Liver-Directed Combined Radiotherapy for Downstaging of the Milan Advanced Hepatocellular Carcinoma Converting to Liver Transplantation

PURPOSE/OBJECTIVE(S)

Recent success of combined immunotherapy sheds a light to the future of advanced hepatocellular carcinoma patients but still remains as a palliative setting. The best oncologic outcome for HCC can be obtained by curative surgery either by resection or liver transplantation (LT). Efficacy of liver-directed combined radiotherapy (LD-CRT) for downstaging and subsequent surgical resection in locally advanced HCC had been reported earlier by our team. In this study, we investigated the role of LD-CRT as a downstaging strategy for converting advanced hepatocellular carcinoma to LT.

MATERIALS/METHODS

We reviewed 55 hepatocellular carcinoma patients who had undergone downstaging LD-CRT and subsequent liver transplantation from January 2009 to February 2022. Patients within Milan criteria at the time of receiving radiotherapy were excluded and clinical characteristics and histopathology of explant liver were evaluated. The overall survival and disease-free survival were assessed using the Kaplan-Meier method RESULTS: The median follow-up period was 48.6 months (range 6.9 - 151.7 months). Of 55 patients, 24 (43.6%) were treatment naïve. At the time of RT, 36 patients presented large tumor (tumor diameter >5 cm) or multiple lesions (>3 lesions), 37 with major vessel involvement or portal vein tumor thrombosis, and 7 with extrahepatic lesion. LD-CRT was given as localized concurrent chemoradiation (CCRT) for 41 patients (74.5%) and transarterial chemoembolization (TACE) plus RT for 10 patents (18.2%). Substantial downstaging has been achieved in 38 (69%) patients with initially over the Milan to within Milan. Specifically, 29 of 37 patients initially with major vessel invasion or with tumor thrombosis were successfully converted to microscopic vessel invasion or tumor thrombus-free status in explant liver. 5-year overall survival was 68.1% and 2-year disease-free survival was 51%, respectively. Recurrence after transplantation was observed in 18 patients (4 intrahepatic recurrence and 14 extrahepatic metastasis) and the majority (14/18) occurred within 2 years.

CONCLUSION

Liver-directed combined radiotherapy as a downstaging strategy for liver transplantation achieved favorable oncologic outcomes in advanced hepatocellular carcinoma patients. This study suggests that active adoption of radiotherapy needs full consideration for locally advanced HCC patients, opening a chance for curative LT.

Mental Stress Classification Based on a Support Vector Machine and Naive Bayes Using Electrocardiogram Signals

Examining mental health is crucial for preventing mental illnesses such as depression. This study presents a method for classifying electrocardiogram (ECG) data into four emotional states according to the stress levels using one-against-all and naive Bayes algorithms of a support vector machine. The stress classification criteria were determined by calculating the average values of the R-S peak, R-R interval, and Q-T interval of the ECG data to improve the stress classification accuracy. For the performance evaluation of the stress classification model, confusion matrix, receiver operating characteristic (ROC) curve, and minimum classification error were used. The average accuracy of the stress classification was 97.6%. The proposed model improved the accuracy by 8.7% compared to the previous stress classification algorithm. Quantifying the stress signals experienced by people can facilitate a more effective management of their mental state.

Lactobacillus intestinalis YT2 restores the gut microbiota and improves menopausal symptoms in ovariectomized rats

There are many studies focusing on the alleviation of menopausal symptoms; however, little is known about the role of gut microorganisms in menopausal symptoms. Ovariectomized (OVX) rats were administered a novel strain (YT2) of Lactobacillus intestinalis (a species with significantly reduced abundance in OVX rats) and the potential probiotic effect on the improvement of menopausal symptoms was evaluated. Of note, the gut microbial composition completely shifted after ovariectomy in rats. Treatment with L. intestinalis YT2 significantly alleviated menopausal symptoms, such as increased fat mass, decreased bone mineral density, increased pain sensitivity, depression-like behaviour, and cognitive impairment. Additionally, the administration of L. intestinalis YT2 restored the intestinal microbial composition, including an increased Firmicutes/Bacteroides ratio. L. intestinalis YT2 also promoted gut barrier integrity by increasing the mRNA levels of tight junction-related markers. In conclusion, L. intestinalis YT2 treatment alleviated menopausal symptoms via the modulation of the gut microbiota. Importantly, these results suggest that L. intestinalis YT2 should be considered as a therapeutic probiotic agent for menopausal women.

Waist circumference and the risk of lumbar and femur fractures: a nationwide population-based cohort study

Although obesity is known to have an influence on fracture, the relationship between lumbar and femur fractures and weight or waist circumference is controversial. We investigated the incidence of fracture with regards to waist circumference using the customised database of the Korean National Health Insurance Service (NHIS). Among 8,922,940 adults who participated at least twice in the NHIS National Health Check-up Program in South Korea between 2009 and 2011, 1,556,751 subjects (780,074 men and 776,677 women) were extracted. Over a mean follow-up of 6.5 years, multivariate-adjusted logistic regression analysis demonstrated that higher waist circumference was associated with an increased risk of femur fractures in both males and females. Moreover, the incidence of lumbar fractures was also positively associated with an increased waist circumference in males and females. An increased waist circumference showed a positive linear relationship with the risk of lumbar and femur fractures in both males and females.

Soft and transparent triboelectric nanogenerator based E-skin for wearable energy harvesting and pressure sensing

The demand for wearable sensor technologies has increased with the recent increase interactions humans-electronic device interactions. However, the supplying power for wearable sensors, such as E-skin and flexible electronics, remains a major technical challenge. Herein, we report a triboelectric nanogenerator (TENG)-based E-skin capable of biomechanical energy harvesting and self-pressure sensing without an external power source. PTFE-molded micro-patterned PDMS and a conductive yarn were combined to implement an E-skin with flexibility, elasticity, high sensitivity, and excellent stability. The manufactured E-skin generates a power of 154 mW m^-2for an external force of 1 kgf and exhibits stable characteristics without deterioration of output even under 4500 cycles of repeated pressure. The E-skin can charge a capacitor and drive an electronic watch as well as monitor physiological signals, such as arterial pulses. The method used in this study can be extended to potential applications for power supply in wearable/soft electronics, medical monitoring, and human-machine interfaces.

Camera-Integrable Wide-Bandwidth Antenna for Capsule Endoscope

This paper presents a new antenna design for a capsule endoscope. The proposed antenna comprises a camera hole and meandered line. These features enable the antenna to be integrated on the same side as the camera, within the capsule endoscope. Moreover, light-emitting diodes can be mounted on the surface of the antenna for illumination. The antenna achieves a wide bandwidth, despite the small size owing to its meandered line structure.

Feasibility Analysis on the Use of Ultrasonic Communications for Body Sensor Networks

Ultrasonic waves have good propagation in the human body and have been widely applied in biomedical device design without any reported side effects. Therefore, ultrasonic waves can provide an alternative method as an information carrier for body sensor networks (BSNs). This paper presents a novel wireless communication method that uses ultrasonic sound waves as a medium for healthcare systems. We investigated the feasibility of our proposal by testing it in a real digital communication experimental setup. To find an acceptable modulation method, the functionality of the proposed ultrasound-based digital communication approach was tested involving three principal modulation methods: amplitude shift keying (ASK), frequency shift keying (FSK), and phase shift keying (PSK). The modulated digital signals obtained from the experiments were compared with the simulated signals. Analysis of the results shows that ultrasonic waves are feasible and can be used for digital communication.

First Report of the Korean Lung Transplantation Registry

BACKGROUND

The Korean Organ Transplantation Registry (KOTRY) began to register lung transplants in 2015. This is an initial report on the status of patients receiving lung transplants over the past 2 years.

METHODS

We analyzed a total of 69 patients who received lung transplants in 2015 and 2016 and who registered with the KOTRY.

RESULTS

The 69 patients were treated in 5 institutions. The average (SD) donor age was 39.2 (12.6) years; there were 40 male patients. The average (SD) recipient age was 55.7 (10.0) years, and the number of male recipients was 46. A total of 66 patients underwent bilateral lung transplantation, 3 underwent single-lung transplantation, and 1 underwent simultaneous heart-lung transplantation. The most frequent indication for lung transplantation was idiopathic pulmonary fibrosis (35 patients), followed by connective tissue disease-related interstitial lung disease (9) and acute respiratory failure (8). Prior to transplantation, 23 patients required ventilator care, and 12 required extracorporeal membrane oxygenation while on the waiting list. Episodes of acute rejection during follow-up were reported in 4, 2, 1, and 1 patients at 3, 6, 9, and 12 months, respectively. Infections requiring hospitalization were reported in 27, 10, 4, and 3 patients at 3, 6, 9, and 12 months, respectively.

CONCLUSION

The establishment of KOTRY renders it possible to collect nationwide data on lung transplantation, improving research on the topic and clarifying clinical feasibility.

Development of a Telemetric, Miniaturized Electrochemical Amperometric Analyzer

In this research, we developed a portable, three-electrode electrochemical amperometric analyzer that can transmit data to a PC or a tablet via Bluetooth communication. We performed experiments using an indium tin oxide (ITO) glass electrode to confirm the performance and reliability of the analyzer. The proposed analyzer uses a current-to-voltage (I/V) converter to convert the current generated by the reduction-oxidation (redox) reaction of the buffer solution to a voltage signal. This signal is then digitized by the processor. The configuration of the power and ground of the printed circuit board (PCB) layer is divided into digital and analog parts to minimize the noise interference of each part. The proposed analyzer occupies an area of 5.9 × 3.25 cm² with a current resolution of 0.4 nA. A potential of 0~2.1 V can be applied between the working and the counter electrodes. The results of this study showed the accuracy of the proposed analyzer by measuring the Ruthenium(III) chloride ( Ru III ) concentration in 10 mM phosphate-buffered saline (PBS) solution with a pH of 7.4. The measured data can be transmitted to a PC or a mobile such as a smartphone or a tablet PC using the included Bluetooth module. The proposed analyzer uses a 3.7 V, 120 mAh lithium polymer battery and can be operated for 60 min when fully charged, including data processing and wireless communication.

Design of a Wireless Sensor System with the Algorithms of Heart Rate and Agility Index for Athlete Evaluation

Athlete evaluation systems can effectively monitor daily training and boost performance to reduce injuries. Conventional heart-rate measurement systems can be easily affected by artifact movement, especially in the case of athletes. Significant noise can be generated owing to high-intensity activities. To improve the comfort for athletes and the accuracy of monitoring, we have proposed to combine robust heart rate and agility index monitoring algorithms into a small, light, and single node. A band-pass-filter-based R-wave detection algorithm was developed. The agility index was calculated by preprocessing with band-pass filtering and employing the zero-crossing detection method. The evaluation was conducted under both laboratory and field environments to verify the accuracy and reliability of the algorithm. The heart rate and agility index measurements can be wirelessly transmitted to a personal computer in real time by the ZigBee telecommunication system. The results show that the error rate of measurement of the heart rate is within 2%, which is comparable with that of the traditional wired measurement method. The sensitivity of the agility index, which could be distinguished as the activity speed, changed slightly. Thus, we confirmed that the developed algorithm could be used in an effective and safe exercise-evaluation system for athletes.

Highly stretchable fiber-based single-electrode triboelectric nanogenerator for wearable devices

In the proposed fiber-based single-electrode triboelectric nanogenerator (FSTENG), energy was generated from the contact between human skin and silicone rubber.

Stretchable Triboelectric Fiber for Self-powered Kinematic Sensing Textile

Stretchable fiber and yarn triboelectric nanogenerator are sought for such applications as wearable sensing system such as cloth communication devices, electronic textiles, and robotic sensory skin. Unfortunately, previously reported triboelectric fiber and yarn are difficult to have stretchable property. We introduce here a new type of stretchable and weavable triboelectric fibers with microdiameter dimensions. The stretchable triboelectric fibers can be reversibly stretched up to 50% in tensile direction while generating voltage output proportional to the applied tensile strain. The reversible distance change induced by the Poisson's ratio difference between the core fiber (silver-coated nylon/polyurethane) and the shell (wrinkled polyvinylidene fluoride-co-trifluoroethylene/carbon nanotube layer) during tensile deformation is the key working principle for electrical generation. Owing to exceptional structural stability, the stretchable triboelectric fibers show high performance retention after 10,000 times repeated stretching/releasing cycle. Furthermore, the stretchable triboelectric fibers are mechanically strong to be woven into a commercial textile for textile based sensors, which can detect magnitude as well as direction of the motion.

Correction: Triboelectric generator for wearable devices fabricated using a casting method

Correction for ‘Triboelectric generator for wearable devices fabricated using a casting method’ by Chang Jun Lee et al., RSC Adv., 2016, 6, 10094–10098.

Triboelectric generator for wearable devices fabricated using a casting method

We fabricate an efficient triboelectric generator (TEG) using inexpensive materials that are readily available in our surroundings. By casting PDMS, we perform micropatterning on the surface of sandpaper.

Association between information provision and decisional conflict in cancer patients

BACKGROUND

In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC).

PATIENTS AND METHODS

We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC.

RESULTS

More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77).

CONCLUSION

This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.

A genetic variation in microRNA target site of KRT81 gene is associated with survival in early-stage non-small-cell lung cancer

BACKGROUND

MicroRNAs (miRNAs) have a key role in carcinogenesis through negative regulation of their target genes. Therefore, genetic variations in miRNAs or their target sites may affect miRNA-mRNA interactions, thereby result in altered expression of target genes. This study was conducted to investigate the associations between single-nucleotide polymorphisms (SNP) located in the miRNA target sites (poly-miRTSs) and survival of patients with early-stage non-small-cell lung cancer (NSCLC).

METHODS

Using public SNP database and miRNA target sites prediction program, 354 poly-miRTSs were selected for genotyping. Among these, 154 SNPs applicable to Sequenom's MassARRAY platform were investigated in 357 patients. A replication study was carried out on an independent patient population (n = 479). Renilla luciferase assay and reverse transcription-polymerase chain reaction were conducted to examine functional relevance of potentially functional poly-miRTSs.

RESULTS

Of the 154 SNPs analyzed in a discovery set, 14 SNPs were significantly associated with survival outcomes. Among these, KRT81 rs3660G>C was found to be associated with survival outcomes in the validation cohort. In the combined analysis, patients with the rs3660 GC + CC genotype had a significantly better overall survival compared with those with GG genotype [adjusted hazard ratio (aHR) for OS, 0.65; 95% confidence interval (CI) 0.50-0.85; P = 0.001]. An increased expression of the reporter gene for the C allele of rs3660 compared with the G allele was observed by luciferase assay. Consistently, the C allele was associated with higher relative expression level of KRT81 in tumor tissues.

CONCLUSION

The rs3660G>C affects KRT81 expression and thus influences survival in early-stage NSCLC. The analysis of the rs3660G>C polymorphism may be useful to identify patients at high risk of a poor disease outcome.

Stretchable, weavable coiled carbon nanotube/MnO2/polymer fiber solid-state supercapacitors

Fiber and yarn supercapacitors that are elastomerically deformable without performance loss are sought for such applications as power sources for wearable electronics, micro-devices, and implantable medical devices. Previously reported yarn and fiber supercapacitors are expensive to fabricate, difficult to upscale, or non-stretchable, which limits possible use. The elastomeric electrodes of the present solid-state supercapacitors are made by using giant inserted twist to coil a nylon sewing thread that is helically wrapped with a carbon nanotube sheet, and then electrochemically depositing pseudocapacitive MnO₂ nanofibers. These solid-state supercapacitors decrease capacitance by less than 15% when reversibly stretched by 150% in the fiber direction, and largely retain capacitance while being cyclically stretched during charge and discharge. The maximum linear and areal capacitances (based on active materials) and areal energy storage and power densities (based on overall supercapacitor dimensions) are high (5.4 mF/cm, 40.9 mF/cm², 2.6 μWh/cm² and 66.9 μW/cm², respectively), despite the engineered superelasticity of the fiber supercapacitor. Retention of supercapacitor performance during large strain (50%) elastic deformation is demonstrated for supercapacitors incorporated into the wristband of a glove.

Chitosan-Polypyrrole Fiber for Strain Sensor

A chitosan/polypyrrole composited fiber as bio-compatible materials for artificial muscles is investigated. The chitosan/polypyrrole fiber (CPF) is fabricated by in-situ chemical polymerization of pyrrole monomer solution using FeCl3 as an oxidant. The electrical resistivity of the fiber is changed according to the strain variation applied to the both ends of the specimen. The sensor built by using the CPF has a higher gauge factor (4) compared to conventional metal strain gauges (~2) indicating a suitable material for delicate force control in sensing work.

Osteoporosis therapy: a novel insight from natural homeostatic system in the skeleton

The skeleton normally responds to mechanical environment to maintain the resulting elastic deformation (strain) of bone, while increased bone strength by an osteoporosis drug results in decreased bone strain. Thus, it can be hypothesized that the effect of osteoporosis therapy is limited by natural homeostatic system in the skeleton. This logic is consistent with the fact that there exists a powerful effect that returns bone mass to its pre-treatment level after the withdrawal of treatment with osteoporosis agents. The present hypothesis provides a new significant insight into the mechanisms by which osteoporosis drugs improve bone fragility. Here we briefly discuss the effects of teriparatide, romosozumab, and odanacatib on bones in animals and humans.

A novel Microchannel Electrode Array: towards bioelectronic medical interfacing of small peripheral nerves

Bioelectronic medicine is an emerging field that relies on electrical signals to modulate complex neuronal circuits, particularly in the peripheral nervous system, as an alternative to drug-enabled therapeutics. Small autonomic nerves are one of the targets in this field, however, interfacing peripheral nerves smaller than 300 μm remains a challenge. Here we report the development of a Microchannel Electrode Array (DCEA) capable of interfacing nerve fascicles as small as 50-300μm. The current μCEA records and stimulates from 28 channels and is designed for easy implantation and removal, bearing promise to enable neural interfacing in BM.

All-solid-state carbon nanotube torsional and tensile artificial muscles

We report electrochemically powered, all-solid-state torsional and tensile artificial yarn muscles using a spinnable carbon nanotube (CNT) sheet that provides attractive performance. Large torsional muscle stroke (53°/mm) with minor hysteresis loop was obtained for a low applied voltage (5 V) without the use of a relatively complex three-electrode electromechanical setup, liquid electrolyte, or packaging. Useful tensile muscle strokes were obtained (1.3% at 2.5 V and 0.52% at 1 V) when lifting loads that are ∼25 times heavier than can be lifted by the same diameter human skeletal muscle. Also, the tensile actuator maintained its contraction following charging and subsequent disconnection from the power supply because of its own supercapacitor property at the same time. Possible eventual applications for the individual tensile and torsional muscles are in micromechanical devices, such as for controlling valves and stirring liquids in microfluidic circuits, and in medical catheters.

Flexible supercapacitor made of carbon nanotube yarn with internal pores

Electrochemical deposition of MnO2 onto carbon nanotube (CNT) yarn gives a high-performance, flexible yarn supercapacitor. The hybrid yarn's blended structure, resulting from trapping of MnO2 in its internal pores, effectively enlarges electrochemical area and reduces charge diffusion length. Accordingly, the yarn supercapacitor exhibits high values of capacitance, energy density, and average power density. Applications in wearable electronics can be envisaged.

Characteristic corrosion resistance of nanocrystalline TiN films prepared by high density plasma reactive magnetron sputtering

Nanocytalline TiN films were deposited on non-alkali glass and Al substrates by reactive DC magnetron sputtering (DCMS) with an electromagnetic field system (EMF). The microstructure and corrosion resistance of the TiN-coated Al substrates were estimated by X-ray diffraction (XRD), scanning electron microscopy (SEM) and electrochemical methods. All the TiN films shows that they have a (111) preferred orientation at room temperature. TiN films deposited on Al substrate using only DCMS 400 W showed a sheet resistance of 3.22 x 10-1 omega/symbol see texts (resistivity, 3.22 x 10-5 omegacm). On the other hand, a relatively low sheet resistance of 1.91 x 10-1 omega/symbol see text (1.91 x 10-5 omegacm) was obtained for the dense nanocrystalline TiN film deposited on Al substrate using DCMS 375 W+ EMF 25 W, indicating that the introduction of an EMF system enhanced the electrical properties of the TiN film. TiN films deposited on Al substrate at 400 degreesC had a (200) preferred orientation with the lowest sheet resistance of 1.28x10-1 omega/symbol see texts (1.28 x 10-5 omegacm) which was attributed to reduced nano size defects and an improvement of the crystallinity. Potentiostatic and Potentiodynamic tests with a TiN-coated Al showed good corrosion resistance (l/corr, = 2.03 microA/cm2, Ecorr = -348 mV) compared to the uncoated Al substrate (/corr = 4.45 microA/cm2, Ecorr = -650 mV). Furthermore, EMF system showed that corrosion resistance of the TiN film also was enhanced compared to DCMS only. For the TiN film deposited on Al substrate at 400 degreesC, corrosion current and potential was 0.63 micro/cm2 and -1.5 mV, respectively. This improved corrosion resistance of the TiN film could be attributed to the densification of the film caused by enhancement of nitrification with increasing high reactive nitrogen radicals.

Partial posterior hyaloidectomy for macular disorders

PURPOSE

To evaluate the effect of partial posterior hyaloidectomy (PPH) in preventing iatrogenic retinal breaks related to the induction of a posterior vitreous detachment (IPVD).

METHODS

Fifty-nine patients who necessitated IPVD for an epiretinal membrane or macular hole were included in this prospective, interventional case series. Extensive removal of vitreous gel, close to the retina, was conducted before IPVD under 23 G (gauge)-vitrectomy system. The PPH involved the limited extent of IPVD and limited removal of the outermost vitreous cortex to an area slightly beyond the margin of the temporal major vascular arcade. The incidence of retinal breaks related to the surgery was compared with 57 eyes that had undergone conventional 23-G total vitrectomy accompanied by extensive IPVD using χ(2)-test.

RESULTS

Patients were followed-up for a mean of 14.3 months (6-30 months) after the surgery. The incidence of peripheral retinal breaks after the PPH was 3.4% (2/59 eyes), which was significantly lower than that in the eyes that underwent conventional 23 G vitrectomy (15.8%, 9/57 eyes, P=0.023) for the same disorders that required an IPVD. No patient complained of postoperative floaters, postoperatively.

CONCLUSIONS

PPH would be an efficient procedure to prevent iatrogenic peripheral retinal breaks related to an IPVD.

Free-standing nanocomposites with high conductivity and extensibility

The prospect of electronic circuits that are stretchable and bendable promises tantalizing applications such as skin-like electronics, roll-up displays, conformable sensors and actuators, and lightweight solar cells. The preparation of highly conductive and highly extensible materials remains a challenge for mass production applications, such as free-standing films or printable composite inks. Here we present a nanocomposite material consisting of carbon nanotubes, ionic liquid, silver nanoparticles, and polystyrene-polyisoprene-polystyrene having a high electrical conductivity of 3700 S cm(-1) that can be stretched to 288% without permanent damage. The material is prepared as a concentrated dispersion suitable for simple processing into free-standing films. For the unstrained state, the measured thermal conductivity for the electronically conducting elastomeric nanoparticle film is relatively high and shows a non-metallic temperature dependence consistent with phonon transport, while the temperature dependence of electrical resistivity is metallic. We connect an electric fan to a DC power supply using the films to demonstrate their utility as an elastomeric electronic interconnect. The huge strain sensitivity and the very low temperature coefficient of resistivity suggest their applicability as strain sensors, including those that operate directly to control motors and other devices.

Change in subfoveal choroidal thickness in central serous chorioretinopathy following spontaneous resolution and low-fluence photodynamic therapy

PURPOSE

To assess the change in subfoveal choroidal thickness (SFCT) in central serous chorioretinopathy (CSC) following spontaneous resolution and low-fluence photodynamic therapy (PDT) using the enhanced depth imaging optical coherence tomography (EDI-OCT).

METHODS

A total of 36 consecutive eyes of 36 patients were included in this retrospective study: 16 eyes with spontaneously resolved CSC and 20 eyes with PDT-treated CSC. Best-corrected visual acuity and SFCT were evaluated at each visit until complete absorption of the subretinal fluid. SFCT of 32 normal subjects were also measured, as the control group. Wilcoxon's singed-rank test was used to evaluate the effects of spontaneous resolution and PDT. To compare the SFCT of the eyes with resolved CSC with that of the normal eyes, Mann-Whitney U-test with Bonferroni correction was also employed.

RESULTS

SFCT of patients was 459.16±77.50 μm at the baseline, and decreased to 419.31±54.49μm after a spontaneous resolution (P=0.015). However, SFCT was not normalized in comparison with that of the normal subjects (P<0.001). SFCT in PDT group was also reduced from 416.43±74.01 to 349.50±88.99 μm (P<0.001), with no significant difference with the normal value (P=0.087).

CONCLUSIONS

SFCT in patients with CSC decreased both after spontaneous resolution and low-fluence PDT. However, only in the PDT group, after disappearance of subretinal fluid, did it decrease to that of normal subjects.

Proteins involved in DNA damage response pathways and survival of stage I non-small-cell lung cancer patients

BACKGROUND

Biological complexity leads to significant variation in the survival of patients with stage I non-small-cell lung cancer (NSCLC). DNA damage response (DDR) pathways play a critical role in maintaining genomic stability and in the progression of NSCLC. Therefore, the development of a prognostic biomarker focusing on DDR pathways is an intriguing issue.

PATIENTS AND METHODS

Expression of several proteins (ATM, ATMpS1981, γH2AX, 53BP1, 53BP1pS25, Chk2, Chk2pT68, MDC1, MDC1pS964, BRCA1pS1423, and ERCC1) and overall survival were investigated in 889 pathological stage I NSCLC patients.

RESULTS

Low expression of BRCA1pS1423 or ERCC1 was significantly associated with worse survival in the whole cohort of patients. Analysis performed based on histology revealed that low expression of γH2AX, Chk2pT68, or ERCC1 was a poor prognostic factor in squamous cell carcinoma patients [adjusted hazard ratio (aHR), Cox P: 1.544, 0.012 for γH2AX; 1.624, 0.010 for Chk2pT68; 1.569, 0.011 for ERCC1]. The analysis of the interaction between two proteins showed that this effect was more pronounced in squamous cell carcinoma patients. However, these effects were not detected in adenocarcinoma patients.

CONCLUSIONS

The proteins involved in DDR pathways exhibited differential expression between squamous cell carcinoma and adenocarcinoma and were important determinants of survival in stage I squamous cell carcinoma patients.

Preliminary study analyzing the methylated genes in the plasma of patients with pancreatic cancer

BACKGROUND AND AIMS

CpG islands of the promoter region of some genes are methylated in pancreatic cancer tissue and the detection of this methylation has been suggested to be useful in the diagnosis of various cancers. The aim of this study was to investigate whether the detection of methylated CpG islands in plasma can be used in the diagnosis of pancreatic cancer.

MATERIAL AND METHODS

Plasma DNA was collected from patients with pancreatic cancer, chronic pancreatitis, and healthy controls. The methylation status of six genes, UCHL1, NPTX2, SARP2, ppENK, p16, and RASSF1A, was checked by methylation-specific PCR and was subsequently confirmed by direct sequencing after bisulfite treatment.

RESULTS

CpG island methylation was detectable in 13 of 16 patients (81.3%) with pancreatic cancer, 1 of 29 healthy controls (3.5%), and 8 of 13 patients with chronic pancreatitis (61.5%). The mean number of genes with CpG island methylation was 1.6±1.2 in pancreatic cancer, 0.04±0.19 in healthy controls, and 1.2±1.1 in chronic pancreatitis. Among six genes, p16 was more specifically methylated in pancreatic cancer compared with chronic pancreatitis (p=0.016). The methylation status was not correlated with smoking history, tumor size, or cancer stage.

CONCLUSIONS

The detection of methylated genes in the plasma may have a role in differentiating between pancreatic cancers and healthy controls but not between pancreatic cancer and chronic pancreatitis.

Surgical management of the esophageal leiomyoma: lessons from a retrospective review

Esophageal leiomyoma is the most common benign tumor of the esophagus. Although enucleation via thoracotomy has been considered standard treatment, minimally invasive surgery is increasingly used for the treatment of this disease. We analyzed our surgical outcomes by comparing thoracotomy and the thoracoscopic approach. A retrospective review was performed of patients who underwent surgical resection of esophageal leiomyomas at the Seoul National University Hospital. Between 1982 and 2005, 63 patients were identified (male, n= 39; female, n= 24) at a mean age of 44.5 years. Thirty-two patients (51%) were symptomatic. Forty-five patients underwent thoracotomy, and 18 patients were resected using thoracoscopy. There was no mortality. The mean length of hospital stay was 10.3 days in the open group and 8.0 days in thoracoscopy group. Intraoperative mucosal repair was required in eight patients. Preoperative endoscopic mucosal biopsy within 1 month was identified as a risk factor for mucosal injury. Among the 11 patients with tumors less than 1.5 cm in size, thoracoscopic resection was attempted on four patients, and three out of the four cases required conversions to thoracotomy. Minimally invasive surgery for esophageal leiomyoma can be performed with good results. Our results suggest that the thoracoscopic approach should be considered as a standard surgical method for the treatment of esophageal leiomyoma. However, in cases of small tumors less than 1.5 cm in size, localization of the tumor may be difficult, and if asymptomatic, a regular monitoring should be considered as an alternative approach in such small tumors.

Passive regulation of volume-flow ratio for microfluidic streams with different hydrophilicity and viscosity

Biochemical solutions have a wide range of hydrophilicity (contact angle and surface tension) and viscosity. A critical challenge is that microfluidic systems typically need expensive or complex pumps to control the various parallel biochemical streams. In this study, without using any pumps, we present a simple scheme that controls the ratio of the volumetric flow rate (VFR) of the parallel streams that have highly different hydrophilicity and viscosity. We accomplish this process by using capillarity to drive and merge two streams, and by regulating relative flow resistance to control the VFR ratio. Our results will significantly simplify the control of the VFR ratio for the various biochemical solutions that are used in microfluidic applications.

Arsenic species in ecosystems affected by arsenic-rich spring water near an abandoned mine in Korea

The objectives of this study were to quantitatively estimate the distribution of arsenic with its speciation and to identify potential pathways for transformation of arsenic species from samples of water, sediments, and plants in the ecosystem affected by the Cheongog Spring, where As(V) concentration reached levels up to 0.270 mg L(-1). After flowing about 100 m downstream, the arsenic level showed a marked reduction to 0.044 mg L(-1) (about 84% removal) without noticeable changes in major water chemistry. The field study and laboratory hydroponic experiments with the dominant emergent plants along the creek (water dropwort and thunbergian smartweed) indicated that arsenic distribution, reduction, and speciation appear to be controlled by, (i) sorption onto stream sediments in exchangeable fractions, (ii) bioaccumulation by and possible release from emergent plants, and (iii) transformation of As(V) to As(III) and organic species through biological activities.

Small cell carcinoma of the uterine cervix: clinicopathologic study of 20 cases in a single center

PURPOSE

To investigate clinicopathologic findings of patients with small cell carcinoma of the uterine cervix (SCCUC), and evaluate their prognosis.

METHODS

We retrospectively reviewed the medical records of 20 patients with histologically confirmed SCCUC treated between October 1996 and December 2004 at Asan Medical Center, Korea. The review included demographic data, pathologic findings, treatments, and outcomes.

RESULTS

Of 1,358 invasive cervical carcinoma, the incidence of SCCUC was 1.5%. Median age was 45.5 years. The clinical stages were Ib in 11, IIa in two, IIb in one, IIIa in one, IIIb in one, IVa in three and IVb in one. Fourteen patients underwent radical hysterectomy. Ten patients are alive and nine show no evidence of disease. Median overall survival was 77.0 months and 5-year overall survival rate was 50%. There was significant difference in overall survival with FIGO stage and tumor mass size.

CONCLUSION

Advanced FIGO stage and tumor mass size are poor prognostic factors for overall survival in patients with SCCUC. Even though SCCUC is a highly aggressive neoplasm, early diagnosis and combined therapeutic modalities may lead to longer survival in some patients.