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Background Several studies have reported patient-related risk factors for late rectal bleeding following conventionally fractionated radiotherapy for prostate cancer. We investigated patient-related risk factors for late rectal bleeding after hypofractionated radiotherapy. Methods A total of 231 patients with local or locally advanced prostate cancer treated with hypofractionated radiotherapy (70 or 67.2 Gy in 28 fractions) were evaluated retrospectively. All patients received intensity-modulated radiotherapy with daily image guidance. The relationships between late rectal bleeding and risk factors like diabetes, hypertension, cirrhosis, and anticoagulant use were analyzed. Results During a median follow-up of 23 months, the crude rates of grade ≥ 1, grade ≥ 2, and grade ≥ 3 late rectal bleeding were 23.8%, 16.9%, and 9.5%, respectively. Cirrhosis and anticoagulant use predicted an increased risk of grade ≥ 3 rectal bleeding in multivariable analyses (hazard ratio [HR] 14.37, 95% confidence interval [CI] 3.09–66.87, P = 0.001, and HR 2.93, 95% CI 1.14–7.55, P = 0.026, respectively). The non-anticoagulant group had a significantly superior 5-year freedom from grade ≥ 3 bleeding compared to the anticoagulant group in a propensity-weighted log-rank analysis (88.0% vs. 76.7%, P = 0.041). A receiver operating characteristic curve analysis revealed that rectal bleeding was minimized in the anticoagulant group if the equivalent dose at fractionation of 2 Gy (EQD2) V77 Gy of the rectum was Conclusions Patients taking anticoagulants or those with cirrhosis had a significantly higher risk of severe late rectal bleeding than other patients after hypofractionated radiotherapy for prostate cancer in the present study. The bleeding risk could be lowered by minimizing hotspots in patients taking anticoagulants.

Herein, coating diamonds on WC–Co by using the hot filament chemical vapor deposition (HFCVD) method are discussed. CVD was performed for 8 h under a deposition pressure of 40 torr using various doping gases such as boron, nitrogen, and argon to control the particle size of the diamond thin films, the surface was then analyzed through scanning electron microscopy (SEM) and Raman spectroscopy. The SEM images confirmed that the diamond crystal size was reduced upon boron and argon doping. In contrast, nitrogen doping promoted the growth of diamond crystals. In the Raman spectra, the D and G bands were observed at 1332 and 1580 cm[Formula: see text], respectively. Thus, the surface roughness can be controlled using a variety of doping gases, which may be used in tools.

A machined surface study was performed according to the surface roughness post-process polishing operation on the aspheric mold core using a diamond turning machine. Machined surface features in the bokeh image must be removed with a subsequent surface polishing process after the aspheric glass molding pressing, as surface defects are caused by the mechanical resolution of ultraprecision diamond turning machines. Therefore, in this paper, we analyze the interrelationship between surface roughness, interference frequencies, and error-approximation aspherical error values to propose a baseline measure for machined surface removal. From the results of profilometer measurements, the form error accuracy before polishing is 1.3 [Formula: see text]m, and after polishing is 0.2 [Formula: see text]m. As a result of the LUPHOS, the root mean square (RMS) average of interference frequencies before polishing is 20 nm, and after polishing is 3 nm. The machining marks are removed from the bokeh image only when the RMS roughness is maintained at 5 nm or less.

Lactoferrin (LF) is known to possess anti-inflammatory activity, although its mechanisms of action are not well-understood. The present study asked whether LF affects the commitment of inducible regulatory T cells (Tregs). LF substantially promoted Foxp3 expression by mouse activated CD4+T cells, and this activity was further enhanced by TGF-β1. Interestingly, blocking TGF-β with anti–TGF-β Ab completely abolished LF-induced Foxp3 expression. However, no significant amount of soluble TGF-β was released by LF-stimulated T cells, suggesting that membrane TGF-β (mTGF-β) is associated. Subsequently, it was found that LF binds to TGF-β receptor III, which induces reactive oxygen species production and diminishes the expression of mTGF-β–bound latency-associated peptide, leading to the activation of mTGF-β. It was followed by phosphorylation of Smad3 and enhanced Foxp3 expression. These results suggest that LF induces Foxp3+ Tregs through TGF-β receptor III/reactive oxygen species–mediated mTGF-β activation, triggering canonical Smad3-dependent signaling. Finally, we found that the suppressive activity of LF-induced Tregs is facilitated mainly by CD39/CD73-induced adenosine generation and that this suppressor activity alleviates inflammatory bowel disease.

Purpose This study aimed to investigate whether a deep learning model for automated detection of unruptured intracranial aneurysms on time-of-flight (TOF) magnetic resonance angiography (MRA) can achieve a target diagnostic performance comparable to that of human radiologists for approval from the Korean Ministry of Food and Drug Safety as an artificial intelligence-applied software. Materials and methods In this single-center, retrospective, confirmatory clinical trial, the diagnostic performance of the model was evaluated in a predetermined test set. After sample size estimation, the test set consisted of 135 aneurysm-containing examinations with 168 intracranial aneurysms and 197 aneurysm-free examinations. The target sensitivity and specificity were set as 87% and 92%, respectively. The patient-wise sensitivity and specificity of the model were analyzed. Moreover, the lesion-wise sensitivity and false-positive detection rate per case were also investigated. Results The sensitivity and specificity of the model were 91.11% [95% confidence interval (CI): 84.99, 95.32] and 93.91% (95% CI: 89.60, 96.81), respectively, which met the target performance values. The lesion-wise sensitivity was 92.26%. The overall false-positive detection rate per case was 0.123. Of the 168 aneurysms, 13 aneurysms from 12 examinations were missed by the model. Conclusion The present deep learning model for automated detection of unruptured intracranial aneurysms on TOF MRA achieved the target diagnostic performance comparable to that of human radiologists. With high standalone performance, this model may be useful for accurate and efficient diagnosis of intracranial aneurysm.

We evaluated the impact of omitting axillary lymph node dissection (ALND) on oncological outcomes in breast cancer patients with residual nodal disease after neoadjuvant chemotherapy (NAC).The medical records of patients who underwent NAC followed by surgical resection and had residual nodal disease were retrospectively reviewed. In total, 1273 patients from 12 institutions were included; all underwent postoperative radiotherapy. Axillary surgery consisted of ALND in 1103 patients (86.6%) and sentinel lymph node biopsy (SLNBx) alone in 170 (13.4%). Univariate and multivariate analyses of disease-free survival (DFS) and overall survival (OS) were performed before and after propensity score matching (PSM).The median follow-up was 75.3 months (range, 2.5-182.7). Axillary recurrence rates were 4.8% in the ALND group (n = 53) and 4.7% in the SLNBx group (n = 8). Before PSM, univariate analysis indicated that the 5-year OS rate was inferior in the ALND group compared to the SLNBx group (86.6% vs. 93.3%, respectively; P = 0.002); multivariate analysis did not show a difference between groups (P = 0.325). After PSM, 258 and 136 patients were included in the ALND and SLNBx groups, respectively. There were no significant differences between the ALND and SLNBx groups in DFS (5-year rate, 75.8% vs. 76.9%, respectively; P = 0.406) or OS (5-year rate, 88.7% vs. 93.1%, respectively; P = 0.083).SLNBx alone did not compromise oncological outcomes in patients with residual nodal disease after NAC. The omission of ALND might be a possible option for axillary management in patients treated with NAC and postoperative radiotherapy.

Background When early‐stage lung cancer is diagnosed, the recommended treatment is anatomical resection using video‐assisted thoracoscopic surgery (VATS) or robotic lobectomy. However, nonanatomical resection, known as wedge resection (WR), which is performed to diagnose pulmonary nodules, can be problematic for clinicians performing VATS or robotic‐assisted thoracic surgery (RATS). The purpose of this study was to evaluate the safety and effectiveness of VATS WR using multiplanar computed tomography reconstruction (CT MPR)‐fluoroscopy after CT guided microcoil localization to achieve complete pulmonary nodule resection. Methods Between January 2016 to December 2020, the medical records of patients who underwent CT‐guided microcoil localization for suspicious malignant pulmonary nodules and VATS WR with CT MPR and intraoperative fluoroscopy were retrospectively reviewed. Results All 130 patients successfully underwent CT‐guided localization. The success rate of VATS WR with CT MPR‐intraoperative fluoroscopy was 98.5%. Mean operation time was 58 min (range 50–84 min). The postoperative complication rate was 3.1%, and no major postoperative complications were reported. The mean postoperative length of hospital stay was 4.7 days (range 4–8 days). Conclusions VATS WR using CT MPR‐fluoroscopy after CT guided microcoil localization is a safe and highly effective approach for complete pulmonary nodule resection. However, even in uniport VATS or recently performed robotic surgery, localization and resection of nonvisible, nonpalpable pulmonary nodules is a challenging problem. Consequently, satisfactory outcomes can be expected if this technique is used for suspicious malignant pulmonary nodule resection., VATS wedge resection with CT multiplanar reconstruction‐fluoroscopy is a safe and highly effective approach for complete pulmonary nodule resection. It will help clinicians perform uniportal VATS or robotic surgery for the localization and resection of nonvisible, nonpalpable pulmonary nodules.

The protein p110γ is an isoform of the catalytic subunit of class I phosphoinositide 3-kinases (PI3Ks). PI3Ks are involved in the regulation of cell survival, growth, proliferation, and migration and have been implicated in the oncogenesis of various cancers. In this study, p110γ expression in non-small cell lung cancer (NSCLC) and its association with clinicopathological factors and patient survival were evaluated. A total of 230 NSCLC tumors were immunohistochemically stained for p110γ. Of these, 174 (75.7%) and 56 (24.3%) were placed in the low and high expression groups, respectively. The positive rate of p110γ was significantly higher in adenocarcinoma than in squamous cell carcinoma (p⟨0.001). Advanced stage NSCLCs showed higher p110γ expression than those at an early stage (p=0.002). Irrespective of the histological tumor type, the patients with high p110γ expression had significantly worse overall survival than those with low p110γ expression (p=0.004). p110γ expression was an independent poor prognostic factor in the multivariate analysis. Our results suggest that p110γ may be involved in the development and progression of NSCLC, and that p110γ has promising potential as a prognostic factor or novel therapeutic target for NSCLC.

A boron-doped diamond (BDD) thin film was synthesized using the hot filament chemical vapor deposition (HFCVD) method. The surface shape, growth rate, bonding structure, and electrochemical properties of the BDD thin films were estimated through scanning electron microscopy (SEM), Raman spectroscopy, and cyclic voltammetry. As the boron doping concentration increased, the growth rate and crystal size of the diamond thin film decreased. Through Raman analysis, it was confirmed that the 1332 cm[Formula: see text] peak of diamond gradually became less intense, and peaks were generated at 480 cm[Formula: see text] and 1220 cm[Formula: see text] due to the bonding of boron to carbon. Cyclic voltammetry analysis of the BDD thin film showed a large potential window with a width of approximately 2.8 V. The highest applied voltage (2 V) versus response current (0.02 A) was obtained at a B/C ratio of 2000 ppm.

Bearings, which are widely used in the industry, require high-energy efficiency and durability, and research toward frictional wear improvement is in progress. In this study, micropatterns were fabricated on the surface of an STB2 bearing steel. Three types of line-shaped micropatterns with intervals of 40, 80, and 150 μm were processed using a milling machine. In addition, the friction efficiency was assessed by measuring the friction coefficient of a bare sample with a diamond-like carbon (DLC) thin film, which has excellent friction efficiency. The friction wear efficiency was further analyzed by comparing the change in friction coefficient and the wear area as a function of the pattern interval. As a result of the wear test, the STB2 specimen to which the pattern was applied showed a difference in the friction coefficient according to the pattern pitch, and the lowest coefficient of friction was shown at 40 μm with the smallest pattern pitch, which confirmed that the distance between the pattern pitches affected the friction characteristics.

Nitrogen-doped homoepitaxial single-crystal diamond (SCD) films were grown on an SCD substrate by hot filament chemical vapor deposition (HFCVD) to confirm the potential that can yield high-quality single-crystal diamonds. The SCD films doped with 50 sccm nitrogen, grown by HFCVD, showed excellent surface properties based on optical microscopy, with a growth rate of 3.4 [Formula: see text]m/h, and a Raman peak around 1332 cm[Formula: see text] with a full width at maximum (FWHM) of 5.8 cm[Formula: see text], indicating high crystallinity. The FWHM of the (004) peak in the rocking curve was 392 arcsec for the nitrogen-doped SCD film, and that of the SCD substrate was 489 arcsec. Therefore, the crystalline properties and growth rates of the SCD films grown in the HFCVD system were improved, and the effect of nitrogen doping was verified.

In this study, an amorphous carbon thin film on a cemented carbide substrate was prepared with surface micropatterns using femtosecond laser machining. The micropatterns that were considered were made of lines, dotted lines, and zigzag dotted lines. We performed a tribology test using a ball-on-disk friction wear test and investigated the coefficient of friction (COF) and wear amount as a function of pattern size and shape. The micropattern made using femtosecond laser patterning exhibited better friction coefficient properties than the bare amorphous carbon samples. Moreover, the pattern size and shape influenced the friction coefficient value of the patterned samples. The dotted line pattern shape showed superior results in friction coefficient characteristics compared to those of other micropatterns.

In this paper, we investigated the changes in the shape precision of a diamond-like carbon (DLC)-coated surface of an aspherical glass lens mold. The press molding process of the experiment involved placing a bulk material made of glass in an ultra-precision mold and applying cylinder pressure at a high temperature. Thermally stable tungsten carbide was used as the mold material. DTM grinding with a resolution of 0.1 [Formula: see text]m was performed to precisely process the tungsten carbide aspherical lens mold. HiPIMS–DLC and ta-C DLC coatings having excellent anti-stiction and hardness were applied on the polished mold. The hardness of the thin film was measured using nanoindentation. For the composition of the DLC, the [Formula: see text]/[Formula: see text] peak values were detected through Raman spectroscopy. Furthermore, the friction coefficient of the DLC thin film was measured using a tribology tester, and the friction coefficients of HiPIMS–DLC and ta-C were 0.018 and 0.014. Using FTS measurements, we confirmed that the precision of the aspherical lens shape (Peak to Valley) of the aspherical lens was 1.5 [Formula: see text]m and 0.5 [Formula: see text]m, respectively.

High-flow nasal cannula (HFNC) therapy has been established as a promising oxygen treatment with various advantages for respiratory mechanics. One of the main mechanisms is to provide positive airway pressure. This effect could reduce lung injury and improve oxygenation; conversely, it may cause a complication of positive pressure ventilation. However, data are scarce regarding the possible adverse effects, particularly in adults. We report a patient who developed HFNC-induced tension pneumocephalus from an unrecognized skull base fracture. Physicians should be cautious when applying HFNC to patients with suspected skull base or paranasal sinus fracture, especially when applying a higher flow rate. How to cite this article Chang Y, Kim T-G, Chung S-Y. High-flow Nasal Cannula-induced Tension Pneumocephalus. Indian J Crit Care Med 2020;24(7):592–595.

Dispersion of carbon black (CB) powder in CB/polymer composites considerably influences their mechanical properties, electrical conductivity, and thermal conductance. In this study, with the aim to improve the dispersion of CB powder in the CB/polymer composites, CB was treated with oxygen and nitrogen plasma generated by radio frequency-plasma enhanced chemical vapor deposition (RF-PECVD), and then, dispersed in a poly(vinylidene fluoride-co-hexafluoropropene) (PVDF-HFP) solution. The solution was then subjected to electrospinning, leading to the formation of a nanofiber mat. The dispersion states of plasma treated CBs have been characterized using scanning electron microscopy and Fourier-transform infrared spectroscopy. A stress–strain curve was used to investigate the influence of dispersion on the mechanical properties of CB/polymer composites.

We consider five-dimensional massive vector-gravity theory which is based on the foliation preserving diffeomorphism and anisotropic conformal invariance. It does not have an intrinsic scale and the only relevant parameter is the anisotropic factor $z$ which characterizes the degree of anisotropy between the four-dimensional spacetime and the extra dimension. We assume that physical scale $M_*$ emerges as a consequence of spontaneous conformal symmetry breaking of vacuum solution. It is demonstrated that a very small mass for the vector particle compared to $M_*$ can be achieved with a relatively mild adjustment of the parameter $z$. At the same time, it is also observed that the motion along the extra dimension can be highly suppressed and the five-dimensional theory can be effectively reduced to four-dimensional spacetime., Comment: References are added

Piezoelectric material has widely used in various applications with its high liable performance and quite smart electro-mechanical characteristics. However, solutions for number of troubles in strength and behavior of fracture have not sufficiently clarified yet. Among these associated solutions, the double torsion (DT) technique is the particular and effective method to measure toughness of fracture and growth behavior of slow crack in ceramic material. From the results of this work, it obtained the practical feasibility of the DT technique for finding growth behavior of crack initiated by kinds of cyclic electric fatigue on piezoelectric ceramics, and found that the initiated crack is able to propagate by using a relatively lower cyclical voltage than before cases under a constant mechanical load if the DT technique is used. In this study, it is also established the experimental method of the crack propagation by cyclic electric fatigue for the piezoelectric ceramics using DT technique, and found the possibility of the power law based on the classical Paris’ equation for analyzing the result of electric fatigue crack test.

A design of a modular antenna/detector array for the electron cyclotron emission (ECE) imaging system at the Korea Superconducting Tokamak Advanced Research (KSTAR) is proposed. The modular antenna/detector array is based on a unit antenna/detector module, which consists of an elliptical mini-lens, a dual-dipole antenna, an antenna balun, a low-noise amplifier, and a metal frame. The proposed modular antenna/detector array resolves the problem in the conventional antenna/detector array where one faulty channel requires the entire array to be removed for the service. With the proposed modular array, each channel module can be easily and independently removed and replaced without interference to the rest of the array, thus minimizing the interrupted service time for maintenance. Moreover, the unit channel modules can be efficiently updated under a variety of the tokamak operation conditions. The antenna/detector modules are optimized to have improved performance, and are tested in a W-band test setup, and consistently provide the gain increase by 10~20 dB as compared with the conventional antenna/detector array. A set of the proposed modular antenna/detector array is currently installed and tested in the KSTAR ECE imaging system, and will consistently produce the improved ECE imaging to monitor MHD instability activities under various plasma operation conditions.

In grid-connected operations, a microgrid can solve the problem of surplus power through regeneration; however, in the case of standalone operations, the only method to solve the surplus power problem is charging the energy storage system (ESS). However, because there is a limit to the capacity that can be charged in an ESS, a separate energy management strategy (EMS) is required for stable microgrid operation. This paper proposes an EMS for a hybrid AC/DC microgrid based on an artificial neural network (ANN). The ANN is composed of a two-step process that operates the microgrid by outputting the operation mode and charging and discharging the ESS. The microgrid consists of an interlinking converter to link with the AC distributed system, a photovoltaic converter, a wind turbine converter, and an ESS. The control method of each converter was determined according to the mode selection of the ANN. The proposed ANN-based EMS was verified using a laboratory-scale hybrid AC/DC microgrid. The experimental results reveal that the microgrid operation performed stably through control of individual converters via mode selection and reference to ESS power, which is the result of ANN integration.

Objective: The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC. Methods: A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III–IV). Results: In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III–IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05). Conclusions: CRT has value as adjuvant treatment for resected GBC with stage III–IV disease. Further study is needed for stage II disease with high-risk features.

We recently reported that lactoferrin (LF) induces Foxp3

The Radiation Therapy Oncology Group (RTOG) 9310 protocol clinical trial established high-dose methotrexate (HDMTX) as the standard for primary central nervous system lymphoma (PCNSL). We aimed to investigate the RTOG 9310 protocol’s PCNSL outcomes by examining progression-free survival (PFS) and overall survival (OS) rates and determining the influential factors. Between 2007 and 2020, 87 patients were histopathologically diagnosed with PCNSL and treated with the RTOG 9310 protocol. All received HDMTX 2.5 g/m2 and vincristine 1.4 mg/m2/day for 1 day during weeks 1, 3, 5, 7, and 9, and procarbazine 100 mg/m2/day for 1 day during weeks 1, 5, and 9. Dexamethasone was administered on a standard tapering schedule from the first week to the sixth week. Whole brain radiotherapy (WBRT), consisting of 45 Gy for patients with less than a complete response to the chemotherapy or 36 Gy for complete responders, was started 1 week after the last dose of chemotherapy was administered. Within three weeks of the completion of WBRT, patients received two courses of cytarabine, which were separated by 3–4 weeks. Clinical, radiological, and histopathological characteristics were retrospectively reviewed. All patients completed five HDMTX cycles and a mean follow-up of 60.2 (range, 6–150) months. Twenty-eight (32.2%) patients experienced recurrence during follow-up. The mean time to recurrence was 21.8 months, while the mean PFS was 104.3 (95% confidence interval (CI), 90.6–118.0) months. Eleven (12.6%) patients died, the mean OS was 132.1 (95% CI, 122.2–141.9) months. The 3- and 5-year survival rates were 92.0% and 87.4%, respectively. One patient experienced acute renal failure, while the remainder tolerated any cytotoxic side effects. On multivariate analysis, the Eastern Cooperative Oncology Group performance score ≤ 2, the International Extranodal Lymphoma Study Group low-risk status, XBP-1, p53, and c-Myc negativity, homogenous enhancement, gross total resection, independently correlated with long PFS and OS. The RTOG 9310 protocol is effective for PCNSL and features good outcomes.

The buffering capacity of buffer agents and their effects on in vitro and in vivo rumen fermentation characteristics, and bacterial composition of a high-concentrate fed Hanwoo steers were investigated in this study. Treatments were comprised of CON (no buffer added), BC0.3%(low buffering capacity, 0.3% buffer), BC0.5%(medium buffering capacity, 0.5% buffer), and BC0.9%(high buffering capacity, 0.9% buffer). Four Hanwoo steers in a 4 × 4 Latin square design were used for the in vivo trial to assess the effect of treatments. Results on in vitro experiment showed that buffering capacity, pH, and ammonia–nitrogen concentration (NH3-N) were significantly higher in BC0.9%and BC0.5%than the other treatments after 24 h incubation. Individual and total volatile fatty acids (VFA) concentration of CON were lowest compared to treatment groups. Meanwhile, in vivo experiment revealed that Bacteroidetes were dominant for all treatments followed by Firmicutes and Proteobacteria. The abundances ofBarnesiella intestinihominis, Treponema porcinum,andVibrio marisflaviwere relatively highest under BC0.9%,Ruminoccocus bromiiandSucciniclasticum ruminisunder BC0.5%, andBacteroides massiliensisunder BC0.3%.The normalized data of relative abundance of observed OTUs’ representative families have grouped the CON with BC0.3%in the same cluster, whereas BC0.5%and BC0.9%were clustered separately which indicates the effect of varying buffering capacity of buffer agents. Principal coordinate analysis (PCoA) on unweighted UniFrac distances revealed close similarity of bacterial community structures within and between treatments and control, in which BC0.9%and BC0.3%groups showed dispersed community distribution. Overall, increasing the buffering capacity by supplementation of BC0.5%and and BC0.9%buffer agents enhanced rumen fermentation characteristics and altered the rumen bacterial community, which could help prevent ruminal acidosis during a high-concentrate diet.

Lung deposition and retention measurements are now required by the newly revised OECD inhalation toxicity testing guidelines 412 and 413 when evaluating the clearance and biopersistence of poorly soluble nanomaterials, such as multi-walled carbon nanotubes (MWCNTs). However, evaluating the lung deposition concentration is challenging with certain nanomaterials, such as carbon-based and iron-based nanomaterials, as it is difficult to differentiate them from endogenous elements. Therefore, the current 28-day inhalation toxicity study investigated the lung retention kinetics of tangled MWCNTs. Male Sprague Dawley rats were exposed to MWCNTs at 0, 0.257, 1.439, and 4.253 mg/m3 for 28 days (6 h/day, 5 days/week, 4 weeks). Thereafter, the rats were sacrificed at day 1, 7, and 28 post-exposure and the pulmonary inflammatory response evaluated by analyzing the bronchoalveolar lavage fluid. Plus, the blood biochemistry, hematology, and histopathology of the lungs were also examined. The lung deposition and retention of MWCNTs were determined based on the elemental carbon content in the lungs after tissue digestion. The number of polymorphonuclear cells and LDH concentration were both found to be significantly higher with the medium and high concentrations (1.439 and 4.253 mg/m3) and dose dependent. The estimated retention half-life for the high concentration (4.253 mg/m3) was about 35 days. The results of this study indicate that tangled MWCNTs seem to have a relatively shorter retention half-life when compared to previous reports on rigid MWCNTs, and the no-observed adverse effect level (NOAEL) for the tested tangled MWCNTs was 0.257 mg/m3 in a previous rat 28-day subacute inhalation toxicity study.

Scoliosis is a 3-dimensional spinal deformity defined as lateral curvature of the spine in the coronal plane of more than 10°. This study describes a case of functional scoliosis after hip injury. In this case, the patient fell whilst inline skating (June 2015) causing severe tilting of her spine, and left hip pain. She received outpatient treatment from July 14, 2015 to December 28, 2015. For approximately 5 months, acupuncture therapy was performed to relax the tension in both hips, Chuna therapy, and foot orthosis were applied to reduce the body’s imbalance. Based on X-ray images, the Cobb angle had decreased from 14.73° (pretreatment) to 1.90° (posttreatment). This case report suggested that Korean medicine treatment could be an effective therapeutic choice for functional scoliosis.

Background As patients with brain metastasis (BM) of non-small cell lung cancer (NSCLC) have dismal prognosis, some of them decide to discontinue further treatment for BM. The objective of this study was to determine factors for renouncing further active therapy in patients with BM of NSCLC, focusing on their demographic and socioeconomic status. Methods Medical records of 105 patients with radiological diagnosis of BM of NSCLC for the recent 11 years at authors’ institution were retrospectively reviewed. Clinical features as well as demographic and socioeconomic characteristics such as marriage status, cohabiting family members, religious affiliations, educational background, and economic responsibility were reviewed. Results Median overall survival (OS) was 13.84 (95% CI: 10.26-17.42) years in 67 patients (group A) who underwent active treatment (radiotherapy and/or chemotherapy) and 4.76 (95% CI: 3.12-6.41) years in 38 patients (group B) who renounced active treatment. Less patients were unmarried (p=0.046), more cohabitating family members (p=0.008), and economically independent (p=0.014) in group A than those in group B. Similarly, the unmarried, and none cohabitating family members had short OS (5.17 and 7.38 years, respectively). In multivariate analysis for predisposing factors of OS in these patients, the following demographic and socioeconomic factors had independent significance: marriage status and cohabitating family members. Conclusion This study suggests that demographic and socioeconomic status as well as clinical factors could influence the decision of further active treatment and prognosis of patients with BM of NSCLC.

Nanocrystalline diamond (NCD) is exceptionally useful for a variety of applications and is of significant interest to researchers in technological and scientific fields due to its excellent mechanical and chemical properties, such as its hardness and high thermal conductivity. We have modified a microwave plasma chemical vapor deposition (MPCVD; Astex Inc.) system with a slot antenna designed for surface wave plasma (SWP) and successfully fabricated high quality thin NCD film. This SWP-CVD process fabricates high quality diamond film at 300 °C, while a normal MPCVD process requires the temperature of the substrate to be above 800 °C. We studied the fabricated NCD samples in detail, measuring their surface morphology by field emission scanning electron microscopy (FESEM); their structural-chemical properties by Raman spectroscopy; and their surface roughness by atomic force microscopy (AFM).

Because of its stable crystal structure, a boron-doped diamond (BDD) has been attracting great attention as a promising material for a next-generation electrode. For instance, the BDD is a wellknown candidate to be exploited as an electrode for the ozone generation with its longer life-time. In this study, we have evaluated ozone-generating characteristics of the BDD electrodes related to the doping concentration of boron. In the experiment, morphology of surface was observing by scanning electron microscopy (SEM) and structural-chemical properties of the synthesized diamond layers were characterized by Raman spectroscopy. Conductivity, carrier concentration, and Hall mobility were determined by a Sheet resistance measurement and Hall effect measurement performed based on the van der Pauw method. The ozone concentration in the water was measured using an ozone colorimeter with DPD reagent.

Angiofibroma is benign hypervascular tumor that usually occurs in the nasopharynx of adolescent male patient and rarely originates from outside of the nasopharynx, called extranasopharyngeal angiofibroma. The clinical and radiologic findings of extranasopharyngeal angiofibroma are similar to other hypervascular tumors, which may delay diagnosis and treatment. We present a case of extranasopharyngeal angiofibroma arising from nasal septum of a 43-yearold male who complained of right nasal obstruction. Contrast enhancement CT revealed a hypervascular tumor of the nasal septum and the tumor was removed by endoscopic resection. Histopathologic examination confirmed the diagnosis of angiofibroma.

Studies of prophylactic cranial irradiation (PCI) focused on elderly patients with small-cell lung cancer (SCLC) are rarely conducted. We aimed to identify whether there is a survival benefit of prophylactic cranial irradiation (PCI) in elderly patients using a single institution’s retrospective data. A total of 234 patients with limited-disease SCLC (LD-SCLC) treated with thoracic chemoradiotherapy were evaluated; of these, 139 patients received PCI. To minimize treatment selection bias, patients were adjusted using the propensity score on factors associated with receipt of PCI. Cox proportional hazard model and Kaplan–Meier analyses were used to identify which subgroup may benefit from PCI. Median follow-up time was 22 months (range 1–150 months). PCI was associated with favorable brain metastasis–free survival, disease-specific survival, and overall survival in the entire population [hazard ratios (HR) 0.588, 95% confidence interval (CI) 0.338–1.024, P = 0.060; HR 0.477, 95% CI 0.331–0.687, P < 0.001; HR 0.543, 95% CI 0.383–0.771, P = 0.001, respectively). However, PCI had no significant relationship with overall survival in patients aged ≥65 years with cT3–4 disease and/or females gender (HR 0.817, 95% CI 0.098–6.849, P = 0.853; HR 1.082, 95% CI 0.114–10.227, P = 0.946, respectively). The benefits and risks of PCI in elderly patients with LD-SCLC need to be scrutinized, especially in those with high T stage tumors and/or females.

Purpose This study is to report clinical outcomes of salvage concurrent chemo-radiation therapy (CCRT) in treating patients with loco-regional recurrence (LRR) following initial complete resection of non-small cell lung cancer. Materials and Methods Between February 2004 and December 2016, 127 patients underwent salvage CCRT for LRR. The median radiation therapy (RT) dose was 66 Gy and clinical target volume was to cover recurrent lesion with margin without elective inclusion of regional lymphatics. Majority of patients (94.5%) received weekly platinum-based doublet chemotherapy during RT course. Results The median follow-up time from the start of CCRT was 25 months. The median survival duration was 49 months, and overall survival (OS) rates at 2 and 5 years were 72.9% and 43.9%. The 2- and 5-year rates of in-field failure-free survival, distant metastasis free survival, and progression free survival were 82.4% and 73.8%, 50.4% and 39.9%, and 34.6% and 22.3%, respectively. Grade ≥ 3 radiation-related esophagitis and pneumonitis occurred in 14 (11.0%) and six patients (4.7%), respectively. On both univariate and multivariate analysis, higher biologically equivalent dose (BED10) (≥ 79.2 Gy10 vs. < 79.2 Gy10; hazard ratio [HR], 0.431), smaller CTV (≤ 80 cm3 vs. > 80 cm3; HR, 0.403), and longer disease-free interval (> 1 year vs. ≤ 1 year; HR, 0.489) were significantly favorable factors for OS. Conclusion The current study has demonstrated that high dose salvage CCRT focused to the involved lesion only was highly effective and safe. In particular, higher BED10, smaller CTV, and longer disease-free interval were favorable factors for improved survival.

To investigate the impact of immediate breast reconstruction (iBR) on patients treated with post-mastectomy radiation therapy (PMRT) using propensity score matching (PSM).After a retrospective review of patients treated with PMRT between 2008 and 2017, we included 153 patients who underwent iBR and 872 patients who did not undergo iBR. Among the 153 patients who underwent iBR, 34 received one-stage iBR with autologous tissue and 119 received two-stage iBR. Conventional fractionated PMRT with a total dose of 50-50.4 Gy in 25-28 fractions was performed in all patients. Propensity scores were calculated via logistic regression.Patients who underwent iBR were younger, had early stage disease, and had more frequent hormone receptor-positive tumor than those who did not undergo iBR. After PSM, 127 patients from each group with well-balanced characteristics were selected. With a median follow-up of 67.5 months, iBR led to better 6-year disease-free survival rates compared to no iBR before PSM (84.8% vs. 71.4%, p = 0.003); after PSM, there was no significant difference (84.8% vs. 75.5%, p = 0.130). On multivariable analysis in the matched cohort, iBR was not associated with inferior disease-free survival (hazard ratio, 0.67; p = 0.175). In the sensitivity analysis, iBR was not associated with a lower disease-free survival across all prognostic groups. The 5-year cumulative incidence of iBR failure was 15.0%.In patients with adverse pathologic factors planning to receive PMRT, iBR did not compromise oncologic outcomes. In addition, iBR can be considered in patients treated with PMRT with several clinicopathologic risk factors.

PURPOSE We evaluated the correlation between stomach volume change and interfractional baseline shifts of the diaphragm in image-guided radiotherapy (IGRT) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS Twenty-four patients with HCC underwent ten fractions of IGRT, and a total of 240 cone beam computed tomography (CBCT) and on-board imager (OBI) kV image sets were acquired. These image sets were retrospectively analyzed. Baseline shifts of the diaphragm relative to bone and stomach volume change ratios were evaluated using four-dimensional simulation CT, kV image, and CBCT images. Associations between baseline shifts and patient physiologic factors were investigated. RESULTS The average baseline shift of the diaphragm in the superior-inferior (SI) direction was 1.5 mm (standard deviation 4.6 mm), which was higher than the shift in other directions (0.7, 2.0 mm and 0.9, 2.6 mm in right-left (RL) and anterior-posterior (AP) directions, respectively). Interfractional baseline shifts of the diaphragm in the SI and AP directions were positively correlated with the stomach volume change ratio (Pearson's r: 0.416 and 0.302, p-value