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Many people experience orthopaedic problems (OPPs), such as knee joint pain, hip joint pain, low back pain, and knee stiffness in their lifetimes. OPPs can impair lower extremity function, cause depression, and worsen quality of life. The aim of this study was to investigate the association between sedentary time (SDT) and OPPs. Retrospective cross-sectional study. This study used data from the 2014–2015 Korea National Health and Nutrition Examination Survey. Survey participants with previous or current osteoarthritis or rheumatoid arthritis, as diagnosed by a doctor, were excluded. OPPs were defined as knee joint pain, hip joint pain, low back pain, and knee stiffness. The cut-off value for SDT was 7.5 hours/day. The study population comprised 3,671 people (1), 856 men and 1,815 women), all of whom were ≥50 years-old. Multiple logistic regression analyses were performed. A total of 328 men (17.7%) and 519 women (28.6%) had OPPs. Men with SDTs ≥7.5 hours had a greater risk of OPPs than did men with SDTs

Music perception deficits are common following acquired brain injury due to stroke, epilepsy surgeries, and aneurysmal clipping. Few studies have examined these deficits following traumatic brain injury (TBI), resulting in an under-diagnosis in this population. We aimed to 1) compare TBI patients to controls on pitch and rhythm perception during the acute phase, 2) determine whether pitch and rhythm perception disorders co-occur, 3) examine lateralization of injury in the context of pitch and rhythm perception, and 4) determine the relationship between verbal short-term memory (STM) and pitch and rhythm perception. Music perception was examined using the Scale and Rhythm tests of the Montreal Battery of Evaluation of Amusia, in association with CT scans to identify lesion laterality. Verbal short-term memory was examined using Digit Span Forward. TBI patients had greater impairment than controls, with 43% demonstrating deficits in pitch perception, and 40% in rhythm perception. Deficits were greater with right hemisphere damage than left. Pitch and rhythm deficits co-occurred 31% of the time, suggesting partly dissociable networks. There was a dissociation between performance on verbal STM and pitch and rhythm perception 39 to 42% of the time (respectively), with most individuals (92%) demonstrating intact verbal STM, with impaired pitch or rhythm perception. The clinical implications of music perception deficits following TBI are discussed.

Complications of laparoscopic adjustable gastric banding (LAGB) are well documented including migration, erosion, prolapse, infection, pouch dilatation, and gastric perforation. Band prolapse within the first 5 years after LAGB is observed in about 5 % of cases, requiring an operative procedure. Here we report our experience of endoscopic treatment of band prolapses. From December 2007 to December 2013, 1,347 consecutive patients (202 male, 1,145 female) underwent LAGB; 47 patients had band prolapses and 7 were treated by endoscopy. All patients were women (median age, 34 years). The mean preoperative body mass index was 38.3 ± 2.9 kg/m2. The mean duration to band prolapse after LAGB was 10.6 ± 5.6 months. The mean duration of endoscopy was 12 ± 3 min. One patient had recurrence of the prolapse 3 months after the first endoscopy and was treated by endoscopy again. There was no operative procedure required and no mortality. Endoscopic treatment of band prolapses is effective without the need for an operative procedure.

Multidrug-resistant (MDR) Gram-negative bacterial infection is widespread all over the world, and recently it led to the reintroduction of colistin for treatment of MDR Pseudomonas aeruginosa and Acinetobacter spp. infection [1]. According to the 2007 European antimicrobial resistance surveillance system (EARSS) consisting of 33 European countries, six countries reported carbapenem resistance rates higher than 25 % among P. aeruginosa isolates [2]. The rate of imipenem-resistant Acinetobacter reached up to 51 % in Korea according to the report of the Korean Nationwide Surveillance of Antimicrobial Resistance (KONSAR) [3]. Polymyxin E (colistin) that was developed in the 1940s is still the principal therapeutic agent for MDR Gram-negative pathogens. Because of the nephrotoxicity and neurotoxicity of colistin, it was not used for a long time [4]. Colistin has lately been considered for MDR treatment due to the emergence of MDR bacteria. However, the efficacy test results of colistin have been quite controversial. Most studies have been retrospective, and the clinical data analysis has been done without control groups [5, 6]. In this study, we evaluated the clinical efficacy of colistin in MDR bacterial infection. We conducted a retrospective hospital-based cohort study at an 850-bed hospital by reviewing the medical records of patients who received intravenous colistin for MDR bacterial infection from May 2007 to December 2010. Demographics, clinical presentation, causative organism, and outcomes were recorded. Patients were excluded if they received colistin treatment for \72 h and were under the age of 18. Types of infection were evaluated, following the United States Centers for Disease Control and Prevention (CDC) criteria. Recent invasive procedure was defined as preceding an invasive procedure within 48 h, including arterial, central venous catheter, urinary catheter, or applying mechanical ventilation before the culture results of MDR infection. MDR bacteria were defined to be resistant to all antibiotic agents such as penicillins, aminoglycosides, ampicillin/sulbactam, cephalosporins, aztreonam, carbapenems, fluoroquinolones, and tetracyclines, except colistin. Interpretation of susceptibility results was carried out according to the current Clinical and Laboratory Standards Institute guidelines. A total of 107 patients were enrolled in this study, and their demographic and clinical data are summarized in Table 1. Sixty-six patients (61.7 %) were over 64 years, and 36 patients (33.6 %) had a hospital stay of more than 125 days before MDR bacteria culture. Common underlying diseases were hypertension (63.5 %), diabetes (34.6 %), chronic obstructive pulmonary disease (24.3 %), cancer (19.6 %), chronic renal failure (CRF), and end-stage renal disease (ESRD; 12.1 % for both CRF and ESRD). More than 95 % of colistin therapy took place in ICUs. Cerebrovascular event (27.1 %) including cerebral infarction or hemorrhage was the most common cause of admission. We evaluated the clinical and microbiological responses both to colistin and to previously exposed antibiotics combined with colistin. Efficacy was evaluated as both clinical and bacteriological responses. After 3 days of colistin therapy, clinical improvement was graded as a good or poor clinical response. A good responder was defined as a patient whose symptoms were improved with bacteriologically clear pathogen within 1 week. Baseline characteristics and various risk factors were compared Y. H. Jun S. J. Jeun S. H. Kang H. J. Choi (&) Division of Infectious Disease, Department of Internal Medicine, Ewha Womans University, Mokdong Hospital, 911-1 MokDong, Yangcheon-Ku, Seoul, Korea e-mail: heechoi@ewha.ac.kr

Background Dexmedetomidine has been shown to reduce pro-inflammatory cytokine levels in rats with sepsis and in severely ill patients. The aim of this study was to document the effects of dexmedetomidine on inflammatory responses during and after surgery. Materials and Methods Patients undergoing laparoscopic cholecystectomy were enrolled. After induction of anaesthesia, patients in the dexmedetomidine group (n = 24, group D) received a loading dose of dexmedetomidine (1.0 μg/kg), followed by infusion of dexmedetomidine at 0.5 μg/kg/h. A saline-treated group (n = 23, group S) served as a control. Intraoperative mean arterial pressure (MAP), heart rate (HR), and amount of rescue analgesic administered as post-anaesthetic care were compared between the groups. The pro-inflammatory cytokines tumour necrosis factor (TNF)-α, interleukin (IL)-1β, and IL-6, and anti-inflammatory cytokines IL-4 and IL-10 were quantified by sandwich enzyme-linked immunoassay at three times: after anaesthesia induction (T0), at the end of peritoneal closure (T1), and 60 min after surgery (T2). The C-reactive protein (CRP) level and leukocyte count were measured on post-operative day 1. Results At time points T1 and T2, the IL-1β, TNF-α, and IL-10 levels were lower in group D than in group S (P

The phylogenetically-conserved vertebrate transcription factor, NFIB, is an orchestrator of glial differentiation in the developing mammalian central nervous system. We found NFIB expression to be reduced in glioblastoma (GBM), the commonest and most lethal primary adult brain cancer, so investigated what effect increased expression of NFIB had on GBM. Increased expression of NFIB in primary GBM cell lines induced expression of markers of glial differentiation, inhibited cell proliferation, reduced stem/progenitor cell growth, altered cell cycle progression and inhibited tumor growth in murine models of GBM. We thus identified NFIB to be a novel tumor suppressor gene in GBM.

Deletions in the 17p13.3 region are associated with abnormal neuronal migration. Point mutations or deletion copy number variants of the PAFAH1B1 gene in this genomic region cause lissencephaly, whereas extended deletions involving both PAFAH1B1 and YWHAE result in Miller-Dieker syndrome characterised by facial dysmorphisms and a more severe grade of lissencephaly. The phenotypic consequences of YWHAE deletion without deletion of PAFAH1B1 have not been studied systematically.We performed a detailed clinical and molecular characterization of five patients with deletions involving YWHAE but not PAFAH1B1, two with deletion including PAFAH1B1 but not YWHAE, and one with deletion of YWHAE and mosaic for deletion of PAFAH1B1.Three deletions were terminal whereas five were interstitial. Patients with deletions including YWHAE but not PAFAH1B1 presented with significant growth restriction, cognitive impairment, shared craniofacial features, and variable structural abnormalities of the brain. Growth restriction was not observed in one patient with deletion of YWHAE and TUSC5, implying that other genes in the region may have a role in regulation of growth with CRK being the most likely candidate. Using array based comparative genomic hybridisation and long range polymerase chain reaction, we have delineated the breakpoints of these nonrecurrent deletions and show that the interstitial genomic rearrangements are likely generated by diverse mechanisms, including the recently described Fork Stalling and Template Switching (FoSTeS)/Microhomology Mediated Break Induced Replication (MMBIR).Microdeletions of chromosome 17p13.3 involving YWHAE present with growth restriction, craniofacial dysmorphisms, structural abnormalities of brain and cognitive impairment. The interstitial deletions are mediated by diverse molecular mechanisms.

Peel of Citrus sunki traditionally has been considered to have a potential anti-inflammatory activity and used to alleviate respiratory symptoms in Korea. However, little is known about the pharmacological activities of C. sunki peel. The present study aimed to investigate whether the extract of C. sunki peel and its fermented product may have any anti-inflammatory activities such as scavenging of reactive oxygen species (ROS), suppression of nitric oxide synthase (iNOS) and cyclooxygenase II (Cox-2) in various cellular systems. Ethanol extract of C. sunki peel showed a potent ROS-scavenging activity from experiments using 2',7'-dichlorofluorescin diacetate as a fluorescent ROS probe in HepG2 cells. In addition, fermented product of extract of C. sunki peel markedly suppressed the production of nitric oxide in lipopolysaccharide (LPS)-activated RAW264.7 murine macrophage cells. Intracellular protein levels of iNOS and Cox-2 stimulated by LPS were also decreased by treatment with fermented product of extract of C. sunki peel. Stepwise fractionation is being performed to isolate more effective constituents with less toxic and less side effects to develop potent anti-inflammatory medicines.

The objectives of this study were to characterize the changes occurring in the levels of insulin-like growth factors (IGF-I and IGF-II) in bovine milk during a one-year lactation period, and to determine the parameters affecting IGF content in bovine milk. Milk was collected individually from lactating Holstein cows (n = 70), and IGF-I and -II levels were determined via radioimmunoassay, using 125 Ι after acid-ethanol treatment. The proximate compositions of the milk samples were determined using a near-infrared milk analyzer. The data were analyzed by the GLM and CORR procedures using SAS software to determine significant differences (p

K(V)11.1 (HERG) channels contribute to membrane potential in a number of excitable cell types. We cloned a variant of K(V)11.1 from human jejunum containing a 171 bp deletion spanning exons 3 and 4. Expression of a full-length cDNA clone containing this deletion gave rise to protein that trafficked to the cell membrane and generated robust currents. The deletion occurred in a G/C-rich region and identical sequence elements of UGGUGG were located at the deletion boundaries. In recent studies these features have been implicated to cause deletions via template switching during cDNA synthesis. To examine this possibility we compared cDNAs from human brain, heart, and jejunum synthesized at lower (42 degrees C) and higher temperatures (70 degrees C). The 171 bp deletion was absent at the higher temperature. Our results suggest that the sequence and secondary structure of mRNA in the G/C rich region leads to template switching producing a cDNA product with a 171 bp deletion.

BACKGROUND The aim of this prospective study was to evaluate the predictive value of [18F]fluorodeoxyglucose positron emission tomography (FDG PET) for the pathological response of breast cancer after completion of neo-adjuvant chemotherapy. METHODS Fifty patients with newly diagnosed, non-inflammatory, large or locally advanced breast cancer undergoing neo-adjuvant chemotherapy were eligible for this study. Clinical assessment was accomplished by comparing initial tumor size with preoperative tumor size. Pathological responses were classified into three groups: pathological non-response (pNR), pathological partial response (pPR) and pathological complete response (pCR). To determine the effect of reduction rate (RR) of peak standardized uptake values for tumor responses, logistic regression analyses were performed. To identify an optimal threshold value of RR for the prediction of pathological response, receiver operating characteristic analysis was performed. RESULTS Eight per cent (four of 50) of the patients had pCR and 46% had pPR. Ten per cent of patients had clinical CR and 52% had clinical PR. In clinical response, the RRs (+/- SD) of CR (-83.4 +/- 12), PR (-81.8 +/- 22.7) and NR (-79.7 +/- 31.9) showed no statistical differences (P > 0.05). However, for pathological responses, the RR of CR (-96.5 +/- 3.4) had a lower value than those of PR (-87.9 +/- 15.1) and NR (-56.2 +/- 29.6) (P = 0.0006; CR versus PR, P < 0.05; CR versus NR, P < 0.05; PR versus NR, P < 0.01). When -88% of RR was used as threshold value for differentiation between pCR and pPR, the area under the curve (AUC) was 0.788 [standard error (SE) 0.106; 95% confidence interval (CI) 0.589-0.920]. The sensitivity and specificity were 100% and 56.5%, respectively. When -79% of RR was used as threshold value for differentiation between pathological responders and non-responders, the AUC was 0.838 (SE 0.059; 95% CI 0.707-0.927). The sensitivity and specificity were 85.2% and 82.6%, respectively. CONCLUSIONS Despite some limitations, this study suggests a possible predictive value of FDG PET for the assessment of the pathological response of primary breast cancer after neo-adjuvant chemotherapy. However, these findings deserve further investigation on a larger number of patients, and more frequent and earlier PET scans in each patient need to be performed to allow a better validation of the differentiation between the responder and non-responder groups.

The Fitzpatrick skin classification has been a useful method to categorize cutaneous sensitivity to ultraviolet radiation (UVR), although it was based originally on responses in white skin. Because the relevance of this phototype in brown skin is in question, we investigated skin phototypes of university students by a self-reporting questionnaire and measured their MEDs in Korean, brown skin. After studying our explanation of the definition of Fitzpatrick skin types, 707 Korean university students answered the questionnaire. We then measured UVB MEDs in 156 randomly selected male students. The order of frequency of skin type was type III (55.0%), IV (29.0%), and V (12.3%) by the questionnaire, with the sun sensitive categories (types I and II) reported only for 3.7%. There was no significant difference in MEDs between types IV and V, and the mean MED of each skin type did not show a monotonic increase with increasing skin type. Subjects with MEDs of 70-90 mJ/cm2 (corresponding to the MED of skin type V, as proposed by Pathak & Fitzpatrick) represented about half or more of the subjects in all categories, even types II and III. Subjects with MEDs lower than 60 mJ/cm2 were more prevalent in types II and III compared with types IV and V. We suggest that there is at best a weak relationship between the skin types, by the Fitzpatrick method, and MEDs in Korean, brown skin.

Summary Esmolol has a beneficial effect on the T helper 1/T helper 2 balance in patients with heart failure. The aim of this study was to investigate the immunomodulatory role of esmolol during and after surgery. Patients undergoing laparoscopic gastrectomy due to gastric cancer were enrolled. Patients in the esmolol group (n = 15) received esmolol during surgery, and a saline-treated group (n = 14) served as a control. Cytokines were quantified by sandwich enzyme-linked immunoassays before, during and after surgery. The esmolol group was associated with higher ratios of interferon-γ/interleukin-4 (T helper 1/T helper 2 signature cytokines) than the saline group during (2.36 vs 0.57, respectively, p = 0.041) and after (5.79 vs 0.69, respectively, p = 0.033) surgery. The postoperative increase in interleukin-6 was attenuated in the esmolol group, and the C-reactive protein level on postoperative day 1 was significantly lower in the esmolol group than in the saline group (mean (SD) 26.2 (18.3) mmol.l−1 vs 56.8 (44.3) mmol.l−1, p = 0.021). Our findings suggest that esmolol played an immunomodulatory role and mitigated the postoperative inflammatory response in patients under surgical and anaesthetic stress.

The purpose of our study was to assess the extrarenal length of renal arterial branches and tumour-feeding arteries on multidetector CT (MDCT) angiography, in addition to the perihilar branching patterns, with relevance to segmental artery clamping.MDCT angiograms of 64 patients with renal masses4 cm were retrospectively reviewed by 2 radiologists. The perihilar branching patterns of the single main renal artery were assessed according to the number of pre-segmental and segmental arteries. The extrarenal lengths of segmental plus pre-segmental arteries and the tumour-feeding arteries, measured on volume-rendered images, were compared according to the vascular segmentation and the tumour location, respectively.In the 116 kidneys, 1 pre-segmental plus 5 segmental arteries (n=48) was the most common branching pattern. The mean extrarenal length of the inferior segmental plus pre-segmental arteries (33.05 mm) and the posterior segmental plus pre-segmental arteries (32.30 mm) was longer than any of the other segmental plus pre-segmental arteries (apical, 23.87 mm; superior, 26.80 mm; middle, 29.23 mm) (p0.05). The mean extrarenal length of the lower pole tumour-feeding arteries (35.94 mm) was longer than those of the upper and mid-pole tumour-feeding arteries (24.95 mm, 29.62 mm), with significant difference between the lower and the upper pole tumour-feeding arteries (p0.05).Tumours in the lower pole, supplied by the inferior or posterior segmental artery, may be more amenable to segmental artery clamping.MDCT angiography with volume rendering can demonstrate the extrarenal length of tumour-feeding arteries and may help in determining the accessibility for segmental artery clamping.

This study investigated the mechanism of action of a gonadotropin-releasing hormone (GnRH) agonist, leuprolide, on proliferation of the hormone-refractory prostate cancer cell line DU145, transfected with short hairpin RNA (shRNA), to reduce expression of the GNRHR1 gene (which encodes the GnRH type 1 receptor). DU145 cell proliferation in the presence of leuprolide (10−9 and 10−7 M) or control medium was measured before and after GnRHR1 knockdown. Reverse transcription—polymerase chain reaction and Western blot analysis were used to measure the degree of GNRHR1 silencing. DU145 cells treated with leuprolide (10−9 and 10−7 M) showed significant growth inhibition compared with control-treated DU145 cells. Transfection with GNRHR1–shRNA significantly decreased GNRHR1 expression at 48 h. DU145 cells transfected with silencing GNRHR1–shRNA showed normal growth patterns; however, there was no significant inhibition of proliferation of DU145 cells transfected with GNRHR1–shRNA compared with cells transfected with control—shRNA in response to leuprolide. These data demonstrated that the antiproliferative effect of leuprolide was mediated by the GnRHR1.

SETTING: Nucleic acid amplification tests can detect Mycobacterium tuberculosis complex rapidly and reliably. OBJECTIVE: To compare the diagnostic performance of the artus ® M. tuberculosis PCR Kit and COBAS ® AMPLICOR™ Mycobacterium tuberculosis Test. In the artus assay, an appropriate cycle threshold (Ct) value was determined for positivity. DESIGN: A total of 238 clinical respiratory specimens were analysed using both the artus and COBAS AMPLICOR assays. In 221 specimens, these results were further compared with culture results. RESULTS: The overall agreement between artus and COBAS AMPLICOR was 96.2% (229/238). Among the nine (3.8%) discrepant specimens, three (1.3%) were artus-positive and COBAS AMPLICOR-negative, while the other six (2.5%) were artus-negative and COBAS AMPLICOR-positive. Using culture as a standard, the sensitivity and specificity of the artus assay were 97.8% and 85.1%, and those of COBAS AMPLICOR assay were 100% and 86.2%, respectively. The difference was not statistically significant. In the artus assay, the minimum Ct value for the positivity determination was 38. CONCLUSION: The artus and COBAS AMPLICOR assays showed comparable diagnostic performance and can be confidently used for detection of M. tuberculosis complex. In the artus assay, a Ct value of 38 could be suggested as an appropriate cut-off value.

An efficient stereocontrolled synthesis of cis-2,5-disubstituted tetrahydrofurans from triethylsilyl ethers of trans-4-phenyl-3-buten-1-ol derivatives19-24 was developed by using phenylselenyl chloride in the presence of potassium carbonate in acetonitrile.

An ideal material has yet to be discovered that can completely treat dentin hypersensitivity; however, calcium phosphate precipitation has exhibited potential value for the treatment of dentin hypersensitivity by the occlusion of dentinal tubules. We hypothesized that a novel mesoporous silica biomaterial (nano CaO@mesoporous silica, NCMS) containing nano-sized calcium oxide particles mixed with 30% phosphoric acid can efficiently occlude dentinal tubules and significantly reduce dentin permeability, even with the presence of pulpal pressure. This highly supersaturated Ca2+-and HPO4 2−ion-containing NCMS paste was brushed onto dentin surfaces, and the ions diffused deeply into the dentinal tubules and formed a CaHPO4·2H2O precipitation with a depth of 100 μm. The results of the dentin permeability tests showed that the novel mesoporous material exhibited a significant reduction in dentin permeability (p < 0.05), even under simulated pulpal pressure, as compared with our previously developed material, DP-bioglass, and a commercial desensitizing material, Seal & Protect®.

Folate, a water-soluble B vitamin and one of the major micronutrients in vegetables, is known as an essential factor for the de novo biosynthesis of purines and thymidylate, and it plays an important role in DNA synthesis and replication. Thus, folate deficiency results in ineffective DNA synthesis, and has been shown to induce the initiation and progression of colorectal cancer (CRC). Recently, the incidence of CRC in Korea has increased markedly in both men and women; this trend may be related to the adoption of a more ‘westernized’ lifestyle, including dietary habits. A hospital-based case–control study was conducted to examine the relationship between folate intake and the risk of CRC within a Korean population. A total of 596 cases and 509 controls, aged 30−79 years, were recruited from two university hospitals. Site- and sex-specific odds ratios (ORs) were estimated using logistic regression models. Cases were more frequently found to have a family history of CRC among first-degree relatives, to consume more alcohol, to be more likely current smokers and less likely to participate in vigorous physical activity than the controls. In the overall data for men and women combined, multivariate ORs (95% confidence interval (CI), P for trend) comparing the highest vs the lowest quartile of dietary folate intake were: 0.47 (0.32–0.69

An efficient stereocontrolled synthesis of cis-2,5-disubstituted tetrahydrofurans from triethylsilyl ethers of trans-4-phenyl-3-buten-1-ol derivatives19-24 was developed by using phenylselenyl chloride in the presence of potassium carbonate in acetonitrile.

A newly developed device that enables easy intraoperative colonic irrigation and subsequent colonoscopy was introduced recently.To evaluate the efficacy of the single-stage procedure with a new device and the significance of on-table colonoscopy, 112 patients with obstructive left colon cancer were recruited.Primary anastomosis after tumor resection was performed in 104 cases. The volume of saline used for irrigation averaged 13.5 l over 12.1 min. Subsequent colonoscopic examination added an average of 10.4 min to the operative time. There were three anastomotic leaks, two wound infections, four acute renal failures, and two operative mortalities. On-table colonoscopy resulted in extended resection in 17 cases.The new device enabled safe, simple, and time-saving, single-stage surgical management of left colon cancer obstruction. The ability to perform on-table colonoscopy enabled treatment and recognition of synchronous bowel pathology.

Aims To evaluate the involvement of multipotential stem and progenitor cells in the pathogenesis of pterygium. Methods Paraffin-embedded and snap-frozen primary pterygium (n=10) were serially sectioned and analysed immunohistochemically to determine the expression level of AC133 (marker for the primitive haematopoietic progenitors), CD34 (marker for the haematopoietic progenitor cells and endothelium), c-Kit (marker for haematopoietic and stromal progenitor cells), and STRO-1 (a differentiation antigen present on bone marrow fibroblast cells and on various nonhaematopoietic progenitor cells). Results In all the primary pterygium, immunoreactivity of AC133 and STRO-1 was found in some of the epithelial and stromal cells, CD34 was observed in the vascular endothelium, and some scattered ovoidal cells were found in the subepithelial connective tissue. C-Kit was expressed mainly in the basal epithelium of the head portions, and some spindle-shaped stromal cells. There is no immunoreactivity of AC133, c-Kit, and STRO-1 in normal conjunctiva, whereas CD34 was mildly stained with vessel wall. Conclusion Multipotential stem and progenitor cells may be involved in the pathogenesis of pterygium through its differentiation into fibroblasts and vascular endothelial cells.

Purpose: The purpose of this study was to assess the feasibility and toxicity of modified fractionation of external beam radiation with the intention of reducing the overall treatment time (OT) by 1 week in cervical cancer. Methods and Materials: Thirty-one patients (Group 1, n = 31) with bulky cervical cancer (≥ 4 cm with Stage II and III, ≥ 5 cm with Stage IB2) were entered into the twice a day (b.i.d.) protocol (18 Gy/10 fx in 2 weeks followed by 18 Gy/12 fx, b.i.d. in 6 days, then midline block at 36 Gy with 45 Gy to the whole pelvis and 51–59 Gy to the parametrium). These patients underwent high-dose-rate brachytherapy with 4 Gy/fx × 7 to point A, biweekly. During the same period, patients with non-bulky tumors (Group 2, n = 31) received conventional treatment and similar brachytherapy. Results: The OT of Group 1 was 7 weeks or less in 61.3%, 7.1–8 weeks in 29%, and more than 8 weeks in 9.7% (19.4%, 51.6%, and 29% in Group 2, respectively, p = 0.003). Incidences of acute complications and treatment breaks were similar in both groups. Late complication (rectal bleeding) occurred only in Group 1 (13%, 4/31), but was self-limited. Locoregional failures occurred within 2 years after completion of radiation therapy in both groups (16% and 13% in Group 1 and 2, respectively, with minimum and median follow-ups of 2 years and 34 months). Conclusion: Partial hyperfractionation on the third week of radiation permitted patients to finish their treatment with shorter OT without excessive acute complications and with acceptable grade 2 late rectal bleeding complications. This treatment scheme may be an effective method for the improvement of local control of bulky cervical cancer.

OBJECTIVES: This study reports population estimates of Pap smear testing among Korean-American women and evaluates correlates of testing. METHODS: Korean Americans in 2 California counties were surveyed by telephone. Frequencies were age-adjusted to the 1990 census to produce population estimates of testing. Logistic regression models were used to evaluate independent correlates of testing RESULTS: Only 50% of the Korean-American women surveyed had a Pap test in the previous 2 years. The strongest independent correlate was having had a regular check-up in the previous 2 years (odds ratio 7.2, 95% confidence interval 4.2, 12.1). CONCLUSIONS: Rates of Pap testing among Korean-American women are well below national objectives. Collaboration and community-sensitive research are essential to collect data and design programs to improve the health of ethnic minority communities.

Background: Metastatic status of internal mammary lymph nodes (IMLNs) has a clinical importance in assessing stage and prognosis of breast cancer. But, when metastasis of IMLN is suspected, the management is controversial. We reviewed 29 breast cancer patients who had IMLN dissection, retrospectively, and investigated the pathologic status of IMLNs. Methods: From August 2005 to December 2011, at Yeungnam University Hospital, 43 patients underwent IMLN biopsy or dissection for suspected IMLN metastasis on lymphoscintigraphy (7 patients), breast ultrasound (1 patient) or PET CT (29 patients), when diagnosed with primary or recurred breast cancer. 6 patients who had stage IV at diagnosis or had too obscure data to identify exact location of IMLN, were excluded. Among them, we reviewed clinicopathologic features of IMLN detected on PET CT and metastatic status of IMLNs was investigated. Results: Total 29 patients were included in this study. 19 patients and 10 patients underwent IMLN dissection when diagnosed with primary or recurred breast cancer, respectively. Unlike conventional IMLN dissections, our IMLN biopsy or dissection was done during Radical mastectomy (in 2 pts.), modified radical mastectomy (in 14 pts.), using incision of breast conserving surgery (in 3 pts.) and separated incision (in 10 pts.), with or without resection of ribs. The mean number of IMLNs was 2.76±2.15 and total metastatic rate of IMLN was 72.4% (21/29). The sensitivity, specificity, positive predictive value, and negative predictive value of PET CT was following: 91.3%, 42.8%, 72.4% and 27.6%. Mean standard uptake value (SUV) of metastatic and non-metastatic IMLN were 3.6±2.9 and 3.9±2.6 and there was no statistical difference (p-value=0.821). During IMLN dissection, besides initial approach intercostals space (ICS), some metastatic IMLN was also found in upper or lower level ICS (42.9%, 6/14). Only IMLN metastasis without axillary nodes metastasis were found in 3 patients and the tumor location of these patients was all inner or central quadrant. Chest X-ray was done postoperatively as routine procedure, and there were no other specific complications such as pneumothorax or hemothorax. Conclusion: IMLN dissection without radical mastectomy can be done safely without complications due to recent advance in diagnostic and surgical skills. If SUV on IMLN is shown on the PET-CT, IMLN dissection is needed, regardless of SUV. If breast cancer is located at inner quadrant, more aggressive dissection of IMLN is needed. Further follow-up and studies are needed to assess locoregional recurrence and to compare improvement in overall survival and disease free survival. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-03-02.

Purpose: The axillary reverse mapping (ARM) technique to identify and preserve arm nodes during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) was developed to prevent lymphedema. In our previous study, we evaluated the incidence of lymphedema after ARM and the difference in arm circumference between arm node preserved group and unpreserved group, after short term follow up. The purpose of this study was to investigate the location and metastatic rate of the arm node, and to evaluate the further follow-up results of the differences in arm circumference after arm node preserving surgery. Methods: From January 2009 to December 2011, 116 breast cancer patients who underwent ARM were included. Blue-dye (2.5ml) was injected into the ipsilateral upper-inner arm. At least 20 minutes after injection, SLNB or ALND was performed and blue-stained arm nodes and/or lymphatics were identified. Patients were divided into two groups, an arm node preserved group (87 patients had ALND, 10 patients had SLNB) and an unpreserved group (15 patients had ALND, 4 patients had SLNB). The difference in arm circumference between preoperative and postoperative time points was checked in both groups. Results: The mean number of identified blue stained arm nodes was 1.41±0.66. The mean follow up period was 16.24(3∼24)months. In the majority of patients (86.2%), arm nodes were located between the lower level of the axillary vein and just below the second intercostobrachial nerve. The location of the arm node was the inferolateral side of axillary and thoracodorsal vessels in 62 patients (53.4%), the inferomedial side in 46 patients (39.7%), the superolateral side in 5 patients (4.3%), and the superomedial side in 3 patients (2.6%) In the arm node unpreserved group, 5 patients (4.3%) had metastasis in their arm node. When comparing between arm circumferences in ipsilateral upper-extremity of the arm node preserved group and unpreserved group, in the SLNB group, there was no significant difference. But in the ALND group, the arm circumference changes of the arm node unpreserved group were bigger than that of the preserved group (0.50±1.15 vs 0.16±0.76, p = 0.066). There were no lymphedema cases among the arm node preserved group, but one lymphedema developed in the unpreserved group(5.2%). There was no locoregional recurrence in both group in follow up periods. Conclusion: After further follow-up, this study showed some differences in arm circumference between two groups. Arm node preserving was possible in all breast cancer patients with identifiable arm nodes, during ALND or SLNB, except for those with high surgical N stage, and lymphedema and locoregional recurrences did not develop in patients with arm node preserving surgery. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-01-05.

ObjectivesIn this study, we aimed to elucidate the demographic and psychological characteristics of maladaptive soldiers in the Republic of Korea Army.MethodsStudy participants were 110 male conscripts who participated in the Green camp, a kind of group psychotherapy for maladaptive soldiers. All the participants were interviewed and diagnosed by a psychiatrist, and classified into two groups according to whether they left or rejoin the army. We analyzed the difference between these two groups in terms of demographic features, psychiatric diagnosis, and the Minnesota Multiphasic Personality Inventory (MMPI) subscores.ResultsCompared with soldiers who rejoined their units, those who left military service exhibited significantly lower educational level (p = 0.041) and higher rate in psychiatric treatment prior to enlistment (p = 0.011). Among the 106 study subjects, 63 (59.4%) and 23(21.7%) were diagnosed as personality disorder and adjustment disorder, respectively. Soldiers who left military service were diagnosed more frequently as mood disorder (p = 0.001) and schizophrenia (p = 0.014), respectively, than those who rejoined their units. The MMPI scores of soldiers who left military service were significantly higher on the psychasthenia (p = 0.028) and schizophrenia (p = 0.039) scales than those of soldiers who rejoined their units.ConclusionMost of the maladaptive soldiers were diagnosed as mental disorder. The results of this study suggest that systematic, consistent psychiatric evaluation and intervention for maladaptive male conscripts is crucial in the army.

Backgrounds: For isotope mapping, many authors defined the sentinel lymph node (SLN) as one containing isotope counts higher than the axillary background. Some defined the SLN by using a node/background ratio. However no study has sought to define optimal guideline, and the number of SLNs needed for precise detection of metastatic SLNs is still on debate. So, we intended to determine the optimal sampling number of SLNs. Patients and Methods: From January 2005 to December 2008, 1,026 patients with primary invasive breast cancer who received sentinel lymph node biopsy (SLNB) using radioisotope at Yeungnam University hospital were enrolled. During SLNB, the ex vivo isotope counts were measured for each SLN. And the number and metastatic status of harvested SLNs were investigated. We defined SLNs as lymph nodes that show isotope count more than 10 times compared with that of axillary background. Each SLN was labeled as S1 (highest isotope count), S2 or S3 and so on, in descending isotope count order. If SLN was positive for metastasis, completion axillary lymph node dissection was performed. Pathologic report was reviewed for analysis. Results: Mean age of patients was 48.9 years (ranges, 22∼83 years) and the mean number of removed SLNs was 2.8 (ranges, 1∼11). Among 311 (311/1026, 30.3%) patients who had SLN metastasis, S1 is positive (S1+) in 258 patients (82.9%), S2 (S1-, S2+) in 40 patients (12.3%), and S3 (S1-, S2-, S3+) in 13 patients (3.9%), respectively. There was no metastasis in SLN defined as S4, S5 and so on. So, the sampling of S1 was sufficient for a positive diagnosis in 82.9% of these cases, additional sampling of S2 and S3 increased metastatic detection rate to 95.2% and 100%, respectively. Average number of sampling SLNs until detecting metastasis in S1, S2 and S3 is 1.24 (1∼4), 2.45(2∼4) and 3.46(3∼5), respectively. Metastatic status of SLN and the corresponding percentage of patients on the basis of the order of radioisotope count SLN=sentinel lymph node Conclusions: We concluded that during sentinel lymph node biopsy using radioisotope, for accurate axillary lymph node staging, at least 3rd isotope-count-order of sentinel lymph node should be removed. Therefore the average number of SLNs needed for detecting metastasis in S3 is four. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-10.

There have been very few published reports on the normal growth and fertility of cloned cats derived from adult somatic cell nuclear transfer (SCNT). Here, we report studies investigating the growth and fertility of cloned male cats produced by SCNT. This study was designed to investigate the reproductive success by natural breeding of cloned male cats with domestic female cats and to measure endocrine hormone profiles related to male reproduction such as testosterone, LH, and FSH. Clones A, B, and C produced 3, 2, and 4 kittens, respectively, after natural mating with 4 domestic female cats, and clone D produced 5 kittens, in spite of being further into puberty than the other cloned male cats. All of the females delivered at 64 to 66 days after natural mating. The results obtained are presented as the mean � SEM. Sexual hormones were analyzed by ANOVA. All statistical analysis was conducted with SAS (SAS Institute Inc., Cary, NC, USA), and P < 0.05 was considered significant. Three of the 14 kittens expressed an odd eye color, which was produced from 1 clone A and 2 clone B cats. The eye color of other F1 kittens varied from brown to blue. Body weight at birth ranged from 72.9 to 134 g. Although clone D had a lower libido and entered puberty later than the other cloned males, it produced gonadal hormones within the average range. Four cloned male cats had normal fertility and were free from any reproductive problems. All of the cloned male cats were similar to two control and donor cats with respect to concentration of gonadal hormones. However, the concentration of testosterone in a castrated donor cat was significantly lower than that from clones A, B, C, D, and control cats (0.4 � 0.1 vs. 5.99 � 5.68; 3.46 � 2.81; 6.41 � 2.17; 3.75 � 0.34; 4.0 � 3.63 ng mL-1; P < 0.05). The concentrations of LH and FSH were not significantly different among any of the cats. A total of 14 kittens, 7 male and 7 female, were produced by the natural breeding of cloned male cats with 4 domestic female cats. These results indicate that cloned male cats have normal reproductive success and lie within the normal range of gonadal hormone production. All of the F1 kittens were produced by natural breeding, delivery, demonstrated normal growth, and are still alive and healthy. This work was supported by KOSEF (grant M10525010001-05N2501-00110).