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Background There remain concerns about the safety and functional benefit of laparoscopic pylorus-preserving gastrectomy (LPPG) compared with laparoscopic distal gastrectomy (LDG). This study evaluated short-term outcomes of a randomized clinical trial (RCT) comparing LPPG with LDG for gastric cancer. Methods The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS)-04 trial was an investigator-initiated, open-label, parallel-assigned, superiority, multicentre RCT in Korea. Patients with cT1N0M0 cancer located in the middle third of the stomach at least 5 cm from the pylorus were randomized to undergo LPPG or LDG. Participants, care givers and those assessing the outcomes were not blinded to group assignment. Outcomes were 30-day postoperative morbidity rate and death at 90 days. Results Some 256 patients from nine institutions were randomized (LPPG 129 patients, LDG 127 patients) between July 2015 and July 2017 and outcomes for 253 patients were analysed. Postoperative complications within 30 days were seen in 19.3 and 15.5 per cent in the LPPG and LDG groups respectively (P = 0·419). Postoperative pyloric stenosis was observed in nine (7.2 per cent) and two (1·5 per cent) patients in the LPPG and LDG groups (P = 0·026) respectively. In multivariable analysis higher BMI was a risk factor for postoperative complications (odds ratio 1·17, 95 per cent c.i. 1·04 to 1·32; P = 0·011). Death at 90 days was zero in both groups. Conclusion Postoperative complications and mortality was comparable in patients undergoing LPPG and LDG. Registration number: NCT02595086 (http://www.clinicaltrials.gov).

Background Incident atrial fibrillation (AF) is associated with an increased risk of dementia. There are limited data about the impact of smoking cessation after AF diagnosis on the risk of incident dementia. Purpose To evaluate the association between changes in smoking status after newly diagnosed AF and the risk of dementia. Methods Among patients with new-onset AF between 2010 and 2016, those who received a national health checkup exam within 2 years before and after the AF diagnosis were included. Patients who had prevalent dementia were excluded. Subjects were categorized into 4 groups according to the status of smoking before and after AF diagnosis: (1) never smoker; (2) ex-smoker; (3) quit-smoker after AF diagnosis; and (4) current smoker. The primary outcome was incident dementia during follow-up. Results A total of 126,252 patients were included (mean age 63, SD 12.0; men 62%; mean CHA2DS2-VASc 2.7). During a median 3 years of follow-up, dementia occurred in 5,925 patients (1.11 per 1000 person-years [1000PY]) (Alzheimer's dementia 1.5 per 1000 PY and vascular dementia 0.24 per 1000 PY, respectively). Never smokers, ex-smokers, quit-smokers, and current smokers were 52%, 27%, 7%, and 14% of the total study population, respectively. After multivariable adjustment, quit-smokers showed a higher risk of dementia than never smokers (hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.03–1.32), but the risk was significantly decreased when compared to current smokers (HR 0.83, 95% CI 0.72–0.95). Alzheimer's dementia and vascular dementia showed consistent results as main (Figure). Conclusion All types of smoking were associated with a significantly higher risk of dementia in patients with new-onset AF. Smoking cessation after AF diagnosis showed a lower risk of dementia compared to patients smoking persistently. These findings may support the promotion of smoking cessation to lower the risk of dementia in patients with new-onset AF. Funding Acknowledgement Type of funding sources: None.

BackgroundDespite improved survival of patients with lupus nephritis (LN), some require kidney transplantation because of progression to end-stage renal disease (ESRD). However, the transplant outcomes of these patients and other recipients have not been thoroughly compared.MethodsIn total, 1848 Korean kidney recipients who underwent transplantation from 1998 to 2017 at two tertiary referral centers were evaluated retrospectively. Among them, 28 recipients with LN, and 50 control recipients matched by age, sex, and donor type, were compared with respect to graft and patient survival. We pooled our data with 17 previous cohort studies in which the graft survival of recipients with LN was described in detail.ResultsDuring the median follow-up period of 9.5 years (maximum 21 years), graft failure (GF) occurred in 10.7% and 16.0% of LN and control recipients, respectively. No differences were found in the rates of GF and death-censored graft failure or patient survival between the two groups. The risks of acute T cell-mediated and antibody-mediated rejection were also similar between the two groups. The pooled analysis showed similar 1- and 5-year graft survival rates between LN and control recipients.ConclusionsKidney transplantation is an acceptable option in patients with concurrent LN and ESRD.

Background Bodyweight variability is a risk factor for atrial fibrillation (AF), but this has not been studied with a focus on patients with diabetes mellitus (DM). Methods A nationwide population-based cohort of 670,797 patients with type 2 DM from the Korean National Health Insurance Service database without a history of AF and with ≥3 measurements of body weight over a 5-year period were followed up for AF development. Intra-individual bodyweight variability was calculated using variability independent of mean (VIM), and high bodyweight variability was defined as the quintile with the highest variability with the lower four quintiles as reference. Results During a median of 7.0 years of follow-up, 22,019 patients (3.3%) were newly diagnosed with AF. Risk of incident AF was increased in those in the highest quintile of bodyweight variability, after adjustment for baseline body mass index (BMI), age, sex, lifestyle factors, comorbidities, number of oral anti-diabetic medication, insulin use, duration of DM, and fasting glucose (HR 1.16, 95% CI 1.12–1.20). High bodyweight variability was significantly associated with AF development regardless of baseline BMI group and direction of overall weight change. This association was stronger in subjects with lower BMI, those on insulin, and those with a DM duration of greater than 5 years. Conclusions High bodyweight variability was associated with AF development, independently of traditional cardiovascular risk factors and baseline BMI. This association was stronger in underweight patients and in advanced diabetic stage. Funding Acknowledgement Type of funding source: None

We investigated whether oral health, represented by missing teeth, was associated with an increased risk of cardiovascular disease, including myocardial infarction (MI), heart failure (HF), stroke, and all-cause mortality. Subjects who underwent routine dental examinations and health checkups provided by the Korean National Health Insurance from 2007 to 2008 ( n = 4,440,970) were followed up for incident MI, HF, stroke, and death until 2016. During follow-up of 7.56 y, 68,063 (1.5%) subjects died, and 31,868 (0.7%) were admitted for MI, 22,637 (0.5%) for HF, and 30,941 (0.7%) for stroke. Cardiovascular events and mortality increased in proportion to tooth loss. Tooth loss was an independent risk factor for cardiovascular events after multivariable analysis adjusted for cardiovascular risk, behavioral, and income factors. Each missing tooth was associated with an approximately 1% increase in MI (HR, 1.010; 95% CI, 1.007 to 1.014), 1.5% increase in HF (HR, 1.016; 95% CI, 1.013 to 1.019) and stroke (HR, 1.015; 95% CI, 1.012 to 1.018), and 2% increase in mortality (HR, 1.022; 95% CI, 1.020 to 1.023). Having ≥5 missing teeth substantially increased risk for cardiovascular outcomes, and even a small number of missing teeth (1 to 4) was associated with an increased risk for MI, stroke, and death. This association was consistent in subgroup analyses and especially strong among the younger subjects (age

Body temperature (BT) monitoring in cattle could be used to early detect fever from infectious disease or physiological events. Various ways to measure BT have been applied at different locations on cattle including rectum, reticulum, milk, subcutis and ear canal. In other to evaluate the temperature stability and reliability of subcutaneous temperature (ST) in highly fluctuating field conditions for continuous BT monitoring, long term ST profiles were collected and analyzed from cattle in autumn/winter and summer season by surgically implanted thermo-logger devices. Purposes of this study were to assess ST in the field condition as a reference BT and to determine any location effect of implantation on ST profile. In results, ST profile in cattle showed a clear circadian rhythm with daily lowest at 05: 00 to 07: 00 AM and highest around midnight and rather stable temperature readings (mean +/- standard deviation [SD], 37.1 degrees C to 37.36 degrees C +/- 0.91 degrees C to 1.02 degrees C). STs are 1.39 degrees C to 1.65 degrees C lower than the rectal temperature and sometimes showed an irregular temperature drop below the normal physiologic one: 19.4% or 36.4% of 54,192 readings were below 36.5 degrees C or 37 degrees C, respectively. Thus, for BT monitoring purposes in a fever-alarming-system, a correction algorithm is necessary to remove the influences of ambient temperature and animal resting behavior especially in winter time. One way to do this is simply discard outlier readings below 36.5 degrees C or 37 degrees C resulting in a much improved mean +/- SD of 37.6 degrees C +/- 0.64 degrees C or 37.8 degrees C +/- 0.55 degrees C, respectively. For location the upper scapula region seems the most reliable and convenient site for implantation of a thermo-sensor tag in terms of relatively low influence by ambient temperature and easy insertion compared to lower scapula or lateral neck.

Background The association between atopic diseases and inflammatory bowel diseases (IBD) still remains unclear. We conducted a nationwide population-based study to investigate the effect of atopic diseases on the development of IBD. Methods A total of 9,950,548 subjects who received medical check-up between 2009 and 2012 were included and followed up until 2017. The presence of any atopic disease including atopic dermatitis (AD), allergic rhinitis (AR), and asthma were evaluated. Patients who developed IBD including Crohn’s disease (CD) and ulcerative colitis (UC) were identified using the claims data from National Health Insurance. Results During a mean follow up of 7.3 years, 1,426 (0.014%) subjects developed CD and 5,916 (0.059%) subjects developed UC. The incidences of CD (per 100,000 person-years) were 4.088, 2.255, and 2.344 in patients with AD, AR, and asthma,, respectively. The incidences of UC were 11.926, 9.857, and 9.377 in patients with AD, AR, and asthma, respectively. Multivariable analysis revealed that the adjusted hazard ratios (aHR) for incident CD in patients with AD, AR, and asthma were 2.21, 1.33, and 1.59 (95% confidence interval (CI) 1.251–3.896, 1.152–1.532, and 1.186–2.123, respectively) compared with controls. The risk for incident UC in patients in AD, AR, and asthma were 1.51, 1.32, and 1.28 (95% CI 1.081–2.101, 1.235–1.416, and 1.110–1.484, respectively) compared with controls. Moreover, increase in the number of atopic diseases gradually increased the risk for CD and UC; CD showed aHR of 1.36 and 1.65 (95% CI 1.180–1.571 and 1.143–2.370), and UC showed aHR of 1.30 and 1.49 (95% CI 1.216–1.398 and 1.247-1.170) in one, and two or more atopic diseases, respectively. Conclusion Patients with any atopic diseases showed an increased risk for IBD, while an increase in the number of atopic diseases gradually increased the risk for IBD.

Background The incidence of inflammatory bowel disease (IBD) is increasing in Asia. Numerous risk factors associated with IBD development have been investigated. This study aimed to demonstrate the risk factors of Crohn’s disease (CD) diagnosed in persons aged >40 years in South Korea and to specify any differences between age groups by using the National Health Insurance Service (NHIS) database. Methods Using the National Health Insurance Service (NHIS) database, a total of 14,060,821 persons aged >40 years who underwent national health screening in 2009 were followed up until December 2017. Patients with newly diagnosed CD were enrolled and compared with non-CD cohort. CD was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration programme codes from the NHIS database. The mean follow-up periods were 7.39 years. Age and sex were adjusted for in the multivariate analysis model. Results During the follow-up, 1337 (1.33/100,000) patients developed CD. Men in the middle-aged group (40–64 years) had a higher risk than women (adjusted HR [aHR] 1.46, 95% CI 1.29–1.66); however, this difference tended to disappear as the age of onset increases. In the middle-aged group, patients with a history of smoking (adjusted hazard ratio [aHR] 1.29, 95% confidence interval [CI] 1.06–1.58) and anemia (aHR 1.99, 95% CI 1.67–2.36) had a significantly higher CD risk. In the elderly group (age, ³65 years), ex-smoking and anemia also increased the CD risk (aHR 1.58 [95% CI 1.16–2.18] and 1.91 [95% CI 1.53–2.38], respectively). Especially in the middle-aged group, those with chronic kidney disease (CKD) had a statistically elevated CD risk (aHR 1.38, 95% CI 1.06–1.79). Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups. (Middle-aged: aHR 0.76 [95%CI 0.65–0.87] and aHR 0.38 [95%CI 0.27–0.53], respectively) (elderly-group: aHR 0.57 [95%CI 0.42–0.77] and aHR 0.52 [95%CI 0.32-.83], respectively) For regular physical activity and dyslipidemia, negative correlation between CD incidences was proved only in the middle-aged group (aHR 0.85 [95%CI 0.74–0.96] and aHR 0. [95%CI 0.75 [95% CI 0.63–0.89], respectively). Conclusion This study demonstrated four risk factors (ex-smoking, anemia, CKD, and lower BMI) and three possible protective factors (alcohol consumption, physical activity, and dyslipidemia) for CD in Asians age >40 years. Individuals with potential risk factors need more cautious monitoring for CD.

There is still controversy as to whether the case volume affects clinical outcomes after liver transplantation. This nationwide retrospective cohort study aimed to investigate the relationship between institutional case volume and post-transplant outcomes after deceased donor liver transplantation.The data was extracted from the database of Korean National Healthcare Insurance Service. A total of 2648 adult deceased donor liver transplantations were performed at 54 centers in Korea from January 2007 to December 2016. Centers were divided into high-, medium-, and low-volume centers according to the average annual number of deceased donor liver transplantations as follows: 10, 10-30, and30.In-hospital mortality rates in high-, medium-, and low-volume centers were 10.3%, 14.3%, and 17.1%, respectively. Multivariable logistic regression analysis revealed that low-volume centers (adjusted odds ratio 1.953; 95% confidence interval, 1.461-2.611; P .001) and medium-volume centers (adjusted odds ratio 1.480; 95% confidence interval, 1.098-1.994; P = .010) had a significantly higher in-hospital mortality compared to high-volume centers. Long-term mortality rates were also higher in low-volume centers (P = .007).Centers with higher volume showed better in-hospital mortality and long-term survival after deceased donor liver transplantation compared to centers with lower volume.

Background Proteinuria has been identified as a sign of systemic endothelial dysfunction and chronic inflammation, and associated with the development of several systemic inflammatory diseases. However, the impact of proteinuria and its severity on the incidence of inflammatory bowel disease (IBD) has not been studied yet. The aim of this study was to determine the association between proteinuria measured by urine dipstick test and the development of IBD. Methods We conducted a nationwide population-based cohort study using claims data from the National Health Insurance (NHI) database, a mandatory health insurance programme covering about 97% of the Korean population. A total of 9,917,400 people aged 20 years or older who had undergone a national health examination conducted by NHI in 2009 were followed until 2017. The study population was classified into four groups, negative, trace, 1+, and ≥2+, depending on the degree of proteinuria measured by urine dipstick test. The primary endpoint was the newly diagnosed IBD, Crohn’s disease (CD) or ulcerative colitis (UC) during the follow-up period, which was detected by both ICD-10 (K50 and K51) and the rare intractable disease registration programme codes which provide co-payment reduction of up to 90% in South Korea. Results The incidence of CD significantly increased according to the degree of proteinuria (adjusted hazard ratio [aHR] with 95% confidence interval [CI], 1.01(0.703–1.451), 1.515(1.058–2.162), and 2.053(1.301–3.24) in trace, 1+, and ≥2+ dipstick groups, respectively) as compared with the dipstick-negative group. However, there was no significant difference in the incidence of UC among the degrees of proteinuria (aHR with 95% CI, 1.12(0.949–1.323), 0.947(0.764–1.174), 1.009(0.741–1.373 in trace, 1+, and ≥2+ dipstick groups, respectively). In subgroup analysis, dipstick-positive proteinuria independently increased the incidence of CD regardless of subgroups. However, in the development of UC, dipstick-positive proteinuria increased the risk of UC in those with diabetes mellitus (DM), but not in those without DM (aHR, 1.527 vs. 0.846; interaction p-value 0.004). Conclusion Proteinuria, measured by dipstick test, may be associated with the development of CD.

SummaryBackground Collagens have long been used in pharmaceuticals and food supplements for the improvement of skin. Aim We evaluated the efficacy of high advanced-collagen tripeptide (HACP) on wound healing and skin recovery. Methods Using an in vitro model, we performed HaCaT cell migration assays and collagen gel contraction assays using HACP concentrations of 1, 10 and 100 μg/mL. In this pilot study, eight healthy volunteers were randomly divided into two groups. Both the control and experimental groups received fractional photothermolysis treatment, but in the experimental group, four subjects received 3 g/day of oral collagen peptide (CP) for 4 weeks. To assess transepidermal water loss in each patient before and after the treatment, we used a Corneometer and a Cutometer, and we also assessed the patient's Erythema Index. Results The cell migration assay showed that HACP enhanced wound closure, but not in a dose-dependent manner. The collagen gel contraction assay showed increased contractility when patients were treated with 100 μg/mL HACP, but the results were not significantly different from those of controls. We found that post-laser erythema resolved faster in the experimental group than in the control group (P

Aim To compare motion of the capitate, scaphoid, and lunate in wrists with a malunited distal radius and contralateral normal wrists during dart-throwing motion (DTM) by three-dimensional kinematic studies using computed tomography (CT) images. Materials and methods CT was performed simultaneously on both wrists in six patients with a unilateral distal radius malunion at three stepwise positions simulating DTM. Using volume registration technique, the kinematic variables of helical axis motion of the capitate, scaphoid, and lunate were calculated and compared between both wrists. The helical motion of the capitate was also evaluated in a scaphoid- and lunate-based coordinate system. Results Among the average rotation and translation of the scaphoid, lunate, and capitate during DTM, only the average rotation of the capitate was significantly different between the uninjured (88.9°) and the injured (70°) wrist (p = 0.0075). Rotation of the capitate relative to the scaphoid (26.3° versus 37.8°, p = 0.029) or lunate (39.2° versus 59.3°, p = 0.028) was smaller in the malunited wrist. The centres of helical axis motion of the three carpal bones were located more dorsally and radially in the injured wrist. Conclusions The present study showed that decreased DTM in wrists with a distal radius malunion resulted from decreased midcarpal motion. The present study of the capitate, scaphoid, and lunate in wrists with distal radius malunion might be the first to present a 3D kinematic analysis of the effect of distal radius malunion on the carpal bones.

This study investigated the effects of dietary glycerin supplementation on rumen fermentation, blood metabolites, growth performance, and carcass characteristics in Korean cattle steers. Steers (n=15; average 30.5 ± 0.2 months old; 607 ± 15.2 kg of body weight [BW]) were equally assigned to three groups: 1) control (wheat bran supplementation only), 2) 6.4% glycerin supplementation (glycerin-absorbed wheat bran), and 3) 8.7% corn starch supplementation (corn starch + wheat bran) group. Both glycerin and corn starch supplementation group received same amount of energy. A concentrate (the amount of 1.35% of BW) and 1.0 kg of oat straw were individually fed twice daily for 4 months. Supplementation was done with top-dressing during concentrate feeding. Steers were weighed at 4 weeks interval, and blood and rumen fluid were collected at 8 weeks interval. Steers were slaughtered at average 34.3 ± 0.2 months old, and longissimus thoracis (LT) samples were collected and analyzed for beef characteristics. Data were analyzed by ANOVA using the GLM Procedure (Proc GLM) in SAS software. Neither glycerin nor corn starch supplementation affected (P > 0.05) feed intake, average daily gain, and feed efficiency. Circulating glucose concentrations were higher (P < 0.05) in glycerin group compared with two other groups at 16 weeks, and triglyceride and non-esterified fatty acid concentrations were unaffected by both supplementation. The pH and acetate, propionate, and butyrate concentrations in rumen fluid were unaffected by both supplementation. Neither glycerin nor corn starch supplementation affected (P > 0.05) carcass weight and quality grade. Neither glycerin nor corn starch supplementation affected (P > 0.05) chemical composition, meat color parameters (CIE a* and b*), glycogen content, reducing sugar content, and sensory traits of the LT samples. In conclusion, dietary crude glycerin supplementation have not affected blood and rumen characteristics, growth performance, and carcass characteristics in Korean cattle steers.

The objective of this study was to investigate the growth performance, physiological and blood parameter responses of beef calves during and after sudden exposure to heat stress condition, compared with calves in thermoneutral conditions. Data were collected from four Korean native calves (BW 136.9 ± 6.23 kg and age 169.6 ± 4.60 d), which were kept at four designated temperature humidity index (THI) levels based on ambient temperature and humidity: Threshold (22 to 24 °C, 60%; THI = 68 to 70), Mild (26 to 28 °C, 60%; THI = 74 to 76), Moderate (29 to 31 °C, 80%; THI = 81 to 83) and Severe (32 to 34 °C, 80%; THI = 88 to 90) stress level. Calves were subjected to ambient temperature (22 °C) for 7 days, after which chamber temperature and humidity were raised to each THI level for 21 days. The blood metabolites were analyzed using biochemical analyzer-TBA-40FR. Physiological parameters of heat stress were measured, including rectal temperature (RT), skin temperature (ST) and heart rate (HR) every three days. Feed and water intake were recorded daily (at 0900), and body weight measured once a week. The results showed that RT (p = 0.001), ST (p = 0.001) and HR (p = 0.001) were significantly increased in the severe stress level compared with the threshold but had no effect on growth performance. Glucose and GOT levels were increased after sudden exposure to heat stress condition; however, as the high temperature condition was maintained, glucose and GOT levels returned to a normal range after 14 days. We suggest that physiological parameters (RT, ST and HR) were important indicators of calves under heat stress. In addition, calves exposed to heat stress had physiological responses that regulated metabolites in the blood, to maintain homeostasis during the long-term heat stress.

Recently, the prevalence of childhood obesity has significantly increased in industrialized countries, including Korea, and now controlling obesity is becoming an economic burden. However, knowledge of the risk factors associated with obesity is still limited. In this study, we aimed to discover additional obesity-associated loci in children. To achieve this, we conducted an exome-wide association analysis of copy number variation (CNV) using whole-exome sequencing (WES) data from a total of 102 cases and 86 controls. We newly identified a CNV locus that overlapped two protocadherin genes, PCDHB7 and PCDHB8, which are brain function-related genes (P-value=6.40 × 10

Objective To investigate the inhibitory effect of cocoa polyphenol extract (CPE) on adipogenesis and obesity along with its mechanism of action. Methods and results 3T3-L1 preadipocytes were cultured with isobutylmethylxanthine, dexamethasone and insulin (MDI), and male C57BL/6N mice (N=44) were fed a high-fat diet (HFD) for 5 weeks with or without CPE. CPE at 100 or 200 μg ml(-1) inhibited MDI-induced lipid accumulation without diminishing cell viability. In particular, CPE reduced the protein expression levels of PPARγ and CEBPα, and blocked mitotic clonal expansion (MCE) of preadipocytes by reducing proliferating signaling pathways. This in turn attenuates lipid accumulation during the differentiation of 3T3-L1 preadipocytes. CPE effectively suppressed MDI-induced phosphorylation of extracellular signal-regulated kinase (ERK) and Akt, and their downstream signals. We then examined whether CPE regulates insulin receptor (IR), a common upstream regulator of ERK and Akt. We found that although CPE does not affect the protein expression level of IR, it significantly inhibits the activity of IR kinase via direct binding. Collectively, the results suggested that CPE, a direct inhibitor of IR kinase activity, inhibits cellular differentiation and lipid accumulation in 3T3-L1 preadipocytes. Consistently, CPE attenuated HFD-induced body weight gain and fat accumulation in obese mice fed with a HFD. We also found that HFD-induced increased fasting glucose levels remained unaffected by CPE. Conclusion This study demonstrates that CPE inhibits IR kinase activity and its proliferative downstream signaling markers, such as ERK and Akt, in 3T3-L1 preadipocytes, and also prevents the development of obesity in mice fed with a HFD.

The objective of this study was to determine the effects of vitamin A (VA) as a supplementation to the diet of cows in late pregnancy on tissue development and birth traits in Korean native calves. In study 1, a VA supplementation at 24,000 IU per day was supplied to a high-VA group (n = 8) from 225 days in gestation to delivery. In study 2, pregnant cows treated with a high level of VA (n = 5) consumed a VA supplementation at 24,000 IU in period 1 (from 150 to 225 days in gestation). In period 2 (from 225 days in gestation to delivery), the treatment diet contained a VA supplementation of 78,000 IU per day. The level of serum VA of pregnant cows decreased as the day of delivery approached, both in the groups in study 1 and in study 2 (P P = 0.01). The level of serum VA of the offspring of pregnant cows fed the high levels of VA also increased by 28.6% (P = 0.033) compared to the control. In study 1 and 2, birth weight of calves in the high-VA group was heavier than the control. We found that the gene expression related muscle development (MyoD, Myf5, Myf6, MyoG, PPARγ, and LPL) tended to increase in the 31-day-old calf among pregnant cows treated with high levels of VA (P < 0.1). However, there were no significant differences either in the early or late adipogenic marker genes (ZFP423, ERK2, KLF2, FABP4, SCD) excluding C/EBPα. We suggest that supplementation of VA at 78,000 IU per day kept the level of serum VA from dropping in late-gestation cows and a sufficient level of VA could enhance both birth weight and muscle development marker genes in the pregnant cows’ offspring, contributing to increased productivity in the calf.

Aim: We sought to compare survival and toxicity between paclitaxel/carboplatin (TC) and doxorubicin/cisplatin (AP) for concurrent chemoradiation (CCR) in intermediate- or high-risk endometrioid endometrial cancer. Methods: The clinical data of 40 patients with intermediate- (FIGO stage IC-IIB, n = 12) or high-risk endometrioid endometrial cancer (FIGO stage IIIA-IVA, n = 28) were reviewed retrospectively between March 2000 and December 2007, who were treated with TC (n = 23, group 1) or AP (n = 17, group 2) for CCR after surgery. Results: Progression-free survival (PFS) and overall survival (OS) were not different between groups 1 and 2 (median PFS and OS; 35 vs 24 and 76 vs 39 months, respectively, P > 0.05). However, ≥6 cycles of chemotherapy improved PFS compared with 3–5 cycles of chemotherapy (51 vs 21 months, P = 0.04), suggesting that ≥6 cycles of chemotherapy was an independent prognostic factor improving PFS (adjusted HR, 0.27; 95% CI, 0.08 to 0.91; P = 0.04). Grade 3 or 4 hematological and non-hematological, especially, gastrointestinal, toxicities related with chemotherapy during CCR were more common in group 2 than in group 1, whereas there was no difference in grade 3 or 4 late complication by CCR between the 2 groups. Conclusion: These findings suggest that TC may have comparable efficacy to AP for CCR with lesser toxicity, and ≥6 cycles of chemotherapy may be more beneficial than 3–5 cycles of chemotherapy in intermediate- or high-risk endometrioid endometrial cancer. However, large-scale randomized controlled trials are needed to support these results.

We present results of non-linear magneto resistance (MR) of polyacetylene nanofibers in high magnetic field up to H = 30 T at low temperature T = 1.5 K. The MR was proven to be of the spin origin; it reaches 16% at highest H . Unexpectedly, the MR was suppressed by increasing electric field E , vanishing at E ≳ 5 × 10 4 V/cm. It is understood that the doping induced spinless charged soliton pairs, which are initially confined to a certain distance because of the interchain phase correlations, and are deconfined in high electric fields, resulting in a vanishing magneto resistance (VMR). The role of the specific, degenerate ground state of the polyacetylene is confirmed by parallel studies of the different magneto resistances of polyaniline nanofibers which contrarily is not affected by the electric field.

A major obstacle in treatment of epithelial ovarian cancer is chemoresistance. The aim of this study was to determine whether distinct gene expression profiles are associated with chemoresistance in epithelial ovarian carcinoma. We performed global gene expression analysis in 13 primary epithelial ovarian cancer tissues including 5 primary chemosensitive tumors and 8 primary chemoresistant tumors using Affymetrix HGU133A microarray. The gene expression patterns of chemosensitive tumors were compared with those of chemoresistant tumors using fold change. Validity of microarray results was examined by semiquantitative RT-PCR. We identified over 320 genes differentially expressed in chemoresistant epithelial ovarian cancer (> or = twofold). Upregulated genes in chemoresistant tumors included cell cycle regulating genes (TOP2A, BCAT1, CDCA8, CCNA2, CENPE), and genes with previously known mechanisms in tumorigenesis (S100A9, APOA1, RNF125, IFI16). Downregulated genes in chemoresistant tumors included genes related to cell adhesion (MUC5B, CITED2), transcription regulating genes (FOXD1, MAD1L1, PAX2), genes involving signal transduction (SOSTDC1, SNX1, SFRP1, FOXA2, PLK2), and stress protein gene (TP53AP1). These data show that gene expression profiling can discriminate primary chemoresistant from primary chemosensitive ovarian cancers. This type of molecular profiling could provide a basis for additional functional studies.

To evaluate the differences in the characterization and recommendation for follow-up of subcentimetre solitary pulmonary nodules (SSPNs) between 5 and 1mm section CT, and to compare the assessments generated by four radiologistsFive hundred and twenty-nine patients who had SSPNs on chest CT reconstructed using both 5 and 1mm sections were enrolled. Two image subsets of 5 and 1mm CT images of each nodule were interpreted independently by four radiologists. Nodule size, consistency (solid, partly solid, non-solid), the presence of calcification, and recommendations for follow-up were evaluated. If a non-calcified solid nodule was confirmed using CT, recommendation for follow-up was based on Fleischner Society guidelines. Data assessed by each radiologist were compared, and interobserver agreements were determined using the intraclass correlation coefficients and kappa value.Using 1mm CT images, the nodule sizes were significantly larger than on 5mm CT images (paired t-test, p0.01). The presence of calcification and nodule consistency were significantly different between 5 and 1mm CT images (McNemar test for the presence of calcification, p0.01; Wilcoxon signed test for nodule consistency, p0.01). On 1mm CT images there was significantly higher agreement regarding nodule consistency than on 5mm CT (kappa=0.78 and 0.67, respectively).Concurrent use of thin-section and thick-section CT can provide more accurate nodule assessment and higher interobserver agreement in SSPN.

Background To evaluate the toxicity and efficacy of a newly developed topoisomerase I inhibitor, CKD-602 in second-line therapy of ovarian cancer. Methods We enrolled 24 patients with recurrent ovarian cancer, of median age 54 years (range, 39–64). Eleven patients had measurable lesions on CT scan, and the other 13 had increased serum CA-125 levels. Eighteen patients had platinum-sensitive disease (minimum treatment free interval≥6 months) and 6 had platinum-resistant disease (minimum treatment free interval 2 /day) was administered intravenously for 5 days every 3 weeks. The median number of courses per patient was 6 (range, 1 to 12). Response was evaluated by the evaluation of the size of the mass by CT scan and CA-125 response. Results The overall response rate was 45.0% (9/20), with 4 patients exhibiting partial responses and 5 patients exhibiting 75% CA-125 responses in 20 evaluable patients. Of the 9 responsive patients, 8 were platinum-sensitive (8/15, 53.3%) and 1 was platinum-resistant (1/5, 20.0%). An additional 5 patients showed stable disease, whereas 6 patients exhibited progressive lesions. Of 24 patients, the most common toxicity was hematological, with grades 3 or 4 neutropenia developing in all 24 patients (100%) and in 94 cycles (71.7%). Grade 3 thrombocytopenia developed in 4 patients (16.7%) and 6 cycles (4.6%). None of the patients experienced grades 3 and 4 gastrointestinal toxicities, including nausea, vomiting, and anorexia. Conclusions The newly developed topoisomerase I inhibitor, CKD-602, showed activity against both platinum-sensitive and -resistant ovarian cancer, with acceptable toxicity.

The aim of this study is to investigate the correlation between ATP-based chemotherapy response assay (ATP-CRA) results and clinical outcomes in ovarian cancer. Twenty-nine fresh tumor specimens were collected. Tumor cells were isolated and cultured for 48 hrs in medium containing anticancer drugs. The median age of patients was 56 years. The sensitivity, positive predictive value, and accuracy of ATP-CRA were respectively 94.1%, 94.1%, and 90.0%. There was a significant relationship between ATP-CRA results and clinical responses (p = 0.046). This study suggests that ATP-CRA has high sensitivity, positive predictive value, and accuracy for predicting response to chemotherapy in ovarian cancer.

Oxygen signaling is critical for stem cell regulation, and oxidative stress-induced stem cell apoptosis decreases the efficiency of stem cell therapy. Hypoxia activates O-linked β-N-acetyl glucosaminylation (O-GlcNAcylation) of stem cells, which contributes to regulation of cellular metabolism, as well as cell fate. Our study investigated the role of O-GlcNAcylation via glucosamine in the protection of hypoxia-induced apoptosis of mouse embryonic stem cells (mESCs). Hypoxia increased mESCs apoptosis in a time-dependent manner. Moreover, hypoxia also slightly increased the O-GlcNAc level. Glucosamine treatment further enhanced the O-GlcNAc level and prevented hypoxia-induced mESC apoptosis, which was suppressed by O-GlcNAc transferase inhibitors. In addition, hypoxia regulated several lipid metabolic enzymes, whereas glucosamine increased expression of glycerol-3-phosphate acyltransferase-1 (GPAT1), a lipid metabolic enzyme producing lysophosphatidic acid (LPA). In addition, glucosamine-increased O-GlcNAcylation of Sp1, which subsequently leads to Sp1 nuclear translocation and GPAT1 expression. Silencing of GPAT1 by gpat1 siRNA transfection reduced glucosamine-mediated anti-apoptosis in mESCs and reduced mammalian target of rapamycin (mTOR) phosphorylation. Indeed, LPA prevented mESCs from undergoing hypoxia-induced apoptosis and increased phosphorylation of mTOR and its substrates (S6K1 and 4EBP1). Moreover, mTOR inactivation by rapamycin (mTOR inhibitor) increased pro-apoptotic proteins expressions and mESC apoptosis. Furthermore, transplantation of non-targeting siRNA and glucosamine-treated mESCs increased cell survival and inhibited flap necrosis in mouse skin flap model. Conversely, silencing of GPAT1 expression reversed those glucosamine effects. In conclusion, enhancing O-GlcNAcylation of Sp1 by glucosamine stimulates GPAT1 expression, which leads to inhibition of hypoxia-induced mESC apoptosis via mTOR activation.

Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. The Korean cervical cancer mortality rate for 1993-2002 based on National Statistical Office data shows an increasing trend, but the actual rates are thought to have decreased by epidemiologists, clinicians and other cancer experts. To explain this gap and solve this problem, we corrected the number of cervical cancer deaths by comparing death certificate cases of unspecified uterine cancer data with the national cancer incidence databases of entire cancer registries in Korea. We used 2 different methods to make a correction. First, we considered "uterus, unspecified" deaths previously registered as "cervix, uterine" cases misclassified and added them to the cervical cancer deaths. Alternatively, we multiplied the total number of registered unspecified uterine cancer deaths by age-specific proportions of registered incident cervical cancer cases among all cancers and added the product to cervical cancer deaths. The overall corrected age-standardized cervical cancer mortality rates per 100,000 women decreased from 5.2 in 1993 to 3.9 in 2002 (estimated annual percentage change (EAPC): -4.05%, 95% CI: -4.88, -3.22). While cervical cancer mortality showed a decreasing tendency in women aged 30-69 years, it increased substantially in women aged > or =70 years (EAPC: 3.62%, 95% CI: 1.92-5.35). Results of this study will provide evidence-based foundation for the evaluation of the existing cervical cancer-screening programs.

Aim: To estimate the relationship between matrix metalloproteinase (MMP)-1 promoter -1607 bp polymorphism and the risk of epithelial ovarian cancer (EOC) in Korean women and to clarify the ethnic difference in genotype distribution of this polymorphism. Methods: Single nucleotide polymorphism (SNP) of MMP-1 promoter -1607 region in 133 EOC patients and 332 cancer-free patients were investigated. Then the associations of this polymorphism with EOC or its clinicopathological parameters were analyzed. In addition, genotype distributions of this polymorphism in Korean women were compared with those of other races by extracting data from the previously published literature. Results: We found no relationship between MMP-1 promoter -1607 bp polymorphism and epithelial ovarian cancer in a Korean population. Furthermore, we found ethnicity-dependent differences in genotype distributions and allele frequencies by comparison with previous articles on this topic. We report significant ethnic differences in the genotype distributions and allele frequencies of the MMP-1 promoter -1607 bp polymorphism. Conclusion: Our results indicate that MMP-1-1607 bp polymorphism shows ethnic diversity, and that the hypothesis that this polymorphism is associated with epithelial ovarian cancer is not supported by this study in a Korean population. Moreover, this finding concurs with results obtained in white Americans and Europeans.

Objectives. To retrospectively evaluate the accuracy of magnetic resonance (MR) imaging for the prediction of depth of myometrial invasion in the preoperative assessment of women with endometrial carcinoma. Methods. We retrospectively reviewed the medical records and MR imaging reports of 120 women with pathologically-proven endometrial carcinoma who underwent preoperative pelvic MR imaging between June 1997 and February 2006. Tumor signal intensity, the appearance of the junctional zone (JZ), the presence of large polypoid tumors and leiomyomas were analyzed. Univariate logistic-regression analysis was performed to identify associations between incorrect MR staging and the study variables. Results. Data from 120 patients were registered for the current study and analyzed. The sensitivity, specificity and accuracy of the MR imaging in assessment of myometrial invasion among patients with endometrial carcinoma were: 50.6%, 89.2% and 62.5% respectively. MR differentiation of deep myometrial invasion from superficial disease had an 83.3% accuracy (100 of 120 cases). Isointense JZ to myometrium (P (P =0.037) on MR imaging were significantly associated with an underestimation of myometrial invasion by endometrial carcinoma. Conclusions. Isointense JZ to myometrium and polypoid tumors are difficult to accurately evaluate for myometrial invasion of endometrial carcinoma by MR imaging.

Cervical cancer is almost invariably associated with infection by human papillomavirus. It is believed that the host genetic factors such as inflammation-induced cytokines may play a role in cervical carcinogenesis. The IL1B gene, encoding IL-1beta cytokine, contains several single nucleotide polymorphisms. One of them which is in the positions -511 (C-T) related with promoter region has been associated with increased IL-1beta production and with increased risk of developing a number of inflammatory diseases and gastric carcinoma. We assessed the association between the IL1B -511 polymorphism and cervical cancer risk in a hospital-based case-control study among 546 Korean women (182 cases; 364 age-matched controls). The allele frequencies of the case subjects (C, 0.42; T, 0.58) were not significantly different from those of control subjects (C, 0.43; T, 0.57). Control subjects were in Hardy-Weinberg equilibrium. The carriers with -511 C/T or T/T genotypes were at higher risk of cervical cancer with odds ratio of 2.42 (95% CI 1.31-4.46, p0.005). However, there was no difference of cervical cancer risk between C/T heterologous genotypes and T/T homologous genotypes. In conclusion, in Korean population, IL1B -511 C/C genotypes were significantly associated with a decreased risk of cervical cancer.

Cancer is primarily a disease of older adults. However, little data is available on the clinical features of cervical cancer in elderly patients. We investigated the trends in incidence and clinical features associated with cervical cancer among the elderly in Korea during the period of 1993-2002. We obtained data from the National Cervical Cancer Incidence Database, which was constructed in collaboration with the Korea Central Cancer Registry (KCCR) and Korea Gynecologic Cancer Registry (KGCR). A total of 44 191 women with cervical cancer were diagnosed between 1993 and 2002. Patients were divided into three groups based on age:/=49 years (Group 1), 50-69 years (Group 2), and/=70 years (Group 3). During this period, upward incidence trends were noted in Group 3 while constant and downward incidence trends were noted in Groups 1 and 2, respectively. Pooled analysis across years revealed that squamous cell carcinoma and advanced stage (IIB, III, and IV) were more common in Group 3 than in Groups 1 and 2. With regard to primary treatments in the elderly patients, surgery appeared to be performed increasingly despite the fact that advanced stage (IIB, III, and IV) was more common in Group 3 than in Groups 1 and 2. Our findings suggest that the incidence of cervical cancer in the elderly is increasing in Korea, while it is decreasing overall. The current health service must emphasize education for the elderly about cervical cancer prevention while concentrating on screening.

The purpose of this study was to determine the ovarian findings on integrated positron emission tomography/computed tomography scans during follow-up in cervical cancer patients with ovarian transposition.We retrospectively reviewed the clinical data and integrated 18F-fluorodeoxyglucose positron emission tomography/computed tomography of women with ovarian transposition during radical hysterectomy for cervical cancer between December 2003 and March 2006.Eighty-four premenopausal women had ovarian transposition performed during the study period. Twelve positron emission tomography/computed tomography scans from 11 patients were registered for the current study and three women were diagnosed with metastasis: two in lung and one in pelvis. Two patients complained of menopausal symptoms during follow-up, and the hormonal tests were consistent with it. In the current study, an integrated positron emission tomography/computed tomography scan detected one patient with right lower abdominal mass with increased 18F-fluorodeoxyglucose uptake, which was identified as a transposed right ovary. Clinical information of ovarian transposition was helpful in interpretation of the lesion. In the patient, transposed ovary was associated with increased fluorodeoxyglucose uptake, with standard uptake values ranging from 3.7 to 5.5. Other positron emission tomography/computed tomography scans did not show abnormal uptake of 18F-fluorodeoxyglucose.Transposed ovary in premenopausal women may appear on integrated positron emission tomography/computed tomography scan as a mass with increased 18F-fluorodeoxyglucose uptake, which may be associated with preserved ovarian function. Clinical information regarding transposition should be noted in order not to interpret these as recurrent or metastatic lesions.

Currently, many studies have shown that nitric oxide (NO) and prostaglandin (PG) are main inflammatory mediators involved in a variety of pathophysiological processes including inflammation and carcinogenesis. In this article, we explored the possible association of polymorphisms, of two representative inflammatory mediators, with the risk for cervical cancer. This study included 176 cases of histologically confirmed invasive cervical cancer, and 172 healthy controls. Allele frequency of 12 single-nucleotide polymorphisms (SNPs) of cyclooxygenase-2 (COX-2) and COX5 of the inducible nitric oxide synthase (iNOS) genes in 43 different normal populations were analyzed. We found that 14 of 17 showed a monomorphic or minimal minor allele frequency; therefore, we did not continue with additional analysis. Three SNPs (2 for COX-2, 1 for iNOS) were chosen for the study. Genotyping of three SNPs (SNP-rs5275 in the untranslated region of exon 10 and rs5277 in the coding region of exon 3 of COX-2, and iNOS Ser(608)Leu allele C/T polymorphism within exon 16 of the iNOS reductase domain) was performed. No significant increase was found in any of the genotypes of the COX-2 or iNOS in the cancer group. We investigated the possible correlation between the genotypes and the clinicopathologic parameters of cervical cancer. No significant association of the genotypes studied was found with respect to clinical stage, lymph node (LN) status, histologic type, or parametrial invasion. Our data did not reveal an association between COX-2 and iNOS polymorphisms with cervical cancer in Korean women.

Objectives To evaluate the toxicity and the efficacy of paclitaxel/carboplatin chemoradiotherapy as a definitive treatment for squamous cell cancer of the uterine cervix. Methods From March 2000 to January 2004, 33 patients with squamous cell cancer of the uterine cervix were treated with concurrent chemoradiotherapy including 2 cycles of paclitaxel (135 mg/m2) and carboplatin (area under the time–concentration curve 4.5 mg min/ml) at 4-week interval. Seven patients received adjuvant chemotherapy with the same chemotherapeutic regimen. All patients received external beam radiotherapy with 41.4–51.4 Gy (median 50.4 Gy) to the whole pelvis. Twenty-eight patients received boost irradiation to the cervix by brachytherapy with 25.6–43.3 Gy (median 34.6 Gy) and 5 patients by external beam radiotherapy with 10.8–14.4 Gy (median 14.4 Gy). Results A median follow-up period was 27 months (range: 6–53 months). Acute hematological toxicity of grade 3 or 4 developed in 20 patients (61%), and acute gastrointestinal toxicity of grade 3 developed in 1 patient (3%). Vesicovaginal fistula occurred in 2 patients (6%). All patients achieved objective response (CR 70%, PR 30%) in 2 months after termination of treatment. One patient had a local progression in cervix, and 4 patients developed distant metastases. The 3-year estimated disease-free survival rates for stages I–IIA, IIB, III and IV were 67%, 91%, 88% and 50%, respectively. The 3-year estimated survival rates for stages I–IIA, IIB, III and IV were 89%, 91%, 88% and 50%, respectively. Conclusion Concurrent chemoradiotherapy with paclitaxel and carboplatin is effective to achieve an excellent pelvic control.

As the relationship between inflammation and carcinogenesis grows stronger, the role of cyclooxygenase-2 (COX-2) and epidermal growth factor (EGFR) has been highlighted in the pathogenesis and progression of human cancer. In view of the fact that vulvar cancer is characterized by precancerous inflammatory changes in elderly patients, the expressions of COX-2 and EGFR are expected to show different patterns of distribution according to age and other prognostic factors. To verify whether there was a relationship between their expression and clinicopathologic parameters in vulvar cancer, we investigated the inflammatory cellular infiltration and the expression of COX-2 and EGFR by immunohistochemical analysis. Eleven of 19 samples (57.8%) were stained positive for COX-2, and 17 (89.4%) for EGFR. The portion of inflammatory cellular infiltration in adjacent normal tissue was also higher in the older age group, and showed a strong correlation with COX-2 positivity (P = 0.002). Furthermore, COX-2 expression was significantly more frequent in patients over 60 years of age compared to those under 50 years (P = 0.009). COX-2 expression was noted to be high in moderate and well-differentiated cases, whereas, poorly differentiated carcinoma was negative for COX-2 expression (P = 0.023). However, EGFR expression was not differently distributed on the basis of stage, age, tumor grading, or presence of lymph node metastasis. Our article suggests that vulvar cancer in elderly patients may be associated with inflammation, and thus with increased COX-2 expression. In light of these findings, a clinical trial designed to assess the addition of COX-2 targeted therapy to conventional treatment in vulvar cancer would be helpful for consideration of additional treatment options and possibly avoiding the serious surgical morbidity in elderly patients.

Background: Excision repair cross-complementing group 1 (ERCC1) is a major DNA repair protein. Recent studies have addressed the association between ERCC1 polymorphism and carcinogenesis. Methods: We investigated a polymorphism of ERCC1 at nucleotide 19007 (C→T, Asn118Asn) in 94 epithelial ovarian cancer patients, 102 endometrial cancer patients, and in 329 control subjects. Results: We observed no evidence of associations between the C19007T ERCC1 polymorphism and risk of epithelial ovarian or endometrial cancer, which had the same adjusted odds ratios of 0.91 (p = 0.711, 0.691 respectively). Conclusion: Our findings suggest that the C19007T ERCC1 polymorphism is unlikely to play an important role in epithelial ovarian or endometrial cancer in Korean women.

Objectives. The aim of the study was to assess whether the genetic polymorphisms were associated with the tumor response in patients treated with platinum-based neoadjuvant chemotherapy (NAC) for bulky cervical cancer. Methods. We retrospectively reviewed the clinical data and recruited paraffin-embedded, formalin-fixed tissues of 36 patients with bulky cervical carcinoma. All patients underwent two or three cycles of platinum-based NAC followed by radical hysterectomy. We determined the genotypes of each single nucleotide polymorphism (SNP) of ERCC1 , ERCC2 , GGH , GSTP1 , MTHFR , SLC19A1 and XRCC1 using single base primer extension assay. Results. The response to platinum-based NAC was higher in patients with SNP of XRCC1 R399Q ( P =0.015), and there was a significant increased chance of treatment response in women with the G/G genotype (OR 38.0; 95% CI 1.66–870.45; P =0.023). The probability of response was also higher in patients with SNP of SLC19A1 6318C/T ( P =0.032). There were dose-dependent influence of the number of alleles on the response to platinum-based chemotherapy ( χ 2 test for linear-by-linear association; P =0.009 for XRCC1 R399Q and P =0.017 for SLC19A1 6318C/T, respectively). Moreover, the multifactor dimensionality reduction (MDR) analysis documented that the combinations of XRCC1 R399Q and GGH -401C/T genetic polymorphisms were significantly associated with response to chemotherapy ( P Conclusions. Genetic polymorphism of XRCC1 R399Q is associated with response to platinum-based NAC in bulky cervical cancer, and MDR analysis documented association between gene–gene interaction of XRCC1 R399Q and treatment response.

To evaluate the accuracy of integrated positron emission tomography (PET) and computed tomography (CT) for depiction of suspected recurrent ovarian carcinoma after treatment, with use of clinical or histological findings as the reference standard.Seventy-seven women (median age, 51 years) with ovarian carcinoma treated with primary cytoreductive surgery followed by platinum-based combination chemotherapy were included, and [18F]fluorodeoxyglucose (FDG) PET/CT was performed for suspected recurrence. In all patients, imaging findings were compared with results of histological examination after surgical exploration or clinical follow-up to determine the diagnostic accuracy of PET/CT in the evaluation of disease status. Fisher's exact test was used to measure the ability of PET/CT to predict recurrent lesions.Forty-five (58.4%) of the 77 patients had documented recurrence during surgical exploration or clinical follow-up, while 32 (41.6%) had no evidence of recurrent tumour. Of the 45 patients with recurrent disease, 27 (60%) were confirmed to have recurrence by surgical biopsy. A correlation was found between PET/CT and histological or clinical analyses (kappa = 0.894). The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET/CT were 93.3%, 96.9%, 94.8%, 97.7% and 91.2%, respectively. PET/CT modified the diagnostic or treatment plan in 19 (24.7%) patients, by leading to the use of previously unplanned therapeutic procedures in 11 (57.9%) patients and the avoidance of previously planned diagnostic procedures in eight (42.1%) patients.Integrated FDG PET/CT is a sensitive post-therapy surveillance modality for the detection of recurrent ovarian cancer; it aids decisions on treatment plans and may ultimately have a favourable impact on prognosis.

This study examined the incidence rates, histologic and stage distribution, and long-term survival rates of patients with cervical cancer in Korea. A total of 44,182 patients diagnosed with cervical cancer between 1993 and 2002 were reported to the Korea Central Cancer Registry and the Gynecologic Oncology Committee of Korean Society of Obstetrics and Gynecology. The age-standardized incidence rates were 19.0, 17.8, and 15.1 per 100,000 women in 1993-1995, 1996-1998, and 1999-2002, respectively. The incidence rates of adenocarcinoma (AC) have been in the range between 1.2 in 1993-1995 and 1.4 in 1999-2002, while those of squamous cell carcinoma declined from 15.1 in 1993-1995 to 12.2 in 1999-2002. The 5-year relative survival rate was 79.2%. Relative survival rates, according to stage by the FIGO, at 5 years were 94.2%, 69.7%, 38.9%, and 21.1% for stages I, II, III, and IV respectively. Relative survivals improved between 1993 and 1997, probably due to the introduction of cervical cancer screening and effective treatment. The incidence rates of AC have been constant despite decreased cervical cancer in Korea. Introduction of cervical cancer screening and effective treatment may have contributed to the improved relative survival.

Objectives. To evaluate the efficacy of self-collected vaginal samples for high-risk HPV detection by the HPV oligonucleotide microarray method (HPVDNAChip™). Methods. One hundred and eighteen patients with abnormal Pap smears were included. Self-collected vaginal and clinician-collected cervical samples for HPV testing were obtained. The result of the HPV DNA test was compared with the histopathological diagnosis or colposcopic finding. Results. Of the 118 patients, 42 (35.6%) had ≥ cervical intraepithelial neoplasia (CIN) III lesions. Using the HPVDNAChip™, high-risk types of HPV were detected in 38 of these 42 patients (90.5%) with the self-collected vaginal samples and in 37 of 42 (88.1%) with the clinician-collected cervical samples. The agreement of HPVDNAchip™ results between self- and clinician-collected samples was very good ( κ = 0.81) with a 93.2% concordance rate. Multiple HPV infections were found in 17 of 88 (19.3%) HPV-positive clinician-collected cervical samples. The rate of multiple HPV infection tended to decrease as the degree of pathologic classification increased. Conclusion. Using the HPVDNAchip™ to assay for HPV infection, results from self-collected vaginal samples were compatible with those from clinician-collected cervical samples.

ERCC1 is a DNA repair gene and has been associated with resistance to DNA damaging agents. In this study we hypothesized that a polymorphism of ERCC1 Asn118Asn (C →T) might affect the platinum-resistance of epithelial ovarian cancer patients to platinum-taxane chemotherapy administered postoperatively. Using the SNapShot assay, we assessed this polymorphism in ERCC1 in 60 ovarian cancer patients. Platinum-resistance was defined as pro - gression on platinum-based chemotherapy or recurrence within 6 months of completing therapy. Although not significant, platinum-resistance was less frequently observed in patients with the C/T + T/T genotype (P = 0.064). Multivariate analysis showed that the C/T + T/T genotypes constituted an independent predictive factor of reduced risk of platinum-resistance in ovarian cancer (odds ratio 0.17, 95% confidence interval 0.04-0.74, P = 0.018, Fisher's exact test). No significant correlation was observed between overall survival and the ERCC1 polymorphism. Our results suggest that genotyping of the ERCC1 polymorphism Asn118Asn may be useful for predicting the platinum-resistance of epithelial ovarian cancer patients. However, these findings require prospective confirmation.

RASSF1A is a tumor suppressor gene that is frequently hypermethylated in various human cancers. In the present study, we examined RASSF1A methylation status in 70 patients with endometrial cancer to search for correlations between the promoter hypermethylation of RASSF1A and the clinicopathologic parameters. Thirty-six of 70 endometrial cancers demonstrated hypermethylation of the RASSF1A promoter. Advanced stage disease (FIGO stage III, IV), lymph node involvement, and high grade (G3) are more frequent in patients with RASSF1A hypermethylation than in those without. We also observed a higher incidence of recurrences and lower disease-free survival (DFS) in patients with RASSF1A hypermethylation (77.8% and 97.0% at 5 years for methylated and unmethylated patients, respectively, p = 0.039). Our results suggest that RASSF1A hypermethylation might be a useful indicator of tumor aggressiveness in endometrial cancer patients.