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Objective: Few studies have investigated the relationship between spinal muscle fatty degeneration and vertebral compression fracture (VCF) progression. This study investigated the associations among spinal muscle fatty degeneration, functional support of the spinal muscles, and VCF progression.Methods: We retrospectively evaluated 49 consecutive elderly patients over 65 years of age who had VCFs between 2013 and 2020. Change in height loss was defined as the difference in height loss in vertebral collapse between the initial and >6-month follow-up visits. Fatty infiltration of the paraspinal and psoas muscles was measured using T2-weighted magnetic resonance imaging at L3 and L4.Results: The VCF height loss change was 6.53±4.9 mm. The cross-sectional area of the paraspinal muscle was 2,418±496 mm2. The fatty infiltration rate of the paraspinal muscle was 4.46%±1.7%. Mild VCF height loss (a change o≤9 mm) was found in 36 patients (group 0), while severe height loss (a change >9 mm) was observed in 13 patients (group 1). The paraspinal-to-psoas muscle ratio was 2.51 in group 0 and 3.33 in group 1 (P

Background An underweight individual is defined as one whose Body Mass Index (BMI) is 2. Currently, the prognosis in patients with colorectal cancer (CRC) who are also underweight is unclear. Methods Information on South Korean patients who underwent curative resection for CRC without distant metastasis was collected from health insurance registry data between January 2014 and December 2016. We compared the overall survival (OS) of underweight and non-underweight (BMI ≥ 18.5 kg/m2) patients after adjusting for confounders using propensity score matching. A nomogram to predict OS in the underweight group was constructed using the significant risk factors identified in multivariate analysis. The predictive and discriminative capabilities of the nomogram for predicting 3- and 5-year OS in the underweight group were validated and compared with those of the tumor, node, and metastasis (TNM) staging system in the training and validation sets. Results A total of 23,803 (93.6%) and 1,644 (6.4%) patients were assigned to the non-underweight and underweight groups, respectively. OS was significantly worse in the underweight group than in the non-underweight group for each pathological stage (non-underweight vs. underweight: stage I, 90.1% vs. 77.1%; stage IIA, 85.3% vs. 67.3%; stage IIB/C, 74.9% vs. 52.1%; and stage III, 73.2% vs. 59.4%, P P P Conclusions Underweight patients had worse OS than non-underweight patients for all stages of CRC. Our nomogram can guide prognostic predictions and the treatment plan for underweight patients with CRC.

Purpose Colonoscopy is an effective method of screening for colorectal cancer (CRC), and it can prevent CRC by detection and removal of precancerous lesions. The most important considerations when performing colonoscopy screening are the safety and satisfaction of the patient and the diagnostic accuracy. Accordingly, the Korean Society of Coloproctology (KSCP) herein proposes an optimal level of standard performance to be used in endoscopy units and by individual colonoscopists for screening colonoscopy. These guidelines establish specific criteria for assessment of safety and quality in screening colonoscopy. Methods The Colonoscopy Committee of the KSCP commissioned this Position Statement. Expert gastrointestinal surgeons representing the KSCP reviewed the published evidence to identify acceptable quality indicators and indicators that lacked sufficient evidence. Results The KSCP recommends an optimal standard list for quality control of screening colonoscopy in the following 6 categories: training and competency of the colonoscopist, procedural quality, facilities and equipment, performance indicators and auditable outcomes, disinfection of equipment, and sedation and recovery of the patient. Conclusion The KSCP recommends that endoscopy units performing CRC screening evaluate 6 key performance measures during daily practice.

Objective We aimed to evaluate the changes in liver function after repeat hepatectomy and their relationship with survival of patient with colorectal cancer. Summary of Background Data Repeat hepatectomy has been accepted as an effective treatment for recurrent liver metastases; however, how repeat hepatectomy changes the liver function during the follow-up period is not well understood. Methods Data regarding patients underwent R0 resections at initial hepatectomy for colorectal cancer with liver metastasis from 2012 to 2017 were retrospectively reviewed. Patients were divided into groups according to the total number of hepatectomies. Overall survival and Child-Turcotte-Pugh score after hepatectomy were analyzed. Results Fifty-three patients underwent single hepatectomy and 37 patients underwent repeat hepatectomy. There was no significant difference in the overall survival rates between the 2 groups. At 27 months after the initial hepatectomy, mean Child-Turcotte-Pugh scores of patients with repeat hepatectomy started to become statistically higher than those of patients with single hepatectomy. Overall survival of patients who survived after 27 months from the initial hepatectomy showed a statistical difference between the 2 groups. The total number of liver metastases ≥ 4 and Child-Turcotte-Pugh score ≥ 6 at 27 months after the initial hepatectomy were significant risk factors for overall survival of patient who survived after 27 months from the initial hepatectomy. Conclusions Liver function after repeat hepatectomy can be deteriorated after a long-term period. Careful approach and continuous assessment of the liver function after hepatectomy are necessary to maintain long-term survival after repeat hepatectomy.

This paper describes a joint response to the Call for Proposals by Samsung, Huawei, GoPro, and HiSilicon on Video Compression with Capability beyond HEVC/H.265, jointly issued by ITU-T SG16 Q.6 (VCEG) and ISO/IEC JTC1/SC29/WG11 (MPEG). In the proposed codec, the coding framework supports hierarchical splitting with binary and ternary trees and flexible coding order representations. Additionally, novel compression tools on inter/intra prediction, in-loop filtering, and entropy coding have been proposed. The proposed compression scheme provides significantly higher compression capability than the state-of-the-art HEVC/H.265 standard for SDR (Standard Dynamic Range) category while maintaining complexity acceptable for emerging applications. When all the proposed algorithmic tools are used, the proposed video codec achieves approximately 40% bit-saving for the SDR cetegory on average compared to HEVC/H.265 anchor.

Summary: Background: The aim of this study was to identify predictive factors for the recurrence of colorectal cancer liver metastasis (CRLM) and then to develop a corresponding novel scoring system that should improve the sensitivity of predicting recurrence in patients with CRLM. Methods: A total of 295 consecutive CRLM patients were enrolled in our institution between January 2002 and December 2015. Multivariate analyses were performed to identify the variables associated with disease recurrence and established the novel scoring system based on it. Results: The scoring system considered seven variables: synchronosity, CA19-9 level, number of liver metastasis, largest size of liver metastasis, resection margin of hepatic lesion, neutrophil-to-lymphocyte ratio and prognostic nutritional index. The area under the curve of ROC was 0.824 (95% confidence interval 0.767–0.882); the sensitivity of our scoring system was 87.9%, specificity was 66.7%, positive predictive value was 20.6%, and negative predictive value was 20.9%. Conclusion: For patients with CRLM undergoing curative hepatic resection, our novel scoring system would improve the sensitivity for prediction of disease recurrence in Case of CRLM patients. Keywords: CA19-9, CRLM, Disease free survival, NLR, Scoring system

In colorectal cancer, whereas mucinous adenocarcinoma (MAC) has several poor clinical prognostic factors compared to adenocarcinoma (AC), the prognosis of MAC remains controversial. We evaluated the prognosis of MAC without distant metastasis and the effects of adjuvant chemotherapy using health insurance registry data managed by South Korea. Patients with colorectal cancer between January 2014 and December 2016 were included (AC, 22,050 [96.8%]; MAC, 729 [3.2%]). We observed no difference in overall survival (OS) between AC and MAC in stages I and II. However, MAC showed a worse OS than AC in stage III disease, especially in patients administered chemotherapy (p < 0.001). These findings persisted after propensity score matching of clinical characteristics between AC and MAC. In addition, transcriptome analysis of The Cancer Genome Atlas (TCGA) data showed increased chemoresistance-associated pathways in MAC compared to AC. In consensus molecular subtypes (CMS) classification, unlike in AC, CMSs 1, 3, and 4 comprised most of MAC and the proportions of CMSs 3 and 4 increased with stage progression. These results suggest clues to overcome resistance to chemotherapy and develop targeted treatments in MAC.

Simple Summary Cannabidiol (CBD), one of the compounds present in the marijuana plant, has antitumor properties. However, the effect of CBD on breast cancer remains unclear. The aim of this study was to assess the effects of CBD for the angiogenesis and stemness of breast cancer cells by decreasing the expression of hypoxia-induced factor-1α (HIF-1α) through the Src/von Hippel–Lindau tumor suppressor protein (VHL) interaction. CBD can suppress angiogenesis and stem cell-like properties of breast cancer through Src/VHL/HIF-1α signaling. Abstract To assess the effect of Cannabidiol (CBD) on the angiogenesis and stemness of breast cancer cells as well as proliferation. Methods: mRNA level and the amount of protein of vascular endothelial growth factor (VEGF) were determined by qRT-PCR and ELISA. The angiogenic potential of breast cancer cells under hypoxic conditions was identified by the HUVEC tube formation assay. The degradation of HIF-1α by CBD and the Src/von Hippel–Lindau tumor suppressor protein (VHL) interaction were assessed by a co-immunoprecipitation assay and Western blotting. To identify the stemness of mamospheres, they were evaluated by the sphere-forming assay and flow cytometry. Results: CBD can suppress angiogenesis and stem cell-like properties of breast cancer through Src/VHL/HIF-1α signaling. CBD may potentially be utilized in the treatment of refractory or recurrent breast cancer.

Yoo Jin Shim,1* Hong Jun Kim,2* Sang Cheul Oh,3 Sun Il Lee,4 Seung Wook Choi11Department of Sports and Leisure, Sungshin Women’s University, Seongbuk-gu, Seoul 02844, Republic of Korea; 2Division of Oncology, Department of Internal Medicine, Kyung Hee University School of Medicine, Dong-dae-mun-gu, Seoul 02447, Republic of Korea; 3Division of Oncology, Department of Internal Medicine, Korea University Guro Hospital, Guro-gu, Seoul 08308, Republic of Korea; 4Department of Surgery, Korea University Guro Hospital, Guro-gu, Seoul 08308, Republic of Korea*These authors contributed equally to this work Objectives: The primary aim of this study was to investigate the beneficial effect of exercise on completion rates of adjuvant treatment, which is one of the major prognostic factors among patients with locally advanced colorectal cancer after undergoing curative resection followed by adjuvant treatment.Design: Prospective pilot studyMethods: We assigned patients who were scheduled to undergo adjuvant treatment (N=39) to the exercise group or the control group in a 2:1 ratio in the order of enrollment. Patients completed questionnaires and underwent assessment of the outcome variables at the start of chemotherapy and upon completion of treatment.Results: A fivefold lower possibility of dose adjustment in the exercise group compared to the control group was demonstrated (OR, 0.188; p=0.023; 95% CI, 0.044–0.793). A significantly smaller proportion of the exercise group had grade 3 or 4 nausea (p=0.018) and neurotoxicity (P=0.024) symptoms. Muscle to fat ratios were significantly reduced in the control group (p=0.039), but not in the exercise group (p=0.742). Serum levels of leptin were significantly increased in the control group (p=0.038), but not in the exercise group (p=0.073). Serum levels of adiponectin were significantly increased in the exercise group (p=0.026) but tended to be decreased in the control group with no statistical significance (p=0.418).Conclusions: Exercise training among patients with colorectal cancer was found to have a beneficial impact on adjuvant treatment completion rates and treatment-associated toxicities. This program was also shown to be beneficial to patients’ body compositions and serum levels of adipokines.Keywords: exercise, chemotherapy, adjuvant, chemoradiotherapy, adjuvant, colorectal neoplasms, body composition, adipokines

Cannabidiol (CBD), one of the compounds present in the marijuana plant, has anti-tumor properties, but its mechanism is not well known. This study aimed to evaluate the apoptotic action of CBD in colorectal cancer (CRC) cells, and focused on its effects on the novel pro-apoptotic Noxa-reactive oxygen species (ROS) signaling pathway. CBD experiments were performed using the CRC cell lines HCT116 and DLD-1. CBD induced apoptosis by regulating many pro- and anti-apoptotic proteins, of which Noxa showed significantly higher expression. To understand the relationship between Noxa and CBD-induced apoptosis, Noxa levels were downregulated using siRNA, and the expression of apoptosis markers decreased. After ROS production was blocked, the level of Noxa also decreased, suggesting that ROS is involved in the regulation of Noxa, which along with ROS is a well-known pro-apoptotic signaling agents. As a result, CBD induced apoptosis in a Noxa-and-ROS-dependent manner. Taken together, the results obtained in this study re-demonstrated the effects of CBD treatment in vivo, thus confirming its role as a novel, reliable anticancer drug.

This paper reports an experimental research on the performance of the passive emergency core cooling system (PECCS) using an integral effect test facility in Korea Atomic Energy Research Institute (KAERI). The PECCS consists of two hybrid safety injection tanks (H-SIT), two medium pressure safety injection tanks (MP-SITs) and an automatic depressurization system consisting of four stages. In this study, an integral effect test (IET) was conducted on a loss of coolant accident (LOCA), which requires the operation of the primary makeup system. The H-SIT (SITs #1 and #3) injection starts successfully when the primary side pressure falls to 10.0 MPa, and the MP-SIT (SITs #2 and #4) injection starts when the pressure falls further to 4.21 MPa. The coolant injection of H-SIT occurs intermittently at certain points of time, rather than continuously. It can be seen that the flow generation of the H-SIT near the pressure plateau occurs exactly when the secondary side is depressurized.

Background The involvement of resection margins after rectal cancer surgery by malignant tumors is a negative prognostic factor. Therefore, it is important to analyze treatment outcomes and establish adjuvant therapy. Methods The Health Insurance Review and Assessment Service collects data from medical institutions in South Korea. We reviewed the database of this prospectively collected cohort for patients who underwent curative resection for rectal cancer. Results Of the 5,620 patients, 113 (2.0%) were diagnosed with resection margin involvement after surgery. The resection margins of patients with mid-rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and undergoing emergency surgery were more frequently involved. Neoadjuvant chemoradiotherapy was a significant preventive factor for resection margin involvement (odds ratio = 0.53; 95% confidence interval [CI], 0.32-0.87; p = 0.012). The OS of patients with adjuvant treatment was better than that of patients without adjuvant treatment (5-year overall survival [OS]: 62.8% vs. 46.3%, p = 0.02). The administration of chemoradiotherapy was also significantly associated with better OS (hazard ratio = 0.36; 95% CI, 0.17-0.77; p = 0.009). Conclusion Efforts to acquire wider resection margins are necessary for patients with mid-rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and emergency surgery. Neoadjuvant chemoradiotherapy was a significant preventive factor for involved resection margin. Patients with resection margin involvement showed better OS after adjuvant treatment than those without adjuvant treatment. The adjuvant chemoradiotherapy was helpful to prevent the worse prognosis of these patients.

Background Resectability of liver metastasis is important to establish a treatment strategy for patients with colorectal cancer. We aimed to evaluate the effect of the distance from metastasis to the centre of the liver on surgical outcomes and survival after hepatectomy. Methods The clinical data of a total of 155 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as 'centrality'. The postoperative outcomes and survival among the patients were then analysed. Results Anatomic resections were more frequently performed, and the operative time was longer in the patients with high centrality (≤1.5 cm) than in the patients with low centrality (>1.5 cm). A size of ≥5 cm for the largest lesion, a number of lesions of ≥3 and centrality of ≤1.5 cm were found to be the independent risk factors of a positive resection margin after hepatectomy. The patients with high centrality showed worse recurrence-free survival than those with low centrality; however, there was no significant difference found in the overall survival. In the multivariate analysis, high centrality was not found to be associated with worse recurrence-free and overall survival. Conclusion Centrality significantly affected the surgical outcomes and treatment strategy for liver metastasis but did not influence the survival of the patients with colorectal cancer. Active efforts through surgical resections are important to treat liver metastasis of high centrality.

Global meta-analyses showed that biochar application can reduce N

Summary Background D3 lymph node dissection is becoming the standard procedure for the treatment of advanced right colon cancer and has shown increasing evidence of its oncologic benefit. However, a clear indication for its application is lacking and data on this topic is unsatisfactory. Thus, the necessity for D3 lymph node dissection in clinical stage I right colon cancer remains controversial. Methods We retrospectively analyzed data from clinical stage I right colon cancer patients who underwent radical surgery at three hospitals of Korea university medical center between January 2015 and June 2018. We compared surgical complications and short-term oncologic outcomes between D2 and D3 lymph node dissections in these patients. Results Among 512 patients, 122 (23.8%) were clinical stage I. Of these, 88 and 34 patients received D2 and D3 lymph node dissection, respectively. There were no statistically significant differences in clinicopathologic variables and surgical outcomes between the two groups. Upstaging occurred in 16 patients (47.1%) in the D3 group and 23 patients (26.1%) in the D2 group. There were four recurrences in the D2 group but no recurrence in the D3 group. Log-rank tests showed no statistically significant difference in disease-free survival rates between the two groups (p = 0.210). Conclusion There was no significant difference in disease-free survival rates between D2 and D3 lymph node dissection in clinical stage I right colon cancer patients. However, recurrence occurred in the D2 group. Efforts to improve the accuracy of clinical staging are required and more studies with better quality are needed.

Background Resectability of liver metastasis is important to establish a treatment strategy for colorectal cancer patients. We aimed to evaluate the effect of distance from metastasis to the center of the liver on the resectability and patient outcomes after hepatectomy.Methods Clinical data of a total of 124 patients who underwent hepatectomy for colorectal cancer with liver metastasis were retrospectively reviewed. We measured the minimal length from metastasis to the bifurcation of the portal vein at the primary branch of the Glissonean tree and defined it as “Centrality”. Predictive effects on positive resection margin and overall survival of centrality were statistically analyzed.Results The value as a predictive factor for the positive resection margin of centrality was analyzed by the receiver operating characteristic curve (area under the curve = 0.72, PConclusion Centrality was related with the positive resection margin of deeply located liver metastasis. Centrality should be considered to establish the surgical strategy for patients with advanced colorectal cancer with liver metastasis.

Forms of intraoperative neurophysiologic monitoring (IONM), including somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs), have been widely used in the field of neurosurgery. This study aimed to evaluate the diagnostic efficacy of IONM in identifying intraoperative events and predicting postoperative neurologic deficits in neurovascular intervention. From January 2013 to December 2016, we retrospectively reviewed patients who underwent neurovascular intervention under general anesthesia with the use of IONM. Associations between significant changes in MEPs or SSEPs which were defined as a decrease more than 50% in amplitude and/or an increase more than 10% in latency and any identifiable intraoperative events and/or postoperative neurologic deficits were determined. The sensitivity and specificity values for both MEPs and SSEPs were calculated. In total, 578 patients (175 men and 403 women) were included. Their mean age was 59.5 years. SSEP changes occurred in 1% (n = 6), and MEP changes occurred in 1.2% (n = 7). Four patients suffered postoperative neurologic deficits, and identifiable intraoperative events were observed in seven patients. Both SSEP and MEP changes were significantly associated with identifiable intraoperative events and/or postoperative neurologic deficits (p

Aluminum alloy A356-T6 and automotive steel sheet SAPH440 were joined using friction stir spot welding and self-piercing riveting. The maximum tensile shear strength values in weld joints were approximately 3.5 kN at a rotation speed of 500 rpm and plunge depth of 1.0 mm. It was confirmed that the intermetallic compound layer of weld joints below 9.23 m did not exceed the permissible thickness 10 m of Al–Fe joints. The self-piercing riveting joints exhibited maximum tensile- shear strength of 7.9 kN, which was higher than that of the weld joints. However, during the riveting process, cracking appeared in the joint on the aluminum side, which was caused by lack of ductility of cast aluminum. In addition, it was observed that the cracks on the aluminum side were getting larger, as the radius of the lower mold increased. Алюминиевый сплав А356-Т6 и автомобильную листовую сталь SAPH440 соединяли с помощью точечной ротационной сварки трением и самопробивной клепки. Максимальный предел прочности на сдвиг при растяжении для сварных соединений составлял примерно 3,5 кН при скорости вращения 500 об/мин и глубине проникновения 1,0 мм. Доказано, что слой интерметаллидов сварных соединений толщиной менее 9,23 мкм не превышал допустимый уровень в 10 мкм для соединений Al–Fe. Клепаные соединения имели предел прочности 7,9 кН в отличие от сварных соединений. Однако при клепке на алюминии появлялись трещины ввиду низкой пластичности литого материала, при этом трещины подрастали по мере увеличения радиуса нижней формы.

Only a few have evaluated the mitigation of greenhouse emissions and profit analysis along with soil carbon sequestration for corn cultivation. This experiment was conducted to evaluate the carbon sequestration and mitigation of greenhouse gas emissions as well as their profit analysis with different composts mixed with biochar during corn cultivation. This experimental data provided the second year of corn cultivation. The soil type used was clay loam. The application amounts of synthetic fertilizer and biochar were 220–30–155 kg ha−1 (N–P–K) as the recommended amount after soil analysis and 2600 kg ha−1 based on 1.3% of soil bulk density. For the biannual experimental results, it appeared that carbon sequestration in cow manure cooperated with biochar was highest at 2.3 tons ha−1 and recovered from 67.3 to 78.5% with biochar application. Furthermore, mitigation of CO2-eq. emission as greenhouse gases was estimated to be at 7.3–8.4 MT ha−1, and its profit was evaluated from $7.2 to 8.4 as lowest, from $57.2 to 66.6 as medium and from $139.7 to 162.7 as highest per hectare regardless of organic compost types used. For agricultural practice in Korea, it is evaluated that the market price of CO2 in corn field cooperated with 2600 kg ha−1 of biochar application ranged from $57.2 to 162.7 per hectare in Korean Climate Exchange. For corn biomass, the treatment with biochar application did not significantly decrease compared with the only organic compost application. Based on these experimental results, it might be applied for carbon trading with clean development mechanism for agricultural practices.