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This study was conducted to investigate the pesticide residue concentrations and assess potential human health risks from vegetable consumption in Incheon. A total of 960 samples were collected from the Incheon areas of Korea in 2019. The pesticide residues were analyzed by the multi-residue method of the Korean Food Code for 373 different pesticides using GC-MS/MS, LC-MS/MS, GC-ECD/NPD, and HPLC-UVD. Among the vegetable samples, 869 samples (90.5%) were free from detectable residues, while 91 samples (9.5%) contained residues, and 16 samples (1.7%) had residues exceeding the Korean maximum residue limit (MRLs). A total of 33 different pesticide residues were found, and 11 residues exceeded MRLs. The most frequently detected pesticide residues were chlorfenapyr, fludioxonil, pyridalyl, hexaconazole, and procymidone. Samples exceeding the MRLs were found in aster scaber, coastal hog fennel, lettuce (leaves), mustard green, mustard leaf, perilla leaves, Pimpinella brachycarpa, radish leaves, shepherd' purse, spinach, and winter-grown cabbage. The potential health risk assessment of pesticides was estimated by calculating the estimated daily intake (EDI) and the acceptable daily intake (ADI). The range of HQs was 0.002-90.621%, which was below 100%. Therefore, the results of this study show that the detected pesticide could not be considered a serious public health problem through the consumption of vegetables.

BACKGROUND: Large-scale epidemiological studies on pancreatic cancer in non-Western populations are insufficient. We investigated the risk factors for pancreatic cancer. METHODS: Using the Korean National Health Insurance database, subjects who participated in the health examination program between 2005 and 2006 were identified and followed up until 2017. Adjusted hazard ratios (HRs) for pancreatic cancer risk were estimated using a Cox proportional hazards model. RESULTS: During 11.5 years follow-up, 22,543 of 7,445,947 participants were newly diagnosed with pancreatic cancer. Compared with normal-weight subjects, pancreatic cancer risk was increased in those with severe obesity (BMI ≥ 28 kg/m(2)) (HR = 1.16; 95% CI, 1.11–1.23). Subjects with diabetes had an increased risk compared with those without diabetes (HR = 1.48; 95% CI, 1.43–1.53). Current smokers had a higher risk than never smokers (HR = 1.43; 95% CI, 1.38–1.48). Current smoking combined with diabetes increased the risk compared with never smokers without diabetes (HR = 2.13; 95% CI, 2.00–2.28). Current smoking combined with BMI ≥ 25 kg/m(2) had an increased risk compared with never smokers with BMI

Background/Aims: This study aimed to compare the efficacy of a recently developed clear-cut knife with that of widely used knives for endoscopic submucosal dissection (ESD) in early gastric cancer (EGC).Materials and Methods: Data were collected retrospectively from the National Health Insurance Service Ilsan Hospital between May 2017 and April 2019. The study included 105 patients (108 lesions) with EGC who underwent ESD. Fifty-six EGCs were dissected using an insulation-tipped diathermic knife in combination with a needle knife, while 52 EGCs were dissected using a clear-cut knife, a single device with an integrated needle and an insulated-tipped knife. Oncologic outcomes and technical success were compared between the two groups.Results: The distribution of the tumor locations, composition of the undifferentiated types of EGCs, and the size of EGCs (14.3±8.0 vs. 16.6±7.3 mm; P=0.130) were not significantly different between the groups. The complete (98.2% vs. 94.2%; P=0.273) and curative (87.5% vs. 88.5%; P=0.878) resection rates were not statistically different. Furthermore, no significant difference between the total procedure times (39±34.1 vs. 35.7±20.1 minutes; P=0.554), areas of the dissected specimen (858.6±406.5 vs. 980.3±393.8 mm2; P=0.119) and dissected areas per minute (32.4±17.9 vs. 35.5±16.2 mm2/min; P=0.345) were noted. Regarding complications, the overall perforation rates (3.6% vs. 4.0%) and bleeding rates (3.6% vs. 8.0%) were not statistically different.Conclusions: The newly developed clear-cut knife is as useful as the combination of classical knives for ESD in EGC.

Background This study aimed to identify the healthcare providers’ experience and perspectives toward end-of-life care decisions focusing on end-of-life discussion and physician’s order of life-sustaining treatment documentation in Korea which are major parts of the Life-Sustaining Treatment Act. Methods A cross-sectional survey was conducted using a questionnaire developed by the authors. A total of 474 subjects—94 attending physicians, 87 resident physicians, and 293 nurses—participated in the survey, and the data analysis was performed in terms of frequency, percentage, mean and standard deviation using the SPSS 24.0 program. Results Study results showed that respondents were aware of terminal illness and physician’s order of life-sustaining treatment in Korea well enough except for some details. Physicians reported uncertainty in terminal state diagnosis and disease trajectory as the most challenging. Study participants regarded factors (related to relationships and communications) on the healthcare providers’ side as the major impediment to end-of-life discussion. Study respondents suggested that simplification of the process and more staff are required to facilitate end-of-life discussion and documentation. Conclusion Based on the study results, adequate education and training for better end-of-life discussion are required for future practice. Also, a simple and clear procedure for completing a physician’s order of life-sustaining treatment in Korea should be prepared and legal and ethical advice would be required. Since the enactment of the Life-Sustaining Treatment Act, several revisions already have been made including disease categories, thus continuous education to update and support clinicians is also called for.

Polyethylene terephthalate (PET) foams were prepared at different saturation temperatures using two supercritical foaming methods. The average cell size, cell number density, and porosity of PET foams obtained using each foaming method were compared. The crystallinity of the PET samples after the saturation step in the two-step foaming process was measured to observe the CO2-induced crystallization. The crystallinity of PET according to the saturation temperature led to a variation in cell size in the two-step foaming. In contrast, the melting of crystals with the increase in the temperature affected the cell number density of the polymeric foam prepared by one-step foaming method. The influence of the PET crystals on the cell nucleation or cell growth in each foaming method was studied from these results.

Energy consumption modeling has evolved along with building technology. Modeling techniques can be largely classified into white box, gray box, and black box. In this study, the thermal behavior characteristics of building components were identified through time-series data analysis using LSTM neural networks. Sensors were installed inside and outside the test room to measure physical quantities. As a result of calculating the overall heat transfer coefficient according to the international standard ISO 9869-1, the U value of the multi-window with antireflection coating was 1.84 W/(m2∙K). To understand the thermal behavior of multiple windows, we constructed a neural network using an LSTM architecture and used the measured data-set to predict and evaluate the heat flux through deep learning. From the measurement data, a wavelet transform was used to extract features and to find appropriate control time-step intervals. Performance was evaluated according to multistep measurement intervals using the error metric method. The multistep time interval for control monitoring is preferably no more than 240 s. In addition, multivariate analysis with several input variables was performed. In particular, the thermal behavior of building components can be analyzed through heat flux and temperature measurements in the transient state of physical properties of pre-installed building components, which were difficult to access with conventional steady-state measurement methods.

This study was conducted to investigate the pesticide residue concentrations and assess potential human health risks from fruit and vegetable consumption in Incheon. A total of 1,146 samples of 20 different types of fruits and vegetables were collected from the Incheon area in 2020. The pesticide residues were analyzed by the multi-residue method of the Korean Food Code for 400 different pesticides. Among the fruit and vegetable samples, 1,055 samples (92.1%) were free from detectable residues, while 91 samples (7.9%) contained residues and 11 samples (1.0%) had residues exceeding the Korean maximum residue limit. A total of 32 different pesticide residues were found and 8 residues exceeded MRLs. The most frequently detected pesticide residues were chlorfenapyr, procymidone, etofenprox, pendimethalin, fluopyram and azoxystrobin. The highest values of short term and long term exposure were obtained in the case of consumption of lettuce(leaves) with chlorfenpyr. For chronic dietary exposure, the cumulative hazard index (cHI) were below 100%. The results of this study showed that the detected pesticides were not exposed to potential health risks through the consumption of fruits and vegetables.

Duodenal varices are ectopic in nature and account for 40% of all ectopic bleeding cases. Ectopic variceal bleeding is rare (1%-5% of all variceal bleeding cases). The three principle approaches used to treat duodenal varices are endoscopic procedures, interventional radiological methods, and surgical interventions. A 59-year-old male with alcoholic liver cirrhosis and chronic hepatitis B infection visited our gastroenterology department with melena. Gastroduodenoscopy and computed tomography identified varices in the second part of the duodenum. We performed percutaneous transhepatic obliteration using glue and coil embolization, which obliterated the varices and resulted in immediate hemostasis. However, 3 months later, he re-visited presenting with newly developed duodenal varices and underwent endoscopic injection sclerotherapy.

BACKGROUND: After endoscopic submucosal dissection of gastric neoplasms, surveillance endoscopy is required for patients with synchronous or metachronous neoplasms. We aimed to evaluate the risk factors associated with surveillance loss in patients who underwent endoscopic submucosal dissection. METHODS: Ninety-five patients treated with endoscopic submucosal dissection for gastric neoplasms between May 2015 and June 2016 were retrospectively reviewed. Clinicopathologic factors, sociodemographic factors, psychiatric measures, and associated risk factors for surveillance loss were evaluated. The chi-square or Fisher exact test, t-test, and logistic regression analysis were used in data analysis. RESULTS: Twenty-five (26.3%) patients were identified as having surveillance loss. Compared to the surveillance group, the surveillance loss group was old and had dysplasia, and a healthy American Society of Anesthesiologists physical status. Similarly, surveillance loss was related to low symptom perception, low incidence of alexithymia, mindful awareness, and high trait forgiveness. Logistic regression analysis showed that dysplasia (odds ratio, 15.23; 95% CI, 1.56–149.09, P=0.019), old age (odds ratio, 7.14; 95% CI, 1.90–26.88, P=0.004), and American Society of Anesthesiologists physical status 1 (odds ratio, 3.99; 95% CI, 1.09–14.60, P=0.037) were associated with surveillance loss. CONCLUSIONS: Dysplasia, old age, and the American Society of Anesthesiologists physical status 1 were associated with surveillance loss in patients who underwent gastric endoscopic submucosal dissection. It could be helpful to proactively monitor patients with such conditions after gastric endoscopic submucosal dissection.

Although carbohydrate antigen 19-9 (CA 19-9) may be elevated in benign diseases, elevated CA 19-9 may cause a fear of cancer and unnecessary follow-up studies. Research on how to approach systematically in this case is very limited. The purpose of this study was to analyze the clinical features and the causes of CA 19-9 elevation without evidence of malignant or pancreatobiliary diseases. We retrospectively reviewed the medical records of patients who had CA 19-9 elevation (≥80 U/mL) and were found to be unrelated to cancer after follow-up. After exclusion, 192 patients were included in this study. The median level of CA 19-9 was 136.5 U/mL. The causes of CA 19-9 elevation were determined in 147 (76.6%) patients, and that was unknown in 45 (23.4%). The estimated causative diseases were hepatic diseases in 63 patients, pulmonary diseases in 32, gynecologic diseases in 38, endocrine diseases in 13, and spleen disease in 1. Of 45 patients with unknown cause, 35 had normalization of CA 19-9 and 10 had persistently elevated CA 19-9. In conclusion, CA 19-9 elevation without malignancies or pancreatobiliary diseases should be systematically evaluated and followed up. We suggest an algorithm to investigate the causes and follow up these patients.

Background: Limited information is available regarding the characteristics of delaminated rotator cuff tears as compared with nondelaminated tears. Furthermore, there is conflicting information regarding the effects of delamination on the anatomic healing of repaired cuffs. Purpose: To evaluate the characteristics and anatomic outcomes of delaminated rotator cuff tears in comparison with nondelaminated tears to determine whether delamination is a negative prognostic factor affecting rotator cuff repair outcomes. Study Design: Cohort study; Level of evidence, 3. Methods: Between 2010 and 2014, 1043 patients were enrolled in the study to assess the prevalence of delamination. Among them, the findings from 531 patients who underwent magnetic resonance imaging or computed tomographic arthrography at least 1 year after surgery were included to determine whether delamination was a negative prognostic factor affecting the anatomic outcomes of arthroscopic rotator cuff repair. Delamination was assessed intraoperatively and defined by distinguishable edge cleavage tearing or interstitial horizontal gap between the articular and bursal surfaces of the torn tendon. One of 3 repair techniques (modified Mason Allen, single row, or double row) was used according to tear configuration and tendon mobilization. The authors evaluated visual analog scale scores for pain and satisfaction and American Shoulder and Elbow Surgeons scores to quantify clinical outcomes. Results: The incidence of delamination was 42.9% (447 of 1043). As compared with those with nondelaminated tears, patients with delaminated tears were older ( P < .001) and had longer symptom duration ( P = .019), larger tear sizes and retractions ( P < .001 for both), higher grades of fatty infiltration of the rotator cuff muscles (all P < .001), and poorer tendon quality ( P < .001). The overall healing failure rate was 19.0% (101 of 531). In univariate analysis, the rate of healing failure for the repaired cuffs was significantly higher in the delaminated group (delaminated tears, 60 of 238, 25.2%; nondelaminated tears, 41 of 293, 14.0%; P = .001). However, results of subgroup and multivariate analyses showed that the presence of delamination was ultimately not an independent risk factor for the failure of cuff healing. Between the delaminated and nondelaminated groups, there was no significant difference in postoperative functional outcomes. Conclusion: The results suggest that delaminated rotator cuff tears might represent chronic degenerative tears of longer symptom duration, with larger tear sizes and higher grades of fatty infiltration in older patients. It appears that delamination could be a confounding factor, not an independent prognostic factor, affecting rotator cuff healing.

Background Safe and accurate needle access to the rhomboid major (RM) during electromyography is challenging due to the overlying trapezius muscle and the risk of pneumothorax. Objective To investigate the RM anatomy associated with the trapezius using ultrasonography and to determine a safe and accurate needle insertion point for needle electromyography of the RM. Design Descriptive study. Setting Department of physical medicine and rehabilitation of a tertiary clinic center. Participants Participants between 23 and 71 years of age without any diseases (N = 25; 13 men, 12 women; 50 scapulae) were included. Interventions Ultrasonography of the RM and trapezius muscles around the scapula. Main Outcome Measures The point at which the lateral margin of the trapezius crosses the medial border of the scapula (point A) was determined. The probe was positioned at the level of the midpoint (point M) between point A and the inferior angle of the scapula. The horizontal distance from the point at which the RM was the thickest (point X) to point M was measured. At point X, the depth of the RM, RM thickness, and the depth of the pleura were measured. Results The mean age and body mass index were 37.4 ± 12.0 years and 22.3 ± 2.1 kg/m2, respectively. Point M was located at a mean distance of 3.9 ± 0.6 cm proximal to the inferior angle of the scapula. The mean distance between point X and point M was 1.0 ± 0.2 cm. At point X, the RM was at a mean depth of 9.7 ± 3.1 mm from the skin and had a mean thickness of 9.9 ± 1.8 mm. The pleura was observed at a mean depth of 28.4 ± 3.8 mm from the skin. Conclusion Needle electromyographic examination of the RM can be performed easily and safely through the lower part of the RM that is not covered by the trapezius. Level of Evidence not applicable.

Investigations into the development of new therapeutic agents for lung inflammatory disorders have led to the discovery of plant-based alternatives. The rhizomes of Anemarrhena asphodeloides have a long history of use against lung inflammatory disorders in traditional herbal medicine. However, the therapeutic potential of this plant material in animal models of lung inflammation has yet to be evaluated. In the present study, we prepared the alcoholic extract and derived the saponin-enriched fraction from the rhizomes of A. asphodeloides and isolated timosaponin A-III, a major constituent. Lung inflammation was induced by intranasal administration of lipopolysaccharide (LPS) to mice, representing an animal model of acute lung injury (ALI). The alcoholic extract (50-200 mg/kg) inhibited the development of ALI. Especially, the oral administration of the saponin-enriched fraction (10-50 mg/kg) potently inhibited the lung inflammatory index. It reduced the total number of inflammatory cells in the bronchoalveolar lavage fluid (BALF). Histological changes in alveolar wall thickness and the number of infiltrated cells of the lung tissue also indicated that the saponin-enriched fraction strongly inhibited lung inflammation. Most importantly, the oral administration of timosaponin A-III at 25-50 mg/kg significantly inhibited the inflammatory markers observed in LPS-induced ALI mice. All these findings, for the first time, provide evidence supporting the effectiveness of A. asphodeloides and its major constituent, timosaponin A-III, in alleviating lung inflammation.

The purpose of the present study is to find the natural compound(s) having a therapeutic potential to treat lung inflammatory disorders. In our screening procedure, the methanol extract of the seeds of Cassia obtusifolia (cassiae semen) inhibited inducible nitric oxide synthase-catalyzed nitric oxide production in alveolar macrophages (MH-S). From the extract, 8 major anthraquinone derivatives were successfully isolated. They are chrysophanol, physcion, 2-hydroxy-emodin 1-methyl ether, obtusifolin, obtusin, aurantio-obtusin, chryso-obtusin, and gluco-obtusifolin, among which aurantio-obtusin (IC50 = 71.7 μM) showed significant inhibitory action on nitric oxide production from lipopolysaccharide-treated MH-S cells, mainly by downregulation of inducible nitric oxide synthase expression. This down-regulatory action of aurantio-obtusin was mediated at least in part via interrupting c-Jun N-terminal kinase/IκB kinase/nuclear transcription factor-κB pathways. Aurantio-obtusin also inhibited IL-6 production in IL-1β-treated lung epithelial cells, A549. Importantly, this compound (10 and 100 mg/kg) by oral administration attenuated lung inflammatory responses in a mouse model of lipopolysaccharide-induced acute lung injury. Therefore, it is for the first time found that aurantio-obtusin may have a therapeutic potential for treating lung inflammatory diseases.

Electrospinning, which produces nano/micro-fiber in a remarkably simple and fast manner, has been applied for numerous materials in various areas. In this study, the characteristics of micro-glass bead/PLA porous fiber composite were studied. The breath figure method was implemented to fabricate porous PLA fibers from PLA solution obtained by dissolving PLA in a solvent mixture (10:1 weight ratio) of dichloromethane (DCM) and N,N-dimethylacetamide (DMAc). The micro-beads (60 μm) were used to make more gaps between fibers and the specific surface area was measured and compared. Furthermore, the sound absorption and the insulation property of the samples were also measured. The specific surface area of samples increased from 1.45 to 4.39 m2/g with the addition of micro-glass beads and porous structure. The insulation property improved from 40 to 35 mW/m K with addition of micro-glass beads due to the formation of air layers.

INTRODUCTION We sought to establish the optimal recording position for antidromic conduction of the superficial peroneal nerve (SPN) by using ultrasonography (USG). METHODS The sensory nerve action potentials (SNAPs) of the intermediate dorsal cutaneous nerve (IDCN) and medial dorsal cutaneous nerve (MDCN) in 64 limbs of 32 healthy participants were recorded (nerve conduction study [NCS]-1). Both nerves were identified by using USG, and the SNAPs were obtained from the USG-guided repositioned electrodes (NCS-2). RESULTS The IDCN and MDCN were located at 29.3% ± 5.1% and 43.9% ± 4.9% of the intermalleolar distance from the lateral malleolus, respectively. Significantly greater amplitude was shown for SNAPs of both nerves in NCS-2 versus NCS-1. DISCUSSION The optimal recording position is likely to be lateral, one-third from the lateral malleolus for the IDCN, and just lateral to the midpoint of the intermalleolar line for the MDCN. When the SPN response is unexpectedly attenuated, USG-guided repositioning of the electrodes should be considered. Muscle Nerve 57: 628-633, 2018.

Introduction We identify sensory branches of the ulnar nerve-palmar ulnar cutaneous nerve (PUCN), dorsal ulnar cutaneous nerve (DUCN), and superficial sensory branch-using ultrasonography. Methods In 60 forearms of 30 healthy adult volunteers, the origin and size of the PUCN, DUCN, and superficial sensory branch were measured by ultrasonography. The relative pathway of the DUCN to the ulnar styloid process was also investigated. Results The PUCN was observed in 47 forearms (78%), and the DUCN was observed in all forearms. Average distances from the pisiform to the origin of the PUCN and DUCN were 11.9 ± 1.4 and 7.0 ± 1.0 cm, respectively. Superficial and deep divisions split 0.9 ± 0.3 cm distal to the pisiform. Cross-sectional areas of the PUCN, DUCN, and superficial sensory branch were 0.3 ± 0.1, 1.5 ± 0.5, and 3.9 ± 1.0 mm2 , respectively. Discussion Sensory branches of the ulnar nerve can be visualized by ultrasonography, helping to differentiate ulnar nerve injury originating at either wrist or elbow. Muscle Nerve 57: 569-573, 2018.

In this work, micro- and nanocellular acrylonitrile-butadiene-styrene (ABS) foams were prepared by using sub- and supercritical CO2 as blowing agents. The sorption kinetics at 10 MPa was first measured. The sorption amount depended on the saturation temperature Arrheniusly. The diffusivities did not follow the Arrhenius relation. This relation was interpreted by a retrograde behavior of ABS/CO2 system. From the kinetics, ABS discs were saturated at 10 MPa at the temperatures from −20 °C to 40 °C, and foamed at the foaming temperature of 20 °C–80 °C. A network of closed cells with a diameter of 600–700 nm and nanopores with a diameter of 100 nm were observed in the foam obtained at low saturation temperatures and high foaming temperatures. The closed cell densities were in a range from 1.12 × 1012 − 9.87 × 1012 cells/cm3 and an experimental correlation based on the CNT model was used to fit the data.

The flexible syntactic foam with increasing attention as an eco-friendly building insulation material was manufactured via mold casting. The total porosity of the dried flexible syntactic foam had a very high value of 0.86 and the large vacant volumes in the microstructure were observed. The hollow glass spheres with the wide range of diameters were uniformly distributed inside the syntactic foam. It had low mechanical strength but showed toughness on a large compressive deformation. The thermal properties of the flexible syntactic foam were measured and compared with other insulation materials by dual probe method. The thermal conductivity and diffusivity of the flexible syntactic foam were 0.053 W/m·K and 0.097 mm2/s respectively. It also has low thermal effusivity thus it can be applied to a burn injury protection layer on high temperature surface.

After endoscopic removal of common bile duct stones, cholecystectomy can be considered to reduce recurrent biliary complications in patients with gallbladder (GB) stones. To date, several retrospective and prospective studies have been reported. However, these studies had limitations with different designs, small sample sizes, and short follow-up durations, and the results varied. Some recent large-scale population-based studies recommended prophylactic cholecystectomy to reduce recurrent biliary complications in patients with concomitant GB stones after endoscopic stone removal. Whether prophylactic cholecystectomy is necessary even in elderly patients with comorbid diseases is controversial. The timing of a cholecystectomy can affect the occurrence of additional biliary events during the waiting period, the development of surgical complications, and the conversion to open surgery. As the optimal timing for cholecystectomy, it is recommended to perform early cholecystectomy after endoscopic retrograde cholangiopancreatography during the same hospitalization period.

Synthetic polymer-based gradient foams have considered as promising category of functionally graded materials with unique properties. In this study, the carbon dioxide (CO2) foaming technology has used for PET-PEN (Polyethylene Terephthalate - Polyethylene Naphthalate) copolymer towards porous functional materials with thermal insulation with reasonable mechanical strength. Through scanning electron microscope based morphological characterization, a potential to fabricate gradient foam structures with micro-pores has identified. It has shown that variation of post-foaming temperature can tune the pore size distribution although the very high post-foaming temperature tends to cause structural instability. Thermal measurement data set the limits of operation, confirmed by simultaneous differential scanning calorimeter and thermo-gravimetric analysis. Mechanical stress and thermal conductivity also has measured to find rationale of thermal insulation with reasonable mechanical strength and to elucidate the actual 3D grid foam of copolymer.

Background and aim We conducted a nationwide validation study of diagnostic algorithms to identify cases of inflammatory bowel disease (IBD) within the Korea National Health Insurance System (NHIS) database. Method Using the NHIS dataset, we developed 44 algorithms combining the International Classification of Diseases (ICD)-10 codes, codes for Rare and Intractable Diseases (RID) registration and claims data for health care encounters, and pharmaceutical prescriptions for IBD-specific drugs. For each algorithm, we compared the case identification results from electronic medical records data with the gold standard (chart-based diagnosis). A multiple sampling test verified the validation results from the entire study population. Results A random nationwide sample of 1697 patients (848 potential cases and 849 negative control cases) from 17 hospitals were included for validation. A combination of the ICD-10 code, ≥ 1 claims for health care encounters, and ≥ 1 prescription claims (reference algorithm) achieved excellent performance (sensitivity, 93.1% [95% confidence interval 91-94.7]; specificity, 98.1% [96.9-98.8]; positive predictive value, 97.5% [96.1-98.5]; negative predictive value, 94.5% [92.8-95.8]) with the lowest error rate (4.2% [3.3-5.3]). The multiple sampling test confirmed that the reference algorithm achieves the best performance regarding IBD diagnosis. Algorithms including the RID registration codes exhibited poorer performance compared with that of the reference algorithm, particularly for the diagnosis of patients affiliated with secondary hospitals. The performance of the reference algorithm showed no statistical difference depending on the hospital volume or IBD type, with P-value Conclusions We strongly recommend the reference algorithm as a uniform standard operational definition for future studies using the NHIS database.

During aging, cells secrete molecules called senescence-associated secretory phenotype (SASP). They constitute chronic low-grade inflammation environment to adjacent cells and tissues. In order to find inhibiting agents of SASP formation, 113 plant constituents were incubated with BJ fibroblasts for 6 days after treatment with bleomycin. Several plant constituents showed considerable inhibition of IL-6 production, a representative SASP marker. These plant constituents included anthraquinones such as aurantio-obtusin, flavonoids including astragalin, iristectorigenin A, iristectorigenin B, linarin, lignans including lariciresinol 9-O-glucoside and eleutheroside E, phenylpropanoids such as caffeic acid and methyl caffeate, steroid (ophiopogonin), and others like centauroside, rhoifolin and scoparone. In particular, methyl caffeate down-regulated SASP factors such as IL-1α, IL-1β, IL-6, IL-8, GM-CSF, CXCL1, MCP-2, and MMP-3. Inhibition of these SASP mRNA expression levels also coincided with the reduction of IκBζ expression and NF-κB p65 activation without affecting the expression levels of senescence markers, p21 or pRb. Taken together, the present study demonstrated that methyl caffeate might be a specific and strong inhibitor of SASP production without affecting the aging process. Its action mechanisms involve the reduction of IκBζ expression and NF-κB p65 activation. Therefore, this compound might be effective in alleviating chronic low-grade inflammation linked to age-related degenerative disorders.

In this study, syntactic foams composed of maximal hollow glass microparticles (HGMPs) volume fraction with improved thermal insulation performance and reasonable mechanical strength were fabricated through a new manufacturing approach. Use of low fraction binder materials diluted in solvent enabled minimal contacts among the HGMPs assisted by a natural capillary trend, as confirmed by in situ and ex situ optical and electron microscope imaging. Composite level samples of practical thickness, fabricated by a layer-by-layer coating approach, exhibited enhanced thermal insulation performance, as characterized by infrared thermal imaging and quantitative thermal conductivity measurement. Via microscope inspection under tensile loading, a favorable particles–binder bonding trend was inspected in terms of mechanical strength. The fabricated composite materials have potential for building insulation applications because of their relatively simple and scalable manufacturing nature, minimal use of binder materials, and mechanical strength to maintain and tailor shape. Further studies are necessary to understand mechanical and thermal properties of the composites, and key fabrication mechanisms involved with self-assembly under complex multi-components and phases.

Introduction Although isolated injury of the sural nerve is frequently reported, entrapment involving the lateral calcaneal branch of the sural nerve (LCSN) is very rare. Methods We report the case of a 29-year-old man with lateral calcaneal neuropathy of the sural nerve without any history of trauma. The diagnosis was based on clinical, electrophysiologic, and radiologic studies, including ultrasonography (US) and MRI. Results US revealed a spindle-shaped swelling in the posterior part of the sural nerve around the lateral malleolus. MRI showed a small lesion in the sural nerve close to the lesser saphenous vein around the level of the lateral malleolus. Two months after conservative management, the numbness and tingling in the lateral calcaneal region improved. Conclusions Entrapment of the LCSN can arise from tight shoes. US is useful for evaluating the cutaneous nerve lesions that may be too small to detect by MRI. Muscle Nerve 54: 801-804, 2016.

OBJECTIVES Pancreatic neuroendocrine tumors (pNETs) are diverse diseases with different prognosis. The American Joint Committee on Cancer (AJCC) and the European Neuroendocrine Tumor Society (ENETS) introduced 2 different tumor node metastasis (TNM) stages, and the World Health Organization (WHO) proposed WHO 2010 grading system for pNETs. Therefore, we aimed to validate the prognostic relevance of these 3 systems for pNETs in South Korea. METHODS The Korean Society of Gastrointestinal Cancer created a retrospective registry of pNETs in 153 patients from 15 hospitals between 2002 and 2012. RESULTS On the basis of the WHO 2010 grade, 2-year progression-free-survival (PFS) rates for G1, G2, and G3 were 92%, 62%, and 25% (P < 0.01). According to ENETS and AJCC staging, 2-year PFS rates for stages I through IV were 94%, 87%, 49%, 20%, and 92%, 61%, 60%, 20%, respectively (P < 0.01). A Cox multivariate regression analysis revealed that the only statistically significant prognostic factor was the TNM classification of either the AJCC or the ENETS stage (P < 0.01). In addition, the κ value between the AJCC and the ENETS stages was 0.46 indicating a "moderate" agreement (P < 0.01). CONCLUSIONS The AJCC and ENETS TNM classifications for pNETs are prognostic for PFS and can be adopted in clinical practice in South Korea.

Background: It is important to understand the anatomical relationship between the medial and lateral branches of superficial radial nerve (SRN) and the first dorsal compartment to prevent and minimize possible injury to these nerves during various procedures around the tip of radial styloid process (RSP). Objective: To delineate the anatomical location of the SRN in relation to the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons. Study Design: Observational study. Setting: Academic medical center. Methods: The width of the first dorsal compartment, distance between the EPB tendon and the closest medial branch of the SRN, and distance between the APL tendon and the closest lateral branch of the SRN were measured. The distances were measured at the RSP (the tip of the RSP) and RSP+1 (1 cm proximal to the tip of the RSP) levels. Results: The median distances between the EPB tendon and the closest medial branch of the SRN at the RSP and RSP+1 were 6.0 mm (range: 1.6 − 11.0 mm) and 3.2 mm (range: -2.0 − 9.4 mm), respectively. The median distances from the APL tendon to the closest lateral branch of the SRN at the RSP and RSP+1 were -2.0 mm (range: -9.0 − 8.4 mm) and 1.0 mm (range: -7.2 − 8.0 mm), respectively. A high percentage of overlap (up to 59%) was observed between the lateral branch of the SRN and the APL tendon. Limitation: This study is limited by its small sample size. Conclusion: Due to the anatomical proximity of the branches of the SRN and the first dorsal compartment around the RSP, physicians must be cautious during procedures near this location. It is important to approach from above the EPB, rather than from above the APL, when performing blind procedures, although ultrasound guidance is preferable. Key words: Superficial radial nerve, abductor pollicis longus, extensor pollicis brevis, cadaver; wrist, first dorsal compartment