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Pleural effusion can be caused by a wide range of benign and malignant conditions. Pleural biopsy and effusion cytology represent two key methods of pathological diagnosis. To compare the performance these two methods, a large cohort of matched pleural biopsy and effusion cytology with clinical follow-up was reviewed.Pleural biopsies and effusion cytology specimens over a period of 18 years were retrieved. Cytology specimens collected within 7 days of pleural biopsy were matched. Reports were reviewed, and the cause for pleural effusion was determined by hospital disease coding and clinical data.Totally, 3026 cases were included. The leading cause of benign effusion was tuberculosis (n = 650). Malignant pleural effusion (MPE) was more common in older females (p 0.001) and mostly due to lung cancer (n = 959), breast cancer (n = 64), and mesothelioma (n = 48). The inadequate/insufficient (B1/C1) rate of biopsy was higher than cytology (15.6% vs. 0.3%) but the rates for other diagnostic categories were similar. Biopsy and cytology showed a correlation coefficient of 0.315, improving to 0.449 when inadequate/insufficient (B1/C1) cases were excluded. The ROM for benign cytology (C2) was lower than biopsy (B2) (p 0.001). Compared with biopsy, the diagnostic accuracy was higher in cytology overall and for metastatic carcinomas (p 0.001) but lower for hematolymphoid malignancies (p = 0.014) and mesotheliomas (p = 0.002).These results suggest that effusion cytology may be better for confirming benignity and diagnosing carcinomatous MPE. In these cases, pleural biopsy may be withheld to reduce procedural risks. However, for suspected hematolymphoid malignancies and mesothelioma, biopsy should be considered.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): This study was supported by unrestricted grants from the Korean Society of Interventional Cardiology. Aims Despite the benefit of culprit-only percutaneous coronary intervention (PCI) in the CULPRIT-SHOCK trial, the optimal revascularization strategy for a refractory cardiogenic shock (CS) requiring mechanical circulatory support devices remains controversial. This study aimed to compare clinical outcomes between the culprit-only and immediate multi-vessel PCI strategies in patients with acute myocardial infarction (AMI) complicated by CS who underwent venoarterial-extracorporeal membrane oxygenation (VA-ECMO). Methods and Results This study was patient-pooled data from the RESCUE and SMC-ECMO registries. A total of 408 AMI patients with multi-vessel disease who underwent VA-ECMO due to refractory CS were included in this analysis. The study population was classified into culprit-only versus immediate multi-vessel PCI according to non-culprit lesion (NCL) treatment strategies. The co-primary endpoints were 30-day mortality or renal-replacement therapy and 12-month follow-up mortality. Among the study population, 241 (59.1%) underwent culprit-only PCI and 167 (40.9%) underwent immediate multi-vessel PCI. Compared with culprit-only PCI, immediate multi-vessel PCI was associated with significantly lower risks of 30-day mortality or renal-replacement therapy (66.8% vs. 54.5%, p=0.02) and all-cause mortality during 12 months of follow-up (59.5% vs. 47.8%, hazard ratio [HR] 0.70; 95% confidence interval [CI] 0.53–0.92, p=0.01) in patients with AMI and CS who underwent VA-ECMO. These results were also consistent in the 290 pairs of propensity score-matched population (55.6% vs. 46.1%, HR 0.71; 95% CI 0.51–0.98, p=0.04). Conclusion Among AMI patients with multi-vessel disease complicated by advanced CS, immediate multi-vessel PCI might be associated with improved clinical outcomes in those undergoing VA-ECMO.

The Advanced Mo-based Rare process Experiment (AMoRE)-Pilot experiment is an initial phase of the AMoRE search for neutrinoless double beta decay of $$^{100}$$ 100 Mo, with the purpose of investigating the level and sources of backgrounds. Searches for neutrinoless double beta decay generally require ultimately low backgrounds. Surface $$\alpha $$ α decays on the crystals themselves or nearby materials can deposit a continuum of energies that can be as high as the Q-value of the decay itself and may fall in the region of interest (ROI). To understand these background events, we studied backgrounds from radioactive contaminations internal to and on the surface of the crystals or nearby materials with Geant4-based Monte Carlo simulations. In this study, we report on the measured $$\alpha $$ α energy spectra fitted with the corresponding simulated spectra for six crystal detectors, where sources of background contributions could be identified through high energy $$\alpha $$ α peaks and continuum parts in the energy spectrum for both internal and surface contaminations. We determine the low-energy contributions from internal and surface $$\alpha $$ α contaminations by extrapolating from the $$\alpha $$ α background fitting model.

Background As the indications for trans-catheter aortic valve replacement (TAVR) expand, it is expected that the number of TAVR patients would increase and the follow-up duration would be longer. It is known that the incidence of leaflet thrombosis is higher in TAVR than in surgical aortic valve replacement (SAVR), but not much is known about the risk factors of late leaflet thrombosis in TAVR. Aim Therefore, in this study, the incidence and risk factors of late leaflet thrombosis at late term after TAVR and the effect on clinical course of late leaflet thrombosis would be investigated. Method There were 176 patients undergone TAVR from January 2015 to October 2020 in one tertiary hospital of south korea. 94 patients had follow-up cardiovascular computed tomography (CT) between 3 months and 2 years after TAVR. Among 94 patients, late leaflet thrombosis was discovered at 20 patients, and risk factors were analyzed by comparing clinical factors, echocardiographic and cardiovascular CT information, and angiographic data between the group with and without late leaflet thrombosis. And the difference in aortic valve hemodynamics between the group with and without leaflet thrombosis was examined and clinical outcomes were compared. Clinical outcome was defined as the composite of all-cause death, stroke, heart failure (HF) admission, redo-aortic valve (AV) replacement and major bleeding after detection of late leaflet thrombosis. Results Indexed mean sinus of Valsalva diameter, AV calcium score and post procedure estimated orifice area (EOA) had predictability of late leaflet thrombosis with AUC value of 0.670 (95% CI [0.546–0.795], p value = 0.020), AUC value of 0.698 (95% CI [0.544–0.851], p value = 0.012) and AUC value of 0.665 (95 percent CI [0.548–0.782], p value = 0.031), respectively (Figure 1). In echocardiography performed at the time of follow-up CT, AV max velocity and AV mean pressure gradient were higher in thrombosis group and EOA and Doppler velocity index were lower in thrombosis group than in no thrombosis group within normal range (Figure 2). Clinical outcome was not significant different between the two groups (log rank p value = 0.560). Conclusion Larger indexed sinus of Valsalva diameter, higher AV calcium score and smaller post procedure AV EOA were risk factors for late leaflet thrombosis after TAVR. Subclinical late leaflet thrombosis have a benign course when properly managed. Funding Acknowledgement Type of funding sources: None.

Introduction Throughout the years of percutaneous coronary intervention (PCI), the debate regarding access route, whether it being trasns-radial or femoral, is an ongoing agenda yet to be solved. Recent guidelines suggest trans-radial approach as an option to be considered in acute coronary syndrome (ACS). However, data on cardiogenic shock patients undergoing PCI is relatively sparse. Purpose Compare the clinical implication of trans-radial and femoral approach in cardiogenic shock patients who had undergone PCI. Method Cardiogenic shock patients who had undergone PCI from January 2014 to December of 2018 were enrolled. Patients were divided according to their access route respectfully. Primary outcome was composite endpoints including all-cause death, re-admission due to heart failure, myocardial infarction (MI) and cerebrovascular accident. Result A total of 694 (572 via femoral approach, 122 via radial approach) cardiogenic shock patients who received PCI were enrolled. Mean age femoral and radial groups was 66.59±12.51 and 66.66±12.8 respectfully. Disease severity was higher for femoral patients compared to radial patients as represented by their LM involvement, mechanical organ support (extracorporeal membrane oxygenation, continuous renal replacement therapy, mechanical ventilation), left ventricular ejection fraction (LVEF) and vasoactive inotropic score. Cox regression analysis after adjusting for conventional risk factors showed that femoral route was a poor prognosticator with respect to composite endpoints (HR=2.059, 95% CI 1.249–3.397, p value = 0.005). Radial approach patients had higher survival probability compared to femoral approach patients (Figure 1). Conclusion Radial approach in cardiogenic shock patients who are in need for PCI with relatively less severe clinical condition could be a reasonable option for access route. Funding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Inha University Hospital

Background In a few studies, obesity was associated with better outcomes in patients with cardiogenic shock (CS). Although this phenomenon, the “obesity paradox”, reportedly manifests differently based on sex in other disease entities, it has not yet been investigated in CS patients. Methods and results 1,227 patients with CS from The REtrospective and prospective observational Study to investigate Clinical oUtcomes and Efficacy of left ventricular assist device for Korean patients with cardiogenic shock (RESCUE) registry in Korea were analyzed. The study population was classified into obese and non-obese groups according to Asian-Pacific criteria (BMI >25.0 kg/m2 for obese). Clinical impact of obesity on in-hospital mortality according to sex was analyzed using logistic regression analysis and restricted cubic spline curves. In-hospital mortality rate was significantly lower in obese men than non-obese men (34.2% vs. 24.1%, p=0.004) while the difference was not significant in women (37.3% vs. 35.8%, p=0.884). As a continuous variable, higher BMI showed a protective effect in men conversely, BMI was not associated with clinical outcomes in women. Comparing to normal-weight patients, obesity was associated with a decreased risk of in-hospital death in men (multivariable-adjusted OR 0.63, CI 0.43–0.92, p=0.016), not in women (multivariable-adjusted OR 0.94, 95% CI 0.55–1.61, p=0.828). Interaction P value for the association between BMI and sex was 0.023. Conclusions Obesity paradox exists and apparently occurs in men among CS patients. The differential effect of BMI on in-hospital mortality was observed according to sex. Funding Acknowledgement Type of funding sources: None.

Background Even though the presence of hyperglycemia has shown to affect the clinical outcome of cardiogenic shock patients, the extent of hyperglycemia and its association with prognosis have not been fully addressed in large population Purpose Investigate the clinical relationship between hyperglycemic status and in-hospital mortality in cardiogenic shock patients Method A total of 1,177 consecutive cardiogenic shock patients were enrolled from January 2014 to December of 2018 at 12 hospitals in South Korea. The primary outcome was in-hospital mortality. Patients were divided into four groups according to their initial plasma glucose level in each of diabetes patients (n=752) and non-diabetes patients (n=425); group 1 (≤8 mmol/L), group 2 (8–12 mmol/L), group 3 (12–16 mmol/L) and group 4 (≥16 mmol/L). Results The groups with higher admission plasma glucose were associated with lower systolic blood pressure and higher lactic acid level in both diabetic and non-diabetic patients. In-hospital mortality increased in groups with higher admission plasma glucose level in non-diabetic patients (group-1:24.2%, group-2: 28.6%, group-3: 38.1%, group-4: 49.0%, p Conclusion In cardiogenic shock patients, plasma glucose obtained at admission was associated with in-hospital mortality in non-diabetic patients Funding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Inha University hospital

There have been limited data on the risk of onward transmission from individuals with Omicron variant infections who return to work after a 5-day isolation.To evaluate the risk of transmission from healthcare workers (HCWs) with Omicron variant who returned to work after a 5-day isolation and the viable-virus shedding kinetics.This investigation was performed in a tertiary care hospital, Seoul, South Korea. In a secondary transmission study, we retrospectively reviewed the data of HCWs confirmed as COVID-19 from March 14Of the 248 HCWs who were diagnosed with COVID-19 within 5 days of the return of an infected HCW, 18 (7%) had contact with the returned HCW within 1-5 days after their return. Of these, nine (4%) had an epidemiologic link other than with the returning HCW, and nine (4%) had contact with the returning HCW, without any other epidemiologic link. In the study of the kinetics of virus shedding (N = 32), the median time from symptom onset to negative conversion of viable virus was four days (95% confidence interval: 3-5).Our data suggest that the residual risk of virus transmission after 5 days of isolation following diagnosis or symptom onset is low.

Résumé Avec l’adhésion de la Corée du Sud à l’Organisation internationale de la Francophonie (OIF) et l’organisation des Jeux Olympiques d’hiver de 2018 à Pyeongchang, en Corée du Sud, la francophonie suscite un intérêt croissant. Une enquête a été menée auprès d’interprètes de conférence exerçant avec un français actif afin d’évaluer la situation actuelle du marché de l’interprétation coréen-français, ainsi que ses perspectives d’avenir. L’essor actuel de la demande survivra-t-il à l’effet Jeux Olympiques ?

A negative muonium ion (${\mathrm{Mu}}^{\ensuremath{-}}$) source using an aluminum foil target (Al target) was developed as a low-energy muon source. ${\mathrm{Mu}}^{\ensuremath{-}}$ ions are produced by irradiating the Al target with a 3-MeV positive muon (${\ensuremath{\mu}}^{+}$) beam and observed using a microchannel plate. An experiment to produce ${\mathrm{Mu}}^{\ensuremath{-}}$ ions was conducted to evaluate the performance of this ${\mathrm{Mu}}^{\ensuremath{-}}$ ion source. The measured event rate of ${\mathrm{Mu}}^{\ensuremath{-}}$ ions was $(1.7\ifmmode\pm\else\textpm\fi{}0.3)\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}3}\text{ }\text{ }{\mathrm{Mu}}^{\ensuremath{-}}/\mathrm{s}$ when the event rate of the incident ${\ensuremath{\mu}}^{+}$ beam was $1.3\ifmmode\times\else\texttimes\fi{}{10}^{6}/\mathrm{s}$. The experiment was conducted at the Muon Science Establishment, D-line in the Materials and Life Science Experimental Facility within the Japan Proton Accelerator Research Complex. The formation probability, defined as the ratio of the ${\mathrm{Mu}}^{\ensuremath{-}}$ ions to the incident muons on the Al target, was $(1.1\ifmmode\pm\else\textpm\fi{}0.2(\mathrm{stat}{)}_{+0.1}^{\ensuremath{-}0.0}(\mathrm{syst}))\ifmmode\times\else\texttimes\fi{}{10}^{\ensuremath{-}6}$. This ${\mathrm{Mu}}^{\ensuremath{-}}$ ion source was first adopted in the commissioning of the muon accelerator at the D-line, and the event rate of the accelerated ${\mathrm{Mu}}^{\ensuremath{-}}$ ions was consistent with the expectation. This ${\mathrm{Mu}}^{\ensuremath{-}}$ ion source boosted the development of the muon accelerator, and the practicality of this low-energy muon source obtained using a relatively simple apparatus was demonstrated.

Background The Korean Organ Transplantation Registry (KOTRY) began to register lung transplants in 2015. This is an initial report on the status of patients receiving lung transplants over the past 2 years. Methods We analyzed a total of 69 patients who received lung transplants in 2015 and 2016 and who registered with the KOTRY. Results The 69 patients were treated in 5 institutions. The average (SD) donor age was 39.2 (12.6) years; there were 40 male patients. The average (SD) recipient age was 55.7 (10.0) years, and the number of male recipients was 46. A total of 66 patients underwent bilateral lung transplantation, 3 underwent single-lung transplantation, and 1 underwent simultaneous heart-lung transplantation. The most frequent indication for lung transplantation was idiopathic pulmonary fibrosis (35 patients), followed by connective tissue disease-related interstitial lung disease (9) and acute respiratory failure (8). Prior to transplantation, 23 patients required ventilator care, and 12 required extracorporeal membrane oxygenation while on the waiting list. Episodes of acute rejection during follow-up were reported in 4, 2, 1, and 1 patients at 3, 6, 9, and 12 months, respectively. Infections requiring hospitalization were reported in 27, 10, 4, and 3 patients at 3, 6, 9, and 12 months, respectively. Conclusion The establishment of KOTRY renders it possible to collect nationwide data on lung transplantation, improving research on the topic and clarifying clinical feasibility.

The α-clusterization of an atomic nucleus has been studied for a long time, even from the earliest days of nuclear physics. Our understanding of the α-cluster structure is, however, mainly limited to the self-conjugate A = 4n (n = 2, 3, 4, · · · ) light nuclei and some of the neutron-rich radionuclides such as 10Be, 11B, and 14C. In order to study the α-cluster structure of a neutron-deficient 22Mg nucleus, we have measured the 18Ne(α, α)18Ne scattering in inverse kinematics by using radioactive 18Ne beams and the 4He gas target at the Center for Nuclear Study radioactive ion beam separator of the University of Tokyo. Recoiling α particles from the scattering were detected by using silicon strip detectors, which constitute ΔE-E telescopes for particle identification. By adopting a thick target method, we were able to investigate a wide range of excitation energies Ex = 9.9 - 16.5 MeV in 22Mg in this work.

The intense γ-rays from classical novae are emitted due to the β-decay of 18F which is produced by the Hot-CNO cycle. The reaction rate of 18F(p,α)15O affects the prediction of the abundance of 18F. The main contribution to this reaction rate is from the resonances in 19Ne near and above the proton threshold. Hence, many experiments and theoretical works have been performed on the low-lying 18F+p resonances. One of the methods for investigating 19Ne parameters is studying the mirror nucleus 19F. α elastic scattering experiment was performed with a 7 MeV/u 15N beam for investigating the resonance parameters in 19F using the thick target method in inverse kinematics at the radioactive beam facility CRIB of the Center for Nuclear Study, the University of Tokyo. The excitation function of 19F was obtained for the excitation energy Ex = 6.7 - 7.7 MeV, and the parameters of the resonance states in 19F were determined using an R-matrix analysis.

We conducted a measurement of 18Ne + α scattering in inverse kinematics , in order to search for experimental evidence of α -cluster structure in 22Mg above the alpha threshold ( E thr = 8 . 14 MeV ) and determine the astrophysical rates of the 18Ne( α , p)21Na reaction under the conditions of break-out from the Hot-CNO cycle. A high intensity 18 Ne beam at 2.54 AMeV was successfully produced at CRIB (CNS Radioactive Ion Beam separator) of the Center for Nuclear Study, the University of Tokyo. This paper presents the in-flight production of the radioactive 18Ne beam by using the production reaction 3He(16O, 18Ne)n with a windowed cryogenic gas target, which was employed in the mentioned resonant α -scattering experiment.

Performances of high-speed switches operating as terahertz on–off-keying (OOK) modulators are reported. Two types of switches, a passive shunt switch and an amplifier switch, are fabricated using 0.25- $\mu \text{m}$ InP double heterojuction bipolar transistor (DHBT) technology. Small-signal tests show that the amplifier switch possesses superior on–off ratio, but the passive switch has broader bandwidth and smaller group delay ripples. A modulator test setup is built with 20-dB path loss between the transmitter and the receiver. The results indicate that carrier power levels of 14 dBm for the shunt switch and 8 dBm for the amplifier switch are required for 20-Gb/s OOK modulation with bit error rate (BER) of 10−2 at 290 GHz.