Hippo-YAP/TAZ signalling coordinates adipose plasticity and energy balance by uncoupling leptin expression from fat mass.

Adipose tissues serve as an energy reservoir and endocrine organ, yet the mechanisms that coordinate these functions remain elusive. Here, we show that the transcriptional coregulators, YAP and TAZ, uncouple fat mass from leptin levels and regulate adipocyte plasticity to maintain metabolic homeostasis. Activating YAP/TAZ signalling in adipocytes by deletion of the upstream regulators Lats1 and Lats2 results in a profound reduction in fat mass by converting mature adipocytes into delipidated progenitor-like cells, but does not cause lipodystrophy-related metabolic dysfunction, due to a paradoxical increase in circulating leptin levels. Mechanistically, we demonstrate that YAP/TAZ-TEAD signalling upregulates leptin expression by directly binding to an upstream enhancer site of the leptin gene. We further show that YAP/TAZ activity is associated with, and functionally required for, leptin regulation during fasting and refeeding. These results suggest that adipocyte Hippo-YAP/TAZ signalling constitutes a nexus for coordinating adipose tissue lipid storage capacity and systemic energy balance through the regulation of adipocyte plasticity and leptin gene transcription.

Inhibitory Regulation of FOXO1 in PPARδ Expression Drives Mitochondrial Dysfunction and Insulin Resistance.

Forkhead box O1 (FOXO1) regulates muscle growth, but the metabolic role of FOXO1 in skeletal muscle and its mechanisms remain unclear. To explore the metabolic role of FOXO1 in skeletal muscle, we generated skeletal muscle-specific Foxo1 inducible knockout (mFOXO1 iKO) mice and fed them a high-fat diet to induce obesity. We measured insulin sensitivity, fatty acid oxidation, mitochondrial function, and exercise capacity in obese mFOXO1 iKO mice and assessed the correlation between FOXO1 and mitochondria-related protein in the skeletal muscle of patients with diabetes. Obese mFOXO1 iKO mice exhibited improved mitochondrial respiratory capacity, which was followed by attenuated insulin resistance, enhanced fatty acid oxidation, and improved skeletal muscle exercise capacity. Transcriptional inhibition of FOXO1 in peroxisome proliferator-activated receptor δ (PPARδ) expression was confirmed in skeletal muscle, and deletion of PPARδ abolished the beneficial effects of FOXO1 deficiency. FOXO1 protein levels were higher in the skeletal muscle of patients with diabetes and negatively correlated with PPARδ and electron transport chain protein levels. These findings highlight FOXO1 as a new repressor in PPARδ gene expression in skeletal muscle and suggest that FOXO1 links insulin resistance and mitochondrial dysfunction in skeletal muscle via PPARδ.

Donor body mass index over 30 is no barrier for pure laparoscopic donor right hepatectomy.

Backgrounds/Aims: Challenges arise when translating pure laparoscopic donor right hepatectomy (PLDRH) results from Asian to Western donors, due to differences in body mass index (BMI). This study compares the outcomes of PLDRH and conventional open donor right hepatectomy (CDRH) in donors with BMI over 30. Methods: Medical records of live liver donors (BMI > 30) undergoing right hepatectomy (2010-2021) were compared: 25 PLDRH cases vs. 19 CDRH cases. Donor and recipient demographics, operative details, and outcomes were analyzed. Results: PLDRH and CDRH had similar donor and recipient characteristics. PLDRH had longer liver removal and warm ischemic times, but a shorter post-liver removal duration than CDRH. Donor complication rates were comparable, with the highest complication being grade IIIa in PLDRH, necessitating needle aspiration for biloma on postoperative day 11. Fortunately, this donor fully recovered without additional treatment. No complications exceeding Clavien-Dindo grade IIIa occurred in either group. Recipient outcomes between the groups were similar. Conclusions: This study supports PLDRH as a viable option for donors with BMI over 30, challenging the notion that high BMI should deter considering PLDRH. The findings provide valuable insights into the safety and feasibility of PLDRH, encouraging further exploration of this technique in diverse donor populations.

Impact of typhoons on anthropogenic nitrogen sources in Lake Sihwa, South Korea.

This study investigated the nitrate dual isotopic compositions (δ15NNO3 and δ18ONO3) of water samples to trace nitrate sources in Lake Sihwa, which encompasses various land-use types (e.g., urban, industry, wetland, and agriculture). The biogeochemical interactions of anthropogenic nitrogen sources (e.g., soil, road dust, and septic water) were also evaluated through multiple pathways from terrestrial boundaries to the water column. Based on increased concentrations of dissolved total nitrogen (DTN; 3.1 ± 1.6 mg/L) after typhoon, the variation of element stoichiometry (N:P:Si) in this system shifted to the relatively N-rich conditions (DIN/DIP; 14.1 ± 8.1, DIN/DSi; 1.4 ± 1.8), potentially triggering the occurrence of harmful algal blooms. Furthermore, discriminative isotopic compositions (δ15NNO3; 4.0 ± 2.1 ‰, δ18ONO3; 6.1 ± 4.3 ‰) after the typhoon suggested the increased DTN input of anthropogenic origins within Lake Sihwa would be mainly transported from urban sources (76 ± 9 %). Consequently, the isotopic-based approach may be useful for effective water quality management under increased anthropogenic activities near aquatic systems.

Impact of Preformed Donor-specific Antibodies in Comparison to ABO Incompatibility in Living Donor Liver Transplantation: A Propensity Score-Matched Analysis.

BACKGROUND: Immunological factors play a pivotal role in the outcomes of solid organ transplantation. We aimed to elucidate the effects of donor-specific antibodies (DSAs) and ABO compatibility on living donor liver transplantation (LDLT) outcomes. METHODS: A retrospective analysis was conducted on 584 LDLT recipients from 2015 to 2020. The recipients were stratified into 3 groups: ABO-compatible recipients without DSAs (group 1), ABO-compatible recipients with DSAs (group 2), and ABO-incompatible recipients without DSAs (group 3). Propensity score matching was used for balanced comparisons. RESULTS: In the matched comparisons, group 2 exhibited a higher incidence of T cell-mediated rejection compared with group 1 (22.7% versus 4.5%, P = 0.030). Despite this, the 5-y survival rates were similar between groups 1 and 2 (81.6% versus 95.5%, P = 0.085). Group 3, in comparison with group 1, showed elevated rates of cytomegalovirus infection (23.2% versus 7.3%, P = 0.008), T cell-mediated rejection (28.0% versus 7.3%, P = 0.001), and antibody-mediated rejection (13.4% versus 0%, P = 0.001). However, the survival rates were comparable between group 3 and group 1 (82.0% versus 86.5%, P = 0.220, respectively). Comparisons between group 2 and group 3 did not reveal significant differences in postoperative outcomes or survival rates (P > 0.05). CONCLUSIONS: DSA positivity and ABO incompatibility contribute to distinct posttransplant complications in LDLT. The integrated consideration of both factors in pretransplant assessment may enhance risk stratification and inform tailored interventions. Further research is required to corroborate these findings and provide mechanistic insights.

Atmospheric mercury uptake and accumulation in forests dependent on climatic factors.

The environmental and climatic factors dictating atmospheric mercury (Hg) uptake by foliage and accumulation within the forest floor are evaluated across six mountain sites, South Korea, using Hg concentration and Hg stable isotope analyses. The isotope ratios of total gaseous Hg (TGM) at six mountains are explained by local anthropogenic Hg emission influence and partly by mountain elevation and wind speed. The extent to which TGM is taken up by foliage is not dependent on the site-specific TGM concentration, but by the local wind speed, which facilitates TGM passage through dense deciduous canopies in the Korean forests. This is depicted by the significant positive relationship between wind speed and foliage Hg concentration (r2 = 0.92, p < 0.05) and the magnitude of δ202Hg shift from TGM to foliage (r2 = 0.37, p > 0.05), associated with TGM uptake and oxidation by foliar tissues. The litter and topsoil Hg concentrations and isotope ratios reveal relationships with a wide range of factors, revealing lower Hg level and greater isotopic fractionation at sites with low elevation, high wind speed, and high mean warmest temperature. We attribute this phenomenon to active TGM re-emission from the forest floor at sites with high wind speed and high temperature, caused by turnover of labile organic matter and decomposition. In contrast to prior studies, we observe no significant effect of precipitation on forest Hg accumulation but precipitation appears to reduce foliage-level Hg uptake by scavenging atmospheric Hg species available for stomata uptake. The results of this study would enable better prediction of future atmospheric and forest Hg influence under climate change.

Identifying the external N and Hg inputs to the estuary ecosystem based on the triple isotopic information (δ15NNO3, Δ17ONO3 and δ18ONO3).

The supply and sources of N and Hg in the Geum estuary of the western coast of Korea were evaluated. Triple isotope proxies (δ15NNO3, Δ17ONO3 and δ18ONO3) of NO3- combined with conservative mixing between river and ocean waters were used to improve isotope finger-printing methods. The N pool in the Geum estuary was primarily influenced by the Yellow Sea water, followed by riverine discharge (821 × 106 mol yr-1) and atmospheric deposition (51 × 106 mol yr-1). The influence of the river was found to be greater for Hg than that of the atmosphere. The triple isotope proxies revealed that the riverine and atmospheric inputs of N have been affected by septic wastes and fossil fuel burning, respectively. From the inner estuary towards offshore region, the influence of the river diminishes, thus increasing the relative impact of the atmosphere. Moreover, the isotope proxies showed a significant influence of N assimilation in February and nitrification in May.

Quantitative source tracking for organic foulants in ultrafiltration membrane using stable isotope probing approach.

Quantitatively identifying the primary sources of organic membrane fouling is essential for the effective implementation of membrane technology and optimal water resource management prior to the treatment. This study leveraged carbon stable isotope tracers to estimate the quantitative contributions of various organic sources to membrane fouling in an ultrafiltration system. Effluent organic matter (EfOM) and aquatic natural organic matter (NOM), two common sources, were combined in five different proportions to evaluate their mixed effects on flux decline and the consequent fouling behaviors. Generally, biopolymer (BP) and low molecular weight neutral (LMWN) size fractions - abundantly present in EfOM - were identified as significant contributors to reversible and irreversible fouling, respectively. Fluorescence spectroscopy disclosed that a protein-like component notably influenced overall membrane fouling, whereas humic-like components were predominantly responsible for irreversible fouling rather than reversible fouling. Fluorescence index (FI) and biological index (BIX), common fluorescence source tracers, showed promise in determining the source contribution for reversible foulants. However, these optical indices were insufficient in accurately determining individual source contributions to irreversible fouling, resulting in inconsistencies with the observed hydraulic analysis. Conversely, applying a carbon stable isotope-based mixing model yielded reasonable estimates for all membrane fouling. The contribution of EfOM surpassed 60 % for reversible fouling and increased with its content in DOM source mixtures. In contrast, aquatic NOM dominated irreversible fouling, contributing over 85 %, regardless of the source mixing ratios. This study emphasizes the potential of stable isotope techniques in accurately estimating the contributions of different organic matter sources to both reversible and irreversible membrane fouling.

A MHz X-ray diffraction set-up for dynamic compression experiments in the diamond anvil cell.

An experimental platform for dynamic diamond anvil cell (dDAC) research has been developed at the High Energy Density (HED) Instrument at the European X-ray Free Electron Laser (European XFEL). Advantage was taken of the high repetition rate of the European XFEL (up to 4.5 MHz) to collect pulse-resolved MHz X-ray diffraction data from samples as they are dynamically compressed at intermediate strain rates (≤103 s-1), where up to 352 diffraction images can be collected from a single pulse train. The set-up employs piezo-driven dDACs capable of compressing samples in ≥340 µs, compatible with the maximum length of the pulse train (550 µs). Results from rapid compression experiments on a wide range of sample systems with different X-ray scattering powers are presented. A maximum compression rate of 87 TPa s-1 was observed during the fast compression of Au, while a strain rate of ∼1100 s-1 was achieved during the rapid compression of N2 at 23 TPa s-1.

Systematic tracing of nitrate sources in a complex river catchment: An integrated approach using stable isotopes and hydrological models.

Quantitative estimation for tracking the transport of various nitrate sources is required to effectively manage nitrate loading in complex river systems. In this study, we validated an integrated framework using field isotopic data (δ15NNO3 and δ18ONO3) of nitrates and hydrological modeling (hydrological simulation program FORTRAN; HSPF) to determine anthropogenic nitrate flux among different land-use types within a watershed. Nitrate isotopic compositions showed different ranges among four land-use types (4.9 to 15.5‰ for δ15NNO3, -4.9 to 12.1‰ for δ18ONO3), reflecting the different nitrate sources (sewage, synthetic fertilizer, effluent and soil) within watersheds. Based on the integration of HSPF modeling, we also found that total nitrate loads might be partially controlled by hydrological conditions such as water discharge (12,040.3-22,793.2 L/s) from upstream to downstream. Among the nitrate sources, the sewage transport showed unique enhancement near urban boundaries, along with an increase in total nitrate load (>193.5 NO3-N g/s km2) in downstream areas. In addition, the isotopic- and model-based nitrate fluxes showed good correlation for urban sources (R2=0.73, p < 0.05) but poor correlations for agriculture-dominated land use (R2=0.13, p > 0.05), reflecting the potential influence of surface runoff and ground infiltration into the watershed. Consequently, this research provided useful information to establish nitrogen management policy controlling point and non-point nitrate source loads in various land-use types for the restoration of water quality and aquatic ecosystem in the complex river system. Considering the recent increase in human activities near aquatic environments, this framework would be effective for individually estimating the quantitative contributions of anthropogenic nitrate sources transported along river-coastal systems.

Innovative approach to reveal source contribution of dissolved organic matter in a complex river watershed using end-member mixing analysis based on spectroscopic proxies and multi-isotopes.

Dissolved organic matter (DOM) in river watersheds dynamically changes based on its source during a monsoon period with storm event. However, the variations in DOM in urban and rural river watersheds that are dominated by point and non-point sources have not been adequately explored to date. We developed an innovative approach to reveal DOM sources in complex river watershed systems during pre-monsoon, monsoon, and post-monsoon periods using end-member mixing analysis (EMMA) by combining multi-isotope values (δ13C-DOC, δ15N-NO3 and δ18O-NO3) and spectroscopic indices (fluorescence index [FI], biological index [BIX], humification index [HIX], and specific UV absorbance [SUVA]). Several potential end-members of DOM sources were collected from watersheds, including top-soils, groundwater, plant group (fallen leaves, riparian plants, suspended algae), and different effluents (cattle and pig livestock, agricultural land, urban, industry facility, swine treatment facility and wastewater treatment facility). Concentrations of dissolved organic carbon, dissolved organic nitrogen, NO3-N, and NH4-N increased during the monsoon period with an increase in the input of anthropogenic DOM, which have higher HIX values owing to the flushing effect. The results of EMMA indicate that soil and agricultural effluents accounted for a substantial contribution of anthropogenic DOM at varying rates based on seasons. We also found that results of EMMA based on combining spectroscopic indices and δ13C-DOC isotope values were more accurate in tracing DOM sources with respect to land-use characteristics compared to applying only spectroscopic indices. The positive relationship between FI, BIX and δ15N-NO3 were revealed that nitrate would be decomposed from DOM affected by intensive agricultural activities. In addition, consistent with the EMMA results, the molecular composition of the DOM was clearly evidenced by a large number of CHON formulas, accounting for over 50% of the total characterized compounds, including pesticides and pharmaceuticals used in agriculture farmland and livestock. Our results clearly demonstrated that EMMA based on combing multi-stable isotopes and spectroscopic indices could be trace the DOM source, which is important for understanding changes in the DOM quality, and application of nitrate isotopes and molecular analysis supports in-depth interpretation. This study provides easy and intuitive techniques for the estimation of the relative impacts of DOM sources in complex river watersheds, which can be verified in various ways rather than relying on a single technique approach.

The Gut Bacterial Community of Chlaenius pallipes (Coleoptera: Carabidae) Associates with Their Habitat and Morphology.

We investigated whether the gut bacterial community of Chlaenius pallipes could represent the health conditions of individuals or populations based on where these beetles inhabit. Considering the ecological traits of the species, the gut bacterial communities of carabid populations inhabiting stable or unstable habitats were compared. Food resource quality (δ15N) and morphological shape, especially body and wing size, may be significant factors that directly or indirectly affect the gut bacterial community of carabid beetles. Firmicutes (51.7%) and Proteobacteria (36.3%) were the predominant phyla in the gut bacterial community of C. pallipes. A significant difference in the gut bacterial community structure was observed between organisms inhabiting unstable and stable habitats in this study. Wing size, as estimated by centroid size, was correlated with differences in the gut bacterial community composition of the species. Even if a factor is not strong enough to determine the survival of carabid beetles, the composition of the gut bacterial community can change. We found that although each individual has a large variation in the gut bacterial community composition, the gut bacterial community can be used to evaluate the condition of each habitat through consistent investigation. Habitat assessment based on changes in the number of carabid beetle species and their composition requires relatively long-term research; however, the gut bacterial community of carabid beetles can help identify short-term environmental changes.

Enhanced processing map of Ti-6Al-2Sn-2Zr-2Mo-2Cr-0.15Si aided by extreme gradient boosting.

A processing map is required for Ti alloys to find processing parameters securing a high formability. This study adopted the extreme gradient boosting (XGB) approach of machine learning to predict a flow curve and plot a processing map with less experiments for the first time. The optimum XGB model predicted flow curves of Ti-6Al-2Sn-2Zr-2Mo-2Cr-0.15Si at 1073-1273 K and 10 s-1. The predicted data were used to plot a processing map, which showed a higher accuracy in the instability map as compared with the map without XGB. The XGB model also anticipated the power dissipation map at low strain rates. The low accuracy at high strain rates would be improved by alleviating the bias towards a flow hardening. This work has successfully proven the potential usefulness of XGB for plotting an enhanced processing map in light of a higher accuracy with less experiments.

Ecological Traits of Fish for Mercury Biomonitoring: Insights from Compound-Specific Nitrogen and Stable Mercury Isotopes.

We coupled compound-specific isotopic analyses of nitrogen (N) in amino acids (δ15NGlu, δ15NPhe) and mercury stable isotopes (δ202Hg, Δ199Hg) to quantify ecological traits governing the concentration, variability, and source of Hg in largemouth bass (LB) and pike gudgeon (PG) across four rivers, South Korea. PG displayed uniform Hg concentration (56-137 ng/g), trophic position (TPcorrected; 2.6-3.0, n = 9), and N isotopes in the source amino acid (δ15NPhe; 7-13‰), consistent with their specialist feeding on benthic insects. LB showed wide ranges in Hg concentration (45-693 ng/g), TPcorrected (2.8-3.8, n = 14), and δ15NPhe (1.3-16‰), reflecting their opportunistic feeding behavior. Hg sources assessed using Hg isotopes reveal low and uniform Δ199Hg in PG (0.20-0.49‰), similar to Δ199Hg reported in sediments. LB displayed site-specific δ202Hg (-0.61 to -0.04‰) and Δ199Hg (0.53-1.09‰). At the Yeongsan River, LB displayed elevated Δ199Hg and low δ15NPhe, consistent with Hg and N sourced from the atmosphere. LB at the Geum River displayed low Δ199Hg and high δ15NPhe, both similar to the isotope values of anthropogenic sources. Our results suggest that a specialist fish (PG) with consistent ecological traits and Hg concentration is an effective bioindicator species for Hg. When accounting for Hg sources, however, LB better captures site-specific Hg sources.

Evidence for superionic H2O and diffusive He-H2O at high temperature and high pressure.

We present the evidence of superionic phase formed in H2O and, for the first time, diffusive H2O-He phase, based on time-resolved x-ray diffraction experiments performed on ramp-laser-heated samples in diamond anvil cells. The diffraction results signify a similar bcc-like structure of superionic H2O and diffusive He-H2O, while following different transition dynamics. Based on time and temperature evolution of the lattice parameter, the superionic H2O phase forms gradually in pure H2O over the temperature range of 1350-1400 K at 23 GPa, but the diffusive He-H2O phase forms abruptly at 1300 K at 26 GPa. We suggest that the faster dynamics and lower transition temperature in He-H2O are due to a larger diffusion coefficient of interstitial-filled He than that of more strongly bound H atoms. This conjecture is then consistent with He disordered diffusive phase predicted at lower temperatures, rather than H-disordered superionic phase in He-H2O.

Metalloendopeptidase ADAM-like Decysin 1 (ADAMDEC1) in Colonic Subepithelial PDGFRα+ Cells Is a New Marker for Inflammatory Bowel Disease.

Metalloendopeptidase ADAM-Like Decysin 1 (ADAMDEC1) is an anti-inflammatory peptidase that is almost exclusively expressed in the gastrointestinal (GI) tract. We have recently found abundant and selective expression of Adamdec1 in colonic mucosal PDGFRα+ cells. However, the cellular origin for this gene expression is controversial as it is also known to be expressed in intestinal macrophages. We found that Adamdec1 mRNAs were selectively expressed in colonic mucosal subepithelial PDGFRα+ cells. ADAMDEC1 protein was mainly released from PDGFRα+ cells and accumulated in the mucosal layer lamina propria space near the epithelial basement membrane. PDGFRα+ cells significantly overexpressed Adamdec1 mRNAs and protein in DSS-induced colitis mice. Adamdec1 was predominantly expressed in CD45- PDGFRα+ cells in DSS-induced colitis mice, with only minimal expression in CD45+ CD64+ macrophages. Additionally, overexpression of both ADAMDEC1 mRNA and protein was consistently observed in PDGFRα+ cells, but not in CD64+ macrophages found in human colonic mucosal tissue affected by Crohn's disease. In summary, PDGFRα+ cells selectively express ADAMDEC1, which is localized to the colon mucosa layer. ADAMDEC1 expression significantly increases in DSS-induced colitis affected mice and Crohn's disease affected human tissue, suggesting that this gene can serve as a diagnostic and/or therapeutic target for intestinal inflammation and Crohn's disease.

Identifying pollution sources of sediment in Lake Jangseong, Republic of Korea, through an extensive survey: Internal disturbances of past aquaculture sedimentation.

Lake sediments are important sinks of various pollutants and preserve historical pollution records caused by anthropogenic activities. Recently, the sediments of Lake Jangseong, South Korea were first detected with high concentrations of organic matter (ignition loss [IL]; total organic carbon [TOC]), nutrients (total nitrogen [TN]; total phosphorus [TP]), and some heavy metals (Zn, Cu, Cd, and Hg). Here, we identified the origins of these concentrations accumulated in the sediments using extensive surveys and various assessments. Sediment pollution assessed by sediment quality guidelines, pollution load index, and potential ecological risk index was found to be of serious concern for IL, TN, TP, and Cd. Thus, we assessed pollution sources through spatial, grid, and vertical distributions and found that the high pollutant concentrations detected in 2020 were confirmed only at a certain location in the lake. Additionally, similar results were detected in the sedimentary layer below a sediment core at a depth of 15.0 cm. The high pollutant concentrations locally occurred around a "hotspot" site that was previously frequently used for aquaculture activities, indicating that the pollutants were accumulated in sediments owing to past cage fish farming rather than from influx of externally sourced pollution. Furthermore, chemical fractionation of phosphorus and heavy metals and assessment of stable isotopes (13C and 15N) of organic matter suggested that the pollutants in the sediments at the "hotspot" sites had different origins than those found at other sites. Accordingly, the by-products discharged after cage fish farming, such as residual feed, fish meal, and waste, accumulated in the sediments and were then exposed to natural internal disturbances caused by the effects of climate change-induced drought. This local distribution and the phosphorus and heavy metal chemical fraction results with low elution potential indicated that the pollutants in the sediments of Lake Jangseong had negligible impact on water quality.

Hierarchically Structured Conductive Polymer Binders with Silver Nanowires for High-Performance Silicon Anodes in Lithium-Ion Batteries.

Silicon (Si) anodes in lithium-ion batteries (LIBs) suffer from huge volume changes that lead to a rapid capacity decrease and short cycle life. A conductive binder can be a key factor to overcome this issue, maintaining continuous electron paths under pulverization of Si. Herein, composites of poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate) (PEDOT:PSS) and poly(vinyl alcohol) (PVA) are augmented with poly(ethylene glycol) (PEG) and poly(ethylene oxide) (PEO) as a binder for Si anodes, which forms hierarchical structures due to different chain lengths of PEG and PEO. The integration of PEG and PEO imparts higher electrical conductivity (∼40%) and stretchability (∼60%) through densely spread hydrogen bonding and cross-linking, compared to conductive polymer binders with PEO or PEG. Further, a silver nanowire (AgNW) network combined with the polymer binder supplies an effective three-dimensional (3D) electrical path, sufficient void space to buffer the volume changes, and highly adhesive interaction with the current collector. The fabricated Si anode demonstrates a higher specific capacity of 1066 mAh g-1 at 0.8 A g-1 after 100 cycles and improved rate capability.

The incidence and clinical features of familial pancreatic cancer in Korea.

BACKGROUND: A history of familial pancreatic cancer (FPC) increases the incidence of pancreatic cancer (PC) among first-degree relatives. We aimed to determine the incidence of FPC and analyze its clinical characteristics. METHODS: Between 2010 and 2014, 1159 patients with PC were included in the study. We evaluated the incidence of FPC, clinicopathological features, and survival prognosis between FPC and non-FPC patients. We further analyzed the clinical outcomes of 389 patients with PC who underwent curative-intent surgery. RESULTS: Familial pancreatic cancer incidence was 3.1% (n = 36) among all patients with PC (n = 1159). FPC was diagnosed at an advanced clinical stage compared to non-FPC (P = .041). The tested variables and 5-year survival rate (5YSR) between FPC and non-FPC after propensity score matching had no differences (5YSR: 4.6% vs 2.6%, P = .834). Among PC patients who underwent curative-intent surgery (n = 389), FPC incidence was 1.8% (n = 7). FPC patients were older than non-FPC patients (75.3 ± 4.7 years vs 64.0 ± 9.9 years, P < .001). 5YSR tended to differ between FPC and non-FPC (14.3% vs 22.5%, P = .07) groups. CONCLUSION: Familial pancreatic cancer is diagnosed at an advanced stage, and FPC that has undergone resection is associated with older age or worse prognosis. A prospective nationwide pedigree registration system was required.

Comparison between autogenous brachial-brachial upper-arm elevated direct arteriovenous fistulas and prosthetic brachial-antecubital indirect forearm arteriovenous grafts.

OBJECTIVES: The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) guidelines recommend forearm arteriovenous grafts (AVGs) as an alternative procedure to transposed basilic vein fistulas for providing secondary access during hemodialysis. Recently, autogenous elevated brachial-brachial vein fistulas (BVE) have become increasingly popular. The aim of this study was to compare the outcomes of BVE and forearm loop AVG (AVG) for secondary access in hemodialysis. METHODS: We retrospectively reviewed the medical records of patients who had received a BVE or forearm AVG at a single center from January 2015 to April 2019. In total, 19 BVE were created via two-stage operations and two via a one-stage operation; 53 forearm AVG's were performed. RESULTS: The AVG group was twice as likely to suffer loss of primary patency compared with the BVE group (odds ratio [OR], 2.666; 95% confidence interval [CI], 1.108-6.412; p = 0.029) per the multivariate analysis. The primary patency and primary assisted patency of the BVE group were superior those of the AVG group, except for secondary patency (p = 0.02, p = 0.07, p = 0.879, respectively). In subgroup analysis, there were no significant differences in primary, primary assisted, or secondary patency between AVG and BVE when brachial vein was used for AVG outflow. In addition, no significant differences were noted regarding the infection rate (12.5% vs 12.3%, p = 0.331, severity >0), postoperative bleeding rate (14.5% vs 3.5%, p = 0.191, severity >1), early thrombus rate (0.0% vs 10.5%, p = 0.122), and early failure rate (7% vs 4.8%, p = 0.591). CONCLUSIONS: The primary patency and primary assisted patency rates of BVE were significantly better than those observed in AVGs, but the complication rates were similar. The appropriate procedure to provide vascular access should be determined by the individual patient's condition and the surgical skill of the operating surgeon.