Effects of phosphate, carbonate, and silicate anions on CO2 emission in a typical oxisol from cerrado region / Efeitos dos ânions fosfato, carbonato e silicato na emissão de CO 2 em um latossolo típico da região do cerrado

The effects of agricultural practices on greenhouse gases emissions (e.g. CO2) at the soil-atmosphere interface have been highlighted worldwide. The use of ground limestone has been considered as the main responsible for CO2 emission from soils. However, liming is need as conditioner of acidic soils and the CO2 emission can be compensated due to carbon sequestration by plants. This study simulated under laboratory conditions the effects of two common agricultural practices in Brazil (P-fertilization and liming) on soil CO2 emission. Columns made of PVC tubes containing 1 kg of a typical Dystrophic Red Latosol from Cerrado region were incubated with CaCO3 (simulating liming), CaSiO3 (simulating slag), and different doses of KH2PO4 (simulating P-fertilization). The soil columns were moistened to reach the field capacity (0.30 cm3cm-3) and, during 36 days, CO2 emissions at the soil surface were measured using a portable Licor LI-8100 analyzer coupled to a dynamic chamber. The results showed that CO2 emission was influenced by phosphate, carbonate, and silicate anions. When using CaSiO3, accumulated CO2 emission (36-day period) was 20% lower if compared to the use of CaCO3. The same amount of phosphate and liming (Ca-carbonate or Ca-silicate) added to the soil provided the same amount of CO2 emission. At the same P dose, as Si increased the CO2emission increased. The highest CO2 emission was observed when the soil was amended with the highest phosphate and silicate doses. Based on this experiment, we could oppose the claim that the use of limestone is a major villain for CO2 emission. Also, we have shown that other practices, such as fertilization using P + CaSiO3, contributed to a higher CO2 emission. Indeed, it is important to emphasize that the best practices of soil fertility management will undoubtedly contribute to the growth of crops and carbon sequestration.

Os efeitos das práticas agrícolas nas emissões de gases de efeito estufa (e.g., CO2) na interface solo-atmosfera têm sido destacados em todo o mundo. O uso de calcário tem sido considerado oprincipal responsável pela emissão de CO2 em solos. Entretanto, a calagem é necessária como condicionador de solos ácidos e a emissão de CO2 pode ser compensada devido ao sequestro de carbono pelas plantas. Este estudo simulou, em condições de laboratório, os efeitos de duas práticas agrícolas comuns no Brasil (adubação fosfatada e calagem) na emissão de CO2 do solo. Colunas de tubos de PVC, contendo 1 kg de amostra de um Latossolo Vermelho Distrófico típico da região de Cerrado, foram incubadas com CaCO3 (simulando calagem), CaSiO3 (simulando escória) e diferentes doses de KH2PO4 (simulando fertilização com P). As colunas de soloforam umedecidas para atingir a capacidade de campo (0,30 cm3 cm-3) e, durante 36 dias, as emissões de CO2na superfície do solo foram medidas usando um analisador portátil Licor LI-8100 acoplado a uma câmara dinâmica. Os resultados mostraram que a emissão de CO2 foi influenciada pelos ânions fosfato, carbonato esilicato. Ao usar CaSiO3, a emissão de CO2 acumulada (período de 36 dias) foi 20% menor se comparado ao uso de CaCO3. A mesma quantidade de fosfato e calcário (Ca-carbonato ou Ca-silicato) adicionado ao solo proporcionou a mesma quantidade de emissão de CO2. Na mesma dose de P, o Si aumentou a emissão de CO2. A maior emissão de CO2 foi observada quando o solo foi alterado com as maiores doses de fosfato e silicato. Com base neste experimento, nega-se que o uso de calcário em solos é um grande vilão para a emissão de CO2. Além disso, foi mostrado que outras práticas, como a fertilização usando P + CaSiO3, contribuíram para uma maior emissão de CO2. Assim, é importante enfatizar que práticas adequadas de manejo da fertilidade do solo, sem dúvida, contribuirão para o crescimento das culturas e o sequestro de carbono.

Effects of experimental bleaching agents on the mineral content of sound and demineralized enamels

Abstract High concentrations of hydrogen peroxide can cause adverse effects on composition and structure of teeth. However, the addition of calcium and fluoride in bleaching agents may reduce enamel demineralization. Objective: To evaluate chemical changes of sound and demineralized enamels submitted to high concentrations of hydrogen peroxide containing fluoride (F) or calcium (Ca). Material and Methods: Enamel blocks of bovine incisors with standard dimensions were obtained and half of them were submitted to pH-cycling to promote initial enamel caries lesions. Sound and demineralized enamel samples were divided into (n=10): (C) Control (no whitening treatment); (HP) 35% hydrogen peroxide; and two experimental groups: (HPF) 35% HP+0.2% F and (HPC) 35% HP+0.2% Ca. Experimental groups were submitted to two in-office bleaching sessions and agents were applied 3 times for 15 min to each session. The control group was kept in remineralizing solution at 37°C during the bleaching treatment. The surface mineral content of sound and demineralized enamels was determined through Fourier Transform Raman spectroscopy (FT-Raman), Energy dispersive Micro X-ray fluorescence spectroscopy (μ-EDXRF); and the subsurface, through cross-sectional microhardness (CSMH). In addition, polarized light microscopy (PLM) images of enamel subsurface were observed. Results: According to three-way (FT-Raman and μ-EDXRF analyses) or two-way analysis of variance (ANOVA) (CSMH) and Tukey test (α=5%), the calcium or fluoride added to high-concentrated bleaching agents increased phosphate and carbonate concentrations on sound and demineralized enamels (p<0.05). However, HPC and HPF were unable to completely reverse the subsurface mineral loss promoted by bleaching on sound and demineralized enamels. The calcium/ phosphate (Ca/P) ratio of sound enamel decreased after HP treatment (p<0.001). Conclusion: Even though experimental bleaching agents with Ca or F reduced mineral loss for both sound and demineralized enamel surfaces, these agents were unable to reverse the enamel subsurface demineralization.

Alveolar bone repair with strontium- containing nanostructured carbonated hydroxyapatite

ABSTRACT Objective: This study aimed to evaluate bone repair in rat dental sockets after implanting nanostructured carbonated hydroxyapatite/sodium alginate (CHA) and nanostructured carbonated hydroxyapatite/sodium alginate containing 5% strontium microspheres (SrCHA) as bone substitute materials. Methods: Twenty male Wistar rats were randomly divided into two experimental groups: CHA and SrCHA (n=5/period/group). After one and 6 weeks of extraction of the right maxillary central incisor and biomaterial implantation, 5 μm bone blocks were obtained for histomorphometric evaluation. The parameters evaluated were remaining biomaterial, loose connective tissue and newly formed bone in a standard area. Statistical analysis was performed by Mann-Withney and and Wilcoxon tests at 95% level of significance. Results: The histomorphometric results showed that the microspheres showed similar fragmentation and bio-absorbation (p>0.05). We observed the formation of new bones in both groups during the same experimental periods; however, the new bone formation differed significantly between the weeks 1 and 6 (p=0.0039) in both groups. Conclusion: The CHA and SrCHA biomaterials were biocompatible, osteoconductive and bioabsorbable, indicating their great potential for clinical use as bone substitutes.

A NIR qualitative and quantitative model of 8 kinds of carbonate-containing mineral Chinese medicines / 中国中药杂志

The aim of this paper is to apply near infrared spectroscopy techniques to construct a rapid identification method for 8 kinds of mineral Chinese Medicines containing carbonates. The qualitative model using clustering analysis method in OPUS software can identify accurately 8 kinds of carbonate-containing mineral Chinese medicines. The near-infrared quantitative model was established by using partial least squares method (PLS) for 7 mineral Chinese Medicines in which main component is calcium carbonate. Compared with the results by EDTA titration, the established quantitative analysis model for calcium carbonate content showed a good prediction result that when the content is between 47.61% -99.17%, the average relative deviation of the prediction result is 0.24% and the average recovery rate was 100.3%. The results also showed that the model using near infrared spectroscopy can get not only a rapid identification of the 8 mineral Chinese medicines containing carbonates, but also an accurate and reliabe content determination of calcium carbonate for the 7 mineral Chinese medicines which contain the component.

Chemokine Systems Link Obesity to Insulin Resistance

Obesity is a state of chronic low-grade systemic inflammation. This chronic inflammation is deeply involved in insulin resistance, which is the underlying condition of type 2 diabetes and metabolic syndrome. A significant advance in our understanding of obesity-associated inflammation and insulin resistance has been recognition of the critical role of adipose tissue macrophages (ATMs). Chemokines are small proteins that direct the trafficking of immune cells to sites of inflammation. In addition, chemokines activate the production and secretion of inflammatory cytokines through specific G protein-coupled receptors. ATM accumulation through C-C motif chemokine receptor 2 and its ligand monocyte chemoattractant protein-1 is considered pivotal in the development of insulin resistance. However, chemokine systems appear to exhibit a high degree of functional redundancy. Currently, more than 50 chemokines and 18 chemokine receptors exhibiting various physiological and pathological properties have been discovered. Therefore, additional, unidentified chemokine/chemokine receptor pathways that may play significant roles in ATM recruitment and insulin sensitivity remain to be fully identified. This review focuses on some of the latest findings on chemokine systems linking obesity to inflammation and subsequent development of insulin resistance.

Current practice in hemodynamic monitoring and management in high-risk surgery patients: a national survey of Korean anesthesiologists / 대한마취과학회지

BACKGROUND: Hemodynamic optimization improves postoperative outcomes in high-risk surgery patients. The monitoring of cardiac output (CO) and dynamic parameters of fluid responsiveness can guide hemodynamic optimization. We conducted a survey to assess the current hemodynamic monitoring and management practices of Korean anesthesiologists during high-risk surgery. METHODS: E-mails containing a link to our survey, which consisted of 33 questions relating to hemodynamic monitoring during high-risk surgery, were sent to 3,943 members of the Korean Society of Anesthesiologists (KSA). The survey web page was open from December 30, 2011 to March 31, 2012. RESULTS: A total of 139 anesthesiologists responded during the survey period. Invasive arterial pressure (97.2%) and central venous pressure (93.4%) were routinely monitored. CO was monitored in 58.5% of patients; stroke volume variations were monitored in 50.9% of patients. However, CO was consistently optimized by < 20% of anesthesiologists. An arterial pressure waveform-derived CO monitor was the most frequently used device to monitor CO (79.0%). Blood pressure, urine output, central venous pressure, and clinical experience were considered to be the best indicators of volume expansion than CO or dynamic parameters of fluid responsiveness. CONCLUSIONS: The survey revealed that KSA members frequently monitor CO and dynamic parameters of fluid responsiveness during high-risk surgery. However, static indices were used more often to judge volume expansion. The current study reveals that CO is not frequently optimized despite the relatively high incidence of CO monitoring during high-risk surgery in Korea.

Clinical statistics: five key statistical concepts for clinicians

Statistics is the science of data. As the foundation of scientific knowledge, data refers to evidentiary facts from the nature of reality by human action, observation, or experiment. Clinicians should be aware of the conditions of good data to support the validity of clinical modalities in reading scientific articles, one of the resources to revise or update their clinical knowledge and skills. The cause-effect link between clinical modality and outcome is ascertained as pattern statistic. The uniformity of nature guarantees the recurrence of data as the basic scientific evidence. Variation statistics are examined for patterns of recurrence. This provides information on the probability of recurrence of the cause-effect phenomenon. Multiple causal factors of natural phenomenon need a counterproof of absence in terms of the control group. A pattern of relation between a causal factor and an effect becomes recognizable, and thus, should be estimated as relation statistic. The type and meaning of each relation statistic should be well-understood. A study regarding a sample from the population of wide variations require clinicians to be aware of error statistics due to random chance. Incomplete human sense, coarse measurement instrument, and preconceived idea as a hypothesis that tends to bias the research, which gives rise to the necessity of keen critical independent mind with regard to the reported data.

The Effect of Obstructive Sleep Apnea on DNA Damage and Oxidative Stress

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) is associated with repeated hypoxia and re-oxygenation. This characteristic of OSAS may cause oxidative stress and DNA damage. However, the link of OSAS with oxidative stress and DNA damage is still controversial. In the current study, we investigated whether OSAS causes DNA damage using alkaline single-cell gel electrophoresis (comet assay) and measuring oxidative stress by monitoring serum malondialdehyde (MDA) levels. METHODS: From March 2009 to August 2010, 51 patients who underwent polysomnography (PSG) during the night were enrolled in this study. We obtained serum from the patients at 6 AM. DNA damage and oxidative stress were evaluated using a comet assay and measuring serum MDA, respectively. We divided the patients into two groups according to the existence of comets appearing in the comet assay. Group 1 included 44 patients with negative assay results and group 2 consisted of seven patients with positive comet assay findings. We compared the age, gender proportion, PSG data (respiratory disturbance index [RDI], lowest O2 saturation level, and arousal index [AI]), time of disease onset, smoking habits, and serum MDA levels between the two groups. RESULTS: The average age and gender proportion of the two groups were not statistically different (P>0.05). The average of RDI for group 1 was 30.4+/-18.4 and 8.0+/-7.7 (P0.05). No relationship between positive comet assay results and OSAS severity was identified. CONCLUSION: Results of the current study showed that OSAS was not associated with DNA damage as measured by comet assays or oxidative stress according to serum MDA levels.

Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation / 대한생식의학회지

Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Extra-Intestinal Manifestation of Helicobacter pylori Infection: Allergic Diseases Including Asthma, Atopy and Idiopathic Urticaria / 대한내과학회지

Helicobacter pylori (H. pylori) infection is known to be negatively associated with allergic diseases including asthma in epidemiologic studies, mainly from the western countries. Bronchial asthma and allergic diseases are initiated by T-cells producing T-helper type 2 (Th2) cytokines (e.g. interleukin-4 (IL-4) and IL-5), which is inhibited by Th1 responses. H. pylori infection appears to inhibit Th2 responses, as well as to drive Th1 inflammation, and recent studies using experimental models of allergic airway disease elucidated a direct link between H. pylori infection and suppression of allergic airway disease through the induction of regulatory T cells. H. pylori has been implicated as a factor in idiopathic urticaria. Its eradication, however, has been shown conflicting results only. Therefore, routine H. pylori eradication for patients with chronic urticaria is not recommended. In Korea, prevalence of H. pylori infection shows a decreasing trend, and studies on association of H. pylori infection with asthma is warranting in the population.

Helicobacter pylori and Hematologic Diseases / 대한내과학회지

Helicobacter pylori has been considered as the possible etiology in many extragastric disease. Hematologic diseases such as immune thrombocytopenic purpura (ITP) and iron-deficiency anemia have been proposed to associate with H. pylori infection, although the hypothesis of an etiological role has not yet been fully investigated. Systematic reviews and meta-analysis have shown a significant increase of platelet counts in ITP patients in whom eradiation was successful compared with untreated, failed eradication or H. pylori-negative patients. H. pylori infection has emerged as a one of causes of refractory iron-deficiency anemia which is unresponsiveness to oral iron therapy. A link between H. pylori infection and iron- deficiency anemia was shown in recent meta-analyses and H. pylori eradication increased hemoglobin levels in these patients. The effect of H. pylori on iron stores may be greatest in those with marginal dietary iron intake or other stressors of iron stores. The guideline of Korean College of Helicobacter and Upper Gastrointestinal Research (2009) and other guidelines of western and Japan recommend that H. pylori should be sought and eradicated in the patients with ITP and unexplained iron-deficiency anemia.

Cerebral Microbleeds: Their Associated Factors, Radiologic Findings, and Clinical Implications / 대한뇌졸중학회지

Cerebral microbleeds (CMBs) are tiny, round dark-signal lesions that are most often detected on gradient-echo MR images. CMBs consist of extravasations of blood components through fragile microvascular walls characterized by lipohyalinosis and surrounding macrophages. The prevalence of CMBs in elderly subjects with no history of cerebrovascular disease is around 5%, but is much higher in patients with ischemic or hemorrhagic stroke. Development of CMBs is closely related to various vascular risk factors; in particular, lobar CMBs are thought to be associated with cerebral amyloid angiopathy. The presence of CMBs has been hypothesized to reflect cerebral-hemorrhage-prone status in patients with hypertension or amyloid microangiopathy. Stroke survivors with CMBs have been consistently found to have an elevated risk of subsequent hemorrhagic stroke or an antithrombotic-related hemorrhagic complication, although studies have failed to establish a link between CMBs and hemorrhagic transformation after thrombolytic treatment. A large prospective study is required to clarify the clinical significance of CMBs and their utility in a decision-making index.

Apical foramen morphology according to the length of merged canal at the apex

OBJECTIVES: The aim of this study was to investigate the relationship between the apical foramen morphology and the length of merged canal at the apex in type II root canal system. MATERIALS AND METHODS: This study included intact extracted maxillary and mandibular human premolars (n = 20) with fully formed roots without any visible signs of external resorption. The root segments were obtained by removing the crown 1 mm beneath the cementum-enamel junction (CEJ) using a rotary diamond disk. The distance between the file tip and merged point of joining two canals was defined as Lj. The roots were carefully sectioned at 1 mm from the apex by a slow-speed water-cooled diamond saw. All cross sections were examined under the microscope at x50 magnification and photographed to estimate the shape of the apical foramen. The longest and the shortest diameter of apical foramen was measured using ImageJ program (1.44p, National Institutes of Health). Correlation coefficient was calculated to identify the link between Lj and the apical foramen shape by Pearson's correlation. RESULTS: The average value of Lj was 3.74 mm. The average of proportion (P), estimated by dividing the longest diameter into the shortest diameter of the apical foramen, was 3.64. This study showed a significant negative correlation between P and Lj (p < 0.05). CONCLUSIONS: As Lj gets longer, the apical foramen becomes more ovally shaped. Likewise, as it gets shorter, the apical foramen becomes more flat shaped.

Interaction between Sleep-Disordered Breathing and Acute Ischemic Stroke

BACKGROUND AND PURPOSE: Sleep-disordered breathing (SDB) is suggested to be strongly associated with ischemic strokes. Risk factors, stroke subtypes, stroke lesion distribution, and the outcome of SDB in stroke patients remain unclear in Korea. METHODS: We prospectively studied 293 patients (159 men, 134 women; age 68.4+/-10.5) with acute ischemic stroke. Cardiovascular risk factors, stroke severity, sleep-related stroke onset, distribution of stroke lesions, and 3-month score on the modified Rankin Scale (mRS) were assessed. Stroke severity was assessed by the US National Institutes of Health Stroke Scale (NIHSS) and the mRS. The apnea-hypopnea index (AHI) was determined 6.3+/-2.2 days after stroke onset with the Apnea Link portable sleep apnea monitoring device. RESULTS: The prevalence of SDB (defined as an AHI of > or =10) was 63.1% (111 men, 74 women). Those in the SDB group were older, had higher NIHSS and mRS scores, greater bulbar weakness, and a higher incidence of sleep-associated stroke onset. Among risk-factor profiles, alcohol consumption and atrial fibrillation were significantly related to SDB. The stroke outcome was worse in patients with SDB than in those without SDB. The lesion location and specific stroke syndrome were not correlated with SDB. CONCLUSIONS: SDB is very common in acute cerebral infarction. Different risk-factor profiles and sleep-related stroke onsets suggest SDB as a cause of ischemic stroke. The higher NIHSS score and greater bulbar involvement in the SDB group seem to show the influence of ischemic stroke on the increased SDB prevalence.

Assessment of Gastritis Using Operative Link for Gastritis Assessment System

Gastritis is an inflammatory condition of the gastric mucosa induced by Helicobacter pylori infection, autoimmunity and chemical agents. Although Sydney system was devised for semiquantitative methods of gastritis, most physicians and pathologists consider it to be too complex and bothersome to use for routine diagnosis. Moreover, Sydney system does not reflect the overall gastritis condition and it cannot directly predict increased gastric cancer risk. To overcome these limitations, a new gastritis staging method, called Operative Link for Gastritis Assessment (OLGA) system was designed by the international group of gastroenterologists and pathologists. This system may achieve simplification of reports for the gastritis condition and it can aid in predicting gastric cancer risk and planning patient surveillance. Herein, we reviewed the routine evaluation methods, clinical implication and advantage/limitations of the OLGA system.

Assessment of Gastritis Using Operative Link for Gastritis Assessment System

Gastritis is an inflammatory condition of the gastric mucosa induced by Helicobacter pylori infection, autoimmunity and chemical agents. Although Sydney system was devised for semiquantitative methods of gastritis, most physicians and pathologists consider it to be too complex and bothersome to use for routine diagnosis. Moreover, Sydney system does not reflect the overall gastritis condition and it cannot directly predict increased gastric cancer risk. To overcome these limitations, a new gastritis staging method, called Operative Link for Gastritis Assessment (OLGA) system was designed by the international group of gastroenterologists and pathologists. This system may achieve simplification of reports for the gastritis condition and it can aid in predicting gastric cancer risk and planning patient surveillance. Herein, we reviewed the routine evaluation methods, clinical implication and advantage/limitations of the OLGA system.

A biochemical and histopathological evaluation of generalized pulp calcification in young permanent teeth.

Pulp calcifications are a frequent finding on bitewing and periapical radiographs in older age-groups but their occurrence in the entire dentition in young subjects is unusual. We report such an unusual occurrence of generalized pulp calcification in a 13-year-old Indian female. Radiographic examination of the dentition revealed pulp calcifications in all permanent teeth, located mostly in the pulp chamber but with some in the root canals. The patient's dental, medical, and family history was noncontributory. Biochemical analysis of the removed pulp calcification from one of the teeth during endodontic treatment showed large amounts of calcium, phosphorus, and carbonate. However, metabolic evaluation of patient through liver and kidney function tests and other blood investigations did not reveal any metabolic disorder. The patient was also evaluated for any systemic, syndromic, or genetic involvement but this was also noncontributory. Therefore, we propose that this unusual case of generalized pulp calcification is of idiopathic origin. In this work, histopathological and biochemical evaluations of the pulp calcification was done to try and understand the initiation and progress of calcifications in pulpal tissue.

Morphometrical Study of Uncinate Processes and Vertebral Body of Cervical Spine

OBJECTIVE: The anatomical knowledge is the most important and has a direct link with success of operation in cervical spine surgery. The authors measured various cervical parameters in cadaveric dry bones and compared with previous reported results. METHODS: We made 255 dry bones age from 19 to 72 years (mean, 42.3 years) that were obtained from 51 subjects in 100 subjects who donated their bodies. All measurements from C3-C7 levels were made using digital vernier calipers, standard goniometer, and self-made fix tool for two different cervical axes (canal and disc setting). We classified into 4 groups (uncinate process, vertebral body, lamina, and pedicle) and measured independently by two neurosurgeons for 28 parameters. RESULTS: We analyzed 23970 measurements by mean value and standard deviations. In comparing with previous literatures, there are some different results. The mean values for uncinate process (UP) width ranged from 5.5 mm at C4 and 5 to 6.3 mm at C3 and C7 in men. Also, in women, the mean values for UP width ranged from 5.5 mm at C5 to 6.3 mm at C7. C7 was widest and C5 was most narrow than other levels. The antero-posterior length of UP tended to increase gradually from C3 to C6. The tip way, tip distance, and base distance of UP also showed increasing pattern from C3 to C7. CONCLUSION: These measurements can provide the spinal surgeons with a starting point to address bony architectures surrounding targeted soft tissues for safeguard against unintended damages during cervical operation.

Survey of the Application of the Korean Clinical Practice Recommendations on Breast Cancer Treatment: The Utility of the Korean Breast Cancer Society Guidelines / 한국유방암학회지

This survey was performed to analyze the usability of the third edition of the Korean breast cancer clinical practice guidelines (KBCCPG) in clinical practice. We made a questionnaire composed of 18 general and 82 specific questions regarding benign breast disease (B; 1 question); non-invasive disease (N; 12 questions); early-stage disease (E; 26 questions); advanced disease (A; 24 questions); and metastatic (M) breast cancer-related problems (19 questions). A total of 100 questionnaires, with a link to an online survey, were delivered via e-mail to over 700 members of the Korean Breast Cancer Society (KBCS), and associated academy members, over 20 days between 26th February and 16th May 2010. Out of 270 respondents who read the e-mail, 96 answered the questionnaire. Participants included 87 surgical oncologists, 5 radiation oncologists, 2 oncoplastic surgeons, 1 pathologist, and 1 medical oncologist. The third KBCCPG were perceived as differing from the second guidelines in terms of the level of clinical evidence required before choosing a recommendation. For the progress of the KBCCPG, the guideline committee should try to reinforce all courses of guideline development with several elements including data from clinical trials of Korean breast cancer patients, securing a multidisciplinary approach, developing consistent and reasonable processes for each step of the revision of the guidelines, induction of liberal scientific and ethical discussion about all issues with all KBCS members. The cost-effectiveness of healthcare and the logical development of the KBCCPG would also be ensured. Timely updates of the clinical guidelines for breast cancer treatment are essential to facilitate optimal decision-making in daily practice, and to ensure adequate patient feedback.

Higher Plasma Thrombospondin-1 Levels in Patients With Coronary Artery Disease and Diabetes Mellitus

BACKGROUND AND OBJECTIVES: Thrombospondin-1 (TSP-1) is associated with atherosclerosis in animals with diabetes mellitus (DM). But, no study has investigated the role of TSP-1 in human atherosclerosis. This study investigated the relationship among plasma TSP-1 concentration, DM, and coronary artery disease (CAD). SUBJECTS AND METHODS: The study involved 374 consecutive subjects with suspected CAD, who had undergone coronary angiography to evaluate effort angina. Patients were divided into four groups as follows: DM(-) and CAD(-), DM(-) and CAD(+), DM(+) and CAD(-), and DM (+) and CAD(+). RESULTS: We found that plasma TSP-1 levels were higher in patients with DM(+) and CAD(+) (n=103) than those in other patients (n=271) (p<0.01). A multivariate analysis showed that male gender {odds ratio (OR), 2.728; 95% confidence interval (CI), 1.035-7.187}, high density lipoprotein-cholesterol (OR, 0.925; 95% CI, 0.874-0.980), glycated hemoglobin (OR, 1.373; 95% CI, 1.037-1.817), and plasma TSP-1 (OR, 1.004; 95% CI, 1.000-1.008) levels were independently associated with the presence of CAD in patients with DM. CONCLUSION: Plasma TSP-1 levels were higher in patients with DM(+) and CAD(+) than those in other patients, and plasma TSP-1 levels were independently associated with the presence of CAD in patients with DM. These findings show a possible link between human plasma TSP-1 concentration and CAD in patients with DM.