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Does epithelioid angiomyolipoma have poorer prognosis, compared with classic angiomyolipoma?

  • Lee, Wonchul;Choi, Se Young;Lee, Chanwoo;Yoo, Sangjun;You, Dalsan;Jeong, In Gab;Song, Cheryn;Kim, Kun Suk;Hong, Bumsik;Hong, Jun Hyuk;Ahn, Hanjong;Kim, Choung-Soo
    • Investigative and Clinical Urology
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    • v.59 no.6
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    • pp.357-362
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    • 2018
  • Purpose: Classic angiomyolipoma (AML) is common benign kidney tumor. However, some studies have claimed that epithelioid angiomyolipoma (EAML) has malignant potential. We compared the patient characteristics and prognosis of EAML and classic AML to demonstrate predicting factors and poorer prognosis of EAML. Materials and Methods: The medical records of 231 patients who were diagnosed with EAML (n=27, 11.7%) or classic AML (n=204, 88.3%), were reviewed. All patients underwent computed tomography (CT) scans before operation or needle biopsy. We assessed the age, sex, tumor size, body mass index, comorbidities, and Hounsfield unit (HU) according to each CT phase. We defined the unfavorable group as patients with recurrence, metastasis and death due to tumor progression. Logistic regression analysis was used to predict EAML. Results: EAML patients were younger (41.2 years vs. 49.1 years, p=0.001), predominantly male (55.6% vs. 28.4%, p=0.005), and had a larger tumor (7.5 cm vs. 4.2 cm, p<0.001). The median pre-contrast HU was not significantly different between EAML and classic AML ($29.9{\pm}23.7$ vs. $14.7{\pm}41.0$, p=0.071). In multivariable analysis, younger age (odds ratio [OR], 0.96; p=0.032), male sex (OR, 3.33; p=0.013), and tumor larger than 4 cm (OR, 3.8; p=0.009) were significant predictive factors. Five patients (18.5%) had unfavorable outcomes, two patients had lymph node metastasis, and three patients had lung metastasis. Conclusions: Patient and tumor characteristics can be helpful in determining the type of AML preoperatively. Younger age, male sex, and larger tumor mass may increase the possibility of diagnosing EAML. EAML has malignant potential and requires careful follow-up.

Predicting Successful Conservative Surgery after Neoadjuvant Chemotherapy in Hormone Receptor-Positive, HER2-Negative Breast Cancer

  • Ko, Chang Seok;Kim, Kyu Min;Lee, Jong Won;Lee, Han Shin;Lee, Sae Byul;Sohn, Guiyun;Kim, Jisun;Kim, Hee Jeong;Chung, Il Yong;Ko, Beom Seok;Son, Byung Ho;Ahn, Seung Do;Kim, Sung-Bae;Kim, Hak Hee;Ahn, Sei Hyun
    • Journal of Breast Disease
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    • v.6 no.2
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    • pp.52-59
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    • 2018
  • Purpose: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. Methods: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (${\geq}3cm$), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent >4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n=239) and was later validated with an independent validation cohort (n=123). Results: Small tumor size (p<0.001) at initial diagnosis, long distance from the nipple (p=0.002), high body mass index (p=0.001), and weak positivity for progesterone receptor (p=0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. Conclusion: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.

Interpretation of androgen and anti-Mullerian hormone profiles in a Hispanic cohort of 5- to 8-year-old girls with premature adrenarche

  • Brar, Preneet Cheema;Dingle, Elena;Ovadia, Daniela;Pivo, Sarah;Prasad, Veeramac;David, Raphael
    • Annals of Pediatric Endocrinology and Metabolism
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    • v.23 no.4
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    • pp.210-214
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    • 2018
  • Purpose: Premature adrenarche (PA) often leads to polycystic ovary syndrome (PCOS). Higher anti-mullerian hormone (AMH) levels are reported in PCOS. We studied the androgen profile and AMH profiles in Hispanic girls with PA (aged 5-8 years) and age and body mass index (BMI) matched controls. Methods: Retrospective review of electronic medical records of girls who met the inclusion criteria for premature adrenarche were done. Results: PA girls (n=76) were matched to control girls (n=12) for age (mean${\pm}$standard deviation) ($6.7{\pm}1years$ vs. $6.2{\pm}1.3years$) and BMI ($20{\pm}10kg/m^2$ vs. $17.8{\pm}2.7kg/m^2$). Dehydroepiandrostenedione sulfate ($63.3{\pm}51.3{\mu}g/dL$ vs. $29.8{\pm}17.3{\mu}g/dL$, P<0.001) and testosterone levels ($11.4{\pm}4.8ng/dL$ vs. $8.2{\pm}2.9ng/dL$, P=0.001) were significantly higher in the PA group than controls. AMH values (<14 years: reference range, 0.49-3.15 ng/mL) were $3.2{\pm}2.2ng/mL$ vs. $4.6{\pm}3.2ng/mL$ respectively in the PA and control groups and were not different (P=0.4). AMH did not show a correlation with bone age (P=0.1), and testosterone (P=0.9) in the PA group. 17-hydroxyprogesterone levels (17-OHP ng/dL) were $39.5{\pm}30.5ng/dL$ vs. $36.8{\pm}19.8ng/dL$ in PA versus control girls. The concentration of 17-OHP was not statistically different between the control and PA groups. Conclusion: Higher AMH was not observed in PA girls and no correlation with BA and androgen levels was observed.

Effects of Game-based Postural Vertical Training on Pusher Behavior, Postural Control, and Activity of Daily Living in Patients With Acute Stroke: A Pilot Study (게임 기반의 자세수직 훈련이 급성 뇌졸중 환자의 밀기행동, 자세조절, 그리고 일상생활동작에 미치는 영향: 사전연구)

  • An, Chang-man;Roh, Jung-suk;Kim, Tack-hoon;Choi, Houng-sik;Choi, Kyu-hwan;Kim, Gyoung-mo
    • Physical Therapy Korea
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    • v.26 no.3
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    • pp.57-66
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    • 2019
  • Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

Effects of ambient temperature and rumen-protected fat supplementation on growth performance, rumen fermentation and blood parameters during cold season in Korean cattle steers

  • Kang, Hyeok Joong;Piao, Min Yu;Park, Seung Ju;Na, Sang Weon;Kim, Hyun Jin;Baik, Myunggi
    • Asian-Australasian Journal of Animal Sciences
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    • v.32 no.5
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    • pp.657-664
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    • 2019
  • Objective: This study was performed to evaluate whether cold ambient temperature and dietary rumen-protected fat (RPF) supplementation affect growth performance, rumen fermentation, and blood parameters in Korean cattle steers. Methods: Twenty Korean cattle steers (body weight [BW], $550.6{\pm}9.14kg$; age, $19.7{\pm}0.13months$) were divided into a conventional control diet group (n = 10) and a 0.5% RPF supplementation group (n = 10). Steers were fed a concentrate diet (1.6% BW) and a rice straw diet (1 kg/d) for 16 weeks (January 9 to February 5 [P1], February 6 to March 5 [P2], March 6 to April 3 [P3], and April 4 to May 2 [P4]). Results: The mean and minimum indoor ambient temperatures in P1 ($-3.44^{\circ}C$, $-9.40^{\circ}C$) were lower (p<0.001) than those in P3 ($5.87^{\circ}C$, $-1.86^{\circ}C$) and P4 ($11.18^{\circ}C$, $4.28^{\circ}C$). The minimum temperature in P1 fell within the moderate cold-stress (CS) category, as previously reported for dairy cattle, and the minimum temperatures of P2 and P3 were within the mild CS category. Neither month nor RPF supplementation affected the average daily gain or gain-to-feed ratio (p>0.05). Ruminal ammonia nitrogen concentrations were higher (p<0.05) in cold winter than spring. Plasma cortisol concentrations were lower (p<0.05) in the coldest month than in the other months. Serum glucose concentrations were generally higher in colder months than in the other months but were unaffected by RPF supplementation. RPF supplementation increased both total cholesterol (p = 0.004) and high-density lipoprotein (HDL) concentrations (p = 0.03). Conclusion: Korean cattle may not be significantly affected by moderate CS, considering that the growth performance of cattle remained unchanged, although variations in blood parameters were observed among the studied months. RPF supplementation altered cholesterol and HDL concentrations but did not affect growth performance.

Prediction of net energy values in expeller-pressed and solvent-extracted rapeseed meal for growing pigs

  • Li, Zhongchao;Lyu, Zhiqian;Liu, Hu;Liu, Dewen;Jaworski, Neil;Li, Yakui;Lai, Changhua
    • Animal Bioscience
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    • v.34 no.1
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    • pp.109-118
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    • 2021
  • Objective: The objective of this study was to determine net energy (NE) of expeller-press (EP-RSM) and solvent-extracted rapeseed meal (SE-RSM) and to establish equations for predicting the NE in rapeseed meal (RSM) fed to growing pigs. Methods: Thirty-six barrows (initial body weight [BW], 41.1±2.2 kg) were allotted into 6 diets comprising a corn-soybean meal basal diet and 5 diets containing 19.50% RSM added at the expense of corn and soybean meal. The experiment had 6 periods and 6 replicate pigs per diet. During each period, the pigs were individually housed in metabolism crates for 16 days which included 7 days for adaption to diets. On day 8, pigs were transferred to respiration chambers and fed their respective diet at 2,000 kJ metabolizable energy (ME)/kg BW0.6/d. Feces and urine were collected, and daily heat production was measured from day 9 to 13. On days 14 and 15, the pigs were fed at 890 kJ ME/kg BW0.6/d and fasted on day 16 for evaluation of fasting heat production (FHP). Results: The FHP of pigs averaged 790 kJ/kg BW0.6/d and was not affected by the diet composition. The NE values were 10.80 and 8.45 MJ/kg DM for EP-RSM and SE-RSM, respectively. The NE value was positively correlated with gross energy (GE), digestible energy (DE), ME, and ether extract (EE). The best fit equation for NE of RSM was NE (MJ/kg DM) = 1.14×DE (MJ/kg DM)+0.46×crude protein (% of DM)-25.24 (n = 8, R2 = 0.96, p<0.01). The equation NE (MJ/kg DM) = 0.22×EE (% of DM)-0.79×ash (% of DM)+14.36 (n = 8, R2 = 0.77, p = 0.018) may be utilized to quickly determine the NE in RSM when DE or ME values are unavailable. Conclusion: The NE values of EP-RSM and SE-RSM were 10.80 and 8.45 MJ/kg DM. The NE value of RSM can be well predicted based on energy content (GE, DE, and ME) and proximate analysis.

The Anti-obesity Effects of Bangpungtongseong-san and Daesiho-tang: A Study Protocol of Randomized, Double-blinded Clinical Trial (방풍통성산 및 대시호탕의 항비만효과 분석: 단일기관 무작위배정 이중맹검 임상시험 프로토콜)

  • Oh, Jihong;Shim, Hyeyoon;Cha, Jiyun;Kim, Ho Seok;Kim, Min Ji;Ahn, Eun Kyung;Lee, Myeong-Jong;Lee, Jun-Hwan;Kim, Hojun
    • Journal of Korean Medicine for Obesity Research
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    • v.20 no.2
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    • pp.138-148
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    • 2020
  • Objectives: The aim of this study is to evaluate the effects of Bangpungtongseong-san (Fangfengtongsheng-san, BTS) and Daesiho-tang (Dachaihu-tang, DST) on weight loss and improvement in lipid metabolism and glucose metabolism. Furthermore, we intend to develop a prediction model for drug effects through the analysis of the single nucleotide polymorphism (SNP), gut-microbiota, and the expression of immune-related biomarkers. Methods: This study is a single-center, randomized, double-blind, parallel-design clinical trial. One hundred twenty-eight participants will be assigned to the BTS group (n=64) and DST group (n=64). Both groups will be administered 4 g medication three times a day for up to 2 weeks. The primary outcomes is weight loss. The secondary outcomes include bioelectrical impedance analysis, waist circumstance, body mass index, total cholesterol, high-density lipoprotein, triglyceride, insulin resistance. The exploratory outcomes include 3-day dietary recall, food frequency questionnaire, quality of life questionnaire, gut microbiota analysis, immune biomarkers analysis, and SNP analysis. Assessment will be made at baseline and at week 4, 8, and 12. Conclusions: This protocol will be implemented by approval of the Institutional Review Board of Dongguk University. The results of this trial will provide a systematic evidence for the treatment of obesity and enable more precise herbal medicine prescriptions.

The Influence of Pronated Foot Posture on Knee Isokinetic Strength, Static and Dynamic Postural Stability in Healthy Young Individuals

  • Chun, Woochan;Kim, Hee-su;Park, Sieun;Park, Jihea;Shim, Seunghee;Park, Sookyoung
    • Physical Therapy Korea
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    • v.28 no.3
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    • pp.168-176
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    • 2021
  • Background: The foot is a complex body structure that plays an important role in static and dynamic situations. Previous studies have reported that altered foot posture might affect knee joint strength and postural stability, however their relationship still remains unclear. Objects: The purpose of this study was to identify whether pronated foot posture has an influence on knee isokinetic strength and static and dynamic postural stability. Methods: Forty healthy young males aged 18 to 26 years were included. Foot posture was evaluated using the Foot Posture Index-6 (FPI-6), and the subjects were divided into two groups according to their FPI-6 scores: a neutral foot group (n = 20, FPI-6 score 0 to +5) and a pronated foot group (n = 20, FPI-6 score +6 or more). Biodex Systems 3 isokinetic dynamometer was used to evaluate knee isokinetic strength and hamstring to quadriceps ratio at three angular velocities: 60°/sec, 90°/sec, and 180°/sec. The static and dynamic postural stability in a single-leg stance under the eyes-open and eyes-closed conditions were measured with a Biodex Balance System. Results: There were no significant differences between the groups in knee isokinetic strength and static postural stability (p > 0.05), but there was a significant difference in the medial-lateral stability index (MLSI) for dynamic postural stability under the eyes-closed condition (p = 0.022). The FPI-6 scores correlated significantly only with the dynamic overall stability index (OSI) and the MLSI (OSI: R = 0.344, p = 0.030; MLSI: R = 0.409, p = 0.009) under the eyesclosed condition. Conclusion: Participants with pronated foot had poorer medial-lateral dynamic stability under an eyes-closed condition than those without, and FPI-6 scores were moderately positively correlated with dynamic OSI and dynamic MLSI under the eyes-closed condition. These results suggest that pronated foot posture could induce a change in postural stability, but not in knee isokinetic strength.

Corni Fructus Inhibits Wrinkle Formation by Reduced Advanced glycation end product (AGEs) (산수유의 최종당화산물 억제로 인한 주름 개선효과)

  • Lee, AhReum;Kim, SooHyun;Kim, SuJi;Kim, KyeongJo;Kwon, Ojun;Choi, JoonYoung;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.32 no.5
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    • pp.1-6
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    • 2017
  • Objectives : Corni Fructus (CF) is traditional herbal medicine used on polyuria, low back pain, and tinnitus. This study aimed to evaluate inhibits skin wrinkle formation effect of CF. Methods : To evaluate the produce inhibition effect of CF, SD-rats were distributed into four groups; normal rats (Nor), AGEs (advenced glycation end product)-induced rats (Con), AGEs-induced rats treated with 100mg/kg CF (CF). To induce AGEs, streptozotocin (50mg/kg) was administered intraperitoneally and after 3 days oral administrated 100mM methyl glyoxal for 3 weeks. Results : The oral administration of CF suppressed the reactive oxygen specis (ROS) in serum. The AGEs in skin tissues was significantly reduced through treatment of CF. Furthermore, the expressions of AGEs related proteins such as polyclonal anti-$N^e$-(carboxymethyl)lysine (CML), anti-$N^e$-(carboxyethyl)lysine (CEL), AGE receptors (RAGE) were decreased in CF treated group compared with the control group in skin tissues. Inflammation-related proteins such as Nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB), monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL-6) reduced in CF treatment group than control group. AGE-induced rats exhibited that the significant decreased collagen however, CF treatment (100mg/kg of body weight) up regulated collagen by improved the expression levels of skin fibril-related genes such as Matrix metalloproteinase (MMP-1). Conclusion : Taken together, our study suggests that CF regulates ROS to prevent accumulation of AGEs and inhibits skin wrinkles. Our finding indicate that CF may be an effective agent for inhibits AGEs formation, and improved skin wrinkle.

Anti-skin-aging Effect of Mori Folium through decreased Advanced glycation end product (AGEs) (최종당화산물 억제를 통한 상엽(桑葉)의 항피부노화 효과)

  • Lee, AhReum;Kim, SooHyun;Kim, SuJi;Kim, KyeongJo;Kwon, Ojun;Choi, JoonYoung;Roh, Seong-Soo
    • The Korea Journal of Herbology
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    • v.32 no.5
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    • pp.7-12
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    • 2017
  • Objectives : Recently, numerous studies reported that excessive generation of advanced glycation end products (AGEs) stimulated expression of skin wrinkle related proteins. This study aimed to evaluate inhibits skin wrinkle formation effect of Mori Folium (MF) through decreased AGEs. Methods : To evaluate the skin wrinkle inhibition effect of MF, SD-rats were divided into three groups; normal rats (Nor), AGEs-induced rats (Con), AGEs-induce rats treated with MF at dose of 100mg/kg body weight (MF). To induced AGEs, streptozotocin (50mg/kg) was injected intraperitoneally, and after 3 days, 100mM methyl glyoxal was administered orally for 3 weeks. After the experiment, the animal's dorsal skin tissues and serum were separated and tested. Results : The oral administration of MF suppressed the AGEs level in serum. Also, the AGEs in skin tissues was significantly reduced through treatment of MF compared with control group. Moreover, the expressions of AGEs related proteins such as polyclonal anti-$N^e$-(carboxymethyl) lysine (CML), anti-$N^e$-(carboxyethyl)lysine (CEL), AGE receptors (RAGE) were reduced in MF group compared with the control group in kidney and skin tissues. The matrix metallo proteinase-1 (MMP-1) reduced by MF treatment with the result that collagen type 1 alpha 2 (COL1A2) was improved that reduced by accumulation of AGEs. Conclusion : The evidence of this study indicate that oral administration of MF reduces the levels of AGEs in serum, skin, and kidney tissues. In conclusion, MF inhibit skin wrinkle formation, suggesting the potential of anti-wrinkle material.