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Our aim was to determine if the AUA-recommended prophylaxis (vancomycin + gentamicin alone) for primary inflatable penile prosthesis surgery is associated with a higher infection risk than nonstandard regimens.We performed a multicenter, retrospective study of patients undergoing primary inflatable penile prosthesis surgery. Patients were divided into those receiving vancomycin + gentamicin alone and those receiving any other regimen. A Cox proportional-hazards model was constructed adjusted for major predictors. A subgroup analysis to identify the appropriate dosage of gentamicin was also performed.A total of 4,161 patients underwent primary inflatable penile prosthesis placement (2,411 received vancomycin + gentamicin alone and 1,750 received other regimens). The infection rate was similar between groups, 1% vs 1.2% for standard vs nonstandard prophylaxis. In the multivariable analysis, vancomycin + gentamicin (HR: 2.7, 95% CI: 1.4 to 5.4,Vancomycin + gentamicin alone for antibiotic prophylaxis for primary inflatable penile prosthesis surgery is associated with a higher infection risk than nonstandard antibiotic regimens while antifungal use is associated with lower infection risk. A critical review of the recommended antimicrobial prophylactic regimens is needed. Prospective research is needed to further elucidate best practices in inflatable penile prosthesis antimicrobial prophylaxis.

The chemically synthesizable quantum emitters such as quantum dots (QDs), fluorescent nanodiamonds (FNDs), and organic fluorescent dyes can be integrated with an easy-to-craft quantum nanophotonic device, which would be readily developed by non-lithographic solution process. As a representative example, the solution dipping or casting of such soft quantum emitters on a flat metal layer and subsequent drop-casting of plasmonic nanoparticles can afford the quantum emitter-coupled plasmonic nanocavity (referred to as a nanoparticle-on-mirror (NPoM) cavity), allowing us for exploiting various quantum mechanical behaviors of light–matter interactions such as quantum electrodynamics (QED), strong coupling (e.g., Rabi splitting), and quantum mirage. This versatile, yet effective soft quantum nanophotonics would be further benefitted from a deterministic control over the positions and orientations of each individual quantum emitter, particularly at the molecule level of resolution. In this review, we will argue that DNA nanotechnology can provide a gold vista toward this end. A collective set of exotic characteristics of DNA molecules, including Watson-Crick complementarity and helical morphology, enables reliable grabbing of quantum emitters at the on-demand position and steering of their directors at the single molecular level. More critically, the recent advances in large-scale integration of DNA origami have pushed the reliance on the distinctly well-formed single device to the regime of the ultra-scale device arrays, which is critical for promoting the practically immediate applications of such soft quantum nanophotonics.

Background Modern-day penile prostheses use infection retardant coating to decrease rates of postoperative infection, subsequently reducing explantation and revision rates as well. The Coloplast Titan models are dipped into antimicrobial solutions right before implantation, and the components used for dipping can be tailored toward the patient. Aim To compare infection, explantation, and revision rates among different dipping solutions used before implantation for patients with diabetes receiving a Coloplast Titan implant. Methods We systematically reviewed 932 patients with diabetes receiving a primary penile implant across 18 different centers from the period April 2003 to August 2018. Of those patients, 473 received a Coloplast device, whereas 459 received an AMS device. Data regarding the type of antimicrobial solution used before implantation were recorded for 468 patients receiving a Coloplast Titan, including whether or not they suffered a postoperative infection and if they underwent explantation and/or revision. Outcome rates were compared using Fisher’s exact and Pearson’s chi-square tests, and logistic regression modeling was performed to account for covariates. Outcomes The main outcome measures of this study were postoperative infection, explantation, and revision rates. Results Of the total 932 patients reviewed, 33 suffered a postoperative infection. Of 468 patients receiving Coloplast implants, there was a 3.4% infection rate. The most commonly used antibiotic combination before dipping was vancomycin + gentamicin (59.0%). There was a significantly lower rate of postoperative infection, explantation, and revision when vancomycin + gentamicin was used than those associated with the use of all other dipping solutions ([1.4% vs 6.4%; P = .004], [1.1% vs 8.3%; P < .001], and [2.5% vs 12.5; P < .001], respectively). After adjusting for age, body mass index, preoperative blood glucose level, and hemoglobin A1c, the use of other dips was an independent predictor of postoperative infection (odds ratio: 0.191; P = .049). The inclusion of rifampin in the dipping solution trended toward being a significant risk factor for infection (P = .057). Including antifungals in the dipping solution did not affect infection (P = .414), explantation (P = .421), or revision (P = .328) rates. Clinical Implications Vancomycin + gentamicin was the most efficacious combination of antibiotics used for dipping in terms of preventing postoperative infection and subsequent explantation and revision. Strengths and Limitations Data were sampled across multiple institutions providing a large sample that may be more representative of the population of interest. A key limitation of the study was its retrospective nature, which prevented us from controlling certain variables. Conclusion The use of rifampin did not provide the same type of protection, possibly representing a shift in resistance patterns of common bacteria responsible for device infection.

Post-translational modifications of chromatin structure by histone acetyltransferase (HATs) play a pivotal role in the regulation of gene expression and diverse biological processes. However, the function of GNAT family HATs, especially Elp3, in the opportunistic human pathogenic fungus Aspergillus fumigatus is largely unknown. To investigate the roles of the GNAT family HATs Elp3 and GcnE in the A. fumigatus, we have generated and characterized individual null Δelp3 and ΔgcnE mutants. The radial growth of fungal colonies was significantly decreased by the loss of elp3 or gcnE, and the number of asexual spores (conidia) in the ΔgcnE mutant was significantly reduced. Moreover, the mRNA levels of the key asexual development regulators were also significantly low in the ΔgcnE mutant compared to wild type (WT). Whereas both the Δelp3 and ΔgcnE mutants were markedly impaired in the formation of adherent biofilms, the ΔgcnE mutant showed a complete loss of surface structure and of intercellular matrix. The ΔgcnE mutant responded differently to oxidative stressors and showed significant susceptibility to triazole antifungal agents. Furthermore, Elp3 and GcnE function oppositely in the production of secondary metabolites, and the ΔgcnE mutant showed attenuated virulence. In conclusion, Elp3 and GcnE are associated with diverse biological processes and can be potential targets for controlling the pathogenic fungus.

Long-term clinical outcome data according to severity of coronary artery spasm (CAS) as assessed by an intracoronary acetylcholine provocation test are limited in series of Asian patients.To investigate 5-year clinical outcomes in patients with CAS according to CAS severity.In total, 5873 consecutive patients with insignificant coronary artery disease (70% fixed stenosis) who underwent an acetylcholine provocation test were enrolled and divided into four groups according to CAS severity during the acetylcholine provocation test: negative, borderline positive, moderately positive and severely positive. CAS severity was assessed by quantitative coronary angiography. We investigated 5-year clinical outcomes according to CAS severity.Over a follow-up period of up to 5 years, before adjustment, the severely-positive CAS group showed a significantly higher incidence of major adverse cardiac events (MACE; composite of death, myocardial infarction and de novo revascularization) (hazard ratio [HR]: 1.834, 95% confidence interval [CI]: 1.047-3.211; P=0.033), total death (HR: 3.124, 95% CI: 1.047-9.322; P=0.041), myocardial infarction (HR: 3.190, 95% CI: 1.069-9.519; P=0.037) and recurrent angina (HR: 1.762, 95% CI: 1.363-2.278; P0.001) compared with the negative group. However, after adjustment for baseline confounders, only the incidence of recurrent angina (HR: 1.323, 95% CI: 1.014-1.726; P=0.039) was significantly higher in the severely-positive CAS group compared with the negative group.The severity of CAS in the positive group was not associated with an increased incidence of MACE after adjustment for covariates compared with the negative group, but the severely-positive CAS group was associated with a higher incidence of recurrent angina compared with the negative group.

R&D management agencies have been taking on key roles in the national R&D ecosystem. The purpose of this study is to suggest ways to improve the role of R&D management agencies for R&D planning and evaluation. It analyzed the regulatory system and relative efficiency of the current use of planning and evaluation cost. Data-collection sources included documents, surveys, and interviews with staff members in agencies responsible for national R&D management. By using DEA models, relative efficiency was measured. Based on the analysis results, we present suggestions for improvement in three areas: (a) establishment of institutional basis; (b) improvement of budget process; (c) improvement measures depending on the causes of inefficiency. Finally, future directions and the limits of this study are discussed.

Coronary artery spasm (CAS) and significant coronary stenosis are known to be major causes of myocardial ischemia. However, their association and the impact of insignificant coronary stenosis (ICS) on long-term clinical outcomes of CAS patients are largely unknown.A total of 2797 patients without significant coronary artery disease (CAD) who underwent the acetylcholine (ACH) provocation test between November 2004 and October 2010 were enrolled. Significant CAS was defined as having ≥70% of temporary narrowing by ACH test and ICS as having70% of fixed stenosis on angiography. Patients were divided into two groups: ICS group (n=764) and non-ICS group (n=845). To adjust potential confounders, a propensity score matching (PSM) analysis was performed using the logistic regression model. Primary endpoint was the composite of total death, myocardial infraction (MI), de novo percutaneous coronary intervention (PCI), and cerebrovascular accidents (CVA). Secondary endpoint was the incidence of recurrent angina requiring repeat coronary angiography (CAG) at 3years.After PSM analysis, two well-balanced groups (548 pairs, total=1096) were generated. The baseline clinical characteristics were similar between the two groups. During the ACH test, compared with the non-ICS group, the ICS group had smaller spastic narrowing diameter (0.69±0.35 vs. 0.73±0.37, P=0.039) and incidence of ST-segment depression (4.0% vs. 0.9%, P=0.001). The incidence of primary and secondary endpoints was similar between the two groups up to 3years.Although, the ICS group was expected to have more adverse long-term clinical outcomes, it was not associated with the increased incidence of major adverse clinical outcomes compared with the non-ICS group up to 3years. Longer term follow-up studies are needed.

Although stress-induced cardiomyopathy (SCMP) is a reversible disease and the prognosis is usually excellent, several complications can occur and can result in fatal adverse events. The formation of left ventricular (LV) thrombus is one of these critical complications of SCMP. This report describes a case of SCMP complicated by formation of a LV thrombus that became increasingly mobile as LV contractility recovered, and for which surgical removal was performed. Here, we report a case of SCMP complicated by LV thrombus and review the literature regarding this topic.

While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

Highlights: • Ti doped ZnO films were prepared on Corning XG glass substrate by ALD. • The electrical properties and optical properties were systematically investigated. • An optimized Ti doped ZnO films had low resistivity and excellent optical transmittance. - Abstract: Titanium doped zinc oxide (Ti doped ZnO) films were prepared by atomic layer deposition methods at a deposition temperature of 200 °C. The Ti content in Ti doped ZnO films was varied from 5.08 at.% to 15.02 at.%. X-ray diffraction results indicated that the crystallinity of the Ti doped ZnO films had degraded with increasing Ti content. Transmission electron microscopy was used to investigate the microstructural evolution of the Ti doped ZnO films, showing that both the grain size and crystallinity reduced with increasing Ti content. The electrical resistivity of the Ti doped ZnO films showed a minimum value of 1.6 × 10{sup −3} Ω cm with the Ti content of 6.20 at.%. Furthermore, the Ti doped ZnO films exhibited excellent transmittance.

The purpose of this study is to verify the existence of congestion in Korean hospitals, to identify the causes of congestion, and to suggest directions for efficiency improvement of hospitals. The result showed that congestion occurred in 71.90% of 1185 hospitals. In addition, it was found that hospital specialization has a negative effect on congestion. In other words, the higher the hospital specialization, the lower the overall congestion rate of the hospital. More specifically, the specialization of hospitals also showed a negative effect on congestion of nurses. On the other hand, hospital specialization was found to have a positive effect on the congestion of the number of doctors, but it does not have a significant effect on the congestion of hospital beds. It was also found that hospital size has an effect on the relationship between hospital specialization and congestion, but the location of the hospital and the type of ownership did not act as a moderator.

Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB) are known to have similar effects on cardiovascular outcomes including total mortality in head-to-head trials, and ACE inhibitors, in particular, are recommended for diabetic patients. However, data is limited

Diabetes Mellitus (DM) can lead to cardiovascular morbidity and mortality. There are limited study of prognostic impact of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) patients with DM as compared with optimal medical therapy (OMT) alone. This is a retrospective single

Left ventricular ejection fraction (LVEF) is a powerful predictor of prognosis in patients with coronary artery disease. The benefit of successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) patients with reduced EF has been investigated, however, there are very

Background: Unprotected left main coronary artery (ULMCA) in the setting of acute myocardial infarction (AMI) is rare but devastating with high mortality rate. However there were limited data regarding incidence and prognosis of AMI with ULMCA disease treated with percutaneous coronary intervention

Background: Angiotensin-Converting Enzyme (ACE) Inhibitors and Angiotensin Receptor Blockers (ARB) are known to have similar effects on cardiovascular outcomes including total mortality in head-to-head trials, and ACE inhibitors, in particular, are recommended for diabetic patients. However, data is

Hypertension (HTN) and its organ damage such as left ventricular hypertrophy (LVH) can lead to worsening heart failure, cardiovascular morbidity and mortality. However, there are limited data regarding the impact of LVH in HTN patients (pts) who underwent successful percutaneous coronary

There are limited data regarding long-term clinical outcomes of patients (Pts) with coronary chronic total occlusion (CTO) lesions according to gender. A total of 822 consecutive CTO pts who underwent diagnostic coronary angiography, receiving either percutaneous coronary intervention (PCI) or

Coronary artery spasm (CAS) is a well-known endothelial dysfunction, which can induce acute coronary syndrome (ACS) or vasospastic angina (VSA). Impaired glycemic control is risk factor for cardiovascular disease. In this study, we evaluated the impact of insulin resistance on CAS in patients

Coronary artery spasm (CAS) refers to an abnormal condition where the epicardial coronary artery contracts. The relationship between alcohol consumption and CAS is even more ambiguous. Therefore, we evaluated drinking patterns such as current drinking status, weekly drinking amount, and drinking

Left ventricular ejection fraction (LVEF) is a powerful predictor of prognosis in patients with coronary artery disease. The benefit of successful percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) patients with reduced EF has been investigated, however, there are very

Myocardial infarction (MI) can lead to worsening cardiovascular morbidity and mortality. However, there are limited data regarding the impact of MI on long-term clinical outcomes of coronary chronic total occlusion (CTO). A total of 640 consecutive CTO pts who underwent diagnostic coronary

Ambient air pollution is well-known to be a serious risk factor for cardiovascular diseases, stroke, and death. However, the association between air pollutants (AP) exposure and coronary artery spasm (CAS) by acetylcholine (Ach) provocation test is not well elucidated yet. A total of 5,822

Drug-eluting stent (DES) has reduced repeat revascularization, especially target lesion revascularization (TLR). However, there were limited data regarding non-TLR after DES implantation. The aim of this study was to evaluate whether here are differences in the incidence and predictors between TLR

Nowadays, population is fast growing into older age group, and the number of older patients (pts) with complex coronary artery disease (CAD) including unprotected left main (LM) disease undergoing revascularization is increasing. The aimof this study is to investigate the impact of age on the

Whether adverse effect of statins on glycemic indices is common to all statins remains controversial and as yet data for pitavastatin are limited. We sought to assess the impact of pitavastatin on new-onset diabetes (NODM) in non-diabetic acute myocardial infarction (AMI) patients. Among a total 12

Although previous studies demonstrated the prognostic value of left ventricular ejection fraction (LVEF) after acute myocardial infarction (AMI), a study assessing long-term clinical outcomes after AMI according to LVEF status is limited and has not been evaluated in larger study populations. We

Percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease is nowadays considered feasible by a number of randomized clinical trials and previous studies advocated one stent technique in PCI for bifurcated ULMCA disease. However there are limited data

L-transposition of the great arteries (L-TGA) is a rare congenital anomaly and could cause complete atrioventricular (AV) block at relatively younger age. We present a case of 43-year-old male who complained of dizziness due to complete AV block. We confirmed L-TGA using transthoracic echocardiography and cardiac computed tomography. Permanent pacemaker was inserted without complications. No invasive treatment including corrective surgery was performed because patient's cardiac function was almost normal and the symptom was completely resolved after pacemaker insertion.