Postoperative effects of laparoscopic Hartmann reversal: A multicenter propensity score matched study.

BACKGROUND: Although the advantages of laparoscopic Hartmann reversal (LHR) compared to open Hartmann reversal (OHR) have been reported in the literature, the number of multicenter studies with good matching investigating this topic is rare. In the present study, we aimed to confirm the advantages of LHR in terms of short-term outcomes through propensity score matching of LHR and OHR groups, using data collected from multiple institutions. METHODS: Patients who underwent Hartmann reversal at six institutions under the Catholic Medical Center of the Catholic University of Korea between January 1, 2005, and December 31, 2021, were included. The patients were divided into the LHR and OHR groups based on the technique used. The two groups were matched using propensity score matching (1:1 ratio, logistic regression with the nearest-neighbor method). The primary outcome was postoperative ileus (POI) frequency, and secondary outcomes were time to solid diet (days) and length of stay (days). RESULTS: Among 337 patients, propensity score matching was performed on 322, after excluding 15 who had undergone open conversion. Of these, 63 patients were assigned to each group through propensity score matching. There was no difference in the frequency of adhesiolysis (77.8% vs. 82.5%, p = 0.503) or the operation time. (210 (IQR 159-290) vs. 233 (IQR 160-280), p = 0.718) between the two groups. As the primary outcome, the LHR group showed significantly lower POI frequency than the OHR group. (4.8% vs. 22.2%, p = 0.0041) Regarding the secondary outcomes, the LHR group showed a shorter period to solid diet than the OHR group. The length of hospital stay was also significantly shorter in the LHR group (4 vs. 6, p < 0.0001; 9 vs. 12, p<0.0001). CONCLUSION: LHR is an effective method to ensure faster recovery of patients after surgery compared to OHR.

Adaptive R&D contract for urgently needed drugs: Lessons from COVID-19 vaccine development.

This paper analyzes an incentive contract for new vaccine research and development (R&D) under pandemic situations such as COVID-19, considering the R&D contract's adaptability to the pandemic. We study how the public sector (government) designs the adaptive R&D contract and offers it to pharmaceutical enterprises. An agency-theoretic model is employed to explore the contract whose terms are an upfront grant as a fixed fee and a sales tax credit as an incentive tool, examining how the values of related parameters affect contract term determinations. We found that the adaptability factor derived from urgent policies such as emergency use authorization (EUA) as well as tax credits, can be utilized as practical incentive tools that lead vaccine developers to increase their effort levels for R&D success. We also found that public-private state-emergency contracts may not follow the conventional wisdom. Counterintuitively, dependency on tax credits (incentive part) decrease as the client's degree of risk averseness increases in the emergency contract.

Menstrual and Reproductive Factors for Gastric Cancer in Postmenopausal Women: The 2007-2020 Korea National Health and Nutrition Examination Survey.

Globally, the incidence of gastric cancer is lower in women than in men. It is thought that menstrual and reproductive factors may be related to their lower incidence of gastric cancer. This cross-sectional study examined menstrual, reproductive, and other factors in 20,784 postmenopausal women from the 2007-2020 Korea National Health and Nutrition Examination Survey (KNHANES). A univariate logistic regression analysis was performed, and then a multivariate logistic regression analysis for significant factors in the univariate analysis was conducted. In the multivariate logistic regression analysis, the age at menarche (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.00-1.06, p = 0.035) and myocardial infarction (OR 2.43, 95% CI 1.05-5.62, p = 0.026) showed a significant association with increased incidence of gastric cancer. The age at menopause (OR 0.97, 95% CI 0.95-1.00, p = 0.03), the age at the first childbirth (OR 0.93, CI 0.89-0.97, p = 0.007), and the experience of alcohol consumption (OR 0.68, 95% CI 0.5-0.91, p = 0.003) showed a significant association with a decreased incidence of gastric cancer. Late menarche, early menopause, early aged first childbirth, and myocardial infarction are estimated to be risk factors for gastric cancer in postmenopausal Korean women.

Reduced port laparoscopic surgery for colon cancer is safe and feasible in terms of short-term outcomes: comparative study with conventional multiport laparoscopic surgery.

PURPOSE: Laparoscopic surgery was previously accepted as an alternative surgical option in treatment for colorectal cancer. Nowadays, single-port laparoscopic surgery (SPLS) is introduced as a method to maximize advantages of minimally invasive surgery. However, SPLS has several limitations compared to conventional multiport laparoscopic surgery (CMLS). To overcome those limitations of SPLS, reduced port laparoscopic surgery (RPLS) was introduced. This study aimed at evaluating the short-term outcomes of RPLS. METHODS: Patients who underwent CMLS and RPLS of colon cancer between August 2011 and December 2013 were included in this study. Short-term clinical and pathological outcome were compared between the 2 groups. RESULTS: Thirty-two patients underwent RPLS and 217 patients underwent CMLS. Shorter operation time, less blood loss, and faster bowel movement were shown in RPLS group in this study. In terms of postoperative pain, numeric rating scale (NRS) of RPLS was lower than that of CMLS. Significant differences were shown in terms of tumor size, harvested lymph node, perineural invasion, and pathological stage. No significant differences were confirmed in terms of other surgical outcomes. CONCLUSION: In this study, RPLS was technically feasible and safe. Especially in terms of postoperative pain, RPLS was comparable to CMLS. RPLS may be a feasible alternative option in selected patients with colon cancer.

Influence of charge densities of randomly sulfonated polystyrene surfaces on cell attachment and proliferation.

Attachment and proliferation of NIH-3T3 fibroblast cells on random polymer surfaces, polystyrene sulfonated acid (PSSAx) with five different degrees of sulfonation (x = 0%, 5%, 10%, 15% and 33%) and on a tissue culture polystyrene (TCPS) surface were studied. The surface properties, wettability and roughness were measured by water-contact angle and atomic force microscopy measurement. The wettability and surface roughness increased with increasing the content of sulfonic acid groups on the surfaces. The number of cells attached on the surface after seeding increased with increasing x and reached to the maximum value on PSSA15. The cell proliferation also increased with increasing x. However, cell proliferation was slow down on PSSA33 in comparison to PSSA10 and PSSA15 surfaces after 48 h culture.

Small-angle X-ray scattering study on poly(ethyl acrylate-co-itaconate) ionomers neutralized with various cations.

The morphology of poly(ethyl acrylate-co-itaconate) ionomers neutralized partly and fully with Na(I), Li(I) and Zn(II) was studied using a small-angle X-ray scattering (SAXS) technique. It was found that the SAXS peak position for the ionomers shifted to lower angle with increasing degree of neutralization for the ionomers containing 5.8 mol% of ionic repeat units. In the case of 11.9 mol% ionomers, with increasing degree of neutralization from 50% to 100% the SAXS peak shifted to slightly higher angles. With the density data and the space-filling concept for a simple cubic lattice, the average radii of multiplets of the ionomers were calculated. For 5.8 mol% ionomers, the radius of the Li-ionomer increased from 0.35 nm to 0.43 nm with increasing neutralization degree from 50% to 100%, and that of the Na-ionomer changed from 0.34 to 0.53 nm. In the case of the 11.9 mol% ionomers, the radius changed from 0.51 to 0.49 nm for the Li-ionomer and from 0.42 nm to 0.47 nm for the Na-ionomer. For the Zn-ionomers, only 100% neutralized ionomers showed a SAXS peak. From the SAXS profiles, the persistence lengths of the polymer chains attached to the scattering centers were also obtained.

Surface modification for polystyrene colloidal particles with controlled charge densities.

A significant amount of polystyrene sulfonated acid (PSSA) and poly(styrene-ran-acrylic acid) (PSAA) random copolymer can be adsorbed by dispersion of PS particles via a swelling-quenching process. A THF-water mixed solvent was used in the swelling process and a large amount of pure water was used, to give a low concentration of THF% in quenching process. Our results showed that functional PSSA groups were randomly and tightly adsorbed to the PS particles. When the mol.% of charged segments was increased, the progressive adsorption of PSSA chains to the PS particles leads to an increase in the electrophoretic mobility and zeta-potential of aqueous dispersions. Thus, we were able to obtain well-distributed surface charge density on the PS particles.