Aim/Background: Korean Radiation Oncology Group evaluated the significance of carcinoembryonic antigen (CEA) levels both as a predictor of tumor response after CRT and as a prognosticator for recurrence-free survival.

Stump appendicitis is an acute inflammation of the residual appendix and is a rare complication after appendectomy. The physician should be aware of the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy so that delayed diagnosis and treatment can be prevented. Stump appendicitis is usually treated by surgical resection, and endoscopic treatment has not been reported previously. A 48-year-old man who had undergone appendectomy 35 years earlier presented to the hospital because of right lower quadrant discomfort. A computed tomography scan showed a large stone in the residual appendix. Colonoscopic findings revealed a large, smooth, protruding lesion at the cecum with a stone inside the appendiceal orifice. Endoscopic removal after incision of the appendiceal orifice was performed successfully.

To examine the relationship between intra‐access pressures and vascular stenosis, we measured the total (pT) and static (pS) pressures and the severity of stenosis before and after percutaneous transluminal angioplasty (PTA). The dynamic pressure (△p) and static intra‐access pressure ratios (SIAPR) were calculated. We analyzed the clinical correlation of △p and SIAPR with the severity and location of stenosis, and searched potential predictive factors for the severity of stenosis using multivariate regression. While SIAPR was significantly decreased only in outflow stenosis after PTA (p < 0.0001), △p was significantly increased in both inflow and in outflow stenosis (p < 0.05). SIAPR was negatively correlated with the severity of stenosis only in outflow stenosis (p < 0.0001), and △p was significantly correlated with both inflow and outflow stenosis (p < 0.05). △p was an independent predictor for the severity of stenosis in both inflow and outflow stenosis (p < 0.05). Thus, our study suggests that △p may be more clinically useful than SIAPR not only in detecting access stenosis regardless of its location, but also providing information about the severity of stenosis.

OBJECTIVE:Silver plays an important part in severe wound management, mainly by reducing microbial growth within dressed wounds and wound beds. However, it is unknown how silver-coated dressing materials affect diabetic wounds. The purpose of this study is to evaluate the efficacy of silver-containing dressing materials for the treatment of methicillin-resistant Staphylococcus aureus (MRSA)-infected wounds in streptozotocininduced diabetic rats.METHODS:Full-thickness skin defects were created on the backs of rats with streptozotocin (STZ)-induced diabetes (n = 108) and were infected with MRSA. The rats were assigned to 6 groups according to the wound dressing used: nanocrystalline silver (Acticoat, Smith & Nephew, Inc, London, UK), silver carboxymethylcellulose (Aquacel-Ag, ConvaTec, Skillman, NJ), silver sulfadiazine (Medifoam silver, Genewel Science Co Ltd, Seongnam, South Korea), nanocrystalline silver (Poly- Mem silver, Ferris Mfg Corp, Burr Ridge, IL), silver sulfadiazine (Ilvadon, Ildong Pharmaceuticals, Seoul, South Korea), and 10% povidone iodide (control). The wound size, histological findings, and bacterial colony count for each group was analyzed and compared to normal Sprague-Dawley rats.RESULTS:Wound size decreased over time in every group. On day 10, a significant difference in wound area was detected between the silver dressing groups and the control group (P = 0.0040). In the wound biopsy, on days 4, 7, and 10, the would-healing effect increased in every group. However, between days 4 (P = 0.8250) and 10 (P = 0.9912), there was no statistical difference between groups. The number of bacteria in each group decreased with time in the bacterial wound culture. The silver dressing groups were more effective on antimicrobial efficacy, but there was no statistically significant difference between the silver dressing groups and the control group.CONCLUSION:Silver-containing dressing materials are an effective method for MRSA-infected wounds, but nano silver-containing dressing materials did not have better results in a diabetic rat model compared to a normal rat model in historical review. Further investigation is necessary to determine the relative safety of these products on the healing wound. Once that is done, the relative value of the products can be determined by balancing their antimicrobial and cytotoxicity characteristics.

UNLABELLED:CuraVAC Ag, a product that delivers negative pressure wound therapy through a polyurethane foam dressing, contains silver nanoparticles, which, when moistened with water, release silver ions onto a wound surface. The in vitro antimicrobial action of silver can destroy both gram-positive and gram-negative bacteria, as well as methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this study was to assess the efficacy and in vivo outcomes of using the product.METHODS:Thirty-six female Sprague-Dawley white rats, 8-weeks old and 250 g - 300 g in weight, were used. The experimental product was prepared using a vacuum-assisted closure (VAC) kit and coating it using the silver nanoparticles. For the control group, a 10% povidone-iodine solution was applied.RESULTS:All groups showed decreases in wound area over time, in the order CuraVAC Ag (group A) > CuraVAC (group B) > control (group C). On the third, fifth, and seventh days, wound healing efficacy scores increased in both group A and group C. Groups A and B showed more rapid decreases than group C in bacterial culture from wounds.CONCLUSION:CuraVAC Ag may be useful for treatment of wounds infected with bacteria..

Kaposi's sarcoma is one of the most serious complications associated with immune suppression treatment after kidney transplantation. Because it usually manifestations as skin lesions or lymphadenopathies, its clinical suspicion and tissue diagnosis is relatively easy. However, Kaposi's sarcoma presented as multiple pulmonary nodules without skin manifestations is not easily detected early and usually has a deadly prognosis. We present the case of a 36-year-old male who underwent kidney transplantation 13 months ago and has been on tacrolimus and mycophenolate mofetil (MMF)-based immune suppression presented dry cough, blood tinged sputum, and multiple pulmonary nodules without any skin lesions. Both bronchoscopic washing cytology and fine needle aspiration cytology of peripheral lung tissues were performed but failed due to low cellular yields. A video-assisted thoracoscopic biopsy subsequently revealed Kaposi's sarcoma. Following the diagnosis, we changed the immune suppression from a tacrolimus and MMF-based regimen to a sirolimus-based regimen. Respiratory symptoms gradually disappeared and we found complete remission on follow-up radiologic evaluations. Thus sirolimus may be the preferred method of treatment for patients with immune suppression after kidney transplantation.

During the past few years, new immunosuppressants, such as tacrolimus, mycophenolate mofetil (MMF) and basiliximab, have been shown to successfully decrease the incidence of acute rejection, possibly acting as potent substrates for safe steroid withdrawal. Therefore, clinical outcome of 3 months steroid withdrawal, while using the above immunosuppressants, was analyzed. Clinical trial registry No. was NCT 01550445. Thirty de novo renal transplant recipients were enrolled, and prednisolone was slowly withdrawn 3 months post-transplantation by 2.5 mg at every two weeks, until 8 weeks. During steroid withdrawal, 10 patients (30.0%) discontinued the protocol and they were maintained on steroid treatment. Among 20 steroid free patients, 8 patients (40.0%) re-started the steroid within 12 months post-transplantation. By the study endpoint, 12 (40%) recipients did not take steroid and survival of patients and grafts was 100%. In conclusion, in kidney transplant patients, 3 months steroid withdrawal while taking tacrolimus, basiliximab and mycophenolate mofetil was not associated with increased mortality or graft loss. Despite various causes of failure of steroid withdrawal during the follow-up period, it is a strategy well advised for kidney transplant recipients with regard to long-term steroid-related complications.

To expand the donor pool, organ donation after cardiac death (DCD) has emerged. However, kidneys from DCD donors have a period of long warm ischemia between cardiac arrest and the harvesting of the organs. Recently, we used extracorporeal membrane oxygenation (ECMO) to minimize ischemic injury during 'no touch' periods in a Maastricht category II DCD donor and performed two successful kidney transplantations. The kidneys were procured from a 49-yr-old male donor. The warm ischemia time was 31 min, and the time of maintained circulation using ECMO was 7 hr 55 min. The cold ischemia time was 9 hr 15 min. The kidneys were transplanted into two recipients and functioned immediately after reperfusion. The grafts showed excellent function at one and three months post-transplantation; serum creatinine (SCr) levels were 1.0 mg/dL and 0.8 mg/dL and the estimated glomerular filtration rates (eGFR) were 63 mL/min/1.73 m(2) and 78 mL/min/1.73 m(2) in the first recipient, and SCr levels were 1.1 mg/dL and 1.0 mg/dL and eGFR were 56 mL/min/1.73 m(2) and 64 mL/min/1.73 m(2) in the second recipient. In conclusion, it is suggested that kidney transplantation from a category II DCD donor assisted by ECMO is a reasonable modality for expanding donor pool.

A high efficiency LCD employing a color-matching backlight system that consists of a collimation lenticular lens sheet, a blazed grating, and a focusing lenticular lens array is proposed and analyzed. The RGB lights that are collimated and dispersed from the collimation lenticular lens sheet and the blazed grating are incident on the RGB color filters by the focusing lenticular lens array. The color-matched transmittance was increased 183% and 121% for divergence angles of 2° and 11°, respectively, compared to a conventional backlight that does not use a blazed grating. The design, simulation, and experimental results for the prototype color-matching backlight system are presented.

We experienced satisfactory outcomes by synchronously transplanting an artery and veinusing an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel ofa flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due toa fall injury. In this patient, the right temporal cranium was missing and the patient had 4×3cm and 6×5 cm scalp defects. We planned a scalp reconstruction using a latissimus dorsifree flap. Intraoperatively, there was a severe injury to the right superficial temporal vesselbecause of previous neurosurgical operations. A 15 cm long pedicle defect was needed toreach the recipient facial vessels. For the vascular graft, the descending branch of the lateralcircumflex femoral artery and two venae comitantes were harvested.The flap survived well and the skin graft was successful with no notable complications. Whenan interposition graft is needed in the reconstruction of the head and neck region for whichmobility is mandatory to a greater extent, a sufficient length of graft from an anterolateralflap pedicle could easily be harvested. Thus, this could contribute to not only resolving thedisadvantages of a venous graft but also to successfully performing a vascular anastomosis.

We experienced satisfactory outcomes by synchronously transplanting an artery and vein using an anterolateral thigh flap pedicle between the vascular pedicle and recipient vessel of a flap for scalp reconstruction. A 45-year-old man developed a subdural hemorrhage due to a fall injury. In this patient, the right temporal cranium was missing and the patient had 4×3 cm and 6×5 cm scalp defects. We planned a scalp reconstruction using a latissimus dorsi free flap. Intraoperatively, there was a severe injury to the right superficial temporal vessel because of previous neurosurgical operations. A 15 cm long pedicle defect was needed to reach the recipient facial vessels. For the vascular graft, the descending branch of the lateral circumflex femoral artery and two venae comitantes were harvested.The flap survived well and the skin graft was successful with no notable complications. When an interposition graft is needed in the reconstruction of the head and neck region for which mobility is mandatory to a greater extent, a sufficient length of graft from an anterolateral flap pedicle could easily be harvested. Thus, this could contribute to not only resolving the disadvantages of a venous graft but also to successfully performing a vascular anastomosis.

Aim: In this study, we examined changes in asymmetric dimethylarginine (ADMA), dimethylarginine dimethylaminohydrolase (DDAH), nitric oxide synthesis (NOS), and the arginine methylation of organ proteins during the development of diabetes in mice.Methods: Db/db mice developed significant obesity and fasting hyperglycemia during diabetogenesis. During diabetogenesis, the expression of ADMA and nNOS was increased, while that of DDAH1 and protein-arginine methyltransferase 1 (PRMT1) was decreased. Additionally, arginine methylation in the liver and adipose tissue was altered during diabetogenesis.Results: Changes were evident at 75, 60, and 52 kDa in liver tissue and at 38 and 25 kDa in adipose tissue. Collectively, DDAH and ADMA are closely associated with the development of obesity and diabetes, and the arginine methylation levels of certain proteins were changed during diabetes development.Conclusion: Protein arginine methylation plays a role in the pathogenesis of diabetes. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

【Purpose: Many topical agents had been used for contaminated wound treatment. Although antimicrobial ointments were widely used as topical agents, their comparative antibacterial and wound healing effects were largely unreported. The purpose of this study was to compare antibacterial effects and wound healing effects of common topical ointments on infected full thickness skin defect in the mouse. Methods: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups: group B (dressing with Bactroban $^{(R)}$ , n=15), group I (dressing with Iodosorb $^{(R)}$ , n=15), group T (dressing with Terramycin $^{(R)}$ , n=15), group G (control group, dressing with dry gauze, n=15). The size of wound defects and the grades of wound healing were evaluated at 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. After the wound was left open for twenty-four hours, many Staphylococcus aureus was cultured. The wound defect size was decreased in order of Bactroban $^{(R)}$ (B), Iodosorb $^{(R)}$ (I), Terramycin $^{(R)}$ and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Bactroban $^{(R)}$ , Iodosorb $^{(R)}$ , Terramycin $^{(R)}$ and gauze dressing group, and the difference was statistically significant. Antibacterial effect for was increased in order of Bactroban $^{(R)}$ , Iodosorb $^{(R)}$ , Terramycin $^{(R)}$ and gauze dressing group, and the difference was statistically significant. Conclusion: Topical antimicrobial ointments application was effective against wound infections by S. aureus. Bactroban $^{(R)}$ may be an optimal topical treatment for infected wounds according to this study. However, further study is necessary to evaluate the clinical efficacy of antimicrobial ointments and to search for the mechanisms that explain their effects.】

【Purpose: Iodine has been used for the prevention or management of wound infection as a topical agent. Although iodine was widely used mainly by Betadine $^{(R)}$ and cadexomer iodine, there was no comparative study on the efficacies of dressing methods of iodine. And also it's wound healing effect was not yet clear. The purpose of this study is to compare antibacterial effects and wound healing effects associated with various dressing methods of iodine on infected full thickness skin defect in the mouse. Methods: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups : group S (dressing with Betadine $^{(R)}$ soaking, n=15), group T (dressing with Betadine $^{(R)}$ topping, n=15), group I (dressing with Iodosorb $^{(R)}$ , n=15), group G (control group, dressing with dry gauze, n=15). The size of the wound defects and the grades of wound healing were evaluated in 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. Results: After the wound was left open for twenty-four hours, many Staphylococcus aureus were cultured. The wound defect size was decreased in order of Betadine $^{(R)}$ soaking, Iodosorb $^{(R)}$ , Betadine $^{(R)}$ topping and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Betadine $^{(R)}$ soaking, Iodosorb $^{(R)}$ , Betadine $^{(R)}$ topping and gauze dressing group, and the difference was statistically significant. Antibacterial effect for S. aureus was increased in order of Iodosorb $^{(R)}$ , Betadine $^{(R)}$ soaking, Betadine $^{(R)}$ topping and gauze dressing group, and the difference was statistically significant. Conclusion: Selection of the effective dressing method of iodine for infected wounds remains a controversial decision. According to this study, Iodosorb $^{(R)}$ may be most effective method for antibacterial effect and Betadine $^{(R)}$ soaking may be most effective method for infected wound healing. However, further study is necessary to evaluate the clinical efficacy of dressing methods of iodine and to search for the mechanisms that explain their effects.】

BACKGROUND:Methicillin-resistant Staphylococcus aureus (MRSA) may cause infections during wound dressing. We aimed to compare the antibacterial activities and wound-healing effects of commercially available silver-coated or silver-impregnated wound dressings on MRSA-infected wounds. METHODS:Full-thickness skin defects were made on the back of rats (N=108) and were infected with MRSA. The rats were divided into the following 6 groups according to the dressing used for the wounds: nanocrystalline silver (Acticoat), silver carboxymethylcellulose (Aquacel-Ag), silver sulfadiazine (Medifoam silver), nanocrystalline silver (PolyMem silver), silver sulfadiazine (Ilvadon), and 10% povidone iodide (Betadine). We analyzed the wound sizes, histological findings, and bacterial colony counts for the groups. We also inoculated the silver materials on Mueller-Hinton agar plates containing MRSA and compared the inhibition zones in the agar plates. RESULTS:The order of the rate of wound-size decrease was Acticoat>Aquacel-Ag>PolyMem silver>Medifoam silver>Ilvadon>Betadine. The histological findings revealed that the Acticoat showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The order of the time required for wound healing was Acticoat>Aquacel -Ag>PolyMem silver>Ilvadon>Medifoam silver>Betadine. The bacterial colony counts reduced in all the groups, except in the Medifoam silver group. The order of the size of the inhibition zone was Acticoat>Aquacel-Ag>Ilvadon>PolyMem silver>Betadine>Medifoam silver. CONCLUSIONS:Silver-coated or silver-impregnated wound dressings can be used for treating MRSAinfected wounds. Considering its superior efficacy in comparison to the efficacies of other silver-coated or silver-impregnated wound dressings, Acticoat should be preferentially used for the treatment of MRSA-infected skin wounds.

A great deal of exhaust gas inside a combustion room goes out through exhaust pipe. But residual gas 'Blowby gas' enters the crankcase through a small gap between the piston and the cylinder wall. Here, if the blowby gas isn't vented, this causes many bad efffcts such as lubricant oil contamination, corrosion by that and crankcase explosion by rising pressure. So most automobiles are constituted with a PCV(Positive Crankcase Ventilation) system to prevent previous problems. PCV valve is the most important part in this ventilation system. When companies are manufacturing new cases, engineers are designing it depending on their experiments than theoretical knowledges. Much efforts and times are needed for new development. This study will show quantitative results to increase the possibilities for the optimal design.

Backgroud/Aims: Endoscopic ultrasonography (EUS) has been used in assessing the depth of cancer invasion of the stomach. The aim of this study was to compare the factors which were likely to affect the diagnostic accuracy of EUS for the depth of invasion in early gastric cancer (EGC). Methods: Seventy eight EGC patients were pre-operatively examined by EUS. The depth of invasion by EUS was compared with the histopathologic finding of the resected specimen. The diagnostic accuracy of EUS was analyzed according to the factors which were likely to affect the accuracy. Results: The diagnostic accuracy of EUS for the depth of invasion was 78% (46/49) in mucosal cancer, 68.4% (13/19) in submucosal cancer (p＜0.05). Overall diagnostic accuracy of EUS in EGC was 75.6%. The diagnostic accuracy of the flat submucosal cancer was 55.6% and was significantly lower than other types of mucosal or submucosal cancers in endoscopic morphology (p＜0.05). Conclusions: The depth of invasion per se with respective endoscopic findings affected the diagnostic accuracy of EUS for the depth of invasion in EGC. Other factors did not affect the diagnostic accuracy of EUS for the depth of invasion in EGC.

Metastatic carcinomas are the largest group of malignant tumors of the liver. But parenchymal liver metastasis from cystic ovarian adenocarcinoma is very rare. We report a case in which the resection of metastatic liver neoplasm from ovarian serous cystadenocarcinoma was done 7 yr after initial treatment. A 48-yr-old oriental housewife complained of easy fatigability and right lower quadrant discomfort. The hepatic mass was detected by ultrasonographic examination. Serum albumin, bilirubin, and aspartate aminotransferase/alanine aminotransferase were normal. Alkaline phosphatase level was slightly increased at 146 IU/L. A tumor marker study showed alpha-fetoprotein 0.97 IU/mL, carcinoembryonic antigen 0.965 ng/mL, cancer antigen 125 1,267 ng/mL and CA 19-9 106.1 ng/mL. The operation involved cholecystectomy and segmentectomy VI and VII of the liver. The patient recovered from the surgery without any complication. On the 10th postoperative day, the patient received a single-regimen chemotherapy with paclitaxel (Taxol, 155 mg/m(2) BSA) and was discharged. She has been carefully followed-up without any evidence of recurrence after completion of the remaining 5 cycles of chemo-therapy, at intervals of three weeks.