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Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications. [ABSTRACT FROM AUTHOR]

Objective image quality assessment (IQA) is a challenge facing digital image and video processing systems because image quality is distorted during various applications, including restoration, compression, storage and transmission. Therefore, this study proposes a new methodology based on a fuzzy interface system called quality evaluation system (QES) to measure the total quality index (TQI) of input videos with many distorted situations. Nine quality metrics [peak signal-to-noise ratio, visual signal-to-noise ratio, weighted signal-to-noise ratio, structural similarity (SSIM), multi-scale SSIM, universal image quality index, visual information fidelity, information fidelity criterion and noise quality measure] were used as inputs for three fuzzy logic controller systems, and their outputs were set as inputs to another fuzzy logic controller system to obtain the TQI of the input video. This process contributes to obtain clear performance of the quality index of the input video despite the failure of some IQA methods in providing quality performance of the input video in some situations. The proposed QES is tested on four videos captured with different digital cameras under different noise levels. Furthermore, the authors evaluated the proposed QES on three databases (TID2008, TID2013 and LIVE) to improve the experimental results. In addition, the authors used wavelet decomposition and image de-noising to enhance the standard Eulerian video magnification technique. The proposed QES was also used to prove that the authors' magnification system has better magnification quality index than other magnification techniques. [ABSTRACT FROM AUTHOR]

Objective To investigate the impact of tracheostomy tube capping on swallowing physiology in stroke patients with dysphagia via videofluoroscopic swallowing study (VFSS). Methods This study was conducted as a prospective study that involved 30 stroke patients. Then, 4 mL semisolid swallowing was conducted with capping of the tracheostomy tube or without capping of the tracheostomy tube. The following five parameters were measured: laryngeal elevation, pharyngeal transit time, post-swallow pharyngeal remnant, upper esophageal sphincter width (UES), and penetration-aspiration scale (PAS) score. Results On assessment of the differences in swallowing parameters during swallowing between 'with capping' and 'without capping' statuses, statistically significant differences were found in the post-swallow pharyngeal remnant (without capping, 48.19%±28.70%; with capping, 25.09%±19.23%; p<0.001), normalized residue ratio scale for the valleculae (without capping, 0.17±0.12; with capping, 0.09±0.12; p=0.013), normalized residue ratio scale for the piriform sinus (without capping, 0.16±0.12; with capping, 0.10±0.07; p=0.015), and UES width (without capping, 3.32±1.61 mm; with capping, 4.61±1.95 mm; p=0.003). However, there were no statistically significant differences in laryngeal elevation (x-axis without capping, 2.48±1.45 mm; with capping, 3.26±2.37 mm; y-axis without capping, 11.11±5.24 mm; with capping, 12.64±6.16 mm), pharyngeal transit time (without capping, 9.19± 10.14 s; with capping, 9.09±10.21 s), and PAS score (without capping, 4.94±2.83; with capping, 4.18±2.24). Conclusion Tracheostomy tube capping is a useful way to reduce post-swallow remnants and it can be considered an alternative method for alleviating dysphagia in stroke patients who can tolerate tracheostomy tube capping when post-swallow remnants are observed. [ABSTRACT FROM AUTHOR]

Objective To investigate the improvement of dysphagia after balloon dilatation and balloon swallowing at the vallecular space with a Foley catheter in stroke patients. Methods This study was conducted between May 1, 2012 and December 31, 2015, and involved 30 stroke patients with complaints of difficulty in swallowing. All patients underwent videofluoroscopic swallowing study (VFSS) before and after vallecular ballooning. VFSS was performed with a 4 mL semisolid bolus. For vallecular ballooning, two trainings were performed for at least 10 minutes, including backward stretching of the epiglottis and swallowing of a balloon located in the vallecular space, by checking the movement of the Foley catheter tip in real time using VFSS. Results After examination of the dysphagia improvement pattern before and after vallecular ballooning, laryngeal elevation (x-axis: pre 2.62±1.51 mm and post 3.54±1.93 mm, p=0.038; y-axis: pre 17.11±4.24 mm and post 22.11±3.46 mm, p=0.036), pharyngeal transit time (pre 5.76±6.61 s and post 4.08±5.49 s, p=0.043), rotation of the epiglottis (pre 53.24°±26.77° and post 32.45°±24.60°, p<0.001), and post-swallow pharyngeal remnant (pre 41.31%±23.77% and post 32.45%±24.60%, p=0.002) showed statistically significant differences. No significant difference was observed in the penetration-aspiration scale score (pre 4.73±1.50 and post 4.46±1.78, p=0.391). Conclusion For stroke patients with dysmotility of the epiglottis and post-swallowing residue, vallecular ballooning can be considered as an alternative method that can be applied without risk of aspiration in dysphagia treatment. [ABSTRACT FROM AUTHOR]

Objective To evaluate the clinical efficacy and safety following percutaneous disc decompression, using navigable disc decompression device for cervical herniated nucleus pulposus (HNP). Methods Twenty subjects diagnosed with cervical HNP and refractory to conservative management were enrolled for the study. The herniated discs were decompressed under fluoroscopic guidance, using radiofrequency ablation device with navigable wand. The sagittal and axial plain magnetic resonance images of the clinically significant herniated disc, decided the space between the herniated base and outline as the target area for ablation. Clinical outcome was determined by Numeric Rating Scale (NRS), Neck Disability Index (NDI), and Bodily Pain scale of Short Form-36 (SF-36 BP), assessed after 48 weeks. After the procedure, we structurally matched the magnetic resonance imaging (MRI) and C-arm images through bony markers. The wand position was defined as being 'correct' if the tip was placed within the target area of both AP and lateral views; if not, the position was stated as 'incorrect'. Results The average NRS fell from 7 to 1 at 48 weeks post procedure (p<0.05). In addition, statistically significant improvement was noted in the NDI and SF-36BP (p<0.05). The location of the wand tip resulted in 16 correct and 4 incorrect placements. Post-48 weeks, 3 of the incorrect tip cases and 1 correct tip case showed unsuccessful outcomes. Conclusion The study demonstrated the promising results and safety of the procedure. Thus, focal plasma ablation of cervical HNP with navigable wand can be another effective treatment option. [ABSTRACT FROM AUTHOR]

The main issue of vison-based automatic harvesting manipulators is the difficulty in the correct fruit identification in the images under natural lighting conditions. Mostly, the solution has been based on a linear combination of color components in the multispectral images. However, the results have not reached a satisfactory level. To overcome this issue, this paper proposes a robust nonlinear fusion method to augment the original color image with the synchronized near infrared image. The two images are fused with Daubechies wavelet transform (DWT) in a multiscale decomposition approach. With DWT, the background noises are reduced and the necessary image features are enhanced by fusing the color contrast of the color components and the homogeneity of the near infrared (NIR) component. The resulting fused color image is classified with a C-means algorithm for reconstruction. The performance of the proposed approach is evaluated with the statistical F measure in comparison to some existing methods using linear combinations of color components. The results show that the fusion of information in different spectral components has the advantage of enhancing the image quality, therefore improving the classification accuracy in citrus fruit identification in natural lighting conditions. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458) and 77.5% (779/1,031) of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110-367), 189.1 patients (range, 90-345), and 40.2 nurses (range, 10-83). The average number of physicians was 6.2 (range, 3-11), but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%), indwelling catheters (19.5%), clean intermittent catheters (12.2%), and external collection urinary drainage (7.9%). However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals. [ABSTRACT FROM AUTHOR]

Hand pose recognition has received increasing attention in an area of human-computer interaction. With the recent spread of many low-cost three-dimensional (3D) cameras, research into understanding more natural gestures has increased. In this study, the authors present a method for hand part classification and joint estimation from a single depth image. They apply random decision forests (RDFs) for hand part classification. Foreground pixels in the hand image are estimated by RDF. Then hand joints are estimated based on the classified hand parts. They suggest a robust feature extraction method for per-pixel classification, which enhances the accuracy of hand part classification. They also propose a tree selection algorithm using legacy trained RDF to classify unseen test data. Selecting trees using the proposed method show better performance than using all the trees as in conventional method. Depth images and label images synthesised by 3D hand mesh model were used for training forests and algorithm verification. The authors' experiments show that the enhanced algorithm outperforms the state-of-the-art method in accuracy. [ABSTRACT FROM AUTHOR]

The gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for differentiating central precocious puberty (CPP) from exaggerated thelarche (ET). Because of this test's limitations, previous studies have clarified the clinical and laboratory factors that predict CPP. The present study investigated the early diagnostic significance of pelvic ultrasound in girls with CPP. The GnRH stimulation test and pelvic ultrasound were performed between March 2007 and February 2015 in 192 girls (aged ＜8 years) with signs of early puberty and advanced bone age. Ninety-three of 192 patients (48.4%) were diagnosed as having CPP and the others (51.6%) as having ET. The CPP group had higher uterine volumes (4.31±2.79 mL) than did the ET group (3.05±1.97 mL, p=0.03). No significant differences were found in other ultrasonographic parameters. By use of receiver operating characteristic curve analysis, the most predictive parameter for CPP was a uterine volume of least 3.30 mL, with an area under the curve of 0.659 (95% confidence interval: 0.576-0.736). The CPP group had significantly higher uterine volumes than did the ET group, but there were no reliable cutoff values in pelvic ultrasound for differentiating between CPP and ET. Pelvic ultrasound should be combined with clinical and laboratory tests to maximize its diagnostic value for CPP. [ABSTRACT FROM AUTHOR]

Objective: To determine clinical and radiological factors that predict the successful outcome of percutaneous disc decompression (PDD) in patients with lumbar herniated nucleus pulposus (HNP). Methods: We retrospectively reviewed the clinical and radiological features of patients who underwent lumbar PDD from April 2009 to March 2013. Sixty-nine patients with lumbar HNP were studied. Clinical outcome was assessed by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Multivariate logistic regression analysis was performed to assess relationship among clinical and radiological factors and the successful outcome of the PDD. Results: The VAS and the ODI decreased significantly at 1 year follow-up (p<0.01). One year after PDD, the reduction of the VAS (ΔVAS) was significantly greater in the patients with pain for <6 months (p=0.03) and subarticular HNP (p=0.015). The reduction of the ODI (ΔODI) was significantly greater in the patients with high intensity zone (p=0.04). Multivariate logistic regression analysis revealed the following 5 factors that were associated with the successful outcome after PDD: pain duration for <6 months (odds ratio [OR]=14.036; p=0.006), positive straight leg raising test (OR=8.425, p=0.014), the extruded HNP (OR=0.106, p=0.04), the sequestrated HNP (OR=0.037, p=0.026), and the subarticular HNP (OR=10.876, p=0.012). Conclusion: PDD provided significant improvement of pain and disability of patients. The Results of the analysis indicated that the duration of pain <6 months, positive straight leg raising test, the subarticular HNP, and the protruded HNP were predicting factors associated with the successful response of PDD in patients with lumbar HNP. [ABSTRACT FROM AUTHOR]

Objective. This study is a pilot study to assess the clinical outcomes of percutaneous disc decompression using the L'DISQ in patients with lumbar discogenic pain. Study Design. An institutional, prospective clinical data analysis. Methods. We ablated the torn annulus using L'DISQ on 20 patients with axial low back pain for at least 3 months (average 29 months) unresponsive to conservative management. Before the therapeutic procedure, all the patients had been diagnosed with lumbar discogenic pain through provocation discography, which had confirmed the level of painful discs. The torn annulus was identified through lumbosacral magnetic resonance image and computed tomographic discogram. Baseline data were prospectively gathered before the procedure and at 1, 4, 12, 24, and 48 weeks post-procedure. Data included pain intensity (visual analog scale [VAS]), measure of disability (Oswestry Disability Index [ODI] and Rolando-Morris Disability Questionnaire [RM]), and health-related quality of life (Bodily Pain Scale of Short Form-36 version 2 [SF-36 BP]). Results. At 48 weeks, the VAS fell from 7.55 ± 1.28 to 3.60 ± 2.28 scores, the ODI and RM had decreased significantly, and the SF-36 BP showed significant improvement (P < 0.05). The success rates of procedure were 55.0% at 48 weeks. There were no complications with the exception of a minor venous bleeding at the site of needle puncture. Conclusions. The L'DISQ device is specifically designed to ablate adjacent disc tissue using a wand that can be navigated into a torn annulus. Following ablation, we measured clinically significant pain improvement and decreased disability for patients with axial low back pain. [ABSTRACT FROM AUTHOR]

In this paper, we propose a probe-rotating atomic force microscope that enables scan in an arbitrary direction in the contact imaging mode, which is difficult to achieve using a conventional atomic force microscope owing to the orientation-dependent probe and the inability to rotate the probe head. To enable rotation of the probe about its vertical axis, we employed a compact and light probe head, the sensor of which is made of an optical disk drive pickup unit. Our proposed mechanical configuration, operating principle, and control system enables axial and lateral scan in various directions. [ABSTRACT FROM AUTHOR]

We report a highly versatile and one-pot microwave route to the mass production of three-dimensional graphene-carbon nanotube-iron oxide nanostructures for the efficient removal of arsenic from contaminated water. The unique three-dimensional nanostructure shows that carbon nanotubes are vertically standing on graphene sheets and iron oxide nanoparticles are decorated on both the graphene and the carbon nanotubes. The material with iron oxide nanoparticles shows excellent absorption for arsenic removal from contaminated water, due to its high surface-to-volume ratio and open pore network of the graphene-carbon nanotube-iron oxide three-dimensional nanostructures. [ABSTRACT FROM AUTHOR]

Background: Fibromyalgia (FM) is characterized by chronic widespread pain with a low pain threshold. The aim of this study was to compare two criteria for the diagnosis and assessment of FM and to analyze the correlation and agreement between the 1990 and 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for FM. Methods: We studied 98 patients who had already been diagnosed as having FM using the 1990 criteria or 2010 preliminary criteria. Tender point examination, FM impact questionnaire (FIQ) and pain visual analog scale (VAS) were obtained. According to the preliminary criteria, FM was quantified as WPI (widespread pain index) and the SS scale (symptom severity) and the two criteria were compared. Results: Among 98 patients, 78.6% of the patients were diagnosed with the 1990 ACR criteria and 93.9% of the patients were diagnosed with the ACR preliminary diagnostic criteria, and there was also significant agreement between the two criteria (P < 0.01). There was a correlation with the WPI and the tender point, with the SS and the FIQ, and with the sum of the WPI and SS and the FIQ. Conclusions: The ACR preliminary diagnostic criteria for FM were in agreement with the 1990 ACR criteria during the disease course. The preliminary criteria were the more sensitive method than the 1990 criteria. In addition, the 2010 criteria might have advantages since it is easy to assess the physical and psychological symptoms and can be quantified. Therefore, the ACR preliminary diagnostic criteria for FM could be used more conveniently for clinical diagnosis and follow up evaluation after starting management of FM. [ABSTRACT FROM AUTHOR]

An institutional, prospective clinical data analysis. To evaluate the safety and efficacy of a new navigable percutaneous disc decompression device (L'DISQ) in patients with lumbar disc herniation with radicular pain. We performed disc decompressions using L'DISQ on 27 patients with persistent disabling back and leg pain for 1 month or longer (average 6.48 months) due to a herniated lumbar intervertebral disc. Baseline data were prospectively gathered before the index procedure and at 1, 4, 12, and 24 weeks post-procedure. Data included pain intensity (visual analog scale [VAS]), measure of disability (Oswestry Disability Index [ODI] and Rolando-Morris Questionnaire [RM]), health-related quality of life (Bodily Pain Scale of Short Form-36 version 2 [SF-36 BP]), and passive straight leg raising test (SLR). The VAS fell from 7.08 ± 1.22 to 1.84 ± 0.99 scores at 24 weeks post-procedure. At 24 weeks, the ODI had fallen from 41.88 ± 10.61 to 16.66 ± 8.55% and the RM from 11.52 ± 3.91 to 2.68 ± 1.97 points. The SF-36 BP dropped significant improvement from 32.89 ± 5.83 to 49.57 ± 4.96 scales. In the SLR test, the angular change of 24 weeks showed considerable improvement from 60.20 ± 20.02 to 83.00 ± 14.29 degrees. No major complication occurred, although two cases developed a disc reherniation 1 month post-procedure. The L'DISQ device is specifically designed to remove herniated disc using a wand that can be navigated into a disc protrusion or extrusion. Following decompression, we measured clinically significant pain improvement and decreased disability for patients with both radicular and axial pain caused by protruded and extruded discs. [ABSTRACT FROM AUTHOR]

The photosynthetic activities of benthic diatoms in response to temperature changes were assessed by measuring chlorophyll fluorescence kinetics. Small benthic diatom species with large surface area to volume (SA/ V) ratios responded to increasing temperature differently from large diatoms, since larger ratios caused lower photosynthetic activity under high-temperature conditions. The small SA/ V ratios of large cells may be advantageous in benthic environments under adverse conditions such as high temperature and/or strong light. A size-dependent differential response of benthic diatoms to changes in environmental factors such as temperature may result in an altered distribution of the different diatom communities. [ABSTRACT FROM AUTHOR]

This study examines flexor digitorum tendons and A1 pulley in patients presenting trigger fingers using high-resolution ultrasonography (US), determines the accurate causes of trigger fingers, and analyzes the relationship between clinical data and US findings. As much as 50 trigger fingers of 41 patients were examined by high-resolution US, and the US findings were analyzed as tendon thickness, fibrillar echotexture, tendon margin, fluid collection, A1 pulley thickening, tendon sheath cyst, and metacarpophalageal (MCP) joint abnormalities. The affected fingers were compared with the asymptomatic opposite sides. Right thumb and ring finger were the most common fingers involved. Mean thickness of flexor digitorum tendons of the affected fingers was increased significantly, compared with that of the opposite fingers. There were various US findings in flexor digitorum tendons as follows; loss of normal fibrillar echogenic pattern (14%), irregularity or blurring of the tendon margin (62%), and fluid collection in the tendon sheath (16%). Thickening of A1 pulley was noted in 44% of fingers, and mean thickness of A1 pulley was 0.7 mm. As much as 6% of fingers had the sheath cysts and 4% of fingers had abnormalities of MCP joints. The patients with extension difficulty of the fingers had thicker flexor digitorum tendon than those without. The patients with locking fingers had more blurred margin of the tendon than those without. US can detect various lesions in clinical trigger fingers, and some US findings correlated with clinical findings. [ABSTRACT FROM AUTHOR]

This paper proposes a video coding scheme for low bit rates environments such as video streaming in internet or mobile networks. Since the annoying artifacts at low bit rates result mostly from the coarse quantization of residual signals, we try to reduce this problem by introducing the hybrid resolution scheme and allocating more bits to the transform coefficients. The intra frames are encoded in the original resolution for their importance, and the inter frames are downsampled and encoded by H.264 with finer quantization steps. The images of original resolution are reconstructed by using the decoded images of reduced resolution and previously reconstructed frames. Each block of original resolution is reconstructed by one of four modes, according to the combination of interpolation of the decoded block of reduced resolution, fetching of the previously reconstructed block of original resolution block, and use of the residual images of original resolution. And, the selection of mode is decided by the R-D optimization. The final bit stream consists of side information, bit stream of the H.264 for the reduced frames, and the residual signals of original resolution. Experimental results show that the proposed method yields better performance than the usual H.264/AVC up to some critical bit rates and the PSNR difference increases up to 3.5 dB at low bit rates. In addition, since the motion estimation is performed with the downsampled frames, the computational load for the overall encoding is much reduced. The proposed video coding system is especially efficient at low bit rates environment, thus it is suitable for video streaming in internet and mobile networks. [ABSTRACT FROM AUTHOR]

In recent video applications such as MPEG or H.264/A VC, the bandwidth requirement for frame memory has become one of the most critical problems. Compressing pixel data before storing in off-chip frame memory is required to alleviate this problem. In this paper, we propose a lossless frame memory recompression scheme including 1) a lossless pixel compression algorithm, 2) an efficient address table organization method for random accessibility, and 3) frame memory placement scheme for compressed data to reduce the effective access time of SDRAM by suppressing row switching. Experimental results show that the proposed method reduces the frame data to 48% compared to that of the uncompressed one with H.264/A VC high profile encoder system, where 6.1kB of SRAM is required for the address table of full HD video. [ABSTRACT FROM AUTHOR]

To expand an inevitably limited rotating range of the existing planar precision stage, we suggest a revolving stage driven by three-separate axial type of transverse flux induction motors spaced 120° apart. It is a non-contact integrated rotating system that uses three-axial vector forces such as normal and thrust force of each motor. In this paper, the primary principles capable of realizing such a contact-less revolving stage are reviewed and compared, with results that seem to confirm the main principles of the suggested system. And then, the positioning method with only the air-gap measurements covering full degree of freedom is presented, compared with that of existing stages. [ABSTRACT FROM AUTHOR]

For lack of a criterion standard for lumbar discogenic pain, the validity of lumbar discography cannot be determined directly. The false-positive rate of discography, however, can be inferred from the prevalence of positive responses in asymptomatic volunteers. Responses in normal volunteers have been reported in only three studies, and the prevalence of positive responses has been“occasionally, zero, and 10%.” None of these studies, however, controlled for both pressure of injection and intensity of response.To determine the prevalence of positive responses to lumbar discography in asymptomatic volunteers, controlled for pressure of injection and intensity of response.Prospective, observational study, conducted in a private spine center.Four lay persons and nine physicians underwent lumbar discography, with manometry.The prevalence of painful responses were tabulated in terms of the intensity of response, the pressure of injection, the segment stimulated, disc morphology, and past history of low back pain.Some 56% of discs were not painful, despite maximum pressurization. The remaining 44% of discs were painful, to various degrees, at various pressures. Most discs required high pressures of injection to be painful but even so, were only mildly painful. A receiver–operator curve was derived to demonstrate combinations of pain intensity and pressure below which the probability of a response was zero or less than 10%.Lumbar discs in asymptomatic volunteers can be made painful, but as a rule, the pain is mild and requires high pressures of injection. If attention is paid to pressure of injection and intensity of response, operational criteria can be defined that provide lumbar discography with a potential false-positive rate of zero or less than 10%. [ABSTRACT FROM AUTHOR]

Intradiscal electrothermal annuloplasty (IDET) is an effective treatment for chronic discogenic low back pain (LBP). However, efficacy of IDET for the treatment of referred leg pain has not been examined. This study was performed to assess the long-term efficacy of IDET for the treatment of referred leg pain in chronic discogenic LBP patients. Data were retrospectively analyzed as an IDET case series from January 1999 to December 2000. The IDET procedure was performed at 1–3 symptomatic levels confirmed by pressure-controlled discography. General pain outcome was evaluated by Visual Analog Scale (VAS). LBP and leg pain were assessed separately using five-point pain scales (subsets of the North American Spine Society[NASS] LBP outcome assessment instrument: 0 = no pain, 4 = worst pain) at the 18-month follow-up. Among 129 patients who underwent IDET, 30 patients underwent subsequent back surgery and were excluded from the study, giving a total of 99 patients. Eighty-three patients (83.8%) had leg pain without sciatica. Fifty-two (52.5%), 21 (21.2%), and 8 (8.0%) patients showed LBP > leg pain, LBP = leg pain and LBP < leg pain, respectively. Fifty-three out of 83 patients (63.9%) showed post-IDET improvement in pain, with a mean VAS score of 3.28 ± 2.31. Thirty patients (36.1%) showed no improvement. A statistically significant (P < 0.05) improvement in subjective back and referred leg pain was observed. Improvements in back and referred leg pain were well-correlated (r = 0.721,P < 0.01). A relatively large number of LBP patients who underwent IDET (84%) presented with referred leg pain without sciatica. The IDET procedure afforded improvements in leg pain that correlated well with improvements in back pain (0.75/4 and 0.88/4, respectively). These data suggest that IDET may relieve associated limb pain in chronic discogenic LBP patients. [ABSTRACT FROM AUTHOR]

A 25-year-old girl presented with progressive deterioration of right side weakness with decreased sensation on the left trunk. She had been treated with high dose steroid due to autoimmune thrombocytopenia for 2 months. Clinical, laboratory and immunologic studies revealed that she had systemic lupus erythematosus (SLE), MRI of spinal cord showed marginal contrast enhancing and fluid containing mass in the cord of the C5-6 level, suggesting intramedullary abcess. She underwent surgery of mass removal with biopsy. The pathologic findings from cord tissues revealed numerous acid fast bacilli (AFB) in necrotic tissues. After surgery and anti-tuberculous treatment, her neurologic symptoms were markedly improved with restoration of right side motor weakness. To our knowledge, this is the first case report of intramedullary tuberculosis in a patient with SLE. Since intramedullary tuberculosis may sometimes mimic neurologic complication of SLE itself, it may pose diagnostic and therapeutic confusion for clinicians. We report a case of spinal cord tuberculosis affecting C5, 6 level which was manifested as Brown—Sequard syndrome in a patient with SLE. Lupus (2000) 9, 147–150 [ABSTRACT FROM AUTHOR]

Objectives: To compare the drug retention times and clinical efficacy of alternative tumour necrosis factor inhibitors (TNFi) and secukinumab in primary and secondary non-responders with ankylosing spondylitis (AS). Methods: AS patients treated with biologics and enrolled in the Korean College of Rheumatology Biologics registry were examined. Patients who did not respond to previous TNFi treatment were defined as primary and secondary non-responders. Data regarding drug discontinuation and clinical efficacy were collected after 1 year. Kaplan–Meier and Cox regression analyses were performed to compare drug survival and associated factors. Logistic regression analyses were conducted to compare the clinical efficacy secukinumab with that of alternative TNFi. Results: In total, 124 patients (83 receiving alternative TNFi and 41 receiving secukinumab) had biologic changes due to clinical inefficacy. Drug retention rates in the alternative TNFi and secukinumab groups were similar (P = 0.096). However, subgroup analyses including only secondary non-responders revealed that secukinumab users showed a higher hazard ratio (HR) for drug discontinuation (HR = 3.77, P = 0.045). In addition, secukinumab was negatively associated with achieving BASDAI50 or a major improvement in the ASDAS. Conclusion: Alternative TNFi showed better drug retention and clinical efficacy in AS patients experiencing previous TNFi failure, in secondary non-responders. Therefore, alternative TNFi may be a more suitable treatment for secondary non-responders. [ABSTRACT FROM AUTHOR]

Magnetic manipulation of a microcantilever for a new concept in atomic force microscopy, which is able to adjust th stiffness of microcantilever and do simultaneous imaging and manipulation of living cell, is presented. With the data of the appropriate magnetic force for operation, the magnetic elements are designed using a magnetic analysis program. The experimental results show that the design process is valid, and the precise manipulation of microcantilever is feasible. [ABSTRACT FROM AUTHOR]

Magnetic flux measurements of a toroidal magnet revealed a concave shaped field distribution with a single minimum value and a null field along the axis of the torus at the point where the field was reversed. The nonlinear magnetic field of the toroidal magnet perpendicular to the Ag[sub 2]O doped superconducting disk sample with the trapped magnetic flux distorted the field line distribution. As a result, the interaction force between the magnet and sample exhibited regions of repulsive, null, attractive, null, and finally repulsive force. The asymmetrical concave shaped force pattern along the axis with two null force points indicates that the magnetic force exerted form the sample changed direction which resulted in the transition from repulsive force to attractive force at the null force point, and the force becomes repulsive again beyond the second null force point as the distance along the axis increases. The lateral stability of the suspended sample under the toroidal magnet is provided by the characteristics of the symmetrical nature of the field line with respect to the axis of the magnet. The magnetic moment of an undoped and 2 % Ag[sub 2]O doped sample was shown to be m = 0.043 emu and 0.06 emu, respectively. The measured suspension force exerted form the doped sample agreed well with the suspension force calculated from magnetostatic force distribution. [ABSTRACT FROM AUTHOR]

Although extra-glomerular involvement of microscopic polyangiitis is not regarded as a characteristic finding of the disease, tubulointerstitial nephritis should be considered as a new subclass of renal involvement. [ABSTRACT FROM AUTHOR]

The field emission properties of boron nitride nanotube (BNNT) field emitters according to vacuum pressure were demonstrated. During the short-term emission operation, the field emission behaviors were almost similar, regardless of the vacuum pressure, even though the turn-on electric field of the BNNT field emitter was slightly increased as the vacuum pressure increased. On the other hand, during the long-term emission operation, both the degradation and fluctuations of the emission current of the BNNT field emitters were dramatically increased as the vacuum pressure increased. The degradation of field emission properties of the BNNT emitters according to vacuum pressure is mainly attributed to the ion bombardment effect, rather than the oxidation effect. The field emission behavior under Ar ambient also strongly demonstrates that the degradation and the fluctuation of the emission current are largely dependent on the ion bombardment effect. [ABSTRACT FROM AUTHOR]

Primary malignant melanoma (PMM) of the gastrointestinal tract is rare. Reported cases of PMM of the lower gastrointestinal tract typically describe anal and rectal involvement rather than colonic lesions. This report describes a rare case of a 50-year-old woman with PMM originating in the colon. The patient presented to Inje University Busan Paik Hospital with a 3-day history of blood-tinged stools. She underwent colonoscopy for a diagnosis of hematochezia. The colonoscopic examination revealed a large-sized semi-pedunculated sigmoid colon polyp with a reddish-colored mucosal surface. Endoscopic mucosal resection was performed, and the final histopathological findings were consistent with a diagnosis of malignant melanoma. Systemic work-up was performed for assessment of metastasis and to identify the primary tumor considering the high metastatic rate of gastrointestinal malignant melanoma; however, no other malignant lesion was detected. Thus, she was diagnosed with colonic PMM. She underwent laparoscopic low anterior resection and lymph node dissection and has been recurrence-free for >2 years. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of a 4-week swallowing rehabilitation program combined with pyriform sinus ballooning in patients with post-stroke dysphagia (PSD). Methods We evaluated a total of 30 patients (n=30) with PSD who were admitted to our medical institution between May of 2014 and October of 2016. These patients were randomly assigned to either the trial group (n=15; a 20-minute conventional rehabilitation followed by a 10-minute pyriform sinus ballooning) or the control group (n=15; a 30-minute conventional rehabilitation). In these patients, the efficacy outcome measures were pharyngeal remnant, the pharyngeal transit time, the Penetration Aspiration Scale (PAS) scores and the Videofluoroscopic Dysphagia Scale (VDS) scores. We compared the differences in efficacy outcome measures at 4 weeks from baseline between the two groups. Results There were significant changes in the pharyngeal remnant, the pharyngeal transit time, the PAS scores and the VDS scores at 4 weeks from baseline between the two groups (p<0.0001, p=0.0001, p<0.0001, and p=0.0048, respectively). There were no treatment-emergent adverse events in our series. Conclusion Our 4-week rehabilitation program combined with pyriform sinus ballooning is an effective and safe modality in patients with PSD. However, further large-scale, long-term, and multi-center studies are needed to corroborate our results. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the prevalence and management status of urologic disease in geriatric hospitals in Korea. Materials and Methods: We conducted population-based analyzed using cohort established by the National Health Insurance Service of Korea, which contains the medical insurance data of 1 million people from 2002 to 2013. The prevalence, prescription rate, and complication incidence of urologic disease in geriatric hospitals were compared with similar-sized general hospitals. We analyzed the changes that followed the adoption of the fixed sum medical fee per day for geriatric hospitals, which began in January 2008. Subgroup analysis was conducted in an elderly group and a propensity score matching (PSM) group. Results: During this time, the number of geriatric hospitals exponentially increased over general hospitals (675.5%/y vs. 30.9%/y). The prevalence, prescription rate, and complication incidence of urologic disease was higher in geriatric hospitals than in general hospitals (2.1, 1.8, and 1.4 times higher). In the elderly group, the prevalence of urologic disorders was higher in geriatric hospitals than in general hospitals, but the prescription rate was lower (26.5% vs. 19.9% and 6.8% vs. 10.0%). This tendency also founded in the PSM analysis. After the medical fee system changed, diagnosis and prescription rates decreased in geriatric hospitals but increased in general hospitals. Conclusions: Urologic diseases are more prevalent yet management has some problem in geriatric hospitals. Lack of institutional urologists and changes in the medical payment system should be associated with this problem. Additional study and political support are needed to overcome this issue. [ABSTRACT FROM AUTHOR]

The objective of this study was to design a non-invasive system for the observation of respiratory rates and detection of apnoea using analysis of real time image sequences captured in any given sleep position and under any light conditions (even in dark environments). A Microsoft Kinect sensor was used to visualize the variations in the thorax and abdomen from the respiratory rhythm. These variations were magnified, analyzed and detected at a distance of 2.5 m from the subject. A modified motion magnification system and frame subtraction technique were used to identify breathing movements by detecting rapid motion areas in the magnified frame sequences. The experimental results on a set of video data from five subjects (3 h for each subject) showed that our monitoring system can accurately measure respiratory rate and therefore detect apnoea in infants and young children. The proposed system is feasible, accurate, safe and low computational complexity, making it an efficient alternative for non-contact home sleep monitoring systems and advancing health care applications. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore the relationships among medical students' assessments on peers' group presentations, instructors' assessments of those presentations, and students' educational achievements in other assignments and tests. Methods: A total of 101 first-year students from a medical school participated in the study. The students' educational achievements in a 4-week long integrated curriculum were analyzed. Student's final grades were comprised of the following education criteria: two written tests (60%), 15 group reports (25%), one individual report (7%), and four group presentations (15%). We compared scores of the group presentation assessed by the peers and the two instructors. Furthermore, we compared peers' assessment scores with each component of the evaluation criteria. Results: Pearson correlation analysis showed significant correlaton for the assessments between peers and instructors (r=0.775, p<0.001). Peer assessment scores also correlated significantly with scores for the group assignments (r=0.777, p<0.001), final grades on the curriculum (r=0.345, p<0.001), and scores for individual assignments (r=0.334, p<0.001); however, no significant correlation was observed between the peer-assessed group presentation scores and the two written test scores. Conclusion: Peer assessments may be a reliable and valid method for evaluating medical students' performances in an integrated curriculum, especially if the assessments are used to academic processes, such as presentations, with explicit evaluation and judgment criteria. Peer assessments on group presentations might assess different learning domains compared to written tests that primarily evaluate limited medical knowledge and clinical reasoning. [ABSTRACT FROM AUTHOR]

Introduction. There is a renewed interest in analgesic testing, influenced by several studies reporting robust surgical results when the diagnosis of discogenic pain is confirmed by relief of pain post-provocative discography after injecting local anesthetic into painful discs. Objective. We anticipated and sought to confirm that injecting local anesthetic in intervertebral discs would provide convincing pain relief and that the degree of pain relief would help confirm or refute the findings of provocative discography. Methods. There were 23 patients in the nonanalgesic group, and 47 patients in the analgesic group. The analgesic patient discs were injected with an equal volume of local anesthetic and nonionic contrast media. Lumbar discography was performed using an automated pressure-controlled provocative discographic (APCPD) technique. Subjects reported global subjective relief at 15 and 45 minutes after APCPD. Pre- and post-procedure pain was rated using a numerical rating scale (NRS) using standardized pain provoking positions. In addition, we further compared the numbers of patients reporting a decrease in NRS scores (≥2) in standardized pain provoking positions. Results. The addition of local anesthetic to APCPD did not affect the number of positive APCPD results that averaged ∼30% positive discs in both groups. The addition of local anesthetic to contrast significantly reduced pain NRS scores by 2/10 or greater during forward flexion and sitting compared with patients whose discs were injected with contrast without local anesthetic. The average pain improvement using standardized pain provocation positions and average subjective relief were not, however, significantly different in the two groups. Only two patients reported overall pain relief equal or greater to 50%. Conclusions. Using an equal mixtures of injected local anesthetic and contrast during provocative discography in a cohort of patients did not provide significant overall subjective pain relief compared to using contrast alone in a comparative separate cohort. [ABSTRACT FROM AUTHOR]

The TLRs gene encodes the principal innate immunity receptor in humans. The TLR2 Arg753Gln and Arg677Trp polymorphisms have been associated with a reduced response of monocytes and cell lines to challenge with mycobacteria. The TLR4 Asp299Gly and Thr399Ile polymorphisms have been associated with a reduction in the inflammatory responses to lipopolysaccharide in humans. It has been suggested that TLR2 and TLR4 polymorphisms may be associated with allergic responses; thus, we hypothesized that TLR2 and TLR4 polymorphisms may modify the relative risk for development of allergic rhinitis. The Taqman assay and high-resolution melt (HRM) were used for genotyping. We analyzed two single nucleotide polymorphisms (SNPs; 597T>C and 1350T>C) in the TLR2 gene and 1 SNP (4216G>C) in the TLR4 gene. We compared the genotype of these SNPs in patients with allergic rhinitis and controls without allergic rhinitis. We also estimated the haplotype frequencies between the two groups. The genotype and allele frequencies of the 597T>C and 1350T>C SNPs in the TLR2 gene were not significantly different between the patients with allergic rhinitis and controls ( P > 0.05). The genotype and allele frequencies of 4216G>C in the TLR4 gene were not significantly different between the patients with allergic rhinitis and controls ( P > 0.05). Haplotype analysis of the following two different (597)–(1350) major haplotypes (frequency >0.05) were present in the TLR2 gene: T–C and C–C. The C–C haplotype was positively associated with allergic rhinitis ( P = 0.048). Our study suggests that the TLR2 gene polymorphisms might be susceptible to the development of allergic rhinitis. Further functional studies of TLR2 genetics in light of the associations with allergic rhinitis inflammation would help clarify the role of TLR2 genetics in clinical evaluations. [ABSTRACT FROM AUTHOR]

Today, the highlighted actuators such a Shape Memory Alloy (hereafter, it is called SMA), will change greatly the next medical device market since their energy integration, lightness and simple structure are superior to those of the conventional electromechanical actuator. Especially, the reason why the SMA actuator system becomes the most important technique for the medical device market of the next generation is that the minimally invasive technique can be applied to the in-vivo lesion due to the superior flexibility of SMA actuator system such a hand. In spite of this advantage, the current SMA actuator is not widespread. The reason is that the non-linear dynamic characteristics of the SMA original hysteresis have not yet been solved. Therefore, to evaluate the thermoelectric characteristics of our developed thermoelectric module for our first basic study, we investigated the temperature variation by stage 1) according to the current increase of the consecutive current and 2) according to the countercurrent of the discontinuous static current. [ABSTRACT FROM AUTHOR]

Amyloidosis is defined as the extracellular deposition of non-branching fibrils composed of a variety of serum-protein precursors. Secondary amyloidosis is associated with several chronic inflammatory conditions, such as rheumatologic or intestinal diseases, familial Mediterranean fever, or chronic infectious diseases, such as tuberculosis. Although the association of amyloidosis with inflammatory bowel disease is known, amyloidosis secondary to ulcerative colitis (UC) is rare. A 36-year-old male patient with a 15-year history of UC presented with nausea, vomiting, and abdominal pain. He had been treated with infliximab for 6 years. At the time of admission, he had been undergoing treatment with mesalazine and adalimumab since the preceding 5 months. Esophagogastroduodenoscopy showed mucosal erythema, edema, and erosions with geographic ulcers at the 2nd and 3rd portions of the duodenum. Duodenal amyloidosis was diagnosed using polarized light microscopy and Congo red stain. Monoclonal gammopathy was not detected in serum and urine tests, while the serum free light chain assay result was not specific. An increase in plasma cells in the bone marrow was not found. Secondary amyloidosis due to UC was suspected. The symptoms were resolved after glucocorticoid therapy. [ABSTRACT FROM AUTHOR]

The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors. [ABSTRACT FROM AUTHOR]

We report a new hybrid integration scheme that offers for the first time a nanowire-on-lead approach, which enables independent electrical addressability, is scalable, and has superior spatial resolution in vertical nanowire arrays. The fabrication of these nanowire arrays is demonstrated to be scalable down to submicrometer site-to-site spacing and can be combined with standard integrated circuit fabrication technologies. We utilize these arrays to perform electrophysiological recordings from mouse and rat primary neurons and human induced pluripotent stem cell (hiPSC)-derived neurons, which revealed high signal-to-noise ratios and sensitivity to subthreshold postsynaptic potentials (PSPs). We measured electrical activity from rodent neurons from 8 days in vitro (DIV) to 14 DIV and from hiPSC-derived neurons at 6 weeks in vitro post culture with signal amplitudes up to 99 mV. Overall, our platform paves the way for longitudinal electrophysiological experiments on synaptic activity in human iPSC based disease models of neuronal networks, critical for understanding the mechanisms of neurological diseases and for developing drugs to treat them. [ABSTRACT FROM AUTHOR]

This study investigated the reliability and validity of the Korean version of the Utrecht Scale for Evaluation of Rehabilitation-Participation (K-USER-P) in patients with stroke. Stroke patients participated in this study. The Utrecht Scale for Evaluation of Rehabilitation-Participation was translated from English into Korean. A total of 120 questionnaires involving the K-USER-P were distributed to rehabilitation hospitals and centers by mail. Of those, 100 questionnaires were returned and 67 were included in the final analysis after exclusion of questionnaires with insufficient responses. We analyzed the questionnaires for internal consistency, test-retest reliability, and construct validity. The results indicated that internal consistency coefficients of the frequency, restriction, and satisfaction domains were 0.69, 0.66, and 0.67, respectively. Test-retest reliability was 0.63, 0.45, and 0.71 for the three domains, respectively. Intercorrelations between the SF-12 and the London Handicap Scale were generally moderate to good. The Korean version of the Utrecht Scale for Evaluation of Rehabilitation-Participation can be used as a measure of the participation level of stroke patients in clinical practice and the local community. [ABSTRACT FROM AUTHOR]

Objective: To identify the level of agreement between patients with rheumatoid arthritis (RA) and physicians in the global assessment of disease activity and to explore factors influencing their discordance. Methods: A total of 4368 patients with RA were analyzed from the KORean Observational study Network for Arthritis (KORONA) database. Patients were divided into four subgroups according to difference from their physicians in the assessment of disease activity by substracting physician's visual analog scale (VAS) from patient's VAS as follows: positive discordance group I (10mm≤discordance < 25 mm), positive discordance group II (≥25 mm), concordance (<|10| mm), and negative discordance (≤-10mm). Multinomial logistic regression analysis was performed to identify factors associated with discordance. Results: Only 1350 (29.2%) patients were classified in the concordance group. Positive discordance was found in 52.3% of the patients (n = 2425), with 33.7% (n = 1563) showing marked discordance (≥25 mm). The high disease activity (OR =1.41), gastrointestinal (GI) disease (OR = 1.28), pain (OR = 1.12), fatigue (OR = 1.07) were consistently associated with positive discordance. Conclusion: More than half of patients with RA thought their disease more severe than their physicians. In addition to high disease activity, pain, fatigue, and sleep disturbance or GI disease were associated with the discordance between physicians and patients with RA. [ABSTRACT FROM AUTHOR]

In many situations, it would be practical for a computer system user interface to have a model of where a person is looking and what the user is paying attention to. In this study, the authors describe a novel feature coding method for head pose estimation. The widely-used sparse coding (SC) method encodes a test sample using a sparse linear combination of training samples. However, it does not consider the underlying structure of the data in the feature space. In contrast, locality-constrained linear coding (LLC) utilises locality constraints to project each input data into its local-coordinate system. Based on the recent success of LLC, the authors introduce locality-constrained sparse coding (LSC) to overcome the limitation of Sparse Coding. The authors also propose kernel locality-constrained sparse coding, which is a non-linear extension of LSC. By using kernel tricks, the authors implicitly map the input data into the kernel feature space associated with the kernel function. In experiments, the proposed algorithm was applied to a head pose estimation application. Experimental results demonstrated the increased effectiveness and robustness of the method. [ABSTRACT FROM AUTHOR]

We examined the genetic diversity and abundance of picocyanobacteria using barcoded amplicon sequencing approaches and flow cytometry in the East Sea and the East China Sea to determine the distribution patterns of diversity during spring in seas adjacent to the Korean Peninsula. Synechococcus clades I and IV, which have been known as coldadapted ecotypes, dominated at most stations. However, the relative abundances of the two dominant clades differed in their spatial patterns. Clade I was exclusively dominant in the shelf area of the East China Sea and the north East Sea. However, the dominant genotypes belonging to clade I had different spatial distributions in the two areas and responded oppositely to seawater temperature. The dominance of distinct genotypes under the different ecological conditions suggests the presence of ecologically different ecotypes within the clade. Abundances of clade IV were greater than those of clade I at most stations in the southwest East Sea, showing an apparently different pattern from that of the other areas. A warm-water adapted clade II was observed at significant levels only at stations located in the eastern East China Sea affected by a branch of the warm Kuroshio Current. These results suggest that the physicochemical properties of influencing water masses play an important role in determining the distribution of Synechococcus genotypes. [ABSTRACT FROM AUTHOR]

Objective To investigate the length of hospital stay (LOS) after stroke using the database of the Korean Health Insurance Review & Assessment Service. Methods We matched the data of patients admitted for ischemic stroke onset within 7 days in the Departments of Neurology of 12 hospitals to the data from the database of the Korean Health Insurance Review & Assessment Service. We recruited 3,839 patients who were hospitalized between January 2011 and December 2011, had a previous modified Rankin Scale of 0, and no acute hospital readmission after discharge. The patients were divided according to the initial National Institute of Health Stroke Scale score (mild, ≤5; moderate, >5 and ≤13; severe, >13); we compared the number of hospitals that admitted patients and LOS after stroke according to severity, age, and sex. Results The mean LOS was 115.6±219.0 days (median, 19.4 days) and the mean number of hospitals was 3.3±2.1 (median, 2.0). LOS was longer in patients with severe stroke (mild, 65.1±146.7 days; moderate, 223.1±286.0 days; and severe, 313.2±336.8 days). The number of admitting hospitals was greater for severe stroke (mild, 2.9±1.7; moderate, 4.3±2.6; and severe, 4.5±2.4). LOS was longer in women and shorter in patients less than 65 years of age. Conclusion LOS after stroke differed according to the stroke severity, sex, and age. These results will be useful in determining the appropriate LOS after stroke in the Korean medical system. [ABSTRACT FROM AUTHOR]

The East/Japan Sea (hereafter, the East Sea) is highly dynamic in its physical phenomena and biological characteristics, but it has changed substantially over the last several decades. In this study, a recent decadal trend of primary productivity in the East Sea was analyzed based on Moderate-Resolution Imaging Spectroradiometer (MODIS)-derived monthly values to detect any long-term change. The daily primary productivities averaged using monthly values from 2003 to 2012 were 719.7 mg⋅C⋅m-2⋅d-1 (S.D. ± 197.5 mg⋅C⋅m-2⋅d-1, n = 120) and 632.3 mg⋅C⋅m-2⋅d-1 (S.D. ± 235.1 mg⋅C⋅m-2⋅d-1, n = 120) for the southern and northern regions of the East Sea, respectively. Based on the daily productivities, the average annual primary production in the East Sea was 246.8 g⋅C⋅m-2⋅y-1, which was substantially higher than that previously reported in deep oceans. However, a decreasing trend (13% per 10 years) in the annual primary production was observed in the East Sea within the study period from 2003 to 2012. The shallower mixed layers caused by increased temperature could be a potential cause for the decline in annual production. However, this decline could also be part of an oscillation pattern that is strongly governed by the Pacific Decadal Oscillation (PDO). A better understanding of primary productivity patterns and their subsequent effects on the marine ecosystem is required for further interdisciplinary studies in the East Sea. [ABSTRACT FROM AUTHOR]

Advances in our understanding of the pathogenesis of primary Sjögren syndrome (pSS) characterize it as a highly complex process encompassing both the initiation of innate immunity and subsequent adaptive immune responses. IL-21 is receiving attention as a potential key player in the pathogenesis of pSS owing to its pleiotropic effects on the type I interferon signalling pathway, and newly identified roles in generation of follicular and IL-17-producing subtypes of helper T cells, as well as plasma-ceil differentiation and B-cell activation. Taking into consideration the diverse biological functions of IL-21 and its clinical relevance to pSS, we propose that this cytokine has a central role in orchestrating the complex immune response in pSS. This hypothesis might provide new insight into the pathogenesis of pSS and facilitate the development of effective therapeutic strategies. [ABSTRACT FROM AUTHOR]

The continued development in the design technology of practical superconducting devices adopting high temperature superconductors tapes has led to a deeper understanding of their electromechanical behaviors. Rare-earth-barium-copper-oxide coated conductor (CC) tapes exhibit anisotropy of transport property (Ic) under magnetic field and its intrinsic strain effect is much significant depending on the orientation to the tape surface and the magnetic field intensity applied. Different experimental systems have already been developed to measure the relation of Ic with mechanical strain ε, magnetic field intensity B, and its angle of orientation, θ. However, few systems and instruments can measure these relationships simultaneously; either Ic-B-θ or Ic-ε-B is usually measured. In this study, a device which can measure these influences simultaneously based on a pair of permanent magnet systems was constructed and the characteristic responses of critical current Ic with strain, magnetic field, and its orientation with respect to the CC tape surface were investigated. The angular dependence of Ic with strain at 77 K in reactive co-evaporation by deposition and reaction GdBCO CC tapes has been measured using the permanent magnet system. The orientation angle of magnetic field with respect to the tape's surface was varied by rotating the rig fixture that holds a pair of permanent magnets. The strain sensitivity of Ic at different angles under low magnetic field was evaluated. As a result, a characteristic surface Ic (ε, θ, B) has been constructed as the characteristic response of Ic with strain and varying orientation under magnetic field. [ABSTRACT FROM AUTHOR]