Background: Triple-negative breast cancer (TNBC), characterized by the lack of expression of estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2, is typically associated with a poor prognosis. The majority of TNBCs show the expression of basal markers on gene expression profiling and most authors accept TNBC as basal-like (BL) breast cancer. However, a smaller fraction lacks a BL phenotype despite being TNBC. The literature is silent on non-basal-like (NBL) type of TNBC. The present study was aimed at defining behavioral differences between BL and NBL phenotypes. Objectives: i) Identify the TNBCs and categorize them into BL and NBL breast cancer. ii) Examine the behavioral differences between two subtypes. iii) Observe the pattern of treatment failure among TNBCs. Materials and Methods: All TNBC cases during January 2009-December 2010 were retrieved. The subjects fitting the inclusion criteria of study were differentiated into BL and NBL phenotypes using surrogate immunohistochemistry with three basal markers $34{\beta}E12$, c-Kit and EGFR as per the algorithm defined by Nielsen et al. The detailed data of subjects were collated from clinical records. The comparison of clinicopathological features between two subgroups was done using statistical analyses. The pattern of treatment failure along with its association with prognostic factors was assessed. Results: TNBC constituted 18% of breast cancer cases considered in the study. The BL and NBL subtypes accounted for 81% and 19% respectively of the TNBC group. No statistically significant association was seen between prognostic parameters and two phenotypes. Among patients with treatment failure, 19% were with BL and 15% were with NBL phenotype. The mean disease free survival (DFS) in groups BL and NBL was 30.0 and 37.9 months respectively, while mean overall survival (OS) was 31.93 and 38.5 months respectively. Treatment failure was significantly associated with stage (p=.023) among prognostic factors. Conclusions: Disease stage at presentation is an important prognostic factor influencing the treatment failure and survival among TNBCs. Increasing tumor size is related to lymph node positivity. BL tumors have a more aggressive clinical course than that of NBL as shown by shorter DFS and OS, despite having no statistically significant difference between prognostic parameters. New therapeutic alternatives should be explored for patients with this subtype of breast cancer.
This survey was willing to suggest the basic data required for strategic planning to improve the recognition rate on radiation by investigating the difference between the college students who major in radiology and who don't about using radiation. As the results of questionnaire survey on 'knowledge, degree of self-consciousness, danger, convenience and management' targeting 441 students who belonged to D college, 75% of them answered that radiation exists in their daily lives and 54% of them answered they did not know about radiation well. It showed that radiation is dangerous no matter how much the amount is (56%) and it is not dangerous if it is managed well (81%). They answered that they enjoy the convenience of radiation (82%) and the use for medical purpose took the highest percentage among them (58%). It showed that it is important to manage the radiation and should be controlled by the government in institutional way than the individual (64%). The negative answer to the question of 'do you trust the government?' was dominant (75% below average). As the results of this survey, it was recognized that both of them who major in radiology or not were aware of positive aspect of radiation (especially medical technology field) well and the improving the perception of radiation led by the government and definite restriction on its safety should be preceded for safe use.
Streptococcus pneumoniae is the leading cause of community-acquired pneumonia throughout the world. The bacteria invade through lung tissue and cause sepsis, shock, and serious sequelae, including rheumatic fever and acute glomerulonephritis. However, the molecular mechanism associated with pneumonia's penetration of lung tissue and invasion of the blood stream are still unclear. We attempted to investigate the host cell response at protein levels to S. pneumoniae D39 invasion using human lung cancer epithelial cells, A549. Streptococcus pneumoniae D39 began to change the morphology of A549 cells to become round with filopodia at 2 hours post-infection. A549 cell proteins obtained at each infection time point were separated by SDS-PAGE and analyzed using MALDI-TOF. We identified several endoplasmic reticulum (ER) resident proteins such as Grp94 and Grp78 and mitochondrial proteins such as ATP synthase and Hsp60 that increased after S. pneumoniae D39 infection. Cytosolic Hsc70 and Hsp90 were, however, identified to decrease. These proteins were also confirmed by Western blot analysis. The identified ER resident proteins were known to be induced during ER stress signaling. These/ data, therefore, suggest that S. pneumoniae D39 infection may induce ER stress.
HCV is a single-stranded RNA virus and more than 1 million new cases are reported annually worldwide. The six major HCV genotypes and numerous subtypes vary in their geographic distribution. It is thought that genetic heterogeneity of HCV may account for some of the differences in disease outcome and response to treatment observed in HCV infected persons. In this study, we determined HCV genotypes among chronic Korean HCV patients and evaluated direct sequence PCR protocols developed. For the study, 232 chronic HCV patient sera were used. HCV RNA was extracted and two pairs of consensus PCR primers were selected in 5'UTR region for amplification of HCV RNA. Amplification products obtained from the HCV positive cases were subjected to automatic sequencing. Sequences were compared with those in GenBank by using the BLAST program. From this study, five HCV genotypes, 1b, 2a, 2b, 2c and 3a were found. HCV genotypes 4, 5 and 6 were not determined. HCV genotype 1b (53.9%, 125/232) and 2a (35.8%, 83/232) were most frequently found. This group was followed by 2b (3.9%, 9/232), 3a (3.4%, 8/232) and 2c (3.0%, 7/232). The data presented here suggest a complex distribution of HCV types and they were well correlated with other reports on Koreans and will be helpful for type-specific follow-up of Korean HCV patients. This study showed that 5'UTR direct sequence analysis is a sensitive and rapid method to identify HCV genotypes.
Ginseng has been known to be highly effective for health as a traditional medicinal herb. Ginseng berry, or fruit of ginseng, contains ginsenoside, saponin, polyphenol, polyacetylene, alkaloid, etc. as the main compounds as does ginseng. The aim of this study is to evaluate any effect of ginseng berry water extract (GBE) on diabetic-associated molecules, such as enzymes, which are responsible for the glucose entry of the cells and the insulin receptor signaling molecules using HepG2 cells. Therefore, two enzymes, ${\alpha}$-amylase and ${\alpha}$-glucosidase, were selected and assayed for their activities in the presence of GBE in vitro. These two enzymes are responsible for producing glucose from dietary starch. Protein-tyrosine phosphatase 1B (PTP1B) and Akt1 are key proteins in the insulin receptor signaling pathway. These two intracellular signaling molecules were investigated for their expression levels in HepG2 cells after insulin and GBE treatment. GBE, at concentrations up to $1,000{\mu}g/ml$, did not exert any inhibitory effect on ${\alpha}$-amylase and ${\alpha}$-glucosidase. It was observed that the expression level of PTP1B was increased by insulin and the $25{\mu}g/ml$ GBE treatment enhanced the PTP1B level. However, GBE at a concentration of $200{\mu}g/ml$ reduced the expression level of PTP1B. In the case of Akt1, the Akt1 level by insulin was decreased by GBE treatment. These data suggest that the water extracts of ginseng berry have an influence on intracellular signaling by insulin.
Novel influenza A virus, subtype H1N1 of swine-lineage, has been transmitted rapidly to many regions of the world. Rapid detection of the virus is essential to instigate appropriate patient care and public health management and for disease surveillance. The aim of this study is to determine the prevalence of novel influenza A (H1N1) virus in Korea using reverse-transcription real time polymerase chain reaction (rRT-PCR). Novel H1N1 virus was detected in a total of 8,948 nasopharyngeal samples from patients with influenza-like illness throughout Korea from August to September 2009. RNA was extracted from $300{\mu}l$of sample using an RNA extraction kit (Zymo Research, CA, USA). In the present study, Genekam kit (Genekam, Duisburg, Germany) was used to detect novel H1N1 virus. Novel H1N1 virus was found in 1,130 samples from a total of 8,948 samples (12.6%). The highest frequency was found in 10- to 19-year-olds (M: 29.3% vs. F: 16.4%), followed by 20- to 29-year-olds (M: 17.9% vs. F: 15.4%), 40- to 49-year-olds (M: 6.5% vs. F: 8.1%), 50- to 59-year-olds (M: 6.0% vs. F: 5.5%), and 30- to 39-year-olds (M: 4.6% vs. F: 3.8%). The mean positive rate was higher in men than in women (M: 14.7% vs. F: 7.4%). Novel H1N1 virus showed the lowest prevalence in patients over 60 years old. The positive rate increased daily and showed a significant high peak in mid-September 2009. In 19 provinces of Korea, Cheonan (41.1%), Busan (37.3%), Gangneung (33.3%), Jinju (32.1%), Ulsan (24.6%), Deajeon (23.7%) areas showed high frequencies and other provinces were found less than 10% of novel H1N1 virus. Since reverse-transcription real time PCR assay is rapid, accurate, and convenient, it may assist public health laboratories in detecting novel H1N1 virus. Moreover, these data could be useful for the management of patients with influenza-like illness.
To prevent the secondary hospital-acquired infection (cross-infection) from occurring in the general radiographic room in the department of radiology, the microbial measurement was conducted at the points making direct close contact with radiologists and patients. For the case of radiologists, the microbial measurement and incubation were focused on the x-ray tube handle of the radiation generating device, and, for the case of patients, the microbial measurement and incubation were focused on the chin supporting device, chest-contact point, and handle. Once disinfected with Aniosurf, the sterilized media were gathered and identified, and the microorganisms were confirmed. Based on the identification results, it was confirmed that the points making direct close contact with radiologists showed a value of 103 CFU for Proteus mirabilis, Staphylococcus epidermidis, Bacillus spp. and Candida spp., and that the points making direct close contact with patients showed a value of 103~5 CFU for Proteus mirabilis, Enterococcu faecium, Pseudomonas aeruginosa, NTM(Non-Tuberculosis Mycobacteria) and Candida spp.. It was also confirmed that the types and number of microorganisms gathered from the points making direct close contact with patients were greater. Fortunately, most of the involved microorganisms were observed to be on the skin surface and are known to become extinct when disinfected in accordance with the hospital-acquired infection control rules. However, since even minor exposure to such microorganisms may be lethal for patients with reduced immunity, caution must be taken. In particular, since the points making contact with patients showed a high level of microbial measurement, it was thought that it would be necessary for radiologists and personnel having frequent access to strictly disinfect the parts, such as instruments and handles, making frequent contact with patients. The purpose of this study was to announce the importance of safe microbial control in the radiographic inspection room in hospital, and this study is expected to be used as the baseline data for preventing hospital-acquired secondary infection and Nth infectious diseases.
Purpose: This study aimed to identify prognostic factors for patients with distant lymph node-involved gastric cancer (GC) using a machine learning algorithm, a method that offers considerable advantages and new prospects for high-dimensional biomedical data exploration. Materials and Methods: This study employed 79 features of clinical pathology, laboratory tests, and therapeutic details from 289 GC patients whose distant lymphadenopathy was presented as the first episode of recurrence or metastasis. Outcomes were measured as any-cause death events and survival months after distant lymph node metastasis. A prediction model was built based on possible outcome predictors using a random survival forest algorithm and confirmed by 5×5 nested cross-validation. The effects of single variables were interpreted using partial dependence plots. A contour plot was used to visually represent survival prediction based on 2 predictive features. Results: The median survival time of patients with GC with distant nodal metastasis was 9.2 months. The optimal model incorporated the prealbumin level and the prothrombin time (PT), and yielded a prediction error of 0.353. The inclusion of other variables resulted in poorer model performance. Patients with higher serum prealbumin levels or shorter PTs had a significantly better prognosis. The predicted one-year survival rate was stratified and illustrated as a contour plot based on the combined effect the prealbumin level and the PT. Conclusions: Machine learning is useful for identifying the important determinants of cancer survival using high-dimensional datasets. The prealbumin level and the PT on distant lymph node metastasis are the 2 most crucial factors in predicting the subsequent survival time of advanced GC.
This study proposes a spirometry reference equation suitable for Asian migrant workers undergoing special health examinations. The study participants were divided according to their region: Central Asia, Northeast Asia, and South Asia Pacific. We confirmed results of the spirometry analysis of migrant workers and the interpretation consistency between the prediction equations. Based on this data, we propose a reference equation suitable for domestic migrant workers and suggest a scaling factor applicable to the spirometer wherein the reference equation is not easily applicable. The kappa-values obtained for men and women, respectively, between the global lung function initiative 2012 (GLI2012)-Southeast Asian and the Southeast Asian equations were 0.819 and 0.770, between the GLI2012-Southeast Asian and the South Asian equations were 0.881 and 0.866, and between the GLI2012-Northeast Asian and the Central Asian equations were 0.831 and 0.833. We propose applying the GLI2012-Northeast Asian equation for Northeast Asian and Central Asian countries, whereas the GLI2012-Southeast Asian equation was found to be more suitable for predicting Southeast Asian and South Asian populations. For spirometry, we recommend applying a scaling factor of 0.87 to the Dr. Choi equation, wherein the GLI2012-Southeast Asian equation is not applicable.
The caries activities of some commercially available children's beverages were measured to determine the risk of dental caries and provide basic data for preventing dental caries. For the experimental beverage, the beverages with the highest market share among carbonated beverages, fruit beverages, milk, and fermented milk products sold in the domestic market were selected. As a control, 0.25% glucose trypticase soy broth was prepared and used. The pH of the beverages, titrate acid and buffering capacity, and the acid production and vitality were measured over time after inoculating the beverages with Streptococcus mutans. The pH of children's beverages was the lowest in soda (2.61±0.02), and milk had the lowest in titratable acid (14.00±0.58). Fermented milk (80.33±3.64) had the highest buffering capacity, and carbonated beverage (9.40±1.06) had the lowest (P<0.05). Carbonated beverages (3 hr and 25 min) had the highest acid production, and milk (4 hr) had the lowest. In conclusion, thorough oral hygiene management is necessary after consuming children's beverages because they have a low pH promote high acid production of S. mutans.
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