Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer.

PURPOSE: Surgical management of obstructive left colon cancer (OLCC) is still a matter of debate. The classic Hartmann procedure (HP) has a disadvantage that requires a second major operation. Subtotal colectomy/total abdominal colectomy (STC/TC) with ileosigmoid or ileorectal anastomosis is proposed as an alternative procedure to avoid stoma and anastomotic leakage. However, doubts about morbidity and functional outcome and lack of long-term outcomes have made surgeons hesitate to perform this procedure. Therefore, this trial was designed to provide data for morbidity, functional outcomes, and long-term outcomes of STC/TC. METHODS: This study retrospectively analyzed consecutive cases of OLCC that were treated by STC/TC between January 2000 and November 2020 at a single tertiary referral center. Perioperative outcomes and long-term outcomes of STC/TC were analyzed. RESULTS: Twenty-five descending colon cancer (45.5%) and 30 sigmoid colon cancer cases (54.5%) were enrolled in this study. Postoperative complications occurred in 12 patients. The majority complication was postoperative ileus (10 of 12). Anastomotic leakage and perioperative mortality were not observed. At 6 to 12 weeks after the surgery, the median frequency of defecation was twice per day (interquartile range, 1-3 times per day). Eight patients (14.5%) required medication during this period, but only 3 of 8 patients required medication after 1 year. The 3-year disease-free survival was 72.7% and 3-year overall survival was 86.7%. CONCLUSION: The risk of anastomotic leakage is low after STC/TC. Functional and long-term outcomes are also acceptable. Therefore, STC/TC for OLCC is a safe, 1-stage procedure that does not require diverting stoma.

Validation of a scoring system to predict bladder dysfunction after laparoscopic rectal cancer surgery.

PURPOSE: A recent trend in  urinary catheter management in patients who underwent laparoscopic rectal cancer surgery is early removal. However, some patients develop bladder dysfunction and require urinary re-catheterization. In 2016, a scoring system to predict bladder dysfunction after laparoscopic rectal cancer surgery was developed in our institution. The aim of this study was to demonstrate the validity of this scoring system and to determine the suitability of patients for early removal of urinary catheter. METHODS: A single-center, retrospective study from a prospective database was conducted on 234 patients who underwent elective laparoscopic rectal cancer surgery between January 2016 and December 2019. According to bladder dysfunction predictive score, the urinary catheter was removed on the first postoperative day (low-risk group) and fifth postoperative day (high-risk group). After catheter removal, all patients were managed using in-house protocols. RESULTS: Of 234 patients, 130 (55.6%) were classified as a low-risk group. The overall incidence of bladder dysfunction was 8.5% (11/130) in the low-risk group and 13.5% (14/104) in the high-risk group. CONCLUSION: The scoring system developed to predict bladder dysfunction showed good overall performance for discriminating between patients suitable or not for early removal of urinary catheter after laparoscopic rectal cancer surgery.

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction.

PURPOSE: Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy. METHODS: Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared. RESULTS: The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43-65) than in the loop ostomy group (60 minutes; IQR, 40-107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9-23]; loop, 21 days [IQR, 14-37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021). CONCLUSION: In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Neural correlates of multidimensional motor outputs in an excitatory parafascicular-zona incerta circuit.

The parafascicular nucleus (Pf) in medial thalamus is interconnected with prefrontal cortex and basal ganglia. Though much research has determined its importance in cognitive regulation of behaviour, its projections to regions in subthalamus remain less known. Such connections include those to zona incerta (ZI), located immediately dorsal to subthalamic nuclei (STN) regulating motor output, and whose role in a motor context is only beginning to be investigated. We thus examined circuits from parafascicular (Pf) thalamus to ZI, and its activity during locomotion and spontaneous behaviours in mice. We found that a distinct group of CaMKIIα-positive excitatory parafascicular neurons, separated from VGLUT2-positive excitatory neurons, project widely into ZI, more than adjacent STN. Our results from fibre photometry and decoding with general linear model (GLM) indicate that PF-ZI pathways do not specifically correlate with amount of locomotion or movement velocity, but instead show more specified activity during relative directional changes of movements observed in turning, sniffing behaviours. These results hint at the PF-ZI pathway having a distinct role in directing action specificity and have implications for subcortical bases in dimensional control of behaviours.

The Association between Organizational Justice and Psychological Well-Being by Regular Exercise in Korean Employees.

Many studies have shown that organizational justice (OJ) is related to psychological determinants of employees' physical and mental health in the workplace, and these health outcomes also lead to the psychological well-being (PW) of employees. Additionally, physical activity is one of the most important issues related to health in the workplace. This study compared the level of perceived OJ according to sociodemographic and lifestyle factors and examined the association between OJ and PW by regular exercise (hours per week) in Korean employees. This study used cross-sectional data obtained from 494 subjects in South Korea. Self-administered questionnaires comprising OJ, PW, and lifestyle factors (e.g., smoking, drinking, sleeping, and exercise) were completed by employees in April 2017. Multiple logistic regression analyses were conducted to estimate the association of procedural justice (PJ) and interactional justice (IJ) with the prevalence odds ratios and 95% confidence intervals of the high risk to PW. After the adjustment of sociodemographic characteristics and lifestyle factors, the main effects of PJ and IJ on the high risk to PW were significantly observed, and when these values were stratified by a regular exercise category, the lowest odds ratio was observed in a group that exercised for 1-2 h (hours per week). Organizations must encourage trust and consideration between employees and supervisors and carry out efforts to improve their environment, such as making the decision-making process fairer and encouraging employees to exercise regularly. This intervention may help prevent a high risk to PW.

Reliability and validity of the Korean version of organizational justice questionnaire.

BACKGROUND: Many studies show that organizational justice (OJ) is related to psychological determinants of employee health. To prevent health problems related to OJ in Korean workplaces and to accurately measure OJ, we developed the Korean version of the Organizational Justice Questionnaire (K-OJQ) and assessed its validity and reliability. METHODS: A questionnaire draft of the K-OJQ was developed using back-translation methods, which was preliminary tested by 32 employees in Korea. Feedback was received and the K-OJQ was finalized. This study used data from 303 workers (172 males, 131 females) in Korea using the K-OJQ, job stress, and lifestyle questionnaires. RESULTS: Cronbach's α coefficients of the internal consistency reliability was 0.92 for procedural justice and 0.94 for interactional justice. Factor analyses using SPSS 24 and Amos 23 extracted two expected factors, named procedural justice (7 items; range, 1.0-5.0) and interactional justice (6 items; range, 1.0-5.0) and showed a reliable fit (χ2 = 182; p = .000; GFI = .912; AGFI = .877; CFI = .965; RMSEA = .077). Furthermore, higher procedural justice and interactional justice levels were correlated with lower job demand (- 0.33; - 0.36), insufficient job control (- 0.36; - 0.41), interpersonal conflict (- 0.45; - 0.51), job insecurity (- 0.33; - 0.34), organizational system (- 0.64; - 0.64), and lack of reward (- 0.55; - 0.63). CONCLUSIONS: The K-OJQ was objectively validated through statistical methods.

Hybrid and Etch-Less Electrooptic Waveguide Modulator Based on Photo-Bleaching and Strain Induced Optical Waveguide Technique in Polymer.

A hybrid and etchless electrooptic (EO) polymer waveguide modulator based on both a photo-bleaching-induced optical waveguide (PBOW) and a strain-induced optical waveguide (SIOW) is described. The SIOW is defined by a metal strip line stressor deposited on top of the upper cladding that introduces the refractive index change within the core region. The PBOW technique is used to form an optical waveguide which is based on a photo-bleaching process, known as a photo-oxidation that is an irreversible decomposition of EO material, resulting in a permanent decrease in index of refraction. It is shown that this proposed fabrication idea combining two etchless techniques can be applicable to a wide range of polymer photonic integrated circuits. Preliminary results obtained from fabricated devices reveal that their half-wave voltage are ranging from 8 V to 10 V, their extinction ratio exhibits more than 15 dB, and the fiber-to-waveguide-to-lens loss is estimated to be ~9.5 dB for TM polarization at 1.55/m wavelength in the active interaction of ~1.5 cm long.

InGaN/GaN nanowires grown on SiO(2) and light emitting diodes with low turn on voltages.

GaN nanowires and InGaN disk heterostructures are grown on an amorphous SiO2 layer by a plasma-assisted molecular beam epitaxy. Structural studies using scanning electron microscopy and high-resolution transmission electron microscopy reveal that the nanowires grow vertically without any extended defect similarly to nanowires grown on Si. The as-grown nanowires have an intermediate region consisting of Ga, O, and Si rather than SiNx at the interface between the nanowires and SiO2. The measured photoluminescence shows a variation of peak wavelengths ranging from 580 nm to 635 nm because of non-uniform indium incorporation. The nanowires grown on SiO2 are successfully transferred to a flexible polyimide sheet by Au-welding and epitaxial lift-off processes. The light-emitting diodes fabricated with the transferred nanowires are characterized by a turn-on voltage of approximately 4 V. The smaller turn-on voltage in contrast to those of conventional nanowire light-emitting diodes is due to the absence of an intermediate layer, which is removed during an epitaxial lift-off process. The measured electroluminescence shows peak wavelengths of 610-616 nm with linewidths of 116-123 nm.

HMGB1 inhibits macrophage activity in efferocytosis through binding to the alphavbeta3-integrin.

Phagocytosis of apoptotic cells is critical to resolution of inflammation. High mobility group box 1 protein (HMGB1), a mediator of inflammation, has been shown to diminish phagocytosis through binding to phosphatidylserine (PS) exposed on the surface of apoptotic neutrophils. However, it is currently unknown whether HMGB1 also modulates the activity of receptors involved in PS recognition on the surface of phagocytes. In the present studies, we found that preincubation of macrophages with HMGB1 decreased their ability to engulf apoptotic neutrophils or thymocytes. Preincubation of macrophages with HMGB1 prevented the enhancement of efferocytosis resulting from exposure to milk fat globule EGF factor 8 (MFG-E8), an opsonin that bridges PS and α(v)ß(3) as well as α(v)ß(5)-integrins on the surface of phagocytes. The inhibitory effect of HMGB1 on the phagocytic activity of macrophages was prevented by preincubation of HMGB1 with soluble α(v)ß(3), but not with soluble α(v)ß(5). HMGB1 colocalized with the ß(3)-integrin on the cell membrane of macrophages and bound to soluble α(v)ß(3), but not to soluble α(v)ß(5). HMGB1 suppressed the interaction between MFG-E8 and α(v)ß(3). HMGB1 also inhibited intracellular signaling events, including ERK phosphorylation and Rac-1 activation, which are activated in macrophages during phagocytosis of apoptotic cells. These results demonstrate that HMGB1 blocks α(v)ß(3)-dependent recognition and uptake of apoptotic cells.