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Clinical implications of systemic atherosclerosis in patients with cardiogenic shock (CS) remain unclear. This study investigated the association between polyvascular disease (PVD) and clinical outcome in CS patients.A total of 1247 CS patients was enrolled from the RESCUE registry, a multicenter, observational cohort between January 2014 and December 2018. They were divided into two groups according to presence of PVD, defined as ≥2 coexistence of coronary artery disease, peripheral arterial disease, or cerebrovascular disease. Primary outcome was all-cause death during 12 months of follow-up.136 (10.9%) patients were diagnosed with PVD. The risk of 12-month all-cause death was significantly higher in the PVD group than in the non-PVD group (54.4% versus 40.4%, adjusted hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.02-1.69, p = 0.034). There was a significant interaction between PVD and vasoactive inotropic score (VIS) (p for interaction = 0.014). Among the 945 patients with VIS84, PVD was associated with a higher risk of 12-month all-cause death (unadjusted HR 1.77, 95% CI 1.30-2.41, p = 0.030); among the 302 patients with VIS ≥84, the incidence of 12-month all-cause death was similar between the PVD and non-PVD groups (unadjusted HR 1.03, 95% CI 0.68-1.56, p = 0.301).Presence of PVD was associated with 12-month all-cause mortality in patients with CS, especially for less severe forms of CS patients with VIS84. Clinicaltrials.govnumber:NCT02985008.

BACKGROUND: Data on direct comparison between various drug-eluting stents with short duration dual antiplatelet therapy (DAPT) are limited, especially in patients with acute coronary syndrome (ACS). AIMS: We sought to compare biodegradable polymer biolimus-eluting stents (BP-BES) with durable polymer everolimus-eluting (DP-EES) and zotarolimus-eluting stents (DP-ZES) in patients with ACS according to different durations of DAPT. METHODS: In the SMART-DATE trial, 2,712 patients with ACS underwent randomisation for allocation of DAPT (6 months [n=1,357] or 12 months or longer [n=1,355]) and type of stent (BP-BES [n=901]), DP-EES [n=904], or DP-ZES [n=907]). The primary endpoint was a composite of cardiac death, myocardial infarction, or stent thrombosis. RESULTS: At 18 months, the primary endpoint was attained by 2.6% with BP-BES, 2.0% with DP-EES, and 2.1% with DP-ZES (HR 1.29, 95% CI: 0.70-2.39, p=0.42 for BP-BES vs DP-EES and HR 1.23, 95% CI: 0.67-2.26, p=0.50 for BP-BES vs DP-ZES). The treatment effect of BP-BES for the primary endpoint was consistent among patients receiving 6-month DAPT as well as those receiving 12-month or longer DAPT (BP-BES vs. DP-EES, pinteraction=0.48 and BP-BES vs DP-ZES, pinteraction=0.87). After excluding 179 patients (101 in the BP-BES group) who did not receive allocated DES, the per-protocol analysis showed similar results. CONCLUSIONS: The risk of a composite of cardiac death, myocardial infarction, or stent thrombosis was not significantly different between patients receiving BP-BES versus DP-EES or DP-ZES across a short or prolonged duration of DAPT after ACS.

Objectives We compared the long-term clinical outcomes of four different types of second-generation drug-eluting stents (DESs) in coronary bifurcation lesions. Background Clinical outcomes of different designs of second-generation DESs are not well known in bifurcation lesions. Methods Patients who underwent percutaneous coronary intervention with second-generation DESs for coronary bifurcation lesion were enrolled from 21 centers in South Korea. A total of 2,526 patients was evaluated and divided into four treatment groups according to DES type: bioabsorbable polymer biolimus-eluting stent (BP-BES group, n = 514), platinum chromium everolimus-eluting stent (PtCr-EES group, n = 473), cobalt nickel zotarolimus-eluting stent (CoNi-ZES group, n = 736), or cobalt chromium everolimus-eluting stent (CoCr-EES group, n = 803). Primary outcome was target lesion failure (TLF, defined as a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization). Inverse probability of treatment weighting (IPTW) was performed to reduce selection bias and potential confounding factors. Results For 5 years of follow-up, the rates of TLF among the four DES groups were not significantly different (6.2% for BP-BES group, 8.2% for PtCr-EES group, 6.5% for CoNi-ZES group, and 8.6% for CoCr-EES group, p = .434). The results were consistent after IPTW adjustment (6.8, 8.4, 6.0, and 7.5%, respectively, p = .554). In subgroup analysis, the similarity of long-term outcomes among the four different types of second-generation DES was consistent across subgroups regardless of side branch treatment (p for interaction = .691). Conclusion There seems to be no significant difference in long-term clinical outcomes among patients who received different types of second-generation DES for coronary bifurcation lesion.

Background Limited data are available on the clinical significance of lactate clearance (LC) in patients with cardiogenic shock (CS). This study investigated the prognostic role of LC in CS patients. Methods We analyzed data from 628 patients in the RESCUE registry, a multicenter, observational cohort enrolled between January 2014 and December 2018. Univariable logistic regression analysis was performed to determine the prognostic implications of 24 h LC, and then patients were divided into two groups according to the cut-off value of 24 h LC (high lactate clearance [HLC] group vs. low lactate clearance [LLC] group). The primary outcome was in-hospital mortality. We also assessed all-cause mortality at 12 month follow-up and compared the prognostic performance of 24 h LC according to initial serum lactate level. Results In the univariable logistic regression analysis, 24 h LC was associated with in-hospital mortality (odds ratio 0.989, 95% confidence interval [CI] 0.985–0.993, p n = 295) (25.5% in the HLC group vs. 42.7% in the LLC group, p p 5 mmol/L than in those with serum lactate ≤ 5 mmol/L (c-statistics of initial serum lactate > 5 mmol/L = 0.782 vs. c-statistics of initial serum lactate ≤ 5 mmol/L = 0.660, p = 0.011). Conclusions Higher LC during the early phase of CS was associated with reduced risk of in-hospital and 12 month all-cause mortalities. Patients with LC ≥ 64% during the 24 h after CS onset could expect a favorable prognosis, especially those with an initial serum lactate > 5 mmol/L. Trial registration: RESCUE (REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock), NCT02985008, Registered December 5, 2016—retrospectively and prospectively registered, https://clinicaltrials.gov/ct2/show/record/NCT02985008

Limited data are available on the association between low-flow time and survival in patients with in-hospital cardiac arrest (IHCA) who undergo extracorporeal cardiopulmonary resuscitation (ECPR). We evaluated data from 183 IHCA patients who underwent ECPR as a rescue procedure. Patients were divided into two groups: patients undergoing extracorporeal membrane oxygenation as an adjunct to standard cardiopulmonary resuscitation for less than 38 min (n = 110) or for longer than 38 min (n = 73). The ECPR ≤ 38 min group had a significantly greater incidence of survival to discharge compared to the ECPR &gt, 38 min group (40.0% versus 24.7%, p = 0.032). The incidence of good neurologic outcomes at discharge tended to be greater in the ECPR ≤ 38 min group than in the ECPR &gt, 38 min group (35.5% versus 24.7%, p = 0.102). The incidences of limb ischemia (p = 0.354) and stroke (p = 0.805) were similar between the two groups, but major bleeding occurred less frequently in the ECPR ≤ 38 min group compared to the ECPR &gt, 38 min group (p = 0.002). Low-flow time ≤ 38 min may reduce the risk of mortality and fatal neurologic damage and could be a measure of optimal management in patients with IHCA.

BACKGROUND Little is known about the causality and pathological mechanism underlying the association between old age and myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). We evaluated the association between old age and myocardial injury in STEMI patients undergoing primary percutaneous coronary intervention (PCI) using cardiovascular magnetic resonance imaging (CMR). METHODS A total of 279 patients with STEMI who underwent primary PCI and CMR were enrolled. Of these, 52 patients were over the age of 70 years (18.6%, Age ≥70 group) and 227 patients were under the age of 70 years (81.4%, Age

Background Little is known about the causality and pathological mechanism underlying the association of seasonal variation with myocardial injury in patients with ST-segment elevation myocardial infarction (STEMI). Objective We evaluated the association of seasonal effect with myocardial injury using cardiovascular magnetic resonance (CMR) imaging in STEMI patients undergoing primary percutaneous coronary intervention (PCI). Methods In 279 patients undergoing primary PCI for STEMI, CMR was performed for a median of 3.3 days after the index procedure. Of these, STEMI occurred in 56 patients in the winter (Winter group), 80 patients in the spring (Spring group), 76 patients in the summer (Summer group), and 67 patients in the autumn (Autumn group), respectively. We compared myocardial infarct size, extent of area at risk (AAR), myocardial salvage index (MSI) and microvascular obstruction (MVO) area as assessed by CMR according to the season in which STEMI occurred. Results In the CMR analysis, the myocardial infarct size was not significantly different among the Winter group (21.0 ± 10.5%), the Spring group (19.6 ± 11.5%), the Summer group (18.6 ± 10.6%), and the Autumn group (21.1 ± 11.3%) (P = 0.475). The extent of AAR, MSI, and MVO areas were similar among the four groups. In the subgroup analysis, myocardial infarct size, extent of AAR, MSI, and MVO were not significantly different between the Harsh climate (winter + summer) and the Mild climate (spring + autumn) groups. Conclusions Seasonal influences may not affect advanced myocardial injury in STEMI patients undergoing primary PCI.

In paper after the strong earthquake of recently the Korea neighborhood, the Korean government survey show that the 86% of school buildings in Korea are in potential damage risk and only 14% of them are designed as earthquake-resistance buildings. Earthquake Reinforcing projects of school have been a leading by the ministry of education, however their reinforcing methods done by not proved a engineering by experiment which results in uneconomical and uneffective rehabilitation for the future earthquake. An experimental and analytical study have been conducted for the shear reinforcing method of column by axis and horizontal axis load using attaching composite beam. Based on the previous research, in this study, Design examples are given to show the performance evaluation for the column reinforcing of old school buildings using nonlinear analysis is going to be conducted and strengthening method is going to be on the market after their performance is proved by the test.

In this study, a novel method is being proposed for the formation of nanostructures, utilizing the electrochemical anodization of Al/metal layers and high density plasma etching. Self-assembled metal oxide pillars formed by anodizing Al/metal layers were employed as an etching mask for nanostructure formation. Once the shape and size of the metal oxide pillars have been determined, the shape and size of the Si dots are dependent on the etching conditions such as etching gas, coil power, and dc-bias. The etch characteristics of Si film and metal oxide pillars were investigated with regard to etch rate, selectivity and profile. Highly ordered Si nanodot arrays were fabricated on a wafer using optimized etching conditions.

Metal-insulator transition properties in polycrystalline VOx thin films, which were deposited using rf magnetron sputtering with a vanadium target on Pt/Ti/SiO2/Si substrates, were studied in terms of structural and electrical characteristics. The phase change of VOx thin films by annealing was confirmed from amorphous VOx films to mixed crystalline phases containing V2O3,VO2,V6O13, and V2O5. The metal-insulator transition of VOx thin films was observed by current-voltage measurement as a function of top-electrode area and the temperature. It was demonstrated that the VOx thin films can be applied to memory devices employing the transition from a high-resistance (off) insulating state to a low-resistance (on) metallic state.

Inductively coupled plasma reactive ion etching of CoZrNb magnetic thin films was studied using a TiN hard mask in a Cl2/O2/Ar gas mix. The etch rates of CoZrNb films and TiN hard mask gradually decreased with increasing Cl2 or O2 gas concentrations. When O2 gas was added in the Cl2/Ar gas mix, the etch rate of TiN hard mask was suppressed effectively so that the etch selectivity of CoZrNb film to TiN hard mask was enhanced. The addition of O2 into the gas mix also led to the anisotropic etching of the CoZrNb films and it was confirmed by Auger electron spectroscopy that there were no redeposited materials on the sidewall of the etched films. Highly anisotropic etching of CoZrNb films was achieved at room temperature under the optimized etching conditions.

High-density plasma reactive ion etching of MTJ stack was investigated in an inductively coupled plasma of Cl 2 /Ar and Cl 2 /O 2 /Ar gas mixes. Thin TiN hard mask was employed and the etching proceeded at ambient temperature. The effect of etch gas on the etch profiles of MTJ stack was examined by varying the gas concentration. In addition, the effects of etch parameters on the etch profiles and magnetic properties of MTJ stacks were investigated. The highly anisotropic etching of MTJ stack arrays with 200×200 and 100×100 nm 2 dimensions was successfully achieved.

The fabrication of nanostructures using self-organized niobium oxide nanopillars was investigated by high-density plasma reactive ion etching in a Cl2/Ar gas. Etch rates and etch profiles of niobium oxide pillars were examined by varying etch parameters. We confirmed that several nanostructures, such as nanotip and nanodot arrays, could be fabricated over large areas using optimal anodizing and etching conditions. The mechanism of forming different nanostructures were classified into two groups, isotropic and anisotropic etch mechanisms. It is expected that a novel technique proposed in this study offers a simple and cost-effective method for fabricating nanostructures from various material systems. © 2005 The Electrochemical Society. DOI: 10.1149/1.1990027 All rights reserved.