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Decreased medial cheek fat volume during aging leads to loss of a youthful facial shape. Increasing facial volume by methods such as adipose-derived stem cell (ASC) injection can produce facial rejuvenation. High-intensity focused ultrasound (HIFU) can increase adipogenesis in subcutaneous fat by modulating cilia on ASCs, which is accompanied by increased HSP70 and decreased NF-κB expression. Thus, we evaluated the effect of HIFU on increasing facial adipogenesis in swine ( n = 2) via modulation of ASC cilia. Expression of CD166 , an ASC marker, differed by subcutaneous adipose tissue location. CD166 expression in the zygomatic arch (ZA) was significantly higher than that in the subcutaneous adipose tissue in the mandible or lateral temporal areas. HIFU was applied only on the right side of the face, which was compared with the left side, where HIFU was not applied, as a control. HIFU produced a significant increase in HSP70 expression, decreased expression of NF-κB and a cilia disassembly factor ( AURKA ), and increased expression of a cilia increasing factor ( ARL13B ) and PPARG and CEBPA , which are the main regulators of adipogenesis. All of these changes were most prominent at the ZA. Facial adipose tissue thickness was also increased by HIFU. Adipose tissue volume, evaluated by magnetic resonance imaging, was increased by HIFU, most prominently in the ZA. In conclusion, HIFU increased ASC marker expression, accompanied by increased HSP70 and decreased NF-κB expression. Additionally, changes in cilia disassembly and length and expression of adipogenesis were observed. These results suggest that HIFU could be used to increase facial volume by modulating adipogenesis.

Natural killer (NK) cells are one of the key members of innate immunity that predominantly reside in the liver, potentiating immune responses against viral infections or malignant tumors. It has been reported that changes in cell numbers and function of NK cells are associated with the development and progression of chronic liver diseases (CLDs) including non-alcoholic fatty liver disease, alcoholic liver disease, and chronic viral hepatitis. Also, it is known that the crosstalk between NK cells and hepatic stellate cells plays an important role in liver fibrosis and cirrhosis. In particular, the impaired functions of NK cells observed in CLDs consequently contribute to occurrence and progression of hepatocellular carcinoma (HCC). Chronic infections by hepatitis B or C viruses counteract the anti-tumor immunity of the host by producing the sheddases. Soluble major histocompatibility complex class I polypeptide-related sequence A (sMICA), released from the cell surfaces by sheddases, disrupts the interaction and affects the function of NK cells. Recently, the MICA/B-NK stimulatory receptor NK group 2 member D (NKG2D) axis has been extensively studied in HCC. HCC patients with low membrane-bound MICA or high sMICA concentration have been associated with poor prognosis. Therefore, reversing the sMICA-mediated downregulation of NKG2D has been proposed as an attractive strategy to enhance both innate and adaptive immune responses against HCC. This review aims to summarize recent studies on NK cell immune signatures and its roles in CLD and hepatocellular carcinogenesis and discusses the therapeutic approaches of MICA/B-NKG2D-based or NK cell-based immunotherapy for HCC., (© 2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Highways, while vital for transportation, often lead to heightened air and noise pollution, adversely affecting nearby communities. This study delves into the effectiveness of highway capping, a sustainable urban development strategy, in addressing these environmental challenges, with a specific focus on the Bundang-Suseo Highway in South Korea. This study employed a multifaceted approach, incorporating on-road monitoring, in situ measurements, and vertical assessments using UAVs. Following the cap's installation, the area experienced more stable pollutant levels, marking a notable shift from the previously fluctuating conditions heavily influenced by the highway. In-depth in situ monitoring near the cap revealed significant reductions in noise and pollutants like UFP and BC. Furthermore, UAV monitoring captured these changes in pollutant levels at different altitudes. Notably, the installation of the highway cap led to increased PM 2.5 , PM 10 , and NO 2 levels at ground level, but a decrease above the cap, emphasizing the critical importance of intentional highway cap design in enhancing urban air quality and reducing exposure to harmful pollutants. This research yields invaluable insights for urban planners, health authorities, and policymakers, aiding the precise identification of pollution-prone areas and advocating for improved highway cap design to enhance urban environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Airway management is a fundamental and intricate process that involves a sequence of integrated tasks. Situations requiring emergency airway management may occur in emergency department, intensive care units, and various other spaces. Emergency airway management can face a variety of challenges during preparation, intubation, and post-intubation, and may result in significant complications for the patients. Therefore, many countries are establishing step-by-step systemization and detailed guidelines, and updating the content based on the latest research. This clinical review introduces the current trends in emergency airway management, such as emergency airway management algorithms, comparison of video and direct laryngoscopy, rapid sequence intubation, pediatric airway management, pre-hospital airway management, surgical airway management, and airway management education.

Quercetin is a flavonol belonging to the flavonoid group of polyphenols. Quercetin is reported to have a variety of biological functions, including antioxidant, pigment, auxin transport inhibitor and root nodulation factor. Additionally, quercetin is known to be involved in bacterial pathogen resistance in Arabidopsis through the transcriptional increase of pathogenesis-related ( PR ) genes. However, the molecular mechanisms underlying how quercetin promotes pathogen resistance remain elusive. In this study, we showed that the transcriptional increases of PR genes were achieved by the monomerization and nuclear translocation of nonexpressor of pathogenesis-related proteins 1 (NPR1). Interestingly, salicylic acid (SA) was approximately 2-fold accumulated by the treatment with quercetin. Furthermore, we showed that the increase of SA biosynthesis by quercetin was induced by the transcriptional increases of typical SA biosynthesis-related genes. In conclusion, this study strongly suggests that quercetin induces bacterial pathogen resistance through the increase of SA biosynthesis in Arabidopsis .

Reactive distillation (RD) provides notable advantages over conventional processes, regarding reduced energy requirements and CO 2 emissions. However, as the benefits of RD may not be universally applicable, a comprehensive feasibility assessment is necessary. This study introduced an automated feasibility evaluation procedure for an RD column using an AI-based region recognition approach, reducing the reliance on expert knowledge and heuristics in graphical methods. Through k -means clustering-based image segmentation, topological information on the reaction and separation reachable region was extracted from ternary diagram landscapes. Subsequently, the extracted information was integrated into tray-by-tray calculations to automate the evaluation. This geometric calculation procedure was applied to assess the feasibility of RD columns with different types of reactions. The feasibility results were obtained within seconds, demonstrating the efficiency of the proposed approach. Furthermore, case studies validated the feasibility of the evaluation results for three practical examples using rigorous simulations, confirming its reliability and applicability., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Rationally engineered porous structures enable lightweight broadband electromagnetic (EM) wave absorbers for countering radar signals or mitigating EM interference between multiple components. However, the scalability of such structures has been hindered by their limited mechanical properties resulting from low density. Herein, an additively manufactured Kelvin foam-based EM wave absorber (KF-EMA) is reported that exhibits multifunctionality, namely EM wave absorption and light-weighted load-bearing structures with constant relative stiffness made possible using bending-dominated lattice structures. Based on tuning design parameters, such as the backbone structures and constituent materials, the proposed KF-EMA features a multilayered 3D-printed design with geometrically optimized KF structures made of carbon black-based backbone composites. The developed KF-EMA demonstrated an absorbance greater than 90% at frequencies ranging from 5.8 to 18 GHz (average EM wave absorption rates of 95.89% and maximum of 99.1% at 15.8 GHz), while the low-density structures of the absorber (≈200 kg m -3 ) still maintained a compression index between the stiffness and relative density (n = 2) under compression. The design strategy paves the way for using metamaterials as mechanically reinforced EM wave absorbers that enable multifunctionality by optimizing unit-cell parameters through a single and low-density structure., (© 2023 Wiley-VCH GmbH.)

The resistive random-access memory (RRAM) with multi-level storage capability has been considered one of the most promising emerging devices to mimic synaptic behavior and accelerate analog computations. In this study, we investigated the reset-first bipolar resistive switching (RS) and multi-level characteristics of a LaNiO 3-x thin film deposited using a reactive magnetron co-sputtering method. Polycrystalline phases of LaNiO 3 (LNO), without La 2 O 3 and NiO phases, were observed at similar fractions of Ni and La at a constant partial pressure of oxygen. The relative chemical proportions of Ni 3+ and Ni 2+ ions in LaNiO 3-x indicated that it was an oxygen-deficient LaNiO 3-x thin film, exhibiting RS behavior, compared to LNO without Ni 2+ ions. The TiN/LaNiO 3-x /Pt devices exhibited gradual resistance changes under various DC/AC voltage sweeps and consecutive pulse modes. The nonlinearity values of the conductance, measured via constant-pulse programming, were 0.15 for potentiation and 0.35 for depression, indicating the potential of the as-fabricated devices as analog computing devices. The LaNiO 3-x -based device could reach multi-level states without an electroforming step and is a promising candidate for state-of-the-art RS memory and synaptic devices for neuromorphic computing.

A proton linac based boron neutron capture therapy system (A-BNCT, 10MeV, 4mA) was successfully developed in Korea. We performed in vitro experiments with U87 and SAS cells and revealed the efficacy of a binary therapy BNCT using epithermal neutrons and boronophenylalanine (BPA). The results revealed that BNCT showed cancer cell selectivity and caused cell death. Further in vitro studies can be a valuable method to characterize an A-BNCT system. We expect BNCT to become a treatment option for cancer patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Rationale: Operative hysteroscopy intravascular absorption syndrome (OHIAS) results from systemic absorption of hypotonic solution during hysteroscopy, which may induce severe hyponatremia within hours. Depending on the serum sodium (Na+) level, this can be life-threatening and requires prompt and careful remedial treatment., Patient Concerns and Diagnoses: A 53-year-old woman underwent hysteroscopic myomectomy for submucosal leiomyoma. Approximately 3 hours postoperatively, the serum Na+ level decreased to 82 mM/L, accompanied by pulmonary edema and lactic acidosis. The patient was strongly suspicious of OHIAS., Interventions and Outcomes: A rapid correction was made using 3% NaCl to prevent brain edema as an initial response. After the serum Na+ level reached 120 mM/L, gradual correction was performed considering osmotic demyelination syndrome, and desmopressin was administered to prevent overcorrection caused by excessive water diuresis. Serum Na+ level normalized in 4 days and the patient recovered without any specific sequelae., Lessons: The detection of OHIAS may be delayed under general anesthesia, and prior vigilance is important if the operation time is prolonged. In severe hyponatremia with an apparently rapid onset, such as OHIAS, a two-step correction process may be safe and useful: rapid correction followed by more gradual correction., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)

Boron neutron capture therapy (BNCT) is a radiation therapy that selectively kills cancer cells and is being actively researched and developed around the world. In Korea, development of the proton linear accelerator-based BNCT system has completed development, and its anti-cancer effect in the U-87 MG subcutaneous xenograft model has been evaluated. To evaluate the efficacy of BNCT, we measured 10 B-enriched boronophenylalanine (BPA) uptake in U-87 MG, FaDu, and SAS cells and evaluated cell viability by clonogenic assays. In addition, the boron concentration in the tumor, blood, and skin on the U-87 MG xenograft model was measured, and the tumor volume was measured for 4 weeks after BNCT. In vitro, the intracellular boron concentration was highest in the order of SAS, FaDu, and U-87 MG, and cell survival fractions decreased depending on the BPA treatment concentration and neutron irradiation dose. In vivo, the tumor volume was significantly decreased in the BNCT group compared to the control group. This study confirmed the anti-cancer effect of BNCT in the U-87 MG subcutaneous xenograft model. It is expected that the proton linear accelerator-based BNCT system developed in Korea will be a new option for radiation therapy for cancer treatment.

We recently reported a lack of interference between inactivated rotavirus vaccine (IRV) and inactivated poliovirus vaccine (IPV) and their potential dose sparing when the two vaccines were administered intramuscularly either in combination or standalone in rats and guinea pigs. In the present study, we optimized the formulations of both vaccines and investigated the feasibility of manufacturing a combined IRV-IPV dissolving microneedle patch (dMNP), assessing its compatibility and immunogenicity in rats. Our results showed that IRV delivered by dMNP alone or in combination with IPV induced similar levels of RV-specific IgG and neutralizing antibody. Likewise, IPV delivered by dMNP alone or in combination with IRV induced comparable levels of neutralizing antibody of poliovirus types 1, 2, and 3. We further demonstrated high stability of IRV-dMNP at 5, 25, and 40 °C and IPV-dMNP at 5 and 25 °C, and found that three doses of IRV or IPV when co-administered at a quarter dose was as potent as a full target dose in inducing neutralizing antibodies against corresponding rotavirus or poliovirus. We conclude that IRV-IPV dMNP did not interfere with each other in triggering an immunologic response and were highly immunogenic in rats. Our findings support the further development of this innovative approach to deliver a novel combination vaccine against rotavirus and poliovirus in children throughout the world., (© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Previous studies have investigated the increased volume of pedestrians to establish success rates of the pedestrian-friendly policy after a street redesign intervention. However, few studies have focused on the effect of street regeneration on air quality perception and user satisfaction. The influence of the physical environment on street vitality may vary, depending on area context and regional factors. A comprehensive understanding of effective interventions could increase pedestrians' satisfaction with their walking environment. This study examines the effect of pedestrianization on individuals' air quality perception and satisfaction, based on three regenerated streets in Seoul, Korea. We analyzed data from 672 questionnaires administered after the pedestrianization project. We used a subset of variables in a binary logistic regression model to understand general determinants of user satisfaction toward their walking environment. Our case study contributes to the verification of pedestrianization effects on air quality perceptions. Results show that overall satisfaction could be acquired through positive perceptions of air quality, as achieved through pedestrianization of streets. Moreover, pedestrian satisfaction varies according to the purpose, activities and health-related behaviors and attitudes. The interrelationships between environmental health, activity, satisfaction and quality of life provide design insights to consider when implementing pedestrianization projects in the future.

Background: Midazolam is frequently used for sedation during spinal anesthesia. However, external environmental factors, such as bright surgical lights, may hamper patient relaxation, which may lead to an increase in the dose of midazolam required and the likelihood of adverse drug effects. We investigated whether using an eye mask to block the external environment could reduce midazolam requirements during spinal anesthesia., Methods: Participants aged 18-‒80 years, scheduled for elective surgery under spinal anesthesia, were randomly divided into a masked group (wearing eye masks during surgery, n = 20) and a control group (no mask, n = 18). The sedation level was assessed using a modified Observer Assessment of Alertness and Sedation (MOAA/S) scale. Midazolam (1 mg) was incrementally administered every 5 min until moderate sedation (MOAA/S score of 3) was achieved. The bispectral index (BIS) was monitored, and the onset and maintenance times of a BIS < 80 were recorded., Results: The two groups had similar demographic characteristics. The midazolam requirements were significantly lower in the masked group than in the control group (2.8 mg vs. 3.7 mg, P = 0.024). However, the onset and maintenance times for a BIS < 80 were similar. In addition, there were no significant differences in the incidence of side effects or patient satisfaction between the two groups., Conclusions: Blocking the external environment with an eye mask during spinal anesthesia can reduce the requirement for sedatives, such as midazolam., Trial Registration: The trial was retrospectively registered with the Clinical Research Information Service (No. KCT0005528, 15/10/2020) entitled "Can we reduce an amount of sleeping pills just by blocking light?"., (© 2021. The Author(s).)

Background: Hemodynamic instability is a frequent adverse effect following administration of dexmedetomidine (DMED). In this study, we evaluated the incidence of DMED-induced hemodynamic instability and its predictive factors in clinical regional anesthesia practice., Methods: One hundred sixteen patients who underwent orthopedic upper limb surgery under brachial plexus block with intravenous DMED administration were retrospectively identified. The primary outcome was the incidence of DMED-induced hemodynamic instability. The participants were allocated to a stable or unstable group by their hemodynamic instability status. Patients' characteristics were compared between the groups. The relationship between the potential risk factors and development of DMED-induced hemodynamic instability was analyzed with a logistic regression model., Results: DMED-induced hemodynamic instability was observed in 14.7% of patients (17/116). The unstable group had more women than the stable group (76.5% vs. 39.4%, P = 0.010). When patients were classified into four subgroup according to body mass index (underweight, normal weight, overweight, and obesity), there was significant difference in the composition of the subgroups in the two groups (P = 0.008). In univariate analysis, female sex, obesity, and pre-existing hypertension were significant predictors of DMED-induced hemodynamic instability. Multivariate analysis demonstrated that female sex (adjusted OR 3.86, CI 1.09; 13.59, P = 0.036) and obesity (adjusted OR 6.41, CI 1.22; 33.57, P = 0.028) were independent predictors of DMED-induced hemodynamic instability., Conclusions: Female and obese patients are more likely to have hemodynamic instability following intravenous DMED administration in clinical regional anesthesia practice. This study suggests that DMED dose may be diminished to prevent hypotensive risk in these populations., Trial Registration: This article was retrospectively registered at WHO clinical trial registry platform (Trial number: KCT0005977 )., (© 2021. The Author(s).)

Objective: We investigated the long-term clinical efficacy of fenofibrate use with regard to mortality and cardiovascular outcomes in patients with type 2 diabetes., Research Design and Methods: We performed a population-based cohort study using data of the South Korean National Health Insurance Service from 2003 to 2014. Of 63,727 participants with diabetes aged 40-79 years, 5,057 users of fenofibrate only were compared with 5,057 nonusers of fenofibrate and/or omega-3 fatty acid with 1:1 propensity matching. The primary end point was a composite of myocardial infarction, stroke, percutaneous coronary revascularization, and cardiac death for a median of 3 years., Results: The primary end point was significantly lower in fenofibrate users compared with those using neither fenofibrate nor omega-3 fatty acid (13.4 vs. 15.5 per 1,000 person-years; hazard ratio [HR] 0.76; 95% CI 0.62-0.94; P = 0.010). Cardiac death (1.8 vs. 3.1 per 1,000 person-years; HR 0.59; 95% CI 0.352-0.987; P = 0.0446), all-cause death (7.6 vs. 15.3 per 1,000 person-years; HR 0.437; 95% CI 0.340-0.562; P < 0.0001), and stroke (6.5 vs. 8.6 per 1,000 person-years; HR 0.621; 95% CI 0.463-0.833; P = 0.0015) were significantly lower in the fenofibrate group. When the duration of fenofibrate use was stratified by quartile, the risk decreased in quartile 4, with an HR of 0.347 (95% CI 0.226-0.532; P < 0.0001). In subgroup analysis, the favorable effect of fenofibrate was sustained consistently across all subsets of patients, including those classified by LDL cholesterol, HDL cholesterol, and triglyceride levels., Conclusions: Use of fenofibrate was associated with a lower rate of total and cardiac mortality and cardiovascular events in patients with type 2 diabetes during a 3-year follow-up in real-world large populations., (© 2021 by the American Diabetes Association.)

Competing Interests: Conflict of Interest: Park MH has no financial conflicts of interest. Hanmi Pharmaceutical Company provided support in the form of salaries for the other authors (Lee J, Nam H, Kyoung DS), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

In this study, we report the construction of a novel composite photocatalyst (BiVO 4 /rGH) composed of quantum dots (QDs) self-decorated BiVO 4 -nanoparticels (NPs) and reduced graphene hydrogel (rGH). The composite structures were prepared using an in-situ growth method. The BiVO 4 /rGH composite photocatalysts exhibited excellent photocatalytic efficiency for the degradation of tetracycline hydrochloride (TCHCl). The promoted photocatalytic activity of the BiVO 4 /rGH is attributed to the synergetic effects of the unique structure involving QDs self-decorated BiVO 4 NPs and a 3D network structure of rGH, which resulted in higher number of photogenerated charge carriers, surplus active sites, and enhanced charge separation. In addition, trapping measurements showed that ·O 2 - and h + , as the main active species, play a crucial role in the degradation of TCHCl over the composite photocatalyst. This study facilitates the design and construction of high efficiency hybrid photocatalysts with multifunctional materials for the removal of water pollutants., Competing Interests: Declaration of competing interest The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Dipeptidyl peptidase-4 inhibitor (DPP-4i) and renin-angiotensin system (RAS) blockade are reported to affect the clinical course of coronavirus disease 2019 (COVID-19) in patients with diabetes mellitus (DM)., Methods: As of May 2020, analysis was conducted on all subjects who could confirm their history of claims related to COVID-19 in the National Health Insurance Review and Assessment Service (HIRA) database in Korea. Using this dataset, we compared the short-term prognosis of COVID-19 infection according to the use of DPP-4i and RAS blockade. Additionally, we validated the results using the National Health Insurance Service (NHIS) of Korea dataset., Results: Totally, data of 67,850 subjects were accessible in the HIRA dataset. Of these, 5,080 were confirmed COVID-19. Among these, 832 subjects with DM were selected for analysis in this study. Among the subjects, 263 (31.6%) and 327 (39.3%) were DPP4i and RAS blockade users, respectively. Thirty-four subjects (4.09%) received intensive care or died. The adjusted odds ratio for severe treatment among DPP-4i users was 0.362 (95% confidence interval [CI], 0.135 to 0.971), and that for RAS blockade users was 0.599 (95% CI, 0.251 to 1.431). These findings were consistent with the analysis based on the NHIS data using 704 final subjects. The adjusted odds ratio for severe treatment among DPP-4i users was 0.303 (95% CI, 0.135 to 0.682), and that for RAS blockade users was 0.811 (95% CI, 0.391 to 1.682)., Conclusion: This study suggests that DPP-4i is significantly associated with a better clinical outcome of patients with COVID-19.

The Z-scheme BiVO 4 /α-Fe 2 O 3 photocatalyst was synthesized by a simple hydrothermal method. The photocatalyst is composed of α-Fe 2 O 3 nanocubes with a regular cubic structure and the BiVO 4 particles distributed on the surface of the α-Fe 2 O 3 nanocubes. The photocatalytic performance of Z-scheme BiVO 4 /α-Fe 2 O 3 photocatalyst was investigated in terms of its capacity for photodegradation of tetracycline hydrochloride. Improved photocatalytic activity was observed for Z-scheme BiVO 4 /α-Fe 2 O 3 photocatalyst compared with pure BiVO 4 and α-Fe 2 O 3 nanocubes under visible light irradiation. Studies of its morphology, physicochemical properties and photoelectrochemical behaviors demonstrated that BiVO 4 loading on the surface of α-Fe 2 O 3 nanocubes forms a Z-scheme heterojunction, which increases the specific surface area and significantly promotes the separation of photoinduced carriers. The main active species were determined to be OH and h + by ESR technique and trapping experiments. We propose a possible photocatalytic mechanism of Z-scheme BiVO 4 /α-Fe 2 O 3 photocatalyst system. This study may also provide a novel and eco-friendly demonstration of a useful strategy for the design and preparation of special structure photocatalytic materials., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Advances in single-cell isolation and barcoding technologies offer unprecedented opportunities to profile DNA, mRNA, and proteins at a single-cell resolution. Recently, bulk multiomics analyses, such as multidimensional genomic and proteogenomic analyses, have proven beneficial for obtaining a comprehensive understanding of cellular events. This benefit has facilitated the development of single-cell multiomics analysis, which enables cell type-specific gene regulation to be examined. The cardinal features of single-cell multiomics analysis include (1) technologies for single-cell isolation, barcoding, and sequencing to measure multiple types of molecules from individual cells and (2) the integrative analysis of molecules to characterize cell types and their functions regarding pathophysiological processes based on molecular signatures. Here, we summarize the technologies for single-cell multiomics analyses (mRNA-genome, mRNA-DNA methylation, mRNA-chromatin accessibility, and mRNA-protein) as well as the methods for the integrative analysis of single-cell multiomics data.

Background: Errors in counting spinal segments are common during interventional procedures when there are transitional vertebrae. In this study, we investigated the prevalence of the transitional vertebrae including thoracolumbar transitional vertebra (TLTV) and lumbosacral transitional vertebrae (LSTV). The relationship between the existence of TLTV and abnormal rib count or the existence of LSTV were also evaluated., Methods: The vertebral levels were counted craniocaudally, starting from C1, based on the assumption of 7 cervical, 12 thoracic, and 5 lumbar vertebrae, using whole spine spiral three-dimensional computed tomographic images. The 20th and 25th vertebrae were defined as L1 and S1, respectively., Results: In total, 150 patients had TLTV, with a prevalence of 11.2% (150/1,340). LSTV was observed in 111 of 1,340 cases (8.3%). Sacralization was observed in 68 of 1,340 cases (5.1%) and lumbarization in 43 of 1,340 cases (3.2%). There was a significant relationship between the existence of TLTV and the abnormal rib count (odds ratio [OR]: 117.26, 95% confidence interval [95% CI]: 60.77-226.27; P < 0.001) and LSTV (OR: 7.38, 95% CI: 3.99-13.63; P < 0.001)., Conclusions: Our study results suggest that patients with TLTV are more likely to have an abnormal rib count or LSTV. If a TLTV or LSTV is seen on the fluoroscopic image, a whole spine image is necessary to permit accurate numbering of the lumbar vertebra., Competing Interests: CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported., (Copyright © the Korean Society of Anesthesiologists, 2020.)

Background: Retropharyngeal hematoma following cervical spine trauma may lead to life-threatening upper airway obstruction and difficult airway management. This retrospective study was performed to investigate whether the extension of retropharyngeal space (RPS) was associated with difficult intubation by direct laryngoscopy in traumatic cervical spine injury., Patients and Methods: Sixty-two patients who had undergone direct endotracheal intubation under general anesthesia for cervical spine surgery were retrospectively identified. Laryngoscopic grade by Cormack-Lehane (C-L) classification was collected; grade 1 or 2 was categorized as easy laryngoscopy, whereas grade 3 or 4 was categorized as difficult laryngoscopy. In these patients, RPS thickness and the proportions of RPS to the vertebral bodies were measured at the 2nd, 5th and 7th cervical spine levels using magnetic resonance imaging (MRI) of the cervical spine. Measures of RPS were compared between easy and difficult laryngoscopy. Relationships between measures of RPS and difficult laryngoscopy were analyzed with logistic regression analysis., Results: RPS thickness at C2 was significantly greater in difficult laryngoscopy (median 14.29 mm, IQR: 9.75-18.04) than easy laryngoscopy (median 5.10, IQR: 4.33-5.94, p <0.001). Proportion of RPS to the C2 vertebral body were significantly higher in difficult laryngoscopy than in easy laryngoscopy ( p <0.001). RPS thickness and the proportion of RPS to the vertebral body were significantly associated with difficult laryngoscopy (OR=2.13, 95% CI: 1.38-3.30; p <0.001 and OR=1.13, 95% CI: 1.05-1.21; p <0.001, respectively)., Conclusion: RPS extension at the upper cervical spine level is associated with difficult direct laryngoscopy in traumatic cervical spine injury., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Neuroblastoma (NB) is the most common childhood cancer, with a very poor prognosis. More than 60% of children with NB die within five years; therefore, a more effective therapy for NB is required. Although ginsenoside has been shown to significantly inhibit the growth of various cancers, the effect of ginsenoside Rk1 on neuroblastoma has not been known yet. Hence, we examined the anticancer effects of highly pure Rk1 on neuroblastoma cell lines. The apoptotic effects of Rk1 on neuroblastoma cells were examined using cell viability assay, flow cytometry and cell staining assay, and the change in gene expression levels were analysed using RT-PCR, western blots, and immunohistochemistry. The metastatic effect of Rk1 was monitored by wound healing assay, invasion and migration with Matrigels. Rk1 inhibited neuroblastoma cell viability dose-dependently. Rk1-induced apoptosis was investigated through nuclear condensation and mitochondrial membrane potential loss, and it showed that Rk1 can induce cell cycle arrest at the G0/G1 phase but also inhibit the metastatic ability of neuroblastoma cells. Moreover, Rk1 (30 mg/kg) injections markedly inhibited xenograft tumor growth. These findings demonstrate that Rk1 might be valuable in the development of anti-cancer agents for neuroblastoma treatment.

Sunspots are concentrations of magnetic field visible on the solar surface (photosphere). It was considered implausible that solar flares, as resulted from magnetic reconnection in the tenuous corona, would cause a direct perturbation of the dense photosphere involving bulk motion. Here we report the sudden flare-induced rotation of a sunspot using the unprecedented spatiotemporal resolution of the 1.6 m New Solar Telescope, supplemented by magnetic data from the Solar Dynamics Observatory. It is clearly observed that the rotation is non-uniform over the sunspot: as the flare ribbon sweeps across, its different portions accelerate (up to ∼50° h -1 ) at different times corresponding to peaks of flare hard X-ray emission. The rotation may be driven by the surface Lorentz-force change due to the back reaction of coronal magnetic restructuring and is accompanied by a downward Poynting flux. These results have direct consequences for our understanding of energy and momentum transportation in the flare-related phenomena.

Unlabelled: In this study, in order to understand accurate calculation of greenhouse gas emissions of urban solid waste incineration facilities, which are major waste incineration facilities, and problems likely to occur at this time, emissions were calculated by classifying calculation methods into 3 types. For the comparison of calculation methods, the waste characteristics ratio, dry substance content by waste characteristics, carbon content in dry substance, and (12)C content were analyzed; and in particular, CO2 concentration in incineration gases and (12)C content were analyzed together. In this study, 3 types of calculation methods were made through the assay value, and by using each calculation method, emissions of urban solid waste incineration facilities were calculated then compared. As a result of comparison, with Calculation Method A, which used the default value as presented in the IPCC guidelines, greenhouse gas emissions were calculated for the urban solid waste incineration facilities A and B at 244.43 ton CO2/day and 322.09 ton CO2/day, respectively. Hence, it showed a lot of difference from Calculation Methods B and C, which used the assay value of this study. It is determined that this was because the default value as presented in IPCC, as the world average value, could not reflect the characteristics of urban solid waste incineration facilities. Calculation Method B indicated 163.31 ton CO2/day and 230.34 ton CO2/day respectively for the urban solid waste incineration facilities A and B; also, Calculation Method C indicated 151.79 ton CO2/day and 218.99 ton CO2/day, respectively., Implications: This study intends to compare greenhouse gas emissions calculated using (12)C content default value provided by the IPCC (Intergovernmental Panel on Climate Change) with greenhouse gas emissions calculated using (12)C content and waste assay value that can reflect the characteristics of the target urban solid waste incineration facilities. Also, the concentration and (12)C content were calculated by directly collecting incineration gases of the target urban solid waste incineration facilities, and greenhouse gas emissions of the target urban solid waste incineration facilities through this survey were compared with greenhouse gas emissions, which used the previously calculated assay value of solid waste.

Unlabelled: In Korea, the amount of greenhouse gases released due to waste materials was 14,800,000 t CO2eq in 2012, which increased from 5,000,000 t CO2eq in 2010. This included the amount released due to incineration, which has gradually increased since 2010. Incineration was found to be the biggest contributor to greenhouse gases, with 7,400,000 t CO2eq released in 2012. Therefore, with regards to the trading of greenhouse gases emissions initiated in 2015 and the writing of the national inventory report, it is important to increase the reliability of the measurements related to the incineration of waste materials. This research explored methods for estimating the biomass fraction at Korean MSW incinerator facilities and compared the biomass fractions obtained with the different biomass fraction estimation methods. The biomass fraction was estimated by the method using default values of fossil carbon fraction suggested by IPCC, the method using the solid waste composition, and the method using incinerator flue gas. The highest biomass fractions in Korean municipal solid waste incinerator facilities were estimated by the IPCC Default method, followed by the MSW analysis method and the Flue gas analysis method. Therefore, the difference in the biomass fraction estimate was the greatest between the IPCC Default and the Flue gas analysis methods. The difference between the MSW analysis and the flue gas analysis methods was smaller than the difference with IPCC Default method. This suggested that the use of the IPCC default method cannot reflect the characteristics of Korean waste incinerator facilities and Korean MSW., Implications: Incineration is one of most effective methods for disposal of municipal solid waste (MSW). This paper investigates the applicability of using biomass content to estimate the amount of CO2 released, and compares the biomass contents determined by different methods in order to establish a method for estimating biomass in the MSW incinerator facilities of Korea. After analyzing the biomass contents of the collected solid waste samples and the flue gas samples, the results were compared with the Intergovernmental Panel on Climate Change (IPCC) method, and it seems that to calculate the biomass fraction it is better to use the flue gas analysis method than the IPCC method. It is valuable to design and operate a real new incineration power plant, especially for the estimation of greenhouse gas emissions.

Unlabelled: Environmental problems and climate change arising from waste incineration are taken quite seriously in the world. In Korea, the waste disposal methods are largely classified into landfill, incineration, recycling, etc. and the amount of incinerated waste has risen by 24.5% from 2002. In the analysis of CO₂emissions estimations of waste incinerators fossil carbon content are main factor by the IPCC. FCF differs depending on the characteristics of waste in each country, and a wide range of default values are proposed by the IPCC. This study conducted research on the existing classifications of the IPCC and Korean waste classification systems based on FCF for accurate greenhouse gas emissions estimation of waste incineration. The characteristics possible for sorting were classified according to FCF and form. The characteristics sorted according to fossil carbon fraction were paper, textiles, rubber, and leather. Paper was classified into pure paper and processed paper; textiles were classified into cotton and synthetic fibers; and rubber and leather were classified into artificial and natural. The analysis of FCF was implemented by collecting representative samples from each classification group, by applying the 14C method, and using AMS equipment. And the analysis values were compared with the default values proposed by the IPCC. In this study of garden and park waste and plastics, the differences were within the range of the IPCC default values or the differences were negligible. However, coated paper, synthetic textiles, natural rubber, synthetic rubber, artificial leather, and other wastes showed differences of over 10% in FCF content. IPCC is comprised of largely 9 types of qualitative classifications, in emissions estimation a great difference can occur from the combined characteristics according with the existing IPCC classification system by using the minutely classified waste characteristics as in this study., Implications: Fossil carbon fraction (FCF) differs depending on the characteristics of waste in each country; and a wide range of default values are proposed by the IPCC. This study conducted research on the existing classifications of the IPCC and Korean waste classification systems based on FCF for accurate greenhouse gas emissions estimation of waste incineration.

Polymerization-induced phase separation of nanoparticle-filled solution is demonstrated as a simple approach to control the structure of porous composites. These composites are subsequently demonstrated as the active component for sodium ion battery anode. To synthesize the composites, we dissolved/dispersed titanium oxide (anatase) nanoparticles (for sodium insertion) and poly(hydroxybutyl methacrylate) (PHBMA, porogen) in furfuryl alcohol (carbon precursor) containing a photoacid generator (PAG). UV exposure converts the PAG to a strong acid that catalyzes the furfuryl alcohol polymerization. This polymerization simultaneously decreases the miscibility of the PHBMA and reduces the mobility in the mixture to kinetically trap the phase separation. Carbonization of this polymer composite yields a porous nanocomposite. This nanocomposite exhibits nearly 3-fold greater gravimetric capacity in Na-ion batteries than the same titanium oxide nanoparticles that have been coated with carbon. This improved performance is attributed to the morphology as the carbon content in the composite is five times that of the coated nanoparticles. The porous composite materials exhibit stable cyclic performance. Moreover, the battery performance using materials from this polymerization-induced phase separation method is reproducible (capacity within 10% batch-to-batch). This simple fabrication methodology may be extendable to other systems and provides a facile route to generate reproducible hierarchical porous morphology that can be beneficial in energy storage applications.

Background: In clinical practice, pregnant women have lower anesthetic requirements for general anesthesia than nonpregnant women. Although the hormonal changes such as progesterone associated with pregnancy may affect the minimum alveolar concentration of volatile anesthetics, the relationship between the anesthetic or analgesic requirements and progesterone level in full-term women has not been studied. In this study, we attempted to identify relationships between anesthetic or analgesic requirements and maternal serum concentrations of progesterone., Methods: We studied 100 parturients >36 weeks' gestation who were scheduled for planned cesarean delivery under general anesthesia. Venous blood was collected to measure the maternal progesterone concentration. Anesthesia was induced with 4 to 5 mg/kg thiopental and 0.8 mg/kg rocuronium. During anesthetic maintenance, sevoflurane 0.5% to 2.0% and nitrous oxide 50% in oxygen were titrated based on arterial blood pressure, heart rate, and bispectral index value. Vital signs, bispectral index, end-tidal sevoflurane concentration, and sevoflurane consumption per hour were recorded. Visual analog scale pain scores and cumulative analgesic consumption were recorded at 2, 24, and 48 hours postoperatively., Results: The mean serum progesterone concentration was 128.2 ± 83.0 ng/mL. There was a significant negative correlation between sevoflurane consumption per hour and serum progesterone concentration (Pearson correlation r = -0.26; 95% confidence interval, -0.44 to -0.05, P = 0.01). Cumulative analgesic consumption at postoperative hours 2 (r = -0.20, P = 0.05), 24 (r = -0.25, P = 0.02), and 48 (r = -0.28, P = 0.01) were correlated inversely with serum progesterone concentration. Women with high progesterone levels (higher than the median value) had lower sevoflurane consumption per hour (P = 0.02) and 48-hour postoperative cumulative analgesic consumption (P = 0.02) than women with low (below the median value) levels., Conclusions: The decreased anesthetic and analgesic requirements of near full-term parturients might partially depend on serum progesterone concentration.

Background: Although the nasopharynx is a commonly used temperature-monitoring site during general anesthesia, it is unknown whether the position of nasopharyngeal temperature probes placed blindly by anesthesia practitioners is optimal. The purposes of this study were (1) to determine where the nasopharyngeal mucosa is in closest proximity to the internal carotid artery (ICA) and (2) to evaluate the tip position of nasopharyngeal temperature probes that were placed by anesthesiology residents and nurse anesthetists., Methods: In the first phase of the study, we reviewed enhanced axial computed tomography images of 100 patients to determine where the nasopharyngeal mucosa was in closest proximity to the left or the right ICA. The distance from this point to the nares was then measured in the sagittal image. In the second phase of the study, nasendoscopy was used to evaluate the positioning of nasopharyngeal temperature probes placed by anesthesiology residents (244 patients) or nurse anesthetists (116 patients). Malpositioned probes were repositioned to an optimal location, and the temperature differences were recorded., Results: In the computed tomography images, the mucosa in closest proximity to the ICA was in the upper, mid-, and lower nasopharynx in 60%, 38%, and 2% of patients, respectively. The average distances between the ICA and the nasopharyngeal mucosa in the upper portion were significantly shorter than those in the lower portion (female: 9.4 vs 16.8 mm, P < 0.001; male: 12.4 vs 18.8 mm, P < 0.001). The average distances (95% prediction interval) from the nares to the upper portion of the nasopharynx through the inferior meatus were 9.1 (8.1-10.2) cm in females and 9.7 (8.6-10.8) cm in males. Temperature probes were correctly positioned in the upper or mid-nasopharynx by residents and nurses in 43% (95% confidence interval [CI], 37%-49%) and 41% (95% CI, 36%-50%), respectively. When the probe was inadvertently placed in the nasal cavity, the median (95% CI) temperature difference from the upper nasopharynx was 0.2°C (0.15°C-0.25°C)., Conclusions: The closest portion of the nasopharyngeal mucosa to the ICA is within the upper or mid-nasopharynx. The depth from the nares to the upper one-third of the nasopharynx is approximately 10 cm. Less than half of nasopharyngeal temperature probes placed blindly by practitioners were optimally positioned.

N2O, which is emitted mainly from nitrogen decomposition via bacteria, livestock manure, agricultural fertilizer use, fossil fuel combustion and waste incineration, is classified as a substance that causes significant destruction of the ozone layer. The N2O measurement methods for these emission sources may be divided into chromatography, optical, and electrical current measurements. Chromatography has been widely utilized for analyzing N2O. However, up until now, few studies have been conducted on N2O using photoacoustic spectroscopy. Therefore, this study aimed to evaluate performance of photoacoustic spectroscopy in this regard based on laboratory and field test results. The repeatability of photoacoustic spectroscopy was measured at 1.12%, which is lower than the repeatability of 3.0% suggested by the ISO 1564 standard, so, it has shown an excellent repeatability. The detection limit was determined to be 0.025 ppm, and the response time was confirmed to be 3 min and 26 s. The results of comparison between these measurements and GC show that the latter has superior accuracy, but mobility and convenience are superior for PAS. On the contrary, GC has a continuous measurement limitation, but PAS makes it possible to conduct continuous measurements. Therefore, PAS can be extremely useful to confirm the characteristics of N2O emissions and to quantify their amount.

In this research, in order to develop technology/country-specific emission factors of methane (CH(4)) and nitrous oxide (N(2)O), a total of 585 samples from eight gas-fired turbine combined cycle (GTCC) power plants were measured and analyzed. The research found that the emission factor for CH(4) stood at "0.82 kg/TJ", which was an 18 % lower than the emission factor for liquefied natural gas (LNG) GTCC "1 kg/TJ" presented by Intergovernmental Panel on Climate Change (IPCC). The result was 8 % up when compared with the emission factor of Japan which stands at "0.75 kg/TJ". The emission factor for N(2)O was "0.65 kg/TJ", which is significantly lower than "3 kg/TJ" of the emission factor for LNG GTCC presented by IPCC, but over six times higher than the default N(2)O emission factor of LNG. The evaluation of uncertainty was conducted based on the estimated non-CO(2) emission factors, and the ranges of uncertainty for CH(4) and N(2)O were between -12.96 and +13.89 %, and -11.43 and +12.86 %, respectively, which is significantly lower than uncertainties presented by IPCC. These differences proved that non-CO(2) emissions can change depending on combustion technologies; therefore, it is vital to establish country/technology-specific emission factors.

Long-term operation of the biomass-to-liquid (BTL) process was conducted with a focus on the production of bio-syngas that satisfies the purity standards for the Fischer-Tropsch (FT) process. The integrated BTL system consisted of a bubbling fluidized bed (BFB) gasifier (20 kW(th)), gas cleaning unit, syngas compression unit, acid gas removing unit, and an FT reactor. Since the raw syngas from the gasifier contains different types of contaminants, such as particulates, condensable tars, and acid gases, which can cause various mechanical problems or deactivate the FT catalyst, the syngas was purified by passing through cyclones, a gravitational dust collector, a two-stage wet scrubber (packing-type), and a methanol absorption tower. The integrated system was operated for 500 h over several runs, and stable operating conditions for each component were achieved. The cleaned syngas contained no sulfur compounds (under 1 ppmV) and satisfied the requirements for the FT process., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Background: We performed this study to determine the beneficial effects of viewing an animated cartoon and playing with a favorite toy on preoperative anxiety in children aged 3 to 7 years in the operating room before anesthesia induction., Methods: One hundred thirty children aged 3 to 7 years with ASA physical status I or II were enrolled. Subjects were randomly assigned to 1 of 3 groups: group 1 (control), group 2 (toy), and group 3 (animated cartoon). The children in group 2 were asked to bring their favorite toy and were allowed to play with it until anesthesia induction. The children in group 3 watched their selected animated cartoon until anesthesia induction. Children's preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) and parent-recorded anxiety Visual Analog Scale (VAS) the night before surgery, in the preanesthetic holding room, and just before anesthesia induction., Results: In the preanesthetic holding room, the group 2 mYPAS and parent-recorded anxiety VAS scores were significantly lower than those of groups 1 and 3 (mYPAS: P = 0.007; parent-recorded anxiety VAS: P = 0.02). In the operating room, the children in group 3 had the lowest mYPAS and parent-recorded anxiety VAS scores among the 3 groups (mYPAS: P < 0.001; parent-recorded anxiety VAS: P < 0.001). In group 3, the mYPAS and parent-recorded anxiety VAS scores of only 3 and 5 children were increased in the operating room compared with their scores in the preanesthetic holding room, whereas the anxiety scores of 32 and 34 children in group 1 and 25 and 32 children in group 2 had increased (P < 0.001). The number of children whose scores indicated no anxiety (mYPAS score <30) in the operating room was 3 (7%), 9 (23%), and 18 (43%) in groups 1, 2, and 3, respectively (P < 0.001)., Conclusions: Allowing the viewing of animated cartoons by pediatric surgical patients is a very effective method to alleviate preoperative anxiety. Our study suggests that this intervention is an inexpensive, easy to administer, and comprehensive method for anxiety reduction in the pediatric surgical population.

Background: The use of intravenous patient-controlled analgesia (IV-PCA) has been increasing because it has advantages such as improved pain relief, greater patient satisfaction, and fewer postoperative complications. However, current research has not considered the patients' thoughts about IV-PCA's cost-effectiveness. The purpose of this study was to investigate the willingness to pay (WTP) for IV-PCA and the relationship between patients' characteristics and WTP in Korea., Methods: We enrolled 400 adult patients who were scheduled for elective surgery. The patient was requested to indicate a series of predefined amounts of money (Korean won; 30,000/50,000/100,000/150,000/200,000/300,000/500,000). We also recorded patient characteristics, such as age, sex, type of surgery, IV-PCA history, education level, the person responsible for medical expenses, type of insurance, net annual income, and residential area. Three days after surgery, we asked about the degree of satisfaction and the WTP for IV-PCA., Results: For IV-PCA, the median WTP was 100,000 won (25-75%; 50,000-200,000 won: US$1 = W1078.04; July 19, 2011) before surgery. All patients' characteristics were not related to preoperative WTP for IV-PCA, whereas the increase in WTP after surgery showed a tendency correlated to higher IV-PCA satisfaction., Conclusions: The median WTP was 100,000 won. The satisfaction of IV-PCA increased patients' WTP after surgery, but the WTP may be independent of patient characteristics in Korea.

Study Objective: To evaluate the reliability of assessments of nasal flow rate for improved nostril selection for nasotracheal intubation., Design: Prospective, randomized, double-blinded study., Setting: Operating room of a university-affiliated hospital., Patients: 118 ASA physical status 1 and 2 patients, aged 18-65 years, scheduled for elective maxillofacial and oral surgery requiring nasotracheal intubation., Interventions: Patients were randomized to the left or right nostril groups. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV(1)) through the mouth and each nostril were measured before anesthesia induction., Measurements: The relationship between the rate of airflow through the selected nostril and frequency of epistaxis and navigability of the nasotracheal tube were evaluated., Main Results: There were no significant differences in the frequency of epistaxis and degree of navigability of the tracheal tube between the left and right nostril groups. In both nostril groups, patients who suffered epistaxis showed significantly less FEV(1) and FEV(1)/FVC values than did patients without epistaxis (P < 0.05). In addition, in both groups patients who passed the tube easily showed significantly higher FEV(1) and FEV(1)/FVC values than did patients who passed the tube with resistance or failed tube passage (P < 0.05)., Conclusion: Measurement of nasal flow rate is a useful clinical method for choosing a nostril for nasotracheal intubation., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Lymphangiomyomatosis (LAM) is a rare lung disease that is characterized by the progressive proliferation of atypical smooth muscle-like cells, which leads to severe respiratory impairment and death. Dyspnea, cough, recurrent pneumothorax, and hemoptysis are the most common clinical symptoms of LAM. We report a 29-year-old female patient with massive hemoptysis during laparoscopic gynecologic surgery under general anesthesia, who was diagnosed with pulmonary LAM.

Background: A preanesthetic visit can increase a patient's satisfaction. However, it is uncertain whether a preanesthetic visit by an anesthesiology resident can achieve the goal. We studied the time distribution for content of preanesthetic interviews (PI) and evaluated the patient's satisfaction with the PI., Methods: We recorded the PI duration of 200 patients by a voice recorder. The degrees of patient satisfaction with the PI and the changes of anxiety level after the PI were quantified by a questionnaire. We analyzed the time distribution for content of the PI and the correlation between patient characteristics and PI duration or a patient's satisfaction., Results: The total PI duration was 184 (134-286) sec (median, 25-75%), and the time distributions for content of the PI were 8 (5-10) of greeting, 45 (23-70) of history taking, 15 (10-20) of physical examination, 50 (25-98) for obtainingan informed consent, 20 (10-30) of explanation for anesthetic planning, 15 (5-28) for explanation of patient controlled analgesia, and 10 (0-4) sec for questions and answers. Age, ASA physical status, and educational level were correlated with PI duration (P < 0.001). The patient's level of satisfaction was "very satisfied" in 39%, "satisfied" in 50%, and "moderate" in 11% of interviews. The anxiety level was "decreased" in 50%, "increased" in 8%, and "not changed" in 42% of patients., Conclusions: Although the duration of a PI given by residents was a relatively short, 89% of patients of were satisfied with the interview. The PI took a longer time to complete in patients of older age, higher ASA physical status, or lower educational levels.

Tracheal rupture is a rare but serious complication that occurs after endotracheal intubation. It usually presents as a linear lesion in the membranous wall of the trachea, and is more prevalent in women and patients older than 50 years. The clinical manifestations of tracheal injury include subcutaneous emphysema and respiratory distress. We report the cases of three female patients of old age presenting tracheal rupture after endotracheal intubation. Two cases received surgical repair without complication and one recovered uneventfully after conservative management. We presume that the tracheal injuries were caused by over-inflation of cuff and sudden movement of the tube by positional change. Therefore, we recommend cuff pressure monitoring during general anesthesia and minimized movement of the head and neck at positional change.

Recently, simulations based on the Monte Carlo code have been increasingly applied for physics phenomena, patient dose and quality assurance of radiation systems. The objective of this study was to use Monte Carlo simulation and measurement to verify dose and dose reduction in cephalography. The collimator was constructed with 3-mm thick lead plate, and attached to the tube head to remove regions of disinterest in the radiation field. A digital phantom patient was constructed to evaluate patient dose. In addition, detectors of pixel size 1×1 cm² and 0.1×0.1 cm² were constructed to check collimator location. The effective dose according to International Commission on Radiological Protection 103 was calculated with and without collimation. The effective doses for simulation with and without collimation were 5.09 and 11.32 µSv, respectively. The results of the calculated effective dose show 61.7 % reduction of field area and 55 % of effective dose. The Monte Carlo simulation is a good evaluation tool for patient dose.

In order to tackle climate change effectively, the greenhouse gas emissions produced in Korea should be assessed precisely. To do so, the nation needs to accumulate country-specific data reflecting the specific circumstances surrounding Korea's emissions. This paper analyzed element contents of domestic anthracite, calorific value, and concentration of methane (CH₄) and nitrous oxide (N₂O) in the exhaust gases from circulating fluidized bed plant. The findings showed the concentration of CH₄ and N₂O in the flue gas to be 1.85 and 3.25 ppm, respectively, and emission factors were 0.486 and 2.198 kg/TJ, respectively. The CH₄ emission factor in this paper was 52% lower than default emission factor presented by the IPCC. The N₂O emission factor was estimated to be 46% higher than default emission factor presented by the IPCC. This discrepancy can be attributable to the different methods and conditions of combustion because the default emission factors suggested by IPCC take only fuel characteristics into consideration without combustion technologies. Therefore, Korea needs to facilitate research on a legion of fuel and energy consumption facilities to develop country-specific emission factors so that the nation can have a competitive edge in the international climate change convention in the years to come.

Introduction: Korea has been making efforts to reduce greenhouse gas (GHG) emissions, including a voluntary commitment to the target of a 30% reduction, based on business-as-usual of the total GHG emission volume, by 2020; 2006 IPCC Guidelines provided default values, applying country-specific emission factors was recommended when estimating national greenhouse gas emissions., Results and Discussion: This study focused on anthracite produced in Korea in order to provide basic data for developing country-specific emission factor. This study has estimated CO(2) emission factors to use worksheet of which five steps consisted according to the fuel analysis method., Conclusion: As a result, the average of net colorific value for 3 years (2007∼2009) was 4,519 kcal/kg, and the CO(2) emission factor was calculated to be 111,446 kg/TJ, which is about 11.8% lower than the 2006 IPCC guidelines default value, and about 7.9% higher than the US EPA emission factor.

Polystyrene (PS) microspheres were synthesized via dispersion polymerization in alcoholic media. A cationic polyelectrolyte, polyethyleneimine (PEI) was successfully used as a steric stabilizer. The concentration of initiator, monomer, and the solubility parameter of medium showed typical phenomena observed in dispersion polymerization. However, the sensitivity to the change in the particles size was almost twofold greater than conventional stabilizers. Spherical PS particles were synthesized with the PEI concentrations ranging from 5 to 20 wt.% to styrene, but conversion over 95% was achieved over 10 wt.% PEI. As-prepared PEI-stabilized PS microspheres were used as the template for the subsequent formation of a silica shell. As a result, a robust silica layer was fabricated on PS microspheres due to the increased interaction between PEI and tetraethyl orthosilicate (TEOS)., (2010 Elsevier Inc. All rights reserved.)

Silica nanotubes were synthesized using the multi-walled carbon nanotubes (MWCNTs) as the template material. First, we prepared silica coated MWCNT composites by surface oxidation of MWCNTs using KMnO(4) in the presence of a phase transfer catalyst and followed by grafting of 2-aminoethyl 3-aminopropyl trimethoxy silane, AEAPS. The amine groups in grafted AEAPS on MWCNTs could activate the silica shell formation by acid-base interaction. The synthesized silica was formed a uniform layer on MWCNTs with a controllable thickness and possessed sturdy 3-dimensional stability. After calcinations at 800 degrees C, the inner MWCNTs of the composite were completely decomposed and the outer silica shell layer maintained without distortion of its original shape. Finally, we could obtain the silica nanotubes having 13.0 nm of average layer thickness.

Core-polystyrene/shell-silica nanocomposite particles are synthesized by simple soap-free emulsion polymerization employing positively charged silica sol. The polymerization is initiated with conventional anionic KPS. It is found that the silica sol should be added after the initiation and nucleation of the soap-free emulsion polymerization in order to obtain colloidally stable composite particles. The excess amount of silica promotes the formation of secondary particles, giving a broader particle size distribution. Above 10 wt% silica relative to styrene, the dispersion stability of the composite particles in water is significantly improved, showing a reduced sedimentation rate. The silica particles of average diameter 25 nm form almost a monolayer shell of approximately 30 nm thickness on the polystyrene particles. The incorporation of silica particles also gives rise to the enhancement of thermal stability when the silica concentration exceeds 10 wt% due to the strong interaction between silica and polystyrene molecules.

The highly monodisperse polystyrene (PS) microspheres were produced by dispersion polymerization using an amphoteric initiator, 2,2'-azobis [N-(2-carboxyethyl)-2-2-methylpropionamidine] (VA-057). The polymerization characteristics were investigated and compared with conventional initiators, 2,2-azobis(isobutyronitrile) (AIBN) and benzoyl peroxide (BPO). The monodisperse PS microspheres having the coefficient of variation (C(v)) of diameter all less than 4% are obtained at very low stabilizer, poly(vinyl pyrrolidone) (PVP) concentrations of 1 and 2 wt%. It is found that the size dependence of the VA-057 system, D(n) proportional, variant [VA-057](0.267), is less sensitive than a conventional initiator system. When the same amount, 2 wt%, of AIBN, BPO, and VA-057 is used under the identical PVP concentration of 2 wt%, the D(n)/C(v)'s are 1.95/11.57, 1.47/22.44, and 2.08 microm/2.50%, respectively. The uniformity of particles was characterized employing an optical analyzer, Turbiscan. For the VA-057 system, the back scattering intensity is linearly reduced with time having a constant sedimentation rate of 48.98 microm/min throughout the settling process. The uniformity of PS particles in the VA-057 system stems from (1) the higher rate of polymerization in early stage of polymerization, followed by significantly faster reduction of the rate, and (2) good dispersion stability of primary particles. Therefore, it is found that the use of an amphoteric initiator, VA-057, is promising for producing monodisperse particles in dispersion polymerization.