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Background Petersen's hernia, which occurs after minimally invasive surgery for gastric cancer, can be reduced by defect closure. This study aimed to demonstrate the incidence of bowel obstruction above Clavien–Dindo classification grade III due to Petersen's hernia between the mesenteric fixation method(MEFIX) and the conventional methods during the 5-year follow-up period after laparoscopic gastric cancer surgery. Methods This prospective, single-blind, non-inferiority randomized controlled trial and multicenter study was conducted at hospitals in Korea. Patients with histologically diagnosed gastric cancer of clinical stage I, II, or III who underwent Roux-en-Y or B- II gastrojejunostomy anastomosis after laparoscopic gastrectomy were enrolled in this study. Patients who met the inclusion criteria were randomly assigned to two groups: a CLOSURE group that underwent Petersen's defect closure method and a MEFIX group that underwent the mesenteric fixation method. Discussion This trial is expected to provide high-level evidence showing that the MEFIX method can quickly and easily close Petersen's defect and reduce postoperative complications compared to the conventional method. It is also expected to be applicable not only after gastric cancer surgery but also after bariatric surgery. Trial registration The MEFIX study protocol was registered in htrp://register.clinicaltrials.gov as NCT05105360 (registration date: November 3, 2021)

Swallowing of foreign bodies (FBs) is the most common indication of therapeutic endoscopy in children. Endoscopic removal may be necessary depending on the type of FB, age of the child, and location of the FB. We attempted to analyze the characteristics of each device used for the endoscopic removal of FBs in children.Medical records of the patient's age, sex, weight, type, location, size, shape, type of device used for endoscopic removal, and endoscopic time were retrospectively collected.A total of 424 FB removal procedures were analyzed. The average age of the patients at the time of FB removal was 4.1 ± 3.7 years. Coins were the most common FBs (192, 45.3%). The most common locations of the FBs were the esophagus (45.7%) and the stomach (48.3%), respectively. For a total of 371 cases, forceps were used in 96 cases (25.9%) for esophageal FBs and in 25 cases for gastric FBs (6.7%), while nets were used in 250 cases (67.4%) for gastric FBs retrieval; the average durations of the procedures were 7.2 ± 7.4 minutes, 8.5 ± 7.2 minutes, and 5.7 ± 7.3 minutes, respectively (The endoscopic procedure duration, in low-weight children, was shorter when retrieval nets were used than that with forceps.

We reviewed our experience with the management of intussusception presenting as a complication of laparoscopic gastrectomy (LG) and studied the feasibility of a laparoscopic intervention to treat or prevent this condition. We retrospectively analyzed the data of 12 patients diagnosed with intussusception, following gastrectomy, from 2008 to 2017, including clinical manifestations, incidence, post-LG time-interval before diagnosis, and treatment. Totally, 12/2300 gastrectomy patients (0.52%) developed intussusception. All 12 had undergone laparoscopic distal gastrectomy for gastric cancer (12/1250, 0.96%) and presented with intussusception through a side-to-side jejunojejunal anastomosis. The mean latency period was 423.8 (range: 86 to 1500) days. Four patients underwent emergent laparoscopic reduction of the efferent loop without bowel resection, along with fixation of the reduced jejunum to the afferent loop and the small bowel mesentery, to prevent a recurrence. One patient required open surgery with manual reduction and segmental resection of the gangrenous small bowel portion. All operated patients recovered without any complications. Intussusception resolved spontaneously in the remaining 7/12 patients. We found that a laparoscopic approach can be used for preventing or managing post-LG intussusception. We found that recurrence can be prevented or treated by anchoring and fixing the (reduced) efferent loop to the afferent loop and the small bowel mesentery.

The goal of this study was to identify the clinical outcomes of uncut Roux-en-Y reconstruction in patients who underwent totally laparoscopic distal gastrectomy (TLDG) over 3-year follow-up.From January 2016 to December 2017, 269 patients who underwent TLDG were enrolled in the study and analyzed retrospectively. They were classified into two groups according to the reconstruction method: uncut Roux-en-Y reconstruction (uncut RY) (n = 154) and Billroth II with Braun anastomosis (B-II/Braun) (n = 115). Postoperative endoscopic findings (residual food, bile reflux, gastritis, and esophagitis) and nutritional status (body weight, serum hemoglobin, total protein, and albumin levels) were assessed every 6 months for 3 years.Residual food was less frequent in the uncut RY group in the 6th month after TLDG (p = 0.022), but there were no differences between the two groups for the rest of the study period. The incidence of bile reflux and gastritis was low in the uncut RY group during all postoperative periods (all p lt; 0.001). In the B-II/Braun group, the frequency of reflux esophagitis was high in the 30th and 36th months after TLDG (both p lt; 0.001), and there were no differences between the two groups during the preceding periods. No significant differences were found with respect to nutritional status, such as body weight, serum hemoglobin, total protein, and albumin levels during all postoperative periods.Three-year follow-up outcomes showed that uncut RY can effectively reduce the incidence of bile reflux and gastritis in the remnant stomach compared to B-II/Braun after TLDG.

Gastrostomy with concurrent laparoscopic Nissen fundoplication (LNF) is often performed as a laparoscopic gastrostomy (LG) by surgeons. Since 2014, we started performing percutaneous endoscopic gastrostomy (PEG) as gastrostomy with LNF. This study aims to compare the outcomes of LG and PEG with LNF. Patients were recruited into two groups: LNF with LG (historical control) or PEG. Demographic data, operation time, time to start feeding, time to full feeding, length of hospital stay (LOS), and complications were compared between the groups. Fourteen patients underwent LNF with LG and 49 underwent LNF with PEG. The median age and body weight of patients were 4.25 years and 14.15 kg in the LG group and 2.58 years and 10.60 kg in the PEG group, respectively. Operation times were significantly shorter in the PEG group (1.81 vs. 2.61 h). The times to start feeding and full feeding as well as LOS were shorter in the PEG group. Nevertheless, complications were similar in both groups. In conclusion, PEG with LNF was associated with significantly shorter operation times, times to start feeding and reach full feeding, and LOS. PEG is a suitable method for LNF in chronically ill children.

Background Use of steatotic livers is a known risk factor for increased primary nonfunction after liver transplantation. This study investigated the efficacy and clinical outcome of simple weight reduction of steatosis for donors undergoing living-donor liver transplantation (LDLT). Material/Methods We defined two groups: the reduction group, which included donors with >30% macrovesicular steatosis and body mass index (BMI) >25 kg/m2, and the conventional group, which included donors with

Parallel processing and double-flow methods, which are used to increase the speed of turbo-code decoding, cause memory contentions. Although memory contentions due to parallel processing can be resolved by adopting the quadratic polynomial permutation (QPP) interleaver, the double-flow method still causes memory contentions because of its read/write sequences from both ends of the input packets. Thus, we propose a modified architecture to resolve memory contentions for the double-flow method to fit the QPP interleaver. In our experiment, the proposed method has a shorter decoding time and smaller hardware size compared the conventional method. A bit-accurate simulation was performed, and hardware implementation with field-programmable gate arrays (FPGAs) led to a high throughput of 80 Mbps. © 2014 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.

We present a method to quantitatively measure the thermal conductivity of one-dimensional nanostructures by utilizing scanning thermal wave microscopy (STWM) at a nanoscale spatial resolution. In this paper, we explain the principle for measuring the thermal diffusivity of one-dimensional nanostructures using STWM and the theoretical analysis procedure for quantifying the thermal diffusivity. The SWTM measurement method obtains the thermal conductivity by measuring the thermal diffusivity, which has only a phase lag relative to the distance corresponding to the transferred thermal wave. It is not affected by the thermal contact resistances between the heat source and nanostructure and between the nanostructure and probe. Thus, the heat flux applied to the nanostructure is accurately obtained. The proposed method provides a very simple and quantitative measurement relative to conventional measurement techniques. § 이 논문은 대한기계학회 2013년도 학술대회(2013. 12. 18.-20., 강원랜드) 발표논문임 † Corresponding Author, omkwon@korea.ac.kr C 2014 The Korean Society of Mechanical Engineers 박경배 · 정재훈 · 황광석 · 정의한 · 권오명 958 Fig. 1 Experimental setup of scanning thermal wave microscopy 저차원 나노구조체인 그래핀과 카본나노 튜브를 방열 소재로 사용하고 있다. 또한 고효율의 열전소자 개발을 위해 열전도도가 매우 낮은 BiTe 계열의 나노선을 적극적으로 활용하고 있다. 나노선의 경우 지름이 포논평균자유행로(Phon-on mean free path)보다 작아지면 소재 내부에서 포논 산란 효과가 커져 열전도도가 벌크값과 달라지게 된다. 또한 표면적 대 체적비(Surface-to-Volume Ratio)가 비약적으로 커져 소재의 표면효과의 영향으로 인해 열전도도가 벌크값과 다르게 된다. 따라서, 나노스케일에서의 저차원 구조체들의 열전도도를 정량적으로 측정하는 것은 다양한 분야에서의 기술 혁신에 있어서 매우 중요한 역할을 수행한다. 나노스케일에서의 열전도도 측정 연구는 정량 적인 계측 방법의 부재로 인해 계측값들에 대한 신뢰성이 상당히 떨어지는 편이다. 예를 들어, Thermal bridge method는 열원과 나노 구조체 사이 의 열접촉저항으로 인해 정확한 파워를 계측하기 어렵고, Thermal bridge의 구조상 소재 내부에서의 열전달 현상을 이미징 할 수가 없다. 또한 Raman spectroscopy 의 경우 공간 해상도가 1μm 수준으로 나노스케일에서의 측정에는 적합하지 않고, 온도와 라만쉬프트 사이의 선형성이 매우 떨어지기 때문에 측정의 정확성이 매우 낮다. 본 연구에서는 나노스케일의 공간해상도로 열 파(Thermal wave)의 진폭 및 위상지연(Phase lag)에 대한 정량적인 측정이 가능한 주사탐침열현미경(Scanning thermal wave microscopy, STWM)의 원리를 설명한 후, 이를 구현하기 위해 필요한 샘플의 열적 설계 및 정량적인 열확산도 계측을 위해 열파의 주파수 영역을 확보하기 위한 이론적 해석 과정을 설명한다. STWM은 열파가 이동한 거리에 따른 위상지연의 상대적인 차이만을 이용하여 열확산계수(Thermal diffusivity)를 계측하며, 이를 통해 열전도도(Thermal conductivity)를 구하게 된다. 따라서 나노선에 인가되는 파워에 영향을 받지 않으며 탐침과 나노선 접점에서의 열접촉저항 등에 의해 측정 결과가 교란 받지 않는다. 또한 고주파의 교류전류를 사용하기 때문에, 탐침과 시편 사이의 공기를 통한 열전달의 영향을 제거할 수 있고, 직류계측에 비해 신호 대 잡음비가 크다. 그리고 열파의 주파수 조정을 통해 공간해상도를 나노스케일 수준으로 향상시킬 수 있기 때문에 높은 해상도로 정량적인 열전도도를 구할 수 있다.

InP quantum dots of 3 nm in diameter have been prepared using a dehalosilylation reaction and passivated with ZnSe to enhance photoluminescence by 6.8 times. Core-shell InP@ZnSe quantum dots dispersed in n-hexane have then been investigated using time-resolved spectroscopy to understand their photoluminescence dynamics. The observed decay times of 0.1, 7, and 1100 ns have been attributed to the relaxation times of electrons in the conduction band, trap sites, and surface states. The surface-state luminescence of core-shell InP@ZnSe quantum dots having the maximum at 760 nm has been distinguished spectrally and dynamically from their band-edge emission having the maximum at 620 nm or from their trap-site emission having the maximum at 660 nm.

Both spectra of transient absorption (lambda(max) = 390 nm) and luminescence (lambda(max) = 590 nm) for the (4)T(1) state of Mn(2+) in ZnS nanoparticles shift to long wavelengths by 40 nm and broaden by 1.7 times as the state becomes banded. The (4)T(1) band of capping Mn(2+) in ZnS nanoparticles decays on the time scale of 0.35 mus, which is much shorter than either the decay time of the (4)T(1) state (2000 micros) for lattice-bound isolated Mn(2+) or that (180 micros) for surface-bound isolated Mn(2+) in ZnS nanoparticles.

This paper deals with fully automating the pavement lane painting operations utilizing robotic technologies. This study includes a novel design of a robot structure that can be easily installed on a support commercial truck and image processing algorithms that can recognize deteriorated lane marks. With this robot system, a single operator within a cab is capable of tracking the existing faded lane mark and performing re-painting operations on-site, so that the dangerous and time consuming manual operations can be eliminated. The feasibility of the developed robot was explored through the experiments with image data acquired from real pavement surface.

The main purpose of a tunnel ventilation system is to maintain CO pollutant concentration and visibility index (VI) under an adequate level to provide drivers with a comfortable and safe driving environment. Moreover, it is necessary to minimize power consumption used to operate the ventilation system. To achieve the objectives, fuzzy control (FLC) methods have been usually utilized due to the complex and nonlinear behavior of the system. The membership functions of the FLC consist of the inputs such as the pollutant level inside the tunnel, the pollutant emitted from passing vehicles, and the output such as the number of running jet-fans. Conventional fuzzy control methods rely on simple experiences and trial and error methods. In this paper, the FLC was optimally redesigned using the genetic algorithm (GA), which is a stochastic global search method. In the process of constructing the objective function of GA, two objectives listed above were included: maintaining an adequate level of the pollutants and minimizing power consumption. The results of extensive simulations performed with real data collected from existing tunnel ventilation system are provided in this paper. It was demonstrated that with the developed controller, the pollutant level inside the tunnel was well maintained near the allowable limit and the energy efficiency was improved compared to conventional control schemes.

Cases of acute myocardial infarction (AMI) that occur during pregnancy or postpartum are rarely reported. Ergot derivatives are known to induce the spasmodic contraction of coronary arteries. Administration of ergot derivatives can cause AMI, even in normal healthy people. In several reported cases, ergot derivatives triggered severe AMI during the postpartum period. Here, we report the case of a forty-year-old woman who was successfully impregnated by artificial fertilization and died after treatment with ergot derivatives. The autopsy revealed AMI with severe coronary atherosclerosis. This is the first case that reports aggravation of pre-existent severe coronary atherosclerosis after postpartum infusion of ergot derivatives.

The role of COX-2 expression and angiogenesis of lung cancer is yet to be delineated. Eighty four non-small cell lung cancer (NSCLC) specimens were evaluated for COX-2 expression, microvessel density (MVD), and vascular endothelial growth factor (VEGF) expression by immunohistochemical methods. The relationships between COX-2 expression and MVD, VEGF expression, and survival time were analyzed. COX-2 expression was observed in the cytoplasm and membrane of the carcinoma cells, and premalignant cells. COX-2 was positive in 67 cases (79.8%). There was a statistically significant correlation between COX-2 expression and tumor size, TNM stage, tumor type, VEGF expression, and vascular pattern with survival in univariate analysis. No significant correlation was seen between COX-2, VEGF expression and MVD. A lack of expression of either COX-2 or VEGF expression or both, however, was associated with lower MVD than the group with both expressed. The difference was statistically significant (P=0.005). Statistically significant differences were also observed according to TNM stage, vascular pattern, COX-2 expression, and VEGF expression. With multivariate analysis, only TNM stage and COX-2 expression retained their significance as independent predictors of survival. COX-2 expression takes part in tumor angiogenesis and is a significant poor prognostic factor in the surgically resected NSCLC. COX-2 inhibitor, either in combination therapy with other agents, or for chemoprevention, may be effective via suppression of angiogenesis in this fatal disease.

The luminescence, shape, and stability of ZnS nanoparticles in ethanol are enhanced by capping the surface with (3-mercaptopropyl)trimethoxy silane (MPS) or by treating the surface with SiO 2 . While MPS forms an exterior network to encapsulate the ZnS surface, SiO 2 surrounds ZnS nanoparticles to smoothen the surface. Both MPS and SiO 2 reform ZnS nanoparticles into more stable shapes and increase their luminescence, especially in the visible region. Thus both treatments are suggested to improve various properties of optoelectronically valuable ZnS nanoparticles.

A 46-year-old woman visited our hospital presenting throat pain and globus sensation. The symptoms occurred seven days after eating raw perch and mullet. An endoscopy under sedation showed a fluke―with an approximate length of 4.8 mm and width of 1.5 mm―on the left aryepiglottic fold, with active motility on the mucosa. It was extracted from the larynx using biopsy forceps and was identified as Clinostomum complanatum. To the best of our knowledge, this is the second reported case of human infection with Clinostomum complanatum diagnosed and treated by an endoscopy in Korea. Endoscopy is a useful tool in the diagnosis and treatment of patients at risk for parasitic infections complaining of throat pain.

The Mn2+ impurity luminescence decay of Mn2+-doped ZnS nanoparticles has been clearly distinguished from ZnS host emission decay by measuring transient absorption and emission kinetic profiles in t...

We report a case of Sertoli cell adenoma in complete androgen insensitivity syndrome (CAIS) in a 22-year-old woman. Polymerase chain reaction-single strand conformation polymorphism and DNA sequencing revealed a single nucleotide substitution on exon 7 of the human androgen receptor (hAR) gene, resulting in a change of CGA (arginine) to CAA (glutamine) in codon 831.

Background Most cases of cryptococcosis are diagnosed when signs of meningitis have appeared. We report a case of lymphonodular cryptococcosis that was diagnosed by fine needle aspiration cytology (FNAC), excisional biopsy of a cervical lymph node and culture of aspirated material. Case An 11-year-old boy presented with a history of fever and enlarged bilateral cervical lymph nodes of two weeks' duration. Past medical history included immunoglobulin replacement for hyper-IgM syndrome for the previous eight years. FNAC smears from a cervical lymph node showed numerous yeasts of various sizes, ranging from 5 to 15 microns in diameter, located in the cytoplasm of multinucleated giant cells and in the background. In air-dried, Diff-Quik-stained slides, the yeasts stained blue and were surrounded by clear halos. Aspirated material collected in the syringe was cultured, and Cryptococcus neoformans was isolated. Conclusion This case report suggests that a combination of FNAC and culture is a simple and useful method of diagnosing fungal infections. Early diagnosis by FNAC makes possible the early initiation of treatment.

ZnO nanocoral reefs and nanofibers are synthesized on the glass substrate dip coated with ZnO seed with nanoparticles with an average size of 5 nm under a hydrothermal reaction. The ratios of length to diameter for the former and the latter are determined to be 100 and 1000, respectively. In addition, we found that a threshold power density for UV lasing action could be remarkably reduced from 40 kW/cm2 for the nanocoral reefs to 8 kW/cm2 for the nanofibers by increasing the cavity length of ZnO nanowires.

The association between rectosigmoid polyps and polyps in the more proximal colon is still a matter of debate, and the need for colonoscopy in patients with rectosigmoid polyps that are detected by flexible sigmoidoscopy is controversial. The aim of this study was to determine whether or not certain characteristics of rectosigmoid polyps are associated with the presence and characteristics of proximal colonic polyps. Seven hundred and twenty-eight patients who underwent total colonoscopy between October 1995 and June 1998 and who had colorectal polyps were retrospectively analyzed. Patients with inflammatory bowel diseases, familial adenomatous polyposis, or any advanced cancer were excluded. The odds ratio (OR) and 95% confidence interval (CI) of prevalence of proximal colonic polyps according to the patients age and sex, as well as the characteristics of rectosigmoid polyps, were calculated. Advanced adenoma was defined as an adenoma larger than 10 mm or an adenoma of any size with villous component, high-grade dysplasia or invasive carcinoma. Among 728 patients with colorectal polyps, 356 patients (48.9%) had polyps only in the rectosigmoid region, 193 patients (26.5%) had polyps only in the proximal colon, and 179 patients (24.6%) had polyps in both the rectosigmoid and proximal colon. In 535 patients with rectosigmoid polyps, the prevalence of proximal colonic polyps, neoplastic polyps and advanced adenomas were 33.4%, 27.3% and 2.9%, respectively. The prevalence of proximal colonic polyps in patients with rectosigmoid polyps was found to be significantly related to the male gender and elderly patients, in addition to the neoplastic histology of the rectosigmoid polyps. However, the prevalence of the proximal colonic polyps was not related to the size, number and shape of rectosigmoid polyps. In 179 patients with both rectosigmoid and proximal colonic polyps, the characteristics of proximal colonic polyps such as size, number and shape were similar to those of rectosigmoid polyps. We recommend total colonoscopic examination in all patients with rectosigmoid adenomas, regardless of the size, number, and shape, especially in elderly males.

Common complications of Henoch-Schonlein purpura (HSP) that lead to surgical intervention include intussusception, perforation, necrosis, and massive gastrointestinal bleeding. Acute appendicitis is rarely seen as a complication of HSP. A seven-year-old boy was admitted for arthralgia, abdominal pain, hematochezia, melena, and purpuric rash on the lower extremities. On admission day abdominal ultrasonography was normal, but on day 5, he became pyrexial and developed right iliac fossa pain and tenderness with guarding. Ultrasonography showed distended appendix surrounded by hyperechoic inflamed fat. On exploration an acutely inflamed, necrotic appendix was removed and grossly there was an appendiceal perforation in the appendiceal tip. Microscopically some of the small blood vessels in the submucosa showed fibrinoid necrosis with neutrophilic infiltrations. The authors report the case of a child who developed acute perforative appendicitis requiring appendectomy while on treatment for HSP.

ZnO nanowall array (ZNWA) has been directionally grown on the buffer layer of ZnO nanoparticles dip-coated on Si-wafer under a soft solution process. Nanowalls on substrate are in most suitable shape and orientation not only as an optical trap but also as an optical waveguide due to their unique growth habit, V[011¯0]⪢V[0001]≈V[0001¯]. Consequently, the stimulated emission at 384 nm through nanowalls is generated by the threshold power density of only 25 kW/cm2. Such UV lasing properties are superior to those of previously reported ZnO nanorod arrays. Moreover, there is no green (defect) emission due to the mild procedure to synthesize ZNWA.

Purpose: To report a case of acute endophthalmitis associated with 23-gauge transconjunctival sutureless vitrectomy and gas tamponade for macular hole surgery. Case summary: A 66-year-old female patient who presented with a macular hole in the left eye was treated with 23-gauge transconjunctival sutureless vitrectomy. On postoperative day 2, the patient developed acute endophthalmitis and was treated with gas-fluid exchange, lensectomy and intravitreal antibiotic injection. Staphylococcus epidermidis was detected in the vitreous fluid of the operated eye. Intraoperative fundus findings showed severe retinal hemorrhage, vascular occlusion and fibrous membranes due to inflammatory response. After treatment, the patient's fundus findings markedly improved and the inflammatory response was controlled. Conclusions: Acute endophthalmitis after sutureless vitrectomy performed via intraocular gas injection may quickly result in inflammation and disease due to infection. Immediate reoperation and intravitreal antibiotic injections are recommended in such cases.

Eosinophilic myocarditis usually results from myocardial damage as a result of drugs or parasites, and is generally associated with increased peripheral eosinophil count. This form of myocarditis is difficult to diagnose clinically. A 25 year-old previously healthy woman was transferred from a local clinic because of hypotension and dyspnea with sudden cardiogenic shock after a three day history of gastrointestinal illness. Echocardiography revealed concentric left ventricular wall thickening with moderate pericardial effusion. Biopsy of endomyocardial tissue from the right ventricle showed diffuse infiltration of inflammatory cells, mostly eosinophils, even though the patient had a peripheral eosinophil count that was normal at the time of biopsy. The patient was treated with corticosteroids for the symptoms of pericarditis, and she recovered without cardiac sequelae, clinically and echocardiographically. We here report a case of acute eosinophilic myopericarditis, with cardiogenic shock, diagnosed by endomyocardial biopsy with normal peripheral eosinophil count at the time of biopsy, and complete recovery without sequelae.