Search

Background Many countries agree with the horizontal equity that medical resources should be allocated according to medical needs, regardless of income. Although the short-term equity index calculated through cross-sectional data doesn't reflect the dynamics of individual income and medical use, it can be supplemented by the long-term equity index using panel data. Koreans tend to choose expensive but highly specialized services without considering their medical needs because they are free to choose service providers. This study aims to empirically examine how the patterns of outpatient medical use that are not based on medical needs differ in terms of short- and long-term equity for each type of medical institution. Methods Using Korea Health Panel Survey(2014-2018), the equity of outpatient medical use(number of visits, medical expenses) of 10,244 people was measured by type of medical institution (tertiary general hospital, general hospital, hospital, clinic, and dentist). Wagstaff&van Doorslaer(2000)’s tool and Jones & Lopez-Nicolas(2004)’s tool were used to calculate the short and long-term horizontal equity index(HI), and mobility index(MI) to compare short and long-term inequity. Results In tertiary general hospitals and dentists, there were short and long-term pro-rich inequalities(HI > 0, p < 0.05). As a result of comparison, long-term inequality was greater in the number of visits (MI < 0), while inequality was easing in the long-term in medical expenses(MI > 0) in tertiary general hospitals. In dentists, long-term inequality was less than short-term inequality in both the number of visits and medical expenses (MI > 0). Conclusions The short-term equity index is likely to underestimate or overestimate inequity in our society, so a long-term perspective is needed. Inequality patterns for each type of medical institution should be considered in healthcare reforms for fair distribution of medical resources. Key messages • Short-term equity index differs from the long-term equity index in outpatient medical use. • The pattern of short and long-term equity indices may differ by type of medical institutions.

Aim To compare the clinical results of femtosecond (FS) laser in situ keratomileusis (LASIK) in high myopic patients and low myopic patients. Methods This study included 212 myopic eyes undergoing LASIK using a VisuMax 500kHz FS laser. All treated eyes were assigned to one of two groups according to preoperative manifest spherical refraction: low myopia group (A, >-4.0 D) and high myopia group (B, ≤-4.0 D). Uncorrected and corrected distance visual acuity (UDVA, CDVA), refractive errors, and higher-order aberrations (HOAs) were measured preoperatively and 1wk, 1, 3 and 6mo postoperatively. Results At 6mo of follow-up, 92% and 76% had a UDVA of 20/20 or better in group A and B, respectively (P=0.037) and UDVA was significantly different between two groups (P=0.042). Six and seven percentage lost one line of CDVA in group A and B, respectively (P=0.572) and no eyes in both groups lost more than two lines. Each group had 87% and 76% of treated eyes within ±0.5 D of the intended correction (P=0.186), and 13% and 43% with a change of >0.50 D in spherical equivalent from 1wk to 6mo postoperatively (P=0.005). In terms of postoperative astigmatism, each group had 89.1% and 76.6% within ±0.50 D, respectively and there was significant difference (P=0.006). Group A tends to induce smaller HOAs than group B. Conclusion FS LASIK is effective and safe for correcting high myopia as well as low myopia. However, high myopic eyes showed more postoperative astigmatism and HOAs which affect visual acuity.

Background In patients with early stage breast cancer, regional nodal irradiation (RNI) is added to whole breast irradiation (WBI) in order to control microscopic regional disease and to prevent systemic spread of cancer. According to recent randomized trials (MA.20 and EORTC 22922-10925), prophylactic RNI was associated with improvement in disease-free survival (DFS) in the patients with high-risk node negative or pN1 breast cancer. However, systemic agents now known to improve loco-regional control, such as taxane or endocrine therapy, were prescribed to a small percentage of patients in the studies. The benefit of RNI found in the previous studies might be attributed to incorporation of less effective systemic treatments. The impact of prophylactic RNI in pN1 breast cancer should be evaluated in the patients receiving modern systemic treatment. The current study was conducted to compare the effect of post-lumpectomy WBI vs WBI plus RNI on DFS in pN1 breast cancer patients who received adjuvant taxane-based chemotherapy. Methods This study is a multicenter, phase 3, randomized controlled non-inferiority trial (NCT03269981). Eligibility criteria are ≥ 20 years female; pathologically proven invasive carcinoma of the breast; one to three positive axillary lymph nodes (pN1) in pathologic specimen; receiving breast-conserving surgery followed by taxane-based chemotherapy; having adjuvant endocrine therapy or anti-HER2 treatment according to molecular subtype of tumor. Patients are randomly assigned in a 1:1 ratio to receive WBI or WBI plus RNI. Patient randomization was stratified by molecular subtype of tumor (i.e. luminal A/luminal B/luminal HER2/HER2-enriched/triple-negative) and methods of axillary management (i.e. sentinel lymph node biopsy/axillary lymph node dissection). The primary outcome is DFS. The secondary outcomes include DFS according to molecular subtype, treatment-related toxicity, and patient's quality of life per EORTC QLQ-C30 and QLQ-BR23. Patients will be followed for survival and disease recurrence for seven years. A total of 1,926 patients are planned to be enrolled, with recruitment initiated in April 2017. As of June 2018, a total of 236 patients were enrolled. Acknowledgement This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (grant number: HA17C0043010018). Citation Format: Kim H, Park W, Choi DH, Ahn SJ, Kim SS, Kim ES, Lee JH, Lee KC, Kim JH, Lee H-S, Kim JH, Kim MY, Park HJ, Kim K, Song SH, Kwon J, Lee IJ, Kim TH, Kim TG, Chang AR, Cho O, Jeong BK, Ha B, Lee J, Ki Y. A phase 3 study of post-lumpectomy radiotherapy to whole breast + regional lymph nodes vs whole breast alone for patients with pN1 breast cancer treated with taxane-based chemotherapy (KROG 1701): Trial in progress [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT2-04-02.

Introduction Recent cardiopulmonary resuscitation (CPR) guidelines emphasize the importance of high-quality chest compression. The aim of this study is to determine the effect of education using music on the chest compression rate. Methods This randomised, open-labeled study enrolled 81 medical students. They were randomly divided into three groups. After they were educated in CPR according to the American Heart Association 2010 guidelines, they performed 100 chest compressions using a mannequin capable of collecting each compression depth and speed. After that, the control group received a verbal feedback about their own results. The metronome group was also notified of their own results, and listened to the metronome sound at 100 beats per minute (bpm). The music group listened to the music (about 100 bpm). Twenty-four hours after their CPR education, chest compressions were performed again with the method identical to the first evaluation. The results were compared using multivariate analysis of variances. Result Compression rate (bpm): There was a significant difference between the control (mean, 110.4; 95% CI: 104.4, 116.5) and metronome group (mean, 98.5; 95% CI: 91.6, 105.4) after education (p=0.01). There was a significant difference between control and music group (mean, 98.2; 95% CI: 94.6, 101.8) after education (pConclusion Both education method of using music and metronome are more effective than conventional method. However the effect of using music may be better than using metronome.

Autologous disc cell implantation, growth factors and gene therapy appear to be promising therapies for disc regeneration. Unfortunately, the replicative lifespan and growth kinetics of human nucleus pulposus (NP) cells related to host age are unclear. We investigated the potential relations among age, replicative lifespan and growth rate of NP cells, and determined the age range that is suitable for cell-based biological therapies for degenerative disc diseases. We used NP tissues classified by decade into five age groups: 30s, 40s, 50s, 60s and 70s. The mean cumulative population doubling level (PDL) and population doubling rate (PDR) of NP cells were assessed by decade. We also investigated correlations between cumulative PDL and age, and between PDR and age. The mean cumulative PDL and PDR decreased significantly in patients in their 60s. The mean cumulative PDL and PDR in the younger groups (30s, 40s and 50s) were significantly higher than those in the older groups (60s and 70s). There also were significant negative correlations between cumulative PDL and age, and between PDR and age. We found that the replicative lifespan and growth rate of human NP cells decreased with age. The replicative potential of NP cells decreased significantly in patients 60 years old and older. Young individuals less than 60 years old may be suitable candidates for NP cell-based biological therapies for treating degenerative disc diseases.

Background: Recently, chemotherapy with a GnRH agonist was reported to protect against ovarian failure. This study was aimed at determining the oncologic effect of a GnRH agonist concurrent with chemotherapy for breast cancer patients. Patients and Methods: A total of 1189 patients aged 20 to 40 years with stage I to III breast cancer who received (neo or adjuvant) chemotherapy from five hospitals in Korea from 2002 to 2012 were reviewed. A gonadotropin releasing hormone (GnRH) agonist was given to 410 patients for ovarian protection during chemotherapy (GnRH agonist group), and 779 patients received chemotherapy without ovarian protection (Chemotherapy alone group). A matching strategy was used to create matched sets of two groups by age, stage, hormone receptor status, Her2/neu status, neo or adjuvant chemotherapy, and institute. Results: Survival analysis using Cox regression showed that the GnRH agonist group had better distant metastatic-free survival (HR=0.65, 95%CI 0.44-0.97) outcomes but similar disease free survival (HR=0.78, 95% CI 0.57-1.08) compared with the chemotherapy alone group. The survival benefit was significant for hormone receptor positive, Her2/neu negative breast cancer on distant metastasis (HR=0.44, 95% CI 0.20-0.99) and disease free survival (HR0.47 95% CI 0.23-0.93). Conclusion: Ovarian protection using a GnRH agonist can be safely considered for premenopausal breast cancer patients for whom chemotherapy is planned. Citation Format: Kim HJ, Lee MH, Lee JE, Park SH, Lee ES, Kang Y-J, Lee JH, Shin HN, Kim SI, Im SA, Ahn SH, Lee KS, Sohn J, Han W, Nam SJ. The oncologic effect of a gonadotropin releasing hormone (GnRH) agonist for ovarian protection during breast cancer chemotherapy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-12-09.

Background Recently, the balance in immune system between immune surveillance and tolerance is known to be associated with the prognosis of breast cancer patients. The aim of this study was to investigate changes of tumor-infiltrating lymphocytes (TILs) and programmed death-ligand1 (PD-L1) status after neoadjuvant chemotherapy (NAC) and their impact on recurrence in patients with locally advanced breast cancer. Methods Paired samples (before and after NAC) of triple negative or HER2+ breast cancer tissue were obtained from clinical stage II or III patients (n=39) undergoing NAC and subsequent breast resection. The assessment of immunohistochemical (IHC) staining for PD-L1 were performed. Immunostaining of forkhead box P3 (Foxp3) and CD4/CD8 were performed for subtyping of TILs in triple negative breast cancer (TNBC) only. Clinicopathologic data including baseline characteristics, tumor response and recurrence were reviewed. Results Proportion of PD-L1 (+) tumor cells in pre-chemotherapy tissue was 20% (5/25) in HER2+ and 28.6% (4/14) in TNBC. It could not predict pathologic complete response. Most post-chemotherapy tissue (21/24) showed same PD-L1 positivity with pre-chemotherapy tissue. The rest showed the decreased PD-L1 positivity after NAC. In cases of TNBC, the increased number of CD8+ T cells was significantly associated with PD-L1 positivity in pre-chemotherapy tissue. (p=0.001) Foxp3+ T cell proportions decreased significantly (p=0.046) and CD8+/Foxp3+ T-cell ratio increased significantly (p=0.023) after NAC. The patients with increased number of CD8+ T cells after NAC had a tendency to live longer without recurrence compared to patients with decreased CD8+ T cells (62.3 vs 38.1 months, p=0.158). Conclusion Our data provides the clinical evidence that PD-L1 positivity are associated with CD8+ T cell proportion and increased CD8+ T cells after NAC might be good prognostic marker. The role of immunologic balance as a prognostic marker for recurrence must be evaluated in future study. Citation Format: Choi YJ, Lee JH, Moon SY, Choi JY, Jung SP, Bae JW, Park KH. Changes of tumor-infiltrating lymphocytes and programmed death-ligand1 positivity after neoadjuvant chemotherapy in patients with locally advanced breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-04-24.

Background In patients with fine needle aspiration (FNA)-proven axillary lymph node metastasis at diagnosis (cN+), the current standard surgical procedure is axillary lymph node dissection (ALND) at definitive surgery after neoadjuvant chemotherapy (NAC). However, growing evidences suggest that SLNB after NAC is feasible and may demonstrate acceptable performance in selected patients. We performed sentinel lymph node biopsy in patients treated with cytologically-confirmed axillary lymph nodes metastases at presentation, who converted to a clinically negative axillary status after NAC (ycN0). Patients and methods We retrospectively evaluated 240 patients with invasive breast cancer with ultrasound-guided FNA-proven axillary nodal metastases at the time of diagnosis. All patients received NAC and underwent surgery at Samsung medical center between October 2007 and May 2013. Among these patients, 75 patients underwent SLNB. These patients converted to clinically node-negative disease (ycN0) after NAC on breast MRI or PET/CT scan. A combined detection technique was used with radioisotope and blue dye for the detection of SLN. Patients with negative SLN on frozen pathology and low clinical suspicion of metastasis during operation were not performed further ALND. Results The detection rate of SLNB was 93.3% (70/75), and median number of retrieved sentinel lymph nodes was 3.0 (range 1-8). False negative rate was 6.7% (1/15). Of these 75 patients, 35 (46.6%) patients had positive sentinel lymph nodes (ypN+) and underwent ALND. Thirty-five (46.6%) patients had tumor-free sentinel lymph nodes (ypN0sn) and 20 patients of them were followed without subsequent ALND. In these SLN-negative patients without further ALND, 9 patients were HER2-enriched subtypes and 9 patients, TNBC subtypes. Only two of them were Luminal B subtypes. The median follow-up period was 12.0 months (range 0-26 months) with 2 events; 1 regional recurrence in ipsilateral supraclavicular node and 1 systemic recurrence in brain on postoperative 7 months and 5 months, respectively. There has not occurred an ipsilateral axillary recurrence so far. Conclusions Although the follow-up was not long enough to conclude, this study tried to demonstrate that SLNB after NAC was feasible and further ALND may not be necessary in patients with SLN-negative disease (ypN0sn). Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-18-04.

Objective There have been few studies on the use of long-standing hands-only cardiopulmonary resuscitation (CPR) by a lone rescuer. This study aimed to evaluate the long-standing (nine minutes) hands-only CPR by a lone rescuer, and the change of chest compression depth over time. The effect of age of rescuer on chest compression depth was also studied. Methods From a total of 404 adult lay-persons who participated in CPR training, 91 subjects were enrolled in the simulation trial of nine minutes of hands-only CPR using a manikin with a Skill-Reporter™. The quality of the chest compression over time and the effects of rescuer age were analysed. Results Of the 91 participants, 74 (81%) fully completed the nine minutes of CPR. No significant differences of incomplete CPR rate between each age group were observed. No significant differences in the degree of reduction in effective chest compressions were observed based on the time course among the different age groups. The total number of compressions decreased abruptly from the six-minute time point onwards (five minutes vs. six minutes, p=0.038). Conclusions Most trained lay-persons could complete the 9 minutes of hands-only CPR. The rate of chest compression shows a significant decrease after 6 minute. We do not find a significant difference in the decrease of adequate chest compressions over time among various age groups in this pilot simulation study.

This paper investigates strategic and organisational context determinants of the sophistication of adopted sales force automation (SFA) systems in three UK industries: financial services, pharmaceuticals, and building/construction. Sophistication of adopted systems is associated with the organisation placing greater emphasis on information orientation, which is itself driven by an increased integration of IT and sales coupled with increased organisational slack. Increased integration of IT and sales is itself driven by increased strategic importance of sales coupled with increased use of internal communication networks. Importantly, a firm's marketing orientation, although also driven by the strategic importance of sales, has no impact on either information orientation or SFA sophistication. We discuss the implications of our findings to aid understanding of SFA implementation failure.

Background Lymphedema affects over 20% of breast cancer patients undergoing axillary dissection. Axillary reverse mapping (ARM) technique to identify and preserve arm node during sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) was developed to prevent lymphedema. The purpose of this study was to investigate the location and the metastatic rate of the arm node, and finally to evaluate the short term incidence of lymphedema after arm node preserving surgery. Patients and Methods From January 2009 to October 2010, 97 breast cancer patients who underwent ARM were enrolled. 2.5ml blue dye was injected in ipsilateral upper inner arm. After at least 20 minutes after injection, SLNB or ALND was performed in the usual manner and blue stained arm nodes and/or lymphatics were identified. We checked arm circumference at baseline and average of 8.8 months after operation in ALND cases and 13.7 months in SLNB cases. Patients were divided into two groups, arm node preserved group (70 patients in ALND, 10 patients in SLNB) and unpreserved group (13 patients in ALND, 4 patients in SLNB). The difference of arm circumference between preoperative and postoperative was checked in these groups. Results: The mean number of identified blue stained arm nodes was 1.4±0.6. The arm nodes were found in the inferolateral side of axillary and thoracodorsal vessels in 57 patients (58.76%), the inferomedial side in 37 patients (38.14%), the superolateral side in 2 patients (2.06%), and the superomedial side in 1 patient (1.04%). In the majority of patients (92%), arm nodes were located between the lower level of the axillary vein and just below the second intercostal brachial nerve. In arm node unpreserved group, 2 patients had metastasis in their arm node. The one had a common pathway between the arm node and the sentinel lymph node. Another did not have a common pathway, but had extranodal extension with N3 metastasis. Among ALND patients, in arm node preserved group, the difference of arm circumference between preoperative and postoperative in ipsilateral and contralateral arm was 0.27cm and 0.07cm, respectively, whereas 0.47cm and −0.03cm in unpreserved group, and one lymphedema was found after 6 months. No difference was found between arm node preserved and unpreserved group amoung SLNB patients (0.21cm and 0.39cm in in preserved group, 0.2cm and 0.02cm in unpreserved group). Conclusion: Arm node preserving was possible in all breast cancer patients with identifiable arm node, during ALND or SLNB, except for those with high surgical N stage, and lymphedema did not developed in patient with arm node preserving surgery. Metastasis was not found in arm node preserving group in current results, but need to be observed in the ongoing progress. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P3-07-16.

Catalytic cracking of paraffinic naphtha requires higher temperature than that for cracking of olefinic naphtha. In the high temperature catalytic cracking, thermal cracking also occurs simultaneously. The degree of thermal cracking and its contribution to ethylene and propylene yield in the catalytic cracking of paraffinic naphtha are experimentally investigated. As the degree of thermal cracking is high at over 650 °C, both thermal and catalytic cracking mechanisms have to be simultaneously considered in the kinetic model. An approximate approach based on transition state theory is proposed for kinetic modeling of the catalytic cracking of paraffinic naphtha, which has a complex chemical reaction network. The pertinent parameters of the developed kinetic model are estimated by a genetic algorithm. Additionally, an integrated modeling software package is developed with a graphical user interface. The efficacy of the proposed approach is shown with its application to industrial catalytic cracking of paraf...

In this study, the inhibitory activities of one hundred plant extracts were analyzed against the IgE-induced allergy reaction in the rat basophilic leukemia (RBL-2H3) cells. Release of IL-4 and beta-hexosaminidase from the IgE-sensitized RBL-2H3 cells treated with the plant extracts were measured. Additionally, the effects of the plant extracts on the cell viability were tested. From the analysis, 17 extracts including Rhamnus davurica Pall. (branch) significantly inhibited beta-hexosaminidase release at 20 µg/mL. And 41 plants such as Artemisia absinthium (leaf and stem) showed high suppressive activities on IL-4 release. All of the extracts proliferated the sensitized cells above 80% compared with control, which was not treated with plant extract samples but treated only with the buffer used for sample preparation. In conclusion, the result suggests that the plants with the inhibitory activities on allergy reaction at cell level are candidates for developing useful anti-allergy materials and need to be study more.

TRPA1 is a cation channel of the transient receptor potential channel family that is predominantly expressed in sensory C-fibers and activated by a wide variety of environmental irritants and endogenous inflammatory mediators relevant for asthma. Activation increases [Ca2+]i, induces inward currents and action potential discharge in lung-innervating C-fibers in vitro and elicits central reflexes in vivo. However, it remained unclear if TRPA1-dependent central reflex activity is associated with changes in lung function. To examine our hypothesis that TRPA1 activation in C-fibers induces bronchoconstriction, we performed head-out-bodyplethysmography in conscious mice and measured the midexpiratory tidal flow (EF50) during inhalation of increasing concentrations of cinnamaldehyde (CA), a TRPA1 agonist. Unexpectedly, CA induced a dose-dependent increase of EF50, characteristic for bronchodilation. Organ bath experiments on explanted, preconstricted tracheal rings to elucidate the nature of bronchodilation revealed that the CA effect was independent from central reflexes and could be mimicked by a variety of electrophilic and non-electrophilic TRPA1 agonists, including arcrolein, AITC, 2-APB, thymol and carvacrol. Surprisingly, the bronchodilatory effect of CA was increased by pre-treatment with TRPA1-antagonists (HC-030031, AP-18, Ruthenium-Red) as well as in tracheas of TRPA1-KO mice, indicating that CA causes a TRPA1-mediated bronchoconstriction which is superimposed by a TRPA1-independent bronchodilation. Since a 5-day organotypic culture of the tracheas was associated with an increased bronchodilation, we conclude that the TRPA1-dependent bronchoconstriction involves sensory neurons. However, the nature of the TRPA1-independent bronchodilation remains unclear since RP-67580, iberiotoxin, indomethacin, tetrodotoxin, propranolol, No-nitro-L-arginine and triphenylphosphine-oxide were ineffective. We conclude that activation of TRPA1 in C-fibers induces bronchoconstriction superimposed by a bronchodilatory effect of unknown etiology.

In this paper, we propose a new method to make a nanotweezer composed of two carbon nanotube (CNT) arms. We fabricated the CNT arm by attaching a multi-wall carbon nanotube on a tungsten-tip via manual assembly. The closing actuation of the nanotweezer is simulated and the simulation is compared with experimental results. Since each CNT arm has a macro actuator, namely a separated tweezer arm, it is possible to close and open the nanotweezer repeatedly. Electrochemical etching is used to cut the carbon nanotube in the CNT arm and the cutting resolution is approximately a few hundred nanometers.

Migration in Asia is dynamic and complex especially intraregional movement of people. The volume of migration flows in the region has dramatically increased over the decades in terms of the overall number of migrants hosted by East Asian countries. The increase is alarming because some 30 to 40 per cent of total migration takes place through unregulated channels. It is unknown how much of this migration flow is human trafficking. However various studies and continuous media reports suggest that human trafficking is widespread throughout the region and on the rise. Trafficking in persons in East Asia has not been widely studied. This is rather curious because Japan for example has a large sex industry employing a significant number of non-Japanese women. As I will discuss later there are many challenges in conducting research on human trafficking in the region. As a result literature on the subject including research-based publications is rather limited particularly in comparison with the number of publications on trafficking in South-East and South Asia. Instead media reports and the United Nations (UN) and other agencies. intervention-oriented studies dominate the literature on East Asian trafficking. Such studies tend to focus on trafficking in women and children for sexual exploitation and highlight serious violations of human rights. Even though these studies are not empirically based and do not present survey results they still improve the understanding of the trafficking processes their underlying causes and impacts on the trafficked persons. (excerpt)

Backgrounds; p53 is a tumor suppressor gene that plays an important role in cell cycle control and apoptosis. In the breast cancer, mutant tumor protein (TP53) is expressed in approximately 30% and patients with mutant TP53 often tend to have poor response to chemotherapy and poor prognosis than those with normal TP53. But, according to a recent study, TP53 inactivation could cause to significant DNA damage and to eventual cell death by mitotic catastrophe. We investigated the expression frequency and prognostic value of mutant TP53 using tissue microarrays of 898 invasive breast cancers. Patients and methods; From January 1995 to December 2005 at Yeungnam university hospital, patients who diagnosed with the primary invasive breast cancer and received operation were included in this study. Patients with bilateral breast cancer or distant metastasis at the time of diagnosis were excluded. According to the immunohistochemical results of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), Ki67, epidermal growth factor (EGFR) and cytokeratin (CK) 5/6, we classified patients into 6 subgroups, luminal A, luminal B1, B2, HER2-enriched, normal breast-like (triple negative nonbasal) and basal-like breast cancers. Immunohistochemical staining for TP53 was performed and we defined more than 10% stain of tumor cell as mutant TP53-positive. Distribution and prognostic significance of mutant TP53 in each subgroup was investigated. Results; In 898 invasive breast cancers, mutant TP53 was identified in 33.5% (301/898). Each expression frequency of mutant TP53 was 10.9% (42/385) in luminal A, 32.1% (45/140) in luminal B1, 50.0% (34/68) in luminal B2, 63.7% (72/113) in HER2-enriched, 54.7% (35/64) in normal breast-like and 57.0% (73/128) in basal-like subtype, respectively. In whole breast cancer patients, patients with mutant TP53 tended to have poor overall survival (OS) and disease free survival (DFS). However, there was no statistical significance (p = 0.187 and p = 0.651). But, in 128 patients with basal-like breast cancer, mutant TP53 showed good prognosis in both OS and DFS (p = 0.003 and p = 0.021). In basal-like breast cancer, the expression of mutant TP53 had no association with other clinicopathologic factors such as tumor size, lymph node metastasis, histological grade, lymphovascular invasion etc. and 98.4% (126/128) patients received adjuvant chemotherapy. In multivariate anaylsis, expression of mutant TP53 was an independent prognostic factor for OS and DFS in basal-like breast cancers (p = 0.008 and p = 0.012). Conclusions: This study showed that basal-like breast cancer with mutant TP53 has a good outcome in both OS and DFS. Further studies are needed to identify the action mechanism of mutant TP53. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-07-07.

Acanthopanax senticosus is a traditional herb in China, Russia and many other Asian countries. However no comprehensive study has evaluated its side effects in humans. We report a rare case of hypokalaemic paralysis possibly attributed to A. senticosus induced pseudohyperaldosteronism.

Purpose To report interim results of Stargardt macular dystrophy(SMD) patients who underwent human embryonic stem cell derived retinal pigment epithelial cells(hES-RPE) transplantation. Methods hESC-RPE cells were manufactured in a fully validated good-manufacturing-practice facility. Total pars plana vitrectomy with induction of posterior vitreous detachment was performed in the eyes with the worst vision. A volume of 150µL of RPE reconstituted in BSS Plus with the target dose of 50000 RPE cells was injected into the subretinal space. Immunosuppression was started at lower dosages of tacrolimus and mycophenolate mofetil. Ophthalmologic examinations; ETDRS visual acuity(VA), visual field examination(VF), fluorescein angiography, spectral-domain OCT, and electroretinography were performed. Results A 45-year-old male SMD patient with initial VA of 1 letter(Counting fingers) had improved to 13 letters(20/640) and smaller central scotoma observed on goldman VF at 52 weeks. A 40-year-old male SMD patient with initial VA of 13 letters(20/640) improved to 30 letters(20/200) at 26 weeks. Subretinal pigmentations with multiple increased autofluorescence spots were noted. A 40-year-old male SMD patient with initial VA of 41 letters(20/160) has stable VA of 41 letters(20/160) at 4 weeks. Subretinal pigmentations around injection site were noted at 4 weeks. Conclusion Two of three SMD patients who received the target dose and relevant immunosuppression showed gradual improvements of visual acuity only in the study eye. No serious systemic or ocular adverse events occurred. Longer follow up and further randomized studies with a control group are needed to determine the safety, tolerability, efficacy.

A beam rotation actuator, which can be utilized to improve the data transfer rate for optical disk systems, has been developed. The newly developed beam rotation actuator with high-resolution and fast response was assembled for micro positioning of an optical storage media. The beam rotation actuator is utilized to put multi-beam spots on more than one track on an optical disk simultaneously in addition to tracing multi-beam spots on tracks in a radial direction. Multi-beam spots turn on an optical axis by rotating dove prism in the optical path at the end of a cantilever arm. The beam rotation actuator is made of bimorph peizoelectric material. The dove prism is responsible for both high-resolution movement as well as multi-beam spot rotation. The dynamic equation of the beam rotation actuator is derived theoretically. The actuator is designed on the grounds of an analytical equation. It is shown that the beam rotation actuator has a natural frequency of 54 Hz or more, and the actuator has high-resolution. The application performance of the beam rotation actuator is verified as the feedback control is applied.

Cholesterol granuloma is an inflammatory reaction to cholesterol crystals deposition. It may develop in a variety of sites including the middle ear, mastoid process or even paranasal sinuses. Very few cases of cholesterol granuloma occurring in the jaws were reported. This report presents a rare case of cholesterol granuloma that developed in the wall of a large mandibular dentigerous cyst. The condition was treated with hemimandibulectomy followed by reconstruction with a free fibular flap.

The effect of current, its magnitude and penetration enhancers (propylene glycol/oleic acid) on the transdermal flux of AZT (Zidovudine) across hairless mouse skin was studied and the results were compared. The in vitro iontophoretic flux from AZT solution increased to about 5-40 fold that obtained by passive diffusion, depending on the magnitude of current density. When the donor side was karaya gum matrix, instead of solution, the flux enhancement effect by iontophoresis was much smaller. Incorporation of penetration enhancers into the matrix increased the passive flux 2-50 fold, depending on the amount of penetration enhancers in the matrix. These enhancers worked synergistically with iontophoresis in the transdermal transport: a much larger flux than that expected from a simple additive effect was observed. Electrical resistance data from our previous work is utilized to further discuss this synergistic effect.

We demonstrate ratchet soliton propagation in individual patterned antiferromagnetically coupled superlattice elements down to 3 μm diameter using magneto-optical Kerr effect measurements. The bulk switching and soliton propagation fields are investigated as a function of the element size. It is found that on the length scale investigated here we do not see significant variation in ratchet behavior depending on the element size. The margin for soliton propagation and additional features related to downscaling are discussed.

In living donor kidney transplantation (LDKT), we evaluated if there was any difference in grafted kidney function according to the type of anesthetic used in the donor because some laboratory studies have demonstrated that volatile anesthetics at clinically relevant concentrations protect the kidneys against renal ischemia-reperfusion injury.In part I of the study, we retrospectively compared grafted kidney function [serum creatinine levels (Cr) and estimated glomerular filtration rates (eGFR) in recipients of LDKT] according to the type of donors' volatile anesthetic (sevoflurane [group Sevo, 166 patients], isoflurane [group Iso, 55] or desflurane [group Des, 61]). In part II, we prospectively compared grafted kidney function and neutrophil gelatinase-associated lipocalin (NGAL) levels in the serum and urine of recipients according to the anesthetic used in the donor (desflurane [group Des, N.=50] vs. propofol [group Pro, N.=50]).In part I, the eGFR of the Des group was greater than that of the Sevo or Iso groups (P=0.017) until POD 7. However, in part II, there were no significant changes in Cr and eGFR by POD 7, no differences in the levels of NGAL in the serum and urine on POD 1 and 2, or in Cr and eGFR on the day of discharge between the Des and Pro groups.The inhalational anesthetic administered to donors does not improve grafted kidney function in recipients undergoing LDKT to a greater extent than propofol.

Serum chitinase-like proteins such as YKL-40 in asthmatic patients are known to positively correlate with disease severity but controversy remains regarding their role. The allergen bronchial provocation test (ABPT) can induce allergic airway inflammation in individuals with atopic asthma.To evaluate the induction and kinetics of YKL-40 during allergen-induced airway inflammation in atopic asthmatics.Thirteen patients were enrolled from May to November 2008. They all underwent ABPT with Dermatophagoides farinae crude extract. Induced sputums (IS) and serum were collected 3 times: 7 days before ABPT (baseline), 7 hours after ABPT, and 24 hours after ABPT. We examined the cytology of induced sputum (IS) and measured levels of YKL-40, interleukin (IL) 4, IL-5, IL-13, IL-33, tumor necrosis factor (TNF) alpha, and eosinophilic cationic protein (ECP) in IS and/or serum.Following ABPT, total inflammatory cells, eosinophils, and neutrophils increased in a time-dependent manner in IS. YKL-40 levels were increased in IS but not in serum at 7 or 24 hours after ABPT (P=.011 and P=.006, respectively). Similarly to YKL-40, IL-5 and ECP levels were also increased in IS at 7 and 24 hours after ABPT (P=.011 for IL-5 and P=.006 for ECP). Overall, YKL-40 levels were well correlated with ECP levels in IS (p=0.576, P.001).YKL-40 levels increased immediately in IS but not in the serum of atopic asthmatics. The correlation between YKL-40 levels and ECP in IS suggests that YKL-40 may play a pathophysiologic role in human atopic asthma.

In the time optimal control problem, it is important to select a switching point accurately in order to improve tracking speed performance. However, the accurate selection of the switching point is not an easy task because of the damping coefficient variations and modeling uncertainties in actual systems. To relieve the difficulty and inconvenience of this task, adaptive model-following control (AMFC) is implemented. AMFC can make the controlled plant follow as closely as possible a desired reference model whose switching point can be calculated easily and accurately, assuring that the error between the reference model and the real system approaches zero. The AMFC is applied for a tracking actuator of a magneto-optical disk drive (MODD) to improve its slow tracking performance. According to the simulation and experimental results, an average tracking time as small as 20 ms is obtained for a 3.5 in. magneto-optical disk drive.

A coarse/fine pair control system is suggested to relieve the difficulty of obtaining high accuracy over a large movement. A coarse actuator which is capable of high force in a large working range is developed using electromagnetic principle. A fine actuator having a high accuracy is introduced using a piezoeletric material. The coarse/fine actuator pair system is applied to magneto-optical (MO) disk drives to enhance the system's performance in terms of speed and accuracy.

Potassium depletion (K⁺-D) induces hypertrophy and hyperplasia of collecting duct cells, and potassium repletion (K⁺-R) induces regression of these changes. The purpose of this study was to examine the time courses of the changes in cellular composition, the origin of intercalated cells (ICs) and the mechanism responsible for these changes. SD rats received K⁺-depleted diets for 1, 7, or 14 days. After K⁺-D for 14 days some of the rats received normal diets for 1, 3, 5, or 7 days. In the inner stripe of the outer medulla, K⁺-D increased significantly the number and proportion of H⁺-ATPase-positive ICs, but decreased the proportion of H⁺-ATPase-negative principal cells (PCs). However, proliferation was limited to H⁺-ATPase-negative PCs. During K⁺-R, the cellular composition was recovered to control level. Apoptosis increased during K⁺-R and exclusively limited in H⁺-ATPase-negative PCs. Double immunolabeling with antibodies to PC and IC markers identified both cells negative or positive for all markers during both K⁺-D and K⁺-R. Electron microscopic observation showed that ultrastructure of AE1-positive some cells were similar to AE1-negative some cells during K⁺-R. LC3 protein expression increased significantly and autophagic vacuoles appeared particularly in PCs on days 14 of K⁺-D and in ICs on days 3 of K⁺-R. These results suggest that PCs and ICs may interconvert in response to changes in dietary K+ availability and that autophagic pathways may be involved in the interconversion.