Endoscopic treatment for rectal neuroendocrine tumor: which method is better?

Recently, research on rectal neuroendocrine tumors (NETs) has increased during the last few decades. Rectal NETs measuring 10 mm, suctioning is not possible due to fibrosis in the lesion, or when the snaring for modified endoscopic mucosal resection does not work well

Autonomous Control Strategy of DC Microgrid for Islanding mode using Power Line Communication

This paper proposes a DC-bus signaling (DBS) method for autonomous power management in a DC microgrid, used to improve its reliability. Centralized power management systems require communication between the power sources and loads. However, the DBS method operates based on the common DC-bus voltage and does not require communication. Based on the DC-bus voltage band, the DC-bus voltage can be used to inform the status of the DC-bus in various scenarios. The DC microgrid operates independently to maintain the system stably in the DC-bus voltage band. The DC microgrid can be divided into a grid-connected mode and an islanding mode. This paper proposes a control strategy based on power management of various independent components in islanding mode. In addition, the autonomous control method for switching the converter???s operation between grid-connected mode and islanding mode is proposed. A DC microgrid test bed consisting of a grid-connected AC/DC converter, a bidirectional DC/DC converter, a renewable energy simulator, DC home appliances and a DC-bus protector is used to test the proposed control strategy. The proposed autonomous control strategy is experimentally verified using the DC microgrid test bed

Comparison of total body irradiation-based or non-total body irradiation-based conditioning regimens for allogeneic stem cell transplantation in pediatric leukemia patients

Purpose : This study aims to compare the outcome of total body irradiation (TBI)- or non-TBI-containing conditioning regimens for leukemia in children. Methods : We retrospectively evaluated 77 children conditioned with TBI (n=40) or non-TBI (n=37) regimens, transplanted at Chonnam National University Hospital between January 1996 and December 2007. The type of transplantation, disease status at the time of transplant, conditioning regimen, engraftment kinetics, development of graft-versus-host disease (GVHD), complications, cause of deaths, overall survival (OS), and event-free survival (EFS) were compared between the 2 groups. Results : Among 34 patients with acute lymphoblastic leukemia (ALL), 28 (82.4%) were in the TBI group, while 72.7% (24/33) of patients with myeloid leukemia were in the non-TBI group. Although the 5-year EFS of the 2 groups was similar for all patients (62% vs 63%), the TBI group showed a better 5-year EFS than the non-TBI group when only ALL patients were analyzed (65% vs 17%&#59; P =0.005). In acute myelogenous leukemia patients, the non-TBI group had better survival tendency (73% vs 38%&#59; P=0.089). The incidence of GVHD, engraftment, survival, cause of death, and late complications was not different between the 2 groups. Conclusion : The TBI and non-TBI groups showed comparable results, but the TBI group showed a significantly higher 5-year EFS than the non-TBI group in ALL patients. Further prospective, randomized controlled studies involving larger number of patients are needed to assess the late-onset complications and to compare the socioeconomic quality of life

Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center Experience

Aims. To investigate the feasibility and safety of endoscopic submucosal dissection (ESD) of gastric epithelial neoplasms in the remnant stomach (GEN-RS) after various types of partial gastrectomy. Methods. This study included 29 patients (31 lesions) who underwent ESD for GEN-RS between March 2006 and August 2016. Clinicopathologic data were retrieved retrospectively to assess the therapeutic ESD outcomes, including en bloc and complete resection rates and procedure-related adverse events. Results. The en bloc, complete, and curative resection rates were 90%, 77%, and 71%, respectively. The types of previous gastrectomy, tumor size, macroscopic type, and tumor histology were not associated with incomplete resection. Only tumors involving the suture lines from the prior partial gastrectomy were significantly associated with incomplete resection. The procedure-related bleeding and perforation rates were 6% and 3%, respectively; none of the adverse events required surgical intervention. During a median follow-up period of 25 months (range, 6–58 months), there was no recurrence in any case. Conclusions. ESD is a safe and feasible treatment for GEN-RS regardless of the previous gastrectomy type. However, the complete resection rate decreases for lesions involving the suture lines

MOMENT RESISTANCE PERFORMANCE OF LARCH LAMINATED TIMBER BEAM-COLUMN JOINTS REINFORCED WITH CFRP

This study evaluates the moment resisting capacity of the drift pin larch beam-column joint with slotted-in steel plates of larch laminated timber. It is reinforced with carbon fiber reinforced plastic (CFRP) to suppress the brittle fracture of the beam-column joint and improve the joint capacity using larch laminated timber, a wood material manufactured by multi-layering of timber as a structural member of heavy timber.The average maximum moment capacity of the control specimen was 16.9 kN·m and the average maximum moments of the Type-A (volume ratio of joint reinforced with CFRP: 3.6%) and Type-B (volume ratio of joint reinforced with CFRP: 5.4%) were increased by 46% and 62%, respectively, compared to that of the control specimen. The capacity of the joint, such as the average yield capacity, ultimate moment capacity, and ductility ratio, of the control, Type-A, and Type-B specimens increased as the reinforcement ratio of the CFRP increased. For the failure mode of the control specimen, splitting failure occurred in both the column and beam members in the end distance direction. However, the splitting failure did not occur in the beam member due to the improvement of the joint and ductility of the specimens reinforced with the CFRP. The Type-A specimen had improved joint capacity and ductility compared to the control specimen; however, brittle failure occurred owing to the external force exceeding the joint capacity. However, in some of the Type-B specimens, the splitting failure did not occur in the column and beam members due to the CFRP reinforcement. Particularly, the Type-B3 specimen exhibited ductility

Multiple extraintestinal manifestations in a patient with acute severe ulcerative colitis: a case report

Patients with inflammatory bowel disease (IBD) are at risk for extraintestinal manifestations (EIM) over the course of their disease. As EIMs can involve nearly every organ, and strongly influence the quality of life, early recognition and adequate treatment are necessary to prevent severe morbidity and mortality in affected patients. Pyoderma gangrenosum is a highly severe and debilitating skin condition that occurs in 1% to 10% of ulcerative colitis (UC) patients. Thromboembolic events are also serious EIMs and usually present as deep vein thromboses in the legs or as pulmonary embolisms. A 19-year-old woman presented with bloody diarrhea lasting for 3 months and deep ulceration on the right foot. She was diagnosed with UC. The patient's skin lesions did not improve with intravenous corticosteroids and oral mesalazine. After she was started on infliximab, we observed rapid resolution of the skin lesions. She continued to complain of mild dyspnea while in the hospital. Computed tomography performed using the thromboembolism protocol revealed pulmonary thromboembolism and deep venous thrombosis. The patient underwent anticoagulant therapy with low-molecular-weight heparin, and her dyspnea gradually improved. Anticoagulation was continued with warfarin. It is rare for IBD patients to have multiple EIMs; however, this case demonstrates that multiple EIMs are a possible presentation in UC and underscores the importance of a meticulous clinical examination and adequate evaluation in the management of IBD patients presenting with EIMs

Summary of the 2017 thyroid radiofrequency ablation guideline and comparison with the 2012 guideline

Radiofrequency ablation (RFA) is a new, minimally invasive modality that serves as an alternative to surgery in patients with thyroid tumors. The Task Force Committee of the Korean Society of Thyroid Radiology developed recommendations for the optimal use of RFA for thyroid tumors in 2012 and revised them in 2017. Herein, we review and summarize the 2017 thyroid RFA guideline and compare it with the 2012 thyroid RFA guideline

Involvement of mTOR signaling in sphingosylphosphorylcholine-induced hypopigmentation effects

<p>Abstract</p> <p>Background</p> <p>Sphingosylphosphorylcholine (SPC) acts as a potent lipid mediator and signaling molecule in various cell types. In the present study, we investigated the effects of SPC on melanogenesis and SPC-modulated signaling pathways related to melanin synthesis.</p> <p>Methods</p> <p>Melanin production was measured in Mel-Ab cells. A luciferase assay was used to detect transcriptional activity of the MITF promoter. Western blot analysis was performed to examine SPC-induced signaling pathways.</p> <p>Results</p> <p>SPC produced significant hypopigmentation effects in a dose-dependent manner. It was found that SPC induced not only activation of Akt but also stimulation of mTOR, a downstream mediator of the Akt signaling pathway. Moreover, SPC decreased the levels of LC3 II, which is known to be regulated by mTOR. Treatment with the mTOR inhibitor rapamycin eliminated decreases in melanin and LC3 II levels by SPC. Furthermore, we found that the Akt inhibitor LY294002 restored SPC-mediated downregulation of LC3 II and inhibited the activation of mTOR by SPC.</p> <p>Conclusions</p> <p>Our data suggest that the mTOR signaling pathway is involved in SPC-modulated melanin synthesis.</p