LEDs are widely used for both general and automotive lighting since their brightness can be easily regulated by controlling their on/off time using methods such as pulse width modulation (PWM). ...However, lighting control using PWM can cause temporal light artefacts, such as the phantom array effect, which affect human visual perception. In this study, we determined the influence of different colour temperatures on the visibility of the phantom array effect using five LEDs with different spectral distributions (red, green, blue, warm white and cool white) and frequencies of temporal modulation ranging from 1 kHz to 11 kHz. The threshold of the warm white LED was between that of the green and red LEDs, and threshold of the cool white LED was between that of the red and blue LEDs. The experimental results revealed a difference in the threshold frequency of the visibility of the phantom array effect, in accordance with the spectral distribution and the colour temperature of the light source.
Abstract
Background
Multiple stenting in the chronic total occlusion (CTO) lesions is frequently required, however associated with poorer clinical outcomes. It is demonstrated that intravascular ...ultrasound (IVUS)-guided CTO-percutaneous coronary intervention (PCI) is related to a lower risk of adverse clinical events.
Purpose
We aimed to evaluate the clinical impact of stent optimization under IVUS guidance for multiple stenting, comparing with single stenting.
Methods
A total of 916 patients receiving drug-eluting stent (DES) under IVUS guidance were classified into two groups (stent optimization and non-optimization) according to optimization criteria (an absolute expansion criteria; minimal stent area ≥4.9 mm2 and a relative expansion criteria; 80% of mean reference lumen area). Of total population, 314 patients (34.3%) were treated with single stent and 575 patients (62.7%) were treated with multiple stents, respectively. Ischemic-driven target-lesion revascularization (TLR)/reocclusion was evaluated.
Results
Under IVUS guidance, 316 patients (34.5%) met IVUS criteria for stent optimization The achieving rates were 53% in the single stent group and 24% in the multiple stents group, respectively, (p<0.001). During a median of 4.7 years, the multiple stent group showed a significantly higher TLR/reocclusion rate, compared with the single stent group (12.8% vs. 5.2%, adjusted hazard ratio HR 2.51, 95% confidence interval CI 1.20–5.25, p=0.01). (Figure 1) Meeting both the absolute and relative expansion criteria was associated with a significantly low rate of TLR/reocclusion rate (12.5% vs. 5.2%, adjusted HR 0.34, 95% CI: 0.15–0.79, p=0.01). Under IVUS-guidance, there was no significant difference between multiple stenting and single stenting in case of achieving the optimization criteria (6.5% vs. 4.2%, p=0.11), whereas non-optimization group in the patients with multiple stenting showed a significantly higher rate of TLR/reocclusion, compared with IVUS-optimization group in the patients with single stenting (14.5% vs. 4.2%, p=0.002). (Figure 2)
Conclusions
In CTO-PCI with DES, multiple stenting significantly increased the risk of TLR/reocclusion. IVUS-guided optimization for multiple stenting showed a comparable long-term risk of TLR/reocclusion to single stenting with IVUS optimization. Hence, achieving IVUS expansion criteria may help to reduce the risk of TLR/reocclusion in CTO-PCI with multiple DES overlapping.
Funding Acknowledgement
Type of funding sources: None.
Introduction
Hwa-Byung is a mental syndrome classified as a “cultural-related syndrome” which reflects the cultural characteristics of Korea in DSM-IV. Hwa-Byung is caused by anger, which is ...characterized by feelings of anger or resent about unreasonable social violence and trauma. Kwon et al (2008) had developed self-report measure to assess severity of Hwa-Byung but it has several limitations to use in current clinical settings. Therefore, we investigated opinions of experts who have professionality in giving treatment of Hwa-Byung patients in the clinical settings.
Objectives
The present study aimed to reach consent of oriental neuropsychiatrists’ opinions about the direction of revision of the Hwa-Byung scale.
Methods
The Delphi method is a survey method that induces people to freely present their opinions without face-to-face processes and reaches consent through continuous feedback of survey results while ensuring anonymity. The Consensus Panel consists of 16 experts who are Oriental neuropsychiatrists and have experience in diagnosing patients with Hwa-Byung. A total of four surveys were conducted as consensus was reached on the fourth round. Each questionnaire was distributed by mail to a panel of experts and was asked to submit a response after receiving the questionnaire.
Results
The results of the study are as follows. First, common factors for Hwa-Byung include anger, resent/blame, modify memory bias and attention bias for anger events. Second, characteristics of young Hwa-Byung patients include stress caused by social factors and excessive immersion in certain things such as drinking or smoking.
Conclusions
Therefore, when revising the Hwa-Byung scale, it would be necessary to include these factors.
Disclosure
No significant relationships.
Introduction
Hwa-Byung is characterized by feelings of anger or resent about unreasonable social violence and trauma. Although Prevalence of Hwa-Byung is high in middle-aged, recently Hwa-Byung is ...occurred in young people. And it is suggested that young Hwa-Byung patients will show different patterns from middle-aged.
Objectives
The purpose of present study was to qualitatively analyze young Hwa-Byung patients’ experiences of symptoms and psychological characteristics related to antecedent events of Hwa-Byung.
Methods
10 women aged 20s were Interviewed using semi-structured questionnaires to in-depth study on their experiences related to Hwa-Byung. The interview data were analyzed using phenomenological approach in order to understand the essence of experiences. In particular, it was analyzed through five steps according to Giorgi (1985). First, by repeatedly reading the material, recurring themes were identified. Second, the meaning units were divided to capture important parts of participants’ statements. Third, similar meaning units were grouped together. Fourth, the determined meaning units were described in psychological term. Finally, research data were integrated and presented according to the described meaning units. Reliability between coders was higher than the minimum reliability coefficient.
Results
In symptoms, two themes and seven sub-themes were emerged. In psychological characteristics, three components and five sub-themes were derived. In particular, the antecedent events of young Hwa-Byung patients were related to vertical social relationships, suggesting that Hwa-Byung need to be understood under social context which make them angry.
Conclusions
Present study revealed the social context of Hwa-Byung by discussing the differences between young and middle-aged patients, and furthermore, differences between Hwa-Byung and depression, PTSD patients.
Disclosure
No significant relationships.
Introduction
Hwa-Byung is a cultural-related mental syndrome that reflects the cultural characteristics of Korean in DSM-IV. This syndrome is caused by anger or resentment towards unreasonable social ...violence and trauma.
Objectives
The purpose of this study is to revise and validate the ’Hwa-Byung scale’, which can be used to diagnose Hwa-Byung and evaluate the severity of its symptoms.
Methods
To begin with, the factors of the Hwa-Byung scale were set based on the previous studies. Additionally, the respective subfactors were generated by the semi-structured interviews with these patients. Based on these factors and previous studies, a 142-item pool was developed and verified by six Oriental Neuropsychiatrists. A pilot study was conducted on 50 patients with Hwa-Byung and the main study for the validation was conducted on 200 Hwa-Byung patients. Item analysis, internal consistency, and exploratory/confirmatory factor analysis were performed. Lastly, this study analyzed the ROC curve to present the diagnostic cut-off score of the scale.
Results
As a result of analyzing the content validity of the item pool, we constructed a preliminary scale. We excluded the inadequate questions from the pilot study results. In the main study, The Hwa-Byung scale showed high internal consistency and its items were suitable for the factor structure. Finally, we suggest an optimal cut-off score of the symptoms sub-scale for screening Hwa-Byung.
Conclusions
Overall, the results of this study indicated the reliability and validity of the Hwa-Byung Scale. Based on these results, we discussed several values and limitations of this study and provided suggestions for further research.
Disclosure
No significant relationships.
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of early and locally-advanced non-small-cell lung ...cancer (NSCLC) was published in 2017, and covered the diagnosis, staging, management and treatment of both early stage I and II disease and locally-advanced stage III disease. At the ESMO Asia Meeting in November 2018, it was decided by both the ESMO and the Korean Society of Medical Oncology (KSMO) to convene a special face-to-face guidelines meeting in 2019 in Seoul. The aim was to adapt the ESMO 2017 guidelines to take into account potential differences related to ethnicity, cancer biology and standard practices associated with the treatment of locally-advanced, unresectable NSCLC in Asian patients. These guidelines represent the consensus opinions reached by those experts in the treatment of patients with lung cancer who represented the oncology societies of Korea (KSMO), China (CSCO), India (ISMPO), Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and it was independent of both local current treatment practices and the treatment availability and reimbursement situations in the individual participating Asian countries.
Summary
Background Although cytomegalovirus (CMV) disease is a severe complication among immunocompromised patients, its cutaneous features have not been frequently reported. As herpes simple virus ...(HSV) infection commonly develops in CMV skin lesions, a study is needed on the pathogenetic role of CMV in cutaneous lesion formation.
Objectives The purpose of this study is to characterize the clinical and histopathological features of cutaneous CMV infection and to determine whether CMV plays a true pathogenetic role in cutaneous lesions, or if it is just an innocent bystander during HSV infection among non‐AIDS (acquired immune deficiency syndrome), immunocompromised patients.
Patients and methods A total of nine human immunodeficiency virus‐negative patients diagnosed with cutaneous CMV infection from July 1999 to February 2005 at Samsung Medical Center were analysed in terms of their clinical and histopathological characteristics. In addition, we examined for the co‐presence of HSV by performing immunohistochemical analysis and polymerase chain reaction.
Results All the patients were immunocompromised; five had haematological diseases and four were organ transplant recipients. The clinical and histopathological features were similar to those of previous studies of patients with AIDS. Multiple anogenital ulcerations were the most frequent cutaneous presentation (66·7%). Most cytopathic changes were found in the dermis, particularly within the vascular endothelial cells (77·8%) and macrophages (66·7%). However, the association of CMV with concurrent HSV infection was even lower than that seen in patients with AIDS. Only one patient revealed a co‐existing cutaneous HSV infection.
Conclusions In non‐AIDS individuals, the cutaneous lesions from CMV infection showed similar clinical and histopathological features to those of patients with AIDS. However, skin lesions may not be highly associated with HSV, and CMV does seem to contribute to lesion development as a cutaneous manifestation among the CMV infected, non‐AIDS, immunocompromised patients.
Abstract Aim This study aimed to evaluate the surgical safety and clinical effectiveness of RH compared to OH and LH for endometrial cancer. Methods We searched Ovid-Medline, Ovid-EMBASE, and the ...Cochrane library for studies published through May 2015. The outcomes of interest included safety (overall; peri-operative and post-operative complications; death within 30-days; and specific morbidities), effectiveness (survival, recurrence, length of stay LOS, estimated blood loss EBL, and operative time OT), and patient-reported outcomes (pain score, pain medication use, length of pain medication use, and time to return to work). Two independent reviewers extracted data and assessed the risk of bias. Results Twenty-four studies comparing RH to OH and 24 comparing RH to LH were identified. No significant differences were found in survival outcomes. The LOS was shorter, there was less EBL, and the rates of complications, readmission, and transfusion were lower with RH compared to OH. However, RH showed a longer OT and a higher incidence of vaginal cuff dehiscence compared to those for OH. Compared to LH, the LOS was shorter, there was less EBL, and the rates of conversion to laparotomy, intra-operative complications, urinary tract injuries, and cystotomy were lower in RH. Several patient-reported outcomes showed a significant benefit of RH, but each outcome was reported in only one study. Conclusions RH may be a generally safer and better option than OH and LH for patients with endometrial cancer. Further prospective studies with long-term follow-up are required.
This study aimed to analyze the use of the revised International Prognostic Scoring System (IPSS-R) assessed after hypomethylating treatment (HMT) for patients with myelodysplastic syndrome (MDS) ...undergoing an allogeneic stem cell transplantation (SCT). Among 115 patients who received pre-SCT HMT, comparison analysis of the prognostic values between the IPSS-R at the time of HMT (IPSS-R@HMT) and at the time of SCT after HMT (IPSS-R@SCT) showed a significantly higher predictive power for overall survival (OS) of the latter. Alteration in IPSS-R risk occurred in 60%, while the patients with 'down-staged' IPSS-R@SCT showed better OS compared with those with 'unchanged' or 'up-staged' risk. On multivariate analysis in all 201 patients, IPSS-R@SCT, monosomal karyotype, treatment failure to pre-SCT treatment, and high hematopoietic cell transplantation-comorbidity index were independently associated with OS. Constructed using these factors, the MDS Transplantation Prognostic Scoring System (MTPSS) identified four risk groups with 4-year OS of 76.4% in low, 61.4% in intermediate-1 and 21.9% in intermediate-2 risk groups, whereas all in the high risk group died within 2 years after SCT (P<0.001). Our study emphasizes the need for further studies aiming to evaluate a transplantation prognostic model such as the MTPSS to make appropriate decisions for transplantation in MDS.
Crown shapes in mammalian teeth vary considerably from species to species, and morphological characters in crown shape have been used to identify species. Cusp pattern is one of the characters in ...crown shape. In the processes governing the formation of cusp pattern, the Shh pathway has been implicated as an important player. Suppression of Shh signaling activity in vitro in explant assays appears to induce supernumerary cusp formation in wild-type tooth germs. However, the in vivo role of Shh signaling in cusp pattern formation and the molecular mechanisms by which Shh regulates cusp patterning are not clear. Here, through in vivo phenotypic analyses of mice in which Shh activity was suppressed and compared with wild-type mice, we characterized differences in the location, number, incidence, and shape of supernumerary cusps in molars at embryonic day 15.5. We found that the distances between cusps were reduced in molars of Shh activity–suppressed mice in vivo. These findings confirm and extend the previous idea that Shh acts as an inhibitor in the reaction-diffusion model for cusp pattern formation by negatively regulating the intercuspal distance. We uncovered a significant reduction of expression level of Sostdc1, which encodes a secreted modulator of Wnt signaling, after suppression of Shh activity. The supernumerary cusp formation in Sostdc1−/− mice and compound Sostdc1 and Lrp mutant mice indicates a strong association between Wnt and Shh signaling pathways in cusp patterning. In further support of this idea, there is a high degree of similarity in the supernumerary cusp patterns of mice lacking Sostdc1 or Shh at embryonic day 15.5. These results suggest that Shh plays an inhibitory role in cusp pattern formation by modulating Wnt signaling through the positive regulation of Sostdc1.
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