Gyung Mo Son, Hong-min Ahn, In Young Lee, Sun Min Lee, Sang-Ho Park, Kwang-Ryul Baek. Journal of Minimally Invasive Surgery 2021;24:113-22. https://doi.org/10.7602/jmis.2021.24.3.113

Background: Automated flow cytometry‐based urine analyzer is increasingly being used to identify and enumerate cells and particles in urine specimens. It measures electrical conductivity which could be transformed to osmolality. Using this machine, all urine specimens could be screened for osmolality without requiring a separate dedicated device. We evaluated the performance of the new instrument, the UF‐5000 (Sysmex Corporation), in the measurement of urine osmolality.Methods: The precision of urine osmolality measurement by the UF‐5000 was evaluated for 20 days and 4 times a day for 2 concentrations. The linearity and detection capability were evaluated according to the Clinical and Laboratory Standards Institute guidelines. For comparison, 270 random urine specimens from patients were tested simultaneously using the UF5000 and the OsmoPro micro‐osmometer (Advanced instruments).Results: The laboratory‐based coefficient variations were less than 5%. Urine osmolality using the UF‐5000 has a verified linear range (y = 1.097x + 16.91,R² = .997). Within the comparison analysis, the mean difference was not large (−7.72%) but each differences were largely dispersed with 95% limits of agreement (LoA) from −70.5 to 55.06%, and the mean absolute difference −28.3 mOsm/kg with 95% LoA from −295.13 to 238.45 mOsm/kg. Cohen's kappa value was 0.54 (95% CI, 0.45‐0.63).Conclusions: The UF‐5000 measured conductivity and generated an acceptable quantitative analysis of urine osmolality. When compared with the results of the freezing point depression method used by the OsmoPro, a percentage of the measured urine osmolality by the UF‐5000 was outside the allowable limit.

Football players are at high risk for lower extremity injuries because they turn on an axis of rotation, turn while decelerating, and repeatedly jump and land. One of the most common sites of injury is the knee. A 25-year-old amateur university football player with pain in the knee medial area (Visual Analog Scale [VAS] score of 6/10), a hamstring muscle injury (VAS of 5/10), and a Tegner Activity Scale level of 3. He was diagnosed as hamstring muscle injury and traumatic knee pain. Balance taping was used for 1.5 months (average, 16 h/d). The Tegner Activity Scale level increased from 3 to 9 after balance taping, indicating increased activity ability. VAS scores for pain in the medial area of the knee and hamstring muscle during knee flexion decreased from 6 and 5 to 0 and 0, respectively. Based on these improvements, the patient was able to resume playing. Balance taping is an effective treatment for football players with a hamstring muscle injury and traumatic knee pain.

Triple-negative breast cancer (TNBC) has higher loco-regional recurrence and visceral metastasis compared to other breast cancer subtypes; however, little is known about the molecular pathogenesis of TNBC. Therefore, we compared the mutation profiles of early TNBC with those of hormone receptor-positive (HR+) and/or human epidermal growth factor receptor 2-negative (HER2-) breast cancer using a customized next-generation sequencing capture panel. DNA was obtained from the primary tumor tissues of 34 patients diagnosed with pT2N0-1M0 HR+/HER2- breast cancer or TNBC. Using SureSelectXT kit (Agilent), next-generation sequencing for 48 breast cancer-associated genes was performed on HiSeq platform (Illumina) with germline confirmation. Also, plasma was collected from 24 patients before surgery, cell-free nucleic acids were extracted, and performed therascreen PIK3CA RGQ PCR assay. Significant mutations were found in TP53, PIK3CA, AR, BRCA1, PTEN, BRCA2, BRIP2, KIT, MET, AKT1, ALK, BARD1, BRAF, CD274, ERBB2, FGFR1, IDH2, NOTCH1, RET, and STK11 (in descending order of occurrence). TP53 mutations were identified in the TNBC group more frequently than in the HR+/HER2- group (P = 0.003). The presence of TP53 mutations was associated with a higher tumor grade (P = 0.008), p53 positivity (P < 0.0001), and a higher Ki-67 index (P = 0.004). PIK3CA was the most frequently mutated gene in HR+/HER2- breast cancer (8/22, 36.4%), but not in TNBC (1/12, 8.3%). The TP53 mutation is associated with higher tumor grade and Ki-67 expression in both groups, and with larger tumor size in TNBC, but not in HR+/HER2- breast cancer. In the foundation of TP53 mutation, concomitant mutation numbers are proportional to tumor size, reflecting clonal progression.

Lee SM, et al. J Korean Med Sci. 2021 Feb;36(9):e64. https://doi.org/10.3346/jkms.2021.36.e64