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To understand siltation processes within the North Port of Incheon, Korea, this study estimated the sedimentation rate and then determined the dominant mechanisms for the siltation. The sedimentation rate was estimated by comparing bathymetric surveys adjusted with the dredged volume, and verified by the penetration depth of 11 gravity cores to the previous dredging surface. The average sedimentation rate was 64 cm/year but varied from 10 cm/year in the interior to about 100 cm/year at the entrance. To determine the dominant mechanisms for siltation, two ADCPs were deployed at the entrance and the interior end of the harbor over a month to estimate sediment flux. Detailed sediment transport processes were examined by two 13-h CTD profiling surveys near the entrance and interior end of the harbor. High siltation at the entrance is attributable to the influx of high turbidity water, the decrease of current velocity, and the formation of an eddy. Low sedimentation inside the harbor was attained by the slow settling of microflocs of about 20–30 mg/l concentration that are maintained regardless of time and space.

To understand the spatiotemporal variability in the floc size distribution, the factors controlling floc size, and the timing of flocculation with sediment flux in the periodically stratified Geum Estuary, Korea, simultaneous measurements of current, salinity, suspended sediment concentration (SSC), and floc size distributions were analyzed and floc size was compared with stratification, turbulence, SSC, and sediment flux. Salinity measurements indicated that the water column was stratified during ebb and well-mixed during flood, consistent with the process of strain-induced periodic stratification. Coincident with periodic stratification was an ebb-flood asymmetry in floc size where coarser, multimodal and variable distributions occurred during the stratified ebb whereas finer, unimodal and relatively constant distributions occurred during the well-mixed flood. Vertically, flocs coarsened downward during the stratified ebb and were vertically homogenous during the well-mixed flood. The ebb-flood asymmetry in floc size was due to the ebb-flood asymmetry in stratification and turbulence. Furthermore, while floc size decreased with turbulence, the SSC increased with turbulence. As a consequence, large flocs occurred with relatively small ebb-directed fluxes whereas small flocs occurred with relatively large flood-directed fluxes. Overall, these observations indicate that the variability of the floc size distribution in periodically stratified estuaries is different than in well-mixed estuaries and that ebb-directed fluxes may be more flocculated than flood-directed fluxes in these systems.

BACKGROUND We investigated the effect of irrigation fluid on coagulation according to the hemodilution level using rotational thromboelastometry (ROTEM). METHODS Venous blood was taken from 12 healthy volunteers and divided into four specimen tubes that were diluted to various levels (0%, 10%, 20%, and 40%) using an irrigation fluid composed of 2.7% sorbitol and 0.54% mannitol. RESULTS Significant prolongation of clotting time was observed in the 40% diluted sample using both INTEM (P = 0.009) and EXTEM (P = 0.001) assays. However, the clot formation time was prolonged significantly in the 10%, 20%, and 40% diluted samples using both INTEM (P < 0.001) and EXTEM (P = 0.002, P < 0.001, and P < 0.001, respectively) assays. A significant decrease of α-angle of INTEM and EXTEM were observed in the 10% (P < 0.001), 20% (P < 0.001 and P = 0.001, respectively), and 40% (P < 0.001) groups compared with the 0% dilution group. The maximum clot firmness (MCF) of INTEM decreased significantly in the 20% (P < 0.001) and 40% (P < 0.001) diluted samples. In the MCF of EXTEM and FIBTEM assays, 10% (P = 0.009 and P = 0.015, respectively), 20% (P = 0.001), and 40% (P < 0.001) samples showed a significant decrease compared with the 0% sample. Nevertheless, most of the ROTEM values were within the reference range, except the 40% sample. CONCLUSIONS Blood became hypocoagulable when it was diluted in vitro with a fluid composed of 2.7% sorbitol and 0.54% mannitol.

Background and objectivesData is insufficient to determine whether perioperative statin use increases or decreases postoperative pain. This study aimed to investigate the association between perioperative statin use and pain outcomes after total knee arthroplasty performed under spinal anesthesia.MethodsThis is a retrospective, observational study based on medical records from a tertiary hospital between January 2005 and October 2017. Medical records of patients who underwent elective total knee arthroplasty under spinal anesthesia as inpatients were analyzed. Pain outcomes were compared through postoperative day (POD) 3 in patients who were taking statins perioperatively versus patients who were not taking statins.ResultsA total of 1088 propensity-matched participants were included in the final analysis (544 patients in the statin group and 544 patients in the non-statin group). The total morphine equivalent consumption through POD 3 was higher in the statin group than in the non-statin group (mean (SD), statin group: 525.4 (119.7) vs non-statin group: 495.3 (115.3), 95% CI of the difference: 15.9 to 44.4, pConclusionsPerioperative statin use is associated with a significant increase in postoperative opioid consumption after total knee arthroplasty performed under spinal anesthesia; however, this increase was so marginal that its clinical importance remains controversial.

To better understand the alteration of the estuarine circulation caused by estuarine dams, four major Korean estuaries were classified by using the Hansen and Rattray stratification–circulation classification scheme. The stratification and circulation parameters were calculated for both discharge and no-discharge periods from the tidally averaged salinity and velocity data obtained from these four Korean estuaries. The estuarine types of the altered Korean estuaries were compared with the previous results for natural estuaries in other countries of similar magnitude in tidal range, water depth, and discharge. This comparison revealed that the estuarine types of the altered Korean estuaries have been shifted from a partially mixed to a well-mixed type (Nakdong River Estuary), from a partially mixed to a coastal bay or a fjord type (Yeongsan River Estuary), and from a well-mixed to a well-mixed type with less tidal modulation (Geum River Estuary). The controlling factors that determined the type in natural estuaries were tide, discharge, and water depth, whereas for altered estuaries, they were the controlled river discharge and water depth. The different estuarine dam gate types with their different modes of operation (surface or bottom discharge) played an important role in the mixing and circulation of the altered estuaries.

It is imperative to develop cost-effective and stable cathode materials with satisfactory activities for both oxygen evolution and oxygen reduction reactions (OER and ORR) in order to build next-generation rechargeable metal–air battery systems. Herein, we developed an effective strategy for fabricating highly active and stable bifunctional oxygen catalysts using a highly active ORR catalyst and hybridizing it with an OER catalyst. The effects of single (S)- and multi (S and N)-doping on the ORR catalytic efficiency of reduced graphene oxide (rGO) sheets were investigated. Cobalt hydroxide (Co(OH)2) nanocrystals with diameters of less than 5 nm were directly grown on SN-rGO via a simple precipitation method at room temperature to produce a bifunctional oxygen catalyst (Co(OH)2@SN-rGO). The Co(OH)2@SN-rGO bifunctional oxygen catalyst exhibited outstanding catalytic activities for both OER and ORR and showed excellent stability up to 40 h. The results demonstrated that the bifunctional oxygen electrode activities of the non-noble metal-based catalyst prepared in this study were as high as those of commercial noble metal-based oxygen electrodes.

Background Delirium is an important postoperative complication. Recent research suggested that 5-hydroxytryptamine 3 (5-HT3) receptor antagonists may have clinical effect in the treatment and prevention of delirium. We investigated the association between 5-HT3 receptor antagonists and the occurrence of postoperative delirium (POD). Methods Retrospectively, the electronic medical records were reviewed in patients aged ≥ 65 years who underwent orthopedic lower limb surgery under regional anesthesia (spinal or combined spinal-epidural anesthesia) and administered intravenous 0.075 mg palonosetron or 0.3 mg ramosetron prior to the end of surgery between July 2012 and September 2015. POD incidence and anesthesia-, surgery-, and patient-related factors were evaluated. To investigate the association between 5-HT3 receptor antagonists and the occurrence of POD, multivariable logistic regression analysis was performed. Results Of the 855 patients included, 710 (83%) were administered 5-HT3 receptor antagonists. POD was confirmed in 46 (5.4%) patients. 5-HT3 receptor antagonists reduced the POD incidence by 63% (odds ratio [OR] 0.37; 95% confidence interval [CI], 0.15–0.94; P = 0.04). Moreover, the POD incidence decreased by 72% (OR 0.28, 95% CI 0.10–0.77, P = 0.01) when palonosetron was administered. Other identified risk factors for POD were emergency surgery, older age, hip surgery, lower body mass index, and intraoperative propofol sedation. Conclusion 5-HT3 receptor antagonists may be related with a significantly reduced risk for POD in older patients undergoing orthopedic lower limb surgery. Notably, palonosetron was more effective for POD prevention.

Neurotoxic effects of local anesthetics (LAs) on developing motor neurons have not been documented. We investigated the neurotoxic effects of LAs on developing motor neurons in terms of cell viability, cytotoxicity, reactive oxygen species (ROS), and apoptosis. Embryonic spinal cord motor neurons were isolated from Sprague-Dawley rat fetuses and exposed to one of the three LAs—lidocaine, bupivacaine, or ropivacaine—at concentrations of 1, 10, 100, or 1000 µM. The exposure duration was set to 1 or 24 h. The neurotoxic effects of LAs were determined by evaluating the following: cell viability, cytotoxicity, ROS production, and apoptosis. In the 1-h exposure group, the motor neurons exposed to lidocaine and bupivacaine had reduced cell viability and increased cytotoxicity, ROS, and apoptosis in a concentration-dependent manner. Lidocaine showed the highest toxicity, followed by bupivacaine. In the 24-h exposure group, all three LAs showed significant effects (decreased cell viability and increased cytotoxicity, ROS, and apoptosis) on the motor neurons in a concentration-dependent manner. The neurotoxic effects of lidocaine were greater than those of bupivacaine and ropivacaine. Ropivacaine appeared to have the least effect on motor neurons. This study identified the neurotoxic effects of lidocaine and bupivacaine on developing spinal cord motor neurons.

Spinal cord ischemia is one of the most serious complications of aortic repair in patients with acute aortic syndrome. However, the effect of hypotension before aortic clamping on spinal cord injury has not been documented. A total of 48 male Sprague-Dawley rats were randomly divided into four groups: the sham group, control group (mean arterial pressure (MAP) &lt, 90% of baseline value before aortic clamping), mild hypotension group (MAP &lt, 80%), and profound hypotension group (MAP &lt, 60%). Spinal cord ischemia was induced using a balloon-tipped catheter placed in the descending thoracic aorta. Neurological function of the hind limbs was evaluated for seven days after reperfusion and recorded using a motor deficit index (MDI). The spinal cord was then harvested for histopathological examination and evaluation of oxidative stress and inflammation. The profound hypotension group demonstrated a significantly higher MDI 48 h post-reperfusion and lower number of normal motor neurons than the other groups (p &lt, 0.001). The levels of tissue malondialdehyde and tumor necrosis factor-&alpha, (TNF-&alpha, ) were also significantly increased in the profound hypotension group compared with other groups. Profound hypotension before aortic clamping can aggravate neurologic outcomes after aortic surgery by exacerbating neurologic injury and reducing the number of normal motor neurons.

Background: Postoperative delirium (PD) is still an issue in post-cardiac surgery patients despite the constant efforts to reduce it. Although various risk factors for PD after cardiac surgery have been identified, there is limited clinical data regarding the effect of intraoperative anesthetic agents on the PD.Methods: The medical records of 534 patients, who had undergone heart valve surgery or coronary artery bypass graft surgery with cardiopulmonary bypass (CPB) between January 2012 and August 2017, were investigated. They were divided into two groups according to the main anesthetic agent: sevoflurane with dexmedetomidine (sevo-dex group, n = 340) and propofol (propofol group, n = 194). The incidence of PD was evaluated as the primary outcome. PD was defined as the positive Confusion Assessment Method for the Intensive Care Unit during the intensive care unit stay. Patient-, surgery-, and anesthesia-related factors and postoperative complications were investigated as secondary outcomes. To reduce the risk of confounder effects between the two groups, 194 patients were selected from the sevo-dex group after propensity-score matching.Results: After propensity-score matching, the incidence of PD was not significantly different between the sevo-dex (6.2%) and propofol (10.8%) groups (P = 0.136). In comparison of the incidence of each type of PD, only hyperactive PD occurred significantly less in the sevo-dex group than in the propofol group (P = 0.021). Older age, lower preoperative albumin levels, and emergency surgery were significant risk factors for PD.Conclusions: The overall incidence of PD after cardiac surgery with CPB is not associated with the main anesthetic agents, sevoflurane and dexmedetomidine-based vs. propofol-based anesthesia. Only hyperactive PD occurred less frequently after in patients receiving sevoflurane and dexmedetomidine-based anesthesia.

Ultrasound-guided erector spinae plane block (ESPB), a recent regional analgesic technique, has been used to manage acute pain after surgery. The aim of this meta-analysis is to identify the benefits of ESPB in patients undergoing laparoscopic cholecystectomy (LC). The authors searched PubMed, EMBASE, CENTRAL, CINAHL, and Web of Science to identify all randomized controlled trials (RCTs) evaluating the effects of ESPB on postoperative pain after LC. Primary outcome was defined as 24 h cumulative opioid consumption. Secondary outcomes were pain scores and the incidence of postoperative nausea and vomiting (PONV). We estimated mean differences (MD) and odds ratio (OR) using a random-effects model. A total of 8 RCTs, including 442 patients, were included in the final analysis. Postoperative opioid consumption was significantly lower in the ESPB group than in the control group (MD &minus, 4.72, 95% CI &minus, 6.00 to &minus, 3.44, p &lt, 0.001). Compared with the control group, the ESPB group also showed significantly lower pain scores and incidence of PONV. A separate analysis of RCTs comparing ESPB with oblique subcostal transversus abdominis plane (OSTAP) block showed that the analgesic efficacy of ESPB was similar to that of OSTAP block. The results of this meta-analysis demonstrated that ESPB may provide effective postoperative analgesia in patients undergoing LC.

In terms of antinociceptive action, the main mode of action of magnesium involves its antagonist action at the N-methyl-d-aspartate (NMDA) receptor, which prevents central sensitization and attenuates preexisting pain hypersensitivity. Given the pivotal function of NMDA receptors in pain transduction, magnesium has been investigated in a variety of pain conditions. The oral and parenteral administration of magnesium via the intravenous, intrathecal, or epidural route may alleviate pain and perioperative anesthetic and analgesic requirements. These beneficial effects of magnesium therapy have also been reported in patients with neuropathic pain, such as malignancy-related neurologic symptoms, diabetic neuropathy, postherpetic neuralgia, and chemotherapy-induced peripheral neuropathy. In addition, magnesium treatment is reportedly able to alleviate fibromyalgia, dysmenorrhea, headaches, and acute migraine attacks. Although magnesium plays an evolving role in pain management, better understanding of the mechanism underlying its antinociceptive action and additional clinical studies is required to clarify its role as an adjuvant analgesic.

Study objective This study aimed to identify the benefits of quadratus lumborum block (QLB) in terms of postoperative analgesic effects in adult participants undergoing hip surgery. Design Meta-analysis of randomized controlled trials. Setting Previous randomized controlled trials that evaluated the analgesic effect of QLB compared to that of no block. Patients Nine studies including 616 participants. Interventions Participants in the treatment group received QLB, whereas those in the control group received no block. Measurements Outcomes were postoperative 24-h opioid consumption (primary), 12-h/24-h visual analog scale (VAS) or numeric rating scale (NRS) pain scores, postoperative nausea and vomiting (PONV), and satisfaction. The effect size was estimated using the standardized mean difference (SMD), mean difference (MD), or risk ratio (RR) with a 95% confidence interval (CI). We used the risk of bias tool (RoB 2) to assess the risk of bias of the included studies and the GRADE approach to determine the level of certainty of the evidence. Main results Compared to no block, the QLB group has less opioid consumption (SMD -1.69, 95% CI -2.54 to -0.84; low level of certainty of the evidence). Estimated MD for morphine consumption was 24 mg. The QLB group had a lower 12-h VAS/NRS pain score (MD -1.16, 95% CI -1.82 to -0.51; moderate level of certainty of the evidence) and 24-h VAS/NRS pain score (MD -0.92, 95% CI -1.42 to -0.43; moderate level of certainty of the evidence). QLB decreased the incidence of PONV (RR 0.43, 95% CI 0.24 to 0.79; moderate level of certainty of the evidence) and increased participants' satisfaction (SMD 1.15, 95% CI 0.63 to 1.67; moderate level of certainty of the evidence). Estimated MD for satisfaction was 1.74 points of Likert scale. There were no significant adverse events associated with the QLB in any of the included trials. Conclusion Our meta-analysis showed that QLB when compared to no block clinically decreased opioid requirements, reduced PONV, and improved participants' satisfaction. QLB also seems to be significantly superior to no block in terms of pain score, but its clinical importance remains unclear.

Postoperative delirium (PD) remains an issue in cardiac surgery despite the constant efforts to reduce its incidence. In this retrospective study, the incidence of PD was evaluated in patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) according to different primary anesthetic agents: sevoflurane and dexmedetomidine- versus propofol-based anesthesia. A total of 534 patients who underwent heart-valve surgery or coronary artery bypass graft surgery with CPB between January 2012 and August 2017 were divided into 2 groups according to the main anesthetic agent: sevoflurane with dexmedetomidine (sevo-dex group, n = 340) and propofol (propofol group, n = 194). The incidence of PD was evaluated as the primary outcome. Patient-, surgery-, and anesthesia-related factors and postoperative complications were investigated as secondary outcomes. To reduce the risk of confounding effects between the 2 groups, 194 patients were selected from the sevo-dex group after propensity-score matching. After propensity-score matching, the incidence of PD was not significantly different between the sevo-dex (6.2%) and propofol (10.8%) groups (P = .136). In comparisons of the incidence of each type of PD, only hyperactive PD occurred significantly less frequently in the sevo-dex group (P = .021). Older age, lower preoperative albumin levels, and emergency surgery were significant risk factors for PD. The overall incidence of PD after cardiac surgery with CPB did not differ between patients receiving sevoflurane and dexmedetomidine-based versus propofol-based anesthesia. Only hyperactive PD occurred less frequently in patients receiving sevoflurane and dexmedetomidine-based anesthesia.

This randomized trial investigated whether a 2-dose administration of intravenous ramosetron (5-hydroxytryptamine type 3 receptor antagonist) is more effective than a single-dose administration in preventing postoperative nausea and vomiting (PONV) in 89 patients who were scheduled to undergo laparoscopic operation for benign gynecologic diseases and to receive intravenous patient-controlled analgesia for relief of postoperative pain. After assignment at a ratio of 1:1, intravenous ramosetron (0.3 mg) was initially administered at the end of skin closure in all patients. Thereafter, ramosetron (0.3 mg) and placebo were administered to the study and control groups, respectively, at 4 hours after the operation. The baseline and operative characteristics were similar between the groups. The incidence of PONV during the 24-hour period after operation which was assessed as the primary endpoint did not differ between the groups. No serious adverse events occurred in either group. A 2-dose administration of intravenous ramosetron may not be superior to a single-dose administration in preventing PONV in patients undergoing laparoscopic operation for benign gynecologic diseases.

Background This study was designed to compare the hemodynamic changes in response to direct laryngoscopy with using the McCoy or Macintosh blade. Methods Seventy seven patients were randomly allocated into two groups. The induction of anesthesia was done with target controlled infusion of propofol (5 microgram/ml) and remifentanil (3 ng/ml) and vecuronium 0.1 mg/kg was also given. The vocal cords were visualized with either the McCoy or the Macintosh laryngoscope blade, and then tracheal intubation was performed. The heart rate and blood pressure were measured just before induction, at intubation and at 1, 3 and 5 minutes after intubation. Results There were no significant differences in the blood pressure and heart rate responses to tracheal intubation with using the McCoy or Macintosh blade. But, in the Macintosh groups, the blood pressure at 1 and 3 minutes and the heart rate at 1 minute after intubation were increased significantly compared with the preintubation values. Also, in the McCoy groups, the blood pressure and heart rate at 1 minute after intubation were significantly higher than the preintubation values. Conclusions The McCoy and the Macintosh blade show similar changes in heart rate and blood pressure after tracheal intuba tion.

Objective: Systemic absorption of irrigation fluid can lead to a disturbed coagulation cascade. We compared the changes in hemostatic properties on using nonelectrolyte solution in monopolar hysteroscopic surgery (HS) with that on using isotonic saline in bipolar HS via rotational thromboelastometry (ROTEM) analysis. Methods: A total of 54 patients were randomized into 2 groups: 1 group underwent monopolar HS using a mixture of 2.7% sorbitol and 0.54% mannitol (the HSMP group), whereas the other group underwent bipolar HS using 0.9% isotonic saline (the HSBP group). The effects of these 2 methods on coagulation were assessed via pre and postoperative laboratory tests, including estimation of the international normalized ratio of prothrombin time and activated partial thromboplastin time and ROTEM analysis. In addition, the hemoglobin, hematocrit, and electrolyte levels and the platelet count were analyzed. Results: Patient characteristics, volume of irrigation fluid absorbed, and type of procedure were comparable between the 2 groups. There were no significant differences in the pre and postoperative values of ROTEM parameters between the 2 groups. Most postoperative ROTEM parameters, as compared with preoperative values, changed in both groups; clot formation time was prolonged, and the α-angle and maximum clot firmness were decreased. All ROTEM parameters were maintained within the normal range. Hematological parameters, including hemoglobin and hematocrit levels and platelet count, were significantly decreased postoperatively in both groups compared to the preoperative values. No pre and postoperative hematological and hemostatic parameters were significantly different between the 2 groups. Conclusion: Irrigation fluid absorbed in healthy women during HS caused hypocoagulable changes in the blood, irrespective of the irrigant type, and no significant differences between HS using monopolar and bipolar electrodes were demonstrated.

To realize advanced Li- and Na-ion batteries (LIBs and SIBs), a scalable free-standing electrode constructed using S, N co-doped reduced graphene oxides and pyrrhotite Fe7S8 (Fe7S8@SN-rGO) has been rationally designed and developed via freeze casting. Freeze casting can generate unidirectional open channels inside the electrode, which enables fast ion transport and provides large contact area between electrode and electrolyte. Furthermore, the aligned SN-rGO frameworks provide effective electron transport routes. In terms of structural stability, sandwiched Fe7S8 within sturdy SN-rGO walls are protected from volume expansion caused by lithiation and sodiation. Consequently, when used in LIBs, Fe7S8@SN-rGO exhibited outstanding rate capability with reversible capacities of 621.1 and 492.1 mA h g−1 at low and high current densities of 0.2 and 4 A g−1, respectively, and excellent cycling stability without drastic capacity decay over 1000 cycles. As an anode for SIBs, the electrode also exhibited a high reversible capacity of 341.3 mA h g−1 at a high current density of 4 A g−1 with a high initial coulombic efficiency of 90.5% and excellent long-term cycling stability for 2000 cycles. The excellent performances of the Fe7S8@SN-rGO suggest that the powerful large-scale energy storage systems can be realized via metal colloid/GO-based freeze casting.

To generate a biobetter that has improved therapeutic activity, we constructed scFv libraries via random mutagenesis of several residues of CDR-H3 and -L3 of hu4D5. The scFv clones were isolated from the phage display libraries by stringent panning, and their anti-proliferative activity against HER2-positive cancer cells was evaluated as a primary selection criterion. Consequently, we selected AH06 as a biobetter antibody that had a 7.2-fold increase in anti-proliferative activity (IC50: 0.81 nM) against the gastric cancer cell line NCI-N87 and a 7.4-fold increase in binding affinity (KD: 60 pM) to HER2 compared to hu4D5. The binding energy calculation and molecular modeling suggest that the substitution of residues of CDR-H3 to W98, F100c, A101 and L102 could stabilize binding of the antibody to HER2 and there could be direct hydrophobic interactions between the aromatic ring of W98 and the aliphatic group of I613 within HER2 domain IV as well as the heavy and light chain hydrophobic interactions by residues F100c, A101 and L102 of CDR-H3. Therefore, we speculate that two such interactions were exerted by the residues W98 and F100c. A101 and L102 may have a synergistic effect on the increase in the binding affinity to HER2. AH06 specifically binds to domain IV of HER2, and it decreased the phosphorylation level of HER2 and AKT. Above all, it highly increased the overall level of p27 compared to hu4D5 in the gastric cancer cell line NCI-N82, suggesting that AH06 could potentially be a more efficient therapeutic agent than hu4D5.

This study explores the technical merits of carbon encapsulation via an electrical wire explosion method to enhance the peroxymonosulfate activation performance of metals. Reflecting the nature of core-shell structures, the outer carbon layers hampered the reductive conversion of peroxymonosulfate to sulfate radicals by the inner metal cores, whereas the metal cores increased the overall electrical conductivity as a pivotal factor in non-radical activation. Hence, the impact of carbon wrapping hinged on the peroxymonosulfate reduction capability of the metals, i.e., kinetic retardation in organic degradation with reactive Cu, Fe, and Ni-Fe, but acceleration with unreactive Ni. Further, composite fabrication switched the major degradative pathway from radical-induced oxidation to mediated electron transfer, as determined from the effects of methanol and chloride, formaldehyde and bromate formation yields, reactivity toward multiple organics, and electron paramagnetic resonance spectral features. The protective carbon shells enabled pH-insensitive peroxymonosulfate activation, prevented metal ion leaching, and alleviated catalyst deactivation.

While estuarine dams have been noted for often resulting in siltation, the flux mechanism and the effect of the dam on the fluxes is not well understood. To gain process-based insight into the spatiotemporal variation and factors that control sediment flux, high resolution in-situ flux measurements were collected at stations 1.5 km and 6.5 km seaward of the Geum estuarine dam, Korea. Fluxes were calculated based on flow collected by Acoustic Doppler Current Profilers (ADCPs) and suspended sediment concentration derived from ADCP acoustic backscatter which was calibrated with water samples. The fluxes were decomposed into components occurring on timescales longer than the tidal cycle (mean-flow flux) and those occurring on the tidal timescale (correlation flux), and ship-borne surveys were conducted to investigate the role of the dam-induced horizontal salinity gradient to stratification and sediment dynamics. Results suggest that the landward correlation fluxes increased because the dam construction amplified the tide and because the correlation flux was proportional to the tidal amplitude, through tidal asymmetry. The dam discharge was found to control the seaward mean-flow fluxes, which were characteristically unsteady and proportional to the discharged volume. Discharge also was found to result in periodic stratification and flocculation asymmetry. The bed level change between the two stations was a balance between the effects of tidal asymmetry and freshwater discharge. For shallow, macrotidal estuaries with small discharge, estuary siltation is expected primarily due to correlation fluxes, and the effect is enhanced when the dam installation amplifies the tides.

The use of lidocaine in spinal anesthesia may increase the risk of transient neurological symptoms (TNS) according to previous meta-analyses. However, the previous meta-analyses lacked data on some other local anesthetics and thus, more evaluations are still needed to compare the effect of lidocaine on the development of TNS. The objective of this study was to compare the risk of TNS according to lidocaine versus other local anesthetics in patients undergoing spinal anesthesia. A total of 39 randomized controlled trials with 4733 patients were analyzed. The incidence of TNS was 10.8% in the lidocaine group and was 2.2% in the control groups (risk ratio (RR) 4.12, 95% confidence interval (CI) 3.13 to 5.43, p &lt, 0.001). In subgroup analysis, lidocaine increased the incidence of TNS compared with other local anesthetics except mepivacaine, ropivacaine or sameridine. The risk of TNS was higher in the hyperbaric (p &lt, 0.001) or isobaric lidocaine (p &lt, 0.001) group compared with the control group, but there were no differences found between the two groups when hypobaric lidocaine was administered (p = 1.00). This study confirmed that lidocaine for spinal anesthesia still causes TNS more frequently than most other local anesthetics, especially when hyperbaric or isobaric lidocaine was used.

PurposeTo investigate the characteristics of human orbital fibroblasts (OFs) cultivated from intraconal, nasal and central adipose tissues.MethodsIntraconal adipose tissues were obtained during orbital decompression surgery for severe proptosis in nine patients with Graves’ orbitopathy (GO). Nasal and central adipose tissues were obtained during upper eyelid blepharoplasty in nine patients with no history of GO. Human OFs were separately cultured from GO intraconal, non-GO nasal, non-GO central orbital adipose deposits. Human dermal fibroblasts were also cultured from redundant resected skin tissue obtained during upper eyelid blepharoplasty in normal controls. Expression of insulin-like growth factor 1 (IGF-1) and thyroid-stimulating hormone (TSH) receptors were investigated using real-time quantitative reverse transcription PCR. Protein levels of interleukin-1β (IL-1β)-induced inflammatory cytokines and generated intracellular reactive oxygen species (ROS) were determined.ResultsIGF-1 and TSH receptor RNA expressions of GO intraconal OFs and non-GO nasal OFs were higher than non-GO central OFs and dermal fibroblasts. The expression of IL-1β induced the IL-6, IL-8, intercellular adhesion molecule-1 and cyclooxygenase-2 of GO intraconal OFs, and non-GO nasal OFs were higher than non-GO central OFs and dermal fibroblasts. Intracellular ROS generation in GO intraconal OFs and non-GO nasal OFs were higher than in non-GO central OFs and dermal fibroblasts, although the differences were not statistically significant.ConclusionsNon-GO nasal OFs had similar characteristics to GO intraconal OFs. We recommend the use of nasal adipose tissue in order to culture OFs as a normal control involving in vitro experiments.

Background The relationship between statin use and incidence of postoperative delirium (POD) is controversial. We investigated the association between perioperative statin use and occurrence of delirium after total knee arthroplasty (TKA) under spinal anesthesia. Methods We retrospectively reviewed the electronic medical records of patients who underwent TKA under spinal anesthesia at single tertiary care hospital between January 2005 and October 2017. POD incidence was recorded for patients who received statins continuously from 1 month before surgery until discharge and for patients who did not receive any statins. Univariable and multivariable logistic regression analyses were conducted to investigate an association between occurrence of POD and perioperative statin use. Results In total, 6,020 procedures were included, and 992 (16.4%) were associated with perioperative statin use. POD was confirmed for 304 (5.0%) procedures. The statin group showed a 1.7% significant lower incidence ( P =0.017) of POD (35/992, 3.5%) than the no-statin group (1,420/5,028, 5.4%). In multivariable logistic regression analysis, the POD incidence in the statin group was 34% lower than that in the no statin group [odds ratio (OR), 0.66; 95% confidence interval (CI), 0.45–0.97; P = 0.036] Moreover, the POD incidence was decreased by 37% (OR, 0.63; 95% CI, 0.40–0.99; P = 0.047), and 79% (OR, 0.21; 95% CI, 0.05-0.88; P = 0.033) respectively, when atorvastatin and simvastatin were administered. Conclusions Continuous perioperative statin use may be associated with a significantly lower risk of delirium after TKA under spinal anesthesia; simvastatin was the most effective statin for POD prevention.

Summary Background This study was aimed at assessing the therapeutic efficacy of green tea on peripheral skin for cold hypersensitive subjects, who had the feeling of cold hands and feet at cold temperatures, one of the most common complaints in Asian women. Methods This randomized and placebo-controlled clinical study included 60 female Korean subjects who had the feeling of cold hands and feet at cold temperatures. The subjects were randomly assigned into two groups to receive fermented green tea or a placebo (hot water). Results The skin temperature of the hands and feet was measured using digital infrared thermography at the baseline and at 15, 30, 45, and 60 min after the oral administration of the tea or placebo. The skin temperature of the hands and feet of the fermented green tea-administered group was significantly higher than that of the placebo-administered group. The temperature difference between the finger and the dorsum of the hand was significantly lower in the fermented green tea-administered group than that in the placebo group. Conclusions Fermented green tea is helpful for cold hypersensitivity. This is the first clinical study to evaluate the efficacy of fermented green tea on peripheral skin in subjects having the feeling of cold hands and feet at cold temperatures by infrared thermography. However, further studies are necessary to evaluate the long-term effects of the fermented green tea for cold hypersensitivity and to elucidate the underlying physiological mechanism.

Previous sedimentological work has shown that throughout the last half-century, average sediment accumulation of 2–6 cm yr− 1 occurred due to the emplacement of estuarine dams and land reclamation in the Nakdong Estuary of South Korea (Williams et al., 2013). To investigate the timing and rate of sedimentation, two sonar altimeters were deployed for nearly a year. In the West Nakdong River, where there is no freshwater discharge from the dam, 4 cm of gradual sedimentation was observed, corresponding to the long-term average accumulation. On the other hand, episodic sedimentation of 6 cm, which also corresponds to the long-term accumulation rate, was observed during two months of summer discharge in the main East Eulsuk Channel. To examine the mechanisms of sedimentation, Acoustic Doppler Current Profilers at three sites measured current velocity and acoustically-derived suspended sediment concentration during increased discharge and wave activity events, and through spring and neap tidal cycles. Sediment flux was decomposed into tidal pumping and advection terms to determine the primary factors controlling sedimentation throughout the estuary. Downstream sediment fluxes were dominated by mean advection, particularly during large discharge events. The difference in the magnitude between the upper and lower stations has been determined to be the main mechanism for convergence of flux (deposition) in the central estuary. In the absence of strong discharge, residual sediment transport caused a flux into the estuary, suggesting the primary mechanism for gradual deposition throughout the year in the West Nakdong River where discharge is entirely blocked.

In this work, we wanted to develop a probiotic from famous longevity villages in Korea. We visited eight longevity villages in Korea to collect fecal samples from healthy adults who were aged above 80 years and had regular bowel movements, and isolated lactic-acid-producing bacteria from the samples. Isolated colonies that appeared on MRS agar containing bromophenol blue were identified by means of 16S rRNA sequencing, and 102 of the isolates were identified as lactic-acid-producing bacteria (18 species). Lactobacillus fermentum was the most frequently found species. Eight isolates were selected on the basis of their ability to inhibit the growth of six intestinal pathogens (Escherichia coli O157:H7, Salmonella enterica subsp. enterica Typhimurium, Salmonella enterica subsp. enterica Enteritidis, Enterococcus faecalis, Staphylococcus aureus, and Listeria monocytogenes) and their susceptibility to 15 antimicrobial agents. Among these eight isolates, four Lactobacillus fermentum isolates were found not to produce any harmful enzymes or metabolites. Among them, Lactobacillus fermentum isolate no. 24 showed the strongest binding to intestinal epithelial cells, the highest immune-enhancing activity, anti-inflammation activity, and anti-oxidation activity as well as the highest survival rates in the presence of artificial gastric juice and bile solution. This isolate, designated Lactobacillus fermentum PL9988, has all the characteristics for a good probiotic.

Existing flocculation models for cohesive sediments are classified into two groups: population balance equation models (PBE) and floc growth models. An FGM ensures mass conservation in a closed system. However, an FGM determines only the average size of flocs, whereas a PBE has the capability to calculate a size distribution of flocs. A new stochastic approach to model the flocculation process is theoretically developed and incorporated into a deterministic FGM in this study in order to calculate a size distribution of flocs as well as the average size. A log-normal distribution is used to generate random numbers based on previous laboratory experiments. The new stochastic flocculation model is tested with three laboratory experiment results. It was found and validated with measured data that the new stochastic flocculation model has the capability to replicate a size distribution of flocs reasonably well under different sediment and carrier flow conditions. Three more distributions (normal, Pearson type 3, and generalized extreme value distributions) were also tested. From the comparison with results of different distribution functions, it is shown that a stochastic FGM using a log-normal distribution has a comparative advantage in terms of simplicity and accuracy.

SummaryBackground Collagens have long been used in pharmaceuticals and food supplements for the improvement of skin. Aim We evaluated the efficacy of high advanced-collagen tripeptide (HACP) on wound healing and skin recovery. Methods Using an in vitro model, we performed HaCaT cell migration assays and collagen gel contraction assays using HACP concentrations of 1, 10 and 100 μg/mL. In this pilot study, eight healthy volunteers were randomly divided into two groups. Both the control and experimental groups received fractional photothermolysis treatment, but in the experimental group, four subjects received 3 g/day of oral collagen peptide (CP) for 4 weeks. To assess transepidermal water loss in each patient before and after the treatment, we used a Corneometer and a Cutometer, and we also assessed the patient's Erythema Index. Results The cell migration assay showed that HACP enhanced wound closure, but not in a dose-dependent manner. The collagen gel contraction assay showed increased contractility when patients were treated with 100 μg/mL HACP, but the results were not significantly different from those of controls. We found that post-laser erythema resolved faster in the experimental group than in the control group (P

It has been customary to exclude top 10-20% of velocity profiles in the Acoustic Doppler Current Profiler (ADCP) measurement due to side lobe effects at the boundary. To better understand the mixing in the Yeongsan estuary, the freshwater advection speed (FAS) was recovered from highly contaminated ADCP data near the surface. The velocity profiles were measured by using ADCP at two stations in the Yeongsan estuary during August 2011: one was located in front of the Yeongsan estuarine dam and the other was deployed near Goha Island. The FAS was recovered from the ADCP data set by applying rigorous post-processing methods and compared with the sediment advection speed (SAS). The SAS was determined by the peak time difference of suspended sediment concentration between two stations in the channel, divided by the distance of two stations. The FAS and the SAS showed very similar value when the freshwater discharge was greater than ton and the SAS was a bit greater when the freshwater discharge was smaller. Since the FAS was on average about 0.8 m/s greater than the velocity at 0.8 of water depth from the bottom, the net discharge, estimated with recovered FAS and integrated over water depth and tidal cycle, was directed seaward during the high discharge contrary to the onshore direction of the net discharge estimated with 0.8 of water depth from the bottom. Moreover, the velocity shear and Richardson number changed when the FAS was used. Thus, the importance of the true FAS is appreciated in the investigation of the surface layer stability. If currents, temperature and salinity were observed for longer time in the future, it could be possible to more accurately understand the formation and decay of stratification as well as the suspended sediment transport processes.