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Purpose The use of intraoperative colonoscopy (IOC) to evaluate the integrity of newly created anastomosis has been advocated by some surgeons. However, it is still unclear whether direct visualization of fresh anastomosis can help reduce anastomotic problems. This study investigates the impact of immediate endoscopic assessment of colorectal anastomosis on anastomotic problems. Methods This is a retrospective cohort study conducted at a single center. Of 1210 patients undergoing radical resection for colorectal cancer from 2017 to 2021, 649 patients who underwent stapled anastomosis for left-sided colorectal cancer were included in the study. The anastomotic complications were compared between patients who underwent IOC immediately after creating the colorectal anastomosis and those who did not. Additionally, patients with subsequent intervention after the IOC assessment were compared to those without the intervention. Results Of 541 patients with IOC assessment, twenty-seven patients (5.0%) developed anastomotic leakage, and six (1.1%) experienced anastomotic bleeding postoperatively. The anastomotic leakage rate was similar to that in patients who did not undergo IOC (4.6%). Of the patients with IOC, 70 patients (12.9%) received reinforcement sutures to secure anastomotic stability. Of 70 patients, thirty-nine (55.7%) showed abnormal findings of mucosal edema, stapler disruption, bleeding, and air leakage in IOC. Thirty-seven patients (94.9%) who underwent reinforcement sutures did not develop postoperative anastomotic problems; however, two patients developed postoperative anastomotic leakage. Those two patients underwent reoperation due to proximal limb ischemia. Conclusion This study demonstrates that IOC assessment with reinforcement sutures does not imminently reduce the rate of anastomotic complications in stapled left-sided colorectal anastomosis. However, its routine use may play a role in detecting early technical failure and preventing postoperative anastomotic complications in some patients. Regarding its limitation in detecting progressive ischemia, an investigation into the indocyanine green (ICG) test combined with the endoscopic assessment would help elucidate the optimal anastomosis condition.

Patients with stage IV colorectal cancer (CRC) who have not undergone primary tumor resection (PTR) are at risk of sudden medical emergencies. Despite the ongoing controversy over the necessity and timing of PTR in patients with stage IV CRC, studies comparing the survival outcomes of elective and emergency surgery in this population are scarce. This is a retrospective study conducted at a single institute. The patients were divided into two groups: the elective surgery (ELS) group (n = 46) and the emergency surgery (EMS) group (n = 26). The primary outcome was 2-year overall survival (OS). During a median follow-up period of 27.0 months, the 2-year OS was significantly better in the ELS group (80% vs. 42.9%, p = 0.002). No significant differences were observed in the 2-year relapse-free survival and 30-day postoperative complication rates. Planning and performing elective surgery could help increase the survival rate of patients with synchronous stage IV CRC, especially those that undergo simultaneous or staged metastasectomy.

Purpose: The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol.Methods: Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution’s ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM).Results: After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups.Conclusion: SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

Background Nurses are presumably the first to see an in-hospital cardiac arrest patient. This study proposed measuring nursing students’ knowledge, self-efficacy, and skills performance in advanced life support (ALS), 6 months after training, by sending videos taken during their final skills test after the ALS training. Methods This is an experimental study using a randomised control group design. This study was conducted from June to December 2018, and the subjects of the study were 4th year students, recruited through a bulletin board at a nursing university. The participants’ knowledge, self-efficacy, and skill performance in ALS were evaluated immediately after the training, and participants were videotaped during the final skills test. Thereafter, the videos were sent to the experimental group through a mobile phone messenger application, once a month, from the third month after training. Approximately six months after training day, a follow-up test was conducted for the measured variables using a blinded method. The paired t-test and Wilcoxon signed-rank test were used to compare the two groups pre-and post-intervention. The statistical significance level was set at p Results Six months after the ALS training, knowledge scores decreased significantly in both groups (p p = 0.089), while it decreased by 10 points in the control group, from 50.67 to 39 (p p Conclusion Self-study with videos taken during an ALS skills test helps enhance the sustainable effects of training such as knowledge, self-efficacy, and skills performance.

The use of intraoperative colonoscopy (IOC) to evaluate the integrity of newly created anastomosis has been advocated by some surgeons. However, whether direct visualization of fresh anastomosis can help reduce anastomotic problems is still unclear. This study investigates the impact of immediate endoscopic assessment of colorectal anastomosis on anastomotic problems. This is a retrospective study conducted at a single center. Among six hundred forty-nine patients who underwent stapled anastomosis for left-sided colorectal cancer, the anastomotic complications were compared between patients who underwent IOC and those who did not. Additionally, patients with subsequent intervention after the IOC were compared to those without the intervention. Twenty-seven patients (5.0%) developed anastomotic leakage, and six (1.1%) experienced anastomotic bleeding postoperatively. Of the patients with IOC, 70 patients received reinforcement sutures to secure anastomotic stability. Of 70 patients, 39 patients showed abnormal findings in IOC. Thirty-seven patients (94.9%) who underwent reinforcement sutures did not develop postoperative anastomotic problems. This study demonstrates that IOC assessment with reinforcement sutures does not imminently reduce the rate of anastomotic complications. However, its use may play a role in detecting early technical failure and preventing postoperative anastomotic complications.

The nanoscale spatiotemporal resolution of single-particle tracking (SPT) renders it a powerful method for exploring single-molecule dynamics in living cells or tissues, despite the disadvantages of using traditional organic fluorescence probes, such as the weak fluorescent signal against the strong cellular autofluorescence background coupled with a fast-photobleaching rate. Quantum dots (QDs), which enable tracking targets in multiple colors, have been proposed as an alternative to traditional organic fluorescence dyes; however, they are not ideally suitable for applying SPT due to their hydrophobicity, cytotoxicity, and blinking problems. This study reports an improved SPT method using silica-coated QD-embedded silica nanoparticles (QD2), which represent brighter fluorescence and are less toxic than single QDs. After treatment of QD2 in 10 μg/mL, the label was retained for 96 h with 83.76% of labeling efficiency, without impaired cell function such as angiogenesis. The improved stability of QD2 facilitates the visualization of in situ endothelial vessel formation without real-time staining. Cells retain QD2 fluorescence signal for 15 days at 4 °C without significant photobleaching, indicating that QD2 has overcome the limitations of SPT enabling long-term intracellular tracking. These results proved that QD2 could be used for SPT as a substitute for traditional organic fluorophores or single quantum dots, with its photostability, biocompatibility, and superior brightness.

To evaluate the efficacy and safety of an injectable lyophilized articular cartilage matrix (LACM) which is in the form of cartilage powder that may increase the convenience of use and become unaffected by donor site morbidity as a potential filler.The safety test was conducted using 20 rabbits with an intravascular embolization model. Commonly used commercial hyaluronic acid (HA), acellular dermal matrix (ADM), polymethyl methacrylate (PMMA), and polylactic acid (PLA) products were selected for comparison of efficacy and adverse effect of LACM. The efficacy test was performed using 30 mice subcutaneous buttock-injection model. Gross assessments of the changes in size of injected materials and histological examinations were conducted.Regarding the safety test, in one rabbit in the HA group, complete blurring occurred in the left eye, and necrosis of the posterior auricular artery was observed in one rabbit in the ADM group. In the ADM, severe ecchymosis around the injection sites was observed, and the bruises lasted longer than in the other groups. The LACM exhibited faster bruise resolution. Comparing the changes in size between weeks 4 and 12 in the mouse model, no significant changes in size were observed in the LACM (p = 0.359), HA (p = 0.421), and ADM (p = 0.097), but a significant change was observed in the PMMA (p = 0.001). In the histological examination, LACM exhibited well-demarcated margins with good biocompatibility.The LACM shows potential as a facial filler according to the in vivo safety and efficacy tests LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Background In-hospital cardiac arrests account for 80% of hospital deaths, and the survival rate is not significantly different from that of pre-hospitalized cardiac arrest patients. The nurses would presumably be the first to see an in-hospital cardiac arrest patient. This study proposed to measure nursing students’ knowledge, self-efficacy, and skills performance of advanced life support (ALS) 6 months after the training by sending their videos taken during the final skills test after the ALS training.Methods This is an experimental study with a randomized control group design. The participants’ knowledge, self-efficacy, and skill performance of ALS were evaluated immediately after the training and participants were videotaped during the final skills test. Thereafter, we sent the video to the experimental group through the mobile phone messenger application once a month from the third month after training. Approximately six months after the training day, we conducted a follow-up test of the measured variables using the blinded method.Results Six months after the ALS training, knowledge scores decreased significantly in both groups (pp = 0.089), while it decreased by 10 in the control group from 50.67 to 39 (pp< 0.001).Conclusion Self-study with videos taken during an ALS skills test helps enhance the sustainable effects of training, such as knowledge, self-efficacy, and skills performance.

This study aimed to evaluate the impact of multimodal postoperative pain management, performing a surgical rectus sheath (RS) block via ropivacaine injection into the surgical field after single-incision laparoscopic appendectomy (SILA). Patients who underwent single-incision laparoscopic appendectomy (SILA) for acute appendicitis were divided into three groups and compared: group 1 (multimodal pain management that included intraoperative application of a surgical RS block), group 2 (conventional pain management with intravenous opioids), or group 3 (multimodal pain management without RS block). Forty, 53, and 42 patients were registered, respectively (Table 1). Time to start a liquid (1.2 ± 0.4 h) in group 1 was statistically significantly shorter than that in group 2 (16.3 ± 8.4 h; p < 0.001) and group 3 (4.93 ± 2.3 h; p < 0.001). The median and max postoperative VAS scores in group 1 (1.6 ± 1.2 and 2.2 ± 1.8, respectively) were statistically significantly lower than that in group 2 (3.0 ± 1.2 and 4.2 ± 1.9, respectively; p < 0.001 on both accounts) and group 3 (2.9 ± 0.6 and 3.4 ± 1.2, respectively; p < 0.001 on both accounts). The postoperative hospital stay for group 1 (17.0 ± 9.4 h) was shorter than that for group 2 (44.7 ± 27.9 h; p < 0.001) and group 3 (35.4 ± 20.9 h; p < 0.001). RS block was a significant factor for reducing length of hospital stay and postoperative pain in 24 h. A surgical RS block combined with multimodal pain management after SILA is a safe and effective method that results in reduced postoperative pain and shorter hospitalization.

Bone morphogenetic protein 2 (BMP-2) is considered an effective growth factor for bone formation, and is used for making osteo-inductive scaffolds, but the related clinical investigations have shown low success rates. In this study, we genetically manipulated teratoma-derived fibroblast (TDF) cells by simultaneous introduction of BMP-2 and herpes simplex virus-thymidine kinase (HSV-tk) encoding genes. Self-production of BMP-2 in TDF cells strongly enhanced the alkaline phosphatase (ALP) activity, calcium content, and elevated the mRNA expression of osteogenic marker genes during in vitro osteogenesis. The bone formation volume was also remarkably enhanced in calvarial and femoral critical-size defect models. Ganciclovir (GCV) treatment induced apoptosis in TDF cells co-expressing HSV-tk and BMP-2, implying that HSV-tk suicide gene can modulate the side-effects of stem cell therapy, e.g., development of uncontrollable teratoma and tumor formation. Altogether, our findings revealed a safe and highly efficient technique with potential therapeutic applications for bone regeneration.

In animal experiments for EMF exposure, it is very important to estimate the SAR values accurately in animals. In this paper, we investigated the variation of SAR values in mice and rats, depending on the number and separation distance of animals and the existence of the water-supplying bottle. The whole-body of mice or rats in a cage were exposed in the reverberation chamber at CDMA and WCDMA frequencies. Simulation results show that the variation of the whole-body averaged SAR is larger when several animals are exposed in a cage, compared to the existence of water-supplying bottle and the amount of water. It turns out that compared to single mouse or rat is located in the cage, the maximum variation of the whole-body averaged SAR values for mice at 850 MHz and 1,950 MHz are 15.3 % and 14.9 % when three mice are located in the cage, and those for rats are 18.7 % and 21.1 % for each frequency when two rats are located in the cage. It is concluded that the variation of SAR values depending on the

Recently, we are simultaneously exposed by various electromagnetic sources due to an increase of mobile commu-nication services. However, EMF(Electric, Magnetic and Electromagnetic Field) study has been performed mainly about only single frequency. The objective of this paper is to develop an multiple-frequency exposure system for in vitro experiment. The exposure unit for in vitro experiments was designed by radial transmission line type to get broadband characteristics to generate signals of CDMA at 836.5 MHz and WCDMA at 1950 MHz frequency simultaneously. The modulated signals were delivered to the conical antenna through amplifier, digital attenuator and RF combiner. SAR values were obtained by the averaged values of 3 measured values at 9 points in petri dish using the fiber optic temperature probe. The measured return loss was under — 15 dB. For 1 W input power, the mean value and standard deviation of SAR were 0.105±0.019 for the CDMA frequency and 0.262±0.055 for the WCDMA frequency.Key words : RTL, Conical Antenna, In Vitro, SAR

In this paper, we studied the propagation of the radio wave in the human body for WBAN system and proposed the path-loss models applicable in the MICS and ISM frequency band. Human Tissues are composed of complicate organ. So it is difficult to measure to insert the probe in human body. Accordingly, the equations were modelled by electromagnetic analysis using the numerical phantom based on the real human. The numerical analysis used XFDTD 6.5 of Remcom co. in commercial software based on the Finite-Difference Time-Domain method. Human body model used a standard adult Korean model developed by ETRI. The proposed channel models will be very helpful to design the WBAN system.

In this paper, image reconstruction algorithm for breast cancer detection using MT(Microwave Tomography) was investigated. The breast cancer detection system under development uses 16 transmit/receive antennas. The signal waveform was a sinusoidal wave at 900 MHz. To solve the 2D inverse scattering problem, we used the 2D FDTD (Finite Difference Time Domain) method for forward calculation and LMA(Levenberg-Marquardt Algorithm) for optimization. The result of the image reconstruction using the numerical phantom by MRI(Magnetic Resonance Imaging) obtained from real patient of breast cancer showed that we can detect the position of the tumor accurately.