Activin suppresses the expression of inflammatory genes and signaling proteins in human leukemia monocytic THP-1 cells.

Activin regulates inflammation, cell proliferation, immune response, wound repair, and endocrine function. In this study, we investigated the effect of activin on inflammatory genes in THP-1 cells and the involvement of NF-κB, AKT, and mitogen-activated protein kinase (MAPK) signaling. Cell viability was determined using a colorimetric assay with the MTS/PES solution. The mRNA levels were analyzed using reverse transcription-quantitative polymerase chain reaction. The expression of NF-κB, AKT, and MAPK signaling proteins was measured using immunoblot analysis. Activin A did not affect THP-1 cell viability at concentrations below 50 ng/ml. Activin decreased the mRNA expression of cytokines (interleukin (IL)-1ß, IL-6, and tumor necrosis factor-α (TNF-α), toll-like receptor 4 (TLR4), and matrix metallo-proteinases (MMP)-9 proteins but did not affect IL-8 expression. Activin increased the expression of TLR2 and MMP-2. In addition, activin inhibited the phosphorylation of NF-κB p65, AKT, and MAPK (c-Jun N-terminal kinase (JNK), extracellular signal-regulated kinase (ERK), and p38 MAPK) signaling proteins. Our results suggest that activin may be involved in anti-inflammation by inhibiting inflammatory gene expression and regulating NF-κB and AKT/MAPK signaling.

Efficacy of electroacupuncture in preventing nausea and vomiting after thyroidectomy: A prospective randomized controlled trial.

OBJECTIVE: Postoperative nausea and vomiting are regarded as a serious concern after thyroidectomy. Electroacupuncture shows the potential to reduce general anesthesia-related side effects. The aim of this study was to evaluate the efficacy of electroacupuncture in preventing postoperative nausea and vomiting that commonly occurs in patients after thyroidectomy. METHODS: This study was a prospective randomized controlled trial with a two-arm, patient blind structure. Sixty-four participants were randomly assigned to the acupuncture (n = 35) or control (n = 29) group. Patients in the acupuncture group received electroacupuncture and intradermal press needles. The primary endpoint was the incidence and severity of postoperative nausea and vomiting, and secondary endpoints were the length of hospital stay, pain severity, and postoperative in-hospital morbidity. RESULTS: The total incidence of postoperative nausea and vomiting was 40.6% (26/64). There was no difference in the incidence between the control (10/29, 34.5%) and acupuncture (16/35, 45.7%) groups (p = 0.362). The severity of postoperative nausea and vomiting was not different between the groups (p = 0.842). Length of hospitalization and postoperative complications were not different between the groups. CONCLUSION: In this randomized controlled trial, electroacupuncture treatment after thyroidectomy is safe and comparable to conventional anti-emetic therapy. TRIAL REGISTRATION: Clinical Research Information Service, KCT0001782. Registered on 26 January 2016.

Association of Surgical Margin Status with Oncologic Outcome in Patients Treated with Breast-Conserving Surgery.

We aimed to compare the prognosis of patients with close resection margins after breast-conserving surgery (BCS) with that of patients with negative margins and identified predictors of residual disease. A total of 542 patients with breast cancer who underwent BCS between 2003 and 2019 were selected and divided into the close margin (114 patients) and negative margin (428 patients) groups. The median follow-up period was 72 (interquartile range, 42-113) months. Most patients received radiation therapy (RTx) and systemic therapy according to their stage and molecular subtype. The 10-year locoregional recurrence-free survival rates of the close and negative margin groups were 88.2% and 95.5%, respectively (p = 0.001). Multivariable analysis showed that adjuvant RTx and margin status after definitive surgery were significantly associated with locoregional recurrence. Of the 57 patients who underwent re-excision, 34 (59.6%) had residual disease. Multivariable analysis revealed that a histological type of positive or close margins and multifocality were independent predictive factors for residual disease. Although the current guidelines suggest that no ink on tumor is an adequate margin after BCS, a close resection margin may be associated with locoregional failure. The treatment strategy for close resection margins after BCS should be based on individual clinicopathological features.

Association between Inflammation-Based Parameters and Prognosis in Patients with Acute Kidney Injury.

Background and Objectives: this study aimed to clarify the relationship between inflammation-based parameters and prognosis in patients with acute kidney injury (AKI). Materials and Methods: We analyzed the prospectively collected data of patients with AKI, who were admitted through the emergency department between March 2020 and April 2021. Their clinical characteristics, inflammation-based parameters, resolving/non-resolving AKI pattern, and major adverse kidney event (MAKE) rates were analyzed. Results: Among 177 patients, 129 (72.9%) had a resolving AKI pattern and 48 (27.1%) had a non-resolving AKI pattern. The outcome of MAKE occurred in 30 (16.9%) participants. Multivariate analyses showed that the neutrophil-to-monocyte ratio was an independent predictor of resolving AKI, and that the neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios were independent predictors of MAKE occurrence. Conclusions: we demonstrated that inflammation-based parameters are valuable predictors of early recovery and MAKE occurrence in patients with AKI.

Clinical Significance of Receptor-Interacting Protein 3 and Parkin, Essential Molecules for Necroptosis, in Breast Cancer.

PURPOSE: Receptor-interacting protein 3 (RIP3) is the main initiator of necroptosis. Parkin prevents the formation of the RIP1-RIP3 complex by promoting polyubiquitination of RIP3. However, the mechanism by which necroptosis affects the clinical features of breast cancer and prognosis is not known. Here, we aimed to study the effect of necroptosis on the clinical features and prognosis of breast cancer by assessing the expression of RIP3 and Parkin. METHODS: Tissue microarrays (TMAs) were constructed from 257 cases of breast cancer. Immunohistochemistry was performed on 4-µm tissue sections from each TMA block. The χ² test, Kaplan-Meier survival analysis with log-rank test, and Cox regression proportional hazard model were used for statistical analysis. RESULTS: Low RIP3 expression resulted in a large tumor size and high nuclear grade. Low RIP3 expression was correlated with human epidermal growth factor receptor 2 positivity, short overall survival (OS), and short disease-free survival (DFS). The triple negative breast cancer group with low RIP3 expression and lymph node (LN) positive group with low RIP3 expression had the shortest OS. High Parkin expression was associated with high histological grade, estrogen and/or progesterone receptor negativity, and lymphatic emboli, but was not correlated with OS and DFS. OS was correlated with LN metastasis and RIP3 loss and DFS with large tumor size, LN metastasis, and RIP3 loss. CONCLUSION: Low RIP3 and high Parkin expression are associated with aggressive clinical features in breast cancer. RIP3, a molecular marker of necroptosis, is an independent factor associated with survival in breast cancer. Further in-depth studies are needed to investigate the role of necroptosis in breast cancer development, metastasis, and treatment in the future.

Decrease of peripheral blood lymphocyte count predicts response to neoadjuvant chemotherapy in breast cancer patients.

Purpose: Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) holds promise as a significant prognostic factor to predict NAC response in breast cancer patients. The absolute peripheral blood lymphocyte (PBL) count has been suggested as an independent predictor of response to NAC. The current study evaluated the relationship between pCR and the change of PBL count in patients treated with NAC. Methods: A total of 61 patients with histologically confirmed breast cancer treated with NAC followed by mastectomy between January 2010 and December 2019 were analyzed retrospectively. Correlational analyses confirmed a statistically significant relationship between PBL count and pCR. Following conformational correlational analyses, patients were divided into two groups according to cutoff values using the receiver operating characteristics curve and a logistic regression was conducted to determine the optimal conditions for achieving pCR. Results: A total of 14 patients (22.9%) achieved pCR. Most PBL counts decreased after NAC relevant to pCR. Logistic regression analysis revealed that a small decrease of PBL was associated with pCR (P=0.028). The cutoff value of PBL decrease was 755×106/L, which was used to divide patients into high and low reduction groups. The pCR rate was 11.43% and 38.46% for the high and low reduction group, respectively (area under the curve, 0.707; 95% confidence interval, 0.556-0.858; P=0.020). The high reduction group was found to have more difficulty achieving pCR. Conclusion: The decrease of PBL is significantly associated with pCR. Our data support that the decrease of PBL after NAC may be useful factors in predicting the response to NAC in breast cancer patients.

Comparison Study of Robotic Thyroidectomies Through a Bilateral Axillo-Breast Approach and a Transoral Approach.

Introduction: Oncological and surgical safeties are pivotal issues of cancer operations. Robotic thyroidectomy adds cosmetic advantage to those safeties. We have performed bilateral axillo-breast approach robotic thyroidectomies (BABART) since 2009 and recently started transoral robotic thyroidectomy (TORT) in 2017. This study aimed to compare the surgical outcomes of a single surgeon's initial TORT and BABART. Materials and Methods: We retrospectively collected data of 103 patients who underwent robotic thyroid lobectomy for papillary thyroid cancer and analyzed the first 14 and 56 cases of TORT and BABART, respectively, after propensity score matching. The surgeon performed 224 BABARTs before starting TORT. Results: There were no significant differences between the BABART and TORT groups in mean age (40.02 ± 9.37 versus 38.69 ± 9.21 years, respectively; P = .7520), sex distribution (P = .3697), mean body mass index (23.60 ± 4.31 versus 23.87 ± 2.45 kg/m2, respectively; P = .4737), and tumor size (0.75 ± 0.35 versus 0.76 ± 0.29 cm, respectively; P = .9969). The TORT group had a longer operative time than the BABART group by 78.04 minutes (P < .0001). The visual analog scale pain scores on postoperative day (POD) 2 and POD 3 were higher in the TORT than the BABART group by 0.59 and 0.77, respectively (P = .0227 and .0119, respectively). The number of retrieved lymph nodes and unintended parathyroidectomies was similar in the two groups. There were no severe complications such as tracheal injury, transection of recurrent laryngeal nerve, or surgical site infection. Conclusion: Our study suggests that both BABART and TORT are safe and feasible during the initial period. TORT can be undertaken without any adverse event if the operator is experienced with other robotic thyroidectomy. The patients may choose the surgical approach based on their preference.

Effectiveness, safety, and economic evaluation of adjuvant moxibustion therapy for aromatase inhibitor-induced arthralgia of postmenopausal breast cancer stage I to III patients: Study protocol for a prospective, randomized, assessor-blind, usual-care controlled, parallel-group, pilot clinical trial.

INTRODUCTION: This study is a prospective, assessor-blinded, parallel-group, randomized controlled pilot trial to explore the effectiveness of 12-week adjuvant moxibustion therapy for arthralgia in menopausal females at stage I to III breast cancer on aromatase inhibitor (AI) administration, compared with those receiving usual care. METHODS/DESIGN: Forty-six menopausal female patients with breast cancer who completed cancer therapy will be randomly allocated to either adjuvant moxibustion or usual care groups with a 1:1 allocation ratio. The intervention group will undergo 24 sessions of adjuvant moxibustion therapy with usual care for 12 weeks, whereas the control group will receive only usual care during the same period. The usual care consists of acetaminophen administration on demand and self-directed exercise education to manage AI-related joint pain. The primary outcome is the mean change of the worst pain level according to the Brief Pain Inventory-Short Form between the initial visit and the endpoint. The mean changes in depression, fatigue, and quality of life will also be compared between groups. Safety and pharmacoeconomic evaluations will also be included. DISCUSSION: Continuous variables will be compared by an independent t test or Wilcoxon rank-sum test between the adjuvant moxibustion and usual care groups. Adverse events will be analyzed using the chi-square or Fisher exact test. The statistical analysis will be performed by a 2-tailed test at a significance level of .05.

Comparison of Diagnostic Performance of B-Mode Ultrasonography and Shear Wave Elastography in Cervical Lymph Nodes.

The purpose of this study was to compare the diagnostic performance of B-mode ultrasonography (US) and shear wave elastography (SWE) for differentiating benign from malignant cervical lymph nodes (LNs). This study evaluated 130 cervical LNs in 127 patients. On conventional B-mode US, short-axis and long-axis diameters, long-to-short-axis ratio, cortical morphology, border, and presence of necrosis or calcification were evaluated. Maximum elasticity value (Emax) was collected for SWE. The area under the receiver operator characteristic curve (AUC), sensitivity, and specificity of B-mode US features and SWE were compared. Final histopathologic results showed 89 benign and 41 metastatic LNs. Among the B-mode US features, cortical morphology had the highest AUC (0.884). When 54 kPa of Emax was applied as a cutoff value, the SWE showed significantly lower AUC than cortical morphology (0.734, P = 0.02). Both sensitivity and specificity for cortical morphology on B-mode US were higher than for Emax (80.5% vs 65.9%, P = 0.212 and 89.9% vs 76.4%, P = 0.026, respectively). Conventional B-mode US resulted in higher diagnostic yield than SWE in evaluating cervical LNs in our study. However, further studies on potential factors that may affect the SWE velocity are needed to validate the diagnostic value of SWE.

Shear wave elastography for the diagnosis of small (≤2 cm) breast lesions: added value and factors associated with false results.

OBJECTIVE: We compared the diagnostic performance of B-mode ultrasound, shear wave elastography (SWE), and combined B-mode ultrasound and SWE in small breast lesions (≤ 2 cm), and evaluated the factors associated with false SWE results. METHODS: A total of 428 small breast lesions (≤ 2 cm) of 415 consecutive patients between August 2013 and February 2017 were included. The diagnostic performance of each set was evaluated using the area under the receiver operating characteristic curve (AUC) analysis. Histologic diagnosis was used as reference standard. Multivariate logistic regression analyses identified the factors associated with false SWE results. RESULTS: Of 428 lesions, 142 (33.2%) were malignant and 286 (66.8%) were benign. The AUC of the combined modality was higher than that of B-mode ultrasound (0.792 vs 0.572, p < 0.001) and that of SWE was higher than that of B-mode ultrasound (0.718 vs 0.572, p < 0.001). Multivariate analysis showed that the smaller lesion size and in situ cancer were associated with false negative, and patient's age, high-risk lesion, shorter distance from the skin or chest wall, and deeper breast thickness were associated with false positive (all p < 0.05). CONCLUSIONS: The addition of SWE to B-mode ultrasound could improve the diagnostic performance in ≤ 2 cm lesions. However, ultrasound lesion size, pathology, and lesion location are likely to affect the SWE value and result in false results. ADVANCES IN KNOWLEDGE: Despite the diagnostic usefulness of SWE in small breast lesions (≤ 2 cm), ultrasound lesion size, pathology, and lesion location were associated with false results.

Dual-modal cancer detection based on optical pH sensing and Raman spectroscopy.

A dual-modal approach using Raman spectroscopy and optical pH sensing was investigated to discriminate between normal and cancerous tissues. Raman spectroscopy has demonstrated the potential for in vivo cancer detection. However, Raman spectroscopy has suffered from strong fluorescence background of biological samples and subtle spectral differences between normal and disease tissues. To overcome those issues, pH sensing is adopted to Raman spectroscopy as a dual-modal approach. Based on the fact that the pH level in cancerous tissues is lower than that in normal tissues due to insufficient vasculature formation, the dual-modal approach combining the chemical information of Raman spectrum and the metabolic information of pH level can improve the specificity of cancer diagnosis. From human breast tissue samples, Raman spectra and pH levels are measured using fiber-optic-based Raman and pH probes, respectively. The pH sensing is based on the dependence of pH level on optical transmission spectrum. Multivariate statistical analysis is performed to evaluate the classification capability of the dual-modal method. The analytical results show that the dual-modal method based on Raman spectroscopy and optical pH sensing can improve the performance of cancer classification.

Basic Facts of Breast Cancer in Korea in 2014: The 10-Year Overall Survival Progress.

We, the Korean Breast Cancer Society (KBCS), present the facts and the trends of breast cancer in Korea in 2014. Data on the total number of newly diagnosed patients was obtained from the Korea Central Cancer Registry database, other data were collected from the KBCS online registry database, and the overall survival data of patients were updated from Statistics Korea. A total of 21,484 female patients were newly diagnosed with breast cancer in 2014. The crude incidence rate and the age-standardized incidence rate (ASR) of breast cancer in female patients, including carcinoma in situ, were 83.4 cases and 63.9 cases per 100,000 women, respectively. The ASR showed an annual increase of 6.1% from 1999 to 2014; however, although the increase of the ASR had slowed since 2008, the incidence rate itself continuously increased. The proportion of early breast cancer increased consistently, and the pathological features changed accordingly. While breast-conserving surgery was mainly performed, the proportion of total mastectomy was slightly increased. The total number of breast reconstruction surgeries increased rapidly. The 5-year and 10-year overall survival rates for all stages of breast cancer patients were 91.2% and 84.8%, respectively. The overall survival rate of Korean patients with breast cancer was extremely high, compared with other developed countries. Thus, we consider that the clinical characteristics of breast cancer have changed over the past decade. A nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.

Predictors and risk factors of hypoparathyroidism after total thyroidectomy.

BACKGROUND: The aim of this study was to evaluate the risk factors for hypoparathyroidism after total thyroidectomy and to determine whether early postoperative serum levels of calcium and phosphorus could be used to predict its development. MATERIALS AND METHODS: The study group consisted of 1030 patients who had undergone total thyroidectomy at our institution between March 2008 and July 2014. The clinicopathologic characteristics, indications for the operation, and surgical details of normocalcemic and hypocalcemic patients were compared, and variations in serum calcium and phosphorus levels were measured every day after the operation. RESULTS: Of the 1030 patients, 291 (28.2%) were found to have transient hypocalcemia and 27 (2.6%) had permanent hypocalcemia. On univariate analysis, younger age (P = 0.001), female gender (P < 0.001), longer operative time (P = 0.009), extent of central neck dissection (CND) (P = 0.003), and malignancy (P = 0.005) were found to be significantly associated with transient hypocalcemia. On multivariate analysis, female gender (P = 0.001), extent of CND (P = 0.017), and the identification of parathyroid gland (PTG) tissue in permanent pathologic sections were significant factors. In addition, the occurrence of postoperative hypocalcemia was correlated with relative changes in serum calcium and phosphorus levels. Patients whose serum calcium levels decreased over 20% on postoperative day 2 were more likely to develop hypoparathyroidism, with 92% specificity. CONCLUSION: Female gender (P = 0.001), extent of CND (P = 0.014), and PTG in permanent pathologic sections (P = 0.035) were found to be significant factors affecting the development of hypocalcemia. Despite some study limitations, we suggest that the relative changes in the serum levels of calcium (20%) and of phosphorus (40%) on the second postoperative day may be reliable predictors of post-thyroidectomy hypoparathyroidism.

Surgical outcomes of robotic thyroidectomy vs. conventional open thyroidectomy for papillary thyroid carcinoma.

BACKGROUND: The purpose of this study was to compare the surgical outcomes of robotic thyroidectomy (RT) using bilateral axillo-breast approach (BABA) with conventional open thyroidectomy (OT) in papillary thyroid carcinoma patients. METHODS: Between January 2009 and December 2013, 815 patients who had received thyroidectomy for papillary thyroid carcinoma were enrolled. Of these, 126 patients received RT and 689 patients underwent OT. Age, gender, body mass index, extent of surgery, tumor size, multiplicity, bilaterality, extrathyroidal extension, and tumor stage were used for the propensity score matching analysis. One hundred and nine patients were selected in each group, and surgical outcomes were compared between the two groups. RESULTS: The RT group showed a significantly longer operating time (290.6 ± 74.4 vs. 107.9 ± 30.8 min, P < 0.001). However, the mean hospital stay after surgery (3.6 ± 0.8 vs. 3.4 ± 1.2 days, P = 0.293), postoperative complication rates (major and minor, P = 0.754 and P = 0.852), and pain score (postoperative day, P = 0.669; postoperative day 1, P = 0.952) were comparable between the two groups. There was no difference in the number of metastatic lymph nodes, but the mean number of retrieved lymph nodes in the RT group was lesser than that in the OT group (3.5 ± 3.5 vs. 5.3 ± 5.2, P = 0.002). CONCLUSIONS: Robotic thyroidectomy via the BABA may be a safe and acceptable surgical technique. But, further development that resolves the limitation of central node dissection is needed.

The Basic Facts of Korean Breast Cancer in 2013: Results of a Nationwide Survey and Breast Cancer Registry Database.

The Korean Breast Cancer Society (KBCS) has reported a nationwide breast cancer data since 1996. We present a comprehensive report on the facts and trends of breast cancer in Korea in 2013. Data on the newly diagnosed patients in the year 2013 were collected from 99 hospitals by using nationwide questionnaire survey. Clinical characteristics such as stage of cancer, histologic types, biological markers, and surgical management were obtained from the online registry database. A total of 19,316 patients were newly diagnosed with breast cancer in 2013. The crude incidence rate of female breast cancer including carcinoma in situ was 76.2 cases per 100,000 women. The median age at diagnosis was 50 years, and the proportions of postmenopausal women with breast cancer accounted for more than half of total patients. The proportion of early breast cancer increased consistently, and the pathologic features have changed accordingly. Breast-conserving surgery was performed in more cases than total mastectomy in the year. The total number of breast reconstruction surgeries markedly increased approaching 3-fold in last 11 years. According to annual percentile change of invasive cancer incidence, the incidence increased rapidly until 2010. And thereafter the increase of it became steadier. For ductal carcinoma in situ, the incidence consistently increased during the same period without any joinpoint. Analysis of nationwide registry data will contribute to defining of the trends and characteristics of breast cancer in Korea.

Doxorubicin-loaded nanoparticles consisted of cationic- and mannose-modified-albumins for dual-targeting in brain tumors.

Albumin nanoparticles have been increasingly viewed as an effective way of delivering chemotherapeutics to solid tumors. Here, we report the one-pot development of a unique prototype of doxorubicin-loaded nanoparticles (NPs) made of naïve albumin (HSA) plus cationic- (c-HSA) or mannose-modified-albumin (m-HSA), with the goal of traversing the blood-brain barrier and targeting brain tumors. c-HSA was synthesized by conjugating ethylenediamine to naïve HSA. Then, m-HSA was derivatized using mannopyranoside via a thiol-maleimide reaction. The c/m-HSA NPs were prepared using a mixture solution of c- and m-HSAs in deionized water and doxorubicin in ethanol/chloroform in the same pot using a high-pressure homogenizer. The c/m-HSA NPs were spherical and well-dispersed, with a particle size of 90.5±3.1nm and zeta-potential of -12.0±0.3mV at c- and m-HSA feed ratios of 5% and 10%, respectively. The c/m-HSA NPs displayed good stability over 3days based on particle size and a linear gradual doxorubicin release over 2days. Specifically, the inhibitory concentration (IC50; 0.5±0.02µg/ml) of c/m-HSA NPs was >2.2-15.6 fold lower than those of doxorubicin or the other HSA NPs. Moreover, among HSA NPs, c/m-HSA NPs exhibited the most prominent performances in transport across the bEnd.3 cell monolayer and uptake in bEnd.3 cells as well as U87MG glioblastoma cells and spheroids. Furthermore, c/m-HSA NPs were localized to a greater extent in brain glioma compared to naïve HSA NPs. Orthotopic glioma-bearing mice treated with c/m-HSA NPs displayed significantly smaller tumors than the mice treated with saline, doxorubicin or HSA NPs. This improved anti-glioma efficacy seemed to be due to the dual-enhanced system of dual cationic absorptive transcytosis and glucose-transport by the combined use of c- and m-HSAs. The c/m-HSA NPs have potential as a novel anti-brain cancer agent with good targetability.

Erratum: The Basic Facts of Korean Breast Cancer in 2011: Results of a Nationwide Survey and Breast Cancer Registry Database.

[This corrects the article on p. 99 in vol. 17, PMID: 25013429.].

Facile one-pot formulation of TRAIL-embedded paclitaxel-bound albumin nanoparticles for the treatment of pancreatic cancer.

Nanoparticle albumin-bound (nab™) technology is an effective way of delivering hydrophobic chemotherapeutics. We developed a one-pot/one-step formulation of paclitaxel (PTX)-bound albumin nanoparticles with embedded tumor necrosis factor-related apoptosis-inducing ligand (TRAIL/PTX HSA-NP) for the treatment of pancreatic cancer. TRAIL/PTX HSA-NPs were fabricated using a high-pressure homogenizer at a TRAIL feeding ratio of 0.2%, 1.0%, and 2.0%. TRAIL/PTX HSA-NPs were spherical and became larger in size (170-230 nm) with increasing TRAIL amount (0.2-2.0%). The loading efficiencies of PTX were in the range of ∼86.4% and significantly low at 2.0% TRAIL (60.4%). Specifically, the inhibitory concentrations (IC50) of TRAIL (1.0 or 2.0%)/PTX HSA-NPs were >20-fold lower than that of plain PTX-HSA NP (0.032±0.06, 0.022±0.005, and 0.96±0.15 ng/ml, respectively) in pancreatic Mia Paca-2 cells. Considering TRAIL loading, bioactivity, and particle size, TRAIL(1.0%)/PTX HSA-NPs were determined as the optimal candidate for further studies. TRAIL(1.0%)/PTX HSA-NPs displayed substantially greater apoptotic activity than plain PTX HSA-NP in both FACS and TUNEL analysis. The loaded PTX and TRAIL were gradually released from the TRAIL(1.0%)/PTX HSA-NPs until ∼24 h, which is considered to be a sufficient time for delivery to the tumor tissue. TRAIL(1.0%)/PTX HSA-NP displayed markedly more antitumor efficacy than plain PTX HSA-NP in Mia Paca-2 cell-xenografted mice in terms of tumor volume (size) and weight (213.9 mm(3) and 0.18 g vs. 1126.8 mm(3) and 0.80 g, respectively). These improved in vitro and in vivo performances were due to the combined synergistic effects of PTX and TRAIL. We believe that this TRAIL/PTX HSA-NP would have potential as a novel apoptosis-based anticancer agent.

The Basic Facts of Korean Breast Cancer in 2012: Results from a Nationwide Survey and Breast Cancer Registry Database.

The Korean Breast Cancer Society has constructed a nationwide breast cancer database through utilization of an online registration program. We have reported the basic facts about breast cancer in Korea in 2012, and analyzed the changing patterns in the clinical characteristics and management of breast cancer in Korea over the last 10 years. Data on patients newly diagnosed with breast cancer were collected for the year 2012 from 97 hospitals and clinics nationwide using a questionnaire survey, and from the online registry database. A total of 17,792 patients were newly diagnosed with breast cancer in 2012. The crude incidence rate of female breast cancer, including invasive cancer and in situ cancer, was 70.7 cases per 100,000 women. The median age at diagnosis was 51 years, and the proportion of postmenopausal women was higher than that of premenopausal women among those diagnosed with breast cancer. The proportion of cases of early breast cancer increased continuously, and breast-conserving surgery was performed in more cases than total mastectomy in that same year. The total number of breast reconstruction surgeries increased approximately 3-fold over last 10 years. The 5-year overall survival rate for all stages of breast cancer patients was extremely high. The clinical characteristics of breast cancer have changed in ways that resulted in high overall survival over the past 10 years in Korea, and the surgical management of the disease has changed accordingly. Analysis of nationwide registry data will contribute to a better understanding of the characteristics of breast cancer in Korea.

Breast sparganosis and incidentally detected subcutaneous and intramuscular sparganosis at several sites: case report and literature review.

Sparganosis is an infestation caused by a tapeworm belonging to the genus Spirometra. We describe a surgically confirmed case of sparganosis in several organs including the breast, both lower extremities, anterior chest wall, inguinal area, and the psoas and gluteus muscles. Mammography, ultrasonography, and MRI imaging findings for our patient were characteristic of sparganosis. Ultrasonography revealed multiple elongated tubular hypoechoic structures with surrounding increased echogenicity. Mammographic findings included tortuous, lobular, and tubular densities. Short tau inversion recovery (STIR) MR images contained several elongated tubular tracts of high signal intensity. These imaging features were highly consistent with pathology results.