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Background Gintonin is a ginseng-derived exogenous G-protein–coupled lysophosphatidic acid (LPA) receptor ligand, which exhibits in vitro and in vivo functions against Alzheimer disease (AD) through lysophosphatidic acid 1/3 receptors. A recent study demonstrated that systemic treatment with gintonin enhances paracellular permeability of the blood–brain barrier (BBB) through the LPA1/3 receptor. However, little is known about whether gintonin can enhance brain delivery of donepezil (DPZ) (Aricept), which is a representative cognition-improving drug used in AD clinics. In the present study, we examined whether systemic administration of gintonin can stimulate brain delivery of DPZ. Methods We administered gintonin and DPZ alone or coadministered gintonin with DPZ intravenously or orally to rats. Then we collected the cerebral spinal fluid (CSF) and serum and determined the DPZ concentration through liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results Intravenous, but not oral, coadministration of gintonin with DPZ increased the CSF concentration of DPZ in a concentration- and time-dependent manner. Gintonin-mediated enhancement of brain delivery of DPZ was blocked by Ki16425, a LPA1/3 receptor antagonist. Coadministration of vascular endothelial growth factor (VEGF) + gintonin with DPZ similarly increased CSF DPZ concentration. However, gintonin-mediated enhancement of brain delivery of DPZ was blocked by axitinip, a VEGF receptor antagonist. Mannitol, a BBB disrupting agent that increases the BBB permeability, enhanced gintonin-mediated enhancement of brain delivery of DPZ. Conclusions We found that intravenous, but not oral, coadministration of gintonin facilitates brain delivery of DPZ from plasma via LPA1/3 and VEGF receptors. Gintonin is a potential candidate as a ginseng-derived novel agent for the brain delivery of DPZ for treatment of patients with AD.

Background/Aims: To investigate the treatment efficacy and renal safety of long-term tenofovir disoproxil fumarate (TDF) therapy in chronic hepatitis B (CHB) patients with preserved renal function. Methods: The medical records of 919 CHB patients who were treated with TDF therapy were reviewed. All patients had preserved renal function with an estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.73 m2. Results: A total of 426 patients (184 treatment-naive and 242 treatment-experienced) were included for analysis. A virologic response (VR) was defined as achieving an undetectable serum hepatitis B virus (HBV) DNA level, and the overall VR was 74.9%, 86.7%, and 89.4% at the 1, 2, and 3-year follow-ups, respectively. Achieving a VR was not influenced by previous treatment experience, TDF combination therapy, or antiviral resistance. In a multivariate analysis, being hepatitis B e antigen positive at baseline and having a serum HBV DNA level ≥2,000 IU/mL at 12 months were associated with lower VR rates during the long-term TDF therapy. The overall renal impairment was 2.9%, 1.8%, and 1.7% at the 1, 2, and 3-year follow-ups, respectively. With regard to renal safety, underlying diabetes mellitus (DM) and an initial eGFR of 60 to 89 mL/min/1.73 m2 were significant independent predictors of renal impairment. Conclusions: TDF therapy appears to be an effective treatment option for CHB patients with a preserved GFR. However, patients with underlying DM and initial mild renal dysfunction (eGFR, 60 to 89 mL/min/1.73 m2) have an increased risk of renal impairment. (Gut Liver 2019;13:93-103.)

This study concerns the accessibility of health information for people with disabilities. More specifically, by interviewing policy elites who have backgrounds in this area, we seek to obtain their opinions regarding the type of information people with disabilities require, and people with disabilities overall awareness of such information. Based on the information obtained, we also aim to identify methods of improving this accessibility. A focus group interview was conducted involving policy elites who had previously participated in decision-making processes for health policy. These elites were sourced from the fields of academia, medicine, and government. Content analysis was performed using NVivo 10, which is a computer-assisted/aided qualitative data-analysis software. The focus-group participants felt that relevant information for people with disabilities is provided in a fragmentary manner through several channels that have relatively low reliability, which creates difficulties for a significant portion of the target recipients. Discussions regarding the type of health information required by people with disabilities yielded the following topic clusters: information regarding health-care providers who specialize in specific disability types and regarding health behaviors for certain lifecycles, and information that helps people with disabilities return to society. Further, the focus group recommended 2 means of providing essential health information to PWDs in the future. As short-term strategies, the participants proposed simplifying the existing, fragmented information channels and the creation of a comprehensive web-based information portal with an associated call center. As a long-term strategy, they proposed the development of smart-device-based information services that are tailored to the needs of individuals. Efforts to reduce the disparities in health information for people with disabilities are essential for addressing the existing inequality regarding the availability of health information.

Background Assessing and satisfying patient expectation are essential in successful patient-centered communication. Recognizing the gap between patient expectation and perception during pharmacist–patient communication can help to identify communication problems and suggest ways to improve communication. Objective To evaluate the gap between patient expectation and perception of sharing information and communications skills during pharmacist–patient communication. Setting Community pharmacies in South Korea. Method A questionnaire was developed to collect expectation and perception of sharing information and communication skills. Items for sharing information included drug effect, dosage/route of administration, adverse drug reactions, storage, drug–drug interactions, drug–food interactions, managing a missed dose or overdose, co-medication, and past drug allergies. Communication skills included friendliness, expertise, easy language, emphasis on main content, confirmation of understanding, enough time, calm environment, and private space. A cross-sectional survey was conducted in 500 convenience sample using an online or written questionnaire in May 2018. Responses about patient expectation and perception were scored using 4-point Likert scales. Gap between patient expectation and perception was calculated as the differences among 4-point Likert scores. Factors associated with patient expectation and gap scores were evaluated using a multivariable regression method. Main outcome measure Patient expectation and perception of sharing information, as well as perception of communication skills during pharmacist–patient communication (questionnaire consisting 35 items). Results This study analyzed responses of 460 participants who answered all items on the questionnaire. Most respondents agreed or strongly agreed that they want to share information with pharmacists. All items had significant gap between patient expectation and perception (p

PURPOSE To evaluate clinical risk factors of disease progression after cataract surgery using phacoemulsification with posterior chamber intraocular lens implantation, in eyes with chronic angle-closure glaucoma (CACG) and coexisting cataract. DESIGN Retrospective study. METHODS The data of 56 eyes of 45 CACG patients who had undergone uncomplicated phacoemulsification with posterior chamber intraocular lens implantation were retrospectively analyzed. Disease progression was defined as glaucomatous optic nerve change or visual field (VF) deterioration according to the European Glaucoma Society guideline. Correlations between VF progression and various preoperative and postoperative factors were determined by χ and independent t tests. Linear regression analysis [(odds ratio (OR)] was used to determine predictive risk factors for disease progression using univariate and multivariate analyses. RESULTS The mean postoperative follow-up period was 45.13 ± 17.54 (24 to 84) months. Fourteen eyes (25%) with cataracts diagnosed with CACG progressed after phacoemulsification, but the remaining 42 eyes (75%) did not. According to univariate analysis, disease progression was significantly associated with older age, more number of preoperative/postoperative antiglaucoma drugs, higher scores of preoperative pattern standard deviation, and lower scores of preoperative and postoperative visual field index (VFI) (P

In the original publication of the article the order of authors has been interchanged and now the same has been provided correctly in this correction.

A simple approach to producing tunable lasing is explored. In this work, a basic planar lasing system with a layer of light emitting conjugated polymer, MEH-PPV, sandwiched between a distributed Bragg reflector (DBR) and silver is utilized. By irradiating MEH-PPV with electrons, the photoluminescence (PL) spectrum of MEH-PPV undergoes blueshift and peak broadening, which in turn alters the lasing wavelength. Furthermore, patterning the MEH-PPV layer by electron irradiation and employing filters allow lasing to be controlled to occur only at certain areas. Thus, our approach allows the fabricated system to possess significant tunability, a highly sought out trait in the field of lasing. The detailed methodology by which tunable lasing is achieved is discussed along with the mechanism behind the irradiation-induced blueshift of the PL spectrum.

To evaluate and compare the efficacy and safety of combined phacoemulsification and goniosynechialysis (PEGS) to phacoemulsification alone (PE) in patients with medically well-controlled chronic angle-closure glaucoma (CACG) with cataracts.Thirty eyes diagnosed with CACG and requiring cataract surgery from January 2008 to October 2010 were prospectively randomized, 15 each to PE and PEGS. Changes in peripheral anterior synechiae (PAS), intraocular pressure (IOP), anterior chamber depth, and number of antiglaucoma drugs from baseline to 2 months after the operation were analyzed, as were the type and number of complications.The PE group showed decreases in PAS (118.67±95.38 degrees) and IOP (2.33±2.38 mm Hg) and a significant reduction in the number of antiglaucoma drugs (0.53±0.83, P0.05) from before to 2 months after surgery. The PEGS group showed similar decreases in PAS (114.00±90.95 degrees), and IOP (4.53±4.16 mm Hg) and number of antiglaucoma drugs (1.20±1.32) (P0.05). However, the amount of decline in both the groups did not show any significantly difference in PAS, reduction of IOP, or number of antiglaucoma drugs (P0.05), The increase in anterior chamber depth from baseline to 2 months after surgery was significantly greater in the PEGS group (P=0.003).The IOP-lowering effects of PEGS do not differ significantly from those of PE in medically well-controlled CACG patients with cataract. These results suggest that additional goniosynechialysis during phacoemulsification is not necessary in such patients.

Artificial lighting in office buildings accounts for about 30% of the total building energy consumption. Lighting energy is important to reduce building energy consumption since artificial lighting typically has a relatively large energy conversion factor. Therefore, previous studies have proposed a dimming control using daylight. When applied dimming control, method based on building modeling does not need illuminance sensors. Thus, it can be applied to existing buildings that do not have illuminance sensors. However, this method does not accurately reflect real-time weather conditions. On the other hand, solar power generation from a PV (photovoltaic) panel reflects real-time weather conditions. The PV panel as the sensor improves the accuracy of dimming control by reflecting disturbance. Therefore, we compared and analyzed two types of sensorless dimming controls: those based on the building modeling and those that based on solar power generation using PV panels. In terms of energy savings, we found that a dimming control based on building modeling is more effective than that based on solar power generation by about 6%. However, dimming control based on solar power generation minimizes the inconvenience to occupants and can also react to changes in solar radiation entering the building caused by dirty window.

Angiomyolipomas (AMLs) are relatively rare hamartomatous or benign tumors that occasionally occur as part of tuberous sclerosis complex (TSC). Mutations in either of the two genes, TSC 1 and TSC 2, have been attributed to the development of TSC. Between 1994 and January 2009, 83 patients were diagnosed with AML at the Samsung Medical Center. In that group of patients, 5 (6%) had AML with TSC (AML-TSC). Mutational analysis of the TSC 2 gene was performed using 7 samples from the 5 AML-TSC patients and 14 samples from 14 patients with sporadic AML without TSC (AML-non-TSC). From this analysis, mutations in TSC genes were identified in 5 samples from the AML-TSC patients (mutation detection rate = 71%) and 3 samples from AML-non-TSC patients (mutation detection rate = 21%). In the case of AML-TSC, 6 mutations were found including 3 recurrent mutations and 3 novel mutations, while in the case of AML-non-TSC, 4 mutations were identified once, including 1 novel mutation. Also MLPA analysis of the TSC2 gene showed that TSC2 exon deletion is more frequently observed in AML-TSC patients than in AML-non-TSC patients. This is the first mutation and multiplex ligation-dependent probe amplification (MLPA) analyses of TSC 2 in Korean AMLs that focus on TSC. This study provides data that are representative of the distribution of mutations and exon deletions at TSC genes in clinically diagnosed AML-TSC cases of the Korean population.

Energy saving starts by knowing how much energy is being consumed. A building factor is easier than any other things in energy saving. Since, especially, it is closely connected with user`s space-use-patterns and manager`s utility-operation-style. An energy metering system lets building users know about energy consumption pattern in buildings and measure energy in real time. Development and materialization of metering systems need more careful plans, so that they depend on a demand of individual facilities and available infrastructures they used to use. But, so far, there is no guidelines how to install metering systems. This paper suggested how to install meters and researched a method for how to analyze by using metered data. For that, Green Building in KIER is used as a test bed. As the results, nevertheless the smallest number of meters is basically one for the whole building energy measuring, it is too limited in analysis. So we needed to add the sort of fuel and utility types and found that it depends on all cases. For this reasons, a guideline should be created in order to install meters as soon as possible. It would be suggest a way to save more energy in building factor.

A need for building energy efficiency is on the issue since energy demand in the building stock in Korea represents about 24% of the final energy consumption. As a way of improving the thermal performance of buildings for reducing maintenance costs and environmental conservation, a lot of effort is shown to improve the building energy efficiency by applying improvement of envelope insulation performance for buildings whose energy efficiency is low relatively through the remodeling. The windows of building envelopes are areas that lead to the biggest heat loss in the building. So windows are considered to be the primary target of energy efficiency in remodeling and various studies for windows have been done. Currently, however, only U-factor and airtightness of windows performance are regulated. Window wall ratio(WWR) and solar heat gain coefficient(SHGC) of windows are not considered when conducting the remodeling. In this study appropriate performance of windows(U-factor and SHGC) for existing residential is proposed according to the window wall ratio by using EnergyPlus. As the results of this study, the U-factor of windows representing the maximum energy savings is but in case of SHGC, the values that indicate the maximum energy savings are different depending on the window wall ratio. Therefore, when conducting the remodeling of windows, to determine energy efficiency by considering only the U-factor is inadequate so it is necessary that appropriate windows are applied to buildings by considering window wall ratio and windows properties(U-factor and SHGC).

Cronkhite-Canada syndrome (CCS) is a rare nonfamilial polyposis syndrome characterized by epithelial disturbances both in the gastrointestinal tract and in the epidermis. The pathologic finding of the polyp is usually a hamartomatous polyp of the juvenile type; however, the possibility of serrated adenoma associated malignant neoplasm was reported in some Japanese cases. Up till now in South Korea, 13 CCS cases have been reported, but there was no case accompanied by the colon cancer. We report the first case of CCS associated with malignant colon polyp and serrated adenoma in Korea. A 72-year-old male patient who complained of diarrhea and weight loss was presented with both hands and feet nail dystrophy, hyperpigmentation, and alopecia. Endoscopic examination showed numerous hamartomatous polyps from the stomach to the colon. The pathologic results confirmed colon cancer and serrated adenoma. Helicobacter pylori eradication and prednisolone was used. Thus, the authors report this case along with a literature review.

In recent years, as the occurrence of torrential rainfall in urban area which caused by global climate change has increased, the flood damage also has increased. It`s because careful consideration of increase tendency for rainfall wasn`t given to the hydraulic structure design standard and the occurrence of rainfall which exceed the design probability rainfall has actually increased. This paper suggests the regression equation which presents the extreme rainfall value in a probability function. The regression equation is made from the observed data and it can be used in design. As a result of the research, it is possible to apply the regression equation to disaster safety assessment of extreme rainfall when the hydraulic structures are designed.

As the exterior of building has been considered one of th important parts, the use of glass that is suitable to express various appearances gets raised. However, windows have 6~7times lower insulating performance than insulated walls. Lately, highly efficient windows are required as the needs for reduction of energy consumption come to the force. Therefore, Nowadays more people use cooling systems in summer, more the use of Low-E glazing is increasing. Because it is good to block Solar Radiant Energy which can cause much of heat loss while cooling system is working. This study measures U-value of the double Low-E glazing window and commonly used single Low-E glazing window. And then the effect of each window on the efficiency rating has been analyzed applying to the certification system of the building energy efficiency rating which has implemented.

The regulation of labelling criterion for genetically modified (GM) foods has been enforced since 2001 in Korea. Therefore, GM soybean (GMS) or GM maize (GMM) processed foods must be labeled as GMO derived. We surveyed to see whether this regulation is kept relevantly or not and the distributive statue of GM processed foods. Using the method of polymerase chain reaction (PCR) based on endogenous gene (Le1n, SSIIb), promoter gene (P35S), terminator gene (NOS) and transgenic gene (RRS, Bt11, Bt176, GA21, T25, Mon810), we detected GMS and GMM processed foods circulating at the market in Busan area. Out of total 100 samples, 38 items were showed to be contaminated with recombinant gene by qualitative PCR. Among 82 domestic and 18 imported items, 32 (39.0%) and 6 (33.3%) items were detected with GM ingredients respectively. Also among the 80 soybean and 20 maize processed foods, 23 (28.7%) and 15 (75.0%) foods were sensitive to detect GMS and GMM ingredients respectively. For the qualitative PCR positive foods, we chased identity preservation (IP) certificates. And we verified that the PCR positive crops were grown up, harvested and shipped separately from GMO but just mixed with GMO in the threshold of the non attentional contamination levels (3%). Thus we can not find out any regulation-violent case at all. The results of this study will help to keep the regulations of GM labelling and be informative to consumers who want to know the laboratory results of GMO testing.

Sphingomonas paucimobilis is an aerobic Gram-negative bacillus found in soil and water. Knowledge regarding the role of this infectious agent is limited because it is rarely isolated from human material. Furthermore, it is an unusual pathogen in cases of peritoneal dialysis (PD)-associated peritonitis. The clinical courses and outcomes of peritonitis caused by S. paucimobilis are variable. Whereas some patients were cured with appropriate antibiotic therapy, others required catheter removal. Cases of PD-associated peritonitis caused by S. paucimobilis have been reported worldwide, and there was a case report of coinfection with S. paucimobilis and Chryseobacterium indologenes in Korea. However, there has been no case caused by S. paucimobilis as a single pathogen. We report a case of PD-associated peritonitis due to S. paucimobilis in which the patient recovered after catheter removal.

There have been increasing concerns about the ESS, in order effectively to deal with the volatility of the system. For those with renewable energy, resulting in the uncertainty of power output, the ESS can prevent possible negative outcomes from a sudden change of load in a short time and simultaneously reinforce electricity supply. In addition, considering the facilities in which the system is surrounded and the purpose of the installation, the accurate SOC of the ESS is determined, and it results in an increase of the efficiency of power supply and the reliability. In this paper, the efficiency for renewable energy is enhanced and at the same time, the ESS with the UPS features is adopted, so as to perform for unplanned blackout. In doing so, the operation algorithm of the ESS based upon renewable energy resources is suggested and the optimal SOC limit is also assessed. In the end, by estimating the reliability of the ESS that involves the UPS system, the quantitative comparison will be made between the existing system and the new system.

Retinopathy of prematurity (ROP) is a retinal disease associated with the development of neovascularization and occurs primarily in premature infants of low gestational age and low birth weight [1]. The disease is thought to result largely from an aberrant retinal response to hyperoxia during supplemental oxygen therapy, compounded by functional retinal hypoxia as oxygen therapy is withdrawn [2]. While guidelines for management and treatment have recently been refined, it remains difficult to identify those infants susceptible to the progressive stages of ROP that is a leading cause of childhood blindness [3-5]. Animal models of oxygen-induced retinopathy (OIR) have been used for more than 40 years to yield insights into ROP. These models have been instrumental in advancing our understanding of the human disease, as well as the mechanisms of normal retinal microvascular development [3]. The normal process of retinal development is driven by the local tissue hypoxia that accompanies retinal growth and maturation [6,7]. As retinal oxygen demand exceeds supply via diffusion from the choroidal circulation, a range of hypoxia-inducible angiogenic factors are released which further drive retinal vasculature formation. Exposure of neonatal rats to hyperoxia increases the diffusion of oxygen from the choroidal circulation, thereby abrogating retinal physiological hypoxia and allowing retinal development to continue in the presence of an attenuated circulation [8]. When hyperoxic exposure is terminated and animals are returned to the normoxia of room air, the mature but poorly vascularized retina becomes acutely hypoxic and the resultant surge in angiogenic factor release leads to aberrant retinal vascularization that resembles ROP [9]. Recent studies in an OIR model have demonstrated the significant changes in the mRNA expression of vascular endothelial growth factor (VEGF), neuropilin 1, neuropilin 2, and mouse telomerase reverse transcription [10-12]. The purpose of this study was to identify altered patterns of retinal mRNA expression in a rat model of OIR and identify potential therapeutic treatment for the neovascularization that occurs in retinopathy.

Zollinger-Ellison syndrome (ZES) is characterized by gastrinoma and resultant hypergastrinemia, which leads to recurrent peptic ulcers. Because gastrinoma is the most common pancreatic endocrine tumor seen in multiple endocrine neoplasia type I (MEN 1), the possibility of gastrinoma should be investigated carefully when patients exhibit symptoms associated with hormonal changes. Ureteral stones associated with hyperparathyroidism in the early course of MEN 1 are known to be its most common clinical manifestation; appropriate evaluation and close follow-up of patients with hypercalcemic urolithiasis can lead to an early diagnosis of gastrinoma. We report a patient with ZES associated with MEN 1, and urolithiasis as the presenting entity. A 51-year-old man visited the emergency department with recurrent epigastric pain. He had a history of calcium urinary stone 3 years ago, and 2 years later he had 2 operations for multiple jejunal ulcer perforations; these surgeries were 9 months apart. He was taking intermittent courses of antiulcer medication. Multiple peripancreatic nodular masses, a hepatic metastasis, parathyroid hyperplasia, and a pituitary microadenoma were confirmed by multimodal imaging studies. We diagnosed ZES with MEN 1 and performed sequential surgical excision of the gastrinomas and the parathyroid adenoma. The patient received octreotide injection therapy and close follow-up.

A paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt, and is commonly related to patent foramen ovale (PFO). However, coexisting pulmonary embolisms, deep vein thromboses (DVT), and multipe systemic arterial embolisms, associated with PFO, are rare. Here, we report a patient who had a cryptogenic ischemic stroke, associated with PFO, which is complicated with a massive pulmonary thromboembolism, DVT, and renal infarctions, and subsequently, the patient was treated using a thrombolytic therapy.

A previously healthy 50-year-old man was transferred to our hospital for evaluation of acute inflammation in his right eye after ocular trauma while using a grass mower. Slit lamp examination showed 1 mm-length full thickness corneal laceration without leakage, 4+ cells and inflammatory membrane in the anterior chamber, 10% hypopyon, posterior synechiae formation, and cataract change. Upon orbital computerized tomography, a metallic intraocular foreign body in the lens was indentified. Vitrectomy, phacoemulsification, foreign body removal, anterior chamber irrigation, and intravitreal antibiotics injections of vancomycin and ceftazidime were performed. In a culture of humor from the anterior chamber grew Pantoea species. More procedures were performed, including intravitreal antibiotics injection of ceftazidime. Upon administering a course of intravenous ceftazidime, fortified ceftazidime and moxifloxacin eye drops, and oral prednisolone, the patient improved.

Purpose: To report a patient with Coats' disease who presented with a premacular membrane that was peeled off after laser photocoagulation. Case summary: A 17-year-old male presented with decreased visual acuity of the right eye, and showed serous elevation, subretinal hemorrhage, telangiectasis and thick premacular membrane upon fundus examination. Upon diagnosis with Coats' disease, the telangiectatic area was treated with argon laser photocoagulation. Two weeks later, the premacular membrane was peeled off spontaneously and the decrease of macular thickness was verified by optical coherence tomography (OCT). The patient's visual acuity was improved to 1.0. Conclusions: The visual acuity of the patient with Coats' disease was improved by spontaneous peeling of the premacular membrane after photocoagulation.

Purpose: To report the case of a child with triple X syndrome presenting with exotropia and chorioretinal coloboma. Case summary: A one-year-old female infant presented with 35PD exotropia in the primary position. The patient had poor fixation of the right eye, and a fundus examination showed chorioretinal coloboma in the inferior region of her right eye. The patient also exhibited syndactyly of the right hand. Brain magnetic resonance imaging revealed a well-defined 2 cm cyst in the right cerebellum. Upon chromosomal study, the patient’s karyotype was found to be 47, XXX. Conclusions: When infants or children present with ophthalmologic findings such as strabismus and coloboma, systemic conditions and congenital problems should be considered.