Adjunctive recombinant human parathyroid hormone agents for the treatment of medication-related osteonecrosis of the jaw: a report of three cases.

Teriparatide has been effective in treating people diagnosed with medication-related osteonecrosis of the jaw (MRONJ). However, its efficacy is not well established to be accepted as a standard of care. The objective of this paper was to investigate the efficacy of recombinant human parathyroid hormone for the treatment of MRONJ. We report three cases of MRONJ patients with osteoporosis as the primary disease who were treated with a teriparatide agent along with other adjunctive measures. Each patient was administered a teriparatide injection subcutaneously for 16 weeks, 36 weeks, or 60 weeks. Surgical intervention including partial resection, sequestrectomy, decortication, and saucerization took place during the teriparatide administration. Complete lesion resolution was identified clinically and radiographically in all three patients. In patients diagnosed with MRONJ, teriparatide therapy is an efficacious and safe therapeutic option to improve healing of bone lesions. These findings demonstrate that teriparatide in combination with another therapy, especially bone morphogenetic protein, platelet-rich fibrin, or antibiotic therapy, can be an effective protocol for MRONJ.

Surgical Outcomes of Low-Flow Bypass Surgery in Intracranial Atherosclerotic Steno-Occlusive Diseases.

BACKGROUND AND OBJECTIVES: The role of bypass surgery in intracranial atherosclerotic steno-occlusive diseases (ICADs) remains controversial. We aimed to analyze the surgical outcomes of bypass surgery in patients with the ICADs in a single tertiary institution. METHODS: Among 1018 cases of low-flow bypass surgery between 2003 and 2022, 215 patients with the ICAD refractory to medical treatment were finally enrolled in this study. Clinical and radiological outcomes were retrospectively evaluated, with survival analyses. RESULTS: All strokes, cerebral infarctions, and intracranial hemorrhages occurred in 12.1% (n = 26), 9.8% (n = 21), and 2.3% (n = 5), respectively, during the clinical follow-up of 54.6 ± 47.6 months (range, 0.6-237.8 months). Among all stroke events, 84.6% (n = 22) occurred within 30 postoperative days. The 2-year and 5-year cumulative risks of all strokes were 12.1% each. The mean modified Rankin Scale scores were 1.6 ± 1.1 (range, 0-5) preoperatively and 0.8 ± 1.2 (range, 0-6) at last (P < .01). The patency of direct bypass was 99.1% (n = 213) just before discharge and 96.3% (n = 184 of 191 patients with available tests) at the last angiographic follow-up of 27.0 ± 27.3 months (range, 2.3-97.3 months). All the patients with available data (n = 190) showed hemodynamic improvement on acetazolamide-challenged single-photon emission computed tomography with 99mTc-hexamethylpropyleneamine oxime during the follow-up of 38.6 ± 36.7 months (range, 2.3-158.6 months). CONCLUSION: Low-flow bypass surgery showed acceptable treatment outcomes in the prevention of recurrent stroke.

Simulation of a Multistaggered Baffle Scrubber to Enhance the Efficiency of Simultaneous Desulfurization and Denitrification.

In this study, we conduct simulation research on simultaneous desulfurization and denitrification in a multistaggered baffle spray scrubber. By employing two-phase flow simulations within the Euler-Lagrange framework and calculating the gas-liquid mass transfer rate with user-defined functions, we comprehensively analyzed the effects of various operational parameters. Initially, we validated our simulation model by comparing the simulation results with experimental data. Under conditions of a 0.2 mm droplet diameter, a liquid-to-gas ratio (L/G) of 12 L/m3, and a gas flow rate of 5 CMM using a full cone nozzle, the simulation indicated a desulfurization efficiency of 99.90 versus 99.84% obtained experimentally and a denitrification efficiency of 92.01 versus 90.67% obtained experimentally. This comparison confirmed the reliability of the simulation model. Our findings indicate that a droplet size of 2 mm is optimal, enhancing the desulfurization efficiency from 99.90 to 99.98% and the denitrification efficiency from 92.01 to 99.76%. However, when the droplet size exceeds 2 mm, efficiencies marginally decrease. Increasing the liquid-to-gas ratio to 16 L/m3 further improves desulfurization and denitrification efficiencies to 99.98 and 99.80%, respectively. In contrast, higher inlet flue gas flow rates reduce these efficiencies, with a decline observed from 100% to as low as 93.90% for denitrification with 2 mm droplets. Additionally, the use of a swirl cone nozzle, compared to full or hollow cone nozzles, better disperses droplets, enhancing the gas-liquid contact and achieving efficiencies of 99.99% for desulfurization and 99.81% for denitrification with 2 mm droplets. These insights are valuable for optimizing operational conditions in industrial-scale spray scrubbers, significantly contributing to mitigating the environmental impacts of industrial emissions.

Natural course of hemodynamically stable hemispheres contralateral to operated hemispheres in adult patients with ischemic moyamoya diseases.

The necessity of bilateral bypass in adult moyamoya disease (MMD) remains unclear despite its recommendation for pediatric and hemorrhagic cases. We aimed to investigate the natural course of hemodynamically stable unoperated hemispheres after bypass surgery for symptomatic and hemodynamically unstable hemispheres in adult patients with ischemic MMD. Among 288 patients, the mean age at the first operation of the unstable hemispheres was 40.8 ± 12.2 years. The mean follow-up period was 62.9 ± 46.5 months. 45 patients (15.6%) experienced stroke events in the unoperated hemisphere, consisting of hemorrhagic stroke in 8 (2.8%) and ischemic stroke in 37 (12.8%), including progressive transient ischemic attack in 25 (8.7%) and infarction in 12 (4.2%). Among them, 39 patients (13.5%) underwent bypass surgery. The annual risk of total stroke is 3.0%/patient-year, with 2.5% for ischemic stroke and 0.5% for hemorrhagic stroke. The 5- and 10-year cumulative risks of ischemic stroke were 13.4% and 18.3%, respectively, and those of hemorrhagic stroke were each 3.2%. The natural course of hemodynamically stable hemispheres contralateral to the operated ones appeared fairly good. Additional bypass surgery on the unoperated hemispheres should be considered for symptomatic and hemodynamically unstable hemispheres in adult patients with ischemic MMD during the follow-up.

Effects of daily versus weekly teriparatide for medication-related osteonecrosis of the jaw: A case-control study.

INTRODUCTION: Medication-related osteonecrosis of the jaw (MRONJ) is uncommon but can result in severe destruction of the jaw. This case-control study investigated the therapeutic effects of daily or weekly administration of teriparatide in the management of MRONJ using a cohort for osteonecrosis of the jaw. METHODS: Patients who were diagnosed with MRONJ and consented to teriparatide administration were assigned either to a group of daily injection or of weekly injection and completed a 4-week course of injection preoperatively and at least an 8-week course postoperatively. The control group received either the intraoperative rhBMP treatment (CG_BMP) or no additional perioperative treatment (CG_noBMP). The state of MRONJ was evaluated 2 months (T1) and 6 months (T2) postoperatively for all participants. RESULTS: Either group of daily injection (8.35 weeks ± 1.58; n = 17) or weekly injection (9.17 ± 3.79; n = 12) showed significantly faster healing than those of CG_BMP (14.40 ± 6.08; n = 25) or CG_noBMP (15.79 ± 9.79; n = 39). MRONJ was resolved completely in 24 out of 29 participants who completed the course of teriparatide injections, whereas 46.9% of CG showed delayed resolution. Multiple regression analysis indicated 7.50 times (95% CI, 1.77-31.82) more likelihood of complete resolution of MRONJ for participants with teriparatide injections. CONCLUSION: A course of daily or weekly administration of teriparatide injections may improve treatment outcomes for patients with MRONJ.

Delayed ischemic events with low-dose prasugrel medication for stent-assisted coil embolization in intracranial aneurysm patients.

OBJECTIVE: Much emphasis has been put on the use of antiplatelet medication for the prevention of ischemic events in the treatment of cerebral aneurysms with stent assistance. In this regard, the effectiveness and safety of a low-dose prasugrel regimen during the periprocedural period was recently reported. The purpose of this study was to present the outcomes of patients on low-dose prasugrel regimens during the follow-up period after stent-assisted coil embolization (SACE) of cerebral aneurysms. METHODS: For the 396 consecutive patients undergoing SACE procedures, low-dose prasugrel therapy (5 mg of prasugrel and 100 mg of aspirin) was recommended for 3 months after the endovascular treatment. The authors performed a retrospective review of a single-center experience focusing on delayed ischemic events beyond 1 month after treatment. The mean follow-up period was 24.6 ± 11.3 months. RESULTS: In this cohort of patients on a low-dose prasugrel regimen, cerebral infarction occurred in 1 patient (0.3%, 95% CI 0%-1.8%) beyond 1 month after SACE. No intracranial hemorrhage occurred. Overall ischemic events occurred in 14 patients (3.5%, 95% CI 2.1%-5.9%), all within 6 months of the coiling procedure. All patients had transient symptoms. The events occurred within 2 months after cessation of prasugrel in 11 patients (78.6%). Prasugrel maintenance for 6 months was found to result in lower ischemic events compared with maintenance for 3 months. CONCLUSIONS: For patients undergoing SACE, a low-dose prasugrel regimen was a safe and reliable treatment option for the prevention of delayed ischemic events. Transient ischemic events often occurred within 2 months of stopping prasugrel medication.

Carbon Nanowalls as Anode Materials with Improved Performance Using Carbon Nanofibers.

In this paper, a new synthesis of carbon nanofibers (CNFs)/carbon nanowalls (CNWs) was performed to improve the characteristics of anode materials of lithium-ion batteries by using the advantages offered by CNWs and CNFs. Among the carbon-based nanomaterials, CNWs provide low resistance and high specific surface area. CNFs have the advantage of being stretchable and durable. The CNWs were grown using a microwave plasma-enhanced chemical vapor deposition (PECVD) system with a mixture of methane (CH4) and hydrogen (H2) gases. Polyacrylonitrile (PAN) and N,N-Dimethyl Formamide (DMF) were stirred to prepare a solution and then nanofibers were fabricated using an electrospinning method. Heat treatment in air was then performed using a hot plate for stabilization. In addition, heat treatment was performed at 800 °C for 2 h using rapid thermal annealing (RTA) to produce CNFs. A field emission scanning electron microscope (FE-SEM) was used to confirm surface and cross-sectional images of the CNFs/CNWs anode materials. Raman spectroscopy was used to examine structural characteristics and defects. Cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and constant current charge/discharge tests were performed to analyze the electrical characteristics. The synthesized CNFs/CNWs anode material had a CV value in which oxidation and reduction reactions were easily performed, and a low Rct value of 93 Ω was confirmed.

Is Thyroid Dysfunction Associated with Unruptured Intracranial Aneurysms? A Population-Based, Nested Case-Control Study from Korea.

Background: Few risk factors for the development of intracranial aneurysms (IAs) are known. We investigated the potential role of thyroid diseases in IA development using nationwide real-world data. Methods: A nested case-control study within the National Health Insurance Service-National Sample Cohort data from 2002 to 2019 was performed. A total of 5335 patients with unruptured IA were matched by age and sex with 80,025 controls at a ratio of 1:15. We estimated the odds ratios (ORs) and corresponding confidence intervals [CIs] between thyroid diseases and unruptured IA using a multivariable conditional logistic regression model. Results: Tobacco smoking, use of antihypertensive medication, and hypothyroidism were significantly associated with an elevated risk for unruptured IA in univariate analysis. In multivariable analysis, a history of hypothyroidism was associated with unruptured IA (adjusted OR: 1.46 [CI: 1.26-1.69]). Among patients with hypothyroidism, long-term use of thyroid hormone for >5 years was associated with a reduced risk for unruptured IA (adjusted OR: 0.69 [CI: 0.48-0.99]). A history of hyperthyroidism was associated with a reduced risk for unruptured IAs (adjusted OR: 0.71 [CI: 0.54-0.93]). In secondary analyses of the data according to sex, the respective observed associations between hypothyroidism and hyperthyroidism and the risk of IAs were found to be statistically significant in females but not in males. Conclusions: Hypothyroidism is associated with an increased risk of unruptured IAs, whereas hyperthyroidism is associated with a reduced risk. Overall, the findings suggest that thyroid hormones may play a protective role in the development of unruptured IAs. Further studies are needed to clarify potential direct causality and the biologic mechanisms relating thyroid dysfunction and unruptured IA.

The ivy sign as a radiological marker for follow-up of postoperative cerebral perfusion status in adult moyamoya disease.

OBJECTIVE: Little is known about the relationship between postoperative changes in cerebral perfusion and the ivy sign representing leptomeningeal collateral burden in moyamoya disease (MMD). This study aimed to investigate the usefulness of the ivy sign in evaluating cerebral perfusion status following bypass surgery in patients with adult MMD. METHODS: Two hundred thirty-three hemispheres in 192 patients with adult MMD undergoing combined bypass between 2010 and 2018 were retrospectively enrolled. The ivy sign was represented as the ivy score on FLAIR MRI in each territory of the anterior, middle, and posterior cerebral arteries. Ivy scores, as well as clinical and hemodynamic states on SPECT, were semiquantitatively compared both preoperatively and at 6 months after surgery. RESULTS: Clinical status improved at 6 months after surgery (p < 0.01). On average, ivy scores in whole and individual territories were decreased at 6 months (all p values < 0.01). Cerebral blood flow (CBF) postoperatively improved in three individual vascular territories (all p values ≤ 0.03) except for the posterior cerebral artery territory (PCAt), and cerebrovascular reserve (CVR) improved in those areas (all p values ≤ 0.04) except for the PCAt. Postoperative changes in ivy scores and CBF were inversely correlated in all territories (p ≤ 0.02), except for the PCAt. Furthermore, changes in ivy scores and CVR were only correlated in the posterior half of the middle cerebral artery territory (p = 0.01). CONCLUSIONS: The ivy sign was significantly decreased after bypass surgery, which was well correlated with postoperative hemodynamic improvement in the anterior circulation territories. The ivy sign is believed to be a useful radiological marker for postoperative follow-up of cerebral perfusion status.

Conformer-Based Dental AI Patient Clinical Diagnosis Simulation Using Korean Synthetic Data Generator for Multiple Standardized Patient Scenarios.

The goal of clinical practice education is to develop the ability to apply theoretical knowledge in a clinical setting and to foster growth as a professional healthcare provider. One effective method of achieving this is through the utilization of Standardized Patients (SP) in education, which familiarizes students with real patient interviews and allows educators to assess their clinical performance skills. However, SP education faces challenges such as the cost of hiring actors and the shortage of professional educators to train them. In this paper, we aim to alleviate these issues by utilizing deep learning models to replace the actors. We employ the Conformer model for the implementation of the AI patient, and we develop a Korean SP scenario data generator to collect data for training responses to diagnostic questions. Our Korean SP scenario data generator is devised to generate SP scenarios based on the provided patient information, using pre-prepared questions and answers. In the AI patient training process, two types of data are employed: common data and personalized data. The common data are employed to develop natural general conversation skills, while personalized data, from the SP scenario, are utilized to learn specific clinical information relevant to a patient's role. Based on these data, to evaluate the learning efficiency of the Conformer structure, a comparison was conducted with the Transformer using the BLEU score and WER as evaluation metrics. Experimental results showed that the Conformer-based model demonstrated a 3.92% and 6.74% improvement in BLEU and WER performance compared to the Transformer-based model, respectively. The dental AI patient for SP simulation presented in this paper has the potential to be applied to other medical and nursing fields, provided that additional data collection processes are conducted.

Mitochondrial Toxic Effects of Antiepileptic Drug Valproic Acid on Mouse Kidney Stem Cells.

Valproic acid (VPA) is a histone deacetylase inhibitor that is used mainly as an antiepileptic and anticonvulsant drug. The side effects of VPA usually appears as hepatic injury and various metabolic disorders. On the other hand, it is rarely reported to cause kidney injury. Despite the many studies on the influence of VPA exposure on the kidneys, the specific mechanism remains unclear. This study examined the changes after VPA treatment to the mouse kidney stem cells (mKSCs). VPA triggers an increase in mitochondrial ROS, but there was no change in either mitochondrial membrane potential or the mitochondrial DNA copy number in mKSCs. The VPA treatment increased the mitochondrial complex III but decreased complex V significantly compared to the DMSO treatment as a control. The inflammatory marker (IL-6) and the expression of the apoptosis markers (Caspase 3) and were increased by VPA. In particular, the expression of the podocyte injury markers (CD2AP) was increased significantly. In conclusion, VPA exposure has adverse effects on mouse kidney stem cells.

Nanostructured Polyaniline Films Functionalized through Auxiliary Nitrogen Addition in Atmospheric Pressure Plasma Polymerization.

Polyaniline (PANI) was synthesized from liquid aniline, a nitrogen-containing aromatic compound, through the atmospheric pressure (AP) plasma process using a newly designed plasma jet array with wide spacing between plasma jets. To expand the area of the polymerized film, the newly proposed plasma jet array comprises three AP plasma jet devices spaced 7 mm apart in a triangular configuration and an electrodeless quartz tube capable of applying auxiliary gas in the center of the triangular plasma jets. The vaporized aniline monomer was synthesized into a PANI film using the proposed plasma array device. The effects of nitrogen gas addition on the morphological, chemical, and electrical properties of PANI films in AP argon plasma polymerization were examined. The iodine-doped PANI film was isolated from the atmosphere through encapsulation. The constant electrical resistance of the PANI film indicates that the conductive PANI film can achieve the desired resistance by controlling the atmospheric exposure time through encapsulation.

Effects of Decamethylcyclopentasiloxane on Reproductive Systems in Female Rats.

The female reproductive system becomes fertile through the action of hormones involved in the hypothalamic-pituitary-ovarian axis. On the other hand, estrogen-like endocrine disruptors released into the environment come into contact with humans by various routes and affect the reproductive system. Exposure to these chemicals can cause problems with the reproductive process, from egg ovulation to implantation, or cause female reproductive diseases. These reproductive problems cause infertility. Decamethylcyclopentasiloxane (D5) is used for lubrication in silicone polymers, households, and personal care products. In the case of D5, it is discharged through factory wastewater and can bioaccumulate. Therefore, it accumulates in the human body. In this study, D5 was administered orally for four weeks to determine the effects of D5 on the reproductive process. As a result, D5 increases the number of follicles in the ovary and suppresses the expression of genes related to the growth of follicles. In addition, it increases the gonadotropin hormone, inducing estradiol enhancement and progesterone reduction. Because of these changes in the reproductive system when exposed to D5, the industry should reconsider using D5.

Six-month stability following extensive alveolar bone augmentation by sausage technique.

BACKGROUND: Resorption of alveolar bone is a common sequela of tooth loss and presents a clinical problem, especially in the esthetic zone. When ridge resorption occurs, adequate bone augmentation is essential to obtain satisfactory esthetic results. The purpose of this study was to determine the increase and retention rate of bone height or width in patients who received extensive bone augmentation and to analyze factors affecting its prognosis and stability. METHODS: This study was performed on patients who received extensive bone augmentation by sausage technique at the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mok-dong Hospital from January 1, 2018, to February 28, 2022. CBCT images were taken before and 6 months after surgery to compare the amount of increase in bone height or width at the graft site. They were measured using reliable points such as adjacent implants or cephalometric landmarks, inferior alveolar nerve canals as reference points. RESULTS: A total of 8 patients underwent extensive bone grafting during the given period (mean age was 53.75 years, 2 males and 6 females). Four patients received horizontal augmentation, and 4 received vertical augmentation. When divided by surgical site, 4 patients are in maxilla and 4 in mandible. The average amount of increase in bone width or bone height was 5.38 mm, and the retention rate was about 79.9% after 6 months. The retention rate of horizontal augmentation was 88.8%, which was higher than that of vertical augmentation, which was 74.5%. The maxillary area accounted for 92.2%, and the amount of bone resorption was lower than that of the mandibular area, which was 72.6%. The average stitch out period was about 2.4 weeks, and postoperative dehiscence was observed about 37.5% of the total, more frequently in the mandible (50.0%) than in the maxilla (25.0%). CONCLUSION: In conclusion, extensive bone augmentation achieved significant horizontal or vertical bone height or width increase, and the retention rate after 6 months was also high. In addition, surgery in the maxillary region showed a more successful bone augmentation than in the mandible, with a higher maintenance rate and fewer cases of dehiscence.

Effects of Sodium Arsenite on the Myocardial Differentiation in Mouse Embryonic Bodies.

Arsenic in inorganic form is a known human carcinogen; even low levels of arsenic can interfere with the endocrine system. In mammalian development, arsenic exposure can cause a malformation of fetuses and be lethal. This study examined the effects of sodium arsenite (SA) as the inorganic form of arsenic in embryonic bodies (EBs) with three germ layers in the developmental stage. This condition is closer to the physiological condition than a 2D cell culture. The SA treatment inhibited EBs from differentiating into cardiomyocytes. A treatment with 1 µM SA delayed the initiation of beating, presenting successful cardiomyocyte differentiation. In particular, mitochondria function analysis showed that SA downregulated the transcription level of the Complex IV gene. SA increased the fission form of mitochondrion identified by the mitochondria number and length. In addition, a treatment with D-penicillamine, an arsenic chelator, restored the beat of EBs against SA, but not mitochondrial dysfunction. These findings suggest that SA is a toxicant that induces mitochondrial damage and interferes with myocardial differentiation and embryogenesis. This study suggests that more awareness of SA exposure during pregnancy is required because even minuscule amounts have irreversible adverse effects on embryogenesis through mitochondria dysfunction.

An Accurate Deep Learning-Based System for Automatic Pill Identification: Model Development and Validation.

BACKGROUND: Medication errors account for a large proportion of all medical errors. In most homes, patients take a variety of medications for a long period. However, medication errors frequently occur because patients often throw away the containers of their medications. OBJECTIVE: We proposed a deep learning-based system for reducing medication errors by accurately identifying prescription pills. Given the pill images, our system located the pills in the respective pill databases in South Korea and the United States. METHODS: We organized the system into a pill recognition step and pill retrieval step, and we applied deep learning models to train not only images of the pill but also imprinted characters. In the pill recognition step, there are 3 modules that recognize the 3 features of pills and their imprints separately and correct the recognized imprint to fit the actual data. We adopted image classification and text detection models for the feature and imprint recognition modules, respectively. In the imprint correction module, we introduced a language model for the first time in the pill identification system and proposed a novel coordinate encoding technique for effective correction in the language model. We identified pills using similarity scores of pill characteristics with those in the database. RESULTS: We collected the open pill database from South Korea and the United States in May 2022. We used a total of 24,404 pill images in our experiments. The experimental results show that the predicted top-1 candidates achieve accuracy levels of 85.6% (South Korea) and 74.5% (United States) for the types of pills not trained on 2 different databases (South Korea and the United States). Furthermore, the predicted top-1 candidate accuracy of our system was 78% with consumer-granted images, which was achieved by training only 1 image per pill. The results demonstrate that our system could identify and retrieve new pills without additional model updates. Finally, we confirmed through an ablation study that the language model that we emphasized significantly improves the pill identification ability of the system. CONCLUSIONS: Our study proposes the possibility of reducing medical errors by showing that the introduction of artificial intelligence can identify numerous pills with high precision in real time. Our study suggests that the proposed system can reduce patients' misuse of medications and help medical staff focus on higher-level tasks by simplifying time-consuming lower-level tasks such as pill identification.

Role of surgery in management of intracranial dural arteriovenous fistulas.

Intracranial dural arteriovenous fistulas (DAVF) are abnormal connections between intracranial arterial and venous systems within the dural layers. Intracranial DAVFs are rare but can occur wherever dural components exist. The pathogenesis of DAVFs is controversial. Venous hypertension is considered as a main cause of clinical symptoms which are subclassified into asymptomatic, benign and aggressive manifestations. To date, several classification schemes have been proposed to stratify the natural course and risks of DAVFs. Currently, endovascular therapy is the main treatment modality. Moreover, the use of radiosurgery and radiotherapy has been limited. Open surgery is also selectively performed as a main treatment modality for specific types of DAVFs and an adjunctive modality for the endovascular approach. Herein, we present a review of the general perspectives of intracranial DAVFs with an emphasis on the role of surgery.

Innovative Variation in the Morphological Characteristics of Carbon Nanowalls Grown on a Molybdenum Disulfide Interlayer.

Carbon is a material with interesting properties which exists in large quantities on Earth, so many studies involving carbon have been conducted. In particular, nano-sized carbon allotropes, referred to as carbon nanomaterials, comprise the subject of various studies currently underway. The electrical, chemical, physical properties of carbon nanowalls (CNWs) are modified by parameters such as surface density, height and thickness. These characteristics have significant effects on CNWs and can be adjusted as a growth interlayer. It was confirmed that the molybdenum disulfide (MoS2) interlayer synthesized in this paper by radio frequency (RF) magnetron sputtering altered the morphological characteristics of the CNWs, including its shaped edge, pores diameter and density. We provide interesting results through FE-SEM, EDS and Raman analysis in this paper. Based on the Raman analysis, both the D-peak of carbon and the ID/IG ratio decreased. Through this study, the effect of MoS2 on the morphological characteristics of CNWs was confirmed.

Clinical Significance of Intracranial Aneurysms in Adult Moyamoya Disease.

OBJECTIVE: We present the relationship between an aneurysm in adult moyamoya disease (MMD) patients and a future stroke event. METHODS: One hundred forty-seven aneurysms were found in 118 adult MMD patients. To find risk factors for future hemorrhagic and ischemic stroke, Kaplan-Meier and Cox-regression analyses were performed on clinical and radiologic factors. In addition to the anatomical classification method based on the circle of Willis, aneurysms occurring in the collateral pathway were analyzed by reflecting the hemodynamic changes in MMD. RESULTS: The initial clinical presentations are divided into ischemia (n = 53, 44.9%), hemorrhage (n = 51, 43.2%), and asymptomatic (n = 14, 11.9%). The mean size of the aneurysms was 2.9 ± 1.67 mm. Thirty-four aneurysms were treated with coil (n = 24) and glue embolization (n = 10). One hundred thirteen aneurysms were conservatively managed. All of aneurysms did not cause recurrent hemorrhagic strokes by aneurysm rupture. The mean follow-up period duration was 78.3 ± 58.9 months. The overall estimated rate of hemorrhage was 10.5%/hemisphere at 5 years and 18.2%/hemisphere at 10 years after the initial angiography. The overall estimated rate of infarction was 2.8%/hemisphere at 5 years and 4.5%/hemisphere at 10 years after the initial angiography. A Cox regression analysis revealed that a collateral pathway aneurysm is a significant risk factor for hemorrhagic stroke (P = 0.045, hazard ratio = 2.366). However, less hemorrhaging occurred in MMD patients with hypertension (P = 0.018, hazard ratio = 0.364). CONCLUSIONS: The presence of a collateral pathway aneurysm appears to reflect the hemodynamic stress exerted on the cerebral hemispheres of MMD patients, suggesting an increased risk of future hemorrhagic strokes.

Pre-validation of an alternative test method for prediction of developmental neurotoxicity.

Exposure to neurodevelopmental toxicants can cause permanent brain injury. Hance, determining the neurotoxicity of unknown substances is essential for the safety of substance. As an alternative method to animal studies, developmental neurotoxicity test (DNT) and the first discriminant function (DF) were established in previous study. This study aimed to increase the predictability of the DNT method and perform a mobility test. Two endpoints of 29 newly investigated substances were used to establish a second-generation DF (2nd GDF). As two endpoints, the half-inhibitory concentration of the cell viability (IC50) was determined using a cell counting kit-8 assay. The half-inhibitory concentration of differentiation (ID50) was determined by measuring the green fluorescent protein (GFP) intensity in 46C cells. The substances were treated dose-dependently to measure IC50 and ID50. The 2nd GDF classified 29 chemicals accurately as toxic and non-toxic. Four participants of three independent laboratories were enrolled to test the mobility. The results of the test set were highly accurate in reproducibility (100% of accuracy, sensitivity, and specificity) and mobility (accuracy 93.33%, sensitivity 90.91%, and specificity 100%). In conclusion, the protocol is transferable, reproducible, and accurate. Therefore, this could be a standardizing method for determining a neurotoxicant as an alternative for animal experiments.