Non-atypical endometrial hyperplasia: risk factors for occult endometrial atypia and malignancy in patients managed with hysterectomy

Lee Shi Hui,Selina Hui Men Chin,Charissa Goh,Lin Xiao Hui,Manisha Mathur,Timothy Lim Yong Kuei,Felicia Chin Hui Xian 대한산부인과학회 2021 Obstetrics & Gynecology Science Vol.64 No.3

ObjectiveTo determine the risk factors for occult endometrial atypia and malignancy in patients diagnosed with non-atypicalendometrial hyperplasia (NEH) on endometrial biopsy. MethodsAll new cases of NEH diagnosed between April 2015 and March 2016 at KK Women’s and Children’s Hospital, whounderwent hysterectomy as first-line treatment, were included in the study. Patients with a history of endometrialhyperplasia or malignancy were excluded from the study. Patient demographics (e.g., age, parity, body mass index[BMI]), medical history, and clinical presentation were obtained for analysis. ResultsIn total, 262 patients were diagnosed with NEH, of which 18.3% (n=48) underwent hysterectomy as first-linemanagement. The average time to surgery was 77.0±35.7 days. All cases were diagnosed by dilation and curettage,and hysteroscopy. The mean age was 51 years, and the mean BMI was 26.9±5.8 kg/m2. Histology from thehysterectomy specimen showed 9 (18.8%) patients with atypical hyperplasia and 2 (4.2%) with grade 1, stage 1Aendometrioid adenocarcinoma. Patients with higher grade final pathology had significantly lower median parity(1 vs. 2, P=0.039), higher mean BMI (30.1±6.5 vs. 25.9±5.3 kg/m2, P=0.033), and BMI ≥30 kg/m2 (54.5% vs. 13.5%,P=0.008, odds ratio 7.68), compared to patients whose final histology showed NEH or no residual hyperplasia. ConclusionOccult endometrial atypia and malignancy were found in 18.8% and 4.2% of patients with an initial diagnosis of NEH,respectively. High BMI and low parity were identified as significant risk factors for high-grade endometrial lesions inpatients with NEH.

Development of an Adaptive-Feedrate Planning and Iterative Interpolator for Parametric Toolpath with Normal Jerk Constraint

Yong Zhang,Hui Zhang,Jiadong Shi,Jiali Jiang,Mingyong Zhao 한국정밀공학회 2021 International Journal of Precision Engineering and Vol.22 No.1

Compared to conventional linear and circular segments, the parametric curve has advantages in approximating and machining, guaranteeing higher machining precision and better machining quality. Therefore, in Computer Numerical Control (CNC) systems, parametric toolpath has become more and more popular for its high-performance in practical machining and the performance of the parametric interpolator has become a standard to illustrate the advanced CNC systems. In this paper, adaptive-feedrate planning and the iterative interpolator have been developed to generate sampling points with respect to error and higher order kinematic constraints. Firstly, a jerk-limited feedrate profile and look-ahead algorithm are utilized to provide reachable feedrate at critical points. Afterwards, normal jerk (i.e. the jerk in a normal direction) are limited to improve machining precision and quality. In theory, it is proved that the normal jerk limitations have relationship with curvature derivative and a novel iterative interpolator is proposed to ensure the normal jerk limitation by considering the corresponding constraints at curvature derivative extreme points. Finally, simulation and experiments are conducted to demonstrate the efficiency and contour performance of the proposed method compared to conventional method and time-optimal method.

Real-Time Tumor Gene Expression Profiling to Direct Gastric Cancer Chemotherapy: Proof-of-Concept “3G” Trial

Yong, Wei Peng,Rha, Sun Young,Tan, Iain Bee-Huat,Choo, Su-Pin,Syn, Nicholas L.,Koh, Vivien,Tan, Shi-Hui,Asuncion, Bernadette Reyna,Sundar, Raghav,So, Jimmy Bok-Yan,Shabbir, Asim,Tan, Chee-Seng,Kim, Hy American Association for Cancer Research 2018 Clinical Cancer Research Vol.24 No.21

<P><B>Purpose:</B> The oxaliplatin plus S-1 and cisplatin plus S-1 regimens are interchangeably used in the management of advanced gastric cancer. The previously reported G-intestinal (G1) and G-diffuse (G2) intrinsic gene expression signatures showed promise for stratifying patients according to their tumor sensitivity to oxaliplatin or cisplatin.</P><P><B>Experimental Design:</B> The proof-of-concept, multicenter, open-label phase II “3G” trial was done to prospectively evaluate the feasibility and efficacy of using genomic classifiers to tailor treatment in gastric cancer. Patients’ tumors were classified as “G1” or “G2” using a nearest-prediction template method, or “G3” (unclear assignment) when FDR ≥ 0.05. The first 30 patients in the “G1” cohort were assigned oxaliplatin plus S-1 (SOX) chemotherapy; thereafter, subsequently recruited “G1” patients were treated with cisplatin plus S-1 (SP) chemotherapy. “G2” patients and “G3” patients were treated with SP and SOX chemotherapy, respectively.</P><P><B>Results:</B> A total of 48, 21, and 12 patients, respectively, were given “G1,” “G2,” and “G3” genomic assignments. Median turnaround time was 7 days (IQR, 5–9). Response rates were 44.8%, 8.3%, 26.7%, and 55.6% for the “G1-SOX,” “G1-SP,” “G2,” “G3” cohorts, respectively; and was higher in G1 patients treated with SOX compared with SP (<I>P</I> = 0.033). Exploratory analyses using the genomic classifier of Lei and colleagues validated the utility of the metabolic signature as a biomarker for predicting benefit from chemotherapy (log-rank <I>P</I> = 0.004 for PFS), whereas the Asian Cancer Research Group classifier did not demonstrate any predictive value.</P><P><B>Conclusions:</B> This bench-to-bedside effort establishes a reasonable turnaround time for gene expression profiling and possible utility of genomic classifiers in gastric cancer treatment stratification. <I>Clin Cancer Res; 24(21); 5272–81. ©2018 AACR</I>.</P>

Correlation of Neutrophil-Lymphocyte and Albumin-Globulin Ratios With Outcomes in Patients With Breast Cancer Undergoing Neoadjuvant Chemotherapy or Upfront Surgery

Shi Hui Yang,Min Li Tey,Siqin Zhou,Phyu Nitar,Hanis Mariyah,Yirong Sim,Grace Kusumawidjaja,Wen Yee Chay,Wong Fuh Yong,Ru Xin Wong 한국유방암학회 2024 Journal of breast cancer Vol.27 No.2

Purpose: Higher neutrophil-lymphocyte ratio (NLRs) indicate a pro-inflammatory state and are associated with poor survival. Conversely, higher albumin-globulin ratio (AGRs) may be associated with improved prognosis. We aimed to investigate the association between NLR and AGR and prognosis and survival in patients with breast cancer. Methods: This retrospective study included all patients with stage I–III breast cancer between 2011 and 2017 in Singapore General Hospital and National Cancer Center Singapore. Multivariate logistic regression analysis of NLR, AGR, age, stage, grade, and subtype was performed. Survival data between groups were compared using Cox regression analysis and log-rank tests. Results: A total of 1,188 patients were included, of whom 323 received neoadjuvant chemotherapy (NACT) and 865 underwent upfront surgery. In patients who underwent NACT, a higher AGR was significantly associated with a higher pCR rate (cut-off > 1.28; odds ratio [OR], 2.03; 95% confidence interval [CI], 1.13–3.74; p = 0.020), better DFS (cut off > 1.55; hazard ratio [HR], 0.37; 95% CI, 0.16–0.85; p = 0.019), and better CSS (cut off > 1.46; HR, 0.39; 95% CI, 0.17–0.92; p = 0.031). Higher NLR was significantly associated with worse DFS (cut off > 4.09; HR, 1.77; 95% CI, 1.07–2.91; p = 0.026) and worse CSS (cut off > 4.09; HR, 1.98; 95% CI, 1.11–3.53; p = 0.021). In patients who underwent upfront surgery, higher AGR correlated with significantly better OS (cut off > 1.17; HR, 0.54; 95% CI, 0.36–0.82; p = 0.004) and higher NLR correlated with worse OS (cut off > 2.38; HR, 1.63; 95% CI, 1.09–2.44; p = 0.018). Conclusion: NLR and AGR are useful in predicting the response to NACT as well as prognosis of patients with breast cancer. Further studies are needed to explore their value in clinical decision making.

Giant electrocaloric effect in BaZr_0.2Ti_0.8O₃ thick film

Ye, Hui-Jian,Qian, Xiao-Shi,Jeong, Dae-Yong,Zhang, Shujun,Zhou, Yue,Shao, Wen-Zhu,Zhen, Liang,Zhang, Q. M. American Institute of Physics 2014 Applied Physics Letters Vol.105 No.15

Bioinspired Synthesis of Chiral 3,4-Dihydropyranones via S-to-O Acyl-Transfer Reactions

Jin, Hui,Lee, Juyeol,Shi, Hu,Lee, Jin Yong,Yoo, Eun Jeong,Song, Choong Eui,Ryu, Do Hyun American Chemical Society 2018 ORGANIC LETTERS Vol.20 No.6

<P>A bioinspired synthesis of chiral 3,4-dihydropyranones via S-to-O acyl-transfer reactions is described. Asymmetric Michael addition-lactonization reactions of β,γ-unsaturated α-keto esters with thioesters are catalyzed by proline-derived urea, providing 3,4-dihydropyranones and spiro-3,4-dihydrocoumarin-fused 3′,4′-dihydropyranones in high yield (up to 94%) with excellent stereoselectivities (up to >20:1 dr, 99% <I>ee</I>) under catalyst loadings as low as 1 mol %.</P> [FIG OMISSION]</BR>

Aprepitant in the Prevention of Vomiting Induced by Moderately and Highly Emetogenic Chemotherapy

Wang, Shi-Yong,Yang, Zhen-Jun,Zhang, Zhe,Zhang, Hui Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.23

Chemotherapy is a major therapeutic approach for malignant neoplasms; however, due to the most common adverse events of nausea and vomiting, scheduled chemotherapeutic programs may be impeded or even interrupted, which severely impairs the efficacy. Aprepitants, 5-HT3 antagonists and dexamethasone are primary drugs used to prevent chemotherapy-induced nausea and vomiting (CINV). These drugs have excellent efficacy for control of acute vomiting but are relatively ineffective for delayed vomiting. Aprepitant may remedy this deficiency. Substance P was discovered in the 1930s and its association with vomiting was confirmed in the 1950s. This was followed by a period of non-peptide neurokinin-1 (NK-1) receptor antagonist synthesis and investigation in preclinical studies and clinical trials (phases I, II and III). The FDA granted permission for the clinical chemotherapeutic use of aprepitant in 2003. At present, the combined use of aprepitant, 5-HT3 antagonists and dexamethasone satisfactorily controls vomiting but not nausea. Therefore, new therapeutic approaches and drugs are still needed.

Chinese herbal medicine (Rupi Sanjie capsule) for the treatment of breast pain: A systematic review and meta-analysis of randomized clinical trials

Bao-yong Lai,Li-yan Jia,Bo-Wen Yu,Shi-Bing Liang,Ai-Jing Chu,Hui-juan Cao,Jian-ping Liu,Xiao-Hua Pei 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.2

Background: Breast pain is one of the most common breast disorders, affecting 41%–69% women in the clinical populations. Chinese herbal medicine (Rupi Sanjie, RPSJ) capsule has been recommended to be commonly used for breast pain in China. This review aimed to systematically collect latest evidence and critically evaluate the eff ;ectiveness and safety of RPSJ capsule for breast pain. Methods: We searched 6 databases from their inception to June 1, 2020 for randomized clinical trials (RCTs) comparing RPSJ capsule with conventional drug therapies, placebo or no treatment. Primary outcomes were breast pain relief, reduction of breast mass and clinical cure rate. Results: Seventeen RCTs were included in total, involving 2899 participants with breast pain. RPSJ capsule showed a significant effects in shortening duration of the breast pain (MD-6.51 days, 95%CI [-8.57, -4.45], n = 82, 1 trial), shortening the duration of breast mass (MD-5.17 days, 95%CI [-7.56, -2.78], n = 82, 1 trial), improving clinical cure rate (RR 1.55, 95% CI [1.21, 2.00], I² = 64%, n = 1398, 10 trials) and total effective rate (RR 1.08, 95% CI [1.03, 1.14], I² = 71%, n = 2170, 14 trials) compared to Tamoxifen (TAM). The meta-analysis showed that the incidence of total adverse events was higher in TAM group than the RPSJ capsule group (RR 0.30, 95%CI [0.21, 0.42], I² = 49%, n = 2122, 13 trials). Conclusions: RPSJ capsule appears to be a potentially effective in treating breast pain and seems generally safe for clinical application. However, this potential benefit is inconclusive due to generally weak evidence, and the findings should be further confirmed in large and rigorous trials.

Depression and the Risk of Breast Cancer: A Meta-Analysis of Cohort Studies

Sun, Hui-Lian,Dong, Xiao-Xin,Cong, Ying-Jie,Gan, Yong,Deng, Jian,Cao, Shi-Yi,Lu, Zu-Xun Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8

Background: Whether depression causes increased risk of the development of breast cancer has long been debated. We conducted an updated meta-analysis of cohort studies to assess the association between depression and risk of breast cancer. Materials and Methods: Relevant literature was searched from Medline, Embase, Web of Science (up to April 2014) as well as manual searches of reference lists of selected publications. Cohort studies on the association between depression and breast cancer were included. Data abstraction and quality assessment were conducted independently by two authors. Random-effect model was used to compute the pooled risk estimate. Visual inspection of a funnel plot, Begg rank correlation test and Egger linear regression test were used to evaluate the publication bias. Results: We identified eleven cohort studies (182,241 participants, 2,353 cases) with a follow-up duration ranging from 5 to 38 years. The pooled adjusted RR was 1.13(95% CI: 0.94 to 1.36; $I^2=67.2%$, p=0.001). The association between the risk of breast cancer and depression was consistent across subgroups. Visual inspection of funnel plot and Begg's and Egger's tests indicated no evidence of publication bias. Regarding limitations, a one-time assessment of depression with no measure of duration weakens the test of hypothesis. In addition, 8 different scales were used for the measurement of depression, potentially adding to the multiple conceptual problems concerned with the definition of depression. Conclusions: Available epidemiological evidence is insufficient to support a positive association between depression and breast cancer.

The Intracellular Mechanism of Action on Escherichia coli of BF2-A/C, Two Analogues of the Antimicrobial Peptide Buforin 2

Gang Hao,Yong-Hui Shi,Ya-Li Tang,Guo-Wei Le 한국미생물학회 2013 The journal of microbiology Vol.51 No.2

In the present study, the antimicrobial peptides BF2-A and BF2-C, two analogues of Buforin 2, were chemically synthesized and the activities were assayed. To elucidate the bactericidal mechanism of BF2-A/C and their different antimicrobial activities, the influence of peptides to E. coli cell membrane and targets of intracellular action were researched. Obviously, BF2-A and BF2-C did not induce the influx of PI into the E. coli cells, indicating nonmemebrane permeabilizing killing action. The FITC-labeled BF2-A/C could penetrate the E. coli cell membrane and BF2-C penetrated the cells more efficiently. Furthermore, BF2-A/C could bind to DNA and RNA respectively, and the affinity of BF2-C to DNA was powerful at least over 4 times than that of BF2-A. The present results implied that BF2-A and BF2-C inhibited the cellular functions by binding to DNA and RNA of cells after penetrating the cell membranes, resulting in the rapid cell death. The structure-activity relationship analysis of BF2-A/C revealed that the cell-penetrating efficiency and the affinity ability to DNA were critical factors for determining the antimicrobial potency of both peptides. The more efficient cellpenetrating and stronger affinity to DNA caused that BF2-C displayed more excellent antimicrobial activity and rapid killing kinetics than BF2-A.