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Introduction Metaplastic carcinoma (MC) of the breast is a rare pathologic entity accounting for Citation Format: Changjin Lim, Jang-il Kim, Yireh Han, Jong-ho Cheun, Ji Gwang Jung, Hong Kyu Kim, Hyeong-Gon Moon, Wonshik Han, Han-Byoel Lee. Metaplastic carcinoma of the breast has comparable prognosis to non-metaplastic triple negative breast cancer despite poor response to chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-07-07.

Introduction : Latissimus dorsi mini-flap (LDMF) with breast conserving surgery (BCS) was introduced as a useful volume replacement technique when the tumor is located in upper or outer portion of breast and the tumor size is large requiring extensive excision of breast tissue. However few studies have assessed quality of life (QoL) and objective cosmetic outcome of LDMF in breast cancer surgery. We tried to evaluate those in patients who underwent BCS with or without LDMF. Methods : This study was a prospective, single-center cohort study of patients who underwent LDMF and BCS between 2011 and 2018. As a control, patients who underwent BCS without any volume replacement and the tumor size equal to or greater than 2.5cm on the upper or upper outer of the breast on preoperative imaging. Breast Q questionnaire and body photo were taken at least 1 year after surgery. Two breast surgeons and one plastic surgeon who did not performed LDMF assessed the cosmetic outcome of the patients with photo. Results : 62 patients were in the BCS with LDMF group and 58 patients were in BCS-only group. Pathologic tumor size was significantly larger in LDMF group than BCS-only group (LDMF 3.89cm vs BCS-only 2.92cm, p= 0.001 ). Psychosocial well-being (P= 0.024), physical well-being (P= 0.000), and satisfaction with surgeon (p= 0.006) were significantly better in the BCS-only group than in the LDMF group respectively. But, there were no significant difference in neither sexual well-being (p= 0.286) nor satisfaction for breast (p=0.278) between BCS and LDMF group. In the physicians assessment, there was no significant difference in the cosmetic outcome score between the two groups (LDMF 2.56/4 vs. BCS-only 2.58/4, p= 0.884). Conclusion : In conclusion, physician assessed cosmetic outcome of LDMF was equivalent to that of BCS without LDMF although the tumor size was significantly larger in patients with LDMF. Some inferiority of QoL might be due to postoperative pain or arm movement discomfort. We are planning to evaluate objective cosmetic results using BCCT.core software. Citation Format: Jang-il Kim, Yireh Han, Changjin Lim, Jong-Ho Cheun, Ji Gwang Jung, Hong Kyu Kim, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han. Assessment of quality of life and objective cosmetic outcome of breast conserving surgery with or without latissimus dorsi mini-flap in breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-18-14.

Background Mammographic Artificial intelligence (AI) algorithms (Lunit insight MMG) draws attention as a diagnostic support tool for breast cancer detection. Lunit insight MMG provides a location suspected of breast cancer with a heatmap and a score reflecting the probability of the presence of suspicious areas. We investigated whether the Lunit insight MMG score is relevant for predicting the response to adjuvant tamoxifen. Methods Patients diagnosed with DCIS and underwent treatment at Seoul National University Hospital in 2010 were retrospectively enrolled. Clinical characteristics, tamoxifen use, survival data, and mammography images were extracted from the electronic medical records, and Lunit insight MMG scores were calculated retrospectively. We classified two groups according to tamoxifen treatment and compared the score change of contralateral breast from baseline to 5 years after surgery for DCIS. Change categories of Lunit insight MMG score included maintaining high risk, maintaining low risk, increasing from low risk to high risk, and decreasing from high risk to low risk. Results Of 100 patients, 50 (50%) had undergone tamoxifen treatment (group 1) and 50 (50%) had not (group 2). The median age of the patients was 48.4 years for group 1 and 51.5 years for group 2 (p=0.172). The median follow-up duration was 8.7 years for the whole cohort. Using Lunit insight MMG score, more patients in group 1 decreased in contralateral breast cancer (CBC) risk compared with group 2 (6.0% vs. 2.0%; P=.008). No patients in group 1 had an increase in CBC risk while 9 patients increased in group 2 (0% vs. 18.0%; P =.008). There was no ipsilateral breast cancer recurrence for the whole cohort, and two patients experienced contralateral invasive breast cancer in group 2. In two patients with CBC, the Lunit insight MMG score increased five years after surgery, one year and three years before the CBC diagnosis. Conclusions Longitudinal Changes of Mammographic AI algorithms Score may be a predictive surrogate marker for response to tamoxifen therapy in hormone receptor-positive DCIS. Citation Format: Changjin Lim, Eun Kyung Park, Hong-Kyu Kim, Eunhye Kang, Ji-Jung Jung, Hyunsu Yeoh, Jang-il Kim, Jung Whan Chun, Han-Byoel Lee, Hyeong-Gon Moon, Wonshik Han. Longitudinal Changes of Contralateral Breast Mammographic Artificial Intelligence Algorithms Score in Ductal Carcinoma In Situ patient with Tamoxifen [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-04-11.

Background: Patients who carry mutated BRCA1 or BRCA2 genes have a significantly increased risk of breast cancer and developing contralateral breast cancer (CBC). In this study, we aimed to investigate the acceptance rate of BRCA1/2 testing in Korean breast cancer patients and to determine the risk of CBC in Korean patients with BRCA 1/2 germline mutations. Methods: This study included 13,109 patients with first primary breast cancer who were treated at Seoul National University Hospital from January 2005 to December 2018. These patients were divided into high-risk for BRCA1/2 mutation group and low-risk group. High risk patients were defined as those who were eligible for BRCA testing per Korean National Health Insurance Service. The high-risk group was further classified into three groups; BRCA1/2 mutation carrier, BRCA 1/2 non carrier and BRCA/12 untested. Results: Among the 4,446 high-risk patients, 962 (21.7%) patients underwent BRCA1/2 testing. The testing rate varied among different indications (47.8% of patients with a family history, 23.3% of patients under 40 years of age, and 13.0% of patients with triple negative breast cancer). The risk of the CBC in BRCA mutation group was higher than other groups (p value < 0.001). The 10-year cumulative risk of CBC was 11.0% BRCA1 mutation carrier and 7.4% for BRCA2 mutation carrier. In the BRCA1/2 non-carriers, the cumulative risk of CBC was 5.7%. Interestingly, the CBC risk for BRCA1/2 non-carriers significantly higher than BRCA1/2 untested group and the low-risk group (p < 0.001). When compared to the BRCA1/2 untested group, the relative risk for CBC was 6.7-fold increase for the BRCA1/2 mutation carrier group (95% CI = 3.65-12.22, p < 0.001), and 2.3-fold increase for the BRCA1/2 non-carriers group (95% CI = 1.44-3.83, p < 0.001). The relative risk for CBC in high-risk group also depended on subtype of breast cancer and family history. Hormone receptor negative breast cancer patients had a 1.5-fold (95% CI = 1.02-2.31, p = 0.04) increased risk of CBC and patients with one or more 1st degree relative with breast cancer had 2.4-fold increased risk (95% CI = 1.55-3.67, p < 0.001). Conclusion: About one out of five Korean breast cancer patients, who are eligible for the BRCA1/2 testing, undergo testing for BRCA1/2 germline mutations. We observed increased CBC risk not only for the BRCA1/2 mutation carriers but also for the BRCA1/2 non-carriers. At present, we are conducting multi-gene panel testing for the BRCA1/2 non-carriers to understand the mechanisms of the increased CBC risk. Citation Format: Eunhye Kang, Ji-Jung Jung, Hyunsu Yeoh, Changjin Lim, Jang-il Kim, Jung Whan Chun, Hong-Kyu Kim, Han-Byoel Lee, Wonshik Han, Hyeong-Gon Moon. Contralateral breast cancer risk in patients with or without BRCA mutation [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-02-14.

Background: Contralateral axillary lymph node metastasis (CAM) in breast cancer is currently classified as a stage IV disease but its prognosis is still controversial. Purpose: To determine outcomes in overall survival (OS) and disease-free survival (DFS) in patients with and without locoregional tumor recurrence who present with contralateral axillary lymph node metastasis (CAM). Methods: Patients with pathologically confirmed invasive breast cancer with metachronous CAM who received treatment between 1988 and 2017 were retrospectively reviewed. Patients with other distant metastases at the time of CAM diagnosis were excluded. The outcome of CAM in cases of IBTR and regional recurrence (RR) were compared to CAM not accompanied by locoregional tumor recurrence. Results: Thirty-eight patients with metachronous CAM were included in the study. Metachronous CAM occurred 55 months (interquartile range, 17-77 months) after surgical treatment of the primary tumor and median follow-up was 95 months (interquartile range, 49-117 months) from the initial operation date and 40 months (interquartile range, 15-54 months) from the diagnosis of CAM. At the time of initial CAM diagnosis, 11 patients had IBTR, 12 patients had RR, and 15 patients had no locoregional recurrence. The estimated 5-year OS was 49.1% and 5-year DFS was 45.3%. Although statistically insignificant due to small sample size, when stratified by loco regional recurrence, the prognosis of CAM patients with IBTR appeared to be better than those without locoregional recurrence (5-year OS: 88.9% vs. 41.4%, HR 5.88, p = 0.09) whereas the prognosis of CAM patients with RR was worse than those without locoregional recurrence (5-year OS: 35.4% vs. 41.4%, HR 0.44, p = 0.20). Axillary lymph node dissection (ALND) improved median OS (83 vs. 36 months, p = 0.069) in all patients. When stratified, improvement in median OS was 13 vs 27 months (p = 0.094) in patients with RR, and 36 vs. 65 months (p = 0.061) in patients without locoregional recurrence. For patients accompanied by IBTR, ALND was performed in 8 out of 11 and only one patient died during the follow-up period. Conclusion: Our study indicates that the patients with CAM have superior survival outcome when compared to other stage IV patients, especially when CAM was accompanied by other loco regional recurrences. These data suggest that the CAM patients may benefit from active loco regional treatment. Citation Format: Ji-Jung Jung, Hyeong-Gon Moon, Wonshik Han, Han-Byoel Lee, Hong-Kyu Kim, Jung Whan Chun, Eunhye Kang, Changjin Lim, Jang-il Kim, Hyunsu Yeoh. Contralateral Axillary Lymph Node Metastasis after Ipsilateral Breast Tumor Recurrence: Is it distant metastasis or locoregional progression? [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-01-04.

Background: The use of intraoperative neuromonitoring (IONM) in thyroid surgery to preserve recurrent laryngeal nerve (RLN) function has been widely accepted. We aimed to evaluate the usefulness of IONM in reoperation for recurrent thyroid cancer patients to help identify the RLN and prevent vocal cord palsy (VCP).Methods: We analyzed 121 consecutive patients (with IONM group, 48 patients; without IONM group, 73 patients) who underwent reoperation for recurrent thyroid cancer after total thyroidectomy from January 2009 to March 2019 in our institution without VCP due to previous operations. Data including age, sex, number of previous operations, histologic subtype of the malignancy at the initial operation, operation time, RLNs at risk, difficulty of RLN identification, surgical procedure, VCP, and other postoperative complications were reviewed. Vocal cord movement evaluations were performed preoperatively and at 2 weeks postoperatively to evaluate RLN function. In patients with VCP, additional evaluations were performed. VCP exceeding 12 months after surgery was considered permanent VCP.Results: VCP was observed in six (12.5%) and 16 (21.9%) patients with and without IONM (P=0.189). Transient and permanent VCP were found in three (6.3%) and three (6.3%) patients with IONM (P=0.098 and P=0.982, respectively) versus in 12 (16.4%) and four (5.5%) patients without IONM.Conclusion: The incidence of transient VCP seems to be lower in reoperations with IONM; however, there was no statistical significances. Further study will be needed to ascertain the efficacy of IONM in reoperation for recurrent thyroid cancer patients.

이 글은 클라우제비츠의 전쟁이론을 그의 이론관과 역사관, 특히 그가 지닌 역사주의와 관련지어 봄으로써 그것의 역사적인 의미를 조명하려 한다. 클라우제비츠가 『전쟁론』을 비롯한 저술에 제시한 이론은 19세기 초엽 프로이센에 만연해있던 사상의 영향을 깊게 받고 있다. 특히 그가 이론과 저술을 통해 추구했던 목표는 이러한 배경으로부터 불가분하다. 클라우제비츠의 이론은 독자들이 미래의 전쟁에 대비할 능력을 길러주기 위해 만들어졌다. 하지만 그는 미래에 사용할 행동 규칙이 아니라 충분한 연구를 통해 조명한 사례를 제시함으로써 이러한 목표에 도달하고자 한다. 그는 현실상의 복잡한 문제에 대해서는 오로지 인간의 직감만이 유효한 해결책을 제시해줄 수 있다고 주장했다. 나아가 그는 이러한 직감이 경험을 통해서만 발달할 수 있다고 보았지만 역사 속의 사례로 경험을 갈음하는 것도 가능하다고 보았다. 따라서 그의 전쟁이론은 미래에 대비하기 위해서 과거인 역사를 연구한다는 모순된 성격을 나타낸다. 현실을 적극적으로 수용하면서 고안된 클라우제비츠의 전쟁이론은 프랑스 혁명을 전후해 전쟁이 겪은 변화와 그 결과 전쟁이 나타낸 상이한 양상이라는 문제에 봉착했다. 클라우제비츠는 ‘절대전쟁’과 ‘제한전쟁’이라는 이원성을 고안함으로써 전쟁의 다양한 양상을 정리했으며 이러한 문제에 대응하고자 했다. 이를 통해 그는 각 전쟁의 개별성을 포괄함과 동시에 각 전쟁의 보편성을 탐색할 수 있는 이론을 형성한다는 모순된 목표를 추구했다. 이 과정에서 그는 역사주의적 태도를 지니게 되었으며, 이는 그가 이 두 전쟁 사이의 우열을 가리는 것을 거부하면서 이것들이 각각의 조건에 따라 자연스럽게 만들어진다고 보는 것에서도 드러난다. 클라우제비츠는 각 전쟁의 개별적이고 다양한 면모를 만들어내는 보편적인 요소를 식별했다고 주장했다. 그는 자신의 연구를 종합하여 폭력, 우연, 정치에의 종속성이라는 전쟁의 세 가지 성격을 제시했다. 이것들은 전쟁을 둘러싼 사회의 영역들인 인민, 군대, 정부에 연결됨으로써 각 시대의 전쟁을 각 시대의 사회와 연결하는 도구로 사용된다. 이를 통해 각 시대의 독특성을 강조했던 클라우제비츠의 역사주의적인 역사관과 다시 한 번 연결된 전쟁은 당시 태동하고 있던 근대 역사학의 연구 대상이 되었다. 클라우제비츠는 최초의 근대적 전쟁 사학자로 볼 수 있으며 그의 저술과 이론 역시 역사저술과 역사이론으로 볼 수 있다. 그는 오로지 과거만을 대상으로 하는 역사 연구를 진행했고 이후 독일에 등장했던 전문 역사가들과 같은 방식으로 과거를 조망했다. 이러한 면모는 지금까지 주목받지 못했으나 전쟁의 이중성과 삼중성이라는 그의 성과를 해석하는 데에 대단히 중요하다. 그러므로 이 글은 역사가로서의 클라우제비츠에 주목하며 그의 저술과 이론을 재조명하고자 한다.

Postoperative adhesion is a natural phenomenon that occurs in damaged tissue cells. Several anti-adhesion agents are currently used, but there is no leading-edge product with excellent adhesion-preventive effects. The purpose of this study was to develop ideal anti-adhesive agents using human-derived acellular dermal matrix (ADM). We developed 5 new biocompatible thermosensitive anti-adhesion barriers (AABs) using micronized human-derived ADM, hyaluronic acid, and temperature-sensitive and biocompatible synthesized polymers. The biocompatibility, anti-adhesion effect, and biodegradability of these AABs were compared with those of commercial thermosensitive anti-adhesion agents. No cytotoxic effects were observed in vitro and in vivo. Animal testing of adhesion resistance confirmed that the adhesion area, strength, and grade of AAB03 were statistically superior to those of the control group. Factors related to adhesion formation, such as lymphocytes, macrophages, microvessels, and collagen fiber density, were observed using specific staining methods; the results confirmed that AAB03 group exhibited significantly lower macrophage counts, microvessel density, and collagen fiber density than the control groups. Furthermore, AAB03 was completely absorbed by 6 weeks. Thus, AAB03 has the potential to be used as a high-performance anti-adhesion agent.

Recently Smartphone is widely used around the world, and over 50% of mobile subscribers are using Smartphone in USA. 24 million people are identified as Smartphone sub-scribers. However, Smartphone has a vulnerability to security, and security-related incidents make damages of Smartphone. Precautions have been made for the infection of most of the damage occurring except for the case of the expert by way of conventional post-countermeasure. In this paper, we propose mobile-based malware analysis service that applies virtualization technology to analyze the behavior. In addition, we implement system that can be prepared in advance to buy a security from a user perspective.

Although the development of mobile devices are made us a free life, they were displayed the subject of this financial crime and attacking forces in the other side. Among finance-related crime is become a serious crime that are targeting smartphones by SMS phishing, phishing, pharming, voice phishing etc. In particular, SMS phishing is increased according to phenomenon using the nature of a text message in the mobile. SMS phishing is become new crime due to the burden to the smartphone user. Their crime is also the advanced way from the existing fraud, such as making the malicious apps. Especially it generates loopholes in the law by a method such as using a foreign server. For safe from SMS phishing attacks, proactive pre-diagnosis is even more important rather than post responses. It is necessary to deploy blocking programs for detecting SMS phishing attacks in advance to do this. In this paper we are investigating the process of block types and block apps that are currently deployed and presenting the evaluation of the application of the detection block setting app.

As recent smartphone is used around the world, all of the subscribers of the mobile communication is up to 47.7% about 24 million people. Smartphone has a vulnerability to security, and security-related incidents are increased in damage with the smartphone. However, precautions have been made, rather than analysis of the infection of most of the damage occurs after the damaged except for the case of the expert by way of conventional post-countermeasure. In this paper, we implement a mobile-based malware analysis systems apply a virtualization technology. It is designed to analyze the behavior through it. Virtualization is a technique that provides a logical resources to the guest by abstracting the physical characteristics of computing resources. The virtualization technology can improve the efficiency of resources by integrating with cloud computing services to servers, networks, storage, and computing resources to provide a flexible. In addition, we propose a system that can be prepared in advance to buy a security from a user perspective.

It is becoming more important as the growing of health information and increasing in cancer patients diagnose over the time gradually. Among the various types of cancer, we focuses on breast cancer diagnosis. The accuracy of breast cancer diagnosis is increasing when the diagnosis is based on evidence and statistics. To do this we use the weka data mining tools and analysis algorithms significantly associated with the decision tree uses rules. In addition, the data pre-processing and cross-validation are used to increase the reliability of the results. The number and cause of the disease becomes important to increase evidence-based medical doctors. As the evidence-based medical, the data obtained from patients in the past through the disease by calculating the probability for future patients to diagnose and predict disease and treatment plan. It can be found by improving the survival rate plays an important role.

Decision-making is to extract information that can be executed in the future, it refers to the process of discovering a new data model that is induced in the data. In other words, it is to find out the information to peel off to find the vein to catch the relationship between the hidden patterns in data. The information found here, is a process of finding the relationship between the useful patterns by applying modeling techniques and sophisticated statistical analysis of the data. It is called data mining which is a key technology for marketing database. Therefore, research for cluster analysis of the current is performed actively, which is capable of extracting information on the basis of the large data set without a clear criterion. The EM and K-means methods are used a lot in particular, how the result values of evaluating are come out in experiments, which are depending on the size of the data by the type of distance-based and probability-based data analysis. Key words: EM, Decision-making, K-Means, Maximization Step, BI-RADS assessment

A thermosensitive/magnetic poly(organophosphazene) hydrogel (a magnetic hydrogel) was designed and synthesized for long-term magnetic resonance (MR) imaging. To turn a thermosensitive poly(organophosphazene) hydrogel (an original hydrogel) into a long-term MR contrast platform, cobalt ferrite (CoFe2O4) nanoparticles, which have hydrophobic surfaces, were bound to the original hydrogel via interactions between the hydrophobic surfaces of the nanoparticles and the L-isoleucine ethyl esters of the polymer. The magnetic hydrogel showed extremely low cytotoxicity and adequate magnetic properties for use in long-term MR imaging, in addition to possessing the same properties of the original hydrogel, such as viscosity, thermosensitivity, biodegradability, biocompatibility, a reversible sol-to-gel phase transition near body temperature, and injectability. The magnetic hydrogel was injected into a rat brain using stereotactic surgery. After the injection, the applicable potentiality as a long-term MR contrast platform was successfully estimated over 4–5 weeks. Consequently, it was shown that a magnetic hydrogel as a long-term MR contrast platform has the potential to be applied in a long-term theranostic hydrogel system. Furthermore, it is expected that this platform can be useful in the clinical field of incurable diseases due to either surgical difficulties or lethality, such as with brain tumors, when the platform is combined with therapeutic drugs for long-term MR theragnosis in further studies.

Background/Objectives: In the information security field, artificial intelligence must be applied first. This is because the frequency of malicious code is too high and the processing method is too difficult, which is very difficult for human to handle.Methods/Statistical analysis: In this paper, we developed a program to classify malicious codes into images and a Tensorflow system to classify malicious codes. The malware used as input was the computer virus code used in the BIG 2015 Challenge. This dataset, called a Kaggle dataset, consists of 10,868 bytes of train set.Findings: We used the Tensorflow SLIM library to develop this machine learning malware learning machine. This resulted in more than 80% accuracy. Especially, when the CRIS-Ensemble algorithm was added, the accuracy was 97%. The study of malicious code analysis using machine learning consists of two major parts. First, the process of making the virus into images is important. To classify 10,868 Kaggle malware datasets that the BIG 2015 winner showed 99.6% accuracy, Tensorflow's accuracy and parameter tuning are important, but finding the way to make good images is the most important techniqueImprovements/Applications: The results show that the malicious code classification system using machine learning can be an effective method to classify malicious code of malicious code by the accuracy of the result and ease of use.

The long-term theranostic hydrogel system for solid tumors was prepared via simple physical mixing, which consisted of three major parts: the thermosensitive/biodegradable poly(organophosphazene) hydrogel, PEGylated cobalt ferrite nanoparticles, and paclitaxel (PTX). The PEGylated cobalt ferrite nanoparticles showed extremely low cytotoxicity due to the surface modification using PEG chains. The long-term theranostic hydrogel system showed adequate properties to be used for long-term MR theragnosis. In particular, the theranostic hydrogel gradually degraded over 28 days, and the PTX was sustainedly released out from the theranostic hydrogel over the same period in vitro. Furthermore, the in vivo efficacy of long-term MR theragnosis using the theranostic hydrogel system was estimated successfully over 3 weeks by using high field (4.7 T) animal MRI and solid tumor-bearing mice. Based on our results, we expect that this system can supply multiple data regarding a) the progress of therapy and b) the treatment processes via one- or two-time i.t. administration for cases in which surgical approaches are difficult to apply. Meanwhile, cancer patients can be free from the pain of multiple surgical treatments and have the advantage of therapy through a simple i.t. administration.