Search

Background/Aims Endoscopic diagnosis of dysplasia or colitic cancer in patients with ulcerative colitis (UC) is more challenging than that of colorectal neoplasia in non-colitic patients. We aimed to evaluate the accuracy of the endoscopic diagnosis of "nonpedunculated" dysplasia or colitic cancer in UC patients. Methods Ten endoscopists from four countries were surveyed using photographs of 61 histologically confirmed dysplastic or non-dysplastic lesions retrieved from the UC registry database of Asan Medical Center. The participants provided their assessment based on the given photographs and their intention to perform biopsy. Results The overall diagnostic performance of the 10 participants is summarized as follows: sensitivity of 88.2% (95% confidence interval [CI], 84.3% to 91.5%), specificity of 34.8% (95% CI, 29.1% to 40.8%), positive predictive value of 63.0% (95% CI, 60.8% to 65.2%), negative predictive value of 70.2% (95% CI, 62.7% to 76.6%), and accuracy of 64.6% (95% CI, 60.7% to 68.4%). The interobserver agreement on the intention to perform a biopsy was poor (Fleiss kappa=0.169). Of the three endoscopic characteristics of the lesions, including ulceration, distinctness of the borders, and pit patterns, only neoplastic pit patterns were significantly predictive of dysplasia (odds ratio, 3.710; 95% CI, 2.001 to 6.881). The diagnostic sensitivity and specificity of neoplastic pit patterns were 68.2% (95% CI, 63.0% to 73.2%) and 63.3% (95% CI, 57.3% to 69.1%), respectively. Conclusions Diagnostic performance based on the endoscopist's intention to perform a biopsy for nonpedunculated potentially dysplastic lesions in UC patients was suboptimal according to this survey-based study.

Despite ethnic differences in cortisol sensitivity, only one study in Caucasians has assessed trabecular bone score (TBS) in patients with subclinical hypercortisolism (SH). We showed that both subtle cortisol excess and reduced adrenal androgen may contribute to impaired bone quality in Asian women with SH. One study in Caucasians has assessed trabecular bone score (TBS), an index of bone microstructure, in adrenal incidentaloma (AI) patients with subclinical hypercortisolism (SH). There are ethnic differences in cortisol sensitivities between Caucasian and Asian populations. We investigated the associations of cortisol and the adrenal androgen dehydroepiandrosterone-sulfate (DHEA-S) with TBS in AI patients with SH, adrenal Cushing’s syndrome (CS), and nonfunctional AI (NFAI). We measured TBS, cortisol levels after the overnight 1 mg dexamethasone suppression test (1 mg DST), and cortisol/DHEA-S in 61 patients with SH (30 men; 31 women), 19 with adrenal CS (4 men; 15 women), and 355 with NFAI (213 men; 142 women). After adjusting for confounders, the serum cortisol level after 1 mg DST was inversely correlated with TBS in men (β = −0.133, P = 0.045) and women (β = − 0.140, P = 0.048). Higher cortisol/DHEA-S ratio was associated with lower TBS in women (β = − 0.252, P

Background/Aims Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD. Methods We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice (n=30) were compared with those performed by the Korean endoscopist. Results The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p

As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines.

HIV-infected men under the age of 50 years had a lower bone mass compared to that of HIV-uninfected men. Lower CD4 T cell counts, independent of whether antiretroviral therapy (ART) was used, were associated with lower BMD. HIV-infected patients with low CD4 T cell counts may need follow-up and intervention regarding bone health, including younger patients.HIV-infected patients have a low bone mineral density (BMD) owing to multifactorial interaction between common osteoporosis risk factors and HIV-related factors, including chronic inflammation and ART. Although HIV infection and ART might affect bone metabolism, little data is available for patients aged under 50 years. We aimed to investigate the association of HIV infection-induced low CD4 T cell counts and ART with BMD in men aged under 50 years.We performed an age- and body mass index-matched case-control study. BMD values of HIV-infected and HIV-uninfected men ( 50 years) were compared, and HIV-infected men were stratified by CD4 T cell counts and ART use.After adjusting confounders, HIV-infected men with CD4 T cell counts ≥ 500 cells/μL (n = 28) and 500 cells/μL (n = 139) had lower BMD at the femoral neck (FN, p 0.001) and total hip (TH, p 0.001) than HIV-uninfected men (n = 167). HIV-infected men with CD4 T cell counts 500/μL had lower BMD at the lumbar spine (LS, p = 0.034) than those with counts of ≥ 500 cells/μL, but not at FN and TH. The CD4 T cell count (γ = 0.169, p = 0.031) was positively correlated with BMD at LS. There was no significant difference in the BMD (p = 0.499- 0.999) between the ART-naïve (n = 75) and ART-user group (n = 92).Despite their relatively younger age, HIV-infected men had a lower BMD than HIV-uninfected men. Lower CD4 T cell counts, irrespective of ART, might result in lower bone mass.

The online version of the original article can be found at https://doi.org/10.1007/s00198-019-04942-7

Some piezoelectric ceramic materials do behave in a nonlinear way when they are subjected to large electric or mechanical stress fields. This macroscopic nonlinearity comes from microscopic domain switchings during which one type of variant switches to other types of variants under large electromechanical fields. This switchable piezoelectric ceramic materials are called ferroelectric ceramics. In the present paper, a typical ferroelectric material particle is represented by a regular dodecahedron representative volume element (RVE) which includes twenty distinct types of variants, and a finite element analysis is carried out on a cubic specimen subjected to both a constant compressive stress and an electric field cycling. The calculation results are compared with experimental observations and isotropy of the responses is discussed.

STN LCDs on plastic film substrates for mobile communication devices have been researched and developed at KETI in KOREA. The plastic film substrate is so weak to heat and pressure that its fabrication process is limited to 110°C. The ITO electrode layer was deposited on the bare plastic film substrate by rf-magnetron sputtering. And in order to maintain uniform cell gap and press on the plastic film substrate without deformation of substrate surface, we utilized newly invented jig and fabrication process. Electro-optical characteristics are better than or equivalent to those of typical glass LCDs though it is thinner, lighter-weight, and more robust than glass LCD.

A new technology realizing reliable interconnection between Plastic Film LCDs panel and a driving circuit was developed under the stepped processing condition of low temperature and pressure with ACFs for Plastic Film LCDs. The conduction failure of interconnection between the two resulted from elasticity, low thermal resistance and high thermal expansion of plastic film substrates. Conductive particles with elasticity similar to that of the plastic film substrate did not damage an ITO electrode on plastic film substrates, and low temperature and pressure in a stepped process also did not deform the surface of plastic film substrates. As a result highly reliable interconnection with minimum contact resistance was accomplished.

This paper is concerned with the virtual mass effect due to the presence of water on the natural frequencies of free-edge annular plates resting on free surface or completely submerged, which has never been studied theoretically. Experiments were carried out for free-edge annular plates to find the so-called nondimensionalized added virtual mass incremental factors. In this paper, theoretical nondimensional added virtual mass incremental factors are obtained by employing the Hankel transformation technique in conjunction with the Fourier-Bessel series approach. It is found that the theoretical nondimensionalized added virtual mass incremental factors for free-edge annular plates resting on free-surface agree well with experimental ones. The proposed method can be applied to different boundary conditions of plates.

Wider application of CT angiography (CTA) improves the diagnosis of acute pulmonary embolism (PE). It also permits the visualisation of saddle embolism (SE), namely thrombi, which are located at the bifurcation of the main pulmonary artery. The aim of this study was to assess the prevalence of SE and whether SE predicts a complicated clinical course in patients with non-high-risk PE.In total, 297 consecutive patients with non-high-risk PE confirmed using CTA in the emergency department were studied. The presence of SE and its ability to predict the occurrence of major adverse events (MAEs) within 1 month were determined.Of the 297 patients, 27 (9.1%) had an SE. The overall mortality at 1 month was 12.5%; no significant difference was observed between the SE and non-SE groups (18.5% vs 11.9%, p=0.32). However, patients with SE were more likely to receive thrombolytic therapy (29.6% vs 8.1%, p0.01) and had significantly more MAEs (59.3% vs 25.6%, p0.01).At the time of diagnosis, SE, as determined using CTA, is associated with the development of MAE within 1 month. It may be a simple method for risk stratification of patients with non-high-risk PE.The prognosis of patients with SE, especially those who are haemodynamically stable, is unclear. This study shows that patients with SE, determined with CTA, is associated with the development of MAE.

Porous Electroosmotic (EO) pump is the type of pump which contains a porous media regime to perform flow moving under electric field application. It can use a constant value of porosity with constant pore diameter limiting the flow rates especially near the wall region in addition to the boundary layer effects. In this study, a composite porous layer has been proposed to use in EO pump with a high porosity value near the wall region rather than the central region of the flow field. A 2D rectangular porous channel of 4mm×1.5mm is employed and it has been divided vertically into three major domains of variable. As a result, an appreciable increase in velocity magnitude especially near wall region but also in the central region.

There are several known routes for the metabolic detoxication of alpha,beta-unsaturated aldehydes and ketones, including conjugation to glutathione and reduction and oxidation of the aldehyde to an alcohol and a carboxylic acid, respectively. In this study, we describe a fourth class of detoxication that involves the reduction of the alpha,beta-carbon=carbon double bond to a single bond. This reaction is catalyzed by NAD(P)H-dependent alkenal/one oxidoreductase (AO), an enzyme heretofore known as leukotriene B4 12-hydroxydehydrogenase, 15-oxoprostaglandin 13-reductase, and dithiolethione-inducible gene-1. AO is shown to effectively reduce cytotoxic lipid peroxidation products such as 4-hydroxy-2-nonenal (HNE) (k(cat) = 4.0 x 10(3) min(-1); k(cat)/K(m) = 3.3 x 10(7) min(-1) M(-1)) and acrolein (k(cat) = 2.2 x 10(2) min(-1); k(cat)/K(m) = 1.5 x 10(6) min(-1) M(-1)) and common industrial compounds such as ethyl vinyl ketone (k(cat) = 9.6 x 10(3) min(-1); k(cat)/K(m) = 8.8 x 10(7) min(-1) M(-1)) and 15-oxoprostaglandin E1 (k(cat) = 2.4 x 10(3) min(-1); k(cat)/K(m) = 2.4 x 10(9) min(-1) M(-1)). Furthermore, transfection of human embryonic kidney cells with a rat liver AO expression vector protected these cells from challenge with HNE. The concentration of HNE at which 50% of the cells were killed after 24 h increased from approximately 15 microM in control cells to approximately 70 microM in AO-transfected cells. Overexpression of AO also completely abolished protein alkylation by HNE at all concentrations tested (up to 30 microM). Thus, we describe a novel antioxidative activity of a previously characterized bioactive lipid-metabolizing enzyme that could prove to be therapeutically or prophylactically useful due to its high catalytic rate and inducibility.

The expression of hepatic microsomal epoxide hydrolase (mEH) and glutathione S-transferases (GSTs) by 2-(allylthio)pyrazine (2-AP), an experimental chemopreventive agent, was investigated in rats. Northern blot analysis revealed that 2-AP caused increases in mEH, rGSTA2/3/5, and rGSTM1/2 mRNA levels. mEH and rGSTA2 proteins were also induced. Molecular basis of the enzyme induction by 2-AP was studied in comparison with oltipraz (Olt). Rats exposed to buthionine sulfoximine, a GSH-depleting agent, before treatment with either 2-AP or Olt exhibited greater increases in the mRNA levels than the individual treatment. Conversely, increases of the mRNAs were prevented by cysteine treatment, indicating that metabolic intermediates or reactive oxygens produced from the agents could be reduced by cysteine. Gel shift analysis revealed that nuclear factor-kappaB, which is associated with the altered cellular redox state, was not activated by the agents. Effects of these agents on the breakage of phix-174 DNA were compared in vitro. 2-AP effectively reduced the conversion of supercoiled DNA to the open circular form induced by benzenetriol and prevented benzenetriol- and iron-catalyzed degradation of DNA, whereas Olt failed to prevent strand breakage of DNA. These results provided evidence that: 1) 2-AP was effective in elevating the hepatic mEH and GST gene expression in rats, which might be mediated with the production of reactive oxygen species; 2) nuclear factor-kappaB activation was not involved in the induction of the detoxifying enzymes by either 2-AP or Olt in spite of their production of reactive oxygens in vivo; and 3) the antioxidant effect of 2-AP in vitro differed from that of Olt.

The MIM device with very low threshold voltage and perfect symmetry was fabricated. The threshold voltage and the symmetry were 1.4 V and 1:1, respectively. A high performance MIM device was formed by newly developed processes based on our unique anodization and annealing treatment.

This paper is concerned with the derivation of the state equations of motion for a spacecraft consisting of a main rigid platform and a given number of flexible appendages changing the orientation relative to the main body. The equations are derived by means of Lagrange’s equations in terms of quasi-coordinates. Assuming that the appendages represent distributed-parameter members, the state equations of motion are hybrid. Moreover, they are nonlinear. Following spatial discretization and truncation, the hybrid equations reduce to a system of nonlinear discretized state equations, which are more practical for numerical calculations and control design. To illustrate the effect of nonlinearity on the dynamic response during reorientation, a numerical example involving spacecraft with a membrane-like antenna is presented.