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Although robotic single-site (RSS) surgery employing cross setup of semirigid instruments allows effective triangulation of instruments, it has some limitations in performing RSS transabdominal and transvaginal surgeries. We introduced the robotic glove port technique (RGPT) using parallel setup of endowristed rigid instruments in performing RSS transabdominal surgery and transvaginal surgery in July of 2017. Thirty-five patients underwent RSS surgery with RGPT. Twenty-one patients had RSS transabdominal reconstructive or fertility-preserving surgeries such as myomectomy (12 patients), adenomyomectomy (3 patients), and ovarian endometriosis cystectomy (6 patients). Fourteen patients underwent robotic transvaginal surgery for natural orifice transluminal endoscopic surgery (NOTES) hysterectomy. All procedures were successfully performed, and no postoperative complications were observed. In all patients, the median total operative time, console time, and docking time were 160 min (range 106-240), 120 min (range 65-180), and 10 min (range 4-25), respectively. There was no conversion to another type of surgery, such as conventional laparoscopy, laparotomy, or traditional multiport robotic surgery. The findings showed that RSS surgery via the RGPT is safe and feasible, using the parallel setup of endowristed rigid instruments is easily performed on transvaginal routes and transabdominal routes. Therefore, this procedure may be an important complement to gynecologic surgeons' armamentarium in the field of robotic reconstructive or fertility-preserving surgeries such as myomectomy, adenomyomectomy, ovarian cystectomy, and transvaginal surgery for NOTES hysterectomy. Nevertheless, further prospective controlled studies are needed to determine its full clinical application.

Coexisting alkalic and tholeiitic basalt lavas has been identified in a seamount chain located near the Australian–Antarctic spreading ridge. The KR1 Seamount Trail (KR1 ST) is a series of volcanic...

We compare the trace element geochemistry of scheelite from the economic Sangdong W-Mo deposit with scheelite from unmineralized or sub-economic prospects in Joongdong and Sangdong area in the southern Taebaeksan metallogenic region, to investigate the ore-forming processes controlling scheelite mineralization and to provide a geochemical model for W exploration. In the Sangdong W-Mo deposit, the Mo substitution into scheelite as a powellite (CaMoO4) component changed colors of scheelite fluorescence under short-wavelength UV from yellow (Mo up to 51,000 µg/g) to blue (Mo up to 3.2 µg/g). Low-Mo scheelite with blue fluorescence occurred in the low-grade periphery of the Sangdong deposit and contained higher concentrations of Sr, possibly indicating a lower degree of fluid-rock interaction of the scheelite-forming fluid with Sr-bearing host. Mo-rich scheelite with yellow fluorescence accumulated in the W-rich center of the Sangdong deposit. Hence, the fluorescence color of scheelite reflected both the fluids oxidation state and the degree of fluid-rock interaction and might be useful for scheelite exploration in the Taebaeksan region. In the Sangdong deposit, Nb concentrations in scheelite were high and negatively correlated with its Eu anomaly values, suggesting extensive batholith-scale fractionation in a large magmatic reservoir. Conversely, much lower Nb concentrations of scheelite in the Joondong area suggests a relatively small or isolated magma reservoir that did not reach the same degree of fractionation at the point of fluid saturation, which would limit the potential for an economic scheelite mineralization. Scheelite Nb/ Ta ratio is found to effectively differentiate economic orebodies and subeconomic prospects in the Taebaeksan metallogenic region and might be a useful parameter for scheelite exploration.

Vaginal dysbiosis, such as bacterial vaginosis (BV) and aerobic vaginitis (AV), is an important cause of premature birth in pregnant women. However, there is very little research on vaginal microbial distribution in AV compared to that in BV. This study aimed to analyze the composition of the vaginal microbiota of pregnant women with AV using microbial community analysis and identify the causative organism using each criterion of the AV scoring system. Also, we compared the quantification of aerobic bacteria using quantitative polymerase chain reaction (qPCR) and their relative abundances (RA) using metagenomics. This prospective case–control study included 228 pregnant Korean women from our previous study. A wet mount test was conducted on 159 women to diagnose AV using the AV scoring system. Vaginal samples were analyzed using metagenomics, Gram staining for Nugent score determination, conventional culture, and qPCR for Staphylococcus spp., Streptococcus spp., and Enterobacteriaceae. The relative abundances (RAs) of eleven species showed significant differences among the three groups (Normal flora (NF), mild AV, and moderate AV). Three species including Lactobacillus crispatus were significantly lower in the AV groups than in the NF group, while eight species were higher in the AV groups, particularly moderate AV. The decrease in the RA of L. crispatus was common in three criteria of the AV scoring system (Lactobacillary, WBC, and background flora grades), while it did not show a significant difference among the three grade groups of the toxic leukocyte criterion. Also, the RAs of anaerobes, such as Gardnerella and Megasphaera, were higher in the AV groups, particularly moderate AV, while the RAs of aerobes were very low (RA < 0.01). Therefore, qPCR was performed for aerobes (Staphylococcus spp., Streptococcus spp., and Enterobacteriaceae); however, their quantification did not show a higher level in the AV groups when compared to that in the NF group. Therefore, AV might be affected by the RA of Lactobacillus spp. and the main anaerobes, such as Gardnerella spp. Activation of leukocytes under specific conditions might convert them to toxic leukocytes, despite high levels of L. crispatus. Thus, the pathogenesis of AV can be evaluated under such conditions.

The Taebaeksan region, located in the northeastern part of South Korea, is an important metallogenic province which hosts numerous Zn-Pb-W-Mo-Fe-Cu (-Au-Ag) mineral systems. The Zn-Pb orebodies in the region (inclusive of skarn, carbonate replacement, and vein-breccia ore types) are hosted on the early Paleozoic carbonate sequences and they are associated with late Cretaceous to early Paleogene magmatic-hydrothermal activities. We collected Zn-Pb orebodies from 15 areas including non-metal deposits, such as high-Ca calcite marble, as well as exploration sites in the Taebaeksan metallogenic province. Thereafter, we studied the geochemistry of the sphalerite present in them to understand the regional Zn-Pb mineralization process and to establish an exploration strategy. The sphalerites collected from the region contained detectable amounts of Fe, Mn, Cd, Co, Cu, Ga, Ge, Mo, Ag, In, Sn, Sb, W, Tl, Pb, and Bi which were identified using microbeam techniques like EPMA and LA-ICP-MS. Sphalerites from economically significant Zn-Pb deposits characteristically have high Mn and low Cd content, while W (-Mo)-bearing deposits have remarkably high Cd content. Correlation trends between trace elements demonstrate the coupled substitution mechanisms such as 3 Zn2+ ↔ 2 (Cu+ or Ag+) + Sn4+ and 2 Zn2+ ↔ Cu+ + In3+, occurring in the sphalerite. High-temperature ores such as skarn and vein-breccia are relatively enriched with Co and In, while Ga, Ag, and Sn tend to be concentrated in the relatively low-temperature ores, such as carbonate replacement type ores. Lead isotope compositions of the sphalerites show a well-defined, positive, linear trend with those of the local Cretaceous intrusions and the sedimentary sequence of the Taebaeksan region. Major economic Zn-Pb deposits show relatively more signatures of non-radiogenic Pb isotope closer to the intrusions, as compared to the minor and sub-economic Zn-Pb orebodies. The Pb isotope signature suggests that Cretaceous magmatic-hydrothermal fluids with a minimal degree of fluid-rock interactions are required for economic Zn-Pb mineralization in the Taebaeksan metallogenic province.

A multi-disciplinary study of the KR1 segment of the Australian–Antarctic Ridge has been conducted since 2011. We present geochemical and age dating results for samples dredged from three sites on the KR1 seamount trail. The majority of the samples are alkaline ocean island basalts with subdominant enriched tholeiites. The samples from the DG05 bathymetric depression include ice-rafted erratics from Antarctica, which consist of gabbro, diabase, various granitoids, volcanic rocks such as trachyte and rhyolite and deformed or undeformed sedimentary rocks. The main provenance of glacial erratics is considered to be the Ross Sea region. However, Carboniferous to Cretaceous ages of erratics indicate that some of these may originate from the western regions of West Antarctica. Based on the size and topography of the volcanic features and geochemical characteristics of the alkaline ocean island basalts (La/SmN = 2.62–3.88; Tb/YbN = 1.54–2.67) and the enriched tholeiites, the KR1 seamount trail is interpr...

The mantle sources of mid-ocean ridge basalts beneath the Indian and Pacific oceans have distinct isotopic compositions with a long-accepted boundary at the Australian–Antarctic Discordance along the Southeast Indian Ridge. This boundary has been widely used to place constraints on large-scale patterns of mantle flow and composition in the Earth’s upper mantle. Sampling between the Indian and Pacific ridges, however, has been lacking, especially along the remote 2,000 km expanse of the Australian–Antarctic Ridge. Here we present Sr, Nd, Hf and Pb isotope data from this region that show the Australian–Antarctic Ridge has isotopic compositions distinct from both the Pacific and Indian mantle domains. These data define a separate Zealandia–Antarctic domain that appears to have formed in response to the deep mantle upwelling and ensuing volcanism that led to the break-up of Gondwana 90 million years ago, and currently persists at the margins of the Antarctic continent. The relatively shallow depths of the Australian–Antarctic Ridge may be the result of this deep mantle upwelling. Large offset transforms to the east may be the boundary with the Pacific domain. A separate mantle domain, distinct from both the Pacific and Indian domains, exists beneath the Southern Ocean, according to isotope compositions of samples from the Australian–Antarctic ridge.

To report a new surgical technique for hysterectomy using robotic natural orifice transluminal endoscopic surgery (NOTES) as a scarless and gasless procedure. Thirteen consecutive patients with benign uterine disease underwent robotic NOTES hysterectomy at Eulji University Hospital between February 2017 and May 2018. Due to the presence of pelvic adhesions, one of these patients underwent hybrid robotic NOTES hysterectomy with the assistance of isobaric single port laparoscopy; however, there was no conversion to another hysterectomy type such as conventional laparoscopy, laparotomy, or traditional multiport robotic surgery. Median uterine weight was 290 g (range 115–892 g). Median docking and console times were 15 min (range 5–25 min) and 135 min (range 92–215 min), respectively. Mean change in hemoglobin on the first postoperative day was 0.67 ± 0.7 g/dL. Median EBL was 50 mL (20–450 mL). Median postoperative hospital stay was 3 days (3–4 days). No patients experienced postoperative complications such as damage to adjacent organs, re-operation, or vaginal cuff hematoma. Our findings show that robotic NOTES hysterectomy is a feasible and safe scarless and gasless surgical technique. It is an effective, minimally invasive vaginal access alternate to NOTES-assisted vaginal hysterectomy or conventional robotic laparoendoscopic single-site surgery hysterectomy in the surgical management of benign uterine disease. Nevertheless, further prospective controlled studies are needed to determine its full clinical application.

The objective of this study was to report on a new surgical technique, hybrid laparoscopic myomectomy that integrates the advantages of transumbilical laparoendoscopic single-site surgery and those of isobaric laparoscopy, and the initial experience with 14 cases. All of the procedures were performed by a single surgeon who has over 18 years of experience in laparoscopic surgery and 4 years of experience in laparoendoscopic single-site surgery. All cases of hybrid laparoscopic myomectomy were completed safely and effectively without conversion to conventional laparoscopic procedure. The median operative time was 75 minutes (range, 30 to 100 minutes). No postoperative complication was observed. The findings show that hybrid laparoscopic myomectomy is a safe and feasible surgical technique, and therefore can be a feasible, minimally invasive alternative to either abdominal or laparoendoscopic single-site surgery myomectomy.

Objective Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important procedure for surgeons. This study aimed to describe the initial clinical experience of NOTES-assisted vaginal hysterectomy (NAVH) and to investigate its feasibility and surgical outcomes compared with single-port laparoscopic-assisted vaginal hysterectomy (SP-LAVH). Design Retrospective chart analysis (Canadian Task Force classification II-1). Setting One university-affiliated hospital. Patients Women undergoing NAVH or SP-LAVH for benign uterine diseases. Intervention NAVH using a novel homemade NOTES system comprised a glove-wound retractor NOTES port or SP-LAVH using conventional laparoscopic instruments and an umbilical glove port. Measurements and Main Results Since July 2012, 16 patients with benign uterine disease have undergone NAVH. Another 32 paired, SP-LAVH patients from the registered database were used to compare these 2 modalities of laparoscopic-assisted techniques for vaginal hysterectomy. All NAVHs were completed successfully without the need of an additional port or conversion to the standard laparoscopic approach. Intraoperative and postoperative surgical outcomes were assessed in both groups of patients. There was also no significant difference between both groups in perioperative outcomes such as estimated blood loss, decrease in hemoglobin on postoperative day 1, amount of analgesic drugs used, postoperative visual analog scale pain score, and febrile complications, except for operative time and length of postoperative hospital stay. The mean operative time was 70.6 ± 12.8 minutes for NAVH and 93.2 ± 21.4 minutes for SP-LAVH (p Conclusion The findings show that NAVH is a feasible and safe surgical technique and has a short operative time and postoperative hospital stay compared with SP-LAVH. This new technique at least offers similar surgical outcomes and superior cosmesis in our opinion compared with SP-LAVH. However, prospective studies are needed to determine its full clinical application.

The objective of this study was to present the initial operative experience of solo surgeon single-port laparoscopic surgery (SPLS) in the laparoscopic treatment of benign gynecologic diseases and to investigate its feasibility and surgical outcomes. Using a novel homemade laparoscope-anchored instrument system that consisted of a laparoscopic instrument attached to a laparoscope and a glove–wound retractor umbilical port, we performed solo surgeon SPLS in 13 patients between March 2011 and June 2012. Intraoperative complications and postoperative surgical outcomes were determined. The primary operative procedures performed were unilateral salpingo-oophorectomy (n = 5), unilateral salpingectomy (n = 2), adhesiolysis (n = 1), and laparoscopically assisted vaginal hysterectomy (n = 5). Additional surgical procedures included additional adhesiolysis (n = 4) and ovarian drilling (n = 1).The primary indications for surgery were benign ovarian tumors (n = 5), ectopic pregnancy (n = 2), pelvic adhesion (infertility) (n = 1), and benign uterine tumors (n = 5). Solo surgeon SPLS was successfully accomplished in all procedures without a laparoscopic assistant. There were no intraoperative or postoperative complications. Our laparoscope-anchored instrument system obviates the need for an additional laparoscopic assistant and enables SPLS to be performed by a solo surgeon. The findings show that with our system, solo surgeon SPLS is a feasible and safe alternative technique for the treatment of benign gynecologic diseases in properly selected patients.

Background: Lipid peroxide (LPO) in comedones, which are produced as a result of sebum oxidation, might potentially induce interleukin-1α (IL-1α) and exacerbate comedogenesis and inflammatory changes in comedones. Objective: To investigate the relationship of proinflammatory cytokines and LPO levels in the extracts of comedones with the acne of clinical difference between smokers and non-smokers, and with the severity and distribution of the acne lesions. Methods: Twenty-two non-smoking and 21 smoking adult acne patients were evaluated by comedone extraction and measurement of proinflammatory cytokines and LPO levels. Acne severity and distribution of the lesions were also analyzed. Results: Relative to the non-smoking group, smokers had significantly higher levels of IL-1α and LPO in comedones. Their levels showed a positive correlation. However, there were no statistically significant difference between the severity or distribution of the disease and the levels of LPO and IL-1α in comedones. Conclusion: Smoking may be involved in the pathogenesis of adult acne by increasing the oxidative stress that results in subsequent accumulation of LPO in comedones. (Ann Dermatol 26(1) 11∼ 16, 2014)

In this study, we analyzed and compared the ultrasonic welding with the laser welding for the pure aluminium thin plates in a series of secondary lithium-ion batteries which are currently being produced by the ultrasonic welding; and performed the experiment for the purpose of the preceding study to replace the ultrasonic welding method with the laser welding method. As a result, the weld width of ultrasonic welding was 5mm, but that of laser welding was about 1~1.5 mm. As a result of tension test, the tensile strength was high when the pulse duration hour was short at the low peak power, while the high tensile strength was achieved when the pulse duration hour was long at the high peak power. The value of tensile strength was higher in the ultrasonic welding while the laser welding showed a maximum 45% better result as for the welding width.

This study applied a laser cleaning method (dry cleaning) that is used for cleaning semiconductor elements to dental implant cleaning. The lasers used in this study were pulsed fiber lasers with wavelengths of 1,064 and 532 nm. The peak output, energy per pulse, energy density per pulse, time of pulse experiment, and number of pulse experiments served as process variables for this study, and the variables were changed for each experiment. As a result, a laser with a wavelength of 532 nm showed much higher cleaning efficiency than its 1,064 nm counterpart. As the wavelength range decreased, the quantized energy increased and the reflection rate of the titanium used for the implant decreased; consequently, the energy absorption rate increased. Therefore, it is proposed that the energy density by wavelength has a greater influence on cleaning than does the output size.

Article history: With the development of advanced processing technology, laser processing systems, which require high-quality precision processing, have attracted considerable attention. Although laser equipment is expensive, it enables quick processing and less deformation of materials. This technology is often applied to secondary batteries, which has thus farinvolved the use of argon tungsten inert gas (TIG) welding. However, the welding characteristicsof argon TIG welding are not yet good, and a laser is used for welding to address this problem. In this study, lap-joint welding was conducted, and the desired welding characteristicswere obtained when the laser power was 1800W and the laser beam travel speed was 1.8 m/min. Lap-joint welding was conducted on Ni-coated SS41. Two cases were compared. No poreswere observed in the Ni-coated SS41 lap-joint welding part, and cracks appeared from the lap-joints. Moreover, the pole rod and tap were welded together in a T-joint form to improve the output of the secondary battery. T-joint laser welding showed better welding characteristics than TIG welding.

Aim Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important topic for surgeons. This study aimed to describe the initial clinical experience of transvaginal NOTES for adnexal masses and investigate its feasibility and surgical outcome. Methods We performed transvaginal NOTES in seven patients with adnexal masses through a 2-cm incision in the posterior vaginal fornix. A transvaginal NOTES system comprising a wound protractor and a surgical glove with sheaths was used. Resection was performed according to the method of standard laparoscopic adnexal surgery. The adnexal mass was removed via the incision of the posterior vaginal fornix after complete resection. Results Since June 2011, seven patients have undergone transvaginal NOTES for adnexal masses. All cases were completed successfully without conversion to standard laparoscopic approach. The median age of the patients was 48 years (range, 36–60) and the median body mass index was 23.6 (range, 20.4–25.3). The median tumor size was 6 cm (range, 3.7–6.7). The median operative time was 45 min (range, 40–80). The estimated blood loss was minimal (range, 5–300 mL). The median postoperative hospital stay was 2 days (range, 1–3). No postoperative complications were observed at follow-up. All the patients were very satisfied with the cosmetic result. Conclusion The findings show transvaginal NOTES with our method to be a feasible, safe and effective surgical technique that results in excellent cosmesis. It may be an alternative technique for the treatment of properly selected female patients with adnexal masses. More experience and instrumental improvement suitable for transvaginal NOTES are needed.

Heat-treatment is one of the core technologies to enhance various characteristics such as strength, hardness, toughness, abrasion resistance and fatigue resistance for the mold material. This paper focuses on characteristics of the laser heat-treatment according to the cylindrical bar diameter variation in case of the SM45C. From the results of the experiments, it has been observed that the maximum hardness is 744Hv when the power is 1630W and the travel of laser is 0.5m/min. And then, the hardness width, depth and microstructure were observed for characteristics. Finally, when the cylindrical bar diameter size grow, the hardness width decrease whereas hardness depth increase.

In this paper, we present research experimental results about the different thickness T-joint welding of the high power continuous wave(CW) Nd:YAG laser for the secondary battery of a vehicle. Although the conventional method used for the secondary battery is a argon TIG welding, we utilize a laser welding to improve Tungsten Inert Gas(TIG) welding`s weakness. The laser, which has a couple of advantage such as aspect ratio, low Heat Affected Zone(HAZ), good welding quality and fast productivity utilized in this work is a CW Nd:YAG laser. In order to observe laser welding sections, we used a optical microscope. Through the analysis of the metallographic, hardness, aspect ratio, and heat input, we obtained the desired data in condition of 1800 W laser beam power and 1.8 m/min and 2.0 m/min laser beam travel speeds. In order to compare electric resistances of the argon TIG welding and laser welding, we made an actual battery and the electric resistance of the laser welding is reduced by 40~45% comparing with the argon TIG welding.

This paper focuses on the research of the anode and cathode in the Ni-MH secondary battery. In this paper, the proposed method employs a continuous wave Nd : YAG laser based on the pure Ni instead of the low carbon steel to improve the conductivity although the conventional secondary battery is based on the resistance spot welded with low carbon steel SS41. It welds a sandwich panel using the pure Ni and the porous thin plate, and the tested optimal conditions for the laser power and irradiation speed were 300 and 350 Watt, and 1.0～1.6m/min, respectively. Finally, we observed a ratio, heat input and cross-section and measured the conductivity of the welding section to test the weldability. Key Words : Pure Ni(순수니켈), Porous Ni(다공질 니켈), Laser welding(레이저 용접), Thin plate(박판) 1. 서 론 최근 자동차 산업에서는 배기가스로 인한 환경오염을 줄이기 위한 다양한 연구가 진행되고 있다. 자동차의 생산량이 매년 증가하면서 자동차에서 배출되는 배기가스 때문에 환경오염이 해마다 증가하고 있어 전 세계 자동차 산업계에서는 배기가스의 배출량을 줄이고자 다양한 방법을 연구하고 있다 (1) .자동차의 배출가스를 줄이는 방법으로 하이브리드 자동차와 전기자동차에 대한 관심이 집중되고 있다. 하이브리드 자동차와 전기자동차의 핵심부품으로는 전지가 중요한 부분을 차지하고 있다. 일반적으로 전지는 핸드폰, 노트북 등 휴대용 전자기기로부터 하이브리드 자동차, 전기자동차, 로봇산업 분야에서 다양한 에너지 저장장치에 이르기까지 여러 형태로 활용되면서 현대 산업사회의 핵심 분야로 자리 잡고 있다

Aim: Risk assessment for cesarean delivery is not a one-time assessment, but rather a procedure that continues throughout pregnancy and labor. The objective of this study was to develop models to determine risk factors of cesarean delivery in three stages in low-risk pregnancy. Material and Methods: The period from pregnancy to childbirth was divided into three stages, including prenatal care, admission and labor. Multivariable logistic regression analysis was used to develop three risk assessment models according to these stages, which were compared by areas under receiver operating characteristic (ROC) curves. Results: We developed three predictive models with different risk factors. The ability of each model to determine the risk of cesarean delivery differed according to the three stages. The ROC curve values differed significantly between the labor (model III) and prenatal care (model I) or admission (model II) models (z = 11.43, P

An experimental investigation with 2.8kW Nd:YAG laser system was carried out to study the effects of different laser process parameters on the microstructure and hardness of STD11. The optical lens with the elliptical profile are designed to obtain a wide surface hardening area with uniform hardness. The Laser beam is allowed to scan on the surface of the work piece varying the power (1600, 1800 and 1900kW) and traverse speed (200, 400, 600, 800 and 1000mm/min) at three different F-numbers of lens. After laser surface treatment three zones, In the microstructure have been observed : melted zone(decarburization), heat affected zone(martensite), and the substrate.

Aim The purpose of this study was to investigate the effect of self-aromatherapy massage on menstrual pain and anxiety. Participants and methods The subjects were 63 female nurses who rated their menstrual pain >5 on a 10-point visual analogue scale. Subjects were non-randomly allocated into three groups: an experimental group (N = 26) who performed self-aromatherapy massage, a placebo group (N = 18), and a no-treatment control group (N = 19). Eleven participants dropped out of the study either because of nausea (experimental group, N = 1) or because they took medication during the trial (placebo group, N = 3; control group, N = 4). The final analysis included 25 in the experimental group, 15 in the placebo group, and 15 in the no-treatment control group. Menstrual pain and anxiety levels were assessed using a visual analogue scale, and we assessed the menstrual pain 4 times during a short time period. Results The menstrual pain was significantly lower in the aromatherapy group than in the other two groups after 24 h. Using multiple regression analysis, the use of aromatherapy was found to be associated with the changes in menstrual pain levels (Beta = −1.74, 95% CI: −2.64 to −0.85, P Conclusion These findings suggest that self-aromatherapy massage of the abdomen using topically applied essential oils may be an effective treatment that decreases menstrual pain and the level of anxiety.

A collection of plasma cells in the skin can represent a broad spectrum of disease entities. Secondary syphilis, primary cutaneous plasmacytoma, primary cutaneous plasmacytosis, cutaneous lymphoid hyperplasia and nodular amyloidosis are considered possible differential diagnoses. We present a case of a 7-year-old girl with an erythematous scaly plaque on her right buttock that had been present for approximately 5 years. Prior to her visit to our department she had been treated at a local dermatology clinic with topical methylprednisolone acetate and topical calcitriol without significant improvement. Histopathological examination revealed psoriasiform hyperplasia, hyperkeratosis, parakeratosis and a band-like or dense perivascular infiltration of plasma cells with a few lymphocytes and histiocytes. Other laboratory tests were within the reference ranges. At our department, the patient was given oral prednisolone along with an intralesional injection of triamcinolone and application of topical methylprednisolone acetate and tacrolimus hydrate to the affected area. The lesion improved significantly but recurred 3 months later. We present a rare case of isolated benign primary cutaneous plasmacytosis in a female pre-adolescent child.

Fusarium species are non-dermatophytic moulds, which are commonly known soil saprophytes and important plant pathogens, and have been frequently reported to be aetiological agents of opportunistic infections in humans. The prevalence of onychomycosis caused by Fusarium species varies in the literature because of geographical differences in mould distribution and diagnostic methods. Onychomycosis caused by Fusarium species is considered rare in Korea, and only four cases have been described to date. Pseudomonas aeruginosa also can infect nails and cause green nail syndrome, and recent research has shown that fungal infection may potentiate the colonisation or growth of P. aeruginosa within a nail. Furthermore, such coinfection with P. aeruginosa can prevent the isolation of the fungus because of bacterial overgrowth in culture. The authors report the cases of two immunocompetent patients with F. solani onychomycosis coinfected with P. aeruginosa. Both presented with a greenish/yellowish discolouration and thickening of a thumbnail, and were treated with systemic ciprofloxacin in combination with itraconazole or terbinafine.

In the development of 3D graphic systems for higher resolution and more realistic modeling and rendering, graphic memories also have been playing a critical role to offer the required high bandwidth. Currently, GDDR5 SDRAM's provide with 7Gbps per pin speed [1], reaching their physical limit originated from single-ended signaling nature: noise in reference voltage and power, and channel crosstalk. Especially, the channel crosstalk takes a dominating portion in 7Gbps timing budget, becoming the main barrier for further speed improvement. Although there has been research on crosstalk canceller in memory interface [2], it imposed stringent restrictions on signal ordering and trace length in PCB and package routing, and had limited performance. Therefore, improving the efficiency of DRAM core draws more attention than pin bandwidth now.

Objective The present study aimed to determine the differences in outcomes between natural orifice transluminal endoscopic surgery-assisted vaginal hysterectomy (NAVH) and conventional laparoscopy-assisted vaginal hysterectomy (LAVH). Methods We retrospectively reviewed the charts of patients who between July 2012 and September 2015, were diagnosed as having benign uterine disease such as uterine myoma, endometriosis, or adenomyosis and managed via NAVH or LAVH in a single-center (Eulji University Hospital). Data such as age, body weight, height, parity, operation time, intra/post-operative complications, and uterus weight were obtained from the clinical charts. NAVH and LAVH recipients were matched 1:3 in terms of baseline characteristics, and the 2 groups were compared regarding surgical outcomes. Results Of the 160 patients with benign uterine disease included in the present study. Forty received NAVH and remaining 120 received LAVH. There were significant differences between the groups regarding operation time and hemoglobin change. Notably, although the operation time was shorter for LAVH, hemoglobin change was lower for NAVH. Additionally, although maximum hospitalization duration was shorter for LAVH, the average length of hospitalization was similar between NAVH and LAVH. There were no significant differences between the groups in terms of other variables. Conclusion NAVH may become a new alternative surgical method of choice for hysterectomy, as it represents a clinically feasible and safe approach; moreover is superior to LAVH in terms of bleeding loss.

It is necessary to draw up many plans to solve problems in the management of groundwater resources in Jeju Island while systematically develop and utilize water resources at an optimal level. It also seems to an evitable option to establish Groundwater Management Areas in Jeju Island. The excess use of groundwater could be discouraged by imposing charges on those licenses. Such policy as allowance trading system do not appear to be because of transaction costs, but could be applied if only were accompanied by complementary method. The methods of using and conserving the limited resources of groundwater should be founded through socially agreeable and appropriate ways. The policy complemented allowance trading system by Pigouian tax could be effective to regulate licenses. This is cutting the numbers of licenses at a constant rate, imposing charges on those who want to continue using licenses, and reimbursing in cash to those who return the licenses.

The major biochemical activities ascribed to Kem1p/Xrn1p of Saccharomyces cerevisiae are 5′–3′ exoribonuclease functioning in RNA turnover and a microtubule-binding protein. Mutational analysis has shown that Kem1p/Xrn1p participates in microtubule-related functions such as nuclear fusion (karyogamy) during mating, chromosome transmission, and spindle pole body duplication. Here, evidence is presented that Kem1p plays a specific role in nuclear fusion by affecting, at the posttranscriptional level, the pheromone induction of the karyogamy-specific transcription factor Kar4p and the expression of Rok1p, a putative RNA helicase. We found that Rok1p itself also affects the pheromone induction of Kar4p and thereby participates in nuclear fusion. Analysis of the active-site mutations, xrn1-D206A or D208A, shows that nuclear fusion as well as the Rok1p synthesis do not require the exoribonuclease activity of Kem1p. Our data provide an important insight into the gene-specific regulatory function mediated by the general RNA-modulating enzymes.

OBJECTIVE Hyperstimulation methods are broadly used for in vitro fertilization (IVF) in patients with infertility; however, the side effects associated with these therapies, such as ovarian hyperstimulation syndrome (OHSS), have not been well studied. N-glycoproteomes are subproteomes used for the remote sensing of ovarian stimulation in follicular growth. Glycoproteomic variation in human follicular fluid (hFF) has not been evaluated. In this study, we aimed to identify and quantify the glycoproteomes and N-glycoproteins (N-GPs) in natural and stimulated hFF using label-free nano-liquid chromatography/electrospray ionization-quad time-of-flight mass spectrometry. METHODS For profiling of the total proteome and glycoproteome, pooled protein samples from natural and stimulated hFF samples were selectively isolated using hydrazide chemistry to obtain the total proteomes and glycoproteomes. N-GPs were validated by the consensus sequence N-X-S/T (92.2% specificity for the N-glycomotif at p

Study Objective To report a single surgeon's experience with 120 laparoendoscopic single-site surgery (LESS) procedures using conventional laparoscopic instruments and a homemade glove port system to treat benign gynecologic diseases. Design Retrospective chart analysis (Canadian Task Force classification III). Setting Eulji University Hospital. Patients One hundred twenty patients who underwent LESS performed by a single surgeon to treat benign gynecologic diseases between November 2010 and November 2012. Intervention LESS using conventional instrumentation was performed using our specialized glove port technique, which consists of the combination of the homemade glove port system designed to minimalize collision of the trocar on the tip of the finger of the surgical glove, a sufficient rectus fasciotomy, the surgeon's position at the patient's head, and adequate positioning of the instruments. Measurements and Main Results The LESS procedures performed were laparoscopically assisted vaginal hysterectomy (n = 50), ovarian cystectomy (n = 25), myomectomy (n = 14), oophorectomy (n = 11), salpingectomy (n = 9), fimbrioplasty or neosalpingstomy (n = 7), and adhesiolysis only (n = 4). Median patient age was 40 years, and median body mass index was 23. Median operative time was 100 minutes (range, 50–145 minutes) for laparoscopically assisted vaginal hysterectomy, 70 minutes (range, 30–150 minutes) for ovarian cystectomy, 107 minutes (range, 65–180 minutes) for myomectomy, 55 minutes (range, 25–130 minutes) for oophorectomy, 85 minutes (range, 35–110 minutes) for salpingectomy, 70 minutes (range, 25–140 minutes) for neosalpingostomy or fimbrioplasty, and 35 minutes (range, 30–60-minutes) for adhesiolysis only. All procedures were completed successfully without the need for additional ports or conversion to the standard laparoscopic approach. One perioperative complication occurred. The complication rate was 83% (1 of 120). Other postoperative complications were not observed at follow-up. Conclusion Our experience shows that LESS using conventional laparoscopic instruments and our glove port technique is a feasible and safe technique for the surgical management of various gynecologic conditions. Therefore, our homemade glove port laparoscopic system used in our specialized technique provides a simple, cost-effective approach to LESS and would probably make laparoscopic procedures using conventional instruments easier.

Natural orifice transluminal endoscopic surgery (NOTES) is currently a very important topic for surgeons. This study aimed to describe the initial clinical experience of transvaginal NOTES for adnexal masses and investigate its feasibility and surgical outcome.We performed transvaginal NOTES in seven patients with adnexal masses through a 2-cm incision in the posterior vaginal fornix. A transvaginal NOTES system comprising a wound protractor and a surgical glove with sheaths was used. Resection was performed according to the method of standard laparoscopic adnexal surgery. The adnexal mass was removed via the incision of the posterior vaginal fornix after complete resection.Since June 2011, seven patients have undergone transvaginal NOTES for adnexal masses. All cases were completed successfully without conversion to standard laparoscopic approach. The median age of the patients was 48 years (range, 36-60) and the median body mass index was 23.6 (range, 20.4-25.3). The median tumor size was 6 cm (range, 3.7-6.7). The median operative time was 45 min (range, 40-80). The estimated blood loss was minimal (range, 5-300 mL). The median postoperative hospital stay was 2 days (range, 1-3). No postoperative complications were observed at follow-up. All the patients were very satisfied with the cosmetic result.The findings show transvaginal NOTES with our method to be a feasible, safe and effective surgical technique that results in excellent cosmesis. It may be an alternative technique for the treatment of properly selected female patients with adnexal masses. More experience and instrumental improvement suitable for transvaginal NOTES are needed.

Risk assessment for cesarean delivery is not a one-time assessment, but rather a procedure that continues throughout pregnancy and labor. The objective of this study was to develop models to determine risk factors of cesarean delivery in three stages in low-risk pregnancy.The period from pregnancy to childbirth was divided into three stages, including prenatal care, admission and labor. Multivariable logistic regression analysis was used to develop three risk assessment models according to these stages, which were compared by areas under receiver operating characteristic (ROC) curves.We developed three predictive models with different risk factors. The ability of each model to determine the risk of cesarean delivery differed according to the three stages. The ROC curve values differed significantly between the labor (model III) and prenatal care (model I) or admission (model II) models (z=11.43, P0.001; z=8.18, P0.001, respectively). There was also a difference in the ROC between models I and II (z=6.76, P0.001).This study shows that the models constructed for the more advanced stages of pregnancy were the more accurate risk factors of cesarean delivery. Therefore, the risk assessment model for cesarean delivery should be differently adapted according to each stage.

OBJECTIVE Recent studies suggest that ovarian volume and antral follicle counts (AFCs) may be useful indicators of menopause status. In this study, we examined several sonographic and endocrine markers of ovarian aging for their ability to discriminate between premenopausal and late menopausal transition (LMT) status. METHODS A total of 40 women aged 40 to 55 years were enrolled in this cross-sectional study. Premenopausal women (n = 21) were required to have regular menstrual cycles (24 to 35 days), and women in LMT (n = 19) must have experienced 3 to 11 months of amenorrhea. Participants underwent a transvaginal ultrasound to determine ovarian volume and AFCs; provided blood for the measurement of antimullerian hormone (AMH), follicle stimulating hormone (FSH), luteinizing hormone, and estradiol; and completed a questionnaire. The correlation between ovarian aging markers and AFCs was investigated. The area under the receiver operating characteristic curve (ROC AUC) was calculated as a measure of diagnostic accuracy. RESULTS Serum AMH levels were more strongly correlated with AFCs than were serum levels of FSH, luteinizing hormone, and estradiol. Serum levels of AMH and FSH had the highest diagnostic accuracy (ROC AUC, 0.893 and 0.890, respectively) for LMT. The inclusion of FSH to AMH in a multivariable model improved the diagnostic accuracy (ROC AUC, 0.932); however, FSH did not have a statistically significant relationship with LMT, whereas AMH tended to be significant (P = 0.017). The ROC curves for sonographic makers (AFC and ovarian volume) and AMH in determining LMT differed significantly (z = 1.76, P G 0.05; z = 1.86, P G 0.05, respectively). CONCLUSIONS AMH alone or in combination with FSH may be a useful indicator of LMT. These data suggest that sonographic markers cannot be substituted for AMH in determining LMT. However, we cannot definitively say that endocrine markers (especially AMH as a single indicator) are better than sonographic markers for determining LMT because serum AMH levels have a strong correlation with AFCs.

Most DRAM interfaces such as GDDR5 and DDR3 use parallel single-ended signaling due to pin-count restriction and backward compatibility. Notwithstanding poor signal and power integrity issues, GDDR5 speed reached beyond 5Gb/s in recent years by utilizing data bus inversion, error-detection coding, data training and channel equalization [1–3]. However, channel crosstalk is becoming a major barrier to further speed improvement. A common solution for channel crosstalk reduction at the system level is to use a shielding line or wide spacing between signal lines, but increasing the number of layers in a chip package and PCB increase system cost. To remove the shielding lines and increase speed, this paper presents a channel crosstalk equalizer with programmable signal ordering capability for the DRAM transmitter. In addition, this paper addresses tri-mode clocking to reduce the system jitter for better timing margin: PLL off, LC-PLL and injection-locked oscillator.

An atypical clinical form of pityriasis versicolor has been infrequently reported, in which cutaneous atrophy is associated with individual pityriasis versicolor lesions. The pathogenesis of this atrophy remains unclear, but is believed to be a delayed-type hypersensitivity reaction to antigens derived from the Malassezia species. A 60-year-old man presented with multiple, slightly scaly, and depressed maculopatches or plaques on the trunk and extremities. Our microscopic examination of the skin scrapings on a KOH preparation revealed numerous short hyphae and spores. The patient was treated daily with 200 mg of itraconazole in combination with topical antifungals, achieving clinical improvement and mycological recovery, which was confirmed upon follow-up 1 month later. This is the first case report of atrophying pityriasis versicolor in Korea. It needs to be differentiated from other atrophying disorders of the skin.