• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.10
• /
• pp.4135-4141
• /
• 2014

Background: Human papillomaviruses (HPV) may play an important role as one of the possible etiologies of oral squamous cell carcinoma (OSCC). The present study aimed to investigate the association between HPV and OSCC in young Japanese patients by examining the presence of HPV DNA and surrogate markers in OSCC tissues. Materials and Methods: Forty young patients with OSCC whose surgical specimens were available were analyzed and compared with 40 patients randomly recruited from a pool of patients aged >40 years. HPV DNA was detected using the polymerase chain reaction-based AMPLICOR$^{(R)}$ HPV test, and surrogate markers of HPV infection were analyzed using immunohistochemical techniques to detect $p16^{INK4a}$ and p53. Results: Only two (5%) young patients and one (2.5%) older patient were positive for HPV DNA. $p16^{INK4a}$ overexpression was identified in six (15%) young patients. p53 staining levels were not high in tissues of most young patients (27 patients, 67.5%). HPV DNA status did not significantly correlate with $p16^{INK4a}$ expression levels. Profiles of increased levels of $p16^{INK4a}$ expression with diminished levels of p53 staining were not associated with the presence of HPV DNA. The combined p53 with $p16^{INK4a}$ profiles were significantly correlated with alcohol consumption in younger patients (p=0.006). Conclusions: Results of the present study indicate that HPV is less likely to cause OSCC in young Japanese patients, and the $p16^{INK4a}$ expression level is not an appropriate surrogate marker for HPV infection in OSCC.

• The Korean Society of Law and Medicine
• /
• v.22 no.2
• /
• pp.111-138
• /
• 2021

'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.1
• /
• pp.315-320
• /
• 2014

Purpose: The purpose of this study was to investigate the recurrence pattern and characteristics of patients based on the 2013 St. Gallen surrogate molecular subtypes after breast-conserving surgery (BCS) in Chinese women. Methods: This retrospective analysis included 709 consecutive breast cancer patients undergoing BCS from 1999-2010 at our institution. Five different surrogate subtypes were created using combined expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2. Locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were calculated. Results: The 5-year LRRFS, DMFS, and DFS rates were 90.5%, 88.2%, and 81.5%, respectively. Multivariate analysis revealed that young age, node-positive disease, and HER2 enrichment were independent prognostic factors in LRRFS patients. There was also an independent prognostic role of lymph node-positive disease in DMFS and DFS patients. Patients with luminal A tumors had the most favorable prognosis, with LRRFS, DMFS, and DFS rates of 93.2%, 91.5%, and 87.4% at 5 years, respectively. Conversely, HER-2-enriched tumors exhibited the highest rate of locoregional recurrence (20.6%). Conclusion: Surrogate subtypes present with significant differences in RFS, DMFS, and LRRFS. Luminal A tumors have the best prognosis, whereas HER2-enriched tumors have the poorest.

• Knee surgery & related research
• /
• v.30 no.4
• /
• pp.319-325
• /
• 2018

Purpose: Body mass index (BMI) is often used to predict surgical difficulty in patients receiving total knee arthroplasty (TKA); however, BMI neglects variation in the central versus peripheral distribution of adipose tissue. We sought to examine whether anthropometric factors, rather than BMI alone, may serve as a more effective indication of surgical difficulty in TKA. Materials and Methods: We prospectively enrolled 67 patients undergoing primary TKA. Correlation coefficients were used to evaluate the associations of tourniquet time, a surrogate of surgical difficulty, with BMI, pre- and intraoperative anthropometric measurements, and radiographic knee alignment. Similarly, Knee Injury and Osteoarthritis Outcome Score (KOOS) was compared to BMI. Results: Tourniquet time was significantly associated with preoperative inferior knee circumference (p=0.025) and ankle circumference (p=0.003) as well as the intraoperative depth of incision at the quadriceps (p=0.014). BMI was not significantly associated with tourniquet time or any of the radiographic parameters or KOOS scores. Conclusions: Inferior knee circumference, ankle circumference, and depth of incision at the quadriceps (measures of peripheral obesity) are likely better predictors of surgical difficulty than BMI. Further study of alternative surgical indicators should investigate patients that may be deterred from TKA for high BMI, despite relatively low peripheral obesity.

• Archives of Plastic Surgery
• /
• v.40 no.5
• /
• pp.559-563
• /
• 2013

Background One of the reasons women with macromastia chose to undergo a breast reduction is to relieve their complaints of back, neck, and shoulder pain. We hypothesized that changes in posture after surgery may be the reason for the pain relief and that patient posture may correlate with symptomatic macromastia and may serve as an objective measure for complaints. The purpose of our study was to evaluate the effect of reduction mammaplasty on the posture of women with macromastia. Methods A prospective controlled study at a university medical center. Forty-two patients that underwent breast reduction were studied before surgery and an average of 4.3 years following surgery. Thirty-seven healthy women served as controls. Standardized lateral photos were taken. The inclination angle of the back was measured. Regression analysis was performed for the inclination angle. Results Preoperatively, the mean inclination angle was 1.61 degrees ventrally; this diminished postoperatively to 0.72 degrees ventrally. This change was not significant (P-value=0.104). In the control group that angle was 0.28 degrees dorsally. Univariate regression analysis revealed that the inclination was dependent on body mass index (BMI) and having symptomatic macromastia; on multiple regression it was only dependent on BMI. Conclusions The inclination angle of the back in breast reduction candidates is significantly different from that of controls; however, this difference is small and probably does not account for the symptoms associated with macromastia. Back inclination should not be used as a surrogate "objective" measure for symptomatic macromastia.

• Journal of Breast Cancer
• /
• v.21 no.4
• /
• pp.399-405
• /
• 2018

Purpose: Vesicle-associated membrane protein 8 (VAMP8) is a soluble N-ethylmaleimide-sensitive factor receptor protein that participates in autophagy by directly regulating autophagosome membrane fusion and has been reported to be involved in tumor progression. Nevertheless, the expression and prognostic value of VAMP8 in breast cancer (BC) remain unknown. This study aimed to evaluate the clinical significance and biological function of VAMP8 in BC. Methods: A total of 112 BC samples and 30 normal mammary gland samples were collected. The expression of VAMP8 was assessed in both BC tissues and normal mammary gland tissues via a two-step immunohistochemical detection method. Results: The expression of VAMP8 in BC tissues was significantly higher than that in normal breast tissues. Furthermore, increased VAMP8 expression was significantly correlated with tumor size (p=0.007), lymph node metastasis (p=0.024) and recurrence (p=0.001). Patients with high VAMP8 expression had significantly lower cumulative recurrence-free survival and overall survival (p<0.001 for both) than patients with low VAMP8 expression. In multivariate logistic regression and Cox regression analyses, lymph node metastasis and VAMP8 expression were independent prognostic factors for BC. Conclusion: VAMP8 is significantly upregulated in human BC tissues and can thus be a practical and potentially effective surrogate marker for survival in BC patients.

• Journal of Veterinary Clinics
• /
• v.23 no.2
• /
• pp.123-128
• /
• 2006

Production of cloned pigs by somatic cell nuclear transfer (SCNT) has unlimited value for developing critical biotechnology such as xenotransplantation. Various efforts have been made to establish this technology, and several litters of live piglets have been produced after transfer of SCNT embryos. However, the efficiency is very low compared to piglet production by artificial insemination or natural mating. So far, most studies have been limited to in vitro production of SCNT embryos. This study was conducted to standardize a surrogate recipient (gilts) for transfer of SCNT embryos to improve pregnancy rate. Potential surrogate gilts over 7 months of age were checked for their estrous status by observing external signs; vaginal fluid, vulva redness, vulva swelling, and standing response to back pressure. Viscosity of vaginal fluid was evaluated and classified as none (0), medium (1), and strong (2). Vulva redness and swelling was respectively assessed by none or shrink (0), medium (1), strong (2). Back pressure was estimated by an immediate move (0), standing less than 10 sec (1), and standing over 10 see (2). And then ovulation status of each surrogate was classified as pre-ovulation (PO-17 surrogates), just prior to ovulation (JPO-20 surrogates), in ovulation (IO-12 surrogates), just after ovulation (JAO-14 surrogates) and after ovulation (AO-24 surrogates) at the time of surgery for embryo transfer (ET). Real-time ultrasonographic scanners have been used for pregnancy diagnosis by observing amniotic vesicles. The first pregnancy diagnosis was done on Day 30 after ET and then repeated 2-week interval. In the results, SCNT embryos transferred into JPO surrogates gave better pregnancy rates (45%) than others (4% to 11%) on Day 30 after ET. These result indicates that surrogate gilts in a status just prior to ovulation can offer optimal condition to establish pregnancy by transfer of SCNT pig embryos.

• Journal of Preventive Medicine and Public Health
• /
• v.51 no.5
• /
• pp.227-233
• /
• 2018

Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.10
• /
• pp.4923-4926
• /
• 2012

Aim: To investigate whether XRCC1 and ADPRT polymorphisms might be associated with outcomes of breast cancer. Methods: A prospective study was conducted with a total of 335 breast cancer patients undergoing chemotherapy consecutively collected from Jan. 2005 to Jan. 2008. Genotyping of XRCC1 and ADPRT polymorphisms was conducted by PCR-RFLP assay. Results: All 335 patients were followed up until death or the end of Jan. 2012, with a median follow-up period of 38.8 (2-64) months. It was shown that the variant genotype of XRCC1 399Gln/Gln was strongly significantly associated with a decreased risk of death from breast cancer, with an HR (95% CI) of 0.52 (0.28-0.91). Similarly, individuals carrying the ADPRT 762Ala/Ala demonstrated longer survival compared to ADPRT 762 Val/Val, with an HR (95% CI) of 0.58 (0.31-0.97). Individuals with combination genotypes of XRCC1 399Gln allele and ADPRT 762Ala/Ala presented with a longer survival, the HR (95% CI) being 0.56 (0.32-0.97). Conclusion: We found a significant association between XRCC1399Gln/Gln and ADPRT 762Ala/Ala polymorphisms and clinical outcomes. These two genotypes could be used as a surrogate markers of clinical outcome in glioma cases receiving chemotherapy.

• Journal of Yeungnam Medical Science
• /
• v.38 no.1
• /
• pp.27-33
• /
• 2021

The gut is a complex organ that has played an important role in digestion, absorption, endocrine functions, and immunity. The gut mucosal barriers consist of the immunologic barrier and nonimmunologic barrier. During critical illnesses, the gut is susceptible to injury due to the induction of intestinal hyperpermeability. Gut hyperpermeability and barrier dysfunction may lead to systemic inflammatory response syndrome. Additionally, gut microbiota are altered during critical illnesses. The etiology of such microbiome alterations in critical illnesses is multifactorial. The interaction or systemic host defense modulation between distant organs and the gut microbiome is increasingly studied in disease research. No treatment modality exists to significantly enhance the gut epithelial integrity, permeability, or mucus layer in critically ill patients. However, multiple helpful approaches including clinical and preclinical strategies exist. Enteral nutrition is associated with an increased mucosal barrier in animal and human studies. The trophic effects of enteral nutrition might help to maintain the intestinal physiology, prevent atrophy of gut villi, reduce intestinal permeability, and protect against ischemia-reperfusion injury. The microbiome approach such as the use of probiotics, fecal microbial transplantation, and selective decontamination of the digestive tract has been suggested. However, its evidence does not have a high quality. To promote rapid hypertrophy of the small bowel, various factors have been reported, including the epidermal growth factor, membrane permeant inhibitor of myosin light chain kinase, mucus surrogate, pharmacologic vagus nerve agonist, immune-enhancing diet, and glucagon-like peptide-2 as preclinical strategies. However, the evidence remains unclear.