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1.
Dev Reprod ; 27(3): 159-165, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38074458

RESUMEN

The Ruvb-like AAA ATPase1 (Ruvbl1; also known as Pontin) is an evolutionary conserved protein belonging to the adenosine triphosphates associated with diverse cellular activities (AAA+) superfamily of ATPases. Ruvbl1 is a component of various protein supercomplexes and is involved in a variety of cellular activities, including chromatin remodeling, DNA damage repair, and mitotic spindle assembly however, the developmental significance of this protein is unknown and needs detailed investigation. We investigated the developmental significance of Ruvbl1 in multiciliated cells of the Xenopus laevis epidermis since ruvbl1 is expressed in the multiciliated cells and pronephros during X. laevis embryogenesis. The knockdown of ruvbl1 significantly impaired cilia-driven fluid flow and basal body polarity in the X. laevis epidermis compared to control embryos, but did not affect cilia morphology. Our results suggest that Ruvbl1 plays a significant role in embryonic development by regulating ciliary beating; however, further investigation is needed to determine the mechanisms involved.

2.
Trials ; 24(1): 311, 2023 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-37149610

RESUMEN

BACKGROUND: Incisional hernia following abdominal surgery is a frequent complication of midline laparotomy. This complication is strongly associated with the technique and material used for suture. While a monofilament absorbable suture is recommended to prevent incisional hernia, it can lead to suture loosening or surgical-knot breakage. Although barbed sutures can be an alternative suture material in abdominal fascial closure, evidence for its safety and effectiveness is lacking. Therefore, we designed a prospective randomized trial to evaluate the safety and efficacy of absorbable barbed sutures for midline fascia closure in minimally invasive surgery for colorectal and gastric cancers in comparison with conventional absorbable monofilament sutures. METHODS: A total of 312 patients who underwent minimally invasive surgery for colorectal and gastric cancers will be randomly allocated to either the absorbable barbed or monofilament suture group for abdominal fascia closure in a 1:1 ratio. The primary outcome is incisional hernia rate within 3 years after surgery, as verified by physical examination and computed tomography. Postoperative complications, including surgical site infection, postoperative pain, and quality of life, will be compared between two groups as secondary outcomes. The investigator will examine the patients until discharge and at 6, 12, 18, 24, and 36 months postoperatively. DISCUSSION: This is the first randomized controlled trial to compare absorbable barbed sutures with monofilament sutures for midline fascia closure in minimally invasive surgery. If absorbable barbed sutures demonstrate superior results to those of monofilament sutures, this type of suture material may be recommended as an alternative option for abdominal fascia closure. TRIAL REGISTRATION: KCT0007069. Registered on January 30, 2023.


Asunto(s)
Técnicas de Cierre de Herida Abdominal , Neoplasias Colorrectales , Hernia Incisional , Neoplasias Gástricas , Humanos , Hernia Incisional/etiología , Hernia Incisional/prevención & control , Calidad de Vida , Estudios Prospectivos , Neoplasias Gástricas/cirugía , Técnicas de Sutura/efectos adversos , Técnicas de Cierre de Herida Abdominal/efectos adversos , Fascia , Procedimientos Quirúrgicos Mínimamente Invasivos , Suturas/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto
3.
STAR Protoc ; 4(2): 102228, 2023 Apr 17.
Artículo en Inglés | MEDLINE | ID: mdl-37071528

RESUMEN

Here, we present a protocol for preparing layer-engineered van der Waals (vdW) materials via an atomic spalling process. We describe steps for fixing bulk crystals and introduce the appropriate stressor materials. We then detail a deposition technique for internal stress regulation of stressor film, followed by layer-engineered atomic-scale spalling to exfoliate vdW materials with a controlled number of layers from bulk crystals. Lastly, we outline a procedure for polymer/stressor film removal. For complete details on the use and execution of this protocol, please refer to Moon et al.1.

4.
Sensors (Basel) ; 23(4)2023 Feb 08.
Artículo en Inglés | MEDLINE | ID: mdl-36850488

RESUMEN

This research proposes an application of generative adversarial networks (GANs) to solve the class imbalance problem in the fault detection and classification study of a plasma etching process. Small changes in the equipment part condition of the plasma equipment may cause an equipment fault, resulting in a process anomaly. Thus, fault detection in the semiconductor process is essential for success in advanced process control. Two datasets that assume faults of the mass flow controller (MFC) in equipment components were acquired using optical emission spectroscopy (OES) in the plasma etching process of a silicon trench: The abnormal process changed by the MFC is assumed to be faults, and the minority class of Case 1 is the normal class, and that of Case 2 is the abnormal class. In each case, additional minority class data were generated using GANs to compensate for the degradation of model training due to class-imbalanced data. Comparisons of five existing fault detection algorithms with the augmented datasets showed improved modeling performances. Generating a dataset for the minority group using GANs is beneficial for class imbalance problems of OES datasets in fault detection for the semiconductor plasma equipment.

5.
Pharmaceuticals (Basel) ; 15(11)2022 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-36355547

RESUMEN

Jaeumgeonbi-Tang (JGT), a traditional herbal medicine, has been used to treat dizziness and vertigo in Korea and China for hundreds of years. The purpose of this study was to evaluate the pharmacological properties of JGT in chronic subjective dizziness (CSD) patients. A randomized, double-blind, parallel-group and placebo-controlled trial was performed with a total of 50 CSD patients. The patients were randomly assigned to one of two groups: JGT or placebo (n = 25 for each). All participants received the treatment (placebo or JGT, 24 g/day) for 4 weeks. We analyzed the serum levels of oxidative stressors, antioxidants, and stress hormones. Serum levels of lipid peroxidation, but not nitric oxide, were significantly decreased in the JGT group. JGT not only prevented the decline of serum total glutathione contents and total antioxidant capacity, but it also increased superoxide dismutase and catalase activities. Serum levels of stress hormones including cortisol, adrenaline, and serotonin were notably normalized by JGT treatment, but noradrenaline levels were not affected. Regarding the safety and tolerability of JGT, we found no allergic, adverse, or side effects in any of the participants. JGT showed beneficial effects on CSD patients by improving redox status and balancing psycho-emotional stress hormones.

6.
J Gastric Cancer ; 22(1): 67-77, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35425655

RESUMEN

Purpose: Tegafur/gimeracil/oteracil (S-1) and capecitabine plus oxaliplatin (CAPOX) are standard adjuvant chemotherapies (ACs) administered after gastrectomy to patients with stage II or III gastric cancer. However, the efficacy of AC in elderly patients remains unclear. The objective of this retrospective multicenter cohort study was to compare the efficacies of S-1 and CAPOX AC in patients aged ≥70 years. Materials and Methods: Nine hundred eighty-three patients who were treated with AC using S-1 (768 patients) or CAPOX (215 patients) were enrolled in this study. Each patient underwent AC after curative gastrectomy for stage II or III gastric cancer at one of 27 hospitals in the Republic of Korea between January 2012 and December 2013. Relapse-free survival (RFS) and overall survival (OS) were analyzed according to AC regimen and age group. Results: Of the 983 patients, 254 (25.8%) were elderly. This group had a similar RFS (P=0.099) but significantly poorer OS (p=0.003) compared with the non-elderly group. Subgroup analysis of the non-elderly group revealed no AC-associated differences in survival. Subgroup analysis of the elderly group revealed significantly better survival in the S-1 group than in the CAPOX group (RFS, P<0.001; OS, P<0.001). Multivariate analysis revealed that the CAPOX regimen was an independent poor prognostic factor for RFS (hazard ratio [HR], 1.891; 95% confidence interval [CI], 1.072-3.333; P=0.028) and OS (HR, 2.970; 95% CI, 1.550-5.692; P=0.001). Conclusions: This multicenter observational cohort study found significant differences in RFS and OS between S-1 and CAPOX AC among patients with gastric cancer aged ≥70 years.

7.
Korean J Clin Oncol ; 18(1): 36-46, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36945330

RESUMEN

Purpose: The present study was performed to investigate the effects of local complications (LC) on long-term survival and cancer recurrence in patients undergoing curative gastrectomy for gastric cancer. Methods: We analyzed 2,627 patients after curative gastrectomy for gastric cancer between January 2001 and December 2006. Patients were classified into groups no complications (NC), LC, or systemic complications (SC). Results: Among the 2,627 patients, 475 patients developed complications (LC group [n=374, 14.2%] and SC group [n=101, 3.9%]). The 5-year cancer-specific survival rate was significantly poorer in the LC group compared to the NC and SC groups (LC, 78.0%; NC, 85.4%; SC, 80.2%; P=0.007). The occurrence of LC was identified as a significant independent prognostic factor for overall and cancer-specific survival (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.46-2.97; P=0.001 and HR, 1.77; 95% CI, 1.12-2.81; P=0.015). The tumor recurrence rates were higher in the LC group than the in other two groups (LC, 23.5%; NC, 15.4%; SC, 15.8%; P<0.001). The occurrence of LC was an independent predictor of tumor recurrence in patients undergoing curative gastrectomy for gastric cancer (HR, 1.55; 95% CI, 1.11-2.17; P=0.011). Conclusion: LC are associated with adverse long-term outcomes in patients after curative gastrectomy for advanced gastric cancer.

8.
Ann Surg Oncol ; 28(8): 4458-4470, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33423177

RESUMEN

BACKGROUND: Few studies have presented evidence pertaining to the adequate minimum number of adjuvant chemotherapy (AC) cycles required to achieve an oncologic benefit for gastric cancer. METHODS: From January 2012 to December 2013, data from patients who underwent curative radical gastrectomy and consequently received AC for pathologic stage 2 or 3 gastric cancer at 27 institutions in South Korea were analyzed. RESULTS: The study enrolled 925 patients, 661 patients (71.5%) who completed 8 cycles of AC and 264 patients (28.5%) who did not. Compared with the mean disease-free survival (DFS) of the patients who completed 8 AC cycles (69.3 months), the mean DFS of patients who completed 6 AC cycles (72.4 months; p = 0.531) and those who completed 7 AC cycles (63.7 months; p = 0.184) did not differ significantly. However, the mean DFS of the patients who completed 5 AC cycles (48.2 months; p = 0.016) and those who completed 1-4 AC cycles (62.9 months; p = 0.036) was significantly lower than the DFS of those who completed 8 AC cycles. In the multivariate Cox proportional hazards analysis, the mean DFS was significantly affected by advanced stage, large tumor size, positive vascular invasion, and number of completed AC cycles (1-5 cycles: hazard ratio 1.45; 95% confidence interval 1.01-2.08; p = 0.041). CONCLUSION: The current multicenter observational cohort study showed that the mean DFS for 6 or 7 AC cycles was similar to that for 8 AC cycles as an adjuvant treatment for gastric cancer.


Asunto(s)
Neoplasias Gástricas , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Estudios de Cohortes , Supervivencia sin Enfermedad , Gastrectomía , Humanos , Estadificación de Neoplasias , República de Corea , Estudios Retrospectivos , Neoplasias Gástricas/tratamiento farmacológico , Neoplasias Gástricas/cirugía
9.
Sensors (Basel) ; 22(1)2021 Dec 24.
Artículo en Inglés | MEDLINE | ID: mdl-35009654

RESUMEN

To address the problems of inefficient agricultural production and labor shortages, there has been active research to develop autonomously driven agricultural machines, using advanced sensors and ICT technology. Autonomously driven speed sprayers can also reduce accidents such as the pesticide poisoning of farmers, and vehicle overturn that frequently occur during spraying work in orchards. To develop a commercial, autonomously driven speed sprayer, we developed a prototype of an autonomously driven agricultural vehicle, and conducted performance evaluations in an orchard environment. A prototype of the agricultural vehicle was created using a rubber-tracked vehicle equipped with two AC motors. A prototype of the autonomous driving hardware consisted of a GNSS module, a motion sensor, an embedded board, and an LTE module, and it was made for less than $1000. Additional software, including a sensor fusion algorithm for positioning and a path-tracking algorithm for autonomous driving, were implemented. Then, the performance of the autonomous driving agricultural vehicle was evaluated based on two trajectories in an apple farm. The results of the field test determined the RMS, and the maximums of the path-following errors were 0.10 m, 0.34 m, respectively.


Asunto(s)
Agricultura , Conducción de Automóvil , Movimiento (Física) , Programas Informáticos , Tecnología
10.
Ann Surg Treat Res ; 99(5): 305-313, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33163460

RESUMEN

PURPOSE: Given the long history of investigation into cancer and its relevance to the lymph node (LN), it would be meaningful to plot the trends of research on cancer-related LN. METHODS: Queries such as "cancer," "lymph node," and "cancer and lymph node" were submitted to PubMed to collect articles on cancer and LN published between 1945 and 2017. The collected articles were then extracted by an automatic web crawler and examined through informetrics and linguistic analysis. RESULTS: The number of articles related to cancer was 2,795,476 and 127,897 articles (4.6%) were found to be relevant to LN. With regard to cancer types, breast cancer was the most studied (37%), followed by gastric cancer (17%). With regard to the subjects in which the surgeon is interested, LN metastasis (57%) was found to be the topic most discussed, followed by LN dissection (22%) and sentinel LN (17%). Publications on LN metastasis gradually increased over time from 1988 to 2017 although those on sentinel LN and LN dissection have stagnated since the early 2000s. CONCLUSION: Although research on cancer was abundant, only a small portion was dedicated to investigating its relevance to LN. Western countries had led the research on cancer-related LN, but Asian countries began to participate as major players, expanding their contributions. While LN metastasis, one of the major cancer-related LN topics, showed a steady increase, those involved in oncologic surgery such as LN dissection and sentinel LN did not.

11.
Neurorehabil Neural Repair ; 34(12): 1111-1123, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33198568

RESUMEN

BACKGROUND: Parkinson's disease (PD) leads to impaired mobility and limited independence. OBJECTIVE: We investigated the effects of acupuncture on gait disturbance and analyzed hemodynamic changes caused by acupuncture in the cerebral cortex of patients with PD. METHODS: Participants (n = 26) with gait disturbance due to PD were randomly assigned to the intervention (acupuncture twice a week for 4 weeks + conventional therapy) or control (conventional therapy) groups. We analyzed gait parameters using the GAITRite system and hemodynamic responses in the cerebral cortices using functional near-infrared spectroscopy, Unified Parkinson's Disease Rating Scale (UPDRS) scores, neurotransmitter levels, as well as the immediate effects of acupuncture in patients with PD. RESULTS: The participants tended to walk with hypometric gait (high cadence, short steps) overground. After acupuncture treatment, those in the intervention group showed a significant reduction in cadence and the UPDRS scores involving "walking and balance" compared with those in the control group (P = .004 and P = .020, respectively); the stride, swing, and single support times were significantly increased (P = .006, P = .001, and P = .001, respectively). Oxyhemoglobin levels in the intervention group while walking on a treadmill were significantly increased in the prefrontal and supplementary motor areas. The oxyhemoglobin levels in the prefrontal cortex and swing time revealed significant positive correlations. CONCLUSIONS: Our findings indicated that acupuncture tended to improve hypometric gait and rearranged activation of the cerebral cortex. Thus, acupuncture may be a useful complementary treatment for gait disturbance, including hypometric gait, in patients with PD. Trial Registration Number. Clinical Research Information Service (KCT0002603), https://cris.nih.go.kr/cris/index.jsp.


Asunto(s)
Terapia por Acupuntura , Corteza Cerebral/fisiopatología , Trastornos Neurológicos de la Marcha/terapia , Plasticidad Neuronal/fisiología , Enfermedad de Parkinson/terapia , Anciano , Animales , Corteza Cerebral/diagnóstico por imagen , Femenino , Neuroimagen Funcional , Trastornos Neurológicos de la Marcha/diagnóstico por imagen , Trastornos Neurológicos de la Marcha/etiología , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Proyectos Piloto , Método Simple Ciego , Espectroscopía Infrarroja Corta
12.
Aging (Albany NY) ; 12(12): 11812-11834, 2020 06 20.
Artículo en Inglés | MEDLINE | ID: mdl-32564009

RESUMEN

FAM83H primarily is known for its function in tooth development. Recently, a role for FAM83H in tumorigenesis, conjunction with MYC and ß-catenin, has been suggested. Analysis of public data indicates that FAM83H expression is closely associated with SCRIB expression in human gastric cancers. Therefore, this study investigated the roles of FAM83H and SCRIB in 200 human gastric cancers and gastric cancer cells. In human gastric carcinomas, both the individual and combined expression patterns of the nuclear FAM83H and SCRIB were independent indicators of shorter survival of gastric carcinoma patients. In MKN-45 and NCI-N87 gastric cancer cells, the expression of FAM83H and SCRIB were associated with proliferation and invasiveness of cells. FAM83H-mediated in vivo tumor growth was attenuated with knock-down of SCRIB. Moreover, immunoprecipitation indicates that FAM83H, SCRIB, and ß-catenin, form a complex, and knock-down of either FAM83H or SCRIB accelerated proteasomal degradation of ß-catenin. In conclusion, this study has found that the individual and combined expression patterns of nuclear FAM83H and SCRIB are prognostic indicators of gastric carcinomas and further suggests that FAM83H and SCRIB are involved in the progression of gastric carcinomas by stabilizing ß-catenin.


Asunto(s)
Carcinoma/patología , Proteínas de la Membrana/metabolismo , Proteínas/metabolismo , Neoplasias Gástricas/patología , Proteínas Supresoras de Tumor/metabolismo , beta Catenina/metabolismo , Animales , Carcinogénesis/genética , Carcinogénesis/patología , Carcinoma/diagnóstico , Carcinoma/mortalidad , Carcinoma/cirugía , Línea Celular Tumoral , Proliferación Celular/genética , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Femenino , Gastrectomía , Mucosa Gástrica/patología , Mucosa Gástrica/cirugía , Técnicas de Silenciamiento del Gen , Humanos , Estimación de Kaplan-Meier , Masculino , Proteínas de la Membrana/genética , Ratones , Persona de Mediana Edad , Pronóstico , Complejo de la Endopetidasa Proteasomal/metabolismo , Estabilidad Proteica , Proteínas/genética , Proteolisis , Estudios Retrospectivos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Proteínas Supresoras de Tumor/genética , Ensayos Antitumor por Modelo de Xenoinjerto
13.
J Gastric Cancer ; 20(2): 152-164, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32595999

RESUMEN

PURPOSE: To compare long-term disease-free survival (DFS) between patients receiving tegafur/gimeracil/oteracil (S-1) or capecitabine plus oxaliplatin (CAPOX) adjuvant chemotherapy (AC) for gastric cancer (GC). MATERIALS AND METHODS: This retrospective multicenter observational study enrolled 983 patients who underwent curative gastrectomy with consecutive AC with S-1 or CAPOX for stage II or III GC at 27 hospitals in Korea between February 2012 and December 2013. We conducted propensity score matching to reduce selection bias. Long-term oncologic outcomes, including DFS rate over 5 years (over-5yr DFS), were analyzed postoperatively. RESULTS: The median and longest follow-up period were 59.0 and 87.6 months, respectively. DFS rate did not differ between patients who received S-1 and CAPOX for pathologic stage II (P=0.677) and stage III (P=0.899) GC. Moreover, hazard ratio (HR) for recurrence did not differ significantly between S-1 and CAPOX (reference) in stage II (HR, 1.846; 95% confidence interval [CI], 0.693-4.919; P=0.220) and stage III (HR, 0.942; 95% CI, 0.664-1.337; P=0.738) GC. After adjustment for significance in multivariate analysis, pT (4 vs. 1) (HR, 11.667; 95% CI, 1.595-85.351; P=0.016), pN stage (0 vs. 3) (HR, 2.788; 95% CI, 1.502-5.174; P=0.001), and completion of planned chemotherapy (HR, 2.213; 95% CI, 1.618-3.028; P<0.001) were determined as independent prognostic factors for DFS. CONCLUSIONS: S-1 and CAPOX AC regimens did not show significant difference in over-5yr DFS after curative gastrectomy in patients with stage II or III GC. The pT, pN stage, and completion of planned chemotherapy were prognostic factors for GC recurrence.

14.
Adv Mater ; 32(5): e1903488, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31483540

RESUMEN

Advances in material science and nanotechnology have fostered the miniaturization of devices. Over the past two decades, the form-factor of these devices has evolved from 3D rigid, volumetric devices through 2D film-based flexible electronics, finally to 1D fiber electronics (fibertronics). In this regard, fibertronic strategies toward wearable applications (e.g., electronic textiles (e-textiles)) have attracted considerable attention thanks to their capability to impart various functions into textiles with retaining textiles' intrinsic properties as well as imperceptible irritation by foreign matters. In recent years, extensive research has been carried out to develop various functional devices in the fiber form. Among various features, lighting and display features are the highly desirable functions in wearable electronics. This article discusses the recent progress of materials, architectural designs, and new fabrication technologies of fiber-shaped lighting devices and the current challenges corresponding to each device's operating mechanism. Moreover, opportunities and applications that the revolutionary convergence between the state-of-the-art fibertronic technology and age-long textile industry will bring in the future are also discussed.

15.
Medicine (Baltimore) ; 98(50): e18357, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31852140

RESUMEN

BACKGROUND: Mild cognitive impairment (MCI) is a symptom characterizing cognitive decline and a transitional state between normal aging and dementia; however, there is no definitive diagnosis and treatment for MCI. Neurofeedback (NF), which is a training mechanism that employs operant conditioning to regulate brain activity, has been increasingly investigated concerning its beneficial effects for dementia and MCI. METHODS: This study investigated cognitive improvement and hemodynamic changes in the prefrontal cortex (PFC) following NF training in patients with MCI. Five patients with MCI received NF training for enhanced beta band activity in the dorsolateral PFC-16 sessions for 8 weeks-with each session divided into 9 5-minute trials. The primary outcome measure was a cognitive assessment tool: the Korean version of the Montreal Cognitive Assessment. The secondary outcome measures were the Central Nervous System Vital Signs for neurocognitive testing, hemodynamic changes using functional near-infrared spectroscopy in the PFC during a working-memory task, and Beck Depression Inventory scores. RESULTS: After completing the training, patients' cognitive function significantly improved in domains such as composite memory, cognitive flexibility, complex attention, reaction time, and executive function. Increased electroencephalogram beta power was observed over NF training sessions (Spearman rank correlation test: r = 0.746, P = .001). The threshold value for gaining positive feedback from pre-NF baseline on beta power significantly increased (Spearman rank correlation test: r = 0.805, P = .001). Hemodynamic response in PFC changed after NF training, and individual differences were identified. Specifically, hypoactivation of the hemodynamic response by emotional distraction recovered following NF training. CONCLUSION: We suggest that patients' cognitive processing efficiency was improved by the NF training. These beneficial results suggest that NF training may have potential therapeutic applications to prevent the progression from MCI to dementia. TRIAL REGISTRATION NUMBER: Clinical Research Information Service (KCT0003433).


Asunto(s)
Ritmo beta/fisiología , Cognición/fisiología , Disfunción Cognitiva/terapia , Neurorretroalimentación/métodos , Anciano , Disfunción Cognitiva/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Corteza Prefrontal/fisiopatología , Resultado del Tratamiento
16.
Gastric Cancer ; 22(5): 1069-1080, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30830639

RESUMEN

BACKGROUND: The aim of this study is to identify an indicator to predict the overcoming of the learning curve of distal gastrectomy in gastric cancer surgery. METHOD: A retrospective multicenter cohort study was conducted in 2100 patients who underwent radical distal gastrectomy performed by nine surgeons in eight hospitals between 2001 and 2006. For each surgeon, an individual CUSUM chart was formulated in terms of operation time or clinical outcomes, including severe complications, number of retrieved lymph nodes, positive resection margin, and hospital stay. The actual changing points (CPs) of the CUSUM charts were analyzed. Based on the CP, patients were divided into pre-CP and post-CP groups, and the clinicopathologic outcomes and survival data were compared between the groups. RESULTS: CP determined by operation time was more reliable than CP determined by a combination of clinical outcomes, as the former was correlated not only with short-term outcomes but also with survival. The outcomes were superior in the post-CP group in terms of numbers of harvested lymph nodes, sufficient lymph node harvesting (> 15), and negative proximal margins. In a survival analysis, the post-CP group showed better survival than the pre-CP group in stage II (76% vs 86.1% p = 0.010) and stage III (51.5% vs 60.6% p = 0.042). CONCLUSION: Overcoming the learning curve of distal gastrectomy for gastric cancer can be better predicted by operation time rather than by a combination of postoperative clinical parameters. It is recommended that surgeons initially operate on early stage cancer patients before overcoming the learning curve.


Asunto(s)
Gastrectomía/mortalidad , Curva de Aprendizaje , Escisión del Ganglio Linfático/mortalidad , Tempo Operativo , Complicaciones Posoperatorias , Neoplasias Gástricas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Neoplasias Gástricas/patología
17.
JAMA Oncol ; 5(4): 506-513, 2019 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-30730546

RESUMEN

IMPORTANCE: Laparoscopic distal gastrectomy is gaining popularity over open distal gastrectomy for gastric cancer because of better early postoperative outcomes. However, to our knowledge, no studies have proved whether laparoscopic distal gastrectomy is oncologically equivalent to open distal gastrectomy. OBJECTIVE: To examine whether the long-term survival among patients with stage I gastric cancer undergoing laparoscopic distal gastrectomy is noninferior to that among patients undergoing open distal gastrectomy. DESIGN: The Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) group, which includes 15 surgeons from 13 institutes, conducted a phase 3, multicenter, open-label, noninferiority, prospective randomized clinical trial (KLASS-01) of patients with histologically proven, preoperative clinical stage I gastric adenocarcinoma from January 5, 2006, to August 23, 2010. Survival and recurrence status of the patients was determined in December 2016. INTERVENTIONS: Patients were randomly assigned (1:1) to laparoscopic distal gastrectomy (n = 705) or open distal gastrectomy (n = 711). Of these patients, 85 received a surgical approach opposite the one to which they were randomized (63 randomized to the open surgery group and 22 to the laparoscopic group). MAIN OUTCOMES AND MEASURES: Difference in 5-year overall survival between the laparoscopic and open distal gastrectomy groups. The noninferiority margin was prespecified as -5% (corresponding hazard ratio of 1.54), with an assumed survival of 90% after 5 years in the open surgery group. RESULTS: Among the 1416 patients (mean [SD] age, 57.3 [11.1] years; 940 [66.4%] male) included in the study, the 5-year overall survival rates were 94.2% in the laparoscopic group and 93.3% in the open surgery group (log-rank P = .64). Intention-to-treat analysis confirmed the noninferiority of the laparoscopic approach compared with the open approach (difference, 0.9 percentage points; 1-sided 97.5% CI, -1.6 to infinity). The 5-year cancer-specific survival rates were similar between the 2 groups (97.1% in the laparoscopic group and 97.2% in the open surgery group, log-rank P = .91; difference, -0.03 percentage points; 1-sided 97.5% CI, -1.8 to infinity). Per-protocol analysis results were consistent with the intention-to-treat results for overall and cancer-specific survival rates. CONCLUSIONS AND RELEVANCE: The KLASS-01 trial revealed similar overall and cancer-specific survival rates between patients receiving laparoscopic and open distal gastrectomy. Laparoscopic distal gastrectomy is an oncologically safe alternative to open surgery for stage I gastric cancer. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT00452751.


Asunto(s)
Adenocarcinoma/cirugía , Gastrectomía/métodos , Laparoscopía , Neoplasias Gástricas/cirugía , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Tasa de Supervivencia , Resultado del Tratamiento
19.
Bioresour Technol ; 273: 341-349, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30448687

RESUMEN

Direct combustion of biomass is considered the most effective and simple means to contribute to CO2 reduction. In this context, the life-cycle potential of microalgal solid fuel, which has been overlooked so far, was comprehensively scrutinized ranging from cultivation to direct combustion. According to the quantitative data, using the raw fuel was confirmed to offer great benefits over the conventional lipid-targeted microalgal fuel systems through exploiting all of the biomass' energy potential, thereby being able to significantly increase the energy yield from biomass. The solid fuel is shown to exhibit diverse positive aspects owing to its remarkable calorific value, productivity and CO2 fixation ability. The combustion test reveals coal-microalgae co-combustion brings beneficial consequences on combustibility and environmental impacts with no notable thermal efficiency drop. This holistic appraisal shows microalgae patently possess high potential as a direct combustion fuel, even outperforming that of extensively used woody fuels.


Asunto(s)
Microalgas , Biomasa , Carbón Mineral
20.
BMC Cancer ; 18(1): 836, 2018 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-30126387

RESUMEN

BACKGROUND: Oxidative stress induces various intracellular damage, which might be correlated with tumorigenesis. Accumulated oxidative stresses might inactivate protein tyrosine phosphatase (PTP) by oxidizing it, and inducing the phosphorylation of H2AX (γH2AX) in response to DNA damage. METHODS: We evaluated the clinical significance of the expression of oxidized-PTP and γH2AX in 169 gastric carcinomas. RESULTS: Immunohistochemical expression of nuclear oxidized-PTP, cytoplasmic oxidized-PTP, and γH2AX expression were significantly associated with each other, and their expressions predicted shorter survival of gastric carcinoma patients. In multivariate analysis, nuclear oxidized-PTP (overall survival; p <  0.001, relapse-free survival; P <  0.001) was an independent indicator of poor prognosis of gastric carcinoma patients. In addition, co-expression patterns of nuclear oxidized-PTP and γH2AX were independent indicators of poor prognosis of gastric carcinoma patients (overall survival; P <  0.001, relapse-free survival; P <  0.001). CONCLUSIONS: This study suggests that oxidative stress-mediated oxidation of PTP might be involved in the progression of gastric carcinomas. In addition, this study suggests that individual and co-expression pattern of nuclear oxidized-PTP and γH2AX might be used as a prognostic marker of gastric carcinomas.


Asunto(s)
Carcinoma/genética , Histonas/genética , Proteínas Tirosina Fosfatasas/genética , Neoplasias Gástricas/genética , Adulto , Anciano , Carcinogénesis/genética , Carcinoma/patología , Daño del ADN/genética , Progresión de la Enfermedad , Supervivencia sin Enfermedad , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Estrés Oxidativo/genética , Pronóstico , Neoplasias Gástricas/patología
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