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1.
Mol Cancer ; 23(1): 45, 2024 02 29.
Artigo em Inglês | MEDLINE | ID: mdl-38424542

RESUMO

BACKGROUND: In the myeloid compartment of the tumor microenvironment, CD244 signaling has been implicated in immunosuppressive phenotype of monocytes. However, the precise molecular mechanism and contribution of CD244 to tumor immunity in monocytes/macrophages remains elusive due to the co-existing lymphoid cells expressing CD244. METHODS: To directly assess the role of CD244 in tumor-associated macrophages, monocyte-lineage-specific CD244-deficient mice were generated using cre-lox recombination and challenged with B16F10 melanoma. The phenotype and function of tumor-infiltrating macrophages along with antigen-specific CD8 T cells were analyzed by flow cytometry and single cell RNA sequencing data analysis, and the molecular mechanism underlying anti-tumorigenic macrophage differentiation, antigen presentation, phagocytosis was investigated ex vivo. Finally, the clinical feasibility of CD244-negative monocytes as a therapeutic modality in melanoma was confirmed by adoptive transfer experiments. RESULTS: CD244fl/flLysMcre mice demonstrated a significant reduction in tumor volume (61% relative to that of the CD244fl/fl control group) 14 days after tumor implantation. Within tumor mass, CD244fl/flLysMcre mice also showed higher percentages of Ly6Clow macrophages, along with elevated gp100+IFN-γ+ CD8 T cells. Flow cytometry and RNA sequencing data demonstrated that ER stress resulted in increased CD244 expression on monocytes. This, in turn, impeded the generation of anti-tumorigenic Ly6Clow macrophages, phagocytosis and MHC-I antigen presentation by suppressing autophagy pathways. Combining anti-PD-L1 antibody with CD244-/- bone marrow-derived macrophages markedly improved tumor rejection compared to the anti-PD-L1 antibody alone or in combination with wild-type macrophages. Consistent with the murine data, transcriptome analysis of human melanoma tissue single-cell RNA-sequencing dataset revealed close association between CD244 and the inhibition of macrophage maturation and function. Furthermore, the presence of CD244-negative monocytes/macrophages significantly increased patient survival in primary and metastatic tumors. CONCLUSION: Our study highlights the novel role of CD244 on monocytes/macrophages in restraining anti-tumorigenic macrophage generation and tumor antigen-specific T cell response in melanoma. Importantly, our findings suggest that CD244-deficient macrophages could potentially be used as a therapeutic agent in combination with immune checkpoint inhibitors. Furthermore, CD244 expression in monocyte-lineage cells serve as a prognostic marker in cancer patients.


Assuntos
Melanoma , Monócitos , Humanos , Animais , Camundongos , Monócitos/metabolismo , Melanoma/tratamento farmacológico , Melanoma/genética , Melanoma/metabolismo , Antígeno B7-H1/genética , Antígeno B7-H1/metabolismo , Macrófagos/metabolismo , Linfócitos T CD8-Positivos , Carcinogênese/metabolismo , Microambiente Tumoral , Família de Moléculas de Sinalização da Ativação Linfocitária/metabolismo
2.
Pain Med ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724239

RESUMO

OBJECTIVE: To investigate the predictive value of thoracic sympathetic ganglion block (TSGB) in response to ketamine infusion therapy (KIT) and spinal-cord stimulation (SCS) in patients with chronic upper-extremity pain including complex regional pain syndrome (CRPS). DESIGN: Retrospective. SETTING: Tertiary hospital single-center. SUBJECTS: Patients who underwent TSGB receiving KIT or SCS within a 3-year window. METHODS: Positive TSGB outcomes were defined as ≥ 2 0-10 Numerical Rating Scale (NRS) score reduction at 2 weeks post-procedure. Positive KIT and SCS outcomes were determined by ≥ 2 NRS score reduction at 2-4 weeks post-KIT and ≥4 NRS score reduction at 2-4 weeks post-SCS implantation, respectively. RESULTS: Among 207 patients who underwent TSGB, 38 received KIT and 34 underwent SCS implantation within 3 years post-TSGB; 33 patients receiving KIT and 32 patients receiving SCS were included. Among 33 patients who received KIT, 60.6% (n = 20) reported a ≥ 2 0-10 NRS pain-score reduction. Positive response to TSGB occurred in 70.0% (n = 14) KIT responders, significantly higher than that in 30.8% (n = 4) KIT non-responders. Multivariable analysis revealed a positive association between positive responses to TSGB and KIT (OR 7.004, 95% CI 1.26-39.02). Among 32 patients who underwent SCS implantation, 68.8% (n = 22) experienced short-term effectiveness. Positive response to TSGB was significantly higher in SCS responders (45.5%, n = 10) than in non-responders (0.0%). However, there were no associations between pain reduction post-TSGB and that post-KIT or post-SCS. CONCLUSIONS: A positive response to TSGB is a potential predictor for positive KIT and SCS outcomes among patients with chronic upper-extremity pain, including CRPS.

3.
Ann Surg ; 277(2): e294-e304, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-34183515

RESUMO

OBJECTIVE: The aim of this study was to expand Operative Stress Score (OSS) increasing procedural coverage and assessing OSS and frailty association with Preoperative Acute Serious Conditions (PASC), complications and mortality in females versus males. SUMMARY BACKGROUND DATA: Veterans Affairs male-dominated study showed high mortality in frail veterans even after very low stress surgeries (OSS1). METHODS: Retrospective cohort using NSQIP data (2013-2019) merged with 180-day postoperative mortality from multiple hospitals to evaluate PASC, 30-day complications and 30-, 90-, and 180-day mortality. RESULTS: OSS expansion resulted in 98.2% case coverage versus 87.0% using the original. Of 82,269 patients (43.8% male), 7.9% were frail/very frail. Males had higher odds of PASC [adjusted odds ratio (aOR) = 1.31, 95% confidence interval (CI) = 1.21-1.41, P < 0.001] and severe/life-threatening Clavien-Dindo IV (CDIV) complications (aOR = 1.18, 95% CI = 1.09-1.28, P < 0.001). Although mortality rates were higher (all time-points, P < 0.001) in males versus females, mortality was similar after adjusting for frailty, OSS, and case status primarily due to increased male frailty scores. Additional adjustments for PASC and CDIV resulted in a lower odds of mortality in males (30-day, aOR = 0.81, 95% CI = 0.71-0.92, P = 0.002) that was most pronounced for males with PASC compared to females with PASC (30-day, aOR = 0.75, 95% CI = 0.56-0.99, P = 0.04). CONCLUSIONS: Similar to the male-dominated Veteran population, private sector, frail patients have high likelihood of postoperative mortality, even after low-stress surgeries. Preoperative frailty screening should be performed regardless of magnitude of the procedure. Despite males experiencing higher adjusted odds of PASC and CDIV complications, females with PASC had higher odds of mortality compared to males, suggesting differences in the aggressiveness of care provided to men and women.


Assuntos
Fragilidade , Humanos , Feminino , Masculino , Fragilidade/complicações , Estudos Retrospectivos , Doença Aguda , Hospitais , Razão de Chances
4.
J Surg Res ; 282: 22-33, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36244224

RESUMO

INTRODUCTION: Safety-net hospitals (SNHs) have higher postoperative complications and costs versus low-burden hospitals. Do low socioeconomic status/vulnerable patients receive care at lower-quality hospitals or are there factors beyond providers' control? We studied the association of private, Medicare, and vulnerable insurance type with complications/costs in a high-burden SNH. METHODS: Retrospective inpatient cohort study using National Surgical Quality Improvement Program (NSQIP) data (2013-2019) with cost data risk-adjusted by frailty, preoperative serious acute conditions (PASC), case status, and expanded operative stress score (OSS) to evaluate 30-day unplanned reoperations, any complication, Clavien-Dindo IV (CDIV) complications, and hospitalization variable costs. RESULTS: Cases (Private 1517; Medicare 1224; Vulnerable 3648) with patient mean age 52.3 y [standard deviation = 14.7] and 47.3% male. Adjusting for frailty and OSS, vulnerable patients had higher odds of PASC (aOR = 1.71, CI = 1.39-2.10, P < 0.001) versus private. Adjusting for frailty, PASC and OSS, Medicare (aOR = 1.27, CI = 1.06-1.53, P = 0.009), and vulnerable (aOR = 2.44, CI = 2.13-2.79, P < 0.001) patients were more likely to undergo urgent/emergent surgeries. Vulnerable patients had increased odds of reoperation and any complications versus private. Variable cost percentage change was similar between private and vulnerable after adjusting for case status. Urgent/emergent case status increased percentage change costs by 32.31%. We simulated "switching" numbers of private (3648) versus vulnerable (1517) cases resulting in an estimated variable cost of $49.275 million, a 25.2% decrease from the original $65.859 million. CONCLUSIONS: Increased presentation acuity (PASC and urgent/emergent surgeries) in vulnerable patients drive increased odds of complications and costs versus private, suggesting factors beyond providers' control. The greatest impact on outcomes may be from decreasing the incidence of urgent/emergent surgeries by improving access to care.


Assuntos
Fragilidade , Pacientes Internados , Idoso , Humanos , Masculino , Estados Unidos/epidemiologia , Pessoa de Meia-Idade , Feminino , Estudos Retrospectivos , Medicare , Estudos de Coortes , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia
5.
J Surg Res ; 282: 34-46, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36244225

RESUMO

INTRODUCTION: Yentl syndrome describing sex-related disparities has been extensively studied in medical conditions but not after surgery. This retrospective cohort study assessed the association of sex, frailty, presenting with preoperative acute serious conditions (PASC), and the expanded Operative Stress Score (OSS) with postoperative complications, mortality, and failure-to-rescue. METHODS: The National Surgical Quality Improvement Program from 2015 to 2019 evaluating 30-d complications, mortality, and failure-to-rescue. RESULTS: Of 4,860,308 cases (43% were male; mean [standard deviation] age of 56 [17] y), 6.0 and 0.8% were frail and very frail, respectively. Frailty score distribution was higher in men versus women (P < 0.001). Most cases were low-stress OSS2 (44.9%) or moderate-stress OSS3 (44.5%) surgeries. While unadjusted 30-d mortality rates were higher (P < 0.001) in males (1.1%) versus females (0.8%), males had lower odds of mortality (adjusted odds ratio (aOR) = 0.92, 95% confidence interval [CI] = 0.90-0.94, P < 0.001) after adjusting for frailty, OSS, case status, PASC, and Clavien-Dindo IV (CDIV) complications. Males have higher odds of PASC (aOR = 1.33, CI = 1.31-1.35, P < 0.001) and CDIV complications (aOR = 1.13, CI = 1.12-1.15, P < 0.001). Male-PASC (aOR = 0.76, CI = 0.72-0.80, P < 0.001) and male-CDIV (aOR = 0.87, CI = 0.83-0.91, P < 0.001) interaction terms demonstrated that the increased odds of mortality associated with PASC or CDIV complications/failure-to-rescue were lower in males versus females. CONCLUSIONS: Our study provides a comprehensive analysis of sex-related surgical outcomes across a wide range of procedures and health care systems. Females presenting with PASC or experiencing CDIV complications had higher odds of mortality/failure to rescue suggesting sex-related care differences. Yentl syndrome may be present in surgical patients; possibly related to differences in presenting symptoms, patient care preferences, or less aggressive care in female patients and deserves further study.


Assuntos
Fragilidade , Humanos , Feminino , Masculino , Fragilidade/complicações , Estudos Retrospectivos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Razão de Chances , Melhoria de Qualidade , Fatores de Risco
6.
Pain Med ; 24(5): 496-506, 2023 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-36255262

RESUMO

OBJECTIVE: To compare the clinical effectiveness of sodium polynucleotide, classic hyaluronic acid, and crosslinked hyaluronic acid for the management of painful knee osteoarthritis. DESIGN: Randomized, double-blind, parallel-group clinical trial. SETTING: Multicenter study. SUBJECTS: Patients with chronic painful knee osteoarthritis. METHODS: Ninety patients were selected and randomized into polynucleotide, classic hyaluronic acid, and crosslinked hyaluronic acid groups (30 per group). Intra-articular injections of the viscosupplement for each group were administered to the patients three times at one-week intervals. The primary outcome was differences in changes of weight-bearing pain scores at 16 weeks between the groups. The secondary outcomes were changes in the intensity of knee pain during weight-bearing, walking, and rest, and functional disability, quality of life, and adverse events during the 16-week follow-up period. RESULTS: At 16 weeks, the polynucleotide group showed a higher reduction in pain score using a Visual Analog Scale score (0-100) than the classic hyaluronic acid (-17.6 [95% CI = -35.1 to -0.1]; P = .048) and crosslinked hyaluronic acid (-22.4 [95% CI = -41.5 to -3.3]; P = .016) groups. The polynucleotide and crosslinked hyaluronic acid groups showed an early-onset reduction in knee pain during weight-bearing, walking, and rest. All three groups showed reductions in functional disability and improved quality of life at 16 weeks without inter-group differences. No severe adverse events were reported throughout the study period. CONCLUSION: Polynucleotide significantly relieves pain more and relieves pain faster in patients with knee osteoarthritis than classic and crosslinked hyaluronic acid, with improved health-related quality of life.


Assuntos
Ácido Hialurônico , Osteoartrite do Joelho , Humanos , Ácido Hialurônico/uso terapêutico , Qualidade de Vida , Articulação do Joelho , Dor/induzido quimicamente , Resultado do Tratamento , Método Duplo-Cego , Injeções Intra-Articulares
7.
Clin Otolaryngol ; 48(1): 39-49, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36268608

RESUMO

OBJECTIVES: Voice change after uncomplicated thyroidectomy has been an important issue in the field of thyroid surgery. The aim of this study was to promote understanding of voice change after uncomplicated thyroidectomy by analysing the results for a large number of patients from a single institute. DESIGN: We retrospectively reviewed the medical records of 2879 consecutive patients who underwent thyroidectomy and voice evaluation between January 2014 and December 2019 in a single institute. All the patients had their vocal status assessed using videostroboscopy, acoustic voice analyses, aerodynamic study, and Thyroidectomy-related Voice and Symptom Questionnaire (TVSQ) scores preoperatively and at 1, 3, and 6 months postoperatively. We analysed the pattern of voice changes over time and differences in voice parameters based on clinical factors. To confirm the usefulness of the TVSQ, the correlation between TVSQ scores and objective parameters was analysed. Lastly, predictive factors for persistent voice symptoms were analysed. SETTING: Tertiary referral hospital. RESULTS: The frequency ranges and TVSQ scores exhibited significant deterioration until 6 months following surgery. Among clinical factors, the extents of thyroidectomy and neck dissection were associated with worse voice parameters. The TVSQ score was significantly correlated with objective voice parameters. The extents of thyroidectomy and neck dissection were predictive of persistent voice symptoms at 6 months after thyroidectomy. CONCLUSION: After uncomplicated thyroidectomy, most voice parameters tended to recover, but some parameters remained aggravated even at 6 months after surgery. With more extensive surgery, worse voice quality and the higher risk of persistent voice symptoms may be anticipated.


Assuntos
Disfonia , Distúrbios da Voz , Humanos , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Qualidade da Voz
8.
Opt Express ; 30(5): 6500-6518, 2022 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-35299433

RESUMO

Adversarial attacks inject imperceptible noise to images to deteriorate the performance of deep image classification models. However, most of the existing studies consider attacks in the digital (pixel) domain where an image acquired by an image sensor with sampling and quantization is recorded. This paper, for the first time, introduces a scheme for optical adversarial attack, which physically alters the light field information arriving at the image sensor so that the classification model yields misclassification. We modulate the phase of the light in the Fourier domain using a spatial light modulator placed in the photographic system. The operative parameters of the modulator for adversarial attack are obtained by gradient-based optimization to maximize cross-entropy and minimize distortion. Experiments based on both simulation and a real optical system demonstrate the feasibility of the proposed optical attack. We show that our attack can conceal perturbations in the image more effectively than the existing pixel-domain attack. It is also verified that the proposed attack is completely different from common optical aberrations such as spherical aberration, defocus, and astigmatism in terms of both perturbation patterns and classification results.

9.
J Am Acad Dermatol ; 84(6): 1619-1627, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33508387

RESUMO

BACKGROUND: Topical calcineurin inhibitors have been used to treat vitiligo, either alone or in combination with phototherapy; however, the long-term safety of these agents remains controversial. OBJECTIVE: To investigate the risk of lymphoma and skin cancer in vitiligo patients who received topical calcineurin inhibitors or phototherapy. METHODS: A multicenter retrospective cohort study of 25,694 vitiligo patients who received topical calcineurin inhibitors or phototherapy for 6 weeks or more between 2001 and 2019 was performed. Cumulative doses of topical calcineurin inhibitors and total phototherapy sessions were determined. Outcomes were the development of lymphoma or skin cancer after enrollment, confirmed through chart review and pathology reports. RESULTS: During 95,203 person-years, 13 cases of lymphoma, 22 of actinic keratosis, 15 of nonmelanoma skin cancer, and 5 of melanoma were observed. The risk of lymphoma and skin cancer was not significantly increased by topical calcineurin inhibitor dose or phototherapy sessions. The interaction between the topical calcineurin inhibitors and phototherapy was not associated with an increased risk of skin cancer. LIMITATIONS: Retrospective study, individual follow-up duration less than 4 years, and no adjustment for comorbidities and medication history. Not generalizable to other races. CONCLUSION: The long-term risk of skin cancer or lymphoma was not associated with the use of topical calcineurin inhibitors, phototherapy, and both treatments in combination in patients with vitiligo.


Assuntos
Inibidores de Calcineurina/efeitos adversos , Linfoma/epidemiologia , Fototerapia/efeitos adversos , Neoplasias Cutâneas/epidemiologia , Vitiligo/terapia , Administração Cutânea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidores de Calcineurina/administração & dosagem , Criança , Pré-Escolar , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Linfoma/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco/estatística & dados numéricos , Pele/patologia , Neoplasias Cutâneas/etiologia , Fatores de Tempo , Adulto Jovem
10.
Surg Endosc ; 35(6): 2855-2861, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32556767

RESUMO

BACKGROUND: There is an increased use of endoscopic thyroidectomy (ET), including robotic-assisted thyroidectomy (RT), to avoid postoperative scars on the anterior neck. The objective of this study was to compare the surgical and oncologic outcomes between ET and conventional open thyroidectomy (COT) for differentiated thyroid carcinoma (DTC). METHODS: We reviewed 4129 patients with DTC who underwent thyroid lobectomy at Seoul St. Mary's Hospital (Seoul, Korea) from January 2009 to December 2014. Patients were categorized according to the type of surgery and statistically compared using propensity score matching analysis. RESULTS: The mean operation time was significantly longer in the ET group than in the OT group (101.2 ± 26.2 min vs. 86.4 ± 27.0 min, p < 0.001). The number of harvested lymph nodes was significantly lower in the ET group than in the OT group (5.5 ± 4.2 vs. 8.3 ± 6.2, p < 0.001). There was no significant difference in the recurrence rate between the two groups (p = 0.879). Kaplan-Meier analysis revealed no significant difference in the disease-free survival after propensity score matching (p = 0.811). The mean follow-up duration was 90.4 ± 21.0 months. CONCLUSIONS: Transaxillary ET including RT for DTC is a safe and feasible alternative to COT with a cosmetically desirable outcome. Further studies are required to confirm our results.


Assuntos
Carcinoma Papilar , Neoplasias da Glândula Tireoide , Tireoidectomia , Carcinoma Papilar/cirurgia , Intervalo Livre de Doença , Humanos , Recidiva Local de Neoplasia , Pontuação de Propensão , Neoplasias da Glândula Tireoide/cirurgia , Resultado do Tratamento
11.
Int J Mol Sci ; 21(7)2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-32260561

RESUMO

The recent development of high-throughput genomics has revolutionized personalized medicine by identifying key pathways and molecular targets controlling tumor progression and survival. Mitogen-activated protein kinase (MAPK) pathways are examples of such targets, and inhibitors against these pathways have shown promising clinical responses in patients with melanoma, non-small-cell lung cancer, colorectal cancer, pancreatic cancer, and thyroid cancer. Although MAPK pathway-targeted therapies have resulted in significant clinical responses in a large proportion of cancer patients, the rate of tumor recurrence is high due to the development of resistance. Conversely, immunotherapies have shown limited clinical responses, but have led to durable tumor regression in patients, and complete responses. Recent evidence indicates that MAPK-targeted therapies may synergize with immune cells, thus providing rationale for the development of combination therapies. Here, we review the current status of ongoing clinical trials investigating MAPK pathway inhibitors, such as BRAF and MAPK/ERK kinase (MEK) inhibitors, in combination with checkpoint inhibitors targeting programmed death protein 1 (PD-1), programmed death-ligand 1 (PD-L1), and cytotoxic T cell associated antigen-4 (CTLA-4). A better understanding of an individual drug's mechanism of action, patterns of acquired resistance, and the influence on immune cells will be critical for the development of novel combination therapies.


Assuntos
Inibidores de Checkpoint Imunológico/uso terapêutico , Imunoterapia/métodos , Neoplasias/tratamento farmacológico , Inibidores de Proteínas Quinases/uso terapêutico , Animais , Ensaios Clínicos como Assunto , Terapia Combinada , Humanos , Quinases de Proteína Quinase Ativadas por Mitógeno/antagonistas & inibidores , Neoplasias/terapia
12.
Int J Mol Sci ; 21(19)2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32992880

RESUMO

In the present study, we investigated the signal transduction of mutants of the eel follicle-stimulating hormone receptor (eelFSHR). Specifically, we examined the constitutively activating mutant D540G in the third intracellular loop, and four inactivating mutants (A193V, N195I, R546C, and A548V). To directly assess functional effects, we conducted site-directed mutagenesis to generate mutant receptors. We measured cyclic adenosine monophosphate (cAMP) accumulation via homogeneous time-resolved fluorescence assays in Chinese hamster ovary (CHO-K1) cells and investigated cell surface receptor loss using an enzyme-linked immunosorbent assay in human embryonic kidney (HEK) 293 cells. The cells expressing eelFSHR-D540G exhibited a 23-fold increase in the basal cAMP response without agonist treatment. The cells expressing A193V, N195I, and A548V mutants had completely impaired signal transduction, whereas those expressing the R546C mutant exhibited little increase in cAMP responsiveness and a small increase in signal transduction. Cell surface receptor loss in the cells expressing inactivating mutants A193V, R546C, and A548V was clearly slower than in the cell expressing the wild-type eelFSHR. However, cell surface receptor loss in the cells expressing inactivating mutant N195I decreased in a similar manner to that of the cells expressing the wild-type eelFSHR or the activating mutant D540G, despite the completely impaired cAMP response. These results provide important information regarding the structure-function relationships of G protein-coupled receptors during signal transduction.


Assuntos
Receptores do FSH/metabolismo , Transdução de Sinais , Animais , Células CHO , Cricetulus , AMP Cíclico/metabolismo , Enguias , Células HEK293 , Humanos , Mutação , Receptores do FSH/genética , Relação Estrutura-Atividade
13.
J Nanosci Nanotechnol ; 19(10): 6347-6351, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31026959

RESUMO

Copper has unique properties, such as low electrical resistivity, that are exploited in a number of applications, including an interconnect layer in integrated circuits and microelectronic devices. Etching techniques are essential for the fabrication of fine structures, devices, and circuits. This article addresses the methods of copper etching with an emphasis on approaches using ferric nitrate. Potentiodynamic polarization tests using benzotriazole as an inhibitor showed that ferric nitrate has higher inhibition efficiency than conventional etchants. This is because benzotriazole in a ferric nitrate solution is adsorbed on the copper surface to a greater extent than in a ferric chloride and cupric chloride solution, as confirmed by Fourier transform infrared analysis. Quantitative atomic force microscopy characterization showed that good surface quality with significantly lower surface roughness can be obtained from a copper film etched in a ferric nitrate solution, which has potential use in microelectronics manufacturing.

14.
World J Surg ; 42(9): 2992-2999, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29511871

RESUMO

BACKGROUND: Postoperative delirium after liver transplantation is relatively common, especially due to preexisting conditions such as hepatic encephalopathy. Most studies of delirium after liver transplantation were based on ICU practices using deep hypnosedation. Therefore, risk factors and consequences of postoperative delirium after liver transplantation were evaluated in the light sedation era. METHODS: A total of 253 liver transplantation patients were evaluated for postoperative delirium. Clinical outcomes including mortality were compared between patients who suffered delirium and those who did not. Risk factors for postoperative delirium were analyzed with subgroup analysis depending on MELD scores and type of liver transplantation. RESULTS: Post-liver transplant delirium developed in 17% of the patients, 88% of which occurred within the first postoperative day. Alcoholic liver cirrhosis, class C Child-Pugh score, higher MELD scores, higher proportion of deceased donor liver transplantation, and reintubation were more frequent in patients who developed delirium, but there was no difference in mortality. Higher preoperative MELD group (15-24 vs. <15; OR 4.10, 95% Cl [1.67-10.09], P = 0.002, ≥25 vs. <15; OR 5.59, 95% CI [2.06-15.19], P < 0.01), higher APACHE II scores (OR 5.59, 95% CI [2.06-15.19], P < 0.01), and reintubation (OR 6.46, 95% CI [2.10-19.88], P < 0.01) were identified as significant risk factors for postoperative delirium. CONCLUSION: Postoperative delirium after liver transplantation was associated with worse clinical outcomes. MELD scores greater than 15 were predictive of postoperative delirium in both living and deceased donor liver transplantation.


Assuntos
Delírio/etiologia , Transplante de Fígado/efeitos adversos , Complicações Pós-Operatórias/etiologia , Adolescente , Adulto , Idoso , Doença Hepática Terminal/cirurgia , Feminino , Humanos , Unidades de Terapia Intensiva , Intubação Intratraqueal , Cirrose Hepática Alcoólica/complicações , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Adulto Jovem
15.
Arch Virol ; 162(8): 2457-2461, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28434099

RESUMO

A new virus was isolated from a bellflower (Campanula takesimana) plant showing veinal mottle symptoms, and its complete genome sequence was determined. The viral genome consists of a positive-sense single-stranded RNA of 8,259 ribonucleotides. Electron microscopic observation revealed that the viral genome is packaged as a filamentous particle with an average length of approximately 760 nm. BLAST searches of protein databases showed that the encoded polyprotein has a maximum amino acid sequence identity of 34.1% (with 95% coverage) to that of the isolate AD of Chinese yam necrotic mosaic virus (CYNMV; genus Macluravirus). Phylogenetic analysis and comparison of the encoded amino acid sequences with those of other viruses demonstrated that the identified virus shows minimal sequence similarity to known viruses and should therefore be considered a member of a new genus in the family Potyviridae. The name bellflower veinal mottle virus (BVMoV) is proposed for this new virus.


Assuntos
Campanulaceae/virologia , Genoma Viral , Vírus de Plantas/genética , Vírus de Plantas/isolamento & purificação , Potyviridae/genética , Potyviridae/isolamento & purificação , Microscopia Eletrônica de Transmissão , Filogenia , Doenças das Plantas/virologia , Folhas de Planta/virologia , Vírus de Plantas/classificação , Vírus de Plantas/ultraestrutura , Potyviridae/classificação , Potyviridae/ultraestrutura , RNA Viral/genética , Análise de Sequência de RNA
16.
Arch Virol ; 162(9): 2885-2889, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28501954

RESUMO

The complete genome sequence of a new virus isolated from a longan (Dimocarpus longan Lour.) plant showing witches' broom syndrome was determined. The viral genome is composed of a monopartite single-stranded RNA of 9,428 nucleotides excluding the 3' poly(A) tail and contains one large single open reading frame encoding a polyprotein of 3086 amino acids. BLAST searches of protein databases showed that the encoded polyprotein has a maximum amino acid sequence identity of 35% (with 85% coverage) to that of the isolate Minnesota of rose yellow mosaic virus (RoYMV; family Potyviridae; genus not assigned). Molecular and phylogenetic analysis of the genome and encoded protein sequences showed that the identified virus has the general features that are characteristic of members of the family Potyviridae although it has extremely low sequence similarity to known members of the family Potyviridae. The name longan witches' broom-associated virus (LWBaV) is proposed for this new virus, which may be considered a member of a new genus in the family Potyviridae.


Assuntos
Genoma Viral , Potyviridae/genética , Potyviridae/isolamento & purificação , Sapindaceae/virologia , Filogenia
17.
J Environ Sci (China) ; 54: 90-100, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28391952

RESUMO

The objective of this study is to estimate the vehicle kilometer traveled (VKT) and on-road emissions using the traffic volume in urban. We estimated two VKT; one is based on registered vehicles and the other is based on traffic volumes. VKT for registered vehicles was 2.11 times greater than that of the applied traffic volumes because each VKT estimation method is different. Therefore, we had to define the inner VKT is moved VKT inner in urban to compare two values. Also, we focused on freight modes because these are discharged much air pollutant emissions. From analysis results, we found middle and large trucks registered in other regions traveled to target city in order to carry freight, target city has included many industrial and logistics areas. Freight is transferred through the harbors, large logistics centers, or via locations before being moved to the final destination. During this process, most freight is moved by middle and large trucks, and trailers rather than small trucks for freight import and export. Therefore, these trucks from other areas are inflow more than registered vehicles. Most emissions from diesel trucks had been overestimated in comparison to VKT from applied traffic volumes in target city. From these findings, VKT is essential based on traffic volume and travel speed on road links in order to estimate accurately the emissions of diesel trucks in target city. Our findings support the estimation of the effect of on-road emissions on urban air quality in Korea.


Assuntos
Poluentes Atmosféricos/análise , Poluição do Ar/estatística & dados numéricos , Monitoramento Ambiental , Emissões de Veículos/análise , Cidades , Veículos Automotores/estatística & dados numéricos , República da Coreia
18.
J Environ Sci (China) ; 54: 21-32, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28391931

RESUMO

Emission characterization of particle number as well as particle mass from three diesel passenger cars equipped with diesel particulate filter (DPF), diesel oxidation catalyst (DOC) and exhaust gas recirculation (EGR) under the vehicle driving cycles and regulatory cycle. Total particle number emissions (PNEs) decreased gradually during speed-up of vehicle from 17.3 to 97.3km/hr. As the average vehicle speed increases, the size-segregated peak of particle number concentration shifts to smaller size ranges of particles. The correlation analysis with various particulate components such as particle number concentration (PNC), ultrafine particle number concentration (UFPNC) and particulate matter (PM) mass was conducted to compare gaseous compounds (CO, CO2, HC and NOx). The UFPNC and PM were not only emitted highly in Seoul during severe traffic jam conditions, but also have good correlation with hydrocarbons and NOx influencing high potential on secondary aerosol generation. The effect of the dilution temperature on total PNC under the New European Driving Cycle (NEDC), was slightly higher than the dilution ratio. In addition, the nuclei mode (DP: ≤13nm) was confirmed to be more sensitive to the dilution temperature rather than other particle size ranges. Comparison with particle composition between vehicle speed cycles and regulatory cycle showed that sulfate was slightly increased at regulatory cycle, while other components were relatively similar. During cold start test, semivolatile nucleation particles were increased due to effect of cold environment. Research on particle formation dependent on dilution conditions of diesel passenger cars under the NEDC is important to verify impact on vehicular traffic and secondary aerosol formation in Seoul.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Material Particulado/análise , Emissões de Veículos/análise , Tamanho da Partícula
19.
Arch Virol ; 160(2): 587-90, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25300414

RESUMO

The complete genome sequence of a new virus isolated from a motherwort plant exhibiting yellow mottle, mild mosaic, and stunting symptoms in Andong, Korea, was determined. The genome of this virus is composed of two single-stranded RNAs (7068 and 4963 nucleotides in length, respectively) carrying poly(A) tails. RNA1 contains one large open reading frame (RNA1-ORF1), while two potential ORFs (RNA2-ORF1 and RNA2-ORF2) were found in RNA2. BLAST searches of protein databases showed that RNA1-ORF1 and RNA2-ORF2 have maximum amino acid sequence identities of 53 % and 57 % to the RNA1-ORF1 and RNA2-ORF2, respectively, of lettuce necrotic leaf curl virus (LNLCV, a recently identified torradovirus). Phylogenetic analysis provided further evidence that the virus identified in this study is probably a member of a new species in the genus Torradovirus. The name "motherwort yellow mottle virus" (MYMoV) is proposed for this new virus.


Assuntos
Genoma Viral/genética , Leonurus/virologia , Doenças das Plantas/virologia , Vírus de Plantas/genética , Vírus de RNA/genética , Sequência de Aminoácidos , Sequência de Bases , Sequenciamento de Nucleotídeos em Larga Escala , Fases de Leitura Aberta/genética , Filogenia , Vírus de Plantas/classificação , Vírus de RNA/classificação , RNA Viral/genética , Análise de Sequência de RNA , Homologia de Sequência de Aminoácidos , Proteínas Virais/genética
20.
J Air Waste Manag Assoc ; 65(4): 445-54, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25947214

RESUMO

UNLABELLED: Carbonaceous species (organic carbon [OC] and elemental carbon [EC]) and inorganic ions of particulate matter less than 2.5 µm (PM2.5) were measured to investigate the chemical characteristics of long-range-transported (LTP) PM2.5 at Gosan, Jeju Island, in Korea in the spring and fall of 2008-2012 (excluding 2010). On average, the non-sea-salt (nss) sulfate (4.2 µg/m3) was the most dominant species in the spring, followed by OC (2.6 µg/m3), nitrate (2.1 µg/m3), ammonium (1.7 µg/m3), and EC (0.6 µg/m3). In the fall, the nss-sulfate (4.7 µg/m3) was also the most dominant species, followed by OC (4.0 µg/m3), ammonium (1.7 µg/m3), nitrate (1.1 µg/m3), and EC (0.7 µg/m3). Both sulfate and OC were higher in the fall than in the spring, possibly due to more common northwest air masses (i.e., coming from China and Korea polluted areas) and more frequent biomass burnings in the fall. There was no clear difference in the EC between the spring and fall. The correlation between OC and EC was not strong; thus, the OC measured at Gosan was likely transported across a long distance and was not necessarily produced in a manner similar to the EC. Distinct types of LTP events (i.e., sulfate-dominant LTP versus OC-dominant LTP) were observed. In the sulfate-dominant LTP events, air masses directly arrived at Gosan without passing over the Korean Peninsula from the industrial area of China within 48 hr. During these events, the aerosol optical depth (AOD) increased to 1.63. Ionic balance data suggest that the long-range transported aerosols are acidic. In the OC-dominant LTP event, a higher residence time of air masses in Korea was observed (the air masses departing from the mainland of China arrived at the sampling site after passing Korea within 60-80 hr). IMPLICATIONS: In Northeast Asia, various natural and anthropogenic sources contribute to the complex chemical components and affect local/regional air quality and climate change. Chemical characteristics of long-range-transported (LTP) PM2.5 were investigated during spring and fall of 2008, 2009, 2011, and 2012. Based on air mass types, sulfate-dominant LTP and OC-dominant LTP were observed. A long-term variation and chemical characteristics of PM2.5 along with air mass and satellite data are required to better understand long-range-transported aerosols.


Assuntos
Movimentos do Ar , Poluentes Atmosféricos/química , Ilhas , Material Particulado , Estações do Ano , República da Coreia , Fatores de Tempo
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