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To develop a new type of orchid with low-temperature tolerance and good fragrance, we generated intergeneric crosses between Korea-native wind orchids and tropical Phalaenopsis. In 2009, 160 cross combinations were made among Sedirea japonica, Phalaenopsis, Doritaenopsis and Neofinetia falcata. High incompatibility was observed from most of crosses as evidenced by traits such as early dropping of seed pods after pod formation or no seed formation after pod maturation. A total of 528 hybrid seedlings were obtained from 12 cross combinations. From these hybrid plants, several lines were selected based on flower type, inflorescence, cold tolerance, and fragrance, and finally the three best lines were selected. The selected lines were generally intermediate in both phenotype and genetic characters of the two parents, but tended to be more similar to Phalaenopsis.

Angiographic findings suggest that central neurocytoma (CN) might originate from neuronal cells of the subventricular zone (SVZ) around the foramen of Monro rather than from the septum pellucidum. The majority of CN cells have neuroblast characteristics. Most importantly, CN-derived tumor spheres have a phenotype of transit-amplifying type C cells, implying that these cells might arise from transformed transit-amplifying type C cells that reside in the SVZ. These CN-derived tumor spheres are also reminiscent of radial glial cells. Immunohistochemical and electrophysiologic studies show that these cells exhibit bipotential neuroglial differentiation in vitro.

In this paper, we design a filter tuning circuit that uses the 55 nm CMOS process. When current is applied to the capacitor, the specific voltage charge time and the capacitance are proportional. By using this principle, capacitor is the same value and complex BPF can keep the same bandwidth automatically not being affected by the temperature and process. Complex BPF has center frequency of 1 MHz, bandwidth of 1.2 MHz and ac response of 12 dB.

In this paper, an ultra low power I2C synchronous slave controller (I2CSSC) is presented for low data rate communication with a master device. An additional level shifter circuit at the SDA data IO and SCL clock input is integrated which makes it independent of the interface voltage levels of the master device. This circuit also isolates the slave device and protects it from high voltage spikes from master. The controller is designed with finite state machine (FSM) model in a synchronous fashion. The design is integrated in a pressure sensor for chip calibration and register configuration and it is fabricated with 180 nm CMOS technology. The I2CSSC occupies a very small area of 5712 μm2 and it requires only 650 gates for its implementation. The current consumption is upto 87 μΑ from 1.8 V power supply and it needs only 157 μ' power for its full operation. The measurement results verify the functional accuracy and rigorousness of the proposed design with all I2C operating modes.

A baseband analog with 4th order complex band-pass filter for Bluetooth Low Energy(BLE) 5.0 application in 55 nm CMOS process is presented. It is composed of three variable gain amplifiers (VGA), two 2nd order complex band-pass filter and two dc offset canceller. To reject image signal and adjacent interferers, the complex band-pass filter is used. Dynamic range of baseband analog is 105 dB. The intermediate frequency(IF) and 3 dB bandwidth are 2 MHz 2.4 MHz, respectively, which is target of BLE 5.0 application. A power consumption of baseband analog is 1.42 mW.

OBJECTIVEThe endoscopic endonasal approach (EEA) is commonly used for the treatment of craniopharyngioma; therefore, it is essential to analyze outcomes in order to understand the benefits and drawbacks. The goal of this paper was to evaluate the clinical features and outcomes associated with this treatment approach.METHODSFrom July 2010 to March 2016, 82 adult craniopharyngioma patients underwent an EEA at the authors’ institution. Of these cases, intraoperative records and immediate postoperative MR images were available for 68 patients. The patients underwent systemized endocrinological evaluation. Eighteen of 68 patients who underwent EEA for recurrence or regrowth of residual lesions after previous surgical management were excluded in the analysis of the anatomical tumor classification. The authors retrospectively analyzed preoperative clinical features and previous anatomical classifications, focusing on the relationship of the pituitary stalk and tumor, to determine predictive factors for the clinical outcome, such as the extent of resection, visual function, endocrinological function, recurrence rate, and complications.RESULTSThe mean tumor size was 2.5 cm (3.1 cm for primary tumors and 1.9 cm for recurrent lesions). Gross-total resection (GTR) was achieved in 62 (91.1%) patients (48 [96.0%] patients with primary tumors and 14 [77.8%] patients with recurrent tumors). The rate of GTR was higher in the primary group than in the group with recurrence (p = 0.038). The overall pre- and postoperative visual impairment scale (VIS) scores were 40.8 and 22.1, respectively (50.9 and 14.3 in the primary group and 30.7 and 29.9 in patients with recurrence, respectively). The improvement rate in VIS score was higher in the primary group than in the recurrent group (p = 0.001). Endocrinological function was improved in 4 patients (5.9%) and deteriorated in 32 of 68 patients (47.1%). Tumor invasion into the center of the pituitary stalk affected the postoperative outcomes most significantly. Cognitive dysfunction was observed in 22 patients before surgery and improved in 20 patients (90.9%) after surgery. Hydrocephalus was found in 7 patients and resolved after surgery in all cases. CSF leakage occurred in 2 (2.9%) of 68 patients and was repaired by revision surgery in both patients. Ten patients without CSF leakage also received antibiotics for the treatment of meningitis. The infection rate was higher in the recurrent group. Postoperative endocrinological evaluation showed no deficits in 12 patients and panhypopituitarism in 55 patients. The remaining patient had growth hormone deficiency. Forty-three patients had new-onset diabetes insipidus, and 1 patient had persistent diabetes insipidus after surgery. There were 2 (2.9%) cases of recurrence during the mean 30.7-month follow-up period; one patient underwent radiosurgery and the other underwent reoperation.CONCLUSIONSThe EEA resulted in excellent surgical outcomes and acceptable morbidity rates, regardless of the anatomical location of the tumor. Invasion of the craniopharyngioma into the center of the pituitary stalk has strong predictive power for postoperative endocrinological outcome.

OBJECTIVEPedicle screw-rod–based hybrid stabilization (PH) and interspinous device–based hybrid stabilization (IH) have been proposed to prevent adjacent-segment degeneration (ASD) and their effectiveness has been reported. However, a comparative study based on sound biomechanical proof has not yet been reported. The aim of this study was to compare the biomechanical effects of IH and PH on the transition and adjacent segments.METHODSA validated finite element model of the normal lumbosacral spine was used. Based on the normal model, a rigid fusion model was immobilized at the L4–5 level by a rigid fixator. The DIAM or NFlex model was added on the L3–4 segment of the fusion model to construct the IH and PH models, respectively. The developed models simulated 4 different loading directions using the hybrid loading protocol.RESULTSCompared with the intact case, fusion on L4–5 produced 18.8%, 9.3%, 11.7%, and 13.7% increments in motion at L3–4 under flexion, extension, lateral bending, and axial rotation, respectively. Additional instrumentation at L3–4 (transition segment) in hybrid models reduced motion changes at this level. The IH model showed 8.4%, −33.9%, 6.9%, and 2.0% change in motion at the segment, whereas the PH model showed −30.4%, −26.7%, −23.0%, and 12.9%. At L2–3 (adjacent segment), the PH model showed 14.3%, 3.4%, 15.0%, and 0.8% of motion increment compared with the motion in the IH model. Both hybrid models showed decreased intradiscal pressure (IDP) at the transition segment compared with the fusion model, but the pressure at L2–3 (adjacent segment) increased in all loading directions except under extension.CONCLUSIONSBoth IH and PH models limited excessive motion and IDP at the transition segment compared with the fusion model. At the segment adjacent to the transition level, PH induced higher stress than IH model. Such differences may eventually influence the likelihood of ASD.

We present a rare case of vestibular schwannoma (VS) with contralateral trigeminal neuralgia. A 59 year-old woman presented with right-sided trigeminal neuralgia and a small VS in the left cerebellopontine angle (CPA) that was found via magnetic resonance imaging. The patient was administered medication; however, her symptoms gradually aggravated, and the size of the tumor increased. Two years after the initial diagnosis, the patient underwent surgical resection. After surgical resection, the patient's facial pain was improved. The trigeminal neuralgia appeared to be related to brainstem displacement caused by the contralateral VS. For VS with contralateral trigeminal neuralgia, surgical resection of the tumor should be considered as a possible treatment strategy.

Background: Cough specific quality of life questionnaire such as Leicester Cough Questionnaire (LCQ) is recommended to assess the impact of cough. A short, simple instrument to quantify cough will be useful like as CAT for COPD. Aims: Develop a short patient-completed questionnaire ( CO ugh A ssessment T est, COAT ), assessing the impact of cough on health status. Methods: The COAT was developed though reliability test and then validated by comparing with Korean version of LCQ (K-LCQ), cough numeric rating scale (NRS, 0-10, 11-point scale) for chronic coughers. Candidate items were surveyed from 19 pulmonologists. Results: Item selection process identified 5 items about cough frequency, daily activity, sleep disturbance, fatigue, and cough hypersensivitity. The COAT composed of 5 items (0-4 scaling of the items, 0-20 score range) was finally developed. Reliability of COAT was tested in reliability test cohort (n=78). Internal consistency was excellent (Cronbach’s a=0.84). Test re-test repeatability was also very good (intra-class correlation coefficient=0.88). Validation of COAT is ongoing in validation cohort (until now n=83, target n=200). Pearson’s correlations of 1) COAT vs. K-LCQ, 2) COAT vs. cough NRS, and 3) K-LCQ vs. cough NRS before treatment were r=-0.61, 0.72, and -0.51, respectively (p Conclusion: The COAT is a useful simple questionnaire for assessing and monitoring cough.

OBJECTIVEThe endoscopic endonasal approach (EEA) and the transcranial approach (TCA) are good options for the treatment of tuberculum sellae (TS) meningiomas. The objective of this study was to identify the key anatomical features in TS meningiomas and compare the two surgical approaches.METHODSThe authors retrospectively reviewed clinical data in 178 patients with TS meningiomas treated at 3 institutions between January 2010 and July 2016. Patients with tumors encasing the internal carotid artery or anterior cerebral artery or involving the anterior clinoid process or cavernous sinus were excluded. Tumors were classified as high-lying or low-lying based on their location, and involvement of the optic canal was evaluated. The surgical outcomes of EEA and TCA were analyzed according to the relevant anatomical features.RESULTSDuring the study period, 84 patients underwent EEA and 94 patients underwent TCA. Based on preoperative MR images, 43 (24.2%) meningiomas were classified as high-lying tumors, 126 (70.8%) as low-lying, and 9 (5.0%) as nonspecific. Gross-total resection (GTR) was performed in 145 patients (81.5%); the GTR rate did not differ significantly between the EEA and TCA groups. Of 157 patients with preoperative visual disturbance, 140 had improved or stable vision postoperatively. However, 17 patients (9.6%) experienced some visual deterioration after surgery. The TCA group had a worse visual outcome than the EEA group in patients with preoperative optic canal involvement (77.6% vs 93.2%, p = 0.019), whereas there was no significant difference in visual outcome based on whether tumors were high-lying or low-lying.CONCLUSIONSThe results of this study support EEA over TCA, at least with respect to visual improvement with acceptable complications, although TCA is still an effective approach for TS meningioma.

Fluorescence-guided surgery using 5-aminolevulinic acid (5-ALA) is now a widely-used modality for glioblastoma (GBM) treatment. However, intratumoral heterogeneity of fluorescence intensity may reflect different onco-metabolic programs. Here, we investigated the metabolic mechanism underlying the heterogeneity of 5-ALA fluorescence in GBM. Using an in-house developed fluorescence quantification system for tumor tissues, we collected 3 types of GBM tissues on the basis of their fluorescence intensity, which was characterized as strong, weak, and none. Expression profiling by RNA-sequencing revealed 77 genes with a proportional relationship and 509 genes with an inverse relationship between gene expression and fluorescence intensity. Functional analysis and in vitro experiments confirmed glutaminase 2 (GLS2) as a key gene associated with the fluorescence heterogeneity. Subsequent metabolite profiling discovered that insufficient NADPH due to GLS2 underexpression was responsible for the delayed metabolism of 5-ALA and accumulation of protoporphyrin IX (PpIX) in the high fluorescence area. The expression level of GLS2 and related NADPH production capacity is associated with the regional heterogeneity of 5-ALA fluorescence in GBM.

Stereotactic radiosurgery is a well-known treatment tool for arteriovenous malformations (AVMs). The method has high validity and minimal invasiveness, but late-onset problems involving tumor formation and vasculopathy induced by radiation have been reported. We present a rare case of a radiation-induced ruptured de novo aneurysm following Gamma Knife surgery (GKS) for an AVM. A 17-year-old, right-handed male underwent GKS for AVM at the left parietal lobe. After 3 years, a follow-up angiogram showed a residual AVM at the angular gyrus. Then, a 2nd GKS was performed for the residual lesion. Six years after the 1st GKS, the AVM disappeared on the angiogram. Seven years later, he suffered a sudden onset of headache. A left carotid angiogram revealed a ruptured aneurysm at the M2-M3 junction of the middle cerebral artery parietal branch. Coil embolization was performed, and the aneurysm was occluded. The patient was discharged without any neurologic deficits.

OBJECTIVEThe endoscopic endonasal approach for treating primary skull base malignancies involving the clivus is a formidable task. The authors hypothesized that tumor involvement of nearby critical anatomical structures creates hurdles to endoscopic gross-total resection (GTR). The aim of this study was to retrospectively review the clinical outcomes of patients who underwent an endoscopic endonasal approach to treat primary malignancies involving the clivus and to analyze prognostic factors for GTR.METHODSBetween January 2009 and November 2015, 42 patients underwent the endoscopic endonasal approach for resection of primary skull base malignancies involving the clivus at 2 independent institutions. Clinical data; tumor locations within the clivus; and anatomical involvement of the cavernous or paraclival internal carotid artery, cisternal trigeminal nerve, hypoglossal canal, and dura mater were investigated to assess the extent of resection. Possible prognostic factors affecting GTR were also analyzed.RESULTSOf the 42 patients, 37 were diagnosed with chordomas and 5 were diagnosed with chondrosarcomas. The mean (± SD) preoperative tumor volume was 25.2 ± 30.5 cm3 (range 0.8–166.7 cm3). GTR was achieved in 28 patients (66.7%) and subtotal resection in 14 patients (33.3%). All tumors were classified as upper (n = 17), middle (n = 17), or lower (n = 8) clival tumors based on clival involvement, and as central (24 [57.1%]) or paramedian (18 [42.9%]) based on laterality of the tumor. Univariate analysis identified the tumor laterality (OR 6.25, 95% CI 1.51–25.86; p = 0.011) as significantly predictive of GTR. In addition, the laterality of the tumor was found to be a statistically significant predictor in multivariate analysis (OR 41.16, 95% CI 1.12–1512.65; p = 0.043).CONCLUSIONSAn endoscopic endonasal approach can provide favorable clinical and surgical outcomes. However, the tumor laterality should be considered as a potential obstacle to total removal.

BACKGROUND Cervical radiculopathy (CR) is a disease of the cervical spine and a space-occupying lesion that occurs because of pathological problems with cervical nerve roots. Nerve root injury to produce functional disability. OBJECTIVE The purpose of this study was to examine the effects of neural mobilization with manual cervical traction (NMCT) compared with manual cervical traction (MCT) on pain, functional disability, muscle endurance, and range of motion (ROM) in individuals with CR patients. METHODS A blinded randomized clinical trial was conducted. Thirty CR patients were divided into two groups - those who received NMCT and those who received MCT. The intervention was applied three times per week for eight weeks. It was measured in order to determine the pain and functional disability in patients with CR. The numeric pain rating scale (NPRS), neck disability index (NDI), ROM, and deep flexor endurance of patients were measured prior to the experiment, four weeks, and eight weeks after the experiment to compare the time points. A repeated-measures analysis of variance was used to compare differences within each group prior to the experiment. And Bonferroni test was performed to examine the significance of each time point. RESULTS There were significant differences within each group prior to the intervention, four weeks after the intervention, and eight weeks after the intervention in NPRS, NDI, ROM, and deep flexor endurance (P< 0.05). NPRS and NDI more decreased, and, ROM and deep flexor endurance increased in the NMCT group than the MCT group (P< 0.05). CONCLUSIONS These results suggest that the NMCT can pain relief, recovery from neck disability, ROM, and deep flexor endurance for patients with CR.

Degree of resection and visual outcome are the main concerns in the surgical resection of tuberculum sellae meningioma (TSM). In addition to the transcranial approach (TCA), the endoscopic endonasal approach (EEA) has been used increasingly. However, the controversy regarding the optimal surgical approach is not clearly resolved.We compared the surgical outcomes of each approach for TSMs from 44 patients receiving EEA and 40 patients receiving TCA in 2 institutions between 2004 and 2015. We analyzed the surgical outcomes and affecting factors for the relapse of tumor and visual outcome.Gross total resection rates and relapse-free survival were not different between the 2 groups; however, the locations of residual or recurred tumor definitely differed. All recurrences in the TCA group were in the sella turcica, whereas residual tumors in EEA group were mainly located at lateral or superior to the clinoid process. The complete or partial improvement rate of visual function in the EEA group was 97.7%, but 9 patients (23.7%) in the TCA group experienced visual deterioration after surgery. EEA and younger age (55 years) were associated with favorable visual outcome. Cerebrospinal fluid leakage occurred in only one case in the EEA group.Surgical approaches do not affect the gross total resection rates, but the locations of residual tumor or recurrence differ according to surgical approaches. EEA is superior to TCA in visual outcome. At least in pure TSMs, the trend seems to be shifting in favor of EEA, considering the huge difference in visual outcome.

We studied hydrogen (H) behavior in amorphous In-Ga-Zn-O (a-IGZO) films under X-ray irradiation by evaluating the threshold voltage (VTH) shift in a-IGZO thin film transistors (TFTs) with different H concentrations in the active layers. We fabricated three types of a-IGZO TFTs: (i) one without a buffer layer and postannealed in N2, (ii) one with a H-resolved buffer layer and postannealed in N2, and (iii) one with a H-resolved buffer layer and postannealed in a mixture of N2 and H2. All three TFTs showed a negative VTH shift after 100 Gy of X-ray exposure. The degree of VTH shift correlated with an increase in conductivity, which, in turn, corresponds to the H concentration in the active layer of the as-fabricated TFTs. Based on spectroscopic ellipsometry analysis, we confirmed a large increase in the donorlike H related D1 state after X-ray irradiation in high-H concentration a-IGZO films. In addition, an increase in the number of H2 molecules in a-IGZO films after X-ray irradiation was observed via thermal desorption spectroscopy analysis. Therefore, we conclude that the increase in conductivity and/or the resulting negative VTH shift in a-IGZO TFTs during X-ray irradiation can be attributed not only to the state transition from acceptorlike to donorlike H in the as-prepared a-IGZO but also to the incorporation of additional H radicals generated by X-ray irradiation.

Background: Chronic cough is defined as a cough lasting more than 8 weeks and socio-economic burden of chronic cough is enormous. The characteristics of chronic cough in Korea are not well understood. The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) published guidelines on cough management in 2014. The current study evaluated the clinical characteristics of chronic cough in Korea and the efficacy of the KATRD guidelines. Methods: This was a multi-center, retrospective observational study conducted in Korea. The participants were over 18 years of age. They had coughs lasting more than 8 weeks. Subjects with current pulmonary diseases, smokers, ex-smokers with more than 10 pack-years or who quit within the past 1 year, pregnant women, and users of cough-inducing medications were excluded. Evaluation and management of cough followed the KATRD cough-management guidelines. Results: Participants with chronic cough in Korea showed age in the late forties and cough duration of more than 1 year. Upper airway cough syndrome was the most common cause of cough, followed by cough-variant asthma (CVA). Gastro-esophageal reflux diseases and eosinophilic bronchitis were less frequently observed. Following the KATRD cough-management guidelines, 91.2% of the subjects improved after 4 weeks of treatment. Responders were younger, had a longer duration of cough, and an initial impression of CVA. In univariate and multivariate analyses, an initial impression of CVA was the only factor related to better treatment response. Conclusion: The causes of chronic cough in Korea differed from those reported in other countries. The current Korean guidelines proved efficient for treating Korean patients with chronic cough.

The purpose of this research is to evaluate the performance of the Ventilation hood and to make better oil collection for improvement. In order to complete the purpose, the research range has limited a kitchen cooking utensil used in preparing food in vessels. Assessment was carried out with reference(ASTM F1704-09) to the specification. Evaluation items of ventilation hood were flow visualization, oil collection rate and noise levels. When filter angle was 40 degrees, oil collection rate was increased by 9%.

Objective While several prognostic models have been presented in NSCLC patients with brain metastasis, none of these models have included molecular markers as an index. The aim of our study was to evaluate the prognostic value of EGFR mutations and to integrate these EGFR mutations into the prognostic index in NSCLC patients with brain metastasis. Materials and methods We analyzed retrospectively 292 lung adenocarcinoma patients with brain metastasis. Clinico-pathological features and overall survival (OS) were compared between patients with EGFR mutations and patients with EGFR wild type. EGFR mutation status was integrated with lung specific graded prognostic assessment (GPA) score. Results Among 292 patients, EGFR mutation status was tested in 183 patients. One hundred and five patients (57.4%) had EGFR activating mutations, 14 (7.7%) had EGFR non-activating mutations and 64 (35.0%) had EGFR wild type. OS was significantly longer in patients with EGFR activating mutations than in those with EGFR wild type patients (20.4 vs. 10.1 months, p = 0.002). However, patients with EGFR non-activating mutations did not show superior OS compared with EGFR wild type patients (14.6 vs. 10.1 months, p = 0.83). Multivariate analysis revealed that the presence of EGFR activating mutation is an independent positive prognostic factor for OS (adjusted hazard ratio 0.56, p = 0.002). Conclusions EGFR activating mutations have a prognostic role in lung adenocarcinoma patients with brain metastasis that is independent of other known prognostic factors. The frequency of EGFR mutation was higher than expected. The presence of EGFR activating mutations should be included as an index in the prognostic models for lung adenocarcinoma patients with brain metastasis.

BACKGROUND: We evaluated the clinical characteristics and factors associated with mortality in very elderly patients ≥ 90 y of age admitted to the ICU. METHODS: We evaluated age-specific rates of admission and mortality in 16,935 subjects ≥ 18 y old and retrospectively analyzed the clinical data of 155 (0.92%) subjects ≥ 90 y old admitted to the ICU from January 2003 to July 2012. The clinical mortality index was defined as the ICU mortality rate associated with clinical risk factors including poor nutrition, do not resuscitate (DNR) order, pneumonia, chronic renal failure, cancer, mechanical ventilation, use of a vasopressor, and admission from a ward. RESULTS: The mortality rate of ICU subjects ≥ 90 y of age was 32.3%. A Cox's regression hazard model revealed that high glucose ( P = .006), poor nutrition ( P = .001), high Simplified Acute Physiology Scoring II scores ( P < .001), DNR order ( P = .002), and vasopressor treatment ( P = .03) were independent predictive factors of mortality in subjects ≥ 90 y of age admitted to the ICU. An increasing number of clinical risk factors was associated with progressively higher mortality rates. All subjects with more than 5 risk factors died. CONCLUSIONS: The very elderly subjects (≥ 90 y) admitted to the ICU had a higher mortality rate compared with subjects of other ages. High Simplified Acute Physiology Scoring II scores, poor nutritional status, high glucose, use of vasopressors, and DNR orders should be considered as important predictors of mortality in very elderly ICU patients. The level of ICU treatment should be carefully considered in very elderly patients presenting with 5 or more risk factors.

The quick, easy, cheap, effective, rugged and safe (QuEChERS) method for sample preparation was applied to determine seven organophosphorus pesticides (OPs) in stomach contents of poisoned postmortem animals. The pesticides consisted of diazinon, edifenphos, ethyl p-nitrophenyl phenylphosphonothioate, fenitrothion, monocrotophos, parathion and phosphamindon, and tested samples included stomach contents from postmortem animals of cattle, goat, dog, cat, birds, deer and rabbit. The pesticides were spiked into the samples which were found to be negative through previous pesticide poisoning analysis, and the pesticides were extracted and cleaned up based on the QuEChERS process and then they were analyzed using gas chromatography (GC)-flame photometric detector (FPD) or GC-nitrogen-phosphorus detector (NPD) with a DB-5 column. Limits of detection ranged from 0.27 to 0.41 mg/kg for the seven pesticides. The mean recoveries ranged from 80 to 99% in GC-FPD and 83 to 90% in GC-NPD. The coefficients of variation were

Object Neurofibromatosis Type 2 (NF2) is an autosomal-dominant inherited disease, characterized by multiple neoplasia syndromes, including meningioma, schwannoma, glioma, and ependymoma. In this report, the authors present their clinical experience with pediatric NF2 patients. In particular, they focused on the clinical course of vestibular schwannoma (VS), including the natural growth rate, tumor control, and functional hearing outcomes. Methods From May 1988 to June 2012, the authors recruited patients who were younger than 18 years and fulfilled the Manchester criteria. In total, 25 patients were enrolled in this study. The authors analyzed the clinical course of these patients. In addition, they measured the natural growth rate of VS before any treatment in these children with NF2. Then, they evaluated the tumor control rate and functional hearing outcomes after the treatment of VS. Results The mean age at the onset of NF2-related symptoms was 9.9 ± 4.5 years (mean ± SD, range 1–17 years). The mean age at the diagnosis of NF2 was 12.9 ± 2.9 years (range 5–17 years). The mean follow-up period was 89.3 months (range 12–311 months). As initial manifestations, nonvestibular symptoms were frequently observed in pediatric patients with NF2. The mean natural growth rate of VS was 0.33 ± 0.41 cm3/year (range 0–1.35 cm3/year). The tumor control rate of VS was 35.3% at 3 years after Gamma Knife surgery (GKS). The actuarial rate of useful hearing preservation was 67% in the 1st year and 53% in the 5th year after GKS. Conclusions Clinical manifestations in children with NF2 were highly variable, compared with their adult counterparts. The natural growth rate of VS in children is slow, and this oncological feature may explain the diverse clinical manifestations besides vestibular symptoms in children with NF2. The treatment outcome of GKS for VS in children with NF2 was not favorable compared with previous reports of affected adults.

Aim To assess the relationship between chest computed tomography (CT) findings of patients with toxocariasis and levels of serological markers. Materials and methods A total of 38 cases of patients diagnosed with toxocariasis by enzyme-linked immunosorbent assay (ELISA), CT, and serological markers were retrospectively reviewed. The presence of nodule with or without ground-glass opacity (GGO) halo, consolidation, focal GGO, pleural effusion, and lymphadenopathy at chest CT were evaluated. Statistical analysis was performed with the Fisher's exact test. Results The most common chest CT findings were nodule ( n = 12, 31.6%) and focal GGO ( n = 12, 31.6%). In patients with normal eosinophil levels, focal GGO ( n = 9, 37.5%) was the most common finding. In contrast, nodule with a GGO halo ( n = 7, 50%) was the most common finding in the eosinophilia group. Nodule with a GGO halo was more common in the eosinophilia group, with a statistically significant difference ( p = 0.017). Nodule was more common in the eosinophilia group, and focal GGO was more common in the normal eosinophil group. Conclusion The most common chest CT findings in toxocariasis were nodule with or without GGO halo, and focal GGO. In the eosinophilia group, nodule with a GGO halo was significantly more frequent. Other CT findings did not show a statistically significant relationship with serological markers.

Purpose A recent study demonstrated that exertional desaturation is a predictor of rapid decline in lung function in patients with chronic obstructive pulmonary disease (COPD); however, the study was limited by its method used to detect exertional desaturation. The main purpose of this study was to explore whether exertional desaturation assessed using nadir oxygen saturation (SpO2) during the 6-minute walk test (6MWT) can predict rapid lung function decline in patients with COPD. Materials and Methods A retrospective analysis was performed on 57 patients with moderate to very severe COPD who underwent the 6MWT. Exertional desaturation was defined as a nadir SpO2 of

In Gamma Knife radiosurgery, the occurrence of reapplying the stereotactic frame leads to re-examination and re-planning. To avoid undergoing invasive second angiography examination for the treatment of vascular lesions, and reduce re-planning time, a mathematical coordinate transformation method using the anatomical information has been developed. The MR or CT images of a human brain before and after frame reapplication were correlated with each other using the Affine transformation. The transformation parameters which minimize the RMS error of the original and transformed coordinates between the images were determined using a genetic algorithm. Three CT image studies of skull phantom and five MR image studies of patients were used for the evaluation. The RMS error in the coordinate transformation of skull phantom and clinical images was 0.3 ± 0.1 mm and 0.6 ± 0.1 mm, respectively. The original treatment plans of patients were converted to new plans using the transformation matrix. For total 9 treatment lesions of 0.2-14.1 cc, 3% and 11% RMS error in the irradiation time and target coverage were found respectively. The deeply-located lesions showed a better RMS error of 3% in the conformity index and similar dose distribution than superficial lesions close to the skull.

The cyst of the soya bean cyst nematode (SCN; Heterodera glycines), an economically important pathogen of soya beans worldwide, represents a unique microhabitat in soil. The fungi inhabiting cysts may include natural antagonists of the SCN as well as saprotrophs and other opportunists. This study aimed to characterise the entire culturable mycobiome of SCN cysts obtained from a long-term soya bean-corn rotation experiment using ITS fungal barcoding. Fusarium was consistently the most frequently isolated taxon across all sampling time points and crop sequences, followed by Ilyonectria. Among fourteen genera frequently isolated from SCN cysts, five fell within the single family Nectriaceae (Sordariomycetes) and five within the order Pleosporales (Dothideomycetes), suggesting independent evolutionary origins and shared adaptations in these groups towards colonisation of SCN cysts. Six genera (Pochonia, Clonostachys, Fusarium, Neonectria, Alternaria, and Leptosphaeria) varied significantly by crop sequence in at least one year.

Volume-regulated anion channels (VRACs) are involved in cellular functions such as regulation of cell volume, proliferation, migration, and cell death. Although leucine-rich repeat&ndash, containing 8A (LRRC8A) has been characterized as a molecular component of VRACs, here we show that Drosophila melanogaster tweety homologue 1 and 2 (TTYH1 and TTYH2) are critical for VRAC currents in cancer cells. LRRC8A-independent VRAC currents were present in the gastric cancer cell line SNU-601, but almost completely absent in its cisplatin-resistant derivative SNU-601-R10 (R10). The VRAC current in R10 was partially restored by treatment with trichostatin A (TSA), a histone deacetylase inhibitor. Based on microarray expression profiling of these cells, we selected two chloride channels, TTYH1 and TTYH2, as VRAC candidates. VRAC currents were completely absent from TTYH1- and TTYH2-deficient SNU-601 cells, and were clearly restored by expression of TTYH1 or TTYH2. In addition, we examined the expression of TTYH1 or TTYH2 in several cancer cell lines and found that VRAC currents of these cells were abolished by gene silencing of TTYH1 or TTYH2. Taken together, our data clearly show that TTYH1 and TTYH2 can act as LRRC8A-independent VRACs, suggesting novel therapeutic approaches for VRACs in cancer cells.

This work assesses the hot ductility behavior of high manganese steel under hot working conditions. Reduction of area (RA) behavior of 16 Mn-0.5 C steel was investigated to consider it for production in a slab and subsequent hot rolling process. All specimens were machined from the as-cast slab. A hot ductility test was accomplished by a cast simulator through a temperature range of 650 °C-1200 °C with 50 °C intervals. The obtained RA values ranged between 30% and 60%, with a maximum at 850°C, and this is far from the general RA behavior of low carbon steel. This result could be attributed to the fact that the specimen is fully austenitic through all test temperatures, and that there is no ferrite at the low temperature end and reduced dynamic recrystallization at the high temperature end. Microstructural evaluation of the fractured specimen revealed that the deformation was concentrated at the grain boundary, and there was little matrix deformation. These results suggest that the grain boundary sliding is the basic cause of the fracture and low values of hot ductility in high manganese steel. †(Received Match 11, 2013)

The emitter geolocation method using the time difference of arrival (TDOA) and the frequency difference of arrival (FDOA) has more accurate performance comparing to the single TDOA or FDOA based method. The estimation performance varies with the sensor paring strategies, the deployment and velocities of the sensors. Therefore, to establish effective strategy on the electronic warfare system, it is required to analyze the relation between the estimation accuracy and the operational condition of sensors. However, in the conventional non-iterative method, the restriction of the deployment of sensors and the reference sensor exists. Therefore, we derive the emitter geolocation method based on a Gauss-Newton method which is available to apply to any various sensor pairs and the deployment and velocities of the sensors. In addition, simulation results are included to compare the performance of geolocation method according to the used measurements: the combined TDOA/FDOA, TDOA, and FDOA. Also, we present that the combined TDOA/FDOA method outperforms over single TDOA or FDOA on the estimation accuracy with the CEP plane.

Despite the favorable outcomes of radiosurgery for central neurocytoma (CN), these results are based on case series that included a limited number of patients and short follow-up periods because of the scarcity of CN. Because CN is a benign tumor with an indolent clinical course, long-term follow-up and analysis of failure pattern are required for the establishment of the role of radiosurgery in the management of CN. Twenty consecutive patients (10 patients who received Gamma Knife radiosurgery (GKRS) as a primary treatment and 10 patients who received GKRS as a secondary treatment) with a radiological follow-up period ≥36 months were included in this study. The mean radiological follow-up duration was 100 months (range 43-149 months). The mean tumor volume was 10.4 cm(3) (range 0.4-36.4 cm(3)) and the mean marginal dose was 15.4 Gy (range 9-20 Gy). Local control failure was found in six patients at the last radiological follow-up. Overall actuarial local control rates were 89.5 % at 5 years and 83.1 % at 10 years. The primary GKRS group included two cases with local failure, with cyst formation or local recurrence. In contrast, in the secondary GKRS group, local control failure was found in four cases (including three cases with an "out-of-field recurrence" pattern) and occurred earlier compared with the primary GKRS group. Our study suggests that GKRS could be a primary or secondary treatment option for CN. However, long-term radiological follow-up is mandatory. In particular, more careful consideration during margin delineation and planning procedure is required in the secondary GKRS group.

The object of this study was to analyze treatment outcomes and to identify the prognostic factors, with a focus on the role of adjuvant radiotherapy (ART), predicting disease progression in atypical meningiomas. From 1997 to 2011, 83 patients with meningioma were included in this study. All patients were histologically confirmed as atypical meningioma and were treated with surgical resection with or without ART. As primary therapy, 27 patients received surgical resection followed by ART, and 56 received no adjuvant therapy. Of 83 evaluable patients, 55 (66.3 %) patients underwent complete resection. The median ART dose was 61.2 Gy and their median age was 52 years. The 5- and 10-year actuarial overall survival rates were 90.2 and 62.0 %, and the 5- and 10-year progression-free survival (PFS) rates were both 48.0 %, with a median follow-up of 43.0 months. Addition of ART (p = 0.016) and complete tumor resection (p = 0.002) were associated with superior PFS. When stratified to four groups according to resection status and ART, the groups of patient with incomplete resection without ART showed significantly worse PFS compared to other three groups (p < 0.001). In conclusion, surgical resection followed by ART led to lower local tumor progression in patients with atypical meningioma defined by the updated 2000/2007 WHO classification. Our results may contribute to the routine use of ART, especially after incomplete resection, until the outcomes of ongoing prospective trials are available.

In the passive emitter localization using instantaneous TDOA (time difference of arrival) and FDOA (frequency difference of arrival) measurements, the estimation accuracy can be improved by collecting additional measurements. To achieve this goal, it is required to increase the number of the sensors. However, in electronic warfare environment, a large number of sensors cause the loss of military strength due to high probability of intercept. Also, the additional processes should be considered such as the data link and the clock synchronization between the sensors. Hence, in this paper, the passive localization of a stationary emitter is presented by using the successive TDOA and FDOA measurements from two moving sensors. In this case, since an independent pair of sensors is added in the data set at every instant of measurement, each pair of sensors does not share the common reference sensor. Therefore, the QCLS (quadratic correction least squares) methods cannot be applied, in which all pairs of sensor should include the common reference sensor. For this reason, a Gauss-Newton algorithm is adopted to solve the non-linear least square problem. In addition, to show the performance of the proposed method, we compare the RMSE (root mean square error) of the estimates with CRLB (Cramer-Rao lower bound) and derived the CEP (circular error probable) planes to analyze the expected estimation performance on the 2-dimensional space.

The purpose of this study is to investigate the possible role of stereotactic radiosurgery (SRS) in the management of patients with brain metastases from hepatocellular carcinoma (HCC). Thirty-two consecutive patients with 80 brain metastases from HCC were treated with SRS. Twenty-eight (87.5 %) patients were male, and the mean age of the patients was 54 ± 12 years (range 22-73). Twenty-seven (84.4 %) patients were classified as RTOG RPA Class 2. The mean tumor volume was 6.14 ± 11.3 cm(3) (range 0.01-67.3). The mean marginal dose prescribed was 20.1 ± 3.6 Gy (range 10.0-25.0). The median overall survival time after SRS was 11.3 ± 5.8 weeks (95 % CI 0-22.7). A greater total volume of brain metastases (14 cm(3)) was the only independent prognostic factor (HR = 2.419; 95 % CI 1.040-5.624; p = 0.040). The actuarial control rate of brain metastases was 51.3 % at 4 months after SRS. The prescribed marginal dose (18 Gy) was significantly related with the actuarial tumor control (HR = 0.254; 95 % CI 0.089-0.725; p = 0.010). The prognosis of patients with brain metastases from HCC is dismal even with the modern technology of radiosurgery. The marginal dose prescribed should be reevaluated to improve upon the current poor local control rates.

DepartmentofNeurosurgery,SeoulNationalUniversityCollegeofMedicine,SeoulNationalUniversityHospital(C.-K.P., D.G.K., H.-W.J.); Department of Neurosurgery,Asan Medical Center, Universityof Ulsan CollegeofMedicine(J.H.K.);andDepartmentofNeurosurgery,SamsungMedicalCenter,SungkyunkwanUniversitySchoolof Medicine, Seoul, South Korea(D.-H.N., S.-B.C., H.J.S.); Department of Neurosurgery, Seoul NationalUniversity Bundang Hospital, Gyeonggi-do (C.-Y.K., Y.-H.K.); and Department of Internal Medicine (T.M.K.,S.-H.L., D.S.H.), Department of Radiology (S.H.C.), and Department of RadiationOncology (I.H.K.), SeoulNational University College of Medicine, Seoul NationalUniversity Hospital, Seoul, South KoreaBackground. To determine the benefit of surgical man-agement in recurrent glioblastoma, we analyzed a seriesof patients with recurrent glioblastoma who had under-gone surgery, and we devised a new scale to predicttheir survival.Methods. Clinical data from 55 consecutive patientswithrecurrentglioblastomawereevaluatedaftersurgicalmanagement. Kaplan–Meier survival analysis and Coxproportional hazards regression modeling were used toidentifyprognosticvariablesforthedevelopmentofapre-dictivescale.Afterthemultivariateanalysis,performancestatus(P ¼ .078)andependymalinvolvement(P ¼ .025)were selected for inclusion in the new prognostic scale.The devised scale was validated with a separate set of 96patients from3 different institutes.Results. A 3-tier scale (scoring range, 0–2 points) com-posed of additive scores for the Karnofsky performancestatus (KPS) (0 for KPS ≥ 70 and 1 for KPS , 70) andependymal involvement (0 for no enhancement and 1forenhancementoftheventriclewallinthemagneticres-onance imaging) significantly distinguished groups withgood(0points;mediansurvival,18.0months),intermedi-ate (1 point; median survival, 10.0 months), and poorprognoses (2 points; median survival, 4.0 months). Thenew scale was successfully applied to the validationcohort of patients showing distinct prognosis among thegroups (median survivals of 11.0, 9.0, and 4.0 monthsfor the 0-, 1-, and 2-point groups, respectively).Conclusions. Wedevelopedapracticalscaletofacilitatedecidingwhethertoproceedwithsurgicalmanagementinpatients with recurrent glioblastoma. This scale wasuseful for the diagnosis of prognostic groups and can beused to develop guidelines for patient treatment.Keywords: ependymal involvement, performance status,recurrent glioblastoma, scoring system,surgery.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), dioxin-like polychlorinated biphenyls (DL-PCBs), polybrominated diphenyl ethers (PBDEs), and hexachlorobenzene (HCB) concentrations were determined in abdominal fat samples from 30 cattle. The relationships between chemicals, age, and gender were investigated. The concentration of PCDD/Fs ranged from 0.01 to 1.36 pg TEQ g−1 fat, DL-PCBs ranged from 0.17 to 1.64 pg TEQ g−1 fat, PBDEs ranged from 135 to 725 pg g−1 fat, and HCB ranged from 25.5 to 2061 pg g−1 fat. A comparison between cattle’s age and gender vs. the concentration of contaminants revealed higher concentrations of PCDD/Fs and DL-PCBs in cattle aged more than 3 years; no difference between genders was apparent. Moreover, the concentrations of PBDEs in cattle fat did not correspond with the age of cattle. Relative to cattle 1.5–2.5 years of age, cattle aged 3 and 4 years had higher concentration of HCB but the concentration difference was not clear at age 5. Human exposures to these compounds from beef sources were calculated based on beef consumption.

Residues of veterinary drugs, pesticides, and environmental contaminants in domestic and imported foods of animal origin were monitored by the National Residue Program and inspection service in Korea in the past decade. In all, 134 substances were analyzed in the monitoring plan; 35 substances were examined in the surveillance and enforcement testing program, and 27 substances were investigated in exploratory projects. The overall trend of violation rates gradually decreased over the past decade. Pesticides were not found in any domestic samples of animal origin. The violation rates of chlortetracycline and oxytetracycline decreased, but quinolone and penicillin detections increased in Korea. Several kinds of residue violations of veterinary drugs, endosulfan, or dioxins were found in the imported products each year. In an example event in 2008, the Korea monitoring plan contributed globally to investigate the dioxin contamination from Chilean pork. Continuous monitoring based on internationally harmonized standards and methods provides the essential scientific basis to manage and ensure food safety.

This study was performed to evaluate the incidence of seizures with its implications on disease progression and the diagnostic value of post-ictal magnetic resonance images (MRI) during the management of high-grade gliomas (HGGs). A total of 406 consecutive patients with newly diagnosed HGGs were retrospectively reviewed. The incidence of seizures during the management was investigated. In patients who experienced a seizure, the causality between seizures and disease progression was assessed by pre-ictal, post-ictal (

BACKGROUND: A thorough investigation of the long-term outcomes of central neurocytoma (CN) after different treatments is required to establish optimal management strategies. OBJECTIVE: We retrospectively reviewed the long-term clinical outcomes of patients with CN according to various treatments and suggest treatment strategies based on 30 years of experience in a single institution. METHODS: Fifty-eight consecutive patients with CN were treated at our institution between 1982 and 2008. Patient demographics, overall survival, local control rates according to multimodal treatments, and functional outcomes were evaluated. The mean clinical and radiological follow-up periods were 119 months (range, 18-304 months) and 98 months (range, 13-245 months), respectively. RESULTS: The initial treatment modality was classified into 4 subgroups: operation only (34 patients), operation followed by radiation therapy (7 patients) or radiosurgery (7 patients), and radiosurgery alone (10 patients). The actuarial overall survival was 91% at 5 years and 88% at 10 years. The actuarial overall survival and local tumor control rate did not differ significantly according to the various treatments and the initial extent of the surgical resection. However, functional outcomes, such as the postoperative seizure outcome at the last follow-up, differed according to the surgical approach. CONCLUSION: The long-term clinical outcomes of CN after multimodal treatment seem to be excellent. Our study suggests that treatment strategies for CN should focus on the patient's quality of life, as well as on tumor control, because of the benign nature of CN.

BACKGROUND Gamma knife radiosurgery (GKRS) is recognized as an important treatment modality for meningioma. OBJECTIVE To analyze the long-term outcomes in meningioma patients treated with GKRS to determine the risk factors related to treatment failure and peritumoral edema (PTE) development. METHODS Between 1998 and 2010, 770 consecutive patients were treated with GKRS for intracranial meningioma. After the exclusion of patients with follow-up periods of less than 5 yr and those with neurofibromatosis, multiple meningiomas, nonbenign meningioma, or radiotherapy, a total of 424 patients were enrolled in this study. The median follow-up duration was 92 mo. The median tumor volume was 4.35 cm3, and the median marginal dose was 14 Gy. RESULTS The overall local tumor control rate was 84%. The actuarial tumor control rates were 91.7% and 78.9% at 5 and 10 yr, respectively. The tumor control rate of a radiologically diagnosed tumor was higher than that of a grade I tumor (82% vs 70.1% at 10 yr, P = .001). In multivariate analysis, factors associated with tumor progression were female sex (hazard ratio: 0.5, P = .025) and a previous history of craniotomy (hazard ratio: 1.9, P = .009). Symptomatic PTE was identified in 36 (8.5%) patients, and the factor associated with poor PTE was the presence of PTE before GKRS (odds ratio: 4.6, P < .001). Permanent complication rate was 4%. CONCLUSION GKRS appears to be an effective treatment modality for meningioma with long-term follow-up. However, the identification of delayed tumor progression in our study suggests that extended follow-up data should be collected after GKRS.

Background The extended endoscopic endonasal approach (EEA) to the anterior cranial base is used for the resection of craniopharyngiomas. Objective We present clinical experience and outcomes of using EEA for craniopharyngiomas. Methods A total of 116 patients in 2 remote institutions were enrolled in this retrospective study. Surgical, endocrinologic, and ophthalmologic outcomes were assessed. Results The mean follow-up was 35 months (range, 1–115). Gross total resection (GTR), near total resection (NTR, >95%), and subtotal resection (STR) were achieved in 46%, 39%, and 15% of the patients, respectively. Surgery performed after 2010 was the only variable significantly associated with greater extent of resection, which might be explained by the learning curve. Overall tumor recurrence rate was 15.5%, with a median interval until recurrence of 14.5 months (range, 3–58). Extent of resection was significantly associated with recurrence-free survival (P = 0.0116). Those who underwent NTR/STR followed by adjuvant radiotherapy had a similar median recurrence-free survival rate compared with those who underwent GTR (26.5 vs. 20 months, P = 0.167). Endocrinologic examination revealed that 47.4% of patients experienced worsening of anterior pituitary function following surgery while 25.5% developed new-onset diabetes insipidus. Of the 89 patients with preoperative visual deficits, 68 (76.4%) experienced improvement in visual field assessment. Conclusion EEA is effective for the surgical resection of craniopharyngiomas, resulting in high rates of visual improvement and low complication rates. Adjuvant radiotherapy is a useful method for tumor control after incomplete resection.