A Hybrid Approach to Industrial Augmented Reality Using Deep Learning-Based Facility Segmentation and Depth Prediction.

Typical AR methods have generic problems such as visual mismatching, incorrect occlusions, and limited augmentation due to the inability to estimate depth from AR images and attaching the AR markers onto physical objects, which prevents the industrial worker from conducting manufacturing tasks effectively. This paper proposes a hybrid approach to industrial AR for complementing existing AR methods using deep learning-based facility segmentation and depth prediction without AR markers and a depth camera. First, the outlines of physical objects are extracted by applying a deep learning-based instance segmentation method to the RGB image acquired from the AR camera. Simultaneously, a depth prediction method is applied to the AR image to estimate the depth map as a 3D point cloud for the detected object. Based on the segmented 3D point cloud data, 3D spatial relationships among the physical objects are calculated, which can assist in solving the visual mismatch and occlusion problems properly. In addition, it can deal with a dynamically operating or a moving facility, such as a robot-the conventional AR cannot do so. For these reasons, the proposed approach can be utilized as a hybrid or complementing function to existing AR methods, since it can be activated whenever the industrial worker requires handing of visual mismatches or occlusions. Quantitative and qualitative analyses verify the advantage of the proposed approach compared with existing AR methods. Some case studies also prove that the proposed method can be applied not only to manufacturing but also to other fields. These studies confirm the scalability, effectiveness, and originality of this proposed approach.

Comparison of outcomes after topography-modified refraction versus wavefront-optimized versus manifest topography-guided LASIK.

BACKGROUND: To compare the outcomes of myopia and myopic astigmatism corrected with topography-modified refraction laser in situ keratomileusis (TMR-LASIK), wavefront-optimized (WFO) LASIK, and topography-guided (TG) LASIK with a correction target based on the manifest refraction (manifest TG-LASIK). METHODS: This observational, retrospective cohort study included patients who underwent LASIK using the WaveLight® EX500 excimer laser to correct myopia and myopic astigmatism between August 2016 and July 2017. Patients who underwent TMR-LASIK (85 patients), WFO-LASIK (70 patients), or manifest TG-LASIK (40 patients) were enrolled, and only one eye from each patient was analyzed. All participants underwent measurement of the uncorrected distance visual acuity (UDVA), best-corrected distance visual acuity (BCVA), manifest refraction, vector analysis of astigmatic change, corneal topography, and corneal wavefront analysis at baseline and at every posttreatment visit. RESULTS: Three months postoperatively, a UDVA of 0.0 logMAR or better and manifest refraction spherical equivalent (MRSE) within ±0.5 diopters (D) did not differ across the TMR-, WFO-, and manifest TG-LASIK groups. However, the residual cylinder in the TMR group was significantly larger than that in the WFO and manifest TG groups. The magnitude of error in the TMR group measured using astigmatism vector analysis was significantly higher than that in the WFO and manifest TG groups. CONCLUSIONS: Although these three LASIK platforms achieved the predicted surgical outcomes, TMR-LASIK overcorrected astigmatism and showed a higher residual postoperative astigmatism compared with WFO- and manifest TG-LASIK.

Percutaneous full endoscopic treatment of cystic lymphangioma of cauda equina: a case report.

Intraspinal epidural lymphangioma of cauda equina are extremely rare, only three cases have been reported in the past. We report a 63-year-old female with lymphangioma at S1-S2 level which was resected under epidural anesthesia using a percutaneous full endoscope with no evidence of recurrence at 19 months follow-up.

Inadequate Bowel Cleansing Efficacy of Split-dose Polyethylene Glycol for Colonoscopy in Type 2 Diabetic Patients: A Prospective and Blinded Study.

BACKGROUND/AIMS: Split-dose polyethylene glycol (PEG) is considered a standard bowel preparation regimen for colonoscopy in the general population. However, it is not clear whether the regimen is optimal for colonoscopy in diabetic patients. The aim of this study was to compare the efficacy and tolerability of split-dose PEG for diabetic versus nondiabetic patients. METHODS: This is a single-center, prospective, investigator-blinded study. A total of 55 consecutive nondiabetic and 50 diabetic patients ingested 2 L PEG solution on the day before the procedure and then 2 L of the solution on the day of colonoscopy. The quality of bowel preparation was graded using the Ottawa scale. RESULTS: There was a significant difference in bowel preparation quality, with a worse preparation except for mid colon in diabetic group (total score: 7.06±1.69 vs. 5.54±1.97, P<0.001; right colon: 2.28±0.57 vs. 1.81±0.72, P<0.001; mid colon: 1.70±0.54 vs. 1.56±0.66, P=0.253; rectosigmoid colon: 1.70±0.76 vs. 1.14±0.62, P<0.001; fluid volume: 1.38±0.53 vs. 1.01±0.59, P=0.001). About 70% of nondiabetic patients had an adequate preparation compared with only 40% of diabetic patients (P=0.003). Diabetic group had longer cecal intubation time (6.4±3.6 vs. 4.5±2.4, P=0.002) and total procedure time (22.1±7.6 vs. 18.1±8.5, P=0.015). Compliance and adverse events were not significantly different. In diabetic group, inadequate bowel preparation had a significant association with higher fasting plasma glucose (136.9±21.8 vs. 121.8±19.4 mg/dL, P=0.016). CONCLUSIONS: Diabetic patients had a worse preparation quality and longer cecal intubation and total procedure time compared with nondiabetic patients. These data suggest that split-dose PEG preparation regimen is not sufficient for optimal bowel preparation in diabetic patients undergoing colonoscopy.

New class of scorpionate: tris(tetrazolyl)-iron complex and its different coordination modes for alkali metal ions.

We report formation of a new metallascorpionate ligand, [FeL3](3-) (IPtz), containing a Fe core and three 5-(2-hydroxyphenyl)-1H-tetrazole (LH2) ligands. It features two different binding sites, oxygen and nitrogen triangles, which consist of three oxygen or nitrogen donors from tetrazole. The binding affinities of the complex for three alkali metal ions were studied using UV spectrophotometry titrations. All three alkali metal ions show high affinities and binding constants (>3 × 10(6) M(-1)), based on the 1:1 binding isotherms to IPtz. The coordination modes of the alkali metals and IPtz in the solid were studied using X-ray crystallography; two different electron-donor sites show different coordination numbers for Li(+), Na(+), and K(+) ions. The oxygen triangles have the κ(2) coordination mode with Li(+) and κ(3) coordination mode with Na(+) and K(+) ions, whereas the nitrogen triangles show κ(3) coordination with K(+) only. The different binding affinities of IPtz in the solid were manipulated using multiple metal precursors. A Fe-K-Zn trimetallic complex was constructed by assembly of an IPtz ligand, K, and Zn precursors and characterized using X-ray crystallography. Oxygen donors are coordinated with the K ion via the κ(3) coordination mode, and nitrogen donors are coordinated with Zn metal by κ(3) coordination. The solid-state structure was confirmed to be a honeycomb coordination polymer with a one-dimensional infinite metallic array, i.e., -(K-K-Fe-Zn-Fe-K)n-.

Comparison of Outcomes after Wavefront-optimized and Topography-guided Transepithelial Photorefractive Keratectomy.

Purpose: To evaluate the outcomes of wavefront-optimized (WFO) and topography-guided (TG) transepithelial photorefractive keratectomy (transPRK) in the treatment of myopia and myopic astigmatism. Methods: Patients who underwent transPRK using the WaveLight® EX500 excimer laser for the correction of myopia and myopic astigmatism between January 2022 and March 2023 were divided into the WFO transPRK (77 eyes of 36 patients) or TG transPRK (63 eyes of 31 patients) groups in this retrospective, observational cohort study. The pre- and postoperative 3-month refractive and visual outcomes of the two groups were analyzed. Results: The uncorrected distance visual acuity was 0.0 logMAR or better in 95% of eyes 3 months postoperatively, and the mean manifest refraction spherical equivalent was within ± 1.0 diopter (D) in 90% of eyes. No significant differences were observed between the groups in terms of the UDVA or astigmatism. A significant induction of higher-order aberrations (HOAs) was observed in both groups. However, the induction of total corneal HOAs (P = .014) and spherical aberrations (P = .000) was significantly lower in the TG group than that in the WFO group. Conclusions: WFO and TG transPRK effectively improved the visual and refractive outcomes; however, the induction of total corneal HOAs and spherical aberration was lesser following the TG ablation.

Clinical Outcomes after Bilateral Implantation of a Wavefront-Shaping Extended Depth of Focus (EDOF) IOL with Mini-Monovision.

Background: To compare the visual outcomes and optical quality of patients who underwent bilateral implantation of EDOF (AcrySof® IQ Vivity IOL, DFT015) for mini-monovision, trifocal (AcrySof® IQ PanOptix, TNFT00), or monofocal (AcrySof® IQ IOL, SN60WF) IOL. Methods: The monocular-corrected and uncorrected distance visual acuities (CDVA and UDVA, respectively) were evaluated postoperatively at 1 and 3 months. The binocular visual acuity by distance, the binocular defocus curve, contrast sensitivity, and patient satisfaction were examined 3 months postoperatively. All patients were asked to complete questionnaires regarding their satisfaction, visual symptoms, and spectacle dependency. Results: This study included 178 eyes from 89 patients. The postoperative binocular UDVA did not differ significantly among the three groups. In the defocus curve, the Vivity group showed better visual acuity over a range of far and intermediate (60 cm) than the other two IOLs groups. In near-vision, the PanOptix group showed the best near-vision, and the Vivity group showed significantly better vision than the IQ group. The Vivity group showed contrast sensitivity and optical quality comparable to the IQ group. Conclusions: The bilateral implantation of AcrySof® IQ Vivity IOL with the mini-monovision approach provided excellent distance and intermediate visual acuity with good near-vision, resulting in high satisfaction.

Limitations of and Solutions to Using 6 mm Corneal Spherical Aberration and Q Value after Laser Refractive Surgery.

This study aimed to evaluate the spherical aberration (SA) in different corneal areas before and after femtosecond laser-assisted in situ keratomileusis (fLASIK) and transepithelial photorefractive keratectomy (tPRK), with the goal of identifying the limitations of and potential improvements in using SA within a 6 mm area. The study included 62 patients who underwent fLASIK and tPRK. Complete eye examinations including keratometry, corneal epithelial thickness, central corneal thickness, and topography were performed preoperatively and postoperatively. Anterior, posterior, and total corneal aberrations were measured preoperatively and three months postoperatively, with pupil diameters ranging from 2 to 8 mm. In the fLASIK group, compared to the preoperative SA, the anterior and total SA increased postoperatively in the 6 and 7 mm areas. In the tPRK group, meanwhile, the anterior and total SA of the 5 mm or larger areas increased postoperatively. An area of 6 mm or larger showed an increase in correlation with the changes in Q value and refractive correction. As the corneal SA and asphericity in the 6 mm zone cannot specifically demonstrate the status of areas smaller than 6 mm or changes in the optical zone after laser refractive surgery, comparison with normal values in various areas of the cornea is necessary.

Targeted inhibition of phosphatidyl inositol-3-kinase p110ß, but not p110α, enhances apoptosis and sensitivity to paclitaxel in chemoresistant ovarian cancers.

The phosphatidylinositol 3-kinase (PI3K) pathway is one of the critical signaling cascades playing important roles in the chemoresistance of human cancer cells, including ovarian cancer. In this study, we investigated the potential of targeting the PI3K p110ß-isoform as a novel approach to overcome the chemoresistance in ovarian cancer. The effects on apoptosis, cell viability, proliferation and migration in chemoresistant ovarian cancer cell were determined following targeted p110ß inhibition by small interfering RNA (siRNA). Seven paclitaxel (PTX)-resistant sublines (SKpacs and A2780pac) were produced from SKOV3 and A2780 ovarian cancer cell lines. We, first, evaluated the expression of PI3K p110 isoforms in chemosensitive and chemoresistant ovarian cancer cell lines and patient specimens, and found that p110ß-isoform was significantly overexpressed both in a panel of ovarian cancer samples, and in PTX-resistant sublines compared with their parent cell lines. RNA interference-mediated p110ß silencing augmented PTX-mediated apoptosis (31.15 ± 13.88 %) and reduced cell viability (67 %) in PTX-resistant cells, whereas targeting p110α did not show a significant change in cell viability and apoptosis. In addition, p110ß silencing impaired cell proliferation (60 %) in PTX-resistant SKpac cells. We also found the combined treatment group with p110ß siRNA and PTX showed a significant inhibition of tumor growth of SKpac cells compared to the PTX-only treated group in a xenograft nude mouse model. Thus, the siRNA-mediated silencing of PI3K p110ß resensitizes PTX-resistant ovarian cancer cells, and may be a useful therapeutic strategy for PTX-resistant ovarian cancers.

Clinical analysis of recurrent sudden sensorineural hearing loss.

OBJECTIVE: Although the literature includes many reports of the causes, pathogenesis, diagnostic criteria, treatment, and prognostic factors of sudden sensorineural hearing loss (SSNHL), few studies have examined recurrent SSNHL. This prompted us to investigate recurrent SSNHL. STUDY DESIGN: Retrospective study of the hearing results of patients with recurrent SSNHL. METHODOLOGY: We reviewed retrospectively the medical charts of 809 patients with SSNHL examined between January 2000 and June 2011 for information on their history, audiometric results, and magnetic resonance imaging findings. RESULTS: Eleven of the 809 patients had recurrent idiopathic SSNHL. In these 11 patients, the more than partial recovery of hearing after the second attack was poorer than after the first attack, and the second attack of SSNHL was ipsilateral in 10 of the 11 patients. CONCLUSION: The hearing outcome was poorer after a recurrent episode than after the first episode, and SSNHL almost always recurs in the same ear.

Correlation between preoperative biometry and posterior chamber phakic Visian Implantable Collamer Lens vaulting.

OBJECTIVE: To evaluate (1) the effect of preoperative biometric factors on vault error and (2) the difference in achieved vault (AV) and expected vault (EV) after Visian Implantable Collamer Lens (ICL) implantation. DESIGN: Retrospective, comparative, interventional case series. PARTICIPANTS: A total of 129 eyes of 75 myopic patients treated with ICL. METHODS: On the basis of the hypothesis that ICL vaulting is due mainly to an inequality between ICL size and the horizontal sulcus-to-sulcus distance (STS) or horizontal white-to-white distance (WTW), we assumed that EV would linearly correlate with ICL horizontal compression, as demonstrated in an ex vivo experiment. Expected vault was defined as follows: EV(WTW[or STS]) = (ICL size - WTW[or STS]) × 1100 µm. With the use of preoperative data as independent variables (including age, anterior chamber depth measured from the central corneal endothelium to the anterior lens capsule, STS, WTW, ICL size, ICL size - STS, ICL size - WTW, STS - WTW, ICL diopter, and mean K-reading), a multiple regression analysis was performed to evaluate meaningful factors affecting AV. MAIN OUTCOME MEASURES: Preoperative ICL EV and postoperative ICL AV. RESULTS: Mean AV was 518.6 (standard deviation [SD] 258.4 µm). The EV(WTW) was 626.6 (SD 220.9 µm), and EV was 242.8 (SD 364.2 µm). Higher ICL compression tended to result in a lower AV than EV, whereas lower ICL compression tended to result in a higher AV than EV. The ICL size - STS was more highly correlated with AV than the ICL size - WTW (Pearson correlation coefficient 0.425 vs. 0.247). Stepwise multivariate regression showed that, in order of the strength of the contribution, ICL size - STS, ICL size, age, and K-reading were significant factors associated with AV (adjusted R(2)=0.369), but ICL size - WTW was not. Among the meaningful factors, ICL size - STS, ICL size, and K-reading were positively correlated with AV, whereas age was negatively correlated. CONCLUSIONS: The ICL vaulting based on only the horizontal compression could not be quantitatively predicted. Additional factors, such as vertical compression by the iris, dampening effect of the ciliary sulcus structure, or innate ICL vault, should be considered to avoid unexpected vaulting after ICL implantation.

Innovative in vitro chemo-hormonal drug therapy for refractory thyroid carcinomas.

More than 95% of the thyroid carcinomas are well differentiated types showing favorable prognosis. However, only a few therapeutic options are available to treat the patients with undifferentiated thyroid carcinomas, especially with refractory thyroid carcinomas that are not amenable to surgery or radioiodine ablation. We investigated the anticancer effects of 20 chemotherapy and hormonal therapy drugs on 8 thyroid carcinoma cell lines. In vitro chemosensitivity was tested using the adenosine-triphosphate-based chemotherapy response assay (ATP-CRA). The tumor inhibition rate (TIR; or cell death rate) or half maximal inhibitory concentration (IC(50)) was analyzed to interpret the results. Of the 12 chemotherapy drugs, etoposide (178.9 index value in follicular carcinoma cell line) and vincristine (211.7 in Hürthle cell carcinoma cell line) were the most active drugs showing the highest chemosensitivity, and of the 8 additional drugs, trichostatin A (0.03 µg/mL IC(50) in follicular carcinoma cell line) showed favorable outcome having the anticancer effect. In our study, the result of etoposide and vincristine show evidence as active anticancer drugs in thyroid carcinoma cell lines and trichostatin A seems be the next promising drug. These drugs may become an innovative therapy for refractory thyroid carcinomas in near future.

Characterization of Pseudomonas sp. NIBR-H-19, an Antimicrobial Secondary Metabolite Producer Isolated from the Gut of Korean Native Sea Roach, Ligia exotica.

The need to discover new types of antimicrobial agents has grown since the emergence of antibiotic-resistant pathogens that threaten human health. The world's oceans, comprising complex niches of biodiversity, are a promising environment from which to extract new antibiotics-like compounds. In this study, we newly isolated Pseudomonas sp. NIBR-H-19 from the gut of the sea roach Ligia exotica and present both phenotypes and genomic information consisting of 6,184,379 bp in a single chromosome possessing a total of 5,644 protein-coding genes. Genomic analysis of the isolated species revealed that numerous genes involved in antimicrobial secondary metabolites are predicted throughout the whole genome. Moreover, our analysis showed that among twenty-five pathogenic bacteria, the growth of three pathogens, including Staphylococcus aureus, Streptococcus hominis and Rhodococcus equi, was significantly inhibited by the culture of Pseudomonas sp. NIBR-H-19. The characterization of marine microorganisms with biochemical assays and genomics tools will help uncover the biosynthesis and action mechanism of antimicrobial metabolites for development as antagonistic probiotics against fish pathogens in an aquatic culture system.

Latex-Based Polystyrene Nanocomposites with Non-Covalently Modified Carbon Nanotubes.

We prepared electrically conductive polystyrene (PS) nanocomposites by incorporating non-covalently surface-modified carbon nanotubes (CNTs) with hydrophilic polymers such as polydopamine (PDA) and poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS). Further, ethylene glycol (EG) was introduced as a second dopant to improve the electrical properties of the nanocomposites prepared with PEDOT:PSS-wrapped CNTs. All conductive PS nanocomposites were prepared through latex-based process, and the morphology and properties of the nanocomposites were investigated. The electrical properties of the nanocomposites with PEDOT:PSS-wrapped CNTs were better than those of the nanocomposites with PDA-coated CNTs owing to the conducting nature of PEDOT:PSS, although the dispersions of both types of modified CNTs in the PS matrix were excellent, as evidenced by morphology and rheology. In the case of PEDOT:PSS modification, the electrical properties of the nanocomposites with EG-doped PEDOT:PSS-wrapped CNTs were superior to those of the nanocomposites without EG treatment.

Individualized tumor response testing for prediction of response to Paclitaxel and Cisplatin chemotherapy in patients with advanced gastric cancer.

The purpose of our study was to determine the most accurate analytic method to define in vitro chemosensitivity, using clinical response as reference standard in prospective clinical trial, and to assess accuracy of adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Forty-eight patients with chemo-naïve, histologically confirmed, locally advanced or metastatic gastric cancer were enrolled for the study and were treated with combination chemotherapy of paclitaxel 175 mg/m(2) and cisplatin 75 mg/m(2) for maximum of six cycles after obtaining specimen for ATP-CRA. We performed the receiver operator characteristic curve analysis using patient responses by WHO criteria and ATP-CRA results to define the method with the highest accuracy. Median progression free survival was 4.2 months (95% confidence interval [CI]: 3.4-5.0) and median overall survival was 11.8 months (95% CI: 9.7-13.8) for all enrolled patients. Chemosensitivity index method yielded highest accuracy of 77.8% by ROC curve analysis, and the specificity, sensitivity, positive and negative predictive values were 95.7%, 46.2%, 85.7%, and 75.9%. In vitro chemosensitive group showed higher response rate (85.7% vs. 24.1%) (P=0.005) compared to chemoresistant group. ATP-CRA could predict clinical response to paclitaxel and cisplatin chemotherapy with high accuracy in advanced gastric cancer patients. Our study supports the use of ATP-CRA in further validation studies.

Clinical outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis after multifocal intraocular lens implantation.

This retrospective study is to evaluate refractive and visual outcomes of topography-guided femtosecond laser-assisted in situ keratomileusis (TGL) for correcting corneal high-order aberrations (HoA) after multifocal intraocular lens (mIOL) implantation. Twenty-eight eyes of 28 patients with both corrected distance visual acuity (CDVA) under 20/25 and subjective visual discomfort at 3 months after mIOL implantation were included in the study. TGL was performed to correct corneal HoA. Visual acuity, manifest refraction, and corneal HoA were measured 3 months after TGL. CDVA was improved in 22 (78.57%) of 28 eyes after TGL. Uncorrected distance visual acuity (0.12 ± 0.16 logMAR) and uncorrected near visual acuity (0.081 ± 0.16 logMAR) were better than those before TGL (P < 0.001). Residual refractive astigmatism showed no difference compared to that before TGL. Root mean square (RMS) of HoA (P = 0.012), spherical aberration (P = 0.013), and RMS of coma (P = 0.001) were reduced relative to those before TGL. Amount of improvement in CDVA was correlated with amount of reduced coma RMS (R = 0.524; P = 0.005) and spherical aberration (R = 0.443; P = 0.021). TGL showed to improve both refractive and visual outcomes in patients with mIOL implantation by correcting corneal HoA.

Topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia: Surgical outcomes.

PURPOSE: To compare the outcomes of topography-guided and wavefront-optimized surgery in patients having laser in situ keratomileusis (LASIK) for myopia. SETTING: Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, and BALGEUN-EYE21 Operation Center, Gwangju, South Korea. DESIGN: Prospective case study. METHODS: Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using Contoura Vision software and the WaveLight EX500 excimer laser. Refractive and visual outcomes were analyzed 3 months postoperatively. RESULTS: The study comprised 43 patients. In both groups, the postoperative uncorrected distance visual acuity (UDVA) was 0.0 logarithm of the minimum angle of resolution or better in 90.7% of eyes and the residual spherical equivalent (SE) refractive error was ±0.75 diopter (D) in 81.4% of eyes. The UDVA, residual SE refractive error, and astigmatism did not differ significantly between the 2 groups. There was significant induction of higher-order aberrations (HOAs) in both groups, although corneal coma and trefoil did not increase and ocular trefoil decreased significantly in the topography-guided group (P = .038). However, in the wavefront-optimized group, corneal coma and trefoil increased significantly (P < .001 and P = .046, respectively) and ocular trefoil did not change significantly. In addition, topography-guided LASIK induced significantly fewer corneal total HOAs (P < .001), coma (P < .001), and trefoil (P = .020) than wavefront-optimized LASIK. CONCLUSION: Although both topography-guided LASIK and wavefront-optimized LASIK safely and effectively achieved the predicted refractive and visual outcomes, topography-guided LASIK induced fewer HOAs and significantly decreased ocular trefoil, corneal total HOAs, and coma.

Predictive value of individualized tumor response testing by ATP-based chemotherapy response assay in ovarian cancer.

The aim of this study is to investigate the correlation between ATP-based chemotherapy response assay (ATP-CRA) results and clinical outcomes in ovarian cancer. Twenty-nine fresh tumor specimens were collected. Tumor cells were isolated and cultured for 48 hrs in medium containing anticancer drugs. The median age of patients was 56 years. The sensitivity, positive predictive value, and accuracy of ATP-CRA were respectively 94.1%, 94.1%, and 90.0%. There was a significant relationship between ATP-CRA results and clinical responses (p = 0.046). This study suggests that ATP-CRA has high sensitivity, positive predictive value, and accuracy for predicting response to chemotherapy in ovarian cancer.

The use of an in vitro adenosine triphosphate-based chemotherapy response assay to predict chemotherapeutic response in breast cancer.

The adenosine triphosphate-based chemotherapy response assay (ATP-CRA) has the advantages of standardization, evaluability, reproducibility, and accuracy, and can be performed on relatively small numbers of tumor cells. A total of 43 patients were enrolled in the present study, and chemosensitivity tests were successfully performed in 40 (93.0%) of these patients. Twenty of the 40 received neoadjuvant chemotherapy or chemotherapy for metastatic breast cancer. The chemotherapy regimens used were doxorubicin plus docetaxel (n=9, 45.0%) or doxorubicin plus paclitaxel (n=11, 55.0%). Mean cell death rate, as determined by ATP-CRA, was lower in non-responders than in responders to therapy (P=0.012). Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for ATP-CRA were 78.6%, 100%, 100%, 66.7%, and 85.0%, respectively. Diagnostic accuracy achieved by immunohistochemistry using estrogen receptor or progesterone receptor was lower than that achieved using ATP-CRA. Expression of p53, erb-B2, Ki67, Bcl-2, Bcl-xL, and annexin I was not significantly associated with response to chemotherapy. Our results show that ATP-CRA has high specificity and positive predictive value for predicting response to chemotherapy.