Comparison of Medisonic with Harmonic HD 1000i and Sonicision ultrasonic energy device in laparoscopic gastrectomy: a pilot randomized clinical trial

Purpose@#This study aimed to compare the clinical performance of Medisonic (Daiwha Corp.) to that of Harmonic HD 1000i (Ethicon Endo-Surgery Inc.) and Sonicision (Medtronic) in patients undergoing gastrectomy for gastric cancer. @*Methods@#A total of 30 patients were enrolled in this prospective randomized study. The patients were randomly assigned to a Medisonic (M group, n = 10), Harmonic HD 1000i (H group, n = 10), or Sonicision (S group, n = 10) groups. Primary outcome was cutting speed and activation times during omentectomy. Other variables were visibility of surgical field, blade stickiness, and clinical outcomes, including operation-related complications. @*Results@#Clinicopathologic characteristics, including age, sex, body mass index, or stage were not different between the 3 groups. Operative outcomes, including operation time, estimated blood loss, and postoperative hospital stay were not different between the 3 groups. There was no significant difference in 30-day postoperative complications. The running time of omentectomy was 7.3, 9.2, and 8.7 minutes in the H, S, and M groups, respectively, with no statistical difference (P = 0.589). We also looked at the activation times during the omentectomy, and there was no statistical difference between the groups (52.6 times vs. 58.9 times vs. 56.2 times in the H, S, and M groups, respectively; P = 0.860). @*Conclusion@#Medisonic is safe and efficient to perform laparoscopic radical gastrectomy and is not inferior to Harmonic HD 1000i or Sonicision in terms of clinical outcomes and cutting/sealing function.

A low risk of nosocomial transmission of subclinical tuberculosis to neonates in a postpartum care center under COVID-19 control measures

We report the results of investigating and managing a tuberculosis (TB) exposure in a postpartum care center. Among the contacts exposed to a nursing assistant with subclinical TB, 5 of 44 neonates (11.4%) had positive tuberculin skin tests (TSTs) at 3 months of age, and all the TST-positive neonates received the Bacille Calmette-Guérin vaccination. Seven of 28 healthcare workers (25.0%) and 1 of 3 household contacts (33.3%) were positive in the initial or repeated interferon-gamma release assay. None of the contacts developed TB disease during the study period. Annual TB examinations of healthcare personnel at a postpartum care center under the Tuberculosis Prevention Act in South Korea enabled the early detection of subclinical TB, which reduced the risk of transmission to neonates under strict coronavirus disease 2019 prevention measures.

A Novel Approach for Gastric Cancer Staging in Elderly Patients Based on the Lymph Node Ratio

Purpose@#To date, no studies have been performed on staging based on the lymph node ratio (LNR) in elderly patients with gastric cancer who may require limited lymph node (LN) dissection due to morbidity and tissue fragility. We aimed to develop a new N staging system using the LNR in elderly patients with gastric cancer. @*Materials and Methods@#The present study included patients aged over 75 years who underwent curative gastrectomy between January 1989 and December 2018.Clinicopathological data including the number of retrieved and metastatic LNs were collected and the LNR values were obtained (LNR = the number of metastatic LNs/the number of retrieved LNs). Eleven LNR groups with intervals of 0.1 were divided into four stages based on the inflection points at which the hazard ratio (HR) increased. Survival analysis was performed to evaluate the prognostic value of the LNR. @*Results@#The four LNR stages included LNR0 (n=364), LNR1 (n=128), LNR2 (n=103), and LNR3 (n=10). In the multivariate analysis, both N staging and LNR staging exhibited significant prognostic values for predicting survival outcomes. However, the incremental change in the hazard ratio (HR) between consecutive stages was greater for the LNR staging than for the N staging (HRs: 1.607, 2.758, and 3.675 for N staging; 1.583, 3.514, and 10.261 for LNR staging). @*Conclusions@#LNR staging is more useful than N staging in predicting the prognosis in elderly patients with gastric cancer and may be used as a complement or alternative to N staging.

Hybrid Robotic and Laparoscopic Gastrectomy for Gastric Cancer:Comparison with Conventional Laparoscopic Gastrectomy

Purpose@#The benefits of robotic gastrectomy remain controversial. We designed this study to elucidate the advantages of a hybrid robot and laparoscopic gastrectomy over conventional laparoscopic surgery. @*Materials and Methods@#A total of 176 patients who underwent gastrectomy for gastric cancer were included in this study. We compared 88 patients treated with hybrid robotic and laparoscopic gastrectomy (HRLG) and 88 patients who underwent conventional laparoscopic gastrectomy (CLG). In HRLG, suprapancreatic lymph node (LN) dissection was performed in a robotic setting. Clinicopathological characteristics, operative details, and short-term outcomes were analyzed for the patients. @*Results@#The number of LNs retrieved from the suprapancreatic area was significantly greater in the HRLG group (11.27±5.46 vs. 9.17±5.19, P=0.010). C-reactive protein levels were greater in the CLG group on both postoperative day (POD) 1 (5.11±2.64 vs. 4.29±2.38, P=0.030) and POD 5 (9.86±6.51 vs. 7.75±5.17, P=0.019). In addition, the neutrophil-to-lymphocyte ratio was significantly greater in the CLG group on both POD 1 (7.44±4.72 vs. 6.16±2.91, P=0.031) and POD 5 (4.87±3.75 vs. 3.81±1.87, P=0.020). Pulmonary complications occurred only in the CLG group (4/88 [4.5%] vs. 0/88 [0%], P=0.043). @*Conclusions@#HRLG is superior to CLG in terms of suprapancreatic LN dissection and postoperative inflammatory response.

Correlation between Dysarthria and Aspiration in Patients with Stroke / 대한연하장애학회지

Objective@#This study examined the correlation between dysarthria and aspiration to determine if dysarthria can predict aspiration in stroke patients. @*Methods@#The medical records of 176 patients with first stroke, who underwent a videofluoroscopic swallowing study (VFSS) and Urimal test of articulation and phonology (U-TAP) at the same time between January 2012 and December 2015 in the authors’ hospital, were reviewed retrospectively. The correlation between the penetration aspiration scale (PAS) score and U-TAP score was analyzed in all patients. The mean PAS score and frequency of each PAS score in the dysarthria group and non-dysarthria group were compared. In addition, the aspiration was analyzed based on the severity of dysarthria in the dysphagia group. All statistical analyses were performed using SPSS software. @*Results@#The correlation between the PAS score and U-TAP score was not statistically significant in all the subjects.The mean PAS score was 3.46±5.52 and 3.07±5.49 in the dysphagia and non-dysphagia group, respectively. The mean PAS score of the dysphagia group was higher than that of the non-dysphagia group. On the other hand, it was not statistically significant. In addition, there was no significant difference in the frequency of the PAS scores between the two groups. The aspiration was compared with the severity of dysarthria according to the U-TAP score; there was no statistically significant difference. @*Conclusion@#No correlation was observed between dysarthria and aspiration in stroke patients. In addition, there was no difference in the frequency of aspiration with or without dysarthria. According to the results of this study, aspiration cannot be predicted by dysarthria in stroke patients. Therefore, each diagnostic test and assessment should be performed for each symptom.

Generation of hematopoietic stem cells from human embryonic stem cells using a defined, stepwise, serum-free, and serum replacement-free monolayer culture method

BACKGROUND: Embryonic stem cells (ESCs) can be expanded infinitely in vitro and have the potential to differentiate into hematopoietic stem cells (HSCs); thus, they are considered a useful source of cells for HSC production. Although several technical in vitro methods for engineering HSCs from pluripotent stem cells have been developed, clinical application of HSCs engineered from pluripotent stem cells is restricted because of the possibility of xenogeneic contamination resulting from the use of murine materials. METHODS: Human ESCs (CHA-hES15) were cultured on growth factor-reduced Matrigel-coated dishes in the mTeSR1 serum-free medium. When the cells were 70% confluent, we initiated HSC differentiation by three methods involving (1) knockout serum replacement (KSR), cytokines, TGFb1, EPO, and FLT3L; (2) KSR, cytokines, and bFGF; or (3) cytokines and bFGF. RESULTS: Among the three differentiation methods, the minimal number of cytokines without KSR resulted in the greatest production of HSCs. The optimized method resulted in a higher proportion of CD34⁺CD43⁺ hematopoietic progenitor cells (HPCs) and CD34⁺CD45⁺ HPCs compared to the other methods. In addition, the HSCs showed the potential to differentiate into multiple lineages of hematopoietic cells in vitro. CONCLUSION: In this study, we optimized a two-step, serum-free, animal protein-free, KSR-free, feeder-free, chemically defined monolayer culture method for generation of HSCs and hematopoietic stem and progenitor cells (HSPCs) from human ESCs.

Models of rehabilitation medical service delivery system in the world

In rehabilitation medicine, differences exist in programs and facilities of rehabilitation medical services provided for the acute, subacute, and chronic phases of a disorder caused by disease or trauma. The establishment of a rehabilitation medical delivery system is important as a way of providing appropriate rehabilitation medical services according to the timing and circumstances of the onset of a condition, but the domestic rehabilitation system is insufficient. The purpose of this study was to investigate the models of rehabilitation medical service delivery in representative countries such as the United States, Japan, and the United Kingdom, and to examine the characteristics of the system of each country. Rehabilitation medical service systems vary from country to country, but each country has a unified mechanism for service linkage in order to deliver various services in an organic relationship with service users (persons with disabilities and families) and providers (government and medical facilities). It is necessary to construct a rehabilitation medical delivery system according to the circumstances in Korea based on a comparative analysis of the systems of other representative countries.

Skin whitening and anti-corrugation activities of glycoprotein fractions from liquid extracts of boiled sea cucumber

Objective To determine skin whitening and wrinkle improvement efficacy, glycoprotein fractions were extracted from liquid extracts of boiled sea cucumber and their effects on tyrosine and elastase inhibitory activities were assayed. Methods Fractions above and below 50 kDa (>50 kDa and 50 kDa enhanced tyrosinase and elastase inhibitory activities by 50.84% and 28.78%, respectively. Correlations of the >50 kDa concentration with tyrosinase inhibitory (R2 = 0.968) and elastase inhibitory (R2 = 0.983) efficacy were significant. Conclusions >50 kDa glycoprotein fraction isolated from liquid extracts of boiled sea cucumber, which can serve as a functional cosmetic ingredient for whitening and wrinkle improvement of skin.

Skin whitening and anti-corrugation activities of glycoprotein fractions from liquid extracts of boiled sea cucumber

OBJECTIVE@#To determine skin whitening and wrinkle improvement efficacy, glycoprotein fractions were extracted from liquid extracts of boiled sea cucumber and their effects on tyrosine and elastase inhibitory activities were assayed.@*METHODS@#Fractions above and below 50 kDa (>50 kDa and 50 kDa enhanced tyrosinase and elastase inhibitory activities by 50.84% and 28.78%, respectively. Correlations of the >50 kDa concentration with tyrosinase inhibitory (R2 = 0.968) and elastase inhibitory (R2 = 0.983) efficacy were significant.@*CONCLUSIONS@#>50 kDa glycoprotein fraction isolated from liquid extracts of boiled sea cucumber, which can serve as a functional cosmetic ingredient for whitening and wrinkle improvement of skin.

Analysis of Age-Related Changes in Asian Facial Skeletons Using 3D Vector Mathematics on Picture Archiving and Communication System Computed Tomography

PURPOSE: There are marked differences in facial skeletal characteristics between Asian and Caucasian. However, ethnic differences in age-related facial skeletal changes have not yet been fully established. The aims of this study were to evaluate age-related changes in Asian midfacial skeletons and to explore ethnic differences in facial skeletal structures with aging between Caucasian and Asian. MATERIALS AND METHODS: The study included 108 men (aged 20-79 years) and 115 women (aged 20-81 years). Axial CT images with a gantry tilt angle of 0 were analyzed. We measured three-dimensional (3D) coordinates at each point with a pixel lens cursor in a picture archiving and communication system (PACS), and angles and widths between the points were calculated using 3D vector mathematics. We analyzed angular changes in 4 bony regions, including the glabellar, orbital, maxillary, and pyriform aperture regions, and changes in the orbital aperture width (distance from the posterior lacrimal crest to the frontozygomatic suture) and the pyriform width (between both upper margins of the pyriform aperture). RESULTS: All 4 midfacial angles in females and glabellar and maxillary angles in males showed statistically significant decreases with aging. On the other hand, the orbital and pyriform widths did not show statistically significant changes with aging. CONCLUSION: The results of this study suggest that Asian midfacial skeletons may change continuously throughout life, and that there may be significant differences in the midfacial skeleton between both sexes and between ethnic groups.

Fatty acid methyl ester profiles and nutritive values of 20 marine microalgae in Korea

OBJECTIVE@#To screen the fatty acid (FA) composition of 20 marine microalgae species, including seven Diophyceae, six Bacillariophyceae, four Chlorophyceae, two Haptophyceae and one Raphidophyceae species.@*METHODS@#Microalgal cells cultured at the Korea Institute of Ocean Science & Technology were harvested during the late exponential growth phase and the FA composition analyzed.@*RESULTS@#The FA composition of microalgae was species-specific. For example, seven different species of Dinophyceae were composed primarily of C14:0, C16:0, C18:0, C20:4n-6, C20:5n-3 and C22:6n-3, while C14:0, C16:0, C16:1, C18:0, C20:5n-3 and C22:6n-3 were abundant FAs in six species of Bacillariophyceae. In addition, four Chlorophyceae, two Haptophyceae and one Raphidophyceae species all contained a high degree of C16:1n-7 [(9.28-34.91)% and (34.48-35.04)%], C14:0 [(13.34-25.96)%] and [(26.69-28.24)%], and C16:0 [(5.89-29.15)%] and [(5.70-16.81)%]. Several factors contribute to the nutritional value of microalgae, including the polyunsaturated FA content and n-3 to n-6 FA ratio, which could be used to assess the nutritional quality of microalgae.@*CONCLUSIONS@#This study is the first comprehensive assessment of the FA composition and nutritional value of microalgae species in South Korea, and identifies the potential utility of FAs as species-specific biomarkers.

Fatty acid methyl ester profiles and nutritive values of 20 marine microalgae in Korea

Objective: To screen the fatty acid (FA) composition of 20 marine microalgae species, including seven Diophyceae, six Bacillariophyceae, four Chlorophyceae, two Haptophyceae and one Raphidophyceae species. Methods: Microalgal cells cultured at the Korea Institute of Ocean Science & Technology were harvested during the late exponential growth phase and the FA composition analyzed. Results: The FA composition of microalgae was species-specific. For example, seven different species of Dinophyceae were composed primarily of C14:0, C16:0, C18:0, C20:4n-6, C20:5n-3 and C22:6n-3, while C14:0, C16:0, C16:1, C18:0, C20:5n-3 and C22:6n-3 were abundant FAs in six species of Bacillariophyceae. In addition, four Chlorophyceae, two Haptophyceae and one Raphidophyceae species all contained a high degree of C16:1n-7 [(9.28-34.91)% and (34.48-35.04)%], C14:0 [(13.34-25.96)%] and [(26.69-28.24)%], and C16:0 [(5.89-29.15)%] and [(5.70-16.81)%]. Several factors contribute to the nutritional value of microalgae, including the polyunsaturated FA content and n-3 to n-6 FA ratio, which could be used to assess the nutritional quality of microalgae. Conclusions: This study is the first comprehensive assessment of the FA composition and nutritional value of microalgae species in South Korea, and identifies the potential utility of FAs as species-specific biomarkers.

Desmoid Type Fibromatosis in the Facet Joint of Lumbar Spine: Case Report and Review of Literature

Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement.

Matrix Metalloproteinase Inhibitors Attenuate Neuroinflammation Following Focal Cerebral Ischemia in Mice

The aim of this study was to investigate whether matrix metalloproteinase (MMP) inhibitors attenuate neuroinflammation in an ischemic brain following photothrombotic cortical ischemia in mice. Male C57BL/6 mice were anesthetized, and Rose Bengal was systemically administered. Permanent focal ischemia was induced in the medial frontal and somatosensory cortices by irradiating the skull with cold white light. MMP inhibitors, such as doxycycline, minocycline, and batimastat, significantly reduced the cerebral infarct size, and the expressions of monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), and indoleamine 2,3-dioxygenase (IDO). However, they had no effect on the expressions of heme oxygenase-1 and neuroglobin in the ischemic cortex. These results suggest that MMP inhibitors attenuate ischemic brain injury by decreasing the expression levels of MCP-1, TNF-alpha, and IDO, thereby providing a therapeutic benefit against cerebral ischemia.

Anti-inflammatory Effect of Quercetin on Picryl Chloride-induced Contact Dermatitis in BALB/c Mice / 한국실험동물학회지

In this study, we investigated that anti-inflammatory effect of quercetin on picryl chloride(PCL)-induced contact dermatitis in BALB/c Mice. Experimental animals were divided into three groups and comprising five animals. All groups of oral administration was begun on the first day of PCL treatment and ceased on day 5. For the induction of contact dermatitis, BALB/c mice were sensitized with 40 microliter of 1.5% picryl choloride (PCL) to the left and right ear, respectively. Ear swelling responses were much weaker in high-dose group (100 mg/kg) than control group (0 mg/kg). Total serum IgE levels and histamine levels were measured by sandwich ELISA method using mouse IgE, histamine measuring Kit. Both total serum IgE and histamine levels were significantly decreased in high-dose group (100 mg/kg) than other groups. Degranulation of mast cells were also confirmed by Toluidine Blue (TB) staining method. In high-dose group (100 mg/kg), the number of mast cells were significantly decreased and there are many mast cells were shown degranulation in control group (0 mg/kg). All of these results demonstrate that the pharmacological actions of quercetin indicate their potential activity for allergic inflammatory diseases through the down-regulation of mast cell activation.

The Prevalence of the Metabolic Syndrome and Cut-off Values of Power and Flexibility in Elderly Males / 대한스포츠의학회지

The purpose of the study was to find out the age-adjusted odds ratio of the metabolic syndrome and the associated cut-off values of the physical fitnessfactors of the elderly males in their 60s and 70s. 477 participants were tested for the cardiorespiratory fitness (VO2max), power, flexibility as well as blood battery and abdominal circumference for the metabolic syndrome status. As a result, 32.2% of the participants had metabolic syndrome with the associated cut-off values of the power and flexibility as 29.0 cm (areas under curve [AUC]: 0.57, p=0.029) and 0.6 cm (AUC: 0.54, p=0.028), respectively. The cardiorespiratory fitness showed no significant difference prevalence rate between groups. The prevalence rate was calculated by dividing the participants into high and low groups. The metabolic syndrome prevalence rate for the low power group was 1.63 (p<0.030) and low flexibility group was 2.01 (p<0.002). The cardiovascular fitness showed no significant prevalence rate.

Clinical Characteristics of Bipolar Disorder Patients with Prepubertal Onset : A Pilot Study / 신경정신의학

OBJECTIVES : This case-based, small scale study was undertaken to identify the characteristics clinical features of children who exhbiit rare prepubertal onset bipolar disorder. METHODS : We analyzed the clinical records of 13 children who had been hospitalized and diagnosed with bipolar disorder. Clinical characteristics and cognitive function of these patients was based on psychiatrists' medical records and psychologists' evaluation reports. RESULTS : Eleven (84.6%) subjects exhibited clinical features of mixed mania and had a chronic clinicalcourse. They never fulfilled the full criteria of the Diagnostic Statistical Manual of Mental disorders- Fourth Edition (DSM-IV) for manic or hypomanic episodes. Mean age at onset of typical symptoms of bipolar disorder was 9.38 (SD=1.80) and mean age at admission was 12.00 (SD=2.45). Twelve (92.3%) had psychiatric comorbidity. Attention-deficit/hyperactivity disorder was the most prevalent comorbid disease and mean age of onset of it was 6.23 (SD=2.17). CONCLUSION : Subjects with prepubertal onset bipolar disorder showed atypical clinical features. These results suggest that most prepubertal onset bipolar disorder patients fail to meet the DSM-IV criteria for typical bipolar I disorder and therefore, we need to develop alternative diagnostic criteria for pediatric bipolar disorder.

Abdominal Wall Endometriosis after Cesarean Section: A Report of Two Cases / 대한산부인과학회지

Extrapelvic endometriosis remains quite rare phenomenon. The majority of extrapelvic endometriosis involve scar tissue following obstetric/gynecologic procedures. Endometriosis involving a cesarean section scar may be more common than previously recongnized. The classic symptom is a painful scar that became swollen and more tender during menstruation. The cause of surgical scar endometriosis is believed to be iatrogenic transplantation of endometrial tissue to the surgical wound. The surgical excision remains the treatment of choice for expected cures and presents the most appropriate diagnostic and therapeutic intervention. We present two cases of endometriosis appearing on the abdominal wall scar of cesarean section with a brief review of the concerned literatures.

Clinical Characteristics of Kawasaki Disease in Infants Younger than 3 Months of Age

PURPOSE: Kawasaki disease(KD) is rare in infants <3 months of age. In this younger group, the diagnosis may be delayed due to lack of most of the clinical criteria, resulting in a high risk of cardiac complications. We examined clinical characteristics in these patients for early recognition and treatment. METHODS: We conducted a retrospective study on the infants with KD aged three months or younger treated at our hospital from January 1998 to July 2002. RESULTS: Of a total of 291 patients treated during the study period, 11(3.8%) were three months old or younger. Of the 11 patients, 10 had atypical presentations. Infants had fewer of the accepted criteria, and the most common findings were fever(100%) and oral mucosal changes(72.7%). Erythema at the site of BCG inoculation was observed in six of the 11 patients(unknown in the remaining five). This feature proved a definite diagnostic clue in two patients in whom cardiac omplications developed in the subacute phase. Cardiac complications were found in six patients(54.5%) : three had coronary dilatation, two had coronary wall irregularity, and one had mitral valve prolapse with regurgitation. Defervescence occurred within 1.1+/-0.3 day in 10 of the 11 patients treated with intravenous immunoglobulin(IVIG) and one was given a second course of IVIG. Echocardiographic abnormality persisted in only one patient with mitral regurgitation at the 6-month follow-up. CONCLUSION: Most patients with KD younger than three months of age have atypical presentations and a high complication rate. For early diagnosis, erythema at the BCG inoculation site, if present, could be used as a valid diagnostic clue to atypical KD in this age group.

Osseointegration Of Implants In Rabbit Bone With A Low Calcium Diet And Irradiation / 대한구강악안면방사선학회지

PURPOSE: To investigate osseointergration of titanium implants into the tibia of rabbits, which were fed a low calcium diet and irradiated. MATERIALS AND METHODS: To prepare the experimental model, control group was fed a normal diet and experimental group was fed a low calcium diet for 4 weeks. And then, titanium implants were inserted into the tibia of each rabbit. Experimental group was subdivided into two groups; low calcium diet/non-irradiation group and low calcium diet/irradiation group. The low calcium diet/irradiation group was irradiated with a single absorbed dose of 15 Gy at the 5th postoperative days. On the 12th, 19th, 33rd, 47th, and 61st days after implantation(1, 2, 4, 6, and 8 weeks after irradiation), the bone formation in the bone-implant interface area was examined by light microscopy and fluorescent microscopy. RESULTS AND CONCLUSIONS: 1. In the control group, there began to form woven bone in the bone-implant interface area on the 12th days after implantation. As the experimental time was going on, the amount of bone which was in contact with the implant was increased. 2. In the low calcium diet/non-irradiation group, there began to form woven bone in the bone-implant interface area on the 19th days after implantation. Although the amount of bone which was in contact with the implant was increased as the experimental time was going on, the extent of increased bone was slightly weak as compared with control group. 3. In the low calcium diet/irradiation group, there began to form woven bone incompletely in the bone-implant interface area on the 19th days after implantation, but there were vascular connective tissues in the bone- implant interface area over the entire experimental period. 4. In the control group and low calcium diet/non-irradiation group, bone labeling bands were observed on the 33rd days after implantation, which suggests that the bone formation and remodeling was in process, but interstitial bone remodeling was not observed in the low calcium diet/irradiation group.