PURPOSE: Epidermal growth factor receptor (EGFR) is considered a potential therapeutic target for anti-EGFR therapy in triple-negative breast cancer (TNBC). However, the frequency of EGFR gene mutation in TNBC is low and varies with ethnicity. This study aimed to investigate the incidence of EGFR gene mutation in TNBC. METHODS: EGFR protein expression was evaluated by immunohistochemistry in tissue microarrays of 493 TNBC cases using four different primary antibodies, which included mutation-specific antibodies. For cases with an immunoreactivity level ≥1+, we performed pyrosequencing analysis for EGFR gene mutation. A case was considered mutation-positive when its mutation frequency minus its limit of detection (LOD) was >10%. Cases with mutation frequency higher than LOD were assessed for EGFR gene mutation status using the Cobas assay and by peptide nucleic acid-mediated polymerase chain reaction (PNA-clamping). RESULTS: Among 493 TNBCs, 148 (30.0%) exhibited staining ≥1+ for EGFR, including 78 with 1+, 49 with 2+, and 21 with 3+. Positive EGFR expression (≥2+) was significantly associated with lymphovascular invasion (p=0.010), but not with overall survival (p=0.444) or disease-free survival (p=0.388). None of the 493 TNBCs harbored an EGFR gene mutation. Among 148 cases with an EGFR staining result ≥1+, five (3.4%) showed mutation frequencies (4.4%–10.9%) higher than LOD (2.6%–4.3%) in exons 19 (L747_P753>Q) or 21 (L858R and L861Q) as determined by pyrosequencing. However, Cobas and PNA-clamping failed to detect the presence of EGFR gene mutation in these five cases. CONCLUSION: No activating mutation of EGFR gene of clinical significance was observed in 148 TNBC cases using three commercially available methods. Thus, EGFR gene mutation appears to be an extremely rare event in patients with TNBC.
Antibodies ; Breast Neoplasms ; Disease-Free Survival ; Epidermal Growth Factor* ; Exons ; Genes, erbB-1 ; Humans ; Immunohistochemistry ; Incidence ; Limit of Detection ; Mutation Rate ; Polymerase Chain Reaction ; Receptor, Epidermal Growth Factor* ; Triple Negative Breast Neoplasms*

Objective: To discuss the association between the length of stay at the intensive care unit (ICU) and sarcopenia among hemiplegic stroke patients. Methods: This study evaluated 66 hemiplegic stroke patients with history of ICU admission using handgrip strength and bioelectrical impedance analysis to obtain height-adjusted appendicular skeletal muscle mass. The diagnosis of sarcopenia was made according to the muscle mass based on the Asian Working Group for Sarcopenia. The patients were divided into sarcopenic and non-sarcopenic groups. The two groups were statistically analyzed, and the significant factors with differences were studied. A multivariate logistic regression analysis was performed to examine the association between length of stay in the ICU and sarcopenia, after adjusting for potential confounders. Results: Among 66 hemiplegic patients with an ICU admission history, 12 patients were diagnosed with sarcopenia. Sarcopenia patients showed lower scores on the Korean version of the Modified Barthel Index and the Korean version of the Mini-Mental State Examination. Additionally, patients with sarcopenia had a longer length of stay in the ICU, and univariate and multivariate analyses confirmed that the ICU length of stay was significantly related to sarcopenia (adjusted odds ratio=1.187; 95% confidence interval, 1.019–1.382; p=0.028). Conclusion The length of stay in the ICU was significantly associated with sarcopenia in hemiplegic stroke patients.

Objective: To evaluate the gait pattern of patients with gait disturbances without consideration of defilades due to assistive devices. This study focuses on gait analysis using the inertial measurement unit (IMU) system, which can also be used to determine the most appropriate assistive device for patients with gait disturbances. Methods: Records of 18 disabled patients who visited the Department of Rehabilitation from May 2018 to June 2018 were selected. Patients’ gait patterns were analyzed using the IMU system with different assistive devices to determine the most appropriate device depending on the patient’s condition. Evaluation was performed using two or more devices, and the appropriate device was selected by comparing the 14 parameters of gait evaluation. The device showing measurements nearer or the nearest to the normative value was selected for rehabilitation. Results: The result of the gait evaluation in all 18 patients was analyzed using the IMU system. According to the records, the patients were evaluated using various assistive devices without consideration of defilades. Moreover, this gait analysis was effective in determining the most appropriate device for each patient. Increased gait cycle time and swing phase and decreased stance phase were observed in devices requiring significant assistance. Conclusion The IMU-based gait analysis system is beneficial in evaluating gait in clinical fields. Specifically, it is useful in evaluating patients with gait disturbances who require assistive devices. Furthermore, it allows the establishment of an evidence-based decision for the most appropriate assistive walking devices for patients with gait disturbances.