The Three Dimensional Conformal Radiotherapy for Hyperkeratotic Plantar Mycosis Fungoides

The localized early-stage of Mycosis fungoides (MF) (stage IA-IIA) is usually treated with topical agents, such as nitrogen mustard, steroids, and phototherapy (UVB/PUVA) as first line therapy; response to these initial treatments is usually good. However, hyperkeratotic plantar lesions are clinically rare and have decreased responsiveness to topical agents. For such cases, physicians may consider local radiotherapy. Here, a case of an 18-year-old Korean woman who was treated with three-dimensional conformal radiotherapy (3D-CRT) for hyperkeratotic plantar lesions that were refractory to UVA-1, methotrexate, and topical steroids is reported. Complete remission was attained after radiotherapy. During the one-year follow-up period, there has been no evidence of disease recurrence and no chronic complications have been observed

Two-Year clinical outcomes after coronary bifurcation stenting in older patients from Korea and Italy

BackgroundOlder patients who treated by percutaneous coronary intervention (PCI) are at a higher risk of adverse cardiac outcomes. We sought to investigate the clinical impact of bifurcation PCI in older patients from Korea and Italy.MethodsWe selected 5,537 patients who underwent bifurcation PCI from the BIFURCAT (comBined Insights from the Unified RAIN and COBIS bifurcAtion regisTries) database. The primary outcome was a composite of target vessel myocardial infarction, clinically driven target lesion revascularization, and stent thrombosis at two years.ResultsIn patients aged ≥75 years, the mean age was 80.1 ± 4.0 years, 65.2% were men, and 33.7% had diabetes. Older patients more frequently presented with chronic kidney disease (CKD), severe coronary calcification, and left main coronary artery disease (LMCA). During a median follow-up of 2.1 years, older patients showed similar adverse clinical outcomes compared to younger patients (the primary outcome, 5.7% vs. 4.5%; p = 0.21). Advanced age was not an independent predictor of the primary outcome (p = 0.93) in overall patients. Both CKD and LMCA were independent predictors regardless of age group.ConclusionsOlder patients (≥75 years) showed similar clinical outcomes to those of younger patients after bifurcation PCI. Advanced age alone should not deter physicians from performing complex PCIs for bifurcation disease

Retrospective analyses of cisplatin-based doublet combination chemotherapy in patients with advanced gastric cancer

<p>Abstract</p> <p>Backgrounds</p> <p>Cisplatin-based chemotherapy, in combination with fluoropyrimidines or taxanes, have demonstrated efficacy against advanced gastric cancer (AGC). This retrospective study was performed with the data obtained from our cancer chemotherapy registry and eight another cancer centers.</p> <p>Methods</p> <p>In 2008, a total of 283 AGC patients were treated with cisplatin-based doublet chemotherapy in the first-line setting: capecitabine plus cisplatin (XP, n = 77), S-1 plus cisplatin (SP, n = 97), taxanes (docetaxel, paclitaxel) plus cisplatin (TP, n = 72), and 5-fluorouracil plus platinum (FP, n = 37). The primary endpoint of this study was overall survival (OS) and the secondary endpoints were safety, response rate and progression-free survival (PFS).</p> <p>Results</p> <p>The median age was 54 years with a range of 28-78 years and median delivered number of chemotherapy cycles were XP: 4, SP: 5, TP: 5 and FP: 5, respectively. Objective tumor responses (38%; 95% CI, 32-43%) were 40% for XP, 42% for SP, 36% for DP, and 24% for FP. The estimated median PFS was 4.5 months (95% CI, 3.6-5.4 months) and the median OS was 12.3 months (95% CI, 10.8-13.7 months). No statistically significant difference was found between each regimen used as first-line chemotherapy. At multivariate analysis, independent prognostic parameters for OS were prior gastrectomy, peritoneal dissemination, performance status and hemoglobin level</p> <p>Conclusion</p> <p>All of the cisplatin-based doublet chemotherapy regimens appear to be active as first-line chemotherapy for AGC. With better patient selection according to clinical parameters and molecular markers, clinical outcomes of AGC patients in first-line setting can be improved.</p

A Numerical Study on the Characteristics of Air–Fuel Mixing Using a Fluidic Oscillator in Supersonic Flow Fields

In this study, numerical simulations were conducted to confirm the possibility of improved mixing performance by using a fluidic oscillator as a fuel injector. Three-dimensional URANS non-reacting simulations were conducted to examine air&ndash;fuel mixing in a supersonic flow field of Mach 3.38. The numerical methods were validated through simulations of the oscillating flow generated from the fluidic oscillator. The results show that the mass flow rate and momentum are reduced at the outlet because the total pressure loss increases inside the fluidic oscillator, which means that higher pressure needs to be applied to supply the same mass flow rate. The simulation showed that the flow structure varies over time as the injected flow is swept laterally. With lateral injection, the fuel distribution is long and narrow, and asymmetric vortexes are generated. However, with central injection, the fuel distribution is relatively similar to the case of using a simple injector. Compared to the simple injector, the penetration length, flammable area, and mixing efficiency were improved. However, the total pressure loss in the flow field increases as well. The results showed that the supersonic fluidic oscillator could be fully utilized as a means to enhance the mixing effect, however a method to reduce the total pressure loss is necessary for practical application

A Hybrid Gate Dielectrics of Ion Gel with Ultra-Thin Passivation Layer for High-Performance Transistors Based on Two-Dimensional Semiconductor Channels

Abstract We propose a hybrid gate structure for ion gel dielectrics using an ultra-thin Al2O3 passivation layer for realizing high-performance devices based on electric-double-layer capacitors. Electric-double-layer transistors can be applied to practical devices with flexibility and transparency as well as research on the fundamental physical properties of channel materials; however, they suffer from inherent unwanted leakage currents between electrodes, especially for channel materials with low off-currents. Therefore, the Al2O3 passivation layer was introduced between the metal electrodes and ion gel film as a leakage current barrier; this simple approach effectively reduced the leakage current without capacitance degradation. In addition, we confirmed that a monolayer MoS2 transistor fabricated with the proposed hybrid gate dielectric exhibited remarkably enhanced device properties compared to a transistor using a normal ion gel gate dielectric. Our findings on a simple method to improve the leakage current properties of ion gels could be applied extensively to realize high-performance electric-double-layer transistors utilizing various channel materials

Clinical impact of diabetes mellitus on 2-year clinical outcomes following PCI with second-generation drug-eluting stents; Landmark analysis findings from patient registry: Pooled analysis of the Korean multicenter drug-eluting stent registry.

BackgroundPatients with diabetes mellitus are at an increased risk for adverse clinical events following percutaneous coronary interventions (PCI). However, the clinical impact of diabetes mellitus (DM) on second-generation drug-eluting stent (DES) implantation is not well-known. The aim of the current analysis was to examine the clinical impact of DM on clinical outcomes and the time sequence of associated risks in patients treated with second-generation DES.MethodsUsing patient-level data from two stent-specific, all-comer, prospective DES registries, we evaluated 1,913 patients who underwent PCI with second-generation DES between Feb 2009 and Dec 2013. The primary outcomes assessed were two-year major cardiac adverse events (MACE), composite endpoints of death from any cause, myocardial infarction (MI), and any repeat revascularization. We classified 0-1 year as the early period and 1-2 years as the late period. Landmark analyses were performed according to diabetes mellitus status.ResultsThere were 1,913 patients with 2,614 lesions included in the pooled dataset. The median duration of clinical follow-up in the overall population was 2.0 years (interquartile range 1.9-2.1). Patients with DM had more cardiovascular risk factors than patients without DM. In multivariate analyses, the presence of DM and renal failure were strong predictors of MACE and target-vessel revascularization (TVR). After inverse probability of treatment weighting (IPTW) analyses, patients with DM had significantly increased rates of 2-year MACE (HR 2.07, 95% CI; 1.50-2.86; P ConclusionsIn the second-generation DES era, the clinical impact of DM significantly increased the 2-year event rate of MACE, mainly caused by clinical events in the early period (0-1 year). Careful observation of patients with DM is advised in the early period following PCI with second-generation DES

Microbiological Characteristics and Predictive Factors for Mortality in Pleural Infection: A Single-Center Cohort Study in Korea.

Identification and understanding of the pathogens responsible for pleural infection is critical for appropriate antibiotic treatment. This study sought to determine the microbiological characteristics of pleural infection and to identify potential predictive factors associated with mortality.In this retrospective study, we analyzed patient data from 421 cases of parapneumonic effusion. A total of 184 microorganisms were isolated from 164 patients, using two culture systems: a standard method and a method using pairs of aerobic and anaerobic blood culture bottles.The most frequently isolated microorganisms were streptococci (31.5%), followed by staphylococci (23.4%), gram-negative bacteria (18.5%) and anaerobes (10.3%). Streptococci were the main microorganisms found in standard culture (41.9%) and community-acquired infections (52.2%), and were susceptible to all antimicrobial agents in drug sensitivity testing. Staphylococci were the most frequently isolated pathogens in blood cultures (30.8%) and hospital-acquired infections (38.3%), and were primarily multidrug-resistant (61.8%). In multivariate analysis, the following were significant predictive factors for 30-day mortality among the total population: CURB-65 ≥ 2 (aOR 5.549, 95% CI 2.296-13.407, p<0.001), structural lung disease (aOR 2.708, 95% CI 1.346-5.379, p = 0.004), PSI risk class IV-V (aOR 4.714, 95% CI 1.530-14.524, p = 0.007), no use of intrapleural fibrinolytics (aOR 3.062, 95% CI 1.102-8.511, p = 0.014), hospital-acquired infection (aOR 2.205, 95% CI 1.165-4.172, p = 0.015), age (aOR 0.964, 95% CI 0.935-0.994, p = 0.018), and SOFA score ≥2 (aOR 2.361, 95% CI 1.134-4.916, p = 0.022).In this study, common pathogens causing pleural infection were comparable to previous studies, and consisted of streptococci, staphylococci, and anaerobes. CURB-65 ≥2, structural lung disease, PSI risk class IV-V, no use of intrapleural fibrinolytics, hospital-acquired infection, older age, and SOFA score ≥ 2 are potential predictors of mortality in pleural infection