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Abstract Background C-reactive protein/albumin (CRP/Alb) ratio has been identified to be associated with prognosis in pancreatic cancer. However, the role of it in biliary tract cancers has not been examined. The aim of this study is to assess the role of CRP/Alb in curatively resected extrahepatic bile duct cancers (EBDC). Methods We retrospectively analyzed 235 patients who underwent curative resection because of EBDC in Seoul National University Bundang Hospital between March 2005 and February 2018. The laboratory data including CRP and albumin levels were obtained by blood tests prior to surgery. The correlations among the preoperative CRP/Alb ratio, clinicopathological factors, and patient outcomes were investigated. Results Men were 143 (60.8%) and mean age was 68 years (range 41–85 years). EBDC perihilar bile duct cancer (n = 61) and distal bile duct cancer (n = 174). Median follow-up was 22 months and median recurrence free survival 17 months, respectively. The optimal prognostic cut-off point of the CRP/Alb ratio for tumor recurrence was 0.18. Multivariate logistic regression analysis for overall survival showed age older than 65 (HR 1.937; 95% CI 1.275–2.944; p = 0.002), advanced staging (Reference stage I, stage II - HR 1.963; 95% CI 1.261–3.056; p = 0.004, stage III - HR 2.158; 95% CI 1.155–4.031; p = 0.016), Increased CA 19-9 (HR 1.735; 95% CI 1.069–2.816; p = 0.026), and CRP/Alb ratio ³ 0.18 (HR 1.638; 95% CI 1.102–2.434; p = 0.015). Multivariate logistic regression analysis for recurrence free survival showed advanced staging (Reference stage I, stage II - HR 1.750; 95% CI 1.127–2.717; p = 0.013), venous invasion (HR 1.742; 95% CI 1.097–2.767; p = 0.019), perineural invasion (HR 2.427; 95% CI 1.114–5.287; p = 0.026), and CRP/Alb ratio ³ 0.18 (HR 1.702; 95% CI 1.144–2.531; p = 0.009). Conclusions Preoperative CRP/Alb ratio is significantly associated with recurrence and overall in patients with resected EBDC. Further studies are necessary to assess the role of preoperative CRP/Alb ratio in EBDC. Legal entity responsible for the study Seoul National University Bundang Hospital. Funding Has not received any funding. Disclosure The author has declared no conflicts of interest.

SummaryBackgroundSuperficial chemical peels are frequently used in acne vulgaris treatment. Although glycolic acid (GA) has been widely used in clinical practice, its pH ranges from 0.08‐2.75 and thus should be neutralized after application to avoid burns.ObjectiveTo evaluate treatment efficacy and safety of chemical peeling using buffered 50% GA (pH 3.0) + 0.5% salicylic acid (SA) solution that does not need to be neutralized in the treatment of acne vulgaris compared to the conventional peeling using Jessner's solution.MethodsWe performed a prospective, randomized, evaluator‐blind, split‐face clinical trial. Twenty patients were randomized by assigning one side of each patient's face to receive a 50% GA (pH 3.0) + 0.5% SA peel (GA side) and the other side to receive the Jessner's solution (Jessner's solution side). All patients underwent 2 sessions of treatment spaced 2 weeks apart. Lesion count, acne severity, subjective efficacy assessment, and side effects were evaluated.ResultsThe total lesion count was significantly reduced for the GA and Jessner's solution sides (P < .001). However, there was no significant difference in the total lesion count, acne severity, or subjective efficacy assessment between the 2 sides (P > .05). The GA side had fewer side effects than the Jessner's solution side.ConclusionThe results of this study suggest that chemical peeling using the 50% GA (pH 3.0) + 0.5% SA solution can be as effective and convenient as the conventional peeling using Jessner's solution in the treatment of acne vulgaris and may show fewer adverse events than the conventional peeling.

Acanthopanax koreanum Nakai (Araliaceae) is one of the most widely cultivated medicinal plants in Jeju Island, Korea, and the roots and stem bark of A. koreanum have been traditionally used as a tonic agent for general weakness. However, the use of A. koreanum for general weakness observed in the elderly, including those with declined cognitive function, has not been intensively investigated. This study was performed to investigate the effect of the ethanol extract of A. koreanum (EEAK) on cholinergic blockade-induced memory impairment in mice. To evaluate the ameliorating effects of EEAK against scopolamine-induced memory impairment, mice were orally administered EEAK (25, 50, 100, or 200 mg/kg), and several behavioral tasks, including a passive avoidance task, the Y-maze, and a novel object recognition task, were employed. Besides, western blot analysis was conducted to examine whether EEAK affected memory-associated signaling molecules, such as protein kinase B (Akt), Ca2+ /calmodulin-dependent protein kinase II (CaMKII), and cAMP response element-binding protein (CREB). The administration of EEAK (100 or 200 mg/kg, p.o.) significantly ameliorated the scopolamine-induced cognitive impairment in the passive avoidance task, the Y-maze, and the novel object recognition task. The phosphorylation levels of both Akt and CaMKII were significantly increased by approximately two-fold compared with the control group because of the administration of EEAK (100 or 200 mg/kg) (p < 0.05). Moreover, the phosphorylation level of CREB was also significantly increased compared with the control group by the administration of EEAK (200 mg/kg) (p < 0.05). The present study suggests that EEAK ameliorates the cognitive dysfunction induced by the cholinergic blockade, in part, via several memory-associated signaling molecules and may hold therapeutic potential against cognitive dysfunction, such as that presented in neurodegenerative diseases, for example, Alzheimer's disease. Copyright © 2017 John Wiley & Sons, Ltd.

Response scales in auditory perception assessment are critical for capturing the true responses of listeners. Despite its impact on data, response scales have received the least attention in auditory perception assessment. In this study, the usability of visual analogue scales for auditory perception assessment was investigated. Five response scales (a unipolar visual analogue scale–negated to regular, a unipolar visual analogue scale—regular to negated, a bipolar visual analogue scale–positive to negative, a bipolar visual analogue scale—negative to positive, and a unipolar 11-point scale (ISO/TS 15666:2021)) for auditory perception assessment are presented. Music and traffic noise were presented to 60 university students at two different levels, i.e., 45 and 65 dBA, respectively. A web-based experimental design was implemented, and tablet pads were provided to the respondents to record their responses. The unipolar 11-point scale required the longest response time, followed by the two unipolar visual analogue scales and two bipolar visual analogue scales with statistical significance. All response scales used in this study achieved statistical reliability and sensitivity for the auditory perception assessment. Among the five response scales, the bipolar visual analogue scale (negative to positive) ranked first in reliability over repeated measures, exhibited sensitivity in differentiating sound sources, and was preferred by the respondents under the conditions of the present study. None of the respondents preferred the unipolar 11-point scale. The visual analogue scale was favoured over the traditional unipolar 11-point scale by young educated adults in a mobile-based testing environment. Moreover, the bipolar visual analogue scale demonstrated the highest reliability and sensitivity, and it was preferred the most by the respondents. The semantic labelling direction from negated to regular, or from negative to positive, is preferred over its opposite counterpart. Further research is necessary to investigate the use of response scales for the general public including children and the elderly, as well as that of semantic adjectives and their counterparts for auditory perception assessment.

The antioxidant activity and hepatoprotective potential of Cirsium setidens Nakai, a widely used medicinal plant, were investigated. The n-butanol (n-BuOH) fraction of leaves and roots of C. setidens had a higher 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging activity than the other soluble fractions. The n- BuOH fraction of roots of C. setidens had a significant hepatoprotective activity at a dose of 500 mg/kg compared to that of a standard agent. The biochemical results were confirmed by histological observations indicating that C. setidens extract decreased ballooning degeneration in response to CCl4 treatment. The n-BuOH fraction reduced CCl4-induced liver injury in rats, and transcript levels of genes encoding antioxidant enzymes such as glutathione peroxidase 1 (GPO1), glutathione peroxidase 3 (GPO3) and superoxide dismutase (SOD1) were elevated in the livers of rats treated with this fraction (500 mg/kg). Based on these results, we suggest that the C. setidens extract has hepatoprotective effect related to its antioxidant activity.

In the present study, we examined the gastroprotective effect of selenium against ethanol-induced gastric mucosal lesions in rats. The gastric mucosal lesions were produced by oral administration with various concentrations of ethanol for three days, and 80% ethanol treatment was determined to be the optimal condition for induction of gastric damage. To identify the protective effect of selenium on ethanol-induced gastric damage, various doses of selenium were given as pretreatment for three days, and then gastric damage was induced by 80% ethanol treatment. Selenium showed a protective effect against ethanol-induced gastric mucosal lesions in a dose dependent manner. Specifically, 100 μg/kg selenium showed the highest level of gastroprotection. In addition, selenium markedly attenuated ethanol-induced lipid peroxidation in gastric mucosa and increased activities of radical scavenging enzymes, such as superoxide dismutase (SOD), catalase, and glutathione peroxidase in a dose-dependent manner. Histological data showed that 100 μg/kg selenium distinctly reduced the depth and severity of the ethanol induced gastric lesion. These results clearly demonstrate that selenium inhibits the formation of ethanol-induced gastric mucosal lesions through prevention of lipid peroxidation and activation of enzymatic radical scavenging.

This study investigates whether the Middle East Respiratory Syndrome (MERS) outbreak in Korea affected online and offline retail sales and determines the presence of a substitution or delay effect between the two. We analyze the monthly retail sales of electronic goods, semi-luxury goods, and groceries using an autoregressive integrated moving average (ARIMA) model with intervention. The findings are as follows. First, offline sales of electronic goods declined by 7.9%, while online sales increased by 7.03%, indicating that these markets can act as substitutes. Second, the offline sales of semi-luxury goods decreased for two months, while online sales remained the same, indicating that there can be a delay effect in the offline market. Finally, despite the slight increase in online sales and the moderate decrease in offline sales, the MERS outbreak did not have a statistically significant effect on grocery sales. Our research findings imply that stakeholders such as the government and retail provided useful information on how to deal with the unexpected outbreak

Abstract Structural changes and their relationship with thermal stability of charged Li 0.33 Ni 1/3 Co 1/3 Mn 1/3 O 2 cathode samples have been studied using time-resolved X-ray diffraction (TR-XRD) in a wide temperature from 25 to 600 °C with and without the presence of electrolyte in comparison with Li 0.27 Ni 0.8 Co 0.15 Al 0.05 O 2 cathodes. Unique phase transition behavior during heating is found for the Li 0.33 Ni 1/3 Co 1/3 Mn 1/3 O 2 cathode samples: when no electrolyte is present, the initial layered structure changes first to a LiM 2 O 4 -type spinel, and then to a M 3 O 4 -type spinel and remains in this structure up to 600 °C. For the Li 0.33 Ni 1/3 Co 1/3 Mn 1/3 O 2 cathode sample with electrolyte, additional phase transition from the M 3 O 4 -type spinel to the MO-type rock salt phase takes place from about 400 to 441 °C together with the formation of metallic phase at about 460 °C. The major difference between this type of phase transitions and that for Li 0.27 Ni 0.8 Co 0.15 Al 0.05 O 2 in the presence of electrolyte is the delayed phase transition from the spinel-type to the rock salt-type phase by stretching the temperature range of spinel phases from about 20 to 140 °C. This unique behavior is considered as the key factor of the better thermal stability of the Li 1−x Ni 1/3 Co 1/3 Mn 1/3 O 2 cathode materials.