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MOTIVATION: Molecular core structures and R-groups are essential concepts in drug development. Integration of these concepts with conventional graph pre-training approaches can promote deeper understanding in molecules. We propose MolPLA, a novel pre-training framework that employs masked graph contrastive learning in understanding the underlying decomposable parts in molecules that implicate their core structure and peripheral R-groups. Furthermore, we formulate an additional framework that grants MolPLA the ability to help chemists find replaceable R-groups in lead optimization scenarios. RESULTS: Experimental results on molecular property prediction show that MolPLA exhibits predictability comparable to current state-of-the-art models. Qualitative analysis implicate that MolPLA is capable of distinguishing core and R-group sub-structures, identifying decomposable regions in molecules and contributing to lead optimization scenarios by rationally suggesting R-group replacements given various query core templates. AVAILABILITY AND IMPLEMENTATION: The code implementation for MolPLA and its pre-trained model checkpoint is available at https://github.com/dmis-lab/MolPLA.
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Programas Informáticos , Aprendizaje Automático , Estructura Molecular , Algoritmos , Desarrollo de Medicamentos/métodosRESUMEN
BACKGROUND: Despite the lack of strong evidence, total omentectomy (TO) remains the recommended procedure for gastric cancer (GC) for T3 or deeper tumors. Partial omentectomy (PO) has recently become a preferred procedure owing to its simplicity during laparoscopic distal gastrectomy (LDG); however, the oncological role of PO needs to be elucidated. METHODS: Overall, 341 patients with T3 or T4a GC who had undergone LDG between 2009 and 2016 were divided into TO (n = 167) and PO (n = 174) groups. Propensity matching was performed with respect to covariance age, sex, T and N stage, tumor size, and degree of tumor differentiation. Clinicopathological characteristics and long-term follow-up data were analyzed for both groups. RESULTS: After successful propensity matching, both groups included 107 patients. In a matched cohort, no significant difference in clinicopathologic features and short-term surgical outcomes was observed between the two groups. Furthermore, no significant difference in relapse-free survival (RFS; p = 0.201) and peritoneal seeding-free survival (PSFS; p = 0.094) was observed. However, tumor recurrence as peritoneal metastasis occurred in 5 (4.7%) patients in the PO group and 13 (12.1%) patients in the TO group. In Cox proportional hazards analysis, omentectomy was not identified as a significant factor for RFS, PSFS, and overall survival; however, advanced N and T4a stage were considered significant factors for RFS and PSFS, respectively. CONCLUSIONS: PO may be adopted during the LDG of T3 or T4a GC without definite gross serosal exposure. More large-scale evidence or prospective study is recommended.
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Neoplasias Gástricas , Humanos , Neoplasias Gástricas/cirugía , Estudios ProspectivosRESUMEN
BACKGROUND: The current gastric cancer staging system relies on the number of metastatic lymph nodes (MLNs) for nodal stage determination. However, incorporating additional information such as topographic status may help address uncertainties. This study evaluated the appropriateness of the current staging system and relative significance of MLNs based on their anatomical location. METHODS: Patients who underwent curative gastrectomy for gastric cancer between 2000 and 2019 at six Catholic Medical Center-affiliated hospitals were included. Lymph node-positive patients were classified into the perigastric (stations 1-6, group P) or extragastric (stations 7-12) groups. The extragastric group was further subdivided into the near-extragastric (stations 7-9, group NE) and far-extragastric (stations 10-12, group FE) groups. RESULTS: We analyzed the data of 3,591 patients with positive lymph node metastases. No significant survival differences were found between group P and the extragastric group in each N stage. However, in N1 and N2, group FE showed significantly worse survival than the other groups (p = 0.013 for N1, p < 0.001 for N2), but not in N3. In the subgroup analysis, group FE had a significantly lower overall survival in N2, regardless of the cancer location. CONCLUSIONS: Our large-scale multi-institutional big data analysis confirmed the superiority of the current numerical nodal staging system for gastric cancer. Nonetheless, in N1 and N2 in which there is an upper limit on metastatic nodes, attention should be paid to the potential significance of topographic information for specific nodal stations.
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Neoplasias Gástricas , Humanos , Neoplasias Gástricas/patología , Escisión del Ganglio Linfático , Estadificación de Neoplasias , Estudios Retrospectivos , Pronóstico , Ganglios Linfáticos/patología , GastrectomíaRESUMEN
The Korean Pathfinder Lunar Orbiter (KPLO)-MAGnetometer (KMAG) consists of three triaxial fluxgate sensors (MAG1, MAG2, and MAG3) that measure the magnetic field around the Moon. The three sensors are mounted in the order MAG3, MAG2, and MAG1 inside a 1.2 m long boom, away from the satellite body. Before it arrived on the Moon, we compared the magnetic field measurements taken by DSCOVR and KPLO in solar wind to verify the measurement performance of the KMAG instrument. We found that there were artificial disturbances in the KMAG measurement data, such as step-like and spike-like disturbances, which were produced by the spacecraft body. To remove spacecraft-generated disturbances, we applied a multi-sensor method, employing the gradiometer technique and principal component analysis, using KMAG magnetic field data, and confirmed the successful elimination of spacecraft-generated disturbances. In the future, the proposed multi-sensor method is expected to clean the magnetic field data measured onboard the KPLO from the lunar orbit.
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BACKGROUND: In 2014, the results derived from the nationwide data of the Korean Anti-reflux Surgery Study (KARS) demonstrated short-term feasibility and safety of anti-reflux surgery. This study aimed to update the longer-term safety and feasibility of laparoscopic anti-reflux surgery up to 1-year follow-up with the KARS nationwide cohort. METHODS: The data of 310 patients with GERD who received anti-reflux surgery up to 2018 were analyzed. Baseline patient characteristics, postoperative symptom resolution, and postoperative complications were evaluated at postoperative 3 months and 1 year using the questionnaire designed by KARS. We divided the patients into two groups according to the operation period (up to and after 2014) to identify changes in the trends of the characteristics of surgical patients and operative qualities. RESULTS: The typical preoperative symptoms were present in 275 patients (91.7%), and atypical symptoms were present in 208 patients (71.0%). Ninety-seven (35.5%) and 124 patients (46.1%) had inadequate PPI responses and hiatal hernia, respectively. At postoperative 1 year, typical and atypical symptoms were either completely or partially controlled in 90.3% and 73.5.0% of patients, respectively. Moderate-to-severe dysphagia, inability to belch, gas bloating, and flatulence at postoperative 1 year were identified in 23.5%, 29.4%, 23.2%, and 22.0% of patients, respectively. The number of surgical patients continuously increased from 2011 to 2018 in Korea. The proportion of patients with hiatal hernia and comorbidities increased (p < 0.01, p = 0.053), and the operation time decreased significantly (p < 0.01) in the late period (2015-2018) as compared with the early period (2011-2014). Symptom control and complication rate were equivalent between the two periods. CONCLUSIONS: Anti-reflux surgery was effective with > 90% of typical symptom resolution and posed a comparable postoperative complication rate with those in Western studies with mid-term to long-term follow-up. This result supports the feasibility and safety of anti-reflux surgery as a treatment for GERD in the Korean population.
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Reflujo Gastroesofágico , Hernia Hiatal , Laparoscopía , Fundoplicación , Reflujo Gastroesofágico/cirugía , Hernia Hiatal/cirugía , Humanos , República de Corea/epidemiología , Resultado del TratamientoRESUMEN
BACKGROUND: Endoscopic submucosal dissection (ESD) for gastric cancer produces an artificial ulcer, and negative effects on the surgical outcomes of additional gastrectomy after ESD are anticipated. The aim of this study is to analyze the effect of ESD on subsequent laparoscopic radical gastrectomy procedures and to compare the surgical results of post-ESD patients with the control group using propensity score (PS) methods. PATIENTS AND METHODS: From 2013 to 2018, 1446 patients underwent totally laparoscopic distal gastrectomy in our center. Among these patients, the clinicopathological factors and short-term surgical outcomes of 107 patients who underwent ESD before surgery (the ESD group) were evaluated. A 1:4 PS matching and inverse probability weighting method was utilized to compare the short-term surgical outcomes of the ESD group with those of a matched control group. RESULTS: A longer operation time was required for the patients who underwent gastrectomy earlier than 24 days after ESD than for the patients who did not. Patients whose ulcer size, due to previous ESD, exceeded 4.6 cm required longer operation times and exhibited more intraoperative blood loss than patients whose ulcer size was small. In the PS matching analysis, patients who underwent distal gastrectomy within 24 days after ESD showed more frequent postoperative morbidity than non-ESD patients. CONCLUSIONS: ESD after laparoscopic distal gastrectomy is largely safe in terms of short-term surgical outcomes, but a short interval between the two procedures and a large ESD scar can make subsequent operation difficult.
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Resección Endoscópica de la Mucosa/efectos adversos , Gastrectomía/métodos , Laparoscopía , Neoplasias Gástricas/cirugía , Anciano , Pérdida de Sangre Quirúrgica , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Tempo Operativo , Puntaje de Propensión , Neoplasias Gástricas/mortalidad , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
BACKGROUND: Laparoscopic total gastrectomy (LTG) for advanced gastric cancer (AGC) is a technically and oncologically challenging procedure for surgeons. OBJECTIVES: The aim of this study was to compare the technical safety and long-term oncological feasibility between LTG and open total gastrectomy (OTG) for patients with AGC using a propensity score (PS)-matched analysis. METHODS: Between 2004 and 2014, 185 patients (OTG: 127, LTG: 58) underwent curative total gastrectomy for AGC. PS matching was performed using the patients' clinicopathological factors, and comparisons were made based on surgical outcomes and long-term survival rates. RESULTS: After PS matching, 102 patients (51 patients in each group) were enrolled. The total numbers of retrieved lymph nodes were similar in both groups. The numbers of retrieved lymph nodes around the splenic hilum were similar in both groups. A longer operation time was required for the LTG group than for the OTG group, but less intraoperative bleeding was observed in the LTG group. The overall morbidity and mortality rates of both groups were similar. Between the 2 groups, there was no difference in the 5-year overall survival rate or disease-free survival rate. CONCLUSIONS: For treating proximal AGC, LTG may be a technically and an oncologically safe and feasible method.
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Gastrectomía/métodos , Neoplasias Gástricas/cirugía , Anciano , Quimioterapia Adyuvante , Estudios de Factibilidad , Femenino , Humanos , Estimación de Kaplan-Meier , Laparoscopía , Masculino , Persona de Mediana Edad , Pronóstico , Puntaje de Propensión , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/patología , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Surgeons normally encounter the left gastric vein (LGV) during laparoscopic gastrectomy (LG) for gastric cancer, and the various anatomic variants of this vessel make the procedure difficult. The objective of this study was to classify anatomic variants of the LGV in the laparoscopic operation field and clarify their clinical significance during LG. METHODS: In total, 405 patients who underwent LG in 2013-2017 for gastric cancer were enrolled in the study. LGV drainage was classified into six types by the anatomic relation of the LGV to the arteries of the celiac axis: Type Ia [LGV runs anteriorly to the common hepatic artery (CHA)], Type Ip (LGV runs posteriorly to CHA), Type II (LGV runs anteriorly to the left gastric artery), Type IIIa [LGV runs anteriorly to the splenic artery (SA)], Type IIIp (LGV runs posteriorly to SA), and Type IV (LGV runs cranially into the proximal portal vein or liver parenchyma). If the LGV was injured during the operation, the patient was included as a member of the injury group (IG). RESULTS: Most patients (n = 391, 96.5%) had a single LGV, whereas 14 (3.5%) patients had double LGVs. Type Ip was the most common of the six drainage types (n = 195, 48.1%). The number of patients in the IG was 49 (13.0%). Types I and III were relatively easily injured when compared with type II (p = 0.025). Patients in the IG had longer operation times, more blood loss, and more lymph node metastases than the non-IG patients. CONCLUSIONS: In most patients, the LGV drains posteriorly to the CHA or anteriorly to the LGA. Gastric surgeons should take great care not to injure the LGV during LG when it is not present on the anterior side of the celiac axis.
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Gastrectomía , Laparoscopía , Neoplasias Gástricas/cirugía , Venas/anomalías , Adenocarcinoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Tempo OperativoRESUMEN
BACKGROUND: Accurately detecting and examining lung nodules early is key in diagnosing lung cancers and thus one of the best ways to prevent lung cancer deaths. Radiologists spend countless hours detecting small spherical-shaped nodules in computed tomography (CT) images. In addition, even after detecting nodule candidates, a considerable amount of effort and time is required for them to determine whether they are real nodules. The aim of this paper is to introduce a high performance nodule classification method that uses three dimensional deep convolutional neural networks (DCNNs) and an ensemble method to distinguish nodules between non-nodules. METHODS: In this paper, we use a three dimensional deep convolutional neural network (3D DCNN) with shortcut connections and a 3D DCNN with dense connections for lung nodule classification. The shortcut connections and dense connections successfully alleviate the gradient vanishing problem by allowing the gradient to pass quickly and directly. Connections help deep structured networks to obtain general as well as distinctive features of lung nodules. Moreover, we increased the dimension of DCNNs from two to three to capture 3D features. Compared with shallow 3D CNNs used in previous studies, deep 3D CNNs more effectively capture the features of spherical-shaped nodules. In addition, we use an alternative ensemble method called the checkpoint ensemble method to boost performance. RESULTS: The performance of our nodule classification method is compared with that of the state-of-the-art methods which were used in the LUng Nodule Analysis 2016 Challenge. Our method achieves higher competition performance metric (CPM) scores than the state-of-the-art methods using deep learning. In the experimental setup ESB-ALL, the 3D DCNN with shortcut connections and the 3D DCNN with dense connections using the checkpoint ensemble method achieved the highest CPM score of 0.910. CONCLUSION: The result demonstrates that our method of using a 3D DCNN with shortcut connections, a 3D DCNN with dense connections, and the checkpoint ensemble method is effective for capturing 3D features of nodules and distinguishing nodules between non-nodules.
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Neoplasias Pulmonares/diagnóstico por imagen , Nódulo Pulmonar Solitario/diagnóstico por imagen , Tomografía Computarizada por Rayos X/métodos , Aprendizaje Profundo , Humanos , Imagenología Tridimensional , Interpretación de Imagen Radiográfica Asistida por ComputadorRESUMEN
BACKGROUND: Trans-axillary endoscopic thyroid surgery offers the advantage of a good cosmetic outcome; however, it requires a wider dissection field compared to the other endoscopic approaches or open surgery. Therefore, it might cause severe postoperative pain occasionally. To reduce the dissection field required, we perform trans-axillary single-incision endoscopic thyroidectomy (SIET) with gas inflation. The aim of this study was to present a single surgeon's experience with SIET and to investigate the learning curve of SIET. METHODS: Between June 2009 and September 2014, a total of 105 patients who underwent hemithyroidectomy for benign thyroid tumor via an SIET procedure were included in the present study. All of the procedures were performed by the same surgeon. Each patient's operative outcomes were collected and retrospectively analyzed. The cumulative summation (CUSUM) analysis was used to assess the learning curve of SIET. RESULTS: No mortality or serious morbidity was observed during the study period. The adverse postoperative outcomes included wound hematoma (2 cases; 1.9 %), transient skin paresthesia (5 cases; 4.76 %), transient voice change (5 cases; 4.76 %), skin pigmentation (1 case; 0.9 %), and fibrous band of wound (1 case; 0.9 %). The overall mean operative time was 105 min, and the mean operative time in the experienced phase was 95 min. CUSUM analysis showed a decreasing trend at the 35th patient, suggesting that more than 35 cases were needed for the surgeon to gain proficiency. In 76.19 % of the cases, patients showed extreme satisfaction with the cosmetic results. CONCLUSION: Our results showed reasonable surgical outcomes compared to previous studies on endoscopic thyroidectomy. The SIET procedure is safe and feasible for benign thyroid tumors and has an acceptable learning curve for surgeons who are proficient in conventional endoscopic thyroidectomy.
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Adenoma/cirugía , Endoscopía/métodos , Bocio Nodular/cirugía , Hematoma/epidemiología , Curva de Aprendizaje , Dolor Postoperatorio/epidemiología , Neoplasias de la Tiroides/cirugía , Tiroidectomía/métodos , Adulto , Axila , Disección , Endoscopía/educación , Femenino , Humanos , Insuflación , Masculino , Persona de Mediana Edad , Tempo Operativo , Parestesia , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Cirujanos , Tiroidectomía/educaciónRESUMEN
We consider the interplay between the antiferromagnetic and Kekulé valence bond solid orderings in the zero energy Landau levels of neutral monolayer and bilayer graphene. We establish the presence of Wess-Zumino-Witten terms between these orders: this implies that their quantum fluctuations are described by the deconfined critical theories of quantum spin systems. We present implications for experiments, including the possible presence of excitonic superfluidity in bilayer graphene.
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BACKGROUND: Possible risk factors for postoperative intra-abdominal abscess (IAA) formation after laparoscopic appendectomy (LA) remain controversial. A perforated appendicitis, diabetes mellitus, peritoneal irrigation, obesity and age are considered to be possible risk factors for postoperative IAA, but the existing evidence is insufficient. This study aimed to identify the risk factors for IAA formation in patients receiving LA. METHODS: Between January 2010 and December 2013, 1,817 patients who underwent 3-port LA were enrolled in this study. Patients were classified into 2 groups according to the development of postoperative IAA, and the differences between the groups were analyzed. RESULTS: The incidence of IAA after LA was 1.5%, and the only identified risk factor for IAA was peritoneal irrigation. On logistic regression analysis of those patients who received peritoneal irrigation, suppurative appendicitis and non-placement of the peritoneal drain were found to be significant risk factors for the development of IAA. CONCLUSIONS: Peritoneal irrigation in a case of abdomen contamination was shown to be a risk factor for the development of postoperative IAA after LA. When peritoneal irrigation is performed, surgeons should consider using peritoneal drainage and postoperative antibiotics (including anti-anaerobic antibiotics) to prevent postoperative IAA formation.
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Absceso Abdominal/etiología , Apendicectomía , Apendicitis/cirugía , Laparoscopía , Complicaciones Posoperatorias/etiología , Absceso Abdominal/epidemiología , Adulto , Anciano , Apendicectomía/métodos , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Resultado del TratamientoRESUMEN
BACKGROUND: Radical gastrectomy for gastric cancer is one of the most invasive procedures in gastrointestinal surgery. A few studies have found that an enhanced recovery after surgery (ERAS) protocol is useful in radical gastrectomy. The aim of this study was to evaluate the appropriate indication and feasibility of an ERAS protocol in radical gastrectomy. METHODS: We studied the clinical characteristics in 147 patients managed with an ERAS protocol after radical gastrectomy. Of these patients, the protocol was completely applied to 99 (group I), meaning 48 patients (group II) did not complete the protocol. RESULTS: The age and ECOG (Eastern Cooperative Oncology Group) status of patients, extent of lymph node dissection, minilaparotomy and insertion of drains were significant influences on compliance to the ERAS protocol. Overall complication rates showed no difference between the two groups; however, local complications were more frequent in group II than group I. Regarding readmission rates within 30 days and after 30 days, there was no significant difference in the incidence and severity grades of causes of readmission between the two groups. CONCLUSIONS: The results of this study suggest that an ERAS protocol is feasible and safely applicable without increasing the morbidity and readmission rate after radical gastrectomy if it is applied to patients with positive and less invasive procedures.
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Gastrectomía/métodos , Ganglios Linfáticos/patología , Cuidados Posoperatorios/métodos , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Adulto , Anciano , Estudios de Cohortes , Intervalos de Confianza , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Gastrectomía/mortalidad , Humanos , Escisión del Ganglio Linfático/métodos , Ganglios Linfáticos/cirugía , Masculino , Persona de Mediana Edad , Análisis Multivariante , Invasividad Neoplásica/patología , Estadificación de Neoplasias , Oportunidad Relativa , Readmisión del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias/fisiopatología , Complicaciones Posoperatorias/terapia , Recuperación de la Función , República de Corea , Neoplasias Gástricas/patología , Factores de Tiempo , Resultado del TratamientoRESUMEN
PURPOSE: Lymph node (LN) metastasis is a crucial factor in the prognosis of patients with gastric cancer (GC) and is known to occur more frequently in cases with an advanced T stage. This study aimed to analyze the survival data of patients with advanced LN metastasis in T1 GC. MATERIALS AND METHODS: From January 2008 to June 2018, 677 patients with pathological stage II GC who underwent radical gastrectomy were divided into an early GC group (EG: T1N2 and T1N3a, n=103) and an advanced GC (AGC) group (AG: T2N1, T2N2, T3N0, T3N1, and T4aN0, n=574). Short- and long-term survival rates were compared between the 2 groups. RESULTS: A total of 80.6% (n=83) of the patients in the EG group and 52.8% (n=303) in the AG group had stage IIA AGC. The extent of LN dissection, number of retrieved LNs, and short-term morbidity and mortality rates did not differ between the 2 groups. The 5-year relapse-free survival (RFS) of all patients was 87.8% and the overall survival was 84.0%. RFS was lower in the EG group than in the AG group (82.2% vs. 88.7%, P=0.047). This difference was more pronounced among patients with stage IIA (82.4% vs. 92.9%, P=0.003). CONCLUSIONS: T1 GC with multiple LN metastases seems to have a worse prognosis compared to tumors with higher T-stages at the same level. Adjuvant chemotherapy is highly recommended for these patients, and future staging systems may require upstaging T1N2-stage tumors.
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BACKGROUND: Single-port laparoscopic surgery is increasingly used to treat various types of diseases requiring surgical intervention. We present the technique and the results of our simple "cross and twine" intracorporeal knotting approach for treatment of a perforated duodenal ulcer. METHODS: From January 2009 to October 2009, 13 patients with perforated duodenal ulcers underwent single-port laparoscopic repair. The laparoscopic procedure included peritoneal lavage and suture of the perforation. The omentum above the repair site was then reinforced. After surgery, patients took an H2 receptor antagonist for 8 weeks and then underwent follow-up gastrofiberscopy. RESULTS: All procedures were completed under the conditions described. The mean operative time was 90.2 ± 24.2 min, and the mean hospital stay was 6.1 ± 0.5 days. The mean number of times that opiates were used for pain was 0.5 ± 1.0, and wound length was 1.9 ± 0.1 cm. There was no operation-related morbidity. Follow-up gastrofiberscopy revealed good lesion healing. CONCLUSIONS: Single-port laparoscopic repair using the "cross and twine" knotting technique is a feasible and safe procedure, and it may be a less invasive laparoscopic surgical technique for scarless surgical treatment of perforated duodenal ulcers.
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Úlcera Duodenal/cirugía , Laparoscopía/métodos , Úlcera Péptica Perforada/cirugía , Técnicas de Sutura , Adulto , Antiulcerosos/uso terapéutico , Cicatriz/prevención & control , Terapia Combinada , Úlcera Duodenal/complicaciones , Úlcera Duodenal/tratamiento farmacológico , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica Perforada/etiología , Resultado del Tratamiento , OmbligoRESUMEN
BACKGROUND: The aim of this study was to elucidate the correlation of high-mobility group protein A2 overexpression with gastric cancer prognosis and compare its prognostic power with that of pre-existing markers. METHODS: Malignant tissues from 396 patients with gastric cancer who underwent gastrectomy from 2008 to 2012 were examined. High-mobility group protein A2 expression was assessed by immunohistochemistry and the sensitivity and specificity for predicting disease progression and overall survival of high-mobility group protein A2 and the prognostic biomarkers p53, Ki-67, human epidermal growth factor receptor 2, cyclooxygenase-2, and epidermal growth factor receptor were compared. RESULTS: A total of 95 samples (24.1%) showed high-mobility group protein A2 overexpression, which was related to advanced stage, undifferentiated histology, and lymphatic and perineural invasion. Additionally, high-mobility group protein A2 overexpression was an independent prognostic factor in multivariate analysis for disease progression and overall survival. Based on Kaplan-Meier survival analysis disease progression and overall survival, the high-mobility group protein A2-overexpressing patients showed worse survival. The recurrence pattern of peritoneal dissemination was more frequently observed in high-mobility group protein A2-positive group. Moreover, chemoresistance was more frequently observed in the high-mobility group protein A2-positive group. High-mobility group protein A2 exhibited a better ability for predicting disease progression and overall survival than other markers, and the prognostic power was enhanced when high-mobility group protein A2 was used with these markers. CONCLUSION: High-mobility group protein A2 overexpression is associated with chemoresistance and a propensity for carcinomatosis peritonei after surgery in patients with gastric cancer. The power to predict the prognosis of patients with gastric cancer can be enhanced with the use of preexisting biomarkers and high-mobility group protein A2.
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Resistencia a Antineoplásicos , Proteína HMGA2/metabolismo , Recurrencia Local de Neoplasia/metabolismo , Neoplasias Peritoneales/metabolismo , Neoplasias Gástricas/metabolismo , Anciano , Biomarcadores de Tumor/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Peritoneales/etiología , República de Corea/epidemiología , Estudios Retrospectivos , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/mortalidadRESUMEN
BACKGROUND: Although laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) offers more advantages than open distal gastrectomy, it does not eliminate the postgastrectomy syndrome, which can negatively impact quality of life (QoL). In this paper, we investigate jejunal pouch interposition (JPI) during LADG and evaluate its potential for long-term use. MATERIALS AND METHODS: Between April, 2004 and April, 2005, 28 patients underwent LADG with JPI (LA-JPI), and an equal number underwent LADG with Billroth-II gastrojejunostomy (LA-B-II). Of these, 25 patients with LA-JPI and 28 with LA-B-II, surviving more than 4 years, were enrolled. We compared clinicopathological characteristics, surgical outcomes, and the patients' QoL. RESULTS: There were no differences in clinicopathological characteristics and surgical outcomes except longer operation time of LA-JPI group than LA-B-II group (P < 0.001). The gastrofiberscopy, performed 4 years after surgery, demonstrated significant higher incidence of bile reflux gastritis in LA-B-II group(P = 0.03). In terms of QoL metrics, we identified a significantly lower incidence rate of appetite change, heartburn, and reductions in physical strength and daily activity levels in the LA-JPI group. In addition, satisfaction with the operative procedure and postoperative life were higher. Although the number of meals per day did not differ, we noted a significantly greater food intake with each meal compared with the preoperative metric (P = 0.04) and reduced body weight loss (P = 0.003) was observed in the LA-JPI group. CONCLUSIONS: These long-term follow-up results suggest that LA-JPI might alleviate postgastrectomy syndrome and that this could help improve the QoL in patients with EGC.
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Gastrectomía/métodos , Yeyuno/cirugía , Laparoscopía , Síndromes Posgastrectomía/prevención & control , Neoplasias Gástricas/cirugía , Estructuras Creadas Quirúrgicamente , Apetito , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Gastrectomía/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Calidad de Vida , Neoplasias Gástricas/patología , Resultado del TratamientoRESUMEN
Personal accessories such as glasses and watches that we usually carry in our daily life can yield useful information from the human body, yet most of them are limited to exercise-related parameters or simple heart rates. Since these restricted characteristics might arise from interfaces between the body and items as one of the main reasons, an interface design considering such a factor can provide us with biologically meaningful data. Here, we describe three-dimensional-printed, personalized, multifunctional electronic eyeglasses (E-glasses), not only to monitor various biological phenomena but also to propose a strategy to coordinate the recorded data for active commands and game operations for human-machine interaction (HMI) applications. Soft, highly conductive composite electrodes embedded in the E-glasses enable us to achieve reliable, continuous recordings of physiological activities. UV-responsive, color-tunable lenses using an electrochromic ionic gel offer the functionality of both eyeglass and sunglass modes, and accelerometers provide the capability of tracking precise human postures and behaviors. Detailed studies of electrophysiological signals including electroencephalogram and electrooculogram demonstrate the feasibility of smart electronic glasses for practical use as a platform for future HMI systems.