The influence of surgical factors on dislocation of the meniscal bearing after Oxford medial unicompartmental knee replacement: a case-control study

The aim of this study was to evaluate the risk factors for dislocation of the bearing after a mobile-bearing Oxford medial unicompartmental knee replacement (UKR) and to test the hypothesis that surgical factors, as measured from post-operative radiographs, are associated with its dislocation From a total of 480 UKRs performed between 2001 and 2012, in 391 patients with a mean age of 66.5 years (45 to 82) (316 female, 75 male), we identified 17 UKRs where bearing dislocation occurred. The post-operative radiological measurements of the 17 UKRs and 51 matched controls were analysed using conditional logistic regression analysis. The post-operative radiological measurements included post-operative change in limb alignment, the position of the femoral and tibial components, the resection depth of the proximal tibia, and the femoral component-posterior condyle classification. We concluded that a post-operative decrease in the posterior tibial slope relative to the pre-operative value was the only significant determinant of dislocation of the bearing after medial Oxford UKR (odds ratio 1.881; 95% confidence interval 1.272 to 2.779). A post-operative posterior tibial slope < 8.45° and a difference between the pre-operative and post-operative posterior tibial slope of > 2.19° may increase the risk of dislocation.

Association between polymorphisms in period genes and bone density in postmenopausal Korean women

OBJECTIVE

In the present study, we aimed to investigate the association between genetic polymorphisms in period (PER) genes and bone mineral density (BMD) in postmenopausal Korean women.

METHODS

The PER1 c.2247C> T and c.2884C> G polymorphisms; the PER2 c.661G> A and c.3731G> A polymorphisms; the PER3 c.2592G> A, c.3029C> T, c.3035C> T, and c.3083T> C polymorphisms, and the 54 bp variable number tandem repeats polymorphism were analyzed in 551 postmenopausal Korean women. Serum leptin, soluble leptin receptor, osteoprotegerin, soluble receptor activator of the nuclear factor-κB ligand, and bone markers including bone alkaline phosphatase and carboxy-terminal telopeptide of type I collagen were measured, and the lumbar spine and femoral neck BMDs were also determined.

RESULTS

The PER2 c.661G> A, PER3 c.3029C> T and c.3035C> T polymorphisms were not observed. The PER2 and PER3 polymorphisms evaluated were not related to BMD, whereas associations of the c.2247C> T and c.2884C> G polymorphisms in PER1 with the lumbar spine BMD were observed both singly and in combination. The CC haplotype homozygotes showed significantly lower lumbar spine BMD than participants with other genotypes. Additionally, 2.01-fold higher odds for osteoporosis of the lumbar spine were found in the CC haplotype homozygotes compared to women not carrying the haplotype CC allele. No significant differences in bone markers were detected according to the PER1 haplotype genotype.

CONCLUSIONS

Our results suggest that both the PER1 c.2247C> T and c.2884C> G polymorphisms may be genetic factors affecting the lumbar spine BMD in postmenopausal Korean women.

Spin-induced band modifications of graphene through intercalation of magnetic iron atoms

Intercalation of magnetic iron atoms through graphene formed on the SiC(0001) surface is found to induce significant changes in the electronic properties of graphene due mainly to the Fe-induced asymmetries in charge as well as spin distribution. From our synchrotron-based photoelectron spectroscopy data together with ab initio calculations, we observe that the Fe-induced charge asymmetry results in the formation of a quasi-free-standing bilayer graphene while the spin asymmetry drives multiple spin-split bands. We find that Fe adatoms are best intercalated upon annealing at 600 °C, exhibiting split linear π-bands, characteristic of a bilayer graphene, but much diffused. Subsequent changes in the C 1s, Si 2p, and Fe 3p core levels are consistently described in terms of Fe-intercalation. Our calculations together with a spin-dependent tight binding model ascribe the diffuse nature of the π-bands to the multiple spin-split bands originated from the spin-injected carbon atoms residing only in the lower graphene layer.

Brain activation patterns of motor imagery reflect plastic changes associated with intensive shooting training

Evidence from previous studies has suggested that motor imagery and motor action engage overlapping brain systems. As a result of this observation that motor imagery can activate brain regions associated with actual motor movement, motor imagery is expected to enhance motor skill performance and become an underlying principle for physical training in sports and physical rehabilitation. However, few studies have examined the effects of physical training on motor imagery in beginners. Also, differences in neural networks related to motor imagery before and after training have seldom been studied. In the current study, using functional magnetic resonance imaging (fMRI), we investigated the question of whether motor imagery can reflect plastic changes of neural correlates associated with intensive training. In fact, motor imagery was used in this study as a tool to assess the brain areas involved in shooting and involved in learning of shooting. We discovered that use of motor imagery resulted in recruitment of widely distributed common cortical areas, which were suggested to play a role in generation and maintenance of mental images before and after 90 h of shooting training. In addition to these common areas, brain activation before and after 90 h of shooting practice showed regionally distinct patterns of activity change in subcortical motor areas. That is, basal ganglia showed increased activity after 90 h of shooting practice, suggesting the occurrence of plastic change in association with gains in performance and reinforcement learning. Therefore, our results suggest that, in order to reach a level of expertise, the brain would change through initial reinforcement of preexistent connections during the training period and then use more focused neural correlates through formation of new connections.

Induction of melanogenesis by rapamycin in human MNT-1 melanoma cells

Background

Melanogenesis is one of the characteristic parameters of differentiation in melanocytes and melanoma cells. Specific inhibitors of phosphatidylinositol 3-kinase (PI3K), such as wortmannin and LY294002, stimulate melanin production in mouse and in human melanoma cells, suggesting that PI3K and mammalian target of rapamycin (mTOR) might be involved in the regulation of melanogenesis.

Objective

The involvement of the mTOR pathway in regulating melanogenesis was examined using human MNT-1 melanoma cells, and the effects of the potent inhibitor of mTOR, rapamycin, in the presence or absence of α-melanocyte-stimulating hormone (α-MSH) were evaluated.

Methods

In cells treated with rapamycin, cell viability, melanin content, and tyrosinase (TYR) activity were measured and compared with untreated controls. Protein levels of TYR, tyrosinase-related protein (TYRP)-1, TYRP-2, and microphthalmia-associated transcription factor (MITF) were also analyzed by Western blot.

Results

In rapamycin-treated cells, the melanin content increased concomitantly with an elevation in TYR activity, which plays a major role in melanogenesis. There was also an up-regulation of TYR, TYRP-1, and MITF proteins. Combined treatment with rapamycin or wortmannin and α-MSH increased melanogenesis more strongly than α-MSH alone.

Conclusion

Rapamycin-induced melanin formation may be mediated through the up-regulation of TYR protein and activity. Furthermore, rapamycin and wortmannin, inhibitors of mTOR and PI3K, respectively, have co-stimulatory effects with α-MSH in enhancing melanogenesis in melanocyte cells.

Fluconazole induced fixed drug eruption

We report on a rare case of fluconazole induced fixed drug eruption in a 62-year old female patient. She was referred to our department for multiple erythematous itchy maculopatches on the face, neck, both upper arms, and trunk area, which had occurred over the previous 6 months. Her attending physician prescribed fluconazole for treatment of onychomycosis. Patch test and oral provocation were performed. The patch test showed a negative result; however, the result for oral provocation was positive, confirming this as a rare case of fluconazole induced fixed drug eruption. To the best of our knowledge, this is the first reported case in Korean dermatologic literature.

Neural correlates of motor imagery for elite archers

Motor imagery is a mental rehearsal of simple or complex motor acts without overt body movement. It has been proposed that the association between performance and the mental rehearsal period that precedes the voluntary movement is an important point of difference between highly trained athletes and beginners. We compared the activation maps of elite archers and nonarchers during mental rehearsal of archery to test whether the neural correlates of elite archers were more focused and efficiently organised than those of nonarchers. Brain activation was measured using functional MRI in 18 right-handed elite archers and 18 right-handed nonarchers. During the active functional MRI imagery task, the participants were instructed to mentally rehearse their archery shooting from a first-person perspective. The active imagery condition was tested against the nonmotor imagery task as a control condition. The results showed that the premotor and supplementary motor areas, and the inferior frontal region, basal ganglia and cerebellum, were active in nonarchers, whereas elite archers showed activation primarily in the supplementary motor areas. In particular, our result of higher cerebellar activity in nonarchers indicates the increased participation of the cerebellum in nonarchers when learning an unfamiliar archery task. Therefore, the difference in cerebellar activation between archers and nonarchers provides evidence of the expertise effect in the mental rehearsal of archery. In conclusion, the relative economy in the cortical processes of elite archers could contribute to greater consistency in performing the specific challenge in which they are highly practised.

Applicability of the Charm II system for monitoring antibiotic residues in manure-based composts

The effluence of veterinary antibiotics (VAs) to aquatic and terrestrial environments is of concern due to the potential adverse effects on human health, such as the production of antibiotic resistant bacteria. One of the main pathways for antibiotics to enter the environment is via the application of manure and/or manure-based composts as an alternative organic fertilizer to agricultural lands. While a wide diversity of manure-based composts are produced in Korea, there is currently no regulatory guideline for VA residues. Hence, monitoring and limiting the concentration of VA residues in manure and/or manure-based composts prior to application to the lands is important to mitigate any environmental burden. The current study was conducted to examine the applicability of the Charm II antibiotic test system for monitoring tetracyclines, sulfonamides and macrolides in manure-based composts. The Charm II system was a highly reproducible method for determining whether VA residue concentrations in manure-based compost exceeded specific guideline values. A wide range of manure-based composts and liquid fertilizers commercially available in Korea were examined using the Charm II system to monitor the residues of the target VAs. For this, the guideline concentrations of VA residues (0.8 mg kg(-1) for tetracyclines, 0.2 mg kg(-1) for sulfonamides, and 0.1 mg kg(-1) for macrolides) stated in 'Official Standard of Feeds' under the 'Control of Livestock and Fish Feed Act' in Korea were adopted to establish control points. Of the 70 compost samples examined 12 exceeded 0.8 mg kg(-1) for tetracyclines and 21 exceeded 0.2 mg kg(-1) for sulfonamides. Of the 25 liquid fertilizer samples examined most samples exceeded these prospective guidelines.

Treatment of oral lichen sclerosus with 1% pimecrolimus cream

Lichen sclerosus is a chronic inflammatory mucocutaneous disorder predominately affecting prepubertal girls and postmenopausal women. Isolated lichen sclerosus affecting the oral mucosa is exceedingly rare, and only 13 patients with biopsy-proved isolated oral disease have been reported in the literature. We report on a 7-year-old Korean girl with a well-demarcated 1.2x1.2 cm atrophic white plaque with an erythematous border and focal telangiectasia on the left vermillion lip, extending to the labial mucosa. No other cutaneous surfaces, including genitalia, were involved. An incisional biopsy of the plaque on the lip revealed a patchy lichenoid infiltrate of lymphocytes associated with sclerosis of the papillary dermis and a thinned epidermis consistent with a diagnosis of linear orofacial lichen sclerosus. Treatment with a short course of 1% pimecrolimus cream effectively prevented the progression of this lesion.

The effects of hormone therapy on metabolic risk factors in postmenopausal Korean women

OBJECTIVE

We sought to assess the prevalence of metabolic syndrome (MetS) among Korean postmenopausal women and to investigate the effect of hormone therapy status and reproductive characteristics on body composition and MetS risk factors.

STUDY DESIGN

We performed a cross-sectional study involving a cohort of 2005 postmenopausal Korean women. We defined MetS using the modified National Cholesterol Education Program (NCEP) criteria proposed by the American Heart Association/National Heart, Lung, and Blood Institute guidelines. The criteria for abdominal obesity were adopted from the cut-offs suggested by the Korean Society for the Study of Obesity. Participants with three or more of the following conditions were classified as having MetS: waist circumference ≥ 85 cm; blood pressure ≥ 130/85 mmHg; fasting plasma triglycerides ≥ 150 mg/dl; high density lipoprotein cholesterol < 50 mg/dl; glucose ≥ 100 mg/dl and/or receiving treatment for their condition.

RESULTS

The prevalence of MetS was 22.1% in the study population and increased with age. After adjusting for age and related reproductive characteristics, it was found that ever-use of hormone therapy (prior or current) was associated with decreased risk of postmenopausal MetS. Among individual risk factors for MetS, current hormone therapy seemed to be associated with decreased prevalence of abdominal obesity and better glucose metabolism and prior use of hormone therapy were associated with lower risk of abdominal obesity and high blood pressure.

CONCLUSION

Postmenopausal hormone therapy is associated with decreased risk of MetS in postmenopausal Korean women.

Early onset of acute GVHD indicates worse outcome in terms of severity of chronic GVHD compared with late onset

Acute GVHD (aGVHD) is an important risk factor for predicting the incidence or severity of chronic GVHD (cGVHD). Transplant outcome can be influenced by the onset time of aGVHD in patients who have received allogeneic PBSC transplants (PBSCTs). The medical records of 134 patients who survived more than 3 months after myeloablative allogeneic PBSCT were retrospectively reviewed. In all, 38 patients (28.4%) developed grade II-IV aGVHD before day +28 (early aGVHD) and 25 patients (18.7%) after day +28 (late aGVHD). The 5-year cumulative incidence of cGVHD was 78.9% in the early-aGVHD group and 56.6% in the late-aGVHD group (P=0.034). The 5-year OS was 51.0% for the early-aGVHD and 80.8% for the late-aGVHD group (P=0.406). Infection was the primary cause of death for the early-aGVHD group (51.4 vs 16.7%, P=0.017), whereas relapse of the primary disease was higher among the patients with late aGVHD, although this was statistically insignificant (58.3 vs 25.7%, P=0.309). In a multivariate analysis, early aGVHD was identified as a risk factor for developing cGVHD (hazard ratio (HR) 2.278, P=0.004). The development of aGVHD early after allogeneic PBSCT increased the risk of cGVHD and infection-related death rate when compared with the late onset of aGVHD.

Source identification and concentration distribution of polychlorinated biphenyls in environmental media around industrial complexes

In order to grasp the concentration distribution and identify sources of PCBs, air and soil samples around Sihwa and Banwol industrial area in Korea were analyzed. In result, the polychlorinated biphenyls (PCBs) concentration of air and soil was ranged from 2.08 to 5.82 ng/m3 (0.0686–1.01 pg WHO-TEQ/m3) and 2.43 to 274 ng/g dry (0.116–60.5 pg WHO-TEQ/g dry), respectively. Air and soil samples showed the very similar isomer composition pattern in each homologue by matrix, respectively. As a result of MLR for soil samples, the whole contribution rate of PCBs products (Aroclor) to soil was ~2 times higher than combustion.

A case of atypical granuloma annulare involving both ears

We report a rare case of granuloma annulare (GA), affecting both ear antihelixes, in a 28-year old male patient that presented with a 1-year history of non-tender, firm, skin-colored, 1~5 mm papules on both ear antihelixes. There was no history of trauma. An excisional biopsy specimen taken from one of the lesions of the right ear revealed infiltration of histiocytes and lymphocytes around a zone of collagen alteration in the dermis. Based on the clinical and pathological findings, the patient was diagnosed with a rare case of bilateral GA of both antihelixes; this is the first report in the Korean dermatology literature.

IVS10+12A>G polymorphism in hMSH2 gene associated with prognosis for patients with colorectal cancer

BACKGROUND

The polymorphisms in DNA repair genes may contribute to a variation in the DNA repair capacity, thereby affecting the risk of carcinogenesis and prognosis of colorectal cancer. Accordingly, the present study analyzed 14 polymorphisms in DNA repair genes and their impact on the prognosis for patients with colorectal cancer.

MATERIALS AND METHODS

Three hundred and ninety-seven consecutive patients with curatively resected colorectal adenocarcinoma were enrolled in the present study. The genomic DNA was extracted from fresh colorectal tissue and 14 polymorphisms of DNA repair genes determined using a real-time PCR genotyping assay.

RESULTS

The median age of the patients was 63 years, and 218 (54.9%) patients had colon cancer, while 179 (45.1%) patients had rectal cancer. A multivariate survival analysis, including age, differentiation, carcinoembryonic antigen level, and stage, revealed a better survival for the patients with the combined IVS10+12AG and GG genotype than for the patients with the IVS10+12AA genotype [disease-free survival: hazard ratio (HR) 0.47, 95% confidence interval (CI) 0.30-0.75, P = 0.002; overall survival: HR 0.50, 95% CI 0.26-0.98, P = 0.042]. None of the other polymorphisms was associated with survival.

CONCLUSION

The IVS10+12A>G polymorphism in the hMSH2 gene was found to be an independent prognostic marker for patients with colorectal cancer.

Survey of PCDDs and PCDFs in air and soil around various incinerators in Korea, 2003-2007

To investigate the levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) pollution in soils and air around incinerators, a total of 574 soil and 48 air samples were collected around 22 incineration facilities in Korea from 2003 to 2007. The concentrations of PCDD/Fs in the flue gases and air ranged from 0.01 to 21.50 ng I-TEQ Sm(-3) and 0.0002 to 9.95 pg I-TEQ Sm(-3), respectively whereas concentrations in soils ranged from n.d. to 153.23 pg I-TEQ g(-1) dw. The average value was 8.14 pg I-TEQ g(-1) dw in soil samples.

A comparative study on the short-term clinicopathologic outcomes of laparoscopic surgery versus conventional open surgery for transverse colon cancer

BACKGROUND

The long-term oncologic stability of laparoscopic surgery for colon cancer was established, and laparoscopic surgery was accepted as an alternative to conventional open surgery for colon cancer. However, transverse colon cancer was excluded from the majority of the previous prospective studies. As a result, debate on laparoscopic surgery for transverse colon cancer continues. This study aimed to compare the clinicopathologic outcome of laparoscopic surgery with that of conventional open surgery for transverse colon cancer.

METHODS

From August 2004 to December 2007, 106 cases of transverse colon cancer were managed by resection at our institution, and 89 of these cases were included in this study. Age, sex, body mass index (BMI), operation time, blood loss, time to first flatus, time to start of diet, hospital stay, complications, tumor size, distal resection margin, proximal resection margin, and number of nodes harvested were compared between the two groups.

RESULTS

No significant differences were found between the laparoscopic and conventional groups in terms of age, sex, BMI, operation time, or hospital stay. The mean blood loss during the operations was significantly less in the laparoscopic group (113.8 +/- 128.9 ml) than in the conventional group (278.8 +/- 268.7 ml; p < 0.05). Moreover, the time to the first flatus was shorter (2.8 +/- 0.9 days vs. 4.4 +/- 2.0 days; p < 0.00) and the diet was started earlier (3.9 +/- 1.7 days vs. 5.4 +/- 1.9 days; p < 0.00) in the laparoscopic group. No intergroup differences in tumor size, proximal resection margin, or number of lymph nodes were observed. The mean distal resection margin was longer in the laparoscopic group (12.5 +/- 4.1 cm vs. 9.2 +/- 6.2 cm; p < 0.05).

CONCLUSION

Laparoscopic and conventional open surgeries were found to have similar clinical outcomes in transverse colon cancer, and the oncologic quality of laparoscopic surgery was found to be acceptable compared with conventional open surgery.

Hemodynamic changes in rat leg muscles during tourniquet-induced ischemia-reperfusion injury observed by near-infrared spectroscopy

In this study, we hypothesized that non-invasive continuous wave near-infrared spectroscopy (CWNIRS) can determine the severity or reversibility of muscle damage due to ischemia/reperfusion (I/R), and the results will be highly correlated with those from physical examination and histological analysis. To test this hypothesis, we performed CWNIRS measurements on two groups of male Sprague-Dawley rats ( approximately 400 g) that underwent 2 h (n = 6) or 3 h (n = 7) of pneumatic tourniquet application (TKA). Tissue oxyhemoglobin [HbO(2)] and deoxyhemoglobin [Hb] concentration changes were monitored during the 2 h or 3 h of 250 mmHg TKA and for an additional 2 h post-TKA. Rats were euthanized 24 h post-TKA and examined for injury, edema and viability of muscles. Contralateral muscles served as controls for each animal. In both groups, [HbO(2)] dropped immediately, then gradually decreased further after TKA and then recovered once the tourniquet was released. However, releasing after 2 h of TKA caused [HbO(2)] to overshoot above the baseline during reperfusion while the 3 h group continued to have lower [HbO(2)] than baseline. We found a significant correlation between the elapsed time from tourniquet release to the first recovery peak of [HbO(2)] and the muscle weight ratio between tourniquet and contralateral limb muscles (R = 0.86). Hemodynamic patterns from non-invasive CWNIRS demonstrated significant differences between 2 h and 3 h I/R. The results demonstrate that CWNIRS may be useful as a non-invasive prognostic tool for conditions involving vascular compromise such as extremity compartment syndrome.

Hyperoxic respiratory challenges to monitor chemotherapy effects on Brca1/p53 deficient mice breast tumors

Abstract #5065

Background: Response to cancer treatments such as radiotherapy, chemotherapy, and photodynamic therapy are less effective when tumors are hypoxic. Hyperoxic gas intervention has been shown to improve tumor oxygenation. Here we report how hemodynamic changes due to oxygen intervention are related to the tumor response during cisplatin treatment of spontaneous mammary tumors developed in mice with conditional inactivation of the Brca1 and p53 genes.&#x2028; Materials and Methods: We treated mammary tumors in Brca1/p53 knockout mice (n=8) with 1.2mg/kg of Cisplatin (i. p. daily for a week), and tumor volume and body weight were monitored during treatment. We imaged tumors during chemotherapy using an optical imaging system that quantifies intrinsic light scattering and absorption by projecting spatially modulated, near infrared (NIR) light (650nm to 980nm) onto tissues and calculating oxy-(Ohb), deoxy-(RHb), total hemoglobin (THb) concentrations, tissue oxygen saturation (StO2) values, and scattering values at all wavelengths. During imaging, animals were anesthetized using 1.5% isoflurane and each animal inhaled medical air (33% O2) for 6 min followed by 100% oxygen for an additional 12 min.&#x2028; Results: Among 8 tumors, 5 (volume=0.38±0.1) showed response to Cisplatin treatment while the other 3 tumors (volume=0.56±0.12) did not. Tumors responding to Cisplatin displayed greater than 2-fold increase in [Ohb] and [RHb] during oxygen intervention compared to non responding tumors (p&lt;0.05). (Fig.1) Significant differences in tumor size changes (data not shown) were also observed between responders and non-responders.&#x2028; &#x2028; Discussion: Breast cancers are heterogeneous in their molecular profiles as well as treatment response. Hyperoxic gas intervention during chemotherapy combined with intrinsic signal optical imaging can be used to evaluate vascular reactivity. Our preliminary results indicate that OHb and RHb reactive tumors are significantly more likely to respond to Cisplatin chemotherapy. This general approach can be extended to other tumor therapy models and can be readily translated to patients.&#x2028; Keywords:Breast Cancer, Brca1/p53 Transgenic Mice, Diffuse Optical Imaging, Cisplatin Chemotherapy.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5065.

Comparative analysis of high resolution synchrotron radiation images of fibrocystic change and breast cancer

Abstract #4009

Background: Synchrotron radiation imaging enables us to observe detailed microscopic structures of a biologic sample without staining. If synchrotron imaging can reveal microstructures of breast tissues with various pathologic conditions effectively, this may be used for clinical purposes related to diagnosis and treatment of breast diseases. We attempted to get high resolution x-ray microscopic images of human breast tissues of fibrocystic change and breast cancer using zone plates and phase contrast technique, and compared distinctive features of breast tissues of these conditions seen in synchrotron images.&#x2028; Material and Methods: X-ray microscopic images were obtained from the Beam line 1B2 of Pohang Light Source, the third generation synchrotron radiation facility with operating energy of 2.5 GeV at Pohang, South Korea. The x-ray was set at 11.1 KeV, and the beam was monochromatized by W/B4C monochromator. The condenser and microscopic objective zone plates were used as x-ray lenses. Formalin-fixed 10 μm thick human breast tissues were attached on Kapton film, and positioned 25 m away from the beam source. Zernike phase plate next to the condenser zone plate was applied for phase contrast imaging. The magnified x-ray image was converted into a visual image on the CsI(TI) scintillation crystal and captured by a full frame CCD camera. The obtained synchrotron images of fibrocystic change and breast cancer tissues were analyzed and compared to one another.&#x2028; Results: High resolution x-ray microscopic images of fibrocystic change and breast cancer tissues with a spatial resolution of 60 nm were obtained. The synchrotron images of fibrocystic change showed a harmonious framework of breast tissues with profuse glandular structures and various collagen strands. However, the synchrotron images of breast cancer tissues revealed altered breast parenchyma with architectural distortion and extensive fibrosis. The collagen strands were thickened, interrupted and irregularly oriented. The glandular elements and ductal structures were atrophic or lost.&#x2028; Discussion: The synchrotron images of breast cancer reveal severe alteration of breast parenchyma, collagen strands and glandular structures, compared to those of fibrocystic change. These changes are important features of breast cancer seen in high resolution synchrotron images.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4009.

A randomised multicentre phase II trial of capecitabine vs S-1 as first-line treatment in elderly patients with metastatic or recurrent unresectable gastric cancer

This randomised multicentre phase II study was conducted to investigate the activity and safety of two oral fluoropyrimidines, capecitabine or S-1, in elderly patients with advanced gastric cancer (AGC). Elderly (⩾65 years) chemo-naive patients with AGC were randomly assigned to receive capecitabine 1250 mg m⁻² two times daily on days 1–14 every 3 weeks or S-1 40–60 mg two times daily according to body surface area on days 1–28 every 6 weeks. Ninety-six patients were enrolled and 91 patients were randomised to capecitabine (N=46) or S-1 (N=45). Overall response rate, the primary end point, was 27.2% (95% CI, 14.1–40.4, 12 of 44 assessable patients) with capecitabine and 28.9% (95% CI, 15.6–42.1, 13 of 45) with S-1. Median times to progression and overall survival in the capecitabine arm (4.7 and 9.5 months, respectively) were similar to those in the S-1 arm (4.2 and 8.2 months, respectively). The incidence of grade 3–4 granulocytopenia was 6.8% with capecitabine and 4.8% with S-1. Grade 3–4 nonhaematologic toxicities were: asthenia (9.1% with capecitabine vs 7.1% with S-1), anorexia (6.8 vs 9.5%), diarrhoea (2.3 vs 0%), and hand–foot syndrome (6.8 vs 0%). Both capecitabine and S-1 monotherapies were active and tolerable as first-line treatment for elderly patients with AGC.

Surgical and pathological outcomes of laparoscopic surgery for transverse colon cancer

PURPOSE

Several multi-institutional prospective randomized trials have demonstrated short-term benefits using laparoscopy. Now the laparoscopic approach is accepted as an alternative to open surgery for colon cancer. However, in prior trials, the transverse colon was excluded. Therefore, it has not been determined whether laparoscopy can be used in the setting of transverse colon cancer. This study evaluated the peri-operative clinical outcomes and oncological quality by pathologic outcomes of laparoscopic surgery for transverse colon cancer.

MATERIALS AND METHODS

Analysis of the medical records of patients who underwent laparoscopic colorectal resection from August 2004 to November 2007 was made. Computed tomography, barium enema, and colonoscopy were performed to localize the tumor preoperatively. Extended right hemicolectomy, transverse colectomy, and extended left hemicolectomy were performed for transverse colon cancer. Surgical outcomes and pathologic outcomes were compared between transverse colon cancer (TCC) and other site colon cancer (OSCC).

RESULTS

Of the 312 colorectal cancer patients, 94 patients underwent laparoscopic surgery for OSCC, and 34 patients underwent laparoscopic surgery for TCC. Patients with TCC were similar to patients with OSCC in age, gender, body mass index, operating time, blood loss, time to pass flatus, start of diet, hospital stay, tumor size, distal resection margin, proximal resection margin, number of lymph nodes, and radial margin. One case in TCC and three cases in OSCC were converted to open surgery.

CONCLUSIONS

Laparoscopic surgery for transverse colon cancer and OSCC had similar peri-operative clinical and acceptable pathological outcomes.

Variation of haemoglobin extinction coefficients can cause errors in the determination of haemoglobin concentration measured by near-infrared spectroscopy

Near-infrared spectroscopy or imaging has been extensively applied to various biomedical applications since it can detect the concentrations of oxyhaemoglobin (HbO(2)), deoxyhaemoglobin (Hb) and total haemoglobin (Hb(total)) from deep tissues. To quantify concentrations of these haemoglobin derivatives, the extinction coefficient values of HbO(2) and Hb have to be employed. However, it was not well recognized among researchers that small differences in extinction coefficients could cause significant errors in quantifying the concentrations of haemoglobin derivatives. In this study, we derived equations to estimate errors of haemoglobin derivatives caused by the variation of haemoglobin extinction coefficients. To prove our error analysis, we performed experiments using liquid-tissue phantoms containing 1% Intralipid in a phosphate-buffered saline solution. The gas intervention of pure oxygen was given in the solution to examine the oxygenation changes in the phantom, and 3 mL of human blood was added twice to show the changes in [Hb(total)]. The error calculation has shown that even a small variation (0.01 cm(-1) mM(-1)) in extinction coefficients can produce appreciable relative errors in quantification of Delta[HbO(2)], Delta[Hb] and Delta[Hb(total)]. We have also observed that the error of Delta[Hb(total)] is not always larger than those of Delta[HbO(2)] and Delta[Hb]. This study concludes that we need to be aware of any variation in haemoglobin extinction coefficients, which could result from changes in temperature, and to utilize corresponding animal's haemoglobin extinction coefficients for the animal experiments, in order to obtain more accurate values of Delta[HbO(2)], Delta[Hb] and Delta[Hb(total)] from in vivo tissue measurements.