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We investigated whether controlled normothermia (CN) after the rewarming phase of targeted temperature management (TTM) is associated with preventing post-rewarming fever and outcomes 6 months after out-of-hospital cardiac arrest (OHCA).This was an analysis of a prospective registry comprising OHCA patients treated with TTM at 22 academic hospitals between October 2015 and December 2018. We calculated the incremental area under the curve (iAUC) for body temperature greater than or equal to 37.5 °C for each patient during the first 24 h after the end of rewarming. The relationships among CN and iAUC, 6-month survival and good neurological outcome were analysed. To minimize differences in the baseline characteristics of the patients, we used propensity score-matched analysis.In total, 1144 patients were enrolled. After propensity score matching, 646 patients (comprising 323 pairs) were obtained. In the unmatched cohort, post-rewarming CN was significantly associated with a lower iAUC (0.34 [1.38] vs. 1.19 [2.27]; p 0.001) but not 6-month survival (adjusted odds ratio (OR): 1.121; 95% confidence interval (CI): 0.836-1.504; p = 0.446) and good neurological outcome (adjusted OR: 1.030; 95% CI: 0.734-1.446; p = 0.863). The results were similar in the propensity score-matched cohort (0.38 [1.56] vs. 1.03 [2.21], p 0.001, OR: 1.347, 95% CI: 0.989-1.835, p = 0.059 and OR: 1.280, 95% CI 0.925-1.772, p = 0.137, respectively).Post-rewarming CN prevents high fever in the normothermia phase of TTM. However, our data suggest the lack of association between CN and the patient's 6-month survival and good neurological outcome.

Aluminum, copper, nickel, and stainless steel 304 (SUS304) are widely used to construct heat exchangers. In this work, test specimens made of these metallic materials were irradiated with chromium ions. The static and dynamic contact angles of water droplets on the test specimens were measured to examine changes in the surface characteristics. Condensate behavior was visually observed and condensation heat transfer performance was experimentally measured. Filmwise condensation occurred on the surfaces of all the specimens that had no ion implantation. After these specimens were irradiated with chromium ions, filmwise condensation or dropwise condensation was induced depending on the ion irradiation conditions. When the substrates were irradiated with chromium ions at an ion energy level of 100 keV and an ion dose of 3 × 1016 ions/cm2, dropwise condensation occurred regardless of material. When the specimens were irradiated at an ion energy level of 70 keV, dropwise condensation, filmwise condensation, or both occurred depending on the substrate material. The condensation heat transfer coefficient of the surface where dropwise condensation occurred appeared to be more than 3.2 times larger than the theoretical value according to Nusselt’s film theory in the subcooling region below 9.5 K.

The adhesion force of a liquid droplet on a solid surface is a key factor influencing mobility of liquid droplets on the solid surface. Most of previous adhesion force models consider the length of the periphery of the wet area even though all parts in the wet area contribute to the adhesion of a liquid droplet. Recently, the authors proposed a new method to determine the adhesion energy of a droplet on a flat solid surface and this concept was verified using various liquid droplets on a hydrophobic solid surface. In this study, experiments are performed to verify that the new concept also can be applied to hydrophilic surfaces. Experimental measurements and analysis of these data demonstrates that the new definition of adhesion energy per unit area is appropriate for describing the movement of a liquid on hydrophilic solid surfaces as well as hydrophobic solid surfaces.

Background: In patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions (pPCI), longer door-to-balloon (DTB) time is known to be associated with an unfavorable outcome. A percentage of patients with acute coronary occlusion present with atypical electrocardiographic (ECG) findings, known as STEMI-equivalents. We investigated whether DTB time for STEMI-equivalent patients was delayed. Methods: This is a retrospective study including patients arriving at an emergency department with the acute coronary syndrome in whom emergent pPCI was performed. ECGs were classified into STEMI and STEMI-equivalent groups. We compared DTB time, with its components, between the groups. We also investigated whether STEMI-equivalent ECG was an independent predictor of DTB time delayed for more than 90 min. Results: A total of 180 patients were included in the present study, and 23 patients (12.8%) presented with STEMI-equivalent ECGs. DTB time was significantly delayed in patients with STEMI-equivalent ECGs (89 (80–122) vs. 81 (70–88) min, p = 0.001). Multivariable logistic regression analysis showed that STEMI-equivalent ECG was an independent predictor of delayed DTB time (odds ratio: 4.692; 95% confidence interval: 1.632–13.490, p = 0.004). Conclusions: DTB time was significantly delayed in patients presenting with STEMI-equivalent ECGs. Prompt recognition of STEMI-equivalent ECGs by emergency physicians and interventional cardiologists might reduce DTB time and lead to a better clinical outcome.

Objectives: Anaphylaxis refractory to epinephrine treatment is a potentially fatal condition requiring additional medications. Neutrophil-to lymphocyte ratio (NLR) is commonly used to predict severity in allergic diseases. The aim of this study was to determine the association between NLR and refractory anaphylaxis. Methods: This was a retrospective, observational study of 126 adult anaphylaxis patients arriving at the emergency department between January 2015 and December 2019. Patients were placed into refractory anaphylaxis, if they required more than two 0.3 mg injections of intramuscular epinephrine for symptom resolution, and non-refractory anaphylaxis groups. NLRs were determined at the time of arrival at the hospital and were compared between groups. Results: Thirty-two (25.4%) patients were categorized as refractory anaphylaxis cases. NLR was significantly lower in the refractory anaphylaxis than in the non-refractory anaphylaxis group (P < 0.001). In the multivariate logistic regression analysis model, NLR was inversely associated with the occurrence of refractory anaphylaxis (adjusted odds ratio 0.33, 95% confidence interval 0.13-0.81, P = 0.016). The area under the receiver operating characteristic curve of NLR for prediction of refractory anaphylaxis was 0.717 (P < 0.001). The optimal cut-off value of NLR was < 0.68 using the Youden index, with 50.0% sensitivity and 80.9% specificity. Conclusions: NLR was independently and inversely associated with the occurrence of refractory anaphylaxis among anaphylactic patients. Therefore, NLR has the potential to be used as an easy and inexpensive test to predict refractory anaphylaxis in patients.

It has been reported that valproic acid (VPA) combined with therapeutic hypothermia can improve survival and neurologic outcomes in a rat asphyxial cardiac arrest model. However, neuroprotective mechanisms of such combined treatment of valproic acid with hypothermia remains unclear. We hypothesized that epigenetic regulation of HSP70 by histone acetylation could increase HSP70-mediated neuroprotection suppressed under hypothermia. Male Sprague-Dawley rats that achieved return of spontaneous circulation (ROSC) from asphyxial cardiac arrest were randomized to four groups: normothermia (37°C ± 1°C), hypothermia (33°C ± 1°C), normothermia + VPA (300 mg/kg IV initiated 5 minutes post-ROSC and infused over 20 min), and hypothermia + VPA. Three hours after ROSC, acetyl-histone H3 was highly expressed in VPA-administered groups (normothermia + VPA, hypothermia + VPA). Four hours after ROSC, HSP70 mRNA expression levels were significantly higher in normothermic groups (normothermia, normothermia + VPA) than in hypothermic groups (hypothermia, hypothermia + VPA). The hypothermia + VPA group showed significantly higher HSP70 mRNA expression than the hypothermia group. Similarly, at five hours after ROSC, HSP70 protein levels were significantly higher in normothermic groups than in hypothermic groups. HSP70 levels were significantly higher in the hypothermia + VPA group than in the hypothermia group. Only the hypothermia + VPA group showed significantly attenuated cleaved caspase-9 levels than the normothermia group. Hypothermia can attenuate the expression of HSP70 at transcriptional level. However, VPA administration can induce hyperacetylation of histone H3, leading to epigenetic transcriptional activation of HSP70 even in a hypothermic status. Combining VPA treatment with hypothermia may compensate for reduced activation of HSP70-mediated anti-apoptotic pathway.

LoRa/LoRaWAN is growing rapidly as an underlying technology for the Internet of Things because of its long-range connectivity and low power. However, its limited scalability, owing to spread spectrum–based modulation and contention-based medium access control, impedes its use in emerging massive applications. In this study, we propose a downlink transmission scheme for enhancing the scalability of LoRa networks. The proposed scheme consists of two mechanisms. First, a modulation parameter is adjusted using the different transmission power limitations between the gateways and end devices to reduce downlink duration. Second, the timing of downlink traffic is selected based on uplink traffic concentration analysis. The proposed scheme reduces the uplink failure, and consequently, allows more end devices to participate in the network. The simulation results show that the proposed scheme is superior to the standard protocol in terms of the packet delivery ratio.

OBJECTIVE To compare the performance of the deep learning-based lesion detection algorithm (DLLD) in detecting liver metastasis with that of radiologists. MATERIALS AND METHODS This clinical retrospective study used 4386-slice computed tomography (CT) images and labels from a training cohort (502 patients with colorectal cancer [CRC] from November 2005 to December 2010) to train the DLLD for detecting liver metastasis, and used CT images of a validation cohort (40 patients with 99 liver metastatic lesions and 45 patients without liver metastasis from January 2011 to December 2011) for comparing the performance of the DLLD with that of readers (three abdominal radiologists and three radiology residents). For per-lesion binary classification, the sensitivity and false positives per patient were measured. RESULTS A total of 85 patients with CRC were included in the validation cohort. In the comparison based on per-lesion binary classification, the sensitivity of DLLD (81.82%, [81/99]) was comparable to that of abdominal radiologists (80.81%, p = 0.80) and radiology residents (79.46%, p = 0.57). However, the false positives per patient with DLLD (1.330) was higher than that of abdominal radiologists (0.357, p < 0.001) and radiology residents (0.667, p < 0.001). CONCLUSION DLLD showed a sensitivity comparable to that of radiologists when detecting liver metastasis in patients initially diagnosed with CRC. However, the false positives of DLLD were higher than those of radiologists. Therefore, DLLD could serve as an assistant tool for detecting liver metastasis instead of a standalone diagnostic tool.

Aluminum substrate specimens are irradiated with nitrogen ions at various ion dose and ion energy levels in order to realize dropwise condensation on the specimen surfaces. Dropwise steam condensation initially occurs on these specimens, but the condensation mode changes into filmwise condensation. When the condensation mode changes to filmwise condensation, the heat transfer coefficient is measured to be approximately 40% lower than that predicted using the Nusselt theory; in addition, the color of the surface changes from yellow-brown to silver-white. This surface color change is the result of the hydrolysis reaction between the condensate and the nitrogen ion-implanted aluminum surface. Non-condensable gas is generated by the hydrolysis reaction, and this non-condensable gas diminishes the heat transfer coefficient. In addition, the material composition of the specimen’s surface changes and causes the transition of the condensation mode.

Purpose To evaluate the clinical feasibility of low-dose orbital CT with a knowledge-based iterative model reconstruction (IMR) algorithm for evaluating Graves' orbitopathy. Methods Low-dose orbital CT was performed with a CTDIvol of 4.4 mGy. In 12 patients for whom prior or subsequent non-low-dose orbital CT data obtained within 12 months were available, background noise, SNR, and CNR were compared for images generated using filtered back projection (FBP), hybrid iterative reconstruction (iDose4), and IMR and non-low-dose CT images. Comparison of clinically relevant measurements for Graves' orbitopathy, such as rectus muscle thickness and retrobulbar fat area, was performed in a subset of 6 patients who underwent CT for causes other than Graves' orbitopathy, by using the Wilcoxon signed-rank test. Results The lens dose estimated from skin dosimetry on a phantom was 4.13 mGy, which was on average 59.34% lower than that of the non-low-dose protocols. Image quality in terms of background noise, SNR, and CNR was the best for IMR, followed by non-low-dose CT, iDose4, and FBP, in descending order. A comparison of clinically relevant measurements revealed no significant difference in the retrobulbar fat area and the inferior and medial rectus muscle thicknesses between the low-dose and non-low-dose CT images. Conclusions Low-dose CT with IMR may be performed without significantly affecting the measurement of prognostic parameters for Graves' orbitopathy while lowering the lens dose and image noise.

BackgroundA precise anatomical understanding of the thoracic paravertebral space (TPVS) is essential to understanding how an injection outside this space can result in paravertebral spread. Therefore, we aimed to clarify the three-dimensional (3D) structures of the TPVS and adjacent tissues using micro-CT, and investigate the potential routes for nerve blockade in this area.MethodsEleven embalmed cadavers were used in this study. Micro-CT images of the TPVS were acquired after phosphotungstic acid preparation at the mid-thoracic region. The TPVS was examined meticulously based on its 3D topography.ResultsMicro-CT images clearly showed the serial topography of the TPVS and its adjacent spaces. First, the TPVS was a very narrow space with the posterior intercostal vessels very close to the pleura. Second, the superior costotransverse ligament (SCTL) incompletely formed the posterior wall of the TPVS between the internal intercostal membrane and vertebral body. Third, the retro-SCTL space broadly communicated with the TPVS via slits, costotransverse space, intervertebral foramen, and erector spinae compartment. Fourth, the costotransverse space was intersegmentally connected to the adjacent retro-SCTL space.ConclusionsA non-destructive, multi-sectional approach using 3D micro-CT more comprehensively demonstrated the real topography of the intricate TPVS than previous cadaver studies. The posterior boundary and connectivity of the TPVS provides an anatomical rationale for the notion that paravertebral spread can be achieved with an injection outside this space.

The formation of liquid droplets on a hydrophobic surface and continuous droplet removal is beneficial in the design of various engineering devices. A liquid droplet on an inclined hydrophobic surface may roll down or attach to the surface depending on the balance among the associated forces. A series of experiments is performed in order to measure the inclination angle of a hydrophobic surface that makes a liquid droplet begin to slide or roll down. Various sizes of sessile drops of deionized water, ethylene glycol, and methylene iodide are examined. The existing adhesion force models have not been successful in predicting the sliding angle because they do not consider the area where the liquid droplet and solid surface are in contact with each other, but rather they consider the length of the periphery of the contact area. In this study, a new method to predict the adhesion energy of a droplet on a flat solid surface is proposed. The proposed method is based on the relationship between the solid and liquid contact area using moment of force analyses. Analyzing the experimental data using the proposed method, the adhesion energy per unit area is evaluated to have a constant value regardless of the droplet volume. The new definition of adhesion energy per unit area is appropriate for describing the movement of a liquid on a hydrophobic solid surface.

Objective . To determine the risk factors associated with clinical insomnia in postherpetic neuralgia (PHN) patients. Design . A retrospective cross-sectional study. Setting . Outpatient department for interventional pain management at a university hospital. Subjects . A total of 111 patients with PHN satisfied the study inclusion criteria and were included in the analyses. Methods . The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ≥ 15). Patient demographics, pain-related factors, and rash severity and location were evaluated with logistic regression analysis to identify risk factors of clinical insomnia among patients with PHN. Results . In total, 50.5% of patients reported mild to severe insomnia symptoms (ISI score ≥ 8) after pain development. Moderate to severe clinical insomnia (ISI score ≥ 15) was observed in 30.6% of PHN patients. Multivariate logistic regression analyses revealed that high pain intensity was the strongest predictor of clinical insomnia (odds ratio (OR) = 12.417, 95% confidence interval (CI): 2.990–51.561, P = 0.001). However, presence of mechanical allodynia (OR = 4.263, 95% CI: 1.040–17.481, P = 0.034) and high anxiety and depression level (OR = 4.452, 95% CI: 1.201–16.508, P = 0.026; OR = 6.975, 95% CI: 1.425–34.138, P = 0.017) were also significantly associated with clinical insomnia after adjusting for pain score. Clinical insomnia was not significantly related to age, gender, rash severity, or location of skin lesion. Conclusions . Insomnia should be addressed as an important part of pain management in PHN patients with these risk factors, especially in patients with severe pain.

Background Interventional pain procedures (IPPs) may be necessary for some cancer patients when conservative treatment fails. However, many IPPs are often delayed or cancelled for cancer patients who are referred to the pain clinic. Methods We retrospectively analyzed the reasons for such cancellations to identify clinically avoidable causes of the delay in IPP. Results We enrolled 350 cancer patients who were referred to our pain clinic for an IPP between March 2016 and February 2018. There were 213 (60.9%) cases that were cancelled, among which 115 (54%) cases were potentially avoidable and 98 (46%) were unavoidable. The most common reasons for cancellation were patient-derived factors, which accounted for 85 (39.9%) cases. Patient refusal was a common reason for cancellation, with 33 (15.5%) cases attributed to this cause. The primary avoidable causes of cancellation were a recommendation that the patient continue with their current pharmacological pain treatment, conflict with another planned treatment, and pain characteristics that were not suitable for an IPP. Together, these accounted for 76.5% of all avoidable cancellations. Conclusions Comprehensive and accurate pain assessments before IPP may result in more favorable outcomes for the efficient use of medical resource and effective pain relief in cancer patients.

Sang Jun Park,1,2 Kyung Bong Yoon,1,2 Dong Ah Shin,3 Kiwook Kim,1 Tae Lim Kim,1 Shin Hyung Kim1,2 1Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea; 3Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea Background: A caudal epidural steroid injection (CESI) is a commonly used method to improve symptoms of lumbosacral pain. We compared the achievement of successful epidurograms and patient-reported clinical outcomes following different needle-insertion depths during CESI.Methods: For the conventional method group, the needle was advanced into the sacral canal. For the alternative method group, the needle was positioned immediately after penetration of the sacrococcygeal ligament. Epidural filling patterns and vascular uptake during fluoroscopy were determined to verify successful epidural injection. Procedural pain scores were investigated immediately after the procedure. Pain scores and patient global impression of symptom change were evaluated at 1-month follow-up.Results: Assessments were completed by 127 patients (conventional method, n=64; alternative method, n=63). The incidence of intravascular injection was significantly lower in the alternative method group than in the conventional method group (3.2% vs 20.3%, P=0.005). Procedural pain during needle insertion was significantly lower in the alternative method group (3.7±1.3 vs 5.3±1.2, P

The purpose of this study was to evaluate the performance of the deep convolutional neural network (DCNN) in differentiating between tuberculous and pyogenic spondylitis on magnetic resonance (MR) imaging, compared to the performance of three skilled radiologists. This clinical retrospective study used spine MR images of 80 patients with tuberculous spondylitis and 81 patients with pyogenic spondylitis that was bacteriologically and/or histologically confirmed from January 2007 to December 2016. Supervised training and validation of the DCNN classifier was performed with four-fold cross validation on a patient-level independent split. The object detection and classification model was implemented as a DCNN and was designed to calculate the deep-learning scores of individual patients to reach a conclusion. Three musculoskeletal radiologists blindly interpreted the images. The diagnostic performances of the DCNN classifier and of the three radiologists were expressed as receiver operating characteristic (ROC) curves, and the areas under the ROC curves (AUCs) were compared using a bootstrap resampling procedure. When comparing the AUC value of the DCNN classifier (0.802) with the pooled AUC value of the three readers (0.729), there was no significant difference (P = 0.079). In differentiating between tuberculous and pyogenic spondylitis using MR images, the performance of the DCNN classifier was comparable to that of three skilled radiologists.

Korean ginseng is considered to be a precious health food in Asia. Today, thieves frequently compromise ginseng farms by pervasive theft. Thus, studies regarding the characteristics of ginseng according to growth region are required in order to deter ginseng thieves and prevent theft. In this study, 6 regions were selected on the basis of Korea regional criteria (si, gun, gu), and two ginseng-farms were randomly selected from each of the 6 regions. Then 4-6 samples of ginseng were acquired from each ginseng farm. The stable isotopic compositions of H, O, C, and N of the collected ginseng samples were analyzed. As a result, differences in the hydrogen isotope ratios could be used to distinguish regional differences, and differences in the nitrogen isotope ratios yielded characteristic information regarding the farms from which the samples were obtained. Thus, stable isotope values could be used to differentiate samples according to regional differences. Therefore, stable isotope analysis serves as a powerful tool to discriminate the regional origin of Korean ginseng samples from across Korea.

Making an SDN data plane flexible enough to satisfy the various requirements of heterogeneous IoT applications is very desirable in terms of software-defined IoT (SD-IoT) networking. Network devices with a programmable data plane provide an ability to dynamically add new packet- and data-processing procedures to IoT applications. The previously proposed solutions for the addition of the programmability feature to the SDN data plane provide extensibility for the packet-forwarding operations of new protocols, but IoT applications need a more flexible programmability for in-network data-processing operations (e.g., the sensing-data aggregation from thousands of sensor nodes). Moreover, some IoT models such as OMG DDS, oneM2M, and Eclipse SCADA use the publish-subscribe model that is difficult to represent using the operations of the existing message-centric data-plane models. We introduce a new in-network data-processing scheme for the SD-IoT data plane that defines an event-driven data-processing model that can express a variety of in-network data-processing cases in the SD-IoT environment. Also, the proposed model comprises a language for the programming of the data-processing procedures, while a flexible data-plane structure that can install and execute the programs at runtime is additionally presented. We demonstrate the flexibility of the proposed scheme by using sample programs in a number of example SD-IoT cases.

Making the data plane of a SDN flexible enough to satisfy the various requirements of heterogeneous IoT applications is very desirable for Software Defined IoT (SD-IoT) networking. The network device having programmable data plane provides an ability to add new packet and data processing procedures dynamically to the IoT applications. Previously proposed solutions for adding programmability to the SDN data plane provide extensibility for packet forwarding operations for new protocols, but IoT applications need more flexible programmability for in-network data processing operations e.g. data aggregation of sensing data from thousands of sensor nodes. Moreover, some IoT models such as OMG DDS, oneM2M, and Eclipse SCADA use publish-subscribe model, which is difficult to represent with the operations of existing message-centric data plane models. We introduce a new in-network data processing scheme for SD-IoT data plane. It defines an event-driven data processing model that can express various in-network data processing cases in the SD-IoT environment. It also proposes a language to program the data processing procedures using the model, and presents a flexible data plane structure that can install and execute the programs at runtime. We demonstrated flexibility of the proposing scheme with sample programs for some example SD-IoT cases.

Nitrogen and argon ions were irradiated on the surface of aluminum alloy. Ion irradiation appeared to increase contact angle of the metallic specimens. In order to investigate the factors affecting the changes of contact angles, changes in the characteristics of the surfaces were examined using SEM, AFM, and X-ray diffraction. The contact angle increased due to surface composition changes and surface roughness changes.

Identification of paint on victim`s clothing and a vehicle are valuable for forensic examination when investigating hit-and-run accidents. Automotive paints on clothes are used to prove a victim caused by traffic accident and to identify a suspected vehicle. The comparison of transferred paints between victim`s vehicle and suspected vehicle can be an important evidence in reconstructing the accident situation and in discovering the truth. The paints such as white, yellow, red, blue, or black are hard to examine particle shape under a stereomicroscope because of it is not included aluminum, pearl, and mica flakes in the pigments. The aim of this study under forensic aspect is to compare pigment among basecoat layers of solid paints by identifying inorganic elemental compositions and binder resins of pigments using by micro-FT-IR and micro-XRF spectrometer. The pigment samples were analyzed by using two methods of FT-IR: Reflectance and ATR method. Two methods of FT-IR were useful in discriminating binder resins of pigments by comparing characteristic peaks and patterns of spectra. Also, XRF spectrometer could identify the elemental compositions in inorganic pigments of trace paints which are difficult to compare the identification by FT-IR.

We visually observed that a dropwise condensation occurred initially and later changed into a filmwise condensation on hydrophobic textured surface at atmosphere pressure condition. It was observed that the condensate nucleated on the pillar side walls of the micro structure and the bottom wall adhered to the walls and would not be lifted to form a spherical water droplet using environmental scanning electron microscope.

Situs inversus totalis is a rare inherent disease in which the thoracic and abdominal organs are transposed. Symptoms of appendicitis in situs inversus (SI) may appear in the left lower quadrant, and the diagnosis of appendicitis is very difficult. We report a case of left-sided appendicitis diagnosed preoperatively after dextrocardia that was detected by chest X-ray, although the chief complaint of the patient was left lower-quadrant pain. The patient underwent an emergent laparoscopic appendectomy under the diagnosis of appendicitis after abdominal computed tomography (CT). In patients with left lower quadrant pain, if the chest X-ray shows dextrocardia, one should suspect left-sided appendicitis. A strong suspicion of appendicitis and an emergency laparoscopic operation after confirmation of the diagnosis by imaging modalities including abdominal CT or sonography can reduce the likelihood of misdiagnosis and complications including perforation and abscess. Laparoscopic appendectomy in SI was technically more challenging because of the mirror nature of the anatomy.

Macrophages reside in the vascular intima of the aorta in plaque prone regions. Intima macrophages were found to be ‘tissue resident’, possessing the ability to self-renew independent of circulating monocytes and having a unique dependence on Csf1 and Flt3 pathways for development. Lineage tracing and depletion experiments showed these cells were regulators of early plaque development in models of atherosclerosis. Using bulk RNAseq on intima resident macrophages and single cell sequencing data from total leukocytes from C57Bl/6 mouse aorta, we identified a core gene expression profile associated with intima resident macrophages. Comparing this gene signatures to single-cell gene expression data obtained from total leukocytes from atherosclerotic aortas identified overlapping gene expression with foamy macrophages, despite foamy macrophages developing exclusively from recruited monocytes at this stage of disease. The intima resident gene signature was expressed in foamy cells in addition to cholesterol handling genes, but not in newly recruited monocytes. Importantly, the intima gene signature was only associated with cells lacking expression of inflammatory genes. Together this suggests there is a niche-driven gene expression program within the aortic intima influencing macrophage differentiation and function. Targeting this newly identified gene set may be important for regulation of the inflammatory pathways and foamy macrophage differentiation in atherosclerosis.

Resident macrophages in peritoenal and pleural cavities exist as two distinct populations: F4/80+ICAM2+macrophages and MHCII+ macrophages. F4/80+ ICAM2+macrophages are derived from CX3CR1+embryonic precursors, and maitained by the transcription factor Gata6. However, the origin and regulating factors that maintain MHCII+ macrophages remain unknown. Here, we show that the MHCII+ macrophages arise postnatally from monocytes, which continuously replenish this subset through adulthood. Gene expression analysis identified distinct surface markers such as CD226 and revealed that the transcription factor IRF4 was selectively expressed in these macrophages relative to other organs. Monocytes first enter peritoneal or pleural cavities to become MHC II+ cells that up-regulate CD226 later as they continue to mature. In the absence of IRF4 or after administration of oral antibiotics, MHCII+CD226−CD11c− monocyte-derived cells accumulated in peritoneal and pleural cavities, but CD11c+ CD226+ macrophages were lost. Thus, MHC II+ resident peritoneal and pleural macrophages are continuously replenished by blood monocytes recruited to the peritoneal and pleural cavities constitutively, starting after birth, where they require IRF4 and signals likely derived from the microbiome to fully differentiate.

This study was carried out to investigate the characteristics of an oxidative-dissolution of fission products (FP) when uranium (U) is dissolved in a Na2CO3–H2O2 carbonate solution. Simulated FP-oxides which contained 12 components were added to the solution to examine their dissolution behaviors. It was found that H2O2 was an effective oxidant to minimize the dissolution of FP. For the 0.5 M Na2CO3–0.5 M H2O2 solution, such elements as Re, Te, Cs, and MoO2 were dissolved with yields of 98 ± 2%, 98 ± 2%, 93 ± 2%, and 26 ± 3%, respectively, for 2 h. Among these components, Re, Te, and Cs were completely dissolved within 10–20 min without regard to the concentrations of Na2CO3, and H2O2 due to their high solubility in the carbonate solution with and without H2O2. However, MoO2 was very slowly dissolved and its yield was 29 ± 3% for 4 h. The pH of the dissolved solution revealed the greatest influence on the dissolution yields of the FP, exhibiting the most effective pH condition in the range of 10–12 in order to create a considerable suppression of the co-dissolution of FP during the oxidative-dissolution of U.

The extraction of Am(III) and Eu(III) using a γ-pre-irradiated N,N′-dimethyl-N,N′-dibutyltetradecyl malonamide (DMDBTDMA) modified with N,N′-dihexyloctanamide (DHOA) in n-dodecane (NDD) at 4.5M HNO3 has been studied as a function of the absorbed dose up to 2×106 Gray. The distribution ratios of Am(III) and Eu(III) were almost constant until a dose of 1×105 Gray and then they decreased gradually up to a dose of 2×106 Gray. The decrease of the distribution ratios of Am(III) and Eu(III) are due to the decreasing concentration of the DMDBTDMA by a γ-pre-irradiation and these results were supported by a determination of the DMDBTDMA concentration with a gas chromatography method. The distribution ratios of Am(III), Eu(III), Ce, Nd and Y with γ-pre-irradiated (DMDBTDMA-DHOA)/NDD have also been studied as a function of the nitric acid concentration and the extraction temperature.

As a preliminary experiment to test the discriminating ability of forensic soil analysis techniques and obtain area-specific information, soil samples were collected from eight areas near the eastern branch of the National Forensic Service (NFS) located in Gangwondo, an eastern province of South Korea. The soil samples were collected from five spots within each sample area using a small-scale (1 m2) soil sampling technique; for each of these five spots, two samples were collected from two places in each spot, (i) one from the surface and (ii) another from 30 cm below the surface. For each sample, the color of the sample with particle size in the range 53–500 μm and the major constituents were determined using a spectrophotometer and X-ray fluorescence spectrometer (XRF), respectively. The carbon content and carbon isotope ratio of the part of the sample of particle size below 53 μm were measured using an element analyzer-isotope ratio mass spectrometer (EA-IRMS). The canonical discriminant and XRF analyses showed an excellent color discriminating ability of 87.5 % and 88.8 %, respectively, with respect to the major constituents. The EA-IRMS results showed that the soils obtained from a 30-cm depth below the surface were generally more enriched in δ13C (0/00) than the surface soils, and that the surface soils contained a higher carbon amount (%). The canonical discriminant analysis confirmed 100 % discriminating ability when all three soil characteristics (i.e., color, composition, and content) were used in the analysis. Out of the two functions obtained from the analysis, Function 1 exhibited greater potential for explaining the SiO2, Fe2O3, and TiO2; thus, Area 6 and 7 could be more easily differentiated than the other areas using this function. Function 2 exhibited greater potential for explaining color factor b* (δ13C and C content), and could more efficiently differentiate Area 2 and 5. However, different results were obtained within the same area based on the soil depth. Therefore, when performing a comparative sampling analysis in forensic science, due care should be taken to prevent the mixing of adjacent soils from various depths. Better results can be achieved by collecting soil samples from different spots within the same area.

In order to investigate the residual amounts of organochlorines and polychlorinated biphenyls (PCBs) in Korean human tissues (blood, adipose tissue, liver, kidney cortex, and lung), the samples were collected from the autopsied cadavers of 40 men and 40 women (from teens to seventies of age). Alpha-BHC, beta-BHC, gamma-BHC, delta-BHC, p,p'-DDT, p,p'-DDD, p,p'-DDE, endrin, dieldein, aldrin, and 7 marker PCBs (28, 52, 101, 118, 138, 153, and 180) were determined in human tissues. The levels of organochlorines and PCB congeners indicated that they have been widely distributed in Korean human body. Positive correlations in terms of age were observed for the following cases: p,p'-DDE, p,p'-DDT, Sigma-DDT, PCB 118, PCB 138, PCB 153, and Sigma-PCB in the adipose tissue, and p,p'-DDE in the lung. Concentration of these compounds showed a significant age-related increase. Accumulation of these compounds in aged people revealed that these compounds were more slowly eliminated in our environment and risk assessment was necessary for further proper action. Significant differences in the levels of PCBs between genders were found for PCB 118 in the adipose tissue and PCB 138 in the liver. Positive correlation coefficients between tissues were detected with p,p'-DDE and p-BHC.

Objective The purpose of this study was to determine the diagnostic utility of low-dose CT with knowledge-based iterative model reconstruction (IMR) for the evaluation of parotid gland tumors. Materials and Methods This prospective study included 42 consecutive patients who had undergone low-dose contrast-enhanced CT for the evaluation of suspected parotid gland tumors. Prior or subsequent non-low-dose CT scans within 12 months were available in 10 of the participants. Background noise (BN), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were compared between non-low-dose CT images and images generated using filtered back projection (FBP), hybrid iterative reconstruction (iDose4; Philips Healthcare), and knowledge-based IMR. Subjective image quality was rated by two radiologists using five-point grading scales to assess the overall image quality, delineation of lesion contour, image sharpness, and noise. Results With the IMR algorithm, background noise (IMR, 4.24 ± 3.77; iDose4, 8.77 ± 3.85; FBP, 11.73 ± 4.06; p = 0.037 [IMR vs. iDose4] and p < 0.001 [IMR vs. FBP]) was significantly lower and SNR (IMR, 23.93 ± 7.49; iDose4, 10.20 ± 3.29; FBP, 7.33 ± 2.03; p = 0.011 [IMR vs. iDose4] and p < 0.001 [IMR vs. FBP]) was significantly higher compared with the other two algorithms. The CNR was also significantly higher with the IMR compared with the FBP (25.76 ± 11.88 vs. 9.02 ± 3.18, p < 0.001). There was no significant difference in BN, SNR, and CNR between low-dose CT with the IMR algorithm and non-low-dose CT. Subjective image analysis revealed that IMR-generated low-dose CT images showed significantly better overall image quality and delineation of lesion contour with lesser noise, compared with those generated using FBP by both reviewers 1 and 2 (4 vs. 3; 4 vs. 3; and 3–4 vs. 2; p < 0.05 for all pairs), although there was no significant difference in subjective image quality scores between IMR-generated low-dose CT and non-low-dose CT images. Conclusion Iterative model reconstruction-generated low-dose CT is an alternative to standard non-low-dose CT without significantly affecting image quality for the evaluation of parotid gland tumors.

Objectives To prospectively determine whether multi-parametric MRI (mpMRI) - contrast-enhanced ultrasound (CEUS) correlated, imaging-guided target biopsy (TB) method could improve the detection of prostate cancer in re-biopsy setting of patients with prior negative biopsy. Methods From 2012 to 2014, a total of 42 Korean men with a negative result from previous systematic biopsy (SB) and elevated prostate-specific antigen underwent 3T mpMRI and real-time CEUS guided TB. Target lesions were determined by fusion of mpMRI and CEUS. Subsequently, 12-core SB was performed by a different radiologist. We compared core-based cancer detection rates (CaDR) using the generalized linear mixed model (GLIMMIX) for each biopsy method. Results Core-based CaDR was higher in TB (17.92%, 38 of 212 cores) than in SB (6.15%, 31 of 504 cores) (p < 0.0001; GLIMMIX). In the cancer-positive TB cores, CaDR with suspicious lesions by mpMRI was higher than that by CEUS (86.8% vs. 60.5%, p= 0.02; paired t-test) and concordant rate between mpMRI and CEUS was significantly different with discordant rate (48% vs. 52%, p=0.04; McNemar’s test). Conclusion The mpMRI-CEUS correlated TB technique for the repeat prostate biopsy of patients with prior negative biopsy can improve CaDR based on the number of cores taken.

To obtain the usual value of aluminum, arsenic, cadmium, chromium, copper, iron, lead, manganese, mercury, molybdenum, nickel, selenium, silicon, tin, vanadium and zinc in the normal human body, the amounts of these 16 metals were determined in 89 male and 61 female Korean cadavers, whose ages ranged from 12 to 87 years. Inductively coupled plasma atomic emission spectrometry was used for analysis of heavy metals in 9 autopsied human organs (liver, kidney, cerebrum, heart, spleen, lung, bone, hair and nail). Distribution of arsenic, nickel, selenium, lead and vanadium in the human body were almost uniform. Cadmium, mercury, manganese, molybdenum, tin and zinc were found in large quantities in the metabolic organs, whereas the concentrations of aluminum, chromium and silicon were greatest in the tissues exposed to the exterior.

In the past a few decades, particular interest has been focused on the distribution and interaction between toxic and essential elements in animals and humans, since such interactions might have adaptive implications to environmental pollution. The current study was performed to assess the correlation of elemental concentration with age and the correlation between toxic and essential elements in Koreans. Toxic elements, such as Cd, Pb, Hg, and essential elements such as Se and Zn, were analyzed in internal organs (liver, kidney cortex, kidney medulla, heart, lung, spleen, cerebrum, testis and bone) of 162 Korean cadavers. The tissues were digested with a microwave digestion system and the 5 elements were determined by inductively coupled plasma atomic emission spectrometry. Positive correlation with age was observed in the following cases: Cd in the liver, kidney cortex, kidney medulla, heart and testis; Pb in testis and bone. The concentration of Hg, Se and Zn was not correlated with age in any of the tissues tested. A significantly high correlation between Hg and Se, Pb and Se was observed in liver, kidney cortex, kidney medulla, heart, lung, spleen, cerebrum, testis and bone. The correlation between Cd and Zn was significant in the liver, kidney cortex, kidney medulla, heart, lung, cerebrum, testis and bone. These results indicate that the distribution of toxic elements is similar to that of essential elements in all tissues.