Comparison of survival outcomes between robotic and laparoscopic radical hysterectomies for early-stage cervical cancer: a systemic review and meta-analysis.

OBJECTIVE: Survival outcomes of robotic radical hysterectomy (RRH) remain controversial. Therefore, we performed a meta-analysis to evaluate survival outcomes between RRH) and laparoscopic radical hysterectomy (LRH) in patients with early-stage cervical cancer. METHODS: Studies comparing between RRH and LRH published up to November 2022 were systemically searched in the PubMed, Cochrane Library, Web of Science, ScienceDirect, and Google Scholar databases. Manual searches of related articles and relevant bibliographies of the published studies were also performed. Two researchers independently extracted data. Studies with information on recurrence and death after minimally invasive radical hysterectomy were also included. The extracted data were analyzed using the Stata MP software package version 17.0. RESULTS: Twenty eligible clinical trials were included in the meta-analysis. When all studies were pooled, the odds ratios of RRH for recurrence and death were 1.19 (95% confidence interval [CI]=0.91-1.55; p=0.613; I²=0.0%) and 0.96 (95% CI=0.65-1.42; p=0.558; I²=0.0%), respectively. In a subgroup analysis, the quality of study methodology, study size, country where the study was conducted, and publication year were not associated with survival outcomes between RRH and LRH. CONCLUSION: This meta-analysis demonstrates that the survival outcomes are comparable between RRH and LRH. TRIAL REGISTRATION: International Prospective Register of Systematic Reviews Identifier: CRD42023387916.

Delineation of LNAPL plumes in a clay-rich site in Gyeongsangnam-do Province, South Korea: integration of geophysical survey data with borehole data and soil sampling information.

To effectively delineate the spatial distribution of oil contaminant plumes, geophysical methods indirectly measure the physical properties of the subsurface and can provide spatial information and images on a large scale, as opposed to traditional direct methods such as borehole drilling, sampling, and chemical analysis, which are time-consuming and costly. However, interpreting geophysical responses over non-aqueous phase liquid (NAPL)-contaminated sites is not straightforward due to inconsistent responses from biodegraded oil contaminants. In this study, we performed multi-geophysical surveys including seismic refraction, ground-penetrating radar, electrical resistivity tomography (ERT), and induced polarization (IP) surveys, to locate NAPL-contaminated zones in a clay-rich site. To reduce ambiguity in discriminating between oil contaminants and clay layers, we first figure out the geological structure of the site by interpreting geophysical data incorporating with borehole data. The ERT data highlighted the heavily contaminated regions in the unsaturated zone but were less distinctive below groundwater levels. Conversely, IP responses revealed potential hotspots within the clay layers, extending beneath the groundwater. Considering the 3D geological model, NAPL-contaminated zones are properly delineated through interpretation of ERT and IP data together with borehole data, and the contaminant source zone was properly estimated within the site.

4D interpretation of time-lapse electrical resistivity monitoring data to identify preferential flow path in a landfill, South Korea.

Monitoring the leakage of leachate from a landfill is critical in preventing possible contamination in the surrounding area. Time-lapse (TL) electrical resistivity tomography (ERT) has been performed along eleven survey lines at four different time points in a landfill in Korea. The TL data sets were interpreted using an in-house 4D inversion algorithm. Changes in 4D inversion results were analyzed in order to interpret a leachate-contaminant region. Since the rainy season started during obtaining TL ERT data sets, the effects of precipitation on TL ERT data are also analyzed. Changes in electrical resistivity (ER) showed that precipitation increases ER of contaminant zones. As hydrogeochemical data offer contamination information in some areas where boreholes are located, these are helpful to interpret and compare with ERT inversion results to evaluate the extent of the contaminated plume. We also classified soil textures from particle size analysis on soil samples and analyzed electrical conductivity (EC) and dissolved oxygen (DO) using groundwater samples obtained from observation wells in the survey site. The information on soil structure as well as the results of 4D inversion provided insight into the location of a preferential flow path.

Correlation of Bone Mineral Density with Pulmonary Function in Advanced Duchenne Muscular Dystrophy.

BACKGROUND: A relationship between bone mineral density (BMD) and physical function has been revealed in the general population and various diseases. However, there is a lack of research investigating the correlation between BMD and respiratory function, one of few measurable physical parameters in patients with advanced Duchenne muscular dystrophy (DMD). OBJECTIVE: To determine whether pulmonary function parameters, including respiratory muscle strength, are related to BMD. DESIGN: Retrospective observational study. SETTING: A tertiary university hospital. PATIENTS: DMD patients who were over 20 years of age, nonambulatory, and supported by mechanical ventilators. METHODS: The patients' age, weight, and pulmonary function as well as the BMD of the first and the fourth lumbar vertebra were assessed. Pulmonary function includes forced vital capacity (FVC), unassisted and assisted peak cough flow (UPCF and APCF), maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP). MAIN OUTCOME MEASURES: A bivariate correlation for BMD and other pulmonary parameters was calculated, and hierarchical regression analysis was used to determine predictors of spine Z-score. RESULTS: It was observed that the decrease in the spine BMD was not significantly correlated with age. However, the body mass index (BMI) and all parameters of pulmonary function were correlated with BMD. Partial correlation analysis adjusted by BMI showed that UPCF and APCF were powerful predictors of spine BMD. CONCLUSIONS: The BMD of the lumbar spine correlated with BMI and PCF in patients with DMD at an advanced stage.

Clinical implication of maximal voluntary ventilation in myotonic muscular dystrophy.

Patients with myotonic muscular dystrophy type 1 (DM1) tend to exhibit earlier respiratory insufficiency than patients with other neuromuscular diseases at similar or higher forced vital capacity (FVC). This study aimed to analyze several pulmonary function parameters to determine which factor contributes the most to early hypercapnia in patients with DM1.We analyzed ventilation status monitoring, pulmonary function tests (including FVC, maximal voluntary ventilation [MVV], and maximal inspiratory and expiratory pressure), and polysomnography in subjects with DM1 who were admitted to a single university hospital. The correlation of each parameter with hypercapnia was determined. Subgroup analysis was also performed by dividing the subjects into 2 subgroups according to usage of mechanical ventilation.Final analysis included 50 patients with a mean age of 42.9 years (standard deviation = 11.1), 46.0% of whom were male. The hypercapnia was negatively correlated with MVV, FVC, forced expiratory volume in 1 second (FEV1), and their ratios to predicted values in subjects with myotonic muscular dystrophy type 1. At the same partial pressure of carbon dioxide, the ratio to the predicted value was lowest for MVV, then FEV1, followed by FVC. Moreover, the P values for differences in MVV and its ratio to the predicted value between ventilator users and nonusers were the lowest.When screening ventilation failure in patients with DM1, MVV should be considered alongside other routinely measured parameters.

Crystal structure of the human glial fibrillary acidic protein 1B domain.

Glial fibrillary acidic protein (GFAP) is a homopolymeric type III intermediate filament (IF) that plays essential roles in cell migration, mitosis, development, and signaling in astrocytes and a specific type of glial cells. Its overexpression and genetic mutations lead to abnormal IF networks and accumulation of Rosenthal fibers, which results in the fatal neurodegenerative disorder Alexander disease. Herein, we present the first crystal structure of human GFAP spanning the central coiled-coil 1B domain at 2.5 Šresolution. The domain forms a tetramer comprising two equivalent parallel coiled-coil dimers that pack together in an antiparallel manner. Its assembly is stabilized by extensive networks of intermolecular hydrogen bonds, salt bridges, and hydrophobic interactions. Furthermore, mapping of the GFAP mutations associated with Alexander disease reveals that most involve residues buried in the core of the interface, and are likely to disrupt the intermolecular interactions and/or introduce steric clashes, thereby decreasing GFAP solubility and promoting aggregation. Based on our structural analysis and previous biochemical studies, we propose that GFAP assembles in the A11 mode in which coiled-coil 1B dimers lie in close axial proximity in an antiparallel fashion to provide a stable tetrameric platform for the organization of the GFAP filament.

Hepatoprotective constituents of Firmiana simplex stem bark against ethanol insult to primary rat hepatocytes.

BACKGROUND: Ethanol causes hepatic cellular damage by alterations in biological functions. This study evaluated the hepatoprotective potential of the methanolic extract originating from Firmiana simplex (Sterculiaceae) stem bark against the ethanol-induced hepatotoxicity in rat primary hepatocytes. MATERIALS AND METHODS: The extract of F. simplex stem bark was successively fractionated into n-hexane, chloroform, ethyl acetate (EtOAc), and n-butanol. Column chromatography with silica gel and sephadex LH-20 was used to isolate the EtOAc fraction. Rat primary hepatocytes were cultured to study the hepatoprotective activity of isolated substances against ethanol-induced toxicity. Intracellular reactive oxygen species (ROS) levels, the antioxidant activities of glutathione reductase (GR) and glutathione peroxidase (GSH-PX) enzymes, and the GSH content were measured to examine the antioxidative property of the isolated compounds. RESULTS: Two flavonoid glycosides, quercitrin (1) and tamarixetin 3-O-rhamnopyranoside (2), were isolated from the active EtOAc fraction. Compound 1 significantly protected rat primary hepatocytes against ethanol-induced oxidative stress by reducing the intracellular ROS level and preserving antioxidative defense systems such as GR, GSH-PX, and total GSH. CONCLUSION: This is the first report on the hepatoprotective activities of the extract of F. simplex. The EtOAc fraction of F. simplex stem bark and its major constituent quercitrin (1) could function as hepatoprotective agents to attenuate the development of alcoholic liver disease.