Purpose: Palpability is known to be a poor prognostic factor for breast cancer. The present study analyzed the clinicopathological characteristics and outcomes of palpable and nonpalpable breast cancers using big data. Methods: Between January 2005 and May 2019, a total of 15,141 patients were enrolled. All patients were diagnosed with invasive ductal carcinomas. Patients with unclear medical records, multiple tumors, bilateral breast cancers, inflammatory breast cancers, inoperable breast cancers and distant metastasis were excluded. Patients were divided into the palpable and nonpalpable breast cancer groups based on physicians’ clinical examinations. The clinicopathological characteristics and disease-specific survivals (DSS) were analyzed. Results: Patients with palpable breast cancers were younger, had larger tumors, and higher tumor-node-metastasis stage (p<0.001) than patients with nonpalpable breast cancers. Palpable breast cancer cases had higher rates of lympho-vascular invasion, higher histologic and nuclear grades than nonpalpable breast cancer cases (p<0.001). The positive proportion of hormone receptor was higher in the nonpalpable breast cancer group than in the palpable breast cancer group, but that of human epidermal growth factor receptor 2 was higher in the palpable breast cancer group than in the nonpalpable breast cancer group (p<0.001). The Ki-67 index was higher in the palpable breast cancer group than in the nonpalpable breast cancer group (p<0.001). Total mastectomy and axillary dissection were performed more frequently in the palpable breast cancer group than in the nonpalpable breast cancer group (p<0.001). Adjuvant chemotherapy was administered more frequently in the palpable breast cancer group than in the nonpalpable breast cancer group. However, radiotherapy and hormonal therapy were performed more frequently in nonpalpable breast cancer group than in the nonpalpable breast cancer group (p<0.001). According to a multivariate analysis, younger age, lower body mass index, larger tumor size, tumor location, higher stage, higher histologic grade and higher Ki-67 index were associated with palpability (p<0.001). DSS was significantly lower in the palpable breast cancer group than in the nonpalpable breast cancer group (p<0.001). Conclusion Palpable breast cancers tend to be triple negative breast cancers and have higher histologic grade and, Ki-67 index and worse prognosis than nonpalpable breast cancers. Therefore, based on the results of the present study, treating palpable breast cancers requires careful attention.

With the increased use of cell therapy in the veterinary sector, there is a growing demand for the development of cell-based medicinal products and the determination of their safety. Currently, the Korean Animal and Plant Quarantine Agency has established a guideline for evaluating the safety of cell-based medicinal products for animal use. The guideline includes items related to definition, classification, management, manufacturing procedure and quality control (standard and test method), stability testing, toxicity testing, pharmacological testing, and performance of clinical trials. In addition, testing protocols related to safety assessment of animal cell-based products such as chromosome karyotyping, tumorigenicity testing, confirmatory testing of biodistribution and kinetics, and target animal safety testing are described in detail. Moreover, because cell-based medicinal products are novel therapies, deviations from traditional designs may be justified in order to obtain relevant safety information on the treatment. Additionally, this guideline can be amended on the basis of new scientific findings.
Animals ; Carcinogenicity Tests ; Cell- and Tissue-Based Therapy ; Classification ; Karyotyping ; Kinetics ; Plants ; Quality Control ; Quarantine ; Toxicity Tests

Sarcotragin C (1), a new sesterterpene metabolite was isolated from a Sarcotragus sp. sponge collected from Chuja Island, Korea. On the basis of the combined spectroscopic analyses, the structure of this compound was determined to be a linear norsesterterpene containing a leucine-derived gamma-lactam moiety. This compound exhibited moderate cytotoxicity against K562 and A549 cell-lines.
Korea ; Porifera*

We identified single nucleotide polymorphism (SNP) markers in the laccase gene to establish a line-diagnostic system for shiitake mushrooms. A total of 89 fungal isolates representing four lines, including Korean registered, Korean wild type, Chinese, and Japanese lines, were analyzed. The results suggest that SNP markers in the laccase gene can be useful for line typing in shiitake mushrooms.
Agaricales ; Asian Continental Ancestry Group ; Humans ; Laccase* ; Polymorphism, Single Nucleotide* ; Shiitake Mushrooms*

BACKGROUND/AIMS: Double balloon enteroscopy (DBE) and capsule endoscopy (CE) are useful for evaluation of obscure gastrointestinal bleeding (OGIB). However, many bleeding sources within reach of conventional upper and lower endoscopes can be missed in patients who have undergone DBE and CE for OGIB. The aim of this study was to determine the incidence and characteristics of OGIB lesions within reach of a conventional endoscope in patients undergoing DBE and CE for the indication of OGIB. METHODS: This retrospective study included 134 patients who were evaluated for OGIB between March 2003 and May 2009 at Soonchunhyang University Hospital. RESULTS: Of the 134 patients, 76 underwent CE, 28 patients underwent DBE, and 30 underwent both CE and DBE. The incidence of OGIB lesions within reach of a conventional upper and lower endoscopy was 9.7% (n=13) and the mean age of patients was 51 years (range: 20 to 69 years). The most commonly missed lesion was duodenal ulcer (n=8). The other missed lesions were gastric ulcer (n=2), terminal ileal ulcer (n=2) and ileocecal valve ulcer (n=1). CONCLUSIONS: The duodenum should be observed closely in initial upper and lower endoscopy by experienced endoscopists. Performing a second EGD and ileocolonoscopy before DBE and CE may increase the diagnostic yield and improve cost-effectiveness in patients with OGIB.
Capsule Endoscopy ; Double-Balloon Enteroscopy ; Duodenal Ulcer ; Duodenum ; Endoscopes ; Endoscopy ; Hemorrhage ; Humans ; Ileocecal Valve ; Incidence ; Retrospective Studies ; Stomach Ulcer ; Ulcer

PURPOSE: The purpose of this study was to evaluate the clinical course and pregnancy outcome according to operative management of appendictis in the Department of Surgery. METHODS: We reviewed the charts of pregnant patients who went through a convential appendectomy and a laparoscopic appendectomy at the Department of Surgery, Catholic University of Korea St. Mary's Hospital, from May 1995 to June 2006. RESULTS: The incidence of acute appendicitis during pregnancy was the highest at the 2nd trimester and at ages from 25 to 30 years. The laparoscopic appendectomy was shorter than the open appendectomy in hospital stay and decreased leukocytosis faster in the first postoperative day, except in cases of perforated appendicitis, but the operation times were similar. There was a significant difference in gestational age at delivery between perforated appendicitis and suppurative. We found one fetal anomaly, but it was not related to either the appendicitis or the operation method. CONCLUSIONS: In this study, we found that a laparoscopic appendectomy was better than an open appendectomy for recovery and was safe in pregnant appendicitis patients at any gestational age. However, follow up and investigation in a larger population is needed to get more accurate results.
Appendectomy ; Appendicitis ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Incidence ; Korea ; Laparoscopy ; Length of Stay ; Leukocytosis ; Pregnancy ; Pregnancy Outcome

A tuberculous pleural effusion may be a sequel to a primary infection or represent the reactivation of pulmonary tuberculosis. It is believed to result from a rupture of a subpleural caseous focus in the lung into the pleural space. It appears that delayed hypersensitivity plays a large role in the pathogenesis of a tuberculous pleural effusion. We encountered a 52 years old man with pleural effusion that developed several days after a CT guided percutaneous needle biopsy of a solitary pulmonary nodule. He was diagnosed with TB pleurisy. It is believed that his pleural effusion probably developed due to exposure of the parenchymal tuberculous focus into the pleural space during the percutaneous needle biopsy. This case might suggest one of the possible pathogeneses of tuberculous pleural effusion.
Biopsy, Needle* ; Humans ; Hypersensitivity, Delayed ; Lung ; Middle Aged ; Needles* ; Pleural Effusion* ; Pleurisy ; Rupture ; Solitary Pulmonary Nodule* ; Tuberculosis, Pulmonary

BACKGROUND: A primary central nervous system lymphoma (PCNSL) is a rare neoplasm with a poor prognosis. The treatment of PCNSL involves a combination of chemotherapy, intrathecal chemotherapy and radiotherapy. This study retrospectively evaluated the treatment outcomes and prognostic factors of Korean patients with PCNSL. METHODS: Between 1995 and 2003, 58 patients diagnosed with PCNSL from the multi-center hospitals were enrolled in this study. Among 56 patients who had received treatment, 16 patients were treated with radiotherapy alone, while 40 patients were treated with combined chemotherapy (CHOP; 9 cases, high-dose methotrexate; 31 cases) and radiotherapy. RESULTS: The median age of the patients was 58 years (range, 19-76). A diffuse large B-cell lymphoma was diagnosed in 56 cases (96.6%), while a peripheral T-cell lymphoma was diagnosed in 2 cases. Of the 47 patients who could be assessed for their response after treatment, a CR and PR was observed in 32 (68%) and 11 patients (23%), respectively, giving an overall response rate of 91% (95% CI, 82~100%). The estimated 3-year overall survival rate for all the patients was 67+/-7.9% and the 3-year disease free survival rate was 53+/-8.3%. The overall survival of the high-dose methotrexate group was superior to that of the CHOP group (77+/-10% versus 47+/-19%, p=0.05). Leukoencephalopathy was observed as a late complication in 9 patients (21%). No significant prognostic factors affecting survival were found by univariate analysis. CONCLUSIONS: Approximately half of the patients could have long-term survival after treatment in this study. High-dose methotrexate containing chemotherapy followed by radiotherapy was found to be an effective treatment.
Central Nervous System* ; Disease-Free Survival ; Drug Therapy ; Humans ; Leukoencephalopathies ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell, Peripheral ; Methotrexate ; Prognosis ; Radiotherapy ; Retrospective Studies* ; Survival Rate

BACKGROUND: Cyclosporine (CSA) plus 4 doses of methotrexate (MTX) is the commonly used regimen for GVHD prophylaxis. It has been previously found that the omission of the day +11 dose of MTX was associated with an increased risk of acute GVHD in the allogeneic BMT setting. However, little is known about its impact in the PBSCT setting. METHODS: Of the 68 patients, 30 patients (44%) received 4 doses of MTX (the MTX4 group), while 38 patients (56%) received less than 4 doses (the MTX3 group) because of their severe mucositis, hepatic dysfunction or renal failure. RESULTS: The cumulative incidence of acute GVHD was 60% in the MTX4 and 86% in the MTX3 group (P=0.038), while that of grade III and IV acute GVHD was 7% in the MTX4 group and 39% in the MTX3 group (P=0.017). Of the 61 patients evaluated for chronic GVHD, the cumulative incidence of chronic GVHD was 54% in the MTX4 group and 97% in the MTX3 group (P=0.001), while that of extensive chronic GVHD was 26% in the MTX4 group and 63% in the MTX3 group (P=0.004). There were no differences in the overall survival and the incidence of relapse between the two groups. On multivariate analyses, MTX3 was a poor prognostic factor in terms of acute GVHD and extensive chronic GVHD. CONCLUSION: This study suggested that omitting day +11 MTX and the clinical situation of the MTX3 group seemed to be associated with an increased incidence of acute and chronic GVHD. Accordingly, administration of day +11 MTX accompanied by active treatment of mucositis may prevent GVHD in the allogeneic PBSCT setting, but we need to conduct a large scale prospective study.
Cyclosporine ; Graft vs Host Disease* ; Humans ; Incidence* ; Methotrexate* ; Mucositis ; Multivariate Analysis ; Peripheral Blood Stem Cell Transplantation* ; Recurrence ; Renal Insufficiency

BACKGROUND: We evaluated the efficacy and toxicity of docetaxel plus cisplatin combination as first-line chemotherapy for advanced gastric cancer. METHODS: Patients with metastatic or recurrent gastric adenocarcinoma, performance score Adenocarcinoma ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination* ; Febrile Neutropenia ; Humans ; Neutropenia ; Stomach Neoplasms*