Mutant pattern of p53 predicts local recurrence and poor survival rate in gastric cancer

Background. TP53 mutation is a poor prognostic factor for various organ malignancies such as colorectal cancer, breast cancer, ovarian cancer, hepatocellular carcinoma, lung adenocarcinoma and clinical pathologists previously evaluated it using immunohistochemistry for p53. The clinicopathologic significance of p53 expression in gastric cancer remains unclear due to inconsistent classification methods. Methods. Immunohistochemistry for p53 protein was performed using tissue microarray blocks generated from 725 cases of gastric cancer, and p53 expression was divided into three staining patterns using a semiquantitative ternary classifier: heterogeneous (wild type), overexpression, and absence (mutant pattern). Results. Mutant pattern of p53 expression had a male predominance, greater frequency in cardia/fundus, higher pT stage, frequent lymph node metastasis, local recurrence clinically, and more differentiated histology microscopically compared with wild type. In survival analysis, p53 mutant pattern was associated with worse recurrent-free survival and overall survival rates, and significance was maintained in subgroup analysis of early versus advanced gastric cancers. In Cox regression analysis, p53 mutant pattern was a significant predicting factor for local recurrence (relative risk (RR=4.882, p<0.001)) and overall survival (RR=2.040, p=0.007). The p53 mutant pattern remained significant for local recurrence (RR=2.934, p=0.018) in multivariate analyses. Conclusions. Mutant p53 pattern on immunohistochemistry was a significant prognostic factor for local recurrence and poor overall survival in gastric cancer

Evaluating Backward Probability Model under Various Hydrogeologic and Hydrologic Conditions

Contaminant source identification improves the understanding of contaminant source characteristics including location and release time, which can lead to more effective remediation and water resources management plans. The backward probability model can provide probabilities of source locations and release times under various contaminant properties and hydrogeologic conditions. The backward probability model has been applied to numerous synthetic and real contamination sites for locating possible contaminant sources, but it is also important to evaluate the reliability of the backward probability model through rigorous verification analyses. Here, we present a model verification framework for the backward probability model using a stepwise approach from simple to complex model settings: comparison with previous studies, transient saturated flow under various hydrogeologic conditions, and transient variably-saturated flow conditions. As a simple condition, one-dimensional homogeneous problems under steady-state and transient flow conditions were verified by comparing with previous studies. Model verifications with complex conditions were conducted by comparing forward and backward probability simulation results. The verification results demonstrate that the backward probability model performs well for homogeneous problems. For heterogeneous problems, the backward probability model results in slightly different backward travel times due to differences in solute decay and boundary conditions assigned for both forward and backward probability simulations, but the backward travel time at the maximum probability can be reproduced well. &nbsp;</p

Effects of tapering tumor necrosis factor inhibitor on the achievement of inactive disease in patients with axial spondyloarthritis: a nationwide cohort study

Objectives To investigate the association between the extent of tapering tumor necrosis factor inhibitor (TNFi) and the likelihood of achieving inactive disease in patients with axial spondyloarthritis (axSpA) Methods We analyzed 1575 1-year follow-up interval data of 776 axSpA patients treated with TNFi for more than 1 year in a nationwide observational cohort. The decision on tapering TNFi was made by patients and their physicians. We quantified TNFi used during interval as a dose quotient (DQ). The intervals were classified into the heavy-tapering (DQ < 50), mild-tapering (DQ 50–99), and control groups (DQ = 100). Outcome variables included achieving Ankylosing Spondylitis Disease Activity Score-inactive disease (ASDAS-ID) and major clinical response of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI50) in the follow-up visit. The effects of TNFi tapering on the outcome were analyzed using the generalized estimating equation. Results At the baseline visit, 91.1% of the patients showed a high disease activity (ASDAS-CRP ≥ 2.1). DQ of each interval was significantly influenced by the ASDAS-CRP measure in the prior follow-up (P < 0.001). ASDAS-ID was observed in 42.3% of the intervals. A multivariable analysis showed that the likelihood of outcome achievement was comparable between the control and mild-tapering groups, but significantly decreased in the heavy-tapering group (vs. the control group, adjusted OR = 0.28, [95% CI, 0.08–0.94]). In contrast, the likelihood to achieve BASDAI50 response was not different among the groups. In the subgroup of patients who reached ASDAS-ID 1 year after TNFi treatment (n = 327), ASDAS-ID was observed in 66.1% of the subsequent intervals, and only the mild-tapering group showed a likelihood of target maintenance comparable with that of the control group (adjusted OR = 1.25 [0.41–3.80]). This likelihood decreased with an increase in ASDAS-CRP. Conclusion Mild tapering of TNFi has efficacy comparable with that of the standard-dose treatment for ASDAS-ID achievement in patients with axSpA.This study was supported by the Korea Health Technology R & D Project through the Korea Health Industry Development Institute funded by the Ministry of Health Welfare, Republic of Korea (grant HI14C1277

A Case of Hypertrophic Osteoarthropathy Associated with Epithelioid Hemangioendothelioma

Epithelioid hemangioendothelioma is a rare vascular tumor, which occurs in the lung, liver, bone, and soft tissue. Hypertrophic osteoarthropathy is a syndrome characterized by subperiosteal new bone formation, joint effusion and clubbing, and may be associated with cyanotic heart disease, chronic pulmonary disease, liver disease, and other miscellaneous diseases. The activation of endothelium and platelets has been suggested to be involved in the development of hypertrophic osteoarthropathy. We report a rare case of hypertrophic osteoarthropathy, which developed in association with hepatic epithelioid hemangioendothelioma with pulmonary metastasis. We also discuss the role of vascular endothelial growth factor in its pathogenesis

Prevalence of Human Papilloma Virus Infections and Cervical Cytological Abnormalities among Korean Women with Systemic Lupus Erythematosus

We performed a multicenter cross-sectional study of 134 sexually active systemic lupus erythematosus (SLE) patients to investigate the prevalence of and risk factors for high risk human papilloma virus (HPV) infection and cervical cytological abnormalities among Korean women with SLE. In this multicenter cross-sectional study, HPV testing and routine cervical cytologic examination was performed. HPV was typed using a hybrid method or the polymerase chain reaction. Data on 4,595 healthy women were used for comparison. SLE patients had greater prevalence of high-risk HPV infection (24.6% vs. 7.9%, P<0.001, odds ratio 3.8, 95% confidence interval 2.5-5.7) and of abnormal cervical cytology (16.4 vs. 2.8%, P<0.001, OR 4.4, 95% CI 2.5-7.8) compared with controls. SLE itself was identified as independent risk factors for high risk HPV infection among Korean women (OR 3.8, 95% CI 2.5-5.7) along with ≥2 sexual partners (OR 8.5, 95% CI 1.2-61.6), and Pap smear abnormalities (OR 97.3, 95% CI 6.5-1,456.7). High-risk HPV infection and cervical cytological abnormalities were more common among Korean women with SLE than controls. SLE itself may be a risk factor for HPV infection among Korean women, suggesting the importance of close monitoring of HPV infections and abnormal Pap smears in SLE patients

Changes in Geochemical Composition of Groundwater Due to CO2 Leakage in Various Geological Media

This study evaluated the effects of CO2 leakage on the geochemical composition of groundwater in various geological media through long-term column experiments. Four columns were set up with soil representing a silicate aquifer; clean sand; a sand and limestone mixture; and alluvium soil, respectively. The experiments were conducted under the same experimental conditions for approximately one year. As the CO2-saturated synthetic groundwater was introduced into the columns, a decrease in pH and increases in electrical conductivity (EC), alkalinity, and concentrations of cations and trace elements were observed in all geological media. However, different patterns of changes were also observed depending on the mineralogical and physico-chemical characteristics of each material. As the column operation continued, while the pH decreased and low alkalinity values were more evident in the silicate soil and clean sand columns, the carbonate column continued to show high alkalinity and EC values in addition to high concentrations of most cations. The alluvium soil showed distinctive cation-exchange behaviors during the initial introduction of CO2. The results indicate that changes in the geochemical composition of groundwater will depend on the characteristic of the geological medium such as pH buffering capacity and cation exchange capacity. This study can be useful for monitoring and managing the impacts of CO2 leakage in various aquifer environments

Comparison of Saturated Hydraulic Conductivity Estimated by Three Different Methods

This study compares saturated hydraulic conductivities ( K s ) of three sandy soils such as coarse, medium and fine sand. The K s was obtained using three different methods: empirical methods based on the grain size analysis, the relative effective porosity model (REPM), and breakthrough curve analyses based on tracer tests. Column drainage tests were performed to characterize the water retention properties of the samples, which are required in the REPM. Bench scale tracer tests with various conditions were conducted to obtain reasonable linear velocities of the samples using breakthrough curve analyses and then K s was estimated using Darcy’s law. For the REPM, the differences of K s for the coarse and fine sand soils were less than one order of magnitude; however, the difference of K s values between the empirical methods and the breakthrough curve analyses was larger than one order of magnitude. The comparison results suggest that the REPM can be a reliable method for estimating K s for soil grains, and is cost effective due to its experimental simplicity

Prognostic Utility of Histological Growth Patterns of Colorectal Lung Oligometastasis

Background Patients with resectable colorectal lung oligometastasis (CLOM) demonstrate a heterogeneous oncological outcome. However, the parameters for predicting tumor aggressiveness have not yet been fully investigated in CLOM. This study was performed to determine the prognostic value of histological growth patterns in patients who underwent surgery for CLOM. Methods The study included 92 patients who were diagnosed with CLOM among the first resection cases. CLOMs grow according to three histological patterns: aerogenous, pushing, and desmoplastic patterns. The growth patterns were evaluated on archival hematoxylin and eosin–stained tissue sections. Results The aerogenous pattern was found in 29.4% (n=27) of patients, the pushing pattern in 34.7% (n=32), the desmoplastic pattern in 6.5% (n=6), and a mix of two growth patterns in 29.4% (n=27). The size of the aerogenous pattern was significantly smaller than that of metastases with other patterns (p=.033). Kaplan-Meier analysis demonstrated that patients showing an aerogenous pattern appeared to have a poorer prognosis, which was calculated from the time of diagnosis of the CLOM (p=.044). The 5-year survival rate from the diagnosis of colorectal cancer tended to be lower in patients with an aerogenous pattern than in those who had a non-aerogenous pattern; however, the difference was marginally significant (p=.051). In the multivariate Cox analysis, the aerogenous pattern appeared as an independent predictor of poor overall survival (hazard ratio, 3.122; 95% confidence interval, 1.196 to 8.145; p=.020). Conclusions These results suggest that the growth patterns may play a part as a histology-based prognostic parameter for patients with CLOM