In this study, experiments and numerical analyses were carried out to examine the flexural and shear performance of a double composite wall (DCW) manufactured using a precast concrete (PC) method. ...One flexural specimen and three shear specimens were fabricated, and the effect of the bolts used for the assembly of the PC panels on the shear strength of the DCW was investigated. The failure mode, flexural and shear behavior, and composite behavior of the PC panel and cast-in-place (CIP) concrete were analyzed in detail, and the behavioral characteristics of the DCW were clearly identified by comparing the results of tests with those obtained from a non-linear flexural analysis and finite element analysis. Based on the test and analysis results, this study proposed a practical equation for reasonably estimating the shear strength of a DCW section composed of PC, CIP concrete, and bolts utilizing the current code equations.
Background: Previous reports demonstrated mechanisms of cardiac toxicity in acute carbon monoxide (CO) poisoning. Still, none established CO-induced cardiomyopathy (CMP) as a clinical entity. The aim ...of this study is to investigate CO-induced CMP in patients with acute CO poisoning in terms of its epidemiology, clinical characteristics, and prognosis. Methods and Results: A retrospective study was conducted on consecutive patients who were diagnosed with acute CO poisoning at the emergency department of Ajou University Hospital during the period of 62 month. Six hundred and twenty-six patients were diagnosed with acute CO poisoning. During the initial echocardiography, 19 patients were abnormal: (1) global hypokinesia/akinesia (n=7), (2) regional wall hypokinesia/akinesia n=12; takotsubo type (n=6), reverse takotsubo type (n=2), non-specific type (n=4). The ejection fraction (EF) was 36.3±13.5% (from 15% to 55%) and less than 45% for 14 patients. In the follow-up echocardiography performed within 12 days after the initial performance, most patients were found to have cardiac wall motion abnormalities, and their EF had returned to normal (ie, EF ≥50%). Conclusions: CO-induced CMP was identified in 3.04% (n=19) of all patients (n=626). It might not be too critical in acute clinical courses of acute CO poisoning because the prognosis seems favorable. Considering the common factors between CO-induced CMP and takotsubo CMP, myocardial stunning subject to a catecholamine surge most likely plays a central role in the development of CO-induced CMP. (Circ J 2014; 78: 1437–1444)
•TSSA showed differences in the bilateral ATR and IF-OF in iRBD patients.•iRBD patients had lower FA and higher MD in the right ATR than controls.•iRBD patients had higher MD in the bilateral ATR and ...right IF-OF than controls.•Higher MD values in the right IF-OF positively correlated with GDS-K scores in iRBD patients.
White matter (WM) tract-specific changes may precede gray matter loss in isolated rapid eye movement sleep behavior disorder (iRBD). We aimed to evaluate tract-specific WM changes using tract-specific statistical analysis (TSSA) and their correlation with clinical variables in iRBD patients.
This was a cross-sectional single-center study of 50 polysomnography-confirmed iRBD patients and 20 age- and sex-matched controls. We used TSSA to identify tract-specific fractional anisotropy (FA) and mean diffusivity (MD) in fourteen major fiber tracts and analyzed between-group differences in these values. Correlations between FA or MD values and clinical variables, including RBD symptom severity, depression and cognition, were evaluated.
Patients with iRBD showed lower FA in the right anterior thalamic radiation (ATR) and higher MD in the bilateral ATR and right inferior fronto-occipital fasciculus (IF-OF) than controls after adjusting for age, sex, and years of education. MD values in the IF-OF positively correlated with scores on the Korean version of the Rapid Eye Movement Sleep Behavior Disorder Questionnaire-Hong Kong (RBDQ-KR, p = 0.042) and the Korean version of the geriatric depression scale (GDS-K, p = 0.002) in iRBD patients. Only GDS-K scores independently correlated with IF-OF MD values after adjusting for RBDQ-KR scores (adjusted p = 0.026).
This study suggests WM microstructural disruption in the bilateral ATR and right IF-OF in patients with iRBD and that alterations in the IF-OF may contribute to depressive symptoms.
It is well known that skin aging is related to the destruction of collagen and elastin fibers by metalloproteinases (MMPs). Aged fibroblasts have a decreased ability to synthesize collagen and ...elastin. Nuclear factor erythroid 2-related factor 2 (NRF2) involves glyoxalase (GLO) activation, which inhibits the production of advanced glycated end products (AGE) and the expression of its receptor (RAGE). RAGE increases nuclear transcription factor-kappa B (NF-κB), which upregulates MMPs and decreases skin elasticity. NRF2 also decreases M1 macrophages, which secrete tumor necrosis factor-alpha (TNF-α), thereby decreasing AGE production. It is well known that radiofrequency (RF) decreases skin elasticity by increasing collagen synthesis. We evaluated whether RF increases skin elasticity via NRF2/GLO and whether they decrease AGE and RAGE expression in aged animal skin. We also compared the effects of RF based on the modes (monopolar or bipolar) or the combination used. In aged skin, NRF2, GLO-1, and M2 macrophage expression was decreased, and their expression increased when RF was applied. M1 and TNF-α demonstrated increased expression in the aged skin and decreased expression after RF application. AGE accumulation and RAGE, NF-κB, and MMP2/3/9 expression were increased in the aged skin, and they were decreased by RF. The papillary and reticular fibroblast markers showed decreased expression in young skin and increased expression in aged skin. The densities of collagen and elastin fiber in the aged skin were low, and they were increased by RF. In conclusion, RF leads to increased collagen and elastin fibers by increasing NRF2/GLO-1 and modulating M1/M2 polarization, which leads to decreased AGE and RAGE and, consequently, decreased NF-κB, which eventually slows collagen and elastin destruction. RF also leads to increased collagen and elastin fiber synthesis by increasing papillary and reticular fibroblast expression.
We aimed to evaluate whether obesity was associated with a certain clinicopathologic characteristics of metachronous CRA. This retrospective longitudinal cohort study included 2,904 subjects who had ...at least one resected CRA at index colonoscopy and who subsequently underwent one or more surveillance colonoscopies within 5 years. Of the 2,904 subjects, 60.9% (n = 1,769) were normal, 35.8% (n = 1,040) were overweight, and 3.3% (n = 95) were obese. Patients with any metachronous CRA were 53.7% (n = 1,559). In multivariate analyses, higher BMI at index colonoscopy was significantly associated with any metachronous CRA (overweight, OR = 1.07; obese, OR = 1.82; p for trend = 0.049). Regarding the multiplicity, the ORs of ≥ 3, ≥ 4 and ≥ 5 metachronous CRAs significantly increased as index BMI increased (p for trend < 0.001, = 0.007 and = 0.004, respectively). In negative binomial regression regarding the incidence for total number of metachronous CRA, the higher BMI the subject has at the time of index colonoscopy, the more metachronous CRAs the subject will have at the surveillance colonoscopy (p for trend = 0.016). Higher index BMI was significantly associated with the risk of multiple metachronous CRAs on surveillance colonoscopy within 5 years.
DEAD-box RNA helicases have been implicated to have a function during stress adaptation processes, but their functional roles in plant stress responses remain to be clearly elucidated. Here, we ...assessed the expression patterns and functional roles of two RNA helicases, AtRH9 and AtRH25, in Arabidopsis thaliana under abiotic stress conditions. The transcript levels of AtRH9 and AtRH25 were up-regulated markedly in response to cold stress, whereas their transcript levels were down-regulated by salt or drought stress. Phenotypic analysis of the transgenic plants and T-DNA-tagged mutants showed that the constitutive overexpression of AtRH9 or AtRH25 resulted in the retarded seed germination of Arabidopsis plants under salt stress conditions. AtRH25, but not AtRH9, enhanced freezing tolerance in Arabidopsis plants. Both AtRH9 and AtRH25 complemented the cold-sensitive phenotype of BX04 Escherichia coli mutant cells, but AtRH25 had much more prominent complementation ability than AtRH9. An in vitro nucleic acid binding assay showed that AtRH9 binds equally to all homoribopolymers, whereas AtRH25 binds preferentially to poly(G). Taken together, these results demonstrate that AtRH9 and AtRH25 impact on the seed germination of Arabidopsis plants under salt stress conditions, and suggest that the difference in cold tolerance capability between AtRH9 and AtRH25 arises from their different nucleic acid-binding properties.
Hypothermia can induce ECG J waves. Recent studies suggest that J waves may be associated with ventricular fibrillation (VF) in patients with structurally normal hearts. However, little is known ...about the ECG features, clinical significance or arrhythmogenic potentials of therapeutic hypothermia (TH)-induced J waves.
We analysed ECGs from 240 patients who underwent TH at six major university hospitals in Korea between August 2010 and December 2013. The prevalence, amplitudes and distributions of the J waves and the development of malignant arrhythmia were analysed.
The average patient body temperature was 33.5±1.0°C during TH. J waves were observed in 98 patients (40.8%). They were newly developed in 91 cases, and pre-existing J waves were augmented in seven patients. J waves during TH were primarily observed in leads II, III, aVF and V4-6. The average amplitude of the J waves was 0.239±0.152 mV. There were four VF events during TH. These events occurred in three patients who were finally diagnosed with Brugada syndrome, idiopathic VF or early repolarisation syndrome, respectively, and in one patient with non-cardiac aetiology (asphyxia).
J waves were recorded in about 40% of the patients who received TH. They were most frequently observed in the inferior limb leads or lateral precordial leads. Life-threatening VF occurred only rarely (1.7%) during TH and were mainly observed in patients with primary arrhythmic disorder. Although a causal relationship between TH-induced J waves and VF remains unknown, administering TH to this potentially susceptible, high-risk population may require careful attention.
During skin aging, the volume of subcutaneous adipose tissue (sWAT) and the adipogenesis potential of adipose-derived stem cells (ASCs) decrease. It is known that the shortening of cilia length by ...pro-inflammatory cytokines is related to the decreased adipogenic differentiation of ASCs via increase in Wnt5a/β-catenin. High-intensity focused ultrasound (HIFU) is known to upregulate heat shock proteins (HSP), which decrease levels of pro-inflammatory cytokines. In this study, we evaluated whether HIFU modulates the cilia of ASCs by upregulating HSP70 and decreasing inflammatory cytokines. HIFU was applied at 0.2 J to rat skin, which was harvested at 1, 3, 7, and 28 days. All results for HIFU-applied animals were compared with control animals that were not treated. HIFU increased expression of HSP70 and decreased expression of NF-κB, IL-6, and TNF-α in sWAT. HIFU decreased the expression of cilia disassembly-related factors (AurA and HDAC9) in ASCs. Furthermore, HIFU increased the expression of cilia assembly-related factors (KIF3A and IFT88), decreased that of WNT5A/β-catenin, and increased that of the adipogenesis markers PPARγ and CEBPα in sWAT. HIFU increased the number of adipocytes in the sWAT and the thickness of sWAT. In conclusion, HIFU could selectively increase sWAT levels by modulating the cilia of ASCs and be used for skin rejuvenation.
Backgrounds/Aims. Watson for Oncology (WFO) is a cognitive technology that processes medical information by analyzing the latest evidence and guidelines. However, studies of the concordance rate ...between WFO and clinicians for advanced gastric cancer (AGC) are lacking. Methods. We retrospectively reviewed 65 patients with AGC who consulted WFO and the Gachon Gil Medical Center multidisciplinary team (GMDT) in 2016 and 2017. The recommendations of WFO were compared with the opinions of the GMDT. WFO provided three treatment options: recommended (first treatment option), for consideration (second treatment option), and not recommended. Results. In total, 65 patients (mean age 61.0 years; 44 males and 21 females) were included in the study. The concordance rate between WFO and the GMDT was 41.5% (27/65) at the recommended level and 87.7% (57/65) at the for consideration level. The main causes of discordance between WFO and the GMDT were as follows. First, WFO did not consider the medical history. Second, WFO recommended the use of agents that are considered outdated in Korea. Third, some patients wanted to be involved in a clinical trial. Fourth, some patients refused to use the biologic agents recommended by WFO for financial reasons as they were not covered by medical insurance. Conclusions. The concordance rate at the recommended level was relatively low but was higher at the for consideration level. Discordances arose mainly from the different medical circumstances at the Gachon Gil Medical Center (GMC) and the Memorial Sloan Kettering Cancer Center (MSKCC), the main WFO consulting center. The utility of WFO as a tool for supporting clinical decision making could be further improved by incorporating regional guidelines.
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