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Effect of adjuvant endocrine therapy on recurrence and contralateral breast cancer in HR-positive DCIS after mastectomy

2026-06-09T06:45:16Z

Title: Effect of adjuvant endocrine therapy on recurrence and contralateral breast cancer in HR-positive DCIS after mastectomy Authors: Yoon, Tae-in; Kim, Ah Yoon; Lee, Su Min; Kim, Jisun; Chung, Il Yong; Ko, Beom Seok; Kim, Hee Jeong; Lee, Jong Won; Son, Byung Ho; Nam, Seok Jin; Kim, Seok Won; Lee, Jeong Eon; Yu, Jonghan; Park, Woong Ki; Yi, On Vox; Ryu, Jai Min; Lee, Sae Byul Abstract: Background: The clinical benefits of adjuvant endocrine therapy for patients with hormone receptor (HR)-positive ductal carcinoma in situ (DCIS) undergoing mastectomy remain controversial. While endocrine therapy is known to reduce recurrence after breast-conserving surgery, its role post-mastectomy is unclear. We aimed to assess the impact of adjuvant endocrine therapy on recurrence and contralateral breast cancer (CBC) in patients with HRpositive DCIS treated with mastectomy. Methods: In this retrospective multicenter cohort study, we included patients with HR-positive, pure DCIS who underwent mastectomy between 2003 and 2018 across three cancer centers in South Korea. Patients were stratified based on receipt of adjuvant endocrine therapy (ETx). Logistic regression and Cox proportional hazards models were used to evaluate associations between ETx and recurrence or CBC. Annual hazard rates were estimated using kernel-smoothed functions. Results: Of 1,186 eligible patients, 599 (50.5 %) received endocrine therapy. Median follow-up was 86.3 months. The recurrence rate was significantly lower in the ETx group compared to no-ETx (7.0 % vs. 11.7 %; OR, 0.57; p = 0.005). Locoregional recurrence was also lower (2.5 % vs. 4.8 %; OR, 0.51; p = 0.04). CBC occurred in 5.3 % overall, with a non-significant reduction in the ETx group (4.2 % vs. 6.5 %; OR, 0.63; p = 0.08). In multivariable Cox models, ETx was associated with reduced recurrence (HR, 0.53; p = 0.01) and CBC (HR, 0.53; p = 0.04). Risk reduction persisted beyond 10 years. Conclusion: Adjuvant endocrine therapy was associated with significant reductions in recurrence and CBC risk after mastectomy for HR-positive DCIS, supporting selective use based on individual risk assessment.

Precipitation-based versus filtration-based liquid-based cytology in endoscopic ultrasound-FNB specimens of solid pancreatic masses: a prospective, randomized trial(with video)

2026-06-18T01:50:02Z

Title: Precipitation-based versus filtration-based liquid-based cytology in endoscopic ultrasound-FNB specimens of solid pancreatic masses: a prospective, randomized trial(with video) Authors: Lee, See Young; Nahm, Ji Hae; Jung, Chan Min; Jo, Jung Hyun; Kim, Hyung Sun; Seong, Yeseul; Lee, Hye Sun; Jeon, Soyoung; Jang, Sung Ill; Cho, Jae Hee Abstract: Background and Aims EUS-guided fine-needle biopsy (FNB) is the standard technique for diagnosing solid pancreatic masses, offering high histologic accuracy. However, adequate tissue acquisition can still be difficult in small or technically demanding lesions. Liquid-based cytology (LBC) may serve as a complementary tool to improve diagnostic yield. This study compared the diagnostic efficacy and cytomorphologic features of 2 LBC techniques—precipitation-based SurePath and filtration-based ThinPrep—using cytologic specimens prepared from the residual fluid remaining after retrieval of core tissue from EUS-FNB specimens. Methods A total of 102 patients with suspected malignant pancreatic tumors who underwent EUS-guided FNB were prospectively randomized into the SurePath and ThinPrep groups in a 1:1 ratio. Cytomorphologic features and slide quality were systematically evaluated. The final diagnosis integrated the cytologic, histologic, and clinical follow-up results. Results The groups had comparable baseline characteristics. Most cases (99.02%) were diagnosed as malignant, and pancreatic ductal adenocarcinoma was predominant (90.20%). SurePath demonstrated superior diagnostic accuracy (97.0% vs 83.9%, P = .002) and sensitivity (97.0% vs 83.7%, P = .002) to ThinPrep, whereas both techniques showed 100% specificity and positive predictive values. SurePath required a significantly shorter interpretation time ( P = .023). Cytomorphologically, SurePath showed more even distributions ( P < .001) and 3-dimensional clusters ( P < .001) and less cytoplasmic blurring ( P = .064). SurePath preparations also demonstrated better preservation of key diagnostic features, including conspicuous nucleoli ( P = .013), hyperchromasia ( P = .035), and coarse chromatin ( P = .009). SurePath achieved greater cellularity than ThinPrep, with 18.6% and 0% of cases, respectively, showing very high cellularity ( P < .001). Conclusions For EUS-guided FNB of solid pancreatic masses, the SurePath LBC technique demonstrated superior diagnostic performance, faster interpretation times, and better preservation of cytomorphologic features than ThinPrep. These findings suggest that SurePath should be the preferred LBC method for evaluating EUS-guided FNB of pancreatic masses. (Clinical trial registration number: KCT0006748). © 2025 American Society for Gastrointestinal Endoscopy.

A multicenter retrospective analysis by the Korean association of pediatric surgeons comparing laparoscopic and open surgical repair of congenital duodenal obstruction

2026-03-16T07:17:11Z

Title: A multicenter retrospective analysis by the Korean association of pediatric surgeons comparing laparoscopic and open surgical repair of congenital duodenal obstruction Authors: Park, Jinyoung; Ko, Dayoung; Koo, Eun-jung; Kwon, Hyunhee; Kim, Ki Hoon; Kim, Dae Yeon; Kim, Seong Chul; Kim, Soo-Hong; Kim, Wontae; Kim, Hae-Young; Kim, Hyun-Young; Nam, So Hyun; Namgoong, Jung-Man; Park, Junbeom; Park, Taejin; Bang, Min-Jung; Seo, Jeong-Meen; Sul, Ji-Young; Son, Joonhyuk; Sim, Joohyun; Ahn, Soo Min; Yang, Hee-Beom; Oh, Jung-Tak; Oh, Chaeyoun; Youn, Joong Kee; Lee, Sanghoon; Lee, Ju Yeon; Ihn, Kyong; Chang, Hye Kyung; Jeong, Yeon Jun; Jung, Eunyoung; Chung, Jae Hee; Cho, Min Jeng; Choe, Yun-Mee; Han, Seok Joo; Ho, In Geol; Hong, Jeong Abstract: Background: This multicenter retrospective study aimed to compare key perioperative outcomes such as operative time, time to full enteral feeding, hospital stay duration, postoperative complications, and mortality, between laparoscopic and open surgical repair of congenital duodenal obstruction (CDO) performed by members of the Korean Association of Pediatric Surgeons (KAPS). Methods: A national survey conducted between 2021 and 2023 provided data from 75 patients. Demographic characteristics, associated anomalies, anatomical types, surgical approach, and postoperative outcomes were compared between the laparoscopic (n = 36) and open (n = 39) groups. Results: Among the 75 patients (30 males, 45 females; male-to-female ratio 1:1.5), no significant differences were observed between groups in sex, birth weight, or gestational age. Surgical procedures included 66 duodenoduodenostomies, four duodenojejunostomies, two gastrojejunostomies, two web excisions with duodenoplasty, and one segmental duodenal resection. Laparoscopic repair was associated with longer operative times (p = 0.005). Time to full enteral feeding was comparable in both groups (p = 0.117). Hospital stay was significantly shorter in the laparoscopic group (p = 0.012). Postoperative complications and mortality did not differ between groups; no deaths occurred. Conclusion: Laparoscopic repair can be considered a safe and effective alternative to open surgery for selected patients with CDO, assuming adequate surgical expertise. (c) 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

A large puncture closer of aortic wall by multi-memory actions with thrombo-hemodynamic control

2026-03-16T07:23:46Z

Title: A large puncture closer of aortic wall by multi-memory actions with thrombo-hemodynamic control Authors: Cho, Sungwoo; Ha, Hyun-Su; Lee, Sangmin; Kim, Hyunjae; Lee, Seok Joon; Kim, Jueun; Lee, Yerin; Lee, Kang Suk; Joo, Hyun-Chel; Sung, Hak-Joon; 하현수; 이예린 Abstract: The vascular wall regulates the pattern and pressure of blood flow. In cardiovascular interventions, catheters are deployed by puncturing the vessel wall, without exception. Despite continuous progress, the outcomes remain highly operator-dependent, and large punctures with high-pressure bleeding continue to pose clinical challenges. As a translatable solution, this study introduces a shape memory vascular wall plug (VWP) that automates both the Body and Wing functions within a single component, supported by a Ring assembly to maximize pressure resistance. The VWP is deployed into a 6-mm puncture in a porcine thoracic aorta under peak blood pressure, and shape recovery is triggered by a 45 degrees C saline flush to enable automated activation. Upon recovery, Body expansion combined with Ring compression tightly seals the puncture tract. The curved Wing induces hemostatic sealing and then flattens to maintain healthy blood flow and physiologic pressures. The VWP achieves suturinglevel performance in aortic puncture closure, demonstrating effective hemostasis, patency, and endothelialization. The flow-blockage ratio required to balance hemostasis with hemodynamics is computationally modeled and validated using whole-blood microfluidics. Pressure resistance is maximized by tuning Ring strain through polymer blending, indicating multi-level strategies in polymer, device design, and memory function to advance the vascular closure technology.