• Archives of Plastic Surgery
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• v.37 no.6
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• pp.736-741
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• 2010

Purpose: Radical surgical extirpation in advanced breast cancer patients produces extensive loss of skin with large defects requiring plastic surgical procedures for the closure. Many reconstructive methods exist, the choice of which depends upon the characteristic of the wound, extent of resection and patient comorbidities. For adequate coverage of the large skin defects following resection of advanced breast cancer, current authors have performed a thoracoabdominal flap. Methods: From August 2008 to June 2009, 4 cases of thoraco-abdominal flap were performed for chest wall reconstruction after mastectomy of advanced breast cancer. Flap dissection was entirely performed in a subfascial plane and the flap involving the external oblique abdominal muscle. The flap was rotated clockwise in left chest wall defects and counterclockwise in right chest defects and the donor site was closed directly. Results: Their mean age, 55.7 years and the average follow-up interval was 9 months. Patients' oncologic status ranged from stage IIIc to stage IV, it was classified according to the TNM staging system. Flap dimensions ranged between $15{\times}15$ and $25{\times}25\;cm$. One flap sustained a partial loss at the distal margin and revision with pectoralis major musculocutaneous island flap. Conclusion: Large chest wall reconstructions are usually required after radical excision of advanced cancer stages patients with poor general conditions. Thoracoabdominal flap is a simple, quick single-stage procedure, and offer to patient fast recovery, low complication rate, enabling further concomitant adjuvant therapy.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.262-269
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• 1999

Background: To review the middle and long term results of aortic valve replacement(AVR) for 11 years, we surveyed and followed up the patients who underwent AVR. Material and Method: Between Feb. 1986 and May 1997, 134 patients underwent AVR. The patients consisted of 71 men and 63 women whose mean age was 38.9 years, ranging from 17 to 70. Result: The concomitant operations were 62 mitral valve replacement(MVR), 14 MVR + tricuspid valve annuloplasty, 10 Cabrol operation, 16 aortic annulus widening, and so forth. We used 119 mechanical(75 St. Jude Medical, 38 CarboMedics, 6 Sorin) and 15 tissue (Carpentier-Edwards) valves. Early postoperative complications occurred in 35 cases; 9 congestive heart failure, 6 low cardiac output, 5 postoperative bleeding, 5 pleural effusion, and so forth. There were 13 early postoperative deaths(9.7%) due to low cardiac output(5), CHF (2), disseminated intravascular coagulopathy(2), and so forth. The cumulative total follow-up period was 452.7 patient-years with a mean of 3.4${\pm}$3.1 years/patient. There were 9 cases of valve-related complications; anticoagulant-related bleeding(4), prosthetic valve endocarditis(2), thromboembolism(2) and prosthetic valve failure(1) occured at rate of 0.9, 0.4, 0.4, 0.2%/ pt-yr, respectively. Late valve-related death occurred in 3 cases(2.0%/pt-yr) associated with anticoagulant-related bleeding(2) and prosthetic valve endocarditis(1). Conclusion: Actuarial survival rate by Kaplan-Meier method was 91.0${\pm}$4.3 % at 11 years.

• Journal of Chest Surgery
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• v.30 no.6
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• pp.607-612
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• 1997

Between March 1963, and December 1994, fifty-three patients with a ruptured aneurysm of sinus of Vasalva(RSV) were operated. The RSV originated from the right coronary sinus in 43 patients(81%), from the non coronary sinus in 7 patients(13%), and from combined sinuses in 2 patients. The RSV from the right coronary sinus mainly drained to the right ventricle(81.4%), and the RSV from the non coronary sinus mainly drained to the right atrium(71.4%). Recently, we are using patch to repair the RSV through a double approach. During the operation, concomitant . procedures were performed; 32 Patch repairs of VSD, 14 aortic valvuloplasty, 10 aortic valve replacement, 2 tricuspid valvuloplasty, and one Bentall's procedure. During the follow up period between 1 and 31 years(mean 8 years, 94% follow up), there were 2 late deaths and 14 late complications. Actuarial 10-year survival rate .was 95%, and 10-year actuarial freedom from late event was 53 %. Factor analysis revealed that the combined SBE is a risk factor of late event. Actuarial freedom from failure of aortic valvuloplasty was 55% at 9 years. Although surgical repair of RSV achieved excellent long term survival, aortic regurgitation and endocarditis revealed significant risk factor in long-term results. Therefore, more attention should be required in patients of RSV associated with aortic regurgitation or endocarditis.

• Korean Journal of Soil Science and Fertilizer
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• v.36 no.5
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• pp.290-303
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• 2003

Modern agriculture has been heavily dependent on chemical fertilizers to meet the food demands of ever increasing population. Progressive depletion of major plant nutrients in soil due to intensive cultivation practices has also necessitated the use of higher dose of chemical fertilizers particularly in soils where the organic matter content is very low. Indiscriminate use of chemical fertilizers and pressure on agriculturists to enhance per area crop yields has led to fast depletion of fossil fuel resources with concomitant increase in the prices of chemical fertilizers and also led to environmental pollution. Hence, the current trend throughout the world is to explore the possibility of using alternate nutrient sources or increasing the efficiency of chemical fertilizers by supplementing them with organic fertilizers and bioinoculants comprising largely microbes like, bacteria, fungi, algae etc to enhance nitrogen and phosphates in the soil thus creating a sustainable agricultural environment. Among the different microbial inoculants or biofertilizers, Azospirillum could be a potential candidate due to its non specific host root colonization. It had the capability to fix $N_2$ in wide pH regimes and even in presence of combined nitrogen. Azospirillum inoculation can increase the crop yield to 10-25% and substitute 25% of recommended doses of nitrogenous fertilizers. Apart from nitrogen fixation, Azospirillum is also involved in the root improvement, the activity which was attributed to an increase in the rate of water and mineral uptake by roots. The ability of Azospirillum to produce phytohormones was reported to enhance the root respiration rate, metabolism and root proliferation. They have also been reported to produce polyhydroxybutyrate, that can be used as a biodegradable thermosplastic. A lot of studies have addressed improvements in enhancing its efficiency to fix nitrogen fixation and hormone production.

• Radiation Oncology Journal
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• v.36 no.3
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• pp.200-209
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• 2018

Purpose: To evaluate the effectiveness and feasibility of chemoradiotherapy (CRT) using simultaneous integrated boost-intensity modulated radiotherapy (SIB-IMRT) in locally advanced pancreatic cancer (LAPC) patients. Materials and Methods: Between January 2011 and May 2015, 47 LAPC patients received CRT using SIB-IMRT. Prior to SIB-IMRT, 37 patients (78.7%) received induction chemotherapy (IC-CRT group) and remaining 10 patients (21.3%) did not received induction chemotherapy (CRT group). During SIB-IMRT, all patients received concomitant chemotherapy, with gemcitabine (n = 37) and capecitabine (n = 10). Results: At the time of analysis, 45 patients had died and 2 patients remained alive and the median follow-up time was 14.2 months (range, 3.3 to 51.4 months). For all patients, the median times of local progression-free survival (LPFS), progression-free survival (PFS), and overall survival (OS) were 18.1, 10.3, and 14.2 months, respectively. The median time of LPFS between IC-CRT and CRT groups was similar (18.1 months vs. 18.3 months, p = 0.711). IC-CRT group had a higher trend in PFS (10.9 months vs. 4.1 months, p = 0.054) and had significantly higher OS (15.4 months vs. 9.5 months, p = 0.007) than CRT group. In multivariate analysis, the use of induction chemotherapy and tumor response were significant factors associated with OS (p < 0.05, each). During SIB-IMRT, toxicity of grade ≥3 was observed in 7 patients (14.9%) in all patients. Conclusions: CRT using SIB-IMRT is feasible and promising in LAPC patients.

• Molecules and Cells
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• v.40 no.2
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• pp.133-142
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• 2017

Previous studies have shown that bone marrow mesenchymal stromal cell (MSC) transplantation significantly improves the recovery of neurological function in a rat model of intracerebral hemorrhage. Potential repair mechanisms involve anti-inflammation, anti-apoptosis and angiogenesis. However, few studies have focused on the effects of MSCs on inducible nitric oxide synthase (iNOS) expression and subsequent peroxynitrite formation after hypertensive intracerebral hemorrhage (HICH). In this study, MSCs were transplanted intracerebrally into rats 6 hours after HICH. The modified neurological severity score and the modified limb placing test were used to measure behavioral outcomes. Blood-brain barrier disruption and neuronal loss were measured by zonula occludens-1 (ZO-1) and neuronal nucleus (NeuN) expression, respectively. Concomitant edema formation was evaluated by H&E staining and brain water content. The effect of MSCs treatment on neuroinflammation was analyzed by immunohistochemical analysis or polymerase chain reaction of CD68, Iba1, iNOS expression and subsequent peroxynitrite formation, and by an enzyme-linked immunosorbent assay of pro-inflammatory factors (IL-$1{\beta}$ and TNF-${\alpha}$). The MSCs-treated HICH group showed better performance on behavioral scores and lower brain water content compared to controls. Moreover, the MSC injection increased NeuN and ZO-1 expression measured by immunochemistry/immunofluorescence. Furthermore, MSCs reduced not only levels of CD68, Iba1 and pro-inflammatory factors, but it also inhibited iNOS expression and peroxynitrite formation in perihematomal regions. The results suggest that intracerebral administration of MSCs accelerates neurological function recovery in HICH rats. This may result from the ability of MSCs to suppress inflammation, at least in part, by inhibiting iNOS expression and subsequent peroxynitrite formation.

• Neonatal Medicine
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• v.15 no.1
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• pp.61-66
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• 2008

Purpose : The purpose of this study was to describe the epidemiologic features of febrile illnesses in newborns and to predict the risk of serious infections in this population. Methods : A retrospective study was conducted on 123 full-term infants <30 days of age with an axillary temperature >38$^{\circ}C$ who were hospitalized between 2000 and 2006. Neonates with prenatal risk factors, congenital anomalies, antibiotic administration prior to admission to the hospital, or suspected hospital-acquired infections were excluded. We evaluated the symptoms, physical examination findings, laboratory data, and clinical course between the high- and low-risk groups for serious infections. Results : The high-risk group included 30 infants with the following diagnoses in order of frequency: aseptic meningitis, urinary tract infection, bacterial meningitis, infectious enteritis, sepsis concomitant with disseminated intravascular coagulopathy, bacteremia, pneumonia, cellulitis, and omphalitis. Leukocytosis and thrombocytopenia were statistically different between the two groups. Factors, such as moaning signs, seizures, body temperature, and pulse rate were statistically significant. Conclusion : Unlike previous studies, we included newborns with clinical bacterial infections and aseptic meningitis as the high-risk group. Leukocytosis, thrombocytopenia, moaning signs, seizures, and changes in vital signs were considered useful predictors for identifying febrile neonates at high-risk for serious infections in spite of a difference in the definition of serious infection.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.52 no.2
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• pp.134-140
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• 2019

A feeding trial was conducted to investigate the effects of dietary fish meal replacement by a blend of lysine cell mass, corn protein concentrate and poultry by-product meal on the growth and blood chemistry of the starry flounder Platichthys stellatus. The fish meal replacer (FMR) was prepared to have the same level of protein as fish meal (FM). With a commercial diet as a positive control, five experimental diets (basal, FM42, FM32, FM22 and FM12) were formulated to contain 52% protein and 10% lipid. The dietary FM levels decreased from 52% (basal) to 42, 32, 22 and 12% with concomitant increase in the FMR to 10, 20, 30, 40 and 50%, respectively. Juvenile starry flounder with an average body weight of 177.3 g were randomly distributed in each (30 fish/tank) of 18 plastic tanks ($139{\times}99{\times}54cm$). After a 45-day feeding trial, the survival rate ranged from 95.6% (FM22) to 100% (control and FM42), while the weight gain of the fish groups varied from 49.7 to 58.4 g. The results clearly revealed that starry flounder can grow well on a diet containing low FM (12%) with a high level of FMR (50%) without any adverse effects.

• Journal of Life Science
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• v.29 no.9
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• pp.964-971
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• 2019

Hepatic lipid accumulation and insulin resistance increases in patients with non-alcoholic fatty liver disease. Piperine is a major compound found in black pepper (Piper nigrum) and long pepper (P. longum). Piperine has been used in fine chemical for its anti-cancer, anti-obesity, anti-diabetic, anti-inflammatory and anti-oxidant properties. However, the signaling-based mechanism of piperine and its role as an inhibitor of lipogenesis and insulin resistance in human hepatocyte cells remains ill-defined. In the present study, we explored the effects of piperine on lipid accumulation and insulin resistance, and explored the potential underlying molecular mechanisms in palmitate-treated HepG2 cells. Piperine treatment resulted in a significant reduction of triglyceride content. Furthermore, piperine treatment decreased palmitate-treated intracellular lipid deposition by inhibiting the lipogenic target genes, sterol-regulatory-element-binding protein 1c (SREBP-1c) and fatty acid synthase (FAS); whereas the expression of carnitine palmitoyl transferase (CPT-1) and phosphorylation of acetyl coenzyme A carboxylase (ACC) gene involved in fatty acid oxidation was increased. Moreover, piperine also inhibited the phosphorylation of insulin receptor substrate (IRS)-1 (Ser307). Piperine treatment modulated palmitate-treated lipid accumulation and insulin resistance in HepG2 cells with concomitant reduction of lipogenic target genes, such as SREBP-1 and FAS, and induction of CPT-1-ACC and phosphorylation of IRS-1 (Tyr632)-Akt pathways. Therefore, piperine represents a promising treatment for the prevention of lipid accumulation and insulin resistance.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.5
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• pp.417-430
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• 2019

The policies developed for the treatment of Helicobacter pylori infection in adults may not be the most suitable ones to treat children and adolescents. Methods used to treat children and adolescents in Europe and North America may not be appropriate for treating children and adolescents in Korea due to differences in epidemiological characteristics of H. pylori between regions. Moreover, the agreed standard guidelines for the treatment of H. pylori infection in children and adolescents in Korea have not been established yet. In this study, the optimal treatment strategy for H. pylori infection control in children and adolescents in Korea is discussed based on these guidelines, and recent progress on the use and misuse of antimicrobial agents is elaborated. Non-invasive as well as invasive diagnostic test and treatment strategy for H. pylori infection are not recommendable in children aged less than ten years or children with body weight under 35 kg, except in cases of clinically suspected or endoscopically identified peptic ulcers. The uncertainty, whether enough antimicrobial concentrations to eradicate H. pylori can be maintained when administered according to body weight-based dosing, and the costs and adverse effects outweighing the anticipated benefits of treatment make it difficult to decide to eradicate H. pylori in a positive noninvasive diagnostic test in this age group. However, adolescents over ten years of age or with a bodyweight of more than 35 kg can be managed aggressively as adults, because they can tolerate the adult doses of anti-H. pylori therapy. In adolescents, the prevention of future peptic ulcers and gastric cancers is expected after the eradication of H. pylori. Bismuth-based quadruple therapy (bismuth-proton pump inhibitor-amoxicillin/tetracycline-metronidazole) with maximal tolerable doses and optimal dose intervals of 14 days is recommended, because in Korea, the antibiotic susceptibility test for H. pylori is not performed at the initial diagnostic evaluation. If the first-line treatment fails, concomitant therapy plus bismuth can be attempted for 14 days as an empirical rescue therapy. Finally, the salvage therapy, if needed, must be administered after the H. pylori antibiotic susceptibility test.