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Managing benign tumours of the external nose involves balancing optimal excision with the preservation of nasal function and aesthetics. This study aims to identify histologic diagnoses, surgical strategies and post-operative outcomes.
Methods
A retrospective cohort study was conducted from November 2006 to March 2023. All surgeries were performed by a single surgeon
Results
The included 24 patients with a mean age of 32.7 ± 19.2 years (range, 3 months to 65 years) at diagnosis. Tumours were predominantly located on the nasal dorsum (n = 11). Among the 11 histologic tumour types, haemangioma was the most common (n = 8). Most patients (70.8 per cent) underwent an open rhinoplasty approach. Recurrence occurred in four patients (16.7 per cent).
Conclusion
Benign tumours of the external nose exhibit diverse pathology. Partial tumour removal may be considered in extensive cases with skin involvement for preserving nasal aesthetics. A tailored surgical strategy is crucial for managing these rare tumours.
Mineralization of microbial biomass is a common phenomenon in geothermal habitats, but knowledge of the structure of the minerals formed in these environments is limited. A combination of spectroscopic, microscopic, and stable isotopic methods, as well as the chemical analysis of spring water, were employed in the present study to characterize calcium carbonate minerals deposited in filamentous cyanobacterial mats in different locations of La Duke hot spring, a circumneutral thermal feature near the north entrance of Yellowstone National Park, Montana, USA. Calcite was the primary crystalline mineral phase associated with biofilm-containing deposits closest to the source of the spring and the suspended microbial biomass in a pool further from the source. The carbonate minerals at all sites occurred as aggregated granules, ~2 μm in diameter, in close association with the microbial biomass. Only in the deposits closest to the source were the granules organized as laminated structures interspersed with microbial biomass. The calcium carbonate grains contained two distinct regions: a dense monolithic calcite core and a porous dendritic periphery containing organic matter (OM). Electron energy loss spectroscopy (EELS) indicated that the voids were infilled with OM and carbonates. The EELS technique was employed to distinguish the source of carbon in the organic matter and carbonate mixture. The studies of carbon isotope compositions of the calcium carbonates and the saturation indices for calcite in the spring waters suggest that processes (abiotic vs. biotic) controlling the carbonate formation may vary among the sampling sites.
Brain ageing, the primary risk factor for cognitive impairment, occurs because of the accumulation of age-related neuropathologies. Identifying effective nutrients that increase cognitive function may help maintain brain health. Tomatoes and lemons have various bioactive functions and exert protective effects against oxidative stress, ageing and cancer. Moreover, they have been shown to enhance cognitive function. In the present study, we aimed to investigate the effects of tomato and lemon ethanolic extracts (TEE and LEE, respectively) and their possible synergistic effects on the enhancement of cognitive function and neurogenesis in aged mice. The molecular mechanisms underlying the synergistic effect of TEE and LEE were investigated. For the in vivo experiment, TEE, LEE or their mixture was orally administered to 12-month-old mice for 9 weeks. A single administration of either TEE or LEE improved cognitive function and neurogenesis in aged mice to some extent, as determined using the novel object recognition test and doublecortin immunohistochemical staining, respectively. However, a significant enhancement of cognitive function and neurogenesis in aged mice was observed after the administration of the TEE + LEE mixture, which had a synergistic effect. N-methyl-d-aspartate receptor 2B, postsynaptic density protein 95, and brain-derived neurotrophic factor (BDNF) levels and tropomyosin receptor kinase B (TrkB)/extracellular signal-regulated kinase (ERK) phosphorylation also synergistically increased after the administration of the mixture compared with those in the individual treatments. In conclusion, compared with their separate treatments, treatment with the TEE + LEE mixture synergistically improved the cognitive function, neurogenesis and synaptic plasticity in aged mice via the BDNF/TrkB/ERK signalling pathway.
The “Fast track” protocol is an early extubation strategy to reduce ventilator-associated complications and induce early recovery after open-heart surgery. This study compared clinical outcomes between operating room extubation and ICU extubation after open-heart surgery in patients with CHD.
Methods:
We retrospectively reviewed 215 patients who underwent open-heart surgery for CHDs under the scheduled “Fast track” protocol between September 2016 and April 2022. The clinical endpoints were post-operative complications, including bleeding, respiratory and neurological complications, and hospital/ICU stays.
Results:
The patients were divided into operating room extubation (group O, n = 124) and ICU extubation (group I, n=91) groups. The most frequently performed procedures were patch closures of the atrial septal (107/215, 49.8%) and ventricular septal (89/215, 41.4%) defects. There were no significant differences in major post-operative complications or ICU and hospital stay duration between the two groups; however, patients in group I showed longer mechanical ventilatory support (0.0 min vs. 59.0 min (interquartile range: 17.0–169.0), p < 0.001). Patients in Group O showed higher initial lactate levels (3.2 ± 1.7 mg/dL versus 2.5 ± 2.0 mg/dL, p = 0.007) and more frequently used additional sedatives and opioid analgesics (33.1% versus 19.8%, p = 0.031).
Conclusions:
Extubation in the operating room was not beneficial for patients during post-operative ICU or hospital stay. Early extubation in the ICU resulted in more stable hemodynamics in the immediate post-operative period and required less use of sedatives and analgesics.
The aim of this study was to evaluate the impact of coronavirus disease 2019 (COVID-19) on treatment outcomes in critically ill patients with carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infection (BSI). This single-centre, retrospective cohort study was conducted in a 1,048-bed university-affiliated tertiary hospital in the Republic of Korea from January 2021 to March 2022. The study participants included consecutive hospitalised adult patients (aged ≥18 years) in the intensive care unit with CRAB monomicrobial BSI. During the study period, a total of 70 patients were included in our study, and 24 (34.3%) were diagnosed with COVID-19. The 28-day mortality rate was 64.3%. In the multivariate Cox proportional hazard regression analysis, diagnosis of COVID-19 (hazard ratio (HR), 2.91; 95% confidence interval (CI): 1.45–5.87), neutropenia (HR, 2.76; 95% CI: 1.04–7.29), Pitt bacteraemia score (per point; HR, 1.30; 95% CI: 1.19–1.41), and appropriate definite antibiotic therapy (HR, 0.31; 95% CI: 0.15–0.62) were independent predictors of 28-day mortality in patients with CRAB BSI. In conclusion, our findings suggested that COVID-19 has a negative prognostic impact on patients with CRAB BSI. Further study is needed to investigate the specific mechanisms of how COVID-19 worsens the prognosis of CRAB infection.
Blood carotenoid concentration measurement is considered the gold standard for fruit and vegetable (F&V) intake estimation; however, this method is invasive and expensive. Recently, skin carotenoid status (SCS) measured by optical sensors has been evaluated as a promising parameter for F&V intake estimation. In this cross-sectional study, we aimed to validate the utility of resonance Raman spectroscopy (RRS)-assessed SCS as a biomarker of F&V intake in Korean adults. We used data from 108 participants aged 20–69 years who completed SCS measurements, blood collection and 3-d dietary recordings. Serum carotenoid concentrations were quantified using HPLC, and dietary carotenoid and F&V intakes were estimated via 3-d dietary records using a carotenoid database for common Korean foods. The correlations of the SCS with serum carotenoid concentrations, dietary carotenoid intake and F&V intake were examined to assess SCS validity. SCS was positively correlated with total serum carotenoid concentration (r = 0·52, 95 % CI = 0·36, 0·64, P < 0·001), serum β-carotene concentration (r = 0·60, 95 % CI = 0·47, 0·71, P < 0·001), total carotenoid intake (r = 0·20, 95 % CI = 0·01, 0·37, P = 0·04), β-carotene intake (r = 0·30, 95 % CI = 0·11, 0·46, P = 0·002) and F&V intake (r = 0·40, 95 % CI = 0·23, 0·55, P < 0·001). These results suggest that SCS can be a valid biomarker of F&V intake in Korean adults.
Reintroductions of large carnivore species present unique opportunities to model population dynamics as populations can be monitored from the beginning of a reintroduction. However, analysis of the population dynamics of such reintroduced populations is rare and may be limited in incorporating the complex movements and environmental interactions of large carnivores. Starting in 2004, Asiatic black bears Ursus thibetanus were reintroduced and tracked in the Republic of Korea, along with their descendants, using radio telemetry, yielding 33,924 tracking points over 12 years. Along with information about habitat use, landscape, and resource availability, we estimated the population equilibrium and dispersal capability of the reintroduced population. We used a mixed modelling approach to determine suitable habitat areas, population equilibria for three different resources-based scenarios, and least-cost pathways (i.e. corridors) for dispersal. Our population simulations provided a mean population equilibrium of 64 individuals at the original reintroduction site and a potential maximum of 1,438 individuals in the country. The simulation showed that the bear population will disperse to nearby mountainous areas, but a second reintroduction will be required to fully restore U. thibetanus. Northern suitable habitats are currently disconnected and natural re-population is unlikely to happen unless supported. Our methodologies and findings are also relevant for determining the outcome and trajectories of reintroduced populations of other large carnivores.
A disaster in the hospital is particularly serious and quite different from other ordinary disasters. This study aimed at analyzing the activity outcomes of a disaster medical assistance team (DMAT) for a fire disaster at the hospital.
Methods:
The data which was documented by a DMAT and emergent medical technicians of a fire department contained information about the patient’s characteristics, medical records, triage results, and the hospital which the patient was transferred from. Patients were categorized into four groups according to results of field triage using the simple triage and rapid treatment method.
Results:
DMAT arrived on the scene in 37 minutes. One hundred and thirty eight (138) patients were evacuated from the disaster scene. There were 25 patients (18.1%) in the Red group, 96 patients (69.6%) in the Yellow group, and 1 patient (0.7%) in the Green group. One patient died. There were 16 (11.6%) medical staff and hospital employees. The injury of the caregiver or the medical staff was more severe compared to the family protector.
Conclusions:
For an effective disaster-response system in hospital disasters, it is important to secure the safety of medical staff, to utilize available medical resources, to secure patients’ medical records, and to reorganize the DMAT dispatch system.
Here, we present an overview of how a tertiary hospital responded to maintain necessary activities and protect patients and staff from the coronavirus disease (COVID-19) outbreak.
Methods:
Gil Medical Center, a tertiary hospital in Incheon, has operated a special response team since January 21, 2020. All visitors were assessed for body temperature and respiratory symptoms, and screened for recent overseas travel. Suspected COVID-19 patients were taken to a screening clinic. All febrile patients with or without respiratory symptoms were taken to a respiratory safety clinic. An isolation ward, which consisted of 10 negative-pressure rooms, was used to treat confirmed cases. More than 120 beds were prepared for the outbreak, and patients with pneumonia were preemptively isolated.
Results:
By May 5, 480 960 visitors were assessed at the control station, 3350 patients visited the triage center, and 1794 were treated in the respiratory safety clinic. Seventeen confirmed cases were admitted to the negative isolation ward, and 350 patients with pneumonia were preemptively isolated. A total of 2977 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction tests were performed.
Conclusions:
While tertiary hospitals play an important role in treating both COVID-19 patients and non-COVID-19 patients, hospital staff have to protect themselves from unexpected in-hospital transmission. A multifaceted response must be undertaken to protect tertiary hospitals and their staff during the COVID-19 epidemic.
Stable carbon isotope ratios were measured on the alpha-cellulose in tree rings of a pine tree (Pinus densiflora) from Yeongwol, Korea. We developed an annual-resolution δ13C series (1835–1905) by correcting the measured data for changes in δ13C of air to minimize non-climatic influences. To investigate the climatic signal in the δ13C series, we performed correlation analysis between δ13C and the Cheugugi climate data. The Cheugugi precipitation data were first recorded by King Sejong (1397–1450) of the Joseon Dynasty. However, the longest set of precipitation data available is the one collected in Seoul (1776–1907). Although many studies support the reliability of the Cheugugi data, no previous studies have investigated the potential of the δ13C signal in tree rings as paleoclimate proxy using the Cheugugi data. Recent precipitation trends in Yeongwol are quite similar to that of Seoul, and we found significant correlations between the Cheugugi data and the δ13C series. We suggest further studies to replicate these results and confirm whether comparing δ13C variations in tree rings and Cheugugi data is a useful method of investigating the potential of the δ13C signal as a paleoclimate proxy in or near the Korean peninsula.
The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute neuropsychology protocol consists of only verbal tasks, and is proposed as a brief screening method for vascular cognitive impairment. We evaluated its feasibility within two weeks after stroke and ability to predict the development of post-stroke dementia (PSD) at 3 months after stroke.
Method:
We prospectively enrolled subjects with ischemic stroke within seven days of symptom onset who were consecutively admitted to 12 university hospitals. Neuropsychological assessments using the NINDS-CSN 5-minute and 60-minute neuropsychology protocols were administered within two weeks and at 3 months after stroke onset, respectively. PSD was diagnosed with reference to the American Heart Association/American Stroke Association statement, requiring deficits in at least two cognitive domains.
Results:
Of 620 patients, 512 (82.6%) were feasible for the NINDS-CSN 5-minute protocol within two weeks after stroke. The incidence of PSD was 16.2% in 308 subjects who had completed follow-up at 3 months after stroke onset. The total score of the NINDS-CSN 5-minute protocol differed significantly between those with and without PSD (4.0 ± 2.7, 7.4 ± 2.7, respectively; p < 0.01). A cut-off value of 6/7 showed reasonable discriminative power (sensitivity 0.82, specificity 0.67, AUC 0.74). The NINDS-CSN 5-minute protocol score was a significant predictor for PSD (adjusted odds ratio 6.32, 95% CI 2.65–15.05).
Discussion:
The NINDS-CSN 5-minute protocol is feasible to evaluate cognitive functions in patients with acute ischemic stroke. It might be a useful screening method for early identification of high-risk groups for PSD.
Thick coatings of tetrahedral amorphous carbon (ta-C) have great existing and potential commercial importance for components such as automobile accessories. We confirmed the feasibility of depositing thick ta-C coating on Si wafer, WC, stainless steel (STS), and Al alloy substrates by a home-made filtered cathode vacuum arc. A ta-C coating of 800 nm thickness was successfully deposited over 20 min continuous coating. Interestingly, coatings with thicknesses exceeding 1 μm were easily delaminated by thermal and internal stress effects when the coating time exceeded 20 min. Varying the bias (0 V ↔ 500 V) was highly effective in controlling the internal stress relaxation of the ta-C. This method showed significant improvements in the stress relaxation of the ta-C coatings. By applying multicycle coating, the thickness and hardness of the ta-C coating could reach 9.3 μm and 45 GPa, respectively, at a coating speed of 3.0 μm/h on a fixed substrate.
A CoCrFeNiMn high-entropy alloy (HEA), in the form of a face-centered cubic (fcc) solid solution, was processed by high-pressure torsion (HPT) to produce a nanocrystalline (nc) HEA. Significant grain refinement was achieved from the very early stage of HPT through 1/4 turn and an nc structure with an average grain size of ∼40 nm was successfully attained after 2 turns. The feasibility of significant microstructural changes was attributed to the occurrence of accelerated atomic diffusivity under the torsional stress during HPT. Nanoindentation experiments showed that the hardness increased significantly in the nc HEA during HPT processing and this was associated with additional grain refinement. The estimated values of the strain-rate sensitivity were maintained reasonably constant from the as-cast condition to the nc alloy after HPT through 2 turns, thereby demonstrating a preservation of plasticity in the HEA. In addition, a calculation of the activation volume suggested that the grain boundaries play an important role in the plastic deformation of the nc HEA where the flow mechanism is consistent with other nc metals. Transmission electron microscopy showed that, unlike conventional fcc nc metals, the nc HEA exhibits excellent microstructural stability under severe stress conditions.
Decreased hemoglobin levels increase the risk of developing dementia among the elderly. However, the underlying mechanisms that link decreased hemoglobin levels to incident dementia still remain unclear, possibly due to the fact that few studies have reported on the relationship between low hemoglobin levels and neuroimaging markers. We, therefore, investigated the relationships between decreased hemoglobin levels, cerebral small-vessel disease (CSVD), and cortical atrophy in cognitively healthy women and men.
Methods:
Cognitively normal women (n = 1,022) and men (n = 1,018) who underwent medical check-ups and magnetic resonance imaging (MRI) were enrolled at a health promotion center. We measured hemoglobin levels, white matter hyperintensities (WMH) scales, lacunes, and microbleeds. Cortical thickness was automatically measured using surface based methods. Multivariate regression analyses were performed after controlling for possible confounders.
Results:
Decreased hemoglobin levels were not associated with the presence of WMH, lacunes, or microbleeds in women and men. Among women, decreased hemoglobin levels were associated with decreased cortical thickness in the frontal (Estimates, 95% confidence interval, −0.007, (−0.013, −0.001)), temporal (−0.010, (−0.018, −0.002)), parietal (−0.009, (−0.015, −0.003)), and occipital regions (−0.011, (−0.019, −0.003)). Among men, however, no associations were observed between hemoglobin levels and cortical thickness.
Conclusion:
Our findings suggested that decreased hemoglobin levels affected cortical atrophy, but not increased CSVD, among women, although the association is modest. Given the paucity of modifiable risk factors for age-related cognitive decline, our results have important public health implications.
A new class of graphene–polyselenophene (PSe) hybrid nanocomposite was successfully synthesized using an in situ synthetic method. The synthesized graphene–PSe nanocomposite exhibited unique properties including a large voltage window, high conductivity, and good mechanical properties. The graphene–PSe nanohybrid reduced the dynamic resistance of electrolyte ions and enabled high charge–discharge rates, thereby enabling high-performance supercapacitance. The results were attributed to synergetic effects between graphene and conducting polymers (CPs), which enhanced charge transport, surface area, and hybrid supercapacitance by combining the properties of electrolytic double-layer capacitors (EDLCs) with those of psedocapacitors. Additionally, a flexible supercapacitor based on the graphene–PSe nanohybrid was successfully demonstrated. To fabricate binder-free supercapacitors, chemical vapor deposition (CVD) and vapor deposition polymerization (VDP) methods were employed. The fabricated all-solid-state supercapacitor exhibited outstanding mechanical and electrochemical performance, even after several bending motions. The novel graphene–PSe nanocomposite material is promising for new energy storage and conversion applications.
Octamer-binding transcription factor 4 (Oct4) is a critical molecule for the self-renewal and pluripotency of embryonic stem cells. Recent reports have shown that Oct4 also controls cell-cycle progression and enhances the proliferation of various types of cells. As the high proliferation of donor fibroblasts is critical to the production of transgenic pigs, using the somatic cell nuclear transfer technique, we analysed the effect of Oct4 overexpression on the proliferation of porcine fibroblasts and embryos. Porcine endogenous Oct4 cDNA was cloned, sequenced and inserted into an expression vector. The vector was transfected into porcine fibroblasts, and a stable Oct4-overexpressed cell line was established by antibiotic selection. Oct4 expression was validated by the immunostaining of Oct4. Cell morphology was changed to sharp, and both proliferation and migration abilities were enhanced in Oct4-overexpressed cells. Real-time RT-PCR results showed that p16, Bcl2 and Myc were upregulated in Oct4-overexpressed cells. Somatic cell nuclear transfer was performed using Oct4-overexpressed cells, and the development of Oct4 embryos was compared with that of wild-type cloned embryos. The cleavage and blastocyst formation rates were improved in the Oct4 embryos. Interestingly, blastocyst formation of the Oct4 embryos was observed as early as day 5 in culture, while blastocysts were observed from day 6 in wild-type cloned embryos. In conclusion, the overexpression of Oct4 enhanced the proliferation of both porcine fibroblasts and embryos.
We propose a fuzzy weighted subtask controller for a redundant robot manipulator. To expand the feasibility of the inverse kinematic solution, we introduce a weighted pseudo-inverse that changes the null-space of the Jacobian. The weights of elements in the pseudo-inverse are obtained using fuzzy rules that are related to the null-space velocity tracking error. With the pseudo-inverse, we develop a task space controller to track a desired task space trajectory and subtask control input. We propose a weighted subtask controller for multiple subtasks. The results of a simulation and experiment using a seven-degree-of-freedom whole arm manipulator robot show the effectiveness of the proposed controller with multiple subtasks.