Multifocal microinvasive squamous cell carcinoma with extensive spread of squamous cell carcinoma in situ (CIS) into the uterine corpus, vagina, and left salpinx diagnosed five years after conization of cervical CIS

BACKGROUND

Multifocal microinvasive squamous cell carcinoma (SCC) with extensive spread of squamous cell carcinoma in situ (CIS) into the uterine corpus, salpinx, and vagina is extremely unusual.

CASE

The authors present a case of 69-year-old woman with hydrometra who was found to have multifocal microinvasive SCC in the endometrium. The CIS had spread superficially throughout the entire endometrium up to the fundus, completely replacing the epithelium. The uterine cervix, vaginal surface and left salpingeal mucosa were involved. She had previously undergone conization due to cervical CIS five years prior. The pathologic reports showed clear resection margins at that time.

CONCLUSION

The present case suggests that CIS in the endometrium spread back to the cervix and vagina, although the definite origin of the first CIS was not determined.

Mutations in calpastatin and μ-calpain are associated with meat tenderness, flavor and juiciness in Hanwoo (Korean cattle): molecular modeling of the effects of substitutions in the calpastatin/μ-calpain complex

The objective of this study was to evaluate the effects of seven single nucleotide polymorphisms (SNPs) in Calpain 1 and Calpastatin genes previously associated with meat tenderness attributes in other cattle breeds in Korean Hanwoo cattle. The Hanwoo resource population was used to study association of 7 SNPs with beef tenderness, flavor, juiciness, intramuscular fat and shear force. In this association study, CAST:c.182A>G (+0.14, P=0.04) and CAST:c.1985G>C (-0.12, P=0.02) had significant effects on juiciness, but no effects on other traits. In contrast, CAPN1:c.1589G>A was associated with meat tenderness (P=0.01) and juiciness (P=0.04). The CAPN1:c.1589G>A (Val530Ile) SNP marker displayed significant effect on the meat tenderness score which is strongly supported by molecular modeling of the CAPN1:c.1589G>A (Val530Ile) variant that inhibits CAST protein from binding more strongly than the wild-type protein, which may explain its effect on meat tenderness.

Gender and age differences in the impact of overweight on obesity-related quality of life among Korean adults

SUMMARY

OBJECTIVE

To investigate gender and age difference in impact of overweight on health-related quality of life (HRQOL) among Korean adults.

METHODS

Cross-sectional obesity-related quality of life (QOL) scores were measured by a Korean obesity-related QOL scale (KOQOL) from 448 Korean adults aged 20-80 years. A body mass index (BMI) was categorized with normal-weight as BMI < 23 kg/m(2), overweight as BMI ≥ 23 kg/m(2) based on the alternative cutoff points for Asians. Each gender was respectively stratified by median age, 45 years for men and 50 years for women, to examine the obesity-related QOL by age groups.

RESULTS

Women had a poorer obesity-related QOL compared to men (p < 0.001). In the younger age group, overweight women had a poorer obesity-related QOL compared with normal-weight women (p < 0.001), however normal-weight and overweight men showed no difference in obesity-related QOL. In the older age group, overweight men showed better QOL on the domains of work-related and psychosocial health than those for normal-weight men, but overweight women still suffered from work-related and routine life QOL.

CONCLUSIONS

This study showed the impact of overweight on obesity-related QOL was different for gender and age group. We should consider the results to manage weight in overweight persons.

Utility of proton MR spectroscopy for differentiating typical and atypical primary central nervous system lymphomas from tumefactive demyelinating lesions

BACKGROUND AND PURPOSE

It may be challenging to differentiate primary CNS lymphomas, especially primary CNS lymphomas with atypical MR features, from tumefactive demyelinating lesions by the use of conventional MR. This study aimed to investigate the usefulness of (1)H-MR spectroscopy for making this discrimination.

MATERIALS AND METHODS

Forty-four patients with primary CNS lymphomas and 21 with tumefactive demyelinating lesions were enrolled. Single-voxel (TE = 144 ms) (1)H-MR spectroscopy scans with the use of the point-resolved spectroscopy sequence were retrospectively analyzed. The Cho/Cr and Cho/NAA area ratios were calculated. The lipid and/or lactate peak was visually categorized into 5 grades on the basis of comparison with the height of the Cr peak. The (1)H-MR spectroscopy findings were compared in all of the primary CNS lymphomas and the tumefactive demyelinating lesions and in the subgroup of atypical primary CNS lymphomas and tumefactive demyelinating lesions. The thresholds and added value of (1)H-MR spectroscopy to conventional MR were calculated by use of receiver operating characteristic curves.

RESULTS

Discrepancies between all of the primary CNS lymphomas and tumefactive demyelinating lesions were found in the Cho/Cr ratio (P = .000), Cho/NAA ratio (P = .000), and the lipid and/or lactate peak grade (P = .000). Lymphoma rather than tumefactive demyelinating lesions was suggested when the Cho/Cr ratio was >2.58, the Cho/NAA ratio was >1.73, and a high lipid and/or lactate peak grade (grade >3) was seen. Higher Cho/Cr ratios, Cho/NAA ratios, and lipid and/or lactate peak grades were found in atypical primary CNS lymphomas when compared with those of tumefactive demyelinating lesions. The area under the receiver operating characteristic curve of conventional MR was improved from 0.827 to 0.870 when Cho/NAA ratio was added in the uncertain cases.

CONCLUSIONS

(1)H-MR spectroscopy may be useful for differentiating primary CNS lymphomas from tumefactive demyelinating lesions. Cho/NAA ratio could provide added value to conventional MR imaging.

Utilisation of combined 18F-FDG PET/CT scan for differential diagnosis between benign and malignant adrenal enlargement

OBJECTIVE

To assess the properties of adrenal lesions with and without known primary cancer and investigate predictors for differential diagnosis between benign and malignant adrenal enlargement.

METHODS

This retrospective study used fluorine-18 fludeoxyglucose positron emission tomography (PET)/CT in 325 patients with adrenal lesions (229 with known primary cancer and 96 without primary cancer). Age, sex, the presence of right and left masses, nodules or hyperplasia, unenhanced attenuation, maximum standardised uptake value (SUVmax) ratio, and the presence of metastasis in other body parts and locations of the primary cancer were assessed. Univariate and multivariate analyses were used to assess variables associated with risk of adrenal metastasis.

RESULTS

Patients with adrenal metastasis vs those without had a higher frequency of primary lung cancer (52.3% vs 30.7%) but a lower frequency of gastrointestinal cancer (7.9% vs 16.6%). The frequency of other abnormalities, including adenoma and hyperplasia, was similar between patients with and without known primary cancer. A higher proportion of patients with adrenal metastasis regardless of primary cancer site were younger, had a nodule or a mass, had an unenhanced attenuation of >10 HU, had an SUVmax ratio of >2.5, and had metastasis in other body parts. Analysis found independent associations of age, unenhanced attenuation of >10 HU, SUVmax ratio of >2.5 and the presence of metastasis in other body parts with adrenal metastasis. The combination of the four variables was strongly associated with adrenal metastasis.

CONCLUSION

PET/CT was useful in characterising adrenal lesions as benign or malignant and helpful in identifying adrenal metastasis and cancer severity.

ADVANCES IN KNOWLEDGE

PET/CT can help in the differential diagnosis between benign and malignant adrenal enlargement.

Composition, storage stability and sensory properties of expanded extrudates from blends of corn starch and goat meat, lamb, mutton, spent fowl meat, or beef

Blends of corn starch (81.72-84.86%) and ground meat (goat meat, lamb, mutton, spent hen meat, beef 15.14-18.28%) were prepared for a target moisture level of 26.5% (with no added water) and cooked-puffed using a single-screw extruder. All extrudates were well expanded and low in fat (< 1.5%), a(w) (< 0.12), bulk density, and shear-force. Trained panel sensory scores indicated all products were bland, with no differences found in flavor attributes among products. The dominant flavor notes were "rice" and "dried grassy" (mean scores of 2.23-2.29 and 1.81-2.15, respectively, on a 0-15 scale). Most panelists did not perceive "meat" note or species-related meat flavor. Total polyunsaturated fatty acid percentage was similar for extrudates with beef, lamb and mutton and highest for those with chicken. When extrudates were stored aerobically at 37°C for up to 120 days, lipid oxidation (as measured in meq. peroxides/kg fat) was lower for products containing goat meat, lamb, or mutton than for those with beef or chicken. The degree of polyunsaturation or unsaturation of their fat only partly accounted for the lipid oxidation differences. ©

Flow characteristics of LIMA radial composite sequential bypass grafting and single LIMA and saphenous vein sequential bypass grafting performed under OPCAB

AIM

The present study was aimed to compare the hemodynamic flow characteristics of LIMA radial artery composite sequential bypass grafting and with single LIMA and saphenous vein sequential bypass grafting performed by off-pump coronary artery bypass grafting (OPCAB).

METHODS

Between March 2007 and February 2008, 121 OPCAB patients were prospectively divided into two groups; Group I (N.=70, left internal thoracic artery [LITA]-left anterior descending [LAD] and Ao-SV sequential grafting), and Group II (N.=51, LITA-RA sequential grafting). The mean flow, pulsatility index (PI) and back flow (BF) were measured using the Transit-time flow meter (TTFM). In Group II, the proximal (p-LITA) and distal LITA (d-LITA) flow in relation to the RA side branch anastomosis were measured separately.

RESULTS

The mean flow and PI of the proximal SV sequential graft and that of the RA graft were 64.4 ± 37.3 mL/min and 2.6 ± 1.6 versus 27.3 ± 18.6 mL/min and 4.1 ± 4.4, respectively (P<0.05). In Group I, the mean LITA flow, PI, and BF were 26.9 ± 16.4 mL/min, 2.6 ± 1.5, and 3.1 ± 6.1% whereas in Group II those of the p-LITA were 37.3 ± 21.6 mL/min, 2.3 ± 1.0, and 2.0 ± 3.5% and the d-LITA were 18.8 ± 12.2 mL/min, 3.9 ± 3.3 and 7.4 ± 11.8% (P<0.01).

CONCLUSION

The results of the present data suggest the hemodynamic flow characteristics of composite bypass grafting to be inferior to the single LIMA and separate aorta-saphenous vein bypass grafting strategy. However, a longer follow up is warranted to assess the implications of these findings on graft durability.

Response of dietary substitution of fishmeal with various protein sources on growth, body composition and blood chemistry of olive flounder (Paralichthys olivaceus, Temminck & Schlegel, 1846)

Animal and/or plant protein sources substituting fishmeal in the diets keep being developed due to its high price. The purpose of this study is to determine response of dietary substitution of fishmeal with silkworm pupae meal, promate meal®, meat and bone meal and/or their combination on the performance of juvenile olive flounder. A 60% fish meal was used as the main protein source, used as the control (Con) diet. The 10 and 20% fishmeal were substituted with silkworm pupae meal and meat and bone meal, referred to as the SPM10, SPM20, MBM10 and MBM20 diets, respectively. And the 10, 20 and 40% fishmeal were substituted with promate meal®, referred to as the PM10, PM20 and PM40 diets, respectively. Finally, the 10 and 20% fishmeal were substituted with combined silkworm pupae meal and promate meal®, refereed to as the SPM + PM10 and SPM + PM20 diets, respectively. Weight gain and specific growth rate of fish fed the MBM10 diet were higher than those of fish fed the Con, SPM20, PM20, PM40 and SPM + PM20 diets. Feed efficiency ratio of fish fed the SPM10, MBM10, MBM20, PM10 and SPM + PM10 diets was higher than that of fish fed the SPM + PM20 and PM40 diets. Protein efficiency ratio of fish fed the MBM10 and MBM20 diets was higher than that of fish fed the SPM20, PM20, PM40 and SPM + PM20 diets. In conclusion, dietary substitution of fishmeal with 10% SPM, 20% MBM, 10% PM and 10% SPM + PM could be made.

Therapeutic effect of high-intensity focused ultrasound combined with transarterial chemoembolisation for hepatocellular carcinoma <5 cm: comparison with transarterial chemoembolisation monotherapy--preliminary observations

OBJECTIVE

To retrospectively compare the therapeutic effects of combined high-intensity focused ultrasound (HIFU) and transarterial chemoembolisation (TACE) with TACE alone for the treatment of non-advanced hepatocellular carcinomas (HCCs) <5 cm.

METHODS

We retrospectively reviewed the tumour responses of 32 HCCs of 25 patients who underwent combined HIFU and TACE, and 46 HCCs of 32 patients who underwent TACE only. The mean follow-up observation of the TACE+HIFU group was on average 31 months and that of the TACE group was 33 months. Those patients who had undergone any other treatment modality (including systemic chemotherapy) during the follow-up observation period were excluded. The therapeutic effects were classified according to the modified Response Evaluation Criteria In Solid Tumors (mRECIST): complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Additionally, we defined CR', PR', SD' and PD' as the therapeutic effects "per tumour".

RESULTS

The disease control rate calculated using the RECIST criteria (CR+PR+SD/All) was 48% in the HIFU+TACE group and 47% in the TACE group (p=0.78, Fisher's exact test). The disease control rate "per tumour" (CR'+PR'+SD'/All) was 78% in the HIFU+TACE group and 54% in the TACE group (p=0.035, Fisher's exact test). In the HIFU+TACE group, no HIFU-related complications requiring treatment were observed. The median survival time was 57 months in TACE+HIFU group and 36 months in the TACE group (p=0.048).

CONCLUSION

This preliminary study shows that the combination therapy of HIFU and TACE is more effective than TACE monotherapy for treating HCCs <5 cm.

Lack of association between GTF2H4 genetic variants and AERD development and FEV1 decline by aspirin provocation

Aspirin-exacerbated respiratory disease (AERD) is prevalent in about 10% of asthma patients and is characterized by a severe decline in forced expiratory volume in 1-s (FEV(1) ), an important phenotype for total lung capacity, upon ingestion of aspirin. The general transcription factor IIH subunit 4 (GTF2H4) is positioned at 6p21.33, a part of the major histocompatibility complex (MHC) class II region that contains a number of genes that play an important role in the immune system. In addition, genetic variants in another general transcription factor IIH gene have revealed significant association with lung disease. To investigate whether GTF2H4 genetic variants could be a causative factor for AERD development and FEV(1) decline by aspirin provocation, five common single-nucleotide polymorphisms (SNPs) were genotyped in 93 patients with AERD and 96 aspirin-tolerant asthma (ATA) controls. As a result, when adjusted for age, gender, smoking status and atopy as covariates, the rs1264307 variant and two haplotypes showed nominal signals in the association with AERD (P = 0.02-0.04), but the significances disappeared after corrections for multiple testing (corrected P > 0.05). In further multiple regression analysis, no genetic variants of GTF2H4 showed significant associations with FEV(1) decline by aspirin provocation in asthmatics (P > 0.05). Despite the need for replications in larger cohorts, our preliminary findings suggest that GTF2H4 variants may not be associated with susceptibility to AERD and obstructive symptoms in asthmatics.

Missed rib fractures on evaluation of initial chest CT for trauma patients: pattern analysis and diagnostic value of coronal multiplanar reconstruction images with multidetector row CT

OBJECTIVE

The objective of this study was to review the prevalence and radiological features of rib fractures missed on initial chest CT evaluation, and to examine the diagnostic value of additional coronal images in a large series of trauma patients.

METHODS

130 patients who presented to an emergency room for blunt chest trauma underwent multidetector row CT of the thorax within the first hour during their stay, and had follow-up CT or bone scans as diagnostic gold standards. Images were evaluated on two separate occasions: once with axial images and once with both axial and coronal images. The detection rates of missed rib fractures were compared between readings using a non-parametric method of clustered data. In the cases of missed rib fractures, the shapes, locations and associated fractures were evaluated.

RESULTS

58 rib fractures were missed with axial images only and 52 were missed with both axial and coronal images (p=0.088). The most common shape of missed rib fractures was buckled (56.9%), and the anterior arc (55.2%) was most commonly involved. 21 (36.2%) missed rib fractures had combined fractures on the same ribs, and 38 (65.5%) were accompanied by fracture on neighbouring ribs.

CONCLUSION

Missed rib fractures are not uncommon, and radiologists should be familiar with buckle fractures, which are frequently missed. Additional coronal imagescan be helpful in the diagnosis of rib fractures that are not seen on axial images.

Change of telomerase activity in peripheral whole blood of head and neck squamous cell carcinoma patients before and after surgery: a pilot study

BACKGROUND The purpose of this study was to evaluate telomerase activity in peripheral whole blood from head and neck squamous cell carcinoma (HNSCC) patients as a biomarker for diagnosis of HNSCC or detection of recurrence during follow-up. MATERIALS AND METHODS Telomerase activity was measured from peripheral whole blood extracts by telomerase repeat amplification protocol (TRAP) in HNSCC patients before and after surgery and in a control group. Sixty-two HNSCC patients and 42 control subjects were included. RESULTS Telomerase activity was found in 41 out of 62 (66.1%) HNSCC patients before surgery and in 8 out of 42 (19.0%) controls (p<0.001). Among 41 HNSCC patients who showed positive telomerase activity before surgery, 32 (78.1%) showed a conversion of telomerase activity to negative after surgery. In follow-up, 6 out of 8 (75%) showed conversion of telomerase activity from negative to positive after recurrence. Telomerase activity was changed to negative in 4 out of 6 (66%) recurred patients with positive telomerase activity after second surgery. CONCLUSION The telomerase activity in peripheral whole blood extracts of HNSCC patients might be a useful biomarker for detecting recurrence after treatment. Further study with larger sample size using a more sensitive detection method of telomerase activity is necessary to verify these results.

Compensatory Growth of Grower Olive Flounder (Paralichthys olivaceus) with Different Feeding Regime at Suboptimal Temperature

Compensatory growth of grower olive flounder (Paralichthys olivaceus) was determined at suboptimal temperature (13.0±1.9°C). Fifteen fish averaging 201.1 g per tank were distributed into 18 of 300 L flow-through tanks. Six treatments were prepared in triplicate: fish were hand-fed with an extruded pellet to apparent satiation once a day for 16 weeks (16 WF); and the other five groups of fish were hand-fed for 15, 14, 13, 12 and 10 weeks after 1-, 2-, 3-, 4- and 6-week feed deprivation, referred to as 15 WF, 14 WF, 13 WF, 12 WF and 10 WF, respectively. A linear relationship between body weight of fish and feed deprivation was observed: Y (Body weight of fish) = −1.81X (Weeks of feed deprivation)+201.07, R² = 0.83. Weight gain of grower olive flounder in 15 WF, 14 WF, 13 WF and 12 WF treatments was comparable to that of fish in 16 WF treatment, but lower than that of fish in 10 WF treatment. Specific growth rate of fish in 15 WF treatment was higher than that of fish in 16 WF, 14 WF and 10 WF treatments. Feed consumption of fish was not affected by feeding regime. Feed and protein efficiency ratios of fish in 15 WF treatment were higher than those of fish in 13 WF, 12 WF and 10 WF treatments. Grower olive flounder could achieve full compensatory growth when fish were daily fed for 12 weeks after 4-week feed deprivation at suboptimal temperature.