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Abstract Reducing the risk of urethral strictures after transurethral surgery for patients with bladder cancer requires effective strategies. We compared the clinical outcomes of a novel drug-injectable urethral catheter set (NIUS) with hyaluronic acid (HA) with those of the conventional intraurethral HA injection method. This six-center, prospective, randomized, single-blind trial included 192 male patients aged ≥ 20 years scheduled to undergo transurethral surgery. The primary outcome was patient-reported satisfaction. Secondary outcomes were patient-reported pain intensity, clinician-reported convenience, and urethral strictures. Cystourethroscopy was performed under direct visualization. Outcomes of the experimental (NIUS with HA) and control (HA) groups were compared using the chi-square test and t-test. The post-transurethral surgery rate was significantly higher in the experimental group than in the control group (p

Muscle atrophy is known to be one of the symptoms leading to sarcopenia, which significantly impacts the quality of life, mortality, and morbidity. Therefore, the development of therapeutics for muscle atrophy is essential. This study focuses on addressing muscle loss and atrophy using Ulmus macrocarpa extract and its marker compound, catechin 7-O-β-D-apiofuranoside, by investigating their effects on biomarkers associated with muscle cell apoptosis. Additionally, protein and gene expression in a muscle atrophy model were examined using Western blotting and RT-PCR. Ulmus macrocarpa has been used as food or medicine due to its safety, including its roots, barks, and fruit. Catechin 7-O-β-D apiofuranoside is an indicator substance of plants of the Ulmus genus and has been reported to have various effects such as antioxidant and anti-inflammatory effects. The experimental results demonstrated that catechin glycoside and Ulmus macrocarpa extract decreased the expression of the muscle-degradation-related proteins Atrogin-1 and Muscle RING-Finger protein-1 (MuRF1) while increasing the expression of the muscle-synthesis-related proteins Myoblast determination (MyoD) and Myogenin. Gene expression confirmation experiments validated a decrease in the expression of Atrogin and MuRF1 mRNA and an increase in the expression of MyoD and Myogenin mRNA. Furthermore, an examination of muscle protein expression associated with the protein kinase B (Akt)/forkhead box O (FoxO) signaling pathway confirmed a decrease in the expression of FoxO, a regulator of muscle protein degradation. These results confirm the potential of Ulmus macrocarpa extract to inhibit muscle apoptosis, prevent muscle decomposition, and promote the development of functional materials for muscle synthesis, health-functional foods, and natural-product-derived medicines.

Ulmus davidiana has been used as food or medicine in oriental due to its safety, including its roots, bark, and fruits. The roots and bark of Ulmus were used as a diuretic and for treatment due to their anti-cancer, antioxidant, and anti-inflammatory effects. Ulmus species are known to contain flavan-3-ols as their main component. In previous research the presence of (+)-catechin 5-O-β-D-apiofuranoside was isolated from the roots of Ulmus davidiana, and (+)-catechin 7-O-β-D-xylopyranoside was confirmed in the bark Ulmus Americana, and the presence of catechin 7-O-β-D apiofuranoside in the stems and bark of Ulmus davidiana var. japonica. The catechin-glycosides of flavan-3-ols have various effects, including antiulcer properties, and have also been used as analgesics. Additionally, chemotaxonomy studies of the Ulmus species have been reported. However, the chemotaxonomy of Ulmus species native to Asia has not been reported. In this study, we report the screening of catechin 7-O-beta-D apiofuranoside from various Ulmus species native to Asia. We confirmed the presence of catechin 7-O-β-D-apiofuranoside in a total of 22 Ulmus samples, including 18 Ulmus species native to China, and 1 sample each from Mongolian, Nicaragua, Vietnam, and Korea through HPLC and LC-MS/MS analysis. We also confirmed the content of the indicator materials. Therefore, the potential of using native Ulmus species from Korea as a natural material has been confirmed.

Non-gonococcal sexually transmitted infections (STIs) include chlamydia, syphilis, and chancroids. Chlamydia is the most common STI caused by Chlamydia trachomatis and is mainly transmitted through sexual intercourse or vertical transmission at birth. Although symptoms are mostly absent or mild, untreated chlamydial infections in females can lead to pelvic inflammatory disease, chronic pelvic pain, and infertility due to the narrowing of fallopian tubes. Syphilis is caused by Treponema pallidum and is divided into phase I, phase II, latent syphilis, and phase III. The incidence of syphilis, including congenital syphilis, has significantly increased in the United States in recent years. The chronic status of this disease can significantly increase morbidity and potentially affect almost all body organs, which, in rare cases, can lead to death. Additionally, untreated maternal syphilis can lead to fetal death and fatal congenital infections in newborns. Chancroid is an STI caused by Haemophilus ducreyi, and its prevalence is gradually decreasing in Korea and worldwide. The symptoms include shallow genital ulcers with suppurative granulomatous inflammation and tender inguinal lymphadenopathy. Chancroids can be differentiated from syphilitic chancres based on their appearance. In contrast to painless chancres, chancroids are painful. Ureaplasma urealyticum, Ureaplasma parvum, and Mycoplasma hominis are considered symbiotic bacteria. Infections caused by these bacteria are usually not considered STIs and do not require treatment unless they are suspected of being associated with infertility. This article presents the 2023 Korean STI guidelines for non-gonococcal bacterial infections.

Abstract The World Health Organization/International Society of Urological Pathology (WHO/ISUP) grading of renal cell carcinoma (RCC) is classified from grade 1–4, regardless of subtype. The National Comprehensive Cancer Network (NCCN) guidelines (2022) state that if there is an adverse pathological feature, such as grade 3 or higher RCC in stage 1 patients, more rigorous follow-up imaging is recommended. However, the RCC guidelines do not provide specific treatment or follow-up policies by tumor grade. Therefore, this study attempted to find out whether tumor grade affects survival rates in patients with metastatic RCC. The Korean Renal Cancer Study Group (KRoCS) database includes 3108 patients diagnosed with metastatic RCC between September 1992 and February 2017, with treatment methods, progression, and survival data collected from 11 tertiary hospitals. To obtain information on survival rates or causes of death, we utilized the Korea National Statistical Office database and institutional medical records. Data were accessed for research purpose on June, 2023. We then reviewed these sources to gather comprehensive and reliable data on the outcomes of our study cohort. This database was retrospectively analyzed, and out of 3108 metastatic RCC patients, 911 had been identified as WHO/ISUP grade. Grades were classified into either a low-grade (WHO/ISUP grade 1–2) or a high-grade group (WHO/ISUP grade 3–4). The patients were then analyzed related to progression and overall survival (OS). In metastatic clear cell RCC patients, the 1-year OS rate was 69.4% and the median OS was 17.0 months (15.5–18.5) followed up to 203.6 months. When comparing the patient groups, 119 low-grade and 873 high-grade cases were identified. No baseline difference was observed between the two groups, except that the high-grade group had a higher ECOG 1 ratio of 50.4% compared with 34.5% for the low-grade group (p = 0.009). There was a significant difference in OS between high-grade and low-grade groups. OS was 16.0 months (14.6–17.4) in the high-grade group and 28.0 months (21.1–34.9) in the low-grade group (p

Background/Objectives: Sarcopenia is characterized by the loss of muscle mass and function, increases in mortality rate, and risk of comorbidities in the elderly. This study evaluated the effects of Alnus japonica hot water extract (AJHW) and its active compound, oregonin, on muscle atrophy and apoptosis in vitro. Methods: AJHW underwent phytochemical analysis. C2C12 cells were subjected to H2O2 and dexamethasone to induce oxidative stress and muscle loss, after which AJHW and oregonin were administered to assess their impacts on cell viability, apoptosis, muscle protein synthesis stimulation, and muscle protein degradation inhibition. Cell viability was assessed via an MTT assay, and apoptosis was analyzed by measuring Bcl-2, Bax, cleaved caspase-3, and cleaved PARP through Western blotting. Western blotting and RT-PCR were utilized to analyze MyoD, Myogenin, Atrogin-1, and MuRF1 protein and gene expression in a muscle atrophy model, as well as the Akt/mTOR and FoxO3α pathways. Results: AJHW was confirmed to contain oregonin, an active compound. AJHW and oregonin significantly increased cell viability and reduced apoptosis by upregulating Bcl-2 and downregulating Bax, cleaved caspase-3, and cleaved PARP. They significantly enhanced muscle protein synthesis through the upregulation of MyoD and Myogenin, while diminishing muscle degradation by downregulating Atrogin-1 and MuRF1. The activation of the Akt/mTOR pathway and inhibition of the FoxO3α pathway were also observed. Conclusions: AJHW and oregonin effectively prevented muscle cell apoptosis, promoted muscle protein synthesis, and inhibited muscle protein degradation in vitro. These results suggest that AJHW and oregonin could serve as therapeutic agents to prevent and treat sarcopenia.

Purpose Increased abdominal imaging brought about an explosive increase in the incidental detection of small renal masses (SRMs). In the absence of optimal guidelines for health screening, as well as subsequent diagnostic and therapeutic action plans, incidentally detected SRMs may likewise increasingly become a dilemma, especially in an aging society. In the current study, we aimed to describe the current practice patterns for incidentally detected SRMs among urologic oncologists and to identify key indicators in action plans for active surveillance. Materials and Methods A survey containing 18 questions on SRM management patterns was designed. In June 2022, an online survey was sent to all 711 active members of the Korean Urological Oncology Society via email. After response collection, a consensus meeting of the Korean Renal Cancer Study Group, which 19 specialists attended, was held to analyze the results. Results In total, 176 responses from participants practicing in an academic setting were obtained (24.8%, 176 of 711). Regarding the age of patients with SRMs, 42.6% (n=72) responded that they would recommend diagnostic evaluation and definitive treatment for anyone under 80 years of age as long as the patient was healthy. The most commonly used target indicators for surveillance termination were a tumor growth rate above a certain velocity (57.9%, n=102) and size increase above a certain diameter (36.9%, n=65). Renal mass biopsy was recommended in very select cases (

Purpose: The relationship with endothelial activation and stress index (EASIX), which represents the degree of endothelial dysfunction, is unwell known in upper tract urothelial carcinoma (UTUC). The present study aims to assess the prognostic value of the EASIX for recurrence-free survival (RFS) and overall survival (OS) in patients with UTUC who underwent radical nephroureterectomy (RNU). Materials and Methods: We retrospectively reviewed the clinical data of 627 patients with UTUC who underwent RNU without neoadjuvant chemotherapy at three hospitals between 2002 and 2019. EASIX scores were calculated using the formula “serum lactate dehydrogenase (U/L)×creatinine (mg/dL)/platelet count (109/L)” and evaluated based on log2-transformed values. We divided the patients according to the EASIX score (>1.27 vs. ≤1.27). Results: Among 627 patients, 380 were finally analyzed. Using maximally selected log-rank statistics, the optimal EASIX cutoff value was 1.27 on the log2 scale. The baseline characteristics were similar between the two groups except for age. The high EASIX score group had worse RFS and OS than the low EASIX score group (log-rank p=0.001 and p=0.006, respectively). At 5 years, the mean RFS and OS difference between the low and high EASIX score groups was 11.1 and 7.35 months, respectively. High EASIX score remained a key prognosticator of RFS and OS after RNU in multivariable analysis. Conclusions: EASIX score may represent endothelial dysfunction in patients with UTUC and may serve as a readily available prognostic factor for oncologic outcomes.

Purpose: To establish the standard of procedure in preparing benign and cancerous prostate tissues and evaluate the quality of proteomics and phosphoproteomics during transurethral resection of the prostate (TUR-P) with different surgical conditions. Materials and Methods: TUR-P tissue samples from three patients, two diagnosed with prostate cancer and one with benign prostatic hyperplasia, were each analyzed under three different conditions, based on differences in energy values, tissue locations, and surgical techniques. Global- and phosphorylated proteomic profiles of prostate tissues were analyzed by liquid chromatography-tandem mass spectrometry. Results: A total of 6,019 global proteins and 4,280 phosphorylated peptides were identified in the nine tissues. The quantitative distributions of proteins and phosphorylation in tissues from the same patient were not affected by changes in the surgical conditions, but indirect relative comparisons differed among patients. Phosphorylation levels, especially of proteins involved in the androgen receptor pathway, important in prostate cancer, were preserved in each patient. Conclusions: Proteomic profiles of prostate tissue collected by TUR-P were not significantly affected by energy levels, tissue location, or surgical technique. In addition, since protein denaturation of samples through TUR-P is rarely confirmed in this study, we think that it will be an important guide for tissue samples in castration resistant prostate cancer patients, where it is difficult to obtain tissue. This result is the first report about proteomic and phosphoproteomic results with TUR-P samples in prostate cancer and will be theoretical basis in protein analysis research with prostate cancer tissues.

Development of alternatives to in-feed antibiotics in the swine industry have been the focused of many pig gut microbiota studies to improve animal health. In this study, we evaluated the effects of probiotic Pediococcus acidilactici (PRO), prebiotic lactulose (PRE), and their synbiotic combination (SYN) on gut microbiota using 16S rRNA gene sequencing in weaned piglets challenged with Shiga-toxin producing Escherichia coli (STEC). Our data showed that prebiotics, probiotics and synbiotics improved the intestinal health in weaned piglets. No significant differences were observed in species richness and species diversity in weaned piglets fed prebiotics, probiotics and their synbiotic combination. However, beta diversity analysis revealed distinct clustering of the microbiota of according to dietary treatment and by oral challenge of STEC. At the phylum level, Firmicutes to Bacteroidetes ratio was lower in the dietary treatment groups than the control group. Oral supplementation of prebiotics, probiotics and synbiotics enriched the abundance of Prevotella and Roseburia. Succinivibrio was elevated in PRO group; however, Phascolarctobacterium was depleted with STEC challenge regardless of dietary treatment. Overall, our data showed that administration of synbiotics in piglets improved intestinal health through gut microbiota modulation. Our data indicated that prebiotics, probiotics and their synbiotic combination could promote intestinal health through gut microbiota modulation in weaned piglets.

The interest in bioconversion through fermentation of sprouts produced in smart farms is increasing due to their potential health benefits. Codonopsis lanceolata (CL) is reported to alleviate inflammatory conditions, but much research is still needed to determine which types and parts of CL are most effective. This study investigated the anti-inflammatory effects of a fermented extract of CL sprouts’ aerial part (F-CSA) against LPS-stimulated RAW 264.7 macrophages and mice. In the screening test, F-CSA showed the most substantial anti-inflammatory effect among several samples, containing the highest total flavonoids, tannins, and polyphenols. UPLC-ESI-Q/TOF-MS and HPLC analysis revealed that F-CSA had the highest amount of luteolin among all the CL samples analyzed. F-CSA reduced the release of inflammatory cytokines and mediators such as NO and PGE2 by inhibiting the expression levels of iNOS and COX-2 in LPS-stimulated macrophages. Further, we found that the anti-inflammatory effects of F-CSA were mediated by inhibiting the JNK/NF-κB signaling pathway. Moreover, F-CSA improved survival rates and reduced plasma levels of NO and IL-6 in CD1 mice stimulated with LPS. These findings suggest that F-CSA, which contains luteolin, can alleviate inflammation in LPS-induced RAW 264.7 cells and a CD1 mouse model by inhibiting the JNK/NF-κB signaling pathways.

Germanium (Ge) has gained great attention not only for future nanoelectronics but for back-end of line (BEOL) compatible monolithic three-dimensional (M3D) integration recently. For high performance and low power devices, various high-k oxide/Ge gate stacks including ferroelectric oxides have been investigated. Here, we demonstrate atomic layer deposited (ALD) polycrystalline (p-) HfO2/GeOx/Ge stack with an amorphous (a-) HfO2 capping layer. The consecutively deposited a-HfO2 capping layer improves hysteretic behaviors (ΔV) and interface state density (Dit) of the p-HfO2/GeOx/Ge stack. Furthermore, leakage current density (J) is significantly reduced (×100) by passivating leakage paths through grain boundaries of p-HfO2. The proposed HfO2 layer with the graded crystallinity suggests possible high-k/Ge stacks for further optimized Ge MOS structures.

ABSTRACT Purpose: Renal artery pseudoaneurysms (RAPs) and arteriovenous fistulas (AVFs) are rare but potentially life-threatening complications after partial nephrectomy (PN). Selective arterial embolization (SAE) is an effective method for controlling RAPs/AVFs. We assessed the clinical factors affecting the occurrence of RAPs/AVFs after PN and the effects of SAE on postsurgical renal function. Materials and Methods: Four hundred ninety-three patients who underwent PN were retrospectively reviewed. They were placed in either the SAE or the non-SAE group. The effects of clinical factors, including R.E.N.A.L. scores, on the occurrence of RAPs/AVFs were analyzed. The influence of SAE on the estimated glomerular filtration rate (eGFR) during the first postoperative year was evaluated. Results: Thirty-three (6.7%) patients experienced RAPs/AVFs within 8 days of the median interval between PN and SAE. The SAE group had significantly higher R.E.N.A.L. scores, higher N component scores, and higher L component scores (all, p

Purpose: Preoperative use of 5α-reductase inhibitors (5ARIs) may cause fibrosis of the prostate tissue and reduce the efficiency of thulium laser surgery for treating benign prostate hyperplasia (BPH). Thus, we investigated the effects of preoperative 5ARI use in this setting. Materials and Methods: This retrospective study examined 184 patients who underwent thulium laser surgery for BPH during 2012–2017. Patients were grouped according to their 5ARI use in order to compare their preoperative and intraoperative characteristics and subsequent outcomes. Surgical efficiency was assessed using vaporesection efficiency. The total operation time, vaporesection time and prostate volume change were measured. Results: The 5ARI+ group included 83 patients (45.1%) and the 5ARI− group included 101 patients (54.9%). There were no significant differences in the two groups' preoperative characteristics, postoperative prostate size, thulium laser energy use, or prostate volume reduction rate. However, relative to the 5ARI− group, the 5ARI+ group had a significant shorter total operative time (65.0 min vs. 70.0 min, p=0.013) and a significantly shorter vaporesection time (48.0 min vs. 54.0 min, p=0.014), which resulted in significantly higher vaporesection efficiency in the 5ARI+ group (0.66 mL/min vs. 0.51 mL/min, p

Objectives We investigated the relationship between cribriform patterns and biochemical recurrence in patients with positive surgical margins after radical prostatectomy. Methods This study was based on radical prostatectomy specimens obtained from 817 patients (165 with margin-positive status) collected at a single center between 2010 and 2016. We retrospectively analyzed and compared body mass index, preoperative prostate-specific antigen, Gleason score, operative methods, postoperative Gleason score, pathological T-stage, tumor percentage involvement, lymphatic and perineural invasion, prostate-specific antigen nadir, location and length of the positive margin, cribriform pattern status, and Gleason grade at the surgical margin in terms of their association with biochemical recurrence. Risk factors for biochemical recurrence were also investigated. Results 21% (31/146) of surgical margin-positive patients had a cribriform pattern. Nadir prostate-specific antigen, perineural invasion and biochemical recurrence rates were significantly higher in cribriform pattern present group than absent group (P = 0.031, 0.043 and 0.045, respectively). According to the Cox regression model, postoperative Gleason score, tumor percentage involvement, location and length of the positive margin, and the presence of a cribriform pattern at the surgical margin were significant predictive factors of biochemical recurrence (P = 0.022, < 0.001, 0.015, 0.001, and 0.022, respectively). Moreover, the biochemical recurrence risk was approximately 3-fold higher in patients with a cribriform pattern at the surgical margin than in those without (HR: 3.41, 95% CI 1.20-9.70, P = 0.022). Conclusions A cribriform pattern at the surgical margin is a significant predictor of biochemical recurrence in patients who undergo radical prostatectomy.

Approximately 13–20% of infants with milk allergies concurrently exhibit beef allergies. Here, we report a 24-month-old infant who exhibited both pork and beef allergies, concurrently with a milk allergy. The infant's laboratory test results were: 3.73 ISU-E (ISAC standardized unit for IgE) for cow milk β-lactoglobulin, 23.8 ISU-E for casein, 12.8 ISU-E for cow milk Bos d 6 of serum albumin, and 4.85 ISU-E for cat Fel d 2. This case report summarizes an infant patient diagnosed with a meat allergy that was associated with cow's milk allergy, using ImmunoCAP ISAC®. Not only ImmunoCAP ISAC® but also immunocap can be used to diagnose milk allergy and meat allergy at the same time, immunocap testing for component antigen is rare. ImmunoCAP ISAC® is used to diagnose these allergies in our case study, as it has advantage that only 1ml of blood is needed to run various component antigen tests.

Mycoplasma pneumoniae is the most common bacterial strain causing atypical pneumonia in children and adolencents. Although it is known to cause mild symptoms, it can also cause severe pulmonary or extrapulmonary complications in rare cases. Necrotizing pneumonia (NP) is often reported as a complication of Streptococcus pneumoniae and is very rarely caused by M. pneumoniae. We report a case in which a 5-year-old boy was diagnosed with lobar pneumonia with symptoms that aggravated even with macrolide antibiotic treatment. Anti-mycoplasma pneumoniae Ig-M test yielded high values, and direct polymerase chain reaction results were also positive. NP caused by M. pneumoniae was confirmed on computed tomography. After treatment involving tosufloxacin and systemic steroid, the lesion decreased in size and improved gradually when followed-up for more than 1 year. The patient did not have any predisposing or risk factors for NP.

AlGaN/GaN metal-oxide semiconductor high electron mobility transistors (MOS-HEMTs) with undoped ferroelectric HfO2 have been investigated. Annealing is often a critical step for improving the quality of as-deposited amorphous gate oxides. Thermal treatment of HfO2 gate dielectric, however, is known to degrade the oxide/nitride interface due to the formation of Ga-containing oxide. In this work, the undoped HfO2 gate dielectric was spike-annealed at 600 °C after the film was deposited by atomic layer deposition to improve the ferroelectricity without degrading the interface. As a result, the subthreshold slope of AlGaN/GaN MOS-HEMTs close to 60 mV/dec and on/off ratio>109 were achieved. These results suggest optimizing the HfO2/nitride interface can be a critical step towards a low-loss high-power switching device.

The potential for ochratoxin A (OTA) degradation by swine intestinal microbiota was assessed in the current study. Intestinal content that was collected aseptically from swine was spiked with 100 ppb OTA and incubated for 6 and 12 h at 39°C. An OTA assay was conducted using the incubated samples, and it was found that 20% of the OTA toxin was detoxified, indicating the presence of microbes capable of OTA degradation. Twenty-eight bacterial species were isolated anaerobically in M 98-5 media and 45 bacterial species were isolated using nutrient broth aerobically. Screening results showed that one anaerobic bacterial isolate, named MM11, detoxified more than 75% of OTA in liquid media. Furthermore, 1.0 ppm OTA was degraded completely after 24 h incubation on a solid ‘corn’ substrate. The bacterium was identified by 16S rDNA sequencing as having 97% sequence similarity with Eubacterium biforme. The isolation of an OTA-degrading bacterium from the swine natural flora is of great importance for OTA biodegradation and may be a valuable potential source for OTA-degradation enzymes in industrial applications.

Introduction After radical nephroureterectomy (RNU), adjuvant chemotherapy (AC) is recommended in either muscle invasive or lymph node positive upper urinary tract urothelial carcinoma (UTUC). However, optimal patient selection remains to be studied. We propose a risk-adapted scoring model for selecting patients for AC in localised UTUC with ≤pT2. Material and methods The model was based on 7 risk factors modified from the risk stratification system in the European Association of Urology guideline for localised UTUC. Each risk factor indicated one point; total scores were used to categorise patients as at low or high risk for disease recurrence. We applied our model to 135 patients with localised UTUC with ≤pT2, who underwent RNU without AC. Recurrence-free survival and cancer-specific survival were analysed based on risk group. Results A risk score of ≥4 points indicated high risk (33/135 patients [24.4%]). The accuracy of predicting recurrence was 82.9% (95% confidence interval [CI]: 75.5–88.9%) with a negative predictive value of 93.1% (95% CI: 87.9–96.2%). Disease recurred in 51.5% of high-risk patients and 6.9% of low-risk patients. Multivariate analysis indicated that high-risk was independently associated with recurrence and cancer-specific death (hazard ratio [HR] = 10.20, 95% CI: 3.94–26.44%, HR = 8.72, 95% CI: 2.47–30.73%, all p <0.001, respectively). Conclusions The risk-adapted scoring model might be an effective way for selecting patients who may benefit from AC after RNU in nonmetastatic UTUC with ≤pT2. These results should be validated in a larger, prospective study. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to identify the causes, symptoms, and complications of hypoproteinemia to prevent hypoproteinemia and provide appropriate treatment to children with atopic dermatitis. Methods: Children diagnosed with atopic dermatitis with hypoproteinemia and/or hypoalbuminemia were retrospectively reviewed. The patients' medical records, including family history, weight, symptoms, treatment, complications, and laboratory test results for allergies and skin cultures, were examined. Results: Twenty-six patients (24 boys) were enrolled. Seven cases had growth retardation; 7, keratoconjunctivitis; 6, aural discharges; 5, eczema herpeticum; 4, gastrointestinal tract symptoms; and 2, developmental delays. In 21 cases, topical steroids were not used. According to the blood test results, the median values of each parameter were elevated: total IgE, 1,864 U/mL; egg white-specific IgE, 76.5 kUA/L; milk IgE, 20.5 kUA/L; peanut IgE, 30 kUA/L; eosinophil count, 5,810/µL; eosinophil cationic protein, 93.45 µg/L; and platelet count, 666.5×10³/µL. Serum albumin and total protein levels decreased to 2.7 g/dL and 4.25 g/dL, respectively. Regarding electrolyte abnormality, 10 patients had hyponatremia, and 12, hyperkalemia. Systemic antibiotics were used to treat all cases, and an antiviral agent was used in 12 patients. Electrolyte correction was performed in 8 patients. Conclusion: Hypoproteinemia accompanying atopic dermatitis is common in infants younger than 1 year and may occur because of topical steroid treatment continuously being declined or because of eczema herpeticum. It may be accompanied by growth retardation, keratoconjunctivitis, aural discharge, and eczema herpeticum and can be managed through skin care and topical steroid application without intravenous albumin infusion. [ABSTRACT FROM AUTHOR]

Water disinfection process in a water treatment process results in the formation of disinfection by-products (DBPs), including total trihalomethanes (TTHMs). It takes a relatively long time to estimate TTHMs concentration level in the water treatment plants; thereby it is impossible to timely control operation parameters to reduce the TTHMs concentration. Here, we developed a predictive model to quantify TTHMs concentration using conventional water quality parameters from six water treatment plants in Han River. Before the developing the model, self-organizing map (SOM) and artificial neural network (ANN) restored missing values in input and output parameters. Then, an ANN model was trained to predict TTHMs by using relevant water quality parameters investigated from Pearson correlation. Pearson Correlation test selected six significant input parameters such as temperature, algae, pre-middle chlorine, post chlorine, total chlorine, and total organic carbon. Based on five-fold jackknife cross-validation, the ANN models built using different types of input data showed different performance in training (range of R² from 0.62 to 0.92) and validation (range of R² from 0.62 and 0.80) steps. This study can be a useful tool for predicting TTHMs concentrations using conventional water quality data in drinking water treatment plants. Machine learning models can be readily developed and utilized by managers working with drinking waters. [ABSTRACT FROM AUTHOR]

The Manual Function Test (MFT) is a tool to assess upper extremity motor impairment associated with stroke. This study investigated psychometric properties of the Korean version of the MFT and to establish normative data. Eighty-one patients were enrolled to evaluate MFT, Fugl-Meyer Assessment (FMA) and manual muscle test (MMT). MFT was completed by eight raters on two occasions separated by 6 weeks. Absolute and relative reliability and validity were examined. Additionally, MFT was assessed on 75 healthy controls of different ages. Intraclass correlation coefficient (ICC) (2,1) values for total and each dimension of Korean MFT ranged from 0.984 to 0.998 in the affected side of hemiplegic patients, indicating inter-rater reliability. Percentage values of standard error of measurement (SEM) and smallest real difference (SRD) ranged 3.10-10.57% and 8.58-29.29% respectively. Test-retest reliability ICCs for all raters were above 0.98. Effect size (ES) and standardized response mean (SRM) were larger in the acute-subacute group (onset to initial evaluation = 4 months) (ES = 0.12; SRM = 0.41) than those in the chronic group (onset to evaluation > 4 months) (ES = 0.01; SRM = 0.11). MFT score was significantly correlated with FMA score (p < 0.001) and MMT score (p < 0.001). In healthy controls, regression analysis indicated that age significantly predicts manual function scores on both dominant and non-dominant. The Korean MFT showed good reliability and validity. Modest responsiveness was observed in patients evaluated early after stroke onset. The Korean MFT is useful in evaluating upper extremity motor deficits for clinical and research purposes. [ABSTRACT FROM AUTHOR]

Heterotopic ossification (HO) is frequently seen on rehabilitation units after spinal cord injuries, fractures, brain injuries, and limb amputations. Currently, there is no effective treatment for HO other than prophylaxis with anti-inflammatory medications, irradiation, and bisphosphonate administration. These prophylactic treatments are not effective for managing ectopic bone once it has formed. Here we describe three cases of established neurogenic HO treated with radiation therapy (RT). All patients had decreased serum alkaline phosphatase (ALP) and bone-specific ALP levels with decreased pain but increased range of motion immediately after RT. Post-treatment X-rays revealed no further growth of the HO. All patients maintained clinical and laboratory improvements 4 or 6 months after the RT. Our results suggest that RT is safe and effective in decreasing pain and activity of neurogenic HO. [ABSTRACT FROM AUTHOR]

Penile glans ischemia or necrosis developing after internal pudendal arterial embolization is very rare; no relevant report has yet appeared. A 53-year-old male who visited our emergency room because of massive urethral bleeding was diagnosed with an internal pudendal artery-urethral fistula; he underwent selective embolization of the internal pudendal artery. However, unexpected penile glans ischemic necrosis developed after embolization. We successfully treated the patients with intravenous infusion of alprostadil, oral pentoxifylline and tadalafil. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the oncologic outcomes between adjuvant radiotherapy (ART) and salvage radiotherapy (SRT) in patients with locally advanced prostate cancer or with adverse pathologic factors including positive surgical margin and high Gleason score. Materials and Methods: We searched the literature published from January 2000 until December 2014 at MEDLINE, PubMed, Web of Science, Embase, ProQuest, and Cochrane Library. To be specific, included were studies comparing ART and SRT settings if they followed up oncologic outcomes more than 5 years. Results: Overall, 3 retrospective, nonrandomized, observational studies, 1 matched control analysis, and 3 prospective randomized controlled studies met our inclusion criteria including a total of 2,380 patients (1,192 ART vs. 1,188 SRT). Higher favorable results were found in ART than in SRT was seen in the 5-year and 10-year biochemical recurrence (BCR)-free survival (risk ratio [RR], 0.61 and 0.70; 95% confidence interval [CI], 0.54-0.69 and 0.63-0.76). ART had a significantly higher 5-year progression-free survival rate than that in SRT (RR, 0.64; 95% CI, 0.51-0.80), but this was not the same for the 10-year progression-free survival rate (RR, 0.88; 95% CI, 0.72-1.08). There was no significant difference for the 5-year and 10-year overall survival rates between ART and SRT (RR, 0.80 and 0.94; 95% CI, 0.59-1.07 and 0.80-1.11). Conclusions: ART showed favorable results in BCR-free survival during the 5-year follow-up period. However, the 10-year progression- free survival and overall survival did not show any difference between ART and SRT. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to evaluate the use of a holmium laser for transurethral deroofing of a prostatic abscess in patients with severe and multiloculated prostatic abscesses. Materials and Methods: From January 2011 to April 2014, eight patients who were diagnosed with prostatic abscesses and who underwent transurethral holmium laser deroofing at Pusan National University Hospital were retrospectively reviewed. Results: Multiloculated or multifocal abscess cavities were found on the preoperative computed tomography (CT) scan in all eight patients. All patients who underwent transurethral holmium laser deroofing of a prostatic abscess had successful outcomes, without the need for secondary surgery. Of the eight patients, seven underwent holmium laser enucleation of the prostate (HoLEP) for the removal of residual adenoma. Markedly reduced multiloculated abscess cavities were found in the follow-up CT in all patients. No prostatic abscess recurrence was found. Transient stress urinary incontinence was observed in three patients. The stress urinary incontinence subsided within 3 weeks in two patients and improved with conservative management within 2 months in the remaining patient. Conclusions: Transurethral holmium laser deroofing of prostatic abscesses ensures successful drainage of the entire abscess cavity. Because we resolved the predisposing conditions of prostatic abscess, such as bladder outlet obstruction and prostatic calcification, by simultaneously conducting HoLEP, there was no recurrence of the prostatic abscesses after surgery. We recommend our method in patients requiring transurethral drainage. [ABSTRACT FROM AUTHOR]

Purpose: We report our experience with the use of a topical steroid, 0.05% clobetasol propionate, for the treatment of phimosis with clinical complications. Materials and Methods: This was a retrospective analysis of the clinical outcomes of all patients presenting with phimosis to a single institution during the time period from October 2008 to May 2012. A total of 88 patients who had a Kikiros retractability grade of 4 or 5 and phimosis-associated clinical complications, such as ballooning of the prepuce, balanoposthitis, or a history of urinary tract infection (UTI), were instructed to apply 0.05% clobetasol propionate cream to the slightly retracted foreskin and to massage gently while retracting the foreskin. The efficacy of treatment was evaluated at 4 weeks from the initiation of therapy. Results: A total of 60 of the 88 patients (68.2%) showed a complete response (i.e., full retraction of the foreskin) to the therapy. The phimotic ring disappeared in 25 of the 88 patients (28.4%) after treatment. Patients who had a history of balanoposthitis, smegma, ballooning of the prepuce, or UTI showed significantly poorer improvement in preputial retraction (p<0.001, p<0.001, p<0.001, and p=0.02, respectively) and phimotic ring disappearance (p<0.001, p=0.001, p<0.001, and p=0.001, respectively) after treatment. No significant local or systemic side effects were associated with the administration of topical steroids. Conclusions: Topical application of 0.05% clobetasol propionate cream and skin stretching is a safe, simple, and effective procedure with no significant side effects for severe phimosis in prepubertal boys. [ABSTRACT FROM AUTHOR]

Sepsis is a complex, multifactorial, rapidly progressive disease characterized by an overwhelming activation of the immune system and the countervailing antiinflammatory response. In the current study in murine peritoneal macrophages, chlorogenic acid suppressed endotoxin-induced high mobility group box 1 (HMGB1) release in a concentration-dependent manner. Administration of chlorogenic acid also attenuated systemic HMGB1 accumulation in vivo and prevented mortality induced by endotoxemia and polymicrobial sepsis. The mechanisms of action of chlorogenic acid included attenuation of the increase in toll-like receptor (TLR)-4 expression and suppression of sepsis-induced signaling pathways, such as c-Jun NH2-terminal kinase (JNK), p38 mitogenactivated protein kinase (MAPK) and nuclear factor (NF)-κB, which are critical for cytokine release. The protection conferred by chlorogenic acid was achieved through modulation of cytokine and chemokine release, suppression of immune cell apoptosis and augmentation of bacterial elimination. Chlorogenic acid warrants further evaluation as a potential therapeutic agent for the treatment of sepsis and other potentially fatal systemic inflammatory disorders. [ABSTRACT FROM AUTHOR]

Preservation of the cavernous nerves (CNs) during radical prostatectomy is crucial for the patient's erectile function. Despite advances in operative technique, the majority of men report compromised erectile function postprostatectomy or complete loss of potency due to CN trauma even with nerve-sparing modifications. This study was designed to investigate whether repeated dosing of udenafil, a phosphodiesterase type 5 inhibitor, helps to improve erectile function after CN injury. Using the CN crush injury model, 8-week-old male Sprague Dawley rats were divided into the following groups; sham-operated group, bilateral CN crush injury exposed to either no udenafil (vehicle) or udenafil (5, 20 mg/kg) daily for two different durations (4 and 8 weeks, p.o.). At both time points, CN electrical stimulation was used to assess erectile function by measuring the intracavernous pressure. The expressions of hypoxia-inducible factor 1-alpha (HIF-1α), transforming growth factor-beta (TGF-β1), nerve growth factor (NGF), endothelin B receptor (ET), endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), and sonic hedgehog homolog (SHH) in penile tissue were examined. Immunohistochemical antibody staining was performed for NGF, eNOS, nNOS, CD31, and alpha-smooth muscle actin (α-SMA). Additionally, terminal deoxynucleotidyl transferase-mediated nick-end labeling assay was performed to quantify apoptosis and the tissue slides were stained for Masson's trichrome to assess the smooth muscle/collagen ratio. Udenafil improved erectile function in a dose- and time-dependent manner with the maximum erectile function recovery achieved by 20 mg/kg udenafil at an 8-week time point. CN injury increased the expression of HIF-1α, TGF-β1, NGF, and ET, however, decreased the expression of eNOS, nNOS, and SHH. Udenafil significantly suppressed these alterations. The results from the histological analyses show that udenafil markedly reduces apoptosis induced by CN injury and augments the smooth muscle/collagen ratio. CN injury induces significantly impaired erectile function and altered gene/protein expression. Chronic administration of udenafil preserves erectile function and has a beneficial role against the pathophysiological consequences of CN injury. [ABSTRACT FROM AUTHOR]

Introduction. Radical prostatectomy is the treatment of choice for prostate cancer patients. Despite the introduction of nerve-sparing surgical techniques, its success is not entirely guaranteed and the majority of patients report compromised erectile function following surgical procedures. Aim. This study was performed to investigate the effect of repeated dosing of udenafil, a novel phosphodiesterase type 5 inhibitor, on penile hypoxia and fibrosis induced by bilateral cavernous nerve resection (BCNR) in rats. Methods. Thirty male Sprague-Dawley rats (300–320 g) were used in this study. The animals were divided into three groups; group I consisted of sham-operated animals (N = 10), animals in group II underwent BCNR alone (N = 10), and animals in group III were orally treated with 10 mg/kg udenafil b.i.d. for 8 weeks following BCNR (N = 10). Main Outcome Measures. The expression of transforming growth factor-β1, hypoxia-inducible factor-1α, endothelial nitric oxide synthase, neuronal nitric oxide synthase, and endothelin B receptor in penile tissue was examined at gene level. Additionally, erectile function, measured by intracavernous pressure (ICP), and pathological changes in the corpus cavernosum were examined. Results. While fibrosis, apoptosis, and the expression of TGF-β1, HIF-1α, and ETB were significantly increased, and the expression of eNOS and nNOS were significantly decreased in group II, compared with the sham-operated animals, repeated dosing of udenafil significantly ameliorated these changes. Erectile function was profoundly impaired in animals that underwent BCNR alone, and udenafil treatment significantly attenuated this impairment as measured by ICP. Conclusions. These results demonstrate that long-term administration of udenafil ameliorates penile hypoxia and fibrosis induced by cavernous nerve resection. This study also suggests the potential beneficial role of repeated dosing of udenafil in the recovery of erectile function in patients with neuronal erectile dysfunction. Lee C-H, Shin J-H, Ahn G-J, Kang K-K, Ahn B-O, and Yoo M. Udenafil enhances the recovery of erectile function and ameliorates the pathophysiological consequences of cavernous nerve resection. J Sex Med 2010;7:2564–2571. [ABSTRACT FROM AUTHOR]

The article presents a case study of an 8-year old boy with left ureteropelvic junction (UPJ) obstruction who was referred to Pusan National University Yangsan Hospital in Pusan, Korea. It states that the patient experienced episodes of intermittent gross hematuria that had first presented at age of 5 years. It mentions that the patient's ultrasonography (USG) showed grade 3 left hydro-nephrosis with renal pelvis dilatation of maximum diameter of 6.4 centimeter (cm).

A 29-year-old woman with mild back pain when coughing and suprapubic discomfort after voiding was admitted to Pusan National University Hospital. Two weeks earlier, she had undergone a hysterectomy and right-sided ureteroneocystostomy for uterine atony and right ureteral injury with bladder rupture. Computed tomography showed that a ureteral J stent extended from the right ovarian vein to the right cardiac chamber. The stent was retrieved via both femoral veins with a snare loop and pigtail catheter. Computed tomography showed that the urinary and vascular tracts were normal 5 months after the procedure. [ABSTRACT FROM AUTHOR]

Abstract Canine mammary gland tumors (MGT) have a poor prognosis in intact female canines, posing a clinical challenge. This study aimed to establish novel canine mammary cancer cell lines from primary tumors and characterize their cellular and molecular features to find potential therapeutic drugs. The MGT cell lines demonstrated rapid cell proliferation and colony formation in an anchorage-independent manner. Vimentin and α-SMA levels were significantly elevated in MGT cell lines compared to normal canine kidney (MDCK) cells, while CDH1 expression was either significantly lower or not detected at all, based on quantitative real-time PCR (qRT-PCR) analysis. Functional annotation and enrichment analysis revealed that epithelial-mesenchymal transition (EMT) phenotypes and tumor-associated pathways, particularly the PI3K/Akt signaling pathway, were upregulated in MGT cells. BYL719 (Alpelisib), a PI3K inhibitor, was also examined for cytotoxicity on the MGT cell lines. The results show that BYL719 can significantly inhibit the proliferation of MGT cell lines in vitro. Overall, our findings suggest that the MGT cell lines may be valuable for future studies on the development, progression, metastasis, and management of tumors.

Abstract Nonalcoholic fatty liver disease (NAFLD) occurs due to the accumulation of fat in the liver, leading to fatal liver diseases such as nonalcoholic steatohepatitis (NASH) and cirrhosis. Elucidation of the molecular mechanisms underlying NAFLD is critical for its prevention and therapy. Here, we observed that deubiquitinase USP15 expression was upregulated in the livers of mice fed a high-fat diet (HFD) and liver biopsies of patients with NAFLD or NASH. USP15 interacts with lipid-accumulating proteins such as FABPs and perilipins to reduce ubiquitination and increase their protein stability. Furthermore, the severity of NAFLD induced by an HFD and NASH induced by a fructose/palmitate/cholesterol/trans-fat (FPC) diet was significantly ameliorated in hepatocyte-specific USP15 knockout mice. Thus, our findings reveal an unrecognized function of USP15 in the lipid accumulation of livers, which exacerbates NAFLD to NASH by overriding nutrients and inducing inflammation. Therefore, targeting USP15 can be used in the prevention and treatment of NAFLD and NASH.

Objectives: This study aimed to assess the processes and clinical outcomes of a joint collaboration between Antimicrobial Stewardship Program (ASP) and the outpatient parenteral antimicrobial therapy (OPAT) unit for delivery of monoclonal antibody therapy for mild-to-moderate COVID-19. Methods: We carried out a retrospective, interim analysis of our COVID-19 monoclonal antibody therapy program. Outcomes included clinical response, incidence of hospitalization, and adverse events. Results: A total of 175 patients (casirivimab-imdevimab, n = 130; bamlanivimab, n = 45) were treated between December 2020 and March 1, 2021. The median time from symptom onset was 6 (IQR 4, 8) days at time of treatment. Of 135 patients available for follow-up, 71.9% and 85.9% of patients reported symptom improvement within 3 and 7 days of treatment, respectively. A total of 9 (6.7%) patients required COVID-19–related hospitalization for progression of symptoms, all within 14 days of treatment. A total of 7 (4%) patients experienced an infusion-related reaction. Conclusions: ASP-OPAT collaboration is a novel approach to implement an efficient and safe monoclonal antibody therapy program for the treatment of mild-to-moderate COVID-19.

Hemicellulose-based hydrogels are three-dimensional networked hydrophilic polymer with high water retention, good biocompatibility, and mechanical properties, which have attracted much attention in the field of soft materials. Herein, recent advances and developments in hemicellulose-based hydrogels were reviewed. The preparation method, formation mechanism and properties of hemicellulose-based hydrogels were introduced from the aspects of chemical cross-linking and physical cross-linking. The differences of different initiation systems such as light, enzymes, microwave radiation, and glow discharge electrolytic plasma were summarized. The advanced applications and developments of hemicellulose-based hydrogels in the fields of controlled drug release, wound dressings, high-efficiency adsorption, and sensors were summarized. Finally, the challenges faced in the field of hemicellulose-based hydrogels were summarized and prospected.

The article presents a proposed multispectral photodetector provides a potential pathway for the integration of visible (VIS)/ near infrared (NIR) vision for application in self-driving, surveillance, computer vision, and biomedical imaging. It mentions about the simplified single-polarity bias operation using single pixel could considerably reduce structural complexity and minimize peripheral circuitry for multispectral selective detection.