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Background With the increasing number of internet users, search engines have become a widely used source of health-related information. However, evaluating the quality of medical information obtained through search engines can be challenging. This study aimed to evaluate the quality of search results related to breast implants obtained from major domestic websites in Korea using systematic evaluation standards. Methods Two main primary search terms (“gaseum” [breast] implant and “yubang” [breast] implant), along with 15 adjunct search terms, were combined and searched in Google, Naver, and Daum. The top 20 websites were evaluated and classified according to their type and provider. They were scored using the Korean Medical Association’s Internet Health Information Certification Standards. The proportion of significant websites, their categorical distribution, and the quality of information scores were then compared. Results Google yielded the highest number of appropriate results, with statistical significance. Blogs (36.4%) and news (34.8%) were the most common types of search results, while healthcare provider groups (49.5%) constituted the most common provider subgroup. Only 1.9% of the search results were from public organizations. Google had a significantly higher average quality score (14.04) than Naver (13.22), and Daum (12.45) (P

Abstract Background The current gastric cancer staging system relies on the number of metastatic lymph nodes (MLNs) for nodal stage determination. However, incorporating additional information such as topographic status may help address uncertainties. This study evaluated the appropriateness of the current staging system and relative significance of MLNs based on their anatomical location. Methods Patients who underwent curative gastrectomy for gastric cancer between 2000 and 2019 at six Catholic Medical Center-affiliated hospitals were included. Lymph node-positive patients were classified into the perigastric (stations 1–6, group P) or extragastric (stations 7–12) groups. The extragastric group was further subdivided into the near-extragastric (stations 7–9, group NE) and far-extragastric (stations 10–12, group FE) groups. Results We analyzed the data of 3,591 patients with positive lymph node metastases. No significant survival differences were found between group P and the extragastric group in each N stage. However, in N1 and N2, group FE showed significantly worse survival than the other groups (p = 0.013 for N1, p

In this study, we explored the potential of genetically engineered exosomes as vehicles for precise drug delivery in gastric cancer therapy. A novel antitumor strategy using biocompatible exosomes (Ex) was devised by genetically engineering adipose-derived stem cells to express an MKN45-binding peptide (DE532) on their surfaces. 17-(Dimethylaminoethylamino)-17-demethoxygeldanamycin (17-DMAG) was encapsulated in engineered exosomes, resulting in 17-DMAG-loaded DE532 exosomes. In both in vitro and in vivo experiments using mouse gastric cancer xenograft models, we demonstrated that 17-DMAG-loaded DE532 Ex exhibited superior targetability over DE532 Ex, 17-DMAG-loaded Ex, and Ex. Administration of the 17-DMAG-loaded DE532 Ex yielded remarkable antitumor effects, as evidenced by the smallest tumor size, lowest tumor growth rate, and lowest excised tumor weight. Further mechanistic examinations revealed that the 17-DMAG-loaded DE532 Ex induced the highest upregulation of the pro-apoptotic marker B-cell lymphoma-2-like protein 11 and the lowest downregulation of the anti-apoptotic marker B-cell lymphoma-extra large. Concurrently, the 17-DMAG-loaded DE532 Ex demonstrated the lowest suppression of antioxidant enzymes, such as superoxide dismutase 2 and catalase, within tumor tissues. These findings underscore the potential of 17-DMAG-loaded DE532 exosomes as a potent therapeutic strategy for gastric cancer, characterized by precise targetability and the potential to minimize adverse effects.

Background As rhinoplasty techniques have become more complex, surgeons often need more than what septal or conchal cartilage can provide. While costal cartilage became more popular for that reason, some surgeons are still uncomfortable with its invasiveness and donor site morbidity. Here, we used lyophilized allogeneic costal cartilage for septorhinoplasty and investigated its safety and usefulness. Methods The costal cartilage was harvested from a cadaveric donor and treated via multiple steps, including defatting and lyophilization, to remove all viable cells and antigenicity. The cartilage was then stored at room temperature and rehydrated 24 hours before use. Lyophilized cartilage allografts were used in 20 patients. Three types of septal graft were performed — spreader, batten, and extension — to correct septal or columellar deviation and enhance the nasal tip. Results The mean follow-up period was 4.3 years. In all cases, the graft successfully met the rhinoplasty purpose. No significant deformation was detected in any of the patients. Although warping was observed in one patient (5%), there was no case of clinical infection, extrusion, or graft removal and no revisional surgery for an unfavorable aesthetic result. Conclusions Lyophilized allogeneic cartilage was used for septorhinoplasty very safely and effectively. It can be carved into any shape and has all other properties required for perfectly replacing autologous costal cartilage. The main advantage of cartilage allografts is a limitless supply of high-quality cartilage without donor site morbidity. The disadvantages include the need for special facilities and manpower and extra covering cost.

Among many risk assessment techniques, qualitative, semi-quantitative or quantitative, risk matrix is a common tool to assess risk by allocating frequency and consequence of an accident to one of the pre divided frequency and consequence categories. However, since there is no standardized way to define these categories, risk matrix with its strength of being straightforward to use and easy to interpret has inherent uncertainties including objective categorization determination and consistency of decisions on frequency and consequence among different users, which usually results in multiple risk outcomes leading to incorrect conclusion about decision making on risk initiated from accidents.The purpose of the study is to predict a long term risk of maritime accident using a 5 × 5 probabilistic risk matrix where each category of frequency and consequence is probabilistically estimated by a Markov chain model. The proposed method to calculate accident risk is illustrated using maritime accident data over 2016–2020 years. The findings are that the most probable frequency and consequence ranges of maritime accidents will be between 182 and 235 with probability of 0.3878 and between 6.8 and 11.6 fatalities with probability of 0.3791, respectively. The expected risk value was computed as 4.6506 on a scale of 2–10. For the validation of the proposed method 90 %, 95 %, and 99 % confidence intervals were constructed which were shown to contain the predicted risk value. The probabilistic risk matrix with Markov chain approach can be applied to predicting risks in different fields of industries.

Abstract Socioeconomic barriers to cancer screening exist at a regional level. The deprivation index is used to estimate socioeconomic gradients and health disparities across different geographical regions. We aimed to examine the impact of deprivation on breast cancer screening participation rates among South Korean women. Municipal breast cancer screening participation rates in women were extracted from the National Cancer Screening Information System and linked to the Korean version of the deprivation index constructed by the Korea Institute for Health and Social Affairs. A generalised linear mixed model was employed to investigate the association between the deprivation index and age-standardised breast cancer screening participation rates in 2005, 2012, and 2018. Participation rates increased gradually across all age groups from 2005 to 2018. Participants in their 60 s consistently had one of the highest participation rates (2005: 30.37%, 2012: 61.57%, 2018: 65.88%). In 2005, the most deprived quintile had a higher estimate of breast cancer screening participation than the least deprived quintile (2nd quintile; estimate: 1.044, p = 0.242, 3rd quintile; estimate: 1.153, p = 0.192, 4th quintile; estimate: 3.517, p = 0.001, 5th quintile; estimate: 6.913, p =

The water temperature in a fish tank is important for fish health. A conventional aquarium heater produces localized heating that causes water temperature variation, resulting in thermal stress to fish. This study presents plane heating with a transparent heater film that is aesthetically attractive when applied to fish tanks. The transparent heater film comprises a metal mesh with an optical transparency of 81 %, sheet resistance of 0.6 Ω/□, and mean heating surface temperature of 57 °C at 20 W. In the test setup, 100 W is applied to compare an aquarium heater and a transparent heater film. Increasing the water temperature from 23 °C to 24 °C at the center of the fish tank needs 28 min with the transparent heater film operating at 33 °C, whereas the same temperature increase needs 50 min with an aquarium heater operating at 49 °C. The planar heater thus results in enhanced heat diffusion and reduced water temperature variation due to its extended heating surface area.

IntroductionIpsilateral left-sided-approach laparoscopic transabdominal preperitoneal herniorrhaphy (LA-TAPP) is a procedure used for inguinal hernia. However, conventional laparoscopic instruments may limit the operator's ability to approach certain areas during the procedure. This study aims to assess the feasibility of using an articulating bipolar grasper (ArtiSential®).Material and methodsBetween January 2017 and May 2022, 184 patients with inguinal hernia underwent LA-TAPP and were divided into an articulating group (AG) and a conventional group (CG). The two groups were compared for clinical characteristics, surgical outcomes, and recurrence rates. Learning curve analysis was also performed using the CUSUM score.ResultsThe AG and CG included 72 and 112 patients, respectively. Both groups had similar age, sex, BMI, hernia location, and hernia type. The AG had a significantly shorter operation time (59.2 ± 29.4 vs. 77.8 ± 22.4 min, p

This study investigated how two different kinds of prominence-induced prosodic strengthening, identificational focus and contrastive focus, are phonetically realized in Seoul Korean. In the experiment, 16 native speakers produced target sentences presented in three different prosodic conditions: default reading, NP1-contrast, and NP2-contrast. The production data presented three crucial characteristics in the phonetic manifestations of prominence-induced prosodic strengthening in Seoul Korean. First, identificational focus gave rise to temporal expansion and pitch enhancement over the constructions under the focus. Second, contrastive focus brought about modification of temporal, pitch, and prosodic structures as well as pre- and post-focus compression. Finally, the two different types of prominence marking interacted with each other; the prosodic realization of contrastive focus overrode the prosodic realization of identificational focus, which was in line with the formal (syntactic) distinction of the two types of focus. To conclude, the current study demonstrates the interplay of information structure and discourse contexts in prosodic strengthening effects induced by prominence, especially in Seoul Korean, which lacks lexical stress and pitch accent.

In this study, a new rupture disk corrosion test (RDCT) method was developed for real-time detection of stress corrosion cracking (SCC) initiation of Alloy 600 in a primary water environment of pressurized water reactors. In the RDCT method, one side of a disk specimen was exposed to a simulated primary water at high temperature and pressure while the other side was maintained at ambient pressure, inducing a dome-shaped deformation and tensile stress on the specimen. When SCC occurs in the primary water environment, it leads to the specimen rupture or water leakage through the specimen, which can be detected in real-time using a pressure gauge. The tensile stress applied to the disk specimen was calculated using a finite element analysis. The tensile stress was calculated to increase as the specimen thickness decreased. The SCC initiation time of the specimen was evaluated by the RDCT method, from which result it was found that the crack initiation time decreased with the decrease of specimen thickness owing to the increase of applied stress. After the SCC initiation test, many cracks were observed on the specimen surface in an intergranular fracture mode, which is a typical characteristic of SCC in the primary water environment.

After radical gastrectomy for gastric cancer, patients should be monitored from two perspectives. One is local recurrence or metastasis, and the other is nutritional and metabolic side effects. Herein, we report a case of severe osteoporosis that was misunderstood for bone metastasis due to increased bone scan and positron emission tomography–computed tomography uptake in the patient who underwent total gastrectomy and consecutive multivisceral metastasectomy. She was administered bisphosphonates, calcium carbonate, and cholecalciferol. After 3 months, a follow-up bone scan revealed decreased intensity of hot-uptake lesions, healed fracture lesions, and eventually improved bone pain. This study supports the need for careful nutritional screening as well as cancer surveillance after gastrectomy for gastric cancer and the need for screening guidelines for bone metabolic diseases.

Summary: Regeneration of electron carriers such as NAD+/NADH is highly desirable and essential for enzymatic conversions. Here, we demonstrate a sustainable strategy for the regeneration of NAD+ as an electron carrier via photon-assisted heterogeneous catalysis. For this, a mid-gap state induced nitrogen-rich polymeric carbon nitride (NPCN) catalyst was synthesized by an additive-assisted thermal copolymerization. Utilizing NPCN as a photocatalyst presented NADH photooxidation efficiency of over 98% and a high hydrogen production rate of 11.18 mmolg−1h−1 with an apparent quantum yield of 9.16% (λ = 420 nm), outperforming other state-of-art metal-free photocatalysts. The experimental and theoretical simulations suggest that mid-gap states in NPCN catalyst are main platform for charge-carrier separation that enhances the overall photocatalytic performance.

PurposeThe discrepancy between preoperative and final pathological staging has been a long-standing challenge for the application of clinical trials or appropriate treatment options. This study aimed to demonstrate the accuracy of preoperative staging of locally advanced gastric cancer using data from a large-scale randomized clinical trial.Materials and methodsOf the 1050 patients enrolled in the clinical trial, 26 were excluded due to withdrawal of consent (n = 20) or non-surgery (n = 6). The clinical and pathological staging was compared. Risk factor analysis for underestimation was performed using univariate and multivariate analyses.ResultsRegarding T staging by computed tomography, accuracy rates were 74.48, 61.62, 58.56, and 85.16% for T1, T2, T3 and T4a, respectively. Multivariate analysis for underestimation of T staging revealed that younger age, ulcerative gross type, circular location, larger tumor size, and undifferentiated histology were independent risk factors. Regarding nodal status estimation, 54.9% of patients with clinical N0 disease were pathologic N0, and 36.4% of patients were revealed to have pathologic N0 among clinical node-positive patients. The percentage of metastasis involvement at the D1, D1+, and D2 lymph node stations significantly increased with the advanced clinical N stage. Among all patients, 29 (2.8%), including 26 with peritoneal seeding, exhibited distant metastases.ConclusionsEstimating the exact pathologic staging remains challenging. A thorough evaluation is mandatory before treatment selection or trial enrollment. Moreover, we need to set a sufficient case number when we design the clinical trial considering the stage migration.

The course-keeping stability of a high speed planing boat should be considered at the design stage for its safe operations. The shape of waterjet intake plane is one of important design parameters of a waterjet propelled planing boat. That has significant influences on the stern flow patterns and pressure distributions. In this study, the effects of the waterjet intake shapes of planing boats on the course-keeping stabilities are investigated. Two kinds of designed planing boats have the same dimensions, but there are differences in waterjet intake plane shapes. Captive and free-running model tests, Computational Fluid Dynamics (CFD) analyses are carried out in order to estimate their hydrodynamic performances including course-keeping stabilities. The results show that the flat and wide waterjet intake plane of the initially designed boat makes the course-keeping stability worse. The waterjet intake shape is re-designed to improve the course-keeping stability. The improved performances are confirmed by free-running model tests and full-scale trials.

Maritime accidents not only incur loss of human lives and physical damages to ships but also cause negative impact on marine safety weakening national competitiveness in maritime transportation. The government established national level plans to reduce maritime accidents. Fishing vessel accidents, among others, take up around 70% of the total maritime accidents in Korean waters.However, researches on fishing vessel accidents have not been studied much compared to commercial ship cases. In this regard, we evaluate risk level of fishing vessel accident with the fuzzy comprehensive evaluation method, where a fuzzy membership function is applied in an attempt to reduce the degree of uncertainty inherited in the given data.For the comprehensive (overall) risk, 9 types of fishing vessel accident are analyzed over the period of 1988–2016 years and risk value is compared against fuzzy risk criteria to determine the risk level. Also risks of each type of accident are calculated and classified into different risk levels.Since the comprehensive risks are calculated on a 100 scale on a yearly basis changes in risk levels are easily visualized year by year. The results obtained from our analysis will help a decision maker establish proper risk reduction measures to mitigate different types of accident and manage effectively the limited and/or scare resources to be employed. The evaluation method can be applied to risk estimation of other sea transportation accidents.

Abstract Background The blood-brain barrier has been a hindrance to developing blood-based diagnostic tests for dementias, as it limits the appearance of brain biomarkers in the blood. Our aim was to see if the natural opening of the blood-brain barrier induced by ischemic stroke would increase serum levels of inflammatory biomarkers known to be elevated in the brains of patients with Alzheimer’s disease and other neurodegenerative dementias. Methods Forty-three patients with acute ischemic stroke presenting to Stony Brook University Hospital were prospectively enrolled in the study. Eight of these patients were clinically diagnosed as having an underlying neurodegenerative dementia. Blood was drawn acutely within 72 h of stroke symptom onset, and serum levels of the classic inflammatory biomarkers, interleukin-6 (IL-6) and C-reactive protein (CRP) were measured, along with levels of S100B protein (S100B) and complement C3 (CC3). Results Serum levels of IL-6 and CRP in patients with acute ischemic stroke and underlying dementia (AIS + D) were significantly higher (p = 0.002 and 0.003, respectively) than in patients with acute ischemic stroke alone (AIS). Serum levels of S100B and CC3 did not differ significantly between the groups. Conclusions This study supports the possibility that opening of the blood-brain barrier may enhance the blood appearance of brain tissue markers of inflammation associated with neurodegenerative dementia. Further study is warranted to test this possibility, given the recent emergence of methods to open the blood-brain barrier for diagnostic or therapeutic purposes.

The corrosion rates of the reactor pressure vessel materials of SA508 Grade 3 were measured using a weight loss method in aerated boric acid solutions to simulate the evaporation of leaked PWR primary water in an ambient environment. The corrosion behavior and products were examined using X-ray diffraction and electron microscopy. SA508 showed typical general corrosion characteristics. The corrosion rate increased steadily as the boron concentration was increased. As the immersion time elapsed, the corrosion rate slowly or rapidly decreased according to the oxidation reaction of iron. The corrosion rate showed a complicated pattern depending on the temperature; it increased gradually and then rapidly decreased again when reaching a certain transition temperature. The corrosion products of SA508 were found to be FeO(OH), Fe2O3, and Fe3O4. As the boron concentration decreased and the temperature was increased, the formation of Fe3O4 was more favorable as compared to the formation of FeO(OH) and Fe2O3. Consequently, the changes of the corrosion rate and behavior were closely related to the oxidation reaction of iron on the surface. The corrosive damage to SA508 appears to be most severe when the oxidation reaction is such that Fe2O3 forms as a corrosion product.

A large percentage of maritime accidents in coastal seas are related to small fishing vessels. In order to investigate causes of maritime accidents, it is often necessary to carry out dynamic simulations for the estimation of trajectories and motions of vessels. Initial conditions of vessels such as main dimensions, loading conditions and hydrostatic properties are required for the accurate simulations. Small fishing vessels usually have few records of hydrostatic properties during their fishing operations. Therefore, in this study, estimation procedures for hydrostatic properties of small fishing vessels are proposed. At first, hull form characteristics of Korean small fishing vessels are investigated. Most of vessels have hard-chines and centerline skegs, they have similar hull forms. Bonjean curves of several small fishing vessels whose gross tonnages are below 10 tons are normalized with vessel breadths and depths. Representative bonjean curves are derived from normalized bonjean curves, and a representative hull plan is obtained as well. If the vessel loading conditions such as total weights and centers of gravity are given, fore and aft drafts can be calculated by using the representative bonjean curves with the constraint that weights and buoyancies are in equilibrium. Metacentric heights are also estimated by using the representative hull plan. Drafts and metacentric heights estimated by proposed iterative estimation procedures are compared with actual vessel data, estimated values are in good agreements with actual values. In addition, normalized fore and aft drafts, metacentric heights of vessels can be formulated as the linear functions of normalized total weights and centers of gravity. Empirical formulas of drafts and metacentric heights are proposed, and it is confirmed that the empirical formulas also provide reasonable results, which are similar to the results by iterative estimation procedures with representative bonjean curves and hull plan.

Summary: Background/Objective: The comprehensive complication index (CCI) was developed following the Clavien-Dindo classification (CDC) to more properly reflect various complications that occur in one patient. In this study, we performed a prospective observational study to validate the usefulness of CCI in a small-volume hospital. Methods: From March 2017 to February 2018, among the patients who had scheduled surgery with general anesthesia in the Department of Surgery in St. Paul hospital in Korea, 240 patients were enrolled after informed consent. A minor-risk surgery, such as appendectomy, and surgery for inguinal hernia were excluded. The complications were estimated in both CDC and CCI in each patient. Patients were investigated with the EORCT-C30 quality of life questionnaire before and after surgery, and the relationship between CCI score and change in the quality of life was evaluated. Results: There were 26 (10.83%), 41 (17.08%), 8 (3.33%), 3 (1.25%), 4 (1.67%), and 2 (0.83%) patients who were classified as grades I, II, IIIa, IIIb, IVa, and IVb, respectively. The average CCI was 22.94 ± 12.79, and distribution ranged from 8.66 to 76.40. CCI was well distributed in patients with complications more than CDC grade. While there was no correlation between preoperative Charlson comorbidity index with CCI, pain scale, and cognitive scale were aggravated significantly when CCI increased. Conclusion: CCI reflected the complication status with a more detailed distribution compared with CDC. Moreover, CCI had a significant relation with pain and the cognitive function scale. CCI might be a useful complication grading system in a small-volume surgical department. Keywords: Complication, General surgery, Classification, Comorbidity

The crack growth responses of as-received and as-welded Alloy 600/182 and Alloy 690/152 welds to constant loading were measured by a direct current potential drop method using compact tension specimens in primary water at 325 °C simulating the normal operating conditions of a nuclear power plant. The as-received Alloy 600 showed crack growth rates (CGRs) between 9.6 × 10−9 mm/s and 3.8 × 10−8 mm/s, and the as-welded Alloy 182 had CGRs between 7.9 × 10−8 mm/s and 7.5 × 10−7 mm/s within the range of the applied loadings. These results indicate that Alloys 600 and 182 are susceptible to cracking. The average CGR of the as-welded Alloy 152 was found to be 2.8 × 10−9 mm/s. Therefore, Alloy 152 was proven to be highly resistant to cracking. The as-received Alloy 690 showed no crack growth even with an inhomogeneous banded microstructure. The cracking mode of Alloys 600 and 182 was an intergranular cracking; however, Alloy 152 was revealed to have a mixed (intergranular + transgranular) cracking mode. It appears that the Cr concentration and the microstructural features significantly affect the cracking resistance and the cracking behavior of Ni-base alloys in PWR primary water. Keywords: Alloys 600/182, Alloys 690/152, Welding, PWSCC, Crack growth rate, Crack propagation

Chemical doping is a viable strategy to tune the electrical properties of pristine graphene, but suffers from stability issues. Here, the authors develop a macromolecular chemical doping approach that makes use of polymeric acid and provides high stability.

PURPOSE The purpose of this study was to investigate effects of activity tracker & application use on adherence, metabolic syndrome factor and body composition of middle and senior-aged. METHODS The subjects of this study were 1,196 middle and senior-aged man and women with health hazard factor. All of subjects divided to two groups, activity tracker & application use group 990(man=492, women=498) was participating in 24 weeks, and control group 206(man=71, women=135) was not in that program. They performed physical activity utilizing activity tracker & application for 24 weeks. The following items were measured before, middle and after the program : physical activity adherence, metabolic syndrome factor and body composition. RESULTS Results of this study showed that physical activity adherence appeared nothing in drop-rate of male(9.35%) and female(8.63%) : So adherence were male(90.65%) and female(91.37%). And changes of metabolic syndrome factor variables were significantly improved in total cholesterol, triglyceride, systolic blood pressure, and glucose in activity tracker & application use group and control group after 24 weeks. Also, body composition were showed significantly different in BMI, weight, waist. CONCLUSIONS Activity tracker & application use accompanied regular physical activity were effective in middle and senior-aged health promotion. This results can be utilized not only in new health promotion program of public health center but also in a local resident health management strategies.

Recent studies concerning graphene quantum dots (GQDs) focus extensively on their application in biomedicine, exploiting their modifiable optical properties and ability to complex with various molecules via π–π or covalent interactions. Among these nascent findings, the potential therapeutic efficacy of GQDs was reported against Parkinson’s disease, which has to date remained incurable. Herein, we present an environmentally friendly approach for synthesizing GQDs through a waste-to-treasure method, specifically from coffee waste to nanodrug. Consistent with the previous findings with carbon fiber-derived GQDs, the inhibitory effects of coffee bean-derived GQDs demonstrated similar effectiveness against abnormal α-synuclein fibrillation and the protection of neurons from relevant subcellular damages. The fact that a GQDs-based nanodrug can be prepared from a non-reusable yet edible source illustrates a potential approach to convert such waste materials into novel therapeutic agents with minimal psychological rejection by patients.

Purpose: Intra-corporeal esophagojejunostomy (EJ) using a linear stapler creates a stapler entry hole that requires secure closure during the totally laparoscopic total gastrectomy (TLTG) procedure for gastric cancer. Since a standard method has not been established yet, the feasibility of using V-loc 180 (Covidien, Mansfield, MA, USA) suture material was evaluated in this study. Materials and methods: During January 2012 to March 2015, 25 patients who underwent linear stapling EJ and V-loc 180 closure of remaining enterotomy were included in this study. Basic clinico-pathological characteristics, surgical outcomes, and short-term complications were analyzed. Results: The mean patient age was 60.4 ± 8.5 years. Nineteen males and six females were included in this study. The mean body mass index was 25.3 ± 2.3 kg/m2. There were 22 stage-I, 2 stage-II, and 1 stage-III gastric cancer patients. The mean operation time was 240.5 ± 44.6 min, and the time for anastomosis was 38.8 ± 11.2 min. The procedures were successfully performed in all cases without any intra-operative complications. There was one case of EJ leakage that occurred at the corner of EJ staple line and not at the enterotomy closure site. Conclusions: The closure of the remaining enterotomy site using V-loc 180 suture following linear stapler EJ is technically feasible and safe during the TLTG procedure. However, further experience and results from other surgeons are necessary to generalize this procedure.

Background: Recent studies have demonstrated the benefits of off-pump coronary bypass grafting over the on-pump technique in patients with chronic kidney disease (CKD). To further reduce the risk of acute kidney injury and the need for renal replacement therapy, even in patients undergoing off-pump coronary artery bypass grafting, we adopted protocol-based perioperative management for patients with CKD. Methods: From December 2012 to March 2015, 265 patients underwent isolated off-pump coronary artery bypass grafting. To analyze renal function in a stable condition, we excluded 12 dialysis-dependent end stage renal failure and 10 emergency or urgent cases. Among the remaining 243 patients, 208 patients had normal kidney function (normal group), and 35 patients had CKD (CKD group). Minimizing contrast exposure, ensuring adequate hydration, using strict drug dosage adjustment, and optimizing hemodynamic status were key elements of the protocol for the CKD group. Results: The risk of acute kidney injury was about ×3 higher in the CKD group than in the normal group (p=0.01). Estimated glomerular filtration rates and serum creatinine levels deteriorated until the third postoperative day in the CKD group. However, by adopting protocol-based perioperative management, this transient renal dysfunction recovered to preoperative levels by the fifth postoperative day without requiring renal replacement therapy in all cases. Conclusion: Off-pump coronary bypass surgery combined with this protocol-based perioperative management strategy in patients with non-dialysis-dependent CKD could mostly be performed without renal replacement therapy.

To date, many population pharmacokinetic models of antibiotics have been developed using blood sampling data after the fourth or fifth dose, which represents steady-state levels. However, if a model developed using blood sampled after the first dose is equivalent to that using blood sampled after the fourth dose, it would be advantageous to utilize the former. The aim of this study was to investigate the effect of blood sampling after the first and/or fourth drug administration on the accuracy and precision of parameter estimates. A previously reported robust, two-compartment model of vancomycin was used for simulation to evaluate the performances of the parameter estimates. The parameter estimation performances were assessed using relative bias and relative root mean square error. Performance was investigated in 72 scenarios consisting of a combination of two blood sampling periods (the first and fourth dose), two total clearances, three infusion times, and four sample sizes. The population pharmacokinetic models from data collected at the first dose and those collected at the fourth dose produced parameter estimates that were similar in accuracy and precision. This study will contribute to increasing the efficiency and simplicity of antibiotic pharmacokinetic studies.

Here, we provide the possibility of a novel chemotherapeutic agent against gastric cancer cells, comprising the combination of 5-fluorouracil (5-FU) and a mitochondria-targeting self-assembly peptide, which is a phenylalanine dipeptide with triphenyl phosphonium (Mito-FF). The anticancer effects and mechanisms of 5-FU and Mito-FF, individually or in combination, were compared through both in vitro and in vivo models of gastric cancer. Our experiments consistently demonstrated that the 5-FU and Mito-FF combination therapy was superior to monotherapy with either, as manifested by both higher reduction of proliferation as well as an induction of apoptotic cell death. Interestingly, we found that combining 5-FU with Mito-FF leads to a significant increase of reactive oxygen species (ROS) and reduction of antioxidant enzymes in gastric cancer cells. Moreover, the inhibition of ROS abrogated the pro-apoptotic effects of combination therapy, suggesting that enhanced oxidative stress could be the principal mechanism of the action of combination therapy. We conclude that the combination of 5-FU and Mito-FF exerts potent antineoplastic activity against gastric cancer cells, primarily by promoting ROS generation and suppressing the activities of antioxidant enzymes.

Background: We report our initial experiences of robot-assisted cardiac surgery using the da Vinci Surgical System. Methods: Between February 2010 and March 2014, 50 consecutive patients underwent minimally invasive robot-assisted cardiac surgery. Results: Robot-assisted cardiac surgery was employed in two cases of minimally invasive direct coronary artery bypass, 17 cases of mitral valve repair, 10 cases of cardiac myxoma removal, 20 cases of atrial septal defect repair, and one isolated CryoMaze procedure. Average cardiopulmonary bypass time and average aorta cross-clamping time were 194.8±48.6 minutes and 126.1±22.6 minutes in mitral valve repair operations and 132.0±32.0 minutes and 76.1±23.1 minutes in myxoma removal operations, respectively. During atrial septal defect closure operations, the average cardiopulmonary bypass time was 128.3±43.1 minutes. The median length of stay was between five and seven days. The only complication was that one patient needed reoperation to address bleeding. There were no hospital mortalities. Conclusion: Robot-assisted cardiac surgery is safe and effective for mitral valve repair, atrial septal defect closure, and cardiac myxoma removal surgery. Reducing operative time depends heavily on the experience of the entire robotic surgical team.

Background: This study aimed to investigate sternal healing over time and the incidence of poor sternal healing in patients undergoing coronary artery bypass graft (CABG) surgery using bilateral internal thoracic arteries. Methods: This study enrolled 197 patients who underwent isolated CABG using skeletonized bilateral internal thoracic arteries (sBITA) from 2006 through 2009. Postoperative computed tomography (CT) angiography was performed on all patients at monthly intervals for three to six months after surgery. In 108 patients, an additional CT study was performed 24 to 48 months after surgery. The axial CT images were used to score sternal fusion at the manubrium, the upper sternum, and the lower sternum. These scores were added to evaluate overall healing: a score of 0 to 1 reflected poor healing, a score of 2 to 4 was defined as fair healing, and a score of 5 to 6 indicated complete healing. Medical records were also retrospectively reviewed to identify perioperative variables associated with poor early sternal healing. Results: Three to six months after surgery, the average total score of sternal healing was 2.07±1.52 and 68 patients (34.5%) showed poor healing. Poor healing was most frequently found in the manubrium, which was scored as zero in 72.6% of patients. In multivariate analysis, the factors associated with poor early healing were shorter post-surgery time, older age, diabetes mellitus, and postoperative renal dysfunction. In later CT images, the average sternal healing score improved to 5.88±0.38 and complete healing was observed in 98.2% of patients. Conclusion: Complete sternal healing takes more than three months after a median sternotomy for CABG using sBITA. Healing is most delayed in the manubrium.

Accumulation of abnormal tau aggregates in neuron is an important pathological signature in multiple neurodegenerative disorders including Alzheimer's disease. Tau is a neuron specific microtubule-associated protein that regulates microtubule stability, which is critical for axonal outgrowth and synaptic plasticity. In a pathological condition, tau dissociates from microtubules and forms insoluble aggregates called neurofibrillary tangles (NFTs). The accumulation of NFTs in neuron directly correlates with microtubule dysfunction and neuronal degeneration. Due to the pathophysiological importance of tau, great efforts have been made to understand tau aggregation processes and find therapeutics to halt or reverse the processes. However, progress has been slow due to the lack of a suitable method for monitoring tau aggregation. In this mini-review, we will review the conventional methods for studying tau aggregation, and introduce recent cell-based sensor approaches that allow monitoring tau aggregation in living cells.

This study presents a UV embossing process to fabricate high aspect ratio silver grid transparent electrodes on a polymer film. Transparent electrodes with a high optical transmittance (93 %) and low sheet resistance (4.6 Ω/sq) were fabricated without any high temperature or vacuum processes. The strong adhesion force between the UV resin and the silver ink enables the fabrication of silver microstructures with an aspect ratio higher than 3. The high aspect ratio results in a low sheet resistance while maintaining a high optical transmittance. Multi-layer transparent electrodes were fabricated by repeating the proposed UV process. Additionally, a large-area of 8-inch touch panel was fabricated with the proposed UV process. The proposed UV process is a relatively simple and low cost process making it suitable for large-area production as well as mass production.

High-speed vessels require good resistance and seakeeping performance for safe operations in rough seas. The resistance and seakeeping performance of high-speed vessels varies significantly depending on their hull forms. In this study, three planing hulls that have almost the same displacement and principal dimension are designed and the hydrodynamic characteristics of those hulls are estimated by high-speed model tests. All model ships are deep-V type planing hulls. The bows of no.2 and no.3 model ships are designed to be advantageous for wave-piercing in rough water. No. 2 and no. 3 model ships have concave and straight forebody cross-sections, respectively. And length-to-beam ratios of no.2 and no.3 models are larger than that of no.1 model. In calm water tests, running attitude and resistance of model ships are measured at various speeds. And motion tests in regular waves are performed to measure the heave and pitch motion responses of the model ships. The required power of no.1 (VPS) model is smallest, but its vertical motion amplitudes in waves are the largest. No.2 (VWC) model shows the smallest motion amplitudes in waves, but needs the greatest power at high speed. The resistance and seakeeping performance of no.3 (VWS) model ship are the middle of three model ships, respectively. And in regular waves, no.1 model ship experiences ‘fly over’ phenomena around its resonant frequency. Vertical accelerations at specific locations such as F.P., center of gravity of model ships are measured at their resonant frequency. It is necessary to measure accelerations by accelerometers or other devices in model tests for the accurate prediction of vertical accelerations in real ships.

The primary water stress corrosion cracking (PWSCC) of Alloy 600 in a PWR has been reported in the control rod drive mechanism (CRDM), pressurizer instrumentation, and the pressurizer heater sleeves. Recently, two cases of boric acid precipitation that indicated leaking of the primary cooling water were reported on the bottom head surface of steam generators (SG) in Korea. The PWSCC resistance of Ni base alloys which have intergranular carbides is higher than those which have intragranular carbides. Conversely, in oxidized acidic solutions like sodium sulfate or sodium tetrathionate solutions, the Ni base alloys with a lot of carbides at the grain boundaries and shows less stress corrosion cracking (SCC) resistance. The role of grain boundary carbides in SCC behavior of Ni base alloys was evaluated and effect of intergranular carbides on the SCC susceptibility were reviewed from the literature.

OBJECTIVE:Although dipeptidyl peptidase-4 (DPP-4) inhibitors have been suggested to have a non-glucoregulatory protective effect in various tissues, the effects of long-term inhibition of DPP-4 on the micro- and macro-vascular complications of type 2 diabetes remain uncertain. The aim of the present study was to investigate the organ-specific protective effects of DPP-4 inhibitor in rodent model of type 2 diabetes. METHODS:Eight-week-old diabetic and obese db/db mice and controls (db/m mice) received vehicle or one of two doses of gemigliptin (0.04 and 0.4%) daily for 12 weeks. Urine albumin excretion and echocardiography measured at 20 weeks of age. Heart and kidney tissue were subjected to molecular analysis and immunohistochemical evaluation. RESULTS:Gemigliptin effectively suppressed plasma DPP-4 activation in db/db mice in a dose-dependent manner. The HbA1c level was normalized in the 0.4% gemigliptin, but not in the 0.04% gemigliptin group. Gemigliptin showed a dose-dependent protective effect on podocytes, anti-apoptotic and anti-oxidant effects in the diabetic kidney. However, the dose-dependent effect of gemigliptin on diabetic cardiomyopathy was ambivalent. The lower dose significantly attenuated left ventricular (LV) dysfunction, apoptosis, and cardiac fibrosis, but the higher dose could not protect the LV dysfunction and cardiac fibrosis. CONCLUSION:Gemigliptin exerted non-glucoregulatory protective effects on both diabetic nephropathy and cardiomyopathy. However, high-level inhibition of DPP-4 was associated with an organ-specific effect on cardiovascular complications in type 2 diabetes.

In both Northern Ireland and Korea, the euphoria following significant breakthroughs towards peace in the late 1990s and early 2000s turned into deep frustration when confronted by continuous stalemates in implementing the agreements. I explore the two peace processes by examining and comparing the breakthroughs and breakdowns of both, in order to identify potential lessons that can be shared for a sustainable peace process. Using a comparative case study, I demonstrate the parallels in historical analyses of why the agreements in the late 1990s and early 2000s in Northern Ireland and Korea were expected to be more durable than those of the 1970s. I also examine the differences between the two peace processes in the course of addressing major challenges for sustaining the two processes: disarmament; relationships between hard-line parties; cross-community initiatives. These parallels and differences inform which lessons can be shared between Northern Ireland and Korea to increase the durability of the peace processes. The comparative case study finds that the commitment of high-level leadership in both conflict parties to keeping negotiation channels open for dialogue and to allowing space for civic engagement is crucial in a sustainable peace process, and that sharing lessons between the two peace processes can be beneficial in finding opportunities to overcome challenges and also for each process to be reminded of lessons from its own past experience.

Nature Communications 6: Article number: 8997 (2015); Published: 8 December 2015; Updated: 15 February 2016 This Article contains errors in Figs 3 and 4. In Fig. 3h, the x axis should have been labelled ‘TG’, and in Fig. 4a, labels denoting the EPPS dose for each image were inadvertently removed. The correct versions of these two figures follow.

Alzheimer's disease is an irreversible neurodegenerative disorder that is characterized by the abnormal aggregation of amyloid-β into neurotoxic oligomers and plaques. Although many disease-modifying molecules are currently in Alzheimer clinical trials, a small molecule that inhibits amyloid-β aggregation and ameliorates the disorder has not been approved to date. Herein, we report the effects of a potent small molecule, 6-methoxy-2-(4-dimethylaminostyryl) benzofuran (KMS88009), that directly disrupts amyloid-β oligomerization, preserving cognitive behavior when used prophylactically and reversing declines in cognitive behavior when used therapeutically. KMS88009 exhibited excellent pharmacokinetic profiles with extensive brain uptake and a high level of safety. When orally administered before and after the onset of Alzheimer's disease symptoms, KMS88009 significantly reduced assembly of amyloid-β oligomers and improved cognitive behaviors in the APP/PS1 double transgenic mouse model. The unique dual mode of action indicates that KMS88009 may be a powerful therapeutic candidate for the treatment of Alzheimer's disease.

Abnormal tau aggregation is a pathological hallmark of many neurodegenerative disorders and it is becoming apparent that soluble tau aggregates play a key role in neurodegeneration and memory impairment. Despite this pathological importance, there is currently no single method that allows monitoring soluble tau species in living cells. In this regard, we developed a cell-based sensor that visualizes tau self-assembly. By introducing bimolecular fluorescence complementation (BiFC) technique to tau, we were able to achieve spatial and temporal resolution of tau-tau interactions in a range of states, from soluble dimers to large aggregates. Under basal conditions, tau-BiFC cells exhibited little fluorescence intensity, implying that the majority of tau molecules exist as monomers. Upon chemically induced tau hyperphosphorylation, BiFC fluorescence greatly increased, indicating an increased level of tau-tau interactions. As an indicator of tau assembly, our BiFC sensor would be a useful tool for investigating tau pathology.