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The paper focuses on fabricating a white cement brick fuel cell (WC–BFC) using agricultural waste rice husk ash (RHA) for sustainable power generation. The samples from each material with three different compositions 0, 2, and 12% of RHA were analysed. First with (RHA + sand) and (RHA + sand + cement) for commercial brick technology. This study aims to replace the present ordinary old concrete brick with WC-BFC technology in the market. Steel is an essential material used in concrete for longs decades due to its strength and stability. Therefore, the brick cost depends on the type of electrode used for brick fabrication. However, Ammonium chloride 0.3 g/ml was used as fuel with regular intervals of time for WC-BFC. Where steel/graphite electrodes generate a higher power density of 2008.93 mW/m2 with 12% RHA concentration and later for long life electrodes, Graphite/Graphite is also optimised to see the effect on the power. These bricks themselves generate massive free power from their own. The proposed technology is eco-friendly, inexpensive, sustainable, and compatible with generating renewable energy for vast brick commercial applications. On one side work as a regular concrete brick, and another side free power supply. This technology itself is clean, safe, and sustainable.

Owing to their distinct physicochemical traits nanostructured semiconductors continue to find immense potential in energy and environment friendly applications. From this point, SmErxFe1-xO3 systems were chemically synthesized and studied in detail for their photoresponse performance and photocatalytic behavior. The material characteristics were initially studied using several analytical tools that include X-ray diffraction (XRD), Raman and microscopic (SEM/TEM) instruments. Substitution of erbium (Er) ions at Fe sites was conceived using X-ray photoelectron spectroscopic (XPS) analysis. Optical band gap and their associated defect states in perovskites (upon Er replacement) was additionally evaluated using UV and PL data. Photocatalytic efficiency of SmErxFe1-xO3 was at first adjudged through comparative studies with SmFeO3 by involving effective treatment of organic dyes under visible light. Secondly, improved electrical conductivity in SmErxFe1-xO3 was capitalized on to fabricate p-n devices that demonstrated remarkable photoelectrical performance. Forward current and response ratio improved significantly in such devices. The bias conditions were also noted to proportionately improve the photo switching potential. Time-dependent photoresponse results affirmed the stability in processed devices. The improved application performance in SmErxFe1-xO3 nanostructures has been reasoned to effective substitution of Er ions, which tend to influence the O-Fe-O interactions and result with the observed electrical characteristics to facilitate the much needed improved charge transfer process.

Study Design: A nationwide population-based study.Purpose: Osteoporotic vertebral compression fracture (OVCF) is a major public health issue. This study examined the incidence and management trends of OVCF in South Korea. Overview of Literature: The incidence rates, management trends, and patterns of OVCF differ in different parts of the world. The age-standardized OVCF incidence rate in 2015 was higher in the United States and Asia than in Europe.Methods: A nationwide database (2012–2016) acquired from the Korean Health Insurance Review and Assessment Service was analyzed. International disease categories in the 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes, medical procedure codes, and examination codes were used to identify and sort OVCF patients aged >50 years.Results: There were 644,500 OVCF cases from 2012 to 2016. OVCF was most common in patients in their seventies (45%) and the number of patients increased from 117,361 in 2012 to 139,889 in 2016 (p p p

Histologic findings on 1-year biopsies such as inflammation with fibrosis and transplant glomerulopathy predict renal allograft loss by 5 years. However, almost half of the patients with graft loss have a 1-year biopsy that is either normal or has only interstitial fibrosis. The goal of this study was to determine if there was a gene expression profile in these relatively normal 1-year biopsies that predicted subsequent decline in renal function. Using transcriptome microarrays we measured intragraft mRNA levels in a retrospective Discovery cohort (170 patients with a normal/minimal fibrosis 1-year biopsy, 54 with progressive decline in function/graft loss and 116 with stable function) and developed a nested 10-fold cross-validated gene classifier that predicted progressive decline in renal function (positive predictive value = 38 ± 34%%; negative predictive value = 73 ± 30%, c-statistic = 0.59). In a prospective, multicenter Validation cohort (270 patients with Normal/Interstitial Fibrosis [IF]), the classifier had a 20% positive predictive value, 85% negative predictive value and 0.58 c-statistic. Importantly, the majority of patients with graft loss in the prospective study had 1-year biopsies scored as Normal or IF. We conclude predicting graft loss in many renal allograft recipients (i.e. those with a relatively normal 1-year biopsy and eGFR >40) remains difficult. This article is protected by copyright. All rights reserved.

This paper presents a numerical model for the analysis of reinforced concrete (RC) joints that explicitly accounts for the bond-slip between the reinforcing bars and the surrounding concrete. A frame element whose displacement fields for the concrete and the reinforcing bars are different from each other to permit slip is introduced. From the fiber section concept, compatibility equations for the concrete, reinforcing bar, and bond are incorporated in the formulation of the element stiffness matrix. For analyses of general loading cases, cyclic stress-strain relations of concrete and reinforcing bar are defined in the material model. For the constitutive model of bond, local bond stress-slip relations for monotonic loads are updated according to the accumulated bond damage at each slip reversal. The numerical applications to the reinforcing bar embedded in the concrete block, RC column anchored in the foundation, and RC beam-column sub-assemblage validate the analysis model and show the effect of bond-slip for the assessment of energy dissipation during loading histories.

We thank the KEKB group for the excellent operation of the accelerator, the KEK cryogenics group for the efficient operation of the solenoid, the KEK computer group and the Pacific Northwest National Laboratory (PNNL) Environmental Molecular Sciences Laboratory (EMSL) computing group for strong computing support, and the National Institute of Informatics and Science Information NETwork 5 (SINET5) for valuable network support. We acknowledge support from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan, the Japan Society for the Promotion of Science (JSPS), and the Tau-Lepton Physics Research Center of Nagoya University; the Australian Research Council including Grants No. DP180102629, No. DP170102389, No. DP170102204, No. DP150103061, and No. FT130100303; the Austrian Science Fund (FWF); the National Natural Science Foundation of China under Contracts No. 11435013, No. 11475187, No. 11521505, No. 11575017, No. 11675166, and No. 11705209; the Key Research Program of Frontier Sciences, Chinese Academy of Sciences (CAS), Grant No. QYZDJ-SSW-SLH011; the CAS Center for Excellence in Particle Physics (CCEPP); the Shanghai Pujiang Program under Grant No. 18PJ1401000; the Ministry of Education, Youth and Sports of the Czech Republic under Contract No. LTT17020; the Carl Zeiss Foundation, the Deutsche Forschungsgemeinschaft, the Excellence Cluster Universe, and the VolkswagenStiftung; the Department of Science and Technology of India; the Istituto Nazionale di Fisica Nucleare of Italy; the National Research Foundation (NRF) of Korea under Grants No. 2015H1A2A1033649, No. 2016R1D1A1B01010135, No. 2016K1A3A7A09005 603, No. 2016R1D1A1B02012900, No. 2018R1A2B3003 643, No. 2018R1A6A1A06024970, and No. 2018R1D1 A1B07047294; the Radiation Science Research Institute, Foreign Large-size Research Facility Application Supporting project, the Global Science Experimental Data Hub Center of theKorea Institute of Science and Technology Information and KREONET/GLORIAD; the Polish Ministry of Science and Higher Education and the National Science Center; the Grant of the Russian Federation Government, Agreement No. 14.W03.31.0026; the Slovenian Research Agency; Ikerbasque, Basque Foundation for Science, Spain; the Swiss National Science Foundation; the Ministry of Education and the Ministry of Science and Technology of Taiwan; and the United States Department of Energy and the National Science Foundation.

The annual modulation signal observed by the DAMA experiment is a long-standing question in the community of dark matter direct detection. This necessitates an independent verification of its existence using the same detection technique. The COSINE-100 experiment has been operating with 106~kg of low-background NaI(Tl) detectors providing interesting checks on the DAMA signal. However, due to higher backgrounds in the NaI(Tl) crystals used in COSINE-100 relative to those used for DAMA, it was difficult to reach final conclusions. Since the start of COSINE-100 data taking in 2016, we also have initiated a program to develop ultra-pure NaI(Tl) crystals for COSINE-200, the next phase of the experiment. The program includes efforts of raw powder purification, ultra-pure NaI(Tl) crystal growth, and detector assembly techniques. After extensive research and development of NaI(Tl) crystal growth, we have successfully grown a few small-size (0.61$-$0.78 kg) thallium-doped crystals with high radio-purity. A high light yield has been achieved by improvements of our detector assembly technique. Here we report the ultra-pure NaI(Tl) detector developments at the Institute for Basic Science, Korea. The technique developed here will be applied to the production of NaI(Tl) detectors for the COSINE-200 experiment., Comment: 12 pages, 12 figures

The powerful “graft versus leukemia” effect thought partly responsible for the therapeutic effect of allogeneic hematopoietic cell transplantation in acute myeloid leukemia (AML) provides rationale for investigation of immune-based therapies in this high-risk blood cancer. There is considerable pre-clinical evidence for potential synergy between PD-1 immune checkpoint blockade and the hypomethylating agents already commonly used for this disease. We report here the results of 17-H-0026 (PD-AML, NCT02996474), an investigator sponsored, single-institution, single-arm open-label ten-subject pilot study to test the feasibility of the first-in-human combination of pembrolizumab and decitabine in adult patients with refractory or relapsed AML (R-AML). In this cohort of previously treated patients, this novel combination of anti-PD-1 and hypomethylating therapy was feasible and associated with a best response of stable disease or better in 6 of 10 patients. Considerable immunological changes were identified using TCRβ sequencing as well as single-cell immunophenotypic and RNA expression analyses on sorted CD3+ T cells in patients who developed immune-related adverse events (irAEs) during treatment. Clonal T cell expansions occurred at irAE onset; single-cell sequencing demonstrated that these expanded clones were predominately CD8+ effector memory T cells with high cell surface PD-1 expression and transcriptional profiles indicative of activation and cytotoxicity. In contrast, no such distinctive immune changes were detectable in those experiencing a measurable anti-leukemic response during treatment. Addition of pembrolizumab to ten-day decitabine therapy was clinically feasible in patients with R-AML, with immunological changes from PD-1 blockade observed in patients experiencing irAEs.One Sentence SummaryAML patients receiving a novel combination of a PD-1 immune checkpoint inhibitor with a hypomethylating agent demonstrated clear evidence of induced immunological responses in those developing autoimmune toxicity during treatment but not in those demonstrating an anti-leukemic response.

Context: YKL-40 is an inflammatory biomarker for endothelial dysfunction that may have a role in Kawasaki disease (KD).Objectives: We investigated the association of serum YKL-40 levels with KD and established laboratory parameters for YKL-40 levels and other inflammatory markers.Methods: YKL-40 levels and other inflammatory markers of 23 KD patients, 9 disease control patients and 11 age-matched healthy controls.Results: YKL-40 concentration in the serum of KD patients significantly increased during the acute disease phase compared with those of disease controls and healthy controls.Conclusions: Increased YKL-40 levels may provide a useful inflammatory marker for patients with KD.

In this paper, we report electrosynthesized cadmium sulfide (CdS) thin films for the electron beam irradiation and solar cell application. Deposited and irradiated CdS thin films are characterized for their structural, surface, morphological, and electrical properties by XRD, FE-SEM, and photoelectrochemical cell measurement. We have confirmed that the optical and photoelectrochemical properties can be improved by irradiation treatment. This work is useful for surface tailoring and providing a novel approach to improve photoelectrochemical properties of nanostructured CdS thin films for the promising applications in nano system devices to convert solar energy. The maximum efficiency and fill factor are found to be 1.8% and 0.49 at 25 kGy, respectively.

Introduction/Background Morcellation has been thought as a risk factor of recurrence or abdominopelvic disease dissemination during surgery for uterine sarcoma. On the strength of advancement in diagnostic technology, capability to predict sarcoma is slightly improved than before. The purpose of this study is to re-evaluate the morcellation in the aspect of risk factor for outcome. Methodology From 2007 to 2017, 123 patients who were treated for stage 1–2 uterine sarcoma including leiomyosarcoma, low-grade endometrial stromal sarcoma (ESS), high-grade ESS were analysed retrospectively. Results Among 123 patients, 96 (78%) had surgery in the presumed benign disease and 53(43%) underwent morcellation to remove uterine mass (morcellation group). Recurrence was detected in 41 (33.3%) patients and 37 cases showed abdomino-pelvic recurrence. There was no statistically significant difference in all types of recurrent rate (34.3% vs. 32.1%, p=0.797), abdomino-pelvic recurrent rate (31.9% vs. 30.0%, p=0.827) and survival rate (82.9% vs. 84.9%, p=0.76) between two group (non-morcellation vs. morcellation). Estimated disease free interval were 92.6 months (95% confidence interval (CI), 73.3–112.0 months) for non-morcellation group and 86.0 months (95% CI, 72.3–99.6 months) for morcellation group. Estimated 5-year disease free survival (DFS) rate was 68.5% and 70.2% (p=0.996) in the non-morcellation and morcellation group, respectively. Estimated 5-year overall survival (OS) was not statistically different between two groups (76.7% vs. 83.1% p=0.762) and morcellation was not associated with all types of recurrence (odds ratio (OR), 0.905; 95% CI 0.424–1.934), abdomino-pelvic recurrence (OR, 0.916; 95% CI 0.416–2.015) and OS (OR, 0.991; 95% CI 0.279–3.513; p=0.989). Conclusion In the patients with the early stage of uterine sarcoma, morcellation during the first operation is not associated with the recurrence or overall survival. However, this contradiction to current knowledge needs further validation through multi-centre study of large sample size. Disclosure Nothing to disclose.

Introduction/Background To evaluate the feasibility and efficacy of neoadjuvant chemotherapy in the management of patients with high-grade neuroendocrine(HGNE) carcinoma of the uterine cervix using a matched case-control study. Methodology We performed a single-center, retrospective study of 58 surgically treated HGNE cervical cancer patients. Of these patients, 13 patients (20.90%) received neoadjuvant chemotherapy before surgery. For a 1-to-2 matched case-control study, the rest 45 patients who underwent initially radical hysterectomy were selected as a control group. Results Between neoadjuvant chemotherapy group and initial radical surgery group, stage(P=0.027), pelvic exam (size >4cm versus ≤4cm, P=0.021) and operation type (open radical hysterectomy versus laparoscopic radical hysterectomy, P=0.005) were statistically different variables. We matched these three variables to the control group. The overall survival rate was not different (66.67% of neoadjuvant chemotherapy group vs. 60.00% of matched control group, P=1.00). The recurrence rate was not different (77.78% of neoadjuvant chemotherapy group vs. 60.00% of matched control group, P=0.575). The estimated blood loss during operation(P=0.04). and intraoperative complication (P=0.026) was lower in neoadjuvant chemotherapy group than matched control group. Conclusion Neoadjuvant chemotherapy followed by surgery was feasible and safe in the treatment of HGNE carcinoma of the uterine cervix. Disclosure Nothing to disclose.

Introduction/Background We investigate prognostic factors and impact of the minimally invasive surgery (MIS) in surgically treated early-stage high-grade (HG) neuroendocrine cervical carcinoma (NECC). Methodology Between 1993 and 2017, 47 patients with FIGO (2009) stage IA-IIA HG NECC were initially treated with radical hysterectomy. Clinicopathological variables of the patients were retrospectively reviewed from electronic medical records. Cox proportional hazards regression was used to identify potential prognostic factors. According to surgical approach, survival curves were compared using the Kaplan-Meier method with log rank test. Results The median follow-up period was 28.2 months (range, 3.83–202.5). Stage IB1 disease was the most common (70.2%). Twenty-nine patients (61.7%) underwent RH via MIS. The overall survival (OS) rate was 63.8.0%, and the disease-free survival (DFS) rate was 38.3%. Lymph-node (LN) metastasis was an independent significant risk factor for OS (HR, 2.594; 95% CI, 1.152–5.842; P=0.021) and DFS (HR, 3.236; 95% CI, 1.188–8.815; P=0.022). The Kaplan-Meier survival curves revealed that there was no significant difference in OS and DFS between the laparotomy group and MIS group (50% vs. 72.4% log-rank p value=0.196, 38.9% vs. 37.9% p=0.975). Moreover, the type of surgical approach was not a risk factor for OS (HR, 0.467; 95% CI, 0.714–1.257; P=0.132) and DFS (HR, 1.048; 95% CI, 0.494–2.224; P=0.093). Conclusion LN metastasis was a poor prognostic factor of survival outcomes in initially surgically treated early-stage HG NECC. There was no difference in survival between the MIS and laparotomy approached. Disclosure Nothing to disclose.

Introduction/Background We investigated the long-term oncologic outcomes and prognostic factors in CC patients following laparoscopic radical trachelectomy (LRT) with vaginal colpotomy. Methodology Between 2004 and 2018, 118 CC patients with FIGO stage IA2-IIA1 were treated with LRT with vaginal colpotomy in Asan medical center. The cases of prior neoadjuvant chemotherapy for CC or intraoperative converted radical hysterectomy were excluded. Total 101 patients were included in this study. Clinicopathological variables of the patients were retrospectively reviewed from electronic medical records. Results The median follow-up period was 54.7 months (IQR, 24.7–77.7). The mean age and tumor size were 32.0 (range, 22–43) and 2.03cm (range, 0.1–7) and Stage IB1 disease was the most common (83.2%), followed by stage IA2 (10%) and IB2 (5.9%). Forty-seven (46.5%) patients had a tumor size greater than 2cm. Twelve patients (11.9%) had lympho-vascular space invasion (LVSI), 26 patients (25.7%) had deep stromal invasion greater than 50%, and 2 patients (2%) had vaginal involvement. Two patients (2.0%) had lymph node metastasis. Twelve (10.9%) had adjuvant chemotherapy after surgery. The 5-year overall survival (OS) rate was 98% and the 5-year disease-free survival (DFS) rate was 91.1%. A deep stromal invasion greater than 50% (P=0.025), tumor grade (P=0.027), vagina involvement (p=0.040), and LVSI (P=0.020) were significant prognostic factors for recurrence. In tumor size below 2 cm, the 5-year DFS was 94.4%. Moreover, in tumor size below 2cm with no risk factors, there was no recurrence. Conclusion LRT with vaginal colpotomy is feasible and has favorable oncologic outcomes in tumor size below 2 cm with no risk factors. And in cases of having above recurrent risk factors, we may consider further adjuvant chemotherapy or warning to the patients about recurrence. However, further study is warranted. Disclosure Nothing to disclose.

Introduction/Background Uterine mesonephric adenocarcinoma (MNAC), very rare neoplasm, is most common in the cervix and less common in the uterine corpus. There are limited reports on MNAC regarding its characteristics, depending on the origin site. However, several pathological studies have recently reported that MNAC in the uterine body (UB-MNAC) has a high tendency to metastasise to distant organs. This study compared the clinical characteristics of MNAC cases to help decide adjuvant therapy. Methodology We extracted data from the medical records of patients diagnosed with primary uterine MNAC between October 2008 and February 2019 and retrospectively analysed it. Results There were seven cases of UB-MNAC and five of MNAC in the uterine cervix (UC-MNAC). Detection rate of distant metastasis/local invasion was higher in the UB-MNAC group (5/7 vs. 1/5). Among advanced UB-MNAC cases, the lungs (n=2), pelvic peritoneum (n=2) and ovary (n=1) were the metastasis sites. Among UC-MNAC cases, only pelvic lymph node metastasis was detected. In the UB-MNAC group, six received adjuvant therapy (Combined chemotherapy - radiation therapy (CCRT): two, chemotherapy: four). In the UC-MNAC group, three received adjuvant therapy (CCRT: two, chemotherapy: one). The follow-up period was 2-78 months (median, 24.5 months). Only one case of UB-MNAC showed progression 7 months after CCRT. There were no significant differences in initial CA-125 levels, clinical symptoms and tumour size. Conclusion Overall survival (OS) or Progression free survival (PFS) application was limited owing to the overall shortage of cases and duration of follow-up observation. It was difficult to determine post-therapy outcome because there were no treatment guidelines that led to adjuvant therapy administration even in early stages. However, recent studies, including this study, showed that UB-MNAC has more aggressive features compared with UC-MNAC from the point of diagnosis. Therefore, we may consider post-surgery treatment more actively in UB-MNAC cases. Disclosure Nothing to disclose.

This study aimed to analyze the use of the revised International Prognostic Scoring System (IPSS-R) assessed after hypomethylating treatment (HMT) for patients with myelodysplastic syndrome (MDS) undergoing an allogeneic stem cell transplantation (SCT). Among 115 patients who received pre-SCT HMT, comparison analysis of the prognostic values between the IPSS-R at the time of HMT (IPSS-R@HMT) and at the time of SCT after HMT (IPSS-R@SCT) showed a significantly higher predictive power for overall survival (OS) of the latter. Alteration in IPSS-R risk occurred in 60%, while the patients with 'down-staged' IPSS-R@SCT showed better OS compared with those with 'unchanged' or 'up-staged' risk. On multivariate analysis in all 201 patients, IPSS-R@SCT, monosomal karyotype, treatment failure to pre-SCT treatment, and high hematopoietic cell transplantation-comorbidity index were independently associated with OS. Constructed using these factors, the MDS Transplantation Prognostic Scoring System (MTPSS) identified four risk groups with 4-year OS of 76.4% in low, 61.4% in intermediate-1 and 21.9% in intermediate-2 risk groups, whereas all in the high risk group died within 2 years after SCT (P

Objectives To investigate the risk factors for drug-induced liver injury (DILI) during the treatment of multidrug-resistant tuberculosis (MDR-TB) and to compare the frequency of DILI in patients with and those without chronic liver disease (CLD). Setting This was a retrospective observational cohort study including 299 consecutive patients who started MDR-TB treatment from January 2009 to December 2013. Design Of the 299 patients, 35 had alcoholic liver disease (ALD group), 16 had hepatitis B virus infection (HBV group) and 11 had hepatitis C virus infection (HCV group). The remaining 237 patients without CLD were selected as the control group. Results DILI occurred in 29 (9.7%) patients. The frequency of DILI was significantly higher in the ALD (17.1%, P = 0.038), HBV (31.3%, P = 0.005) and HCV groups (27.3%, P = 0.037) than in the control group (6.3%). Among all patients taken together, having HBV and HCV infection were independent risk factors for the occurrence of DILI during MDR-TB treatment. Conclusion DILI during MDR-TB treatment occurred more frequently in patients with CLD due to ALD, HBV and HCV infection than in those without CLD.

Serum YKL-40 is an inflammatory biomarker of endothelial dysfunction and may play a role in the inflammatory process of Behçet disease (BD).Serum YKL-40 levels were evaluated in patients with BD in order to identify associations with other inflammatory cytokines and establish laboratory parameters. Serum YKL-40 levels were also compared with BD clinical features and disease activity.In total, 112 patients with BD and 45 age- and sex-matched healthy volunteers were included. Disease activity was assessed with BD Current Activity Form score and Electronic Medical Record-based Activity Index (EMRAI) score.Serum YKL-40 levels were significantly higher in patients with BD (median 41·88, range 12·52-171·30 ng mL(-1) ) than in healthy volunteers (median 20·92, range 5·01-64·20 ng mL(-1) ; P 0·01). The cut-off value for YKL-40 (30·005 ng mL(-1) ) was determined from the receiver operating characteristic curve. EMRAI scores and the proportion of patients in the active phase of BD presenting with two or more major criteria were significantly higher in patients with elevated YKL-40 levels (P = 0·04 and P = 0·04, respectively). A statistically significant elevation in YKL-40 levels was observed in patients with active BD compared with patients with inactive BD (P = 0·05). Serum YKL-40 values were positively correlated with interleukin-6 and EMRAI scores (both P = 0·04), indicating that serum YKL-40 levels are increased in patients with BD and positively correlate with disease activity.YKL-40 may play a role in the pathophysiology of BD and provide a useful marker for monitoring patients with BD.

Background context It has been reported that newly developed osteoporotic vertebral compression fractures (OVCFs) occur at a relatively high frequency after treatment. While there are many reports on possible risk factors, these have not yet been clearly established. Purpose The purpose of this study was to investigate the risk factors for newly developed OVCFs after treatment by vertebroplasty (VP), kyphoplasty (KP), or conservative treatment. Study design/setting A retrospective comparative study. Patient sample One hundred thirty-two patients who had radiographic follow-up data for one year or longer among 356 patients who were diagnosed with OVCF and underwent VP, KP or conservative treatment between March 2007 and February 2016. Outcome measures All records were examined for age, sex, body mass index (BMI), rheumatoid arthritis and other medical comorbidities, osteoporosis medication, bone mineral density (BMD), history of vertebral and nonvertebral fractures, treatment methods used, level of fractures, and presence of multiple fracture sites. Methods Patients were divided into those who manifested new OVCF (Group A) and those who did not (Group B). For the risk factor analysis, student's t-tests and chi-square tests were used in univariate analysis. Multivariate logistic regression analysis was carried out on variables with a p Results Newly developed OVCFs occurred in 46 of the 132 patients (34.8%). Newly developed OVCF increased significantly with factors such as average age (p=.047), low BMD T-score of the lumbar spine (p=.04) and of the femoral neck (p=.046), advanced age (>70 years) (p=.011), treatment by cement augmentation (p=.047) and low compliance with osteoporosis medication (p=.029). In multivariate regression analysis, BMD T-score of the lumbar spine (p=.009) and treatment by cement augmentation (p=.044) showed significant correlations with the occurrence of new OVCFs with a predictability of 71.4%. Conclusion Osteoporotic vertebral compression fracture patients with low BMD T-score of the lumbar spine and those who have been treated by cement augmentation have an increased risk of new OVCFs after treatment and, therefore, require especially careful observation and attention.

As the technology nodes become smaller it is becoming more important to control all aspects of influencing parameters for the deposition of thin films using CVD tools and for plasma etch tools. This is especially important in a high volume manufacturing (HVM) environment with new tool installations and the need to achieve production ramp timelines. Controlling tool parameters including chamber wafer temperature is critical for fast ramp to production. Production ramp up cycle time is very important. Chamber matching in process tools is becoming a critical path item for production ramp. Monitoring chamber temperature is one of the process control parameters for thin films, plasma etch, diffusion, and clean process tools. The current method of measuring wafer temperature is manual and time consuming. Table 1 shows the Manual versus Automation method comparison. KLA-Tencor's new Factory Automation System (Fig. 1) helps simplify and automate chamber temperature data collection, supporting chamber matching activities for high volume fab ramps. This automation system utilizes a host manufacturing execution system (MES) to send Process Job/Control Job commands to SensArray FOUPs and delivers wafers via overhead hoist transfer (OHT) to process tools to collect temperature data. Upon return of the Automation FOUP and wafer, temperature data are automatically uploaded to the MES system.

For the prompt prescription of patients suffering from infectious diseases such as tuberculosis or bloodstream infection, a rapid antimicrobial susceptibility test (RAST) is highly necessary. This paper describe rapid antibiotic susceptibility test system composed of biochips and automated expert system, which can determine the antibiotic susceptibility of bacteria and mycobacteria derived from various parts of body. With RAST, antibiotic susceptibility was available in six hours, which was conventionally taking more than two days. Device design consideration, clinical verification, commercialization, and application of RAST system to infectious diseases are reviewed.

Background Although malunion resulting from reconstruction for scaphoid fracture nonunion is a typical complication, there has been little consideration regarding its clinical outcomes. Hypothesis The quality of restoration of the scaphoid anatomy may have little effect on clinical outcomes. Materials and Methods Twenty-five patients with scaphoid fracture nonunion underwent curettage and internal fixation with bone grafting performed by a single surgeon, and they were followed up for a minimum of 5 years. Some of these patients comprised the malunion group if the height/length ratio (H/L ratio) in the most central longitudinal computed tomographic image was more than 0.6. We compared the clinical outcomes of the malunion group with a well-union group based on various clinical scores (Patient Evaluation Measure, Disabilities of the Arm, Shoulder and Hand, modified Mayo wrist scoring system). Results The average follow-up period was 81 months (range: 65–110), and 15 cases among the 25 patients were included in the malunion group. There were no statistical differences in the clinical scores between malunions (15 cases) and well unions (10 cases), and there was no correlation between the H/L ratios and the clinical outcomes. Conclusion The clinical outcomes of malunited scaphoids after reconstruction for scaphoid fractures nonunion did not differ significantly from well-united scaphoids at a minimum 5-year follow-up. Level of evidence Level IV, prognostic case series.

Purpose: To evaluate the ultrasound characteristics of the spinal accessory nerve (SAN) and correlate nerve location with neck lymph node level. Materials and Methods: 50 participants with 100 SANs were enrolled in this study. The SAN was traced from the trapezius muscle to the upper neck and was identified by a hypoechoic linear structure without color Doppler flow. The ultrasound characteristics of the SAN, such as visibility, diameter, relationship with adjacent structures, and its correlation with lymph node levels, were evaluated. Results: The SAN was identified in 96 %-100 % of segments. The mean diameter of the SAN was 0.54 ± 0.09 mm. The SANs was located between the trapezius and levator scapulae muscles and 90.8 % were traced into the trapezius muscle. In the upper neck, the SAN passed deep into the sternocleidomastoid (SCM) muscle in 38 % of cases and between the two heads of the SCM muscle in 62 % of cases. The SAN was found at neck lymph node levels II, III, IV, and V, but not I or VI. Conclusion: Continuous ultrasound monitoring of the SAN and its correlation with lymph node levels is possible in most patients. Our current findings may assist in the future prevention of SAN injury during ultrasound-guided procedures.

Background Allergic respiratory conditions have been associated with increased susceptibility to viral infection due to impaired interferon (IFN)-related immune responses, but the mechanisms for reinforcement of mucosal immunity against viral infection in allergic diseases are largely unknown. Objectives To determine whether IFN induction would be impaired in allergic nasal mucosa and to identify whether higher loads of influenza A virus (IAV) in allergic nasal mucosa could be controlled with IFN treatment. Methods Influenza A virus mRNA, viral titres and IFN expression were compared in IAV-infected normal human nasal epithelial (NHNE, N = 10) and allergic rhinitis nasal epithelial (ARNE, N = 10) cells. We used in vivo model of allergic rhinitis (BALB/c mice, N = 10) and human nasal mucosa from healthy volunteers (N = 72) and allergic rhinitis patients (N = 29) to assess the induction of IFNs after IAV infection. Results Influenza A virus mRNA levels and viral titres were significantly higher in ARNE compared with NHNE cells. IFN-β and IFN-λs were induced in NHNE and ARNE cells up to 3 days after IAV infection. Interestingly, induction of IFN-λs mRNA levels and the amount of secreted proteins were considerably lower in ARNE cells. The mean IFN-λs mRNA level was also significantly lower in the nasal mucosa of AR patients, and we found that recombinant IFN-λ treatment attenuated viral mRNA levels and viral titres in IAV-infected ARNE cells. In vivoAR mouse exhibited higher viral load after IAV infection, but intranasal inoculation of IFN-λ completely decreased IAV protein expression and viral titre in nasal mucosa of IAV-infected AR mouse. Conclusion Higher susceptibility of the allergic nasal mucosa to IAV may depend on impairment of type III IFN induction, and type III IFN is a key mechanistic link between higher viral loads and control of IAV infection in allergic nasal mucosa.

BACKGROUND AND PURPOSE: Intravoxel incoherent motion MR imaging can simultaneously measure the diffusion and perfusion characteristics of brain tumors. Our aim was to determine the utility of intravoxel incoherent motion–derived perfusion and diffusion parameters for assessing the treatment response of metastatic brain tumor following gamma knife radiosurgery. MATERIALS AND METHODS: Ninety-one consecutive patients with metastatic brain tumor treated with gamma knife radiosurgery were assessed by using intravoxel incoherent motion imaging. Two readers independently calculated the 90th percentile and the 10th percentile histogram cutoffs for perfusion, normalized CBV, diffusion, and ADC. Areas under the receiver operating characteristic curve and interreader agreement were assessed. RESULTS: With the combination of the 90th percentile histogram cutoff for perfusion and the 10th percentile histogram cutoff for diffusion, the sensitivity and specificity for differentiating recurrent tumor and treatment were 79.5% and 92.3% for reader 1 and 84.6% and 94.2% for reader 2, respectively. With the combination of the 90th percentile histogram cutoff for normalized CBV and the 10th percentile histogram cutoff for ADC, the sensitivity and specificity for differentiating recurrent tumor and treatment were 69.2% and 100.0% for reader 1 and 74.3% and 100.0% for reader 2, respectively. Compared with the combination of 90th percentile histogram cutoff for normalized CBV and the 10th percentile histogram cutoff for ADC, adding intravoxel incoherent motion to 90th percentile histogram cutoff for normalized CBV substantially improved the diagnostic accuracy for differentiating recurrent tumor and treatment from 86.8% to 92.3% for reader 1 and from 89.0% to 93.4% for reader 2, respectively. The intraclass correlation coefficients between readers were higher for perfusion parameters (intraclass correlation coefficient range, 0.84–0.89) than for diffusion parameters (intraclass correlation coefficient range, 0.68–0.79). CONCLUSIONS: Following gamma knife radiosurgery, intravoxel incoherent motion MR imaging can be used as a noninvasive imaging biomarker for differentiating recurrent tumor from treatment effect in patients with metastatic brain tumor.

BACKGROUND AND PURPOSE: The increased cochlear signal on FLAIR images in patients with acoustic neuroma is explained by an increased concentration of protein in the perilymphatic space. However, there is still debate whether there is a correlation between the increased cochlear FLAIR signal and the degree of hearing disturbance in patients with acoustic neuroma. Our aim was to investigate the clinical significance of an increased cochlear 3D FLAIR signal in patients with acoustic neuroma according to acoustic neuroma extent in a large patient cohort. MATERIALS AND METHODS: This retrospective study enrolled 102 patients with acoustic neuroma, who were divided into 2 groups based on tumor location; 22 tumors were confined to the internal auditory canal and 80 extended to the cerebellopontine angle cistern. Pure tone audiometry results and hearing symptoms were obtained from medical records. The relative signal intensity of the entire cochlea to the corresponding brain stem was calculated by placing regions of interest on 3D FLAIR images. Statistical analysis was performed to compare the cochlear relative signal intensity between the internal auditory canal acoustic neuroma and the cerebellopontine angle acoustic neuroma(.) The correlation between the cochlear relative signal intensity and the presence of hearing symptoms or the pure tone audiometry results was investigated. RESULTS: The internal auditory canal acoustic neuroma cochlea had a significantly lower relative signal intensity than the cerebellopontine angle acoustic neuroma cochlea (0.42 ± 0.15 versus 0.60 ± 0.17, P < .001). The relative signal intensity correlated with the audiometric findings in patients with internal auditory canal acoustic neuroma (r = 0.471, P = .027) but not in patients with cerebellopontine angle acoustic neuroma (P = .427). Neither internal auditory canal acoustic neuroma nor cerebellopontine angle acoustic neuroma showed significant relative signal intensity differences, regardless of the presence of hearing symptoms (P > .5). CONCLUSIONS: The cochlear signal on FLAIR images may be an additional parameter to use when monitoring the degree of functional impairment during follow-up of patients with small acoustic neuromas confined to the internal auditory canals.

Behçet disease (BD) is a chronic multisystemic vasculitis affecting blood vessels of any calibre or type. Recent evidence suggests that the clinical expression of BD is lessening.To examine the clinical expression of BD in Korea during the past three decades via a large patient registry.Initial manifestations of patients with BD seen at a tertiary referral hospital between 1983 and 2012 were reviewed retrospectively, stratifying patients by decade to compare epidemiological data and cardinal symptoms.In total 3674 patients with BD were reviewed. Significant proportional declines occurred with respect to male sex, complete type BD and major presenting features (genital ulcers, ocular involvement and skin lesions), whereas the mean patient age rose progressively, as did the frequencies of joint, gastrointestinal and central nervous system manifestations (all P0·0001).During the past three decades, clinical expression of BD in Korea has changed, resulting in fewer instances of complete type disease, declining male propensity, and shifting patterns of organ involvement.

The multi-valued resistive switching (RS) characteristics and mechanism in a WO x /AlO y heterojunction-based nonvolatile memory have been investigated. Although Al/WO x /Pt and Al/AlO y /Pt show different RS characteristics, bipolar and unipolar modes, respectively, the Al/WO x /AlO y /Pt structure shows both bipolar and unipolar RS characteristics, depending on the magnitude of the applied voltage. Three resistance states, which are defined as the low-resistance state (LRS), the mid-high-resistance state (mid-HRS) and the high-resistance state (HRS), are observed. A model combining two different RS mechanisms, oxygen ions involving the redox process at the interface and filamentary conduction, is proposed, and provides a simple physical concept to understand the multi-valued RS behavior. Our findings will be useful to design and optimize oxide heterojunction-based non-volatile RS memory devices.

Steady-state visual evoked potential (SSVEP) has been widely used in electroencephalogram (EEG)-based brain-computer interfaces (BCIs) due to its high information transfer rate (ITR) and short training time. Current methods usually measure SSVEP from electrodes on the scalp, which is an uncomfortable and time-consuming method. Furthermore, most research relies on expensive and non-portable EEG devices. To utilise BCIs in daily life, however, these are critical issues to address. Hence, a wearable EEG device for in-ear SSVEP detection is proposed. The system is 40 × 21 × 10.5 mm 3 and weighs 14.2 g, thus being light weight and wearable. Moreover, the system has a noise level of 0.11 μVrms, which is comparable with commercial EEG systems. Six subjects participated in an offline BCI experiment that consisted of six visual targets using the developed in-the-ear EEG system. The results showed a highest ITR of 11.03±4.18bits/min with an accuracy of 79.9 ± 13.1%, and the experiments demonstrated that the system can be utilised for unobtrusive monitoring of SSVEP in BCI applications.

Background: The objective of this study is to construct a preoperative nomogram predicting lymph node metastasis (LNM) in early-cervical cancer patients. Methods: Between 2009 and 2012, 493 early-cervical cancer patients received hysterectomy and pelvic/para-aortic lymphadenectomy. Patients who were diagnosed during 2009–2010 were assigned to a model-development cohort (n=304) and the others were assigned to a validation cohort (n=189). A multivariate logistic model was created from preoperative clinicopathologic data, from which a nomogram was developed and validated. A predicted probability of LNM

We thank the KEKB group for the excellent operation of the accelerator, the KEK cryogenics group for the efficient operation of the solenoid, and the KEK computer group and the National Institute of Informatics for valuable computing and SINET4 network support. We acknowledge support from the Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan, the Japan Society for the promotion of Science (JSPS), and the Tau-Lepton Physics Research Center of Nagoya University; the Australian Research Council and the Australian Department of Industry, Innovation, Science and Research; the National Natural Science Foundation of China under contract Nos. 10575109, 10775142, 10875115 and 10825524; the Ministry of Education, Youth and Sports of the Czech Republic under contract Nos. LA10033 and MSM0021620859; the Department of Science and Technology of India; the BK21 and WCU program of the Ministry Education Science and Technology, National Research Foundation of Korea, and NSDC of the Korea Institute of Science and Technology Information; the Polish Ministry of Science and Higher Education; the Ministry of Education and Science of the Russian Federation and the Russian Federal Agency for Atomic Energy; the Slovenian Research Agency; the Swiss National Science Foundation; the National Science Council and the Ministry of Education of Taiwan; and the U.S. Department of Energy and the National Science Foundation. This work is supported by a Grant-in-Aid from MEXT for Science Research in a Priority Area ("New Development of Flavor Physics"), and from JSPS for Creative Scientific Research ("Evolution of Taulepton Physics").

Both palmoplantar pustulosis (PPP) and pompholyx are clinically characterized by acute eruptions of vesicles or pustules on the palms or soles.This study aims to compare the expression of certain inflammatory mediator genes and proteins between patients with PPP and pompholyx using skin tissue samples.Skin biopsies obtained from lesional skin from patients with PPP (n = 7) and pompholyx (n = 5) were analysed by quantitative RT-PCR to measure the mRNA levels of nine genes, including IL-4, IL-8, IL-9, IL-17, IL-22, IFN-γ, CCL-20, granzyme and perforin. For immunohistochemical analysis, 34 paraffin-embedded skin specimens (PPP, n = 22; pompholyx, n = 12) were stained with anti-IL-8, IL-17A, IL-22 and granzyme B antibodies.Of genes analysed, IL-8 and IL-17A mRNA expression levels were significantly higher in the PPP group than the pompholyx group (P = 0.012 in both), whereas the mRNA expression of granzyme B was significantly higher in pompholyx when compared with PPP (P = 0.004). Regarding the IL-17A immunohistochemical staining, tissue from the PPP lesions contained significantly more IL-17A(+) cells in both the epidermis and papillary dermis when compared with pompholyx (P0.001 and P = 0.019 respectively). Moreover, the intensity of the IL-8 immunoreactivity was also greater in the PPP skin lesions than the pompholyx tissue (P0.001).IL-8 and IL-17A, both are increased in PPP tissue, may represent important immunologic mediators that help to differentiate this clinical entity from pompholyx. This study may provide useful clues in distinguishing PPP from pompholyx, as well as helping to understand the pathogeneses of these two diseases.

Zinc sulfide (ZnS(O)) thin films doped with Mn, Ni, and Co ions are synthesized by chemical bath deposition technique onto glass substrates. X-ray diffraction study reveals that the undoped and metal-doped ZnS(O) films possess a hexagonal wurtzite crystal structure. The morphological change, upon metal-ions doping, from nanorod structures to cluster (Mn doping), compact (Ni doping), and granular shapes (Co doping) is observed. X-ray photoelectron spectroscopy reveals the presence and incorporation of metal ions into ZnS(O) lattice sites and the formation of a metal–ZnS combined structure. The band gap energy of the undoped ZnS(O) film is found to be larger than 4.0 eV, while it is 3.8, 3.7, and 3.6 eV for the Mn–ZnS(O), Ni–ZnS(O), and Co–ZnS(O) films, respectively. All the undoped and metal-doped ZnS(O) samples exhibit blue luminescence, which originates from the surface defects and trap centers. Thus, the photoluminescence (PL) (blue light emission) is due to the radiative recombination from various trap levels (shallow donor levels) to the valence band. The decrease in the PL peak intensity for the doped samples indicates the reduction of surface defects suggesting the incorporation of metal ions into the host lattice of ZnS(O). Based on the PL results, the PL energy-level diagram for the undoped and metal-doped ZnS(O) samples is proposed.

Postmenopausal women with osteoporotic fracture (OF) had higher plasma dipeptidyl-peptidase 4 (DPP4) levels than those without. Furthermore, higher plasma DPP4 levels were significantly associated with higher bone turnover and a higher prevalence of OF. These results indicated that DPP4 may be associated with OF by mediating bone turnover rate. Evidence indicates that dipeptidyl-peptidase 4 (DPP4) plays a distinct role in bone metabolism. However, there has been no report on the association, if any, between circulating DPP4 levels and osteoporosis-related phenotypes, including osteoporotic fracture (OF). Therefore, we performed a case-control study to investigate these associations in postmenopausal women. This study was conducted in multiple centers in Korea. We enrolled 178 cases with OF and 178 age- and body mass index-matched controls. OF was assessed by an interviewer-assisted questionnaire and lateral thoracolumbar radiographs. Bone turnover markers (BTMs), bone mineral density (BMD), and plasma DPP4 levels were obtained in all subjects. After adjustment for potential confounders, subjects with OF had significantly higher DPP4 levels than those without (P = 0.021). Higher DPP4 levels were significantly positively associated with higher levels of all BTMs, but not with BMD at all measured sites. The differences in DPP4 levels according to OF status disappeared after an additional adjustment for each BTM, but not after adjustment for any BMD values. BTMs explained approximately half of the relationship between DPP4 and OF. The risk of OF was 3.80-fold (95% confidence interval = 1.53–9.42) higher in subjects in the highest DPP4 quartile than in those in the lowest quartile after adjustment for potential confounders, including femoral neck BMD. DPP4 may be associated with OF by at least partly mediating the bone turnover rate. Circulating DPP4 levels may be a potential biomarker that could increase the predictive power of current fracture risk assessment models.

Background: Non-alcoholic steatohepatitis (NASH) and cryptogenic cirrhosis (CC) are increasing indications for orthotopic liver transplantation (OLT). The aim of this study is to describe our outcomes and delineate predictors of recurrence of NASH and CC after OLT. Methods: This is a retrospective study from 1996 to 2008. Donor and recipient demographics, metabolic profile, insulin and steroid intake, immunosuppression regimen, operative factors, outcomes, and pathologies were reviewed. Fisher's exact test, Cox regression models, and Kaplan-Meier plots were used. Results: A total of 83 patients were included. Recurrence occurred in 20 patients. Thirty-four percent of the patients with metabolic syndrome (MS) had recurrence of NASH or CC compared with 13% of the patients without MS (p = 0.05). Recurrence also occurred in 32% of the patients with hypertension (HTN) vs. 12% in those without HTN (p = 0.05). Thirty-seven percent of those on insulin had recurrence vs. 6% of those not on insulin (p = 0.05). Five-yr survival probability for patients with MS, HTN, and insulin use was 52%, 61%, and 58%, respectively. Conclusions: Higher recurrence of NASH and CC was associated with presence of MS, HTN and insulin use. Recurrence should be further evaluated in larger studies, with special emphasis on management of MS and prevention strategies.

To review the effect of teriparatide as an adjunctive modality for bisphosphonate-related osteonecrosis of the jaws (BRONJ), we describe a series of cases of teriparatide therapy for the treatment of BRONJ and serial changes of serum osteoclacin (s-OC) and serum C-terminal telopeptide cross-link of type I collagen (s-CTX).Management of BRONJ is quite challenging and the currently recommended modalities for BRONJ are still suboptimal. For the improvement of bony remodeling, some clinicians advocated bisphosphonate holiday although validity of this drug holiday has been debated so far. Recently, the use of teriparatide was introduced in several cases, but the number of the publication is limited and mostly anecdotal so far.Bisphosphonate was suspended and teriparatide was given to six patients diagnosed with BRONJ by single bone specialist. Medical record review and interviews were carried out. S-CTX and s-OC were measured at the baseline, 2 months and 3 months later teriparatide therapy. The outcome of the treatment and the change of biochemical markers were compared.In all six patients, s-OC values were significantly elevated within 2 months after teriparatide treatment and the BRONJ lesions were healed. S-CTX values were also elevated in four patients, whereas those of the rest two patients stayed within minimal change. The change was marginally significant at 3 months.In terms of the multifactorial etiology of BRONJ, bone formation suppression was noticed in the patients. Based upon this finding, the short-term use of teriparatide might be beneficial to the resolution of BRONJ lesions by improving suppressed bone remodeling.

The present study evaluates the incidence and mortality of vertebral fractures in Korea, using data from the Health Insurance Review Assessment Service, which includes nationwide information entrusted by Korean government. A vertebral compression fracture is a serious complication associated with osteoporosis of the spine. We evaluated the incidence of vertebral fracture and subsequent mortality in South Korea, using nationwide data from the Health Insurance Review and Assessment Service (HIRA). All new visits or admissions to clinics or hospitals for fractures were recorded in nationwide cohort by the Korean HIRA using International Classification of Disease, tenth Revision (ICD-10) code. The incidence of vertebral fracture and excess mortality associated with vertebral fracture were evaluated, in men and women aged 50 years or more between 2005 and 2008. Standardized mortality ratio (SMR) was calculated to determine excess mortality associated with vertebral fracture. The crude overall incidence of vertebral fractures was 984 per 100,000 person years from 2005 to 2008. The overall mortality rate at 3 months, 6 months, 1 year, and 2 years after vertebral fracture in men (5.56%, 9.41%, 14.6%, and 20.61%, respectively) were higher than that in women (2.41%, 4.36%, 7.16%, and 10.48%, respectively). In both genders, the age-specific mortality rates were more than those of the general population. The SMR was highest during the first 3 months and gradually declined to 2.53 in men and 1.86 in women at the 2-year period. The incidence of vertebral fracture in South Korea was comparable with other countries such as Switzerland, and the mortality after vertebral fracture is higher than that of normal populations. The incidence of osteoporotic vertebral fracture and following high mortality are likely to become serious socioeconomic problems.

Failure loads of a friction stir spot welding (FSSW) joint of two aluminum alloy 6061-T6 sheets under specific loading cases were predicted using the finite-element method. The detailed modelling technique of a FSSW joint using available experimental data is presented in this paper. The characteristics and dimensions of different zones of the FSSW joint including the stir zone (SZ), heat-affected zone (HAZ), thermal-mechanically affected zone (TMAZ), and base metal (BM) were obtained from literature. The mechanical properties calculated from a relation between the measured hardness values and the corresponding strengths for each zone were then applied to the failure prediction model. In this model the ESI–Wilkins–Kamoulakos (EWK) rupture model of the PAM-CRASH commercial software was employed to verify the case of the lap-shear tension test. The failure load obtained in this model showed a good agreement with the experimental value in the reference. The failure prediction for the other loading cases (peel-tension test and cross-tension test) was then conducted following the same analysis procedure.

Low portal vein flows in liver transplant have been associated with poor allograft survival. Identifying and ameliorating causes of inadequate portal flow is paramount. We describe successful reversal of significant splenic vein siphon from a spontaneous splenorenal shunt during liver transplant. The patient is a 43-year-old male with cirrhosis from hepatitis C and Budd-Chiari syndrome, who had a variceal hemorrhage necessitating an emergent splenorenal shunt with 8 mm PTFE graft. Imaging in 2006 revealed thrombosis of the splenorenal shunt and evidence of a new spontaneous splenorenal shunt. The patient developed hepatocellular carcinoma and underwent transplant in 2009. After reperfusion, portal flows were low (150-200 mL/min). A mesenteric varix was ligated without improvement. Due to adhesions, direct collateral ligation was not attempted. In order to redirect the splenic siphon, the left renal vein was stapled at its confluence with the inferior vena cava. Portal flows subsequently increased to 1.28 L/min. Postoperatively, the patient had stable renal and liver function. We conclude that spontaneous splenorenal shunts can cause low portal flows. A diligent search for shunts with understanding of flow patterns is critical; ligation or rerouting of splanchnic flow may be necessary to improve portal flows and allograft outcomes.

U.S. Choi and D.Y. Kim Immunocytochemical detection of Ki-67 in Diff-Quik-stained cytological smears of canine mammary gland tumours Objective: To investigate whether Diff-Quik stained fine needle aspirate smears can be used to evaluate Ki-67 expression by immunocytochemistry. Methods: Both cytological and histological samples were obtained from 24 dogs with spontaneously developed mammary gland tumours. The cytological and histological specimens were examined by Diff-Quik and H&E stains, respectively. After examination, both samples were immunostained using the same Ki-67 antibody. The % Ki-67 values were calculated based on the percentage of positively stained tumour cells per 500 and 1000 tumour cells in cytology and histology specimens, respectively. Results: Ki-67 staining was successful in 17/24 smears (71%) and 19/23 sections (83%). The correlation coefficient between the percentage of Ki-67-positive cells in cytological smears and in the histological sections was 0.677 (P

Background Donation-after-death liver transplantation (DCD-LT) carries higher complication rates compared with donation-after-brain death liver transplantation (DBD-LT). In this report we describe our experience with biliary complications in DCD-LT with emphasis on anatomical patterns and outcomes. Materials and Methods We performed retrospective review of patients' medical records from August 2004 to December 2008, during which time total of 26 DCD-LTs were performed. Mean follow-up was 29 months (range 3 to 51 months). Results Biliary complications occurred in 12 patients (46%), of whom 9 were related to DCD (35%). Four patients had more than 1 biliary complication, and 4 had concomitant arterial problems (stricture/thrombosis). Treatment of complications included: ERCP (n = 5, 3 resolved), conversion to roux (n = 5, 2 resolved), revision of roux (n = 1), percutaneous transhepatic cholangiography (n = 1), artery revision (n = 3). Three patients with casts had operative extraction of casts depicting a mummified biliary tree; histology showed casts and fibrosis and anastomotic suture material. Six patients underwent retransplantation (23%). Among retransplanted patients, 2 deaths occurred (7.7%). Conclusion Our experience with DCD-LT reveals a high prevalence of biliary complications with a new and wide spectrum of clinicopathologic findings. Better strategies for prevention of these unique biliary complications are needed to better justify the added risks and costs for performance of DCD-LT.