Search

Background: This study investigated the clinical outcomes of surgical treatment of primary chest wall soft tissue sarcoma (CW-STS). Methods: Thirty-one patients who underwent surgery for CW-STS between 2000 and 2015 were retrospectively reviewed. The disease-free and overall survival rates were estimated using the Kaplan-Meier method, and prognostic factors were analyzed using a Cox proportional hazards model. Results: The median follow-up duration was 65.6 months. The most common histologic type of tumor was malignant fibrous histiocytoma (29%). The resection extended to the soft tissue in 14 patients, while it reached full thickness in 17 patients. Complete resection was achieved in 27 patients (87.1%). There were 5 cases of local recurrence, 3 cases of distant metastasis, and 5 cases of combined recurrence. The 5-year disease-free rate was 49%. Univariate analysis indicated that incomplete resection (p＜0.001) and stage (p=0.062) were possible risk factors for recurrence. Multivariate analysis determined that incomplete resection (p=0.013) and stage (p=0.05) were significantly associated with recurrence. The overall 5- and 10-year survival rates were 86.8% and 64.3%, respectively. No prognostic factor for survival was identified. Conclusion: Long-term primary CW-STS surgery outcomes were found to be favorable. Incomplete microscopic resection and stage were risk factors for recurrence.

Background Anterior mediastinal lesions account for approximately half of all mediastinal masses and computed tomography (CT) is known to exhibit limited differentiating performance. Our aim was to evaluate the age‐ and gender‐specific distribution of anterior mediastinal lesions and the diagnostic accuracy of multi‐detector CT (MDCT). Methods This retrospective study included 549 consecutive patients with proven anterior mediastinal lesions and diagnostic MDCT scans. The age‐ and gender‐specific distribution of proven diagnoses and diagnostic accuracy were reviewed. The CT features of malignant and benign diseases having the lowest accuracy were compared with those of the most commonly misdiagnosed diseases. Results The proportion of malignancy showed a V‐shape relationship with age (lowest, 52.7% [50s]). The most prevalent malignancies were lymphoma (20s), lymphoma/thymoma (30s), thymoma (40s–50s), and thymoma/thymic carcinoma (≥60s). The most prevalent benign diseases were thymic remnant/hyperplasia (20s–30s), and thymic bed cyst (≥40s). The first‐choice diagnostic accuracy of MDCT decreased with age regardless of gender: 75.4% (20s), 75.0% (30s), 67.8% (40s), 58.5% (50s), and 53.4% (≥60s), primarily due to incorrect diagnoses of thymic bed cyst and thymic carcinoma (accuracy, 42.3% and 30.5%), which were prevalent in older patients and mostly misdiagnosed as thymoma. The most powerful differentiating MDCT features were water attenuation (≤20 HU) (OR, 42.7 [95%CI, 8.8–‐208.3], P

Purpose Treatment after failure of circumferential resection margin (CRM) conversion after preoperative chemoradiotherapy (pCRT) for locally advanced rectal cancer (LARC) has not been evaluated well. We conducted a single‐center, retrospective analysis to fill this information gap. Methods From 2008 to 2016, we included 112 patients who had predictive CRM involvement on baseline magnetic resonance imaging (MRI) and who underwent surgery following pCRT for LARC. Baseline and posttreatment radiologic and clinical factors were analyzed. Results Of 493 patients with LARC, 112 had CRM involvement by baseline MRI (mrCRM). In 40 patients (35.7%), mrCRM involvement was converted as negative posttreatment CRM (ymrCRM−). Multivariate analysis showed the risk factors for persistent CRM involvement (ymrCRM+) after pCRT were extramural venous invasion (mrEMVI+) (P = 0.030) and lower tumor location (P = 0.007). In addition, persistent CRM involvement after pCRT was an independent risk factor for predicting pathologic CRM involvement. The Cox proportional hazard model showed baseline positive mrEMVI remained significant for disease-free survival (DFS) (P < 0.001). On posttreatment MRI, abdominoperineal resection (P = 0.031), intersphincteric resection (P = 0.006), and persistent CRM involvement (P = 0.001) remained significant for local recurrence-free survival. With regard to DFS, persistent CRM involvement (P = 0.048) and positive EMVI on posttreatment MRI (ymrEMVI) (P = 0.014) were significant. In the patient subgroup with persistent CRM involvement, 5-year DFS in patients with mrEMVI and ymrEMVI was 29.8% and 21.2%, respectively. Conclusion Patients who fail to convert to negative CRM have extremely poor oncologic outcomes. Lower tumor height and negative mrEMVI status were good responders to ymrCRM conversion. Our results suggest that these patients require a more intensive treatment modality.

Castleman disease is a relatively rare disease, characterized by well-circumscribed benign lymph-node hyperplasia. The disease may develop anywhere in the lymphatic system, but is most commonly reported as unicentric Castleman disease in the mediastinum along the tracheobronchial tree. It is usually asymptomatic and detected on plain chest radiography as an incidental finding. We report an incidentally detected case of Castleman disease in the paravertebral space that was preoperatively diagnosed as a neurogenic tumor and treated by complete surgical resection.

The computing domain of today's computer systems is moving very fast from arithmetic to data processing as data volumes grow exponentially. As a result, processing-in-memory (PIM) studies have been actively conducted to support the data processing in or near memory devices to address the limited bandwidth and high power consumption due to data movement between CPU/GPU and memory. However, most PIM studies so far have been conducted in a way that the processing units are designed only as an accelerator on the base die of 3D-stacked DRAM, not involved inside memory while not servicing the standard DRAM requests during the PIM execution. Therefore, in this paper, we show how to design and operate the PIM computing units inside DRAM by effectively coordinating with standard DRAM operations while achieving the full computing performance and minimizing the implementation cost. To make our goals, we extend a standard DRAM state diagram to depict the PIM behaviors in the same way as standard DRAM commands are scheduled and operated on the DRAM devices and exploit several levels of parallelism to overlap memory and computing operations. Also, we present how the entire architecture layers from applications to operating systems, memory controllers, and PIM devices should work together for the effective execution by applying our approaches to our experiment platform. In our HBM2-based experimental platform to include 16-cycle MAC (Multiply-and-Add) units and 8-cycle reducers for a matrix-vector multiplication, we achieved 406% and 35.2% faster performance by the all-bank and the per-bank schedulings, respectively, at (1024 × 1024) × (1024 × 1) 8-bit integer matrix-vector multiplication than the execution of only its operand burst reads assuming the external full DRAM bandwidth. It should be noted that the performance of the PIM on a base die of a 3D-stacked memory cannot be better than that provided by the full bandwidth in any case.

Context: Eclipta prostrata L. (Asteraceae) (EP) has been widely used for the treatment of skin disease in Asian traditional medicine. Objective: This study investigates the potency of EP in promoting hair growth in vivo and in vitro. Materials and methods: C57BL/6N mice were divided into four groups (n = 4) as follows: control (topical treatment of normal saline), topical 3% minoxidil to the dorsal skin of mice for 14 days, and low (1 mg/day) and high (10 mg/day) doses of EP orally administered once a day for 14 days. Dorsal hairs of C57BL/6N mice were depilated to synchronize anagen induction. Hair growth activity was evaluated by gross and microscopic observations. Sections of dorsal skin were stained with haematoxylin and eosin. We also treated the various concentrations of EP (5, 10 and 50 μg/mL) for 24 h on the human dermal papilla cells (HDPs) and examined the effects of EP on the expression of FGF-7 and mTOR signalling. Results: EP enhanced the induction of anagen in the dorsal skin of mice, characterized by the appearance of inner root sheath along with hair shaft, the emergence of hair shaft through the epidermis. EP increased the expression of FGF-7, while decreased the level of FGF-5 in C57/BL6 mice. EP also increased the expression of FGF-7, activated the mTOR signalling in HDPs. Discussion and conclusions: These results suggest that EP has a potency to enhance the growth of hair follicle, promoting hair growth through regulation of FGF-7 and FGF-5.

The present work describes the design and synthesis of a novel series of 1,3-diaryl-4-sulfonamidoarylpyrazole derivatives 1a–q and 2a–q and their in vitro biological activities. The target compounds were evaluated for antiproliferative activity against NCI-60 cell line panel. Compounds 1c, 1g, 1k–m, 1o, 2g, 2h, 2k–m, 2o, and 2q showed the highest mean inhibition percentages at 10 µM single-dose testing and were selected to be tested at 5-dose mode. The ICs50 of the most potent compounds were determined over the 60 cell lines. Compound 2l exhibited the strongest activity against different cell lines with IC50 0.33 µM against A498 renal cancer cell line. Compound 2l was tested over a panel of 20 kinases to determine its molecular target(s), and its IC50 values over the most sensitive kinases were defined. In vitro stability and in vivo pharmacokinetic profile of compound 2l was also investigated.

This paper proposes a new network model for the building evacuation problem considering congestion levels and provides a mixed integer linear programming (MILP) model and an efficient heuristic algorithm solving the problem. Constructing an optimization model with several congestion levels, we introduce a new network called the multi-class time-expanded (MCTE) network having several exclusive arcs connecting the same tail and head nodes. The MCTE networks make both the MILP model and the heuristic algorithm reflect a realistic situation in congested networks. Considering MCTE networks makes the problem difficult to solve, which motivates us to develop an efficient heuristic algorithm. We test our heuristic algorithm using several real-world networks such as a multiplex cinema, a subway station, and a large-size complex shopping mall in addition to an artificial network for clear comparison between the proposed algorithm and the MILP approaches. The results indicate that the proposed algorithm runs fast and produces a near-optimal solution compared with those from MILP models with a commercial solver.

Situs inversus is a rare hereditary disorder in which various anomalies have been reported with internal rotation abnormalities. This case involved an 85-year-old woman who had been diagnosed with transverse colon cancer and who underwent reduced-port laparoscopic surgery. All intra-abdominal organs were reversed left to right and right to left. The aberrant midcolic artery was identified during surgery. The total surgery time was 170 minutes, and the patient lost 20 mL of blood. The patient was discharged on the 8th postoperative day without complications.

Abstract Background This study aims to evaluate the efficacy and safety of thread-embedding acupuncture (TEA) with polydioxanone thread embedded at various acupoints, compared with sham TEA, for the treatment of non-specific chronic neck pain. Methods/design This study will be an 8-week-long, two-armed, parallel, randomized, subject-assessor-blinded, sham-controlled pilot trial. Fifty eligible patients will be randomly allocated into the real TEA group or the sham TEA group. The real TEA group will receive TEA treatment at 14 fixed acupoints in the neck region. The sham TEA group will receive the same treatment as the real TEA group, but with a sham device with the thread removed. Both groups will receive treatment once a week for a total of four sessions. The primary outcome will be the mean change in the visual analog scale (VAS) from baseline to week 6 (2 weeks post intervention). Clinical relevance (ratio of the number of patients with decreases on the VAS of ≥15 mm or with percentiles ≥ 30% and ≥ 50% relative to baseline to the total number of patients), Neck Disability Index, pressure pain threshold, the Hospital Anxiety and Depression Scale, EuroQol 5-Dimensions questionnaire, Patient Global Impression of Change, blinding test, and adverse events will be used to assess secondary outcomes. Discussion The results of this study will provide valuable data for a large-scale clinical trial to evaluate the clinical effects of polydioxanone TEA in the treatment of patients with non-specific chronic neck pain. Trial registration Clinical Research Information Service (CRIS), Republic of Korea, KCT0002452. Registered on 6 September 2017.

Background: South Korea, home of the soybean, features diverse traditional fermented soy products. Jipjang (汁醬) is made by mixing autumn vegetables in meju powder prepared by boiling and fermenting soybeans and wheat with saccharified water. Jipjang has been documented since the early Joseon period, but its traditional path has been severed, becoming a local specialty in some southern regions and altered into other forms of jang. However, some jongka (宗家, traditional Korean family) continue to pass down jipjang recipes via the jongbu (the head daughter-in-law). Method: We conducted in-depth interviews with the jongbu of six jongkas in the Kyeongsang and Chonla provinces to investigate their jipjang recipes. Results: The Kalam, Hakbong, and Dongkye Jongka made their own meju powder by hand before mixing with hard-steamed glutinous rice or glutinous rice glue and pickled vegetables. The Nosongjeong Jongka used commercial meju mixed with glutinous rice glue, wheat yeast, eggplant, chives, and gourd. The Chunwujae Jongka mixed hard-steamed glutinous rice in meju with thin jocheong made by boiling yeotkireum water and 10 other ingredients. The Cheongjaekongpa Jongka mixed commercial meju with vegetables but used a modernized recipe. Conclusion: Although kanjang, doenjang, and gochujang require months to ferment and ripen, thereby taking longer from production to sale; using an electric rice cooker can enable jipjang to be made within a week. Hence, with the development of improved pickling technology, jipjang is predicted to become more economically feasible than other jang products. We will continue to identify Korean traditional fermented foods made in jongka and systematize their recipes. Keywords: Fermentation, Jipjang, Jongka, Korean foodways, Soybeans, Traditional food

Abstract Background We investigated the efficacy and safety of thread-embedding acupuncture (TEA) for chronic low back pain (LBP) in a randomized controlled pilot trial with the aim of laying the foundation for a large-scale randomized controlled trial on this topic. Methods Forty participants were recruited for this two-arm, assessor-blinded randomized controlled pilot trial. The participants were randomly allocated to a TEA group (experimental group) or an acupuncture group (control group). The TEA group received TEA once every 2 weeks for 8 weeks (four sessions in total), while the acupuncture group received acupuncture twice per week for 8 weeks (16 sessions in total). The primary outcome was the visual analog scale (VAS) score for pain and the secondary outcomes were short-form McGill Pain Questionnaire (SF-MPQ) and Oswestry Disability Index (ODI) scores. Assessments were performed at screening and at 2, 4, 6, 8, and 10 weeks after treatment initiation (the 10-week assessment was conducted at 2 weeks after treatment cessation). Results Of the 40 participants, 36 completed the study and four dropped out. Both the TEA group and the acupuncture group showed significant improvements in VAS, SF-MPQ, and ODI scores in a time-dependent manner. Furthermore, with regard to ODI, a significant interaction between group and time was observed, with the two groups exhibiting a different pattern of change at 8 weeks according to contrast analysis with Bonferroni’s correction. No serious adverse event occurred, and hematological and biochemical test findings were within normal limits. Conclusion This pilot study has provided basic data for a larger clinical trial to demonstrate the efficacy and safety of TEA for chronic LBP. Trial registration Clinical Research Information Service of the Korea National Institute of Health, ID: KCT0001819. Registered on 15 February 2016.

There have been no studies on the effects of polyhexamethylene guanidine phosphate (PHMG) after a long period of exposure in the rodent model. We aimed to evaluate long-term lung damage after PHMG exposure using conventional chest computed tomography (CT) and histopathologic analysis in a rat model. A PHMG solution was intratracheally administrated to 24 male rats. At 8, 26, and 52 weeks after PHMG instillation, conventional chest CT was performed in all rats and both lungs were extracted for histopathologic evaluation. At 52 weeks after PHMG instillation, four carcinomas had developed in three of the eight rats (37.5%). Bronchiolo-alveolar hyperplasia and adenoma were found in rats at 8, 26, and 52 weeks post-instillation. The number of bronchiolo-alveolar hyperplasia significantly increased over time (P-value for trend< 0.001). The severity of lung fibrosis and fibrosis scores significantly increased over time (P-values for trend = 0.002 and 0.023, respectively). Conventional chest CT analysis showed that bronchiectasis and linear density scores suggestive of fibrosis significantly increased over time (P-value for trend < 0.001). Our study revealed that one instillation of PHMG in a rat model resulted in lung carcinomas and progressive and irreversible fibrosis one year later based on conventional chest CT and histopathologic analysis. PHMG may be a lung carcinogen in the rat model.

Background and aimsThe low-salt diet is considered important for control of ascites in cirrhotic patients. To validate whether the spot urine sodium (Na)/potassium (K) ratio could replace 24-h urine Na (uNa) excretion in assessing low-salt diet compliance.MethodsWe prospectively studied 175 patients. 24-h urine collection and spot urine collection were performed. Subsequently, 24-h uNa, urine creatinine (uCr), and spot urine Na and K were assessed. A complete urine collection was confirmed based on 24-h uCr excretion levels of 15mg/kg/day for men and 10mg/kg/day for women. The area under the receiver operating characteristic (AUROC) curve analysis was performed to evaluate the feasibility of spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day.ResultsOut of 175 patients, 24-h urine samples were completely collected in 57 patients only. Moreover, urine samples were not completely collected in 118 patients because their 24-h uCr excretion level was less than the established criteria. In complete urine collection group, AUROC curve for spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day was 0.874±0.051 (PConclusionsThe spot urine Na/K ratio reflects 24-h uNa, but the AUROC value obtained in this study is lower than that of a previous study. Considered the large number of patients with incomplete urine collection, validating 24-h complete urine collection criteria is necessary.

ObjectiveThe demand for treating degenerative lumbar spinal disease has been increasing, leading to increased utilization of medical resources. Thus, we need to understand how the budget of insurance is currently used. The objective of the present study is to overview the utilization of the National Health Insurance Service (NHIS) by providing the direct insured cost between patients receiving surgery and patients receiving nonsurgical treatment for degenerative lumbar disease.MethodsThe NHIS-National Sample Cohort was utilized to select patients with lumbar disc herniation, spinal stenosis, spondylolisthesis or spondylolysis. A matched cohort study design was used to show direct medical costs of surgery (n = 2,698) and nonsurgical (n = 2,698) cohorts. Non-surgical treatment included medication, physiotherapy, injection, and chiropractic. The monthly costs of the surgery cohort and nonsurgical cohort were presented at initial treatment, posttreatment 1, 3, 6, 9, and 12 months and yearly thereafter for 10 years.ResultsThe characteristics and matching factors were well-balanced between the matched cohorts. Overall, surgery cohort spent $50.84/patient/month, while the nonsurgical cohort spent $29.34/patient/month (pConclusionSurgical treatment initially led to more government reimbursement than nonsurgical treatment, but the charges during follow-up period were not different. The results of the present study should be interpreted in light of the costs of medical services, indirect costs, societal cost, quality of life and societal willingness to pay in each country. The monetary figures are implied to be actual economic costs but those in the reimbursement system instead reflect reimbursement charges from the government.

Multiple risk factors such as age, body mass index (BMI), preoperative diagnosis, smoking, diabetes mellitus, malalignment of an implant, and presence of ipsilateral hindfoot fusion have been shown to contribute to failure of total ankle arthroplasty (TAA). However, the exact causes of TAA failure remain uncertain, and various causes can lead to a need for revision surgery. We report a case of early aseptic loosening of the implant following TAA in a patient with severe varus deformity of the ipsilateral knee.

Moderate Intensity Low Oxygen Diluted (MILD) combustion has been investigated for a long time in order to minimize NOX emission still enhancing thermal efficiencies in the combustion equipment. Many researches about MILD combustion have been recently performed, but studies on MILD combustion of renewable fuel such as ethanol has been very scarce and particularly, specific information on the NOX production in ethanol-air MILD combustion has not been reported yet. In order to satisfy the condition for MILD combustion, internal recirculation is known to be essential in order to entrain the combustion products gas into air and fuel jets of combustion system. In this work, a series of numerical analysis with simplified opposed jet geometry have been done using the OPPDIF in Ansys program. Numerical analysis on how the recirculation ratio (KV) affects NOX emission in the ethanol-air combustion for MILD formation were carried out under the condition of various burnt gas dilution in reactant flow. The results show that the temperature was decreased by the increase of the recirculation ratio and the maximum heat release value became also low by the increase of the recirculation ratio. It was also found that the pyrolysis zone of the heat release was disappeared and the two heat release peaks are merged into one as combustion pattern is changed to MILD combustion mode.

Alkaline water electrolysis (AWE) refers to a representative water electrolysis technology that applies electricity to synthesize hydrogen gas without the production of carbon dioxide. The ideal polymer electrolyte membranes for AWE should be capable of transporting hydroxide ions (OH−) quickly in harsh alkaline environments at increased temperatures. However, there has not yet been any desirable impedance measurement method for estimating hydroxide ions’ conduction behavior across the membranes, since their impedance spectra are significantly affected by connection modes between electrodes and membranes in the test cells and the impedance evaluation environments. Accordingly, the measurement method suitable for obtaining precise hydroxide ion conductivity values through the membranes should be determined. For this purpose, Zirfon®, a state-of-the-art AWE membrane, was adopted as the standard membrane sample to perform the impedance measurement. The impedance spectra were acquired using homemade test cells with different electrode configurations in alkaline environments, and the corresponding hydroxide ion conductivity values were determined based on the electrochemical spectra. Furthermore, a modified four-probe method was found as an optimal measurement method by comparing the conductivity obtained under alkaline conditions.

Renal fibrosis is a chronic pathological process that seriously endangers human health. However, the current therapeutic options for this disease are extremely limited. Previous studies have shown that signaling factors such as JAK2/STAT3, Smad3, and Myd88 play a regulatory role in renal fibrosis, and β-elemene is a plant-derived sesquiterpenoid organic compound that has been shown to have anti-inflammatory, anti-cancer, and immunomodulatory effects. In the present study, the anti-fibrotic effect of β-elemene was demonstrated by in vivo and in vitro experiments. It was shown that β-elemene inhibited the synthesis of extracellular matrix-related proteins in unilateral ureteral obstruction mice, and TGF-β stimulated rat interstitial fibroblast cells, including α-smooth muscle actin, vimentin, and connective tissue growth factor, etc. Further experiments showed that β-elemene reduced the expression levels of the above-mentioned fibrosis-related proteins by blocking the phosphorylation of JAK2/STAT3, Smad3, and the expression or up-regulation of MyD88. Notably, knockdown of MyD88 attenuated the phosphorylation levels of STAT3 and Smad3 in TGF-β stimulated NRK49F cell, which may be a novel molecular mechanism by which β-elemene affects renal interstitial fibrosis. In conclusion, this study elucidated the anti-interstitial fibrosis effect of β-elemene, which provides a new direction for future research and development of drugs related to chronic kidney disease.

Immune checkpoint inhibitors, increasingly used to treat malignant tumors, are revolutionizing cancer treatment by improving the patient survival expectations. Despite the high antitumor efficacy of antibody therapeutics that bind to PD-1/PD-L1, study on small molecule-based PD-1/PD-L1 inhibitors is required to overcome the side effects of antibody therapeutics caused by their size and affinity. Herein, we investigated antitumor potential of Salvia plebeia R. Br. extract (SPE), which has been used as a traditional oriental medicine and food in many countries, and its components by the blockade of PD-1/PD-L1 interaction. SPE and its component cosmosiin effectively blocked the molecular interaction between PD-1 and PD-L1. SPE also inhibited tumor growth by increasing CD8+ T-cells in the tumor through the activation of tumor-specific T-cells in a humanized PD-1 mouse model bearing hPD-L1 knock-in MC38 colon adenocarcinoma tumor. This finding presents a preclinical strategy to develop small molecule-based anticancer drugs targeting the PD-1/PD-L1 immune checkpoint pathway.

Background: We sought to investigate the possible associations of rest-activity patterns with cortical amyloid burden, medial temporal lobe (MTL) neurodegeneration, and cognitive function in patients in the early stage of cognitive impairment. Methods: Rest-activity patterns were assessed in 100 participants (70 with mild cognitive impairment and 30 with mild dementia) using wrist actigraphy. All participants underwent 18F-flutemetamol positron emission tomography (PET) imaging to quantify cortical amyloid burden, structural brain magnetic resonance imaging (MRI) to quantify MTL grey matter volume, neuropsychological testing, and clinical diagnosis. We used multiple linear regression models adjusted for covariates, including demographics, diabetes, hypertension, depressive symptom, psychotropic medication, sleep medication, weekend effect, and apolipoprotein-ε allele status. Findings: After adjusting for possible confounders, we found that the midline estimation of statistic of rhythm (MESOR) associated positively with frontal/executive function (estimate = 1.17, standard error [SE] = 0.37, p = 0.002). The least active 5-h (L5) onset time associated positively with MTL grey matter volume and memory function (estimate = 1.24, SE = 0.33, p = 0.001, and estimate = 3.77, SE = 1.22, p = 0.003, respectively), particularly in amyloid-negative participants. Additional path analysis revealed that MTL grey matter volume partially mediated the association between L5 onset time and memory function in amyloid-negative participants. Interpretation: Decreased MESOR and advanced L5 onset time may be useful as early signs of cognitive decline or MTL neurodegeneration. Furthermore, amyloid pathology may act as a moderator of the relationships between rest-activity patterns, neurodegeneration, and cognitive function. Funding: Korea Centres for Disease Control and Prevention (#4845–303); National Research Foundation of Korea (2019M3C7A1031905, 2019R1A5A2026045).

Recanalization of a completely occluded vertebral artery, which involves ruptured vertebral dissecting aneurysm, to a normal configuration is rare. Here we report the case of a recanalized vertebral artery dissecting aneurysm in a 51-year-old woman that was treated using endovascular trapping and the right vertebral artery was completely occluded. Six months after the procedure, transfemoral cerebral artery angiography showed a normal configuration of the antegrade recanalized vertebral artery. We also suggest three possible mechanisms for the phenomenon of antegrade recanalization, of which we consider the water-hammer effect mechanism to be the most probable. Endovascular trapping, regardless of the presence of a true or false lumen, is capable of providing promising results and good prognosis through antegrade revascularization or complete occlusion. Keywords: Recanalization, Vertebral artery dissecting aneurysm, Endovascular trapping, Aneurysmal Subarachnoid Hemorrhage

Purpose: Medial meniscus posterior root tear (MMPRT) should be repaired to the correct position as possible to maintain hoop tension of the meniscus. In this study, we propose a comparison of the outcome between the medial tunnel and the lateral tunnel in the pullout suture technique using the tibial tunnel for anatomical repair of posterior root tear of medial meniscus. Methods: From April 2010, of patients who underwent pullout suture, 51 cases (24 medial tunnel group (MTG) and 27 lateral tunnel group (LTG)) were able to follow-up with second look arthroscopy. Original Coronal Ratio of Root Attachment (CRORA) was defined as the ratio of the distance from the medial edge of the tibial plateau to the root attach site divided by the entire tibial medial–lateral width on preoperative computed tomography. Error between postoperative CRORA and original CRORA was calculated. We compared this error, clinical outcome, and arthroscopic finding between MTG and LTG. Results: The mean error ratio of postoperative CRORA divided by original CRORA was 0.86 ± 0.11 in MTG, which was significantly ( p = 0.001) lower than that (1.02 ± 0.06) in LTG. The mean value of the root attach point in the MTG with a post/original CRORA value of 0.86 ± 0.11 means statistically significant medialization after the operation. There was no statistically significant difference in changes of International Knee Documentation Committee (IKDC) and Lysholom score between MTG and LTG. The difference between the two groups of arthritis progression was not statistically significant. Conclusion: In patients with MMPRT, CRORA may provide a basis for coronal assessment of root repair position before and after surgery, and lateral tibial tunnel technique can help anatomical repair by reducing technical error due to guide pin slip medially compared to medial tibial tunnel technique.

In this study, a two-dimensional Immersed Boundary Lattice Boltzmann Method (IB-LBM) is employed to investigate computationally effect of flow past a pair of square cylinders in side-by-side arrangement at Re=100, for various corner radii. Numerical simulations were performed simultaneously by varying center to center distance between two cylinders (1.5–5.0 D) in the transverse direction and by changing the corner radius (R) from R/D = 0.0 (square) to 0.5 (circular) with 0.1 increment. Aerodynamic characteristics, including the lift and drag coefficients, were quantitatively calculated and compared with each other. Vorticity contours were used as visualization aids to understand the wake pattern and underlying mechanism. The results indicate different features in lift and drag time histories and in wake patterns for a selected range. The numerical results reveal that the flow characteristics and vortex shedding depend significantly on the corner radius and gap spacing. A square cylinder exhibited the maximum average drag value, and the inverse was observed in the case of a circular cylinder. Furthermore, aerodynamic forces were reduced by rounding the corner radius. Keywords: Square cylinder, Circular cylinder, Corner radius, Side by side arrangement, Immersed boundary method, Lattice Boltzmann method, Rounded corners

Background: Jongka (宗家, a traditional Korean family) is a traditional Korean familial system that has existed since the mid-Chosun period (1392–1910). The present study explores the etymology and historical value of a representative ancestral ritual food of jongka, “ssam (쌈).” Over many years, ssam has been gradually modified from its original form. This study seeks to identify the history of ssam's transformation and to determine its original form. Methods: Three related dishes were considered, and finally, the “mitssam (밑쌈)” of Bangchon jongka was selected for a field study in which the author visited a jongka to prepare “mitssam” and participated in bulcheonwi (不遷位, unmovable ancestral tablet) ancestral rites. Results: It was found that the name “mitssam” is a misnomer of the proper name “mwissam (뮈쌈)” with the “mwi (뮈)” in “mwissam” being a pure Korean word referring to a sea cucumber (海蔘). Haesamjeon (海蔘煎, a pancake made with sea cucumber) probably first appeared in records in the later 17th century and early 18th century. The pure Korean word “mwi” used in the 19th century fell out of use in the 20th century as the modern term “missam (미쌈)” took over. “Mwi” was eventually replaced with “mi (미);” members of the jongka pronounced “mwissam” as “mitssam” when speaking the term, and eventually “mitssam” became the name of the dish. Conclusion: Apart from “mwissam,” other lost jongka ancestral ritual foods and related recipes should be recovered. They should be maintained along with modern recipes and Korea's traditional food culture values. Keywords: Ancestral ritual food, Haesamjeon, Jongka, Korea, Ssam food

Objective This study was conducted to evaluate the effect of different levels of total digestible nutrients (TDN) and sodium stearoyl-2-lactylate (SSL) supplementation on growth performance and blood and carcass characteristics in Hanwoo steers during the early fattening period. Methods Sixty Hanwoo steers (average body weight, 333±36.4 kg) were randomly allotted to 3 treatments, with twenty steers per treatment, and ten steers per pen with a size of 80 m2. Dietary treatments were as follows: CON, basal diet; treatment (TRT) 0.5, 0.5% down-spec of TDN with 0.1% SSL; TRT 1.0, 1.0% down-spec of TDN with 0.1% SSL. Results The results demonstrated that average daily gain and feed efficiency increased with TRT 0.5 (0.85 kg and 11.68) vs CON (0.82 kg and 11.27) or TRT 1.0 (0.78 kg and 10.74), indicating that 0.1% SSL supplementation in the feed of early fattening steers may result in a saving of 0.5% TDN. No significant differences were observed amongst all treatments (p> 0.05) for blood metabolite concentration and blood corpuscle values, which were all within the normally accepted range for healthy steers. Conclusion Our study suggests that a TDN 0.5% down spec with 0.1% SSL supplemented feed may be effective and profitable for the early fattening period of Hanwoo steers without causing adverse effects.

Objective This study was done to evaluate the effect of sodium stearoyl-2-lactylate (SSL) supplementation in a total mixed ration (TMR) on the lactation performance, blood parameters, and economic efficacy of mid-lactation Holstein cows. Methods Twenty-four cows (body weight 647±11.7 kg) were randomly divided into 4 treatment groups, with six cows per group. The dietary treatments were as follows: basal diet (CON); CON+17.5 g of top dressed SSL (treatment [TRT] 0.05); CON+35 g of SSL (TRT 0.1); and CON+70 g of SSL (TRT 0.2) per 35 kg TMR. Results The highest level of SSL supplementation (TRT 0.2) significantly improved milk yield during the second period compared to the TRT 0.05 group (5 to 8 wks; 33.28 vs 31.09 kg/d), during the third period compared to both the CON and TRT 0.05 groups (p

We report the rare case of a 58-year-old woman who was diagnosed with fungal empyema thoracis combined with osteoradionecrosis. After 32 months of home care followed by open window thoracostomy, thoracoplasty with serratus anterior muscle transposition and a latissimus dorsi myocutaneous flap was performed successfully. Although thoracoplasty is now rarely indicated, it is still the treatment of choice for the complete obliteration of thoracic spaces.

Magnaporthe oryzae is a filamentous fungus, which causes significant destruction to cereal crops worldwide. To infect plant cells, the fungus develops specialised constricted structures such as the penetration peg and the invasive hyphal peg. Live-cell imaging of M. oryzae during plant infection reveals that nuclear migration occurs during intermediate mitosis, in which the nuclear envelope neither completely disassembles nor remains entirely intact. Remarkably, in M. oryzae, mitotic nuclei show incredible malleability while undergoing confined migration through the constricted penetration and invasive hyphal pegs. Here, we review early events in plant infection, discuss intermediate mitosis, and summarise current knowledge of intermediate mitotic nuclear migration in M. oryzae.

This study measured indoor and outdoor levels of hydrocarbon volatile organic compounds (VOCs), such as benzene, toluene, ethylbenzene, and xylene isomers (collectively referred to as BTEX), as well as 13 carbonyl compounds, at 20 homes in Seoul, South Korea. Along with the sampling of BTEX and carbonyls, indoor concentrations of the air pollutants nitrogen oxide (NO) and carbon dioxide (CO2) were also measured at each home. These measurements were used to understand the characteristics of BTEX and carbonyls by calculating the various ratios and correlation coefficients between measured contaminant levels. We found that carbonyls were mostly originated from indoor sources, while BTEX were originated from both indoor and outdoor sources. A high correlation between indoor levels of NO and BTEX indicated that traffic emissions were also an important sources of BTEX.

Background: In the agrarian society of historical Korea, jesa (祭祀, traditional rite from ancestors), rituals practiced for praying to the gods for a rich harvest, was one of the most important rites. Since its founding, Chosun adopted Korean Confucianism and Neo-Confucianism as its governing principles, and karye (家禮, family rites of Zhu Xi), the customary formalities of the family, was perceived as an obligatory guideline to practice with the Confucian rites. This study aims to examine periodic changes in how the ritual table was set up in Korea's traditional head families, or jongka (宗家, the traditional Korean family), from the Chosun Dynasty (1392–1910) to the present time. Methods: We compared the varieties of food and their positioning in a diagram illustrating the placement of ritual food or jinseoldo (diagram illustrating the placement of ritual foods for ancestral rites), from karye, and three guides about family rites published during the Chosun era. We also analyzed the food arrangement style for ancestral rites from the ritual standards of the Japanese colonial era and the Simplified Family Ritual Standards issued by the Korean government. In addition, we visited eight head families to observe the varieties and positioning of fruits on the ritual table. Results: During the Japanese rule (1910–1945), the Japanese Government General of Korea declared the ritual standards for the purpose of simplifying the ritual practices of Chosun, but with an ulterior motive to disintegrate Korea's traditional rites and put the nation under its control. After independence from Japanese rule, the Korean government insisted on a new set of family ritual standards. However, the standards imposed from the outside rarely affected the rites practiced by families. Conclusion: The examination of historical records revealed that kakarye (家家禮, different rituals by each family) was being practiced among families, which causes only formalities to remain and sincerity to disappear. This is unfortunate as sincerity matters more than formalities. (The “Supplementary File” provides further explanations of each term mentioned in this article.) Keywords: Ancestral rites, Ancestral ritual food, Historical changes, Jongka, Table setting

Abstract Background and aims Although it is important to analyze the hemodynamic factors related to the right ventricle (RV) after left ventricular assist device (LVAD) implantation, previous studies have focused only on the alteration of the ventricular shape and lack quantitative analysis of the various hemodynamic parameters. Therefore, we quantitatively analyzed various hemodynamic parameters related to the RV under normal, heart failure (HF), and HF incorporated with continuous flow LVAD therapy by using a computational model. Methods In this study, we combined a three-dimensional finite element electromechanical model of ventricles, which is based on human ventricular morphology captured by magnetic resonance imaging (MRI) with a lumped model of the circulatory system and continuous flow LVAD function in order to construct an integrated model of an LVAD implanted-cardiovascular system. To induce systolic dysfunction, the magnitude of the calcium transient function under HF condition was reduced to 70% of the normal value, and the time constant was reduced by 30% of the normal value. Results Under the HF condition, the left ventricular end systolic pressure decreased, the left ventricular end diastolic pressure increased, and the pressure in the right atrium (RA), RV, and pulmonary artery (PA) increased compared with the normal condition. The LVAD therapy decreased the end-systolic pressure of the LV by 41%, RA by 29%, RV by 53%, and PA by 71%, but increased the right ventricular ejection fraction by 52% and cardiac output by 40%, while the stroke work was reduced by 67% compared with the HF condition without LVAD. The end-systolic ventricular tension and strain decreased with the LVAD treatment. Conclusion LVAD enhances CO and mechanical unloading of the LV as well as those of the RV and prevents pulmonary hypertension which can be induced by HF.

Background: Jongka food is the implementation of banka food in jongka, where in banka food stems from royal cuisine that has been passed on to yangban (nobleman) family. Jongka food is historically passed down, and connects different time periods between generations in the same spatial context of jongka, is a traditional Korean family system, where the eldest sons have kept their family lineage alive through generations dating over 400 years since the mid-Chosun era. Jongka bulcheonwi stems from Korea; however, its Confucian ceremonial culture now only remains in Korea. Methods: This study examines the concept and formation process of jongka, and introduces everyday family food, as well as old cookbooks that contain their recipes. The bulcheonwi ceremony table-setting and ancestral ritual food, as seen in actual jongka sites, are also described. Results: This study has examined 6 types of food in six different jongka houses, passed down through jongbu, were analyzed. Thus, the importance of discovering more jongka food, and recording such findings, is emphasized. Moreover, the bulcheonwi ancestral ritual food table setting through three-dimensional maps and a layout plan from two jongka ispresented. Pyeon (䭏) and jeok (炙), which are parts of ancestral ritual food, and carry different meanings for different families, were introduced, presenting examples from four jongka. Moreover, existing literature was assessed to identify the sources of jeok building principles and theoretical backgrounds. Conclusion: Jongson and jongbu have protected the jongtaek (noble house), and inherited their family’s foods by living by bongjesa (奉祭祀) and jeopbinkaek (接賓客). It is important to continuously discover and record of jongka and ancestral ritual foods used in bulcheonwi. This study aims to allow society to perceive jongka as a unique Korean cultural heritage that all of society protects and shares, instead of regarding them as families with old histories. (For further clarification on the terms mentioned in this article, please see “Supplementary file”.) Keywords: Ancestral ritual food, Bulcheonwi, Category, Jongka, Jongka food, Korean food

Background: The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in K orea h ave not been r eported. We analyzed t he o utcomes of M PM i n the context of multimodal treatment, including surgery. Methods: The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared. Results: The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23). Conclusion: Multimodal treatment incorporating surgery did not show better outcomes than n on-surgical treatment. A n ationwide multicenter data r egistry a nd p rospective r andomized controlled studies are necessary to optimize the treatment of MPM.

ObjectiveTo evaluate the compliance and satisfaction of rehabilitation recommendations for advanced cancer patients hospitalized in the palliative care unit.MethodsAdvanced cancer patients admitted to a hospice palliative care unit were recruited. Patients with advanced cancer and a life expectancy of less than 6 months, as assumed by the oncologist were included. Patients who were expected to die within 3 days were excluded. ECOG and Karnofsky performance scales, function ambulatory category, level of ambulation, and survival days were evaluated under the perspective of comprehensive rehabilitation. Problem-based rehabilitations were provided categorized as physical therapy at the gym, bedside physical therapy, physical modalities, medications and pain intervention. Investigation of compliance for each category was completed. Patient satisfaction was surveyed using a questionnaire.ResultsForty-five patients were recruited and received evaluations for rehabilitation perspective. The subjects were reported to have gait-related difficulties (71.1%), pain (68.9%), poor medical conditions (68.9%), bladder or bowel problems (44.4%), dysphagias (11.1%), mental status issues (11.1%), edemas (11.1%), spasticity (2.2%), and pressure sores (2.2%). In the t-test, patients with good compliance for GymPT showed higher survival days (p

Abstract Background Early detection followed by prompt intervention is essential for the treatment of periprosthetic joint infection (PJI). D-dimer, a fibrin degradation product, characteristically changes rapidly during early postoperative period and has a short half-life. The aim of this prospective study was to measure postoperative change of D-dimer level after joint arthroplasty in conjunction with ESR and CRP. Methods ESR, CRP, and D-dimer levels were measured on the day before surgery, postoperative days 1, 2, 3, and 5 and weeks 2 and 6 in 65 patients who underwent elective primary total hip arthroplasty (38 hips in 38 patients) or total knee arthroplasty (27 knees in 27 patients). We compared perioperative changes of the three biomarkers. Results ESR level was elevated from postoperative day 1 and reached a peak level of 45 mm/h at postoperative day 5. The elevation persisted until postoperative week 6. CRP level was elevated from postoperative day 1 and reached a peak level of 10 mg/dl between postoperative day 2 and day 3. The CRP level was decreased to the normal level around postoperative week 2. D-dimer level was sharply elevated and peaked to 4.5 μg/dl at postoperative day 1. At postoperative day 2, it decreased to baseline level. After then, it slowly elevated again and reached a second peak at postoperative week 2. Conclusion D-dimer showed a more rapid rise and fall than ESR and CRP in very early postoperative period. The D-dimer test might be effective in early detection of PJI, if combined with levels of ESR and CRP. The postoperative change of D-dimer in our study can serve as a baseline for early diagnosis of PJI.

Lentil (Lens culinaris; Fabaceae), one of the major pulse crops in the world, is an important source of proteins, prebiotics, lipids, and essential minerals as well as functional components such as flavonoids, polyphenols, and phenolic acids. To improve crop nutritional and medicinal traits, hybridization and mutation are widely used in plant breeding research. In this study, mutant lentil populations were generated by γ-irradiation for the development of new cultivars by inducing genetic diversity. Molecular networking via Global Natural Product Social Molecular Networking web platform and dipeptidyl peptide-IV inhibitor screening assay were utilized as tools for structure-based discovery of active components in active mutant lines selected among the lentil population. The bioactivity-based molecular networking analysis resulted in the annotation of the molecular class of phosphatidylcholine (PC) from the most active mutant line. Among PCs, 1-stearoyl-2-hydroxy-sn-glycero-3-phosphocholine (18:0 Lyso PC) was selected for further in vivo study of anti-obesity effect in a high-fat diet (HFD)-induced obese mouse model. The administration of 18:0 Lyso PC not only prevented body weight gain and decreased relative gonadal adipose tissue weight, but also attenuated the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol, and leptin in the sera of HFD-induced obese mice. Additionally, 18:0 Lyso PC treatment inhibited the increase of adipocyte area and crown-like structures in adipose tissue. Therefore, these results suggest that 18:0 Lyso PC is a potential compound to have protective effects against obesity, improving obese phenotype induced by HFD.

Purpose: The presence of a flow-related signal in the normal dural sinus time of flight magnetic resonance angiography (TOF MRA) is common. This study aimed to identify changes in signal intensity in the dural sinus caused by changes in patient position. Materials and Methods: The researchers performed an elevation TOF MRA of the cerebral region in 52 patients, who showed abnormal flow-related signals in the dural sinuses on supine position. Flow-related signal intensity in the dural sinuses was then analyzed. Results: Flow-related signals were seen in 114 sites (52 patients), specifically in the internal jugular vein (IJV), sigmoid sinus (SS), inferior petrosal sinus (IPS), and cavernous sinus (CS) in 29 sites, 33 sites, 32 sites, and 20 sites, respectively. After head elevation, flow-related signal changes were then observed in the IJV, SS, IPS, and CS in 107 sites (107/114, 93.9%). There was loss of signal (62/114, 54.4%), or decrease (39/114, 34.2%), increase (6/114, 5.3%), or no change (7/114, 6.1%) in the signal intensity, and flow related signals were more frequent on the left than on the right. Conclusion: Flow-related signals in the dural sinuses on TOF MRA were decreased or disappeared by head elevation in 88.6% of the sites. Head elevation may help distinguish between pathologic and physiologic states.

Background: Although the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation has been recommended for accurate estimates of glomerular filtration rate (eGFR), there is little information regarding differences in GFR estimates obtained using the Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) equations in East Asian cancer patients. We investigated discrepancies in GFR and toxicities in patients treated with cisplatin-based chemotherapy using three equations equations. Methods: A total of 229 patients were retrospectively recruited. We calculated eGFR using the three equations and separated patients into three categories based on GFR < 10 (group A), 10–50 (group B), and > 50 (group C) mL/min/1.73m². We analyzed chemotherapy toxicities. Results: The mean eGFR calculated using the CG was the lowest of the values derived using the three equations. Estimates using the MDRD and CKD-EPI equations resulted in reclassifying 32 (71.1%) and 33 (73.3%) of 45 patients, originally placed in group B using the CG into group C. However, only 1 (7.7%) of 13 patients placed in group B using the MDRD were reclassified into group C using the CKD-EPI. Twenty-eight of 45 patients classified into group B using the CG equation were treated with reduced doses of cisplatin. However, these patients did not show significant differences in toxicities compared with other patients taking full doses of cisplatin. Conclusion: The CG equations underestimated GFR compared to the MDRD and CKD-EPI equations. Therefore, when GFR is estimated using CG equations, East Asian cancer patients may receive insufficient doses of chemotherapeutic agents, including cisplatin.

This study reports on an innovative press-loaded blister hybrid system equipped with gas-chromatography (PBS-GC) that is designed to evaluate the mechanical fatigue of two representative types of commercial Nafion membranes under relevant PEMFC operating conditions (e.g., simultaneously controlling temperature and humidity). The influences of various applied pressures (50 kPa, 100 kPa, etc.) and blistering gas types (hydrogen, oxygen, etc.) on the mechanical resistance loss are systematically investigated. The results evidently indicate that hydrogen gas is a more effective blistering gas for inducing dynamic mechanical losses of PEM. The changes in proton conductivity are also measured before and after hydrogen gas pressure-loaded blistering. After performing the mechanical aging test, a decrease in proton conductivity was confirmed, which was also interpreted using small angle X-ray scattering (SAXS) analysis. Finally, an accelerated dynamic mechanical aging test is performed using the homemade PBS-GC system, where the hydrogen permeability rate increases significantly when the membrane is pressure-loaded blistering for 10 min, suggesting notable mechanical fatigue of the PEM. In summary, this PBS-GC system developed in-house clearly demonstrates its capability of screening and characterizing various membrane candidates in a relatively short period of time (

Background: Renal dysfunction is recognized as an important risk factor for thromboembolic (TE) events in patients with atrial fibrillation (AF) under medical treatment.Objective: To investigate whether renal dysfunction is a useful predictor of TE events among patients receiving AF ablation. We also aimed to determine whether the diagnostic accuracy of the CHA(2)DS(2)-VASc score in predicting TE events could be improved by adding renal dysfunction into the scoring system.Methods: We enrolled a total of 547 patients with AF who underwent catheter ablation. Renal dysfunction was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m(2). The clinical end point was the occurrence of TE events (ischemic stroke, transient ischemic attack, or other systemic embolisms) during follow-up after catheter ablation.Results: During a follow-up of 38.9 ± 22.5 months, 16 patients (2.9%) experienced TE events. Both the CHA(2)DS(2)-VASc score and renal dysfunction were independent predictors of TE events in the multivariate analysis. Among patients with a CHA(2)DS(2)-VASc score of 0 or 1, renal dysfunction can further stratify them into 2 groups with different event rates (4.3% vs 0.3%; P = .046). A new scoring system derived by assigning 1 more point representing renal dysfunction to the CHA(2)DS(2)-VASc score could improve its predictive accuracy; the area under the receiver operating characteristic curve increased from 0.84 to 0.88 (P = .043).Conclusions: Renal dysfunction was a significant risk factor for TE events after catheter ablation of AF and may improve the diagnostic accuracy of the CHA(2)DS(2)-VASc score. [ABSTRACT FROM AUTHOR]

In 2011, a large community outbreak of human adenovirus (HAdV) in Taiwan was detected by a nationwide surveillance system. The epidemic lasted from week 11 through week 41 of 2011 (March 14-October 16, 2011). Although HAdV-3 was the predominant strain detected (74%), an abrupt increase in the percentage of infections caused by HAdV-7 occurred, from 0.3% in 2008-2010 to 10% in 2011. Clinical information was collected for 202 inpatients infected with HAdV; 31 (15.2%) had severe infection that required intensive care, and 7 of those patients died. HAdV-7 accounted for 10%, 12%, and 41% of infections among outpatients, inpatients with nonsevere infection, and inpatients with severe infection, respectively (p<0.01). The HAdV-7 strain detected in this outbreak is identical to a strain recently reported in the People's Republic of China (HAdV7-HZ/SHX/CHN/2009). Absence of circulating HAdV-7 in previous years and introduction of an emerging strain are 2 factors that caused this outbreak. [ABSTRACT FROM AUTHOR]

Background: Catheter ablation of paroxysmal atrial fibrillation has been performed for more than 10 years. However, data about the long-term results were limited.Objectives: To evaluate the long-tem efficacy following paroxysmal atrial fibrillation ablation and to investigate whether there were different patterns of recurrences in patients with different CHADS(2) scores.Methods: A total of 238 patients with paroxysmal atrial fibrillation who received a catheter ablation from 2004 to 2007 were enrolled. Free of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after ablation.Results: There were 121 patients (50.8%) suffering from recurrences after the first ablation procedure during a median follow-up period of 5 years. The CHADS(2) score and left atrial diameter were significant predictors of recurrences in the multivariate analysis. Different patterns of recurrence were observed in different groups of patients categorized on the base of CHADS(2) score. Among patients with a CHADS(2) score of ≥3 without recurrences at 2 years postablation, 63.6% experienced episodes of arrhythmias during the subsequent follow-up period. In contrast, in patients with a CHADS(2) score of 0 without recurrences at 2 years postablation, the future recurrence rate was only 2.7%.Conclusions: After a successful ablation, recurrences may continue to occur without reaching a plateau during the long-term follow-up, especially in patients with a high CHADS(2) score. The optimal follow-up strategy may differ and should be individualized for patients with different scores. [ABSTRACT FROM AUTHOR]