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Production of chitosan-based composite film reinforced with lignin-rich lignocellulose nanofibers from rice husk

Journal of Bioresources and Bioproducts 2024年第2期9卷 174-184页

作者： Hye Jee Kang Yeon Ju Lee Jin Kyoung Lee Irnia Nurika Sri Suhartini Deokyeong Choe dong hyun Kim hoon Choi Natasha P.Murphy Ho Yong Kim Young hoon Jung School of Food Science and Biotechnology Kyungpook National UniversityDaegu 41566Republic of Korea CPR S&T Co. Ltd.Gunpo 15880Republic of Korea Department of Agroindustrial Technology Faculty of Agricultural TechnologyUniversitas BrawijayaMalang 65145Indonesia Renewable Resources and Enabling Sciences Center National Renewable Energy LaboratoryGoldenCO 80401United States Center for Bio-based Chemistry Korea Research Institute of Chemical TechnologyUlsan 44429Republic of Korea

Lignocellulosic nanofibers(LCNFs),implying lignin-containing cellulose fibers,maintain the prop-erties of both lignin and cellulose,which are hydrophobic and hydrophilic,respectively.The pres-ence of hydrophobic lignin in LCNFs is expected to be an economical and attractive option that can improve the thermal and mechanical properties of polymers.Thus,this study was conducted to produce lignin-rich LCNFs from sugar-rich waste obtained from rice husks after acidic pretreat-ment.The LCNFs were produced from the lignin-rich solid fractions obtained after pretreatment and enzymatic hydrolysis,which were then incorporated as an additive into a chitosan-based film.The variations in lignin content in the range of approximately 50.6%-66.8%in differently obtained LCNFs gave significantly different optical strengths and mechanical properties.These controllable processes may allow for customized film formation.Additionally,the glucose-rich liquid fractions obtained after pretreatment and enzymatic hydrolysis were used as a substrate for ethanol fermentation to achieve total utilization of rice husk biomass waste.In conclusion,the lignin-rich biomass fraction holds promise as a suitable material for chitosan-LCNF film and has the potential to increase the economic feasibility of the biomaterial industry.

关键词： Rice husk Lignocellulose nanofiber Lignin-based material Chitosan film Upcycling

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Trends in colorectal cancer incidence according to an increase in the number of colonoscopy cases in Korea

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 51-60页

作者： Ga Hee Kim Yeong Chan Lee Tae Jun Kim Sung Noh Hong dong Kyung Chang Young-Ho Kim dong-hoon Yang Chang Mo Moon Kyunga Kim hyun Gun Kim Eun-Ran Kim Division of Gastroenterology Department of Internal MedicineAsan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Department of Digital Health Samsung Advanced Institute for Health Science and TechnologySungkyunkwan University School of MedicineSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineSamsung Medical CenterSungkyunkwan University School of MedicineSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineEwha Womans UniversitySeoul 07985South Korea Biomedical Statistics Center Samsung Medical CenterSeoul 06351South Korea Division of Gastroenterology Department of Internal MedicineSoonchunhyang University College of MedicineSeoul 04401South Korea

BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies.Colonoscopy-related complications by age group were also determined.RESULTS The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age group.During the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age.Since 2009,the increase has been rapid,showing a pattern similar to the increase in colonoscopies.The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007.The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age.CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed.As the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over.

关键词： Colorectal cancer Preinvasive colorectal cancer Colorectal polypectomy Colonoscopy

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4-Hydroxycinnamic acid attenuates neuronal cell death by inducing expression of plasma membrane redox enzymes and improving mitochondrial functions

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Food Science and Human Wellness 2023年第4期12卷 1287-1299页

作者： Sujin Park YoonA Kim Jaewang Lee hyunsoo Seo Sang-Jip Nam dong-Gyu Jo dong-hoon hyun Department of Life Science Ewha Womans UniversitySeoul 03760South Korea Department of Chemistry and Nano Science Ewha Womans UniversitySeoul 03760South Korea School of Pharmacy Sungkyunkwan UniversitySuwon 16419South Korea

Many approaches to neurodegenerative diseases that focus on amyloid-βclearance and gene therapy have not been successful.Some therapeutic applications focus on enhancing neuronal cell survival during the pathogenesis of neurodegenerative diseases,including mitochondrial dysfunction.Plasma membrane(PM)redox enzymes are crucial in maintaining cellular physiology and redox homeostasis in response to mitochondrial dysfunction.Neurohormetic phytochemicals are known to induce the expression of detoxifying enzymes under stress conditions.In this study,mechanisms of neuroprotective effects of 4-hydroxycinnamic acid(HCA)were examined by analyzing cell survival,levels of abnormal proteins,and mitochondrial functions in two different neuronal cells.HCA protected two neuronal cells exhibited high expression of PM redox enzymes and the consequent increase in the NAD^(+)/NADH ratio.Cells cultured with HCA showed delayed apoptosis and decreased oxidative/nitrative damage accompanied by decreased ROS production in the mitochondria.HCA increased the mitochondrial complexes I and II activities and ATP production.Also,HCA increased mitochondrial fusion and decreased mitochondrial fission.Overall,HCA maintains redox homeostasis and energy metabolism under oxidative/metabolic stress conditions.These findings suggest that HCA could be a promising therapeutic approach for neurodegenerative diseases.

关键词： NADH-quinone oxidoreductase 1(NQO1) Cytochrome b5 reductase 4-Hydroxycinnamic acid Neuroprotection Improved mitochondrial functions

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Depolarization mitigated in ferroelectric Hf_(0.5)Zr_(0.5)O_(2)ultrathin films(<5 nm)on Si substrate by interface engineering

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Journal of Advanced Ceramics 2024年第3期13卷 282-292页

作者： Se hyun Kim Younghwan Lee dong hyun Lee Geun Hyeong Park hyun Woo Jeong Kun Yang Yong Hyeon Cho Young Yong Kim Min Hyuk Park Department of Materials Science and Engineering College of EngineeringSeoul National UniversitySeoul 08826Republic of Korea Research Institute of Advanced Materials College of EngineeringSeoul National UniversitySeoul 08826Republic of Korea Inter-university Semiconductor Research Center College of EngineeringSeoul National UniversitySeoul 08826Republic of Korea Pohang Accelerator Laboratory Pohang University of Science&TechnologyPohang 790784Republic of Korea

(Hf,Zr)O_(2)offers considerable potential for next-generation semiconductor devices owing to its nonvolatile spontaneous polarization at the nanoscale.However,scaling this material to sub-5 nm thickness poses several challenges,including the formation of an interfacial layer and high trap concentration.In particular,a low-k SiO_(2)interfacial layer is naturally formed when(Hf,Zr)O_(2)films are directly grown on a Si substrate,leading to high depolarization fields and rapid reduction of the remanent polarization.To address these issues,we conducted a study to significantly improve ferroelectricity and switching endurance of(Hf,Zr)O_(2)films with sub-5 nm thicknesses by inserting a TiO_(2)interfacial layer.The deposition of a Ti film prior to Hf_(0.5)Zr_(0.5)O_(2)film deposition resulted in a high-k TiO_(2)interfacial layer and prevented the direct contact of Hf_(0.5)Zr_(0.5)O_(2)with Si.Our findings show that the high-k TiO_(2)interfacial layer can reduce the SiO_(2)/Si interface trap density and the depolarization field,resulting in a switchable polarization of 60.2μC/cm^(2)for a 5 nm thick Hf_(0.5)Zr_(0.5)O_(2)film.Therefore,we propose that inserting a high-k TiO_(2)interfacial layer between the Hf_(0.5)Zr_(0.5)O_(2)film and the Si substrate may offer a promising solution to enhancing the ferroelectricity and reliability of(Hf,Zr)O_(2)grown on the Si substrate and can pave the way for next-generation semiconductor devices with improved performance.

关键词： ferroelectric charge trapping hafnia depolarization

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Evolution of nonmetallic inclusions in 80-t 9CrMoCoB large-scale ingots during electroslag remelting process

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International Journal of Minerals,Metallurgy and Materials 2024年第7期31卷 1525-1539页

作者： Shengchao Duan Min Joo Lee Yao Su Wangzhong Mu dong Soo Kim Joo hyun Park School of Mechanical and Materials Engineering North China University of TechnologyBeijing 100144China Department of Materials Science and Chemical Engineering Hanyang UniversityAnsan 15588Rep.of Korea Department of Materials Science and Engineering KTH Royal Institute of TechnologyBrinellvägen 23Stockholm 10044Sweden Department of Engineering Science and Mathematics Division of Materials ScienceLuleåUniversity of Technology97187 LuleåSweden Casting&Forging Business Unit Nuclear Business GroupDoosan EnerbilityChangwon 51711Rep.of Korea

In combination with theoretical calculations,experiments were conducted to investigate the evolution behavior of nonmetallic inclusions(NMIs)during the manufacture of large-scale heat-resistant steel ingots using 9CrMoCoB heat-resistant steel and CaF_(2)–CaO–Al_(2)O_(3)–SiO_(2)–B_(2)O_(3)electroslag remelting(ESR)-type slag in an 80-t industrial ESR furnace.The main types of NMI in the consumable electrode comprised pure alumina,a multiphase oxide consisting of an Al_(2)O_(3)core and liquid CaO–Al_(2)O_(3)–SiO_(2)–MnO shell,and M_(23)C_(6)carbides with an MnS core.The Al_(2)O_(3)and MnS inclusions had higher precipitation temperatures than the M_(23)C_(6)-type carbide under equilibrium and nonequilibrium solidification processes.Therefore,inclusions can act as nucleation sites for carbide layer precipitation.The ESR process completely removed the liquid CaO–Al_(2)O_(3)–SiO_(2)–MnO oxide and MnS inclusion with a carbide shell,and only the Al_(2)O_(3)inclusions and Al_(2)O_(3)core with a carbide shell occupied the remelted ingot.The M_(23)C_(6)-type carbides in steel were determined as Cr_(23)C_(6)based on the analysis of transmission electron microscopy results.The substitution of Cr with W,Fe,or/and Mo in the Cr_(23)C_(6)lattice caused slight changes in the lattice parameter of the Cr_(23)C_(6)carbide.Therefore,Cr_(21.34)Fe_(1.66)C_(6),(Cr_(19)W_(4)C_(6),Cr_(18.4)Mo_(4.6)C_(6),and Cr_(16)Fe_(5)Mo_(2)C_(6)can match the fraction pattern of Cr_(23)C_(6)carbide.The Al_(2)O_(3)inclusions in the remelted ingot formed due to the reduction of CaO,SiO_(2),and MnO components in the liquid inclusion.The increased Al content in liquid steel or the higher supersaturation degree of Al_(2)O_(3)precipitation in the remelted ingot than that in the electrode can be attributed to the evaporation of CaF_(2)and the increase in CaO content in the ESR-type slag.

关键词： nonmetallic inclusion heat-resistant steel electroslag remelting M_(23)C_(6) carbide MnS inclusion supersaturation degree

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Achieving Ultra-Broad Microwave Absorption Bandwidth Around Millimeter-Wave Atmospheric Window Through an Intentional Manipulation on Multi-Magnetic Resonance Behavior

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Nano-Micro Letters 2024年第9期16卷 291-307页

作者： Chuyang Liu Lu Xu Xueyu Xiang Yujing Zhang Li Zhou Bo Ouyang Fan Wu dong‑hyun Kim Guangbin Ji School of Materials Science and Technology Nanjing University of Aeronautics and AstronauticsNanjing 210016JiangsuPeople’s Republic of China School of Materials Science and Engineering Nanjing University of Science and TechnologyNanjing 210094JiangsuPeople’s Republic of China School of Physics Nanjing University of Science and TechnologyNanjing 210094JiangsuPeople’s Republic of China School of Mechanical Engineering Nanjing University of Science and TechnologyNanjing 210094JiangsuPeople’s Republic of China School of Physics Chungbuk National UniversityCheongju 28644South Korea Department of Chemistry School of ScienceTianjin UniversityTianjin 300072People’s Republic of China

The utilization of electromagnetic waves is rapidly advancing into the millimeter-wave frequency range,posing increasingly severe challenges in terms of electromagnetic pollution prevention and radar stealth.However,existing millimeter-wave absorbers are still inadequate in addressing these issues due to their monotonous magnetic resonance pattern.In this work,rare-earth La^(3+)and non-magnetic Zr^(4+)ions are simultaneously incorporated into M-type barium ferrite(BaM)to intentionally manipulate the multi-magnetic resonance behavior.By leveraging the contrary impact of La^(3+)and Zr^(4+)ions on magnetocrystalline anisotropy field,the restrictive relationship between intensity and frequency of the multi-magnetic resonance is successfully eliminated.The magnetic resonance peak-differentiating and imitating results confirm that significant multi-magnetic resonance phenomenon emerges around 35 GHz due to the reinforced exchange coupling effect between Fe^(3+)and Fe^(2+)ions.Additionally,Mosbauer spectra analysis,first-principle calculations,and least square fitting collectively identify that additional La^(3+)doping leads to a profound rearrangement of Zr^(4+)occupation and thus makes the portion of polarization/conduction loss increase gradually.As a consequence,the La^(3+)-Zr^(4+)co-doped BaM achieves an ultra-broad bandwidth of 12.5+GHz covering from 27.5 to 40+GHz,which holds remarkable potential for millimeter-wave absorbers around the atmospheric window of 35 GHz.

关键词： Microwave absorption Ultra-broad bandwidth M-type barium ferrite Magnetocrystalline anisotropy field Multimagnetic resonance

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Highly Aligned Ternary Nanofiber Matrices Loaded with MXene Expedite Regeneration of Volumetric Muscle Loss

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Nano-Micro Letters 2024年第4期16卷 269-292页

作者： Moon Sung Kang Yeuni Yu Rowoon Park Hye Jin Heo Seok hyun Lee Suck Won Hong Yun Hak Kim dong‑Wook Han Department of Cogno‑Mechatronics Engineering College of Nanoscience and NanotechnologyPusan National UniversityBusan 46241Republic of Korea Medical Research Institute School of MedicinePusan National UniversityYangsan 50612Republic of Korea Department of Anatomy School of MedicinePusan National UniversityYangsan 50612Republic of Korea Engineering Research Center for Color‑Modulated Extra‑Sensory Perception Technology Pusan National UniversityBusan 46241Republic of Korea Department of Biomedical Informatics School of MedicinePusan National UniversityYangsan 50612Republic of Korea Periodontal Disease Signaling Network Research Center and Dental and Life Science Institute School of DentistryPusan National UniversityYangsan 50612Republic of Korea BIO‑IT Fusion Technology Research Institute Pusan National UniversityBusan 46241Republic of Korea Present Address:Osstem Implant Inc. Seoul 07789Republic of Korea

Current therapeutic approaches for volumetric muscle loss(VML)face challenges due to limited graft availability and insufficient bioactivities.To overcome these limitations,tissue-engineered scaffolds have emerged as a promising alternative.In this study,we developed aligned ternary nanofibrous matrices comprised of poly(lactide-co-ε-caprolactone)integrated with collagen and Ti_(3)C_(2)T_(x)MXene nanoparticles(NPs)(PCM matrices),and explored their myogenic potential for skeletal muscle tissue regeneration.The PCM matrices demonstrated favorable physicochemical properties,including structural uniformity,alignment,microporosity,and hydrophilicity.In vitro assays revealed that the PCM matrices promoted cellular behaviors and myogenic differentiation of C2C12 myoblasts.Moreover,in vivo experiments demonstrated enhanced muscle remodeling and recovery in mice treated with PCM matrices following VML injury.Mechanistic insights from next-generation sequencing revealed that MXene NPs facilitated protein and ion availability within PCM matrices,leading to elevated intracellular Ca^(2+)levels in myoblasts through the activation of inducible nitric oxide synthase(i NOS)and serum/glucocorticoid regulated kinase 1(SGK1),ultimately promoting myogenic differentiation via the m TOR-AKT pathway.Additionally,upregulated i NOS and increased NO–contributed to myoblast proliferation and fiber fusion,thereby facilitating overall myoblast maturation.These findings underscore the potential of MXene NPs loaded within highly aligned matrices as therapeutic agents to promote skeletal muscle tissue recovery.

关键词： Ti_(3)C_(2)T_(x)MXene nanoparticle Ternary nanofibrous matrices Myogenesis Regeneration of volumetric muscle loss Next generation sequencing

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Generation of double knockout cattle via CRISPR-Cas9 ribonucleoprotein(RNP)electroporation

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Journal of Animal Science and Biotechnology 2024年第1期15卷 456-462页

作者： Gyeong-Min Gim Kyeong-Hyeon Eom dong-Hyeok Kwon Dae-Jin Jung Dae-hyun Kim Jun-Koo Yi Jae-Jung Ha Ji-hyun Lee Seong-Beom Lee Woo-Jae Son Soo-Young Yum Won-Wu Lee Goo Jang Laboratory of Theriogenology and Biotechnology Department of Veterinary Clinical ScienceCollege of Veterinary Medicine and the Research Institute of Veterinary ScienceSeoul National UniversitySeoulRepublic of Korea LARTBio Co. Ltd.SeoulRepublic of Korea Gyeongsangbukdo Livestock Research Institute YeongjuRepublic of Korea Comparative Medicine Disease Research Center Seoul National UniversitySeoulRepublic of Korea

Background Genome editing has been considered as powerful tool in agricultural fields.However,genome editing progress in cattle has not been fast as in other mammal species,for some disadvantages including long gestational periods,single pregnancy,and high raising cost.Furthermore,technically demanding methods such as microinjection and somatic cell nuclear transfer(SCNT)are needed for gene editing in cattle.In this point of view,electroporation in embryos has been risen as an alternative.Results First,editing efficiency of our electroporation methods were tested for embryos.Presence of mutation on embryo was confirmed by T7E1 assay.With first combination,mutation rates for MSTN and PRNP were 57.6%±13.7%and 54.6%±13.5%,respectively.In case of MSTN/BLG,mutation rates were 83.9%±23.6%for MSTN,84.5%±18.0%for BLG.Afterwards,the double-KO embryos were transferred to surrogates and mutation rate was identified in resultant calves by targeted deep sequencing.Thirteen recipients were transferred for MSTN/PRNP,4 calves were delivered,and one calf underwent an induction for double KO.Ten surrogates were given double-KO embryos for MSTN/BLG,and four of the six calves that were born had mutations in both genes.Conclusions These data demonstrated that production of genome edited cattle via electroporation of RNP could be effectively applied.Finally,MSTN and PRNP from beef cattle and MSTN and BLG from dairy cattle have been born and they will be valuable resources for future precision breeding.

关键词： Beta-lactoglobulin Cattle CRISPR-Cas9 Electroporation Knockout MSTN PRNP

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Highly Elastic,Bioresorbable Polymeric Materials for Stretchable,Transient Electronic Systems

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Nano-Micro Letters 2024年第6期16卷 1-13页

作者： Jeong‑Woong Shin dong‑Je Kim Tae‑Min Jang Won Bae Han Joong hoon Lee Gwan‑Jin Ko Seung Min Yang Kaveti Rajaram Sungkeun Han Heeseok Kang Jun Hyeon Lim Chan‑Hwi Eom Amay J.Bandodkar Hanul Min Suk‑Won Hwang KU‑KIST Graduate School of Converging Science and Technology Korea University145 Anam‑roSeongbuk‑guSeoul 02841Republic of Korea SK Hynix 2091Gyeongchung‑daeroBubal‑eupIcheon‑siGyeonggi‑do 17336Republic of Korea Hanwha Systems Co. Ltd.188Pangyoyeok‑roBundang‑guSeongnam‑siGyeonggi‑do 13524Republic of Korea Department of Electrical and Computer Engineering North Carolina State UniversityRaleighNC 27606USA Center for Advanced Self‑Powered Systems of Integrated Sensors and Technologies(ASSIST) North Carolina State UniversityRaleighNC 27606USA Department of Integrative Energy Engineering Korea University145 Anam‑roSeongbuk‑guSeoul 02841Republic of Korea Biomaterials Research Center Korea Institute of Science and Technology(KIST)5 Hwarang‑ro 14‑gilSeongbuk‑guSeoul 02792Republic of Korea Semiconductor R&D Center Samsung Electronics Co.Ltd.Hwaseong‑siGyeonggi‑do 18448Republic of Korea Center for Advanced Biomolecular Recognition Biomedical Research DivisionKorea Institute of Science and Technology(KIST)Seoul 02792Republic of Korea

Substrates or encapsulants in soft and stretchable formats are key components for transient,bioresorbable electronic systems;however,elastomeric polymers with desired mechanical and biochemical properties are very limited compared to nontransient counterparts.Here,we introduce a bioresorbable elastomer,poly(glycolide-co-ε-caprolactone)(PGCL),that contains excellent material properties including high elongation-at-break(<1300%),resilience and toughness,and tunable dissolution behaviors.Exploitation of PGCLs as polymer matrices,in combination with conducing polymers,yields stretchable,conductive composites for degradable interconnects,sensors,and actuators,which can reliably function under external strains.Integration of device components with wireless modules demonstrates elastic,transient electronic suture system with on-demand drug delivery for rapid recovery of postsurgical wounds in soft,time-dynamic tissues.

关键词： Biodegradable elastomer Conductive polymer composites Biomedical device Transient electronics

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Survival benefit of concurrent chemoradiotherapy for advanced ampulla of Vater cancer

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World Journal of Clinical Cases 2024年第2期12卷 267-275页

作者： Chae Hwa Kwon hyung Il Seo dong Uk Kim Sung Yong Han Suk Kim Nam Kyung Lee Seung Baek Hong Ji hyun Ahn Young Mok Park Byeong Gwan Noh BioMedical Research Institute Pusan National University HospitalBusan 49241South Korea Department of Surgery Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Internal Medicine Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Radiology Pusan National University School of Medicine and Biomedical Research InstitutePusan National University HospitalBusan 49241South Korea Department of Pathology and Biomedical Research Institute Pusan National University HospitalBusan 49241South Korea

BACKGROUND Currently,there is no standard adjuvant therapy for patients with resected ampulla of Vater(AoV)cancer.AIM To evaluate the effectiveness of adjuvant concurrent chemoradiotherapy(CCRT)in patients with advanced AoV cancer who underwent curative resection.METHODS This single-centered,retrospective study included 29 patients with advanced AoV cancer who underwent pancreaticoduodenectomy between 2006 and 2018.The impact of CCRT on advanced AoV cancer was analyzed.RESULTS The 1-,3-,and 5-yr recurrence-free survival(RFS)rates for patients with advanced AoV cancer were 82.8%,48.3%,and 40.8%,respectively,and the overall survival(OS)rates were 89.7%,62.1%,and 51.7%,respectively.Lymphovas-cular invasion was found to be a significant risk factor for RFS and OS in patients with advanced AoV cancer in the univariate analysis,whereas T stage and lymph node metastasis were significantly associated with OS in the multivariate analysis.Compared to the patients who did not receive adjuvant CCRT,those who received adjuvant CCRT did not show statistically significant improvements in the RFS and OS,although they had a significantly lower average age and significantly higher platelet-to-lymphocyte ratio.CONCLUSION Adjuvant CCRT did not improve survival outcomes in patients with advanced AoV cancer.These findings contribute to existing knowledge on the effectiveness of CCRT in this patient population and provide important insights for clinical decision-making.

关键词： Advanced ampulla of Vater cancer Adjuvant concurrent chemoradiotherapy Recurrence Survival Vater cancer

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