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Background Rapid on-site evaluation (ROSE) for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been advocated to qualitatively diagnose biopsy samples. However, adequate ROSE criteria during EBUS-TBNA are unclear. The aim of this study was to determine adequacy criteria of ROSE in EBUS-TBNA samples and suggest an appropriate algorithm. Methods Patients who underwent EBUS-TBNA for nodal evaluation between March and July 2013 at Seoul National University Hospital were included prospectively. The ROSE slides were reviewed independently by two pathologists, and the results were compared to the final pathologic results. Diagnostic yields, sensitivity, specificity, and accuracy were calculated in order to make nodal evaluations. Results EBUS-TBNA was performed on 300 lymph nodes in 133 patients. Samples were nondiagnostic in 7.7%, 6.3%, and 1.7% of the cytologic, histologic, and overall pathologic results, respectively. On the ROSE slides, a large tissue core size (≥2 cm), microscopic anthracotic pigment (MAP), and increased lymphocyte density (LD; ≥40 cells/field [40×, mean of 10 fields]) were significantly associated with adequate final cytologic or histologic results. Malignant cells were not statistically associated with adequacy but were considered a parameter indicating an adequate diagnosis. Using four sequential criteria, tissue core size, the presence of malignant cell, MAP, and LD ≥40 cells/field, the sensitivity and accuracy rates of ROSE increased from 64.4% to 98.6% and from 64.7% to 97.3%, respectively. Conclusions A high adequacy rate of ROSE in EBUS-TBNA can be achieved by sequentially applying four criteria: tissue core size, malignant cells, MAP, and increased LD. [ABSTRACT FROM AUTHOR]

Summary: Objectives: The incidence of Pneumocystis jirovecii pneumonia (PCP) in patients without HIV infection (non-HIV PCP) has been increasing along with the increased use of chemotherapeutic agents and immunosuppressants, but the prognostic factors of non-HIV PCP remain unclear. This study aimed to identify the prognostic factors of non-HIV PCP. Methods: Immunocompromised patients without HIV infection who were diagnosed and treated for PCP were included. The PCP diagnosis was based on positive direct fluorescent antibody (DFA) or polymerase chain reaction (PCR) results and compatible clinical symptoms and radiological findings. Results: In total, 372 non-HIV patients with positive PCP DFA or PCR findings were screened and 173 were included. Univariate analysis indicated that age, smoking, chronic lung disease or hematologic malignancy, chemotherapeutic agents, high alveolar–arterial oxygen gradient (D[A–a]O2), C-reactive protein, albumin, blood urea nitrogen (BUN), CMV antigenemia, combined bacteremia, high percentage of neutrophils and rate of co-infection in BAL fluid, and mechanical ventilator care were related to the prognosis of non-HIV PCP. Multivariate analysis revealed that high D(A–a)O2, combined bacteremia, increased BUN and preexisting lung disease were indicators of a poor prognosis. Conclusions: High D(A–a)O2, combined bacteremia, increased BUN and preexisting lung disease were independent factors of poor prognosis in non-HIV PCP patients. [Copyright &y& Elsevier]

Abstract: Suprascapular neuropathy after an arthroscopic repair of a SLAP lesion is theoretically possible, but it has been rarely reported. We present a case of suprascapular nerve injury at the spinoglenoid notch as a complication of an improperly inserted suture anchor after repair of a type II SLAP lesion. The diagnosis was confirmed by the magnetic resonance imaging findings and an electrodiagnostic study, and direct compression of the nerve was visualized under repeat arthroscopy. An anatomic study of the superior glenoid shows that the available bone stock of the superior glenoid rim for the anchor insertion is found to decrease posteriorly. During the repair of a SLAP lesion, surgeons should consider the possibility of an iatrogenic injury to the suprascapular nerve by an improperly inserted suture anchor. [Copyright &y& Elsevier]

Abstract: Introduction: As the population of patients with lung cancer increases, the expenditure on lung cancer treatment will become a huge economic burden in many countries. To support public health services for the treatment of lung cancer, the calculation of lung cancer-specific costs is important. Methods: This study included newly diagnosed 76 lung cancer patients who had survived for at least 5 years after the diagnosis in a tertiary care hospital in South Korea. Direct medical costs were calculated from health care claims obtained from Seoul National University Hospital, which included out-of-pocket expenditures. Direct non-medical and indirect costs were calculated from national statistics. Results: Mean direct medical costs, direct non-medical costs, and indirect costs amounted to $21,321, $6444 and $4943 respectively, based on an exchange rate of Korean Won 1200=US $1. The average cost for treatment of one lung cancer patient for all 5 years was $32,708. This constituted 44.7% of the per capita income during the same 5-year period. Conclusion: The economic burden of lung cancer treatment is significant in Korea. [Copyright &y& Elsevier]

Background: Caveolin-1, as a major component of caveolae, is involved in the regulation of cell cycle by impacting various signaling pathways. Previous studies of caveolin-1 in cancer showed two contrary results. In most in vitro studies, caveolin-1 played a role as a tumor suppressor. On the other hand, the elevated expression of caveolin-1 was often reported to be associated with poor clinical outcome in human studies. These results indicate differential biological functions of caveolin-1 depending on the development and progression stage of cancer in vivo. Methods: To clarify the correlation between the clinicopathologic profiles of pulmonary squamous cell carcinomas and the expression of caveolin-1, 107 cases of formalin-fixed and paraffin-embedded tissues of pulmonary squamous cell carcinomas were immunohistochemically evaluated for the expression of caveolin-1 by the tissue-array method. Results: Caveolin-1 was expressed in 34 cases (31.7%) among 107 cases of pulmonary squamous cell carcinoma. The expression of caveolin-1 was statistically correlated with pathologic stage (stage I and II vs. III; P<0.001), pT (T1 and T2 vs. T3 and T4; P=0.001), and pN (N1 vs. N2 and N3; P=0.0143). The patients with caveolin-1 expression in pulmonary squamous cell carcinomas showed a poorer prognosis than those in caveolin-1-negative group (P=0.0345). Conclusion: The expression of caveolin-1 is significantly correlated with advanced pathologic stage and poor prognosis in pulmonary squamous cell carcinoma. The results of current study suggest that the expression level of caveolin-1 may be a candidate factor for predicting prognosis in patients with pulmonary squamous cell carcinoma. [Copyright &y& Elsevier]

Hydrogen is widely accepted as a promising energy carrier replacing fossil fuels. In this context hydrogen storage is one of the critical challenges in realizing hydrogen economy which relies on hydrogen as the commercial fuel. Due to very low volumetric energy density of pure hydrogen, it is highly compressed as a gas phase or liquified at extremely low temperature. However, chemically combined state in other materials has advantages in terms of storage conditions and associated safety concerns. The present study focuses on a development of a hydrogen storage applicable to special fuel cell (FC) mobilities such as forklift but not limited to. We adopts a solid-state storage method using metal hydride composite prepared by processing La 0.9 Ce 0.1 Ni 5 and extended natural graphite (ENG). The isothermal hydrogen absorption/desorption behavior of the composite is measured at 20–80 °C. The results suggest that around 10 bar is sufficient to store 1.2 wt% of hydrogen. A cylindrical reactor is manufactured and experiments are carried out with the fabricated hydrogen storage material by changing operation conditions. The results of satisfaction are obtained in terms of the amount of hydrogen storage (>83 standard liter) and the absorption time (~10 min) under relatively moderate conditions of temperature (~19 °C) and pressure (~11 bar). As for scaling-up, a reactor of 2.0 kWh is designed based on the experimental results. CFD analysis is performed based on the hottest operation conditions focusing on a cooling water flow. The flow pattern and the temperature distribution of the cooling water are expected to be adequate not deviating from the stable operating conditions. CFD would be further applied to optimize the incorporated modular reactors. • La 0.9 Ce 0.1 Ni 5 and extended natural graphite (ENG) were processed to store hydrogen. • PCT behaviors were measured at 20–80 °C. • Thermal conductivity was measured to offer thermos-physical data. • Cylindrical reactor was manufactured and hydrogen absorption/desorption cycles were carried out to examine the performance. • Modular type reactor was designed and analyzed by CFD to scale up the reactor. [ABSTRACT FROM AUTHOR]

Background: Linezolid improves the treatment outcomes of multidrug-resistant tuberculosis substantially. We investigated whether use of linezolid instead of ethambutol increases the proportion of sputum culture conversion at 8 weeks of treatment in patients with pulmonary tuberculosis.Methods: We did a phase 2, multicentre, randomised, open-label trial for patients with pulmonary tuberculosis at the three affiliated hospitals to Seoul National University and National Medical Center (Seoul-Seongnam, South Korea). Patients, aged 20-80 years, with a positive sputum for pulmonary tuberculosis, but without resistance to rifampicin, and current treatment administered for 7 days or fewer, were randomly assigned at a 1:1:1 ratio into three groups. The control group received ethambutol (2 months) with isoniazid, rifampicin, and pyrazinamide. The second group used linezolid (600 mg/day) for 2 weeks and the third group for 4 weeks instead of ethambutol for 2 months. We used a minimisation method to randomise, and stratified according to institution, cavitation on chest radiographs, and diabetes. The primary endpoint was the proportion of patients with negative culture conversion of sputum in liquid media after 8 weeks of treatment. The results of this trial were analysed primarily in the modified intention-to-treat population. The trial is registered with ClinicalTrials.gov, number NCT01994460.Findings: Between Feb 19, 2014, and Jan 13, 2017, a total of 429 patients were enrolled and 428 were randomly assigned into either the control group (142 patients), the linezolid 2 weeks group (143 patients), or the linezolid 4 weeks group (143 patients). Among them, 401 were eligible for primary efficacy analyses. In the modified intention-to-treat analyses, negative cultures in liquid media at 8 weeks of treatment were observed in 103 (76·9%) of 134 control patients, 111 (82·2%) of 135 in the linezolid 2 weeks group, and 100 (75·8%) of 132 in the linezolid 4 weeks groups. The difference from the control group was 5.4% (95% CI -4·3 to 15·0, p=0·28) for the linezolid 2 weeks group and -1·1% (-11·3 to 9·1, p=0·83) for the linezolid 4 weeks group. Numbers of patients who experienced at least one adverse event were similar across the groups (86 [62·8%] of 137 in control, 79 [57·2%] of 138 in the linezolid 2 weeks group, and 75 [62·0%] of 121 in the linezolid 4 weeks group). Resistance to linezolid was not identified in any patient.Interpretation: Higher rates of culture conversion at 8 weeks of treatment with short-term use of linezolid were not observed. However, safety analyses and the resistance profile suggested the potential role of linezolid in shortening of treatment for drug-susceptible tuberculosis.Funding: Ministry of Health and Welfare, South Korea. [ABSTRACT FROM AUTHOR]

The OWL-Net (Optical Wide-field patroL Network) is composed of 0.5-m wide-field optical telescopes spread over the globe (Mongolia, Morocco, Israel, South Korea, and USA). All the observing stations are identical, operated in a fully robotic manner, and controlled by the headquarters located in Daejeon, Korea. The main objective of the OWL-Net is to obtain the orbital information of Korean LEO and GEO satellites using purely optical means and to maintain their orbital elements. The aperture size of the mirror is 0.5 m in the Ritchey-Chretien configuration, and its field of view is 1.1 deg on the CCD sensor. The telescope is equipped with an electrically cooled 4 K CCD camera with a 9-µm pixel size, and its pixel scale is 1 arcsec/pixel. A chopper wheel with variable speed is adopted to obtain multiple points in a single shot. Each observatory is equipped with a heavy-duty environment monitoring system for robust robotic observation. The headquarters has components for status monitoring, scheduling, network operation, orbit calculation, and database management. The test-phase operation of the whole system began in early 2017, although test runs for individual sites began in 2015. Although the OWL-Net has 7 observation modes for artificial satellites and astronomical objects, we are concentrating on a few modes for LEO satellites and calibration during the early phase. Some early results and analysis for system performance will be presented, and their implications will be discussed. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is induced by matrix degradation and inflammation mediated by bromo-domain-containing protein 4 (BRD4)-dependent catabolic factors. BRD4 acts as both a transcriptional regulator and an epigenetic reader. BBC0901 was identified as an inhibitor of BRD4 using a DNA-encoded library screening system. We aimed to demonstrate the effects of BBC0901 on OA pathogenesis by in vitro, ex vivo , and in vivo analyses. BBC0901 inhibited the expression of catabolic factors that degrade cartilage without significantly affecting the viability of mouse articular chondrocytes. Additionally, ex vivo experiments under conditions mimicking OA showed that BBC0901 suppressed extracellular matrix degradation. RNA sequencing analysis of gene expression patterns showed that BBC0901 inhibited the expression of catabolic factors, such as matrix metalloproteinases (MMPs) and cyclooxygenase (COX)2, along with reactive oxygen species (ROS) production. Furthermore, intra-articular (IA) injection of BBC0901 into the knee joint blocked osteoarthritic cartilage destruction by inhibition of MMP3, MMP13, COX2, interleukin (IL)6, and ROS production, thereby obstructing the nuclear factor kappa-light-chain-enhancer of activated B cell and mitogen activated protein kinase signaling. In conclusion, BBC0901-mediated BRD4 inhibition prevented OA development by attenuating catabolic signaling and hence, can be considered a promising IA therapeutic for OA. [Display omitted] [ABSTRACT FROM AUTHOR]

Background Diagnosis of intrathoracic tuberculosis (TB) lymphadenitis remains a challenge because of difficulties in obtaining adequate tissue and the lack of a sensitive test. Recently, Xpert MTB/RIF assay is being used for rapid diagnosis of pulmonary TB, but it has not yet been widely validated in intrathoracic TB lymphadenitis. The aim of this study was to assess the additional role of Xpert MTB/RIF in diagnosing intrathoracic TB lymphadenitis using endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimen. Methods Consecutive patients who underwent Xpert MTB/RIF assay using EBUS-TBNA specimen from January 2012 and November 2013 at a tertiary referral hospital were recruited. Among them, the cases with malignant lymph nodes were excluded. Results Among 73 patients, 13 (17.8%) cases were diagnosed with intrathoracic TB lymphadenitis. In detail, 10 patients were diagnosed using conventional methods only (histology or AFB culture) and 3 patients were additionally diagnosed when adding Xpert MTB/RIF assay. The median time to diagnosis using Xpert MTB/RIF (1 day) was shorter than conventional methods (3 days for histology, 14 days for AFB culture). Rifampin resistance was not detected in any patients. Conclusion In patients with enlarged intrathoracic lymph nodes and low suspicion of malignancy, combination of conventional diagnostic methods with Xpert MTB/RIF could lead to additional and rapid diagnosis of intrathoracic TB lymphadenitis. [ABSTRACT FROM AUTHOR]

Summary: Background: During the observation of many patients with nontuberculous mycobacteria (NTM) infections, we have often isolated different NTM species in the same patient. In this study we elucidated the patterns of multiple NTM species isolation. Methods: The analysis included all patients from whom more than one species of mycobacteria were cultured from a respiratory specimen at Seoul National University Hospital, a tertiary referral hospital in South Korea, between January 2002 and December 2008. The demographic characteristics and clinical and radiographic findings were reviewed retrospectively. Results: Multiple NTM species were isolated from 37 patients. Four patients with Mycobacterium gordonae, Mycobacterium terrae, or Mycobacterium lentiflavum were excluded due to the possibility of contamination. Transition to another NTM species was observed in 23 patients (69.7%), while alternating isolation of two or three NTM species was seen in nine patients. Two species were isolated simultaneously from different sputum samples collected from one patient on the same day. Conclusions: Different NTM species were isolated from the same patients. [Copyright &y& Elsevier]

Abstract: Single crystalline ZnO thin film on p-GaN/sapphire (0001) substrate, using two different precursors by hydrothermal route at a temperature of 90°C were successfully grown. The effect of starting precursor on crystalline nature, surface morphology and optical emission of the films were studied. ZnO thin films were grown in aqueous solution of zinc acetate and zinc nitrate. X-ray diffraction analysis revealed that all the thin films were single crystalline in nature and exhibited wurtzite symmetry and c-axis orientation. The thin films obtained with zinc nitrate had a more pitted rough surface morphology compared to the film grown in zinc acetate. However the thickness of the films remained unaffected by the nature of the starting precursor. Sharp luminescence peaks were observed from the thin films almost at identical energies but deep level emission was slightly prominent for the thin film grown in zinc nitrate. [Copyright &y& Elsevier]

Abstract: The rate of in vitro maturation (IVM) of canine oocytes has not improved in comparison to that of other mammalian species. This study aims to improve the efficiency of canine oocytes IVM using the antioxidant, extracellular superoxide dismutase (EC-SOD). Thus, the effect of conditioned medium of EC-SOD transgenic mouse embryonic fibroblasts cultured with MEF culture medium (DMEM+5% FBS) for in vitro nuclear maturation in canine oocytes was investigated. In experiment I, oocytes were collected from the ovaries of domestic bitches, which were allotted to one of two groups: (1) TCM199+1% FBS (n =108) or (2) DMEM+5% FBS (n =112), cultured for 48h and investigated for in vitro nuclear maturation of canine oocytes using Hoechst staining. Meiotic progression to metaphase II in group 1 was 1.8% compared to 1.8% in group 2. In experiment II, EC-SOD levels were examined in NTg-CMEF and Tg-CMEF at 0, 2 and 4 days obtained from EC-SOD transgenic mice generated in our laboratory. The concentration of EC-SOD in Tg-CMEF at day 2 (371.7±3.1ng/ml) was the highest for all groups (P <0.05). EC-SOD levels in Tg-CMEF were higher than in NTg-CMEF; therefore, the efficiency of Tg-CMEF for IVM was investigated. In experiment III, oocytes were allotted to one of three groups: (1) Tg-CMEF at day 0 (n =84), (2) Tg-CMEF at day 2 (n =92) or (3) Tg-CMEF at day 4 (n =98), cultured for 48h and the IVM of canine oocytes investigated. The mean percentage of MII oocytes in IVM was 2.4, 4.4 and 2.0% for groups 1, 2 and 3, respectively. In experiment IV, the effects of conditioned medium of EC-SOD transgenic mouse embryonic fibroblasts (Tg-CMEF) cultured in MEF culture medium were compared with conditioned medium acquired from non-transgenic mouse embryonic fibroblasts (NTg-CMEF) on IVM of canine oocytes. In this experiment, meiotic progression to metaphase II was 7.1% in Tg-CMEF versus 0% in NTg-CMEF (P <0.05). Tg-CMEF was more effective than NTg-CMEF. In conclusion, it was verified that canine oocytes were able to effectively progress to metaphase II in IVM when cultured in Tg-CMEF. [Copyright &y& Elsevier]

Abstract: In the present study, canine oocytes were exposed to various concentrations of and durations of exposure to EDTA saturated with Ca2+ (Ca-EDTA), a cell membrane-impermeable metal ion chelator, to determine if parthenogenetic activation could be induced. When oocytes were cultured for 48 or 72h in parthenogenetic activation medium (PAM) without Ca-EDTA (control) or PAM supplemented with 1 or 5mM Ca-EDTA, the highest rate of pronuclear formation (PN) was obtained in oocytes cultured in 1mM Ca-EDTA for 48h (8.0%; P <0.05). There was no pronuclear formation in the control group (PAM without Ca-EDTA). Oocytes treated with 5mM Ca-EDTA for 48h or 1mM Ca-EDTA for 72h formed a parthenogenetic pronucleus (3.1 and 4.5, respectively). However, there was no pronuclear formation in oocytes treated with 5mM Ca-EDTA for 72h. In summary, exposure to Ca-EDTA can induce pronuclear formation in canine oocytes. [Copyright &y& Elsevier]