Purpose: Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM. Methods: Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated. Results: In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations. Conclusion The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.

Purpose: Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM. Methods: Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated. Results: In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations. Conclusion The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.

Purpose: Breast cancer gene (BRCA) mutation is a well-known risk factor for breast cancer, and clinical interest in prophylactic mastectomy has increased in recent years.We investigated patients who were BRCA mutation carriers and underwent contralateral risk-reducing mastectomy (RRM), focusing on the incidence of occult malignancy after contralateral RRM. Methods: Prospectively collected data of patients with breast cancer treated at a single institution were retrospectively reviewed. Patients who underwent RRM with BRCA mutation who underwent RRM between January 2010 and November 2023 were included in this study.Among patients who underwent contralateral RRM, those with a primary cancer diagnosis were included, and those with occult malignancy on the contralateral RRM side were reviewed additionally. The demographics and pathologies of both primary breast cancer and occult malignancies were evaluated. Results: In our institution, 925 patients were identified as BRCA mutation carriers, and 320 patients underwent contralateral RRM along with primary breast cancer surgery. BRCA2 mutation occurred more frequently (54.8%) in the overall BRCA mutation cohort. Furthermore, we reviewed 320 patients diagnosed with breast cancer and detected as BRCA mutation carriers who underwent contralateral RRM; high proportion of them were BRCA1 mutation carriers.Interestingly, we found a low incidence of only seven patients (2.2%) with occult malignancy on contralateral RRM side, which is different from that reported in other nations. Conclusion The incidence of occult malignancy in the contralateral breast of breast cancer patients with breast cancer with BRCA mutation is significantly low, and may be influenced by several factors. Increased utilization of screening and advancements in diagnostic technologies in South Korea have reduced the chance of occult malignancy in RRM, and a variety of pathologic examination methods may affect the rate of incidence.

Background: Worldwide, sepsis is the leading cause of death in hospitals. If mortality rates in patients with sepsis can be predicted early, medical resources can be allocated efficiently. We constructed machine learning (ML) models to predict the mortality of patients with sepsis in a hospital emergency department. Methods: This study prospectively collected nationwide data from an ongoing multicenter cohort of patients with sepsis identified in the emergency department. Patients were enrolled from 19 hospitals between September 2019 and December 2020. For acquired data from 3,657 survivors and 1,455 deaths, six ML models (logistic regression, support vector machine, random forest, extreme gradient boosting [XGBoost], light gradient boosting machine, and categorical boosting [CatBoost]) were constructed using fivefold cross-validation to predict mortality. Through these models, 44 clinical variables measured on the day of admission were compared with six sequential organ failure assessment (SOFA) components (PaO 2 /FIO 2 [PF], platelets (PLT), bilirubin, cardiovascular, Glasgow Coma Scale score, and creatinine).The confidence interval (CI) was obtained by performing 10,000 repeated measurements via random sampling of the test dataset. All results were explained and interpreted using Shapley’s additive explanations (SHAP). Results: Of the 5,112 participants, CatBoost exhibited the highest area under the curve (AUC) of 0.800 (95% CI, 0.756–0.840) using clinical variables. Using the SOFA components for the same patient, XGBoost exhibited the highest AUC of 0.678 (95% CI, 0.626–0.730). As interpreted by SHAP, albumin, lactate, blood urea nitrogen, and international normalization ratio were determined to significantly affect the results. Additionally, PF and PLTs in the SOFA component significantly influenced the prediction results. Conclusion Newly established ML-based models achieved good prediction of mortality in patients with sepsis. Using several clinical variables acquired at the baseline can provide more accurate results for early predictions than using SOFA components. Additionally, the impact of each variable was identified.

Background and Objectives: Monocarboxylate transporter 4 (MCT4) transmembrane proteins are encoded by SLC16A3 and control lactate metabolism to promote tumor growth. Materials and Methods: Gene expression of SLC16A3 encoding MCT4 was analyzed in the database of Gene Expression Omnibus. Protein expression of MCT4 was evaluated using immunohistochemical staining in 138 papillary thyroid carcinomas (PTCs) and 21 anaplastic thyroid carcinomas (ATCs). Results: The mRNA expression of SLC16A3 was significantly higher in ATCs compared with PTCs and normal thyroid tissue (p＜0.01, and p＜0.001, respectively). Normal thyroid tissue did not express MCT4 in immunohistochemical staining compared with ATC that was 100% positive for MCT4 protein expression. The MCT4 expression in ATCs was significantly enhanced compared with that in PTC (p＜0.001). Conclusion MCT4 expression is associated with de-differentiation and might be helpful as a biomarker and therapeutic target for thyroid cancer.

Background and Objectives: Monocarboxylate transporter 4 (MCT4) transmembrane proteins are encoded by SLC16A3 and control lactate metabolism to promote tumor growth. Materials and Methods: Gene expression of SLC16A3 encoding MCT4 was analyzed in the database of Gene Expression Omnibus. Protein expression of MCT4 was evaluated using immunohistochemical staining in 138 papillary thyroid carcinomas (PTCs) and 21 anaplastic thyroid carcinomas (ATCs). Results: The mRNA expression of SLC16A3 was significantly higher in ATCs compared with PTCs and normal thyroid tissue (p＜0.01, and p＜0.001, respectively). Normal thyroid tissue did not express MCT4 in immunohistochemical staining compared with ATC that was 100% positive for MCT4 protein expression. The MCT4 expression in ATCs was significantly enhanced compared with that in PTC (p＜0.001). Conclusion MCT4 expression is associated with de-differentiation and might be helpful as a biomarker and therapeutic target for thyroid cancer.

Background and Objectives: Monocarboxylate transporter 4 (MCT4) transmembrane proteins are encoded by SLC16A3 and control lactate metabolism to promote tumor growth. Materials and Methods: Gene expression of SLC16A3 encoding MCT4 was analyzed in the database of Gene Expression Omnibus. Protein expression of MCT4 was evaluated using immunohistochemical staining in 138 papillary thyroid carcinomas (PTCs) and 21 anaplastic thyroid carcinomas (ATCs). Results: The mRNA expression of SLC16A3 was significantly higher in ATCs compared with PTCs and normal thyroid tissue (p＜0.01, and p＜0.001, respectively). Normal thyroid tissue did not express MCT4 in immunohistochemical staining compared with ATC that was 100% positive for MCT4 protein expression. The MCT4 expression in ATCs was significantly enhanced compared with that in PTC (p＜0.001). Conclusion MCT4 expression is associated with de-differentiation and might be helpful as a biomarker and therapeutic target for thyroid cancer.