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In an 8-year period at two medical center, 138 patients underwent uterine artery embolization, and 11 of them were diagnosed with uterine necrosis. Among them, three were successfully conceived. However, one of them developed an arteriovenous malformation after an artificial abortion, and another experienced complications, including placenta previa and placenta accreta spectrum, which resulted in early preterm delivery and recurrent postpartum hemorrhage, necessitating subtotal hysterectomy. Therefore, it is crucial to prepare for potential adverse pregnancy outcomes in subsequent pregnancies for patients with a history of uterine necrosis.

[68Ga]Ga-FAPI-04 is a promising radiopharmaceutical that binds specifically to fibroblast activation protein, which is overexpressed in more than 90% of malignant epithelial tumors but not in normal healthy tissue. This study aimed to develop an efficient method for producing 68Ga-labelled FAPI-04 using a cassette-based automated synthesizer. [68Ga]GaCl3 was eluted from an Eckert & Ziegler Medical germanium-68/gallium-68 generator using 2.5 mL of 0.1 M HCl. The synthesis of the [68Ga]Ga-FAPI-04 was performed using different concentrations of HEPES (1~2.5 M; 4-(2-hydroxyethyl) piperazine-1-ethanesulfonic acid) in 3~10 minutes; amounts of FAPI-04 precursor (5~50 µg) and reaction temperature (25°C~100°C) were optimized on the BIKBoxⓇ synthesizer. The labeling efficiency of [68Ga]Ga-FAPI-04 was greater than 96% (decay corrected) using 25 µg FAPI-04 synthesized in 10 minutes at 100°C in 2 M HEPES (pH 3.85), and its stability was greater than 99% at 6 hours. The total synthesis time of [68Ga]Ga-FAPI-04 was 32.4 minutes, and the product met all quality control criteria. In this study, we developed and optimized a labeling method using [68Ga]Ga-FAPI-04 using a cassette-based synthesizer. The devised method is expected to be useful for supplying [68Ga]Ga-FAPI-04 for diagnosis in clinical practice.

[18F]Fluorocholine is a radiopharmaceutical used non-invasively in positron emission tomography to diagnose parathyroid adenoma, prostate cancer, and hepatocellular carcinoma by evaluating the choline metabolism. In this study, a radiolabeling method for [18F]fluorocholine was optimized using a solid phase extraction (SPE) cartridge. [18F]Fluorocholine was labeled in two steps using an automated synthesizer. In the first step, dibromomethane was reacted with [18F]KF/K2.2.2/K2CO3 to obtain the intermediate [18F]fluorobromomethane. In the second step, [18F]fluorobromomethane was passed through a Sep-PakⓇ Silica SPE cartridge to remove the impurities and then reacted with N,N-dimethylaminoethanol (DMAE) in a Sep-PakⓇ C18 SPE cartridge to label [18F]fluorocholine. The reaction conditions of [18F]fluorocholine were optimized. The synthesis yield was confirmed according to the number of silica cartridges and DMAE concentration. No statistically significant difference in the synthesis yield of [18F]fluorocholine was observed when using four or three silica cartridges (P＞0.05). The labeling yield was 11.5±0.5% (N=4) when DMAE was used as its original solution. On the other hand, when diluted to 10% with dimethyl sulfoxide, the radiochemical yield increased significantly to 30.1±5.2% (N=20). In conclusion, [18F]Fluorocholine for clinical use can be synthesized stably in high yield by applying an optimized synthesis method.

The germanium-68/gallium-68 (68Ge/68Ga) generator has high spatial utilization and requires little maintenance, making it economical and easy to produce. Thus, the frequency of use of 68Ga radiopharmaceuticals is rapidly increasing worldwide. Therefore, this study attempted to develop an automated synthesizer for the routine clinical application of 68Ga radiopharmaceuticals. The automated synthesizer was based on a fixed tubing system and the structure was designed after adjusting the position of the parts to reflect the synthesis method. Using various components that can be supplied in Korea, the automated synthesizer was manufactured at a much lower price cost than that of a commercialized automated synthesizer sold by companies. 68Ga-DOTA-[Tyr3]-octreotide (68Ga-DOTATOC) was synthesized to evaluate the performance of the automated synthesizer. 68Ga-DOTATOC could be synthesized with about 65% of non-decay corrected yield, and the synthesized 68Ga-DOTATOC met all quality control standards. We have synthesized 68Ga-DOTATOC more than 100 times, and only faced a few problems caused by mechanical errors. In this study, we successfully developed a simple automated synthesizer for 68Ga radiopharmaceuticals with high reproducibility. As various 68Ga radiopharmaceuticals have recently been developed, it is expected that the automated synthesizer developed in this study will be useful for routine clinical use.

Background The importance of molecular pathology tests has increased during the last decade, and there is a great need for efficient training of molecular pathology for pathology trainees and as continued medical education. Methods The Molecular Pathology Study Group of the Korean Society of Pathologists appointed a task force composed of experienced molecular pathologists to develop a refined educational curriculum of molecular pathology. A 3-day online educational session was held based on the newly established structure of learning objectives; the audience were asked to score their understanding of 22 selected learning objectives before and after the session to assess the effect of structured education. Results The structured objectives and goals of molecular pathology was established and posted as a web-based interface which can serve as a knowledge bank of molecular pathology. A total of 201 pathologists participated in the educational session. For all 22 learning objectives, the scores of self-reported understanding increased after educational session by 9.9 points on average (range, 6.6 to 17.0). The most effectively improved items were objectives from next-generation sequencing (NGS) section: ‘NGS library preparation and quality control’ (score increased from 51.8 to 68.8), ‘NGS interpretation of variants and reference database’ (score increased from 54.1 to 68.0), and ‘whole genome, whole exome, and targeted gene sequencing’ (score increased from 58.2 to 71.2). Qualitative responses regarding the adequacy of refined educational curriculum were collected, where favorable comments dominated. Conclusions Approach toward the education of molecular pathology was refined, which would greatly benefit the future trainees.

Background The metastatic brain tumor is the most common brain tumor. The aim of this study was to demonstrate the clinicopathological and molecular pathologic features of brain metastases (BM). Methods A total of 269 patients were diagnosed with BM through surgical resection at Seoul St. Mary’s Hospital from January 2010 to March 2020. We reviewed the clinicopathological features and molecular status of primary and metastatic brain tissues using immunohistochemistry and molecular pathology results. Results Among 269 patients, 139 males and 130 females were included. The median age of primary tumor was 58 years (range, 13 to 87 years) and 86 patients (32.0%) had BM at initial presentation. Median BM free interval was 28.0 months (range, 1 to 286 months). The most frequent primary site was lung 46.5% (125/269), and followed by breast 15.6% (42/269), colorectum 10.0% (27/269). Epidermal growth factor receptor (EGFR) mutation was found in 50.8% (32/63) and 58.0% (40/69) of lung primary and BM, respectively. In both breast primary and breast cancer with BM, luminal B was the most frequent subtype at 37.9% (11/29) and 42.9% (18/42), respectively, followed by human epidermal growth factor receptor 2 with 31.0% (9/29) and 33.3% (14/42). Triple-negative was 20.7% (6/29) and 16.7% (7/42), and luminal A was 10.3% (3/29) and 7.1% (3/42) of breast primary and BM, respectively. In colorectal primary and colorectal cancer with BM, KRAS mutation was found in 76.9% (10/13) and 66.7% (2/3), respectively. Conclusions We report the clinicopathological and molecular pathologic features of BM that can provide useful information for understanding the pathogenesis of metastasis and for clinical trials based on the tumor’s molecular pathology.

Background Accurate molecular classification of breast core needle biopsy (CNB) tissue is important for determining neoadjuvant systemic therapies for invasive breast cancer. The researchers aimed to evaluate the concordance rate (CR) of molecular subtypes between CNBs and surgical specimens. Methods This study was conducted with invasive breast cancer patients who underwent surgery after CNB at Seoul St. Mary’s Hospital between December 2014 and December 2017. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 were analyzed using immunohistochemistry. ER and PR were evaluated by Allred score (0–8). HER2 was graded from 0 to +3, and all 2+ cases were reflex tested with silver in situ hybridization. The labeling index of Ki67 was counted by either manual scoring or digital image analysis. Molecular subtypes were classified using the above surrogate markers. Results In total, 629 patients were evaluated. The CRs of ER, PR, HER2, and Ki67 were 96.5% (kappa, 0.883; p

Purpose To evaluate the mid- and long-term outcomes of inferior vena cava (IVC) filter insertion in patients with underlying deep vein thrombosis for prevention of pulmonary thromboembolism, based on a single center experience. Materials and Methods A total of 166 IVC filter insertion procedures in 160 patients, between February 2004 and December 2014, were retrospectively reviewed. Severity of deep vein thrombosis, indwelling time of the IVC filter, retrieval rate, and complication rate depending on the type of IVC filter were analyzed based on the patients' radiologic findings and medical records. Results IVC filter insertion procedures were successfully performed in all patients. Among the 99 attempts at filter retrieval, 91 trials succeeded (91.9%, 91/99) and 8 trials failed. Indwelling time of the IVC filter showed a positive correlation with failure of filter retrieval (p = 0.01). There was no procedure-related complication after all IVC filter insertion procedures. Eight delayed complications (5.0%, 8/160 patients with IVC filter insertion) were observed [caval thrombosis below the IVC filter (n = 7) and IVC penetration (n = 1)]. Günther Tulip filter was associated with a significant incidence of complication (p = 0.036). Conclusion IVC filter insertion in patients with lower extremity deep vein thrombosis for prevention of pulmonary thromboembolism can be regarded as a safe treatment modality with an acceptable complication rate.

Primary intestinal lymphoma is a rare disease. It accounts for approximately 1∼4% of gastrointestinal malignancy. Extranodal lymphoma of the intestine mainly arises from B cells. Diffuse large B-cell lymphoma is the most common type of the disease. Approximately 40% of intestinal lymphoma can be cured, while 60% have varied disease progression. Ki-67 proliferation has been recently used as an index of cell growth to predict the progression of the disease. Reported herein is a case of a rapidly progressive small bowel diffuse large B-cell lymphoma in a 51-year-old man with a high Ki-67 expression level. He visited the emergency department because of hematochezia. Abdominal computed tomography revealed distal small bowel segmental wall thickening. He underwent operation due to spontaneous small bowel perforation. The result of the pathological examination of the resected specimen was compatible with diffuse large B-cell lymphoma. The Ki-67 index within 5 months was 90%.

This study tested the association between genotypes of the single nucleotide polymorphism (SNP) marker, rs81437607 and capric acid (FA_C10_0) compositions in longissimus dorsi muscle in pigs. Eighteen fatty acid (FA) compositions were measured in a total of 974 F2 animals among 1,106 F2 progeny produced between Landrace and Jeju Black Pig (JBP). Among FA compositions tested, we identified a cluster of highly significant SNPs for capric acid compositions on 58 Mb position of Sus scrofa chromosome 12 (SSC12) using genome-wide association study (GWAS) with F2 genotypes from SNP panel analysis. GWAS results showed that the rs81437607 was the highest trait-related SNP marker with capric acid levels. Three genotypes (C/C, C/T and T/T) of rs81437607 marker were found in F2 population by further pyrosequencing. Association analysis results showed the significant differences between rs81437607 genotypes and capric acid compositions (p

Growth traits, such as body weight, directly influence productivity and economic efficiency in the swine industry. In this study, we estimate heritability for body weight traits usinginformation from pedigree and genome-wide single nucleotide polymorphism (SNP) chip data. Four body weight phenotypes were measured in 1,105 F2 progeny from an intercross between Landrace and Jeju native black pigs. All experimental animals were subjected to genotypic analysis using PorcineSNP60K BeadChip platform, and 39,992 autosomal SNP markers filtered by quality control criteria were used to construct genomic relationship matrix for heritability estimation. Restricted maximum likelihood estimates of heritability were obtained using both genomic- and pedigree- relationship matrix in a linear mixed model. The heritability estimates using SNP information were smaller (0.36-0.55) than those which were estimated using pedigree information (0.62-0.97). To investigate effect of common environment, such as maternal effect, on heritability estimation, we included maternal effect as an additional random effect term in the linear mixed model analysis. We detected substantial proportions of phenotypic variance components were explained by maternal effect. And the heritability estimates using both pedigree and SNP information were decreased. Therefore, heritability estimates must be interpreted cautiously when there are obvious common environmental variance components.

Background: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous O2 saturation, and lactate were measured. Results: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

Purpose To determine the efficacy of embolization with super-selective catheterization of the internal iliac arterial branches to treat heavily injured trauma patients with pelvic arterial bleeding. Materials and Methods A retrospective analysis was performed using the medical records of 37 patients who underwent trans-arterial embolization for trauma-associated pelvic arterial hemorrhage in a regional trauma center between July 2010 and July 2013. In each patient, hemodynamic stability, embolization level, elapsed time for trans-arterial embolization, clinical outcome and embolization-related complications were evaluated. Comparison of elapsed time, and presence of complication was done according to embolization level. Results Transarterial embolization was conducted in 37 patients. Hemodynamic stability of each patient was classified into hemodynamic stable (n = 9), and unstable (n = 28). Twenty-nine of 37 patients underwent embolization after super-selective catheterization of more than 2nd order branch of internal iliac artery with a microcatheter, and 8 patients underwent proximal internal iliac artery embolization without super-selective catheterization. The mean elapsed procedure time for super-selective embolization (34.76 ± 20.0 minutes) was not significantly longer than proximal internal iliac artery embolization (33.87 ± 16.73 minutes, p = 0.215). Conclusion Pelvic arterial embolization with super-selective catheterization is a safe and feasible treatment for heavily injured patients with trauma-associated pelvic arterial bleeding.

We developed a polymerase chain reaction (PCR)-based molecular method for sexing and identification using sexual dimorphism between the Zinc Finger-X and -Y (ZFX-ZFY) gene and polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) for mitochondrial DNA (mtDNA) cytochrome B (CYTB) gene in meat pieces and commercial sausages from animals of different origins. Sexual dimorphism based on the presence or absence of SINE-like sequence between ZFX and ZFY genes showed distinguishable band patterns between male and female DNA samples and were easily detected by PCR analyses. Male DNA had two PCR products appearing as distinct two bands (ZFX and ZFY), and female DNA had a single band (ZFX). Molecular identification was carried out using PCR-RFLP of CYTB gene, and showed clear species classification results. The results yielded identical information on the sexes and the species of the meat samples collected from providers without any records. The analyses for DNA isolated from commercial sausage showed that pig was the major source but several sausages originated from chicken and Atlantic cod. Applying this PCR-based molecular method was useful and yielded clear sex information and identified the species of various tissue samples originating from livestock.

The effect of biological control of the root-knot nematode, Meloidogyne incognita, on cucumber and lettuce was evaluated with green manure crop species in greenhouse. Nematicidal effect of sudan grass cultivation in cucumber greenhouse was comparable to that of chemical treatment with fosthiazate GR, showing the high activity of 88.6%. Sudan grass cultivation in lettuce greenhouse significantly reduced the number of M. incognita in soil, showing 93.5% of nematiidal activity. In addition, since growth of sudan grass was superior to other green manure crop species, it is considered that cultivation of sudan grass is proper to control M. incognita in greenhouse.

Purpose: This study was done to explore experiences of persons living through the periods of cancer diagnosis, treatment, and self-care. Methods: With permission, texts of 29 cancer survival narratives (8 men and 21 women, winners in contests sponsored by two institutes), were analyzed using Kang’s Korean-Computerized-Text-Analysis-Program where the commonly used Korean-Morphological- Analyzer and the 21st-century-Sejong-Modern-Korean-Corpora representing laymen’s Korean-language-use are connected. Experiences were explored based on words included in 100 highly-used-morphemes. For interpretation, we used ‘categorizing words by meaning’, ‘comparing use-rate by periods and to the 21st-century-Sejong-Modern-Korean-Corpora’, and highly-used-morphemes that appeared only in a specific period. Results: The most highly-used-word-morpheme was first-person-pronouns followed by, diagnosis·treatment-related- words, mind-expression-words, cancer, persons-in-meaningful-interaction, living and eating, information-related-verbs, emotion-expression- words, with 240 to 0.8 times for layman use-rate. ‘Diagnosis-process’, ‘cancer-thought’, ‘things-to-come-after-diagnosis’, ‘physician·husband’, ‘result-related-information’, ‘meaningful-things before diagnosis-period’, and ‘locus-of-cause’ dominated the life of the diagnosis-period. ‘Treatment’, ‘unreliable-body’, ‘husband · people · mother · physician’, ‘treatment-related-uncertainty’, ‘hard-time’, and ‘waiting-time represented experiences in the treatment-period. Themes of living in the self-care-period were complex and included ‘living-as-a-human’, ‘self-managing-of-diseased-body’, ‘positive-emotion’, and ‘connecting past · present · future’. Conclusion: The results show that the experience of living for persons with cancer is influenced by each period’s own situational-characteristics. Experiences of the diagnosis and treatment-period are negative disease-oriented while that of the self-care period is positive present-oriented. [ABSTRACT FROM AUTHOR]