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Background: Currently, there is no dedicated tool to record the early outcomes of robot-assisted radical cystectomy (RARC), and existing criteria for longer-term outcomes require a minimum of 3 months for assessment. However, early evaluation is essential to prevent future morbidity and mortality, especially in surgeries with a high risk of complications in the short term. We propose a comprehensive approach to report early RARC outcomes and investigate the influence of surgeon experience on these results. Patients and Methods: We retrospectively analyzed the outcomes of patients who underwent RARC for bladder cancer between April 2009 and April 2020. The cohort was divided chronologically into three groups: patients 1–60 in group 1, 61–120 in group 2, and 121–192 in group 3. Patients with yields of ≥ 16 lymph nodes (LN), negative soft tissue surgical margins, absence of transfusion, and absence of major complications at 30 days were regarded as attaining the RARC tetrafecta. Results: Of the 192 included patients, 93 (48.4%) achieved RARC tetrafecta, with the proportion increasing with surgical experience from 41.7% in group 1 to 55.6% in group 3. Age [odds ratio (OR) 0.947; 95% confidence interval (CI) 0.924–0.970; P = 0.021], LN yield (OR 1.432; 95% CI 1.139–1.867; P = 0.001), and greater surgical experience with RARC (> 120 patients; OR 2.740; 95% CI 1.231–6.100; P = 0.014) were significantly associated with the achievement of RARC tetrafecta. Conclusions: RARC tetrafecta could be a comprehensive method for reporting early outcomes in patients undergoing RARC, with improvements aligned with the surgeon's experience. [ABSTRACT FROM AUTHOR]

Background: The relationship between high-density lipoprotein cholesterol (HDL-C) and gastroesophageal cancer is not constant. Methods: In this population-based cohort study, 4.518 million cancer-free individuals among those who underwent national cancer screening in 2010 were enrolled and followed up until December 2017. HDL-C level was classified into eight groups at 10 mg/dL intervals. The risk of gastroesophageal cancers by HDL-C was measured using adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs). Results: During 8 years of follow-up, 38,362 gastric and 3022 esophageal cancers developed. Low HDL-C level was associated with an increased risk of gastric cancer; aHR was 1.19 (95% CI 1.09–1.30) for HDL-C < 30 mg/dL, 1.07 (95% CI 1.03–1.12) for HDL-C of 30–39 mg/dL, and 1.07 (95% CI 1.03–1.12) for HDL-C of 40–49 mg/dL comparing to HDL-C of 60–69 mg/dL. HDL-C was positively associated with esophageal cancer risk; aHR was 1.30 (1.12–1.51) for HDL-C of 70–79 mg/dL, 1.84 (1.53–2.22) for HDL-C of 80–89 mg/dL, 2.10 (1.67–2.61) for HDL-C ≥ 90 mg/dL. These site-specific effects of HDL-C were robust in sensitivity analyses. The range of HDL-C for the lowest cancer risk was different by sex and site. The hazardous effect of low HDL-C on gastric cancer was prominent in never and past smokers, and extremely high HDL-C increased gastric cancer risk (aHR 1.19; 95% CI 1.04–1.36) only in current smokers. Unfavorable effect of high HDL-C on gastroesophageal cancer risk was remarkable in smokers. Conclusions: Low HDL-C increased the risk of gastric cancer, wherein high HDL-C was associated with esophageal cancer risk with discrepancies by sex and smoking status. [ABSTRACT FROM AUTHOR]

To evaluate the recurrence rate and risk factors of recurrence after robot-assisted laparoscopic partial nephrectomy for solitary renal cell carcinoma (RCC). A total of 1265 cases of initial solitary localized RCC were analyzed. The baseline characteristics, complexity (REANL nephrometry score), intra- and peri-operative outcomes, and recurrence were evaluated. Logistic regression was performed to evaluate the factors affecting recurrence after RAPN for solitary localized RCC. Recurrence after robot-assisted partial nephrectomy (RAPN) occurred in 29 patients (2.29%). The median follow-up was 36.0 months. The N domain (nearness to collecting system/sinus) (odd ratio (OR) 3.517, 95% confidence interval (CI) 1.557–7.945, p = 0.002), operation time (OR 1.005, 95% CI 1.001–1.010, p = 0.013), and perioperative transfusion (OR 5.450, 95% CI 1.197–24.816, p = 0.028) affected recurrence. Distant metastasis among patients with recurrence was significantly associated with nearness to the collecting system/sinus (OR 2.982, 95% CI 1.162–7.656, p = 0.023) and distance between the mass and collecting system/sinus (OR 0.758, 95% CI 0.594–0.967, p = 0.026). Nearness to the collecting system/sinus, operation time, and perioperative transfusion affect recurrence after RAPN for solitary localized RCC. Moreover, the proximity to the collecting system/sinus and distance between the mass and collecting system/sinus were significantly related to distant metastasis after RAPN. [ABSTRACT FROM AUTHOR]

We compared the progression patterns after radical nephroureterectomy (RNU) and elective distal ureterectomy (DU) in patients with urothelial carcinoma of the distal ureter. Between Jan 2011 and Dec 2020, 127 patients who underwent RNU and 46 who underwent elective DU for distal ureteral cancer were enrolled in this study. The patterns of progression and upper tract recurrence were compared between the two groups. Progression was defined as a local recurrence and/or distant metastasis after surgery. Upper tract recurrence and subsequent treatment in patients with DU were analyzed. Progression occurred in 35 (27.6%) and 10 (21.7%) patients in the RNU and DU groups, respectively. The progression pattern was not significantly different (p = 0.441), and the most common progression site was the lymph nodes in both groups. Multivariate logistic regression analysis revealed that pT2 stage, concomitant lymphovascular invasion, and nodal stage were significant predictors of disease progression. Upper tract recurrence was observed in nine (19.6%) patients with DU, and six (66.7%) patients had a prior history of bladder tumor. All patients with upper tract recurrence after DU were managed with salvage RNU. Elective DU with or without salvage treatment was not a risk factor for disease progression (p = 0.736), overall survival (p = 0.457), cancer-specific survival (p = 0.169), or intravesical recurrence-free survival (p = 0.921). In terms of progression patterns and oncological outcomes, there was no difference between patients who underwent RNU and elective DU with/without salvage treatment. Elective DU should be considered as a therapeutic option for distal ureter tumor. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate and compare the perioperative outcomes of robot-assisted adrenalectomy (RAA) and laparoscopic adrenalectomy (LA) using propensity score matching. This retrospective study included 395 patients who underwent minimally invasive adrenalectomy: 354 who underwent LA and 41 who underwent RAA between February 2015 and March 2023. To mitigate potential confounding factors, 2:1 propensity score matching was conducted based on age, sex, body mass index, American Society of Anesthesiologists score, tumor laterality, and tumor size. Perioperative outcomes and complications were compared between the two groups, and prognostic factors for complications were analyzed. Propensity score matching analysis identified 123 patients, with 82 and 41 in the LA and RAA groups, respectively. Operative time (81.4 ± 26.6 min vs. 83.5 ± 25.9 min, P = 0.675), estimated blood loss (77.7 ± 68.3 mL vs. 83.2 ± 73.9 mL, P = 0.683), and post-operative stay (3.8 ± 1.0 days vs. 4.0 ± 0.9 days, P = 0.211) showed no significant differences between two groups. Intraoperative complications occurred in 8 patients (9.8%) in the LA group, while no patients (0%) experienced intraoperative complications in the RAA group (P = 0.051). In both groups, post-operative complications occurred in 2.4% (P = 1). The only factor contributing to complications after adrenalectomy was tumor size (OR 1.026, 95% CI 1.001–1.051, P = 0.042). RAA exhibited comparable perioperative outcomes and presented an improved intraoperative complication rate compared with LA. Tumor size was the only factor that contributed to complications after adrenalectomy. [ABSTRACT FROM AUTHOR]

Background and aims: The use of conventional oral sulfate tablets (OSTs) has gained popularity; nonetheless, they may be not only inconvenient to swallow but also difficult to dissolve. A novel mini-OST has recently been developed to enhance compliance with conventional OST use. This study aimed to compare the efficacy, tolerability, and safety between mini-OST and conventional OST. Methods: This was a prospective, randomized, investigator-blinded, multicenter, and non-inferior phase 3 trial conducted between September 2022 and December 2022. The efficacy, safety, and tolerability were compared between mini-OST and conventional OST. Results: Exactly 83 patients were evaluated based on a full analysis set (FAS), whereas 82 patients were evaluated as a per-protocol set (PPS). With respect to the efficacy of preparation, successful and high-quality preparation was excellent in the mini-OST and conventional OST groups on both FAS and PPS analyses, without significant differences between the two groups. On the FAS analysis, the satisfaction and tolerability scores were high in both groups, without significant differences. The first bowel movement after taking the investigational product occurred 30 min earlier in the mini-OST group than in the OST group. Mild, moderate, and severe adverse events (AEs) were comparable between the two groups; however, any AEs were more common in the mini-OST group than in the conventional OST group overall. Conclusions: Compared with conventional OST, the novel mini-OST preparation showed similar efficacy, tolerability, and safety, including mild eight solicited AEs and moderate-to-severe AEs. Clinical trial registration NCT05670470. [ABSTRACT FROM AUTHOR]

Purpose: The outcomes of colorectal endoscopic submucosal dissection (ESD) in 15–19-mm tumors are unclear. This study compared the effectiveness and safety of colorectal ESD for 15–19-mm tumors and tumors exceeding that size. Methods: From August 2018 to December 2020, 213 cases of colorectal tumors removed by colorectal ESD at a tertiary hospital were enrolled in this study. The cases were divided into two groups according to the pathologically measured size of the resected lesion: an intermediate group (15–19 mm, n = 62) and a large group (≥ 20 mm, n = 151). The en bloc resection rate, complete resection rate, and complications were investigated retrospectively. Results: The en bloc resection rate was significantly higher in the intermediate than large group (100% vs. 94%, p = 0.049), and the mean total procedure time was shorter in the intermediate than large group (29.2 ± 12.6 vs. 48.4 ± 28.8 min, p < 0.001). However, the mean procedure speed was significantly lower in the intermediate than large group (0.25 ± 0.10 vs. 0.28 ± 0.11 cm2/min, p = 0.031). The complete resection rate, post-procedural bleeding, and perforation rate were not significantly different between the two groups. In multivariate analyses, the total procedure time and mean procedure speed were significantly associated with lesion size. Conclusion: Colorectal ESD of 15–19-mm lesions is effective, and has a shorter procedure time and higher en bloc resection rate than the same procedure for larger lesions. [ABSTRACT FROM AUTHOR]

Background and Aims: Surgically altered gastrointestinal (GI) tract anatomy hinders deep enteroscopy. While enteroscopy-assisted endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered GI anatomy has been heavily investigated, the role of non-ERCP balloon-assisted enteroscopy (BAE) has yet to be fully elucidated.Please check and confirm the author names and initials are correct. Also, kindly confirm the details in the metadata are correct.I have checked all you asked and have no correction. Thank you. Methods: A multicenter retrospective study of non-ERCP BAEs in patients with surgically altered GI tract anatomy at two tertiary academic hospitals was performed from January 2006 to December 2020. Altered GI tract anatomy was defined by surgical reconstruction affecting the length, angle, or overall trajectory of the endoscope during the intended approach. The main outcome measurements included technical success rate, diagnostic and therapeutic yields, and complication rate.Please check the edit made in the title of the article and correct if necessary.No more correction. Thank you. Results: A total of 68 patients with surgically altered GI tract anatomy underwent 56 antegrade and 24 retrograde non-ERCP BAE procedures. The technical success rate was 86.2% in both, including 83.9% via antegrade approach and 91.7% via retrograde approach. Antegrade approach in Roux-en-Y anatomy was associated with the lowest success rate of 77.8%, whereas retrograde approach in patients with colon resection resulted in the highest rate of 100%. The diagnostic and therapeutic yields of non-ERCP BAE were 79.4% and 82.9%, respectively. The diagnostic yields varied according to the procedural indications. The major complication was luminal perforation in one case (1.3%). Conclusions: Non-ERCP BAE is effective and safe via both antegrade and retrograde approaches with a high technical success rate and diagnostic and therapeutic yields in patients with surgically altered GI tract anatomy. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the long-term oncological outcomes of robot-assisted radical prostatectomy (RARP) vs. open radical prostatectomy (ORP) in pathologically proven prostate cancer with seminal vesicle invasion (SVI). Methods: We performed a cohort study involving men who underwent radical prostatectomy for prostate cancer with SVI. We adjusted the confounders for RARP versus open surgery using the stabilized inverted probability of treatment weighting. Multivariable survival regression analysis was used to compare the treatment effect of RARP vs. ORP on biochemical recurrence (BCR) and clinical progression (CP). Results: Between January 2000 and December 2012, 272 of 510 men (53.3%) underwent RARP at four tertiary hospitals in Korea. The median follow-up in the entire cohort was 75.7 months (interquartile range, 58.9–96.6 months). Among 389 BCR events, 205 (75.4%) and 184 (77.3%) occurred in the robot-assisted and open groups, respectively. The 5-year BCR-free survival was 22.2% and 20.5% among men who underwent RARP and ORP, respectively (hazard ratio (HR) 0.90; 95% confidence interval (CI), 0.73–1.10; P = 0.29 by the log-rank test). Ninety-nine patients experienced CP (55 and 44 in the RARP and open groups, respectively), representing Kaplan–Meier estimated 5-year event-free rates of 82.1% and 86.1% in the RARP and open groups, respectively, (HR 1.20; 95% CI 0.80–1.79; P = 0.39). Conclusion: The long-term outcomes of RARP for prostate cancer with SVI were comparable to those of open surgery in this large multi-institutional study. However, this result should be confirmed by well-designed prospective randomized controlled trials. [ABSTRACT FROM AUTHOR]

Objectives: Currently, a prostate biopsy is guided by transrectal ultrasound (US) alone. However, this biopsy cannot be performed in men without an anus. The aim of this study was to show the outcomes of a new transperineal US (TPUS)-guided biopsy technique in patients who underwent Miles' operation. Methods: Between April 2009 and March 2022, TPUS-guided biopsy was consecutively conducted in 9 patients (median, 71 years; range, 61–78 years) with high prostate-specific antigen values (22.60 ng/mL; 6.19–69.7 ng/mL). Their anuses were all removed due to rectal cancer. TPUS-guided biopsy was performed according to information on prostate magnetic resonance imaging. The technical success rate, cancer detection rate, and complication rate were recorded. Tumor sizes were compared between benign and cancer groups using an unpaired t-test with Welch's correction. Results: The new TPUS-guided biopsy was successfully performed in all patients. Cancer was detected in 77.8% (7/9) of the patients. These were all categorized as PI-RADS 5. Among them, the detection rate of significant cancer (Gleason score 7 or higher) was 66.7% (6/9). The median tumor size was 2.4 cm (1.7–3.1 cm). However, two patients were diagnosed with benign tissue with PI-RADS 3 or PI-RADS 4. Their median tumor size was 1.0 cm (0.8–1.2 cm). There was significant difference between the cancer and benign groups (p = 0.037) in terms of tumor size. Neither post-biopsy bleeding nor infections occurred. Conclusions: New TPUS-guided biopsy technique may contribute to detecting large PI-RADS 5 prostate cancer in men after Miles' operation. Key points: The new transperineal ultrasound (TPUS) technique can offer an accessible route in men without an anus. A PI-RADS 5 tumor is a good indication for the new TPUS-guided biopsy technique. The TPUS-guided biopsy is difficult to target a small prostate tumor (< 1.5 cm). [ABSTRACT FROM AUTHOR]

Hypoxia, defined as a local insufficiency in the oxygen level, is one of the typical phenomena found in spinal cord injury and solid tumors. Deficiency in the oxygen offers a reductive environment and results in the conversion of nitro groups to amino groups, which can be utilized in the initiation of stimuli-sensitive cascade reactions. A novel hypoxia-sensitive material was synthesized as composed of a hypoxia-activatable trigger unit and two pyrene dyes bound via carbamate linkers, and it produced fluorescence and ultrasound signals. The material was successfully produced through seven synthetic steps and characterized via1H-NMR and UV-vis absorption analysis. The material maintained its chemical structure at the normoxic state, but underwent degradation into free pyrene dyes, activated trigger units, and carbon dioxides by cascade reactions under the reductive hypoxic condition. Accompanied by the material decomposition, remarkably rapid recovery of the quenched fluorescence was observed within 3 min, and its intensity was completely saturated after 15 min. Notably, the fluorescence intensity from the degraded material was 9.2-fold stronger than that from the same concentration of native pyrene dyes because both the activated trigger unit and free pyrene exhibited bright fluorescence emission. Moreover, the carbon dioxide generated during the degradation of the material formed nanobubbles in the media, increasing the ultrasound contrast by 1.2-fold over the background. In summary, the synthesized material was found to produce a potent, hypoxia-sensitive system to visualize the hypoxic condition in terms of fluorescence and ultrasound responses. [ABSTRACT FROM AUTHOR]

The cathepsin B-responsive prodrugs are promising strategies to reduce the serious adverse effects of anticancer drugs by improving the cancer selectivity that can be specifically activated by overexpressed cathepsin B in targeted cancer cells. However, clinical translation of such therapeutic approaches has been restricted by low antitumor efficacy that is mainly attributable to undesirable pharmacokinetic profiles and inefficient tumor-targeting of cathepsin B-responsive prodrugs, due to their small-molecule structure. In recent decades, many researchers have widely investigated the drug delivery system (DDS) to improve the in vivo pharmacokinetic profiles and tumor-targeting efficiency of cathepsin B-responsive prodrugs via the application of polymers, dendrimers, antibodies, lipids, and inorganic nanoparticles as drug carriers. In addition, the potential therapeutic efficacy of DDS for cathepsin B-responsive prodrugs is demonstrated in multiple studies and combinatorial treatment with typical therapeutic modalities can effectively overcome the challenges of tumor heterogeneity and multidrug resistance. In this review, recent advances and progress of new DDS for cathepsin B-responsive prodrugs are outlined, and their clinical trials are discussed. Besides, potential challenges and the outlooks for clinical translation of cathepsin B-responsive prodrugs are highlighted. [ABSTRACT FROM AUTHOR]

Background: The presence of atrophic gastritis (AG) and intestinal metaplasia (IM) is associated with an increased risk of gastric cancer (GC). Thus, the development of new strategies to improve AG/IM is essential for reducing the incidence of GC. Aims: We aimed to evaluate the efficacy of rebamipide for improving AG/IM. Methods: This was a prospective, randomized, pilot study from a single tertiary referral center. Fifty-three (rebamipide, n = 34 vs. placebo, n = 19) patients, who underwent endoscopic resection for gastric dysplasia or early GC, were analyzed. We obtained tissue samples from the antrum and corpus of the stomach, at the time of screening and 1-year later. The histologic grading of inflammation was performed by histopathologists Results: The AG grade in the antrum improved significantly after rebamipide treatment (pre-administration, 1.870 ± 0.932 vs. post-administration, 1.430 ± 0.986; P = 0.013). Additionally, the severity of IM in the antrum was significantly improved (pre-administration, 1.750 ± 0.963 vs. post-administration, 1.370 ± 1.032; P = 0.038). The rebamipide subgroup analysis revealed that patients with no Helicobacter pylori (HP) infection showed significant improvements in AG in the antrum (pre-administration, 1.880 ± 1.040 vs. post-administration, 1.250 ± 0.894; P = 0.028) and IM in antrum (pre-administration, 1.840 ± 1.012 vs. post-administration, 1.180 ± 0.912; P = 0.020). Conclusions: This study demonstrated that the administration of rebamipide improves AG and IM in the antrum, especially in patients with HP non-infection (KCT0001915). [ABSTRACT FROM AUTHOR]

A new town is strategically built within a short period compared to naturally developed cities. It is considered an appropriate study area for analyzing the urban climate problems such as surface urban heat islands (SUHIs) that is differently generated according to urban planning and development. In this study, we suggest comprehensive method for determining and comparing changes in surface UHI distribution during 1989–2048 in two new towns with different urban planning. First, a substantial increase in built-up areas was observed from 1989 (< 5%) to 2018 (> 40%) in both new towns. However, SUHI phenomenon-increasing patterns were different of about 12.25% depending on urban planning and urban morphology. Results also showed the importance of vertical and horizontal structures which can have a great influence on SUHI intensity and accordingly, the difference in SUHI distribution between two new towns was confirmed. Moreover, without effective mitigation, the built-up area in both new towns is estimated to increase to approximately 60%, and the SUHI intensity in most areas to increase by 4 °C in 2048. In addition, the spread and intensification of the SUHI phenomenon are predicted to be greater due to the characteristics of the building structure and the active urban expansion. Thus, these results combined with architectural assessment models can improve the understanding of thermal environmental impacts of urbanization and provide directions for sustainable urban development and renovation. [ABSTRACT FROM AUTHOR]

Genetic analysis and culturing techniques for gastric non-Helicobacter pylori Helicobacter (NHPH) are progressing. NHPH is reported to accompany nodular gastritis, gastric MALT lymphoma, and mild gastritis. However, only a few gastric cancer cases infected by NHPH have been reported. PCR analysis specific for NHPH and H. pylori was performed for DNA from gastric mucosa of 282 Korean gastric cancer patients, who were treated with endoscopic submucosal dissection. For more precise strain detection of NHPH, NHPH-positive mucosa was stained by immunohistochemistry specific for Helicobacter suis. The Cancer Genome Atlas (TCGA) classification was analyzed for these 3 gastric cancer sub-groups by in situ hybridization and immunohistochemistry. Among 281 patients, 3 patients (1.1%) were positive for NHPH. One patient (Patient 1) was also positive for H. pylori by PCR, another patient (Patient 3) was positive for serum IgG for H. pylori, and the other patient (Patient 2) had no evidence for H. pylori infection. Gastric mucosa of Patients 2 and 3 were positive for H. suis staining. All three NHPH-positive gastric cancers were located in the antrum, and belonged to the Chromosomal Instability Type of TCGA classification. Gastric NHPH can be a cause of gastric cancer, although likely with lower pathogenesis than H. pylori. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the detection rates of prostate cancer (PCa) and clinically significant PCa (csPCa) using magnetic resonance imaging-targeted biopsy (MRI-TBx) in men with low prostate-specific antigen (PSA) levels (2.5–4.0 ng/mL). Clinicopathologic data of 5502 men with PSA levels of 2.5–10.0 ng/mL who underwent transrectal ultrasound-guided biopsy (TRUS-Bx) or MRI-TBx were reviewed. Participants were divided into four groups: LP-T [low PSA (2.5–4.0 ng/mL) and TRUS-Bx, n = 2018], LP-M (low PSA and MRI-TBx, n = 186), HP-T [high PSA (4.0–10.0 ng/mL) and TRUS-Bx, n = 2953], and HP-M (high PSA and MRI-TBx, n = 345). The detection rates of PCa and csPCa between groups were compared, and association of biopsy modality with detection of PCa and csPCa in men with low PSA levels were analyzed. The detection rates of PCa (20.0% vs. 38.2%; P < 0.001) and csPCa (11.5% vs. 32.3%; P < 0.001) were higher in the LP-M group than in the LP-T group. Conversely, there were no significant differences in the detection rates of PCa (38.2% vs. 43.2%; P = 0.263) and csPCa (32.3% vs. 39.4%; P = 0.103) between the LP-M and HP-M groups. Multivariate analyses revealed that using MRI-TBx could predict the detection of csPCa (odds ratio 2.872; 95% confidence interval 1.996‒4.132; P < 0.001) in men with low PSA levels. In summary, performing MRI-TBx in men with low PSA levels significantly improved the detection rates of PCa and csPCa as much as that in men with high PSA levels. [ABSTRACT FROM AUTHOR]

Abnormal expression of insulin gene enhancer-binding protein 1 (ISL1) has been demonstrated to be closely associated with cancer development and progression in several cancers. However, little is known about ISL1 expression in metastatic castration-resistant prostate cancer (CRPC). ISL1 has also been recognized as a positive modulator of epithelial–mesenchymal transition (EMT). In this study, we focused on ISL1 which showed maximum upregulation at the mRNA level in the enzalutamide-resistant cell line. Accordingly, we found that ISL1 was overexpressed in enzalutamide-resistant C4-2B cells and its expression was significantly related to EMT. Our findings reveal the important role of ISL1 in androgen receptor (AR)-dependent prostate cancer cell growth; ISL1 knockdown reduced the AR activity and cell growth. ISL1 knockdown using small-interfering RNA inhibited AR, PSA, and EMT-related protein expression in C4-2B ENZR cells. In addition, knock-down ISL1 reduced the levels of AKT and p65 phosphorylation in C4-2B ENZR cells and these suggest that knock-down ISL1 suppresses EMT in part by targeting the AKT/NF-κB pathway. Further, ISL1 downregulation could effectively inhibit tumor growth in a human CRPC xenograft model. Together, the present study shows that downregulation of ISL1 expression is necessary for overcoming enzalutamide resistance and improving the survival of CRPC patients. [ABSTRACT FROM AUTHOR]

Background: A sessile-serrated adenoma (SSA) has a high risk for incomplete resection. Little is known regarding how to immediately detect remnant SSA tissue after endoscopic resection. We investigated the usefulness of narrow-band imaging (NBI) to detect remnant SSA tissue after endoscopic mucosal resection (EMR). Methods: We performed a prospective randomized study on 138 patients who had suspicious SSA on colonoscopy at five centers. After EMR on the suspected SSA determined on the endoscopic morphology, all lesions were randomized into two inspection methods, NBI and white light endoscopy (WLE), to detect remnant tissue on the resected margin. If remnant tissue was detected, an additional resection was performed. Finally, we obtained quadrant biopsies on the resection margin to evaluate the incomplete resection. The proportion of incomplete resection was calculated by combining the detection of remnant tissue and the positivity of SSA cells on the final quadrant biopsies. The primary outcome was the proportion of remnant tissue detection, and the secondary outcome was the proportion of incomplete resection of SSA. Results: In all, 145 lesions from 138 patients were removed. The diagnostic rate of SSA was 87.6% (127/145). After randomization, NBI inspection was performed on 69 lesions, and WLE inspection was performed on 76 lesions. The histologic diagnostic rate of SSA was 89.9% (62/69) in the NBI group and 85.5% (65/76) in the WLE group (p > 0.05). There were no significant differences in the detection of remnant tissue (12.9% (8/62) vs. 15.4% (10/65), p > 0.05), the proportion of SSA in remnant tissue (11.3% (7/62) vs. 12.3% (8/65), p > 0.05), or the proportion of incomplete resection (6.5 (4/62) vs. 10.8 (7/65), p > 0.05) between the NBI and WLE inspection groups, respectively. Conclusion: NBI was not superior to WLE for detecting remnant SSA tissue after EMR and could not decrease the proportion of incomplete resection of SSA. [ABSTRACT FROM AUTHOR]

This study aims to compare oncologic and functional outcomes after radical nephroureterectomy (RNU) and segmental ureterectomy (SU) in patients with upper urinary tract urothelial carcinoma (UTUC). We retrospectively collected data on patients who underwent either RNU or SU of UTUC. Propensity score matching was performed among 394 cases to yield a final cohort of 40 RNU and 40 SU cases. Kaplan–Meier analysis and the log-rank test were used to compare overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), and intravesical recurrence-free survival (IVRFS) between the groups. We also compared the change in postoperative estimated glomerular filtration rate (eGFR). There was no significant difference in terms of CSS, PFS, and IVRFS between the RNU and SU groups, but the RNU group had a better OS than the SU group (p = 0.032). Postoperative eGFR was better preserved in the SU group than in the RNU group (p < 0.001). SU provides comparable CSS, PFS, and IVRFS for patients with UTUC compared to RNU, even in patients with advanced-stage and/or high-grade cancer. Further, SU achieves better preservation of renal function. [ABSTRACT FROM AUTHOR]

Storing bio-specimens in adequate temperatures is an important task in hospitals. Usually an assigned employee records manually the temperatures of the hospital cold storages such as refrigerators and freezers that keep them at regular intervals. In this research, a low power wireless Bluetooth Low Energy network is applied where the central monitoring personal computer, receives the temperature data and stores in a database. The system consists of many beacons which are wirelessly sending the measured temperature data, and the central monitoring computer which allows the user to monitor that data. In the case of wireless signals getting blocked due to obstacles, repeaters called bridges send the data to the central computer forming a so-called scatter net. Once the data is received by the Bluetooth module connected to the monitoring computer, an application saves the data into a database. This web application forms a website where the users holding the authentication information can log in and monitor the temperature data in the form of tables and graphs. The same information can be viewed by a smartphone and a person in charge receives a warning SMS message. This system also provides a scheduled backup system where the database is automatically backed up periodically. The suggested system has the advantage of managing reagent records with reduced manpower whilst coping for emergency situations automatically. [ABSTRACT FROM AUTHOR]

We evaluated the predictive role of circulating tumor DNA (ctDNA) detection by targeted deep sequencing in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint blockades (ICB). To determine the feasibility of ctDNA detection in our panel encompassing 40 genes, we collected 10 ml of blood from 20 patients at the time of radical nephrectomy. We analyzed somatic mutations in primary tumors and ctDNA samples from these patients. We finally collected 10 ml of blood before and after 1 month of treatment, respectively, from four patients with mRCC who received first-line ICB treatment. Variants were detected in primary tumors of 15 patients (75%) and ctDNA was detected in the plasma of 9 patients (45%). We examined the predictive role of ctDNA in four patients who received first-line ICB therapy. In two patients showing partial response, ctDNA levels decreased after 1 month of ICB treatment. However, in one patient who showed disease progression, ctDNA levels increased after 1 month of ICB treatment. Taken together, ctDNA detection in plasma by targeted deep sequencing was feasible in patients with RCC. Moreover, the levels of ctDNA could be an early predictor of treatment response in patients with mRCC who receive ICB therapy. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori infection and hyperplastic polyp are known to have strong connections, but there are not enough randomized controlled trial data. Aims: To evaluate the effect of H. pylori eradication on gastric hyperplastic polyp. Method: This is an open-labeled, single-center, randomized controlled trial. Patients with hyperplastic polyp and current infection of H. pylori were randomly assigned to eradication or non-eradication groups. All participants underwent follow-up endoscopy to investigate the regression of gastric polyps. Gastric polyp regression was defined as the disappearance of polyps or a reduction of more than 50% in size. Results: Thirty-two patients were randomized to eradication (n = 17) and non-eradication groups (n = 15). Final included patients were 14 in eradication group and 13 in non-eradication group. All patients showed polyp regression in eradication group, whereas no regression was observed in non-eradication group (P < 0.001). Disappearance of polyp (n = 7) and decrease in size (n = 7) were observed in eradication group. In non-eradication group, no change (n = 5), increase of size (n = 5), and increase of number (n = 3) were observed. Mean regression time was 6.8 months, and disappearance time was 9.8 months. In non-eradication group, hyperglycemia was noted in 50% of progression group but not noted in no change group (P = 0.057). Conclusions: H. pylori eradication induced regression of hyperplastic polyp, and persistent H. pylori infection was related to progression of gastric polyp. Clinical Trial Registration: ClinicalTrials.gov ID: NCT03065868 [ABSTRACT FROM AUTHOR]

In this paper, a generalized compensation method of reactive power applicable to a multi-line system under non-sinusoidal conditions is studied. The compensation is confined to parallel compensation with passive components, i.e., inductors and capacitors. If the required reactive currents containing harmonics are given, an L–C network, composed of passive components and generating the required reactive currents, is synthesized. The proposed L–C network is composed of a star-connected part and a circular connected part. It is shown that the proposed method is comprehensive, easy, and systematic to apply. [ABSTRACT FROM AUTHOR]

During the development stage of a liquid rocket engine structural analyses are needed for increasing structural reliability and identify necessary design changes. These analyses need enormous efforts for detail modeling and cause large computational cost. With increasing computational power, the modeling can be more detailed than in the past. In this study, non-linear static structural and free vibration analyses taking into account the static loading as preloading are performed for a 750 kN class liquid rocket engine system. The finite element (FE) structural analyses are performed using the general purpose commercial code, Abaqus 2016. The effects of the static loadings on stress distributions and the free vibration results are analyzed. Additionally a simple kinematic model using rigid body elements is made up to investigate the elasticity effects on the rotation angles due to engine gimbaling. The strains measured from a ground firing test are converted to equivalent stresses to be compared with the FE analysis results. And a certain leakage problem solved using the FE analysis results is also presented. [ABSTRACT FROM AUTHOR]

Background: The personality traits of endoscopists have been suggested to affect the adenoma detection rate (ADR). We thus evaluated the relationship between endoscopists' personality traits and the ADR during colonoscopy using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Methods: In total, 1230 patients (asymptomatic and aged 50–80 years) who underwent screening or surveillance (≥ 5 years) colonoscopy were recruited from 13 university hospitals by 20 endoscopists between September 2015 and December 2017. We retrospectively measured the ADR, polyp detection rate (PDR), and number of adenomas per colonoscopy (APC). All 20 endoscopists completed all 567 true/false MMPI-2 items. Results: The overall mean colonoscopy withdrawal time, PDR, ADR, and APC were 7.3 ± 2.8 min, 55%, 45.3%, and 0.97 ± 1.58, respectively. No significant difference was observed in the MMPI-2 clinical scales (e.g., hypochondriasis and psychasthenia), content scales (e.g., obsessiveness and type A character), or supplementary scales (e.g., dominance and social responsibility) between the high ADR group (ADR ≥45%, n = 10) and the low ADR group (ADR < 45%, n = 10). In multivariate logistic regression analysis, the ADR was associated significantly with patient age and sex. The ADR was related significantly to endoscopists' colonoscopy experience and the per-minute increase in the colonoscopy withdrawal time (OR 1.21, 95% CI 1.06–1.38, p = 0.005). In a logistic regression analysis adjusted for patient factors, the ADR was associated significantly with ego strength (OR 1.04, 95% CI 1.00–1.09, p = 0.044), as measured by the MMPI-2. Conclusions: With the exception of ego strength, the endoscopists' personality traits were not associated with adenoma or polyp detection. [ABSTRACT FROM AUTHOR]

Removal of magnesium and calcium cations in water, called water softening, is an important procedure for industrial use. Although ion exchange resin and chelate resin are one of the most widely used materials for desalination, they have a drawback in regeneration, in which huge amount of salt or strong acidic/basic aqueous solution needs to be applied. In this research, sulfonamide-derived cation capturing system was suggested as an alternative. Sulfonamide derivatives usually show a sharp transition from charged to uncharged form at a specific pH, which alleviates the condition of regeneration. A variety of sulfonamide derivatives were introduced to polystyrene microbeads. 1.88±0.05 mmol/g of the sulfonamide-based ligand was introduced in maximal amount Cation chelating capacities of products were quantified through calcium ion capturing test, identifying several sulfonamides as promising cation capturing systems. Finally, their metal ion capturing capacities within specific pH ranges and regeneration properties in moderate acidic condition were verified. Among the surface-treated sulfonamide derivatives, glycine-conju-gated sulfonamide group, which had 0.90±0.01 mmol/g of ion capturing capacity and rapidly regenerated at pH 5.0, was found to be most appropriate for water softening application. [ABSTRACT FROM AUTHOR]

Background: Although colonoscopy preparation may cause symptom flares in patients with ulcerative colitis (UC), little is known about the standard preparation regimen in this population.Aim: We aimed to compare 4L polyethylene glycol (4L-PEG) with 2L polyethylene glycol plus ascorbic acid (2L-PEG-Asc) in quiescent UC patients.Methods: Patients with inactive UC undergoing colonoscopy for surveillance or checkup of mucosal healing were prospectively enrolled at 5 tertiary hospitals. They were randomly assigned to 4L-PEG and 2L-PEG-Asc groups. The Boston Bowel Preparation Scale (BBPS) was used for the preparation quality. Symptoms were assessed using the Simple Clinical Colitis Activity Index (SCCAI) before colonoscopy, at 1 and 4 weeks after the procedure.Results: Overall, 109 patients were included in the study (4L-PEG group 53, 2L-PEG-Asc group 56, the mean age at diagnosis 42.25 years, male 77). The quality of preparation was comparable between the groups (BBPS ≥ 6, 96.2 vs. 92.9%, p = 0.679). Although 26 patients (23.8%) had increased SCCAI scores within 4 weeks after colonoscopy, resulting in a medication dose-up or add-on in 3 patients (2.7%), the rise in scores was not different between the groups. No serious adverse events during preparation were observed in either group. However, the 2L-PEG-Asc group was more likely to be willing to repeat the preparation with the same agent than the 4L-PEG group (82.1 vs. 64.2%, respectively, p = 0.034).Conclusion: PEG-based regimens with different volumes are equally effective and safe in inactive UC patients. 2L-PEG-Asc is more acceptable in this population as indicated by the willingness for further usage. [ABSTRACT FROM AUTHOR]

Background and Aim: Nonvariceal upper gastrointestinal bleeding (NVUGIB) is a potentially life-threatening hospital emergency requiring hemodynamic stabilization and resuscitation. This study is carried out to determine whether hospital volume can influence outcome in patients with NVUGIB.Method: This is a retrospective study with a prospective cohort database (KCT 0000514. cris.nih.go.kr). Eight teaching hospitals were divided into two different groups: high-volume centers (HVC, ≥60 NVUGIB patients/year, four clinics) and low-volume centers (LVC, <60 NVUGIB patients/year, four clinics). Baseline characteristics of patients, risk stratification, and outcomes between hospitals of different volumes were compared. From February 2011 to December 2013, a total of 1584 NVUGIB patients enrolled in eight clinics were retrospectively reviewed. The main outcome measurements consisted of continuous bleeding after treatment, re-bleeding, necessity for surgical/other retreatments, and death within 30 days.Results: Similar baseline characters for patients were observed in both groups. There was a significant difference in the incidence of poor outcome between the HVC and LVC groups (9.06 vs. 13.69%, P = 0.014). The incidence rate of poor outcome in high-risk patients (Rockall score ≥8) in HVC was lower than that in high-risk patients in LVC (16.07 vs. 26.92%, P = 0.048); however, there was no significant difference in poor outcome in the lower-risk patients in either group (8.72 vs. 10.42%, P = 0.370).Conclusions: Significant correlation between hospital volume and outcome in NVUGIB patients was observed. Referral to HVC for the management of high-risk NVUGIB patients should be considered in clinical practice. [ABSTRACT FROM AUTHOR]

Background: After endoscopic submucosal dissection (ESD) for early gastric cancer (EGC), negative pathological findings cause concern about the adequacy of the procedure and local recurrence after ESD.Aim: To investigate the incidence of local recurrence in cases with negative pathological findings after ESD for EGC and pathologically complete resection (CR) during long-term follow-up.Methods: We reviewed 453 patients who underwent ESD for ECG from January 2007 to December 2010, respectively. Of these patients, in 17 cases the pathology results confirmed no residual tumor (NRT), and in 421 cases they showed CR in the ESD specimen. Finally, 17 NRT and 358 CR cases were followed up during surveillance. Patient characteristics, endoscopic and pathological data were analyzed for risk factors of local recurrence. We also re-evaluated the pathology of the NRT group to identify hidden malignant cells in the previous ESD specimens.Results: There was no difference between the two groups in terms of recurrence during follow-up surveillance (median 55.7 months). Late local recurrence of EGC was found in two cases (11.8%) in the NRT group, and three early local recurrences (5.6%) were found in the CR group. A review of the pathology in the NRT group revealed hidden malignant cells in five patients (29.4%).Conclusions: Even when the pathological report indicates NRT after ESD, it might be necessary to re-evaluate ESD specimens with a width <2 mm, and long-term endoscopic surveillance should be routinely used for detecting local EGC recurrence after ESD. [ABSTRACT FROM AUTHOR]

Background: Capsule endoscopy (CE) has proven to be highly effective at detecting small bowel lesions, but studies regarding the diagnostic impact of CE on ileitis are rare.Aims: We evaluated the diagnostic value of small bowel CE for isolated ileitis observed during ileocolonoscopy.Methods: The CE results in 137 patients initially diagnosed with ileitis without colonic mucosal abnormalities on ileocolonoscopy at one of eight tertiary referral centers between October 2002 and June 2015 were retrospectively analyzed.Results: Among the 137 patients with isolated ileitis observed on ileocolonoscopy, 117 (85.4%) revealed positive small bowel CE findings (85.4%). The rate of positive small bowel CE findings was 92.9% in cases of ileal aphthous ulcer or erosion, and 90.9% in cases of ileal ulcer. Among 117 positive CE cases, the most common final diagnosis by CE was Crohn's disease (CD) (n = 44, 32%). No findings were identified in 20 (14.6%) of 137 cases. Ileal erosion/ulcer, rather than findings such as nodularity and erythema or elevated erythrocyte sedimentation rate (ESR) (>10 mm/h), was significant predictive factors for positive CE findings in multivariate analysis.Conclusions: Small bowel CE showed a high diagnostic yield (85.4%) in symptomatic patients with isolated ileitis on ileocolonoscopy. Erosion or ulcer of the small bowel was a common finding on CE (66.4%), and approximately one-third of patients were diagnosed with CD. In patients with isolated ileitis on ileocolonoscopy, CE should be considered to evaluate small bowel lesions when the patient shows an elevated ESR or when the ileitis manifests as ileal ulcer or erosion rather than a nodular or erythematous lesion. [ABSTRACT FROM AUTHOR]

Background: The most concerning complication of capsule endoscopy (CE) is capsule retention (CR) in the gastrointestinal (GI) tract; however, the clinical outcomes and management of patients with CR are still uncertain.Aims: This study aimed to investigate the clinical outcomes and management of CR.Methods: The outcomes of CR in multiple centers between October 2002 and June 2018 were retrospectively reviewed. Data on CE indication, findings, and management details were analyzed.Results: A total of 2705 consecutive small-bowel CE procedures were performed. CR was detected in 20 cases (0.7%). The most common site of CR was the small bowel (19 cases), followed by the esophagus (one case). In patients who underwent CE, CR was detected in nine (0.6%) of 1397 patients with obscure GI bleeding. Further, CR occurred in 11 (6.5%) of 169 patients with Crohn's disease based on the final diagnoses after CE. Capsule retrieval was safely performed surgically in nine cases and endoscopically in six cases. The retained capsules dislodged after steroid treatment in two cases, whereas three cases of CR resolved without any intervention. In multivariate analysis, the development of abdominal symptoms after CR was a significant predictive factor for requiring endoscopic or surgical interventions for capsule extraction.Conclusions: This large multicenter study shows that CR is a rare complication with favorable clinical outcomes. Three-fourths of the patients with CR were managed with endoscopic or surgical intervention, which was required particularly in patients with abdominal symptoms after CR. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate focal therapy (hemiablation) eligibility in men undergoing prostate biopsy and multiparametric magnetic resonance imaging (mpMRI) with reference to histopathology from radical prostatectomy (RP) specimens. Methods: Subjects were selected among 810 men who underwent prostate biopsy, mpMRI, and RP from January 2016 to December 2017. Hemiablation eligibility criteria were biopsy-proven unilateral cancer, prostate-specific antigen ≤ 15 ng/ml, and Gleason score (GS) ≤ 3 + 4. Evidence of non-organ-confined disease or Prostate Imaging Reporting and Data System score ≥ 4 on the contralateral lobe on mpMRI was classified as ineligible for hemiablation. Of the 810, data for 185 who met the screening criteria were compared to final pathology findings. Significant cancer at RP was defined as any of the following: (1) GS 6 with tumor volume ≥ 0.5 ml; (2) GS ≥ 3 + 4; or (3) the presence of advanced stage (≥ pT3). Results: Among the 185 candidates for hemiablation, 62 (33.5%) had unilateral cancer on final RP histopathology. Among the 123 bilateral cancers, 50 (27%) were organ confined and had GS ≤ 3 + 4 = 7 and bilateral multifocal tumor in which the index tumor was confined to one lobe and the secondary tumor in the contralateral lobe had tumor volume < 0.5 ml and GS ≤ 6. A total of 112 (60.5%) patients in this series were considered suitable for hemiablation. Significant cancer on biopsy and mpMRI-negative lobes were found in 72 (38.9%) of 185 lobes, including 1 (0.5%) with advanced stage. Conclusions: The combination of standard prostate biopsy and mpMRI did not accurately identify lobes that could be considered as non-treated regions. [ABSTRACT FROM AUTHOR]

Background: Colonic bubbles obscure the colonic mucosa during colonoscopy following bowel preparation with polyethylene glycol plus ascorbic acid (PEG-Asc). Simethicone is used to enhance visualization during colonoscopy. We aimed to determine the optimal timing of simethicone addition to improve bowel preparation using PEG-Asc.Methods: This prospective, randomized study enrolled patients undergoing elective colonoscopy from April 2017 to January 2018. They were randomly assigned to one of the following three groups: PEG-Asc only (control) or simethicone addition in the morning on the day of colonoscopy (PEG-S1) or in the evening of the day prior to colonoscopy (PEG-S2). The primary outcome was the quality of colon cleansing, and the secondary outcomes were the adenoma detection rate (ADR), polyp detection rate (PDR), and diminutive (≤ 5 mm) ADR.Results: In total, 240 patients were randomly allocated to the three groups; six patients were withdrawn. Of the 234 patients evaluated, 78, 79, and 77 were allocated to the control, PEG-S1, and PEG-S2 groups, respectively. The bubble scores of all colonic segments were lowest in the PEG-S2 group. There was no significant difference in ADR or PDR among the three groups. However, the diminutive ADR was significantly higher in the PEG-S2 group compared to the other two groups (control 5.1% vs. PEG-S1 8.9% vs. PEG-S2 20.8%; P = 0.009).Conclusion: Addition of simethicone to PEG-Asc at the optimal time prevents the formation of air bubbles and so improves the quality of bowel preparation, especially enhancing diminutive ADR. [ABSTRACT FROM AUTHOR]

Fecal microbiota transplant (FMT) is a safe and effective treatment for recurrent or refractory Clostridioides (Clostridium) difficile infection (RCDI) in the short term. However, there are a paucity of data on long-term durability and safety of FMT. The aim of this study is to determine the long-term efficacy and safety of FMT for RCDI. Ninety-four patients underwent FMT via retention enema for RCDI between 2008 and 2012 and completed a follow-up questionnaire 4 to 8 years following the last FMT. Of these, 32 were unreachable and 37 were deceased; 23 of the remaining 25 participants completed the survey. No CDI recurrences were reported in patients treated with FMT; 12 of the 23 participants (52.2%) received at least one course of non-CDI antibiotic(s). Nine participants (40.9%) received probiotics and 4 (17.4%) received both non-CDI antibiotics and probiotics. All 23 participants rated their overall health compared with pre-FMT. Current health was considered "much better" in 17 patients (73.9%); "somewhat better" in 3 patients (13.0%); and "about the same" in 3 patients (13.0%). A total of 11 participants (47.8%) reported an increase in weight of more than 5 kg (kg) post-FMT and 9 participants (39.1%) reported no change in weight (± 5 kg). Four of the 23 participants (17.4%) reported improvement or resolution (undifferentiated colitis, n = 1; Crohn's disease, n = 2; ulcerative colitis, n = 1) of pre-existing gastrointestinal condition following FMT. Eight of 23 participants (34.8%) experienced new medical condition(s) post-FMT. The long-term efficacy (48–96 months) of FMT for RCDI appears to be durable even after non-CDI antibiotic use. Thirty percent had improvement of their pre-existing medical conditions following FMT; 73.9% reported "much better" overall health following FMT. [ABSTRACT FROM AUTHOR]

The objective of this study is to eliminate the tackiness of sticky paint particles occurring in paint booths using calcium hydroxide. It ultimately aims to identify the optimal filtration velocity to determine the optimal operation condition for particle collection in the filter. As the filtration velocity increased further in the range of 0.2–0.5 m/min, the pressure drop increased rapidly, while the cleaning efficiency, overall collection efficiency, and fractional collection efficiency tended to decrease. The filtration velocity for optimal filtration condition was identified to be 0.2 m/min. [ABSTRACT FROM AUTHOR]

Self-healing material has been intensively studied in the last decade due to its capability of improving materials' lifetime and safety. Among the numerous proposed self-healing mechanisms, reversible metal-ligand coordination bond is considered as a strong candidate for a healing moiety because of its high tunability of mechanical properties based on the thermodynamic characteristics and kinetic parameters of metal ions or ligands. Furthermore, the dipolar nature of coordination bond can enhance the dielectric property of the material. Herein, zinc-imidazole coordination bond, having a fast ligand exchange rate in ambient condition, was employed as a healing moiety to synthesize room temperature self-healable polydimethylsiloxane (PDMS). Imidazole modified PDMS cross-linked by ligand and zinc ratio 4.5 (IMZ-PDMS-1100 L/Z 4.5) exhibited ultimate tensile strength (UT) of 60.73 kPa with ultimate extensibility (UE) of 211%. These mechanical properties could be adjusted by varying L/Z ratio and IMZ content. In comparison with previously reported metal-ligand based self-healing PDMS, IMZ-PDMS-1100 L/Z 4.5 showed faster healing rate that recovered 98% of UT and UE after 31 h healing and even faster healing rate was achieved with higher IMZ content. Moreover, cross-linked IMZ-PDMS displayed high dielectric constant of 8.30±0.74 at 1 MHz, which was 2.7 times higher than conventional PDMS. [ABSTRACT FROM AUTHOR]

Background: The inappropriate selection of patients with early gastric cancer (EGC) for endoscopic submucosal dissection (ESD) may lead to additional surgery because of a non-curative resection. This study was performed to assess the accuracy of clinical decisions in ESD for EGC.Methods: A total of 607 cases of EGC treated by ESD were prospectively enrolled from January 2011 to June 2014 at a single academic hospital. The 607 EGCs were divided into three groups (overestimated, same-estimated, and underestimated) based on pre-procedure endoscopic findings (indication) and pathological diagnosis after ESD (criteria). We evaluated the discrepancy rates between pre-procedure indication and pathological criteria, and then analyzed the pre-procedure factors that could influence the occurrence of the discrepancies.Results: The absolute, expanded, and beyond the expanded indication has its accuracy on curability criteria in 87%, 77.6%, and 55.6% of cases, respectively. The ratio of overall indication-criteria discrepancies was 250/607 (41.2%). The curability was significantly lower in the underestimated group compared to the overestimated and same-estimated groups (41.6% vs. 94.6%, 94.4%, p < 0.001). In multivariate analysis examining the predictive factors for discrepancies in the 598 EGCs with absolute/expanded indications, the endoscopic size ≥ 20 mm [odds ratio (OR) 2.493, confidence interval (CI) 1.546-4.022, p < 0.001], presence of ulcers (OR 1.712, CI 1.070-2.738, p = 0.025), patient age < 60 years (OR 1.689, CI 1.044-2.733, p = 0.033), and undifferentiated type EGC on forceps biopsy (OR 5.397, CI 2.027-14.369, p = 0.001) were all associated with discrepancies.Conclusions: Indication judged by pre-procedural endoscopy is not sufficiently accurate to be used as a good measurement for post-procedural criteria. [ABSTRACT FROM AUTHOR]

The present study aims to compare the contents of minerals (essential major—K, Ca, Mg, Na, P, S; essential trace—Fe, Mn, Zn, Cu, B, Mo, As, Se, Ni, V, Cr, Co; non-essential—Sn, Ga, Li, Be, Rb, Sr, Al, Pd, Cd, Hg, Pb, Ge) in strawberry (stem, leaf, and fruit) cultivated in two different cultivation systems, soil and hydroponic. The concentrations of 30 minerals in the acid-digested strawberry samples were determined by ICP-MS and ICP-OES. Hydroponic strawberry (leaf > fruit > stem) indicated higher values for most minerals which were below the plant toxicity levels. In leaves collected from the hydroponic system, it was observed there were larger amounts of Fe, Zn, B, As, Se, Ni, V, Cr, Al, Cd, and Pd. Hydroponic fruits were the significant sources of K, P, Mn, Zn, Cr, and Co. Hydroponic strawberry leaves could contribute twice as many higher and safe daily intake of minerals to humans than other fruits. This analysis shows that, firstly, higher quality and safely edible produce can be provided by the hydroponic system; and secondly, strawberry leaf is a potential mineral source. [ABSTRACT FROM AUTHOR]

Background and Aims: Compared with ulcer bleeding (UB) in non-variceal upper gastrointestinal bleeding (NVUGIB), non-ulcer bleeding (NUB) is often considered to have a low risk of poor outcomes and is treated less intensively without any risk stratification. We conducted this study to assess the predictability of scoring systems for NUB and compare the outcomes of NUB and UB.Methods: A total of 1831 UGIB patients were registered in the database during the period from February 2011 to December 2013. Among them, 1424 patients with NVUGIB were divided into two groups: Group UB (1101 patients with peptic ulcer bleeding) and Group NUB (323 patients with non-peptic ulcer-related bleeding).Results: The most common cause of bleeding in Group NUB was Mallory-Weiss tears (51.1%), followed by Dieulafoy lesions (18.9%). A receiver operating characteristic (ROC) analysis revealed that the pre-Rockall score [area under the ROC (AUROC) = 0.798; 95% CI 0.707-0.890] and full Rockall score (AUROC = 0.794; 95% CI 0.693-0.895) were relatively good at predicting overall mortality in NUB. Glasgow-Blatchford score (AUROC = 0.783; 95% CI 0.730-0.836) was the most closely correlated with the need for clinical intervention in NUB. Those who had Glasgow-Blatchford score of 0 did not require any interventions, including blood transfusions. There were no statistical differences in overall mortality (p = 0.387), bleeding-related mortality (p = 0.447), or the incidence of re-bleeding (p = 0.117) between the two groups.Conclusions: Scoring systems are useful to predict mortality and the need for clinical intervention in patients with NUB. [ABSTRACT FROM AUTHOR]

Background: Although the mortality rates for non-variceal upper gastrointestinal bleeding (NVUGIB) have recently decreased, it remains a significant medical problem.Aim: The main aim of this prospective multicenter database study was to construct a clinically useful predictive scoring system by using our predictors and compare its prognostic accuracy with that of the Rockall scoring system.Methods: Data were collected from consecutive patients with NVUGIB. Logistic regression analysis was performed to identify the independent predictors of 30-day mortality. Each independent predictor was assigned an integral point proportional to the odds ratio (OR) and we used the area under the curve to compare the discrimination ability between the new predictive model and the Rockall score.Results: The independent predictors of mortality included age >65 years [OR 2.627; 95 % confidence interval (CI) 1.298-5.318], hemodynamic instability (OR 2.217; 95 % CI 1.069-4.597), serum blood urea nitrogen level >40 mg/dL (OR 1.895; 95 % CI 1.029-3.490), active bleeding at endoscopy (OR 2.434; 95 % CI 1.283-4.616), transfusions (OR 3.811; 95 % CI 1.640-8.857), comorbidities (OR 3.481; 95 % CI 1.405-8.624), and rebleeding (OR 10.581; 95 % CI 5.590-20.030). The new predictive model showed a high discrimination capability and was significantly superior to the Rockall score in predicting the risk of death (OR 0.837;95 % CI 0.818-0.855 vs. 0.761; 0.739-0.782; P = 0.0123).Conclusions: The new predictive score was significantly more accurate than the Rockall score in predicting death in NVUGIB patients. We need to prospectively validate the accuracy of this score for predicting mortality in NVUGIB patients. [ABSTRACT FROM AUTHOR]

Background and Aims: Because the invasive procedure of colorectal endoscopic submucosal dissection (ESD) entails a extensive mucosal defect and submucosal exposure, the procedure may have a substantial risk of complications including delayed bleeding, perforation and bacteremia and/or endotoxemia. The aim of our study was to investigate whether Surgicel(®) would be effective in reducing complications after colorectal ESD.Patients and Methods: Between 2012 and 2013, 52 consecutive patients who underwent a colorectal ESD were enrolled. After the removal of colorectal epithelial neoplasm, surgicel was sprayed onto the submucosal surface using the wet type of application (Surgicel(®) group). We evaluated tumor type, location, size, histology, procedure time, hospital stay and associated complication. For assessing inflammatory reaction, white blood cells and body temperature were monitored. In assessing the effectiveness of Surgicel(®) application, we retrospectively compared the clinical outcomes with 52 other consecutive large colorectal tumor patients who had previously received conventional ESD, as control group (non-Surgicel(®) group).Results: Of the 52 patients, three patients were excluded. Forty-nine patients were ultimately enrolled in this study. During the follow-up period, rebleeding occurred in 0 (0% in Surgicel(®) group) patients and 4 (7.7% in non-Surgicel(®) group) patients; fever (>37.7) in 2 (4.1%) and 10 (19.2%) patients, respectively (p = 0.019); and leukocytosis in 9 (18.4%) and 16 (30.8%) patients, respectively (p = 0.172). C-reactive protein level was 0.35 ± 0.18 and 9.83 ± 2.44 (p < 0.001). The mean hospitalization period was 4.22 ± 0.94 and 5.13 ± 0.27 days, respectively (p < 0.001). The group (surgicel vs. non-surgicel, p = 0.005, odds ratio 11.114 (2.104-58.718)) was identified as independent predictor for complication such as fever or delayed bleeding by multivariated analysis.Conclusions: Surgicel(®) application after colorectal ESD may be an effective method to reduce some complications and mean hospitalization period. Therefore, surgicel application may be considered to be a valuable clinical method. [ABSTRACT FROM AUTHOR]

We evaluated the optimal conditions for fluidization of nickel oxide (NiO) and its reduction into high-purity Ni during hydrogen reduction in a laboratory-scale fluidized bed reactor. A comparative study was performed through structural shape analysis using scanning electron microscopy (SEM); variance in pressure drop, minimum fluidization velocity, terminal velocity, reduction rate, and mass loss were assessed at temperatures ranging from 400 to 600 °C and at 20, 40, and 60 min in reaction time. We estimated the sample weight with most active fluidization to be 200 g based on the bed diameter of the fluidized bed reactor and height of the stocked material. The optimal conditions for NiO hydrogen reduction were found to be height of sample H to the internal fluidized bed reactor diameter D was H/D=1, reaction temperature of 550 °C, reaction time of 60 min, superficial gas velocity of 0.011 m/s, and pressure drop of 77 Pa during fluidization. We determined the best operating conditions for the NiO hydrogen reduction process based on these findings. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive decline and neurodegeneration in the hippocampus. Despite the pathological importance of the hippocampal degeneration in AD, little topographical evidence exists of impaired hippocampal connectivity in patients with AD. To investigate the anatomical connections of the hippocampus, we injected the neurotracer 1,1′-dioctadecyl-3,3,3′3,3′-tetramethyl-indocarbocyanine perchlorate (DiI) into the hippocampi of 5XFAD mice, which were used as an animal model of AD. In wild-type controls, DiI-containing cells were found in the entorhinal cortex, medial septum, locus coeruleus, dorsal raphe, substantia nigra pars compacta, and olfactory bulb. Hippocampal inputs were decreased in multiple brain regions in the 5XFAD mice compared to wild-type littermate mice. These results are the first to reveal alterations at the cellular level in hippocampal connectivity in the brains of 5XFAD mice. These results suggest that anatomical mapping of hippocampal connectivity will elucidate new pathogenic mechanisms and therapeutic targets for AD treatment. [ABSTRACT FROM AUTHOR]

Objective: To compare oncological and functional mid-term outcomes following robotic partial nephrectomy (RPN) and radiofrequency ablation (RFA) for treating T1a renal cell carcinoma (RCC) using propensity score-matching.Methods: Between December 2008-April 2016, 63 patients from each treatment group were propensity score-matched for age, sex, American Society of Anesthesiologists score, tumour size, tumour laterality, tumour histology, R.E.N.A.L. nephrometry score and preoperative estimated glomerular filtration rate (eGFR). Post-treatment follow-up periods for RPN and RFA ranged from 1-90 months (median, 24.6) and 1-65 months (21), respectively. Tumour location, percentage of eGFR preservation and 2-year recurrence-free survival rate were compared between groups.Results: Exophytic and endophytic RCC occurred in 73.0 % (46/63) and 27.0 % (17/63) of the RPN group, and 52.4 % (33/63) and 47.6 % (30/63) of the RFA group, respectively (p=0.017). There was 91.7 % preservation of eGFR in the RPN group and 86.8 % in the RFA group (p=0.088). Two-year recurrence-free survival rate was 100 % in the RPN and 95.2 % in the RFA group (p=0.029).Conclusions: RPN provides a higher recurrence-free survival rate than RFA. However, RFA is a better treatment option for an endophytic or recurrent RCC that is difficult to treat with RPN.Key Points: • RPN provides a higher recurrence-free survival rate than RFA. • Unlike RPN, repeat RFA is easy to perform for recurrent RCC. • Endophytic RCC could be better treated with RFA. [ABSTRACT FROM AUTHOR]

Background: This study investigated the clinical relevance and prognostic impact of the overall expression of programmed cell death protein ligand-1 (PD-L1) and programmed cell death protein ligand-2 (PD-L2), in patients with Epstein-Barr virus-associated gastric cancer (EBVaGC).Methods: After reviewing 1318 consecutive cases of surgically resected or endoscopic submucosal dissected gastric cancers, the expression status of PD-L1 and PD-L2 in 120 patients with EBVaGC identified by EBV-encoded RNA in situ hybridisation was retrospectively analysed using immunohistochemistry (IHC). For each IHC marker, positivity was separately in intraepithelial tumour cells (iTu-) and immune cells in the tumour stroma area (str-).Results: Among 116 eligible patients, 57 (49.1%) and 66 patients (56.9%) were determined as iTu-PD-L1-positive and str-PD-L1-positive, respectively, whereas 23 (21.6%) and 45 patients (38.8%) were determined as iTu-PD-L2 positive and str-PD-L2 positive, respectively. Intraepithelial tumour cell PD-L1 positivity was found to be significantly associated with lymph node (LN) metastasis (P=0.012) and a poor disease-free survival (DFS) (P=0.032), yet not overall survival (P=0.482). In a multivariate analysis, iTu-PD-L1 positivity was independently associated with a poor DFS (P=0.006, hazard ratio=12.085). In contrast, str-PD-L2-positivity was related to a lower T category (P=0.003), absence of LN metastasis (P=0.032) and perineural invasion (P=0.028). Intraepithelial tumour cell and str-PD-L2 positivity showed a trend towards an improved DFS, although not significant (P=0.060 and P=0.073, respectively).Conclusions: Intraepithelial tumour cells PD-L1 expression can be used to predict a poor outcome in patients with EBVaGC and can represent a rational approach for PD-1/PD-L pathway-targeted immunotherapy. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine the prognostic role of Prognostic Nutritional Index (PNI) dynamics in the pre- and postoperative periods for patients with renal cell carcinoma (RCC) who undergo radical nephrectomy (RN). Methods: The study analyzed 324 patients with RCC who underwent RN. The overall population was classified into four groups according to four types of pre- to postoperative PNI dynamics as follows: group 1 (low → low PNI), group 2 (low → high PNI), group 3 (high → low PNI), and group 4 (high → high PNI). The level of PNI was calculated using the following formula: 10 × serum albumin level (g/dL) + 0.005 × absolute lymphocyte counts in blood (/mm). The primary end point was cancer-specific survival (CSS), and the secondary end point was overall survival (OS). Results: The patients with higher pre- and postoperative PNI (>45) had better survival outcomes than those with lower pre- and postoperative PNI (≤45). Notably, the patients in group 4 showed the best CSS and OS rates, whereas the patients in group 1 had the worst survival outcomes. Furthermore, PNI dynamics were identified as an independent predictor of CSS and OS outcomes, in addition to pre- and postoperative PNI, tumor size, and pathologic T (pT) stage. The patients with localized RCC (≤pT2) showed significant differences in both CSS and OS estimates, whereas the patients with advanced pT stage (≥pT3) demonstrated a difference only in OS outcomes, according to PNI dynamics. Conclusions: This study is the first to provide the independent prognostic importance of dynamics of nutritional status for patients with RCC. [ABSTRACT FROM AUTHOR]