Metasurfaces have attracted great attention due to their ability to manipulate the phase,amplitude,and polarization of light in a compact form.Tunable metasurfaces have been investigated recently through the integrati...Metasurfaces have attracted great attention due to their ability to manipulate the phase,amplitude,and polarization of light in a compact form.Tunable metasurfaces have been investigated recently through the integration with mechanically moving components and electrically tunable elements.Two interesting applications,in particular,are to vary the focal point of metalenses and to switch between holographic images.We present the recent progress on tunable metasurfaces focused on metalenses and metaholograms,including the basic working principles,advantages,and disadvantages of each working mechanism.We classify the tunable stimuli based on the light source and electrical bias,as well as others such as thermal and mechanical modulation.We conclude by summarizing the recent progress of metalenses and metaholograms,and providing our perspectives for the further development of tunable metasurfaces.展开更多
AIM To evaluate the prognostic value of the neutrophil-tolymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in patients with colorectal cancer(CRC).METHODS Between April 1996 and December 2010, medical record...AIM To evaluate the prognostic value of the neutrophil-tolymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in patients with colorectal cancer(CRC).METHODS Between April 1996 and December 2010, medical records from a total of 1868 patients with CRC were retrospectively reviewed. The values of simple inflammatory markers including NLR and PLR in predicting the long-term outcomes of these patients were evaluated using Kaplan-Meier curves and Cox regression models.RESULTS The median follow-up duration was 46 mo(interquartile range, 22-73). The estimation of NLR and PLR was based on the time of diagnosis. In multivariate Cox regression analysis, high NLR (≥ 3.0) and high PLR(≥ 160) were independent risk factors predicting poor long-term outcomes in patients with stage Ⅲ and Ⅳ CRC. However, high NLR and high PLR were not prognostic factors in patients with stage Ⅰ and Ⅱ CRC.CONCLUSION In this study, we identified that high NLR (≥ 3.0) and high PLR (≥ 160) are useful prognostic factors to predict long-term outcomes in patients with stage Ⅲ and Ⅳ CRC.展开更多
AIM： To identify patients with a high-risk of having a synchronous cancer among gastric cancer patients. METHODS： We retrospectively analyzed the prospective gastric cancer database at the National Cancer Center, Ko...AIM： To identify patients with a high-risk of having a synchronous cancer among gastric cancer patients. METHODS： We retrospectively analyzed the prospective gastric cancer database at the National Cancer Center, Korea from December 2000 to December 2004. The clinicopathological characteristics of patients with synchronous cancers and those of patients without synchronous cancers were compared. Multivariate analysis was performed to identify the risk factors for the presence of a synchronous cancer in gastric cancer patients. RESULTS： 111 of 3291 gastric cancer patients （3.4%） registered in the database had a synchronous cancer. Among these 111 patients, 109 had a single synchronous cancer and 2 patients had two synchronous cancers. The most common form of synchronous cancer was colorectal cancer （42 patients, 37.2%） followed by lung cancer （21 patients, 18.6%）. Multivariate analyses revealed that elderly patients with differentiated early gastric cancer have a higher probability of a synchronous cancer. CONCLUSION： Synchronous cancers in gastric cancer patients are not infrequent. The physicians should try to find synchronous cancers in gastric cancer patients, especially in the elderly with a differentiated early gastric展开更多
Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding, and guidelines for gastrointestinal bleeding are divided into two separate sections, they may not be distinguished f...Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding, and guidelines for gastrointestinal bleeding are divided into two separate sections, they may not be distinguished from each other in clinical practice. Most patients are first observed with signs of bleeding such as hematemesis, melena, and hematochezia. When a patient with these symptoms presents to the emergency room, endoscopic diagnosis and treatment are considered together with appropriate initial resuscitation. Especially, in cases of variceal bleeding, it is important for the prognosis that the endoscopy is performed immediately after the patient stabilizes. In cases of suspected lower gastrointestinal bleeding, full colonoscopy after bowel preparation is effective in distinguishing the cause of the bleeding and treating with hemostasis. The therapeutic aspect of endoscopy, using the mechanical method alone or injection with a certain modality rather than injection alone, can increase the success rate of bleeding control. Therefore, it is important to consider the origin of bleeding and how to approach it. In this article, we aim to review the role of endoscopy in diagnosis, treatment, and prognosis in patients with acute gastrointestinal bleeding in a real clinical setting.展开更多
AIM: To evaluate the eff icacy of colonoscopy follow-up after short-term anti-tuberculosis treatment in patients with nonspecific ulcers on ileocecal areas being suspicious of tuberculous colitis. METHODS: We prospect...AIM: To evaluate the eff icacy of colonoscopy follow-up after short-term anti-tuberculosis treatment in patients with nonspecific ulcers on ileocecal areas being suspicious of tuberculous colitis. METHODS: We prospectively analyzed the colonoscopic fi ndings before and after short term anti- tuberculosis treatment in 18 patients with nonspecifi c ulcers on the ileocecal area and compared them with 7 patients of confi rmed tuberculous colitis by acid-fast bacilli or caseating granuloma on colonic biopsy. RESULTS: Mean duration for short-term follow- up was 107.3 d with combined chemotherapy containing isoniazid, rifampicin, ethambutol and pyrazinamide. Seven patients with tuberculous colitis showed complete healing of active ulcers after short- term medication. After short-term anti-tuberculosis treatment, follow-up colonoscopy findings devided 18 patients with nonspecific ulcers into two groups by ulcer state. One is the "suspicious tuberculous colitis group" showing healing of ulcers and erosions and another is the "suspicious inflammatory bowel disease group" showing active ulcers with or without aggravation of the lesion. Finally, all 9 of the "suspicious tuberculous colitis group" were diagnosed as tuberculous colitis showing no recurrence of ulcers after termination of 9 mo of anti-tuberculosis medication. Patients of the "suspicious inflammatorybowel disease group" were f inally diagnosed as Crohn's disease or nonspecifi c colonic ulcers during long-term follow up. CONCLUSION: Follow-up colonoscopy shows a healing stage ulcer or scarring change without an active ulcer with just 2 mo to 3 mo of medication in patients with tuberculous colitis. Colonoscopy follow-up after short term anti-tuberculosis trial in patients with nonspecif ic ulcers on the ileocecal area is valuable in making early differential diagnosis of tuberculous colitis.展开更多
AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonogra...AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonography （US） were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS： The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% （10/58）; 22-15 mm, 25.4% （4/26）, and 16-20 mm, 50% （5/20）. The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% （P 〈 0.05）, respectively. EUS correctly distinguished 12 （63.2%） of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm （4/10, 40%） than for polyps greater than 1.0 cm （8/9, 88.9%） （P = 0.02）.CONCLUSION： Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.展开更多
Background:Cancer-associated fibroblasts(CAFs)play an important role in the induction of chemo-resistance.This study aimed to clarify the mechanism underlying CAF-mediated resistance to two tyrosine kinase inhibitors(...Background:Cancer-associated fibroblasts(CAFs)play an important role in the induction of chemo-resistance.This study aimed to clarify the mechanism underlying CAF-mediated resistance to two tyrosine kinase inhibitors(TKIs),sorafenib and lenvatinib,and to identify a novel therapeutic target for overcoming TKI resistance in hepatocellular carcinoma(HCC).Methods:We performed a systematic integrative analysis of publicly available gene expression datasets and whole-transcriptome sequencing data from 9 pairs of CAFs and para-cancer fibroblasts isolated from human HCC and para-tumor tissues,respectively,to identify key molecules that might induce resistance to TKIs.We then performed in vitro and in vivo experiments to validate selected targets and related mechanisms.The associations of plasma secreted phosphoprotein 1(SPP1)expression levels before sorafenib/lenvatinib treatment with progression-free survival(PFS)and overall survival(OS)of 54 patients with advanced HCC were evaluated using Kaplan-Meier and Cox regression analysis.Results:Bioinformatic analysis identified CAF-derived SPP1 as a candidate molecule driving TKI resistance.SPP1 inhibitors reversed CAF-induced TKI resistance in vitro and in vivo.CAF-derived SPP1 activated rapidly accelerated fibrosarcoma(RAF)/mitogen-activated protein kinase(MAPK)and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)through the integrin-protein kinase C-alpha(PKCα)signaling pathway and promoted epithelial-to-mesenchymal transition(EMT).A high plasma SPP1 level before TKI treatment was identified as an independent predictor of poor PFS(P=0.026)and OS(P=0.047)in patients with advanced HCC after TKI treatment.Conclusions:CAF-derived SPP1 enhances TKI resistance in HCC via bypass activation of oncogenic signals and EMT promotion.Its inhibition represents a promising therapeutic strategy against TKI resistance inHCC.Moreover,plasma SPP1 level before TKI treatment represents a potential biomarker for treatment response prediction.展开更多
AIM： To determine the accuracy of 1.5-T magnetic resonance imaging （MRI） in the evaluation of gastric wall invasion and perigastric lymph node metastasis in gastric adenocarcinoma.METHODS： Twenty resected gastric ...AIM： To determine the accuracy of 1.5-T magnetic resonance imaging （MRI） in the evaluation of gastric wall invasion and perigastric lymph node metastasis in gastric adenocarcinoma.METHODS： Twenty resected gastric specimens containing 20 tumors were studied with a 1.5-T MR system using a commercial head surface coil. MR scanning was performed with a T1 weighted image （TR/TE = 500/20）, and a T2 weighted image （TR/TE = 2500/90）. MR findings were compared with pathologic findings.RESULTS： A T1-weighted image demonstrated three layers in the normal gastric wall. All of the gastric tumors were well demonstrated by lesions and location. In a MRI findings of gastric wall invasion, there was 1 case of T1, 7 of T2, 11 of T3. Pathologic results of resected specimens included 3 cases of pT1, 4 of pT2, and 12 of pT3. The accuracy of T staging with MRI was 74% （14 of 19）. MRI findings of lymph node metastasis included 6 cases of NO, 13 cases of N1. The accuracy of the N staging with MRI was 47% （9 of 19）.CONCLUSION： MRI has a high diagnostic accuracy in the evaluation of the T staging of gastric cancerin vitro and thus potentially enables preoperative histopathologic staging.展开更多
AIM:To investigate the efficacy of cap-fitted colonoscopy(CFC) with regard to cecal intubation time.METHODS:Two hundred and ninety-five patients undergoing screening colonoscopy at Gospel Hospital,Kosin University Col...AIM:To investigate the efficacy of cap-fitted colonoscopy(CFC) with regard to cecal intubation time.METHODS:Two hundred and ninety-five patients undergoing screening colonoscopy at Gospel Hospital,Kosin University College of Medicine were enrolled in this randomized controlled trial between January and December 2010.Colonoscopies were conducted by a single endoscopist.Patient characteristics including age,sex,body mass index,history of abdominal surgery,quality of preparation,and the presence of diverticulosis were recorded.RESULTS:One hundred and fifty patients were allocated into a CFC group and 145 into a non-CFC(NCF) group.Cecal intubations were achieved in all patients.Cecal intubation time in the CFC group was significantly shorter than in the NCF group for specific conditions:age ≥ 60 years,prior abdominal surgery,and poor bowel preparation.The number of detected adenomas was higher in the CFC group than in the NCF group(P = 0.040).CONCLUSION:CFC facilitated shortening of the cecal intubation time in difficult cases,and was more sensitive for detecting adenomas than was NCF.展开更多
Although electrical stimulation is therapeutically applied for neural regeneration in patients, it remains unclear how electrical stimulation exerts its effects at the molecular level on spinal cord injury （SCI）. To...Although electrical stimulation is therapeutically applied for neural regeneration in patients, it remains unclear how electrical stimulation exerts its effects at the molecular level on spinal cord injury （SCI）. To identify the signaling pathway involved in electrical stimulation improving the function of injured spinal cord, 21 female Sprague-Dawley rats were randomly assigned to three groups： control （no surgical intervention, n = 6）, SCI （SCI only, n = 5）, and electrical simulation （ES; SCI induction followed by ES treatment, n = 10）. A complete spinal cord transection was performed at the 10^th thoracic level. Electrical stimulation of the injured spinal cord region was applied for 4 hours per day for 7 days. On days 2 and 7 post SCI, the Touch-Test Sensory Evaluators and the Basso-Beattie-Bresnahan locomotor scale were used to evaluate rat sensory and motor function. Somatosensory-evoked potentials of the tibial nerve of a hind paw of the rat were measured to evaluate the electrophysiological function of injured spinal cord. Western blot analysis was performed to measure p38-RhoA and ERK1/2-Bcl-2 pathways related protein levels in the injured spinal cord. Rat sensory and motor functions were similar between SCI and ES groups. Com- pared with the SCI group, in the ES group, the latencies of the somatosensory-evoked potential of the tibial nerve of rats were significantly shortened, the amplitudes were significantly increased, RhoA protein level was significantly decreased, protein gene product 9.5 expression, ERK1/2, p38, and Bcl-2 protein levels in the spinal cord were significantly increased. These data suggest that ES can promote the recovery of electrophysiological function of the injured spinal cord through regulating p38-RhoA and ERK1/2-Bcl-2 pathway-related protein levels in the injured spinal cord.展开更多
Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarc...Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarcinoma.Here we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the stomach.The tumor was completely excised by endoscopic snare polypectomy.FGPs should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.展开更多
AIM:To investigate the relationship between the function of vagus nerve and peptide YY 3-36 and ghrelin levels after subtotal gastrectomy.METHODS:We enrolled a total of 16 patients who underwent subtotal gastrectomy d...AIM:To investigate the relationship between the function of vagus nerve and peptide YY 3-36 and ghrelin levels after subtotal gastrectomy.METHODS:We enrolled a total of 16 patients who underwent subtotal gastrectomy due to gastric cancer.All surgeries were performed by a single skilled surgeon.We measured peptide YY 3-36,ghrelin,leptin,insulin,growth hormone levels,and body weight immediately before and one month after surgery.RESULTS:Vagus nerve preservation group showed less body weight loss and less increase of peptide YY 3-36 compared with vagotomy group(-5.56 ± 2.24 kg vs-7.85 ± 1.57 kg,P = 0.037 and 0.06 ± 0.08 ng/mL vs 0.19 ± 0.12 ng/mL,P = 0.021,respectively).Moreover,patients with body weight loss of less than 10% exhibited reduced elevation of peptide YY 3-36 level,typically less than 20% [6(66.7%) vs 0(0.0%),P = 0.011,odd ratio = 3.333,95% confidence interval(1.293,8.591)].CONCLUSION:Vagus nerve preservation contributes to the maintenance of body weight after gastrectomy,and this phenomenon may be related to the suppressed activity of peptide YY 3-36.展开更多
In this study, we aimed to investigate the prevalence and perception of premature ejaculation （PE） in young and middle-aged Korean men. The study was conducted using an Internet-assisted questionnaire. A total of 2 ...In this study, we aimed to investigate the prevalence and perception of premature ejaculation （PE） in young and middle-aged Korean men. The study was conducted using an Internet-assisted questionnaire. A total of 2 037 Korean male adults, aged 20 years or older, were randomly sampled based on age and residency. The questionnaire developed by the PE Study Group of the Korean Andrological Society includes four categories （overall sexual function, symptoms, distress and treatment） with a total of 16 questions. For each question, symptoms were evaluated by a scale ranging from 0 to 10. Intravaginal ejaculation latency time was ‘5-10 min＇ in 38.6%, followed by ‘longer than 10 min＇ in 2919%, ‘2-5 min＇ in 23.6%, ‘1-2 min＇ in 5.4% and ‘shorter than 1 min＇ in 2.5%. In our series, 27.5% of respondents reported having PE. Control over ejaculation within a recent 3-month period was 6.2 points on average. Respondent complaints of PE-related stress averaged 7.1 points and stress-related complaints from sexual partners averaged 7.1 points. The effect of PE on sexual life was 6.8 points. Of the respondents determined as having PE, 42.6% responded that they were inclined to receive treatment. Results from this study suggest that the prevalence of PE diagnosed by the respondent on his own was approximately 27.5% in young and middle-aged men in Korea. PE-related stress had a significant effect on the stress, sexual activity and quality of life of the respondent and his sexual partner.展开更多
Previous reports of a solitary metastatic hepatocellular carcinoma have been rare. Because this tumor has a different treatment modality and prognosis, an accurate differential diagnosis is essential. Here we report a...Previous reports of a solitary metastatic hepatocellular carcinoma have been rare. Because this tumor has a different treatment modality and prognosis, an accurate differential diagnosis is essential. Here we report a rare case of a solitary chest wall metastasis from unknown primary site of hepatocellular carcinoma. It involves a 51-year-old man who was admitted to our hospital because of a palpable left upper chest wall mass. The mass was resected and pathologic examination confirmed a diagnosis of metastatic hepatocellular carcinoma. Despite our investigation, no evidence was found that indicated the primary origin of the hepatocellular carcinoma. Four months later, the patient was admitted again because of spinal cord compression at the third and fourth thoracic vertebrae. Emergent decompressive laminectomy was performed and microscopic features revealed the same pathology as the initial chest wall mass resected 4 months earlier. After one year, a follow-up abdominal computed tomography （CT） still revealed no evidence of primary hepatocellular carcinoma.展开更多
The shift of dark-grown seedlings into light causes enormous transcriptome changes followed by a dramatic developmental transition.Here,we show that microRNA(miRNA)biogenesis also undergoes regulatory changes during d...The shift of dark-grown seedlings into light causes enormous transcriptome changes followed by a dramatic developmental transition.Here,we show that microRNA(miRNA)biogenesis also undergoes regulatory changes during de-etiolation.Etiolated seedlings maintain low levels of primary miRNAs(pri-miRNAs)and miRNA processing core proteins,such as Dicer-like 1,SERRATE,and HYPONASTIC LEAVES 1,whereas during de-etiolation both pri-miRNAs and the processing components accumulate to high levels.However,the levels of most miRNAs do not notably increase in response to light.To reconcile this inconsistency,we demonstrated that an unknown suppressor decreases miRNA-processing activity and light-induced SMALL RNA DEGRADING NUCLEASE 1 shortens the half-life of several miRNAs in de-etiolated seedlings.Taken together,these data suggest a novel mechanism,miRNA-biogenetic inconsistency,which accounts for the intricacy of miRNA biogenesis during de-etiolation.This mechanism is essential for the survival of de-etiolated seedlings after long-term skotomorphogenesis and their optimal adaptation to ever-changing light conditions.展开更多
A conventional electrode composite for rechargeable zinc-ion batteries(ZIBs)includes a binder for strong adhesion between the electrode material and the current collector.However,the introduction of a binder leads to ...A conventional electrode composite for rechargeable zinc-ion batteries(ZIBs)includes a binder for strong adhesion between the electrode material and the current collector.However,the introduction of a binder leads to electrochemical inactivity and low electrical conductivity,resulting in the decay of the capacity and a low rate capability.We present a binder-and conducting agent-free VO_(2) composite electrode using in situ polymerization of dopamine on a flexible current collector of pyroprotein-based fibers.The as-fabricated composite electrode was used as a substrate for the direct growth of VO_(2) as a self-supported form on polydopamine-derived pyroprotein-based fibers(pp-fibers@VO_(2)(B)).It has a high conductivity and flexible nature as a current collector and moderate binding without conventional binders and conducting agents for the VO_(2)(B) cathode.In addition,their electrochemical mechanism was elucidated.Their energy storage is induced by Zn^(2+)/H^(+) coinsertion during discharging,which can be confirmed by the lattice expansion,the formation of by-products including Zn_(x)(OTf)_(y)(OH)_(2x−y)·nH_(2)O,and the reduction of V^(4+)to V^(3+).Furthermore,the assembled Zn//pp-fibers@VO_(2)(B) pouch cells have excellent flexibility and stable electrochemical performance under various bending states,showing application possibilities for portable and wearable power sources.展开更多
AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of F...AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of FDG uptake of BM in gastric carcinoma.METHODS We retrospectively enrolled 309 gastric cancer patients who underwent staging FDG PET/CT and curative surgical resection. FDG uptake of primary tumor was visually classified as positive or negative FDG uptake. Mean FDG uptake of BM(BM SUV) and BM-to-liver uptake ratio(BLR) were measured. The relationships of BM SUV or BLR with clinical factors were evaluated. The prognostic values of BM SUV, BLR, and other clinical factors for predicting recurrence-free survival(RFS) and overall survival(OS) were assessed.RESULTS Of 309 patients, 38 patients(12.3%) experienced cancer recurrence and 18 patients(5.8%) died. Patients with advanced gastric cancer, positive FDG uptake, and recurrence had higher values of BM SUV and BLR than those with early gastric cancer, negative FDG uptake, and no recurrence(P < 0.05). BM SUV and BLR were significantly correlated with hemoglobin level, neutrophil-to-lymphocyte ratio, and platelet-tolymphocyte ratio(P < 0.05). On multivariate analysis, multiple tumors, T stage, lymph node metastasis, tumor involvement of resection margin, and BLR were significantly associated with RFS(P < 0.05). T stage, lymph node metastasis, hemoglobin level, and BLR were significantly associated with OS(P < 0.05). CONCLUSION BLR on PET/CT was an independent prognostic factor for RFS and OS in gastric cancer patients with curative surgical resection.展开更多
Alzheimer's disease(AD)is the most serious age-related neurodegenerative disease and causes destructive and irreversible cognitive decline.Failures in the development of therapeutics targeting amyloid-β(Aβ)and t...Alzheimer's disease(AD)is the most serious age-related neurodegenerative disease and causes destructive and irreversible cognitive decline.Failures in the development of therapeutics targeting amyloid-β(Aβ)and tau;principal proteins inducing pathology in AD,suggest a paradigm shift towards the development of new therapeutic targets.The gram-negative bacteria and lipopolysaccharides(LPS)are attractive new targets for AD treatment.Surprisingly,an altered distribution of gram-negative bacteria and their LPS has been reported in AD patients.Moreover,gram-negative bacteria and their LPS have been shown to affect a variety of AD-related pathologies,such as Aβ homeostasis,tau pathology,neuroinflammation,and neurodegeneration.Moreover,therapeutic approaches targeting gram-negative bacteria or gram-negative bacterial molecules have significantly alleviated AD-related pathology and cognitive dysfunction.Despite multiple evidence showing that the gram-negative bacteria and their LPS play a crucial role in AD pathogenesis,the pathogenic mechanisms of gram-negative bacteria and their LPS have not been clarified.Here,we summarize the roles and pathomechanisms of gram-negative bacteria and LPS in AD.Furthermore,we discuss the possibility of using gram-negative bacteria and gram-negative bacterial molecules as novel therapeutic targets and new pathological characteristics for AD.展开更多
Ultra-high performance concrete (UHPC) is featured by a compressive strength 5 times higher than that of ordinary concrete and by a high durability owing to the control of the chloride penetration speed by its dense s...Ultra-high performance concrete (UHPC) is featured by a compressive strength 5 times higher than that of ordinary concrete and by a high durability owing to the control of the chloride penetration speed by its dense structure. The high strength characteristics of UHPC offer numerous advantages like the reduction of the quantities of cables and foundations by the design of a lightweight superstructure in the case of the long-span bridge preserving its structural performance through axial forces and structures governed by compression. This study conducted the conceptual design of a hybrid cable-stayed bridge with central span of 1000 m and exploiting 200 MPa-class UHPC. The economic efficiency of the conceptual design results of the hybrid cable-stayed bridge with central span of 1000 m and of Sutong Bridge, the longest cable-stayed bridge in the world, was analyzed.展开更多
BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation...BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation,and forceful vomiting can potentially lead to esophageal perforation,as reported in several previous cases.However,pharyngeal perforation during bowel preparation has not been previously documented.Here,we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.CASE SUMMARY A 38-year-old man with a history of hypertension,dyslipidemia,diabetes mellitus,and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain.The patient complained of sudden pain in the neck,throat,and anterior chest following forceful vomiting during bowel preparation.Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation,and upper gastrointestinal endoscopy revealed pharyngeal perforation.The perforation site was located above the upper esophageal sphincter,which distinguished it from Boerhaave’s syndrome.Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist,considering the patient's mild symptoms,stable vital signs,and the small size of the lesion;the perforation resolved without endoscopic or surgical intervention.The patient was discharged from hospital two weeks after the perforation.CONCLUSION Despite its rarity,pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.展开更多
基金financially supported by the POSCO-POSTECH-RIST Convergence Research Center program funded by POSCOthe National Research Foundation (NRF) grants (Grant Nos. NRF2019R1A2C3003129, CAMM-2019M3A6B3030637, and NRF-2019R1A5A8080290) funded by the Ministry of Science and ICT, Republic of Korea+1 种基金the Hyundai Motor Chung Mong-Koo fellowshipthe NRF fellowship (Grant No. NRF-2021R1A6A3A13038935) funded by the Ministry of Education, Republic of Korea
文摘Metasurfaces have attracted great attention due to their ability to manipulate the phase,amplitude,and polarization of light in a compact form.Tunable metasurfaces have been investigated recently through the integration with mechanically moving components and electrically tunable elements.Two interesting applications,in particular,are to vary the focal point of metalenses and to switch between holographic images.We present the recent progress on tunable metasurfaces focused on metalenses and metaholograms,including the basic working principles,advantages,and disadvantages of each working mechanism.We classify the tunable stimuli based on the light source and electrical bias,as well as others such as thermal and mechanical modulation.We conclude by summarizing the recent progress of metalenses and metaholograms,and providing our perspectives for the further development of tunable metasurfaces.
文摘AIM To evaluate the prognostic value of the neutrophil-tolymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in patients with colorectal cancer(CRC).METHODS Between April 1996 and December 2010, medical records from a total of 1868 patients with CRC were retrospectively reviewed. The values of simple inflammatory markers including NLR and PLR in predicting the long-term outcomes of these patients were evaluated using Kaplan-Meier curves and Cox regression models.RESULTS The median follow-up duration was 46 mo(interquartile range, 22-73). The estimation of NLR and PLR was based on the time of diagnosis. In multivariate Cox regression analysis, high NLR (≥ 3.0) and high PLR(≥ 160) were independent risk factors predicting poor long-term outcomes in patients with stage Ⅲ and Ⅳ CRC. However, high NLR and high PLR were not prognostic factors in patients with stage Ⅰ and Ⅱ CRC.CONCLUSION In this study, we identified that high NLR (≥ 3.0) and high PLR (≥ 160) are useful prognostic factors to predict long-term outcomes in patients with stage Ⅲ and Ⅳ CRC.
文摘AIM： To identify patients with a high-risk of having a synchronous cancer among gastric cancer patients. METHODS： We retrospectively analyzed the prospective gastric cancer database at the National Cancer Center, Korea from December 2000 to December 2004. The clinicopathological characteristics of patients with synchronous cancers and those of patients without synchronous cancers were compared. Multivariate analysis was performed to identify the risk factors for the presence of a synchronous cancer in gastric cancer patients. RESULTS： 111 of 3291 gastric cancer patients （3.4%） registered in the database had a synchronous cancer. Among these 111 patients, 109 had a single synchronous cancer and 2 patients had two synchronous cancers. The most common form of synchronous cancer was colorectal cancer （42 patients, 37.2%） followed by lung cancer （21 patients, 18.6%）. Multivariate analyses revealed that elderly patients with differentiated early gastric cancer have a higher probability of a synchronous cancer. CONCLUSION： Synchronous cancers in gastric cancer patients are not infrequent. The physicians should try to find synchronous cancers in gastric cancer patients, especially in the elderly with a differentiated early gastric
文摘Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding, and guidelines for gastrointestinal bleeding are divided into two separate sections, they may not be distinguished from each other in clinical practice. Most patients are first observed with signs of bleeding such as hematemesis, melena, and hematochezia. When a patient with these symptoms presents to the emergency room, endoscopic diagnosis and treatment are considered together with appropriate initial resuscitation. Especially, in cases of variceal bleeding, it is important for the prognosis that the endoscopy is performed immediately after the patient stabilizes. In cases of suspected lower gastrointestinal bleeding, full colonoscopy after bowel preparation is effective in distinguishing the cause of the bleeding and treating with hemostasis. The therapeutic aspect of endoscopy, using the mechanical method alone or injection with a certain modality rather than injection alone, can increase the success rate of bleeding control. Therefore, it is important to consider the origin of bleeding and how to approach it. In this article, we aim to review the role of endoscopy in diagnosis, treatment, and prognosis in patients with acute gastrointestinal bleeding in a real clinical setting.
文摘AIM: To evaluate the eff icacy of colonoscopy follow-up after short-term anti-tuberculosis treatment in patients with nonspecific ulcers on ileocecal areas being suspicious of tuberculous colitis. METHODS: We prospectively analyzed the colonoscopic fi ndings before and after short term anti- tuberculosis treatment in 18 patients with nonspecifi c ulcers on the ileocecal area and compared them with 7 patients of confi rmed tuberculous colitis by acid-fast bacilli or caseating granuloma on colonic biopsy. RESULTS: Mean duration for short-term follow- up was 107.3 d with combined chemotherapy containing isoniazid, rifampicin, ethambutol and pyrazinamide. Seven patients with tuberculous colitis showed complete healing of active ulcers after short- term medication. After short-term anti-tuberculosis treatment, follow-up colonoscopy findings devided 18 patients with nonspecific ulcers into two groups by ulcer state. One is the "suspicious tuberculous colitis group" showing healing of ulcers and erosions and another is the "suspicious inflammatory bowel disease group" showing active ulcers with or without aggravation of the lesion. Finally, all 9 of the "suspicious tuberculous colitis group" were diagnosed as tuberculous colitis showing no recurrence of ulcers after termination of 9 mo of anti-tuberculosis medication. Patients of the "suspicious inflammatorybowel disease group" were f inally diagnosed as Crohn's disease or nonspecifi c colonic ulcers during long-term follow up. CONCLUSION: Follow-up colonoscopy shows a healing stage ulcer or scarring change without an active ulcer with just 2 mo to 3 mo of medication in patients with tuberculous colitis. Colonoscopy follow-up after short term anti-tuberculosis trial in patients with nonspecif ic ulcers on the ileocecal area is valuable in making early differential diagnosis of tuberculous colitis.
文摘AIM： To assess the ability of endoscopic ultrasonography （EUS） to differentiate neoplastic from non- neoplastic polypoid lesions of the gallbladder （PLGs）.METHODS： The uses of EUS and transabdominal ultrasonography （US） were retrospectively analyzed in 94 surgical cases of gallbladder polyps less than 20 mm in diameter.RESULTS： The prevalence of neoplastic lesions with a diameter of 5-20 mm was 27.2% （10/58）; 22-15 mm, 25.4% （4/26）, and 16-20 mm, 50% （5/20）. The overall diagnostic accuracies of EUS and US for small PLGs were 80.9% and 63.9% （P 〈 0.05）, respectively. EUS correctly distinguished 12 （63.2%） of 19 neoplastic PLGs but was less accurate for polyps less than 1.0 cm （4/10, 40%） than for polyps greater than 1.0 cm （8/9, 88.9%） （P = 0.02）.CONCLUSION： Although EUS was more accurate than US, its accuracy for differentiating neoplastic from non-neoplastic PLGs less than 1.0 cm was low. Thus, EUS alone is not sufficient for determining a treatment strategy for PLGs of less than 1.0 cm.
文摘Background:Cancer-associated fibroblasts(CAFs)play an important role in the induction of chemo-resistance.This study aimed to clarify the mechanism underlying CAF-mediated resistance to two tyrosine kinase inhibitors(TKIs),sorafenib and lenvatinib,and to identify a novel therapeutic target for overcoming TKI resistance in hepatocellular carcinoma(HCC).Methods:We performed a systematic integrative analysis of publicly available gene expression datasets and whole-transcriptome sequencing data from 9 pairs of CAFs and para-cancer fibroblasts isolated from human HCC and para-tumor tissues,respectively,to identify key molecules that might induce resistance to TKIs.We then performed in vitro and in vivo experiments to validate selected targets and related mechanisms.The associations of plasma secreted phosphoprotein 1(SPP1)expression levels before sorafenib/lenvatinib treatment with progression-free survival(PFS)and overall survival(OS)of 54 patients with advanced HCC were evaluated using Kaplan-Meier and Cox regression analysis.Results:Bioinformatic analysis identified CAF-derived SPP1 as a candidate molecule driving TKI resistance.SPP1 inhibitors reversed CAF-induced TKI resistance in vitro and in vivo.CAF-derived SPP1 activated rapidly accelerated fibrosarcoma(RAF)/mitogen-activated protein kinase(MAPK)and phosphatidylinositol 3-kinase(PI3K)/protein kinase B(AKT)/mammalian target of rapamycin(mTOR)through the integrin-protein kinase C-alpha(PKCα)signaling pathway and promoted epithelial-to-mesenchymal transition(EMT).A high plasma SPP1 level before TKI treatment was identified as an independent predictor of poor PFS(P=0.026)and OS(P=0.047)in patients with advanced HCC after TKI treatment.Conclusions:CAF-derived SPP1 enhances TKI resistance in HCC via bypass activation of oncogenic signals and EMT promotion.Its inhibition represents a promising therapeutic strategy against TKI resistance inHCC.Moreover,plasma SPP1 level before TKI treatment represents a potential biomarker for treatment response prediction.
文摘AIM： To determine the accuracy of 1.5-T magnetic resonance imaging （MRI） in the evaluation of gastric wall invasion and perigastric lymph node metastasis in gastric adenocarcinoma.METHODS： Twenty resected gastric specimens containing 20 tumors were studied with a 1.5-T MR system using a commercial head surface coil. MR scanning was performed with a T1 weighted image （TR/TE = 500/20）, and a T2 weighted image （TR/TE = 2500/90）. MR findings were compared with pathologic findings.RESULTS： A T1-weighted image demonstrated three layers in the normal gastric wall. All of the gastric tumors were well demonstrated by lesions and location. In a MRI findings of gastric wall invasion, there was 1 case of T1, 7 of T2, 11 of T3. Pathologic results of resected specimens included 3 cases of pT1, 4 of pT2, and 12 of pT3. The accuracy of T staging with MRI was 74% （14 of 19）. MRI findings of lymph node metastasis included 6 cases of NO, 13 cases of N1. The accuracy of the N staging with MRI was 47% （9 of 19）.CONCLUSION： MRI has a high diagnostic accuracy in the evaluation of the T staging of gastric cancerin vitro and thus potentially enables preoperative histopathologic staging.
文摘AIM:To investigate the efficacy of cap-fitted colonoscopy(CFC) with regard to cecal intubation time.METHODS:Two hundred and ninety-five patients undergoing screening colonoscopy at Gospel Hospital,Kosin University College of Medicine were enrolled in this randomized controlled trial between January and December 2010.Colonoscopies were conducted by a single endoscopist.Patient characteristics including age,sex,body mass index,history of abdominal surgery,quality of preparation,and the presence of diverticulosis were recorded.RESULTS:One hundred and fifty patients were allocated into a CFC group and 145 into a non-CFC(NCF) group.Cecal intubations were achieved in all patients.Cecal intubation time in the CFC group was significantly shorter than in the NCF group for specific conditions:age ≥ 60 years,prior abdominal surgery,and poor bowel preparation.The number of detected adenomas was higher in the CFC group than in the NCF group(P = 0.040).CONCLUSION:CFC facilitated shortening of the cecal intubation time in difficult cases,and was more sensitive for detecting adenomas than was NCF.
基金supported by a grant from Wonkwang Institute of Clinical Medicine in 2011
文摘Although electrical stimulation is therapeutically applied for neural regeneration in patients, it remains unclear how electrical stimulation exerts its effects at the molecular level on spinal cord injury （SCI）. To identify the signaling pathway involved in electrical stimulation improving the function of injured spinal cord, 21 female Sprague-Dawley rats were randomly assigned to three groups： control （no surgical intervention, n = 6）, SCI （SCI only, n = 5）, and electrical simulation （ES; SCI induction followed by ES treatment, n = 10）. A complete spinal cord transection was performed at the 10^th thoracic level. Electrical stimulation of the injured spinal cord region was applied for 4 hours per day for 7 days. On days 2 and 7 post SCI, the Touch-Test Sensory Evaluators and the Basso-Beattie-Bresnahan locomotor scale were used to evaluate rat sensory and motor function. Somatosensory-evoked potentials of the tibial nerve of a hind paw of the rat were measured to evaluate the electrophysiological function of injured spinal cord. Western blot analysis was performed to measure p38-RhoA and ERK1/2-Bcl-2 pathways related protein levels in the injured spinal cord. Rat sensory and motor functions were similar between SCI and ES groups. Com- pared with the SCI group, in the ES group, the latencies of the somatosensory-evoked potential of the tibial nerve of rats were significantly shortened, the amplitudes were significantly increased, RhoA protein level was significantly decreased, protein gene product 9.5 expression, ERK1/2, p38, and Bcl-2 protein levels in the spinal cord were significantly increased. These data suggest that ES can promote the recovery of electrophysiological function of the injured spinal cord through regulating p38-RhoA and ERK1/2-Bcl-2 pathway-related protein levels in the injured spinal cord.
文摘Fundic gland polyps(FGPs)are currently the most common type of gastric polyps and are usually benign.However,although rare,gastric adenocarcinoma of FGP has been recently proposed as a new variant of gastric adenocarcinoma.Here we report the first case of a49-year-old woman with focal signet ring cell carcinoma that arose from an FGP of the stomach.The tumor was completely excised by endoscopic snare polypectomy.FGPs should therefore be evaluated for malignant changes although they occur rarely,if the FGP has an erosive or irregular surface.
文摘AIM:To investigate the relationship between the function of vagus nerve and peptide YY 3-36 and ghrelin levels after subtotal gastrectomy.METHODS:We enrolled a total of 16 patients who underwent subtotal gastrectomy due to gastric cancer.All surgeries were performed by a single skilled surgeon.We measured peptide YY 3-36,ghrelin,leptin,insulin,growth hormone levels,and body weight immediately before and one month after surgery.RESULTS:Vagus nerve preservation group showed less body weight loss and less increase of peptide YY 3-36 compared with vagotomy group(-5.56 ± 2.24 kg vs-7.85 ± 1.57 kg,P = 0.037 and 0.06 ± 0.08 ng/mL vs 0.19 ± 0.12 ng/mL,P = 0.021,respectively).Moreover,patients with body weight loss of less than 10% exhibited reduced elevation of peptide YY 3-36 level,typically less than 20% [6(66.7%) vs 0(0.0%),P = 0.011,odd ratio = 3.333,95% confidence interval(1.293,8.591)].CONCLUSION:Vagus nerve preservation contributes to the maintenance of body weight after gastrectomy,and this phenomenon may be related to the suppressed activity of peptide YY 3-36.
文摘In this study, we aimed to investigate the prevalence and perception of premature ejaculation （PE） in young and middle-aged Korean men. The study was conducted using an Internet-assisted questionnaire. A total of 2 037 Korean male adults, aged 20 years or older, were randomly sampled based on age and residency. The questionnaire developed by the PE Study Group of the Korean Andrological Society includes four categories （overall sexual function, symptoms, distress and treatment） with a total of 16 questions. For each question, symptoms were evaluated by a scale ranging from 0 to 10. Intravaginal ejaculation latency time was ‘5-10 min＇ in 38.6%, followed by ‘longer than 10 min＇ in 2919%, ‘2-5 min＇ in 23.6%, ‘1-2 min＇ in 5.4% and ‘shorter than 1 min＇ in 2.5%. In our series, 27.5% of respondents reported having PE. Control over ejaculation within a recent 3-month period was 6.2 points on average. Respondent complaints of PE-related stress averaged 7.1 points and stress-related complaints from sexual partners averaged 7.1 points. The effect of PE on sexual life was 6.8 points. Of the respondents determined as having PE, 42.6% responded that they were inclined to receive treatment. Results from this study suggest that the prevalence of PE diagnosed by the respondent on his own was approximately 27.5% in young and middle-aged men in Korea. PE-related stress had a significant effect on the stress, sexual activity and quality of life of the respondent and his sexual partner.
文摘Previous reports of a solitary metastatic hepatocellular carcinoma have been rare. Because this tumor has a different treatment modality and prognosis, an accurate differential diagnosis is essential. Here we report a rare case of a solitary chest wall metastasis from unknown primary site of hepatocellular carcinoma. It involves a 51-year-old man who was admitted to our hospital because of a palpable left upper chest wall mass. The mass was resected and pathologic examination confirmed a diagnosis of metastatic hepatocellular carcinoma. Despite our investigation, no evidence was found that indicated the primary origin of the hepatocellular carcinoma. Four months later, the patient was admitted again because of spinal cord compression at the third and fourth thoracic vertebrae. Emergent decompressive laminectomy was performed and microscopic features revealed the same pathology as the initial chest wall mass resected 4 months earlier. After one year, a follow-up abdominal computed tomography （CT） still revealed no evidence of primary hepatocellular carcinoma.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Science,ICT and Future Planning(NRF-2017R1A2B4010255 and 2018R1A6A1A03025607)NRF-2017R1A6A3A11035981 to M.Y.R.+1 种基金and NRF-2017H1A2A1044209 to S.W.C.The research was supported in part by Brain Korea 21(BK21)PLUS programS.W.C.and G.M.K.are fellowship awardees of the BK21 PLUS program.The research in Hungary was supported by grants from the Economic Development and Innovation Operative Program(GINOP-2.3.2-15-2016-00015 and GINOP-2.3.2-15-2016-00032).
文摘The shift of dark-grown seedlings into light causes enormous transcriptome changes followed by a dramatic developmental transition.Here,we show that microRNA(miRNA)biogenesis also undergoes regulatory changes during de-etiolation.Etiolated seedlings maintain low levels of primary miRNAs(pri-miRNAs)and miRNA processing core proteins,such as Dicer-like 1,SERRATE,and HYPONASTIC LEAVES 1,whereas during de-etiolation both pri-miRNAs and the processing components accumulate to high levels.However,the levels of most miRNAs do not notably increase in response to light.To reconcile this inconsistency,we demonstrated that an unknown suppressor decreases miRNA-processing activity and light-induced SMALL RNA DEGRADING NUCLEASE 1 shortens the half-life of several miRNAs in de-etiolated seedlings.Taken together,these data suggest a novel mechanism,miRNA-biogenetic inconsistency,which accounts for the intricacy of miRNA biogenesis during de-etiolation.This mechanism is essential for the survival of de-etiolated seedlings after long-term skotomorphogenesis and their optimal adaptation to ever-changing light conditions.
基金supported by“Regional Innovation Strategy (RIS)”through the National Research Foundation of Korea (NRF)funded by the Ministry of Education (MOE) (2021RIS-001)supported by National Research Foundation (NRF)funded by the Ministry of Science and Technology (NRF-2021R1F1A1064111)Ministry of Education (NRF-2017R1A6A1A06015181)of the Republic of Korea.
文摘A conventional electrode composite for rechargeable zinc-ion batteries(ZIBs)includes a binder for strong adhesion between the electrode material and the current collector.However,the introduction of a binder leads to electrochemical inactivity and low electrical conductivity,resulting in the decay of the capacity and a low rate capability.We present a binder-and conducting agent-free VO_(2) composite electrode using in situ polymerization of dopamine on a flexible current collector of pyroprotein-based fibers.The as-fabricated composite electrode was used as a substrate for the direct growth of VO_(2) as a self-supported form on polydopamine-derived pyroprotein-based fibers(pp-fibers@VO_(2)(B)).It has a high conductivity and flexible nature as a current collector and moderate binding without conventional binders and conducting agents for the VO_(2)(B) cathode.In addition,their electrochemical mechanism was elucidated.Their energy storage is induced by Zn^(2+)/H^(+) coinsertion during discharging,which can be confirmed by the lattice expansion,the formation of by-products including Zn_(x)(OTf)_(y)(OH)_(2x−y)·nH_(2)O,and the reduction of V^(4+)to V^(3+).Furthermore,the assembled Zn//pp-fibers@VO_(2)(B) pouch cells have excellent flexibility and stable electrochemical performance under various bending states,showing application possibilities for portable and wearable power sources.
基金Supported by Soonchunhyang University Research Fund and Research Fund of Catholic Kwandong University International St.Mary's Hospital
文摘AIM To determine the relationship between F-18 fluorodeoxyglucose(FDG) uptake of bone marrow(BM) on positron emission tomography/computed tomography(PET/CT) and clinical factors and to assess the prognostic value of FDG uptake of BM in gastric carcinoma.METHODS We retrospectively enrolled 309 gastric cancer patients who underwent staging FDG PET/CT and curative surgical resection. FDG uptake of primary tumor was visually classified as positive or negative FDG uptake. Mean FDG uptake of BM(BM SUV) and BM-to-liver uptake ratio(BLR) were measured. The relationships of BM SUV or BLR with clinical factors were evaluated. The prognostic values of BM SUV, BLR, and other clinical factors for predicting recurrence-free survival(RFS) and overall survival(OS) were assessed.RESULTS Of 309 patients, 38 patients(12.3%) experienced cancer recurrence and 18 patients(5.8%) died. Patients with advanced gastric cancer, positive FDG uptake, and recurrence had higher values of BM SUV and BLR than those with early gastric cancer, negative FDG uptake, and no recurrence(P < 0.05). BM SUV and BLR were significantly correlated with hemoglobin level, neutrophil-to-lymphocyte ratio, and platelet-tolymphocyte ratio(P < 0.05). On multivariate analysis, multiple tumors, T stage, lymph node metastasis, tumor involvement of resection margin, and BLR were significantly associated with RFS(P < 0.05). T stage, lymph node metastasis, hemoglobin level, and BLR were significantly associated with OS(P < 0.05). CONCLUSION BLR on PET/CT was an independent prognostic factor for RFS and OS in gastric cancer patients with curative surgical resection.
基金funded by the Basic Science Research Program of the National Research Foundation of Korea(NRF)which is funded by the Ministry of Science,ICT&Future Planning(NRF-2018R1D1A3B07041059 to M.M.and NRF-2016R1A5A2012284 to Y.-M.R)+3 种基金by the Cooperative Research Program for Agriculture Science and Technology Development(Project No.PJ01428603)Rural Development Administration,Republic of Koreaby the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare,Republic of Korea(grant number:HF21C0021).
文摘Alzheimer's disease(AD)is the most serious age-related neurodegenerative disease and causes destructive and irreversible cognitive decline.Failures in the development of therapeutics targeting amyloid-β(Aβ)and tau;principal proteins inducing pathology in AD,suggest a paradigm shift towards the development of new therapeutic targets.The gram-negative bacteria and lipopolysaccharides(LPS)are attractive new targets for AD treatment.Surprisingly,an altered distribution of gram-negative bacteria and their LPS has been reported in AD patients.Moreover,gram-negative bacteria and their LPS have been shown to affect a variety of AD-related pathologies,such as Aβ homeostasis,tau pathology,neuroinflammation,and neurodegeneration.Moreover,therapeutic approaches targeting gram-negative bacteria or gram-negative bacterial molecules have significantly alleviated AD-related pathology and cognitive dysfunction.Despite multiple evidence showing that the gram-negative bacteria and their LPS play a crucial role in AD pathogenesis,the pathogenic mechanisms of gram-negative bacteria and their LPS have not been clarified.Here,we summarize the roles and pathomechanisms of gram-negative bacteria and LPS in AD.Furthermore,we discuss the possibility of using gram-negative bacteria and gram-negative bacterial molecules as novel therapeutic targets and new pathological characteristics for AD.
文摘Ultra-high performance concrete (UHPC) is featured by a compressive strength 5 times higher than that of ordinary concrete and by a high durability owing to the control of the chloride penetration speed by its dense structure. The high strength characteristics of UHPC offer numerous advantages like the reduction of the quantities of cables and foundations by the design of a lightweight superstructure in the case of the long-span bridge preserving its structural performance through axial forces and structures governed by compression. This study conducted the conceptual design of a hybrid cable-stayed bridge with central span of 1000 m and exploiting 200 MPa-class UHPC. The economic efficiency of the conceptual design results of the hybrid cable-stayed bridge with central span of 1000 m and of Sutong Bridge, the longest cable-stayed bridge in the world, was analyzed.
文摘BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation,and forceful vomiting can potentially lead to esophageal perforation,as reported in several previous cases.However,pharyngeal perforation during bowel preparation has not been previously documented.Here,we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.CASE SUMMARY A 38-year-old man with a history of hypertension,dyslipidemia,diabetes mellitus,and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain.The patient complained of sudden pain in the neck,throat,and anterior chest following forceful vomiting during bowel preparation.Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation,and upper gastrointestinal endoscopy revealed pharyngeal perforation.The perforation site was located above the upper esophageal sphincter,which distinguished it from Boerhaave’s syndrome.Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist,considering the patient's mild symptoms,stable vital signs,and the small size of the lesion;the perforation resolved without endoscopic or surgical intervention.The patient was discharged from hospital two weeks after the perforation.CONCLUSION Despite its rarity,pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.
