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Macrophages are a critical part of the human immune response, and their collective heterogeneity is implicated in disease progression and prevention. A nondestructive, label-free tool does not currently exist for profiling the dynamic, antigenic responses of single macrophages in a collection to correlate with specific molecular expression and correlated biophysical properties at the cellular level, despite the potential for diagnosis and therapeutics. Herein, we develop a nanosensor chemical cytometry (NCC) that can profile the heterogeneity of inducible nitric oxide synthase (iNOS) responses from macrophage populations. By integrating a near-infrared (nIR) fluorescent nanosensor array and collagen layer with microfluidics, the cellular lensing effect of the macrophage was utilized to characterize both nitric oxide (NO) efflux and refractive index (RI) changes at a single-cell level. Using a parallel, multichannel approach, distinct iNOS heterogeneities of macrophages can be monitored at an attomolar (10-18 mol) sensitivity in a nondestructive and real-time manner with a throughput of exceeding the 200 cells/frame. We demonstrate that estimated mean NO efflux rates of macrophage populations are elevated from 342 (σ = 199) to 464 (σ = 206) attomol/cell·hr with a 3% larger increase in the heterogeneity, and estimated RI of macrophage decrease from 1.366 (σ = 0.015) to 1.359 (σ = 0.009) with trimodal subpopulations under lipopolysaccharide (LPS) activation. These measured values are also in good agreement with Griess assay results and previously reported measurements. This work provides an efficient strategy for single-cell analysis of macrophage populations for cellular manufacturing and biopharmaceutical engineering.

Background: Cimifugin is one of the components of the root of Saposhnikovia divaricata. The extract derived from S. divaricata is traditionally used as an analgesic. This study was conducted to evaluate the analgesic effect of intrathecal cimifugin in the formalin test.Methods: Male Sprague–Dawley rats (n = 20) were randomized into four groups for intrathecal administration of 70% dimethylsulfoxide and various doses of cimifugin (100 μg, 300 μg, and 1,000 μg). The typical flinch response after the injection of 5% formalin into the hind paw was assessed in two distinct phases: phase 1 until 10 min, and phase 2 from 10 min to 60 min. ED50 values were calculated via linear regression.Results: Intrathecal cimifugin significantly reduced the flinch response in both phases of the formalin test. Significant antinociceptive effects of cimifugin were found with the dose of 300 μg in phase 1 and the dose of 100 μg in phase 2. The ED50 value (95% confidence intervals) of intrathecal cimifugin was 696.1 (360.8–1,342.8) μg during phase 1 and 1,242.8 (42.0–48,292.5) μg during phase 2.Conclusions: Intrathecal cimifugin has an antinociceptive effect against formalin-induced pain. Cimifugin has an anti-inflammatory effect at low concentrations, and non-inflammatory analgesic effect at higher concentrations.

The chili pepper (Capsicum annuum L.) is a food source that is rich in flavonoids such as luteolin and apigenin. Flavonoids are known to have anti-inflammatory and antioxidant activities, however, studies on the flavonoids composition identified and the anti-inflammatory and antioxidant effects in pepper leaves (PL) and fruits (PF) are insufficient. In the present study, we investigated the antioxidant and anti-inflammatory effects in vitro, and the flavonoids contents of the PL and PF. Pepper extracts showed radical scavenging activities and ameliorated the lipopolysaccharide (LPS)-stimulated inflammatory response by decreasing nitric oxide production and interluekin-6 and tumor necrosis factor alpha levels in RAW 264.7 cells, with more effective activities noted for PL than for PF. Furthermore, PL extracts markedly inhibited the LPS-induced production of reactive oxygen species accumulation. The flavonoid profile and content of pepper were dependent on the part, with PL showing higher total flavonoids than PF. In particular, the content of luteolin glycosides in PL was twice that in PF. Thus, PL may be useful to prevent oxidative stress and inflammation-related diseases.

ObjectiveTo measure the paediatric user and prescription prevalence in inpatient and ambulatory settings in South Korea, Hong Kong, Taiwan, Japan and Australia by age and gender. A further objective was to list the most commonly used drugs per drug class, per country.Design and settingHospital inpatient and insurance paediatric healthcare data from the following databases were used to conduct this descriptive drug utilisation study: (i) the South Korean Ajou University School of Medicine database; (ii) the Hong Kong Clinical Data Analysis and Reporting System; (iii) the Japan Medical Data Center; (iv) Taiwan’s National Health Insurance Research Database and (v) the Australian Pharmaceutical Benefits Scheme. Country-specific data were transformed into the Observational Medical Outcomes Partnership Common Data Model.PatientsChildren (≤18 years) with at least 1 day of observation in any of the respective databases from January 2009 until December 2013 were included.Main outcome measuresFor each drug class, we assessed the per-protocol overall user and prescription prevalence rates (per 1000 persons) per country and setting.ResultsOur study population comprised 1 574 524 children (52.9% male). The highest proportion of dispensings was recorded in the youngest age category (ConclusionsCountry-specific paediatric drug utilisation patterns were described, ranked and compared between four East Asian countries and Australia. The widespread use of mucolytics in East Asia warrants further investigation.

Purpose To compare 12-month treatment outcomes of Type 3 neovascularization among its different stages as classified using an optical coherence tomography-based method. Methods This retrospective observational study included 40 patients (40 eyes) who were newly diagnosed with Type 3 neovascularization. The patients were initially administered 3 monthly anti-vascular endothelial growth factor injections. Repeat treatment was performed when recurrence of fluid was noted. Disease staging was classified using the optical coherence tomography-based method. The best-corrected visual acuity at diagnosis and at 12 months and degree of change in best-corrected visual acuity were compared among the different stages of the disease. In addition, incidence of progression in the disease stages was estimated. Results Among the 40 patients, 14 (35.0%) were classified as Stage 2 and 26 (65.0%) were classified as Stage 3. The best-corrected visual acuity values at diagnosis and at 12 months were 0.61 ± 0.31 (20/81 Snellen equivalents) and 0.46 ± 0.30 (20/57) in the Stage 2 group and 0.67 ± 0.42 (20/93) and 0.70 ± 0.49 (20/100) in the Stage 3 group, respectively. There was a significant difference in best-corrected visual acuity change between the two groups (P = 0.036). During the follow-up period, 3 retinal pigment epithelium tears and 2 submacular hemorrhages had developed in the Stage 3 group. Progression of the disease from Stage 2 to Stage 3 was noted in 2 patients (14.3%). Conclusion The visual outcome was worse in Stage 3 than in Stage 2, and adverse events that may lead to abrupt visual deterioration developed only in Stage 3. Further studies are needed to reveal whether anti-vascular endothelial growth factor therapy can suppress the progression of the disease stages.

As neural stem cells (NSCs) interact with biophysical cues from their niche during development, it is important to understand the biomolecular mechanism of how the NSCs process these biophysical cues to regulate their behaviors. In particular, anisotropic geometric cues in micro-/nanoscale have been utilized to investigate the biophysical effect of the structure on NSCs behaviors. Here, a series of new nanoscale anisotropic wrinkle structures with the a range of wavelength scales (from 50 nm to 37 μm) was developed to demonstrate the effect of the anisotropic nanostructure on the fate commitment of NSCs. Intriguingly, two distinct characteristic length scales promoted the neurogenesis. Each wavelength scale showed a striking variation in terms of dependency on the directionality of the structures, suggesting the existence of at least two different ways in the processing of anisotropic geometries for neurogenesis. Furthermore, the combined effect of the two distinctive length scales was observed by employing hierarchical multiscale wrinkle structures with two characteristic neurogenesis-promoting wavelengths. Taken together, the wrinkle structure system developed in this study can serve as an effective platform to advance the understanding of how cells sense anisotropic geometries for their specific cellular behaviors. Furthermore, this could provide clues for improving nerve regeneration system of stem cell therapies.

Edward Chia-Cheng Lai,1–4 Patrick Ryan,5 Yinghong Zhang,4 Martijn Schuemie,5 NChantelle Hardy,4 Yukari Kamijima,6 Shinya Kimura,7 Kiyoshi Kubota,6 Kenneth KC Man,8,9 Soo Yeon Cho,10 Rae Woong Park,10 Paul Stang,5 Chien-Chou Su,1,3 Ian CK Wong,8,9 Yea-Huei Yang Kao,1,3 Soko Setoguchi4,11 1School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, Tainan, Taiwan; 2Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan; 3Health Outcome Research Center, National Cheng-Kung University, Tainan, Taiwan; 4Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA; 5Janssen Research & Development, LLC, Titusville, NJ, USA; 6NPO Drug Safety Research Unit Japan, Tokyo, Japan; 7Japan Medical Data Center Co.,Ltd, Tokyo, Japan; 8Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, University of Hong Kong, Hong Kong, China; 9Research Department of Practice and Policy, UCL School of Pharmacy, London, UK; 10Department of Biomedical Informatics, School of Medicine, Ajou University, Suwon, Korea; 11Institute for Health, Rutgers University and Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA Objective: The goal of the Asian Pharmacoepidemiology Network is to study the effectiveness and safety of medications commonly used in Asia using databases from individual Asian countries. An efficient infrastructure to support multinational pharmacoepidemiologic studies is critical to this effort. Study design and setting: We converted data from the Japan Medical Data Center database, Taiwan’s National Health Insurance Research Database, Hong Kong’s Clinical Data Analysis and Reporting System, South Korea’s Ajou University School of Medicine database, and the US Medicare 5% sample to the Observational Medical Outcome Partnership common data model (CDM). Results: We completed and documented the process for the CDM conversion. The coordinating center and participating sites reviewed the documents and refined the conversions based on the comments. The time required to convert data to the CDM varied widely across sites and included conversion to standard terminology codes and refinements of the conversion based on reviews. We mapped 97.2%, 86.7%, 92.6%, and 80.1% of domestic drug codes from the USA, Taiwan, Hong Kong, and Korea to RxNorm, respectively. The mapping rate from Japanese domestic drug codes to RxNorm (70.7%) was lower than from other countries, and we mapped remaining unmapped drugs to Anatomical Therapeutic Chemical Classification System codes. Because the native databases used international procedure coding systems for which mapping tables have been established, we were able to map >90% of diagnosis and procedure codes to standard terminology codes. Conclusion: The CDM established the foundation and reinforced collaboration for multinational pharmacoepidemiologic studies in Asia. Mapping of terminology codes was the greatest challenge, because of differences in health systems, cultures, and coding systems. Keywords: clinical coding, computer communication networks, feasibility studies, pharmacoepidemiology, pharmacovigilance

Although ingrown nail (IN) is common, there is no large-scale study regarding its epidemiology and risk factors, such as foot deformity. The purpose of this study is to determine the demographics of IN and clarify its association with bone-related comorbidities of the ankle, foot and toe. Patients in a representative sample cohort of the National Health Information Database of South Korea from 2004 to 2013 who had IN were compared with a control group without IN. Ten-year overall incidence was 307.5/100 000 person-years (95% confidence interval, 304.1-310.9). IN incidence and prevalence showed an increasing trend, and IN was more common in women than in men. Incidence showed bimodal peaks, among teenagers and among participants in their 50s. The IN group showed more common valgus deformity (64.3%) than did the control group (61.6%), and flat foot was also a significant risk factor of IN. There were increasing tendencies of IN incidence and prevalence among females. Confirmed bone deformity, especially acquired valgus or varus deformity, and flat foot were associated with IN.

Supplemental Digital Content is available in the text, We evaluated whether nucleos(t)ide analog (NA) influences the risk of non-hepatocellular carcinoma (non-HCC) malignancies in patients with chronic hepatitis B (CHB). A total of 9867 patients with CHB were followed up for ≥12 months for the occurrence of any type of malignancy between 1998 and 2013. Patients who received NA for ≥180 days were defined as the NA group. Propensity score matching produced the control (n = 2220) and NA groups (n = 2220) after adjustment for age, sex, and the presence of diabetes mellitus and liver cirrhosis. The National Health Insurance Service sample cohort dataset was used for external validation. Regarding non-HCC malignancies, only old age was an independent risk factor (>50 years; hazard ratio 3.17, 95% confidence interval 1.71–5.88, P 50 years old are encouraged to undergo surveillance for malignancies similar to the general population.

Purpose Distributed research networks (DRNs) afford statistical power by integrating observational data from multiple partners for retrospective studies. However, laboratory test results across care sites are derived using different assays from varying patient populations, making it difficult to simply combine data for analysis. Additionally, existing normalization methods are not suitable for retrospective studies. We normalized laboratory results from different data sources by adjusting for heterogeneous clinico-epidemiologic characteristics of the data and called this the subgroup-adjusted normalization (SAN) method. Methods Subgroup-adjusted normalization renders the means and standard deviations of distributions identical under population structure-adjusted conditions. To evaluate its performance, we compared SAN with existing methods for simulated and real datasets consisting of blood urea nitrogen, serum creatinine, hematocrit, hemoglobin, serum potassium, and total bilirubin. Various clinico-epidemiologic characteristics can be applied together in SAN. For simplicity of comparison, age and gender were used to adjust population heterogeneity in this study. Results In simulations, SAN had the lowest standardized difference in means (SDM) and Kolmogorov–Smirnov values for all tests (p

Although Mycobacterium avium complex (MAC) is the most common pathogen in nontuberculous mycobacterial (NTM) pulmonary diseases, endobronchial lesions caused by MAC infections are very rare even in an immunocompromised host. Herein, we describe the case of a 59-year-old, HIV-negative and non-immunocompromised woman who developed multifocal pulmonary infiltrations with endobronchial lesion caused by M. avium. Bronchoscopic examination revealed white- and yellow-colored irregular mucosal lesions in the bronchus of the left lingular division. M. avium was identified using sputum culture and bronchial washing fluid culture. Following the recommendations of the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA), the patient was begun on treatment with antimycobacterial drugs. After treatment, pneumonic infiltration decreased.

Objective The adoption rate of electronic health record (EHR) systems in South Korea has continuously increased. However, in contrast to the situation in the United States (US), where there has been a national effort to improve and standardize EHR interoperability, no consensus has been established in South Korea. The goal of this study was to determine the current status of EHR adoption in South Korean hospitals compared to that in the US. Methods All general and tertiary teaching hospitals in South Korea were surveyed regarding their EHR status in 2015 with the same questionnaire as used previously. The survey form estimated the level of adoption of EHR systems according to 24 core functions in four categories (clinical documentation, result view, computerized provider order entry, and decision supports). The adoption level was classified into comprehensive and basic EHR systems according to their functionalities. Results EHRs and computerized physician order entry systems were used in 58.1% and 86.0% of South Korean hospitals, respectively. Decision support systems and problem list documentation were the functions most frequently missing from comprehensive and basic EHR systems. The main barriers cited to adoption of EHR systems were the cost of purchasing (48%) and the ongoing cost of maintenance (11%). Discussion The EHR adoption rate in Korean hospitals (37.2%) was higher than that in US hospitals in 2010 (15.1%), but this trend was reversed in 2015 (58.1% vs. 75.2%). The evidence suggests that these trends were influenced by the level of financial and political support provided to US hospitals after the HITECH Act was passed in 2009. Conclusions The EHR adoption rate in Korea has increased, albeit more slowly than in the US. It is logical to suggest that increased funding and support tied to the HITECH Act in the US partly explains the difference in the adoption rates of EHRs in both countries.

Purpose: The purpose of this study was to identify the factors influencing emergency department (ED) nurses` turnover intention. Methods: The study was conducted with 241 nurses from ED of 20 general hospitals in Busan. The survey data were collected from May 1 to July 31, 2010 and were analyzed using frequencies, percentages, means, t-test, ANOVA, Pearson correlation coefficient and stepwise multiple regression with the SPSS Win 17.0 program. Results: There were statistically significant differences in turnover intention depending on age, regular change in department, and nursing experiences. A significant positive correlation was found between job stress and turnover intention and a significant negative correlation between organizational commitment and turnover intention. The significant factors influencing turnover intention were regular change in department, job stress, and organizational commitment, which explained about 13.7% of the variance. Conclusion: Considering this results, nursing managers should analyze these main factors which affect turnover intention and create ways to decrease turnover intentions, and thus decrease high turnover intention.

Purpose: The purpose of this study was to monitor the use of health-related quality of life (HRQOL) instruments in Korean studies of patients with diabetes. Methods: Of 86 Korean studies initially identified, 17 studies met the inclusion criteria. For each study, a description of the instrument and its psychometric properties were monitored by the Instrument Review Criteria of the Scientific Advisory Committee. These criteria include conceptual definition, attributes, taxonomy, reliability, validity, responsiveness, administrative mode, and language adaptations. Results: Five generic and one diabetes specific type questionnaires were identified from the 17 studies. Of those studies, conceptual definitions with the attributes of multi-dimension and subjectiveness were provided for 11 studies (71%). In the analysis of conceptual taxonomy, only 6 studies were classified as HRQOL, while other studies were done as QOL or health status. In monitoring of psychometric properties, reliability, validity, and responsiveness were reported for 88.2%, 64.7%, and 29.4%, respectively. One generic instrument was developed with a Korean population, while the other instruments were developed for Western countries. However, language adaptations were performed for only a few of the instruments. Conclusion: The psychometric properties including responsiveness of most instruments warrants further research, and the development of diabetes-specific HRQOL measurements should be sought to facilitate intervention outcomes across Korean studies of patients with diabetes.

E. coli O157 is responsible for a number of human infections through the consumption of foods of animal origin, particularly those originating from cattle. Food poisoning by Escherichia coli O157 causes diarrhea, bloody stools and abdominal pain in humans, and may lead to severe kidney failure or brain injury. For these reasons, E. coli O157 has been the subject of increasingly stringent international regulations. A novel peptide nucleic acid (PNA) array was developed to identify E. coli O157 quickly and accurately. This PNA array exhibited high specificity, significantly detecting E. coli O157 strains without cross-reacting with other bacterial strains. The detection limit of the E. coli O157 PNA array was 100 CFU/ml. The E. coli O157 PNA array is indeed a better option for early detection and accurate diagnosis of the causative agent of a food-borne disease outbreak, which is crucial in planning and implementing strategic measures to prevent and control widespread outbreaks.

Parainfluenza virus 감염은 횡문근융해증의 하나의 원인이 될 수 있다. 횡문근융해증은 지속된 금식기간동안 미토콘드리아 지방산 ${\beta}$ -oxidation 장애에 의해 악화될 수 있다. 또한 후기 발생 isovaleric 산증을 가진 환아들에게서 고암모니아혈증이 이화작용을 일으키는 상태 후 발생할 수 있다. 본 케이스는 pa...

Purpose: The aim of this study was to determine the prioritization of research topics by Korean oncology nurses. Methods: A descriptive and cross-sectional survey was conducted via the website of the Korean Oncology Nursing Society, with participation sought by email from all of its members. Results: Overall, ‘pain’ and ‘quality of life’ were the most important among the 74 topics, ‘cancer prevention’ was ranked 47th, while ‘informatics’ and ‘telehealth’ were ranked 62nd and 72nd, respectively. Korean oncology nursing research needs to be expanded to include community-based cancer prevention. In addition, research on informatics and telehealth in the oncology nursing area is necessary given the current dramatic changes in the implementation of information technology in medical services. Conclusion: These findings may contribute toward the development of a Korean oncology nursing research agenda and the provision of information to funding agencies with respect to setting the priorities of oncology nursing research.

Purpose: The purpose of this present study was to develop and evaluate the psychometric properties of a needs scale for patients with cancer undergoing follow-up care (NS-C). Methods: A preliminary NS-C of 48 was derived from literature reviews and in-depth interviews with patients with cancer. Content validation of the items was established by oncology physicians and nurses. Each item was scored on a five-point Likert scale. The preliminary NS-C and Eastern Cooperative Oncology Group (ECOG) performance status questionnaires were administered to 873 patients with cancer recruited from three university hospitals. The data were analyzed using factor analysis, multidimensional scaling analysis, ANOVA, Pearson correlation coefficients, and Cronbach’s alpha. Results: From the factor analysis, 25 significant items in six subscales were derived. The subscales were named physical symptoms, diet and exercise, support, relationship with health professionals, treatment/prognosis, and keeping mind under control. The NS-C also established item convergent and discriminant validity, and known-groups validity. Cronbach’s alpha of the subscales ranged from .90 to .92. Conclusion: This study suggests that the NS-C is an easy, reliable and valid instrument to measure the needs of patients with cancer. Health professionals may use the NS-C for patients with cancer both in practice and research.

†‡ Severe acute lung injury (ALI), leading to respiratory failure caused by H1N1 infection, developed in a 34-yearold man during a work-up for non-small cell lung cancer. Although he fully recovered through instant treatment with oseltamivir, mechanical ventilation was required again, 7 days later, due to subsequent diffuse alveolar hemorrhage (DAH). Finally, his condition improved and he was able to move out of the intensive care unit. However, multiple pulmonary metastatic nodules appeared over a period of one month, suggesting the aggressive nature of lung cancer. Although he was discharged after chemotherapy, his prognosis seemed poor, considering the rapidity of growth of the lung cancer. It is important to recognize that DAH can occur after acute lung injury caused by influenza virus.

Purpose: We studied the feasibility and results of a tissue-engineered ileal conduit using a poly (e-caprolactone) (PCL) nano-sheet seeded with muscle-derived stem cells to replace a conventional ileal conduit in rats. Materials and Methods: Muscle-derived stem cells were isolated from the gastrocnemius muscle of female Sprague-Dawley rats (200-250 g, n=6) by use of a preplate technique and were cultured on a PCL nano-sheet. The PCL nano-sheet was implanted into the omentum of rats and was then made into a conical shaped conduit. Rats were sacrificed 4 and 8 weeks after implantation, and morphologic changes were assessed by HE50:282-287) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

Purpose : The differential diagnosis for a pulmonary nodule is intriguing in cancer patients. Metastasis might be a preferential diagnosis, and yet possibilities of other medical conditions still exist. Pulmonary tuberculosis should be enlisted in the differential diagnosis for a pulmonary nodule in cancer patients in Korea. This study was aimed at analyzing the incidence and clinical features of pulmonary tuberculosis that were misdiagnosed as pulmonary metastasis during radiologic follow-up in pediatric cancer patients. Methods : We retrospectively studied 422 cancer patients less than 18 years old in the Korea Cancer Center Hospital from January 2001 to June 2007. We collected episodes of lung metastasis of primary tumor and tuberculosis during treatment or follow-up, and analyzed medical records. Results : There were 5 cases of tuberculosis confirmed after surgery which were initially regarded as cancer. Two patients had respiratory symptoms such as cough and sputum but the other 3 patients did not. One patient had a family history of tuberculosis. Acid-fast M. tuberculosis was found in one case upon tissue specimen analysis. Two cases were Mantoux positive and the sputum examination was negative in all cases. The polymerase chain reaction for tuberculosis on a pathologic specimen was used to differentiate M. tuberculosis from non-tuberculosis mycobacterium (NTM). It was positive in one case. Lung lesions in one case showed a concurrence of tuberculosis along with lung metastasis. One of these patients died after cancer recurrence. Conclusion : It is necessary to consider the possibility of tuberculosis when a lung mass is newly detected during treatment or follow-up in patients with childhood cancer.