Vitzro Tech (South Korea)

This study evaluated the feasibility and safety of Synchroseal (SS), a new articulating bipolar energy-based device, in da Vinci robotic gastrectomy for gastric cancer. A prospective study of 25 patients using SS was compared with retrospective data from 218 patients treated with conventional ultrasonic shears (US). Propensity score matching (PSM) ensured comparability. Metrics analyzed included C-reactive protein (CRP) levels, operative time, lymph nodes (LNs) retrieved, intraoperative blood loss, laboratory tests, hospital stay duration, and complication rates. PSM yielded a balanced comparison between the two groups (standardized differences < 0.1). SS (n = 25) significantly reduced CRP levels on postoperative days 2, 4, and 6 compared to US (n = 123) [7.67 ± 4.73 vs. 10.18 ± 5.66, (p = 0.040), 5.11 ± 3.33 vs. 6.65 ± 4.23, (p = 0.090), 2.74 ± 2.10 vs. 4.26 ± 3.78, (p = 0.001)]. Additionally, SS showed lower serum amylase levels and shorter operation times than US [67.60 ± 48.31 vs. 168.66 ± 316.92, (p = 0.027) and 234.52 ± 65.03 vs. 274.75 ± 54.90, (p = 0.002)]. Although SS retrieved fewer total LNs (31.80 ± 9.5 vs. 36.88 ± 14.96, p = 0.034), both groups achieved adequate LN dissection (> 30 LNs). No significant differences were observed in other parameters. SS led to lower postoperative CRP and serum amylase levels, shorter operation time, and adequate LN dissection, suggesting reduced postoperative inflammation and faster sealing function as potential benefits.

ABSTRACT The Ministry of Environment of Korea has proposed a ban on landfill disposal of municipal solid waste (MSW) from 2026. Thus, it is inferred that the amount of incineration ash will increase drastically. Against this backdrop, this study assessed the applicability of a plasma melting process to fly ash. Fly ash was collected from 14 incineration facilities to analyze its basic properties and perform melting experiments. Furthermore, scanning electron microscope (SEM) analysis and economic feasibility assessment were conducted. The molten fly ash slag exhibited a pH value of 9.9, and the ignition loss of fly ash was found to range from 14.5 to 25.7 wt.%. None of seven toxic elements (arsenic (As), cadmium (Cd), cyanide (CN), mercury (Hg), hexavalent chromium (Cr(VI)), copper, and lead (Pb)) was detected from the molten slag. In addition, 99.3 wt.% of chloride ion (Cl−), 97.9 wt.% of fluoride ion (F−), and 98.1 wt.% of sulphate ion (SO4 2−) were removed. The contents in the molten slag were found to be 0.19, 7.8, 27.8, 33.1, and 38 mg/kg for Cd, Pb, zinc, nickel, and F, respectively, and none of CN, Hg, and As was detected, thereby meeting the criteria for soil pollution. All of the environmental standards were met, and SEM analysis confirmed stable quality with high density and no surface pore. In the economic feasibility assessment, a profit of approximately 152.4 $/ton was also estimated compared to landfill disposal.

There has been an increasing demand for robotic coil positioning during repetitive transcranial magnetic stimulation (rTMS) treatment. Accurate coil positioning is crucial because rTMS generally targets specific brain regions for both research and clinical application with other reasons such as safety, consistency and reliability and individual variablity. Some previous studies have employed industrial robots or co-robots and showed they can more precisely stimulate the target cortical regions than traditional manual methods. In this study, we not only developed a custom-TMS robot for better TMS coil placement but also analyzed the therapeutic effects on depression. Treatment effects were evaluated by measuring regional cerebral blood flow (rCBF) using single-photon emission computed tomography and depression severity before and after rTMS for the two positioning methods. The rTMS preparation time with our robotic coil placement was reduced by 53% compared with that of the manual method. The position and orientation errors were also significantly reduced from 11.17 mm and 4.06° to 0.94 mm and 0.11°, respectively, confirming the superiority of robotic positioning. The results from clinical and neuroimaging assessments indicated comparable improvements in depression severity and rCBF in the left dorsolateral prefrontal cortex between the robotic and manual rTMS groups. A questionnaire was used to determine the patients’ feelings about the robotic system, including the safety and preparation time. A high safety score indicated good acceptability of robotic rTMS at the clinical site.

Heritability of stroke is assumed not to be low, especially in the young stroke population. However, most genetic studies have been performed in highly selected patients with typical clinical or neuroimaging characteristics. We investigated the prevalence of 15 Mendelian stroke genes and explored the relationships between variants and the clinical and neuroimaging characteristics in a large, unselected, young stroke population. We enrolled patients aged ≤55 years with stroke or transient ischemic attack from a prospective, nationwide, multicenter stroke registry. We identified clinically relevant genetic variants (CRGVs) in 15 Mendelian stroke genes (GLA, NOTCH3, HTRA1, RNF213, ACVRL1, ENG, CBS, TREX1, ABCC6, COL4A1, FBN1, NF1, COL3A1, MT-TL1, and APP) using a customized, targeted next generation sequencing panel. Among 1,033 patients, 131 (12.7%) had 28 CRGVs, most frequently in RNF213 (n=59), followed by ABCC6 (n= 53) and NOTCH3 (n=15). The frequency of CRGVs differed by ischemic stroke subtypes (p< 0.01): the highest in other determined etiology (20.1%), followed by large artery atherosclerosis (13.6%). It also differed between patients aged ≤35 years and those aged 51 to 55 years (17.1% vs 9.3%, p= 0.02). Only 27.1% and 26.7% of patients with RNF213 and NOTCH3 variants had typical neuroimaging features of the corresponding disorders, respectively. Variants of uncertain significance (VUSs) were found in 15.4% patients. CRGVs in 15 Mendelian stroke genes may not be uncommon in the young stroke population. The majority of patients with CRGVs did not have typical features of the corresponding monogenic disorders. Clinical implications of having CRGVs or VUSs should be explored. ANN NEUROL 2023;93:768-782.

Pylorus-preserving gastrectomy (PPG) is a surgical treatment option for cT1N0M0 gastric cancer located in the middle third of the stomach. However, data for the long-term post-PPG clinical outcomes related to metachronous gastric neoplasms (mGNs) in the residual stomach are currently lacking. Therefore, we aimed to evaluate the safety of PPG by focusing on mGNs. In this single-center, retrospective study, we reviewed the data for 362 patients who underwent PPG with a 3-cm antral cuff and 139 who underwent endoscopic submucosal dissection (ESD) for middle-third gastric cancer between January 2013 and December 2015. The histopathologic features of the antrum in the ESD group, which could not be determined in the PPG group, were analyzed to investigate the risk factors for mGNs. The estimated and actual incidence of mGNs in the antrum were compared in the PPG group. The incidence of mGNs was 6.5% (9/139) in the ESD group. The presence of a synchronous adenoma (odds ratio [OR], 8.46; 95% confidence interval [CI], 1.55-46.34), carcinoma (OR, 15.71; 95% CI, 2.67-92.56) and moderate-to-severe intestinal metaplasia (OR, 9.77; 95% CI, 1.14-83.92) were associated with a higher risk of overall mGNs. However, when confined to the antrum, no significant association was observed between these factors and mGNs. In the ESD group, 2 of 9 mGNs (1.4%) were located at the 3-cm antral cuff. In the PPG group, both mGNs (0.6%) were located in the proximal remnant stomach. Pylorus-preserving gastrectomy was a safe therapeutic option with regard to the occurrence of metachronous adenomas or carcinomas in our series. Despite the low mGN incidence in the 3-cm antral cuff after PPG, the presence of synchronous neoplasms or moderate-to-severe intestinal metaplasia was a risk factor for mGNs in the ESD group; thus, further studies on longer antral cuffs with long-term follow-up are needed.

TiO2 was a photocatalyst that used to the most common product because of the high efficiency. TiO2 (P-25, commercial nanomaterial product) is the most typical photocatalyst product and TiO2 (GST) was a sludge recycling product. This study was reported to evaluate an acute toxicity of TiO2 (P-25 and GST) according to OECD test guideline 402 and 423 in Sprague-Dawley (SD) female rats via route of oral and dermal. There was investigated the lethal dose (LD50), and mortality, clinical signs, body weight changes and gross findings were continually monitored for 14 days following the single administration. After administration, TiO2 (P-25) was calculated that LD50 was considered to be a dose of over 2000 mg/kg body weight for both different route of exposure, and TiO2 (GST) was the same. Other items were no observed an adverse effect between P-25 and GST; no mortality and clinical signs, accidental body weight loss, no gross findings. On the basis of the above results, the toxicity of the GST was almost equal to that of the commercial product, P-25 and there was no toxicological evidence.

ABSTRACT Osteoarthritis (OA) is a chronic degenerative disease of articular cartilage that is the most common joint disease worldwide. Mesenchymal stem cells (MSCs) have been the most extensively explored for the treatment of OA. Recently, it has been demonstrated that MSC-derived extracellular vesicles (EVs) may contribute to the potential mechanisms of MSC-based therapies. In this study, we investigated the therapeutic potential of human adipose-derived stem cells EVs (hASC-EVs) in alleviating OA, along with the mechanism. EVs were isolated from the culture supernatants of hASCs by a multi-filtration system based on the tangential flow filtration (TFF) system. The isolated EVs were characterised using dynamic light scattering (DLS), transmission electron microscopy (TEM), nanoparticle tracking analysis (NTA) and flow cytometry analysis. The hASC-EVs not only promoted the proliferation and migration of human OA chondrocytes, but also maintained the chondrocyte matrix by increasing type Ⅱ collagen synthesis and decreasing MMP-1, MMP-3, MMP-13 and ADAMTS-5 expression in the presence of IL-1β in vitro. Intra-articular injection of hASC-EVs significantly attenuated OA progression and protected cartilage from degeneration in both the monosodium iodoacetate (MIA) rat and the surgical destabilisation of the medial meniscus (DMM) mouse models. In addition, administration of hASC-EVs inhibited the infiltration of M1 macrophages into the synovium. Overall results suggest that the hASC-EVs should be considered as a potential therapeutic approach in the treatment of OA.