Inhibition of Phosphatidylinositol 3-kinase (PI3K) Signaling Synergistically Potentiates Antitumor Efficacy of Paclitaxel and Overcomes Paclitaxel-Mediated Resistance in Cervical Cancer.

Acquired paclitaxel (PTX) resistance limits its effectiveness and results in advanced cancer progression. This review investigated whether the inhibition of phosphatidylinositol 3-kinase (PI3K) signaling overcomes paclitaxel resistance in cervical cancer. It was established paclitaxel-resistant cell lines (PTX-R ME180/PTX-R HeLa) and determined the combination index for paclitaxel and PI3K inhibitors (BYL-719/ LY294002) by tetrazolium dye assay. Flow cytometry was used to detect the cell cycle and apoptosis. Migration and invasion were explored by wound healing and transwell assays. Genes related to multiple pathways were assessed by a western blot. It was found that the PI3K pathway was significantly activated in paclitaxel-resistant HeLa and ME180 cells compared to parental cells. PTX + PI3K inhibitor combined therapy showed a synergistic effect by strengthening paclitaxel-induced S and G2M arrest in PTX-R cell sublines by the inactivation of cyclin A1, cyclin B1, cyclin E, and Cdc2 expression. Moreover, combination therapy significantly enhanced drug sensitivity and apoptosis through the activation of Bax, and cleavage of poly-(ADP-ribose) polymerase compared with paclitaxel alone. In addition, PI3K inhibition also suppressed tumor migration and invasion by targeting ß-catenin and matrix metalloproteinase-2/9. The authors suggest that the combination of a PI3K inhibitor with paclitaxel may enhance antitumor activity through a cascade of PI3K signaling events.

Potential of indigenous bacteria driven U(VI) reduction under relevant deep geological repository (DGR) conditions.

Understanding the biogeochemical U redox processes is crucial for controlling U mobility and toxicity under conditions relevant to deep geological repositories (DGRs). In this study, we examined the microbial reduction of aqueous hexavalent uranium U(VI) [U(VI)aq] by indigenous bacteria in U-contaminated groundwater. Three indigenous bacteria obtained from granitic groundwater at depths of 44-60 m (S1), 92-116 m (S2), and 234-244 m (S3) were used in U(VI)aq bioreduction experiments. The concentration of U(VI)aq was monitored to evaluate its removal efficiency for 24 weeks under anaerobic conditions with the addition of 20 mM sodium acetate. During the anaerobic reaction, U(VI)aq was precipitated in the form of U(IV)-silicate with a particle size >100 nm. The final U(VI)aq removal efficiencies were 37.7%, 43.1%, and 57.8% in S1, S2, and S3 sample, respectively. Incomplete U(VI)aq removal was attributed to the presence of a thermodynamically stable calcium uranyl carbonate complex in the U-contaminated groundwater. High-throughput 16S rRNA gene sequencing analysis revealed the differences in indigenous bacterial communities in response to the depth, which affected to the U(VI)aq removal efficiency. Pseudomonas peli was found to be a common bacterium related to U(VI)aq bioreduction in S1 and S2 samples, while two SRB species, Thermodesulfovibrio yellowstonii and Desulfatirhabdium butyrativorans, played key roles in the bioreduction of U(VI)aq in S3 sample. These results indicate that remediation of U(VI)aq is possible by stimulating the activity of indigenous bacteria in the DGR environment.

Identifying the origin and fate of dissolved U in the Boeun aquifer based on microbial signatures and C, O, Fe, S, and U isotopes.

The uranium inventory in the Boeun aquifer is situated near an artificial reservoir (40-70 m apart) intended to supply water to nearby cities. However, toxic radionuclides can enter the reservoir. To determine the U mobility in the system, we analyzed groundwater and fracture-filling materials (FFMs) for environmental tracers, including microbial signatures, redox-sensitive elements and isotopes. In the site, U mass flux ranged from only 9.59 × 10-7 µg/L/y to 1.70 × 10-4 µg/L/y. The δ18O-H2O and 14C signatures showed that groundwater originated mainly from upland recharges and was not influenced by oxic surface water. We observed U accumulations (∼157 mg/kg) in shallow FFMs and Fe enrichments (∼226798 mg/kg) and anomalies in the 230Th/238U activity ratio (AR), 230Th/234U AR, δ56Fe and δ57Fe isotopes, suggesting that low U mobility in shallow depths is associated with a Fe-rich environment. At shallow depths, anaerobic Fe-oxidizers, Gallionella was prevalent in the groundwater, while Acidovorax was abundant near the U ore deposit depth. The Fe-rich environment at shallow depths was formed by sulfide dissolution, as demonstrated by δ34S-SO4 and δ18O-SO4 distribution. Overall, the Fe-rich aquifer including abundant sulfide minerals immobilizes dissolved U through biotic and abiotic processes, without significant leaching into nearby reservoirs.

Optical characteristics of type-II hexagonal-shaped GaSb quantum dots on GaAs synthesized using nanowire self-growth mechanism from Ga metal droplet.

We report the growth mechanism and optical characteristics of type-II band-aligned GaSb quantum dots (QDs) grown on GaAs using a droplet epitaxy-driven nanowire formation mechanism with molecular beam epitaxy. Using transmission electron microscopy and scanning electron microscopy images, we confirmed that the QDs, which comprised zinc-blende crystal structures with hexagonal shapes, were successfully grown through the formation of a nanowire from a Ga droplet, with reduced strain between GaAs and GaSb. Photoluminescence (PL) peaks of GaSb capped by a GaAs layer were observed at 1.11 eV, 1.26 eV, and 1.47 eV, assigned to the QDs, a wetting-like layer (WLL), and bulk GaAs, respectively, at the measurement temperature of 14 K and excitation laser power of 30 mW. The integrated PL intensity of the QDs was significantly stronger than that of the WLL, which indicated well-grown GaSb QDs on GaAs and the generation of an interlayer exciton, as shown in the power- and temperature-dependent PL spectra, respectively. In addition, time-resolved PL data showed that the GaSb QD and GaAs layers formed a self-aligned type-II band alignment; the temperature-dependent PL data exhibited a high equivalent internal quantum efficiency of 15 ± 0.2%.

Biogenic formation and growth of uraninite (UO2).

Biogenic UO2 (uraninite) nanocrystals may be formed as a product of a microbial reduction process in uranium-enriched environments near the Earth's surface. We investigated the size, nanometer-scale structure, and aggregation state of UO2 formed by iron-reducing bacterium, Shewanella putrefaciens CN32, from a uranium-rich solution. Characterization of biogenic UO2 precipitates by high-resolution transmission electron microscopy (HRTEM) revealed that the UO2 nanoparticles formed were highly aggregated by organic polymers. Nearly all of the nanocrystals were networked in more or less 100 nm diameter spherical aggregates that displayed some concentric UO2 accumulation with heterogeneity. Interestingly, pure UO2 nanocrystals were piled on one another at several positions via UO2-UO2 interactions, which seem to be intimately related to a specific step in the process of growing large single crystals. In the process, calcium that was easily complexed with aqueous uranium(VI) appeared not to be combined with bioreduced uranium(IV), probably due to its lower binding energy. However, when phosphate was added to the system, calcium was found to be easily associated with uranium(IV), forming a new uranium phase, ningyoite. These results will extend the limited knowledge of microbial uraniferous mineralization and may provide new insights into the fate of aqueous uranium complexes.

Angiographic and clinical outcomes of stent-alone treatment for spontaneous vertebrobasilar dissecting aneurysm.

PURPOSE: Spontaneous vertebrobasilar dissecting aneurysm (VBD) is a very challenging disease with an unpredictable clinical course and controversies on treatment strategy. The present study reports radiological and clinical outcomes of stent-alone treatment (SAT) for VBD. METHODS: Twenty-four VBDs treated with SAT are included in the present study. Clinical and angiographic data were reviewed retrospectively. RESULTS: A total of 24 lesions in 22 patients with a mean follow-up period of 16.21 months were included. Of the 24 individual lesions, 23 were intracranial vertebral artery lesions and 1 lesion was located in the basilar artery. There were six cases of ruptured dissections with the other cases having various symptoms. The immediate post-SAT angiographic outcomes included 5 lesions with good remodeling over 90% recovery and 19 poorly remodeled lesions. The latest angiographic outcomes included 17 cases of good remodeling (remodeling rate over 90%), 6 cases of poor remodeling (remodeling rate below 70%), and 1 case with morphological aggravation. The overlapping stent technique was used in seven cases and it was significantly associated with good angiographic results. None of the rupture cases underwent re-rupture post SAT. There was one case of a symptomatic complication of a femoral arteriovenous fistula. CONCLUSIONS: The SAT could be a feasible alternative for the treatment of VBD. The overlapping technique was significantly associated with good angiographic outcome. We expect that technological development of the intracranial stent will allow better procedural outcomes of SAT.

Transarterial coil embolization of a carotid-cavernous fistula which occurred during stent angioplasty.

Intracranial endovascular procedures are less invasive and relatively safe; however, these procedures do carry a risk of complications, such as thromboembolization, arterial injury, and vessel occlusion. We present a case of carotid-cavernous fistula development secondary to injury of the cavernous segment of the internal carotid artery (ICA) during stent angioplasty and its treatment by transarterial coil embolization. Probable causes of this complication and its treatment method are discussed. To the best of our knowledge, this is the first report of such a case.

Uranium and other trace elements' distribution in Korean granite: implications for the influence of iron oxides on uranium migration.

To understand trace radionuclide (uranium) migration occurring in rocks, a granitic batholith located at the Korea Atomic Energy Research Institute (KAERI) site was selected and investigated. The rock samples obtained from this site were examined using mineralogical methods, including scanning electron microscopy (SEM) and electron probe microanalysis (EPMA). The changes in the distribution pattern of uranium (U) and small amounts of trace elements, and the mineralogical textures affected by weathering, were examined. Based on the element distribution analyses, it was found that Fe2+ released from fresh biotite is oxidized in short geological time, forming amorphous iron oxides, such as ferrihydrite, around silicate minerals. In that case, the amorphous ferrihydrite does not show distinct adsorption for U. However, as it gradually crystallizes to goethite or hematite, the most U-rich phases were found to be associated with the secondary iron oxides having granular forms. This evidence suggests that the geological subsurface environment is favorable for the crystallized iron oxides to keep their structures more stable for a long time as compared with the amorphous phases. There is a possibility that the long residence of U which is in contact with the stable crystalline phases of iron may finally lead to the partial sequestration of U in their structure. Consequently, it seems that Fe-oxide crystallization can be a dominating mechanism for U uptake and controls long-term U transport in granites with low U contents.

Intravascular ultrasonography-guided stent angioplasty of an extracranial vertebral artery dissection.

The authors report on a case of intravascular ultrasonography (IVUS)-guided stent angioplasty for iatrogenic extracranial vertebral artery (VA) dissection in a 49-year-old man after coil embolization for an unruptured aneurysm of the right posterior inferior cerebellar artery. Insignificant dissections occurred during the procedure. Postoperatively, the patient experienced gradually worsening posterior neck pain and headache, and follow-up angiography 8 months after the coil embolization revealed expansion of the dissection. The patient underwent stent angioplasty with IVUS guidance and his symptoms improved. To the authors' knowledge, this is the first report of IVUS-guided stent angioplasty of an extracranial VA dissection. It was safe and feasible to treat extracranial VA dissections with stent placement under IVUS guidance. Intravascular environments are in real time with IVUS, and this technique is useful in the confirmation of a true lumen and evaluation of appropriate stent apposition. More clinical experience with this technique is necessary and mandatory, and devices with smaller diameters with improved trackability are essential for further introduction of IVUS into the field of endovascular neurosurgery.

Risk Factor Analysis for Poor Outcomes in Supraorbital Keyhole Aneurysm Clipping for Ruptured Anterior Circulation Aneurysms.

BACKGROUND: The transciliary keyhole approach has been actively employed for unruptured intracranial aneurysms in many institutions, although applying this technique to ruptured aneurysms remains controversial. We investigated risk factors related to poor surgical outcomes in ruptured aneurysms and attempted to clarify the differences between conventional craniotomy and keyhole surgery. METHODS: A retrospective review was performed at a single institution of medical records and images from surgeries of 188 patients who underwent keyhole surgery for ruptured anterior circulation aneurysms between July 2007 and February 2015. RESULTS: The study included 116 (62%) female and 72 (38%) male patients; age range was 23-86 years. Preoperative clinical grades were good in almost all patients except for a few patients with poor clinical grades. Mean aneurysm size was 5.5 mm, and the most common aneurysm location was the anterior communicating artery (n = 82). Most patients (n = 158; 91.5%) showed good clinical outcomes. Univariate analysis of risk factors associated with poor-grade outcomes after 3 months was performed. Hunt and Hess grade (odds ratio [OR] 13.50, P < 0.0001), World Federation of Neurosurgical Societies scale (OR 7.69, P < 0.0001), aneurysm size (OR 1.21, P = 0.019), and vasospasm (OR 6.43, P = 0.0003) were statistically significant, whereas Fisher grade, skin-to-skin time (operation time), rebleeding, and ventricle puncture were not statistically significant. CONCLUSIONS: Because incidence of poor surgical outcome of keyhole surgery is not different from known conventional craniotomy, this approach is an acceptable treatment option in a good-grade ruptured anterior circulation aneurysm.

ESTIMATION OF EXPOSURE DOSES FOR THE SAFE MANAGEMENT OF NORM WASTE DISPOSAL.

Naturally occurring radioactive materials (NORM) wastes with different radiological characteristics are generated in several industries. The appropriate options for NORM waste management including disposal options should be discussed and established based on the act and regulation guidelines. Several studies calculated the exposure dose and mass of NORM waste to be disposed in landfill site by considering the activity concentration level and exposure dose. In 2012, the Korean government promulgated an act on the safety control of NORM around living environments to protect human health and the environment. For the successful implementation of this act, we suggest a reference design for a landfill for the disposal of NORM waste. Based on this reference landfill, we estimate the maximum exposure doses and the relative impact of each pathway to exposure dose for three scenarios: a reference scenario, an ingestion pathway exclusion scenario, and a low leach rate scenario. Also, we estimate the possible quantity of NORM waste disposal into a landfill as a function of the activity concentration level of U series, Th series and 40K and two kinds of exposure dose levels, 1 and 0.3 mSv/y. The results of this study can be used to support the establishment of technical bases of the management strategy for the safe disposal of NORM waste.

Stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery origin and treatment with the stent-in-stent technique. Report of two cases.

The authors report two cases of stent fracture and restenosis after placement of a drug-eluting device in the vertebral artery (VA) origin, and describe management of restenosis with the stent-in-stent technique. Two women, one 62 and the other 67 years of age, underwent stent placement in the VA origin to treat symptomatic and angiographically significant stenosis in this vessel. Sirolimus-eluting coronary stents (Cypher) were used in both cases. Four months after placement of the devices, the symptoms recurred. Follow-up angiography performed 5 months after insertion of the devices revealed a transverse stent fracture with separation of the fragments and severe in-stent restenosis in both cases. The restenoses were treated with reinsertion of coronary stents (Cypher and Jostent FlexMaster) by using the stent-in-stent technique. After stent reinsertion, the patients exhibited relief of symptoms. This paper is the first report of fracture in a drug-eluting stent and restenosis after stent placement in the VA origin. Restenosis caused by such a fracture can be managed successfully by performing the stent-in-stent maneuver. The physical properties of metallic devices, stent strut geometry, and anatomical peculiarities of the subclavian artery may be associated with stent fractures. Earlier follow-up angiography studies (within 6 months) are warranted.

Oxidation Mechanism of Si1-xGex Nanowires with Au Catalyst Tip as a Function of Ge Content.

Si1-xGex nanowires (NWs) (0.22 ≤ x ≤ 0.78) were synthesized using a vapor-liquid-solid procedure with a Au catalyst. We measured the intrinsic physical, chemical, and electrical properties of the oxidized Si1-xGex NWs using several techniques, including transmission electron microscopy, X-ray photoemission spectroscopy, and optical pump-THz probe spectroscopy. We suggest two distinct oxidation mechanisms depending on the Ge content in the Si1-xGex NWs: (i) when the Ge content is around 0.22, a Au catalytic effect brings about oxidation in both the axial and lateral directions; and (ii) when the Ge content is greater than 0.22, the Au tip is detached from the NW body and does not act as a catalyst, which is a result of the high degree of Ge-atom participation in the oxidation process. Additionally, we measured the photoconductivity decay time distribution for the Si1-xGex NWs before and after oxidation process; the decay time is significantly shortened in oxidized Si1-xGex NWs (0.22 < x), whereas it is maintained for Si-rich Si1-xGex NWs (x ≈ 0.22) as compared to the as-grown Si1-xGex NWs. It indicates that the number of defect states is generated with the formation of defective Ge oxide at the oxide-shell-layer/Si1-xGex-core-NW interface.

Al2O3 Passivation Effect in HfO2·Al2O3 Laminate Structures Grown on InP Substrates.

The passivation effect of an Al2O3 layer on the electrical properties was investigated in HfO2-Al2O3 laminate structures grown on indium phosphide (InP) substrate by atomic-layer deposition. The chemical state obtained using high-resolution X-ray photoelectron spectroscopy showed that interfacial reactions were dependent on the presence of the Al2O3 passivation layer and its sequence in the HfO2-Al2O3 laminate structures. Because of the interfacial reaction, the Al2O3/HfO2/Al2O3 structure showed the best electrical characteristics. The top Al2O3 layer suppressed the interdiffusion of oxidizing species into the HfO2 films, whereas the bottom Al2O3 layer blocked the outdiffusion of In and P atoms. As a result, the formation of In-O bonds was more effectively suppressed in the Al2O3/HfO2/Al2O3/InP structure than that in the HfO2-on-InP system. Moreover, conductance data revealed that the Al2O3 layer on InP reduces the midgap traps to 2.6 × 1012 eV-1 cm-2 (compared to that of HfO2/InP, that is, 5.4 × 1012 eV-1 cm-2). The suppression of gap states caused by the outdiffusion of In atoms significantly controls the degradation of capacitors caused by leakage current through the stacked oxide layers.

Electrical properties and thermal stability in stack structure of HfO2/Al2O3/InSb by atomic layer deposition.

Changes in the electrical properties and thermal stability of HfO2 grown on Al2O3-passivated InSb by atomic layer deposition (ALD) were investigated. The deposited HfO2 on InSb at a temperature of 200 °C was in an amorphous phase with low interfacial defect states. During post-deposition annealing (PDA) at 400 °C, In-Sb bonding was dissociated and diffusion through HfO2 occurred. The diffusion of indium atoms from the InSb substrate into the HfO2 increased during PDA at 400 °C. Most of the diffused atoms reacted with oxygen in the overall HfO2 layer, which degraded the capacitance equivalent thickness (CET). However, since a 1-nm-thick Al2O3 passivation layer on the InSb substrate effectively reduced the diffusion of indium atoms, we could significantly improve the thermal stability of the capacitor. In addition, we could dramatically reduce the gate leakage current by the Al2O3 passivation layer. Even if the border traps measured by C-V data were slightly larger than those of the as-grown sample without the passivation layer, the interface trap density was reduced by the Al2O3 passivation layer. As a result, the passivation layer effectively improved the thermal stability of the capacitor and reduced the interface trap density, compared with the sample without the passivation layer.

Microbial copper reduction method to scavenge anthropogenic radioiodine.

Unexpected reactor accidents and radioisotope production and consumption have led to a continuous increase in the global-scale contamination of radionuclides. In particular, anthropogenic radioiodine has become critical due to its highly volatile mobilization and recycling in global environments, resulting in widespread, negative impact on nature. We report a novel biostimulant method to effectively scavenge radioiodine that exhibits remarkable selectivity for the highly difficult-to-capture radioiodine of >500-fold over other anions, even under circumneutral pH. We discovered a useful mechanism by which microbially reducible copper (i.e., Cu(2+) to Cu(+)) acts as a strong binder for iodide-iodide anions to form a crystalline halide salt of CuI that is highly insoluble in wastewater. The biocatalytic crystallization of radioiodine is a promising way to remove radioiodine in a great capacity with robust growth momentum, further ensuring its long-term stability through nuclear I(-) fixation via microcrystal formation.

Structural and Electrical Properties of EOT HfO2 (<1 nm) Grown on InAs by Atomic Layer Deposition and Its Thermal Stability.

We report on changes in the structural, interfacial, and electrical characteristics of sub-1 nm equivalent oxide thickness (EOT) HfO2 grown on InAs by atomic layer deposition. When the HfO2 film was deposited on an InAs substrate at a temperature of 300 °C, the HfO2 was in an amorphous phase with an sharp interface, an EOT of 0.9 nm, and low preexisting interfacial defect states. During post deposition annealing (PDA) at 600 °C, the HfO2 was transformed from an amorphous to a single crystalline orthorhombic phase, which minimizes the interfacial lattice mismatch below 0.8%. Accordingly, the HfO2 dielectric after the PDA had a dielectric constant of ∼24 because of the permittivity of the well-ordered orthorhombic HfO2 structure. Moreover, border traps were reduced by half than the as-grown sample due to a reduction in bulk defects in HfO2 dielectric during the PDA. However, in terms of other electrical properties, the characteristics of the PDA-treated sample were degraded compared to the as-grown sample, with EOT values of 1.0 nm and larger interfacial defect states (Dit) above 1 × 10(14) cm(-2) eV(-1). X-ray photoelectron spectroscopy data indicated that the diffusion of In atoms from the InAs substrate into the HfO2 dielectric during the PDA at 600 °C resulted in the development of substantial midgap states.

Pipeline Embolization Device for Large/Giant or Fusiform Aneurysms: An Initial Multi-Center Experience in Korea.

PURPOSE: The purpose of this study was to assess the safety and early outcomes of the Pipeline device for large/giant or fusiform aneurysms. MATERIALS AND METHODS: The Pipeline was implanted in a total of 45 patients (mean age, 58 years; M:F=10:35) with 47 large/giant or fusiform aneurysms. We retrospectively evaluated the characteristics of the treated aneurysms, the periprocedural events, morbidity and mortality, and the early outcomes after Pipeline implantation. RESULTS: The aneurysms were located in the internal carotid artery (ICA) cavernous segment (n=25), ICA intradural segment (n=11), vertebrobasilar trunk (n=8), and middle cerebral artery (n=3). Procedure-related events occurred in 18 cases, consisting of incomplete expansion (n=8), shortening-migration (n=5), transient occlusion of a jailed branch (n=3), and in-stent thrombosis (n=2). Treatment-related morbidity occurred in two patients, but without mortality. Both patients had modified Rankin scale (mRS) scores of 2, but had an improved mRS score of 0 at 1-month follow-up. Of the 19 patients presenting with mass effect, 16 improved but three showed no changes in their presenting symptoms. All patients had excellent outcomes (mRS, 0 or 1) during the follow-up period (median, 6 months; range, 2-30 months). Vascular imaging follow-up (n=31, 65.9%; median, 3 months, range, 1-25 months) showed complete or near occlusion of the aneurysm in 24 patients (77.4%) and decreased sac size in seven patients (22.6%). CONCLUSION: In this initial multicenter study in Korea, the Pipeline seemed to be safe and effective for large/giant or fusiform aneurysms. However, a learning period may be required to alleviate device-related events.

Modeling in-situ transport of uranine and colloids in the fracture network in KURT.

An in-situ dipole migration experiment was conducted using the conservative tracer uranine and latex colloids in KAERI (Korea Atomic Energy Research Institute) Underground Research Tunnel (KURT). The location and dimensions of the fractures between the two boreholes were estimated using the results of a borehole image processing system (BIPS) investigation, and the connectivity of the fractures was evaluated by a packer test. To investigate the flow and transport of uranine and colloids through an in-situ fracture network, a fracture network transport model was newly developed. The model consists of a series of one-dimensional advection-dispersion-matrix diffusion equations for each channel of the fracture network. Using the fracture network transport model, the most probable representation and the hydrologic parameters of the fracture network can be estimated by fitting the breakthrough of uranine. While the fracture network might not be unique, the representation chosen was adequate to describe the breakthrough of uranine and it represents a reasonable approach to modeling transport in the fracture network. An additional evaluation showed that the colloid transport in this study was influenced by filtration on the fracture surface rather than the enhancement of the colloid velocity. Overall, the model can explain successfully the in-situ experimental results of uranine and colloid transports through the fracture network.

Standards for endovascular neurosurgical training and certification of the society of korean endovascular neurosurgeons 2013.

The need for standard endovascular neurosurgical (ENS) training programs and certification in Korea cannot be overlooked due to the increasing number of ENS specialists and the expanding ENS field. The Society of Korean Endovascular Neurosurgeons (SKEN) Certification Committee has prepared training programs and certification since 2010, and the first certificates were issued in 2013. A task force team (TFT) was organized in August 2010 to develop training programs and certification. TFT members researched programs and systems in other countries to develop a program that best suited Korea. After 2 years, a rough draft of the ENS training and certification regulations were prepared, and the standard training program title was decided. The SKEN Certification Committee made an official announcement about the certification program in March 2013. The final certification regulations comprised three major parts: certified endovascular neurosurgeons (EN), certified ENS institutions, and certified ENS training institutions. Applications have been evaluated and the results were announced in June 2013 as follows: 126 members received EN certification and 55 hospitals became ENS-certified institutions. The SKEN has established standard ENS training programs together with a certification system, and it is expected that they will advance the field of ENS to enhance public health and safety in Korea.