• Journal of Preventive Medicine and Public Health
• /
• v.55 no.3
• /
• pp.263-272
• /
• 2022

Objectives: Infections with hepatitis B, C, and D virus (HBV, HCV, and HDV) are a major public health problem and lead to serious complications such as cirrhosis and hepatocellular carcinoma. We aimed to determine the seroprevalence of hepatitis B surface antigen (HBsAg), anti-HCV, anti-HDV immunoglobulin G, alpha-fetoprotein (AFP), and dual and triple hepatitis virus infections in Mongolia. Methods: A total of 2313 participants from urban and rural regions were randomly recruited for this cross-sectional study. A questionnaire was used to identify the risk factors for hepatitis virus infections, and the seromarkers were measured using immunoassay kits. Results: Among all participants, the prevalence of HBV, HCV, and HDV was 15.6%, 36.6%, and 14.3%, respectively. The infection rates were significantly higher in females and participants with a lower education level, rural residence, older age, and a history of blood transfusion. HBV and HCV co-infection was found in 120 (5.2%) participants and HBV, HCV, and HDV triple infection was detected in 67 (2.9%) participants. The prevalence of elevated AFP was 2.7%, 5.5%, and 2.6% higher in participants who were seropositive for HBsAg (p=0.01), anti-HCV (p<0.001), and anti-HDV (p=0.022), respectively. Elevated AFP was more prevalent in participants co-infected with HBV and HCV (5.8%, p=0.023), HBV and HDV (6.0%, p<0.001), and triple-infected with HBV, HCV, and HDV (7.5%) than in uninfected individuals. Conclusions: Nearly half (49.8%) of the study population aged ≥40 years were infected with HBV, HCV, or HDV, and 22.4% had dual or triple infections.

• Journal of Chest Surgery
• /
• v.55 no.1
• /
• pp.10-19
• /
• 2022

Background: According to the eighth TNM (tumor-node-metastasis) staging system, the presence of separate tumor nodules in the same lobe is designated as a T3 descriptor. However, it remains unclear whether adjuvant chemotherapy confers survival advantages in this setting. Methods: We retrospectively identified 142 pathologic T3N0M0 patients with additional pulmonary nodules in the same lobe from a single-institutional database from 2004 to 2019. The main outcomes were overall survival and recurrence-free survival. Multivariable Cox regression was used to identify the benefit of adjuvant chemotherapy while adjusting for other variables. Results: Sixty-one patients received adjuvant chemotherapy (adjuvant group) and 81 patients did not receive adjuvant therapy after surgery (surgery-only group). There were no demonstrable differences between the 2 groups regarding hospital mortality and postoperative complications, indicating that treatment selection had not significantly occurred. However, the use of adjuvant chemotherapy was associated with improved 5-year overall survival (70% vs. 59%, p=0.006) and disease-free survival (60% vs. 46%, p=0.040). A multivariable Cox model demonstrated that adjuvant chemotherapy was associated with a survival advantage (adjusted hazard ratio, 0.54; p<0.001). In exploratory analyses of subgroups, the effect of adjuvant chemotherapy seemed to be insufficient in those with small main tumors (<4 cm). Conclusion: Adjuvant chemotherapy was associated with better survival in T3 cancers with an additional tumor nodule in the same lobe. However, the role of adjuvant chemotherapy in patient subgroups with small tumors or those without risk factors should be determined via large studies.

• Journal of Chest Surgery
• /
• v.55 no.1
• /
• pp.49-54
• /
• 2022

Background: We compared the safety and effectiveness of robotic anatomical resection and video-assisted thoracoscopic surgery (VATS). Methods: A retrospective analysis was conducted of the records of 4,283 patients, in whom an attempt was made to perform minimally invasive anatomical resection for lung cancer at Seoul National University Hospital from January 2011 to July 2020. Of these patients, 138 underwent robotic surgery and 4,145 underwent VATS. Perioperative outcomes were compared after propensity score matching including age, sex, height, weight, pulmonary function, smoking status, performance status, comorbidities, type of resection, combined bronchoplasty/angioplasty, tumor size, clinical T/N category, histology, and neoadjuvant treatment. Results: In total, 137 well-balanced pairs were obtained. There were no cases of 30-day mortality in the entire cohort. Conversion to thoracotomy was required more frequently in the VATS group (VATS 6.6% vs. robotic 0.7%, p=0.008). The complete resection rate (VATS 97.8% vs. robotic 98.5%, p=1.000) and postoperative complication rate (VATS 17.5% vs. robotic 19.0%, p=0.874) were not significantly different between the 2 groups. The robotic group showed a slightly shorter hospital stay (VATS 5.8±3.9 days vs. robotic 5.0±3.6 days, p=0.052). N2 nodal upstaging (cN0/pN2) was more common in the robotic group than the VATS group, but without statistical significance (VATS 4% vs. robotic 12%, p=0.077). Conclusion: Robotic anatomical resection in lung cancer showed comparable early outcomes when compared to VATS. In particular, robotic resection presented a lower conversion-to-thoracotomy rate. Furthermore, a robotic approach might improve lymph node harvesting in the N2 station.

• Journal of Chest Surgery
• /
• v.55 no.1
• /
• pp.69-76
• /
• 2022

Background: While the use of bioprosthetic valves for mitral valve replacement (MVR) is increasing, very few studies have compared bovine pericardial and porcine valves in the mitral position to help guide bioprosthetic selection. Methods: In the present study, patients who underwent MVR using bovine pericardial valves were compared with those who underwent MVR with porcine bioprostheses between January 1996 and July 2018. Those with prior MVR, infective endocarditis, congenital mitral valve disease, or ischemic mitral regurgitation were excluded. The primary outcomes were structural valve deterioration (SVD) and mitral valve reoperation from any cause, and death was regarded as a competing risk. Competing risk analysis and propensity score-matching were used for comparisons. Results: Among the 388 patients enrolled, pericardial and porcine bioprostheses were implanted in 217 (55.9%) and 171 (44.1%), respectively. Propensity score-matching yielded 122 pairs of patients that were well-balanced for all baseline covariates. No significant differences were observed between the groups in unadjusted (p=0.09) and adjusted overall survival (hazard ratio [HR], 1.13; 95% confidence interval [CI], 0.72-1.76; p=0.60). Competing risk analysis revealed no significant differences in the risks of mitral reoperation (HR, 1.07; 95% CI, 0.50-2.27; p=0.86) and development of SVD (HR, 1.57; 95% CI, 0.56-4.36; p=0.39) between the groups. Matched population analysis confirmed similar results regarding reoperation (HR, 0.99; 95% CI, 0.40-3.22; p=0.98) and SVD (HR, 1.39; 95% CI, 0.41-4.73; p=0.60). Conclusion: No significant differences in survival or valve durability were observed between bovine pericardial and porcine bioprosthetic MVR. These findings require further validation through studies with larger sample sizes.

• Journal of Chest Surgery
• /
• v.55 no.2
• /
• pp.118-125
• /
• 2022

Background: A time course analysis was undertaken to evaluate how perioperative process-of-care and outcome measures evolved after implementation of an enhanced recovery after thoracic surgery (ERATS) program. Methods: Outcome and process-of-care measures were compared between patients undergoing major elective thoracic surgery during a 9-month pre-ERATS implementation period to those at 1-3, 4-6, and 7-9 months post-ERATS implementation. Outcome measures included length of stay, the 30-day readmission rate, 30-day emergency department visits, and minor and major adverse events. Process measures included first time to activity, out-of-bed, ambulation, fluid diet, diet as tolerated, as well as removal of the first and last chest tube, epidural, patient-controlled analgesia, and Foley and intravenous catheters. Results: In total, 704 patients (352 pre-ERATS, 352 post-ERATS) were included. Mobilization-related process measures, including time to first activity (16.5 vs. 6.8 hours, p<0.001), out-of-bed (17.6 vs. 8.9 hours, p<0.001), and ambulation (32.4 vs. 25.4 hours, p=0.04) saw statistically significant improvements by 1-3 months post-ERATS implementation compared to pre-ERATS. Time to Foley removal improved by 4-6 months post-ERATS (19.5 vs. 18.2 hours, p=0.003). Outcome measures, including the 30-day readmission rate and emergency department visits, steadily decreased post-ERATS. By 7-9 months post-ERATS, both minor (18.2% vs. 7.9%, p=0.009) and major (13.6% vs. 4.4%, p=0.007) adverse events demonstrated statistically significant improvements. Length of stay trended towards improvement from 6.2 days pre-ERATS to 4.8 days by 7-9 months post-ERATS (p=0.06). Conclusion: The adoption of ERATS led to improvements in multiple process-of-care measures, which may collectively and gradually achieve optimization of clinical outcomes.

• Journal of Chest Surgery
• /
• v.55 no.3
• /
• pp.206-213
• /
• 2022

Background: Surgical repair of partial anomalous pulmonary venous return (PAPVR) to the superior vena cava (SVC) using the Warden procedure has favorable outcomes. However, there remain some concerns after the Warden procedure, such as sinoatrial nodal dysfunction and systemic or pulmonary venous stenosis. We investigated the outcomes of the Warden procedure for repair of PAPVR to the SVC. Methods: This retrospective study included 22 consecutive patients who underwent the Warden procedure for PAPVR between 2002 and 2018. The median age and body weight at operation were 27.5 months (interquartile range [IQR], 5.0-56.8 months) and 13.2 kg (IQR, 6.5-16.0 kg), respectively. The median follow-up duration was 6.2 years (IQR, 3.5-11.6 years). Results: There were no cases of early or late mortality. No patients had postoperative heart rhythm problems, except 1 patient who showed transient sinoatrial nodal dysfunction in the immediate postoperative period. Procedure-related complications requiring reintervention occurred in 5 patients, including 3 of 4 SVC stenosis cases and 2 pulmonary venous stenosis cases during follow-up. The rate of freedom from reintervention related to the Warden procedure was 75.9% at 10 years. Conclusion: In cases requiring extension or creation of an atrial septal defect to achieve a sufficient venous pathway, or interposition of an entire circumferential conduit between the SVC and right atrium due to the shortness of the SVC in the Warden procedure, stenotic complications of the venous pathway occurred. Careful observation of changes in the pressure gradient or anatomical stenosis is required in such patients.

• Korean Journal of Ichthyology
• /
• v.34 no.1
• /
• pp.25-33
• /
• 2022

We investigated to elucidate the early life history of siberian stone loach, Barbatula nuda (Pisces: Nemacheilidae). Adult fish were collected using net in the Sangcheoncheon Stream, Cheongpyeong-myeon, Gapyeong-gun, Gyeonggi-do, Korea, 26th April 2020. HCG 10 IU/g was injected to female and male fish and fertilized by dry method in the laboratory. The number of eggs of B. nuda was 1,308±293 (TL: 70.64~79.24 mm), and the egg color was yellowish grey. Fertilized eggs measured 1.13±0.01 mm (n=10) in diameter and showed adhesion. The fertilized eggs started hatching after 104 hours. At the time of egg development, the 15℃ group showed an average hatching rate of 80.1±1.2% and the 20℃ group showed 61.5±6.8%, so the 15℃ group was suitable (p<0.05). Newly hatched larva an average were 3.12±0.06 mm (n=10) in total length. At 4 days after hatching, the total length was 4.89±0.09 mm (n=10), and feeding began with the mouth and anus opened, and entered to preflexion larvae stage. At 21 days after hatching, the total length was 10.98±0.40 mm (n=10), and the distal part of the notochord was bent to 45°, and entered to postflexion larvae stage At 26 days after hatching, the total length was 13.47±0.37 mm (n=10), and entered the juvenile stage.

• Journal of Electrochemical Science and Technology
• /
• v.13 no.1
• /
• pp.148-158
• /
• 2022

The electrochemical CO₂ reduction (ECR) to produce value-added fuels and chemicals using clean energy sources (like solar and wind) is a promising technology to neutralize the carbon cycle and reproduce the fuels. Presently, the ECR has been the most attractive route to produce carbon-building blocks that have growing global production and high market demand. The electrochemical CO₂ reduction could be extensively implemented if it produces valuable products at those costs which are financially competitive with the present market prices. Herein, the electrochemical conversion of CO₂ obtained from flue gases of a power plant to produce diesel and formic acid using a consistent techno-economic approach is presented. The first scenario analyzed the production of diesel fuel which was formed through Fischer-Tropsch processing of CO (obtained through electroreduction of CO₂) and hydrogen, while in the second scenario, direct electrochemical CO₂ reduction to formic acid was considered. As per the base case assumptions extracted from the previous outstanding research studies, both processes weren't competitive with the existing fuel prices, indicating that high electrochemical (EC) cell capital cost was the main limiting component. The diesel fuel production was predicted as the best route for the cost-effective production of fuels under conceivable optimistic case assumptions, and the formic acid was found to be costly in terms of stored energy contents and has a facile production mechanism at those costs which are financially competitive with its bulk market price. In both processes, the liquid product cost was greatly affected by the parameters affecting the EC cell capital expenses, such as cost concerning the electrode area, faradaic efficiency, and current density.

• Korean Journal of Ichthyology
• /
• v.34 no.1
• /
• pp.34-43
• /
• 2022

A distribution survey was conducted from March to August 2021 to evaluate the distribution status, habitat characteristics, and threat of extinction of the Korean cold-water fish Ladislabia taczanowskii Dybowski (Cypriniformes, Cyprinidae). Historical distribution reports were divided into 1997~2005, 2006~2012, 2013~2019, and distribution surveyed 169 sampling sites, and 1,040 individuals were collected from 72 sites. Areas where the habitat was confirmed were Namhan River (27 stations), Han River (17 stations), Bukhan River (16 stations), Samcheok Osipcheon (4 stations), Yeongokcheon (3 stations), Gangneung Namdaecheon (2 stations), Jeoncheon (1 station), Chucheon (2 stations). The main habitat of L. taczanowskii was upstream of the river with a high altitude of more than 300 m, 2~30 m water flow width, 0.3~1.5 m water depth, and high ratio (50~90%) boulder bottoms. The main reasons for the decline in population size were assumed as river works, construction of reservoirs and bridges, discharge of contaminated water into the river, the inflow of summer vacationers, and weir. Compared to our results there exists evidence that states a 36.1% reduction in occupancy within 10 years, in a small appearance range (7,820 km²) and occupancy area (288 km²), number of disconnected locations (19 locations), and a decline in habitat quality. Therefore, L. taczanowskii is now considered as Vulnerable (VU) based on the results (VU A2ac, Near meets B1b (i, ii, iii)+B2b (i, ii, iii)) of IUCN Red List categories and criteria. Lastly, the conservation plan of Ladislabia taczanowskii was discussed.

• Korean Journal of Ichthyology
• /
• v.34 no.1
• /
• pp.44-56
• /
• 2022

Fish fauna was observed off the coast of Busan (Cheongsapo) and Ulsan (Bangeojin) using underwater visual census from November 2016 to October 2017. A total of 1,486 individuals of 25 species in Cheongsapo and 3,859 individuals of 31 species were identified in Bangeojin. Dominant species in the number of individuals were Trachurus japonicus (20.9%), Halichoeres tenuispinis (12.6%), and Chromis notata (11.9%) in Cheongsapo, Siganus fuscescens (42.0%), Pempheris japonica (8.4%), and Chromis notata (8.0%) in Bangeojin. There was no significant difference in the species composition of Cheongsapo and Bangeojin but spring vs. summer, spring vs. autumn, summer vs. winter, autumn vs. winter showed a significant difference. Contribution species of seasonal differences were commonly high rates by Halichoeres tenuispinis and Parajulis poecilepterus. Of the total 38 species, 17 (44.7%) temperate, 6 (15.8%) tropical, and 15 (39.5%) subtropical species observed coastal waters off Cheongsapo and Bangeojin.