Multicentre study.
To define the clinical characteristics of patients with tuberculosis (TB) destroyed lung due to past TB.
We reviewed patients with TB-destroyed lung between May 2005 and June 2011.
...A total of 595 patients from 21 hospitals were enrolled. The mean age was 65.63 ± 0.47 (mean ± standard error); 60.5% were male. The mean number of lobes involved was 2.59 ± 0.05. Pleural thickening was observed in 54.1% of the patients. Mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV(1)), FEV(1)/FVC, bronchodilator response and number of exacerbations per year were respectively 2.06 ± 0.03 l (61.26% ± 0.79), 1.16 ± 0.02 l (49.05% ± 0.84), 58.03% ± 0.70, 5.70% ± 0.34, and 0.40 ± 0.04. The number of lobes involved was significantly correlated with FVC and FEV(1), and with the number of exacerbations per year. Use of long-acting muscarinic antagonists or long-acting beta-2 agonists plus inhaled corticosteroids resulted in bronchodilatory effects. Multivariable regression analysis showed that age, initial FEV(1) (%) and number of exacerbations during follow-up were independent factors affecting change in FEV(1).
Decreased lung function with exacerbation, and progressive decline of FEV(1) were observed in patients with TB-destroyed lung.
ABO incompatibility is no longer considered a contraindication for adult living donor liver transplantation (ALDLT) due to various strategies to overcome the ABO blood group barrier. We report the ...largest single‐center experience of ABO‐incompatible (ABOi) ALDLT in 235 adult patients. The desensitization protocol included a single dose of rituximab and total plasma exchange. In addition, local graft infusion therapy, cyclophosphamide, or splenectomy was used for a certain time period, but these treatments were eventually discontinued due to adverse events. There were three cases (1.3%) of in‐hospital mortality. The cumulative 3‐year graft and patient survival rates were 89.2% and 92.3%, respectively, and were comparable to those of the ABO‐compatible group (n = 1301). Despite promising survival outcomes, 17 patients (7.2%) experienced antibody‐mediated rejection that manifested as diffuse intrahepatic biliary stricture; six cases required retransplantation, and three patients died. ABOi ALDLT is a feasible method for expanding a living liver donor pool, but the efficacy of the desensitization protocol in targeting B cell immunity should be optimized.
This article presents the clinical results of ABO‐incompatible adult living donor liver transplantation in a single institution.
Context. The near-Earth asteroid 3200 Phaethon (1983 TB) is an attractive object not only from a scientific viewpoint but also because of JAXA’s DESTINY+ target. The rotational lightcurve and spin ...properties were investigated based on the data obtained in the ground-based observation campaign of Phaethon. Aims. We aim to refine the lightcurves and shape model of Phaethon using all available lightcurve datasets obtained via optical observation, as well as our time-series observation data from the 2017 apparition. Methods. Using eight 12-m telescopes and an optical imager, we acquired the optical lightcurves and derived the spin parameters of Phaethon. We applied the lightcurve inversion method and SAGE algorithm to deduce the convex and non-convex shape model and pole orientations. Results. We analysed the optical lightcurve of Phaethon and derived a synodic and a sidereal rotational periods of 3.6039 h, with an axis ratio of a∕b = 1.07. The ecliptic longitude (λp) and latitude (βp) of the pole orientation were determined as (308°, −52°) and (322°, −40°) via two independent methods. A non-convex model from the SAGE method, which exhibits a concavity feature, is also presented.
Statins are potent inhibitors of hydroxyl-3-methylglutaryl co-enzyme A (HMG-CoA) reductase, and have emerged as potential anti-cancer agents based on preclinical evidence. In particular, compelling ...evidence suggests that statins have a wide range of immunomodulatory properties. However, little is known about the role of statins in tumour immune tolerance. Tumour immune tolerance involves the production of immunosuppressive molecules, such as interleukin (IL)-10, transforming growth factor (TGF)-β and indoleamine-2,3-dioxygenase (IDO) by tumours, which induce a regulatory T cell (Treg) response. In this study, we investigated the effect of simvastatin on the production of IL-10, TGF-β and IDO production and the proliferation of Tregs using several cancer cell lines, and Lewis lung cancer (3LL) cells-inoculated mouse tumour model. Simvastatin treatment resulted in a decrease in the number of cancer cells (3LL, A549 and NCI-H292). The production of the immune regulatory markers IL-10, TGF-β in 3LL and NCI-H292 cells increased after treatment with simvastatin. The expression of IDO and forkhead box P3 (FoxP3) transcription factor was also increased in the presence of simvastatin. In a murine 3LL model, there were no significant differences in tumour growth rate between untreated and simvastatin-treated mice groups. Therefore, while simvastatin had an anti-proliferative effect, it also exhibited immune tolerance-promoting properties during tumour development. Thus, due to these opposing actions, simvastatin had no net effect on tumour growth.
Despite the significant impact of multi-drug-resistant bacteraemia, especially extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) and carbapenem-resistant Enterobacterales (CRE), ...the burden of disease has not been investigated thoroughly.
To evaluate the clinical outcomes and socio-economic burden of ESBL-E and CRE bacteraemia nationwide in the Republic of Korea.
A search was undertaken for all cases of ESBL-E and CRE bacteraemia and matched controls in 10 hospitals in the Republic of Korea over 6 months. Patients with ESBL-E or CRE bacteraemia were classified as the R group, and matched controls with antibiotic-susceptible bacteraemia and without infection were classified as the S and N groups, respectively. Patients' clinical data were collected, and the economic burden was estimated based on medical expenses, loss of productivity and total costs.
In total, 795 patients were identified, including 265 patients with ESBL-E or CRE bacteraemia and their matched controls. The mean total length of stay for patients with ESBL-E and CRE in the R group was 1.53 and 1.90 times that of patients in the S group, respectively. The 90-day mortality rates for ESBL-E in the R and S groups were 12.1% and 5.6%, respectively, and the corresponding figures for CRE were 28.6% and 12.0%. There were significant differences in the total costs between the R, S and N groups for both ESBL-E and CRE (ESBL-E: $11,151 vs $8712 vs $6063, P=0.004; CRE: $40,464 vs $8748 vs $7279, P=0.024).
The clinical and economic burden imposed by ESBL-E or CRE bacteraemia was extremely high. These findings suggest that efforts to control resistant bacteraemia are necessary to reduce this burden.
Antibiotic resistance threatens public health worldwide, and inappropriate use of antibiotics is one of the main causes.
To evaluate qualitative use of antibiotics in asymptomatic bacteriuria (ABU) ...and urinary tract infection (UTI).
Cases of positive urine culture (≥105 colony-forning units/mL) performed in inpatient, outpatient and emergency departments in April 2021 were screened in 26 hospitals in the Republic of Korea. The cases were classified as ABU, lower UTI and upper UTI. The appropriateness of antibiotic use was evaluated retrospectively by infectious disease specialists using quality indicators based on clinical guidelines for ABU and UTI.
This study included a total of 2697 patients with ABU or UTI. The appropriateness of antibiotic use was assessed in 1157 patients with ABU, and in 677 and 863 patients with lower and upper UTI, respectively. Among the 1157 patients with ABU, 251 (22%) were prescribed antibiotics without appropriate indications. In 66 patients with ABU in which antibiotics were prescribed with appropriate indications, the duration was adequate in only 23 (34.8%) patients. The appropriateness of empirical and definite antibiotics was noted in 527 (77.8%) and 353 (68.0%) patients with lower UTI, and 745 (86.3%) and 583 (78.2%) patients with upper UTI, respectively. The duration of antibiotics was adequate in 321 (61.8%) patients with lower UTI and 576 (78.7%) patients with upper UTI.
This nationwide qualitative assessment of antibiotic use in ABU and UTI revealed that antibiotics were often prescribed inappropriately, and the duration of antibiotics was unnecessarily prolonged.
Modified local meteorology owing to heterogeneities in the urban–rural surface can affect urban air quality. In this study, the impacts of urban land-surface forcing on ozone air quality during a ...high ozone (O3) episode in the Seoul metropolitan area, South Korea, are investigated using a high-resolution chemical transport model (CMAQ). Under fair weather conditions, the temperature excess (urban heat island) significantly modifies boundary layer characteristics/structures and local circulations. The modified boundary layer and local circulations result in an increase in O3 levels in the urban area of 16 ppb in the nighttime and 13 ppb in the daytime. Enhanced turbulence in the deep urban boundary layer dilutes pollutants such as NOx, and this contributes to the elevated O3 levels through the reduced O3 destruction by NO in the NOx-rich environment. The advection of O3 precursors over the mountains near Seoul by the prevailing valley-breeze circulation in the mid- to late morning results in the build-up of O3 over the mountains in conjunction with biogenic volatile organic compound (BVOC) emissions there. As the prevailing local circulation in the afternoon changes to urban-breeze circulation, the O3-rich air masses over the mountains are advected over the urban area. The urban-breeze circulation exerts significant influences on not only the advection of O3 but also the chemical production of O3 under the circumstances in which both anthropogenic and biogenic (natural) emissions play important roles in O3 formation. As the air masses that are characterized by low NOx and high BVOC levels and long OH chain length are advected over the urban area from the surroundings, the ozone production efficiency increases in the urban area. The relatively strong vertical mixing in the urban boundary layer embedded in the sea-breeze inflow layer reduces NOx levels, thus contributing to the elevated O3 levels in the urban area.
A new active clamping zero-voltage switching (ZVS) pulse-width modulation (PWM) current-fed half-bridge converter (CFHB) is proposed in this paper. Its active clamping snubber (ACS) can not only ...absorb the voltage surge across the turned-off switch, but also achieve the ZVS of all power switches. Moreover, it can be applied to all current-fed power conversion topologies and its operation as well as structure is very simple. Since auxiliary switches in the snubber circuit are switched in a complementary way to main switches, an additional PWM IC is not necessary. In addition, it does not need any clamp winding and auxiliary circuit besides additional two power switches and one capacitor while the conventional current-fed half bridge converter has to be equipped with two clamp windings, two ZVS circuits, and two snubbers. Therefore, it can ensure the higher operating frequency, smaller-sized reactive components, lower cost of production, easier implementation, and higher efficiency. The operational principle, theoretical analysis, and design considerations are presented. To confirm the operation, validity, and features of the proposed circuit, experimental results from a 200-W, 24-200Vdc prototype are presented.
PDF
