association level are required; (4) each hospital should create a voluntary reporting system for the handling of incidents; (5) medical physicists should establish incident reporting, analysis and countermeasures; and (6) government should develop education and training programs. It was confirmed that the current risk management system should be changed by education in the hospital and at the national level in order to improve risk management related to radiation therapy. In addition, it was recognized that a dedicated staff and a risk management certification system and organization for patient safety in radiotherapy are needed.

Magnetic resonance imaging features of ovarian fibroma, fibrothecoma, and thecoma.

OBJECTIVE: To retrospectively evaluate the conventional and functional (diffusion- or perfusion-weighted) magnetic resonance (MR) imaging features of ovarian fibroma, fibrothecoma, and thecoma. MATERIALS AND METHODS: Histologically proven ovarian fibromas (n = 19), fibrothecomas (n = 7), and thecomas (n = 2) were reviewed (26 patients). The morphologic and signal intensity (SI) characteristics on conventional MR imaging (n = 28, all cases) were analyzed. The b 1000 signal intensity on diffusion-weighted image (DWI) (n = 22) and the time-to-signal intensity curve on perfusion-weighted image (PWI) (n = 7) were also analyzed. The presence and shape of the ipsilateral ovarian tissue surrounding the lesions were evaluated on T2-weighted image. RESULTS: Twenty-two cases (79%) were predominantly solid tumor. Majority of the detected lesions exhibited the characteristic homogeneous low SI on T1- (24/28, 86%) and T2- (19/28, 68%) weighted image. Conversely, a number of lesions exhibited high SI (9/28, 32%) on T2-weighted image. Most lesions presented with a detectable ipsilateral ovary on T2-weighted image (24/28, 86%). Tumors larger than 6 cm more likely showed atypical morphology (mixed solid and cystic, cystic), atypical SI (high on T1- and T2-weighted image), and large amount ascites. Larger tumor group (>6 cm) was more likely diagnosed as fibrothecoma or thecoma than fibroma by pathology. On DWI, 16 lesions showed low b 1000 signal intensity (16/22, 73%). On PWI, all lesions showed curve type 1 or 2 (7/7, 100%), which tends to characterize benign lesions. All (16/16, 100%) pre-menopausal women had a detectable ipsilateral ovary, and six (60%) out of 10 post-menopausal women had a detectable ipsilateral ovary (p < 0.05). CONCLUSIONS: Combining conventional morphologic and signal intensity characteristics with the findings from DWI or PWI might help differentiate ovarian fibroma, fibrothecoma, and thecoma from ovarian malignancy, although further prospective larger scale study using DWI and PWI is needed.

ER-60 (PDIA3) is highly expressed in a newly established serous ovarian cancer cell line, YDOV-139.

Characterization of a newly established serous ovarian cancer cell line, YDOV-139 was performed and ER-60 (PDIA3), which was highly expressed in YDOV-139, was evaluated as novel biomarker for ovarian cancer. The YDOV-139 cell line was established using ascites samples from a 67-year-old Korean woman with recurrent ovarian cancer, and was characterized with respect to various biological and genetic features. Gene expression profiles were analyzed using cDNA microarrays, and proteomic evaluation was performed by two-dimensional gel electrophoresis (2-DE) and matrix-assisted laser desorption ionization-time of flight peptide mass fingerprinting (MALDI-TOF/PMF). Four candidate markers that were strongly up-regulated in YDOV-139 were validated by real-time polymerase chain reaction (PCR) and immunohistochemistry (IHC). The epithelial-like characteristics of YDOV-139 were evident from morphologic studies, and the average population doubling time was 120 h. When transplanted into nude mice, YDOV-139 cells successfully induced tumor masses in all three animals. Chemosensitivity tests showed that gemcitabine had the highest chemosensitivity index against YDOV-139 cells. HLA typing revealed A*24/A*31, B*07/B*35, Cw03*(09)/w*07, and DRB1*01/DRB1*15 alleles. Compared with human ovarian surface epithelial (HOSE) cells, 2,520 genes and 23 protein spots were differentially expressed in YDOV-139. Validation by real-time PCR showed that mRNA expression of LCN2, MDK, SLCO4A1, and ER-60 (PDIA3) were strongly elevated in ovarian cancers. In IHC analysis, ER-60 (PDIA3) was significantly overexpressed in both borderline tumors and invasive ovarian cancers (P<0.001). The molecular characteristics of YDOV-139 may have implications for future ovarian cancer research and ER-60 (PDIA3) should be investigated further as a potential biomarker of ovarian cancer.

Evaluation of serum and urinary angiogenic factors in patients with endometriosis.

PROBLEM: The aim of this study was to evaluate serum and urinary levels of vascular endothelial growth factors, tumor necrosis factor-alpha (TNF-alpha), and soluble fms-like tyrosine kinase (sFlt-1) in patients with endometriosis. METHOD OF STUDY: During surgery for pelvic pain, pelvic mass or infertility, serum and urine were collected. Of 70 patients, 46 had histology-proven endometriosis and 24 patients without endometriosis participated as controls. RESULTS: Serum TNF-alpha levels and urinary sFlt-1 levels corrected for creatinine excretion were significantly increased in the endometriosis group (P=0.001 and P=0.011 respectively). Serum sFlt-1 levels and urinary sFlt-1 levels corrected for creatinine were significantly higher in patients with minimal-to-mild disease (P=0.014 and P=0.015 respectively), where serum TNF-alpha levels were increased in moderate-to-severe endometriosis (P<0.001). CONCLUSION: The pathogenesis of minimal-to-mild endometriosis and moderate-to-severe endometriosis seems to be different. Increased sFlt-1 levels in serum and urine of minimal-to-mild disease indicate that sFlt-1 may have an important role in inhibiting angiogenic process of the disease.