Health-related quality of life using WHODAS 2.0 and associated factors 1 year after stroke in Korea: a multi-centre and cross-sectional study.

BACKGROUND: Little is known about the self-perceived level of disability of stroke survivors in the community. We aimed to characterise Health-related quality of life (HRQoL) 1 year after stroke and investigate how sociodemographic and stroke-related factors and medical adherence explain the self-perceived level of disability in a Korean stroke population. METHODS: This was a multicentre cross-sectional study. A total of 382 ischaemic stroke survivors at 1 year after onset from 11 university hospitals underwent a one-session assessment, including socioeconomic variables, the modified Rankin Scale (mRS), various neurological sequelae, the Morisky, Green and Levin-Medication Adherence Questionnaire (MGL), and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) 36-items. The relationship between disability and different variables was analysed using ordinal logistic regression. RESULTS: The prevalence of disability based on global WHODAS 2.0 was 62.6% (mild, 41.6%; moderate, 16.0%; severe, 5.0%). The prevalence of severe disability was higher in participation in society (16.8%) and getting around (11.8%) than in other domains. Low MGL- motivation was the only factor determining a significant association between all six domains of disability after adjustment. Different predictors for specific domains were age, mRS, dysarthria, trouble seeing, cognition problems, and MGL-motivation for understanding and communicating; age, recurrent stroke, mRS, hemiplegia, facial palsy, general weakness, and MGL-motivation for getting around; age, education, mRS, hemiplegia, and MGL-motivation for self-care; education, recurrent stroke, hemiplegia, dysarthria, and MGL-motivation for getting along with people; age, education, income, mRS, hemiplegia, dysarthria, MGL-knowledge, and MGL-motivation for life activities; living without a spouse, mRS, hemiplegia, dysarthria, trouble seeing, cognition problems, general weakness, and MGL-motivation for participation in society. CONCLUSIONS: Self-perceived disability according to the WHODAS 2.0 at 1 year after stroke was highly prevalent. Each disability domain showed a different prevalence and associated factors. Interventions promoting medical adherence to motivation seemed to help achieve high HRQoL in all domains.

Clinical outcomes of single-incision robotic cholecystectomy versus conventional 3-port laparoscopic cholecystectomy

Background: Few studies have compared the surgical results of single-incision robotic cholecystectomy (SIRC) with those of conventional laparoscopic cholecystectomy (CLC). The purpose of this study was to evaluate the relative clinical efficacy of SIRC by comparing the number of postoperative days, pain level and complications between the 2 surgical methods. Methods: We retrospectively collected demographic, perioperative and postoperative data for all patients who underwent SIRC or CLC performed by a single surgeon from June 2016 to May 2017. Operative time was recorded, divided into anesthesia time, docking time, console time and total operation time. Postoperative pain was measured with the Numerical Pain Rating Scale. Results: A total of 121 patients underwent cholecystectomy during the study period, of whom 61 had SIRC and 60 had CLC. The mean total operation time of SIRC and CLC was 93.52 (SD 20.27) minutes and 37.67 (SD 19.73) minutes, respectively (p < 0.001). The total operation time excluding console time of SIRC was significantly longer than that of CLC (82.77 [SD 18.27] min v. 37.67 [SD 19.73] min) (p < 0.001). The mean Numerical Pain Rating Scale score was 4.73 (SD 1.23) (SIRC: 4.75 [SD 1.24]; CLC: 4.70 [SD 1.22]) (p = 0.8) within 1 hour after the operation; scores after 6 hours and 1 day decreased in a similar manner in the 2 groups (p = 0.1). Conclusion: Postoperative pain, use of an additional port, complication rates, operation time and cost of SIRC were similar to or greater than those of CLC. Large randomized controlled trials are needed to examine the true benefits of SIRC.

Contexte: Peu d'études ont comparé les résultats chirurgicaux de la cholécystectomie robotique par incision unique (CRIU) à ceux de la cholécystectomie laparoscopique classique (CLC). Le but de la présente étude était d'évaluer l'efficacité clinique relative de la CRIU en comparant le nombre de jours postopératoires, l'intensité de la douleur et les complications avec les 2 méthodes chirurgicales. Méthodes: Nous avons recueilli de manière rétrospective les données démographiques, périopératoires et postopératoires de tous les patients soumis à une CRIU ou à une CLC effectuée par un seul chirurgien entre juin 2016 et mai 2017. Le temps opératoire a été enregistré, subdivisé entre anesthésie, temps d'installation, temps à la console et durée totale de l'intervention. La douleur postopératoire a été mesurée au moyen d'une échelle numérique d'évaluation de la douleur. Résultats: En tout, 121 patients ont subi une cholécystectomie durant la période de l'étude, dont 61, une CRIU et 60, une CLC. La durée opératoire totale moyenne des CRIU et des CLC a été de 93,52 (É.-T. 20,27) minutes et de 37,67 (É.-T. 19,73) minutes, respectivement (p < 0,001). La durée opératoire totale excluant le temps à la console a été significativement plus longue avec la CRIU qu'avec la CLC (82,77 [É.-T. 18,27] minutes c. 37,67 [É.-T. 19,73] minutes) (p < 0,001). Le score moyen à l'échelle numérique d'évaluation de la douleur a été de 4,73 (É.-T. 1,23) (CRIU : 4,75 [É.-T. 1,24]; CLC : 4,70 [É.-T. 1,22]) (p = 0,8) 1 heure suivant l'intervention; après 6 heures et après 1 jour, les scores avaient diminué de façon similaire dans les 2 groupes (p = 0,1). Conclusion: La douleur postopératoire, l'utilisation d'un port additionnel, les taux de complication, le temps opératoire et le coût de la CRIU ont été similaires ou supérieurs à ceux de la CLC. Il faudra réaliser de plus grands essais randomisés et contrôlés pour analyser les bénéfices réels de la CRIU.

Loss of Expression of AZGP1 Is Associated With Worse Clinical Outcomes in a Multi-Institutional Radical Prostatectomy Cohort.

BACKGROUND: Given the uncertainties inherent in clinical measures of prostate cancer aggressiveness, clinically validated tissue biomarkers are needed. We tested whether Alpha-2-Glycoprotein 1, Zinc-Binding (AZGP1) protein levels, measured by immunohistochemistry, and RNA expression, by RNA in situ hybridization (RISH), predict recurrence after radical prostatectomy independent of clinical and pathological parameters. METHODS: AZGP1 IHC and RISH were performed on a large multi-institutional tissue microarray resource including 1,275 men with 5 year median follow-up. The relationship between IHC and RISH expression levels was assessed using the Kappa analysis. Associations with clinical and pathological parameters were tested by the Chi-square test and the Wilcoxon rank sum test. Relationships with outcome were assessed with univariable and multivariable Cox proportional hazards models and the Log-rank test. RESULTS: Absent or weak expression of AZGP1 protein was associated with worse recurrence free survival (RFS), disease specific survival, and overall survival after radical prostatectomy in univariable analysis. AZGP1 protein expression, along with pre-operative serum PSA levels, surgical margin status, seminal vesicle invasion, extracapsular extension, and Gleason score predicted RFS on multivariable analysis. Similarly, absent or low AZGP1 RNA expression by RISH predicted worse RFS after prostatectomy in univariable and multivariable analysis. CONCLUSIONS: In our large, rigorously designed validation cohort, loss of AZGP1 expression predicts RFS after radical prostatectomy independent of clinical and pathological variables. Prostate 76:1409-1419, 2016. © 2016 Wiley Periodicals, Inc.

Gallstones and the Risk of Gallbladder Cancer Mortality: A Cohort Study.

OBJECTIVES: Despite epidemiologic data, definitive evidence for the role of gallstones as a cause for gallbladder cancer is lacking. The goal of this study was to evaluate the association between gallstones, determined by ultrasound, and the risk of gallbladder cancer mortality in a large study of Korean men and women. In addition, the association between gallstones and cholecystectomy, and risk of hepatobiliary cancer mortality was investigated. METHODS: A cohort study was performed for 396,720 South Korean men and women who underwent a health checkup from 2002 to 2012. Hazard ratios for mortality outcomes were estimated using Cox-proportional hazards regression analysis. Vital status and cause of death assignment were based on linkage to the National Death Index of death certificate records. RESULTS: From a total of 2,158,906.2 person-years of follow-up (median follow-up of 5.4 years), we identified 224 deaths from hepatobiliary cancer, comprising 174 cases of liver/intrahepatic bile ducts cancer, 20 cases of gallbladder cancer, and 30 cases of biliary tract cancer. Gallstones were significantly associated with increased risk of hepatobiliary cancer mortality, especially liver/intrahepatic biliary cancer, and gallbladder cancer mortality. The multivariable-adjusted hazard ratios (95% confidence intervals) for hepatobiliary cancer, liver/intrahepatic biliary cancer, and gallbladder cancer mortality comparing subjects having gallstones with those without gallstone disease were 2.74 (1.83-4.10), 2.34 (1.45-3.77), and 7.35 (2.60-20.8), respectively. Cholecystectomy was not significantly associated with hepatobiliary cancer mortality. CONCLUSIONS: In this large cohort study, gallstones were associated with increased risk of hepatobiliary cancer mortality, especially liver/intrahepatic cancer, and gallbladder cancer mortality independent of potential confounders. Future studies with longer follow-up periods that include data on incident cancer cases should provide a more comprehensive view of the role of gallstones in cancer development.

Effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction.

[Purpose] This study examined the effects of neuromuscular training on knee joint stability after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 16 adults who underwent arthroscopic anterior cruciate reconstruction and neuromuscular training. The Lysholm scale was used to assess functional disorders on the affected knee joint. A KT-2000 arthrometer was used to measure anterior displacement of the tibia against the femur. Surface electromyography was used to detect the muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus before and after neuromuscular training. [Results] There was significant relaxation in tibial anterior displacement of the affected and sound sides in the supine position before neuromuscular training. Furthermore, the difference in the tibial anterior displacement of the affected knee joints in the standing position was reduced after neuromuscular training. Moreover, the variation of the muscle activation evoked higher muscle activation of the vastus medialis oblique, vastus lateralis, biceps femoris, and semitendinosus. [Conclusion] Neuromuscular training may improve functional joint stability in patients with orthopedic musculoskeletal injuries in the postoperative period.

Effects of trunk rotation induced treadmill gait training on gait of stroke patients: a randomized controlled trial.

[Purpose] This study was conducted to find out the effect of arm swing during treadmill training on the gait of stroke patients. [Subjects and Methods] This study subjects were 20 stroke subjects patients who were randomly assigned to either the experimental group (EG) or the control group (CG), 10 subjects in each group. Therapists induced arm swing of affected side of EG subjects using Nordic poles, while subjects in CG had the affected arm restricted to prevent arm swing. Training was performed for 30 minutes, 3 times a week for 4 weeks. The timed up and go test (TUG), the dynamic gait index (DGI) and the 6-minute walk test (6MWT) were assessed before and after the training. [Results] After the training, there were no significant differences in the TUG times of EG and CG. There were significant differences in the DGI and the 6-minute walking distance of EG, but not of CG. There were also significant differences in the improvements of the DGI and the 6-minute walking distance between the groups. [Conclusion] Arm swing training had a positive effect on patients' gait ability. Further studies are required to generalize the results of this study.

The effect of chest expansion resistance exercise in chronic stroke patients: a randomized controlled trial.

[Purpose] The aim of this study was to examine the initial effects of chest expansion resistance exercise (CERE) applied to chronic stroke patients on their pulmonary functions, chest expansion, and functional gait ability. [Subjects] Forty chronic stroke patients without any respiration-related rehabilitation program experience (21 men and 19 women; times elapsed since occurrence of stroke: 21.8 ± 5.3 months) were randomly and equally allocated to a CERE group (experimental group) and a control group. [Methods] An ordinary stroke rehabilitation program was performed on the subjects. While the experimental group received a CERE intervention, the control group performed passive range of motion exercise with automatic instruments. [Results] The CERE group's chest expansion significantly increased after the intervention, whereas the control group did not see any significant difference. As regards VC (vital capacity), FVC (forced vital capacity), and FEV1 (forced expiratory volume in one second), there were no significant changes in either the CERE or control group. In the 10MTWT (10-meter timed walking test), there were no significant changes in either group, but in the 6MWT (6-minute walk test), while there were no significant differences in the control group, the CERE group saw significant changes. [Conclusion] The results of application of CERE to chronic stroke patients demonstrated the importance of respiratory exercise in an approach to stroke rehabilitation treatment intervention and the need to add respiratory exercise to a rehabilitation intervention program.

Glucaric Acid Production from Miscanthus sacchariflorus via TEMPO-Mediated Oxidation with an Efficient Separation System.

In this study, production and isolation of glucaric acid from lignocellulosic biomass were performed via potassium cation-based TEMPO-mediated oxidation for the ease of glucaric acid isolation. To optimize the oxidation conditions, response surface methodology (RSM) was adopted using standard glucose as the raw material. Among the oxidation conditions, the dosage of oxidant and pH of reaction affected the glucaric acid production, and the optimum conditions were suggested by RSM analysis: 5 °C of reaction temperature, 4.23 equiv dosage of KClO per mole of glucose, and pH of 12. Furthermore, glucaric acid was produced from lignocellulosic biomass-derived enzymatic hydrolysate from Miscanthus under optimum conditions. The impurities such as xylose and lignin in enzymatic hydrolysate inhibited the efficiency of glucose oxidation. As a result, more oxidant was required to produce sufficient glucaric acid from the enzymatic hydrolysate compared to standard glucose. The produced glucaric acid was simply isolated by controlling the pH in the form of glucaric acid monopotassium salt, which showed lower solubility in water, and the purity of isolated glucaric acid was over 99%. The overall mass balance of feedstock to glucaric acid was analyzed, suggesting that 86.38% (w/w) glucaric acid could be produced from initial glucan in feedstock.

Prognostic significance of quantitative carcinoembryonic antigen and cytokeratin 20 mRNA detection in peritoneal washes of gastric cancer patients.

BACKGROUND/AIMS: Peritoneal carcinomatosis is the most common recurrence type in gastric cancer. Disseminated tumor cells derived from serosal invasion may be indicators of early peritoneal seeding and subsequent peritoneal dissemination. Reverse-transcriptase polymerase chain reaction (RT-PCR) techniques have been introduced to aid in detection of disseminated tumor cells in peritoneal washes, however, use of a single molecular marker lacks adequate sensitivity. We sought to improve both sensitivity and specificity in detecting disseminated tumor cells in peritoneal washes by using two markers; carcinoembryonic antigen (CEA) and cytokeratin 20 mRNA (CK20 mRNA). METHODOLOGY: Between July 2007 and June 2010, peritoneal washing samples were collected from 131 patients who underwent surgery for histologically proven gastric cancer. CEA and CK20 mRNA levels were quantified using a Light Cycler. RESULTS: Analysis using of the two markers had higher sensitivity (93.9%) and specificity (87.7%) than single marker detection (p<0.01, p<0.001 respectively). These analyses also correlated with various clinicopathological factors, and aided in predicting survival and peritoneal recurrence. CONCLUSIONS: Two-marker analysis has a significant correlation of survival or peritoneal recurrence in gastric cancer, and this analysis may be more useful as a prognostic predictor of peritoneal recurrence compared with RT-PCR mediated detection of CEA or CK20 alone.

Prognostic factors associated with long-term survival and recurrence in pancreatic adenocarcinoma.

BACKGROUND/AIMS: It is very important to determine the prognostic factors for pancreatic adenocarcinoma when choosing surgical and conservative management strategies. In this study, we identified prognostic factors for survival and recurrence in patients with histologically proven pancreatic adenocarcinoma. METHODOLOGY: Between January 2003 and December 2009, 82 patients with histologically proven pancreatic adenocarcinoma were considered for this study. Follow-up consisted of personal contact with patients or review of electronic medical records at this center and was terminated on December 31, 2011 or upon the patient's death. RESULTS: Overall survival rates of all patients at 1, 3, and 5 years were 51.9, 21.6 and 16.0%. Preoperative jaundice was the only independent prognostic factor for total pancreatic cancer patients, while N stage and perineural invasion in pathological findings was identified as an independent prognostic factor for survival of patients with surgical resection. Chemotherapy was the only independent prognostic factor for survival of patients who underwent palliative surgical bypass. CONCLUSIONS: Preoperative jaundice in any patients, lymph node metastasis, perineural invasion in patients with surgical resection, and chemotherapy in patients undergoing palliative surgical bypass are important prognostic factors for survival of pancreatic cancer.

The ameliorative effects of L-2-oxothiazolidine-4-carboxylate on acetaminophen-induced hepatotoxicity in mice.

The aim of the study was to investigate the ameliorative effects and the mechanism of action of L-2-oxothiazolidine-4-carboxylate (OTC) on acetaminophen (APAP)-induced hepatotoxicity in mice. Mice were randomly divided into six groups: normal control group, APAP only treated group, APAP + 25 mg/kg OTC, APAP + 50 mg/kg OTC, APAP + 100 mg/kg OTC, and APAP + 100 mg/kg N-acetylcysteine (NAC) as a reference control group. OTC treatment significantly reduced serum alanine aminotransferase and aspartate aminotransferase levels in a dose dependent manner. OTC treatment was markedly increased glutathione (GSH) production and glutathione peroxidase (GSH-px) activity in a dose dependent manner. The contents of malondialdehyde and 4-hydroxynonenal in liver tissues were significantly decreased by administration of OTC and the inhibitory effect of OTC was similar to that of NAC. Moreover, OTC treatment on APAP-induced hepatotoxicity significantly reduced the formation of nitrotyrosin and terminal deoxynucleotidyl transferase dUTP nick end labeling positive areas of liver tissues in a dose dependent manner. Furthermore, the activity of caspase-3 in liver tissues was reduced by administration of OTC in a dose dependent manner. The ameliorative effects of OTC on APAP-induced liver damage in mice was similar to that of NAC. These results suggest that OTC has ameliorative effects on APAP-induced hepatotoxicity in mice through anti-oxidative stress and anti-apoptotic processes.

Effect of resection margin status on recurrence pattern and survival in distal pancreatectomy for left-sided pancreatic ductal adenocarcinoma.

BACKGROUND: The association of resection margin status with recurrence and survival after pancreatectomy for pancreas ductal adenocarcinoma (PDAC) remains controversial. The aim of this study was to identify the effect of R1 resection on recurrence pattern and survival after distal pancreatectomy for left-sided PDAC. METHODS: Patients who underwent distal pancreatectomy for PDAC at two high-volume institutions between January 2010 and December 2017 were retrospectively reviewed. Perioperative characteristics, pathological outcomes, recurrence pattern, and survival data were collected to compare R0 resection and R1 resection. RESULTS: Among 558 patients who underwent distal pancreatectomy for PDAC, 158 patients (28.3%) showed R1 resection margin. R1 patients were associated with large tumor size (3.3 cm vs. 3.7 cm, p = .006) and lower number of positive lymph nodes (1.3 vs. 2.0, p = .001). Median overall survival (37.3 months vs. 20.1 months, p < .001) and recurrence-free survival (14.6 months vs. 6.9 months, p < .001) significantly differed between the R0 and R1 groups. Disease recurrence patterns were not statistically different between the two groups (p = .182). Among the recurrence patterns, peritoneal carcinomatosis had the shortest recurrence-free survival (5.6 months, p < .05) and overall survival (13.6 months, p < .05) compared with all other recurrence patterns. CONCLUSIONS: R1 resection margin after distal pancreatectomy was associated with poor survival and early recurrence. There is no significant difference in recurrence pattern between R0 and R1. Among the recurrence patterns, peritoneal carcinomatosis showed the worst prognosis.

Enhancement of elongation at break and UV-protective properties of poly(lactic acid) film with cationic ring opening polymerized (CROP)-lignin.

In this study, the intrinsic brittleness of poly(lactic acid) (PLA) was overcome by chemical modification using ethyl acetate-extracted lignin (EL) via cationic ring-opening polymerization (CROP). The CROP was conducted to promote homopolymerization under starvation of the initiator (oxyrane). This method resulted in the formation of lignin-based polyether (LPE). LPE exhibited enhanced interfacial compatibility with nonpolar and hydrophobic PLA owing to the fewer hydrophilic hydroxyl groups and a long polyether chain. In addition, because of the UV-protecting and radical-scavenging abilities of lignin, LPE/PLA exhibited multifunctional properties, resulting in improved chemical properties compared with the neat PLA film. Notably, one of the LPE/PLA films (EL_MCF) exhibited excellent elongation at break of 297.7 % and toughness of 39.92 MJ/m3. Furthermore, the EL_MCF film showed superior UV-protective properties of 99.52 % in UVA and 88.95 % in UVB ranges, both significantly higher than those of the PLA film, without sacrificing significant transparency in 515 nm. In addition, the radical scavenging activity improved after adding LPE to the PLA film. These results suggest that LPEs can be used as plasticizing additives in LPE/PLA composite films, offering improved physicochemical properties.

Palmar reconstruction using full-thickness skin grafts from the groin and lateral malleolus regions: A comparison of long-term outcomes.

Using the skin of the lateral malleolus region for reconstruction of smaller areas of the palm may yield better outcomes than using the skin of the groin region. However, no previous study has provided long-term data comparing the groin and lateral malleolus regions as donor sites for full-thickness skin grafts (FTSGs) in palmar reconstruction. Therefore, this study aimed to compare the groin and lateral malleolus regions as donor sites for FTSGs in palmar reconstruction over a long-term follow-up period. The patients were classified into groin and lateral malleolus region groups (n = 15 each). Measurements were obtained at the graft site, the contralateral site corresponding to the graft site, and the donor site. A chromameter was used to measure skin color, and the Patient and Observer Scar Assessment Scale (POSAS) was used to evaluate the scar at the skin graft site. Compared to the groin region group, the lateral malleolus region group showed skin colors that were closer to the original color of the palm in terms of lightness and red/green values. Additionally, the lateral malleolus region group received better esthetic ratings in the POSAS. Our results revealed that using the lateral malleolus region for FTSGs in palmar reconstruction resulted in better outcomes than using the groin region, even over a long period.

Prognostic significance of the metastatic lymph node ratio in patients with gastric cancer.

BACKGROUND: In gastric cancer, the classification of lymph node status is still a controversial prognostic factor. Recent studies have proposed a new prognostic factor (metastatic lymph node ratio: MLR) for gastric cancer patients who undergo curative resection. The present study tested the hypothesis that MLR was better than the current pN staging system by analyzing the correlation between MLR and the International Union Against Cancer/American Joint Committee on Cancer (UICC/AJCC) staging system, by analyzing the correlation between MLR and 5-year overall survival (OS), by comparing area under the curve (AUC), and by performing univariate and multivariate analyses for OS. METHODS: Of 409 patients who were diagnosed with gastric adenocarcinoma between January 2003 and December 2006, 370 patients underwent curative resection and were included in this study. The prognostic significance of the number of metastatic lymph nodes and the metastatic lymph node ratio were compared in AUC and univariate and multivariate Cox regression analyses. RESULTS: MLR was significantly correlated with the depth of invasion and the number of lymph node metastases (p < 0.001). Increasing MLR also was statistically correlated with a lower 5-year OS rate (p < 0.001). The AUC of MLR and the number of lymph node metastases were not significantly different (p = 0.825). MLR was an independent prognostic factor on multivariate analysis, but the number of metastatic lymph nodes was not. CONCLUSIONS: MLR can be a prognostic factor in patients who undergo radical resection for gastric cancer and can overcome the limitations of existing prognostic factors.

Removal of Hexavalent Chromium(VI) from Wastewater Using Chitosan-Coated Iron Oxide Nanocomposite Membranes.

Chromium is a toxic and carcinogenic heavy metal that originates from various human activities. Therefore, the effective removal of chromium from aqueous solutions is an extremely important global challenge. Herein, we report a chitosan-coated iron oxide nanoparticle immobilized hydrophilic poly(vinylidene) fluoride membrane (Chi@Fe2O3-PVDF) which can potentially be used for efficient removal of hexavalent chromium(VI) by a simple filtration process. Membrane filtration is an easy and efficient method for treating large volumes of water in a short duration. The adsorption experiments were conducted by batch and continuous in-flow systems. The experimental data showed rapid capture of hexavalent chromium (Cr(VI)) which can be explained by the pseudo-second-order kinetic and Langmuir isotherm model. The nanocomposite membrane exhibited high adsorption capacity for Cr(VI) (14.451 mg/g in batch system, 14.104 mg/g in continuous in-flow system). Moreover, its removal efficiency was not changed significantly in the presence of several competing ions, i.e., Cl-, NO3-, SO42-, and PO43-. Consequently, the Chi@Fe2O3-PVDF-based filtration process is expected to show a promising direction and be developed as a practical method for wastewater treatment.

Rapid and Efficient Removal of Anionic Dye in Water Using a Chitosan-Coated Iron Oxide-Immobilized Polyvinylidene Fluoride Membrane.

Anionic dyes are one of the most serious contaminants in water as these molecules are known to be toxic to many living organisms. Herein, we report the development of functionalized polyvinylidene fluoride membranes modified with chitosan-coated iron oxide nanomaterials (Fe-PVDF) for the efficient treatment of anionic dye-contaminated water. Aqueous solutions of anionic dyes could be captured rapidly by passing through the functionalized membrane under reduced pressure. Under neutral conditions, Fe-PVDF showed a maximum removal capacity of 74.6 mg/g for Evans blue (EB) through the adsorption process. In addition, the adsorption capacity was significantly enhanced up to 434.78 mg/g under acidic conditions. The adsorption process for EB matched well with the Langmuir model, indicating monolayer adsorption of the dye to the membrane surface. Moreover, Fe-PVDF can be reusable by a simple washing step in an alkaline solution, and thus, the composite membrane was applied several times without a significant decrease in its adsorption performance. The same composite membrane was further applied to the removal of five other different anionic dyes with high efficiencies. The adsorption mechanism can be explained by the electrostatic interaction between the positively charged chitosan and the negatively charged dye as well as the affinity of the sulfate groups in dye molecules for the surface of the iron oxide nanoparticles. The easy preparation and rapid decolorization procedures make this composite membrane suitable for efficient water treatment.

Decrease in Sleep Duration and Poor Sleep Quality over Time Is Associated with an Increased Risk of Incident Non-Alcoholic Fatty Liver Disease.

The impact of changes in sleep duration and sleep quality over time on the risk of non-alcoholic fatty liver disease (NAFLD) is not known. We investigated whether changes in sleep duration and in sleep quality between baseline and follow-up are associated with the risk of developing incident NAFLD. The cohort study included 86,530 Korean adults without NAFLD and with a low fibrosis score at baseline. The median follow-up was 3.6 years. Sleep duration and quality were assessed using the Pittsburgh Sleep Quality Index. Hepatic steatosis (HS) and liver fibrosis were assessed using ultrasonography and the fibrosis-4 index (FIB-4). Cox proportional hazard models were used to determine hazard ratios (HRs) and 95% confidence intervals (Cis). A total of 12,127 subjects with incident HS and 559 with incident HS plus intermediate/high FIB-4 was identified. Comparing the decrease in sleep duration of >1 h, with stable sleep duration, the multivariate-adjusted HR (95% CIs) for incident HS was 1.24 (1.15-1.35). The corresponding HRs for incident HS plus intermediate/high FIB-4 was 1.58 (1.10-2.29). Comparing persistently poor sleep quality with persistently good sleep quality, the multivariate-adjusted HR for incident HS was 1.13 (95% CI, 1.05-1.20). A decrease in sleep duration or poor sleep quality over time was associated with an increased risk of incident NAFLD, underscoring an important potential role for good sleep in preventing NAFLD risk.

Biologic filler using human fibroblasts and placenta extracts.

Soft tissue augmentation with injectable materials has been a challenging problem for plastic and reconstructive surgeons. Although filler materials have been used for soft tissue augmentation, adverse effects such as inflammation, distortion, and repeated procedures due to absorption still exist. In this study, biologic filler containing human fibroblasts and placenta extracts was developed to overcome these problems as a concept of cell therapy.In an in vivo assay, 40 nude mice were divided into 4 groups: 1 control group and 3 experimental groups. Biologic fillers containing human fibroblasts untreated (control), cultured with 0.1% placenta extract (group 1), cultured with 10% fetal bovine serum (group 2), and cultured with both 0.1% placenta extract and 10% fetal bovine serum (group 3) were used in each groups. Cultured human fibroblasts were injected into the back of each mouse with fibrin glue to maintain the shape and volume. These groups were compared during an 8-week period. The gross, histologic, and biomolecular studies were proceeded to evaluate the effect of biologic filler.In geometric maintenance, volumes in experimental groups were 1.6 (group 1), 1.2 (group 2), and 1.9 times (group 3) more reserved than that in the untreated control group (control) at 8 weeks. In histology, abundant proliferation of fibroblasts as well as extracellular matrices including collagen and glycosaminoglycan was visualized in experimental groups. Enzyme-linked immunosorbent assay was used to analyze collagen and glycosaminoglycan, and reverse transcription-polymerase chain reaction was used to analyze the messenger RNA expression of COL1A1, a gene for collagen type 1, which shows a significant difference between control and experimental groups. There is no statistically significant difference between groups 1 and 2; on the other hand, group 3 statistically has the best outcome among the experimental groups.

Prognostic value of carcinoembryonic antigen and carbohydrate antigen 19-9 in periampullary cancer patients receiving pancreaticoduodenectomy.

BACKGROUND: We assessed the use of serum concentrations of carbohydrate antigen (CA) 19-9 and carcinoembryonic antigen (CEA) measured during the preoperative diagnostic workup as prognostic factors for survival in patients with periampullary carcinoma. METHODS: A retrospective review of patients diagnosed with periampullary carcinoma who underwent radical surgery was conducted. Factors related to the survival of periampullary carcinoma patients, including CA 19-9 and CEA, were analyzed. RESULTS: The mean age of the 112 patients included in the results was 66.41 ± 10.513 years. In the study, the percentage of patients with elevated serum CA 19-9 and CEA concentrations was 65.2% and 24.1%, respectively. CA 19-9 concentrations were correlated with the tumor stage, pre-operative jaundice, and lymphovascular invasion, but CEA concentrations were not. The median overall survival was longer for the normal serum CA 19-9 group than the group with increased CA 19-9 (56 months vs. 25 months, p = 0.003); however, there was no statistically significant difference between the normal serum CEA group and the group with increased CEA (43 months vs. 25 months, p = 0.077). Independent factors related to overall survival were sex, age, stage, presence of jaundice, lymphovascular invasion, perineural invasion, margin status, and elevated serum CA 19-9 concentrations. CONCLUSIONS: Periampullary carcinoma patients with elevated serum CA 19-9 concentrations at diagnosis are expected to have poor overall survival. CA 19-9 may be a useful marker for predicting prognosis in patients with periampullary carcinoma at the time of diagnosis.