Self-assembling peptides are biomedical materials with unique structures that are formed in response to various environmental conditions. Governed by their physicochemical characteristics, the ...peptides can form a variety of structures with greater reactivity than conventional non-biological materials. The structural divergence of self-assembling peptides allows for various functional possibilities; when assembled, they can be used as scaffolds for cell and tissue regeneration, and vehicles for drug delivery, conferring controlled release, stability, and targeting, and avoiding side effects of drugs. These peptides can also be used as drugs themselves. In this review, we describe the basic structure and characteristics of self-assembling peptides and the various factors that affect the formation of peptide-based structures. We also summarize the applications of self-assembling peptides in the treatment of various diseases, including cancer. Furthermore, the in-cell self-assembly of peptides, termed reverse self-assembly, is discussed as a novel paradigm for self-assembling peptide-based nanovehicles and nanomedicines.
In recent years, the incidence of thyroid cancer and obesity has increased rapidly worldwide. Many studies have been conducted on the relationship between thyroid cancer and obesity; however, the ...potential mechanisms are not well understood, and few studies have been performed in Asia. This study aimed to identify the relationship between the risk of thyroid cancer and obesity in the Korean population based on a large cohort of data.
We analyzed clinical data from a total of 351,402 individuals (males: 181,709, females: 169,693) aged over 20 years who received medical examinations arranged by the national insurance program from 2003 to 2008. Newly diagnosed thyroid cancer was identified using insurance claims data. The median follow-up duration was 7.01 years.
The mean body mass index (BMI) of the subjects was 23.6 ± 3.2 kg/m2 (males, 24 ± 3; females, 23.1 ± 3.3). A total of 3308 individuals (0.94%) developed thyroid cancer during the study period. The risk of thyroid cancer was higher with increasing BMI in both men and women. Hazard ratios (95% confidence interval) for obese (25–29.9 kg/m2) and extremely obese (≥30 kg/m2) groups were 1.23 (1.13–1.34) and 1.26 (1.02–1.50), respectively, compared to the normal group (18.5–22.9 kg/m2). In particular, the association between the risk of thyroid cancer and BMI was more remarkable in the male group than female group.
Our findings show that higher BMI is positively associated with the risk of thyroid cancer. Furthermore, this study supports the positive association between obesity and the increased incidence of thyroid cancer.
•A study of the relationship between the risk of thyroid cancer and obesity.•This study used large-scaled sample cohort data of Koreans.•Higher BMI is positively associated with the risk of thyroid cancer.
To compare the oncological and perioperative outcomes of different nephroureterectomy approaches in patients with non-metastatic upper tract urothelial carcinoma (UTUC).
We retrospectively analyzed ...the data of 422 patients who underwent open, laparoscopic, or robotic nephroureterectomy for non-metastatic UTUC. Perioperative and postoperative survival outcomes were compared using Kaplan-Meier analyses and Cox-proportional hazard models.
Of the patients, 161, 137, and 124 were treated with an open, laparoscopic, and robotic approach, respectively. Laparoscopic and robotic approaches involved significantly less blood loss (p = 0.001), shorter hospital stay (p < 0.001), and longer operation time (p < 0.001) compared with the open approach. There were no significant differences in intraoperative complications (open, 8.1%; laparoscopic, 5.1%; robotic, 7.3%; p = 0.363) or early postoperative complications (open, 14.9%; laparoscopic, 14.6%; robotic, 13.7%; p = 0.880). The laparoscopic and robotic groups showed significantly less postoperative analgesic use (p = 0.015). The robotic group showed significantly longer progression-free, cancer-specific, and overall survivals than the open approach group on univariate Kaplan-Meier analysis, but surgery type was not significantly associated with survival outcomes per multivariate Cox proportional tests (all p-values > 0.05).
The laparoscopic and robotic approaches yielded better perioperative outcomes, such as less intraoperative bleeding, shorter hospital stays, less analgesic usage, and non-inferior oncological outcomes, compared with the open approach. Further prospective studies are needed to compare these surgical techniques.
We evaluated the contribution of tumor volume (TV) to localized prostate cancer (PCa) patients' prognosis. We retrospectively analyzed the data of 2394 patients who underwent radical prostatectomy ...(RP) for localized PCa. The effect of TV and tumor prostate ratio (TV/PV) on PCa patients' prognosis was analyzed through Kaplan-Meier and Cox-proportional analysis. The mean prostate volume for all patients was 36.5 ± 15.4 cc, and the mean TV was 5.9 ± 8.3 cc. A significant positive relationship was observed between the classification by risk group in D' Amico risk classification and the National Comprehensive Cancer Network risk group (P < 0.001). The high TV showed significantly worse pathologic outcomes than the low TV in terms of high rates of extra-capsular extension, seminal vesicle invasion, and positive surgical margin (P < 0.05). The patients with high TV and TV/PV had significantly shorter biochemical recurrence-free survivals than those with low TV and TV/PV (P < 0.001). Finally, based on multivariate Cox-proportional analyses, TV and TV/PV was an independent predictor to predict shorter biochemical recurrence-free survival as both a TV (HR: 1.04, 95% CI 1.04-1.05, P < 0.001) and TV/PV (HR: 1.42, 95% CI 1.13-1.78, P = 0.003). TV was revealed to be an independent prognostic factor in the postoperative biochemical recurrence. Patients with a high number of positive core and longer tumor length were significantly related to higher TV.
Ki-67 is known to be useful in estimating the fraction of proliferation tumor cells in various malignancies. We tried to investigate clinical association of Ki-67 (MIB-1) expression with the ...oncological outcomes in patients with localized prostate cancer (PCa) after the radical prostatectomy (RP).
We retrospectively analyzed the data of 1,561 patients who underwent RP for localized PCa. According to the propensity score having Ki-67 expression, 183 patients with positive Ki-67 expression were matched to 549 patients without Ki-67 expression. By using multivariate Cox-proportional hazards models and logistic regression tests, the prognostic value of each variable was tested.
After propensity score matching, positive Ki-67 group showed significant worse clinical characteristics and pathologic outcomes than negative Ki-67 group. The multivariate analysis showed that the Ki-67 expression was significantly associated with several adverse pathologic outcomes including higher pathologic stage (p = 0.006), higher grade group (p = 0.005), seminal vesicle invasion (p = 0.036), and positive surgical margin (p = 0.025). The group with Ki-67 expression showed significant worse biochemical recurrence-free survival (p<0.001) than negative Ki-67 group. Subsequent multivariate Cox analyses showed that Ki-67 was independent predictor for BCR after RP (HR 1.549, 95% CI 1.187-2.021, p = 0.001).
In our study, high Ki-67 expression was significantly related with adverse pathological and finally with worse biochemical recurrence-free survival. Further studies are needed to validate the prognostic value of Ki-67 more exactly in PCa patients.
Diffusion-weighted imaging (DWI) has been shown to be an important component of multiparametric magnetic resonance imaging (mpMRI). We compared performance of DWI for detection of prostate cancer ...(PCa) in peripheral zone (PZ) and transition zone (TZ) of prostate.
We reviewed data of 460 subjects who underwent preoperative 3.0-Tesla mpMRI and subsequently radical prostatectomy. Level of suspicion for PCa was graded using 5-grade Likert-scale from DWI. Topographic analyses were performed for location of tumor foci at each surgical specimen. Among those with DWI grade ≥ III, we analyzed concordance rate on the location of radiologic and pathologic index lesions between DWI and surgical specimens.
Among 460 patients, 351 (76.3%) patients showed suspicious DWI lesions (57.5% in PZ, 42.5% in TZ). Multivariates regression analyses revealed significant associations between high DWI grade and adverse pathologic outcomes including pathologic stage, Gleason score, tumor volume and extracapsular extension (all p < 0.05). Overall concordance rates between DWI and surgical specimen were 75.8%, significantly higher in PZ than TZ (82.2% vs. 67.1% p = 0.002). Such concordance rate showed a positive linear association with increase in DWI grading (p < 0.001). Among 109 patients with DWI grade I-II, 28 (25.7%) harbored high grade disease (pathologic Gleason score ≥ 4 + 3).
DWI detects tumors in PZ of prostate more accurately than those in TZ. Such accuracy of DWI was shown to be more evident with higher DWI grade. Meanwhile, a negative DWI did not guarantee absence of high grade PCa.
The prognosis of patients with pathologic stage T3a renal cell carcinoma (RCC) that is up-staged from a small renal tumor remains controversial. We evaluated the prognosis of patients with RCC who ...were up-staged from clinical stage T1 to pathologic stage T3a.
We retrospectively reviewed the data of 3431 patients who were surgically treated for clinical stage T1 RCC. The survival outcomes were compared using Kaplan-Meier and Cox proportional analyses.
Among the clinical stage T1 patients, 215 (6.3%) were finally up-staged to pathologic stage T3a. Patient age (HR 1.302, 95% CI 1.018-1.046, p < 0.001), tumor diameter (HR 1.686, 95% CI 1.551-1.834, p < 0.001), and hilar location (HR 1.765, 95% CI 1.147-2.715, p = 0.010) were significantly associated with upstaging. Kaplan-Meier analyses showed significantly shorter recurrence-free, cancer-specific and overall survivals (all p < 0.001) in patients who were up-staged. Multivariate Cox analyses revealed pathologic upstaging as an independent predictor of shorter recurrence-free (HR 2.195, 95% CI 1.459-3.300, p < 0.001), cancer-specific (HR 2.238, 95% CI 1.252-4.003, p = 0.007), and overall survivals (HR 1.632, 95% CI 1.029-2.588, p = 0.037). Subgroup analysis of pathologic stage T3a showed no significant difference in survival of the partial nephrectomy group when compared to the radical nephrectomy group (all p > 0.5).
Patients up-staged from clinical stage T1 to pathologic stage T3a RCC showed shorter survival outcomes than those without upstaging. However, partial nephrectomy, compared with radical nephrectomy, showed comparable outcomes in patients who were up-staged.
A wide-coverage unmanned aerial vehicle (UAV) antenna system for air-to-ground communications is proposed in this paper. The proposed antenna system has reconfigurable beam patterns based on five ...sets of dual-polarization and high gain antennas. Each antenna set is configured by a dual-polarization crossed inverted-V radiator and switched feed network to drive switched beamforming operations. Depending on the switch modes of the proposed antenna, main beam direction and circular polarization types can be independently selected. Further, each antenna set is faced toward the ground level at different angles from the center of UAV to provide wide beam coverage. To verify the antenna performance, each antenna set is designed at the center frequency of 5.7 GHz and total five sets are integrated with a switched feed network and a microcontroller. To implement the wide angle switched beamforming with 2-D angle-shifted main beams, a 3-D printed conformal fixture is used to connect both the antenna module and a drone body. The maximum measured bandwidth was more than 22% and the measured peak gain with the de-embedded switch feed network loss was about 10.2 dBic.
To compare the outcomes of robotic partial nephrectomy (RPN) with those of open PN (OPN) in patients with highly complex renal tumors defined as RENAL nephrometry score ≥ 10.
We analyzed clinical ...data from a total of 149 patients who underwent OPN or RPN for a highly complex renal mass at our institution between 2003 and 2017. Perioperative data, complication profiles, functional outcomes, pathologic variables, and oncologic outcomes were evaluated in both groups.
The median (interquartile range, IQR) patient age was 52.0 (42.0-59.0) years, and the median (IQR) follow-up period was 30.0 (7.0-54.0) months. Among the patients, 64 (43.0%) and 85 (57.0%) underwent OPN and RPN, respectively. The RPN group showed higher rates of clinical T1b and ≥ T2 than the OPN group (p = 0.019). There were no significant differences between the groups in terms of intraoperative outcomes such as operation time, estimated blood loss, warm ischemic time, and transfusion. Notably, the RPN group showed significantly shorter length of hospital stay than the OPN group (p < 0.001). Regarding the complication profiles and renal functional outcomes, no significant differences were reported between the groups. The estimated glomerular filtration rate decline from baseline at the last follow-up showed no significant differences between the two groups (p = 0.351). Kaplan-Meier survival analysis also showed no significant differences in survival outcomes between the groups (log-rank test, all p > 0.05).
RPN performed in patients with highly complex renal tumors offers perioperative, functional, and oncologic outcomes comparable to those associated with OPN.
Abstract
To evaluate the clinical impact of preoperative glycemic status upon oncological and functional outcomes after radical prostatectomy in patients with localized prostate cancer, we analyzed ...the data of 2664 subjects who underwent radical prostatectomy with preoperative measurement of hemoglobin A1c within 6 months before surgery. The possible association between high hemoglobin A1c (≥ 6.5 ng/dL) and oncological/functional outcomes was evaluated. Among all subjects, 449 (16.9%) were categorized as the high hemoglobin A1c group and 2215 (83.1%) as the low hemoglobin A1c group. High hemoglobin A1c was associated with worse pathological outcomes including extra-capsular extension (HR 1.277, 95% CI 1.000–1.630,
p
= 0.050) and positive surgical margin (HR 1.302, 95% CI 1.012–1.674,
p
= 0.040) in multi-variate regression tests. Kaplan–Meier analysis showed statistically shorter biochemical recurrence-free survival in the high hemoglobin A1c group (
p
< 0.001), and subsequent multivariate Cox proportional analyses revealed that high hemoglobin A1c is an independent predictor for shorter BCR-free survival (HR 1.135, 95% CI 1.016–1.267,
p
= 0.024). Moreover, the high hemoglobin A1c group showed a significantly longer incontinence-free survival than the low hemoglobin A1c group (
p
= 0.001), and high preoperative hemoglobin A1c was also an independent predictor for longer incontinence-free survival in multivariate Cox analyses (HR 0.929, 95% CI 0.879–0.981,
p
= 0.008). The high preoperative hemoglobin A1c level was independently associated with worse oncological outcomes and also with inferior recovery of urinary continence after radical prostatectomy.
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