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Printing woodblocks with inscription of “Hunmongjahoe”, in the collection of the Pusan National University Museum, is engraved the “Hunmongjahoe” written by Se-jin Choi who is a translator at the reign of King Joongjong of the Joseon Dynasty on the woodblocks, and it is consists of totally 52 pieces of ‘In’, ‘Sang’, ‘Jung’ and ‘Ha’. A conservation treatment was performed because a number of damage to the woody part due to insect damage was confirmed on above woodblocks. A number of traces presumed as the insect holes generated by harmful insects were observed on the surface and inside of the woodblocks as a result of X-ray inspection to determine the approximate size of damage by insects prior to the conservation treatment. In addition, all 52 pieces were identified as Acer spp. as a result of species identification to confirm the tree species used in the woodblocks production. 3D Scan was conducted for digital recording and precise measurement of Printing woodblocks with inscription of “Hunmongjahoe” after the pre-treatment survey and analysis, and it was possible to produce various size-specific end pieces as a result of it. The conservation treatment of woodblocks were performed in the order of cleaning, consolidation treatment, edge of a woodblocks manufacturing and assembly, and it was possible to stably preserve and treat woody part which were degraded and peeled off due to the insects as a result of applying above conservation treatment method.

To evaluate the diagnostic performance of the Welch Allyn Spot Vision photoscreener in preschool children for detecting exotropia, the most prevalent type of strabismus among Asian children.Children aged 3-6 years were screened using the Spot Vision photoscreener and then underwent a complete ophthalmologic examination on the same day. A child with exodeviation ≥8 Δ in the primary position using the cover-uncover test and the alternate prism cover test was confirmed to have exotropia. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the photoscreener in detecting exotropia were calculated. Subgroup analyses were performed according to the angle of deviation (≥25 Δ vs.25 Δ) and fusional control (good/fair vs. poor).Two hundred and ten children were included in this study. Among 80 exotropia-confirmed children, 23 needed referrals for exodeviation (screening-positive) and 57 were proven to be screening-negatives with the photoscreener. The overall sensitivity, specificity, PPV and NPV of the photoscreener for detecting exotropia were 28.8%, 95.4%, 79.3% and 68.5%, respectively. The positive and negative likelihood ratios were 6.26 and 0.75, respectively. Compared with the 57 children with false-negatives (71.3%), those with true-positive results with the photoscreener had significantly larger angles of exodeviation (p = 0.02) and a higher proportion of poor fusional control (p = 0.004). The photoscreener had low sensitivity even in detecting exotropia ≥25 Δ or those with poor fusional control (35.2% and 43.6%, respectively). Approximately 65% (42 out of 64) of the children with a significant exodeviation which needed strabismus surgery were not identified by the Spot Vision Photoscreener.The Spot Vision photoscreener has low sensitivity for detecting exodeviation. It should not be used alone for assessing exotropia in preschool-aged children.

To evaluate the applicant experience with preference signaling during the 2022 Urology Residency Match.An anonymous electronic survey was emailed to all urology residency applicants who applied to Rutgers Robert Wood Johnson Medical School during the 2021-2022 application cycle. The survey collected information regarding applicant demographics, applicant characteristics, preference signal destinations, match outcomes, and attitude towards preference signaling.A total of 601 applicants applied to the 2022 Urology Residency Match, 283 of which applied to the urology residency program at Rutgers Robert Wood Johnson Medical School. Of the 283 applicants, 53 (19%) responded to our survey. Rate of interview for preference signaled programs was 54.23%, with a significantly lower rate of interview for comparative, non-signaled programs (40.54%; P = .001). Of respondents, 14.29%, 26.19%, and 35.71% matched to their home program, a program they signaled, or a program where they completed an away rotation, respectively. 96% of applicants favored continuation of the preference signaling program.Our study suggests preference signaling in the 2022 Urology Match may have been an effective method of expressing interest in a program. Respondents of our survey overwhelmingly favor continuation of the program in future urology matches. However, it may not address the underlying, growing problem of the increasing application burden on applicants and programs alike. We encourage more comprehensive studies to further clarify the effects of preference signaling on the Urology Match.

PURPOSE: To assess changes in retinopathy of prematurity (ROP) diagnosis in single and serial retinal images. DESIGN: Cohort study. PARTICIPANTS: Cases of ROP recruited from the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) consortium evaluated by 7 graders. METHODS: Seven ophthalmologists reviewed both single and 3 consecutive serial retinal images from 15 cases with ROP, and severity was assigned as plus, preplus, or none. Imaging data were acquired during routine ROP screening from 2011 to 2015, and a reference standard diagnosis was established for each image. A secondary analysis was performed using the i-ROP deep learning system to assign a vascular severity score (VSS) to each image, ranging from 1 to 9, with 9 being the most severe disease. This score has been previously demonstrated to correlate with the International Classification of ROP. Mean plus disease severity was calculated by averaging 14 labels per image in serial and single images to decrease noise. MAIN OUTCOME MEASURES: Grading severity of ROP as defined by plus, preplus, or no ROP. RESULTS: Assessment of serial retinal images changed the grading severity for > 50% of the graders, although there was wide variability. Cohen’s kappa ranged from 0.29 to 1.0, which showed a wide range of agreement from slight to perfect by each grader. Changes in the grading of serial retinal images were noted more commonly in cases of preplus disease. The mean severity in cases with a diagnosis of plus disease and no disease did not change between single and serial images. The ROP VSS demonstrated good correlation with the range of expert classifications of plus disease and overall agreement with the mode class (P = 0.001). The VSS correlated with mean plus disease severity by expert diagnosis (correlation coefficient, 0.89). The more aggressive graders tended to be influenced by serial images to increase the severity of their grading. The VSS also demonstrated agreement with disease progression across serial images, which progressed to preplus and plus disease. CONCLUSIONS: Clinicians demonstrated variability in ROP diagnosis when presented with both single and serial images. The use of deep learning as a quantitative assessment of plus disease has the potential to standardize ROP diagnosis and treatment.

Although various coronavirus disease 2019 (COVID-19) vaccines have been delivered to the public worldwide, data on cancer populations are limited. Vaccine hesitancy related to safety concerns is observed among cancer patients. We report the perception of COVID-19 vaccines and their safety profile after vaccination among cancer patients.Between April and November 2021, a multicenter survey was conducted on 318 patients treated in any hemato-oncology outpatient clinic among three hospitals under the Korea University Medical Center. The medical records of the patients were reviewed to obtain detailed clinical and hematological toxicity data.A perception survey was conducted among 293 patients. Among them, 53.9% were concerned about developing vaccine-related adverse events (VRAEs) and 23.5%, about negative effects on cancer treatment. During the study period, 255 and 186 patients participated in a safety survey after the first and second doses, respectively. After the first dose, 62% of patients reported VRAEs (2.4%, grade 3), whereas 48.9% reported VRAEs (2.7%, grade 3) after the second dose. For both doses, injection-site pain and sore arm pain were the most common VRAEs, followed by myalgia, fatigue, and headache. No grade 4/5 VRAEs were observed, and there were no differences in complete blood count after vaccination. Multivariate analysis revealed female sex, active cancer treatment, and mRNA vaccines as independent risk factors for VRAE development in cancer patients.Despite high levels of concern, COVID-19 vaccines were well tolerated by cancer patients, with a safety profile consistent with that of the general population.

We investigated the efficacy and safety of a trastuzumab biosimilar, Herzuma®, in combination with treatment of physician's choice (TPC) in patients with HER2+ metastatic breast cancer (MBC) who had failed at least two HER2 directed chemotherapies.

Since the Covid-19 pandemic in 2019, the use of plastics has increased exponentially, so it is imperative to manage and dispose of these plastic wastes safely.This review focuses on the management strategies governed by the policies of each country to reduce plastic waste through physical collection methods and methods that use eco-imitation technologies.Thus far, physical treatment methods have been applied to sewage and drinking water treatment. The abilities of bio-inspired treatment methods are being assessed in terms of capturing microplastics (MPs) and nanoplastics (NPs), extracting substances from marine organisms, reducing toxicity, and developing alternatives to petroleum-based plastics.Various post-treatment methods have been proposed to collect and remove MPs and NPs that have reached into aquatic ecosystems and subsequently reduce their toxicity. However, there are limitations that the effectiveness of these methods is hindered by the lack of policies governing the entire process of plastic use before the post-treatment.We purpose to reduce plastic waste through methods that use eco-imitation technologies.These eco-imitation methods are attracting attention as viable future plastic waste treatment options in line with the goals of sustainable development.

Purpose: To report a child with idiopathic intracranial hypertension secondary to recombinant human growth hormone treatment.Case summary: An 11-year-old girl presented with blurred vision in both eyes starting 6 weeks earlier. She did not have any underlying disease and her body mass index was normal. She had started recombinant human growth hormone injections for idiopathic short stature 3 months earlier. The best corrected visual acuity was 20/25 in both eyes. Fundoscopy revealed bilateral disc edema with peripapillary hemorrhage and increased tortuosity of the retinal vessels. Bilateral enlargement of the blind spot was found on automated visual field examination. Magnetic resonance imaging and venography of the brain showed no evidence of structural or vascular lesions related to increased intracranial pressure. A lumbar puncture showed an elevated opening pressure of 26 cmH2O with normal cerebrospinal fluid constituents. She was diagnosed with growth hormone-related idiopathic intracranial hypertension and it was recommended that the growth hormone injection be discontinued and oral acetazolamide started. After 4 weeks of treatment, the optic disc edema and visual field defect improved. At the 2-year follow-up, she had a normal visual field with a normal optic nerve in both eyes.Conclusions: Ophthalmologists should be aware of the clinical features and treatment of idiopathic intracranial hypertension secondary to recombinant human growth hormone treatment, which is a very rare, vision-threatening complication. Complete neuro-ophthalmological examinations should be performed immediately in children complaining of visual disturbances or headache during treatment with recombinant human growth hormone.

Purpose: To evaluate the diagnostic performance of spot vision screener in detecting refractive errors as amblyogenic risk factor in preschool Korean children.Methods: This prospective study included 51 children aged between 3 to 6 who underwent complete ophthalmologic evaluation including measurement of refraction using SpotTM Vision Screener (VS100S-2, Welch Allyn Inc., Skaneateles Falls, NY; version 3.0.02.32) and an autorefractometer before and after cycloplegia. The sensitivity and specificity of Spot photoscreening for the detection of amblyogenic risk factors were calculated. We compared the outcome measures of refractive error using spot vision screener and the autorefractometer of non-cycloplegics and cycloplegics.Results: For detection of amblyogenic risk factor by refractive errors, spot vision screener had 90.5% sensitivity, 44.4% specificity, 88.4% positive predictive value and 50.0% negative predictive value. There was a significant difference between non-cycloplegic photoscreening and cycloplegic autorefraction (mean +0.86 diopter [D], p < 0.001), which was more prominent in hyperopic eyes (+2.71 ± 1.17 vs. +5.00 ± 1.39 D, p < 0.001) compared with myopic eyes (-2.51 ± 1.41 D vs. -2.58 ± 1.32 D, p = 0.599).Conclusions: Spot vision screener can help to detect vision issues quickly and easily in young children. Spot vision screener achieved acceptable sensitivity and positive predictive value in Korean preschool aged children, supporting the use of automated vision screening.

Endoscopic ultrasound (EUS)-guided hepaticogastrostomy (HGS) may be a feasible and useful alternative in patients with malignant biliary obstruction (MBO) after failed endoscopic retrograde cholangiopancreatography (ERCP). To date, the risk factors for adverse events (AEs) and long-term outcomes of EUS-HGS have not been fully explored according to stent type. Therefore, we evaluated potential risk factors for AEs and long-term outcomes of EUS-HGS.In total, 120 patients who underwent EUS-HGS were retrospectively reviewed. A multivariate analysis through Cox proportional hazard and logistic regression model was used to identify the risk factors for stent dysfunction and AEs, respectively. Stent patency and patient survival were evaluated using Kaplan-Meier plots with a log-rank test for each stent.The technical and clinical success rates were 96.2% (102/106) and 83.0% (88/106). The median duration of stent patency was longer in self-expandable metal stents (SEMS) compared to plastic stents (PS) (158 vs. 108 days). Kaplan-Meier analysis indicated that the type of stent was not associated with stent patency (Hazard ratios [HR] 0.997, 95% confidence interval [CI] [0.525-1.896]) or overall survival. In addition, multivariate analysis indicated that hilar MBO significantly associated with stent dysfunction (HR, 2.340; 95% CI, 1.028-5.326, p = 0.043) and late AEs.Given the lower incidence of AEs and better long-term outcomes of EUS-HGS, it can be considered a safe alternative to ERCP or percutaneous approaches regardless of which stent is used. Furthermore, hilar MBO was established as a potential risk factor for stent dysfunction and late AEs.

test piece was produced using deteriorated pine tree for the conservation treatment of woodblocks cultural heritage, and weight change, color change and penetration diffusion characteristics of the test piece according to the application of Dammar, Wax, Paraloid B-72, Animal glue and H.P.C treatment agent. As a result, it was confirmed that Dammar is the most suitable treatment agent for the strengthening of the material while maintaining the original color of the wood. A test piece was produced using deteriorated porous natural wood, which the damage condition is similar to that of woodblocks cultural heritage and the main tree of woodblocks cultural heritage based on above result, and the application of each Dammar concentration (2%, 5%) and wetting of each Dammar concentration (10%, 15%) were conducted in order to find out the application concentration and treatment method of Dammar, and weight change, penetration diffusion characteristics, etc. were observed. As a result, it was found that the Dammar 2% application was the best as an effective method for the strengthening of the material while maintaining the original color of the wood. Therefore, it is judged that Dammar 2% application is most suitable for the strengthening treatment of woodblocks cultural heritage with severe insect damage and degradation.

Background: Palbociclib plus endocrine therapy (ET) demonstrated significant progression-free survival (PFS) benefit in Young Pearl, a randomized phase ll trial comparing palbociclib + ET versus capecitabine in premenopausal women with hormone receptor positive, HER2 negative metastatic breast cancer (MBC). This exploratory analysis investigated potential biomarkers of palbociclib plus ET on PFS. Patients and methods: Of 178 patients randomized (92 palbociclib plus ET; 86 capecitabine), we performed targeted sequencing (141 patients) and whole transcriptome sequencing (165 patients) using baseline tumor samples to examine genomic alteration in relation to drug response on PFS. Hazard ratios (HRs) were estimated using unstratified Cox proportional hazards models. Results: PIK3CA (41%) and TP53 (33%) mutations and CCND1 copy number variation (29%) were found most frequently in targeted sequencing of 141 patients. ESR1 mutations were found only in 3.5% of patients of this population. Luminal type showed better prognosis in palbociclib + ET arm but no impact on PFS difference in capecitabine arm. High TMB, TP53 mutation, PTEN loss of function mutation and RB1 pathway alteration showed worse prognosis in palbociclib plus ET arm. Patients with BRCA2 pathogenic mutations showed worse prognosis regardless of PAM50 subtypes. AURKA mutation/amplification, BRIP1/MYC/RAD51C amplification were significantly associated to the patients with short PFS

Structural lesion evaluation in axial spondyloarthropathy (SpA) can improve accuracy of diagnosis. However, structural lesions (bone erosions) are difficult to be assessed using conventional MRI compared to computed tomography (CT).To evaluate the diagnostic performance of ultrashort echo time (UTE) for detecting bone erosion in axial SpA compared to T1WI and three-dimensional double-echo steady-state (3D DESS) imaging using CT as the reference standard.Retrospective.Fourteen patients (eight females, 57.1%) and 14 healthy controls (seven females, 50.0%) who underwent sacroiliac (SI) joint MRI and CT.3 T; TSE T1WI, 3D DESS, 2D UTE.The bilateral SI joints were assessed for bone erosion. Three observers scored bone erosion for all three sequences of MRI. CT was used as the gold standard. Diagnostic confidence in axial SpA was measured based on a four-point confidence score.Correlation of erosion scores between CT and MRI were evaluated using Spearman's correlation test. Sensitivity, specificity, and positive-negative predictive values were calculated. Confidence scores were compared using the Wilcoxon sum rank test. Statistical significance was set at P 0.05.Compared with erosion scores of CT, the correlation coefficients for each MRI sequence showed significant low-to-high positive correlations (0.39-0.72). UTE imaging showed the highest correlation coefficients for all observers (0.70, 0.72, and 0.67, respectively). The specificity of UTE imaging was equal or higher than those of T1WI and 3D DESS for all observers (0.86 vs. 0.71 vs. 0.57; 0.93 vs. 0.71 vs. 0.57; 0.79 vs. 0.79 vs. 0.43). All observers had the highest confidence in interpreting UTE imaging for detecting bone erosion among the three sequences (3.5, 3.4, and 3.3 for UTE; 3.1, 3.0, and 2.6 for T1WI; and 3.2, 2.7, and 2.4 for DESS).UTE imaging can detect bone erosions in patients with axial SpA and show higher specificity than conventional T1WI and 3D DESS.4 TECHNICAL EFFICACY: Stage 2.

Purpose: T-DM1, an antibody-drug conjugate, has significant antitumor activity in patients with HER2-positive metastatic breast cancer (mBC) patients who had progressed after trastuzumab-based chemotherapy. This study was conducted to investigate the clinical practice and factors related with outcomes of T-DM1 use for HER2-positive mBC patients in the nation-wide real-world setting. Method: This complete enumeration study included the patients with HER2-positive mBC who received T-DM1 as palliative therapy from August 2017 to December 2018 under the registry of Health Insurance Review & Assessment Service in Korea. Safety and outcomes of T-DM1 including overall response rate (ORR), progression-free survival (PFS), and overall survival were evaluated. Factors significant in univariate analysis were analyzed in multivariate model. Result: From the sixty institutions, a total of 824 patients were enrolled. Mean age was 58 years-old, 818 patients (99.3%) were female and 516 patients (62.6%) had relapsed after curative treatment. About 40% patients received T-DM1 as first or second line treatment, 21.5% received it as third line and 37.3% as fourth or over line. During a median follow-up of 16.8 months, the ORR was 32.8%, median PFS was 7.2 months and median OS was not reached. In multivariate analysis, clinical factors associated with the lower PFS were age (< 65 year-old, hazard ratio[HR] 1.53, 95% confidence interval[CI]: 1.214-1.919, p < 0.001), poor ECOG performance status (PS ≥ 2, HR 1.98, 95% CI: 1.493-2.626, p < 0.001), previous pertuzumab use (HR 1.40, 95% CI: 1.118-1.742, p = 0.003) and previous lapatinib use (HR 1.29, 95% CI: 1.047-1.586, p =0.017). The common grade 3-4 adverse events were thrombocytopenia (13.0%), neutropenia (2.9%), and elevation of liver enzyme (2.5%). Hypokalemia (≤ 3.0 mmol/L) and any-grade bleeding event such as epistaxis and gum-bleeding occurred in 25 (3.1%) and 94 patients (11.4%), respectively. Conclusion: This is the first, nationwide, real-world data about T-DM1 use of the HER2-positive metastatic breast cancer patients in Korea. The efficacy and toxicity profile of T-DM1 in the real-world practice were comparable with those of randomized trials. Patients’ factors and previous anti-HER2 therapy could predict the outcomes of T-DM1. Further studies to reveal the subtypes of good responders to T-DM1 and the sequence of anti-HER2 therapy are warranted. Citation Format: Sun Kyung Baek, Jae-Ho Jeong, Yeon-Hee Park, Hee Kyung Ahn, Min Hwan Kim, In Hae Park, Young Ju Suh, Dae-Won Lee, Sung Hoon Sim, Jee Hyun Kim, Hyun-Jeong Shim, Yeesoo Chae, Su-Jin Koh, Hyorak Lee, Jieun Lee, Jae-Ho Byun, Youngmi Seol, Eun Mi Lee, Jin Seok Ahn, Kyung-Hae Jung, Seock-Ah Im, Keun Seok Lee, Joohyuk Sohn, Kyoung Eun Lee. A nationwide real-world study for evaluation of efficacy and safety of T-DM1 in patients with HER2-positive locally-advanced unresectable or metastatic breast cancer in Korea (KCSG BR19-15) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-32.

Endoscopic retrograde cholangiopancreatography (ERCP) is challenging in patients undergoing Roux-en-Y (REY) reconstruction; although balloon-assisted enteroscopy is the first-line treatment, it is not always available considering equipment and expertise. We aimed to evaluate the feasibility of using a cap-assisted colonoscope as the primary approach for ERCP in REY reconstruction. We included 47 patients with REY who underwent ERCP using a cap-assisted colonoscope between January 2017 and February 2022. The primary outcome was intubation success for ERCP using a cap-assisted colonoscope during REY reconstruction. The secondary outcomes were cannulation success, procedure-related adverse events, and variables affecting successful intubation. Comparing side-to-side jejunojejunostomy (SS-JJ) and side-to-end jejunojejunostomy (SE-JJ) groups, the intubation success rate using a cap-assisted colonoscope in the SS-JJ group was higher than that in the SE-JJ group (34 of 38 (89.5%) vs. 1 of 9 (11.1%), p < 0.001). Successful intubation was achieved in 37 (97.4%) and 8 (88.9%) patients in the SS-JJ and SE-JJ groups, respectively, after applying the rescue technique using a balloon-assisted enteroscope for failed ERCP using only a colonoscope. No perforation occurred. Multivariable analysis showed that SS-JJ was a predictive factor for successful intubation (odds ratio [95% confidence interval] = 37.06 [3.91–925.56], p = 0.005). Usage of a cap-assisted colonoscope can be crucial for ERCP in patients undergoing REY reconstruction. Anatomically, SS-JJ can facilitate easy and accurate identification of the afferent limb and a highly successful ERCP using a cap-assisted colonoscope.

Natural products with significant antioxidant activity have been receiving attention as one of the treatment strategies to prevent age-related macular degeneration (AMD). Reactive oxygen intermediates (ROI) including oxo-N-retinylidene-N-retinylethanolamine (oxo-A2E) and singlet oxygen-induced damage, are believed to be one of the major causes of the development of AMD. To investigate the therapeutic effects of methanol extracts of Dipterocarpus tuberculatus Roxb. (MED) against blue light (BL)-caused macular degeneration, alterations in the antioxidant activity, apoptosis pathway, neovascularization, inflammatory response, and retinal degeneration were analyzed in A2E-laden ARPE19 cells and Balb/c mice after exposure of BL. Seven bioactive components, including 2α-hydroxyursolic acid, ε-viniferin, asiatic acid, bergenin, ellagic acid, gallic acid and oleanolic acid, were detected in MED. MED exhibited high DPPH and ABTS free radical scavenging activity. BL-induced increases in intracellular reactive oxygen species (ROS) production and nitric oxide (NO) concentration were suppressed by MED treatment. A significant recovery of antioxidant capacity by an increase in superoxide dismutase enzyme (SOD) activity, SOD expression levels, and nuclear factor erythroid 2–related factor 2 (NRF2) expression were detected as results of MED treatment effects. The activation of the apoptosis pathway, the expression of neovascular proteins, cyclooxygenase-2 (COX-2)-induced inducible nitric oxide synthase (iNOS) mediated pathway, inflammasome activation, and expression of inflammatory cytokines was remarkably inhibited in the MED treated group compared to the Vehicle-treated group in the AMD cell model. Furthermore, MED displayed protective effects in BL-induced retinal degeneration through improvement in the thickness of the whole retina, outer nuclear layer (ONL), inner nuclear layer (INL), and photoreceptor layer (PL) in Balb/c mice. Taken together, these results indicate that MED exhibits protective effects in BL-induced retinal degeneration and has the potential in the future to be developed as a treatment option for dry AMD with atrophy of retinal pigment epithelial (RPE) cells.

BackgroundFertility is an important issue for young women with breast cancer, but studies about physicians’ knowledge, attitudes, and practices toward fertility preservation (FP) are largely based on Western populations and do not reflect recent international guidelines for FP. In this international study, we aimed to assess the knowledge, attitudes, and practices of physicians from South Korea, other Asian countries, and Latin America toward FP in young women with breast cancer, and identify the related barriers.MethodsThe survey was conducted anonymously among physicians from South Korea, other Asian countries, and Latin America involved in breast cancer care between November 2020 and July 2021. Topics included knowledge, attitudes, and perceptions toward FP; practice behaviors; barriers; and participant demographics. We grouped related questions around two main themes—discussion with patients about FP, and consultation and referral to a reproductive endocrinologist. We analyzed the relationships between main questions and other survey items.ResultsA total of 151 physicians completed the survey. Most participants’ overall knowledge about FP was good. More than half of the participants answered that they discussed FP with their patients in most cases, but that personnel to facilitate discussions about FP and the provision of educational materials were limited. A major barrier was time constraints in the clinic (52.6%). Discussion, consultations, and referrals were more likely to be performed by surgeons who primarily treated patients with operable breast cancer (FP discussion odds ratio [OR]: 2.90; 95% confidence interval [CI]: 1.24–6.79; FP consultation and referral OR: 2.98; 95% CI: 1.14–7.74). Participants’ knowledge and attitudes about FP were significantly associated with discussion, consultations, and referrals.ConclusionPhysicians from South Korea, other Asian countries, and Latin America are knowledgeable about FP and most perform practice behaviors toward FP well. Physicians’ knowledge and favorable attitudes are significantly related to discussion with patients, as well as consultation with and referral to reproductive endocrinologists. However, there are also barriers, such as limitations to human resources and materials, suggesting a need for a systematic approach to improve FP for young women with breast cancer.

Background Disruptions of the intestinal epithelial barrier (IEB) are frequently observed in various digestive diseases, including irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). This study assessed the improvement in the IEB during the laxative activity of phlorotannin (Pt) harvested from Ecklonia cava in constipation by examining the changes in the expression of the regulatory proteins for the tight junction (TJ) and adherens junction (AJ), and inflammatory cytokines in Sprague Dawley (SD) rats with loperamide (Lm)-induced constipation after a Pt treatment. Results The Pt treatment induced laxative activity, including the improvement of feces-related parameters, gastrointestinal transit rate, and histological structure of the mid colon in Lm-treated SD rats. In addition, significant recovery effects were detected in the histology of IEB, including the mucus layer, epithelial cells, and lamina propria in the mid colon of Lm + Pt treated SD rats. The expression levels of E-cadherin and p120-catenin for AJ and the ZO-1, occludin, and Claudin-1 genes for TJ in epithelial cells were improved remarkably after the Pt treatment, but the rate of increase was different. Furthermore, the Pt treatment increased the expression level of several inflammatory cytokines, such as TNF-α, IL-6, IL-1β, IL-13, and IL-4 in Lm + Pt treated SD rats. Conclusions These results provide the first evidence that the laxative activity of Pt in SD rats with Lm-induced constipation phenotypes involve improvements in the IEB.

Objectives: To accurately differentiate clumpy artifacts from tophi with foot and ankle DECT. Methods and materials: In session 1, 108 clumpy artifacts from 35 patients and 130 tophi images from 25 patients were analyzed. Reviewers classified green pixelation according to anatomic location, shape (linear, stippled, angular, oval), and height and width ratio. In session 2, green pixelation confined to the tendon was evaluated (shape, height and width ratio, occupied area in the tendon, accompanied peritendinous green pixelation). Results: In session 1, while tophi were noted at various locations, almost all clumpy artifacts were located at the tendon (99%, p < 0.0001). Most clumpy artifacts were linear, stippled, and wide, while most tophi were angular and oval (p < 0.05). In session 2, the shape of green pixelation from clumpy artifacts and tophi was significantly different (p < 0.0001) and most clumpy artifacts occupied less than 50% of the tendon (p = 0.02), and most tophi were accompanied by peritendinous green pixelation (p < 0.0001). Univariant logistic regression showed that tophi were significantly correlated with peritendinous deposits, angular and oval shape, and more than 50% of the tendon (p < 0.05). Conclusion: Clumpy artifacts can be differentiated from tophi in DECT. Clumpy artifacts typically are located in the tendon with a linear or stippled shape, wide, and less than 50% of a tendon’s cross-section. Tophi, on the other hand, typically are oval, larger than 50% of the tendon’s cross-section, and associated with adjacent peritendinous green pixelation. Advances in knowledge: Clumpy artifacts can be differentiated from tophi in image findings by their location and shape.

In the present study, safe management and value improvement of bamboo sunblind, which is an item of cultural heritage, were performed by adopting stable conservation treatment methods. The bamboo sunblind used in the present study was excavated from No. 1 catchment site in Baesanseongji, Busan. It was determined that the main material used to make the sunblind was bamboo, and herbal plants were used to weave the bamboo using lacquer as an adhesive agent. All contaminants and soil adhered to the sunblind was removed. Thereafter, the sunblind, which was recovered in the form of blocks, was washed separately after fixing it to a temporary plaster frame and to avoid the blocks from breaking during washing. Then, polyethylene glycol (PEG) impregnation was utilized for the reinforcement treatment. Based on the preliminary test results, the shape of the sunblind was fixed using a stainless-steel frame to prevent physical damage that may occur during the drying process. Thereafter, the bamboo sunblind was vacuum freeze-dried. PEG 20% (in ethyl alcohol) was applied as a surface treatment agent for stabilization the sunblind. After the surface treatment, the bamboo sunblind were joined together to fit the maximum width, and the rectangular shape of the sunblind was restored—as best as possible—while filling in the missing parts by maximizing the use of unknown members such as in the disturbed layers below bamboo sunblind surface. The conservation treatment was completed by fixing the bamboo sunblind into the fabricated frame.

From the collection of the National Kimhae Museum, qualitative analyses using microscopic observation, SEM-EDS, Raman spectroscopy, FT-IR-ATR spectroscopy, and GC-MS were conducted on three burnished red potteries—Jeoksaekmaoyeonwa burnished red pottery (Neolithic age red pottery), Dandomaoyeonwan burnished red pottery(Bronze age red pottery) and Jeoksaekmaoyeongajimun burnished red pottery(Bronze age red pottery)—to investigate the components of the red pigments and the binder. After the layers of the primer were separated from the red surface, crystals of red pigment particles and minerals were found on the red surface. Through SEM-EDS, Raman estimates that the red pigment is Among soil pigments with iron oxide(Fe2O3) as the main color development source, Red Ocher(Fe2O3). A band characteristic of the Urushiol polymer was detected in the FTIR-ATRspectra(4000∼600cm-1), GC-MS analysis confirmed the presence of the benzenemethanol-2-prophenyl, 4-heptylphenol, 1-tetracecanol, heptafluorobutyric texidecane, all of which are the ingredients of the directional structure of the lacquer present in the red layer. Therefore, it seemed that the three burnished red pottery: Jeoksaekmaoyeonwan pottery(Neolithic age burnished red pottery), Dandomaoyeonwan pottery(bronze age burnished red pottery) and the Jeoksaekmaoyeongajimun pottery(bronze age burnished red pottery) made by mixing minerals and Red Ocher(Fe2O3), with lacquer.

The mechanism of the crack propagation in three dimensional (3D) glass-fiber warp interlock epoxy composites under fatigue loading was investigated via time-lapse micro-computed tomography (µCT) observations. Two different composite samples were manufactured by means of a resin transfer molding (RTM) process under two different constant injection pressure conditions to generate intrayarn and interyarn voids separately. Fatigue loads were applied by blocks of 105 cycles and followed by µCT measurements. Regions of interest for micro tomography scans were selected based on hot spots detected by infrared thermography. After the analysis of the obtained data, it was observed that detectable cracks were generally initiated by debonding in the zone between two adjacent warp yarns and grew along their interface. Then, these cracks propagated along one of the warp yarns aligned in the loading direction while remaining in the middle of the specimen cross-section. The coalescence of the cracks and further propagation to the weakest zones were observed around and after the middle lifetime. Finally, we demonstrated the influence of the void defects at different material scales. I was found that interyarn voids have relatively little influence on the fatigue performance whereas they can, sometimes, attract and deviate cracks in the matrix zone between adjacent yarns. It was also shown that the intrayarn voids are crucial to degenerate the fatigue performance of the yarns at the micro-scale.

To better understand the influence of the prepreg parameters such as surface roughness, fibres/matrix distribution (e.g. presence or absence of pure matrix layer on the prepreg surface) and initial matrix crystallinity, two different carbon fibres/Poly-Ether-Ketone-Ketone prepregs are used to fabricate unidirectional laminate by Vacuum-Bag-Only (VBO) process. By an in-situ monitoring set-up, the laminate thickness and the temperature difference along the thickness direction are measured throughout the consolidation cycle. The quality of laminate is assessed in terms of interlaminar shear strength and void content. A finite element model has been developed to describe the intimate contact establishment by the deformation of surface roughness between the glass transition temperature and the melting temperature of the matrix. In particular, the model takes into account the real profilometer data and the variable Young’s modulus of matrix in terms of temperature and crystallinity. Finally, the high influence of the matrix crystallinity degree and the surface roughness on the intimate contact phenomenon is highlighted.

Purpose: The survival benefit of neoadjuvant chemotherapy (NAC) prior to surgical resection in colorectal cancer with liver metastases (CRCLM) patients remains controversial. The aim of this study was to compare overall outcome of CRCLM patients who underwent NAC followed by surgical resection versus surgical treatment first.Methods: We retrospectively analyzed 429 patients with stage IV colorectal cancer with synchronous liver metastases who underwent simultaneous liver resection between January 2008 and December 2016. Using propensity score matching, overall outcome between 60 patients who underwent NAC before surgical treatment and 60 patients who underwent surgical treatment first was compared.Results: Before propensity score matching, metastatic cancer tended to involve a larger number of liver segments and the primary tumor size was bigger in the NAC group than in the primary resection group, so that a larger percentage of patients in the NAC group underwent major hepatectomy (P

Perilymph fistula (PLF) is defined as an abnormal communication between the middle ear cavity and perilymphatic space of the inner ear. Most cases of PLF are responsible for pressure change caused by internal trauma or external trauma. However, spontaneous PLF might occur without an obvious history of barotrauma. We report two cases of possible spontaneous PLF in the postpartum period: both cases involved progressive sensorineural hearing loss with positional dizziness. Although the leakage of perilymph was not found during exploration, both hearing loss and dizziness improved immediately after PLF repair. It is necessary to consider the possibility of PLF in patients who have sudden or progressive sensorineural hearing loss with positional nystagmus. Early surgical exploration is recommended even if the history of barotrauma is not clear.