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This paper presents the conceptual design of the electrical power system using Li-ion cell technology for a satellite application. Compared to a conventional NiCd cell, a Li-ion cell has a lot of advantages such as an energy density, mass and a volume. Normally, a Li-ion cell has three times than conventional NiCd cells in a capacity such as a cell voltage. The normal voltage of a NiCd cell is around +1.2V and a Li-ion cell could be in +3.6V. However, the handling procedure for a Li-ion cell in charge and discharge might be difficult than a conventional NiCd cell, which means that the charge and discharge of each cell should be monitored and controlled by electrical circuits to prevent an over-charge and over-discharge. Therefore, in this paper we propose the design consideration and the characteristics of a Li-ion cell during charging and discharging battery packs in the point of view of electrical power system.

Background Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) injection in an occupational clinical setting. Methods A retrospective analysis was conducted with data from 143 cases of HCWs exposed to HBV in 15 secondary and tertiary teaching hospitals between January 2005 and June 2013. Data were taken from the infection control records of each hospital. Results Active vaccination after HBV exposure was started in 119 cases (83.2%) and postvaccination testing for hepatitis B antibody showed positive seroconversion in 93% of cases. In 98 cases (68.5%), HBIG was administered within 24 hours after HBV exposure; however, 45 HCWs (31.5%) received an HBIG injection more than 24 hours postexposure and 2 among the 45 received an injection after 7 days. Although 31.5% received an HBIG injection more than 24 hours postexposure, no cases of seroconversion to hepatitis b antibody positivity occurred. Conclusions For susceptible HCWs, HBIG administered between 24 hours and 7 days postexposure may be as effective as administration within 24 hours in preventing occupational HBV infection.

Identification of the causative microorganism is important in the management of pyogenic vertebral osteomyelitis (PVO). The aim of this study was to investigate whether culture positive rates differ between needle biopsy sites in patients with PVO, and which tissues are best for microbiological diagnosis. Between January 2005 and December 2013, we conducted a retrospective cohort study of PVO patients who had soft-tissue abscesses (paraspinal or psoas abscesses) and who received needle biopsy for microbiological diagnosis. Needle biopsy sites were classified into two anatomical categories: vertebral bodies, or soft tissues (intervertebral discs, paraspinal abscesses, or psoas abscesses). A generalized estimating equation model was developed to identify factors associated with tissue-culture positivity. During the study period a total of 136 tissues were obtained by needle biopsy from 128 PVO patients with soft-tissue abscesses. The culture positive rates of vertebral bodies and soft tissues were 39.7% (29/73), and 63.5% (40/63), respectively (p

Background There are limited data describing the clinical characteristics of pyogenic spondylitis caused by Gram-negative bacteria (GNB). The aim of this study was to investigate the predisposing factors and clinical characteristics of pyogenic spondylitis caused by GNB compared to Gram-positive cocci (GPC). Methods We performed a retrospective review of medical records from patients with culture-confirmed pyogenic spondylitis at four tertiary teaching hospitals over an 8-year period. Results A total of 344 patients with culture-confirmed pyogenic spondylitis were evaluated. There were 62 patients (18.0%) with pyogenic spondylitis caused by GNB and the most common organism was Escherichia coli (n = 35, 10.2%), followed by Pseudomonas aeruginosa (n = 10, 2.9%). Pyogenic spondylitis caused by GNB was more frequently associated with the female gender (64.5 vs. 35.5%, P

Two new species of the genus Ceratophysella from Korea, Ceratophysella biclavata n. sp. and Ceratophysella platyna n. sp. are described and illustrated. Ceratophysella biclavata differs from the closely related species Ceratophysella sigillata (Uzel 1891) by the shape of antennal bulb on antennal segment IV, the number of clavate tenent hairs and the number of granules between p1 upon abdominal segment V. Ceratophysella platyna resembles Ceratophysella denticulata (Bagnall 1941) and Ceratophysella communis (Folsom 1898), but distinctly differs from the latter by the shape of tenent hairs. A key to the identification of the Korean species of Ceratophysella is included. In addition, the known species Hypogastrura gracilis (Folsom 1899) is described and recorded for the first time from Korea.

Vascular endothelial growth factor-C (VEGF-C) is known to be an important lymphangiogenetic factor. Lymphatic spread is a key prognostic factor in intrahepatic cholangiocarcinoma (ICC). We studied the expression of VEGF-C in ICC tissues to clarify its clinicopathologic significance.The expression of VEGF-C in surgical specimens obtained from 36 patients with ICC who underwent hepatic resection was examined by immunohistochemistry and Western blotting. Strong staining was defined as the presence of VEGF-C immunoreactivity in at least 50% of the tumor cells. Immunoreactivity in approximately 10% to approximately 50% of the tumor cells was considered as weak staining, and less than 10% as no staining.Of the 36 patients with ICC, 15 patients (41.7%) showed a strong positive result for VEGF-C. Eleven cases (30.6%) were negative and 10 cases (27.8%) showed weak immunoreactivity. VEGF-C expression was significantly correlated with lymph node metastasis (P = 0.032) and positive surgical margin (P = 0.03). Patients who had strong positive staining for VEGF-C showed significantly less favorable survival rates compared with patients who had negative or weak staining (P0.01). Other significant prognostic factors by univariate analysis were vascular invasion, lymph node involvement, and positive surgical margin. Multivariate analysis demonstrated that strong VEGF-C expression (P = 0.028) and vascular invasion (P = 0.021) were independent factors indicating poor prognosis.Our data suggest that VEGF-C expression serves as an independent and important prognostic factor in ICC patients, and it may play an important role in the lymph node metastasis of ICC.

The 2009 pandemic influenza A (H1N1) was a considerable public health concern worldwide. Significant morbidity and mortality were observed in complicated cases, despite the early administration of neuramidase inhibitors. The limitations of neuramidase inhibitor monotherapy have renewed interest in combination antiviral therapy or higher-dose oseltamivir therapy. Herein, we report our clinical experience and virological outcomes with high-dose oseltamivir or combination antiviral therapy in seriously complicated 2009 pandemic influenza A (H1N1) infection. Eight patients were treated with high-dose oseltamivir (150 mg twice a day), and 6 patients were treated with triple combination antiviral drugs (150 mg oseltamivir twice a day, 100 mg amantadine twice a day, and 300 mg ribavirin three times a day). Nine of 14 patients (64%) developed acute respiratory distress syndrome and 6 (43%) required mechanical ventilation. Viral clearance was obtained in 9 of 12 patients (75%) after 5 days of antiviral therapy. Two patients died within 5 days of antiviral therapy. The overall mortality rate was 29% (4/14).

Three species of interstitial Collembola in Entomobryidae were identified from South Korean coast. One of them, Sinella (Coecobrya) maritima, is new to science. So far 21 halophilous species in 10 families of Collembola, including the new species in this paper, were reported from the Korean peninsula.

E-mail: jwka@krict.re.krReceived November 16, 2011, Accepted November 23, 2011Key Words : Calix[4]pyrrole, Fluorescence probes, Calix[2]pyreno[2]pyrrole, TNTThe elevated selectivity and sensitivity for specific analytesare the core requirements for an ideal chemical probes. Asignal induced by guest binding must be sensitive enough sothat accurate real time monitoring could be satisfactorilyachieved.

We investigate the charge retention characteristics in a metal–insulator–semiconductor capacitor containing Ge nanocrystals (~3 nm in diameter) using capacitance–voltage measurements with various gate bias sweep rates. The metal–insulator–semiconductor capacitor is fabricated by pulsed laser deposition and rapid thermal oxidation. The capacitance–voltage curve shows the strong hysteresis indicating charging/discharging of carriers during the gate bias sweeping. The stored charge densities, evaluated from the flat band voltage shifts, show the non-dispersive carrier relaxation, which is a characteristic property for nanocrystals arranged in a layer. In addition, we observe an interesting capacitance ledge during forward bias sweeping. From the trap distribution determination by the Terman method, the capacitance ledge is due to an energetically localized trap at 0.33 eV + Ev. The energetic position of the trap is in agreement with the ground-state hole energy level in the Ge nanocrystals. This suggests the possibility that the trap level is related to the fact that the stored charges initially tunnel out at the ground-state hole energy level.

Two new species of the genus Leeonychiurus Sun & Arbea, 2014 from South Korea, i.e. L. koreanus sp. nov. and L. analis sp. nov., are described and illustrated. The former differs from other known congeners by having only 2 distinct pseudocelli on each side of Abd. III (three in all other species). The second species, L. analis sp. nov., being rather similar to L. koreanus sp. nov., can easily be distinguished due to the presence of dorsal pso on Th. I (absent in L. koreanus sp. nov.) and three dorsal pso on Abd. III (only two pso in L. koreanus sp. nov.), chaetotaxy of anal valves is also specific, characterized by the presence of chaetae a1 and the absence of chaeta c0 on upper anal valve. An identification key to all known species of the genus Leeonychiurus species is also provided.

Background Natural killer (NK) cells are essential immune cells against several pathogens. Not much is known regarding the roll of NK cells in Orientia tsutsugamushi infection. Thus, this study aims to determine the level, function, and clinical relevance of NK cells in patients with scrub typhus. Methodology/Principal findings This study enrolled fifty-six scrub typhus patients and 56 health controls (HCs). The patients were divided into subgroups according to their disease severity. A flow cytometry measured NK cell level and function in peripheral blood. Circulating NK cell levels and CD69 expressions were significantly increased in scrub typhus patients. Increased NK cell levels reflected disease severity. In scrub typhus patients, tests showed their NK cells produced higher amounts of interferon (IFN)-γ after stimulation with interleukin (IL)-12 and IL-18 relative to those of HCs. Meanwhile, between scrub typhus patients and HCs, the cytotoxicity and degranulation of NK cells against K562 were comparable. CD69 expressions were recovered to the normal levels in the remission phase. Conclusions This study shows that circulating NK cells are activated and numerically increased, and they produced more IFN-γ in scrub typhus patients., Author summary Orientia tsutsugamushi is an obligate intracellular bacterium. It primarily invades endothelial cells, macrophages, monocytes, and dendritic cells. Plasma concentrations of interferon (IFN)-γ, several cytokines and chemokines, which are known to recruit natural killer (NK) cells and T cells, were found to be increased in scrub typhus patients. NK cells are known as essential immune cells against several pathogens. In murine models of Rickettsial infection, the clearance of bacteria was found to be significantly associated with NK cell activity. Not much is known regarding NK cells’ role in O. tsutsugamushi infection in humans. This study is very possibly the first to measure NK cells’ level and function of in scrub typhus patients, or to examine NK cell levels’ clinical relevance. This study’s results demonstrate that circulating NK cells are activated and numerically increased in scrub typhus patients. Notably, increased production IFN-γ by NK cells of scrub typhus patients suggests their contribution to enhancement of intracellular bacterial killing in infected antigen presenting cells. Moreover, disease severity corresponded to increased NK cell levels. These findings importantly suggest that NK cells play a role in protecting the host against O. tsutsugamushi infection.

Cell free DNA (cfDNA) present in the blood stream shows great potential as a useful cancer marker for molecular diagnosis and cancer progression monitoring. Especially, analyzing the cfDNA with Next Generation Sequencing (NGS) technology allows high through put examination of various genes concurrently at a low cost. However, there are still debates regarding clinically meaningful variant frequency to identify mutations in cfDNA, especially with ultra-deep sequencing. In this study, we examined the clinical utility of Ion AmpliSeq Cancer Hotspot Panel v2 (ICP; Ion Torrent) with Proton platforms. ICP, covering 2800 COSMIC mutations from 50 cancer genes was used to analyze cfDNA of 125 serum samples from lung cancer patients. The percentage of on target was 92% with mean depth of 22,868x. We identified aberrations of TP53 (72%), EGFR (43%), PTEN (26%), PIK3CA (26%), BRAF (16%), KRAS (14%), KIT (10%) and RET (10%) with the cut-off criteria of variant frequency >0.1% and p Citation Format: Jae Sook Sung, Jong Won Lee, Boyeon Kim, Saet Byeol Lee, Chang Won Park, Hae Mi Kim, Nak-Jung Kwon, Won Jin Jang, Yoon Ji Choi, Jung Yoon Choi, Eun Joo Kang, Kyung Hwa Park, Sung Yong Lee, Yeul Hong Kim. Clinical significance of low frequency EGFR and KRAS mutations of cell free DNA using Ion AmpliSeq Cancer Hotspot Panel in lung cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 5680. doi:10.1158/1538-7445.AM2017-5680

Staphylococcus aureus is a leading cause of bacteremia in hospitalized patients. Whether or not S. aureus bacteremia (SAB) is associated with clonality, implicating potential nosocomial transmission, has not, however, been investigated. Herein, we examined the epidemiology of SAB using whole genome sequencing (WGS). 152 SAB isolates collected over the course of 2015 at a single large Minnesota medical center were studied. Staphylococcus protein A (spa) typing was performed by PCR/Sanger sequencing; multilocus sequence typing (MLST) and core genome MLST (cgMLST) were determined by WGS. Forty-eight isolates (32%) were methicillin-resistant S. aureus (MRSA). The isolates encompassed 66 spa types, clustered into 11 spa clonal complexes (CCs) and 10 singleton types. 88% of 48 MRSA isolates belonged to spa CC-002 or -008. Methicillin-susceptible S. aureus (MSSA) isolates were more genotypically diverse, with 61% distributed across four spa CCs (CC-002, CC-012, CC-008 and CC-084). By MLST, there was 31 sequence types (STs), including 18 divided into 6 CCs and 13 singleton STs. Amongst MSSA isolates, the common MLST clones were CC5 (23%), CC30 (19%), CC8 (15%) and CC15 (11%). Common MRSA clones were CC5 (67%) and CC8 (25%); there were no MRSA isolates in CC45 or CC30. By cgMLST analysis, there were 9 allelic differences between two isolates, with the remaining 150 isolates differing from each other by over 40 alleles. The two isolates were retroactively epidemiologically linked by medical record review. Overall, cgMLST analysis resulted in higher resolution epidemiological typing than did multilocus sequence or spa typing.

Background Abacavir is a widely-used nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) infection. Mandatory postmarketing surveillance was conducted in Korea to monitor the safety and evaluate the effectiveness of Ziagen® (abacavir sulfate 300 mg; ViiV Healthcare, Middlesex, UK). Materials and methods An open-label, multi-center, non-interventional postmarketing surveillance study was conducted from June 2010 to June 2016 to monitor the safety and effectiveness of Ziagen across 12 hospitals in Korea. Subjects older than 18 years taking Ziagen according to prescribing information were enrolled. The primary outcome was defined as the occurrence of any adverse events after Ziagen administration. Secondary outcomes included the occurrence of adverse drug reactions, occurrence of serious adverse events, and effectiveness of Ziagen administration. Results A total of 669 patients were enrolled in this study, with a total observation period of 1047.8 person-years. Of these, 90.7% of patients were male. The mean age of patients was 45.8±11.9 years. One-hundred ninety-six (29.3%) patients reported 315 adverse events, and four patients reported seven serious adverse events, without any fatal events. There was one potential case of an abacavir hypersensitivity reaction. Among the 97 adverse drug reactions that were reported from 75 patients, the most frequent adverse drug reactions included diarrhea (12 events), dyspepsia (10 events), and rash (9 events). No ischemic heart disease was observed. In the effectiveness analysis, 91% of patients achieved HIV-1 RNA under 50 copies/mL after 24 months of observation with abacavir administration. Conclusion Our data showed the safety and effectiveness of Ziagen in a real-world setting. During the study period, Ziagen was well-tolerated, with one incident of a clinically suspected abacavir hypersensitivity reaction. The postmarketing surveillance of Ziagen did not highlight any new safety information. These data may be helpful in understanding abacavir and the HIV treatment practices in Korea.

A new species, Desoria mulyeongariensis, shares some characters with D. choi (Lee), such as the number of setae on retinaculum and apical setae on manubrium. However, it could be easily distinguished from D. choi by the number of ommatidia. This species is also well characterized by having long and thickened smooth macrosetae on the body, and 6 basomedian setae on labium.

Serum tumor necrosis factor-α (TNF-α) was evaluated in Vibrio vulnificus-infected patients at admission. The median TNF-α concentration in the non-survivor group was determined to be 261.0 pg/mL, in contrast to 69.5 pg/mL in the survivor group (P = 0.001). Hence, serum TNF-α concentration may potentially be an early predictor of the mortality in patients with Vibrio septicemia.

We determined the association between DNA load and mortality in patients with Vibrio vulnificus infection. Real-time PCR performed on sera of 27 culture-positive patients showed a significantly higher median DNA load in nonsurvivors than in survivors. Hence, real-time PCR can be used as an early prognostic factor in V. vulnificus septicemia.

Successful empirical therapy of Staphylococcus aureus infections requires the ability to predict methicillin resistance. Our aim was to identify predictors of methicillin resistance in community-onset (CO) invasive S. aureus infections. Sixteen hospitals across Korea participated in this study from May to December 2012. We prospectively included cases of S. aureus infection in which S. aureus was isolated from sterile clinical specimens ≤ 72 hours after hospitalization. Clinical and epidemiological data were gathered and compared in methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) cases. Community-associated (CA) infections were defined as in previous studies. In total, there were 786 cases of community-onset S. aureus infection, 102 (13.0%) of which were CA-MRSA. In addition to known risk factors, exposure to 3rd generation cephalosporins in the past 6 months [odds ratio (OR), 1.922; 95% confidence interval (CI), 1.176-3.142] and close contact with chronically ill patients in the past month (OR, 2.647; 95% CI, 1.189-5.891) were independent risk factors for MRSA infection. However, no clinical predictors of CA-MRSA were identified. Methicillin resistance, CO infection, and appropriateness of empirical antibiotics were not significantly related to 30-day mortality. MRSA infection should be suspected in patients recently exposed to 3rd generation cephalosporins or chronically-ill patients. There were no reliable predictors of CA-MRSA infection, and mortality was not affected by methicillin resistance.

BackgroundViruses are increasingly recognized as major causes of community-acquired pneumonia (CAP). Few studies have investigated the clinical predictors of viral pneumonia, and the results have been inconsistent. In this study, the clinical predictors of viral pneumonia were investigated in terms of their utility as indicators for viral pneumonia in patients with CAP.MethodsAdult patients (≥ 18 years old) with CAP, tested by polymerase chain reaction (PCR) for respiratory virus, at two teaching hospitals between October 2010 and May 2013, were identified retrospectively. Demographic and clinical data were collected by reviewing the hospital electronic medical records.ResultsDuring the study period, 456 patients with CAP were identified who met the definition, and 327 (72%) patients were tested using the respiratory virus PCR detection test. Viral pneumonia (n = 60) was associated with rhinorrhea, a higher lymphocyte fraction in the white blood cells, lower serum creatinine and ground-glass opacity (GGO) in radiology results, compared to non-viral pneumonia (n = 250) (p < 0.05, each). In a multivariate analysis, rhinorrhea (Odd ratio (OR) 3.52; 95% Confidence interval (CI), 1.58-7.87) and GGO (OR 4.68; 95% CI, 2.48-8.89) were revealed as independent risk factors for viral pneumonia in patients with CAP. The sensitivity, specificity, positive- and negative-predictive values (PPV and NPV) of rhinorrhea were 22, 91, 36 and 83%: the sensitivity, specificity, PPV and NPV of GGO were and 43, 84, 40 and 86%, respectively.ConclusionSymptom of rhinorrhea and GGO predicted viral pneumonia in patients with CAP. The high specificity of rhinorrhea and GGO suggested that these could be useful indicators for empirical antiviral therapy.

Influenza vaccines are the primary method for preventing influenza and its complications. Considering the increasing demand for influenza vaccines, vaccine manufacturers are required to establish large-scale production systems. This phase IV randomized trial was conducted to evaluate the lot consistency of trivalent split influenza vaccines regarding immunogenicity and safety. A total of 1,023 healthy adults aged 18-64 y were enrolled in the study. Subjects were randomly assigned in a 1:1 ratio to receive the GC FLU® Prefilled Syringe or the GC FLU® Injection, and they were further randomized to one of 3 lots of each vaccine in a 1:1:1 ratio. In both GC FLU® Injection and GC FLU® Prefilled Syringe groups, immune responses were equivalent between lots for each of the 3 vaccine strains on day 21. The 2-sided 95% CI of GMT ratios between pairs of lots were between 0.67 and 1.5, meeting the equivalence criteria. After vaccination, all 3 criteria of the European Medicines Agency were met in both GC FLU® Injection and GC FLU® Prefilled Syringe groups. The vaccines showed tolerable safety profiles without serious adverse events. The demonstration of lot consistency, robust immunogenic responses and favorable safety profiles support the reliability of mass-manufacturing systems for the GC FLU® Injection and GC FLU® Prefilled Syringe.

A calix[4]pyrrole fused with 2,5-dihydrothiophene, possessing both a deep, π-electron-rich pocket upon anion binding and chelating ligands on the periphery, was developed. The receptor selectively forms an ion-pair complex with CsF through H-bonding and a cation-π interaction. In the process, it adopt a conformationally fixed cone conformation. The receptor displays exceptionally high affinity toward the Hg(II) ion and forms stable complexes while maintaining a rigid 1,3-alternate conformation. This metal ion-induced conformational locking is unprecedented in calix[4]pyrrole chemistry.

The aim of this study was to prove the diagnostic value of interim 18F-Fluorodeoxyglucose-positron-emission tomography combined with computed tomography (PET/CT) scan for predicting pathological complete response (pCR) compared to other factors in neoadjuvant chemotherapy.Twenty-seven patients with breast cancer were included in this retrospective study. They all underwent scheduled neoadjuvant chemotherapy. Patients underwent PET/CT at baseline, mid-point (interim), and preoperatively (after completion of chemotherapy). The metabolic response was calculated as follows: ΔStandardized uptake value (SUV)(%)=(1st SUV(max)-2nd SUV(max))/1st SUV(max) × 100.The change in SUVmax between baseline and interim PET/CT scans was significantly larger than between interim and preoperative PET/CT scan. An optimal cut-off ΔSUV value of 78.3% was proposed for discriminating patients with pCR from those without pCR. Metabolic CR, defined as a change of SUV(max) greater than the cut-off value, can predict pCR according to univariate analysis (p=0.012; Relative risk (RR)=25.3). Furthermore, metabolic CR was the most powerful factor for predicting pCR than other possible factors according to multivariate analysis (p=0.003).It is possible to use interim (18)F-FDG PET-CT as an effective method to predict early response in patients with breast cancer treated with neoadjuvant chemotherapy.

ObjectivesThe in vivo efficacy of a cefotaxime-ciprofloxacin combination against Vibrio vulnificus and the effects on rtxA1 expression of commonly used antibiotics are unknown.MethodsIn vitro time-kill studies were performed to evaluate synergism. Female BALB/c mice were injected subcutaneously with 1×10(7) or 1×10(8) cfu of V. vulnificus. Antibiotic therapy was initiated at 2 h after inoculation in the following four therapy groups: cefotaxime; ciprofloxacin; cefotaxime-plus-ciprofloxacin; and cefotaxime-plus-minocycline. The cytotoxicity of V. vulnificus for HeLa cells was measured using the lactate dehydrogenase assay; rtxA1 transcription was measured in a transcriptional reporter strain using a β-galactosidase assay.ResultsIn vitro time-kill assays exhibited synergism between cefotaxime and ciprofloxacin. In the animal experiments, the 96-h survival rate for the cefotaxime-plus-ciprofloxacin group (85%; 17/20) was significantly higher than that of the cefotaxime-plus-minocycline (35%; 7/20) and cefotaxime alone (0%; 0/20) groups (PConclusionsCiprofloxacin is more effective at reducing rtxA1 transcription and subsequent cytotoxicity than either minocycline or cefotaxime, and the combination of ciprofloxacin and cefotaxime was more effective in clearing V. vulnificus in vivo than previously used regimens. These data suggest that the combination of ciprofloxacin and cefotaxime is an effective option for the treatment of V. vulnificus sepsis in humans.

While several reproductive and lifestyle-related factors are already well-known as established risk factors for breast cancer, environmental factors have attracted attention only recently. The objective of the current study was to assess the association between the breast cancer incidences in females, the mortality rate and the number of motor vehicles on the one side and the consumption of gasoline which could work as a major source of air pollution at the other side. The breast cancer incidences and the mortality trends were compared with various indices of westernization like dietary patterns or industrialization with 10 years lag of time. Geographical variations with 10, 15 and 20 years lag of time were assessed between the breast cancer incidence in 2010 and the number of motor vehicles as well as the consumption of gasoline. The upward trend of motor vehicle numbers proved to be comparable to those of breast cancer incidence and mortality. However, the consumption of gasoline started to decrease since the mid-1990s. The geographic distribution of motor vehicle numbers and gasoline consumption in 1990 is in a positive correlation with the breast cancer incidence rates in 2010 and the 20-year lag time (R 2 0.379 with the number of motor vehicles and 0.345 with consumption of gasoline). In a linear relationship between the breast cancer incidences in 2010 and the log transformed number of motor vehicles, the log transformed consumption of gasoline in 2000 also showed a positive relationship (R 2 0.367 with the number of motor vehicles and 0.329 with consumption of gasoline). The results of the current study indicate that there may be a positive relation between the number of vehicles, gasoline consumption and the incidence of breast cancer from the aspects of long-term trends and geographical variation.

Although most Klebsiella pneumoniae liver abscesses have been reported to be monomicrobial, clinical outcomes have not been compared between antimicrobial therapy with and without anti-anaerobic coverage. A propensity score-matched cohort study was conducted using the 731 cases of K. pneumoniae liver abscess. Clinical outcomes were compared between a group discontinuing anti-anaerobic agents after K. pneumoniae identification and a group continuing. A total of 170 cases were matched at a 1:1 ratio using their propensity to discontinue anti-anaerobic agents. The McNemar's test showed no difference in mortality rates (1.8% for discontinuation versus 2.3% for continuation; P = 1.00) or relapse (1.8% versus 2.9%; P = 0.73) between groups. Early discontinuation of anti-anaerobic agents had no association with treatment failure by means of the generalized estimating equation model (odds ratio 0.48; P = 0.14) and the Kaplan-Meier method (P = 0.85) in matched groups. Early discontinuation of anti-anaerobic agents does not affect the clinical outcomes of patients with K. pneumoniae liver abscess.

An amorphous Si layer prepared by ion-beam-assisted electron beam deposition (IBAED) method is oxidized by a rapid thermal oxidation technique. We observe a nanocrystal band located at about 4 nm from the Si/SiOx interface by cross-sectional transmission electron microscope observation. The metal–oxide–semiconductor (MOS) structure employing the oxide layer with the nanocrystal band exhibits a large capacitance–voltage hysteresis indicative of trapping of electrons/holes. In contrast, a relatively small capacitance–voltage hysteresis is found for the MOS diode prepared by conventional electron beam deposition (EBD) without ion-beam assistance. Such a marked difference shows that the ion-beam irradiation plays an important role in the formation of nuclei, which would grow to nanocrystals during subsequent rapid thermal oxidation process. Interestingly, the MOS prepared by IBAED shows a characteristic capacitance transient behavior, indicative of non-dispersive carrier relaxation. In addition, the charge retention times shows a bias dependence and a maximum of 72 s near the mid-gap voltage. Such a bias-dependent retention time is interpreted in terms of the tunneling of trapped charges in nanocrystals through empty interface states. © 2001 Elsevier Science B.V. All rights reserved.

Although it has been suggested that some biological activities of platelet-activating factor (PAF) are mediated by, at least in part, reactive oxygen intermediates (ROI), the precise mechanisms underlying the interaction between the two remains to be elucidated. Antioxidants, such as α-tocopherol acid succinate, N-acetyl-L-Cysteine, pyrrolidinedithiocarbamate failed to inhibit PAF-induced immediate systemic reactions such as lethality, symptoms of disseminated intravascular coagulation, and histological changes such as pulmonary edema and hemorrhage in renal medullae 10 min following PAF injection. In contrast, antioxidants significantly inhibited both the in vivo and in vitro PAF-induced NF-κB activation and NF-κB-dependent TNF-α expression. The effects of the antioxidants were due to their inhibition of PAF-induced degradation of IκBα, a protein responsible for keeping NF-κB in an inactive form. A protein tyrosine kinase and N-tosyl-L-phenylalanine chloromethyl ketone sensitive serine protease were involved in both PAFand H2O2-induced NF-κB activation. Collectively, these data indicate that the PAF-induced NF-κB activation is selectively mediated through the generation of ROI.

We report a 42-y-old female with Guillain-Barré syndrome (GBS) who presented with scrub typhus for a duration of 2 weeks. Subsequently, ascending paralysis and facial diplegia developed. GBS was confirmed with nerve conduction studies and cerebrospinal fluid examinations. After administration of intravenous immunoglobulin, symptoms gradually disappeared.

There are no well-matched, controlled studies comparing azithromycin with doxycycline for the treatment of complicated scrub typhus. A retrospective propensity score-matched case-control study was performed for patients who presented with complicated scrub typhus and were treated with doxycycline or azithromycin between 2001 and 2011. Data on comorbidities, clinical manifestations, laboratory studies, treatments, and outcomes were extracted for analysis. The clinical characteristics and outcomes of the azithromycin-treated group ( n = 73) were compared to those of the doxycycline-treated group ( n = 108). Of 181 patients, 73 from each group were matched by propensity scores. There were no significant differences in baseline characteristics between the matched groups. The treatment success and survival rates were not significantly different (89% [65/73 patients] versus 96% [70/73 patients] and 96% [70/73 patients] versus 96% [70/73 patients], respectively [ P > 0.05]). No difference was observed in the time to defervescence or length of hospital stay between the two groups ( P > 0.05). In complicated scrub typhus patients ( n = 181), multivariate analysis showed that only APACHE II score was an independent risk factor for mortality (95% confidence interval, 1.11 to 1.56; P < 0.001). Our data suggest that outcomes of azithromycin therapy are comparable to those of doxycycline therapy in patients with complicated scrub typhus.

The efficacy and safety of raltegravir (RAL) with tenofovir (TDF)/emtricitabine (FTC) have been well studied in human immunodeficiency virus (HIV)-infected patients. However, limited clinical data are available on the use of RAL with abacavir (ABC)/lamivudine (3TC) or zidovudine (ZDV)/3TC. We investigated HIV-1-infected Korean adults, including 13 antiretroviral-naive patients and 15 antiretroviral-experienced patients, treated with RAL plus ABC/3TC or ZDV/3TC. Virological suppression was achieved in 12 of the 13 (92%) antiretroviral-naive patients within 24 weeks and in all (100%) patients within 96 weeks. In 13 of the 15 treatment-experienced patients, ritonavir-boosted lopinavir (LPV/r) was replaced with RAL because of hyperlipidemia (n = 11) and diarrhea (n = 2). A significant decrease in median total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels was observed in these patients (P < 0.01, each). No adverse event related to RAL was observed in any of the 28 patients. The RAL plus ABC/3TC or ZDV/3TC regimens were effective and safe in antiretroviral-naive Korean HIV-infected patients, and replacing LPV/r with RAL significantly improved lipid abnormalities in patients previously treated with regimens including LPV/r.

We evaluated three commercial colistin susceptibility testing methods using 213 bloodstream Acinetobacter isolates identified by gene sequencing. Compared to the agar dilution reference method, excellent categorical agreements (both 99.1%) were observed using Vitek 2 and Etest, compared to 87.3% (95.7% for Acinetobacter baumannii and 80.7% for non- baumannii Acinetobacter isolates) using MicroScan.

Background Streptococcus pneumoniae causes a broad spectrum of illnesses ranging from mild upper respiratory tract infections to invasive pneumococcal disease (IPD). Quantitative data on the burden of pneumococcal disease, important for the establishment of appropriate vaccination strategies, is currently lacking in adults. Methods This multicenter, retrospective cohort study was designed to estimate the clinical and economic burden of IPD in adults over the last decade. Data were collected from patients with IPD at 10 university hospitals in South Korea. We estimated the proportion of IPD among all hospitalized patients, the case fatality rate, and the direct medical costs of IPD. Data were further analyzed according to age and risk groups. Results During the study period, 970 patients with IPD were identified. The mean age for all patients was 60.9 years; patients aged 50–64 years (33.0%) were most numerous, followed by those aged 65–74 years (27.4%). Overall, the proportion of IPD was 0.36 cases/1000 hospitalized patients and the case fatality rate was 30.9%, which increased significantly with age (p < 0.01). The mean direct medical costs were estimated to be US $7,452 without a difference between age and risk groups. On multivariate analysis, old age, advanced ECOG performance status, bacteremic pneumonia, and nosocomial infection were independent risk factors of 30-day case fatality. Conclusions The clinical disease burden of IPD increased significantly with age and direct medical costs from IPD were substantial, regardless of age and co-morbid conditions. The current age-based vaccination strategy appears to be appropriate.

Background Despite the importance of invasive Staphylococcus aureus (ISA) infection, its overall burden in non-selected populations has only been defined in a small number of studies in Europe and North America. To define the characteristics of ISA infections in Korea, we conducted a multi-center cohort study to estimate population-based incidence rates. Methods We conducted a multicenter prospective cohort study at nine university-affiliated active-surveillance core centers (ASCs) in three regions of Korea. To cover all available clinical microbiologic laboratories, we classified the laboratories in these regions into three groups according to their clinical environment as: 1) Nine ASCs, 2) Five major commercial laboratories and 3) Forty-four acute-care hospital-affiliated microbiology laboratories. We requested all the laboratories to report prospectively their numbers of cases of S. aureus isolated from normally sterile sites. Detailed clinical information was collected about the cases in the nine ASCs. Results From 1 July 2009 to 30 June 2011, a total of 1,198 cases of ISA infection were identified at the nine ASCs, including 748 (62%) methicillin-resistant S. aureus (MRSA) infections. Most (81%) ISA infections were healthcare-associated (HCA): 653 (55%) hospital-onset and 322 (27%) community-onset. 223 (19%) were community-associated infections. The most common primary diagnosis was catheter-associated infection (225 cases, 19%). Respiratory tract infection (160, 13%), skin & soft tissue (152, 13%) and bone & joint infections (120, 10%) were also common. 30-day and 12-week mortality rates were 25.6% (262/1,024) and 36.5% (314/860), respectively. Complications, including metastatic infection within 12 weeks, occurred in 17.8% of ISA infections. The most common site of metastatic infection was the lung (9.8%, 84/860). Based on the total of 2,806 observed cases of ISA infection, estimated annual rates of ISA and invasive MRSA infections were 43.3 and 27.7 per 100,000 populations, respectively. Conclusions Our data provide important information about the clinical characteristics of ISA infections. We estimate that over 21,000 ISA infections and 13,000 invasive MRSA infections occurred in Korea in 2010.

Three troglobiontic species of Anurida Laboulbene, i.e. A. troglodyta sp. nov., A. decipiens Yosii, 1966, and A. plurichaetotica Yosii, 1966, were found in limestone caves of Korea during recent investigation. The new species, A. troglodyta sp. nov., is characterized by morel-like PAO having more than 100 vesicles and by having 16–17 sensilla on antennal segment IV. It is most similar to A. plurichaetotica , A. okamotoi Yosii, 1970, and A. irieti Yosii, 1970 also possessing several macrochaetae on dorsal side of a head, but can easily be distinguished by characteristic PAO and the absence of macrochaetae in p1-position on abdominal tergum V. A. decipiens is redescribed based on new material from the cave of the types’ origin.

Non-small cell lung cancers (NSCLC) are characterized by a unique pattern of genetic driver mutations, and some of mutations may be used to predict prognosis and targeted treatment such as EGFR TKIs. Cell free (cfDNA) present in the blood stream shows much potential as a useful cancer maker for early diagnosis and cancer progression monitoring. Especially, analyzing the cfDNA with Next Generation Sequencing (NGS) technology allows high through put examination of various genes concurrently at a low cost. However, there are still no standardized methods to identify mutations in cfDNA. In this study, we examined the viability of PGM and Proton platforms. Ion AmpliSeq Cancer Hotspot Panel v2 (Ion Torrent), covering 2800 COSMIC mutations from 50 cancer genes was used to analyze cfDNA of 125 serum samples from NSCLC patients. The on target was 88% and mean depth was 643x using PGM platform. And, the on target was 92% and mean depth was 22,868x in Proton platform. To validate the results of two NGS platforms, we analyzed EGFR status by sanger sequencing in available 100 tumor tissues. EGFR mutations were identified in 34 (34%) by sanger sequencing. EGFR mutations were identified in 32 (25.6%) and 28 (22.4%) by PGM and Proton platform. Interestingly, out of 34 mutations of tumor tissue, EGFR mutations were matched to 11 and 26 in PGM and Proton platform, respectively. These results showed concordance of 76.5% between the tDNA (sanger sequencing) and cfDNA (Proton). In addition, KRAS (codon 12 and 13) mutations were 4 (3.2%) and 18 (14.4%), respectively. In our study, we demonstrated that Proton platform of high depth is a useful assay to identify somatic mutations of cfDNA in NSCLCs. [This research was supported by the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HI14C0066)] Citation Format: Jae Sook Sung, Jong Won Lee, Boyeon Kim, Saet Byeol Lee, Nak-Jung Kwon, Won-Chul Lee, Hae Mi Kim, Won Jin Jang, Yun Ji Choi, Kyung Hwa Park, Yeul Hong Kim. Comparison and evaluation of somatic mutation using PGM and proton platform in cell free DNA of non-small cell lung cancer patients. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3614.

Background The World Health Organization recommends the surveillance of influenza-like illness (ILI) and severe acute respiratory infection (SARI) to respond effectively to both seasonal influenza epidemics and pandemics. In Korea, the “Hospital-based Influenza Morbidity and Mortality (HIMM)” surveillance system has been operated to monitor ILI and SARI occurrences. Materials and Methods A multi-center prospective observational study was conducted. Adult patients with acute respiratory infection (ARI) were enrolled during the 2011-12, 2012-2013, and 2013-2014 influenza seasons at the 10 university hospitals using the HIMM surveillance system. With respect to SARI and pneumonia development, risk profiles were analyzed in patients with ARI in Korea. Results A total of 5,459 cases were eligible for this analysis. Among 5,459 cases with ARI, 2,887 cases (52.9%) were identified that they had influenza infection. Among enrolled cases, 750 cases belonged to the SARI group, while 4,709 cases belonged to the non-SARI group. With respect to pneumonia development, 317 cases were accompanied by pneumonia, and 5,142 cases were not. Multivariate analyses revealed that the following factors were associated with an increased risk of SARI: Old age (≥65 years) (odds ratio [OR] 2.69, 95% confidence interval [CI] 2.2-3.32), chronic heart disease (CHD) (OR 2.24, 95% CI 1.68-2.98), cerebrovascular disease (CVD) (OR 1.49, 95% CI 1.05-2.10), chronic obstructive pulmonary disease (COPD) (OR 2.34, 95% CI 1.48-3.69), asthma (OR 2.33, 95% CI 1.62-3.36), chronic kidney disease (CKD) (OR 2.62, 95% CI 1.73-3.99), chronic liver disease (OR 1.71, 95% CI 1.04-2.81), and autoimmune diseases (OR 2.53, 1.57-4.08). Multivariate analyses revealed that the following factors were independent risk factors for pneumonia development: Old age (≥65 years) (OR 5.71, 95% CI 4.10-7.94), CHD (OR 1.54, 95% CI 1.07-2.22), COPD (OR 2.34, 95% CI 1.48-3.69), asthma (OR 2.33, 95% CI 1.62-3.36), CKD (OR 2.62, 95% CI 1.73-3.99), immunocompromised conditions (OR 3.12, 95% CI 1.47-6.62), and autoimmune diseases (OR 3.35, 95% CI 1.79-6.27). The risk of SARI and pneumonia was increased by the number of concurrent chronic medical conditions. Conclusion The risk of SARI and pneumonia development among adult patient with ARI was significantly increased by the presence or number of concurrent chronic medical conditions in Korea.

The aim of this study was to investigate whether menatetrenone (MNT) suppresses hepatocellular carcinoma (HCC) recurrence in patients undergoing hepatectomy. Between January 2005 and September 2009, 101 patients who underwent curative hepatectomy for primary HCC were enrolled in the study. Patients were divided into two groups: a non-MNT group (n=51), and an MNT group (n=50) that was administered 45 mg of MNT daily. During the observation period, recurrence was observed in 33 patients in the non-MNT group and in 28 patients of the MNT group (p=0.545). In patients with a preoperative Des-γ-carboxy-prothrombin (DCP) level lower than 40 AU/l (n=38), the cumulative disease-free survival rates at 12, 36, and 60 months in the non-MNT group, were 81.3%, 0.0%, and 0.0%, respectively, while those in the MNT group were 78.3%, 58.1%, and 31.0%, respectively (p=0.060). MNT has a moderately suppressive effect on HCC recurrence after hepatectomy, especially in patients with a normal preoperative DCP level.

Previously, Pseudomonas putida was considered a low-virulence pathogen and was recognized as a rare cause of bacteremia. Recently, however, multidrug-resistant and carbapenem-resistant P. putida isolates have emerged, causing difficult-to-treat nosocomial infections in seriously ill patients. Currently, the outcome of multidrug-resistant or carbapenem-resistant P. putida bacteremia remains uncertain. Here, we report 18 cases of P. putida bacteremia with high rates of carbapenem resistance and mortality. From January 2005 through December 2011, all cases of nosocomial P. putida bacteremia were identified and analyzed at Chonnam National University Hospital and Chonnam National University Hwasun Hospital. Electronic medical records were reviewed retrospectively. Four (22%) and five (23%) of 18 P. putida isolates were resistant to imipenem and meropenem, respectively. Common primary infection sites were central venous catheter (7, 39%), pneumonia (5, 28%), and cholangitis (2, 11%). Fourteen (78%) patients had indwelling devices related to the primary site of infection. The 30-day mortality rate was 39% (7/18): 40% (2/5) in patients with carbapenem-resistant P. putida bacteremia vs. 38% (5/13) in patients with carbapenem-susceptible P. putida bacteremia. Nosocomial P. putida bacteremia showed high resistance rates to most potent β-lactams and carbapenems and was associated with high mortality rates.

Extracellular high mobility group box-1 (HMGB1) contributes to tumor growth and invasiveness. We evaluated the diagnostic and prognostic ability of serum HMGB1 for pancreatic ductal adenocarcinoma (PDAC). Serum HMGB1 measured by enzyme-linked immunosorbent assay (ELISA) were compared among normal, chronic pancreatitis, PDAC group in both training (n = 25, each group) and independent validation set (n = 45, each group). To determine the usability of serum HMGB1 as a diagnostic predictor of PDAC, receiver operating characteristic (ROC) curves with sensitivity/specificity and logistic regression were evaluated. To assess the HMGB1-associated prognosis of PDAC, Kaplan-Meier survival and Cox proportional-hazards regression were applied. Serum HMGB1 was correlated with presence and advanced-stage of PDAC. Logistic regression exhibited serum HMGB1 was a remarkable biomarker to predict PDAC as a single or multiple-markers; sensitivity/specificity of serum HMGB1 were superior to carbohydrate antigen (CA) 19-9 or carcinoembryonic antigen (CEA) in both training and independent datasets. Kaplan-Meier survival analysis showed PDAC patients with high serum HMGB1 levels (>30 ng/mL; median survival, 192 days) had a worse prognosis than patients with low HMGB1 levels (≤30 ng/mL; 514 days) by log-rank (P = 0.017). Cox proportional-hazards model showed the relative hazard ratios in high-serum HMGB1 group was 3.077 compared with the low-serum HMGB1 group. In conclusion, serum HMGB1 is a desirable diagnostic and prognostic biomarker for PDAC compared with pre-existing PDAC biomarkers, CA19-9 and CEA.

2-(or4-)-[4-(Dimethylamino)styryl]-1-methylpyridinium iodides (2-ASP and 4-ASP) form 1∶1 inclusion complexes withβ-cyclodextrin (β-CD). The association constant is about 1000 M−1 for both dyes in aqueous solution at 25°C. The complexation results in a 7.6- and 4.9-fold increase in the fluorescence intensities of 2-ASP and 4-ASP, respectively. The formation of inclusion complexes ofn-alkylamines (n=4–10),n-alkylammonium ions (n=4–10),n-alkyl alcohols (n=4–9), andn-alkyltrimethylammonium bromides (C n TAB:n=12, 14, 16) with β-CD was studied by a fluorescent-probe method using 2-ASP as a probe. The association constantsK were obtained from nonlinear least-square regression analysis of the fluorescence titration data. The logarithm of the 1∶1 association constants varies approximately linearly with the number of carbon atoms (n c) of the alkyl chain up ton c=7 and then the dependence of logK onn c is less pronounced for longer alkyl chains: for C n TAB, 1∶2 complexation was also observed. Combining the present result with a previous work [15], we found that the increasing order of stability of β-CD complexes of amphiphilic molecules with the same hydrocarbon tail but different head groups is ammonium < sulfonate < alcohol ≅ amine < sulfate. The association constants obtained from this method are compared with those given by other investigators and the discrepancies are discussed.

Three species of Pogonognathellus Paclt are described from eastern North America: P. belmontorum n. sp. from the southern Appalachians, Alabama and Florida, P. brevifulvus n. sp. from Massachusetts and Michigan, and P. magnibrunneus n. sp. from the southern Appalachians and New York. The first two species are members of the pale/grey clade and the third is a member of the longicornis clade. The setal complexes at the apices of the third and fourth antennal segments are described.

Background The effect of a humanized anti–human leukocyte antigen–DR monoclonal antibody, IMMU-114, on the allogeneic immune response was investigated in vitro. Methods Responder peripheral blood mononuclear cells were cocultured with inactivated self or allogeneic stimulator peripheral blood mononuclear cells in the presence of control antibody or IMMU-114. Thymidine incorporation rates were then measured. Phenotypic changes in peripheral blood mononuclear cells and the intracellular Th1-type cytokines interleukin-2, interferon-γ, and tumor necrosis factor–α were analyzed using flow cytometry. The concentrations of interleukin-2, interferon-γ, and tumor necrosis factor–α in the mixed lymphocyte reaction culture medium were measured. Results Thymidine incorporation rates at a 1:1 responder/stimulator ratio of allogeneic, allogeneic + IMMU-114, self, and self + IMMU-114 were 22,080.7 ± 602.4, 2,254.5 ± 118.1, 1,284.0 ± 227.8, and 494.5 ± 27.5 cpm, respectively ( P = .038). IMMU-114 decreased the frequencies of human leukocyte antigen–DR–expressing CD16+56+ NK cells, CD19+ B cells, and CD3+25+ activated T cells. Conclusion Intracellular cytokine assay and measurement of Th1-type cytokines in the mixed lymphocyte reaction culture medium revealed that IMMU-114 significantly decreased the titers of interleukin-2, interferon-γ, and tumor necrosis factor–α. IMMU-114 significantly suppresses the allogeneic immune response in vitro, partly through inhibition of the Th1 response.

Candida auris is a newly described species whose clinical significance is not clear. Here, we describe the first three cases of nosocomial fungemia caused by C. auris , which confirms that it is a causative agent of bloodstream infections. All three patients presented persistent fungemia for 10 to 31 days. The isolates obtained from the three patients were misidentified as Candida haemulonii and Rhodotorula glutinis by the Vitek 2 and the API 20C systems, respectively. C. auris was confirmed by sequence analysis of the internal transcribed spacer region and D1/D2 regions of the 26S ribosomal DNA of the rRNA gene. The MIC ranges of amphotericin B (AMB), fluconazole (FLU), itraconazole, and voriconazole were 0.5 to 1, 2 to 128, 0.125 to 2, and 0.06 to 1 μg/ml, respectively. All isolates were susceptible to caspofungin (MIC = 0.06 μg/ml) and micafungin (MIC = 0.03 μg/ml). One patient developed breakthrough fungemia while receiving FLU therapy, and two patients who received FLU therapy followed by AMB showed therapeutic failure and fatal outcomes. Our cases show that C. auris fungemia can be persistent, despite FLU or AMB therapy, which emphasizes the importance of accurately identifying this species.