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Objective: This study explored the prognostic factors of chronic subdural hematoma in patients who underwent burr hole drainage, both overall and in elderly patients.Methods: This study enrolled 120 patients with chronic subdural hematoma who underwent burr hole drainage at a single center between January 2016 and December 2020. Old age was defined as >65 years, and a good prognosis was defined as a decrease in the modified Rankin scale from admission to the last follow-up. Factors correlated with good prognosis in elderly patients compared with total patients were evaluated using the chi-square test and logistic regression analysis.Results: Among the 120 patients, 66 (55.0%) were ≥65 years old, and 76 (63.3%) had severe symptoms on admission. Old age (≥65) was the only factor significantly correlated with severe symptoms (P=0.021; odds ratio [OR], 2.618; 95% confidence interval [CI], 1.154–5.942). The following variables were significantly associated with the prognosis in both groups: diabetes (total: P=0.008; OR, 0.207; 95% CI, 0.064–0.664; old age: P=0.011; OR, 0.017; 95% CI, 0.044–0.672) and severe symptoms on admission (total: P

Traumatic brain injury (TBI) is one of the leading causes of death in the pediatric population in Korea. In addition, it can cause disability in children and adolescents, with physical and mental consequences. This causes a substantial burden on the health care system and occurs globally and not just in Korea. We searched and reviewed current data on the epidemiologic characteristics of pediatric TBI in Korea. Our review provides the recent epidemiological trend mainly focusing on incidence and mortality along with worldwide reported data. This review will be helpful to understand the global epidemiology of pediatric TBI and its differences between countries.

Many studies have been performed to predict a reliable and accurate stress-range distribution and fatigue damage regarding the Gaussian wide-band stress response due to multi-peak waves and multiple dynamic loads. So far, most of the approximation models provide slightly inaccurate results in comparison with the rain-flow counting method as an exact solution. A step-by-step study was carried out to develop new approximate spectral moments that are close to the rain-flow counting moment, which can be used for the development of a fatigue damage model. Using the special parameters and bandwidth parameters, four kinds of parameter-based combinations were constructed and estimated using the R-squared values from regression analysis. Based on the results, four candidate empirical formulas were determined and compared with the rain-flow counting moment, probability density function, and root mean square (RMS) value for relative distance. The new approximate spectral moments were finally decided through comparison studies of eight response spectra. The new spectral moments presented in this study could play an important role in improving the accuracy of fatigue damage model development. The present study shows that the new approximate moment is a very important variable for the enhancement of Gaussian wide-band fatigue damage assessment.

This study proposes a computational fluid dynamics (CFD)-modified potential (CMP) model. This hybrid model uses linear potential theory with a corrected damping ratio obtained from CFD simulations to analyze the seakeeping performance of a small vessel. According to the analysis procedure of the proposed model, a motion analysis, including the prediction of the roll and pitch damping ratio of a small barge, was conducted; to verify reliability; the results were compared to those of an experiment performed in a physical tank. The relative errors in the experiment for peak amplitude in the roll motion response amplitude operators (RAOs) using the CMP model were relatively small, whereas those obtained from only the potential analysis were large errors in all three conventionally used roll-damping ratios. In addition, the computational time consumed by the CMP model was longer than that consumed by the potential theory but faster than the full CFD simulation for all wave conditions. Subsequently, based on the motion analysis results, the seakeeping performance was evaluated in a real sea environment, and the results on the single significant amplitude (SSA) were discussed through comparison with the results of the potential analysis and experiment.

Background Spontaneous subdural hematoma rarely presents with a hypervascular or malignant tumor but even less frequently in a benign tumor like meningioma. We encountered a patient with acute subdural hematoma associated with benign meningioma. Here, we report this case along with a review of previous reports, especially focusing on their clinical features and possible bleeding mechanisms. Case presentation A 53-year-old Asian woman presented with severe headache and progressive neurologic deterioration due to cerebral edema. The patient was submitted to open surgery for evacuation of the subdural hematoma and concurrent tumor removal on the ipsilateral parietal convexity. A hypervascular, encapsulated mass was identified during surgery and completely removed including the adjacent dura mater (Simpson grade 0). The tumor was histologically confirmed as an angiomatous meningioma (World Health Organization grade I). Her clinical course was uneventful after surgery. Conclusions Although meningiomas are commonly benign according to their histological traits, they can lead to spontaneous bleeding and cause neurologically unstable condition. Therefore, meningiomas need to be considered as a cause of spontaneous subdural hematoma if radiologically suspicious, which should be reflected by proper management for a positive outcome.

Nonalcoholic fatty liver disease (NAFLD) is a risk factor for progression of steatohepatitis, liver cirrhosis, and liver cancer. Although pathological condition of NAFLD, which arises from an excessive accumulation of triglyceride in the liver, is accompanied by elevated sterol regulatory element-binding protein 1c (SREBP1c) level, it is largely unknown which factors are involved in the modification of SREBP1c. In this study, we discovered that neddylation of SREBP1c competes with its ubiquitination and stabilizes SREBP1c protein level, and eventually promotes hepatic steatosis. We also demonstrated that human homolog of mouse double minute 2 (HDM2) acts as an E3 neddylation ligase of SREBP1c. Further, treatment with the neddylation inhibitor, MLN4924, attenuates high-fat diet-induced hepatic steatosis by reducing the levels of SREBP1c protein and hepatic triglyceride. Our results indicate that the blockade of SREBP1c neddylation could be a novel approach in the defense against NAFLD.

A significant development has been made on a new fatigue damage model applicable to Gaussian wide band stress response spectra using numerical approximation methods such as data processing, time simulation, and regression analysis. So far, most of the alternative approximate models provide slightly underestimated or overestimated damage results compared with the rain-flow counting distribution. A more reliable approximate model that can minimize the damage differences between exact and approximate solutions is required for the practical design of ships and offshore structures. The present paper provides a detailed description of the development process of a new fatigue damage model. Based on the principle of the Gaussian wide band model, this study aims to develop the best approximate fatigue damage model. To obtain highly accurate damage distributions, this study deals with some prominent research findings, i.e., the moment of rain-flow range distribution M R R ( n ) , the special bandwidth parameter μ k , the empirical closed form model consisting of four probability density functions, and the correction factor Q C . Sequential prerequisite data processes, such as creation of various stress spectra, extraction of stress time history, and the rain-flow counting stress process, are conducted so that these research findings provide much better results. Through comparison studies, the proposed model shows more reliable and accurate damage distributions, very close to those of the rain-flow counting solution. Several significant achievements and findings obtained from this study are suggested. Further work is needed to apply the new developed model to crack growth prediction under a random stress process in view of the engineering critical assessment of offshore structures. The present developed formulation and procedure also need to be extended to non-Gaussian wide band processes.

Accurate interpretation of radiological data is important for reliable paleopathological study of mummies. This is especially true for the mummified heart, an anatomically complicated organ that is distorted and displaced due to long-term dehydration and the action of gravity. In the present study, we compared post-factum autopsy results for mummified hearts of differing preservation statuses with corresponding radiological (computed tomography [CT]-image) findings in order to obtain information necessary for accurate radiological diagnosis. We found that the valvular apparatus (especially the aortic valve and chordae tendinae) was easily distinguishable on the CT images of mummies in which more cardiac structures were preserved. We also identified several situations that are known to incur misdiagnosis of cardiac CT images: the presence of pseudo-cavities in the cardiac wall, confusion of the valvular apparatus with cardiac-wall debris, and invisibility of cardiac structures on CT images due to collapse or adhesion. While acknowledging the merits of top-priority CT scanning in non-invasive research, post-factum autopsy also has value as a complementary and confirmatory analysis for enhanced accuracy of diagnoses in paleo-radiological studies.

As interest in eco-friendly ships increases, methods for status monitoring and forecasting using in-service data from ships are being developed. Models for predicting the energy efficiency of a ship in real time need to effectively process the operational data and be optimized for such an application. This paper presents models that can predict fuel consumption using in-service data collected from a 13,000 TEU class container ship, along with statistical and domain-knowledge methods to select the proper input variables for the models. These methods prevent overfitting and multicollinearity while providing practical applicability. To implement the prediction model, either an artificial neural network (ANN) or multiple linear regression (MLR) were applied, where the ANN-based models showed the best prediction accuracy for both variable selection methods. The goodness of fit of the models based on ANN ranged from 0.9709 to 0.9936. Furthermore, sensitivity analysis of the draught under normal operating conditions indicated an optimal draught of 14.79 m, which was very close to the design draught of the target ship, and provides the optimal fuel consumption efficiency. These models could provide valuable information for ship operators to support decision making to maintain efficient operating conditions.

Simple Summary Neddylation is a process in which the small ubiquitin-like molecule NEDD8 is covalently conjugated to target proteins by sequential enzymatic reactions. Because neddylation plays critical roles in regulating cancer growth and migration, it is emerging as an effective therapeutic target. The major tumor suppressor protein p53 reduces cancer cell migration and is inhibited by neddylation. As p53 is lost or mutated in 50% of various cancer types, this study attempted to investigate how neddylation affects cancer cell migration according to p53 status. Neddylation blockade reduced or caused no change in migration of wild type or mutant p53 cancer cell lines. In contrast, neddylation blockade induced migration of p53-null cancer cell lines. These results were mediated by the differential effect of neddylation blockade on the epithelial–mesenchymal transition activator Slug according to p53 status. Thus, the p53 status of cancer cells should be considered when developing neddylation-targeted anticancer drugs. Abstract The tumor suppressor protein p53 is frequently inactivated in human malignancies, in which it is associated with cancer aggressiveness and metastasis. Because p53 is heavily involved in epithelial–mesenchymal transition (EMT), a primary step in cell migration, p53 regulation is important for preventing cancer metastasis. p53 function can be modulated by diverse post-translational modifications including neddylation, a reversible process that conjugates NEDD8 to target proteins and inhibits the transcriptional activity of p53. However, the role of p53 in cancer migration by neddylation has not been fully elucidated. In this study, we reported that neddylation blockade induces cell migration depending on p53 status, specifically via the EMT-promoting transcription factor Slug. In cancer cell lines expressing wild type p53, neddylation blockade increased the transcriptional activity of p53 and expression of its downstream genes p21 and MDM2, eventually promoting proteasomal degradation of Slug. In the absence of p53, neddylation blockade increased cell migration by activating the PI3K/Akt/mTOR/Slug signaling axis. Because mutant p53 was transcriptionally inactivated but maintained the ability to bind to Slug, neddylation blockade did not affect the migration of cells expressing mutant p53. Our findings highlight how the p53 expression status influences neddylation-mediated cell migration in multiple cancer cell lines via Slug.

Neddylation is a process by which NEDD8 is covalently conjugated to target proteins by sequential enzymatic reaction. Its role in cancer cell migration has only been recently acknowledged. Previously in cancer cell migration, the epithelial to mesenchymal transition (EMT) process has been well-known to play an important role in both invasion and metastasis by promoting mesenchymal phenotype in epithelial cells. However, the role of neddylation in the EMT process and its mechanistic details are yet to be elucidated. We recently reported that neddylation plays a crucial role in cancer cell migration through the PI3K-Akt pathway. Here, we report that inhibiting neddylation activates the hypoxia-inducible factor 1α (HIF-1α) through the PI3K-Akt pathway, which eventually regulates the EMT-activator ZEB1 (zinc finger E-box binding homeobox 1) in various cancer cell lines. As induction of HIF-1α is known to deteriorate the state of cancer and EMT process is one of the hallmarks of metastasis in cancer, our findings uncover the role of neddylation between HIF-1α and ZEB1.

Background Pituitary blastoma is a malignant neoplasm of the pituitary gland that was recognized by the World Health Organization in 2017. It is commonly diagnosed in children before 24 months of age. Here, we report the first case of a young adult patient who was diagnosed with pituitary blastoma with increased levels of growth hormone instead of adrenocorticotropic hormone and provide a review of the literature. Case Description A 19-year-old woman presented to our hospital with visual disturbance. She had a medical history of Wilms’ tumor and multinodular goiter. The brain imaging showed a 3.2 × 2.5 × 1.8-cm solid sellar and suprasellar cystic mass that upwardly displaced the optic chiasm. She had an elevated level of growth hormone but a normal level of adrenocorticotropic hormone, cortisol, and prolactin. The mass was subtotally removed through the left pterional craniotomy. The pathologic examination suggested a pituitary blastoma. Thereafter, the patient was treated with chemotherapy and radiotherapy. At 4-year follow-up postsurgery, her overall well-being is good. Conclusions Although in this case the patient was a young adult, pituitary blastoma should be taken into consideration when children have an enhanced sellar and suprasellar mass with peripherally located cysts.

Neddylation is a cellular process that covalently conjugates substrate proteins with the small ubiquitin-like molecule NEDD8. As neddylation is required for fast turnover of proteins in proliferating cancer cells, the neddylation process is currently regarded as a potential target for cancer therapy. However, little is known about the role of neddylation in cancer invasion and metastasis. Unexpectedly, we here found that the neddylation blockade stimulates migration of lung cancer and glioblastoma cells. Mechanistically, C-CBL acts as the E3 ligase for neddylation of the proto-oncogene c-Src. After neddylation, c-Src is poly-ubiquitinated and degraded through the proteasome, which inhibits the PI3K-AKT pathway responsible for cell migration. In human lung cancer tissues, the downregulation of C-CBL was associated with c-Src/AKT, cancer metastasis, and poor survival in patients. Therefore, C-CBL is likely to play a tumor suppressive role by antagonizing a robust oncogenic signaling driven by c-Src. This study provides new insight about the role of neddylation in cancer metastasis. It also implies that the metastasis risk should be carefully evaluated before the clinical application of neddylation inhibitors as anticancer regimens.

Gliomas are the most common pediatric tumors of the central nervous system. In this review, we discuss the clinical features, treatment paradigms, and evolving concepts related to two types of pediatric gliomas affecting two main locations: the optic pathway and thalamus. In particular, we discuss recently revised pathologic classification, which adopting molecular parameter. We believe that our review contribute to the readers’ better understanding of pediatric glioma because pediatric glioma differs in many ways from adult glioma according to the newest advances in molecular characterization of this tumor. A better understanding of current and evolving issues in pediatric glioma is needed to ensure effective management decision.

This article presents the results of experiments aimed at testing the hypotheses that mummifi cation of human bodies in Joseon Dynasty burials was caused by an exothermic reaction and subsequent destruction of intestinal microfl ora. Well-preserved mummies of that period were discovered only in the Hoegwakmyo tombs, where the lime-soil-mixture barrier was present. Experiments were conducted using animal bodies placed in miniature grave models. Immediately after contact with moisture, the temperature inside the coffi n surrounded by a lime-soil-mixture increased to 130.8±23.5°C and remained stable for 141.0±64.7 minutes. The examination of bacterial cultures on MacConkey or blood agar plates showed that the entire fl ora normally existing in the rat intestine was completely sterilized by high temperature. We also demonstrate that the same mummifi cation can be reproduced regardless of the sizes of miniature graves.

Summary Background CT radiation is arguably carcinogenic. Results from single-centre studies, mostly retrospective, have advocated lowering the CT radiation dose for the diagnosis of appendicitis. However, adoption of low-dose CT has been slow. We aimed to assess the effectiveness of low-dose CT compared with standard-dose CT in the diagnosis of appendicitis in adolescents and young adults. Methods We did this pragmatic, multicentre, randomi s ed controlled non-inferiority trial at 20 South Korean teaching hospitals with little experience with low-dose CT. Patients aged 15–44 years with suspected appendicitis were randomly assigned (1:1), via computer-generated random assignments (permuted block sizes of two, four, six, and eight) concealed in sequentially numbered envelopes, to receive low-dose CT (2 mSv) or standard-dose CT (≤8 mSv). Randomisation was stratified by site. Group allocation was concealed from patients, outcome assessors, and adverse event adjudicators; care providers, site pathologists, and data collectors were aware of allocation. The primary endpoint was the negative (unnecessary) appendectomy rate among all appendectomies, with a non-interiority margin of 4·5% for low-dose versus standard-dose CT. Primary analy s is was by modified intention to treat, which included all patients who received an appendectomy in the group to which they were assigned. This trial is registered with ClinicalTrials.gov, number NCT01925014. Findings Between Dec 4, 2013, and Aug 18, 2016, we assigned 1535 patients to the low-dose CT group and 1539 patients to the standard-dose CT group. 22 (3·9%) of 559 patients had a negative appendectomy in the low-dose group versus 16 (2·7%) of 601 patients in the standard-dose group (difference 1·3%, 95% CI −0·8 to 3·3; p=0·0022 for the non-inferiority test). We recorded 43 adverse events in 43 (2·8%) of 1535 patients in the low-dose group and 41 adverse events in 40 (2·6%) of 1539 patients in the standard-dose group. One life-threatening adverse event of anaphylaxis caused by an iodinated contrast material occurred in the low-dose group. Interpretation Radiation dose of appendiceal CT for adolescents and young adults can be reduced to 2 mSv without impairing clinical outcomes. In view of the vast number of appendiceal CT examinations done worldwide, use of low-dose CT could prevent a sizeable number of radiation-associated cancers in the future. Funding Korea Health Industry Development Institute, Seoul National University Bundang Hospital, Dasol Life Science, and Bracco Imaging Korea.

The enlargement of ships has increased the relative hull deformation owing to draft changes. Moreover, design changes such as an increased propeller diameter and pitch changes have occurred to compensate for the reduction in the engine revolution and consequent ship speed. In terms of propulsion shaft alignment, as the load of the stern tube support bearing increases, an uneven load distribution occurs between the shaft support bearings, leading to stern accidents. To prevent such accidents and to ensure shaft system stability, a shaft system design technique is required in which the shaft deformation resulting from the hull deformation is considered. Based on the measurement data of a medium-sized oil/chemical tanker, this study presents a novel approach to predicting the shaft deformation following stern hull deformation through inverse analysis using deep reinforcement learning, as opposed to traditional prediction techniques. The main bearing reaction force, which was difficult to reflect in previous studies, was predicted with high accuracy by comparing it with the measured value, and reasonable shaft deformation could be derived according to the hull deformation. The deep reinforcement learning technique in this study is expected to be expandable for predicting the dynamic behavior of the shaft of an operating vessel.

OBJECTIVE The circadian pattern of the onset time of aneurysmal subarachnoid hemorrhage (aSAH) has been reported by various authors. However, the effect of the degree of physical exertion on the circadian pattern has not been studied in detail. Therefore, we conducted this study to investigate the effect of physical exertion on the circadian pattern of aSAH. METHODS Of the 335 patients presenting with aSAH from January 2012 to December 2017, 234 patients with identifiable onset time and metabolic equivalent (MET) values were enrolled. The onset time of aSAH was divided into 4-hour intervals. The patient's physical exertion was then assessed on a scale between 1 and 8 METs using generally accepted MET values, and categorized into two groups-light exertion (1 to 4 METs) and moderate to heavy exertion (5 to 8 METs)-to determine the effect of the degree of physical exertion on the onset time distribution of aSAH. Multivariate analysis was used to calculate the odds ratio (OR) between the two groups to determine the effect of the degree of physical exertion on each set of time periods. RESULTS There was a definite bimodal onset pattern that peaked at 08:00-12:00 hours followed by 16:00-20:00 hours (p

To investigate the acute and long-term effects of vitamin D supplementation on the recovery of patients with traumatic brain injury (TBI).A retrospective study was conducted involving 345 patients with TBI who visited a single trauma center. Vitamin D serum levels were measured without supplementation at admission, 1 month, and 3 months post-TBI (control group) from August to December 2016. From January 2017, vitamin D supplementation was provided to patients with TBI with low vitamin D serum levels at admission (supplement group). The outcomes were investigated by assessing performance function (Extended Glasgow Outcome Scale) and cognitive function (Mini-Mental Status Examination, and Clinical Dementia Rating) at 1 week and 3 months post-TBI.The mean vitamin D serum level in patients with TBI at admission was 13.62 ± 9.01 ng/mL. The level significantly increased from 14.03 ± 8.68 ng/mL at admission to 37.42 ± 12.57 ng/mL at 3 months post TBI in the supplement group (P0.001). The cognitive outcomes (Mini-Mental Status Examination/Clinical Dementia Rating, P = 0.042/P = 0.044) and GOS-E score (total TBI, P = 0.003; mild-to-moderate TBI, P = 0.002) significantly improved from the first week to 3 months post TBI in the patients with vitamin D supplementation.Administration of vitamin D supplements in mild-to-moderate TBI patients with significant vitamin D deficiency during the acute phase of the injury may improve long-term performance and cognitive outcomes. Therefore, the treatment strategies should be individually planned for the patients with TBI based on their baseline vitamin D level.

Background Despite advances in skull base surgery, achieving effective surgical management of jugular foramen schwannomas (JFSs) that avoids postoperative cranial nerve (CN) deficits remains a challenge. Subtotal resection followed by radiosurgery (rather than radical resection) is increasingly being viewed as a better treatment strategy. Here, an institutional database was retrospectively analyzed for outcomes after surgical treatment of JFSs to evaluate the optimal strategy for managing JFSs. Methods Twenty-two patients with JFSs were operated on by either radical resection ( n = 13) or conservative resection plus radiosurgery ( n = 9). These 2 different groups were compared in terms of early (≤4 weeks after surgery) and late postoperative functional outcome and oncologic control. Results No deaths occurred in either group, but there were 3 surgery-related complications in the radical resection group. Postoperative CN deficits and additional procedures related to CN morbidity were generally higher in the radical resection group, but the differences were not statistically significant. The conservative surgery group showed a statistically significant improvement in the level of dysphagia and dysphagia-related functional state in the late postoperative period. There was 1 case of recurrence after radical resection over a mean follow-up period of 73 months. All tumors in the conservative surgery group were controlled over a mean period of 34 months. Conclusions Our results suggest that conservative resection of JFSs via a familiar intracranial approach plus radiosurgery may be an effective surgical alternative for improving functional outcome with adequate oncologic control.

Fatigue analysis for life extension of a ship is different from that of a newly constructed ship since the current corrosion margin and voyage routes of the past and future must be considered, thereby complicating the life extension procedure. This research introduces the fatigue analysis case for the life extension project of a moss LNG carrier using full spectral fatigue analysis, which has been previously used for newly constructed ships. It is expected that the fatigue analysis methodologies and full spectral fatigue analysis program used in this study will be applicable to other life extension projects.

Worldwide recently, connectivity of everything became hot issue in electronics engineering to make the Internet of Things (IoT) possible. In a point of IoT, it has been problematic for conventional indoor positioning systems to adopt system where devices can communicate only at the designated time slots. We propose membership management and positioning method of multiple objects using an UWB communication. The simple and unique management algorithm is composed of two stages. In the first stage, a master device sends a signal to each tag devices in order to confirm the communication ability status. In the second stage, the master device sends another signal to the confirmed tags to initiate ranging and positioning. The efficiency of the proposed management algorithm compared to conventional method is proved by experiments in ordinary classroom which exemplifies indoor coverage in buildings.

The purpose of this research is to develop a full-spectral fatigue analysis program, based on rigid-body ship motion analysis, in order to perform a full-spectral fatigue analysis that considers hydroelasticity effects. To gain credibility, fatigue anal ysis results of two ship types, performed by the developed program, were compar ed with those of a classification society, and it was found that both are identical. Full-spectral fatigue analysis considering hydroelasticity effects would be developed in further studies by including flexible-body ship motion analysis results and by supplementing the developed program with a wide-band fatigue damage model.

Neddylation is a process by which NEDD8 is covalently conjugated to target proteins by sequential enzymatic reaction. Its role in cancer cell migration has only been recently acknowledged. Previously in cancer cell migration, the epithelial to mesenchymal transition (EMT) process has been well-known to play an important role in both invasion and metastasis by promoting mesenchymal phenotype in epithelial cells. However, the role of neddylation in the EMT process and its mechanistic details are yet to be elucidated. We recently reported that neddylation plays a crucial role in cancer cell migration through the PI3K-Akt pathway. Here, we report that inhibiting neddylation activates the hypoxia-inducible factor-1α through the PI3K-Akt pathway, which eventually regulates the EMT-activator zinc finger E-box binding homeobox 1 in various cancer cell lines. As induction of hypoxia-inducible factor-1α is known to deteriorate the state of cancer and EMT process is one of the hallmarks of metastasis in cancer, our findings uncover the novel association of hypoxia-inducible factor-1α and zinc finger E-box binding homeobox 1 through the process of neddylation. Citation Format: Yang-Sook Chun, Jieun Seo, Jun Bum Park. Molecular mechanism of neddylation-dependent suppression of cancer cell migration [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4873.

Objective We investigated whether clipping or endovascular treatment (EVT) can reduce the incidence of delayed hydrocephalus. We also investigated whether additional procedures, namely lumbar drainage and extra-ventricular drainage (EVD), decrease the incidence of delayed hydrocephalus in patients with subarachnoid hemorrhage (SAH). Materials and methods One-hundred and fifty-two patients who had undergone an operation for SAH were enrolled in this study. Clinical data, radiological data, and procedural data were investigated. Procedural data included the operating technique (clipping vs. EVT) and the use of additional procedures (no procedure, lumbar drainage, or EVD). Delayed hydrocephalus was defined as a condition in which the Evan's index was 0.3 or higher, as assessed using brain computed tomography more than 2 weeks after surgery, requiring shunt placement due to neurological deterioration. Results Of the 152 patients, 45 (29.6%) underwent surgical clipping and 107 (70.4%) underwent EVT. Twenty-five (16.4%) patients developed delayed hydrocephalus. Age (p = 0.019), procedure duration (p = 0.004), and acute hydrocephalus (p = 0.030) were significantly correlated with the incidence of delayed hydrocephalus. However, the operation technique (p = 0.593) and use of an additional procedure (p = 0.378) were not significantly correlated with delayed hydrocephalus incidence. Conclusion No significant difference in the incidence of delayed hydrocephalus was associated with operation technique or use of an additional procedure in patients with SAH. However, delayed hydrocephalus was significantly correlated with old age, long procedural duration, and acute hydrocephalus. Therefore, we recommend that additional procedures should be discontinued as soon as possible.

Long-term memory formation is attributed to experience-dependent gene expression. Dynamic changes in histone methylation are essential for the epigenetic regulation of memory consolidation-related genes. Here, we demonstrate that the plant homeodomain finger protein 2 (PHF2) histone demethylase is upregulated in the mouse hippocampus during the experience phase and plays an essential role in memory formation. PHF2 promotes the expression of memory-related genes by epigenetically reinforcing the TrkB-CREB signaling pathway. In behavioral tests, memory formation is enhanced by transgenic overexpression of PHF2 in mice, but is impaired by silencing PHF2 in the hippocampus. Electrophysiological studies reveal that PHF2 elevates field excitatory postsynaptic potential (fEPSP) and NMDA receptor-mediated evoked excitatory postsynaptic current (EPSC) in CA1 pyramidal neurons, suggesting that PHF2 promotes long-term potentiation. This study provides insight into the epigenetic regulation of learning and memory formation, which advances our knowledge to improve memory in patients with degenerative brain diseases.

Soluble N-ethylmaleimide-sensitive-factor attachment protein receptor (SNARE) proteins generate energy required for membrane fusion. They form a parallelly aligned four-helix bundle called the SNARE complex, whose formation is initiated from the N terminus and proceeds toward the membrane-proximal C terminus. Previously, we have shown that this zippering-like process can be controlled by several flavonoids that bind to the intermediate structures formed during the SNARE zippering. Here, our aim was to test whether the fluorescence resonance energy transfer signals that are observed during the inner leaflet mixing assay indeed represent the hemifused vesicles. We show that changes in vesicle size accompanying the merging of bilayers is a good measure of progression of the membrane fusion. Two merging vesicles with the same size D in diameter exhibited their hydrodynamic diameters 2D + d (d, intermembrane distance), 2D and 2D as membrane fusion progressed from vesicle docking to hemifusion and full fusion, respectively. A dynamic light scattering assay of membrane fusion suggested that myricetin stopped membrane fusion at the hemifusion state, whereas delphinidin and cyanidin prevented the docking of the vesicles. These results are consistent with our previous findings in fluorescence resonance energy transfer assays.

A riser system experiences a tri-modal process. It is excited by combined loads composed of low frequency response due to riser tension, mid-range excitation frequency from waves and high frequency excitation due to vortex induced-vibration. This study proposes ideal tri-modal spectrum formulations for parametric study. The formulated spectrum is used to compare various fatigue damage models developed to predict fatigue damage for wide band spectrum through theoretical or empirical approaches. The most reasonable fatigue damage is calculated as a reference by inverse Fourier transform, rain-flow counting method and Palmgren–Miner rule. The results conclude that the Benasciutti–Tovo and JB models currently represent the most appropriate fatigue damage for tri-modal spectrum.

To date, there are still very few reports on benign-tumor cases based on East Asian skeletal series, even though other regions and continents have been well represented. In our study on the Joseon Human Skeletal Series, we identified benign bone tumors in two skeletons (cases Nos. 75 and 96). Our radiological analyses showed both cases to be homogeneous sclerotic bone masses aligned with the cranial vault suture. In a subsequent series of differential diagnoses, we determined both cases to be osteoma, the most common bone-tumor type reported for archaeological samples. Our study is the osteoarchaeological basis for this, the first-ever report on benign bone neoplasm in a pre-modern East Asian population.

Personal information exposed in the Internet is increasing by t he public data opening and sharing, vitalization of SNS(Social Network Service) and growth of information shared between users . Exposed personal information in the Internet can infringe upon targeted users using linkage attack or background attack. To prevent these attack De-identification models were appeared a few years ago. The ’k-anonymity’ has been introduced in the f irst place, and the ‘l-diversity’ and ’t-closeness’ have been followed up as solutions, and diverse algorithms have been bein g suggested for performance improvement nowadays. However, industry or public sectors actually needs a whole solution as a system for the de-identification process rather than performance of the de-identification algorithm. This paper explains a way of de-identification techique for ‘k-anonymity’, ‘ l-diversity’, and ’t-closeness’ algorithm using QI(Quasi-Identifier) grouping met hod in the relational database.Keywords: K-anonymity, L-diversity, T-closeness, De-identification Algorithms

Analysis of ancient DNA (aDNA) extracted from Ascaris is very important for understanding the phylogenetic lineage of the parasite species. When aDNAs obtained from a Joseon tomb (SN2-19-1) coprolite in which Ascaris eggs were identified were amplified with primers for cytochrome b (cyt b) and 18S small subunit ribosomal RNA (18S rRNA) gene, the outcome exhibited Ascaris specific amplicon bands. By cloning, sequencing, and analysis of the amplified DNA, we obtained information valuable for comprehending genetic lineage of Ascaris prevalent among pre-modern Joseon peoples.

Objective To investigate whether the clinician-performed ultrasonography based on the specific criteria for paediatric appendicitis could decrease the negative appendectomy rate without treatment failure. Methods The study was a retrospective review of paediatric patients with suspected appendicitis who presented at the emergency department of a teaching hospital over a period of 18 months. The clinicians performed the ultrasound and decided whether the patients with suspected appendicitis should be referred to surgery or managed conservatively. The determinative ultrasound criteria were the presence of periappendiceal fat infiltration and/or an obstructing appendicolith. Results The 166 paediatric patients with suspected appendicitis underwent ultrasonography performed by clinicians on weekdays; forty (24.1%) cases with an obstructing appendicolith and/or periappendiceal fat infiltration were treated surgically, and none had a pathologically negative appendectomy, which was significantly lower than the number in the computed tomography scan group (10.4%, 11/106) on weeknights or weekends. The remaining 126 (75.8%) patients without obstructing appendicolith or periappendiceal fat infiltration were treated conservatively, regardless of their appendiceal diameter, and no patients experienced a treatment failure. Conclusions The clinician-performed ultrasonography bases on the strict use of above specific ultrasound criteria to determine treatment strategies for suspected paediatric appendicitis can reduce the negative appendectomies without treatment failure. (Hong Kong j.emerg.med. 2015;22:31-40)

ObjectBrain metastases from hepatocellular carcinoma (HCC) are rare, and the evidence of the effectiveness of Gamma Knife surgery (GKS) in this disease is lacking. The authors report their institutional experience with GKS in patients with brain metastases from HCCs.MethodsThe authors retrospectively reviewed the medical records of 73 consecutive patients who had a combined total of 141 brain metastases arising from HCCs and were treated with GKS. Sixty-four (87.7%) patients were male, and the mean age of the patients was 52.5 years (range 30–79 years). The mean tumor volume was 7.35 cm3 (range 0.19–33.7 cm3). The median margin dose prescribed was 23 Gy (range 15–32 Gy). Univariate and multivariate survival analyses were performed to identify possible prognostic factors of outcomes.ResultsThe estimated rate of local tumor control was 79.6% at 3 months after GKS. The median overall survival time after GKS was 16 weeks. The actuarial survival rates were 76.7%, 58.9%, and 26.0% at 4, 12, and 24 weeks after GKS, respectively. In the univariate analysis, an age of ≤ 65 years, Child-Pugh Class A (pertaining to liver function), high Karnofsky Performance Scale score (≥ 70), and low Radiation Therapy Oncology Group recursive partitioning analysis class (I or II) were positively associated with the survival times of patients. No statistically significant variable was identified in the multivariate analysis.ConclusionsAlthough survival was extremely poor in patients with brain metastases from HCCs, GKS showed acceptable local tumor control at 3 months after the treatment. The authors suggest that GKS represents a noninvasive approach that may provide a valuable option for treating patients with brain metastases from HCCs.

Objective The purpose of this study was to analyze the variability of clopidogrel responses according to duration of a clopidogrel drug regimen after stent-assisted coil embolization (SAC), and to determine the correlation between the variability of clopidogrel responses and thromboembolic or hemorrhagic complications. Methods A total of 47 patients who underwent SAC procedures to treat unruptured intracranial aneurysms were enrolled in the study. Preoperatively, patients received more than seven days of aspirin (100 mg) and clopidogrel (75 mg), daily. P2Y12 reaction unit (PRU) was checked with the VerifyNow test one day before the procedure (pre-PRU) and one month after the procedure (post-PRU). PRU variability was calculated as the difference between the initial response and the follow-up response. Patients were sorted into two groups based on their response to treatment : responsive and hypo-responsive. Results PRU variability was significantly greater in the hypo-responsive group when compared to the responsive group (p=0.019). Pre-PRU and serum platelets counts were significantly correlated with PRU variation (p=0.005 and p=0.004, respectively). Although thromboembolic complication had no significant correlated factors, hemorrhagic complication was correlated with pre-PRU (p=0.033). Conclusion In conclusion, variability of clopidogrel responses during clopidogrel medication was correlated to serum platelet counts and the initial clopidogrel response. Thromboembolic and hemorrhagic complications did not show correlation with the variability of clopidogrel response, or the clopidogrel response after one month of medication; however, hemorrhagic complication was associated with initial clopidogrel response. Therefore, it is recommended to test patients for an initial clopidogrel response only, as further tests would be insignificant.

Hexanoic acid can be used for diverse industrial applications and is a precursor for fine chemistry. Although some natural microorganisms have been screened and evolved to produce hexanoic acid, the construction of an engineered biosynthetic pathway for producing hexanoic acid in yeast has not been reported. Here we constructed hexanoic acid pathways in Kluyveromyces marxianus by integrating 5 combinations of seven genes (AtoB, BktB, Crt, Hbd, MCT1, Ter, and TES1), by which random chromosomal sites of the strain are overwritten by the new genes from bacteria and yeast. One recombinant strain, H4A, which contained AtoB, BktB, Crt, Hbd, and Ter, produced 154 mg/L of hexanoic acid from galactose as the sole substrate. However, the hexanoic acid produced by the H4A strain was re-assimilated during the fermentation due to the reverse activity of AtoB, which condenses two acetyl-CoAs into a single acetoacetyl-CoA. This product instability could be overcome by the replacement of AtoB with a malonyl CoA-acyl carrier protein transacylase (MCT1) from Saccharomyces cerevisiae. Our results suggest that Mct1 provides a slow but stable acetyl-CoA chain elongation pathway, whereas the AtoB-mediated route is fast but unstable. In conclusion, hexanoic acid was produced for the first time in yeast by the construction of chain elongation pathways comprising 5–7 genes in K. marxianus.

The riser systems for floating offshore structures are known to experience tri-modal dynamic responses. These are owing to the combined loadings from the low-frequency response due to riser tension behavior, middle-range frequency response coming from w inds and waves, and high-frequency response due to vortex induced-vibration. In this study, fatigue damage models were applied to predict the fatigue damages in a well-separated tri-modal spectrum, and the resultant fatigue damages of each model were compared with the most reasonable fatigue damage calculated by the inverse Fourier transform of the spectrum, rain-flow counting method, and Palmgren-Miner rule as a reference. The results show that the fatigue damage models developed for a wide-band spectrum are applicable to the tri-modal spectrum, and both the Benasciutti- Tovo and JB models could most accurately predict the fatigue damages of the tri-modal spectrum responses.

The anatomical location and somatotopic organization of the corticospinal tract (CST) in the corona radiata (CR) of the normal human brain have not been studied using diffusion tensor tractography so far. In this study, the anatomical location and somatotopic organization of the CST in the CR were evaluated by determining the highest probabilistic locations and distances between the upper and lower extremities in the slices of upper and lower CR in the brain. In the mediolateral direction, the average of the highest probabilistic locations for the upper and lower extremities were 40.27 and 37.16% at the upper CR level and 38.19 and 37.14% at the lower CR level, respectively. In the anteroposterior direction, the average of the highest probabilistic locations for the upper and lower extremities were 62.52 and 75.65% at the upper CR level and 60.19 and 68.12% at the lower CR level, respectively. The average distances between upper and lower extremities for the mediolateral direction were 2.41 mm at the upper CR level and 1.21 mm at the lower CR level. The average distances between upper and lower extremities for the anteroposterior direction were 5.23 mm at the upper CR level and 4.47 mm at the lower CR level, respectively. Our findings suggest that the anatomical location and somatotopic organization for the upper extremity are located anterolaterally to the lower extremity in the CR of a normal human brain and distances between the upper and lower extremities become decreased as the CST descends from the upper to the lower CR level.

An efficient and scalable NAD(P)+ regeneration system to promote alcohol dehydrogenase-catalysed oxidation reactions is reported. Indirect electrochemical oxidation of NADH was established with 2,2′-azino-bis-(3 ethyl-benzo-thiazoline-6-sulfonic acid) (ABTS), being the most efficient mediator amongst the candidates screened. ABTS exhibited very high catalytic performance of 1200 catalytic turnovers per hour. In a three-dimensional electrochemical cell with a high working electrode surface area of 24 m2 and optimised concentrations of substrate, enzyme, cofactor and mediator, TTNs of 1860 for the mediator and of 93 for the cofactor were measured. Besides, a maximum STY of 1.4 g l−1 h−1 was determined. Here we show the highest TTN ever reported for a mediated NAD+ regeneration in an electro-enzymatic process. The use of the three-dimensional electrochemical reactor led to an 8-fold improvement of the STY compared to a published system, based on a two-dimensional cell.

Marine structures on offshore fields are continuously subjected to wide band random loadings due to the combinations of wind-sea and swell, wind-sea and hull girder vibration, and wind-sea and drift/restoring. Those kinds of loadings are translated into wide band spectra with multiple peaks in frequency domain which violate a primary assumption of narrow band Gaussian process. It is known that it follows no more Rayleigh distribution and spectral fatigue procedure based on Rayleigh distribution therefore becomes inaccurate and conservative. This paper proposes a new probability density function (PDF) instead of Rayleigh PDF in order to improve fatigue prediction under wide band Gaussian process and explain a detailed development procedure. The validity of the new fatigue prediction model is first verified by comparing rainflow stress range distribution with two different PDFs: Dirlik and new ones. Then accuracy of the new model is second verified by comparing fatigue damages from various fatigue models with rainflow fatigue damages which is obtained from bimodal stress spectra.