Purpose: Atypical hyperplasia (AH) management remains controversial due to variable malignant disease progression rates. While Western studies report 10% to 25% upgrade rates, data from Asian populations, particularly from referral academic centers, are limited. We aimed to identify predictive factors for malignant upgrade in Korean women with AH at academic hospitals. Methods: This retrospective multi-institutional study analyzed 340 patients diagnosed with AH on initial biopsy who underwent subsequent excision at five Korean academic hospitals from 2000 to 2022. Malignant upgrade was defined as ductal carcinoma in situ or invasive cancer on the final pathology. Multivariate logistic regression was used to identify independent predictors of upgrades. Results: Among 340 patients (319 atypical ductal hyperplasia, 20 atypical lobular hyperplasia, and 1 mixed), 128 (37.6%) experienced a malignant upgrade, 98 (76.6%) to ductal carcinoma in situ, and 30 (23.4%) to invasive cancer. In multivariate analysis, multifocal atypia (odds ratio [OR], 25.61; 95% confidence interval [CI], 11.20–58.55; P<0.001) and Breast Imaging-Reporting and Data System 4c-5 lesions (OR, 11.02; 95% CI, 1.43–84.86; P=0.021) were significant predictors. Multifocal atypia showed an 84.4% upgrade rate. Core needle biopsy had higher upgrade rates than vacuum-assisted biopsy (45.2% vs. 20.0%; P<0.001). The upgrade rates decreased from 50% to 25% over the study period (P<0.05). Conclusion The 37.6% upgrade rate in this tertiary referral cohort exceeded that in Western reports, with multifocal atypia emerging as the strongest predictor. These findings support immediate excision for multifocal atypia while allowing individualized management for unifocal lesions with favorable imaging in Korean tertiary care settings.

The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer. The median age of women diagnosed with breast cancer was 53.4 years, with the highest incidence occurring in the 40–49 age group. The most common molecular subtype was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative, accounting for 69.1% of cases, while HER2-positive subtypes comprised 19.3%. During the coronavirus disease 2019 pandemic, the national breast cancer screening rate declined. However, the incidence of early-stage breast cancer (stages 0 and I) continued to increase, accounting for 65.6% of newly diagnosed cases in 2021. Our results showed that the overall survival rate for patients with breast cancer has improved, primarily due to a rise in early-stage diagnoses and advancements in treatment.

Purpose: This study assessed the temporal trends of uptake of national general health and cancer screening among women with breast cancer in Korea between 2009 and 2016. Materials and Methods: We retrospectively analyzed the claims data from the Korean National Health Insurance Service database. Participants included 101,403 breast cancer patients diagnosed between 2009 and 2016. Information on participation in national screening programs, including breast cancer screening, general health, and gastric, colorectal, and cervical cancers, up to 2020 was collected. Screening participation rates within the first 2 and 5 years postdiagnosis were calculated by diagnosis year and fitted with joinpoint regression models to assess temporal trends. Results: Overall, the participation rate in breast cancer screening within 2 years postdiagnosis increased from 10.9% to 14.0% from 2009-2016, with an annual percentage change (APC) of 3.7% (p < 0.05). The participation rate in breast cancer screening was lower than that in general health checkup and screening for other cancers within 2 and 5 years postdiagnosis. A steady increase in screening trends was also observed for general health, gastric, colorectal, and cervical cancers, with APC of 5.3%, 5.7%, 6.9%, and 7.6% in the 2-year postdiagnosis rate, and APC of 3.6%, 3.7%, 3.7%, and 4.4% in 5-year postdiagnosis rate, respectively. The screening rate was highest among age groups 50-59 and 60-69 in 2009 and significant upward trends were observed in all age groups for general health checkup and gastric, colorectal, and cervical cancer screening. Conclusion Among female breast cancer survivors in Korea, the uptake rate of screenings for general health and various cancers, including breast, gastric, colorectal, and cervical cancers, has shown a gradual increase in recent years.

The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer. The median age of women diagnosed with breast cancer was 53.4 years, with the highest incidence occurring in the 40–49 age group. The most common molecular subtype was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative, accounting for 69.1% of cases, while HER2-positive subtypes comprised 19.3%. During the coronavirus disease 2019 pandemic, the national breast cancer screening rate declined. However, the incidence of early-stage breast cancer (stages 0 and I) continued to increase, accounting for 65.6% of newly diagnosed cases in 2021. Our results showed that the overall survival rate for patients with breast cancer has improved, primarily due to a rise in early-stage diagnoses and advancements in treatment.

The Korean Breast Cancer Society (KBCS) has collected nationwide registry data on clinicopathologic characteristics and treatment since 1996. This study aimed to analyze the clinical characteristics of breast cancer in Korea and assess changes in breast cancer statistics for 2021 using data from the KBCS registry and the Korean Central Cancer Registry. In 2021, 34,628 women were newly diagnosed with breast cancer. The median age of women diagnosed with breast cancer was 53.4 years, with the highest incidence occurring in the 40–49 age group. The most common molecular subtype was hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative, accounting for 69.1% of cases, while HER2-positive subtypes comprised 19.3%. During the coronavirus disease 2019 pandemic, the national breast cancer screening rate declined. However, the incidence of early-stage breast cancer (stages 0 and I) continued to increase, accounting for 65.6% of newly diagnosed cases in 2021. Our results showed that the overall survival rate for patients with breast cancer has improved, primarily due to a rise in early-stage diagnoses and advancements in treatment.

Purpose: We investigated the treatment response and prognosis using the neutrophil-tolymphocyte ratio (NLR) and standardized uptake value (SUV) of 18F-fluorodeoxyglucose positron emission tomography ( 18F-FDG PET) in neoadjuvant settings. Methods: Baseline NLR and maximum SUV (SUVmax ) were retrospectively analyzed in 273 females with breast cancer who received neoadjuvant chemotherapy followed by surgery.Of these, 101 patients underwent 18F-FDG PET after 3–4 neoadjuvant chemotherapy cycles, which allowed the measurement of ΔSUVmax , an early reduction in SUVmax . NLR and early SUVmax reduction (ΔSUVmax) were classified as low and high, respectively, relative to the median values. Results: The mean NLR was lower, and the mean ΔSUVmax was higher in patients with pathologic complete response (pCR) than in those with residual tumors. The ΔSUVmax was an independent variable associated with pCR. Furthermore, the high NLR group had poor recurrence-free survival (RFS) and overall survival. Among patients with ΔSUVmax data, high NLR (adjusted hazard ratio, 2.82; 95% confidence intervals [CI], 1.26–6.28; P = 0.016) and low ΔSUVmax (adjusted hazard ratio, 2.39; 95% CI, 1.07–5.34; P = 0.037) were independent prognostic factors for poor RFS. The categorization of the patients into four groups according to the combination of NLR and ΔSUVmax showed that patients with high NLR and low ΔSUVmax had significantly poorer RFS. Conclusion Baseline NLR and ΔSUVmax were significantly associated with the prognosis of patients with breast cancer who received neoadjuvant chemotherapy. These results suggest that metabolic non-responders with defective immune systems have worse survival outcomes.

PURPOSE: Hip rotation testing is important in the evaluation of chronic back pain. The purpose of this study was to investigate hip and lumbopelvic movement during hip medial rotation (HMR) in individuals with chronic lower back pain (CLBP). METHODS: This study targeted 112 subjects in total: 28 healthy males and 28 healthy females, and 27 males with CLBP and 29 females with CLBP. Motion-capture device was used to measure the hip medial rotation angle (HMRA), lumbopelvic rotation angle (LPRA), and the rotation angle of the hip when lumbopelvic rotation starts during hip medial rotation. RESULTS: When evaluating the healthy males and females using the hip medial rotation test (HMRT), healthy males showed a smaller HMRA than did healthy females (p<0.05). When evaluating the healthy males and the males with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements than did healthy males (p<0.05) in addition, their lumbopelvic movements occurred earlier during HMR (p<0.05). Finally, when evaluating the males and the females with CLBP using the HMRT, males with CLBP showed a smaller HMRA and more lumbopelvic movements (p<0.05), and their lumbopelvic movements occurred earlier during HMR (p<0.05). CONCLUSION: The HMRT is an important test for the evaluation of males, and especially males with CLBP, as they often experience an increased LPRA and decreased HMRA, with lumbopelvic movement occurring earlier during HMR when compared to other groups.
Back Pain ; Female ; Hip ; Humans ; Low Back Pain ; Male ; Sex Characteristics

PURPOSE: This study aimed to identify predictive factors for decreased blood pressure in patients prescribed with propacetamol in the emergency room using clinical and laboratory indicators of sepsis. METHODS: Among patients aged 18 years or older with a fever, who visited Chungbuk National University hospital's emergency room between July and December of 2014, 246 patients underwent intravenous infusion of propacetamol to control body temperature. Of these, 112 patients fulfilled all study requirements. Patients whose systolic or diastolic blood pressure dropped below 90 mmHg or 60 mmHg, respectively, were included in the blood pressure decline group. Additional inclusion criteria were a decline in systolic blood pressure of more than 30-mmHg and thereby treated with fluids or inotropics after intravenous infusion of propacetamol. Remaining patients were included in the blood pressure maintenance group. The relationship of each factor between the two groups was then investigated. RESULTS: Twenty-nine patients (25.9%) showed a significant decrease in blood pressure, and among many factors, high-sensitivity C-reactive protein (hs-CRP) (cut off value, 11.86; sensitivity, 72.4%; specificity, 69.9%; area under curve [AUC], 0.698) and procalcitonin (cut off value, 0.67; sensitivity, 75.9%; specificity, 60.2%; AUC, 0.667) levels showed a statistically significant effect. Of the 29 patients with a decrease in blood pressure, 10 patients received fluids and inotropics; procalcitonin in particular showed a significant effect. CONCLUSION: When propacetamol is administered to patients at the emergency room, and if hs-CRP or procalcitonin levels are high, there is an increased risk of a decrease in blood pressure. In particular, if procalcitonin levels are high, aggressive treatment is required, such as administration of inotropics in addition to fluids.
Area Under Curve ; Blood Pressure* ; Body Temperature ; C-Reactive Protein ; Chungcheongbuk-do ; Emergency Service, Hospital ; Fever* ; Humans ; Infusions, Intravenous ; Sensitivity and Specificity ; Sepsis

PURPOSE: Troglitazone (TRO) is a peroxisome proliferator-activated receptor gamma (PPARgamma) agonist. TRO has antiproliferative activity on many kinds of cancer cells via G1 arrest. TRO also increases Cu2+/Zn2+-superoxide dismutase (CuZnSOD) and catalase. Cell cycle, and SOD and catalase may affect on radiation sensitivity. We investigated the effect of TRO on radiation sensitivity in cancer cells in vitro. MATERIALS AND METHODS: Three human cervix cancer cell lines (HeLa, Me180, and SiHa) were used. The protein expressions of SOD and catalase, and catalase activities were measured at 2-10 microM of TRO for 24 hours. Cell cycle was evaluated with flow cytometry. Reactive oxygen species (ROS) was measured using 2',7'-dichlorofluorescin diacetate. Cell survival by radiation was measured with clonogenic assay. RESULTS: By 5 microM TRO for 24 hours, the mRNA, protein expression and activity of catalase were increased in all three cell lines. G0-G1 phase cells were increased in HeLa and Me180 by 5 microM TRO for 24 hours, but those were not increased in SiHa. By pretreatment with 5 microM TRO radiation sensitivity was increased in HeLa and Me180, but it was decreased in SiHa. In Me180, with 2 microM TRO which increased catalase but not increased G0-G1 cells, radiosensitization was not observed. ROS produced by radiation was decreased with TRO. CONCLUSION: TRO increases radiation sensitivity through G0-G1 arrest or decreases radiation sensitivity through catalase-mediated ROS scavenging according to TRO dose or cell types. The change of radiation sensitivity by combined with TRO is not dependent on the PPARgamma expression level.
Catalase ; Cell Cycle ; Cell Line ; Cell Survival ; Cervix Uteri ; Chromans ; Female ; Flow Cytometry ; Fluoresceins ; Humans ; PPAR gamma ; Radiation Tolerance ; Reactive Oxygen Species ; RNA, Messenger ; Thiazolidinediones ; Uterine Cervical Neoplasms