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The association of resection margin status with recurrence and survival after pancreatectomy for pancreas ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to identify the effect of R1 resection on recurrence pattern and survival after distal pancreatectomy for left-sided PDAC.Patients who underwent distal pancreatectomy for PDAC at two high-volume institutions between January 2010 and December 2017 were retrospectively reviewed. Perioperative characteristics, pathological outcomes, recurrence pattern, and survival data were collected to compare R0 resection and R1 resection.Among 558 patients who underwent distal pancreatectomy for PDAC, 158 patients (28.3%) showed R1 resection margin. R1 patients were associated with large tumor size (3.3 cm vs. 3.7 cm, p = .006) and lower number of positive lymph nodes (1.3 vs. 2.0, p = .001). Median overall survival (37.3 months vs. 20.1 months, p .001) and recurrence-free survival (14.6 months vs. 6.9 months, p .001) significantly differed between the R0 and R1 groups. Disease recurrence patterns were not statistically different between the two groups (p = .182). Among the recurrence patterns, peritoneal carcinomatosis had the shortest recurrence-free survival (5.6 months, p .05) and overall survival (13.6 months, p .05) compared with all other recurrence patterns.R1 resection margin after distal pancreatectomy was associated with poor survival and early recurrence. There is no significant difference in recurrence pattern between R0 and R1. Among the recurrence patterns, peritoneal carcinomatosis showed the worst prognosis.

Anionic dyes are one of the most serious contaminants in water as these molecules are known to be toxic to many living organisms. Herein, we report the development of functionalized polyvinylidene fluoride membranes modified with chitosan-coated iron oxide nanomaterials (Fe-PVDF) for the efficient treatment of anionic dye-contaminated water. Aqueous solutions of anionic dyes could be captured rapidly by passing through the functionalized membrane under reduced pressure. Under neutral conditions, Fe-PVDF showed a maximum removal capacity of 74.6 mg/g for Evans blue (EB) through the adsorption process. In addition, the adsorption capacity was significantly enhanced up to 434.78 mg/g under acidic conditions. The adsorption process for EB matched well with the Langmuir model, indicating monolayer adsorption of the dye to the membrane surface. Moreover, Fe-PVDF can be reusable by a simple washing step in an alkaline solution, and thus, the composite membrane was applied several times without a significant decrease in its adsorption performance. The same composite membrane was further applied to the removal of five other different anionic dyes with high efficiencies. The adsorption mechanism can be explained by the electrostatic interaction between the positively charged chitosan and the negatively charged dye as well as the affinity of the sulfate groups in dye molecules for the surface of the iron oxide nanoparticles. The easy preparation and rapid decolorization procedures make this composite membrane suitable for efficient water treatment.

Background Little is known about the self-perceived level of disability of stroke survivors in the community. We aimed to characterise Health-related quality of life (HRQoL) 1 year after stroke and investigate how sociodemographic and stroke-related factors and medical adherence explain the self-perceived level of disability in a Korean stroke population. Methods This was a multicentre cross-sectional study. A total of 382 ischaemic stroke survivors at 1 year after onset from 11 university hospitals underwent a one-session assessment, including socioeconomic variables, the modified Rankin Scale (mRS), various neurological sequelae, the Morisky, Green and Levin-Medication Adherence Questionnaire (MGL), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-items. The relationship between disability and different variables was analysed using ordinal logistic regression. Results The prevalence of disability based on global WHODAS 2.0 was 62.6% (mild, 41.6%; moderate, 16.0%; severe, 5.0%). The prevalence of severe disability was higher in participation in society (16.8%) and getting around (11.8%) than in other domains. Low MGL- motivation was the only factor determining a significant association between all six domains of disability after adjustment. Different predictors for specific domains were age, mRS, dysarthria, trouble seeing, cognition problems, and MGL-motivation for understanding and communicating; age, recurrent stroke, mRS, hemiplegia, facial palsy, general weakness, and MGL-motivation for getting around; age, education, mRS, hemiplegia, and MGL-motivation for self-care; education, recurrent stroke, hemiplegia, dysarthria, and MGL-motivation for getting along with people; age, education, income, mRS, hemiplegia, dysarthria, MGL-knowledge, and MGL-motivation for life activities; living without a spouse, mRS, hemiplegia, dysarthria, trouble seeing, cognition problems, general weakness, and MGL-motivation for participation in society. Conclusions Self-perceived disability according to the WHODAS 2.0 at 1 year after stroke was highly prevalent. Each disability domain showed a different prevalence and associated factors. Interventions promoting medical adherence to motivation seemed to help achieve high HRQoL in all domains.

Objectives: This study was performed to identify and find the clustering of healthy behaviors and the factors related to the clustering among Korean adults aged 19-64.Methods: The data of 9,519 Korean adults aged between 19 and 64 years who participated in the 6th Korea National Health and Nutrition Examination Survey were used as the analysis target. Following the recommendation of the Health Plan 2020 for health-promoting lifestyle, four variables, including nonsmoking, moderate drinking, sufficient physical activity, and healthy diet, were used in the study. The multinomial logistic regression analysis was performed to analyze the relationships among demographic characteristics, health-related characteristics, and clustering of healthy behaviors.Results: The significant elements of healthy behaviors clustering included sufficient physical activities for males, and non-smoking, moderate drinking, and healthy diet for females. Clustering healthy behaviors were higher for “females, the elderly, people with higher level of education, people with higher household income, people with diabetes, and people who perceive their subjective health status is good.Conclusions: In this study, the factors related to the clustering of healthy behaviors were identified. In order to spread the practice of healthy behaviors, multiple interventions are more effective than individual health behaviors.

Background We assessed the use of serum concentrations of carbohydrate antigen (CA) 19–9 and carcinoembryonic antigen (CEA) measured during the preoperative diagnostic workup as prognostic factors for survival in patients with periampullary carcinoma. Methods A retrospective review of patients diagnosed with periampullary carcinoma who underwent radical surgery was conducted. Factors related to the survival of periampullary carcinoma patients, including CA 19–9 and CEA, were analyzed. Results The mean age of the 112 patients included in the results was 66.41 ± 10.513 years. In the study, the percentage of patients with elevated serum CA 19–9 and CEA concentrations was 65.2% and 24.1%, respectively. CA 19–9 concentrations were correlated with the tumor stage, pre-operative jaundice, and lymphovascular invasion, but CEA concentrations were not. The median overall survival was longer for the normal serum CA 19-9 group than the group with increased CA 19–9 (56 months vs. 25 months, p = 0.003); however, there was no statistically significant difference between the normal serum CEA group and the group with increased CEA (43 months vs. 25 months, p = 0.077). Independent factors related to overall survival were sex, age, stage, presence of jaundice, lymphovascular invasion, perineural invasion, margin status, and elevated serum CA 19–9 concentrations. Conclusions Periampullary carcinoma patients with elevated serum CA 19–9 concentrations at diagnosis are expected to have poor overall survival. CA 19–9 may be a useful marker for predicting prognosis in patients with periampullary carcinoma at the time of diagnosis.

Introduction Radiofrequency ablation (RFA) is one of the best curative treatments for hepatocellular carcinoma in selected patients, and this procedure can be applied either percutaneously or laparoscopically. Laparoscopic RFA has the benefit of direct visual control of the RFA procedure. Cluster electrodes (Octopus RF electrodes) can create a common ablation zone. Aim Using these two methods (laparoscopic approach and no touch technique), this present study evaluated the technical and clinical outcomes of early experience with laparoscopic RFA and a no-touch technique. Material and methods Between November 2015 and November 2018, 21 patients underwent laparoscopic RFA for hepatocellular carcinoma with a no-touch technique using cluster electrodes. Laparoscopic RFA is recommended for patients with a contraindication for surgical resection, patients wants and a relative contraindication for conventional percutaneous RFA, such as lesions adjacent to the gastrointestinal tract, gallbladder, bile duct, or heart. Results In the 21 tumors, 2 were treated with a single electrode, 12 with 2 electrodes, and 7 tumors with 3 electrodes. The mean time of ablation per lesion was 20.43 ±8.77 min. There was no mortality, local tumor progression, delayed destructive biliary damage, or liver abscess at the follow-up computed tomography. No technical failures occurred. Conclusions Laparoscopic RFA can access lesions for which percutaneous RFA is contraindicated or risky. Cluster electrodes can create sufficient ablation zones without contact and can achieve a sufficient margin with a low complication rate and no tumor dissemination. Therefore, laparoscopic RFA with a no-touch technique might be a safe and feasible treatment for HCC tumor in selected patients.

Summary Background The objective of this study was to determine the appropriate timing for surgical intervention for Grade II acute cholecystitis patients. The study compares the clinical outcomes of patients in Group A, who were treated with early laparoscopic cholecystectomy (ELC) within the first two weeks of hospitalization, and Group B, treated with delayed laparoscopic cholecystectomy (DLC) after recovering from symptoms and that received conservative treatment and were discharged for more than two weeks. Methods From November 2011 to June 2019, from a total of 196 acute cholecystitis patients that received percutaneous transhepatic gallbladder drainage (PTGBD) insertion, we conducted a retrospective review of the group that received early laparoscopic cholecystectomy within 2 weeks and the group that received delayed laparoscopic cholecystectomy. The clinical characteristics and post-treatment outcomes were evaluated. Results In all patients treated with PTGBD insertion, Group A, the patients who were treated with ELC, showed a significantly longer mean operative time than Group B, the patients who were treated with DLC (72.46 ± 46.396 vs. 54.08 ± 27.12, P = 0.001). Similarly, Group A showed a significantly longer postoperative hospital stay compared to Group B (5.71 ± 5.062 vs. 4.27 ± 2.931, P = 0.014). Conclusion In patients with Grade II acute cholecystitis with PTGBD insertion, DLC produces better outcomes with shorter hospital stay and operative time than ELC. These results suggest that DLC may lead to a better outcome than ELC, specifically when deciding the timing for laparoscopic cholecystectomy in patients diagnosed with acute Grade II cholecystitis.

This article investigates the effect of the performance evaluation period on the long-term investment portfolio choice and the agency problem of outsourced investments. Though investors with the prospect utility are required to raise the portfolio weight on risky assets such as stocks for a long investment horizon, institutional investors and professional fund managers cannot help lowering the portfolio weight on risky assets to minimize the loss and to avoid disappointing clients with a short evaluation period. We find empirical evidence in the Korean capital market that stocks and bonds are indifferent to investors with the prospect utility for an evaluation period with 16 months and the optimal portfolio weight of stocks and bonds is 30% to 70%. Therefore there exists the agency problem between investors (principal) and managers (agent) due to frequent performance evaluations, which is able to explain current excessive investment in fixed income markets of most national pension funds. Our result implies that we need to consider extending the evaluation period of the investment performance to achieve the goal of asset and liability management (ALM) of national long-term funds in this low-interest-rate environment.

Background: The self-perceived level of disability for stroke survivors in community is little known. We aimed to characterize HRQoL 1 year after stroke and to investigate how socio-demographic and stroke-related factors and medical adherence explain the self-perceived level of disability among a Korean stroke population.Methods: This study was a multi-center and cross-sectional study. A total of 426 ischemic stroke survivors at 1 year after onset recruited from 11 university hospitals underwent a one-session assessment including: socioeconomic variables, the modified Rankin Scale (mRS), various neurological sequelae, the modifed Morisky scale (MMS), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-items. The relationship between disability and different variables was analyzed using ordinal logistic regression. Results: The prevalence of disability by global WHODAS 2.0 score was 62.6% (41.6% for mild; 16.0% for moderate; 5.0% for severe) in subjects. Prevalence of severe disability was higher in Participation in society (16.8%) and Getting around (11.8%) than in the other domains. Low MMS motivation was the only factor determining the significant association between all six domains of disability after adjustment. Different predictors for specific domains were age, mRS, dysarthria, trouble seeing, cognition problem and MMS-motivation for Understanding and communicating; age, recurrent stroke, mRS, hemiplegia, facial palsy, general weakness and MMS-motivation for Getting around; age, education, mRS, hemiplegia and MMS-motivation for Self-care; age, education, recurrent stroke, hemiplegia, dysarthria and MMS-motivation for Getting along with people; age, education, income, mRS, hemiplegia, dysarthria, MMS-knowledge and MMS-motivation for Life activities; living without spouse, recurrent stroke, mRS, hemiplegia, dysarthria, trouble seeing, cognition problem, general weakness and MMS-motivation for Participation in society.Conclusions: Self-perceived disability by the WHODAS 2.0 had almost double the prevalence compared to hemiplegia, one of the most common neurological sequelae 1 year after stroke. Each domain of disability increased with various associated factors. Interventions promoting medical adherence of motivation seem to help high HRQoL in all domains.

The impact of changes in sleep duration and sleep quality over time on the risk of non-alcoholic fatty liver disease (NAFLD) is not known. We investigated whether changes in sleep duration and in sleep quality between baseline and follow-up are associated with the risk of developing incident NAFLD. The cohort study included 86,530 Korean adults without NAFLD and with a low fibrosis score at baseline. The median follow-up was 3.6 years. Sleep duration and quality were assessed using the Pittsburgh Sleep Quality Index. Hepatic steatosis (HS) and liver fibrosis were assessed using ultrasonography and the fibrosis-4 index (FIB-4). Cox proportional hazard models were used to determine hazard ratios (HRs) and 95% confidence intervals (Cis). A total of 12,127 subjects with incident HS and 559 with incident HS plus intermediate/high FIB-4 was identified. Comparing the decrease in sleep duration of >1 h, with stable sleep duration, the multivariate-adjusted HR (95% CIs) for incident HS was 1.24 (1.15–1.35). The corresponding HRs for incident HS plus intermediate/high FIB-4 was 1.58 (1.10–2.29). Comparing persistently poor sleep quality with persistently good sleep quality, the multivariate-adjusted HR for incident HS was 1.13 (95% CI, 1.05–1.20). A decrease in sleep duration or poor sleep quality over time was associated with an increased risk of incident NAFLD, underscoring an important potential role for good sleep in preventing NAFLD risk.

675 Background: The association of resection margin status with recurrence and survival after pancreatectomy for pancreas ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to identify the effect of R1 resection on recurrence pattern and survival after distal pancreatectomy for left-sided PDAC. Methods: Patients who underwent distal pancreatectomy for PDAC at two high-volume institutions between January 2010 and December 2017 were retrospectively reviewed. Perioperative characteristics, pathological outcomes, recurrence pattern and survival data were collected to compare R0 resection and R1 resection. Results: Among 558 patients who underwent distal pancreatectomy for PDAC, 158 patients (28.3%) showed R1 resection margin. R1 patients were associated with large tumor size (3.3 cm vs. 3.7 cm, p= 0.006) and lower number of positive lymph nodes (1.3 vs. 2.0, p= 0.001). Median overall survival (37.3 months vs. 20.1 months, p< 0.001) and recurrence-free survival (14.6 months vs. 6.9 months, p< 0.001) significantly differed between the R0 and R1 groups. Disease recurrence patterns were not statistically different between the two groups ( p = 0.182). Among the recurrence patterns, peritoneal carcinomatosis had the shortest recurrence-free survival (5.6 months, p < 0.05) and overall survival (13.6 months, p < 0.05) compared with all other recurrence patterns. Conclusions: R1 resection margin after distal pancreatectomy was associated with poor survival and early recurrence. There is no significant difference in recurrence pattern between R0 and R1. Among the recurrence patterns, peritoneal carcinomatosis showed the worst prognosis.

Chromium is a toxic and carcinogenic heavy metal that originates from various human activities. Therefore, the effective removal of chromium from aqueous solutions is an extremely important global challenge. Herein, we report a chitosan-coated iron oxide nanoparticle immobilized hydrophilic poly(vinylidene) fluoride membrane (Chi@Fe2O3–PVDF) which can potentially be used for efficient removal of hexavalent chromium(VI) by a simple filtration process. Membrane filtration is an easy and efficient method for treating large volumes of water in a short duration. The adsorption experiments were conducted by batch and continuous in-flow systems. The experimental data showed rapid capture of hexavalent chromium (Cr(VI)) which can be explained by the pseudo-second-order kinetic and Langmuir isotherm model. The nanocomposite membrane exhibited high adsorption capacity for Cr(VI) (14.451 mg/g in batch system, 14.104 mg/g in continuous in-flow system). Moreover, its removal efficiency was not changed significantly in the presence of several competing ions, i.e., Cl−, NO3−, SO42−, and PO43−. Consequently, the Chi@Fe2O3-PVDF-based filtration process is expected to show a promising direction and be developed as a practical method for wastewater treatment.

Considering the emergence of bacterial resistance and low proteolytic stability of antimicrobial peptides (AMPs), herein we developed a series of ultra-short triazine based amphipathic polymers (TZP) that are connected with ethylene diamine linkers instead of protease sensitive amide bond. The most potent oligomers, TZP3 and TZP5 not only displayed potent antibacterial action on various drug-resistant pathogens but also exhibited a strong synergic antibacterial activity in combination with chloramphenicol against multidrug-resistant Pseudomonas aeruginosa (MDRPA). Since most of atopic dermatitis (AD) infections are caused by bacterial colonization, we evaluated the potency of TZP3 and TZP5 on AD in vitro and in vivo. In vitro AD analysis of these two polymers showed significant inhibition against the release of β-hexosaminidase and tumor necrosis factor (TNF-α) from RBL-2H3 cells. In AD-like skin lesions in BALB/c mice model, these two polymers displayed significant potency in suppressing dermal and epidermal thickness, mast cell infiltration and pro-inflammatory cytokines expression. Moreover, these polymers exhibited remarkable efficacy over the allergies caused by the imbalance of Th1/Th2 by regulating total IgE and IgG2a. Finally, the impact of treatment effects of these polymers was examined through analyzing the weights and sizes of spleen and lymph node of AD-induced mice.

Summary: Background and objective: Although the incidence of carcinoma is not high in gallbladder polyps, it is essential to diagnose gallbladder cancer at an early stage to achieve a good therapeutic outcome. Therefore, the aim of this study was to define the characteristics of gallbladder polyps to establish sound criteria for surgical indications. Methods: In the current study, data from 516 patients with gallbladder polyps who underwent cholecystectomy were reviewed to correlate clinical features with histopathologic findings and identify risk factors with receiver-operating characteristic curves (ROCs). Results: Among the 516 patients who underwent cholecystectomy, 24 patients (4.6%) had cancerous change. The cancer group was significantly older (65.5 years (median, range 35–85)) than the non-cancer group (42 years (median, range 23–82)) (p

The purpose of this randomized controlled trial was to compare the effects of abdominal binder after laparoscopic cholecystectomy.From August to December 2020, 66 patients who were set to undergo cholecystectomy were selected for a prospective trial at Kangbuk Samsung Hospital, Seoul, Republic of Korea, and their clinical characteristics and postoperative surgical outcomes were evaluated. Among 66 patients, 33 patients belong to the abdominal binder group and the other 33 patients belong to the control group.The average hospital stay was 2.46 ± 1.29 days, and was not significantly different between the two groups. The average postoperative pain score (visual analogue scale, 0-10) 12, 24, and 48 hours after surgery were not significantly different. However, the degree of comfort score was significantly higher for the control group patients (2.56 vs. 3.33,No postoperative recovery benefit and no reduction in hospital stay was found in patients who used an abdominal binder while undergoing laparoscopic cholecystectomy. Statistically, between the group that used the binder and the one that did not, no significant differences in surgical outcome nor postoperative outcome were observed. The only exception was that the degree of comfort score was significantly higher in the control group. Therefore, in terms of patient benefit and convenience, wearing an abdominal binder after laparoscopic cholecystectomy is not recommended.

Background & aims Progranulin (PGRN) is known to promote tumorigenesis and proliferation of several types of cancer cells. However, little is known about the clinicopathological features of patients with gastrointestinal stromal tumors (GISTs) with regard to PGRN expression. Methods A retrospective analysis was performed on patients with GISTs who underwent curative surgical resection between 2007 and 2017. PGRN expression was evaluated by immunohistochemical (IHC) analysis and semi-quantitatively categorized (no expression, 0; weak, 1+; moderate, 2+; strong, 3+). Tumors with a staining intensity of 2+ or 3+ were considered high PGRN expression. Results Fifty-four patients were analyzed; 31 patients (57%) were male. The median age at surgery was 60 years (range, 33–79), and the most common primary site was the stomach (67%). Thirty-five patients (65%) had spindle histology; 42 patients (78%) were separated as a high-risk group according to the modified National Institutes of Health (NIH) classification. High PGRN-expressing tumors were observed in 27 patients (50%), had more epithelioid/mixed histology (68% vs. 32%; p = 0.046), and KIT exon 11 mutations (76% vs. 24%; p = 0.037). Patients with high PGRN-expressing tumors had a worse recurrence-free survival (RFS) (36% of 5-year RFS) compared to those with low PGRN-expressing tumors (96%; p60 years) were independent prognostic factors for poor RFS. Conclusions High PGRN-expressing GISTs showed more epithelioid/mixed histology and KIT exon 11 mutations. PGRN overexpression was significantly associated with poor RFS in patients with GISTs who underwent curative resection.

Background Nasal bone fractures occur frequently because the nasal bone is located at the forefront of the face. The goal of this study was to examine the cause, change in severity, change in incidence, and demographics of nasal bone fracture according to today's lifestyle. Methods A total of 2,092 patients diagnosed as having nasal bone fractures at our department between 2002 and 2017 were included in this study. We retrospectively examined patients' medical records to extract information regarding age, sex, cause of injury, combined facial bone fractures, and related injuries such as skull base fracture, spinal cord injury, brain hemorrhage, and other bone fractures. Fracture severity was classified by nasal bone fracture type. Results No statistically significant difference was found in annual number of patients treated for nasal bone fracture. The proportion of patients who underwent closed reduction was significantly decreased over time for those with nasal bone fractures caused by traffic accidents. However, it was not significantly changed for those with nasal bone fractures due to other causes. The number of patients with combined facial bone fractures increased over time. Incidences of severe nasal bone fracture also increased over time. Conclusion The study suggested that there is a decrease in the frequency and increase in the severity of nasal bone fracture due to traffic accident. Many protective devices prevent nasal bone fractures caused by a small amount of external force; however, these devices are not effective against higher amounts of external force. This study highlights the importance of preoperative thorough evaluation to manage patients with nasal bone fractures due to traffic accident.

INTRODUCTION: The longitudinal relationship between sleep duration, sleep quality, and the risk of nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to examine the association between sleep duration, sleep quality, and NAFLD development.METHODS: Using the Pittsburgh Sleep Quality Index, sleep duration and quality were evaluated for 143,306 NAFLD-free Korean adults with a mean age of 36.6 years, who were followed for an average of 4.0 years. Hepatic steatosis (HS) was assessed using ultrasonography and liver fibrosis by the fibrosis-4 index (FIB-4) or the NAFLD fibrosis score. Flexible parametric proportional hazard models were used to determine the hazard ratios (HRs) and 95% confidence intervals.RESULTS: There were 27,817 subjects with incident HS, of whom 1,471 had incident HS plus intermediate/high FIB-4. Multivariable-adjusted HRs (95% confidence intervals) for incident HS comparing sleep durations of ≤5, 6, 8, and ≥ 9 hours with 7 hours were 1.19 (1.14-1.23), 1.07 (1.04-1.10), 0.98 (0.94-1.02), and 0.95 (0.87-1.03), respectively. The corresponding HRs for incident HS plus intermediate/high FIB-4 were 1.30 (1.11-1.54), 1.14 (1.01-1.29), 1.11 (0.93-1.33), and 1.08 (0.71-1.63). The association between sleep duration and HS plus intermediate/high FIB-4 was inverse in individuals with good sleep quality but tended to be U-shaped in those with poor sleep quality. The results were similar if FIB-4 was replaced by the NAFLD fibrosis score.DISCUSSION: In young adults, short sleep duration was independently associated with an increased risk of incident NAFLD with or without intermediate/high fibrosis score, suggesting a role for inadequate sleep quantity in NAFLD risk and severity.

Background In contrast to fillers made from artificial substances, platelet-rich fibrin matrix (PRFM) filler does not cause hypersensitivity reactions or foreign body reactions. PRFM is also highly accessible in terms of cost. Hence, in this study, the efficacy of PRFM for soft tissue augmentation and volume maintenance was evaluated in an animal experiment. Methods Twenty nude mice were injected with hyaluronic acid filler, fibrin glue, PRFM filler, and normal saline (control). The remaining volume was measured 4 times over the course of 8 weeks using the volumetric taping bowl method and magnetic resonance imaging. Results All nude mice survived and showed no signs of infection, such as erythema or edematous changes, during the study period. Migration of the injected substance was not detected at 2, 4, or 8 weeks after the procedure. The remaining volumes of normal saline at 2, 4, and 8 weeks were 10.50%, 2.00%, and 0.00%; fibrin glue, 20.50%, 9.00%, and 2.50%; hyaluronic acid filler, 82.00%, 35.00%, and 17.33%; and PRFM filler, 70.31%, 26.75%, and 14.37%, respectively. Conclusions PRFM filler had a high soft-tissue filling capacity compared with the control. It also showed a similar effect to hyaluronic acid filler. Thus, PRFM filler could be a good alternative for correcting soft-tissue deficits.

Cytokeratin 17 (CK17), a basal/myoepithelial cell keratin, is a poor prognostic marker for cancers of organs such as the stomach, ovary, and breast as well as a useful diagnostic marker for pancreatobiliary adenocarcinoma. However, its expression pattern and prognostic significance have not been studied in gallbladder adenocarcinoma. We constructed a tissue microarray from samples from 82 consecutive patients with gallbladder adenocarcinoma treated by cholecystectomy at the Kangbuk Samsung Hospital from 2000 to 2011. CK17 expression was examined by immunohistochemistry and correlated with clinicopathologic prognostic factors. CK17 stained the cytoplasm of tumor cells and immunohistochemical interpretation was possible in 77 cases. Among these, 41 (53.2%) were considered positive using a 5% cutoff determined by a receiver operating characteristic curve (area under the curve=0.656, P=0.021). CK17 expression was associated with poor tumor differentiation (P

Exposure of concrete structures to chloride-bearing solutions such as sea water or de-icing salts brine can affect their durability to stand against deterioration caused by corrosion of steel reinforcement. In order to monitor the chloride ingress into concrete, embedded chloride sensors can be used in concrete structures. Through the sensors, they monitor the initiation of corrosion of steel reinforcement with time, and measure the open circuit potential and polarisation of steel reinforcement, humidity inside the concrete, chloride content and many more. This paper provides an overview of the latest development of chloride permeation measurement in concrete by evaluating the current techniques being used in industry and highlighting a new approach to monitor chloride ion progress in concrete structures wirelessly.

Given the increased concerns about the degenerative decline in the physical performance of the elderly, there is a need for developing effective strategies to suppress the age-related loss of skeletal muscle mass and functional capacity through a lifestyle intervention. This randomized controlled trial examined whether a combination of Korean mistletoe extract (KME) supplement and exercise affected muscle mass, muscle function, and targeted molecular expressions. Sixty-seven subjects aged 55-75years were assigned to placebo, low-dose (1g/d), or high-dose (2g/d) of KME for 12weeks. The body composition was significantly changed in the high-dose group during the intervention period as determined by skeletal muscle mass (P=0.040), fat free mass (P=0.042), soft lean mass (P=0.023), skeletal muscle index (P=0.041), fat-free mass index (P=0.030), percent body fat (P=0.044), and fat mass to lean mass ratio (P=0.030). Knee strength was measured by Cybex, demonstrating a significant effect in the KME groups compared to the placebo group (P=0.026 for peak torque and P=0.057 for set total work), which was more pronounced after adjusting for age, gender, protein, and energy intake (P=0.009 for peak torque and P=0.033 for set total work). The dynamic balance ability was remarkably improved in the high-dose group over a 12-week period as determined by Timed "Up and Go" (P=0.005 for fast walk test and P=0.024 for ordinary walk test). Consistent with these results, RT-PCR, multiplex analyses, and immunocytofluorescence staining revealed that a high-dose KME supplementation was effective for suppressing intracellular pathways related to muscle protein degradation, but stimulating those related to myogenesis. In particular, significant differences were found in atrogin-1 mRNA (P=0.002 at a single administration and P=0.001 at a 12-week administration), myogenin mRNA (P