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Objective While postoperative cerebrospinal fluid (CSF) leak rates of pituitary tumors have been frequently studied, there are fewer studies examining postoperative CSF leak rates for extrasellar tumors. The purpose of this study was to identify risk factors for the development of postoperative CSF leak in patients undergoing endoscopic surgery for extrasellar tumors. Methods A retrospective chart review was done for patients who underwent endoscopic resection for extrasellar tumors between 2008 and 2020. Age, gender, tumor type, tumor location, tumor size, reconstruction technique, medical comorbidities, and other potential risk factors were identified. Data was analyzed to identify significant risk factors for development of postoperative CSF leak. Results There were 100 patients with extrasellar tumors who developed intraoperative CSF leaks. Seventeen patients (17%) developed postoperative CSF leaks. Leaks occurred at a median of 2 days following surgery (range 0–34 days). Clival tumors had a significantly higher incidence of postoperative leak than those in other sites (p Conclusion Extrasellar tumors, particularly clival tumors, have a higher rate of postoperative CSF leak than pituitary tumors. Prophylactic lumbar drains can be considered for patients at high risk for developing postoperative CSF leak.

Objectives Sinonasal mucosal melanoma (SNMM) is an extremely rare and challenging sinonasal malignancy with a poor prognosis. Standard treatment involves complete surgical resection, but the role of adjuvant therapy remains unclear. Crucially, our understanding of its clinical presentation, course, and optimal treatment remains limited, and few advancements in improving its management have been made in the recent past. Methods We conducted an international multicenter retrospective analysis of 505 SNMM cases from 11 institutions across the United States, United Kingdom, Ireland, and continental Europe. Data on clinical presentation, diagnosis, treatment, and clinical outcomes were assessed. Results One-, three-, and five-year recurrence-free and overall survival were 61.4, 30.6, and 22.0%, and 77.6, 49.2, and 38.3%, respectively. Compared with disease confined to the nasal cavity, sinus involvement confers significantly worse survival; based on this, further stratifying the T3 stage was highly prognostic (p Conclusions We present findings from the largest cohort of SNMM reported to date. We demonstrate the potential utility of further stratifying the T3 stage by sinus involvement and present promising data on the benefit of immune checkpoint inhibitors for recurrent, persistent, or metastatic disease with implications for future clinical trials in this field.

Introduction: olfactory neuroblastoma (ONB) is a rare cancer of the sinonasal region. We provide a comprehensive analysis of this malignancy with molecular and clinical trial data on a subset of our cohort to report on the potential efficacy of somatostatin receptor 2 (SSTR2)-targeting imaging and therapy.Methods: we conducted a retrospective analysis of 404 primary, locally recurrent, and metastatic olfactory neuroblastoma (ONB) patients from 12 institutions in the United States of America, United Kingdom and Europe. Clinicopathological characteristics and treatment approach were evaluated. SSTR2 expression, SSTR2-targeted imaging and the efficacy of peptide receptor radionuclide therapy [PRRT](177Lu-DOTATATE) were reported in a subset of our cohort (LUTHREE trial; NCT03454763).Results: dural infiltration at presentation was a significant predictor of overall survival (OS) and disease-free survival (DFS) in primary cases (n = 278). Kadish-Morita staging and Dulguerov T-stage both had limitations regarding their prognostic value. Multivariable survival analysis demonstrated improved outcomes with lower stage and receipt of adjuvant radiotherapy. Prophylactic neck irradiation significantly reduces the rate of nodal recurrence. 82.4% of the cohort were positive for SSTR2; treatment of three metastatic cases with SSTR2-targeted peptide-radionuclide receptor therapy (PRRT) in the LUTHREE trial was well-tolerated and resulted in stable disease (SD).Conclusions: this study presents pertinent clinical data from the largest dataset, to date, on ONB. We identify key prognostic markers and integrate these into an updated staging system, highlight the importance of adjuvant radiotherapy across all disease stages, the utility of prophylactic neck irradiation and the potential efficacy of targeting SSTR2 to manage disease.

Background Telemedicine is an emerging medium for the delivery of ambulatory care, but the reimbursement profile of telemedicine visits in the surgical setting has not been well studied. Methods A retrospective assessment of telemedicine encounters for thyroid and parathyroid conditions occurring from April 2015 to April 2017 was performed. Financial reimbursement from commercial payers for new and established patient visits were compared between telemedicine visits and in-person visits. Patient “savings” in terms of travel distance and drive time were calculated. Results A total of 290 telemedicine encounters were conducted; 7% were initial consultations, 47% were postoperative visits, and 45% were follow-up visits. The median patient age was 57 years. The median round-trip travel distance saved was 123.6 miles with estimated drive time of 2.4 hours per encounter. In 2% of cases, a second in-person visit within the 90-day global period occurred after a postoperative telemedicine encounter. Charges were filed for 67 encounters. The initial unpaid claims rate was 6%, which was consistent with the unpaid claims rate for in-person visits. The charge-to-collection ratio was comparable to that of in-person visits. There was a higher ratio of level 2 visits in the telemedicine encounters. Over the study period, 70 clinic hours were liberated via the use of telemedicine. Conclusion Endocrine surgery telemedicine visits have the same level for level reimbursement profile as in-person visits. Down-coding and elimination of components of in-office physical examinations may lead to modest decreases in overall reimbursement. Other advantages include reallocation of clinic resources and decreased travel burden for patients.

In this study, eggs of black-tailed gull (Larus crassirostris), a top trophic level predator of marine ecosystem were, for the first time, monitored to assess the temporal and spatial trends of emerging pollutants in South Korea. Two Island regions, namely, Baekryeong-do (Site A) and Hong-do (Site B) were investigated from 2012 to 2018, and the total levels of short chain chlorinated paraffins (SCCPs), medium chain CPs (MCCPs), and organophosphate flame retardants (OPFRs) for both Site A and B were 1180–2931 and 694–2023 ng/g lipid weight (lw), 1287–4898 and 1034–3075 ng/g lw, and 203–499 and 233–409 ng/g lw, respectively. The time-trends of the concentration of pollutants showed an increasing tendency from 2012 to 2018, with the levels predicted to be doubled within three years, following the results of regression analysis. A shift in temporal-trends from shorter to longer chain CPs was noted, suggesting the effect of industrial-related contamination. Especially, significantly high levels of CPs and OPFRs were found in the site adjacent to China, which is reasonable as China is the largest producer and consumer of FRs and plasticizers worldwide. This study is valuable to understand the temporal increment of emerging pollutants as the alternatives of phased-out FRs and plasticizers, while raising the need for continuous environmental management.

Contrast-induced sialadenitis (CIS) is a rare, delayed pseudoallergic reaction from iodine containing contrast. Previously reported cases of CIS demonstrated that the two major salivary glands (parotid and submandibular) can be affected. The initial encounter of this entity can raise alarms to physicians as the differential diagnoses include serious infectious and inflammatory conditions such as Ludwig’s angina and angioedema. Subsequently, it may lead to unnecessary testing and increased healthcare cost. Here we present a 60-year-old male who presented with bilateral sublingual gland swelling following exposure to iodinated contrast. With timely diagnosis by the otolaryngologist, the patient received conservative management that led to a full resolution within a few days. To date, this is the first case of CIS only involving the sublingual glands. We conclude that CIS can involve any of the major salivary glands.

A method for the simultaneous determination in mussel of 8 polychlorinated biphenyls (PCBs), 23 organochlorine pesticides (OCPs), and 35 polycyclic aromatic hydrocarbons (PAHs), including alkyl-PAHs, was optimised using ultrasound-assisted cloudy extraction and gas chromatography–tandem mass spectrometry (GC-MS/MS). Optimal selection of the extraction solvent and the dispersing solvent contributed to a high extraction yield and a clean extract. The ranges of the lower limits of detection of PCBs, OCPs and PAHs were 0.012–0.058, 0.01–0.29 and 0.01–0.5 μg kg−1, respectively. The feasibility of the proposed method was validated by analysing standard reference materials of mussel with satisfactory results. The precision achieved by this method was in the range of 0.677–2.69% (PCBs), 1.14–6.60% (OCPs) and 0.694–7.46% (PAHs), and its accuracy was in the range of 101–104% (PCBs), 99.6–106% (OCPs) and 101–110% (PAHs). The advantages of the method include the simultaneous measurement of 66 analytes and the simplicity, low cost and high sensitivity of the procedure. When the proposed method was used to analyse the target compounds in 11 mussel samples, the analytical results displayed a concentration range of 0.41–0.45 µg kg−1 for PCBs, 0.26–6.49 µg kg−1 for OCPs, and 3.48–30.69 µg kg−1 for PAHs.

Background Acute invasive fungal rhinosinusitis (AIFRS) is an aggressive, potentially fatal disease that can spread rapidly to the orbit and intracranial structures causing significant mortality and morbidity. Objective In this study, we present a 10-year experience from a tertiary academic medical center of patients presenting with AIFRS. Data on presentation, mortality rate, comorbidities, surgical, and medical management were analyzed. Methods A retrospective chart review was performed in a tertiary academic medical center of patients with AIFRS from January 2009 through February 2019. Data collected included demographics, presenting symptoms, comorbidities, immunosuppression status, endoscopic and imaging findings, orbital and intracranial complications, surgical and medical management, as well as outcomes and mortality. Results A total of 34 patients were identified. In our series, mortality was noted to be 61.8%, excluding patients who were lost to follow-up. The most common presenting symptoms included facial pain, ophthalmologic complaints, headaches, and proptosis. Only 4 of the 34 patients did not undergo surgical intervention, as they were not deemed surgical candidates; they all succumbed to their disease. Twenty-six of the 30 surgical patients (86.7%) underwent endoscopic sinus surgery, 8 underwent an open approach (26.7%), while 7 patients underwent orbital exenteration (23.3%). All patients had surgical pathology consistent with AIFRS. Fungal species isolated from culture included Aspergillus, Mucor/ Rhizopus, Candida, Cunninghamella Scedosporium boydii, Paecilomyces, and Scopulariopsis. Medical therapies included intravenous amphotericin B, caspofungin, posaconazole, voriconazole, isavuconazole, and micafungin. Conclusion AIFRS was associated with 61.8% mortality in our series of 34 patients over the past 10 years. Early diagnosis, as well as rapid and aggressive surgical and medical management, is necessary for optimal outcomes in this devastating disease.

Background This study examined possible risk factors for myringosclerosis formation after ventilation tube insertion (VTI). Methods A retrospective study was performed in a single tertiary referral center. A total of 582 patients who underwent VTI were enrolled in this study. Patients were divided into two groups based on the presence or absence of myringosclerosis: MS+ and MS−. Characteristics of patients were collected through medical chart review; these included age, gender, nature and duration of effusion, type of ventilation tube (VT), duration and frequency of VTI, incidence of post-VTI infection, incidence of intraoperative bleeding, and presence of postoperative perforation. Incidences of risk factors for myringosclerosis and the severity of myringosclerosis in association with possible risk factors were analyzed. Results Myringosclerosis developed in 168 of 582 patients (28.9%) after VTI. Patients in the MS+ group had an older mean age than those in the MS− group. The rates of myringosclerosis were higher in patients with older age, serous otitis media, type 2 VT, post-VTI perforation, and frequent VTI. However, there were no differences in occurrence of myringosclerosis based on gender, duration of effusion, duration of VT placement, incidence of post-VTI infection, or incidence of intraoperative bleeding. The severity of myringosclerosis was associated with the duration of effusion and frequency of VTI. Conclusion Older age, serous effusion, type 2 VT, presence of post-VTI perforation, and frequent VTI may be risk factors for myringosclerosis after VTI; the severity of myringosclerosis may vary based on the duration of effusion and frequency of VTI., Graphical Abstract

Studies on the monitoring of mercury accumulation using high trophic-level predators of the marine ecosystem have been scarce in South Korea. In this study, we compared the mercury concentrations of the eggs of the black-tailed gulls, a higher-order predator, breeding in two coastal areas. Breeding sites with varying mercury concentrations in land-origin freshwater fish and freshwater and marine sediments were selected in the southeastern (Hongdo Island) and western (Baengnyeongdo Island) seas. The 5-year mean total mercury concentration in eggs collected during the breeding seasons from 2012 to 2016 was higher in those collected from Hongdo than in those collected from Baengnyeongdo. This difference in mercury concentration in eggs was observed for each year. In addition, the total mercury concentration in eggs was consistently higher on Hongdo, which also had higher mercury pollution, than on Baengnyeongdo Island. These results support the suitability of black-tailed gull eggs for monitoring of mercury pollution.

EWSR1-PATZ1 is a rare gene fusion recently recognized to occur in round and spindle cell sarcomas. To date, fewer than 20 cases have been described in the literature. However, no dedicated case reports have detailed its presentation in the head and neck region. We recently cared for a 52-year-old woman with an isolated, single right level 5A cervical mass. Excisional biopsy at an external hospital revealed pathology results consistent with EWSR1-PATZ1 polyphenotypic round and spindle cell sarcoma. The patient subsequently underwent surgical excision of the tumor and right neck lymph node dissection followed by adjuvant chemoradiation. Laryngoscope, 2020.

Objectives The purpose of this study were to evaluate the clinical characteristics of temporal bone metastasis (TBM) and to determine whether the characteristics differed according to primary malignancy. Methods We retrospectively analyzed data on 20 patients diagnosed with TBM between January 2000 and January 2017. Demographics, the period from diagnosis of primary malignancy to TBM diagnosis, the period from TBM diagnosis to death, the type and staging of primary malignancy, otologic manifestations, and TBM sites were assessed. After the primary malignancies were divided into solid cancers and hematologic malignancies, each parameter was compared between the two groups. Results The most common primary malignancy with TBM was lung cancer (45%). The most common otologic symptoms and signs were facial palsy (30.5%) and hearing loss (30.5%). The temporal squama (23%) and the facial nerve (20%) were the most commonly involved. Most TBMs occurred late in the disease process after the primary malignancy first metastasized to other organs. Hematologic malignancies metastasized significantly more frequently to the external auditory canal and the middle ear/mastoid compared to solid cancers (P=0.001 and P=0.004, respectively). Conclusion If otologic manifestations such as facial palsy and hearing loss are presented in patients at advanced stages of malignancy, TBM of primary malignancy should be suspected. In addition, hematologic malignancies tend to metastasize to the external auditory canal and the middle ear cleft more commonly than solid cancers do.

Context Routine radioactive iodine (RAI) ablation for low-risk differentiated thyroid cancer (DTC) is not supported by current practice guidelines. Objective To assess recent stage-specific trends in use of RAI ablation. Design, Setting, and Patients Retrospective study of patients with DTC (1999 to 2015) identified from the California Cancer Registry. Statistical analysis included standardized differences, P values, and multivariable analyses using RAI as the predictor variable. Main Outcome Measures Trends and drivers of RAI ablation for low-risk DTC. Results Of 46,906 patients with DTC who underwent near-total or total thyroidectomy [mean age 48.2 ± 15.5 (standard deviation) years, 77% female), 25,457 (54%) received RAI. The proportion of patients with regional/distant disease who received RAI remained stable at 68%. Use of RAI for patients with localized disease (no extrathyroidal extension, lymph node, or distant metastases) decreased from 55% (1999) to 30% (2015), with the most substantial change occurring in tumors 4 cm. In multivariable analyses, patients with localized disease were less likely to receive RAI if they were >65 years old [odds ratio (OR) 0.77, 95% confidence interval (CI): 0.71 to 0.83], had tumors

This study sought to analyze the particulate matter (PM) deposited on the surface of pine needles (Pinus densiflora) and pollutants within the needles and to investigate their utility as bioindicators. First-year needles of pines native to South Korea were collected at least 2 m above the ground. A total of four sampling points were selected: two parks around an industrial complex and two urban parks. After desorbing the PM deposited on the surface of the collected needles using ultrasonic waves, the PM and needles were classified; 21 metals, including Pb, contained in each medium were analyzed using inductively coupled plasma-mass spectrometry (ICP-MS). Useful bioindicators for air-pollution monitoring among the PM deposited on the needles included Al, As, Be, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Ba, Bi, Cs, Li, Rb, Se, Sr, Tl, U, V, and Zn contents. In an analysis of elements identified in PM and needles, Al and Mn were determined to be equally useful as monitoring indicators across a wide area. Elements with high concentrations in pine needles due to PM deposition were As, Cu, Mn, Ni, Pb, Rb, and Sr. The pine needles themselves accounted for 99.95% of the combined mass of the needles and PM, with PM representing only 0.053% of the combined mass. Therefore, washing is expected to have little effect on the pollutant concentrations within the needles.

The brake systems are composed of brake disc, brake pad and caliper and, these three parts play an important role for braking. In this study, heat fluid analysis is conducted for five different ventilated disc models, and two piece brake disc model separated in rotor and housing is used. In this case, each model has a different number of holes and vent shape. The basic heat flux and braking power equations are applied for the heat fluid analysis. The cooling performance with/without the braking operation is also analyzed for given five models where the material properties and boundary conditions are set to be identical. From our analysis results, it is found that the number of disc holes and ventilated pins strongly influences on the cooling performance.

We assessed the optimal time for intact parathyroid hormone (iPTH) measurement for early detection of post-total thyroidectomy (TT) hypocalcemia in patients with papillary thyroid carcinoma (PTC). In this single-center prospective cohort study, 143 patients who underwent TT with central neck dissection with or without lateral neck dissection for PTC were included. Biochemical profiles including iPTH, corrected total calcium, and ionized calcium within 24 h after surgery were analyzed. The 4-h postoperative iPTH was the most reliable predictor of post-TT transient or permanent hypoparathyroidism (cutoff for hypocalcemia was 3.75 pg/mL, AUC = 0.885, P

BACKGROUND Unplanned readmissions within 30 days of discharge is a quality measure introduced by the Centers for Medicare Services. This measure has been used to rate hospital quality and also to penalize hospitals for excess readmissions. It has been hypothesized that shorter hospital stays and fewer readmissions are associated with endoscopic skull base procedures. In this study we analyze endoscopic skull base procedures performed at our institution over a 10-year period to identify rates and factors associated with readmissions after endoscopic skull base surgery. METHODS A retrospective chart review was performed at a tertiary care academic medical center identifying patients who underwent endoscopic skull base surgery over the past 10 years. Data on patient demographics and tumor variables, as well as patient variables such as body mass index (BMI), revision surgery, history of skull base radiation, medical comorbidities, intraoperative cerebrospinal fluid (CSF) leaks, and postoperative CSF leaks, were recorded. RESULTS Eight hundred thirty-three patients were included in our study. Sixty-one patients (7.3%) were readmitted a total of 66 times within 30 days. The most common reasons were as follows: hyponatremia (n = 18); CSF leak (n = 17); epistaxis (n = 3); diabetes insipidus (n = 3); rhinorrhea (n = 3); as well as other reasons. Statistical analysis revealed that the presence of intraoperative CSF leak was the only statistically significant variable associated with increased rate of readmissions within 30 days of discharge (p < 0.001). CONCLUSION Presence of intraoperative CSF leak was the only statistically significant variable associated with an increased risk for readmission after surgery. Other tumor and patient variables were not associated with an increased risk of readmission within 30 days.

Background: Chronic suppurative otitis media (CSOM) was considered as a contraindication of cochlear implantation (CI) in the past. Recently, various surgical options have been adopted for CI in CSOM patients with showing a low complication rate. Objectives: To evaluate surgical outcomes of CI in patients with CSOM and to propose a management algorithm for those patients. Methods: Thirty-six consecutive patients with CSOM who underwent single stage or staged CI were enrolled. Speech performance, including Categories of Auditory Performance (CAP) test and sentence score, and complications were retrospectively analyzed. Results: The average follow-up was 3.1 years (range 0.5–9.2 years). Postoperative median CAP and sentence scores were 6 and 78%, respectively. Three (8.3%) of the 36 patients had postoperative complications. One experienced breakdown of the ear canal closure. Recurrence of the pars tensa retraction was observed in another patient with adhesive otitis media who underwent CI and cartilage tympanoplasty as a single stage operation. Electrode extrusion occurred in another patient who underwent staged CI with maintenance of a previous open cavity. Subtotal petrosectomy and cavity obliteration were used to manage the latter 2 complications. All implant patients with good mastoid pneumatization exhibited no complications. There were no significant differences in postoperative speech performance and complication rates between single stage CI and staged CI. Based on these current findings, a management algorithm was proposed according to type of CSOM, presence of open cavity, and mastoid pneumatization. Conclusions: Patients with CSOM show good postoperative speech performance after CI. Proper surgical options according to type of CSOM, presence of open cavity, and mastoid pneumatization may help in reducing complications.

Chronic rhinosinusitis (CRS) with eosinophilic mucin is considered rare in Korea. The object of this study was to categorize CRS patients with eosinophilic mucin into several groups and compared the groups based on their clinicopathological and radiological features. In total, 105 CRS patients with eosinophilic mucin from four tertiary medical centers which are located at Chungcheong province of Korea were included for this study. The patients were divided into four groups for analysis, based on the presence or absence of an allergy (A) to a fungus or fungal element (F) in the mucin. The following were the four groups: allergic fungal rhinosinusitis (AFRS, A+F+), AFRS-like sinusitis (A+F−), eosinophilic fungal rhinosinusitis (EFRS, A−F+), and eosinophilic mucin rhinosinusitis (EMRS, A−F−). Their clinical manifestation, the presence of associated disease, radiological finding, treatment, and treatment outcome were reviewed and compared. There were no patients in the AFRS-like sinusitis group, 47 patients were assigned to the AFRS group, 27 to the EFRS group, and 41 to the EMRS group. Patients of AFRS group showed a significantly higher association with allergic rhinitis than did the other groups. The mean total serum IgE level in the AFRS patients was significantly higher than in the EFRS and EMRS patients. In the AFRS group and EFRS group, 67.6% and 74.1% had unilateral disease, respectively, in contrast to the EMRS group (4.9%). The mean Hounsfield unit values of the area of high attenuation in the AFRS patients were significantly higher than those in the other groups. Significant clinicopathological differences existed among the subgroups of CRS with eosinophilic mucin. AFRS tends to be an allergic response to colonizing fungi in atopic individuals. In EFRS, local allergies to fungi might play a role in the disease. EMRS is thought to be unconnected with fungal allergies, and it showed different form compared with the AFRS and EFRS groups.

는 세라믹-세라믹으로 Key Words: Hip Squeak(고관절 마찰소음); Hip Joint(인공고관절); Mode-Coupling(모드연성); Negative Slope(음의 기울기) 초록: 본 논문은 복소수 고유치해석을 통하여 세라믹-세라믹 인공고관절 시스템에서의 동적 불안정성을 연구하고자 하였다. 시스템 파라메터 연구를 통해서 모드 연성 기반의 불안정성을 연구하였고, 음의 기울기를 포함하는 유한요소 해석 모델을 구현하여 음의 기울기에 의한 불안정성에 대해 조사하였다. 그 결과 토션이 지배적인 시스템 모드가 음의 기울기에 의해 불안정해 지며, 이는 축하중에 크게 영향을 받는다는 점을 확인하였다. Abstract: This study investigated the dynamic instability of a ceramic-on-ceramic artificial hip joint system through complex eigenvalue analysis. We examined the mode-coupling mechanism through eigenvalue sensitivity analysis with the variation of system parameters. In addition, we constructed a finite element model including the negative slope of friction curve for investigating the negative-slope mechanism in the hip squeak problem. The numerical results show that the torsion-dominant mode becomes unstable due to the presence of the negative slope while the axial load is the important factor influencing the negative-slope type instability.

The restoration of a damaged endothelium might be a fascinating way to reduce significantly late-thrombosis and restenosis in the stent treatment. It has been recently reported that the recruitment of endothelial progenitor cells (EPCs), capable for repairing a damaged endothelium, can be important in the vascular stent application. Therefore, we focused on the hypothesis that stromal cell-derived factor-1α (SDF-1α) acts as a key chemokine for the mobilization and recruitment of EPCs to the damaged endothelium lesion. In this study, the effect of SDF-1α released from a cobalt-chromium alloy (Co-Cr) plate, vascular stent material, was investigated on the recruitment of EPCs in vitro. Dopamine-conjugated heparin was synthesized to introduce heparin onto Co-Cr. Heparin-coated Co-Cr surfaces were examined by water contact angle and attenuated total reflectance-Fourier transform infrared (ATRFTIR) to prove successful coating of heparin. Finally, SDF-1α was bound to the coated heparin derivative. Amounts of loaded and released SDF-1α were measured by ELISA, and the recruited EPC by released SDF-1α was evaluated using two different migration assays. The quantity of SDF-1α bound to the heparin-modified surface increased in a concentration-dependent manner and SDF-1α was released over 28 days. Transwell migration assay revealed that soluble SDF-1α released from the heparin-coated Co-Cr induced significantly more EPC recruitment than bare Co-Cr and heparin-coated Co-Cr. More importantly, fibrin gel migration assay further demonstrated that EPCs evidently respond to heparin-based substrate with SDF-1α and this type of behaviors was surprisingly found at as low level as less 1 ng/day of SDF-1α. These results are strongly encouraging for further in vitro and in vivo studies. Open image in new window

Intra-articular (IA) injection of hyaluronic acid (HA) in combination with nonsteroidal anti-inflammatory drugs, such as ketorolac (KL), have been clinically investigated to provide more rapid and profound pain relief in patients with osteoarthritis. However, its safety, local tolerance, and potential for pharmacokinetic interaction have not been assessed. In this study, the pharmacokinetics and toxicity of a combination of HA and KL were evaluated in normal rats following four-week repeated-dose injection. Rats received HA or KL alone at 4 mg/kg or 16 mg/kg, respectively, or HA/KL combination at 4/4 mg/kg, 4/8 mg/kg, or 4/16 mg/kg on a weekly basis. The rats exhibited temporal, reversible changes in hematology, serum chemistry, and urinalysis caused primarily by KL treatment. No deleterious effects were observed on the joint following repeated IA HA/KL administration, which showed only minimal to mild levels of temporary inflammatory changes in synovial membrane. The plasma KL level following IA injection rose as fast as that of intra-muscular injection, with no alteration with the co-administered HA. In conclusion, repeated IA administration of HA/KL combination was tolerated well in normal rats, encouraging future studies of IA injection of HA/KL combination on osteoarthritis-induced animal models and even patients.

Objectives Proton-pump inhibitor (PPI) prescribing practices in laryngopharyngeal reflux disease (LPR) differ among physicians. We assessed the improvement in reflux symptom index (RSI) and reflux finding score (RFS) after treating LPR with three different regimens. Design A prospective, double-blind, randomized clinical trial. Setting Chungnam national university hospital in Korea. Participants From July 2015 to July 2017, 100 patients with LPR included in the study. The patients were prescribed one of the following regimens for 3 months: group A, ilaprazole 10 mg, once a day (QD), n = 29; group B, ilaprazole 10 mg, twice a day (BID), n = 27; and group C, ilaprazole 10 mg BID plus mosapride citrate 5 mg three times a day (TID), n = 44. Main outcome measures The total RSI and RFS scores and each subitems in RSI and FRS of the patients were evaluated. Results Total RFS and RSI scores improved significantly at the 3-month follow-up in all groups, and the improvements were of similar magnitudes. Regarding the RFS, the degrees of improvement in vocal cord oedema (P = 0.002) and diffuse laryngeal oedema (P = 0.003) scores differed significantly among the three groups. Moreover, overweight or obese patients in group C showed the greatest improvement in RFS. However, age had no effect on treatment efficacy. Conclusion Three PPI therapeutic strategies showed similar efficacies against LPR according to total RFS and RSI scores. The addition of a prokinetic resulted in improvements in specific endoscopic findings, such as vocal cord oedema and diffuse laryngeal oedema. Furthermore, the addition of a prokinetic to PPI therapy was particularly beneficial for overweight or obese patients.

To determine whetherA retrospective analysis was performed in 108 patients who underwentThe BRAFThe BRAF

Polyamide4 (PA4)-polyurethane (PU)-PA4 triblock copolymers were synthesized by isocynated (NCO)-terminated PU prepared from 4,4'-diphenyl methane diisocyante (MDI) and polytetramethylene glycol (PTMG) as an initiator and potassium pyrrolidonate (P-py) as a catalyst for anionic ring opening polymerization of 2-pyrrolidone. Subsequently copolymer was controlled to contain different or same molecular weight of PA4 hard block with same or different molecular weight of PU soft block in order to investigate the effects of those differences on various properties of triblock copolymers as a thermoplastic elastomer. As the results shown in typical properties of block copolymeric elastomers, the mechanical strength and melting point (Tm) of the copolymers increased with an increase in molecular weight of PA4 block while the elongation at break increased with an increase in that of PU block.

α1-Adrenergic receptors (α1-ARs) elicit a negative inotropic effect (NIE) in the mouse right ventricular (RV) myocardium but a positive inotropic effect (PIE) in the left ventricular (LV) myocardium. Effects on myofilament Ca2+sensitivity play a role, but effects on Ca2+handling could also contribute. We monitored the effects of α1-AR stimulation on contraction and Ca2+transients using single myocytes isolated from the RV or LV. Interestingly, for both the RV and LV, we found heterogeneous myocyte inotropic responses. α1-ARs mediated either a PIE or NIE, although RV myocytes had a greater proportion of cells manifesting a NIE (68%) compared with LV myocytes (36%). Stimulation of a single α1-AR subtype (α1A-ARs) with a subtype-selective agonist also elicited heterogeneous inotropic responses, suggesting that the heterogeneity arose from events downstream of the α1A-AR subtype. For RV and LV myocytes, an α1-AR-mediated PIE was associated with an increased Ca2+transient and a NIE was associated with a decreased Ca2+transient, suggesting a key role for Ca2+handling. For RV and LV myocytes, α1-AR-mediated decreases in the Ca2+transient were associated with increased Ca2+export from the cell and decreased Ca2+content of the sarcoplasmic reticulum. In contrast, for myocytes with α1-AR-induced increased Ca2+transients, sarcoplasmic reticulum Ca2+content was not increased, suggesting that other mechanisms contributed to the increased Ca2+transients. This study demonstrates the marked heterogeneity of LV and RV cellular inotropic responses to stimulation of α1-ARs and reveals a new aspect of biological heterogeneity among myocytes in the regulation of contraction.

Chronic kidney disease is now recognized as a major health problem, but current therapies including dialysis and renal replacement have many limitations. Consequently, biodegradable scaffolds to help repairing injured tissue are emerging as a promising approach in the field of kidney tissue engineering. Poly(lactic-co-glycolic acid) (PLGA) is a useful biomedical material, but its insufficient biocompatibility caused a reduction in cell behavior and function. In this work, we developed the kidney-derived extracellular matrix (ECM) incorporated PLGA scaffolds as a cell supporting material for kidney tissue regeneration. Biomimetic PLGA scaffolds (PLGA/ECM) with different ECM concentrations were prepared by an ice particle leaching method, and their physicochemical and mechanical properties were characterized through various analyses. The proliferation of renal cortical epithelial cells on the PLGA/ECM scaffolds increased with an increase in ECM concentrations (0.2, 1, 5, and 10%) in scaffolds. The PLGA scaffold containing 10% of ECM has been shown to be an effective matrix for the repair and reconstitution of glomerulus and blood vessels in partially nephrectomized mice in vivo, compared with only PLGA control. These results suggest that not only can the tissue-engineering techniques be an effective alternative method for treatment of kidney diseases, but also the ECM incorporated PLGA scaffolds could be promising materials for biomedical applications including tissue engineered scaffolds and biodegradable implants.

SiO 2 thin films were deposited by a cold arc plasma jet at atmospheric pressure. The cold arc plasma jet was operated with O 2 gas of 30 L min -1 , while a He/TEOS mixture of 1000 sccm was added to the plume of the plasma jet as a precursor. The plasma jet was continuously moved in the xy direction for uniform film thickness. The deposition rate at various conditions was studied by controlling the substrate distance, precursor inlet position, and substrate temperature; the physical and chemical properties of the films were characterized by SEM and XPS. A high deposition rate was attained using the cold arc plasma jet deposition system in open air; it is suggested that this originates from the abundant oxygen atoms produced in the cold arc plasma jet.

Tin free steel plate (TFS) that is substrate of the PET-laminated steel has been treated by atmospheric pressure plasma at room temperature in order to enhance the surface adhesive properties. After plasma treatment, the water-contact angle measurement was conducted and the surface-free energy of the TFS plate was proved to be increased. Besides, the peel-off test for adhesive property of PET-laminated steel also was conducted and the adhesion between TFS and polymer (PET) was enhanced remarkably. From the results of XPS and SEM analysis, we could confirm that new functional groups causing the adhesion enhancement were generated under the carbon cleaning effect and surface oxidation effect by reactive species in the plasma, such as atomic oxygen etc.

Objectives Recently, S-phenylmercapturic acid (S-PMA) and trans,trans -muconic acid ( t,t -MA) in urine have been proposed as reliable biomarkers for monitoring occupational exposure to benzene. The aim of this study was to test the applicability of S-PMA and t,t -MA as exposure biomarkers and to monitor the occupational exposure level and the extent of environmental contamination from benzene in Korea. Methods The urinary excretion of S-PMA and t,t -MA in rats after the intraperitoneal administration of benzene (0.88~800 mg/kg body weight, 7 days) was examined. These biomarkers were also validated in human urine samples collected from elementary schoolchildren in several industrial areas including chemical manufacturing plants, oil refineries, and natural gas-producing installations in Korea. Urine was collected from elementary schoolchildren in a mountain village with no known occupational exposure to benzene and air pollution as the reference group. Results In rats, there was a significant relationship between the benzene concentration and the excretion of the urinary S-PMA and t,t -MA as a function of concentration, and the excretion of benzene metabolites peaked on the first day after intraperitoneal administration. In human urine, higher levels of S-PMA and t,t -MA were detected more frequently in petrochemical industrial areas than in areas with no known occupational exposure to benzene. Conclusion These results show that the quantitative determination of S-PMA and t,t -MA in urine can be used as a reliable exposure biomarker for benzene, and they also suggest that extensive attention to benzene exposure is needed for maintaining the health of the population in Korea.

We have developed two electrode configurations that employ one primary supply circuit with a variable resistor for large-volume, high-pressure glow discharges without glow-to-arc transitions, and have investigated their electrical and the photoimages in microhollow cathode sustained discharges. The applied voltage and the discharge current between electrodes were controlled by changing the resistance of a variable resistor, which could replace the secondary supply circuit in microhollow cathode sustained discharges for the formation of secondary discharge. The electrical and the optical measurements showed that the discharge passed through three distinct stages: no discharges, microhollow cathode discharges, and microhollow cathode sustained discharges. Compared with the two-supply circuit system that has a primary and a secondary supply circuit, this electrode configuration is very simple and inexpensive process in generating large-volume plasmas at high pressures.

The cold arc plasma jet was introduced to decontaminate chemical and biological warfare (CBW) agents for the application of a portable CBW decontamination system. The cold arc plasma jet is a low temperature, high density plasma that produces highly reactive species such as oxygen atoms and ozone. Moreover, it is possible to maintain stable plasma without He or Ar. The discharge operated on N2-02 mixture of 30 L/min, and the high voltage pulse (23 kHz, 30% duty ratio) power was applied to the inner electrode. In the decontamination experiments, Bacillus subtilis and Escherichia Coli were chosen as simulants for biological agents and DMMP (Dimethylmethylphosphonate) was chosen as a simulant for chemical agents. The experimental results showed that B. subtilis and E. coli were efficiently decontaminated. Also, DMMP absorbed on the metal substrate and the glass substrate was removed after plasma treatment. Finally, we identified that DMMP was decomposed very well in the plasma effluent.

Summary form only given. Xe is good candidate for mercury free light source. Since Xe atom has very large value of collision cross-section, its positive column easily reaches a constricted state which lowers the lighting efficiency. Therefore, it is important to prevent Xe positive column from constriction for high efficient light source. To achieve diffused positive column, high voltage pulse driving system has been widely used in low pressure Xe lamp. There is a problem to use the pulse power system in the commercial aspect: the price of a high voltage pulse power inverter is too high for home use. In this work, we suggested the noble gas mixing combination, Xe-N2, for high efficient low pressure Xe lamp. The energy transfer mechanism of Xe-N2 mixture is as follows. An excited N2 molecules is produced by the collision between an electron having a low energy about 2-4 eV and N2. The energy of excited molecules is directly transferred to the neutral Xe atom and the excited Xe and metastable Xe are produced. We use optical emission spectroscopy (OES) to determine excited species in discharge and ELENDIF to calculate electron temperature and EEDF of positive column. From the calculation results, the Xe-N2 mixture shows the 10-20% of VUV radiation enhancement comparing with pure Xe discharge in the low reduced electric field