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Purpose: The aim of this study was to investigate the association between angiolymphatic invasion (ALI) and bladder cancer in patients who underwent radical cystectomy (RC).Materials and Methods: Multicenter retrospective data from 495 bladder cancer patients who underwent RC between 2007 and 2019 were enrolled in this study. Patients were stratified into 2 groups according to the presence of ALI. The effect of ALI was analyzed by the Kaplan-Meier method and Cox regression hazard models for patients’ cancer-specific survival (CSS), overall survival (OS), and recurrence-free survival (RFS).Results: The median age of the 495 patients in the study was 65 years, with median and mean follow-up durations of 23.3 months and 37.1 months, respectively. ALI was present in 182 patients (36.8%). ALI was significantly associated with worse RFS as well as CSS and OS (p

Evapotranspiration (ET) is the amount of water lost from the global surface, and it represents water and Earth's energy cycle. The intensity and frequency of climate variables have been changed because of the ongoing climate crisis, leading to increased climate disasters, such as heat waves and droughts. The abrupt climate crisis affects the variation of ET because climate variables highly influence ET. However, the future potential ET (PET) estimates include various uncertainty resulted from the variations in the projection of climate variables. In this context, the uncertainty in the projected future PETs should be quantified for the high reliability. Therefore, this study projected future global PET using Penman-Monteith (PM) for the near (2031-2065) and far (2066-2100) futures and quantified the corresponding uncertainty. The six climate variables of 14 CMIP6 GCMs were used for estimating historical PET which were compared to those from the NCEP/NCAR reanalysis data using the five evaluation metrics. The changes in PETs for four Shared Socio-economic Pathways (SSPs) scenarios were calculated for the near and far futures compared to the historical period (1980-2014). Subsequently, the uncertainties of PETs were quantified using the reliability ensemble average method. As a result, the future PET in high latitudes showed the most significant variability compared to the other latitudes. The future PET in the southern hemisphere was higher than the historical PET. Especially the PET in the mid-latitudes of southern hemisphere was the highest among the other latitudes. In addition, the uncertainty of PET was the highest in the high latitudes of the northern hemisphere while the mid-latitude in the northern was the lowest. This study provides insight into evaluating the global water cycle based on PET and helps establish appropriate policies for climate impact assessment.

This study evaluated the inherent uncertainty of future runoff prediction using eleven Coupled Model Intercomparison Project 6 (CMIP6) global climate models (GCMs) and a hydrological model (HM). The soil and water assessment tool (SWAT) model was used as a hydrologic model, and SWAT-CUP was used for parameter calibration. The future runoff projection was simulated utilizing two shared socioeconomic pathways (SSPs) scenarios, SSP2-4.5 and SSP5-8.5, for near (2021–2060) and far (2061–2100) futures. Jensen-Shannon divergence (JS-D) was used to quantify the uncertainties between the past and future probability distributions considering different GCMs and calibrated parameter sets of HM. The JS-D value for each GCM and calibrated HM parameter set was calculated at the range of 0.026–0.075 and 0.035–0.058, respectively. As a result, the uncertainty in the selection of GCMs was found to be greater than in the determination of values for HM parameters. Bayesian model averaging (BMA), which is a statistical approach that can combine estimations from multiple models and produce reliable probabilistic predictions, was applied to quantify the uncertainty by each GCM and HM parameters. When estimating the future runoff, INM-CM4-8 caused the greatest uncertainty, and the calibrated set of HM parameters using the year of high runoff caused the greatest uncertainty. This approach can help the uncertainty analysis in the future runoff estimation.

Purpose: To compare perioperative outcomes according to surgical methods among bladder cancer patients who underwent radical cystectomy (RC) with neobladder urinary diversion.Materials and Methods: Between June 2007 and January 2020, 89 bladder cancer patients who received RC with neobladder urinary diversion were enrolled in this study. Patients were stratified into surgical methods – (1) open RC with neobladder (ONB) reconstruction, (2) robotassisted RC (RARC) with extracorporeal neobladder (ECNB) reconstruction, and (3) RARC with intracorporeal neobladder (ICNB) reconstruction. Perioperative outcomes were compared among the 3 groups, with major complications defined according to Clavien-Dindo grades III–V within 90 days. Logistic regression analysis was performed to identify significant factors for postoperative complications.Results: Of 89 patients, 28 (31%) had ONB, 31 (35%) had ECNB, and 30 (34%) had ICNB. The median operative time was 471 minutes, and the ICNB group (424.5 minutes) was significantly less than ONB (444.5 minutes) and ECNB groups (542.9 minutes) (p=0.001). Transfusion rate was also significantly less in the ICNB group (13%) (p=0.001). Complications were recorded in 67 patients (75%) and major complications in 22 of all patients (25%). The major complication rate was significantly less in ICNB (13.4%) than in ONB (25%) and ECNB (35%) (p=0.003). Multivariate analysis showed surgical methods (ICNB) (odds ratio [OR], 0.709; p=0.003) and age (OR, 1.150; p=0.001) were significant factors related to occurrence of major postoperative complications.Conclusions: RARC with ICNB reduces postoperative complications compared to ONB and ECNB.

Hydrological drought is assessed through river flow, which depends on river runoff and water withdrawal. This study proposed a framework to project future hydrological droughts considering agricultural water withdrawal (AWW) for shared socioeconomic pathway (SSP) scenarios. The relationship between AWW and potential evapotranspiration (PET) was determined using a deep belief network (DBN) model and then applied to estimate future AWW using projections of the twelve global climate models (GCMs). 12 GCMs were bias-corrected using the quantile mapping method, climate variables were generated, and river flow was estimated using the soil and water assessment tool (SWAT) model. The standardized runoff index (SRI) was used to project the changes in hydrological drought characteristics. The results revealed a higher occurrence of severe droughts in the future. Droughts would be more frequent in the near future (2021-2060) than in the far future (2061-2100) and more severe when AWW is considered. Droughts would also be more severe for SSP5-8.5 than for SSP2-4.5. The study revealed that the increased PET due to rising temperatures is the primary cause of the increased drought frequency and severity. The AWW will accelerate the drought severities in the future in the Yeongsan River basin.

YBa2Cu3O7–y (YBaCuO) superconductors used in energy storage devices are superconducting permanent magnets in bulk form. YBaCuO bulk superconductors are fabricated by interior seeded melt growth. Because the seed crystal growth is based on a slow diffusion reaction, long-term heat treatment is required to fabricate a single crystal in order to improve the magnetic properties of the bulk YBaCuO superconductor. We fabricated a single-grain bulk YBaCuO superconductor by controlling the distance between the seed and the upper surface of the YBaCuO bulk. The magnetic levitation force and trapped magnetic field were measured for the YBaCuO superconducting bulk. The correlation between the superconducting magnetic properties of the specimens and the microstructure of each crystallographic plane were evaluated.

Background and Objectives: There is currently no consensus on the criteria for admitting older adults to the intensive care unit. Methods: This single-center retrospective study evaluated the baseline and clinical characteristics of older adults admitted to the intensive care unit between January 2017 and June 2017; patients were analyzed according to their age group. Factors associated with in-hospital mortality were specifically determined using logistic regression analysis. Results: Among 582 patients included in the present study, 34.2%, 46.6%, and 19.2% were aged 65–74, 75–84, and over 84 years, respectively. In terms of clinical outcomes, although there were no significant differences in the length of intensive care unit and hospital stay and intensive care unit mortality, significant differences were observed in terms of in-hospital mortality, hospital discharge disposition, and neurologic outcomes at discharge ( p = 0.039, p = 0.005, and p = 0.032, respectively). Predictive factors for in-hospital mortality were age (⩾85 years), initial mental status (stupor to coma), a Korean Triage and Acuity Scale level of 1, underlying diagnosis of cancer, abdominal pain or discomfort, apnea, and a chief compliant of dyspnea. Conclusion: Compared to those aged 65–84 years, in-hospital mortality was 1.96-fold higher in those aged over 84 years. However, the overall mortality in our cohort was not considerably different from that of the younger population. Intensive care unit admission should be considered in selected older adults after evaluating the risk factors for mortality.

We evaluated the role of prostate health index (PHI) in predicting Gleason score (GS) upgrading in International Society of Urological Pathology Grade Group (ISUP GG) 1 & 2 prostate cancer (PCa) or adverse pathologic outcomes at radical prostatectomy (RP). A total of 300 patients with prostate specific antigen ≥ 3 ng/mL, PHI and prostate biopsy (71 patients with RP included) were retrospectively included in the study. The primary study outcomes are PCa and clinically significant PCa (csPCa, defined as ISUP GG ≥ 2) diagnostic rate of PHI, and GS upgrading rate at RP specimen. The secondary outcomes are the comparison between GS upgrading and non-upgrading group, GS upgrading and high-risk PCa (ISUP GG ≥ 3 or ≥ pT3a) predictability of preoperative clinical factors. Overall, 139 (46.3%) and 92 (30.7%) were diagnosed with PCa and csPCa, respectively. GS upgrading rate was 34.3% in all patients with RP. Significant differences were shown in the total prostate volume (p = 0.047), the distribution of ISUP GG at biopsy (p = 0.001) and RP (p = 0.032), respectively. PHI values ≥ 55 [Odds ratio (OR): 3.64 (95% confidence interval (CI) = 1.05–12.68, p = 0.042] and presence of PI-RADS lesion ≥ 4 (OR: 7.03, 95% CI = 1.68–29.51, p = 0.018) were the significant predictors of GS upgrading in RP specimens (AUC = 0.737). PHI values ≥ 55 (OR: 9.05, 5% CI = 1.04–78.52, p = 0.046) is a significant factor for predicting adverse pathologic features in RP specimens (AUC = 0.781). PHI could predict GS upgrading in combination with PIRADS lesions ≥ 4 in ISUP GG 1 & 2. PHI alone could evaluate the possibility of high-risk PCa after surgery as well.

OBJECTIVE The aim of this study was to compare functional outcomes after partial nephrectomy (PN) between moderate and high complex renal tumors evaluated with a diethylenetriamine pentaacetic acid (DTPA) scan [moderate vs. high: RENAL nephrometry score (RNS) 7-9 vs. 10-12]. METHODS From January 2004 to December 2019, 471 patients with an RNS of 7-9 (moderate) and 164 patients with an RNS of 10-12 (high) who underwent PN were analyzed for renal function outcomes. The glomerular filtration rate (GFR) was measured using a DTPA scan and calculated the GFR using the Modification of Diet in Renal Disease (MDRD) formula, respectively. Trifecta/pentafecta outcome, recurrence-free survival, and overall survival were compared after propensity score matched analysis (PSMA). RESULTS After PSMA, 156 cases in each group were matched without significant difference in the preoperative factor. At the postoperative first year, there was no significant difference in the trifecta (p = 0.320), MDRD-based (p = 0.729), or DTPA-based pentafecta achievement rate (p = 0.964) between groups. At postoperative 5 years, DTPA-based total GFR (93.6% vs. 93.8%) and the operated kidney GFR preservation rate (89.9% vs. 81.7%) did not differ significantly (p > 0.05). Kaplan-Meier survival analysis showed no significant differences in survival outcomes (p > 0.05). Significant predictors of de novo chronic kidney disease (CKD) stage 3 or higher at the postoperative first year were age [hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.03-1.17, p = 0.005] and preoperative DTPA-based total GFR (HR 0.94, 95% CI 0.91-0.98, p = 0.001). CONCLUSION High complex tumors can be treated with PN without significant deterioration in renal function. The postoperative function of the operated kidney was preserved by up to 80% in the long term compared with the preoperative period. However, PN should be selectively performed with caution to avoid the occurrence of postoperative CKD.

INTRODUCTION AND OBJECTIVE:To identify whether the concurrent systematic biopsy (SB) is still necessary in the magnetic resonance imaging fusion-targeted biopsy (MRIFTB) eraMETHODS:Total of 714 men...

Due to the recent appearance of shares socioeconomic pathway (SSP) scenarios, there have been many studies that compare the results between Coupled Model Intercomparison Project (CMIP)5 and CMIP6 general circulation models (GCMs). This study attempted to project future drought characteristics in the Cheongmicheon watershed using SSP2-4.5 of Australian Community Climate and Earth System Simulator-coupled model (ACCESS-CM2) in addition to Representative Concentration Pathway (RCP) 4.5 of ACCESS 1-3 of the same institute. The historical precipitation and temperature data of ACCESS-CM2 were generated better than those of ACCESS 1-3. Two meteorological drought indices, namely, Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) were used to project meteorological drought while a hydrological drought index, Standardized Streamflow Index (SDI), was used to project the hydrological drought characteristics. The metrological data of GCMs were bias-corrected using quantile mapping method and the streamflow was obtained using Soil and Water Assessment Tool (SWAT) and bias-corrected meteorological data. As a result, there were large differences of drought occurrences and severities between RCP4.5 and SSP2-4.5 for the values of SPI, SPEI, and SDI. The differences in the minimum values of drought index between near (2021–2060) and far futures (2061–2100) were very small in SSP2-4.5, while those in RCP4.5 were very large. In addition, the longest drought period from SDI was the largest because the variation in precipitation usually affects the streamflow with a lag. Therefore, it was concluded that it is important to consider both CMIP5 and CMIP6 GCMs in establishing the drought countermeasures for the future period.

Previous studies reported that severity of dengue is associated with multiple factors, including secondary infection, age, viral load and infecting serotype and genotype. In addition, other studies have reported that a dengue virus-2 (DENV-2) infection is associated with a prognosis of more severe clinical manifestations than DENV-1 and DENV-4 infections. For these reasons, the ability to identify the DENV serotypes is critical for optimal patient diagnosis and epidemiological studies. In this study, we developed a TaqMan probe-based, one-step real-time reverse transcriptase-polymerase chain reaction (RT-PCR) system for detection and serotyping DENV. Our linear dynamic range (101 to 107 copies/reaction) showed the R2 values of DENV-1, 2, 3 and 4 as 0.998, 0.998, 0.994, and 0.998, respectively. The detection limits of DENV-1, 2, 3, and 4, were 10 copies/reaction, 100 copies/reaction, 10 copies/reaction, and 100 copies/reaction, respectively. Specificity test results indicated that this system is specific for DENV-1, 2, 3, and 4 and does not react with other viruses. Finally, we validated our results with five different real-time PCR instruments. Our results showed that the Ct values of the four serotype templates were similar in five real-time PCR instruments. Thus, this system provides an accurate method for detection and serotyping of DENV, which can be applied in diagnostics, surveillance, and epidemiology. Dengue can be found in many nations with varying socioeconomic and monetary resources. The results of our validation analyses using five different real-time PCR instruments suggest that this method can easily and confidently be used world-wide.

This paper presents the results of an experimental investigation of the thermal and hydraulic performance of a printed circuit heat exchanger (PCHE) for use in the cryogenic temperature region. Compact PCHEs with multiple corrugated, longitudinal flow microchannels were fabricated using chemical etching and diffusion bonding to evaluate their thermal and hydraulic performance. The testing of the PCHEs was conducted with helium gas at cryogenic temperatures. The pressure drop and thermal effectiveness values obtained from the measured pressures and temperatures are discussed. The thermal performance was predominantly affected by the axial conduction heat transfer in the low Reynolds number ranges of theses experiments. A simple performance calculation model is presented, and the effectiveness calculated from the model is compared with the experimental data. The design of the cryogenic PCHE was then modified to reduce axial conduction losses.

A newly developed type PCHE (Printed Circuit Heat Exchanger), which has a longitudinal corrugation flow channel, was fabricated using etching and diffusion bonding to evaluate its hydraulic performance. The result of a three-dimensional numerical simulation are presented, conducted using commercial Computational Fluid Dynamics (CFD) software FLUENT in the lower Reynolds number range (Re < 150). The validity of the numerical results through comparison with the measured data obtained via experimentation with helium gas is demonstrated. The results of CFD prediction show fairly good agreement with experimental data. The local friction factors associated with different hydraulic diameters and inclination angles are discussed. The correlation of the friction factor is presented from numerical simulation results.

In closed wet cooling towers, the heat transfer between the air and external tube surfaces can be composed of the sensible heat transfer and the latent heat transfer. The heat transfer coefficient can be obtained from the equation for external heat transfer of tube banks. According to experimental data, the mass transfer coefficient was affected by the air velocity and spray water flow rate. This study provides the correlation equation for mass transfer coefficient based on the analogy of the heat and mass transfer and the experimental data. The results from this correlation equation showed fairly good agreement with experimental data. The cooling capacity and thermal efficiency of the closed wet cooling tower were calculated from the correlation equation to analyze the performance of heat exchanger for the tower.

When circulated air passes through the cooling coil in an air-conditioning system, the air is over-cooled to eliminate the moisture and decrease the temperature. The cooled air is then reheated to recover the temperature. The purpose of the present study was to evaluate the performance of a cooling/reheating system with regard to both cooling and reheating energy savings affected by exchanging heat between the cooled air and the reheated air with a compact heat exchanger. The thermal and dehumidification behaviors of the system were evaluated experimentally and then compared with simulation data. The results show that the energy saving rate was as high as 50% under the present experimental conditions and was affected by the face velocity of the heat exchanger, the inlet temperature, the inlet humidity ratio, and the effectiveness of heat exchanger. Furthermore, the experimental data were found to be in fairly good agreement with the simulation data.

The new concept spark plug was developed to study its influence on the combustion characteristics of SI engine. It has pre-ignition chamber in the lower end of spark plug and flame hole, in which fresh mixture gas can be introduced without any fuel supply system. This spark plug was tested with a commercial SI engine. Fuel consumption rate, emission gas and MBT timing were measured in the engine dynamometer for various flame hole numbers, hole positions, hole sizes of the pre-ignition chamber of the spark plug. And average flame propagation speed was measured by using the head gasket ionization probe in single cylinder engine. The new concept spark plug induces fast bum in combustion compared with the conventional spark plug, and MBT(Minimum advance for Best Torque) timing was retarded about crank angle. The flame hole number, hole direction and volume of pre-ignition chamber were found to influence the combustion characteristics.

Hemimasticatory spasm (HMS) is a rare disorder of the trigeminal nerve characterized by paroxysmal involuntary contractions of the unilateral jaw-closing muscles. HMS has been frequently described in association with facial hemiatrophy or localized scleroderma. A 42-year-old female presented with involuntary paroxysmal spasms of the left face, of 6 months duration. Her lower face on the left was markedly hypertrophied without skin lesions. An electrophysiological study indicated that the masseter reflexes and masseteric silent period were attenuated on the affected side. Surface electromyography demonstrated irregular bursts of motor unit potentials at high frequencies up to 200 Hz. Magnetic resonance imaging of the head showed marked hypertrophy of the left masseter muscle. Biopsy of the hypertrophied masseter muscle was normal. Repeated local injections of botulinum toxin noticeably reduced the size of the hypertrophied muscle as well as improved the patient’s symptoms.

PCHE (Printed Circuit Heat Exchanger) is one of the promising cryogenic compact heat exchangers due to its compactness, high NTU and robustness. The essential procedure for fabricating PCHE is chemical etching and diffusion bonding. These technologies can create sufficiently large heat transfer area for a heat exchanger with numerous micro channels (Dh

A multiplex real-time polymerase chain reaction (PCR) kit was developed for the qualitative detection of the Roundup-Ready Soybean (RRS). This system consists of a screening assay for cauliflower mosaic virus 35S promoter and nos terminator, and an event-specific assay for RRS containing the lectin gene as an internal positive control. The limit of detection value was determined to be approximately 0.1%.

A simplified method is developed to predict the hourly cooling load of the next day. Only four building specifications and the estimated temperature and humidity of the next day are used to predict the cooling load. The sensible heat loads are calculated using the sensible heat coefficient, outdoor air coefficient, and sensible heat constant. Similarly, the latent heat loads are calculated using the outdoor air coefficient, latent heat constant. Four building specifications, that is, sensible heat coefficient, outdoor air coefficient, sensible heat constant and latent heat constant are determined from the building design data for cooling load. In order to validate the prediction model, two benchmarking buildings are selected, and cooling loads are measured in the actual operation conditions. The predicted results show fairly good agreement with the measured data for both buildings.Copyright © 2010 by ASME

To investigate if diabetes is more common in drug-induced parkinsonism patients. We performed a hospital-based retrospective case-control study on 44 drug-induced parkinsonism (DIP) patients, 177 Parkinson disease patients, and 176 acute stroke patients matched for age and sex who were seen over the same period at the same hospital. The frequency of diabetes, age-at onset and sex were compared between DIP and IPD or acute stroke. Multivariate analysis showed that patients with diabetes are more frequent in DIP compared with IPD (p0.001, adjusted OR 5.48; 95% CI, 2.52-11.94). The frequency of diabetes in DIP was comparable to that in acute stroke patients (p=0.16, adjusted OR 0.62; 95% CI, 0.32-1.21). These data suggest that diabetes may be a risk factor for DIP. Drugs with dopamine receptor blocking potency should be avoided in elderly with diabetes.

An aging-suppressor gene, klotho, is a candidate factor for vascular disease because its deficiency leads to impaired endothelium-dependent vasodilation and impaired angiogenesis. We investigated the association of polymorphisms in klotho with ischemic stroke. We searched for sequence variants in promoter and exons of klotho gene. For the association study, selected variants were genotyped in control subjects and in patients with ischemic stroke and vascular dementia. The association with ischemic stroke was further investigated with its subtypes classified based on Trial of Org 10172 in Acute Stroke Treatment (TOAST). No significant association was observed for both G-395A and C1818T with ischemic stroke and vascular dementia (P>0.05). The analysis with subtypes of ischemic stroke revealed the associations that the A allele of G-395A increased the risk of cardioembolic stroke (CE, OR=2.60; P=0.006), and subjects carrying the A allele were susceptible to CE in both of dominant (AA+GA versus GG; OR=2.50; P=0.046) and recessive (AA versus GA+GG; OR=6.52; P=0.007) models. Further analysis of data partitioned by gender showed that the associations of G-395A with CE only existed in women (A versus G; OR=4.33; P=0.002), AA+GA versus GG; OR=5.68; P=0.014, and AA versus GA+GG; OR=9.07; P=0.012), but the significance disappeared in men (P>0.05). The sequence variant of G-395A in klotho might be a genetic risk factor for CE in females.

Sequence variants of angiotensin converting enzyme (ACE) insertion/deletion (I/D), angiotensinogen (AGT) T235M, angiotensin II type 1 receptor (AT1R) A1166C, and plasminogen activator inhibitor-1 (PAI-1) 4G/5G were analyzed to see their genetic associations with vascular dementia as its candidate genetic risk factors involving renin-angiotensin and fibrin systems. While the ACE I/D, AT1R A1166C, and PAI-1 4G/5G did not contribute to the genetic susceptibility to vascular dementia (P0.05), a significant association with vascular dementia was shown in the T235M polymorphism of AGT. The frequency of the M allele in patients was higher than in controls with the odds ratio (OR) estimate of 1.51 (P0.05). In a dominant model, the TM+MM genotypes increased the risk of vascular dementia compared to the TT genotype (OR=2.01; P0.001). The current results suggested that AGT T235M polymorphism might be a risk factor of vascular dementia.

Purpose: Short life expectancy influences decision-making when treating very old patients with acute ischemic stroke (AIS). We investigated mortality and survival duration in very old AIS patients (≥ 80 years) who received hospital care. Patients and Methods: Mortality data were obtained from medical records, structured telephone inquiries, death certificates from the Korean National Statistical Office, and social security data 5 ± 1.9 years after stroke onset. Age, gender, vascular risk factors, and functional outcomes from modified Rankin scales (MRS) at discharge were analyzed as predictors of mortality. Results: Among 134 patients, 92 (68.7%) died. On KaplanMeier analysis, duration of survival of patients aged 80 - 84 years was longer than those aged 85 - 89 or 90 - 94 (24 ± 6.4, 8 ± 7.3, 7 ± 2.0 months, respectively, p = 0.002). Duration of survival of patients discharged in a state of MRS 0 - 1 was longer than the remaining groups at 47 ± 4.8 months (p < 0.001). In Cox proportional hazard analysis, age and MRS at discharge were independent predictors of mortality. Conclusion: Long-term outcomes of very old patients with AIS are not uniformly grave, therefore predictors of mortality and estimated duration of survival should be considered during decision- making for treatment.