High-Gain Millimeter-Wave Patch Array Antenna for Unmanned Aerial Vehicle Application.

A high-gain millimeter-wave patch array antenna is presented for unmanned aerial vehicles (UAVs). For the large-scale patch array antenna, microstrip lines and higher-mode surface wave radiations contribute enormously to the antenna loss, especially at the millimeter-wave band. Here, the element of a large patch array antenna is implemented with a substrate integrated waveguide (SIW) cavity-backed patch fed by the aperture-coupled feeding (ACF) structure. However, in this case, a large coupling aperture is used to create strongly bound waves, which maximizes the coupling level between the patch and the feedline. This approach helps to improve antenna gain, but at the same time leads to a significant level of back radiation due to the microstrip feedline and unwanted surface-wave radiation, especially for the large patch arrays. Using the SIW cavity-backed patch and stripline feedline of the ACF in the element design, therefore, provides a solution to this problem. Thus, a full-corporate feed 32 × 32 array antenna achieves realized gain of 30.71-32.8 dBi with radiation efficiency above 52% within the operational band of 25.43-26.91 GHz. The fabricated antenna also retains being lightweight, which is desirable for UAVs, because it has no metal plate at the backside to support the antenna.

Multiplex Assay for Identifying Animal Species Found in the Tibetan Area Using the Mitochondrial 12S rRNA Gene.

Southwestern China has an area with unique natural conditions located in alpine regions at altitudes from 2000 to 5000 m; this area is referred to as the Qinghai-Tibetan plateau (QTP). Unique animals, such as yaks (Bos grunniens), are found extensively on the plateau of Southwestern China due to its unique environment. In recent years, the prevalence of fake meat products such as fake jerky has increased in this area. This research was conducted as an attempt to develop a reliable multiplex polymerase chain reaction (mPCR) detection method for identifying nine animal species found in QTP. We developed the mPCR method using the specific sites found in 12S rRNA region of these nine species, which was effective in discriminating between the nine species and was successful in terms of validated reproducibility, detection limit (<6 pg total DNA), discrimination of mixed samples, and specificity (approximately 99%) using real meat samples. Our results show that the mPCR detection method can overcome the limitations of prior detection methods, such as restriction fragment length polymorphism or high-resolution melting analysis methods.

Characterisation of gene expression related to milk fat synthesis in the mammary tissue of lactating yaks.

This research communication describes the profile of gene expression related to the synthesis of yak milk as determined via quantitative reverse transcription polymerase chain reaction (RT-qPCR). Significant up-regulation during lactation were observed in genes related to fatty acid (FA) uptake from blood (LPL, CD36), intracellular FA transport (FABP3), intracellular FA activation of long- and short-chain FAs (ACSS1, ACSS2, ACSL1), de novo synthesis (ACACA), desaturation (SCD), triacyglycerol (TAG) synthesis (AGPAT6, GPAM, LPIN1), lipid droplet formation (PLIN2, BTN1A1, XDH), ketone body utilisation (BDH1, OXCT1), and transcription regulation (THRSP, PPARGC1A). In particular, intracellular de novo FA synthesis (ACSS2, ACACA, and FABP3) and TAG synthesis (GPAM, AGPAT6, and LPIN1), whose regulation might be orchestrated as part of the gene network under the control of SERBF1 in the milk fat synthesis process, were more activated compared to levels in dairy cows. However, the genes involved in lipid droplet formation (PLIN2, XDH, and BTN1A1) were expressed at lower levels compared to those in dairy cows, where these genes are mainly controlled by the PPARG regulator.

Evaluation of Suitable Internal Control Genes for RT-qPCR in Yak Mammary Tissue during the Lactation Cycle.

The yak is primarily found throughout the Tibetan high plateau and the surrounding mountainous area of south central Asia; among its others attributes, its milk is very important for the local population. A key concern in the field of yak research is the better understanding of which genes control the production and composition of milk. The most accurate and sensitive method for gene expression analysis is quantitative reverse transcription polymerase chain reaction (RT-qPCR). It is essential for reliable RT-qPCR to be able to the normalize the data using internal control genes (ICGs). However, it is critical to assess the reliability of the normalization by testing multiple ICGs. Our objective was to uncover a reliable normalization for RT-qPCR data obtained from yak mammary tissue during the lactation cycle. We assessed the reliability of 10 ICGs (ACTB, EIF6, GAPDH, LRP10, MRPL39, MRPS15, MTG1, RPS8, RPS23, and UXT) using geNorm. The analysis revealed that all of the tested ICGs can be considered to be reliable, but the use of the 6 most stable ICGs should be applied to yield a reliable normalization factor (NF). We compared the results of 3 target genes (CSN1S1, ESR1, and MYC) normalized using 6, 3, or 1 of the best ICGs. We did not observe overall differences between the 3 normalization strategies with the exception of 1 time point in MYC. The use of only a single ICG is not recommended; thus, we concluded that the calculation of the NF using the 3 best ICGs, MRPS15, RPS23, and UXT, is a reliable normalization strategy for RT-qPCR data obtained from yak mammary tissue during pregnancy and lactation. A dilution effect of the ICGs due to a large increase in the mRNA of abundantly expressed genes in bovine and porcine mammary tissue during the lactation cycle was previously observed. To test for the presence of a dilution effect in our study, we evaluated the pattern of non-normalized RT-qPCR data of ICGs from pregnancy to lactation and compared them with the total RNA concentration, milk yield, and non-normalized RT-qPCR data of 3 target genes. With a few exceptions, the non- normalized RT-qPCR data for the tested ICGs was significantly increased by lactation and had a positive correlation with total RNA and the non-normalized RT-qPCR data of CSN1S1. These data clearly indicated the presence of a "concentration effect" of single mRNA that remains unexplained but needs to be accounted for during the normalization of RT-qPCR data. Based on our findings, we recommend that the NF of the MRPS15, RPS23, and UXT genes should be used in the normalization of RT-qPCR data obtained from mammary tissue of lactating yaks during pregnancy and lactation.

Traumatic pulmonary pseudocysts after blunt chest trauma: Prevalence, mechanisms of injury, and computed tomography findings.

BACKGROUND: Traumatic pulmonary pseudocyst (TPP) is a rare complication of blunt chest trauma and closely related with severe injury. However, it has been poorly documented. We present a retrospective review of TPP cases treated at our hospital. METHODS: The medical records and chest computed tomography scans of patients with TPP treated from January 2010 to December 2013 were retrospectively studied. RESULTS: A total of 978 patients underwent chest computed tomography for blunt chest trauma during the study period, and 81 (8.3%) had a total of 150 TPPs. The most common mechanism of injury was being struck by a motorized vehicle (n = 25, 30.9%). The mean (SD) Injury Severity Score (ISS) of the 81 patients was 33.2 (11.4). The prevalence of TPP was higher in younger patients (p = 0.011), but the total number of fractured ribs was significantly lower (p = 0.001). In a subgroup analysis performed according to pseudocyst location, the intraparenchymal group had more severe injuries than the subpleural group (ISS, 23.3 vs. 32.4, p < 0.001; chest Abbreviated Injury Scale [AIS] score, 3.4 vs. 4.0, p < 0.001; number of associated injuries, 2.9 vs. 4.0, p = 0.001). By multivariate analysis, ISS, age, and number of associated injuries were significantly different in these two groups (p = 0.038, p = 0.006, and p = 0.045, respectively). CONCLUSION: The prevalence of TPP among cases of blunt chest trauma was 8.3% and was higher in those struck by a vehicle and younger patients. Intraparenchymal pseudocyst was found to be related to more severe injuries. TPP was a self-limiting condition that does not require specific treatment. LEVEL OF EVIDENCE: Prognostic/epidemiologic study, level IV.

Comparison of HER2 expression between primary colorectal cancer and their corresponding metastases.

The aim of this study was to compare human epidermal growth factor 2 (HER2) status in primary colorectal cancer and paired liver or lung metastasis. Gene amplification of HER2 has been intensively evaluated in contemporary oncology, especially in breast and stomach cancer. The knowledge of HER2 status in primary and metastatic sites may be of potential value for therapeutic decision making in metastatic colon cancer. The HER2 status was assessed by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) in 94 colorectal cancer with corresponding liver or lung metastases. HER2 amplification was present in 19 of the 188 (10.1%) of both primary and metastases combined. Four (4.6%) patients showed HER2 amplification in the metastasis and 10 (10.6%) patients showed HER2 amplification in the primary tumor. In 14 cases (14.8%), the HER2 status of the primary lesions was different from that of the associated metastases. The presence of HER2 overexpression in KRAS mutant colon cancer was found in 5.3%. No relationship was found between HER2 expression and KRAS status (P = 0.486). The evidence of HER2 positive metastatic lesion and primary colorectal cancer suggest that HER2 assessment might be considered in selected cases when this may help change the therapeutic decision.

Surgical outcome and prognostic factors in patients with gallbladder carcinoma.

BACKGROUNDS/AIMS: Gallbladder carcinoma is usually associated with an unfavorable prognosis, and the clinical outcome has not improved much. This study was conducted to evaluate outcomes with gallbladder carcinoma according to the type of surgery performed, and the prognostic factors for survival. METHODS: One hundred and six patients with gallbladder carcinoma, who underwent surgery for the purpose of curative resection between January 1999 and June 2012 were reviewed retrospectively. RESULTS: Out of 106 patients, curative resection was achieved in 75 (70.8%). The cumulative 1-, 2- and 5-year survival rates of the gallbladder carcinoma patients were 93.4%, 80.9% and 63.0%, respectively. Radical resections, including extended cholecystectomy, were more beneficial for long term survival of patients. The 5-year survival rate in patients who underwent curative resection (56.9%) was significantly higher than in those who underwent palliative resection (0%, p=0.000). Multivariate analysis revealed that curative resection, preoperative CA19-9, T-stage, N-stage and differentiation of histology were independently significant prognostic factors. CONCLUSIONS: Curative resection and early detection of patients with gallbladder carcinoma were the most important factors for long term survival. Radical resection improves survival for patients with localized gallbladder carcinoma and can help to access exact prognosis and treatments.

What does absence of lymph node in resected specimen mean after neoadjuvant chemoradiation for rectal cancer.

BACKGROUND: The effect of insufficient node sampling in patients with rectal cancer managed by neoadjuvant chemoradiation followed by surgery has not been clearly determined. We evalulated the impact of insufficient sampling or even abscence of lymph nodes in the specimen on survival in patients at high-risk (T3, T4 or node positive) for rectal cancer. METHODS: We conducted a single institution, retrospective analysis of all patients who underwent surgical rectal resection following neoadjuvant chemoradiation for treatment of mid to lower rectal cancer between 1997 and 2009. ypNX was defined as the absence of lymph nodes retrieved in the resected specimen. RESULTS: A total of 132 patients underwent resection for treatment of rectal cancer following neoadjuvant chemoradiation. Ninety four patients (71.2%) were considered as having node-negative disease, including ypNx and ypN0. In 38 patients (28.8%), the primary tumor was associated with regional lymph node metastases (ypNpos). The mean number of retrieved nodes per specimen was 14.2, respectively. The five-year overall survival from initial operation for the ypNx group was 100%, respectively. The estimated five-year overall survival for ypN0 and ypNpos was 84.0% and 60.3%, respectively (P =0.001). No significant differences in overall survival were observed between the ypNx and ypN0 group (P =0.302). CONCLUSION: Absence of recovered LN in resected specimens after neoadjuvant chemoradiation was observed in 7.6% of specimens. Absence of LN should not be regarded as a risk factor for poor survival or as a sign of less radical surgery.

Factors influencing hepatocellular carcinoma prognosis after hepatectomy: a single-center experience.

BACKGROUND/AIMS: Recurrence after hepatic resection is one of the most important factors impacting the prognosis and survival of patients with hepatocellular carcinoma (HCC). We identified prognostic factors affecting overall survival (OS) and disease-free survival (DFS) in patients with HCC after hepatic resection. METHODS: This study was of a retrospective cohort design, and 126 patients who underwent hepatic resection for HCC at Gachon University Gil Medical Center between January 2005 and December 2010 were enrolled. Various clinical, laboratory, and pathological data were evaluated to determine the prognostic factors affecting OS and DFS. RESULTS: Two- and 4-year OS and 2- and 4-year DFS were 78.1% and 65% and 51.1% and 26.6%, respectively. In a multivariate analysis, preoperative α-fetoprotein (> 400 ng/mL), tumor size (≥ 5 cm), multiple tumors (two or more nodules), presence of portal vein invasion, modified Union for International Cancer Control (UICC) stage III/IV, and Barcelona Clinic Liver Cancer (BCLC) stage B/C were independent prognostic factors affecting a shorter OS. In the multivariate analysis, presence of microvascular invasion, modified UICC stage III/IV, and BCLC stage B/C were independent prognostic factors for a shorter DFS. CONCLUSIONS: The presence of vascular invasion was an independent poor prognostic factor for OS and DFS in patients with HCC after hepatic resection. Thus, close postoperative surveillance for early detection of recurrence and additional treatments are urgently needed in patients with vascular invasion after hepatic resection.

A centrifugally actuated point-of-care testing system for the surface acoustic wave immunosensing of cardiac troponin I.

A fully automated point-of-care testing (POCT) system with a surface acoustic wave (SAW) immunosensor was developed for rapid and sensitive detection of cardiac troponin I (cTnI) in body fluid (plasma and whole blood). The assay, based on gold nanoparticle sandwich immunoassay and subsequent gold staining, was performed on the SAW immunosensor packaged inside a disposable microfluidic cartridge. The entire fluidic process, including plasma separation, reagent transport, metering, and mixing, was carried out by controlling the centrifugal force acting on the rotating cartridge and laser-irradiated ferrowax microvalves. On investigation of sensor response to various cTnI concentrations, the system exhibited a high performance with a detection limit of 6.7 pg mL(-1), and the coefficient of variation was less than 10% over the entire test range (10 pg mL(-1) to 25 ng mL(-1)). On comparing this POCT system with a clinically utilized system in a physical laboratory (Centaur® XP; Siemens), a correlation coefficient of 0.998 was found, validating the diagnostic capability of the SAW immunosensor.

Surgical management and results for cystic neoplasms of pancreas.

BACKGROUNDS/AIMS: The diagnosis for cystic neoplasm of pancreas is based on the morphologic criteria through imaging studies, but the pre- and postoperative diagnoses are often inconsistent. This study aims at the analysis of clinical characteristics and the results of surgical treatments. METHODS: A retrospective review was performed on 93 patients who have undergone surgery for pancreatic cystic diseases in our hospital from January 2001 to February 2013. Among them, 69 patients were confirmed as cystic neoplasms based on pathologic findings. Their clinical manifestations, diagnostic accuracy, surgical method and complications, pathologic findings were analyzed. RESULTS: Serous cystic neoplasm was the most common (n=22), followed by mucinous cystic neoplasm (n=18), intraductal papillary mucinous tumor (n=11), solid pseudopapillary tumor (n=9), neuroendocrine tumor (n=7), and cystic lymphangioma (n=2). The most common clinical symptom is abdominal pains (49.3%). Preoperative imaging studies were consistent with pathological findings in 72% of patients. Cystic fluid CEA levels of 400 ng/ml or more were reliable to detect mucin secreting tumors. Pancreatoduodenectomy was performed for 13 cases and the remaining 54 patients were treated with left-side pancreatectomy. Malignancy was found in 9 cases (13%) of mucin secreting tumors; 5 cases (27.8%) in mucinous cystic neoplasm and 4 cases (36.4%) in intraductal papillary mucinous tumor. Two of these survived without recurrences during the follow-up periods. CONCLUSIONS: Exact treatment protocols for cystic neoplasm of pancreas are not decided because tumors are found with atypical forms. Surgical management is suggested for resectable tumors because a good prognosis can be expected with proper surgery if precancerous lesions are suspected at the time of discovery.

Clinical manifestations of abdominal wall endometriosis: a single center experience.

OBJECTIVE: This study aimed to investigate the clinical manifestations and treatment outcomes of abdominal wall endometriosis (AWE). MATERIALS AND METHODS: Patients diagnosed with AWE at the Gil Medical Center from January 2002 to September 2010 were retrospectively reviewed. RESULTS: Thirty-seven women were treated for AWE during the study period. Median age was 34 (range 24-45) years, and median duration from last pelvic surgery until symptom onset was 30 (range 6-96) months. The most common initial symptom was a palpable mass (36, 97.2 %), followed by cyclic or spontaneous pain (21, 56.8 %). Preoperative diagnoses were accurate in 20 of 29 patients (68.9 %), who underwent a preoperative imaging study. The accuracy of abdominal US was 80 % (12/15). All patients underwent wide excision, and the median tumor size was 3.5 (range 1.0-10.0) cm. One patient experienced recurrence at 34 months postoperatively. CONCLUSIONS: Physicians should be aware of AWE in any woman presenting with palpable mass and/or pain at the abdominal wall, especially after pelvic surgery. Adequate preoperative estimation and wide excision might be essential for the treatment of AWE.

Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study.

OBJECTIVE: To compare surgical outcomes and quality of life between single-port laparoscopic appendectomy (SPLA) and conventional laparoscopic appendectomy (CLA) in patients with acute appendicitis. BACKGROUND: A prospective randomized single center study was performed to compare the outcome of SPLA and CLA in patients with acute appendicitis. METHODS: A total of 248 patients were randomized, but because of 18 withdrawals, the outcome of 224 is analyzed, 116 in CLA and 114 in SPLA. RESULTS: There was no significant difference in the overall complication rate (P = 0.470). There were no significant differences in infectious complications between the SPLA group and the CLA group (10.2% and 12.4%, respectively). The wound complication rate between the 2 groups was not significant (5.1% and 10.6%, respectively; P = 0.207). Cosmetic satisfaction score, 36-item short-form health survey, and postoperative pain scores were not significantly different between 2 groups. CONCLUSIONS: SPLA failed to show any advantages over CLA relative to pain and cosmesis. However, SPLA is as safe as CLA (RCT number 01348464).

Sensitive and simultaneous detection of cardiac markers in human serum using surface acoustic wave immunosensor.

We present a rapid and sensitive surface acoustic wave (SAW) immunosensor that utilizes gold staining as a signal enhancement method. A sandwich immunoassay was performed on sensing area of the SAW sensor, which could specifically capture and detect cardiac markers (cardiac troponin I (cTnI), creatine kinase (CK)-MB, and myoglobin). The analytes in human serum were captured on gold nanoparticles (AuNPs) that were conjugated in advance with detection antibodies. Introduction of these complexes to the capture antibody-immobilized sensor surface resulted in a classic AuNP-based sandwich immunoassay format that has been used for signal amplification. In order to achieve further signal enhancement, a gold staining method was performed, which demonstrated that it is possible to obtain gold staining-mediated signal augmentation on a mass-sensitive device. The sensor response due to gold staining varied as a function of cardiac marker concentration. We also investigated effects of increasing operating frequency on sensor responses. Results showed that detection limit of the SAW sensor could be further improved by increasing the operating frequency.

Mutations in K-ras and epidermal growth factor receptor expression in Korean patients with stages III and IV colorectal cancer.

K-Ras somatic mutations in advanced colorectal cancer (CRC) can predict resistance to mAbs that target the epidermal growth factor receptor (EGFR). The relationships between K-ras mutations and the EGFR status have not yet been examined, especially in Korean patients. A total of 82 colorectal tumors (stage III-IV) were analyzed. K-Ras mutations at codons 12 and 13 were detected by polymerase chain reaction-single strand conformational polymorphism. The EGFR expressions were examined by immunohistochemistry, and these were graded according to a modified EGFR expression scoring system. The relationships between the patients' characteristics and the survival time and the gene mutation status were analyzed. The EGFR expression was positive in 69 patients (84.1%) and negative in 13 patients (15.9%). The K-ras mutation rate was 35.4%. In all, 20 (68.9%) cases were mutated at codon 12 and 9 (31.1%) cases were mutated at codon 13. No relationship was observed between the EGFR status and K-ras mutation. The median overall survival (OS) was 68.1 months. There was no difference between the K-ras mutant group and the wild type group for overall survival (30.3% vs 21.0%, respectively, at 36 months, P = .777). K-ras mutation and the EGFR status were not independent prognostic factors for OS (P = .105 and P = .499, respectively). For the Korean patients with CRC, the rate of an EGFR protein expression was greater than that for the patients in Western countries, and the rate of K-ras mutations was lower than that for patients in Western countries. This study found no correlation between the EGFR status and K-ras mutations in colorectal tumors.

A retrospective clinicopathological analysis of appendiceal tumors from 3,744 appendectomies: a single-institution study.

PURPOSE: This study was conducted to describe the clinicopathological characteristics of appendiceal tumors and to evaluate their appropriate management. METHODS: Between September 2000 and September 2005, 28 appendiceal tumors were identified by a retrospective review of 3,744 appendectomies. RESULTS: Twenty-eight patients were found to have appendiceal tumors (incidence, 0.7%).The largest single group of tumors were benign mucinous cystadenomas (50%); carcinoids (32.1%) were next, and they were followed by malignant tumors (17.9%). Four out of five patients who had malignant appendiceal tumors presented with periappendiceal abscess. None of the patients was correctly diagnosed preoperatively. One-stage curative resection was possible in more than 76% of the patients, and the rate of making the correct preoperative diagnosis was 35%. CONCLUSION: Most appendiceal tumors presented with appendicitis and periappendiceal abscess. Appendiceal tumors should be included in the differential diagnosis when an unexpected appendiceal mass is encountered during appendectomy.

Clinical comparison of choledochal cysts between children and adults.

BACKGROUNDS/AIMS: Choledochal cyst of the bile duct is characterized by cystic dilatation of the intra- or extrahepatic bile ducts. It is a relatively uncommon disease and there is still much controversy regarding its etiology as being congenital or acquired. METHODS: The medical records of 60 patients who underwent surgical treatments for choledochal cyst between April 1995 and April 2009 at the Gachon University Gil Hospital were reviewed retrospectively. To compare the clinical characteristics, patients under 19 years of age were grouped into children and the others were grouped into adults. RESULTS: Of the overall 60 patients, 24 were grouped into children and 36 were grouped into adults. Female predominance was common in both groups (M : F=1 : 6.5). The most common clinical symptom was abdominal pain (73.3%) in both groups. Children had remarkable jaundice (33.3% vs. 0%) and gastrointestinal symptoms including nausea and vomiting. Fever and chills were more common in children because of the associated complications of cholangitis. According to the Todani classification, type I was the most common form of choledochal cyst in both groups, and type IVa was significantly more common in children than adults (45.3% vs. 16.7%). Thirty patients (50%) had anomalous pancreaticobiliary ductal union which was confirmed by preoperative imaging studies or intraoperative cholangiography. All patients except for one child underwent cyst excision with hepaticojejunostomy. CONCLUSION: There was no significant difference in the clinical characteristics of choledochal cysts between children and adults. However, combined diseases especially bile duct malignancy were common in aged patients, early detection and more aggressive surgery is necessary for patients with choledochal cysts.

[2 cases of gastric mucosa-associated lymphoid tissue lymphoma presenting as a submucosal tumor-like lesion].

Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is the most common form of primary extranodal lymphomas. In most cases, it is developed as multifocal and mucosal lesions, and its initial diagnosis is made by biopsy of suspicious lesions on endoscopy. However, when gastric MALT lymphoma afflict submucosal site without typical mucosal lesion, further procedures are necessary for diagnosis, such as endoscopic mucosal resection and endoscopic ultrasonography. We recently experienced two cases of submucosal tumor-like gastric MALT lymphoma. Both cases were without any mucosal lesion. One case was confirmed by endoscopic mucosal resection, and the latter was by wedge resection. Treatment modalities included endoscopic mucosal resection, surgery, H. pylori eradication, and/or chemotherapy. Both cases achieved complete remission until our 18 months' and 16 months' follow up.

[The usefulness of in vitro interferon-gamma assay for differential diagnosis between intestinal tuberculosis and Crohns disease].

BACKGROUND/AIMS: It is difficult to clinically and endoscopically differentiate intestinal tuberculosis (ITB) and Crohns disease (CD). The aim of this study was to evaluate the usefulness of in vitro interferon-gamma (INF-gamma) assay for differential diagnosis between ITB and CD. METHODS: Sixty patients for whom differential diagnosis between ITB and CD was difficult were enrolled between January 2007 and January 2009. The INF-gamma-producing T-cell response to early secreted antigenic target 6 and culture filtrate protein 10 were measured by T-SPOT.TB blood test in vitro. We evaluated the usefulness of T-SPOT.TB blood test by comparing its results with the final diagnosis. RESULTS: Twenty and forty patients were revealed to be positive and negative in T-SPOT.TB blood test, respectively. Of the 20 patients found to be positive, 12 patients (60%) were finally diagnosed as ITB, 6 patients as CD, and 2 patients as Behcets enterocolitis. Of the 40 patients with negative results, 38 patients (95%) were diagnosed as CD; one as Behcets enterocolitis; one as nonspecific colitis; none as ITB. The sensitivity and specificity of T-SPOT.TB blood test for ITB were 100% and 83.3%, respectively. Positive and negative predictive values of T-SPOT.TB blood test for ITB were 60.0% and 100%, respectively. CONCLUSIONS: When differential diagnosis between ITB and CD is difficult, T-SPOT.TB blood test may be a helpful and rapid diagnostic tool to exclude ITB. Prospective large-scaled studies are required for further evaluation of the usefulness of T-SPOT.TB blood test for differential diagnosis between ITB and CD.

Multiple primary malignancies involving colorectal cancer--clinical characteristics and prognosis with reference to surveillance.

BACKGROUND/AIM: The purpose of this study was to investigate clinically useful information for effective screening for synchronous and metachronous second primary cancers and to suggest potential surveillance tool. METHODS: We retrospectively reviewed 1,063 patients who were treated with potentially curative surgery for colorectal cancer at Gachon University, Gil Hospital from 1997 to 2007. RESULTS: The incidence of synchronous or metachronous cancer in addition to colorectal cancer was 5.3% (57 patients). The most common second primary cancer was stomach (54.3%), followed by cancers in cervix (12.2%). The time interval between the first and second tumor in colorectal cancer associated with metachronous extracolonic malignancy ranged from 1.1 to 10.8 years. The incidence of early-stage tumor was higher in patients with synchronous cancer than in those with a metachronous cancer with statistical significance (p = 0.034). The 5-year survival rate of the colorectal cancer group without second primary cancer was 70.1%, whereas that for the second primary cancer group was 63.8% (p = 0.253). The 5-year survival rate of the colorectal cancer group with stomach cancer was 70.5%, whereas that for the second primary cancer other than stomach cancer group was 56.6% (p = 0.282). CONCLUSION: The frequent association between colorectal cancer and gastric cancer suggests an inclusion of gastrofiberscope when surveillancing patients with colorectal cancer in Korean population. Second primary cancers may develop even 10 years after the initial operation; thus, a need for lifelong surveillance even more than 5 years may be necessary.