Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis...Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma(CCA), and chronic proliferative inflammation may be involved in biliary carcinogenesis and in inducing the upregulation of cell-proliferating factors. With the use of advanced imaging modalities, there has been much improvement in the management of hepatolithiasis and the diagnosis of hepatolithiasis-associated CCA(HLCCA). However, there are many problems in managing the strictures in hepatolithiasis and differentiating them from infiltrating types of CCA. Surgical resection is recommended in cases of single lobe hepatolithiasis with atrophy, uncontrolled stricture, symptom duration of more than 10 years, and long history of biliaryenteric anastomosis. Even after resection, patients should be followed with caution for development of HL-CCA, because HL-CCA is an independent prognostic factor for survival. It is not yet clear whether hepatic resection can reduce the occurrence of subsequent HL-CCA. Furthermore, there are no consistent findings regarding prediction of subsequent HL-CCA in patients with hepatolithiasis. In the management of hepatolithiasis, important factors are the reduction of recurrence of cholangitis and suspicion of unrecognized HL-CCA.展开更多
AIM: To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS: We compared prospectively SES...AIM: To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS: We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile duct stones (≥ 15 mm). When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS: No significant differences were observed in the mean largest stone size (A: 20.8 mm, B: 21.3 mm), bile duct diameter (A: 21.4 turn, B: 20.5 ram), number of stones (A: 2.2, B: 2.3), or procedure time (A: 18 min, B: 19 rain) between the two groups. The rates of complete stone removal with one session was 85% in group A and 86% in group B (P = 0.473). Mechanical lithotripsy was required for stone removal in nine of 27 patients (33%) in group A and nine of 28 patients (32%, P = 0.527) in group B.CONCLUSION: SES + ELBD did not show significant benefits compared to conventional EST, especially for the removal of large (≥ 15 mm) bile duct stones.展开更多
In this paper, several periodic Hamming correlation lower bounds for frequency hopping sequences with low hit zone, with respect to the size p of the frequency slot set, the sequence length L, the family size M, low h...In this paper, several periodic Hamming correlation lower bounds for frequency hopping sequences with low hit zone, with respect to the size p of the frequency slot set, the sequence length L, the family size M, low hit zone LH ( or no hit zone NH ), the maximum periodic Hamming autocorrelation sidelobe Ha and the maximum periodic Hamming crosscorrelation He, are established. It is shown that the new bounds include the known LempeI-Greenberger bounds, T.S. Seay bounds and Peng-Fan bounds for the conventional frequency hopping sequences as special cases.展开更多
AIM: To examine how High-mobility group box I (HMGB1) regulates hepatocyte apoptosis and, furthermore, to determine whether glycyrrhizin (GL), a known HMGB1 inhibitor, prevents HMGBl-induced hepatocyte apoptosis.
To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patien...To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.RESULTSThe median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.展开更多
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
The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum i...The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation.展开更多
In the future electronics,all device components will be connected wirelessly to displays that serve as information input and/or output ports.There is a growing demand of flexible and wearable displays,therefore,for in...In the future electronics,all device components will be connected wirelessly to displays that serve as information input and/or output ports.There is a growing demand of flexible and wearable displays,therefore,for information input/output of the nextgeneration consumer electronics.Among many kinds of light-emitting devices for these next-generation displays,quantum dot light-emitting diodes(QLEDs)exhibit unique advantages,such as wide color gamut,high color purity,high brightness with low turn-on voltage,and ultrathin form factor.Here,we review the recent progress on flexible QLEDs for the next-generation displays.First,the recent technological advances in device structure engineering,quantum-dot synthesis,and high-resolution full-color patterning are summarized.Then,the various device applications based on cutting-edge quantum dot technologies are described,including flexible white QLEDs,wearable QLEDs,and flexible transparent QLEDs.Finally,we showcase the integration of flexible QLEDs with wearable sensors,micro-controllers,and wireless communication units for the next-generation wearable electronics.展开更多
AIM:To evaluate the efficacy and safety of three different concentrations of diluted atropine for the control of myopia in Korean children,and to assess the risk factors associated with rapid myopia progression.METH...AIM:To evaluate the efficacy and safety of three different concentrations of diluted atropine for the control of myopia in Korean children,and to assess the risk factors associated with rapid myopia progression.METHODS:A total of 285 children,with refractive errors within the range of-6 diopters(D)between 5 and 14 years of age were included.After using 0.01%,or 0.025%,or 0.05% atropine,for about 1y,changes in refraction,axial lengths and frequency of adverse events were analyzed.Logistic regression analyses were performed to evaluate the risk factors associated with rapid myopia progression.RESULTS:The changes in the mean spherical equivalent values were -0.134 D/mo in the before atropine group,-0.070 D/mo in the 0.01% atropine group,-0.047 D/mo in the 0.025% atropine group,and -0.019 D/mo in the 0.05% atropine group,with significant differences between the groups(P〈0.001).The axial elongation was 0.046 mm/mo,0.037 mm/mo,0.025 mm/mo,and 0.019 mm/mo respectively,with significant differences between the groups(P=0.003).The incidence of photophobia and near vision difficulty was not different among the three atropine groups(P=0.425and P=0.356,respectively).Multivariate logistic regression analyses showed that only highly myopic parents were a significant predictive factor of rapid myopia progression in Korean children(odds ratio,8.155;95% confidence interval,3.626-18.342;P〈0.001).CONCLUSION:Treatment with 0.01%,0.025% and 0.05% atropine solution inhibits myopia progression in Korean children in a dose-dependent manner.Children with highly myopic parents preferentially shows a rapid myopia progression rate.展开更多
Endoscopic submucosal dissection(ESD) is currently widely accepted as a standard treatment option for early gastrointestinal neoplasms in Korea.However,ESD has technical difficulties and a longer procedure time than c...Endoscopic submucosal dissection(ESD) is currently widely accepted as a standard treatment option for early gastrointestinal neoplasms in Korea.However,ESD has technical difficulties and a longer procedure time than conventional endoscopic resection.So it may have a higher risk of complications than conventional endoscopic resection techniques.We,the ESD study group of Korean Society of Gastrointestinal Endoscopy,have experienced many complications,mostly treated by endoscopic or conservative management.Here,we introduce and share our experiences for managementof post ESD complications and review published papers on the topic.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 investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS: Consecutive patients w...AIM: To investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire. RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than nonnfected patients [34/396 (8.6%) vs 145/2684 (5.4%), P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation (P = 0.008). Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis. CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.展开更多
Wnt/β-catenin regulates cellular functions related to tumor initiation and progression, cell proliferation, differ- entiation, survival, and adhesion, β-Catenin-independent Wnt pathways have been proposed to regulat...Wnt/β-catenin regulates cellular functions related to tumor initiation and progression, cell proliferation, differ- entiation, survival, and adhesion, β-Catenin-independent Wnt pathways have been proposed to regulate cell polarity and migration, including metastasis. In this review, we discuss the possible roles of both β-catenin-dependent and -independent signaling pathways in tumor progression, with an emphasis on their regulation of Rho-family GTPases, cytoskeletal remodeling, and relationships with cell-cell adhesion and cilia/ciliogenesis.展开更多
AIM:To systematically assess the association between diabetes and incidence of gastric cancer.METHODS:We searched MedLine (PubMed),EMBASE,and the Cochrane Library without any limitations with respect to publication da...AIM:To systematically assess the association between diabetes and incidence of gastric cancer.METHODS:We searched MedLine (PubMed),EMBASE,and the Cochrane Library without any limitations with respect to publication date or language,we also searched the references of qualifying articles.Casecontrol studies and cohort studies comparing the risk of gastric cancer between diabetic patients and control subjects were included.We excluded studies reporting only standardized incidence ratios without control groups and those that investigated only mortality but not incidence.Seventeen studies met our criteria,and the qualities of these studies were assessed using theNewcastle-Ottawa Quality Assessment Scale.We performed a meta-analysis of pre-existing diabetes and gastric cancer incidence using the DerSimonian-Laird method for random-effects.For subgroup analyses,we separated the studies by study type,region,sex and method to determine confounding factors and reliability.We also conducted subgroup analyses to examine the effects of smoking,Helicobacter pylori (H.pylori) infection,and cancer site.Publication bias was evaluated using Begg's test.RESULTS:A random-effects model meta-analysis showed an increased gastric cancer risk in diabetic patients [relative risk (RR)=1.19;95%CI:1.08-1.31].Subgroup analyses indicated that this result persisted in cohort studies (RR=1.20;95%CI:1.08-1.34),in studies on populations of both Western (RR=1.18;95%CI:1.03-1.36) and Eastern countries (RR=1.19;95%CI:1.02-1.38),in a female subgroup (RR=1.24;95%CI:1.01-1.52),and in highly qualified studies (RR=1.17;95%CI:1.05-1.31).Moreover,these results persisted when the analysis was confined to studies adjusted for well-known gastric cancer risk factors such as smoking (RR=1.17;95%CI:1.01-1.34) and H.pylori infection (RR=2.35;95%CI:1.24-4.46).CONCLUSION:Pre-existing diabetes mellitus may increase the risk of gastric cancer by approximately 19%.This effect seems to be unrelated to geographical region.展开更多
To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in ...To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed. RESULTSOverall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95). CONCLUSIONThe recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.展开更多
AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic pseudo-obstruction.METHODS:Consecutive 42 patients who underwent surgery for chronic constipation withi...AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic pseudo-obstruction.METHODS:Consecutive 42 patients who underwent surgery for chronic constipation within the last 13 years were prospectively collected.We identified a subgroup with colonic pseudo-obstruction(CPO) features,with dilatation of the colon proximal to the narrowed transitional zone,in contrast to typical slowtransit constipation(STC),without any dilated colonic segments.The outcomes of surgical treatments for chronic constipation with features of CPO were analyzed and compared with outcomes for STC.RESULTS:Of the 42 patients who underwent surgery for constipation,33 patients had CPO with dilatation of the colon proximal to the narrowed transitional zone.There were 16 males and 17 females with a mean age of 51.2 ± 16.1 years.All had symptoms of chronic intestinal obstruction,including abdominal distension,pain,nausea,or vomiting,and the mean duration of symptoms was 67 mo(range:6-252 mo).Preoperative defecation frequency was 1.5 ± 0.6 times/wk(range:1-2 times/wk).Thirty-two patients underwent total colectomy,and one patient underwent diverting transverse colostomy.There was no surgery-related mortality.Postoperative histologic examination showed hypoganglionosis or agangliosis in 23 patients and hypoganglionosis combined with visceral neuropathy or myopathy in 10 patients.In contrast,histology of STC group revealed intestinal neuronal dysplasia type B(n = 6) and visceral myopathy(n = 3).Early postoperative complications developed in six patients with CPO;wound infection(n = 3),paralytic ileus(n = 2),and intraabdominal abscess(n = 1).Defecation frequencies 3 mo after surgery improved to 4.2 ± 3.2 times/d(range:1-15 times/d).Long-term follow-up(median:39.7 mo) was available in 32 patients;all patients had improvements in constipation symptoms,but two patients needed intermittent medication for management of diarrhea.All 32 patients had distinct improvements in constipation symptoms(with a 展开更多
AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed...AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were included.Study subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 mo.Complete virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific an展开更多
文摘Although the incidence of hepatolithiasis is decreasing as the pattern of gallstone disease changes in Asia, the prevalence of hepatolithiasis is persistently high, especially in Far Eastern countries. Hepatolithiasis is an established risk factor for cholangiocarcinoma(CCA), and chronic proliferative inflammation may be involved in biliary carcinogenesis and in inducing the upregulation of cell-proliferating factors. With the use of advanced imaging modalities, there has been much improvement in the management of hepatolithiasis and the diagnosis of hepatolithiasis-associated CCA(HLCCA). However, there are many problems in managing the strictures in hepatolithiasis and differentiating them from infiltrating types of CCA. Surgical resection is recommended in cases of single lobe hepatolithiasis with atrophy, uncontrolled stricture, symptom duration of more than 10 years, and long history of biliaryenteric anastomosis. Even after resection, patients should be followed with caution for development of HL-CCA, because HL-CCA is an independent prognostic factor for survival. It is not yet clear whether hepatic resection can reduce the occurrence of subsequent HL-CCA. Furthermore, there are no consistent findings regarding prediction of subsequent HL-CCA in patients with hepatolithiasis. In the management of hepatolithiasis, important factors are the reduction of recurrence of cholangitis and suspicion of unrecognized HL-CCA.
文摘AIM: To compare small sphincterotomy combined with endoscopic papillary large balloon dilation (SES + ELBD) and endoscopic sphincterotomy (EST) for large bile duct stones. METHODS: We compared prospectively SES + ELBD (group A, n = 27) with conventional EST (group B, n = 28) for the treatment of large bile duct stones (≥ 15 mm). When the stone could not be removed with a normal basket, mechanical lithotripsy was performed. We compared the rates of complete stone removal with one session and application of mechanical lithotripsy. RESULTS: No significant differences were observed in the mean largest stone size (A: 20.8 mm, B: 21.3 mm), bile duct diameter (A: 21.4 turn, B: 20.5 ram), number of stones (A: 2.2, B: 2.3), or procedure time (A: 18 min, B: 19 rain) between the two groups. The rates of complete stone removal with one session was 85% in group A and 86% in group B (P = 0.473). Mechanical lithotripsy was required for stone removal in nine of 27 patients (33%) in group A and nine of 28 patients (32%, P = 0.527) in group B.CONCLUSION: SES + ELBD did not show significant benefits compared to conventional EST, especially for the removal of large (≥ 15 mm) bile duct stones.
基金This work was supported by the National Natural Science Foundation of China (Grant No. 60572142) the NSFC/RFBR Joint Research Scheme, the NSFC/K0SEF Joint Research Scheme, and IITA, South Korea.
文摘In this paper, several periodic Hamming correlation lower bounds for frequency hopping sequences with low hit zone, with respect to the size p of the frequency slot set, the sequence length L, the family size M, low hit zone LH ( or no hit zone NH ), the maximum periodic Hamming autocorrelation sidelobe Ha and the maximum periodic Hamming crosscorrelation He, are established. It is shown that the new bounds include the known LempeI-Greenberger bounds, T.S. Seay bounds and Peng-Fan bounds for the conventional frequency hopping sequences as special cases.
基金Supported by Samsung Biomedical Research Institute grant,No.SBRI C-A8-219-1
文摘AIM: To examine how High-mobility group box I (HMGB1) regulates hepatocyte apoptosis and, furthermore, to determine whether glycyrrhizin (GL), a known HMGB1 inhibitor, prevents HMGBl-induced hepatocyte apoptosis.
文摘To clarify the role of neoadjuvant concurrent chemoradiotherapy (NACCRT) followed by surgical resection for localized or locally advanced perihilar cholangiocarcinoma (CCA).METHODSWe retrospectively reviewed 57 patients who underwent surgical resection with or without NACCRT for perihilar CCA; 12 patients received NACCRT and 45 patients did not received NACCRT. Patients with locally advanced perihilar CCA requiring NACCRT were defined as follows: (1) a mass involving unilateral branches of the portal vein or hepatic artery with insufficient volume of the anticipated remnant lobe; or (2) an infiltrating mass in the main portal vein that was too long for reconstruction, identified at preoperative staging.RESULTSThe median disease-free survival (DFS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 26.0 and 15.1 mo, respectively (P = 0.91). The median overall survival (OS) durations of the neoadjuvant and non-neoadjuvant CCRT groups were 32.9 and 27.1 mo, respectively (P = 0.26). The NACCRT group showed a downstaging tendency compared to the non-NACCRT group as compared with the tumor stage confirmed by histological examination after surgery and the tumor stage confirmed by imaging test at the time of diagnosis (P = 0.01).CONCLUSIONNACCRT does not prolong DFS and OS in localized or locally advanced perihilar CCA. However, NACCRT may allow tumor downstaging and improve tumor resectability.
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.
基金Supported by grant from the Korea Healthcare Technology R and D Project,Ministry of Health and Welfare,South Korea,No.A100054
文摘The excess consumption of alcohol is associated with alcoholic liver diseases(ALD). ALD is a major healthcare problem, personal and social burden, and significant reason for economic loss worldwide. The ALD spectrum includes alcoholic fatty liver, alcoholic hepatitis, cirrhosis, and the development of hepatocellular carcinoma. The diagnosis of ALD is based on a combination of clinical features, including a history of significant alcohol intake, evidence of liver disease, and laboratory findings. Abstinence is the most important treatment for ALD and the treatment plan varies according to the stage of the disease. Various treatments including abstinence, nutritional therapy, pharmacological therapy, psychotherapy, and surgery are currently available. For severe alcoholic hepatitis, corticosteroid or pentoxifylline are recommended based on the guidelines. In addition, new therapeutic targets are being under investigation.
基金This research was supported by IBS-R006-D1 and IBS-R006-A1.
文摘In the future electronics,all device components will be connected wirelessly to displays that serve as information input and/or output ports.There is a growing demand of flexible and wearable displays,therefore,for information input/output of the nextgeneration consumer electronics.Among many kinds of light-emitting devices for these next-generation displays,quantum dot light-emitting diodes(QLEDs)exhibit unique advantages,such as wide color gamut,high color purity,high brightness with low turn-on voltage,and ultrathin form factor.Here,we review the recent progress on flexible QLEDs for the next-generation displays.First,the recent technological advances in device structure engineering,quantum-dot synthesis,and high-resolution full-color patterning are summarized.Then,the various device applications based on cutting-edge quantum dot technologies are described,including flexible white QLEDs,wearable QLEDs,and flexible transparent QLEDs.Finally,we showcase the integration of flexible QLEDs with wearable sensors,micro-controllers,and wireless communication units for the next-generation wearable electronics.
基金Supported by the Catholic Medical Center Research Foundation made in the program year of 2018(No.5-2018-B0001-00006)
文摘AIM:To evaluate the efficacy and safety of three different concentrations of diluted atropine for the control of myopia in Korean children,and to assess the risk factors associated with rapid myopia progression.METHODS:A total of 285 children,with refractive errors within the range of-6 diopters(D)between 5 and 14 years of age were included.After using 0.01%,or 0.025%,or 0.05% atropine,for about 1y,changes in refraction,axial lengths and frequency of adverse events were analyzed.Logistic regression analyses were performed to evaluate the risk factors associated with rapid myopia progression.RESULTS:The changes in the mean spherical equivalent values were -0.134 D/mo in the before atropine group,-0.070 D/mo in the 0.01% atropine group,-0.047 D/mo in the 0.025% atropine group,and -0.019 D/mo in the 0.05% atropine group,with significant differences between the groups(P〈0.001).The axial elongation was 0.046 mm/mo,0.037 mm/mo,0.025 mm/mo,and 0.019 mm/mo respectively,with significant differences between the groups(P=0.003).The incidence of photophobia and near vision difficulty was not different among the three atropine groups(P=0.425and P=0.356,respectively).Multivariate logistic regression analyses showed that only highly myopic parents were a significant predictive factor of rapid myopia progression in Korean children(odds ratio,8.155;95% confidence interval,3.626-18.342;P〈0.001).CONCLUSION:Treatment with 0.01%,0.025% and 0.05% atropine solution inhibits myopia progression in Korean children in a dose-dependent manner.Children with highly myopic parents preferentially shows a rapid myopia progression rate.
文摘Endoscopic submucosal dissection(ESD) is currently widely accepted as a standard treatment option for early gastrointestinal neoplasms in Korea.However,ESD has technical difficulties and a longer procedure time than conventional endoscopic resection.So it may have a higher risk of complications than conventional endoscopic resection techniques.We,the ESD study group of Korean Society of Gastrointestinal Endoscopy,have experienced many complications,mostly treated by endoscopic or conservative management.Here,we introduce and share our experiences for managementof post ESD complications and review published papers on the topic.
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.
基金Supported by The Korean Society of Gastroenterology Research Fund, No. 2005-1
文摘AIM: To investigate prevalence of C/onorchis sinensis in patients with gastrointestinal symptoms, and the relation of the infection to hepatobiliary diseases in 26 hospitals in Korea. METHODS: Consecutive patients who had been admitted to the Division of Gastroenterology with gastrointestinal symptoms were enrolled from March to April 2005. Of those who had been diagnosed with clonorchiasis, epidemiology and correlation between infection and hepatobiliary diseases were surveyed by questionnaire. RESULTS: Of 3080 patients with gastrointestinal diseases, 396 (12.9%) had clonorchiasis and 1140 patients (37.2%) had a history of eating raw freshwater fish. Of those with a history of raw freshwater fish ingestion, 238 (20.9%) patients had clonorchiasis. Cholangiocarcinoma was more prevalent in C. sinensis-infected patients than nonnfected patients [34/396 (8.6%) vs 145/2684 (5.4%), P = 0.015]. Cholangiocarcinoma and clonorchiasis showed statistically significant positive cross-relation (P = 0.008). Choledocholithiasis, cholecystolithiasis, cholangitis, hepatocellular carcinoma, and biliary pancreatitis did not correlate with clonorchiasis. CONCLUSION: Infection rate of clonorchiasis was still high in patients with gastrointestinal diseases in Korea, and has not decreased very much during the last two decades. Cholangiocarcinoma was related to clonorchiasis, which suggested an etiological role for the parasite.
文摘Wnt/β-catenin regulates cellular functions related to tumor initiation and progression, cell proliferation, differ- entiation, survival, and adhesion, β-Catenin-independent Wnt pathways have been proposed to regulate cell polarity and migration, including metastasis. In this review, we discuss the possible roles of both β-catenin-dependent and -independent signaling pathways in tumor progression, with an emphasis on their regulation of Rho-family GTPases, cytoskeletal remodeling, and relationships with cell-cell adhesion and cilia/ciliogenesis.
基金Supported by Grant from the Seoul National University Hospital Research Fund,No.04-2011-0540
文摘AIM:To systematically assess the association between diabetes and incidence of gastric cancer.METHODS:We searched MedLine (PubMed),EMBASE,and the Cochrane Library without any limitations with respect to publication date or language,we also searched the references of qualifying articles.Casecontrol studies and cohort studies comparing the risk of gastric cancer between diabetic patients and control subjects were included.We excluded studies reporting only standardized incidence ratios without control groups and those that investigated only mortality but not incidence.Seventeen studies met our criteria,and the qualities of these studies were assessed using theNewcastle-Ottawa Quality Assessment Scale.We performed a meta-analysis of pre-existing diabetes and gastric cancer incidence using the DerSimonian-Laird method for random-effects.For subgroup analyses,we separated the studies by study type,region,sex and method to determine confounding factors and reliability.We also conducted subgroup analyses to examine the effects of smoking,Helicobacter pylori (H.pylori) infection,and cancer site.Publication bias was evaluated using Begg's test.RESULTS:A random-effects model meta-analysis showed an increased gastric cancer risk in diabetic patients [relative risk (RR)=1.19;95%CI:1.08-1.31].Subgroup analyses indicated that this result persisted in cohort studies (RR=1.20;95%CI:1.08-1.34),in studies on populations of both Western (RR=1.18;95%CI:1.03-1.36) and Eastern countries (RR=1.19;95%CI:1.02-1.38),in a female subgroup (RR=1.24;95%CI:1.01-1.52),and in highly qualified studies (RR=1.17;95%CI:1.05-1.31).Moreover,these results persisted when the analysis was confined to studies adjusted for well-known gastric cancer risk factors such as smoking (RR=1.17;95%CI:1.01-1.34) and H.pylori infection (RR=2.35;95%CI:1.24-4.46).CONCLUSION:Pre-existing diabetes mellitus may increase the risk of gastric cancer by approximately 19%.This effect seems to be unrelated to geographical region.
基金Supported by the National R&D Program for Cancer Control,Ministry for Health,Welfare and Family Affairs,South Korea,No.0920050the Medical Research Center Program through the National Research Foundation of Korea grant funded by the Korea government,No.NRF-2015R1A5A2009656
文摘To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed. RESULTSOverall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95). CONCLUSIONThe recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.
文摘AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic pseudo-obstruction.METHODS:Consecutive 42 patients who underwent surgery for chronic constipation within the last 13 years were prospectively collected.We identified a subgroup with colonic pseudo-obstruction(CPO) features,with dilatation of the colon proximal to the narrowed transitional zone,in contrast to typical slowtransit constipation(STC),without any dilated colonic segments.The outcomes of surgical treatments for chronic constipation with features of CPO were analyzed and compared with outcomes for STC.RESULTS:Of the 42 patients who underwent surgery for constipation,33 patients had CPO with dilatation of the colon proximal to the narrowed transitional zone.There were 16 males and 17 females with a mean age of 51.2 ± 16.1 years.All had symptoms of chronic intestinal obstruction,including abdominal distension,pain,nausea,or vomiting,and the mean duration of symptoms was 67 mo(range:6-252 mo).Preoperative defecation frequency was 1.5 ± 0.6 times/wk(range:1-2 times/wk).Thirty-two patients underwent total colectomy,and one patient underwent diverting transverse colostomy.There was no surgery-related mortality.Postoperative histologic examination showed hypoganglionosis or agangliosis in 23 patients and hypoganglionosis combined with visceral neuropathy or myopathy in 10 patients.In contrast,histology of STC group revealed intestinal neuronal dysplasia type B(n = 6) and visceral myopathy(n = 3).Early postoperative complications developed in six patients with CPO;wound infection(n = 3),paralytic ileus(n = 2),and intraabdominal abscess(n = 1).Defecation frequencies 3 mo after surgery improved to 4.2 ± 3.2 times/d(range:1-15 times/d).Long-term follow-up(median:39.7 mo) was available in 32 patients;all patients had improvements in constipation symptoms,but two patients needed intermittent medication for management of diarrhea.All 32 patients had distinct improvements in constipation symptoms(with a
文摘AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate(TDF) for chronic hepatitis B(CHB) patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue(NA) treatments were included.Study subjects were treated with TDF alone(n = 13) or in combination with lamivudine(LAM,n = 12) or entecavir(ETV,n = 4) for ≥ 6 mo.Complete virologic response(CVR) was defined as an achievement of serum hepatitis B virus(HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil(ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients(93.1%) were hepatitis B e antigen(HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo(range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2% and 96.6%,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4%,12%,and 27% at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific an