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Background/Aims: This study aimed to review the indications, methods, cooperation, complications, and outcomes of percutaneous endoscopic gastrostomy (PEG). Methods: Questionnaires were sent to 200 hospitals, of which 62 returned their questionnaires, with a response rate of approximately 30%. Descriptive statistics were calculated to analyze the responses to the questionnaires. Results: In 2019, a total of 1,052 PEGs were performed in 1,017 patients at 62 hospitals. The main group who underwent PEG was older adult patients with brain disease, particularly stroke. Nutritional supply was an important purpose of the PEG procedure. “The pull method” was the most commonly used for initial PEG insertion. The complications related to PEG were mostly mild, with leakage being the most common. Patients who underwent PEG procedures were primarily educated regarding the post-procedure management and complications related to PEG. Preoperative meetings were skipped at >50% of the institutions. Regarding the cooperation between the nutrition support team (NST) and the physician performing PEG, few endoscopists answered that they cooperated with NST before and after PEG. Moreover, the rate of NST certification obtained by physicians performing PEG and the frequency of attendance at NST-related conferences were relatively low. Conclusions: This study shows a similar trend to that found in the previous PEG guidelines. However, it covers new aspects, including team-based work for PEG procedure, nutrition support, and education for patients and guardians. Therefore, each medical institution needs to select an appropriate method considering the medical environment and doctor’s abilities.

Background Differentiating between bacterial and nonbacterial colitis remains a challenge. We aimed to evaluate the value of serum procalcitonin (PCT) and C-reactive protein (CRP) in differentiating between bacterial and nonbacterial colitis. Methods Adult patients with three or more episodes of watery diarrhea and colitis symptoms within 14 days of a hospital visit were eligible for this study. The patients’ stool pathogen polymerase chain reaction (PCR) testing results, serum PCT levels, and serum CRP levels were analyzed retrospectively. Patients were divided into bacterial and nonbacterial colitis groups according to their PCR. The laboratory data were compared between the two groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic accuracy. Results In total, 636 patients were included; 186 in the bacterial colitis group and 450 in the nonbacterial colitis group. In the bacterial colitis group, Clostridium perfringens was the commonest pathogen (n=70), followed by Clostridium difficile toxin B (n=60). The AUC for PCT and CRP was 0.557 and 0.567, respectively, indicating poor discrimination. The sensitivity and specificity for diagnosing bacterial colitis were 54.8% and 52.6% for PCT, and 52.2% and 54.2% for CRP, respectively. Combining PCT and CRP measurements did not increase the discrimination performance (AUC, 0.522; 95% confidence interval, 0.474–0.571). Conclusion Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

Study Design Level III retrospective study. Purpose We investigated the impact of short-segment lumbar fusion on the restoration of global sagittal alignment and the correlations between spino-pelvic parameters and clinical outcomes. Overview of Literature Sagittal imbalance leads to energy consumption and pain in maintaining a standing position. For adult spinal deformity, it is critical to create optimal lumbar lordosis (LL) in order to achieve restoration of sagittal imbalance. However, surgeons do not pay attention to correcting LL in short-segment lumbar fusion. Methods A total of 69 patients with transforaminal lumbar interbody fusion (TLIF) for degenerative spinal disease were evaluated with a minimum 2-year follow-up. All patients underwent TLIF with hyper-lordotic angle cages to achieve higher LL. Radiological spino-pelvic parameters including sagittal vertical axis (SVA) and clinical outcomes using the Oswestry Disability Index (ODI) and Numeric Rating Scale (NRS) were evaluated. Results The average LL was 35.8°±9.9° before surgery, 42.3°±9.3° 1 year after surgery, and 40.3°±10.2° 2 years after surgery (p

In recent years, various studies have been conducted on oscillating-water-column-type wave energy converters (OWC-WECs) with multiple chambers with the objective of efficiently utilizing the limited space of offshore/onshore structures. In this study, a numerical investigation based on a numerical wave tank was conducted on single, dual, and triple OWC chambers to examine the hydrodynamic performances and the energy conversion characteristics of the multiple water columns. The boundary value problem with the Laplace equation was solved by using a numerical wave tank based on a finite element method. The validity of the current numerical method was confirmed by comparing it with the measured data in the previous experimental research. We undertook a series of numerical simulations and observed that the water column motion of sloshing mode in a single chamber can be changed into the piston motion of different phases in multiple OWC chambers. Therefore, the piston motion in the multiple chambers can generate considerable airflow at a specific resonant frequency. In addition, the division of the OWC chamber results in a reduction of the time-dependent variability of the final output power from the device. As a result, the application of the multiple chambers leads to an increase of the energy conversion performance as well as a decrease of the variability of the wave energy converter.

PURPOSE The purpose of this study was to determine the effect of exercise types on the Wnt/BMP signaling and the response to myogenic mechanism by downhill and uphill training in the aged rat skeletal muscles. METHODS Young and old rats were randomly assigned to control groups; young (YC) and old (OC), and two types of running training groups: old downhill exercise (ODE) and old uphill exercise (OUE). Training was progressively carried out on a treadmill at a speed of 21 m/min with a slope of +10° for uphill training vs 16 m/min with a slope of -16° for downhill training: 60 min/day, 5 days/week for 8 weeks respectively. RESULTS Downhill and uphill training significantly increased the protein levels of Wnt3a, β-catenin and LEF-1 in aged rats. On the contrary, GSK3β was reduced by running training. In addition, the expression patterns of Wnt7a, Fzd7, PKC, p-AKT, and p-mTOR in extensor digitorum longus (EDL) and soleus (SOL) muscle were significantly increased in both ODE and OUE groups. Expression patterns of BMP-2, BMP-7, and p-Smad-1/5/8 in EDL and SOL muscles were significantly increased in both ODE and OUE groups. Especially, ODE group showed more increased expression pattern than OUE group. The expression patterns of MyoD, Myf5, and Myogenin were significantly increased in both DOE and OUE groups. Myf5 and Myogenin showed more increased expression pattern in ODE group than OUE group. CONCLUSIONS The downhill and uphill exercise training may play a mediating role in increasing the expression of these reduced myogenesis related factors. Furthermore, the formation process and hypertrophy of skeletal muscle weakened due to aging can be improved and maintained.

Biological repair of cartilage lesions remains a significant clinical challenge. A wide variety of methods involving mesenchymal stem cells (MSCs) have been introduced. Because of the limitation of the results, most of the treatment methods have not yet been approved by the Food and Drug Administration (FDA). However, bone marrow aspirate concentrate (BMAC) and human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) implantation were approved by Korea FDA. The aim of this study was to evaluate clinical and magnetic resonance imaging (MRI) outcomes after two different types of MSCs implantation in knee osteoarthritis. Fifty-two patients (52 knees) who underwent cartilage repair surgery using the BMAC (25 knees) and hUCB-MSCs (27 knees) were retrospectively evaluated for 2 years after surgery. Clinical outcomes were evaluated according to the score of visual analogue scale (VAS), the International Knee Documentation Committee (IKDC) subjective, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Cartilage repair was assessed according to the modified Magnetic Resonance Observation of Cartilage Repair Tissue (M-MOCART) score and the International Cartilage Repair Society (ICRS) cartilage repair scoring system. At 2-year follow-up, clinical outcomes including VAS, IKDC, and KOOS significantly improved ( P < 0.05) in both groups; however, there were no differences between two groups. There was no significant difference in M-MOCART [1-year ( P = 0.261), 2-year ( P = 0.351)] and ICRS repair score ( P = 0.655) between two groups. Both groups showed satisfactory clinical and MRI outcomes. Implantation of MSCs from BMAC or hUCB-MSCs is safe and effective for repairing cartilage lesion. However, large cases and a well-controlled prospective design with long-term follow-up studies are needed.

A numerical study was performed to investigate the applicability of the linear decomposition method for the hydrodynamic energy conversion of an oscillating-water-column type wave energy converter (OWC-WEC). Hydrodynamic problems of the OWC chamber were decomposed into the excitation and radiation problems with the time-domain numerical method based on the linear potential theory. A finite element method was applied to solve the potential flow in the entire fluid domain including OWC chamber structure. The validity of the linear decomposition method was examined by comparing with the direct interaction method for the turbine–chamber interaction based on the linear pressure drop characteristics. In order to estimate the hydrodynamic energy conversion performance under the irregular waves, the response spectrum method was applied with the transfer function based on the linear decomposition method. Under the various irregular wave conditions, the pneumatic power of OWC-WEC calculated by the response spectrum based on the linear decomposition method agreed well with the direct irregular wave simulation results.

The present study uses an acceptability judgment experiment designed to explore the nature of Korean why-stripping with reference to voice. First, it investigates whether the acceptability of Korean why-stripping is affected by the voice mismatch between antecedent and ellipsis clauses. Second, it examines whether there is a difference in acceptability between passive antecedents with active ellipsis clauses (Passive-Active) and active antecedents with passive ellipsis clauses (Active-Passive). One finding indicates that Korean why-stripping prefers voice matches over voice mismatches: voice matches make it easier to link the remnant to its correlate in the antecedent clause. The other finding indicates that Passive-Active why-stripping is more acceptable than Active-Passive why-stripping. The study also evaluates whether the second finding supports Arregui et al.’s (2006) Recycling Hypothesis according to which passive clauses are more likely to be remembered as active than the other way around, creating an illusion of grammaticality or Poppels and Kehler’s (2019) hypothesis according to which there exists a penalty against passive ellipsis clauses, which applies to both matched and mismatched cases of English VP ellipsis. The results confirm the hypothesis of Poppels and Kehler in that Active-Active why-stripping is more acceptable than Passive-Passive why-stripping and that Passive-Active why-stripping is more acceptable than Active-Passive why-stripping [ABSTRACT FROM AUTHOR]

In this study, a time-domain numerical method based on three-dimensional potential flow was developed to analyze the hydrodynamic characteristics of an inclined oscillating-water-column (OWC) wave energy converter (WEC). A finite element method was applied to solve the potential flow around and inside the OWC chamber. A turbine−chamber interaction was considered to take into account the pressure drop inside the OWC chamber, which is a nonlinear function of airflow speed via turbine operation. The instantaneous pressure drop was updated on the free-surface boundary condition inside the chamber in the time-domain to account for the coupling effect between the turbine and the chamber. The present numerical method was verified by comparing it with the model test results. The hydrodynamic characteristics of an inclined OWC chamber in terms of potential flow, such as the water column motion and the three-dimensional flow distribution around the chamber, were investigated. In terms of hydrodynamic performance, the energy conversion efficiency of the chamber showed a nonlinear response characteristic dependent on the incident wave height. In addition, numerical calculations were carried out to clarify the relationship between the main geometric parameters and the hydrodynamic response of the inclined OWC chamber.

The International Energy Agency Technology Collaboration Programme for Ocean Energy Systems (OES) initiated the OES Wave Energy Conversion Modelling Task, which focused on the verification and validation of numerical models for simulating wave energy converters (WECs). The long-term goal is to assess the accuracy of and establish confidence in the use of numerical models used in design as well as power performance assessment of WECs. To establish this confidence, the authors used different existing computational modelling tools to simulate given tasks to identify uncertainties related to simulation methodologies: (i) linear potential flow methods; (ii) weakly nonlinear Froude−Krylov methods; and (iii) fully nonlinear methods (fully nonlinear potential flow and Navier−Stokes models). This article summarizes the code-to-code task and code-to-experiment task that have been performed so far in this project, with a focus on investigating the impact of different levels of nonlinearities in the numerical models. Two different WECs were studied and simulated. The first was a heaving semi-submerged sphere, where free-decay tests and both regular and irregular wave cases were investigated in a code-to-code comparison. The second case was a heaving float corresponding to a physical model tested in a wave tank. We considered radiation, diffraction, and regular wave cases and compared quantities, such as the WEC motion, power output and hydrodynamic loading.

This study examines two syntactic analyses of P/Case-drop in Korean gapping (aka right-node-raising or right-peripheral ellipsis): LF copying (Abe & Hoshi 1997) and PF deletion (Kim 1997). We employ two online acceptability rating experiments to investigate to what extent the distribution of P/Case-drop is controlled by grammatical and extragrammatical constraints. The experimental findings suggest that (a) linear non-parallelism elicits a processing cost for gapping and (b) P/Case-drop is a costly operation, which results in higher frequencies of PP fragments (in relation to NP fragments) and Case-marked NP fragments (in relation to Case-less NP fragments). We argue that the parallelism effect follows from the parser’s general preference to keep the structure of each conjunct maximally parallel in a coordination structure (Kim et al. 2020). Given this, we conclude that P/Case-drop phenomena in Korean gapping are better explained by a PF deletion analysis, supplemented with extra deletion (An 2016, 2019; Erschler 2022) and ellipsis parallelism (Frazier, Munn & Clifton 2000; Kehler 2000; Frazier & Clifton 2001; Carlson 2002), rather than by an LF copying analysis. [ABSTRACT FROM AUTHOR]

Linguistic Research 38(2): 271-299. The present study uses an acceptability judgment experiment designed to investigate whether the acceptability of Korean why-stripping is affected by (i) the polarity difference of the antecedent clause, (ii) the marker ani ‘not’ immediately preceding why, or (iii) the type (i.e., short-form or long-form) of negation in the antecedent clause. We propose that way ‘why’ in Korean why-stripping originates in CP and the non-wh remnant is a focus phrase associated with way ‘why’, following Yoshida et al.’s (2015) clausal ellipsis analysis of English why-stripping. Based on the experimental findings, we show that Korean why-stripping favors affirmative antecedent contexts over negative antecedent contexts, as expected from the processing perspective (Fischler et al. 1983; Herbert and Kübler 2011). We also show that the pre-why (i.e., clause-initial) ani ‘not’ in Korean why-stripping is not a negative marker but a discourse marker of conveying elements of surprise or disbelief (cf. Koo 2008). We further show that the type (i.e., short-form or long-form) of negation in the antecedent clause does not matter in why-stripping. In sum, we defend a grammar-plus-processing analysis of Korean why-stripping. [ABSTRACT FROM AUTHOR]

The skeletal muscle in aged rats adapts rapidly following a period of exercise. This adaptation includes structural remodeling and biochemical changes such as an up-regulation of antioxidant enzymes, content of stress and heat shock proteins (HSPs). However, the associated molecular mechanisms mediating different types of exercise training-induced adaptations are not yet completely understood. Therefore, the purpose of this study was to investigate the effects of duration and frequency exercise on the expression of HSPs, antioxidant enzymes, and mitogen-activated protein kinase (MAPKs) in the skeletal muscles of aged rats. Young (3-month-old) and aged (20-month-old) male Sprague-Dawley rats were randomly assigned to 6 groups and extensor digitorum longus (EDL; fast twitch muscle fiber) and soleus (SOL; slow twitch muscle fiber) skeletal muscles were collected immediately. The expression pattern of HSPs in skeletal muscles was decreased in old groups compared with young groups. Especially, HSPs showed lower expression in SOL than EDL muscle. Interestingly, HSPs in aged rats was increased significantly after S1 (single long-duration; 1x30 min, 5 days/week for 6 weeks) and M1 types (multiple short-duration; 3x10 min⋅day-1, 5 days⋅week-1 for 6 weeks) than S2 (single long-duration; 1x30 min, 3 days/week for 6 weeks) and M2 (multiple short-duration; 3x10 min⋅day-1, 3 days·week-1 for 6 weeks) types of exercise training. Also, superoxide dismutase (SODs) showed similar expression as HSP did. On the contrary, the p-ERK and p-JNK were down regulated. In addition, p-p38 level in the SOL muscle was activated markedly in all exercise groups. These results demonstrate that increasing of HSP expression through duration and frequency exercise can lead to protection and training-induced adaptation against aging-induced structural weakness in skeletal muscles. [ABSTRACT FROM AUTHOR]

Multi-modality imaging is beneficial for both preclinical and clinical applications as it enables complementary information from each modality to be obtained in a single procedure. In this paper, we report the design, fabrication, and testing of a novel tri-modal in vivo imaging system to exploit molecular/functional information from fluorescence (FL) and photoacoustic (PA) imaging as well as anatomical information from ultrasound (US) imaging. The same ultrasound transducer was used for both US and PA imaging, bringing the pulsed laser light into a compact probe by fiberoptic bundles. The FL subsystem is independent of the acoustic components but the front end that delivers and collects the light is physically integrated into the same probe. The tri-modal imaging system was implemented to provide each modality image in real time as well as co-registration of the images. The performance of the system was evaluated through phantom and in vivo animal experiments. The results demonstrate that combining the modalities does not significantly compromise the performance of each of the separate US, PA, and FL imaging techniques, while enabling multi-modality registration. The potential applications of this novel approach to multi-modality imaging range from preclinical research to clinical diagnosis, especially in detection/localization and surgical guidance of accessible solid tumors. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective study. Purpose: To investigate the influence of fat infiltration at low back extensor muscles on osteoporotic vertebral fracture. Overview of Literature: In persons with stronger back muscles, the risk of osteoporotic vertebral fractures will likely be lower than in those persons with weaker back muscles. However, the degree of influence of fat infiltration of the back extensor muscle on osteoporotic vertebral fracture remains controversial. Methods: Two hundred and thirty-seven patients who had undergone lumbar spine magnetic resonance imaging and bone mineral density (BMD) were enrolled in this study. The amount of low back extensor muscle was determined using the pseudocoloring technique on an axial view of the L3 level. The patients were divided into two groups: osteoporotic vertebral fracture group (group A) and non-fracture group (group B). The amount of low back extensor muscle is compared with BMD, degenerative change of disc, osteophyte grade of facet joint and promontory angle to reveal the association between these factors. Results: A negative correlation is found between age and the amount of low back extensor muscle (p =0.001). The amount of low back extensor muscle in group A and group B was 60.3%±14.5% and 64.2%±9.3% respectively, thus showing a significantly smaller amount of low back extensor muscle in the osteoporotic vertebral fracture group (p =0.015). Conclusions: Fat infiltration of low back extensor muscle was increased in osteoporotic vertebral fracture patients. Therefore, fat infiltration of low back extensor muscle in an elderly person may be a risk factor of osteoporotic vertebral fracture. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate the relative surgical risk and problems in hip hemiarthroplasty for treatment of an unstable intertrochanteric fracture in elderly patients over 80 years old. Materials and Methods: Between April 2005 and May 2010, 58 patients whose age was over 80 years were available for inclusion in this study. They were divided into two groups: group 1 included 30 patients with femoral neck fracture and group 2 included 28 patients with intertrochanteric fracture. No significant differences in average age, concomitant disease, and walking ability before development of fracture were noted between the two groups. The following factors, including interval from development of fracture to operation, operation time, amount of blood loss, start time of walking after operation, duration of hospital stay, complications, revision rate, and walking ability were compared between the two groups. Results: Operation time was an average of 85.2 minutes in group 1 and 97.5 minutes in group 2(P=0.03). The amount of bleeding was an average of 483 cc in group 1 and 695 cc in group 2(P=0.006). Similar results for walking start and recovery of walking ability after operation were observed in the two groups. No significant differences were observed in duration of hospital stay, complications, and revision rate. While 25 patients in group 1(83.3%) showed restoration of walking ability after operation to the same level of walking before injury, 19 patients in group 2(67.8%) showed restoration of walking ability postoperatively. Conclusion: Even though patients in group 2 showed a longer operation time and a higher amount of blood loss, compared with those in group 1, patients in group 2 had similar surgical risk and complications, compared with those in group 1. Therefore, primary hip hemiarthropalsty could be a good treatment option for intertrochanteric fracture in elderly. [ABSTRACT FROM AUTHOR]

A UHF band near-field antenna using microstrip lines and stubs for tagging stacked tags in a smart table is presented. It is shown that a suitable near-field reader antenna can be designed from signal lines, ground lines, and several stubs to generate coupled electric and magnetic fields. The proposed near-field reader antenna satisfactorily operates in a UHF radio frequency identification (RFID) smart table, and the measurements show that the antenna is capable of detecting 200 stacked tags in a reading area of 200 mm × 190 mm and achieves a detection rate of 97% when the tags are stacked in a smart table. The proposed UHF RFID smart table is successfully implemented for casino chip management. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52: 1116–1119, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.25115 [ABSTRACT FROM AUTHOR]

Several dielectric as well as conducting pipes buried in the lossy half ground are reconstructed from the scattered fields measured along the air–earth interface. The iterative inversion method using the hybrid optimization algorithm combining the genetic and Levenberg–Marquardt algorithms is used in finding the positions, sizes, and medium parameters, such as the permittivities and conductivities, of the buried pipe cylinders, as well as those of the background lossy half ground. Ill posedness of the inversion caused by the errors in the measured scattered fields is regularized by filtering out the evanescent modes of the scattered fields. © 2001 John Wiley & Sons, Inc. Microwave Opt Technol Lett 31: 140–143, 2001. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the expression of PGC-1α/FNDC5/irisin induced by attenuation of high-fat diet (HFD)-induced bone accrual and determine whether swimming exercise could improve attenuating bone accrual through this mechanism. Eight-week-old Sprague--Dawley rats were divided into two groups for the first 8 weeks: CD, control diet (n = 10); and HFD, high-fat diet (n = 20). HFD-fed rats were again divided into two groups for further 8 weeks treatment: HFD (n = 10) and HFD with swimming exercise (HEx, n = 10). During this time, the CD group continuously fed the normal diet. Throughout the 16 weeks study period, the rats were weighed once every week. Samples were collected for analysis after last 8 weeks of treatment in the 16 weeks. Morphological and structural changes of the femur and tibial bone were observed using micro-CT, and Osteocalcin, CTX-1 and irisin levels in the blood were measured by enzymelinked immunosorbent assay. The expression of IL-1, β-catenin, FNDC5 and PGC-1α, in the femur were evaluated by immunohistochemistry. Eight weeks of HFD increased body weight and epididymal fat mass and decreased bone mineral density (BMD). Subsequent 8 weeks of swimming exercise improved obesity, BMD, bone microstructure, and bone metabolic factors in the HEx group. The irisin levels in the blood and the expressions of FNDC5 and PGC-1α in the bone were significantly lower in the HFD group than in the CD group, but elevated in the HEx group than in the HFD group. Swimming exercise is effective in improving obesity-worsened bone health and increases blood irisin and bone PGC-1α and FNDC5 levels. [ABSTRACT FROM AUTHOR]

In recent years, modular-type floating islands have been considered as a promising option for future ocean space utilization. A modular floating island consists of a number of standardized pontoon-type modules and connectors between them. In this study, the motion responses of a modular floating island in waves was investigated based on frequency-domain numerical analysis. The numerical method is based on the potential flow theory and adopts a higher-order boundary element method with Green’s function. First, motion RAOs were directly compared with the model test data by reference to validate the present numerical method. Then, numerical investigations were conducted to analyze the motion characteristics of the floating island by considering various modules shapes and arrangements. It was found that motion responses were reduced in a single central module compared to when divided central modules were used. Finally, the effect of modular arrangement on the motion responses in irregular waves was discussed. It was confirmed that multiple-layer outer modules are more effective in calming the central module than using single-layer outer modules, except under very long period conditions.