Psycho-oncology in Korea: Past, present and future

Background: Psycho-oncology in Korea was introduced among the circle of consultation-liaison psychiatrists, in the 1990s. For almost 25 years, the field has been developing at a steady pace as the psychosocial needs of patients with cancer continue to increase. In this study, we review the history of psycho-oncology in Korea, in a chronological order, within the domains of clinical practice, research activity, training, and public policy. Main body: Before the 1990s, patients with cancer with psychiatric comorbidities were usually taken care of by consultation-liaison psychiatrists in general hospitals. In 1993, psycho-oncology was first introduced by psychiatrists. Psychologists, nurses, and social workers have also been increasingly involved in providing psychosocial care for patients with cancer. Professionals from various disciplines began to communicate, and agreed to found the Korean Psycho-Oncology Study Group (KPOSG) in 2006, the first academic society in this field. In 2009, National Cancer Center published the Recommendations for Distress Management in Patients with Cancer, which are consensus-based guidelines for Korean patients. In 2014, the KPOSG was dissolved and absorbed into a new organization, the Korean Psycho-Oncology Society (KPOS). It functions as a center of development of psycho-oncology, publishing official journals, and hosting annual conferences. There are many challenges, including, low awareness of psycho-oncology, presence of undertreated psychiatric disorders in patients with cancer, shortage of well-trained psycho-oncologists, stigma, and suicide risk. It is important to improve the cancer care system to the extent that psycho-oncology is integrated with mainstream oncology. Considering the socio-cultural characteristics of Korean cancer care, a Korean model of distress management is being prepared by the KPOS. Conclusion: This article provides an overview of the development, current issues, and future challenges of psycho-oncology in Korea. Through its long journey to overcome the many barriers and stigmas of cancer and mental illnesses, psycho-oncology is now acknowledged as an essential part of integrated supportive care in cancer. Active research and international cooperation can gradually shape the Korean model of distress management.ope

Isolated primary schwannoma arising on the colon: report of two cases and review of the literature

Primary schwannoma of the large intestine is an extremely rare neoplasm. Here, we report two cases of colonic schwannoma confirmed pathologically after laparoscopic resection. A 52-year-old female and a 59-year-old female were referred by their general practitioners to our coloproctologic clinic for further evaluation and management of colonic submucosal masses. Colonoscopies performed in our institution revealed round submucosal tumors with a smooth and intact mucosa in the mid-ascending and descending colon, respectively. Computed tomography (CT) scans showed an enhancing soft tissue mass measuring 2 × 2 cm in the right colon and well-defined soft tissue nodule measuring 1.5 × 1.7 cm in the proximal descending colon, respectively. We performed laparoscopic right hemicolectomy and segmental left colectomy under the preoperative impression of gastrointestinal stromal tumors. Two cases were both diagnosed to be benign schwannoma of the colon after immunohistochemical stains (S-100 (+), smooth muscle actin (-), CD117 (-), and CD34 (-))

Design of Highly Sensitive C2H5OH Sensors Using Self-Assembled ZnO Nanostructures

Various ZnO nanostructures such as porous nanorods and two hierarchical structures consisting of porous nanosheets or crystalline nanorods were prepared by the reaction of mixtures of oleic-acid-dissolved ethanol solutions and aqueous dissolved Zn-precursor solutions in the presence of NaOH. All three ZnO nanostructures showed sensitive and selective detection of C2H5OH. In particular, ultra-high responses (Ra/Rg = ∼1,200, Ra: resistance in air, Rg: resistance in gas) to 100 ppm C2H5OH was attained using porous nanorods and hierarchical structures assembled from porous nanosheets, which is one of the highest values reported in the literature. The gas response and linearity of gas sensors were discussed in relation to the size, surface area, and porosity of the nanostructures

Tailored Graphene Micropatterns by Wafer-Scale Direct Transfer for Flexible Chemical Sensor Platform

2D materials, such as graphene, exhibit great potential as functional materials for numerous novel applications due to their excellent properties. The grafting of conventional micropatterning techniques on new types of electronic devices is required to fully utilize the unique nature of graphene. However, the conventional lithography and polymer-supported transfer methods often induce the contamination and damage of the graphene surface due to polymer residues and harsh wet-transfer conditions. Herein, a novel strategy to obtain micropatterned graphene on polymer substrates using a direct curing process is demonstrated. Employing this method, entirely flexible, transparent, well-defined self-activated graphene sensor arrays, capable of gas discrimination without external heating, are fabricated on 4 in. wafer-scale substrates. Finite element method simulations show the potential of this patterning technique to maximize the performance of the sensor devices when the active channels of the 2D material are suspended and nanoscaled. This study contributes considerably to the development of flexible functional electronic devices based on 2D materials.

Design of Selective Gas Sensors Using Additive-Loaded In2O3 Hollow Spheres Prepared by Combinatorial Hydrothermal Reactions

A combinatorial hydrothermal reaction has been used to prepare pure and additive (Sb, Cu, Nb, Pd, and Ni)-loaded In2O3 hollow spheres for gas sensor applications. The operation of Pd- and Cu-loaded In2O3 sensors at 371 °C leads to selective H2S detection. Selective detection of CO and NH3 was achieved by the Ni-In2O3 sensor at sensing temperatures of 371 and 440 °C, respectively. The gas responses of six different sensors to NH3, H2S, H2, CO and CH4 produced unique gas sensing patterns that can be used for the artificial recognition of these gases

Phase II randomized trial of neoadjuvant metformin plus letrozole versus placebo plus letrozole for estrogen receptor positive postmenopausal breast cancer (METEOR)

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background Neoadjuvant endocrine therapy with an aromatase inhibitor has shown efficacy comparable to that of neoadjuvant chemotherapy in patients with postmenopausal breast cancer. Preclinical and clinical studies have shown that the antidiabetic drug metformin has anti-tumor activity. This prospective, multicenter, phase II randomized, placebo controlled trial was designed to evaluate the direct anti-tumor effect of metformin in non-diabetic postmenopausal women with estrogen-receptor (ER) positive breast cancer. Methods/Design Patients meeting the inclusion criteria and providing written informed consent will be randomized to 24 weeks of neoadjuvant treatment with letrozole (2.5 mg/day) and either metformin (2000 mg/day) or placebo. Target accrual number is 104 patients per arm. The primary endpoint will be clinical response rate, as measured by calipers. Secondary endpoints include pathologic complete response rate, breast conserving rate, change in Ki67 expression, breast density change, and toxicity profile. Molecular assays will be performed using samples obtained before treatment, at week 4, and postoperatively. Discussion This study will provide direct evidence of the anti-tumor effect of metformin in non-diabetic, postmenopausal patients with ER-positive breast cancer. Trial registration ClinicalTrials.gov Identifier NCT0158936

Phase II randomized trial of neoadjuvant metformin plus letrozole versus placebo plus letrozole for estrogen receptor positive postmenopausal breast cancer (METEOR)

This study is being supported by grant no 04-2012-0290 from the SNUH Research fund and by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIP)(No. 2013005540). Letrozole and metformin are being supplied by the pharmaceutical company, Shin Poong Pharm. Co., Ltd.Background : Neoadjuvant endocrine therapy with an aromatase inhibitor has shown efficacy comparable to that of neoadjuvant chemotherapy in patients with postmenopausal breast cancer. Preclinical and clinical studies have shown that the antidiabetic drug metformin has anti-tumor activity. This prospective, multicenter, phase II randomized, placebo controlled trial was designed to evaluate the direct anti-tumor effect of metformin in non-diabetic postmenopausal women with estrogen-receptor (ER) positive breast cancer. Methods/Design : Patients meeting the inclusion criteria and providing written informed consent will be randomized to 24 weeks of neoadjuvant treatment with letrozole (2.5 mg/day) and either metformin (2000 mg/day) or placebo. Target accrual number is 104 patients per arm. The primary endpoint will be clinical response rate, as measured by calipers. Secondary endpoints include pathologic complete response rate, breast conserving rate, change in Ki67 expression, breast density change, and toxicity profile. Molecular assays will be performed using samples obtained before treatment, at week 4, and postoperatively. Discussion : This study will provide direct evidence of the anti-tumor effect of metformin in non-diabetic, postmenopausal patients with ER-positive breast cancer. Trial registration : ClinicalTrials.gov Identifier NCT01589367Peer Reviewe

K+ channels in mucous cells isolated from the rat sublingual gland

The basolateral, voltage dependent K+ channels of mucous cells dissociated from rat sublingual gland were studied using the patch-clamp technique. In the cell-attached mode, two typed of K+ channels could be observed in these cells. One had a large conductance of 222±7 ps(n=3). Acetylcholine (ACH; 10-5 M) activated both K+ channels by increasing the open probability (Po). Open probability for the large conductance channels by increased frin 0.18 in the control slution to a maximum value of 0.85 after addition of Ach. Whereas, Po for the small conductance channels increased from 0.002 in the control solution to a maximum value of 0.31. K+ channel activation by 10-5M Ach was observed in 2 other mucous cells. When the osmolarity of bath solution was reduced to 60% of control, both large and small conductance K+ channels were activated. Open probability for the large and small conductance K+ channels increased significantly (P<0.05) from 0.006±0.001 (n=4) and 0.002±0.001 (n=4) in the control solution to a aximum value of 0.30±0.04 and 0.12±0.03 in the hypotonic solution, respectively. It is concluded that both K+ channels may play a crucial role in secretion induced by muscarinic receptor activation and in regulatory volume decrease (RVD)

Effects of various neurotransmitters on the intracellular calcium concentration in trigeminal ganglion neurons

Functional neurotransmitter receptors which elevate intracellular free calcium concentration ([Ca2i]j have been identified in freshly isolated trigeminal ganglion (TG) neurons in neonatal rat pups. Measurement of [Ca2´], was performed using fura-2 acetoxymethyl ester (Flea-2) based ratio microspectrofluorimetry. In our experiments only small sized neurons (<30 m) according to somatic diameter were used. In single intact neurons, the expression percentage and magnitudes of [Ca´+], increase responding to each agonist were determined. Application of bradykinin (BK), substance P (SP), calcitonin gene related peptide (CGRP), ATP and capsaicin elevated [Ca"], in the expression percentages of 24%, 37%, 31%, 77% and 50%, respectively, and elevated [Ca 2´], from 1.630.04 (MeanS.E) to 1.920.05, from 1.360.08 to 1.880.12, from 1.33 0.03 to 1.610.09, from 1.350.04 to 2.20.15 and from 1.260.06 to 2.90.26, respectively. The purinergic receptor which respond to ATP was most frequently expressed (77%). A [Ca`], increase in response to all neurotransmitters was transient in nature, except in response to capsaicin. Increase of [Ca2i], evoked by capsaicin was not transient: [Ca2´], was maintained at a higher concentration than the prestimulus level. The magnitude of [Ca 2´], increase evoked by capsaicin was bigger than for any other neurotansmitters. Our results show that a subpopulation of trigeminal ganglion neurons with small diameter express functional receptors responsible for elevating [Ca2i], coexisting with other neurotransmitter receptors in the early neonatal stage. Our data may have implications for studying orofaciai pain transmission which is associated with intracellular calcium increase