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Background: The superficial veins are commonly used in conventional autogenous arteriovenous fistulas and the placement of prosthetic grafts. When they are unsuitable, however, the use of the deep veins (venae comitantes) is generally considered to be a reasonable alternative. This study conducted a comparative analysis of clinical outcomes for arteriovenous grafts between 2 groups based on the type of venous outflow: superficial veins or venae comitantes. Methods: In total, 151 patients who underwent arteriovenous grafts from November 2005 to March 2022 were retrospectively analyzed. The patients were divided into 2 groups: group A (superficial veins, n=89) and group B (venae comitantes, n=62). The primary, secondary patency, and complication rates were analyzed in each group. A propensity score-matched analysis was performed. Results: In total, 55 well-balanced pairs were matched. Kaplan-Meier analysis revealed no significant differences in the primary patency rate between the 2 groups at 1-year, 3-year and 5-year intervals (group A, 54.7%, 35.9%, 25.4% vs. group B, 47.9%, 16.8%, 12.6%; p=0.14), but there was a difference in the secondary patency rate (group A, 98.2%, 95.3%, 86.5% vs. group B, 87.3%, 76.8%, 67.6%; p=0.0095). The rates of complications, simple percutaneous transluminal angioplasty, and stent insertion were comparable between the groups. Conclusion: Although this study demonstrated not particularly favorable secondary patency rates in the venae comitantes group, the venae comitantes may still be a viable option for patients with unsuitable superficial veins because there were no significant differences in the primary patency and complication rates between the 2 groups.

Patients who have undergone mechanical valve replacement require anticoagulation therapy with warfarin to prevent thromboembolism. However, administering warfarin to pregnant patients increases their risk of warfarin embryopathy or central nervous system disorders. Consequently, safer alternatives, such as heparin or low-molecular-weight heparin injection, are substituted for warfarin. However, limited research has been conducted on this subject, with no large-scale studies and particularly few investigations involving multiparous patients. A patient who had previously undergone mechanical mitral valve replacement for atrial septal defect and mitral stenosis received anticoagulant therapy with enoxaparin during 2 pregnancies. Upon confirmation of pregnancy, warfarin was replaced with subcutaneously injected enoxaparin with a dosage of 1 mg/kg at 12-hour intervals. The enoxaparin dosage was controlled using an anti-factor Xa assay, with a target range of 0.3–0.7 IU/mL. Intravenous heparin injections were administered starting 3 days prior to the expected delivery date and were continued until delivery, after which warfarin was resumed. No complications were observed during the deliveries.

Purpose Although radical cystectomy (RC) and concurrent chemoradiotherapy (CCRT) are curative options for muscle-invasive bladder cancer (MIBC), the optimal treatment strategy for MIBC patients with a history of nephroureterectomy for upper tract urothelial carcinoma (UTUC) remains unclear. This retrospective analysis was conducted to compare survival rates and evaluate prognostic factors related to treatment outcomes. Materials and Methods We conducted a multi-institutional retrospective study of patients with MIBC after nephroureterectomy for UTUC between 2005 to 2023. Out of 75 patients, 30 underwent bladder-preserving therapy (BPT), including 22 patients who underwent radiation therapy (RT) and 8 patients who underwent CCRT, while 45 patients underwent RC. The overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) after BPT and RC were evaluated using Kaplan-Meier curves. Cox regression analysis was used to identify variables associated with OS, CSS, and PFS. Posttreatment changes in renal function were compared. Results At 3 years, the OS, CSS, and PFS rates in the BPT group were 52.4%, 71.7%, and 31.3%, respectively, with no significant difference compared to RC. In multivariate analysis, bladder cancer T stage was the only predictive factor for OS, CSS, and PFS. Similar results were also observed in the RT group compared to RC. A significant decrease in renal function was detected among patients in the RC group, while patients in the BPT group maintained preserved renal function. Patients in the BPT group experienced a lower grade of toxicity after treatment compared to those in the RC group, and the rates of survival with functional bladder at 1 year, 3 years, and 5 years were 87.0%, 69.9%, and 69.9%, respectively. Conclusions Bladder-preserving therapy, including RT alone, may be a viable treatment option for patients with MIBC who have undergone nephroureterectomy, as it can achieve comparable oncologic outcomes to RC, while potentially preserving bladder and renal function.

Bahn et al explore the role of the lipid raft protein Prominin-1 in liver regeneration. They show that Prominin-1 promotes hepatocyte proliferation after acute liver injury by interacting with the signal transducer GP130, confining it to lipid rafts and activating IL-6 signaling pathway and eventual activation of STAT3.

Purpose: Nocturia is the most bothersome of lower urinary tract symptoms in men. Desmopressin, a synthetic analog of the human hormone vasopressin, has been used for the treatment of nocturia. However, the guidelines include varying recommendations for the use of desmopressin for the management of nocturia in men. Therefore, the Korean Urological Association (KUA) developed recommendations for desmopressin for the treatment of nocturia in men. Materials and Methods: A rigorous systematic review was performed and Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to rate the certainty of evidence for patient outcomes and to develop the evidence into recommendations. The steering group, guidelines development group, systematic review team, and external review group consisted of members of the Korean Continence Society, Korean Society of Geriatric Urological Care, and KUA, respectively, who were involved in the guidelines development process. Results: The guidelines address the benefits, harms, patients’ values and preferences, costs, and resources related to desmopressin by using a single clinical question: What is the effectiveness of desmopressin compared to that of placebo, behavior modification, or other pharmacological therapies?Conclusions: The guidelines development panel suggests desmopressin for men with nocturia instead of placebo, behavior modification, or alpha-blocker monotherapy (low certainty of evidence, weak recommendation). Additionally, the panel suggests desmopressin combination therapy with alpha-blockers for men with nocturia instead of alpha-blocker monotherapy or alpha-blocker combination therapy with anticholinergic agents (low certainty of evidence, weak recommendation).

(1) Background: To identify the association between the presence or absence of a raphe and aortic valve dysfunction, as well as the presence of aortopathy in patients with a bicuspid aortic valve (BAV); (2) Methods: This retrospective study enrolled 312 participants (mean (SD) age, 52.7 (14.3) years; 227 men (72.8%)) with BAV. The BAVs were divided into those with the presence (raphe+) or absence (raphe−) of a raphe. Valvular function was classified as normal, aortic regurgitation (AR), or aortic stenosis (AS) using TTE. The pattern of BAV aortopathy was determined by the presence of dilatation at the sinus of Valsalva and the middle ascending aorta using CCT; (3) Results: BAVs with raphe+ had a higher prevalence of AR (148 (79.5%) vs. 48 (37.8%), p < 0.001), but a lower prevalence of AS (90 (48.6%) vs. 99 (78.0%), p < 0.001) compared with those with raphe−. The types of BAV aortopathy were significantly different (p = 0.021) according to those with BAV–raphe+ and BAV–raphe−; (4) Conclusions: The presence of a raphe was significantly associated with a higher prevalence of AR, but a lower prevalence of AS and combined dilatation of the aortic root and middle ascending aorta. The presence of a raphe was an independent determinant of AR.

CREB-regulated transcription coactivator 2, CRTC2, has been associated with regulation of glucose and lipid homeostasis. Here Han et al. show that Creb/Crtc2 modulates lipid and glucose metabolism by inhibiting the expression of mi-R34 that, in turn, represses the expression of Sirt1 and PPARα and consequently Fgf21 levels.

Background: There have been a number of studies on mitral valve replacement and repeated percutaneous mitral balloon valvotomy for mitral valve restenosis after percutaneous mitral balloon valvotomy. However, studies on mitral valve repair for these patients are rare. In this study, we analyzed postoperative outcomes of mitral valve repair for mitral valve restenosis after percutaneous mitral balloon valvotomy. Methods: In this study, we assessed 15 patients (mean age, 47.7±9.7 years; 11 female and 4 male) who underwent mitral valve repair between August 2008 and March 2013 for symptomatic mitral valve restenosis after percutaneous mitral balloon valvotomy. The mean interval between the initial percutaneous mitral balloon valvotomy and the mitral valve repair was 13.5±7 years. The mean preoperative Wilkins score was 9.4±2.6. Results: The mean mitral valve area obtained using planimetry increased from 1.16±0.16 cm2 to 1.62±0.34 cm2 (p=0.0001). The mean pressure half time obtained using Doppler ultrasound decreased from 202.4±58.6 ms to 152±50.2 ms (p=0.0001). The mean pressure gradient obtained using Doppler ultrasound decreased from 9.4±4.0 mmHg to 5.8±1.5 mmHg (p=0.0021). There were no early or late deaths. Thromboembolic events or infective endocarditis did not occur. Reoperations such as mitral valve repair or mitral valve replacement were not performed during the follow-up period (39±16 months). The 5-year event-free survival was 56.16% (95% confidence interval, 47.467–64.866). Conclusion: On the basis of these results, we could not conclude that mitral valve repair could be an alternative for patients with mitral valve restenosis after percutaneous balloon mitral valvotomy. However, some patients presented with results similar to those of mitral valve replacement. Further studies including more patients with long-term follow-up are necessary to determine the possibility of this application of mitral valve repair.

Trichoderma species are widely used for the commercial production of cellulolytic enzymes. In the present investigation, medium components were optimized using a central composite design and response surface methodology to produce endoglucanase (EG) from Trichoderma harzianum KUC1716. From the various medium components tested, cellulose, soy peptone, and thiamine HCl were selected as the optimal carbon, nitrogen, and vitamin sources, respectively. The highest EG (1.97 U/mL) production was obtained with 1.85% cellulose, 0.48% soy peptone, and 0.10% thiamine HCl. EG production in the optimized medium was 2.6 fold higher than in the unoptimized medium. In addition, the crude enzyme preparation from T. harzianum KUC1716 supplemented with β-glucosidase from Schizophyllum commune KUC9397 was used to hydrolyze various types of lignocellulosic materials and showed significant saccharification yields on all lignocellulosic materials, surpassing that of a commercial enzyme cocktail. It was verified that the crude enzyme preparation derived from T. harzianum KUC1716 could replace the commercial enzymes. This highlights the potential of the crude enzymes for use in biomass conversion systems.

Objective To investigate whether prostate-specific antigen (PSA) fluctuation correlates with a prostate cancer and to assess whether PSA fluctuation could be used for diagnosis of prostate cancer. Materials and Methods Our study included 229 patients who were performed a prostate biopsy (non-cancer group, 177; prostate cancer group, 52). Enrolled patients were provided twice PSA tests within 6 months. PSA fluctuation (%/month) was defined as a change rate of PSA per a month. Independent t test was used to compare between two groups. Receiver operator characteristic curve was used to assess the availability as a differential diagnostic tool and the correlation. Simple linear regression was performed to analyze a correlation between PSA fluctuation and other factors such as age, PSA, PSA density, and prostate volume. Results There were significant differences in PSA, PSA density, percentage of free PSA, and PSA fluctuation between two groups. PSA fluctuation was significantly greater in non-cancer group than prostate cancer group (19.95±23.34%/month vs 9.63±8.57%/month, P=0.004). The most optimal cut-off value of PSA fluctuation was defined as 8.48%/month (sensitivity, 61.6%; specificity, 59.6%; AUC, 0.633; P=0.004). In a simple linear regression model, only PSA level was significantly correlated with PSA fluctuation. Conclusion Patients with wide PSA fluctuations, although baseline PSA levels are high, might have a low risk of diagnosis with prostate cancer. Thus, serial PSA measurements could be an option in patients with an elevated PSA level.

This study investigated the morphological and functional characteristics of the aortic valve and the left ventricular (LV) systolic functional parameters and myocardial mass related to the severity of myocardial fibrosis (MF) in patients with severe aortic valve stenosis (AS).We retrospectively enrolled 81 patients (48 men; mean age: 59±12 years) with severe AS who underwent transthoracic echocardiography (TTE), cardiac computed tomography (CCT), and cardiovascular magnetic resonance (CMR) within 1 month and subsequent aortic valve surgery. Degree of MF was determined on delayed contrast-enhanced CMR with visual sub-segmental analysis-based quantification and was classified into three groups (no, mild, and severe) for identifying the differences in LV function and characteristics of the aortic valve. One-way ANOVA, Chi-square test or Fisher's exact test were used to compare variables of the three groups. Univariate multinomial logistic regression analysis was performed to determine the association between the severity of MF and variables on imaging modalities.Of 81 patients, 34 (42%) had MF (mild, n = 18; severe, n = 16). Aortic valve calcium volume score on CCT, aortic valve area, LV mass index, LV end-diastolic volume index on CMR, presence of mild aortic regurgitation (AR), transaortic mean pressure gradient, and peak velocity on TTE were significantly different among the three groups and were associated with severity of MF on a univariate multinomial logistic regression analysis. Aortic valve calcium grade was different (p = 0.008) among the three groups but not associated with severity of MF (p = 0.375).A multi-imaging approach shows that severe AS with MF is significantly associated with more severe calcific AS, higher LV end-diastolic volume, higher LV mass, and higher prevalence of mild AR.

Medium components for β-glucosidase (BGL) production in Schizophyllum commune KUC9397 were optimized using a central composite design and response surface methodology. From the various medium components tested, cellulose, soy peptone, and thiamine HCl were selected as the optimal carbon, nitrogen, and vitamin sources, respectively. The highest BGL production was obtained with 2.96% cellulose, 2.30% soy peptone, and 0.11% thiamine HCl. BGL production in the optimized medium was increased 7.2-fold compared to production in an unoptimized medium. Crude enzyme preparation from S. commune KUC9397 was used to saccharify pretreated lignocellulosic biomass. The crude enzyme preparations showed statistically equal saccharification rates as Cellobiase, a commercial BGL. This finding indicates that crude enzymes produced by S. commune KUC9397 have good potential for application in cellulosic biomass conversion systems in place of Cellobiase.

Purpose The precise etiology and classification of nocturia in women is not enough. We evaluated age related changes and classified the type of nocturia by age in women. Methods We included 118 women 20 years or older with nocturia at least one time during night time. Subjects were divided into three groups by the age: group 1, under 40 years; group 2, 40 through 59 years; group 3, 60 years and above. The causes of nocturia and its pattern changed by age in women were evaluated using 3 days frequency volume chart. Nocturia was devided into three types: nocturnal polyuria, decreased nocturnal bladder capacity and mixed type. Results The mean age was 57.2±11.8 and the mean nocturnal frequency was 2.7±1.8. In all age group, noctural polyuria was the major cause for noturia (40.8%), followed by low nocturnal bladder capacity (23.7%). As a major cause of nocturia, there was a significant increase of the incidence of nocturnal polyuria in aged people: group 1, 32.4%; group 2, 41.0%; group 3: 47.6% (P

In this study, the optimum conditions for pretreatment of corn stover using organosolv were determined. The predicted optimum conditions, determined using the response surface methodology, were ethanol concentration of 56.6 wt %, reaction temperature of 187.5 °C, and 320 mL of liquid throughput. Moreover, the pretreatment using recycled organosolv was carried out under the predicted optimum conditions. The pretreatment effect of the organosolv decreased as the organosolv was reused in the pretreatment process. When performing pretreatment with the initial organosolv, enzymatic digestibility for glucan was 71.0%. The digestibility was reduced as low as less than 66% in the first reuse process. Nevertheless, when repeatedly reusing the organosolv, the glucan digestibility remained mostly stable. It was confirmed that organosolv can be reused in the flow-through pretreatment of corn stover.

Eight aminoacyl-tRNA synthetases (M, K, Q, D, R, I, EP and LARS) and three auxiliary proteins (AIMP1, 2 and 3) are known to form a multi-tRNA synthetase complex (MSC) in mammalian cells. We combined size exclusion chromatography (SEC) with reversed-phase liquid chromatography multiple reaction monitoring mass spectrometry (RPLC-MRM-MS) to characterize MSC components and free ARS proteins in human embryonic kidney (HEK 293T) cells. Crude cell extract and affinity-purified proteins were fractionated by SEC in non-denaturing state and ARSs were monitored in each fraction by MRM-MS. The eleven MSC components appeared mostly in earlier SEC fractions demonstrating their participation in complex formation. TARSL2 and AIMP2-DX2, despite their low abundance, were co-purified with KARS and detected in the SEC fractions, where MSC appeared. Moreover, other large complex-forming ARS proteins, such as VARS and FARS, were detected in earlier fractions. The MRM-MS results were further confirmed by western blot analysis. Our study demonstrates usefulness of combined SEC-MRM analysis for the characterization of protein complexes and in understanding the behavior of minor isoforms or variant proteins.

Twenty different aminoacyl-tRNA synthetases (ARSs) link each amino acid to their cognate tRNAs. Individual ARSs are also associated with various non-canonical activities involved in neuronal diseases, cancer and autoimmune diseases. Among them, eight ARSs (D, EP, I, K, L, M, Q and RARS), together with three ARS-interacting multifunctional proteins (AIMPs), are currently known to assemble the multi-synthetase complex (MSC). However, the cellular function and global topology of MSC remain unclear. In order to understand the complex interaction within MSC, we conducted affinity purification-mass spectrometry (AP-MS) using each of AIMP1, AIMP2 and KARS as a bait protein. Mass spectrometric data were funneled into SAINT software to distinguish true interactions from background contaminants. A total of 40, 134, 101 proteins in each bait scored over 0.9 of SAINT probability in HEK 293T cells. Complex-forming ARSs, such as DARS, EPRS, IARS, Kars, LARS, MARS, QARS and RARS, were constantly found to interact with each bait. Variants such as, AIMP2-DX2 and AIMP1 isoform 2 were found with specific peptides in KARS precipitates. Relative enrichment analysis of the mass spectrometric data demonstrated that TARSL2 (threonyl-tRNA synthetase like-2) was highly enriched with the ARS-core complex. The interaction was further confirmed by coimmunoprecipitation of TARSL2 with other ARS core-complex components. We suggest TARSL2 as a new component of ARS core-complex.

Background and Objective: Since methomyl shows a highly significant toxicity, the clinical outcome of acute methomyl pesticide intoxication is extremely critical. Methomyl is a kind of carbamate poisons. Similar to intoxications with other carbamate insecticides, methomyl intoxication inhibits the activity of acetylcholinesterase, which is contained within synaptic junctions between neurons. Most of the methomyl intoxication cases present with symptoms of cholinergic excess, which provokes respiratory failure, cardiovascular failure, and/or cardiorespiratory failure. Methomyl poisoning in humans has not yet been fully evaluated and most studies have reported sporadic cases or series of intoxication. Methomyl poisoning remains a continuing challenge, because this difficult-to-treat clinical condition is frequently associated with significantly high mortality and morbidity. We evaluated the usefulness of extracorporeal membrane oxygenation in the treatment of methomyl intoxication. Methods: A systematic literature review was conducted using the PRISMA guidelines without language restriction. We searched for scientific publications via PubMed, Embase, Cochrane central register of controlled trial, Google Scholar, the KoreaMed, and the Research Information Sharing Service database. The goal of this study was to report on incidence, associated complications, and morbidity/mortality of methomyl poisoning, and to draw special attention to its management with extracorporeal membrane oxygenation. Results: Only 1 case of a child treated with extracorporeal membrane oxygenation for carbamate or organophosphate intoxication was identified in the literature. After carbamate or organophosphate intoxication, the patient suffered from severe complications including neurological deficits, renal insufficiency, and severe respiratory failure. This child was treated with continuous hemofiltration and extracorporeal membrane oxygenation, but expired after 38 days of extracorporeal membrane oxygenation. In case of our patient, he recovered from the methomyl intoxication after 7 days of VA-ECMO. Conclusions: With only a few exceptions, acute methomyl poisoning is potentially life-threatening and has high incidences of morbidity and mortality. Therefore, physicians should keep in mind the possibility of extracorporeal membrane oxygenation for the quick support of intoxication. Extracorporeal membrane oxygenation support might be an alternative to overcome the cholinergic excess, such as respiratory failure, cardiovascular failure, and/or cardiorespiratory failure, especially in the case of severe acute methomyl intoxication. [ABSTRACT FROM AUTHOR]

A response surface methodology (RSM) tool with the Box-Behnken design was used to determine the optimum pretreatment conditions of Helianthus tuberosus residue for the enzymatic production of fermentable sugar with aqueous ammonia and sulfuric acid solutions, for various parameters such as pretreatment solution concentration, temperature, and reaction time. The pretreatment of biomass was performed using these optimized parameters in aqueous ammonia and sulfuric acid solution, followed by hot water, under the same conditions. The process was then performed by changing the sequence. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare serum nitrotyrosine concentrations in healthy dogs with those in dogs with myxomatous mitral valve disease (MMVD). Fifty client-owned dogs were included in this study. Based on echocardiographic results, dogs were categorized into healthy (control), mild-, moderate-, and severe-MMVD groups. Serum nitrotyrosine concentrations were determined from enzyme-linked immunosorbent assays. No significant difference between control dogs and dogs with mild MMVD was detected (p = 0.31). However, dogs with moderate MMVD had significantly higher serum concentrations of nitrotyrosine (p = 0.04) than that in controls, and dogs with severe MMVD had significantly lower serum concentrations of nitrotyrosine (p = 0.03) than that in moderate MMVD dogs. There were negative correlations in the association of serum nitrotyrosine with age (n = 30, R2= 0.067, p = 0.27), left atrial-to-aortic root diameter ratio (n = 30, R2= 0.02, p = 0.57), and platelet count (n = 30, R2= 0.39, p = 0.003); however, only the platelet correlation was significant. Among dogs with MMVD, there was no significant difference in serum nitrotyrosine concentration between males and females. The results of this study suggest that tyrosine nitration end-products might be potential biomarkers for the detection of MMVD in dogs. [ABSTRACT FROM AUTHOR]

Background: In this article, it was analyzed how snow melting affects the assembly of lichen and moss communities in a small area of the coastal region of Barton Peninsula, which is in maritime Antarctic. In the small area, even though there is a huge gap of difference of the environment between the snow-filled area and snow-melt one, the latter did not have distinctive environmental gradients. Results: Depending on the snow melting time, coverage and species diversity of lichens and mosses tend to increase remarkably. For species with significant changes depending on the snow-covered period, there are Andreaea regularis, crustose lichens, Placopsis contortuplicata, Usnea aurantiaco-atra, and snow algae. In this area, the process of vegetation assembly process has shown the directional development in the order of snow algae→crustose, lichen sub-formation→fruticose lichen, moss cushion sub-formation (Andreaea sociation)→fruticose lichen, and moss cushion sub-formation (Usnea sociation), according to the order of snow melting. These directional development stages are shown in gradual change in small area with the snow melting phenomena. However, in the snow-free area, where water is sufficiently supplied, it is expected that moss carpet sub-formation (Sanionia sociation) will be developed. Vegetation development in the small area with the snow melting phenomena, depending on differences of resistance on snow kill and moisture settled by species in according to the time of snow melting, tolerance model to form community is followed. Conclusions: The research results explain the development of vegetation in the Antarctic tundra and its spatial distribution according to the period for growth of lichens and mosses in the summer time by differences of snow melting in the small area. In the future, if research for the community development process in a large scale will be done, it will be helpful to figure out temporal and spatial dynamic of vegetation in the Antarctic tundra where snow and glaciers melt rapidly due to climatic warming. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods: A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. Results: The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion: Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome. [ABSTRACT FROM AUTHOR]

Background: Mitral valve repair is favored over replacement due to superior outcomes. However, extensive infective endocarditis (IE) often has been considered unreconstructable. We retrospectively analyzed the mid-term outcomes of an individualized repair approach using a lifting annuloplasty strip.Methods: Between December 2007 and March 2014, 27 consecutive patients with acute single mitral valve IE (age 43 ± 16 years, 11 men) underwent lifting mitral annuloplasty (LMA) with a strip (Mitracon® strip, 28 mm in 4, 32 mm in 10, and 34 mm in 13). Blood culture was positive in 70 % (Streptococcus 10, Staphylococcus 4, HACEK 3, Enterococcus 1, Gram negative bacilli 1). One case (4 %) had a previously repaired mitral valve-the repair was redone. Via right thoracotomy (74 %) or median sternotomy (26 %), repair was performed by removal of vegetation and resection of infected tissue, the defect typically then being repaired using a bovine pericardial patch (81 %). Artificial chordae were formed in 5 patients. Nine (33 %) of them had posterior leaflet augmentation (PLA) to get sufficient coaptation height. Clinical and echocardiographic follow-up were performed.Results: Compared with preoperative ones, postoperative echocardiograms revealed decreases of left ventricular (LV) end-diastolic dimensions (57.2 ± 6.3 versus, 45.4 ± 6.2, or 44.8 ± 4.1 mm, all p < 0.01). The LV ejection fraction decreased immediately, but recovered (64.4 ± 9.6 % vs. 54.5 ± 9.8 %, or 65.2 ± 6.1 %, p = 0.002, p = 1.000, respectively). The latest follow-up echocardiograms (median 28 months) universally showed no or minimal regurgitation, with a preserved mitral valve opening area (2.27 ± 0.48 cm(2)). During the clinical follow-up (median, 54 months), one (3.7 %) death was observed (in-hospital, due to biliary sepsis and pneumonia). There was no reoperation or major cardiovascular event. The 5 year survival rate was 96.3 %.Conclusions: The repair technique of LMA and/or PLA in patients with IE achieved good structural and functional outcomes as well as an excellent 5 year survival rate. An individualized repair approach should be recommended in patients with acute phase IE. [ABSTRACT FROM AUTHOR]

Medium components for ß-glucosidase (BGL) production in Schizophyllum commune KUC9397 were optimized using a central composite design and response surface methodology. From the various medium components tested, cellulose, soy peptone, and thiamine HCl were selected as the optimal carbon, nitrogen, and vitamin sources, respectively. The highest BGL production was obtained with 2.96% cellulose, 2.30% soy peptone, and 0.11% thiamine HCl. BGL production in the optimized medium was increased 7.2-fold compared to production in an unoptimized medium. Crude enzyme preparation from S. commune KUC9397 was used to saccharify pretreated lignocellulosic biomass. The crude enzyme preparations showed statistically equal saccharification rates as Cellobiase, a commercial BGL. This finding indicates that crude enzymes produced by S. commune KUC9397 have good potential for application in cellulosic biomass conversion systems in place of Cellobiase. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is a life-threatening arrhythmia that carries the high risk of thromboembolic complication. Stroke often develops in patients who undergo successful Cox Maze procedure, despite the fact that the procedure has shown a high rate of success in sinus conversion from AF. This study examined the preoperative risk factors predictive of stroke following Cox Maze procedure in patients with mitral valve disease. Methods: 240 patients with the mean age of 57 years underwent Cox-Maze IV procedure with mitral valve repair from November 2007 through December 2010. All patients were available during the follow-up period with the mean duration of 23.6 months. This study excluded those patients who had undergone mitral valve replacement because of maintenance of warfarin medication Results: Sixteen patients had an ischemic stroke. Of these sixteen patients, six had a transitional ischemic accident while the remaining ten had cerebral infarction. Twelve of sixteen showed sustained sinus rhythm, three showed AF and one had pacing rhythm. Univariate analysis showed that only preoperative stroke history was associated with postoperative stroke (p = 0.03). High CHA2DS2-VASc score, rheumatic etiology, large left atrium (LA), preoperative or postoperative LA thrombus, age, sex, hypertension, and concomitant surgery were not associated with predictive risks for stroke. Conclusions: In the group of patients who underwent the Cox-Maze procedure with mitral valve repair, having a stroke history was the only preoperative risk factor that could lead to a stroke event after surgery. Accordingly, patients with affliction of ischemic stroke, albeit sustained sinus rhythm, may require prophylactic anticoagulation. [ABSTRACT FROM AUTHOR]

Background. Aortic valve reconstruction surgery (AVRS), consisting of aortic leaflet reconstruction with tailored pericardial patches and fixation of the sinotubular junction with properly sized fabric rings, is performed for the treatment of aortic valve diseases. The early and midterm outcomes of AVRS were analyzed. Methods. Between December 2007 and December 2012, 262 patients with isolated aortic valve disease underwent AVRS in one center. Clinical outcomes, effective orifice area, mean gradients, and left ventricular mass index were evaluated yearly. Results. Mean follow-up duration was 36.0 ± 17.1 months and was complete in 100% of surviving patients. There was no hospital mortality, but there were 3 late deaths (1.1% late mortality). Seven patients (2.7%) required reoperation: 5 because of endocarditis and 2 because of suture disruption of the leaflets. Ten patients (3.8%) experienced neurologic events. Aortic valve regurgitation was absent or trivial in 226 patients (87.3%) and mild in 29 (11.2%), mild to moderate in 3 (1.2%), and moderate to severe in 1 (0.4%). The mean valve gradient and valve orifice index were 10.6 ± 5.3 mm Hg and 1.3 ± 0.4 cm²/m², respectively. Conclusions. The data from the first 5 years after AVRS reveal good clinical and hemodynamic outcomes, suggesting that AVRS is a new alternative technique to the practice of replacement with stented bioprostheses and mechanical prostheses. However, whether the reconstructed aortic valve represents a truly long-term valve remains to be demonstrated. [ABSTRACT FROM AUTHOR]

Background Quadricuspid aortic valve (QAV) is a rare congenital anomaly. We investigate the mid-term results of aortic valve reconstruction by tricuspidization in patients with QAV. Methods We analyzed the outcome of eight consecutive patients who underwent aortic valve reconstruction surgery (AVRS) with pericardial leaflets with symptomatic quadricuspid aortic valve (QAV) disease between December 2007 and May 2012. AVRS consists of leaflet reconstruction and fixation of the sino-tubular junction in order to maintain coaptation of the new valve. Results Six males and two females were included; ages ranged from 19 to 63 years (mean age, 51 years). According to Hurwitz and Roberts's classification, three patients had type A, three patients had type B, one patient had type C, and one patient had type E. All patients had significant aortic regurgitation (AR): moderate in three patients, moderate to severe in one patient, and severe in four patients. Concomitant ascending aorta wrapping with an artificial vascular graft was performed in one case. There was no occurrence of mortality during the follow-up period (42.4 ± 18.0 months). No redo-operation was required. The NYHA functional class showed improvement from 2.1 ± 0.2 to 1.1 ± 0.2 (p = 0.008). The latest echocardiograms showed AR absent or trivial in seven patients, and mild in one patient. The aortic valve orifice area index (AVAI) was 1.03 ± 0.49 cm²/m². Compared with preoperative echocardiograms, the left ventricular (LV) ejection fraction showed improvement from 57.6 ± 17.0 to 63.7 ± 13.2% (p = 0.036); the end-diastolic and end-systolic LV dimensions showed a significant decrease, from 63.5 ± 9.6 to 49.5 ± 3.1 mm (p = 0.012) and 43.6 ± 11.8 to 32.1 ± 5.4 mm (p = 0.012), respectively. Conclusion In patients with QAV, AVRS with tricuspidization showed satisfactory early and mid-term results. Long-term follow-up will be necessary in order to study the durability of AVRS; however, it can be considered as a potential standard procedure. [ABSTRACT FROM AUTHOR]

Background Empty fruit bunch (EFB) has many advantages, including its abundance, the fact that it does not require collection, and its year-round availability as a feedstock for bioethanol production. But before the significant costs incurred in ethanol production from lignocellulosic biomass can be reduced, an efficient sugar fractionation technology has to be developed. To that end, in the present study, an NaOH-catalyzed steam pretreatment process was applied in order to produce ethanol from EFB more efficiently. Results The EFB pretreatment conditions were optimized by application of certain pretreatment variables such as, the NaOH concentrations in the soaking step and, in the steam step, the temperature and time. The optimal conditions were determined by response surface methodology (RSM) to be 3% NaOH for soaking and 160°C, 11 min 20 sec for steam pretreatment. Under these conditions, the overall glucan recovery and enzymatic digestibility were both high: the glucan and xylan yields were 93% and 78%, respectively, and the enzymatic digestibility was 88.8% for 72 h using 40 FPU/g glucan. After simultaneous saccharification and fermentation (SSF), the maximum ethanol yield and concentration were 0.88 and 29.4 g/l respectively. Conclusions Delignification (>85%) of EFB was an important factor in enzymatic hydrolysis using CTec2. NaOH-catalyzed steam pretreatment, which can remove lignin efficiently and requires only a short reaction time, was proven to be an effective pretreatment technology for EFB. The ethanol yield obtained by SSF, the key parameter determining the economics of ethanol, was 18% (w/w), equivalent to 88% of the theoretical maximum yield, which is a better result than have been reported in the relevant previous studies. [ABSTRACT FROM AUTHOR]

Background: Use of lignocellulosic biomass has received attention lately because it can be converted into various versatile chemical compounds by biological processes. In this study, a two-step pretreatment with dilute sulfuric acid and aqueous ammonia was performed efficiently on rice straw to obtain fermentable sugar. The soaking in aqueous ammonia process was also optimized by a statistical method. Results: Response surface methodology was employed. The determination coefficient (R²) value was found to be 0.9607 and the coefficient of variance was 6.77. The optimal pretreatment conditions were a temperature of 42.75°C, an aqueous ammonia concentration of 20.93%, and a reaction time of 48 h. The optimal enzyme concentration for saccharification was 30 filter paper units. The crystallinity index was approximately 60.23% and the Fourier transform infrared results showed the distinct peaks of glucan. Ethanol production using Saccharomyces cerevisiae K35 was performed to verify whether the glucose saccharified from rice straw was fermentable. Conclusions: The combined pretreatment using dilute sulfuric acid and aqueous ammonia on rice straw efficiently yielded fermentable sugar and achieved almost the same crystallinity index as that of α-cellulose. [ABSTRACT FROM AUTHOR]

Biomass was pretreated with proton beam irradiation (PBI) in order to enhance enzyme digestibility. Rice straw and soaking in aqueous ammonia (SAA)-treated rice straw were treated with 1-25 kGy doses of PBI at a beam energy of 45 MeV. The optimal doses of PBI for efficient sugar recovery were 15 and 3 kGy for rice straw and SAA-treated rice straw, respectively. When PBI was applied to rice straw at 15 kGy, the glucose conversion reached 68% of the theoretical maximum at 72 h. When 3 kGy of PBI was applied to SAA-treated rice straw, approximately 90% of the theoretical glucose conversion was obtained at 12 h compared to a 89% conversion at 48 h. After 2 h of enzymatic saccharification, the initial reaction rates of raw rice straw pretreated with 15 kGy of PBI and SAA-treated rice straw pretreated with 3 kGy of PBI were 1.4 × 10 and 9.7 × 10 g L s, respectively. Further, the results of X-ray diffractometry support the effect of PBI on sugar recovery, whereas scanning electron microscopy images revealed a more rugged rice straw surface. [ABSTRACT FROM AUTHOR]

Biological conversion of biomass into fuels and chemicals requires hydrolysis of the polysaccharide fraction into monomeric sugars prior to fermentation. Hydrolysis can be performed enzymatically or with mineral acids. In this study, dilute sulfuric acid was used as a catalyst for the pretreatment of rapeseed straw. The purpose of this study is to optimize the pretreatment process in a 15-mL bomb tube reactor and investigate the effects of the acid concentration, temperature, and reaction time. These parameters influence hemicellulose removal and production of sugars (xylose, glucose, and arabinose) in the hydrolyzate as well as the formation of by-products (furfural, 5-hydroxymethylfurfural, and acetic acid). Statistical analysis was based on a model composition corresponding to a 3³ orthogonal factorial design and employed the response surface methodology to optimize the pretreatment conditions, aiming to attain maximum xylan, mannan, and galactan (XMG) extraction from hemicellulose of rapeseed straw. The obtained optimum conditions were: H2SO4 concentration of 1.76% and temperature of 152.6 °C with a reaction time of 21 min. Under these optimal conditions, 85.5% of the total sugar was recovered after acid hydrolysis (78.9% XMG and 6.6% glucan). The hydrolyzate contained 1.60 g/L glucose, 0.61 g/L arabinose, 10.49 g/L xylose, mannose, and galactose, 0.39 g/L cellobiose, 0.94 g/L fructose, 0.02 g/L 1,6-anhydro-glucose, 1.17 g/L formic acid, 2.94 g/L acetic acid, 0.04 g/L levulinic acid, 0.04 g/L 5-hydroxymethylfurfural, and 0.98 g/L furfural. [ABSTRACT FROM AUTHOR]

Abstract  A log of waste oak wood collected from a Korean mushroom farm has been tested for ammonia percolation pretreatment. The waste log has different physical characteristics from that of virgin oak wood. The density of the waste wood was 30% lower than that of virgin oak wood. However, there is little difference in the chemical compositions between the woods. Due to the difference in physical characteristics, the optimal pretreatment conditions were also quite different. While for waste oak the optimum temperature was determined to be 130°C, for virgin oak wood the optimum pretreatment was only achieved at 170°C. Presoaking for 12 h with ammonia solution before pretreatment was helpful to increase the delignification efficiency. [ABSTRACT FROM AUTHOR]

The silica and urushiol based organic/inorganic hybrid was prepared with TEOS and urushiol by sol-gel process. GLYMO, as a silane-coupling agent, was used to obtain crack-free homogeneous films in various molar ratios, and to improve the adhesion between corona-treated BOPP substrate and the coatings. Two kinds of coating solutions were prepared; one was composed of TEOS and urushiol, the other was a mixture of TEOS, GLYMO and urushiol. Urushiol created less cracks on the film in a narrow range of molar ratios. As the amounts of urushiol were increased, the coating solutions quickly became heterogeneous. GLYMO was sufficient to prevent microcracks on the coated film and provided homogeneous coating solution. TEOS/urushiol and TEOS/GLYMO/urushiol coating solution gave insignificant effect on the permeability coefficients of oxygen, nitrogen and carbon dioxide, because the unsaturated alkyl side chain of urushiol might retard the formation of a dense structure between the inorganic silicate and the organic urushiol phase. From the antibacterial test of uncoating PP substrate and the coated film with hybrid solution, the reduction of bacteria of coating film was calculated to be 99.8%. [ABSTRACT FROM AUTHOR]

Acid-catalyzed hydrolysis is controlled not only by temperature and acid concentration but also by the physical state of the cellulose. Under low temperature and acid condition the cellulose structure stays in stable crystalline form. Therefore, the prevailing reaction mode is endwise hydrolysis. Glucose then becomes the main sugar product. However, when temperature and/or acid concentration is raised to a certain level, the cellulose structure becomes unstable by breakage of hydrogen bonding, the primary force that holds the cellulose chains. Once the crystalline structure of the cellulose is disrupted, acid molecules can penetrate into the inner layers of the cellulose chains. In support of this hypothesis, we have experimentally verified that a substantial amount of oligomers is formed as reaction intermediates under extremely low-acid and high-temperature conditions. We also found that the breakage of hydrogen bonds occurs rather abruptly in response to temperature. One such condition is 210°C, 0.07% H2SO4. Glucose, once it is formed in the hydrolysate, interacts with acid-soluble lignin, forming a lignin-carbohydrate complex. This occurs concurrently with other reactions involving glucose such as decomposition and reversion. On the basis of these findings, a comprehensive kinetic model is proposed. This model is in full compliance with our recent experimental data obtained under a broad range of reaction conditions. [ABSTRACT FROM AUTHOR]

The accurate identification of pills is essential for their safe administration in the medical field. Despite technological advancements, pill classification encounters hurdles such as ambiguous images, pattern similarities, mixed pills, and variations in pill shapes. A significant factor is the inability of 2D imaging to capture a pill’s 3D structure efficiently. Additionally, the scarcity of diverse datasets reflecting various pill shapes and colors hampers accurate prediction. Our experimental investigation shows that while color-based classification obtains a 95% accuracy rate, shape-based classification only reaches 66%, underscoring the inherent difficulty distinguishing between pills with similar patterns. In response to these challenges, we propose a novel system integrating Multi Combination Pattern Labeling (MCPL), a new method designed to accurately extract feature points and pill patterns. MCPL extracts feature points invariant to rotation and scale and effectively identifies unique edges, thereby emphasizing pills’ contour and structural features. This innovative approach enables the robust extraction of information regarding various shapes, sizes, and complex pill patterns, considering even the 3D structure of the pills. Experimental results show that the proposed method improves the existing recognition performance by about 1.2 times. By improving the accuracy and reliability of pill classification and recognition, MCPL can significantly enhance patient safety and medical efficiency. By overcoming the limitations inherent in existing classification methods, MCPL provides high-accuracy pill classification, even with constrained datasets. It substantially enhances the reliability of pill classification and recognition, contributing to improved patient safety and medical efficiency.

Design: This is a cross-sectional study. Setting: University research laboratory. Participants: Fifteen healthy adults (mean age: 27.47 years) volunteered for this study. Intervention: The individuals performed standard bridge exercise and modified bridge exercises with right leg-lift (single-leg-lift bridge exercise, single-leg-lift bridge exercise on an unstable surface, and single-leg-lift hip abduction bridge exercise). Main outcome measures: During the bridge exercises, electromyography of the rectus abdominis, internal oblique, erector spinae, and multifidus muscles was recorded using a wireless surface electromyography system. Two-way repeated-measures analysis of variance (exercise by side) with post hoc pairwise comparisons using Bonferroni correction was used to compare the electromyography data collected from each muscle. Results: Bilateral internal oblique muscle activities showed significantly greater during singleleg- lift bridge exercise (95% confidence interval: right internal oblique = -8.99 to -1.08, left internal oblique = -6.84 to -0.10), single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right internal oblique = -7.32 to -1.78, left internal oblique = -5.34 to -0.99), and single-leg-lift hip abduction bridge exercise (95% confidence interval: right internal oblique = -17.13 to -0.89, left internal oblique = -8.56 to -0.60) compared with standard bridge exercise. Bilateral rectus abdominis showed greater electromyography activity during single-leg-lift bridge exercise on an unstable surface (95% confidence interval: right rectus abdominis = -9.33 to -1.13, left rectus abdominis = -4.80 to -0.64) and single-leg-lift hip abduction bridge exercise (95% confidence interval: right rectus abdominis = -14.12 to -1.84, left rectus abdominis = -6.68 to -0.16) compared with standard bridge exercise. In addition, the right rectus abdominis muscle activity was greater during single-leg-lift hip abduction bridge exercise compared with single-leg-lift bridge exercise on an unstable surface (95% confidence interval = -7.51 to -0.89). For erector spinae, muscle activity was greater in right side compared with left side during all exercises (95% confidence interval: standard bridge exercise = 0.19-4.53, single-leg-lift bridge exercise = 0.24-10.49, single-leg-lift bridge exercise on an unstable surface = 0.74-8.55, single-leg-lift hip abduction bridge exercise = 0.47-11.43). There was no significant interaction and main effect for multifidus. Conclusions: Adding hip abduction and unstable conditions to bridge exercises may be useful strategy to facilitate the co-activation of trunk muscles. [ABSTRACT FROM AUTHOR]

Amyloid-β (Aβ) in human plasma was detected and quantified by an antibody-free method, selected reaction monitoring mass spectrometry (SRM-MS) in the current study. Due to its low abundance, SRM-based quantification in 10 μL plasma was a challenge. Prior to SRM analysis, human plasma proteins as a whole were digested by trypsin and high pH reversed-phase liquid chromatography (RPLC) was used to fractionate the tryptic digests and to collect peptides, Aβ1-5, Aβ6-16, Aβ17-28 and Aβ29-40(42) of either Aβ1-40 or Aβ1-42. Among those peptides, Aβ17-28 was selected as a surrogate to measure the total Aβ level. Human plasma samples obtained from triplicate sample preparations were analyzed, obtaining 4.20 ng mL-1 with a CV of 25.3%. Triplicate measurements for each sample preparation showed CV of <5%. Limit of quantification was obtained as 132 pM, which corresponded to 570 pg mL-1 of Aβ1-40. Until now, most quantitative measurements of Aβ in plasma or cerebrospinal fluid have required antibody-based immunoassays. Since quantification of Aβ by immunoassays is highly dependent on the extent of epitope exposure due to aggregation or plasma protein binding, it is difficult to accurately measure the actual concentration of Aβ in plasma. Our diagnostic method based on SRM using a surrogate peptide of Aβ is promising in that actual amounts of total Aβ can be measured regardless of the conformational status of the biomarker. [ABSTRACT FROM AUTHOR]

Recently, not only Korea but also the world has been suffering from problems related to coastal erosion. The hard defense method has been primarily used as a countermeasure against erosion. However, this method is expensive and has environmental implications. Hence, interest in other alternative methods, such as the eco-friendly vegetation method, is increasing. In this study, we aim to analyze the hydraulic characteristic of submerged rigid vegetation according to the cross-sectional change through a hydraulic experiment and numerical simulation. From the hydraulic experiment, the reflection coefficient, transmission coefficient, and energy dissipation coefficient were analyzed according to the density, width, and multi-row arrangement of the vegetation zone. From numerical simulations, the flow field, vorticity distribution, turbulence distribution, and wave distribution around the vegetation zone were analyzed according to the crest depth, width, density, and multi-row arrangement distance of the vegetation zone. The hydraulic experiment results suggest that the transmission coefficient decreased as the density and width of the vegetation zone increased, and the multi-row arrangement condition did not affect the hydraulic characteristics significantly. Moreover, the numerical simulations showed that as the crest depth decreased, the width and density of vegetation increased along with vorticity and turbulence intensity, resulting in increased wave height attenuation performance. Additionally, there was no significant difference in vorticity, turbulence intensity, and wave height attenuation performance based on the multi-row arrangement distance. Overall, in the case of submerged rigid vegetation, the wave energy attenuation performance increased as the density and width of the vegetation zone increased and crest depth decreased. However, the multi-row arrangement condition did not affect the wave energy attenuation performance significantly.

Abstract High expression of cluster of differentiation (CD)39 and CD73 has cardio-protective effects. We hypothesised that the expression of CD39 and CD73 would differ between propofol- and volatile anaesthetic-based anaesthesia in patients undergoing open heart surgery (OHS). The objective of this prospective randomized trial was to compare the changes in CD39 and CD73 levels in CD4+ T cells between propofol- and sevoflurane-based anaesthesia during OHS. The study randomly allocated 156 patients undergoing OHS to a propofol or sevoflurane group. Blood was obtained preoperatively and up to 48 hours after weaning from cardiopulmonary bypass (CPB). The expression levels of CD39 and CD73 in circulating CD4+ T cells, serum cytokines and other laboratory parameters were analysed. The primary outcome was the expression of CD39 and CD73 on CD4+ T cells. Demographic data and perioperative haemodynamic changes did not show significant differences between the two groups. The expression of CD39 and CD73 in the sevoflurane group was significantly lower than in the propofol group (P