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Background Hypocapnia has been traditionally advocated during general anesthesia, even though it may induce deleterious physiological effects that result in unfavorable outcomes in patients. This study investigated the association between intraoperative end-tidal carbon dioxide (EtCO2) and length of hospital stay (LOS) in patients who underwent pylorus-preserving pancreaticoduodenectomy (PPPD). Methods The medical records of 759 patients from 2006 to 2015 were reviewed. The patients were divided into two groups based on the mean EtCO2 value during general anesthesia: the hypocapnia group (

Background/Purpose Predicting the mortality in patients admitted to the ICU is important for determining a treatment strategy and public health policy. Although many scores have been developed to predict the mortality, these scores were based on Caucasian population. We aimed to develop a new prognostic index, the New nutritional index (NNI), to predict 90-days mortality after ICU admission based on Korean population. Methods Patients (1453) who admitted intensive care unit (ICU) of the Gangnam Severance hospital were analyzed. After exclusion, 984 patients were randomly divided into internal (n = 702) and external validation (n = 282) data set. The new nutritional index (NNI) was developed using univariate and multivariate logistic regression with backward selection of predictors. Receiver operating characteristic (ROC) curve analysis and comparison of the area under the curve (AUC) verified the better predictor of 90 days-mortality after ICU admission. Results The NNI better predicted 90 days-mortality compared to modified NUTRIC score, APACHE II scores, SOFA scores, CRP, glucose, total protein, and albumin level in internal and external data sets, with AUC of 0.862 (SE: 0.017, 95% CI: 0.829–0.895) and 0.858 (SE: 0.015, 95% CI: 0.829–0.887), respectively. The calibration plots using external data set for validation showed a close approximation to the logistic calibration of each nomogram, and p-value of Hosmer and Lemeshow test was 0.1804. Conclusion The NNI has advantages as a predictor of 90 days mortality based on nutritional status in the Korean population.

Here we present the synthesis and properties of quinoline-substituted zinc(II) phthalocyanine, Zn[Pc(O-QN) 4 ]. Zn[Pc(O-QN) 4 ] can function as a highly selective chemosensor against Fe3+ and Zn2+ ions, exhibiting efficient fluorescence quenching and enhancement, respectively. Various characterization techniques were employed to investigate the intermolecular interactions of Zn[Pc(O-QN) 4 ] with metal ions. A double-electron exchange and a forbidden photoinduced electron transfer behavior in Zn[Pc(O-QN) 4 ] were attributed to such opposite responses. Furthermore, by taking advantage of selectivity, we successfully employed Zn[Pc(O-QN) 4 ] to stain and record confocal fluorescence microscopy images of Chang liver cells in the presence of metal ions.

Purpose Preoperative chemoradiation therapy (CRT) has become the standard treatment for patients with locally advanced rectal cancer, 15%-30% of patients still progress while being treated with CRT. The aim of this study was to identify as important biomarker of poor response and evaluate the mechanism associated with CRT resistance. Methods This study included 60 human colon tumour pre-irradiation specimens. Expressions of epidermal growth factor receptor (EGFR), p53, Kruppel-like factor 5 (KLF5), C-ern, Ki67 were assessed and correlated with tumor regression grades and complete remission. We added in vitro study with biomarker which has been identified as important biomarker of poor response to evaluate the mechanism associated with CRT resistance. Results Pathologic complete remission (pCR) was achieved by 9 patients (18%). EGFR and KLF5 were significantly associated with pCR (P = 0.048, P = 0.023, respectfully). And multivariate analysis showed high KLF5 intensity was worse factor for pCR (P = 0.012). In vitro study, radiation or chemotherapy therapy stabilized KLF5 protein levels in a time- and dose-depended manner in HCT116 and Caco-2 cells. KLF5 overexpression in HCT116 stable cell line showed significantly better cell viability by increasing cyclinD1 and b-catenin compared to control cells in MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, suggesting that KLF5 mediates cell survival. Conclusion KLF5 was significantly associated with the presence of KRAS mutations, and KLF5 was an independent poor response predictor of CRT in rectal cancer. Our study is pilot study and more research will be needed in the future.

The neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and mean platelet volume (MPV) have been reported to be associated with the prognosis of various types of tumors. This study evaluated the prognostic value and clinical use of inflammatory markers for predicting 1-year survival in patients undergoing cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). This retrospective study included 160 patients who underwent CRS with HIPEC between July 2014 and April 2017. Data on NLR, PLR, and MPV were collected preoperatively and on postoperative days (POD) 1, 2, 3, 4, and 5. In a multivariate analysis using a cox proportional hazard regression model, higher values of preoperative NLR and MPV, PLR, and MPV on POD 2, 3, and 5 were associated with reduced 1-year survival after CRS with HIPEC. Patients with increased MPV showed lower rates of 1-year survival following CRS with HIPEC. In addition, elevated preoperative NLR and postoperative PLR were correlated with poor survival. These markers are able to stratify patients by risk profile, which may ultimately improve perioperative management and be helpful in improving outcomes following CRS with HIPEC.

We have found a very easy, low-cost, highly-efficient technique for recycling copper (Cu) materials from polymer-coated waste Cu wire (WCW) by applying voltages using an induction-heating furnace. Voltages ranging from 562–969 V were applied to find the optimum conditions for removing the polymer coating from WCW to obtain pure Cu material. Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy, X-ray diffraction, and optical imaging were used to determine the required removal temperature of the polymer and its removal mechanism. FTIR analysis confirmed that the polymer coating on the WCW was polyester. Moreover, we successfully removed the polyester coating from the WCW by applying a voltage of 969 V.

Continuous stirred tank reactor(CSTR) model which can be applied to control and management of the surface flow wetland is developed to simulate the water quality in this research. The model solution is obtained from the optimization model using the least-squares and 4th-order Runge-Kutta methods. The model is applied to simulate BOD and TSS in the wetland database of U.S. EPA, in which the hydraulic and water quality data are enough and the number of pond is just one for simple analysis of running results. The model is tested in two different cases, one constant volume case and another constant volume and flow rate case considering only reaction term, mass flux term and both reaction and mass flux terms respectively. It is found that the model simulates the real water quality very well with both reaction and mass flux terms rather than only reaction term and the settling velocity of TSS becomes . The model can be applied in wetlands treatment efficiently.

This paper presents a methodology and framework for the development of an automated least-squares optimization tool for calibrating water quality parameters in QUAL2E. The method has been applied to estimate the optimal water quality parameters in simulation of stream water quality for the Anyang stream in Korea. The Monte Carlo analysis is used to assess the relative importance of model parameters for water quality constituents. It is found that μmax and ρ are the most influential parameters for Chlorophyll-a modeling and K 1 and K 3 are critical parameters for variation of DO and BOD in the Anyang stream. A computer program for automated parameter calibration has been developed using a nonlinear GRG optimization algorithm. The application framework provides an intuitive and easy-to-use interface and allows visual evaluation of results. According to the simulation results, the automated approach is computationally efficient for evaluation of model parameters and converges on a best fit more rapidly and reliably than a trial and error method. The methodology proposed herein can be extended to other models to obtain the best possible parameter values.

The objective of this paper is to evaluate the reliability of four mathematical models—Berthouex and Stevens' [4], San's [14], Ozer's [6], and the rule-based method—that can be used to fit flocculent settling data. Each approach was critically reviewed for its strengths and limitations, and investigated for its fitting capability using the data obtained from the authors' research and the related references. Three comparison criteria, goodness-of-fit, mathematical consistency, and design results, were used. The results from this study show that the rule-based approach yielded considerably lower sum of square error (SSE) than the other approaches. Berthouex and Stevens' approach violated the criterion of constraints for all the data sets. For the design results for average TSS removal efficiency, all approaches except Berthouex and Stevens' method showed relatively consistent results. But, in terms of reliability, the rule-based approach provided better results than the other approaches.

A partial C-terminal cDNA sequence of a novel Drosophila mitogen-activated protein kinase phosphatase (MKP), designated DMKP-3, was identified from an epitope expressed sequence tag database, and the missing N-terminal cDNA fragment was cloned from a Drosophila cDNA library. DMKP-3 is a protein of 411 amino acids, with a calculated molecular mass of 45.8kDa; the deduced amino acid sequence is most similar to that of mammalian MKP-3. Recombinant DMKP-3 produced in Escherichia coli retained intrinsic tyrosine phosphatase activity. In addition, DMKP-3 specifically inhibited extracellular-signal-regulated kinase (ERK) activity, but was without a significant affect on c-Jun N-terminal kinase (JNK) and p38 activities, when it was overexpressed in Schneider cells. DMKP-3 interacted specifically with Drosophila ERK (DERK) via its N-terminal domain. In addition, DMKP-3 specifically inhibited Elk-1-dependent trans-reporter gene expression in mammalian CV1 cells, and dephosphorylated activated mammalian ERK in vitro. DMKP-3 is uniquely localized in the cytoplasm within Schneider cells, and gene expression is tightly regulated during development. Thus DMKP-3 is a Drosophila homologue of mammalian MKP-3, and may play important roles in the regulation of various developmental processes.

The development and application of a one-dimensional heat transport model in highly transient streams governed by unsteady flow is described here. The resultant framework consists of two modules called the hydrodynamic and heat transport modules. In the hydrodynamic module, the hydraulic variables such as flow depth and velocity are simulated. Based on this information, the heat transport module is executed to calculate temperatures. A new approach—coupling heat transport in the surface water and diffusion in the sediment zone—is developed and applied for this module. In this approach, an interaction term accounts for the flux of heat energy between the water and sediments, which affects the distribution of water temperature in clear and shallow streams. Implicit finite difference methods called the Preissmann four-point and the Crank-Nicolson schemes are used to solve each module. Application of this framework demonstrates that the model effectively simulates the hydraulic variables and temperatures.

Gene expression changes have been associated with type 2 diabetes mellitus (T2DM); however, the alterations are not fully understood. We investigated the effects of anti-diabetic drugs on gene expression in Zucker diabetic fatty (ZDF) rats using oligonucleotide microarray technology to identify gene expression changes occurring in T2DM. Global gene expression in the pancreas, adipose tissue, skeletal muscle, and liver was profiled from Zucker lean control (ZLC) and anti-diabetic drug treated ZDF rats compared with those in ZDF rats. We showed that anti-diabetic drugs regulate the expression of a large number of genes. We provided a more integrated view of the diabetic changes by examining the gene expression networks. The resulting sub-networks allowed us to identify several biological processes that were significantly enriched by the anti-diabetic drug treatment, including oxidative phosphorylation (OXPHOS), systemic lupus erythematous, and the chemokine signaling pathway. Among them, we found that white adipose tissue from ZDF rats showed decreased expression of a set of OXPHOS genes that were normalized by rosiglitazone treatment accompanied by rescued blood glucose levels. In conclusion, we suggest that alterations in OXPHOS gene expression in white adipose tissue may play a role in the pathogenesis and drug mediated recovery of T2DM through a comprehensive gene expression network study after multi-drug treatment of ZDF rats.

Lipin1 protein, a product of the LPIN1 gene, is required for normal adipose tissue development and metabolism. Lipin1 deficiency results in immature adipocyte development in cases of mouse fatty liver dystrophy and human lipodystrophy. Recently, pioglitazone has been reported to increase human adipocyte lipin1 expression. We evaluated the effects of LPIN1 polymorphisms on rosiglitazone response in patients with type 2 diabetes (T2DM). A total of 262 patients were treated with 12 weeks of rosiglitazone (4 mg/day) in addition to their previous drug regimen medications. Six single nucleotide polymorphisms (SNPs) at the LPIN1 locus were genotyped: rs11693809, rs10192566, rs2278513, rs2577262, rs2716610, and rs1050800. Because rs11693809, rs10192566, and rs2278513 are in nearly complete linkage disequilibrium (D'>0.958, r(2) >0.882), we analyzed rs10192566, rs2577262, rs2716610, and rs1050800. Rs10192566 was significantly associated with rosiglitazone treatment response. Patients with the G allele in rs10192566 had a larger decrease in fasting plasma glucose, 2-h postprandial glucose, and HbA1c than those without. This genetic effect remained significant after adjustment for age, sex, and initial body weight. No other SNPs were associated with response. These data suggest that LPIN1 genetic variations can affect rosiglitazone treatment response in T2DM.

Background Glucagon-like peptide-1 (GLP-1) is a gut-derived incretin hormone that plays an important role in glucose homeostasis. Its functions include glucose-stimulated insulin secretion, suppression of glucagon secretion, deceleration of gastric emptying, and reduction in appetite and food intake. Despite the numerous antidiabetic properties of GLP-1, its therapeutic potential is limited by its short biological half-life due to rapid enzymatic degradation by dipeptidyl peptidase IV. The present study aimed to demonstrate the therapeutic effects of constitutively expressed GLP-1 in an overt type 2 diabetic animal model using an adenoviral vector system. Methods A novel plasmid (pAAV-ILGLP-1) and recombinant adenoviral vector (Ad-ILGLP-1) were constructed with the cytomegalovirus promoter and insulin leader sequence followed by GLP-1(7–37) cDNA. Results The results of an enzyme-linked immunosorbent assay showed significantly elevated levels of GLP-1(7–37) secreted by human embryonic kidney cells transfected with the construct containing the leader sequence. A single intravenous administration of Ad-ILGLP-1 into 12-week-old Zucker diabetic fatty (ZDF) rats, which have overt type 2 diabetes mellitus (T2DM), achieved near normoglycemia for 3 weeks and improved utilization of blood glucose in glucose tolerance tests. Circulating plasma levels of GLP-1 increased in GLP-1-treated ZDF rats, but diminished 21 days after treatment. When compared with controls, Ad-ILGLP-1-treated ZDF rats had a lower homeostasis model assessment for insulin resistance score indicating amelioration in insulin resistance. Immunohistochemical staining showed that cells expressing GLP-1 were found in the livers of GLP-1-treated ZDF rats. Conclusions These data suggest that GLP-1 gene therapy can improve glucose homeostasis in fully developed diabetic animal models and may be a promising treatment modality for T2DM in humans. Copyright © 2007 John Wiley & Sons, Ltd.

Environmental remediations such as dredging operations cause contaminated sediments from the bottom of water bodies to become suspended into the water column. These resuspended particles are significant water quality concerns and cause adverse effects to aquatic organisms. In this paper, we present a vertically integrated two-dimensional flocculent sediment transport model to better model concentration changes of resuspended bottom sediments. The flocculent transport model has been applied to the Savannah River cutterhead dredge field study involving the resuspension of bottom sediments. The results showed that the model predictions correlate reasonably well with field data. These comparisons suggest that the flocculent sediment transport model can be used to predict the concentration profiles of a plume of toxic compounds resulting from cutterhead dredge operation.

A Web-based dredge plume simulation software has been developed for estimating sediment transport and contaminant release from dredging operations. This application software comprises a near-field source model and far-field sediment transport model, combined with the settling analysis of flocculent particles. It is designed to run on all computing platforms with a standard Web browser and is accessible over the Internet. This paper describes its internal software structures and the major features of the application software. In addition, an example application of sediment transport in the Savannah River, GA, is included to illustrate typical input and output screens and to demonstrate the accuracy of the model. The water quality assessment software developed herein will greatly enhance the ability of the predictive tool for estimating sediment transport and resuspension during dredging operations.

Linear mode conversion of ordinary and extraordinary waves into upper hybrid waves has been investigated by adopting a time-dependent numerical model. In order to solve the wave equations as an initial-valued problem, the finite difference method is used in both time and space. It is examined how wave coupling occurs in a cold magnetized plasma, where inhomogeneity lies perpendicular to the ambient magnetic field, by analyzing time histories of both electric and magnetic field components. The results show that electromagnetic energy of ordinary and extraordinary waves is transferred into electrostatic energy when the resonant condition at upper hybrid resonances is satisfied.

A new approach is proposed to simulate the daily variation of chlorophyll a in one-dimensional streams. This approach uses the plant primary production rate to quantify the phytoplankton growth rate. The delta method, which is a piecewise analytical solution technique, is applied to determine the diurnal variation in plant primary production rate. The approach is tested by applying it to the Gumsuck stream in the Kyonggi-Do province in Korea. The optimization technique with constraints is used to obtain the best running results. Application of this approach shows that the values calculated using the method presented here are in good agreement with the measured values. Therefore, we conclude that this technique realistically simulates the daily variation of chlorophyll a.