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Background To investigate outcomes of salvage whole-brain radiotherapy (WBRT) for recurrent brain metastases (BM) from breast cancer (BC), to identify prognostic factors of overall survival (OS), and to propose a novel prognostic classification for OS in these patients. Materials and methods We identified 54 patients who had received salvage WBRT as the second brain-focused treatment for recurrent BM from BC (2000–2014). The median follow-up duration was 4.9 months. A recursive partitioning analysis (RPA) was conducted to develop a model to predict OS at the time of salvage WBRT. Results The median OS was 6.8 months. OS according to BC-specific graded prognostic assessment (breast-GPA), modified breast-GPA, and updated breast-GPA did not represent our cohort. In the multivariate analysis, a long time before salvage WBRT (≥16 months), control of primary BC or extracranial metastases, systemic treatment after salvage WBRT, and administration of a biologically effective dose for an α/β of 10 Gy (BED10) of salvage WBRT >37.5 Gy showed superior OS. We proposed three RPA classes based on the control of both primary BC and extracranial metastasis and BED10 of salvage WBRT: class I, class II, and class III. In this model, patients with class I experienced the best OS (34.6 months; class II, 5.0 months; class III, 2.4 months; P, Highlights • Multicenter retrospective study of salvage WBRT for recurrent brain metastasis. • Subsequent use of systemic treatment after salvage WBRT showing better OS. • Limitations of previous graded prognostic assessments for recurrent brain metastasis. • Novel RPA classification consisting of four simple clinical factors predicts OS.

New powertrain technologies, such as those used in Hybrid Electric Vehicles, have a price premium which is often offset by lower running costs. Total Cost of Ownership (TCO) combines these purchase and operating expenses to identify the most economical vehicles overall. This is a valuable assessment for both private and fleet purchasers. To date, no studies have compared Total Cost of Ownership across more than two vehicle markets or analysed historic costs. To address this gap, this research provides a more extensive assessment of TCO in three industrialized countries — the U.S.A. (California specifically), the UK, and Republic of Korea — for the time period from 2015 ∼ 2019. As an early analysis of the regional characteristics of TCO, this study aims to examine how TCO varies across different geographic regions and develop an analysis methodology for future analysis of environmental vehicles. To analyze the TCO under identical conditions for each region, the TCO result is calculated using data from conventional vehicles by utilizing sufficient statistical data. The TCO model includes registration and road taxes as well as insurance, fuel, financial interest, depreciation, and maintenance costs. To represent the local features, the research considers four vehicles from different manufacturers. Using the proposed TCO model, the regional characteristic is analyzed and a sensitivity analysis is performed with the parameters constituting the TCO model. This research has implications for both fleet purchasers and private owners considering new vehicles. The findings are also relevant for carmakers aiming to develop vehicle sales strategies optimized for specific regions.

Purpose Spontaneous rib fractures (SRFs) are defined as fractures without apparent blunt force trauma. This study evaluated the incidence and risk factors of SRFs after treatment of breast cancer patients based on bone scans. In addition, we analyzed radiation-associated SRFs and identified radiotherapy (RT) factors related to SRF. Methods We retrospectively reviewed 1,265 patients with breast cancer who underwent surgery in 2015 at our institution, and were followed-up with at least three bone scans. Bone scans were conducted approximately every 12 months after breast cancer treatment. The endpoint was SRF detected by bone scan. In this study, 754 (60%) patients were treated with chemotherapy, 867 (69%) with RT, and 946 (75%) with anti-hormone therapy. Results The median follow-up duration was 37.5 months. A total of 209 (16.5%) patients experienced SRFs during follow-up. The incidence of SRFs increased sharply during the 3-year follow-up period after completion of treatment. In multivariate analyses, abnormal bone density, chemotherapy, and RT were significant risk factors for SRFs. In patients treated with RT (n = 867), 159 (18%) rib fractures occurred: 127 (80%) in the ipsilateral breast and 32 (20%) in the contralateral breast. Among the ipsilateral SRF patients who received tumor bed boost (n = 84), the SRF occurred inside the boost field in 80 (95%) cases. Multivariate analysis of RT subgroups showed that hypofractionated RT increased the rate of SRFs (p = 0.002). Conclusions Most of the rib fractures that occurred after treatment were spontaneous. Hypofractionated RT increased the risk of ipsilateral rib fractures in RT-treated patients.

To identify the risk factors leading to new brain metastases (BM) following brain-directed treatment for initial BM resulting from breast cancer (BC). In this multi-institutional study, 538 BC patients with available follow-up imaging after brain-directed treatment for initial BM were analyzed. Tumor molecular subtypes were classified as follows: hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2−, n = 136), HER2-positive (HER2+, n = 253), or triple-negative BC (TNBC, n = 149). In 37.4% of patients, new BM emerged at a median of 10.5 months after brain-directed treatment for initial BM. The 1-year actuarial rate of new BM for HR+/HER2−, HER2+, and TNBC were 51.9%, 44.0%, and 69.6%, respectively (p = 0.008). Initial whole-brain radiotherapy (WBRT) reduced new BM rates (22.5% reduction at 1 year, p 4) (p

Introduction We evaluated the incidence of cardiac events after chemoradiotherapy in patients with stage III non-small cell lung cancer (NSCLC) based on baseline cardiovascular risk and the heart substructures’ radiation dose. Methods From 2008 to 2018, the cardiac events of 258 patients with stage III NSCLC who received definitive chemoradiotherapy were reviewed. The 10-year cardiovascular risk was calculated using the Atherosclerotic Cardiovascular Disease (ASCVD) scoring system. Dose-volume histograms were estimated for each cardiac chamber. A multivariate competing-risk regression analysis was conducted to assess each cardiac event’s subhazard function (SHR). Results The median follow-up was 27.5 months overall and 38.9 months for survivors. Among the 179 deaths, none was definitely related to cardiac conditions. Altogether, 32 cardiovascular events affected 27 patients (10.5%) after chemoradiotherapy. Ten were major cardiac adverse events, including heart failure (N = 6) and acute coronary syndrome (ACS, N = 4). Most cardiovascular events were related to well-known risk factors. However, the volume percentage of the left ventricle (LV) receiving 60 Gy (LV V60) > 0 was significantly associated with ACS (SHR = 9.49, 95% CI = 1.28–70.53, P = 0.028). In patients with high cardiovascular risk (ASCVD score > 7.5%), LV V60 > 0% remained a negative ACS prognostic factor (P = 0.003). Meanwhile, in patients with low cardiovascular risk, the LV radiation dose was not associated with ACS events (P = 0.242). Conclusions A high LV radiation dose could increase ACS events in patients with stage III NSCLC and high cardiovascular risk. Pre-treatment cardiac risk evaluation and individualized surveillance may help prevent cardiac events after chemoradiotherapy.

Purpose We aimed to analyze the treatment outcomes of ipsilateral cervical lymph node (CLN)-positive breast cancer without other distant metastasis and compare the outcomes with those of supraclavicular lymph node (SCL)-positive breast cancer. Methods Seventy-eight patients with breast cancer and ipsilateral CLN metastasis above the supraclavicular fossa (CLN[+] group) were treated at 7 institutions (2000-2014). Seventy-four patients received systemic chemotherapy and breast surgery followed by locoregional radiotherapy. Outcomes of the CLN(+) group were compared with those of the SCL(+) group, which included 183 patients with SCL involvement. Results The median follow-up duration was 55.9 months. Twenty-two regional failures were found in 15 patients-axillary lymph node (LN) in 8, SCL in 6, internal mammary LN in 3, previously involved CLN in 4, and previously uninvolved ipsilateral CLN in one patient. The 5-year overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates were 68.6%, 46.7%, 68.4%, and 57.0%, respectively. Neck dissection did not improve LRRFS and DFS (p = 0.86 and p = 0.26, respectively). Multivariate analysis showed that hormone receptor negativity and the presence of extracapsular extension were prognostic factors for poor DFS. On comparison with stage IIIC using propensity score matching, survival outcomes of the CLN(+) and SCL(+) groups were not different (5-year OS, p = 0.75; DFS, p = 0.88; LRRFS, p = 0.86; and DMFS, p = 0.45). Conclusion The comparable clinical outcomes indicate that patients with breast cancer who have ipsilateral CLN metastasis without other distant metastasis may benefit from locoregional treatment of the ipsilateral breast and systemic therapies, as do those with N3c disease.

Pleuropulmonary blastoma (PPB) is a rare intrathoracic neoplasm in children. Although surgery with or without chemotherapy mainly conducted, the response of radiotherapy (RT) has not been evaluated yet. For unresectable tumor, RT might be considered as one option to decrease tumor extent to relieve obstructing symptoms or to facilitate successive treatment. We report one child in whom PPB with DICER1 mutation recurred after surgery and lead to respiratory distress. She emergently received palliative RT with a relatively low dose (20 Gy), and symptoms sufficiently relieved. Even she showed an 84.3% reduction in diameter and maintained the remission status for 1 year. These might reflect possible radiosensitivity of PPB, and further investigations of RT might be necessary for unresectable PPB.

Purpose We first analyzed the prognostic power of albumin-to-alkaline phosphatase ratio (AAPR) before radical radiotherapy (RT) in non-metastatic nasopharyngeal carcinoma (NPC) patients. Materials and methods The records of 170 patients with biopsy-proven, non-metastatic NPC treated by radical RT between 1998 and 2016 at our institution were retrospectively reviewed. Median follow-up duration was 50.6 months. All patients received intensity-modulated RT and cisplatin based chemotherapy before, during, or after RT. The major treatment of patients was based on concurrent chemoradiotherapy (92.4%). The AAPR was calculated by the last value of both albumin and alkaline phosphatase within 1 month immediately preceding RT. The optimal cut-off level of AAPR was determined by using Cutoff Finder, a web-based system. Propensity score matching (PSM) analysis was performed. Results The optimal cut-off level of AAPR was 0.4876. After PSM analysis of whole cohort, an AAPR was not related to survival outcomes. In PSM analysis for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC), an AAPR ≥ 0.4876 was related to better overall survival (OS), progression-free survival (PFS), and locoregional relapse-free survival (LRRFS) (OS: hazard ratio [HR], 0.341; 95% confidence interval [CI], 0.144 to 0.805; p=0.014; PFS: HR, 0.416; 95% CI, 0.189 to 0.914; p=0.029; and LRRFS: HR, 0.243; 95% CI, 0.077 to 0.769; p=0.016, respectively). Conclusion The AAPR, inexpensive and readily derived from a routine blood test, could be an independent prognostic factor for patients with LA-NPC. And it might help physicians determine treatment plans by identifying the patient's current status. Future prospective clinical trials to validate its prognostic value are needed.

Purpose To identify prognostic factors influencing progression-free survival (PFS) of aggressive fibromatosis (AF) after postoperative radiotherapy (PORT) and assess correlations between immunohistochemistry (IHC) features of β-catenin/smooth muscle actin (SMA) and PFS. Materials and Methods Records of 37 patients with AF treated by PORT from 1984 to 2015 were retrospectively reviewed. Fifteen patients underwent wide excision for AF and 22 patients received debulking operation. The median total dose of PORT was 59.4 Gy. IHC staining results of β-catenin and SMA were available for 11 and 12 patients, respectively. Results The median follow-up duration was 105.9 months. Five-year PFS rate was 70.9%. Tumor size or margin status was not related to PFS in univariate analysis (p = 0.197 and p = 0.716, respectively). Multivariate analysis showed that increased interval from surgery to PORT (>5.7 weeks) was a marginal risk factor for PFS (p = 0.054). Administration of PORT at the initial diagnosis resulted in significantly improved PFS compared to deferring PORT after recurrence (p = 0.045). Patient with both risk factors of deferring PORT after recurrence and interval from surgery to PORT >5.7 weeks had significantly lower 5-year PFS than patients without risk factor (34.1% vs. 100.0%; p = 0.012). Nuclear β-catenin intensity tended to inversely correlate with 5-year PFS, although it did not reach statistical significance (62.5% at low vs. 100.0% at high; p = 0.260). SMA intensity was not related to PFS (p = 0.700). Conclusion PORT should be performed immediately after surgery irrespective of margin status or tumor size especially in recurrent case. Nuclear β-catenin staining intensity of IHC might correlate with local recurrence.

e14008 Background: We analyzed the treatment outcome of breast cancer patients with brain metastases (BM) in Korea to identify the prognostic factors and the role of whole brain radiation therapy (WBRT). Methods: Seven hundred thirty patients of breast cancer with BM treated at 17 institutions in Korea from 2000 to 2014 were analyzed. The median follow-up duration was 12 months. The analysis consisted of three cohorts: in cohort A, a total of 730 patients were included; in cohort B, 538 patients with available follow-up imaging after initial brain-directed treatment; and in cohort C, 54 patients receiving salvage WBRT due to recurrent BM after initial Stereotactic radiosurgery or WBRT. Overall survival (OS) was calculated from BM diagnosis in cohort A or from the last day of salvage WBRT in cohort C. Results: Median OS of cohort A was 15 months. In multivariate analysis, histologic grade 3, extracranial metastasis, number of BM > 4, hormone receptor (HR) or HER2 negativity, and shorter time interval to diagnosis of BM were associated with inferior OS. Among 538 patients in cohort B, 201 showed subsequent development of new BM at a median of 11 months after stereotactic radiosurgery or WBRT for the management of initial BM (at 1 year, HR+/HER2- 51.9%, HER2+ 44.0%, and TNBC 69.6%, respectively; p = 0.008). Upfront WBRT reduced subsequent development of new BM, which showed the significant difference among molecular subtypes (HR+/HER2-, 42% reduction at 1 year, p < 0.001; HER2+, 18.5%, p = 0.004; TNBC, 16.9%, p = 0.071). Multivariate analysis showed that shorter time interval to BM, TNBC subtype, extracranial systemic disease, number of BM > 4, and involvement of both tentoria increased subsequent development of new BM. Anti-HER2 therapy for HER2+ patients and upfront WBRT significantly reduced risk of new BM. In cohort C, upfront WBRT prolonged the salvage WBRT-free duration (median 6.9 vs. 8.7 months, p = 0.058). Median OS was 6.8 months after salvage WBRT. Longer interval to salvage WBRT, controlled primary tumor, high dose of salvage WBRT (BED10 > 37.5 Gy), and systemic treatment after salvage WBRT showed better OS. Uncontrolled extracranial systemic disease and salvage WBRT due to local progression without distant intracranial failure showed worse OS. Conclusions: The rates of new BM showed the significant differences among molecular subtypes. Upfront WBRT decreased subsequent development of new BM and this effect was dependent on the molecular subtype as well. Anti-HER2 therapy for HER2+ patients significantly decreased the subsequent development of new BM. On salvage WBRT setting, the patients having high dose of salvage WBRT, stable extracranial systemic disease and subsequent systemic therapy showed better OS.

This paper presents a compact monopulse antenna which can be fitted inside of a small diameter radome. The monopulse antenna is composed of four antenna elements and each antenna consists of a square open-ended waveguide(OEWG), a stepped impedance matching structure, and a conformal aperture. Because of the compactness and the conformal aperture of the element that can be mounted on the inner surface of the radome, the center space of the radome can be secured, which can provide a space for other sensors or devices. To verify the monopulse performance of the designed antenna, its sum (Σ) and difference (Δ) patterns are calculated. The Σ pattern gains of the antenna are 15.3 dB, 15.1 dB, and 15.4 dB for f l GHz, f c GHz, and f h GHz, respectively. The normalized null depths of the Δ patterns are under -40 dB within the operational frequency.

Remarkable progress in breast cancer treatment has improved patient survival, resulting in an increased incidence of brain metastasis (BM). Current treatment options for BM are limited and are generally used for palliative purposes. Historically, local treatment, consisting of radiotherapy and surgery, is the standard of care due to delivery limitations of systemic treatments through the blood–brain barrier. However, as novel biological mechanisms for tumors and BM have been discovered, several innovative systemic agents, such as small-molecular-targeted therapy and immunotherapy, have begun to change the treatment paradigm. In addition, efforts to maximize antitumor effects have been attempted using combination therapy, informed by tumor biology. In this comprehensive review, we will highlight various clinical trials investigating the treatment of BM in breast cancer patients, discuss presently available treatment options, and suggest potential directions of future therapeutic targets.

This paper introduces a dual-polarized open-ended waveguide (OEWG) with squinted beam for X-band monopulse antenna which can be placed on a small diameter cylinder. The antenna consists of a quadruple-ridged feeding structure in a square OEWG and an inclined aperture to achieve dual-polarization and squinted beam characteristics, respectively. The bandwidth of the antenna is from 8 GHz to over 12 GHz in an aperture dimension of 22 mm×22 mm (width×height). Using four designed OEWG antennas, X-band monopulse antenna is designed and its sum (Σ) and difference (A) patterns are calculated. The (Δ) pattern gains of the antenna are 9.7 dB, 12.1 dB, and 14 dB for 8 GHz, 10 GHz, and 12 GHz, respectively. The null depths of the A patterns are under −30 dB within the operational frequency.

In this article, the design procedures and radiation characteristics of a compact high-power antenna are discussed. The antenna is designed to efficiently radiate a high-power ultrawideband nanosecond bipolar pulse. The fabricated antenna realizes directive radiation and a wide bandwidth of 0.2–3.44 GHz (17.2:1) with dimensions of 300 × 300 × 260 mm3 (width × height × length). The measured far-voltage is 4.2 kV when the antenna is excited by a 2.5 kV amplitude bipolar pulse with a 1.3 nanosecond pulse width. © 2015 Wiley Periodicals, Inc. Microwave Opt Technol Lett 57:1296–1301, 2015

This paper presents a modified TEM horn that improves radiation characteristics at a low frequency region. The proposed antenna consists of an asymmetric TEM (ATEM) horn and a loop structure with an elliptical shape. The bandwidth and gain at low frequency region can be enhanced by using the ATEM horn configuration and adding a loop structure with an elliptical shape to the ATEM horn. The bandwidth of the proposed antenna is from 2.14 to over 20 GHz, whereas that of the conventional TEM horn is from 2.7 to over 20 GHz, where the dimensions of both antennas are the same except for the thickness of the loop structure. The physical and electrical dimensions of the proposed antenna are 60 mm × 62.5 mm × 64 mm (width × height × length) and 0.428 λ L × 0.445 λ L × 0.456 λ L, where λ L corresponds to the lowest frequency of the bandwidth. The realized gain of the proposed antenna is improved by 0.802 dB on average at the low frequency region (2 to 8 GHz), where the maximum gain increase is 2.932 dB when compared to a conventional TEM horn.

There are many economical and industrial as well as social demands enabling smart management of railway vehicle including parts management by introducing RFID system in railway vehicle. In this paper, overseas researches and developments which use cases of RFID were investigated and analyzed. In this process, cases of various industries adopting RFID technology as well as cases of railway part were investigated. RFID system is used mainly for railway vehicle position detection and identification of vehicles in the field of railway. Also there are cases of application on traceability management of railway vehicle parts. The system in which RFID technology can be applied to railway parts management and traceability management is necessary for smart management of domestic railway vehicle.

We have studied on the possibility of railway stability system using RFID tag. UHF RFID tag was desinged, manufactured and tested. Proposed UHF tag antenna has PIFA type structure and inset feed multi matching technique was attempted for impedance matching of antenna. The impedance bandwidth (VSWR < 3) of the proposed tag antenna covers 917∼923 MHz. Measured peak gain is 3.225 dBi and UHF band with an omni-directional radiation pattern. RFID reader and tag installed in motor car and track, respectively. Then, tag recognition rate according to velocity of car (under 45 km/h) represented 100 %.

This letter presents a compact directive antenna to radiate a high-power ultrawideband (UWB) pulse. The proposed antenna is composed of a modified biconical-based radiator (electric dipole), magnetic dipoles, a feedthrough insulator, and a coaxial cable. The electrical size of the antenna is $0.195{\lambda _L} \times 0.195{\lambda _L} \times 0.176{\lambda _L}$ ( ${\hbox{width}} \times {\hbox{height}} \times {\hbox{length}}$ ), where ${\lambda _L}$ is the wavelength corresponding to the lowest frequency of the bandwidth. The fabricated antenna realizes a bandwidth of 0.207–2.60 GHz (12.56:1) and a far-voltage of 131.3674 kV with a front–back ratio of 22.72 dB. The antenna is designed to radiate a $\pm 75~\hbox{kV}$ amplitude bipolar pulse with a 0.83-ns pulse width through the frequency band from 0.207 to 2.33 GHz.

In this paper, a dual-band antenna is proposed for the RF power harvester system as well as RFID tag. The proposed antenna operates as the passive and active RFID tag antenna in the UHF and microwave band, respectively. In addition, to charge the battery of an active RFID tag in the microwave band, it harvest the RF signal for tagging from the passive RFID tag antenna in the UHF band. The proposed antenna operates in the UHF band (917~923.5 MHz) and microwave band (2.4~2.45 GHz). In order to obtain the dual-band operation, the dipole structure and meander parasitic elements are proposed as the and dipole antenna, respectively. The radiating dipole structure in the microwave band acts as the coupled feed for the meander parasitic elements in the UHF band. The impedance bandwidth (VSWR

In this paper, a circular dual mode horn with modified aperture is proposed to improve a E/H-plane radiation pattern symmetry of a conventional oversized circular dual mode horn. The proposed antenna consists of a feeding section, a mode generation section and a phase matching section which has aperture shape transition from circle to ellipse or rectangle to improve a E/H-plane radiation pattern symmetry. To compare the performances between the proposed antenna and the convenional circular dual mode horn, the conventional circular dual mode horn and the proposed circular dual mode horn with rectangular aperture are fabricated and researched at 15 GHz. The measured results show that the conventional circular dual mode horn has 3.394 dB difference while the proposed antenna has only 0.539 dB difference between E and H-plane radiation patterns within the -11 dB beamwidth() which is required beamwidth of the feed horn for the maximum aperture efficiency where f/d ratio of reflector antenna is 1.

A single-layer reflectarray with a combination of element types is proposed. Three element types-square patch, square ring and ring-loaded patch (RLP)-are used together to design the reflectarray by compensating for the drawbacks of one type by the others. The gain of the proposed reflectarray is 29.1 dBi, which is 1.9 dB higher than that of the reference reflectarray that was designed with only the RLP.

PurposeThe paper aims to clarify the relationships between various components of knowledge possessed by the members of system integration (SI) project team and the project performance of those team members. From this lessons are learnt on SI project management issues and managerial implications regarding team member knowledge management for project performance are provided.Design/methodology/approachThe authors validated the model and tested the hypotheses using the structural equation model analysis LISREL.FindingsUsing data from 49 SI projects performed by a prominent consulting firm, the authors discovered a positive relationship between SI project team member knowledge and project performance. Notably, tacit knowledge was found to be influential, but explicit knowledge was not. The leadership capability of team leaders and the communication capability among team members were found to be important factors affecting project performance.Research limitations/implicationsA limited number of SI projects were analyzed due to difficulties with project selection and frequent movement of consultants during the data gathering process. As a result, additional analyses considering project size and complexity were not performed. Project team members' personal knowledge obtained through experience in similar projects or similar industries is very important to improve SI project performance. Leaders of participating SI projects have to think over project team members' tacit product knowledge and tacit process knowledge when building their project's team.Originality/valueThe main contribution of this paper lies in the establishment of a causal relationship between SI project team member knowledge and project performance, as well as in the proposed managerial implications for SI project knowledge management.

This paper proposes an online fault diagnosis system for induction motors through the combination of discrete wavelet transform (DWT), feature extraction, genetic algorithm (GA), and neural network (ANN) techniques. The wavelet transform improves the signal-to-noise ratio during a preprocessing. Features are extracted from motor stator current, while reducing data transfers and making online application available. GA is used to select the most significant features from the whole feature database and optimize the ANN structure parameter. Optimized ANN is trained and tested by the selected features of the measurement data of stator current. The combination of advanced techniques reduces the learning time and increases the diagnosis accuracy. The efficiency of the proposed system is demonstrated through motor faults of electrical and mechanical origins on the induction motors. The results of the test indicate that the proposed system is promising for the real-time application.

Jae Sik Kim,1 Sang Don Lee,2 Sang Jin Lee,3 Moon Kee Chung21Department of Urology, The Catholic University of Korea Incheon St Mary's Hospital, Incheon, 2Pusan National University Yangsan Hospital and Research Institute for Convergence of Biomedical Science and Technology, Yangsan, 3Genitourinary Cancer Branch, National Cancer Center, Goyang, KoreaBackground: To develop a targeting therapy for hormone-independent prostate cancer, we constructed and characterized conditionally replicating oncolytic adenovirus (Ad) equipped with mRFP(monomeric red fluorescence protein)/ttk (modified herpes simplex virus thymidine kinase) This construct was then further modified to express both mRFP/ttk and a soluble form of cytokine FLT3L (fms-related tyrosine kinase 3 ligand) simultaneously.Methods: To construct the recombinant oncolytic adenovirus, E1a and E4 genes, which are necessary for adenovirus replication, were controlled by the prostate-specific enhancer sequence (PSES) targeting prostate cancer cells expressing prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA). Simultaneously, it expressed the mRFP/ttk fusion protein in order to be able to elicit the cytotoxic effect.Results: The Ad5/35PSES.mRFP/ttk chimeric recombinant adenovirus was generated successfully. When replication of Ad5/35PSES.mRFP/ttk was evaluated in prostate cancer cell lines under fluorescence microscopy, red fluorescence intensity increased more in LNCaP cells, suggesting that the mRFP/ttk fusion protein was folded functionally. In addition, the replication assay including wild-type adenovirus as a positive control showed that PSES-positive cells (LNCaP and CWR22rv) permitted virus replication but not PSES-negative cells (DU145 and PC3). Next, we evaluated the killing activity of this recombinant adenovirus. The Ad5/35PSES.mRFP/ttk killed LNCaP and CWR22rv more effectively. Unlike PSES-positive cells, DU145 and PC3 were resistant to killing by this recombinant adenovirus. Finally, in order to potentiate therapeutic efficacy, we developed a recombinant adenovirus expressing multiexogenous genes, mRFP/ttk and sFLT3L.Conclusion: In the present study, a replication-competent adenovirus was successfully designed to replicate conditionally in PSA-positive and PSMA-positive prostate cancer cells. This recombinant adenovirus is equipped with the fusion protein of suicidal and red-fluorescence fusion protein together with sFLT3L. This construct would be expected to have potent antitumor effects and deserves more extensive investigation.Keywords: adenovirus, prostate cancer, hormone-independent, suicide gene

This paper shows a process for designing of a magnetic sensor used in position measurement of a transverse flux linear motor (TFLM). Parametric method is adopted using several chosen variables. This sensor operates based on the principle of hall effect and hence magnetic flux density is focused. The design target is to obtain very low total harmonic distortion (THD) which should be less than 3% and peak flux density is expected to be above 0.1T. The specifications of the designed sensor are verified by the FEM analysis and some experiments.

To perform a multicenter survey to determine how many parents understood the optimal time for surgical correction of cryptorchidism in children.We enrolled 377 parents of patients who had recently undergone surgical correction of cryptorchidism. These parents were divided into 3 groups according to their indicated preference of the optimal patient age for surgical correction: group 1 (1 year old, 39 parents, 10.3%), group 2 (1-2 years old, 169 parents, 44.8%), and group 3 (3 years, 169 parents, 44.8%).The mean age of the children who underwent orchiopexy was 4.9 ± 5.2 years. The interval from diagnosis to surgical correction of cryptorchidism was 17.1 ± 29.8, 15.4 ± 14.4, and 29.0 ± 24.4 months in groups 1, 2, and 3, respectively (P.001). The mean age of the parents was significantly associated with the perception of the optimal time for surgical correction of cryptorchidism (P = .021 and P = .002). The number of highly educated parents was lowest in group 3 (P.001). The number of parents with2 children was 69.2% in group 1, 71.0% in group 2, and 84.0% in group 3 (P = .009). In group 3, the parents often delayed surgery because of the patient being too young (49.1%) and the parents' expectations of spontaneous descent (48.5%).Parents younger in age, with higher education levels and with fewer children, preferred early orchiopexy. Active intervention by a physician and public education for parents might be necessary to encourage earlier treatment of cryptorchidism.

The MCFC system of BOP (Balance of Plant) is contained various mechanical equipments. One of the equipments of the heat exchangers is important component for efficiency and cost. In MCFC system, several heat exchangers are used according to the application. Most typical heat exchanger is the humidifier in BOP for MCFC, which is named for the humidifier because it is to preheat the fuel and water so that a reactor will convert some of the incoming fuel to hydrogen. Then, hot side fluid service is used the exhausted gas from the fuel cell and cold side fluid service is the fuel and water. The operation temperature range is about 25∼500 Celsius Degree.[1] This heat exchanger has the problems of multiphase fluid and phase change heat transfer. So it is necessary to analyze the heat transfer characteristics and to propose the reasonable design methodology for the humidifier. In this study, the thermal characteristic for the humidifier is estimated by using commercial tool of heat exchanger design, rating and simulation. Also this study presents the results for test facility of fabrication and for testing.Copyright © 2011 by ASME

To investigate changes in temperature of the tissue pad (contrary to active blade) of ultrasonic laparoscopic coagulation shears (LCS) and histological changes of tissue surrounding the pad during activation.Three types of ultrasonic LCS were assessed: SonoSurg (SSg) (Olympus, Tokyo, Japan), AutoSonix (AS) (Tyco, Pembroke, Bermuda) and Harmonic Scalpel (HS) (JohnsonJohnson, Cincinnati, OH, USA). Vibration amplitudes were 70%/100% (SSg), Level 3/Level 5 (AS) and Level 5 (HS). Durations of vibration were 5 s, 10 s, 15 s and 20 s. Changes in temperature of the tissue pad were evaluated by cutting chicken parts extracorporeally with the three types of LCS. Histological changes around the tissue pad of the SSg were evaluated in a laparoscopic porcine model.At intermediate power (70% or Level 3), the SSg tissue pad temperatures were 33 degrees C, 42 degrees C, 55 degrees C and 70 degrees C, whereas the AS tissue pad temperatures were 45 degrees C, 72 degrees C, 80 degrees C and 100 degrees C. At maximum power, the temperatures of the SSg tissue pad were 38 degrees C, 45 degrees C, 70 degrees C and 95 degrees C, those of the AS were 50 degrees C, 65 degrees C, 70 degrees C and 90 degrees C and those of the HS were 49 degrees C, 65 degrees C, 75 degrees C and 90 degrees C. Histological changes occurred at 10 s, 15 s and 20 s.Surgeons should be aware that the temperature of the tissue pad also becomes elevated when using ultrasonic LCS. Thus, they should be concerned with surrounding tissues and organs around both the tissue pad and the active blade during activation. Regardless of the LCS type and power, a short activation time within 5 s is a safe method for using the instrument.

This paper presents circuit design and operation principle of a newly developed phase-shifted PWM full-bridge converter for capacitor charging. The proposed system is designed with soft switching techniques to achieve high efficiency. Also, proposed system is series type and it is used for pulse corona occurrence of DeSOx, DeNOx system using magnetic pulse compressor (MPC). The MPC system is required high withstanding voltage because it uses high voltage application. To overcome the problem associated with high voltage stress, the high voltage transformer separated with three sections. The performance test of the capacitor charging power supply (CCPS) was carried out with a 2µF load capacitor at 20kV output voltage and pulse repetition frequency is 300Hz.

To evaluate the efficacy of double-J stenting as an initial procedure to manage ureteral injuries detected late after gynecological surgery.Eight patients whom the insertion of double-J stent was done primarily were evaluated. Medical records were investigated retrospectively.Ureteral injuries were unilateral in seven and in one patient was bilateral (nine ureters in total). In two patients that double-J stentings were failed underwent open surgery. In six patients (seven ureters), double-J stentings were successful either by cystoscopy or ureteroscopy and four ureters were recovered without sequelae. However, in three ureters, stenosis was remained and managed by ureteral dilation with placement of double-J stent. But, one was lost at follow-up schedule.Ureteral double-J stenting, as first-line treatment, could avoid invasive urological surgery in damaged ureter detected after gynecological surgery. More cases are needed for accurate conclusions.

This paper presents a digital control scheme for a UPS inverter system. The inverter provides a near sinusoidal output voltage waveform with low harmonic distortion factor and must be controlled with very fast dynamic response and robustness to load changes or parameter variations. The proposed scheme is based on the current regulated voltage controller. The filter inductor current is forced to follow the current command calculated from the desired capacitor voltage and the sensed output load current. Clearly, the sensed output current signal acts as a disturbance feedforward signal which leads to a fast dynamic response of the controller to sudden changes of output load current. In order to guarantee the robustness of the system, a PI capacitor voltage controller is added as in the conventional double feedback loop controller. The natural problems of this controller, i.e. the phase difference between the output voltage and its reference caused by the AC quantity of the feedback signal, are compensated by using a synchronization controller for the output voltage phase and frequency. The algorithm of the proposed scheme is described and digital simulation and experimental results from a 5 kVA prototype are provided for verification.

This study examines corporate e-learning systems in terms of the role of stakeholders and end-user satisfaction. The study identifies possible Critical Success Factors (CSFs) in e-learning systems (content, technical features, management, and organisational support) and tests whether a consensus occurs among stakeholders that these factors facilitate successful implementation. The study shows that stakeholder consensus on the importance of these factors has a positive influence on perceived implementation quality in e-learning systems, which in turn is positively related to user satisfaction. The paper concludes with key implications of this finding for business and management.

Purpose: Patients in the intensive care unit (ICU) are usually at greater risk for acquiring urinary tract infection (UTI). Few studies have focused on UTI specifically acquired within the ICU. We retrospectively studied and compared the microbiology and antibiotic sensitivity of UTI in ICUadmitted patients between 2001 and 2008. Materials and Methods: We reviewed the medical records of a total of 1,818 ICU patients who had undergone a urine culture exam in 2001 and 2008 in a single hospital. Changes in causative organisms and their antibiotic sensitivity between 2001 and 2008 were analyzed. Results: The common pathogens in 2008 were Escherichia coli (20.3%), Pseudomonas (19.5%), Enterococcus (18.0%), Klebsiella (7.8%), coagulasenegative Staphylococcus (CNS) (4.3%), and Staphylococcus (4.3%). Pseudomonas species significantly increased in 2008 compared with 2001 (p=0.002). Gram-negative organisms showed relatively higher sensitivities to amikacin, imipenem, and Tazocin (72.1%, 76.2%, and 74.6%, respectively), whereas they showed relatively lower sensitivities to third-generation cephalosporins and ciprofloxacin (43% to 59%). Gram-positive organisms showed high sensitivities to teicoplanin and vancomycin (91.2% and 86.8%, respectively), whereas they showed low sensitivities to ampicillin and ciprofloxacin (25% and 26.5%, respectively). The antibiotic resistance of Pseudomonas species was nearly double that of E. coli. Conclusions: E. coli, Pseudomonas, and Enterococcus were the three most common organisms in ICU-acquired UTI in our study. In particular, Pseudomonas species were found to have increased significantly in recent years. Pseudomonas species had a significantly lower susceptibility to antibiotic sensitivity than did the other organisms. (Korean J Urol 2009; 50:1108-1113) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Vesicouterine fistula is a rare disease that comprises 1 to 4% of all reported urogenital fistulas. Repeated cesarean section may be related to the formation of vesicouterine fistula. We experienced a case of vesicouterine fistula, and the patient’s symptom was gross hematuria during her mensturation period after repeated cesarean section. (Korean J Urol 2008;49: 860-862) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

No study adopted the statistical parametric mapping (SPM) analyses of (18)F-fluorodeoxy glucose (FDG) PET in a large number of patients with oculopalatal tremor (OPT). To determine regional cerebral glucose metabolism in patients with OPT, nine patients with OPT underwent FDG-PET of the brain. Their glucose metabolism was compared with that of 50 normal controls (NC) by using SPM analyses. Three patients had bilateral and six showed unilateral pseudohypertrophic degeneration of the inferior olivary nucleus (ION) on MRI. Compared with NC, OPT patients did not show any metabolic derangement in the anterolateral medulla where the pseudohypertrophic ION locates. Instead, six patients with unilateral ION changes had hypometabolism in ipsilesional pontine tegmentum and hypermetabolism in contralesional thalamus. Their metabolic changes did not depend on the lateralization of ION changes. Our study failed to present any metabolic evidence for the role of ION in the generation of OPT. In part, the failure might originate from the different pathomechanism between OPT and pure palatal tremor or sensitivity/specificity issues of PET and SPM analyses. But, our results suggest that impaired cell groups of the paramedian tract and thalamic tremor cells may contribute to the generation of OPT.

Purpose: Extracorporeal magnetic innervation (ExMI) therapy has been known to be safe and immediately effective in stress urinary incontinence (SUI). However, no long term follow-up results have been reported. Therefore; herein, are reported our results from a two year follow-up study on ExMI therapy, with pelvic floor muscle exercises, for SUI. Materials and Methods: The study group was comprised of 94 patients with SUI. ExMI therapy was performed for 20 minutes (10Hz and 50Hz for each 10 minutes), twice a week, for 6 weeks. Thereafter, 44 of the 94 patients underwent pelvic floor muscle exercises. Objective measures (quality-of-life surveys, pad changes, and leak episodes per day) were evaluated before, immediately after and 24 months after the ExMI therapy. Results: After 6-week of ExMI therapy, the quality-of-life score improved from 5.1±0.9 to 1.8±1.1. The mean frequency of pad changes was reduced from 2.1±1.6 to 1.1±1.0. The mean frequency of leak episodes was also reduced from 2.8±1.8 to 1.7±1.5 times. After 24 months, the 44 patients having also undergone pelvic floor muscle exercise had persistent improvements in their leak episodes per day compared to the 50 patients that had not. Conclusions: When ExMI therapy was followed by pelvic floor muscle exercises, the favorable effect in leak episodes per day after ExMI therapy may persist for at least 24 months. (Korean J Urol 2006;47:1334-1338) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Staphylococcus aureus and Staphylococcus epidermidis strains isolated at eight large medical centers in Korea were examined for methicillin resistance and resistance to eight other antibiotics; cefazolin, cefamandole, cefuroxime, cefoxitin, cefotaxime, moxalactam, penicillin G and vancomycin. Methicillin resistance was found in 296 of 1225 strains (24.2%) of S. aureus and 126 of 348 strains (36.2%) of S. epidermidis. Methicillinresistant strains were isolated from all sources with the frequency of isolation ranging from 11% to 60%. From pleural effusion, throat swab and blood, methicillin-resistant strains of S. aureus were more frequently isolated with statistical significance (Chi-squared test, 95% confidence). Almost all of Methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE) strains were multiply resistant to one or more tested eight antibiotics. However only 7(2.4%) of 296 MRSA strains and 2(1.6%) of 126 MRSE strains were resistant to vancomycin. Vancomycin was the most effective antibiotic against staphylococcal isolates as well as MRSA and MRSE.