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BACKGROUND: Circulating cell-free nucleic acids are known to be a noninvasive diagnostic tool for cancer detection. Heterogeneous nuclear ribonucleoprotein (hnRNP) B1, a nuclear core complex, is overexpressed in early stage lung cancer. We intended to evaluate the usefulness of plasma hnRNP B1 mRNA in differentiating non-small cell lung cancer (NSCLC) from other benign lung diseases, especially pulmonary tuberculosis, which is highly prevalent in Korea and often difficult to distinguish from lung cancer. METHODS: Plasma RNA was extracted from 30 patients with NSCLC, 30 patients with benign lung diseases including pulmonary tuberculosis, and 10 healthy controls. Plasma hnRNP B1 mRNA was measured by TaqMan Gene Expression Assay (Applied Biosystems, USA), and pre-developed beta-actin (ACTB) mRNA was used for normalization. We analyzed the relative gene expression data using the delta-delta Ct method. RESULTS: Plasma hnRPN B1 mRNA was measurable in 93.3% (28/30) of NSCLC patients. Normalized 2-DeltaDeltaCt of plasma hnRPN B1 mRNA was 62.2 (95%Cl, 6.4-210.1) in NSCLC patients and 2.7 (95%Cl, 0.5-13.6) in benign lung disease patients (P

We have been developing an underwater robot for harbour construction using a parallel mechanism The robot is attached to the rope of a crane, which curries a large stone into the undersea The robot`s yaw and pitch are controlled by hydraulic cylinders but its roll is uncontrollable. We mount propellers in both side of the robot to generate the roll motion This paper studies on the control for the roll motion of a underwater robot. A gyro-sensor is used to measure the angle in a roll motion We develop the dynamic model to describe the robot`s roll motion by a second order non-linear system and identify the model parameters by recursive least square and adaptive identifier. PD control, recursive model based control and adaptive model based control are applied with the dynamic model which computes the control input to compensate disturbances. This paper introduces the underwater robot system and presents the simulated and experimental results of the proposed controller.

This paper presents a parallel typed walking robot to improve walking space and stability region. The robot is designed by inserting an intermediate mechanism between upper leg mechanism and lower leg mechanism. The leg mechanism is composed of three legs and base, which form a parallel mechanism with ground. Seven different types of walking robot are invented by combining the leg mechanisms and an intermediate mechanism. Topology is applied to design the leg mechanism. A motor vector is adopted to determine Jacobian and a wrench vector is used to analyze dynamics of the robot. We explore the stability region of the robot from the reaction force of legs and compute ZMP including the holding force to contact the foot to a wall. This investigates a walking stability when the robot walks on the ground as well as on the wall. We examine the walking space generated by support legs and by swing legs. The robot has both a large positional walking space and a large orientational walking space so that it can climb from a floor up to a wall.

Speech bandwidth extension (SBE) assumes that high-frequency components of a speech signal, e.g., the frequency band of 4-7 kHz, can be estimated by parameters extracted from the narrowband signal (0-4 kHz). Therefore, it is very important to understand the characteristics of the highband signal as well as perceptual cues to represent the highband signal. This letter proposes a new SBE algorithm using a temporal envelope model. The temporal envelope model considers band-limited temporal envelopes as the perceptual cue of the 4-7 kHz band signal while it deemphasizes the importance of rapidly varying components. To implement the SBE with no additional bits, the proposed method adopts a Gaussian mixture model (GMM) to estimate the temporal envelope of the highband signal from that of the narrowband one. Simulation results confirm that the proposed SBE algorithm shows better perceptual quality than a conventional source-filter model-based approach.

This paper designs a four legged parallel walking robot to go through a narrow hole. Topology design is conducted for a leg mechanism composed of four legs, base and ground, which constitute a redundant parallel mechanism. This mechanism is subdivided into four sub-mechanism composed of three legs. A motor vector is adopted to determine the 6×8 Jacobian of the redundant parallel mechanism and the 6×6 Jacobian of the sub-mechanisms, respectively. The condition number of the Jacobian matrix is used as an index to measure a dexterity. We analyze the condition numbers of the Jacobian over the positional and orientational walking space. The analysis shows that a sub-mechanism has lots of singularities within workspace but they are removed by a redundant parallel mechanism improving a dexterity. From the results, we can propose a parallel typed walking robot to enlarge walking space and stability region. The robot is designed by inserting an intermediate mechanism between upper and lower leg mechanisms. The robot is reasonably small so that it can go through a narrow hole.

Serological anlysis of recombinant cDNA expression libraries (SEREX) has led to identification of several categories of new antigens recognized by the immune system of cancer patients, which are referred to as the cancer immunome. We analyzed normal testis cDNA expression libraries with serumobtained from non-small lung cancer patient and isolated 40 distinct antigen designated KP-LuT-1 through KP-LuT-40. Among these antigens 20 antigens were previously identified by SEREX analysis of other tumor types, and 20 out of 40 antigens (50%) did not match entries in Cancer Immunome Database and were considered newly identified antigens. Sequencing analysis showed that the antigens comprised 26 functional known proteins and 14 noble/uncharacterized gene products. Of these, the hypothetical protein KP-LuT-6 was shown tissue-restricted. RT-PCR showed it to be expressed strongly only in normal testis. In addition to normal tissues-restricted expression, KP-LuT-6 mRNA was detected in lung tumor samples(3/10), stomach tumor samples(3/10), and breast tumor samples(1/5), whereas not detected in colon tumor samples(0/12). These data suggest that KP-LuT-6 is a cancer/testis (CT)-like antigen as a potential target for cancer immunotherapies.

In this study, we have tried to find new targets and effective drugs for imatinib-resistant chronic myelogenous leukemia (CML) cells displaying loss of Bcr-Abl kinase target dependence. The imatinib-resistant K562/R1, -R2 and -R3 cells showed profound declines of Bcr-Abl level and concurrently exhibited up-regulation of Bcl-2 and Ku70/80, and down-regulation of Bax, DNA-PKcs and BRCA1, suggesting that loss of Bcr-Abl after exposure to imatinib might be accompanied by other cell survival mechanism. K562/R3 cells were more sensitive to camptothecin (CPT)- and radiation-induced apoptosis than K562 cells, indicating hypersensitivity of imatinib-resistant cells to DNA damaging agents. Moreover, when K562 cells were treated with the combination of imatinib with CPT, the level of Bax and the cleavage of PARP-1 and DNA-PK were significantly increased in comparison with the effects of each drug. Therefore, our study suggests that CPT can be used to treat CML with loss of Bcr-Abl expression.

Bcr-Abl-independent signaling pathways are known to be involved in imatinib resistance in some patients with chronic myelogenous leukemia (CML). In this study, to find new targets for imatinib-resistant CML displaying loss of Bcr-Abl kinase target dependence, we isolated imatinib-resistant variants, K562/R1, K562/R2, and K562/R3, which showed profound declines of Bcr-Abl levels and its tyrosine kinase activity, from K562 cells. Importantly, the imatinib resistance mechanism in these variants also included aberrant acetylation of nonhistone proteins such as p53, Ku70, and Hsp90 that was due to upregulation of histone deacetylases (HDACs) and down-regulation of histone acetyltransferase (HAT). In comparison with K562 cells, the imatinib-resistant variants showed up-regulation of HDAC1, -2, and -3 (class I HDACs) and class III SIRT1 and down-regulation of CBP/p300 and PCAF with HAT activity, and thereby p53 and cytoplasmic Ku70 were aberrantly acetylated. In addition, these were associated with down-regulation of Bax and up-regulation of Bcl-2. In contrast, the class II HDAC6 level was significantly decreased, and this was accompanied by an increase of Hsp90 acetylation in the imatinib-resistant variants, which was closely associated with loss of Bcr-Abl. These results indicate that alteration of the normal balance of HATs and HDACs leads to deregulated acetylation of Hsp90, p53, and Ku70 and thereby leads to imatinib resistance, suggesting the importance of the acetylation status of apoptosis-related nonhistone proteins in Bcr-Abl-independent imatinib resistance. We also revealed that imatinib-resistant K562 cells were more sensitive to suberoylanilide hydroxamic acid, an HDAC inhibitor, than K562 cells. These findings may have implications for HDAC as a molecular target in imatinib-resistant leukemia cells.

Background: Although most of the literature about health-related quality of life (HRQoL) focuses on breast cancer patients, few studies compared the HRQoL in disease-free breast cancer survivors with that of the general population. Materials and methods: We administered the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Quality of Life Questionnaire Breast Cancer Module, McGill Quality of Life Questionnaire, Beck Depression Inventory, and Brief Fatigue Inventory to 1933 disease-free survivors for over 1 year after being diagnosed with stage 0 to III breast cancer. We performed multivariate-adjusted analyses in all HRQoL comparisons. Results: The scores for some HRQoL scales were comparable for both disease-free breast cancer survivors and the general female population; however, there was clinically significant difference in cognitive and social functioning, fatigue, insomnia, and financial difficulties between the two groups. Radiotherapy and systemic adjuvant therapy variables did not limit the HRQoL. Demographic characteristics such as age, time since surgery, and comorbidity were associated with some HRQoL scales and fatigue and depression were associated with almost all HRQoL scales. Conclusions: Disease-free survivors of breast cancer had good HRQoL, which was less affected by the type of treatment than it was by demographic characteristics, time since surgery, comorbidity, fatigue, and depression.

The abilities of NKG2D ligands to specifically mark stressed or transformed cells and activate NK cells suggest the possibility that the expression levels of NKG2D ligands in cancers may be helpful to predict the efficacy of NK cell-based cancer immunotherapy. Therefore, a multiplex RT-PCR was developed and used for rapid and simultaneous analysis of the expression level of NKG2D ligands in cancer cells and tissues. With total RNAs isolated from various cancer cell lines, the multiplex RT-PCR revealed various expression patterns of NKG2D ligands. With total tissue RNAs, the gastrointestinal tumors showed consistently increased NKG2D ligands, compared with adjacent normal tissues. However, NKG2D ligands were not always consistently increased in tumor tissues and expression patterns of NKG2D ligands were heterogeneous between patients, especially in breast and lung cancers. In addition, expression patterns of NKG2D ligands were very similar between various paired primary and their multidrug-resistant/metastatic cells, except MCF-7 sublines. These results demonstrated that the multiplex RT-PCR might be a useful diagnostics to detect the expression levels of NKG2D ligands in tissues as well as cells, and suggested that the gastrointestinal tumors might be good candidates for NK cell-based cancer immunotherapy, since it showed significantly higher levels of NKG2D ligands than adjacent normal tissues.

REarranged during Transfection (RET) fusion genes are detected in approximately 1% of lung adenocarcinomas and known primarily as oncogenic driver factors. Here, we found a novel RET fusion gene, KIAA1217-RET, and examined the functional differences of RET51 and RET9 protein, fused with KIAA1217 in cancer progression and drug response. KIAA1217-RET, resulting from the rearrangement of chromosome 10, was generated by the fusion of KIAA1217 exon 11 and RET exon 11 from a non-small cell lung cancer patient. Expression of this gene led to increased cell growth and invasive properties through activations of the PI3K/AKT and ERK signaling pathways and subsequently enabled oncogenic transformation of lung cells. We observed that cells expressing KIAA1217-RET9 fusion protein were more sensitive to vandetanib than those expressing KIAA1217-RET51 and both isoforms attenuated cellular growth via cell cycle arrest. These results demonstrated that KIAA1217-RET fusion represents a novel oncogenic driver gene, the products of which are sensitive to vandetanib treatment, and suggested that the KIAA1217-RET-fusion gene is a promising target for lung cancer treatment.

Purpose We evaluated the clinical usefulness of a prognostic scoring system (“the ProVent score”) in Korean patients requiring prolonged mechanical ventilation. Material and methods We retrospectively analyzed the data of 184 patients in a medical intensive care unit of a tertiary care hospital between January 2004 and December 2013. Results The patients' median age was 65 years, and 66.8% were male. One-year mortality was 67.4%. On day 21 of mechanical ventilation, the ProVent score was 0 in 13 patients (7.1%), 1 in 39 patients (21.2%), 2 in 73 patients (39.7%), 3 in 42 patients (22.8%), and greater than or equal to 4 in 17 patients (9.2%). For patients with a ProVent score ranging from 0 to greater than or equal to 4, 1-year mortality was 46.2%, 53.8%, 68.5%, 76.2%, and 88.2%, respectively. The Kaplan-Meier curves of 1-year survival for each ProVent score showed statistically significant differences (log-rank test: P = .001). Logistic regression analysis showed that only thrombocytopenia was independently associated with 1-year mortality in our cohort (odds ratio = 4.786, P Conclusions In our study, the ProVent score could be applied to predict 1-year mortality for patients requiring prolonged mechanical ventilation in Korea. Among variables contributing to this score, only thrombocytopenia was an independent prognostic factor for 1-year mortality.

Objective High-flow nasal cannula (HFNC) therapy is an oxygen delivery system. However, evidence regarding the clinical applications of HFNC is still emerging. We herein evaluated the clinical predictors of HFNC therapy success for adult patients with acute hypoxemic respiratory failure. Methods We retrospectively reviewed the medical records of the subjects with acute hypoxemic respiratory failure supported by HFNC therapy in the medical intensive care unit between July 2011 and March 2013. Therapy success was defined as the avoidance of intubation. The patients' baseline characteristics and the serial changes in the respiratory parameters after HFNC therapy at 1 and 24 hours were measured. Results Of the 75 eligible patients, 62.7% successfully avoided intubation. Overall, HFNC therapy significantly improved the physiologic parameters, such as partial pressure of arterial oxygen (PaO2), saturation of arterial oxygen (SaO2), respiratory rate (RR), and heart rate (HR), throughout the first 24 hours. After the adjustment for the other clinical variables, Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), cardiogenic pulmonary edema, and PaO2 improvement at 1 and 24 hours were associated with therapy success. The overall intensive care unit (ICU) mortality was 25.3%. However, out of 37.3% of the patients who required intubation, the ICU mortality in this proportion of patients was 67.9%. The ICU mortality in the therapy failure group was associated with the use of a vasopressor and a limited PaO2 improvement at 1 hour. Conclusion HFNC therapy showed a good compliance and the improvement of the physiologic parameters in an adult population. The failure to improve oxygenation within 24 hours was a useful predictor of intubation. Among the failure group, the vasopressor use and failed oxygenation improvement were associated with ICU mortality.

Background: Parenchymal lung destruction secondary to tuberculosis is often associated with chronic airflow limitation and bronchodilators are used empirically in patients with tuberculosis-destroyed lung and chronic airflow obstruction (TDL-CAO). Aims and objectives: This multicenter retrospective study examined the impact of bronchodilators on the annual change in the forced expiratory volume in 1 second (FEV 1 ) in TDL-CAO patients. Methods: The study classified 126 patients with TDL-CAO into three groups: 1) patients without bronchodilators between two pulmonary function tests (PFTs); 2) patients with bronchodilators from before the initial PFT until the last PFT; and 3) patients with bronchodilators after the initial PFT until the last PFT. Results: The median FEV 1 declined by 21 and 10 mL/yr in groups 1 and 2, respectively, while it increased by 11 mL/yr in group 3 ( P for trend = 0.009). The annual decline in FEV 1 did not differ between groups 1 and 2, while theannual decline in FEV 1 in group 3 was significantly slower than in groups 1 and 2 ( P = 0.026), even after adjusting for covariates (adjusted P = 0.049). Conclusions: Long-term bronchodilator use does not affect the lung function decline in TDL-CAO patients, but the improvement in FEV 1 after bronchodilator initiation appears to delay the disease course, suggesting that bronchodilator use be considered in TDL-CAO patients.

Background: In patients with chronic obstructive pulmonary disease (COPD), the extent of physical activity is correlated with disease severity and prognosis. In elderly patients with COPD, the determinants of physical activity will differ from those of younger patients. Aim and objectives: We assessed the levels of physical activity and clinical characteristics associated with low-level activity in elderly COPD patients. Methods: This was a multicenter study of 160 elderly patients with COPD. Health-related quality of life was measured using St. George's Respiratory Questionnaire (SGRQ), and anxiety and depression status were assessed employing the Hospital Anxiety and Depression (HAD) scale. Multivariate logistic regression was performed to identify independent predictors of low-level physical activity. Results: Of all the 160 patients, 103 (64.4%) engaged in low-level physical activity. Upon univariate analysis, a decreased distance in the 6-min walk test (6MWD < 250 m), an increased score on the modified Medical Research Council dyspnea scale (mMRC ≥2), the total SGRQ score, and an HAD depression score ≥8, were significantly associated with low-level physical activity. Upon multivariate analysis, an mMRC grade ≥2 [hazard ratio (HR) 2.550; 95% confidence interval (CI) 1.075∼6.049; p=0.034], and an HAD depression score ≥8 (HR 2.076; 95% CI 1.016∼4.241; p=0.045) were independently associated with low-level physical activity. Conclusions: Two-thirds of elderly patients with COPD reported low levels of physical activity. The severity of dyspnea and depressive mood were independently associated with low-level physical activity in elderly COPD patients.

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is used widely to diagnose intrathoracic granulomatous lymphadenopathy (IGL). 1 Histological, microbiological, and molecular tests are the mainstay for diagnosing IGL, while there is little information on tuberculosis-polymerase chain reaction (TB-PCR) using EBUS-TBNA samples. Aims and objectives: This study describes the efficacy of TB-PCR using EBUS-TBNA samples in IGL patients. Methods: A retrospective study examining a prospectively collected database. The pathology was classified into five grades: I) granulomatous reaction with caseation; II) granulomatous reaction without caseation; III) necrosis; IV) non-specific; and V) inadequate. 2 Results: Forty-two patients were diagnosed with IGL [15 tuberculous lymphadenitis (TBL), 27 sarcoidosis]. TB-PCR was performed in 37 patients (13 TBL, 24 sarcoidosis); 7 of the 13 TBL patients (54%) were TB-PCR positive. Of the seven patients whose histological results were non-diagnostic (grades IV and V), four were diagnosed with TBL based on a positive TB-PCR, preventing further invasive evaluations such as mediastinoscopy. Conclusion: TB-PCR of EBUS-TBNA samples is useful for diagnosing IGL.

Introduction Previous studies have shown that plasma free amino acid (PFAA) profiles are altered in cancer patients compared with healthy controls. A multivariate index based on PFAAs was generated from a Japanese dataset and has been previously demonstrated to be clinically valuable for discriminating patients in the early stages of lung cancer. However, it remains unclear whether similar PFAA profile changes occur in cancer patients from other populations. Therefore, this study aimed to validate the performance of this index in discriminating lung cancer patients from controls in the Korean population. Methods Samples were collected from a total of 142 Korean subjects (72 lung cancer/70 controls) for this study. PFAAs were quantified by high-performance liquid chromatography–electrospray ionization-mass spectrometry, and the clinical performance characteristics of the amino acid multivariate index were evaluated across cancer stages and histological types. Results The concentrations of several PFAAs were significantly decreased in the Korean lung cancer patients compared with the controls. Significant decreases in threonine, citrulline, histidine and tryptophan and increases in proline, isoleucine, phenylalanine and ornithine were observed, which are similar to the PFAA changes reported by a previous Japanese study. The area under the receiver-operator characteristic curve (AUC of the ROC) for the index was 0.80, and similar performances were demonstrated for the different histological types. Conclusions These results suggest that the amino acid multivariate index previously developed from a Japanese dataset has the potential to aid in the early detection of lung cancers of different histological types in Korean patients.

Background and objective We evaluated the clinical utility of rapid identification of microorganisms in bronchoalveolar lavage (BAL) fluid using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) in terms of the clinical outcomes of ventilated patients with pneumonia. Methods Patients for whom microorganisms were identified via MALDI-TOF MS (from March 2013 to February 2014; post-intervention group) were compared with patients for whom microorganisms were identified using conventional methods (from March 2012 to February 2013; pre-intervention group). All pneumonia types (community-acquired, hospital-acquired, healthcare-associated and ventilator-associated pneumonia) were included in the analysis. Results In total, 77 patients (50 men, mean age 67.2 ± 12.5 years) were included (40 patients in the pre-intervention group and 37 in the post-intervention group). The time from BAL fluid collection to microorganism identification and the availability of antimicrobial susceptibility results was shorter in the post- compared with the pre-intervention group (51.9 ± 11.3 vs 67.3 ± 17.4 h, P

Purpose The purpose of the study is to evaluate outcomes and objective parameters related to poor prognosis in patients who were defined as prolonged acute mechanical ventilation (PAMV; ventilator care ≥ 96 hours) in the medical intensive care unit of a university-affiliated tertiary care hospital in Korea. Material and methods We analyzed retrospectively clinical data gathered from the medical records on day 4 of MV between 2008 and 2013. In total, 311 were categorized as PAMV. Results Their median age was 67 years (range, 18-93 years), and 71.7% were male. The 28-day mortality rate after intensive care unit admission was 34.7%. Four variables on day 4 of mechanical ventilation (need for neuromuscular blockers [hazard ratio {HR}, 2.432; 95% confidence interval, 1.337-4.422], need for vasopressors [HR, 2.312; 95% confidence interval, 1.258-4.248], need for hemodialyses [HR, 1.913; 95% confidence interval, 1.018-3.595], and body mass index ≤ 21 kg/m 2 [HR, 1.827; 95% confidence interval, 1.015-3.288]) were independent factors associated with mortality based on a Cox proportional hazards model. As the number of these prognostic factors increased, the survival rate decreased. Conclusions Four clinical factors (body mass index ≤ 21, requirement for neuromuscular blockers, vasopressors, and hemodialysis) on day 4 of mechanical ventilation were associated with 28-day mortality in PAMV patients.

Summary Aims Brain-type glycogen phosphorylase (BGP) is the major isoform of glycogen phosphorylase found in fetal and neoplastic tissues, and is generally thought to induce glucose supply during an ischaemic period. This study was performed to investigate BGP expression in non-small-cell lung carcinoma (NSCLC). Methods A total of 119 cases of NSCLC, including 63 squamous cell carcinomas (SqCCs) and 56 adenocarcinomas (ACs), were imunohistochemically evaluated for BGP expression, and its expression was correlated with clinico-pathological parameters. Results In total, 76.5% were positive, while non-neoplastic bronchial epithelial cells were weakly positive and pneumocytes were negative. High BGP expression was noted in 78.6% of ACs and 36.5% of SqCCs ( p = 0.001). Microvessel density was higher in the low BGP expression tumours (29.6 ± 16.9/mm 2 ) than in the high expression tumours (22.8 ± 13.8/mm 2 ) ( p = 0.017). BGP expression did not correlate with patient age or tumour stage, but was more frequent in females than males. Kaplan-Meier analysis showed that high BGP expression was associated with poorer survival ( p = 0.032). Conclusions BGP is expressed in NSCLC, particularly AC, and is an independent poor prognostic factor.

This paper presents a fully observable and global kinematic calibration method for a parallel manipulator. A constraint operator is introduced to constrain a mobile platform with a planar table and digital indicators. Taking calibration data from the optimal configurations makes the kinematic parameters fully observed while shifting a constraint plane leads to the global calibration. We eliminate the concern over the poor parameter observability due to the constrained movements and the local calibration due to a single planar constraint. The low-cost and high-accuracy digital indicators are used as a device to check if the constrained movement is completed. Using only one planar table for a mechanical fixture avoids the misalignment of multiple constraint planes. We apply the calibration method to the Stewart–Gough platform. Calibration results verify that the method, which improves the robustness under the constrained movements, is a fully observable and global calibration manner.

Objective: To identify the computed tomography (CT) findings to predict recurrent bleeding in patients with massive hemoptysis. Methods: Fifty-eight patients with massive hemoptysis underwent both CT and conventional bronchial angiography for bronchial artery embolization. Retrospective analysis was done to analyze the statistical differences in the initial CT findings between the nonrecurrent and recurrent hemoptysis groups using the Mann-Whitney U test and the Χ 2 or Fisher exact test. Stepwise logistic regression analysis was used to find predictive variables for the recurrence of hemoptysis. Results: After embolization, recurrence of hemoptysis was observed in 15 of 58 patients (26%). The diameter of bronchial (P= 0.001) and nonbronchial systemic arteries (P < 0.05), total number of dilated bronchial and nonbronchial systemic arteries (P = 0.001), pleural thickening (P = 0.01), extrapleural fat thickening (P = 0.004), and enhancing vascular structures within the extrapleural fat layer (P = 0.04) were significantly different in the nonrecurrent and recurrent hemoptysis groups. Stepwise logistic regression analysis showed that the total number of dilated bronchial and nonbronchial systemic arteries (odds ratio, 3.540; 95% confidence interval: 1.175, 10.662; P = 0.025) was a significant CT variable associated with the recurrence of hemoptysis. Conclusions: CT bronchial angiography may help in the prediction of recurrent bleeding in patients with massive hemoptysis.

Identification of pathogenic Mycobacterium species is important for a successful diagnosis of mycobacteriosis. The purpose of this study was to develop an oligonucleotide array which could detect and differentiate mycobacteria to the species level by using the internal transcribed spacer (ITS) sequence. Using a genus-specific probe and 20 species-specific probes including two M. avium-intracellulare complex (MAC)-specific probes, we have developed an ITS-based oligonucleotide array for the rapid and reliable detection and discrimination of M. tuberculosis , MAC, M. fortuitum , M. chelonae , M. abscessus , M. kansasii , M. gordonae , M. scrofulaceum , M. szulgai , M. vaccae , M. xenopi , M. terrae , M. flavescens , M. smegmatis , M. malmoense , M. simiae , M. marinum , M. ulcerans , M. gastri , and M. leprae . All mycobacteria were hybridized with a genus-specific probe (PAN-03) for detection of the genus Mycobacterium . Mycobacterial species were expected to show a unique hybridization pattern with species-specific probes, except for M. marinum and M. ulcerans , which were not differentiated by ITS-based probe. Among the species-specific probes, two kinds of species-specific probes were designed for MAC in which there were many subspecies. The performance of the oligonucleotide array assay was demonstrated by using 46 reference strains, 149 clinical isolates, and 155 clinical specimens. The complete procedure (DNA extraction, PCR, DNA hybridization, and scanning) was carried out in 4.5 h. Our results indicated that the oligonucleotide array is useful for the identification and discrimination of mycobacteria from clinical isolates and specimens in an ordinary clinical laboratory.

We report a rare case of multidrug-resistant pulmonary and testicular tuberculosis (TB) in a 25-year-old immunocompetent patient. The patient was suspected to have a testicular cancer. He underwent radical orchiectomy, and surgical pathology revealed a granuloma containing acid-fast bacilli in the testis. Bronchial washing fluid culture grew Mycobacterium tuberculosis resistant to isoniazid, rifampin, and ethambutol. To our knowledge, this patient represents the first case of testicular TB in multidrug-resistant pulmonary TB.

This paper examines the parameter observability of a calibration system that consrains a mobile platform to a planar table to take the calibration data. To improve the parameter observability, we find the optimal configurations providing the calibration with maximum contribution. The QR-decomposition is used to compute the optimal configurations that maximize the linear independence of rows of an observation matrix. The calibration system is applied to the parallel type manipulator constructed for a machining center. The calibration results show that all the necessary kinematic parameters assigned in a Stewart-Gough platform are identifiable and convergent to desirable accuracy.

Medicinal mushrooms are increasingly used to treat a wide variety of disease processes. Aqueous extract from the fruiting body or mycelia of Phellinus linteus has been reported to produce antitumor and immunomodulatory activities in vivo and in vitro. However, the therapeutic mechanism has not been known. In the present study, we investigated whether proteoglycan (PL) isolated from P. linteus has an effect on the immunomodulatory activities of the murine splenic lymphocytes (MSLs). Treatment with PL caused a four-fold augmentation in [3H]thymidine incorporation compared to untreated control group in MSLs. Flow cytometric analysis indicated that the affected cell population was mainly CD19(+) cells, but not CD3(+) cells. These data suggested that the main target of PL was the B cells, but not T cells. PL also enhanced the expression of co-stimulatory molecules, CD80 and CD86, in murine B cells in a time-dependent manner. Accordingly, we investigated if intracellular [Ca(2+)] and reactive oxygen intermediates (ROI) were the principal downstream components that contributed to PL-induced activation, with respect to both increases of proliferation and induction of co-stimulatory molecules. However, PL has no influence on the [Ca(2+)] concentration and the ROI formation in murine B cells, whereas the genistein, protein tyrosine kinase (PTK) inhibitor or staurosporine, protein kinase C (PKC), blocked the proliferation and the induction of co-stimulatory molecules, CD80 and CD86, in B cells stimulated with PL. Taken together, these data suggest that PL is a biological response modifier that stimulates proliferation and expression of co-stimulatory molecules in B cells, probably by regulating PTK and PKC signaling pathways.

Wastewater treatment processes are usually located in rural seclusion. we designed an unmanned and automated control system for a sequencing batch reactor (SBR) wastewater treatment pilot plant. The pilot plant was constructed in the countryside, a small distance from a large city. Networks and wireless modules were employed for data transmission. A local controller was installed in the SBR pilot plant as a client, and a monitoring system was located in another place as a server. The communication system consisted of an asymmetric digital subscriber line (ADSL) network and a code division multiple access (CDMA) module. A remote control and monitoring system were constructed in a laboratory in the city. We describe a fuzzy inference system which was constructed with the operator's assistance, and acquired sensor data to determine the threshold and influent.

This paper studies the observability of calibration system with a constraint movement by a constraint operator. The calibration system with the constraint movement need only simple sensing device to check whether the constraint movements are completed within an established range. However, it yields the concern about the poor parameter observability due to the constraint movements. This paper uses the QR-decomposition to find the optimal calibration configurations maximizing the linear independence of rows of a observation matrix. The number of identifiable parameters are examined by the rank of the observation matrix, which represents the parameter observability. The method is applied to a parallel typed machining center and the calibration results are presented. These results verify that the calibration system with low-cost indicators and simple planar table is accurate as well as reliable.

Purpose. To evaluate the feasibility of using a serially passaged culture of human nasal epithelial cell monolayers on a permeable support for in vitro drug transport studies. The optimum conditions for passaged culture as well as the correlation between the transepithelial electrical resistance (TEER) value and drug permeability (Papp) were evaluated.

This paper introduces a constraint operator for the kinematic calibration of a parallel mechanism. By adopting the concept of a constraint operator, the movement between two poses is constrained. When the constrained movements are satisfied, the active joint displacements are taken and inputted into the kinematic model to compute the theoretical movements. A cost function is derived by the errors between the theoretical movement and the actual movement. The parameters that minimize the cost function are estimated and substituted into the kinematic model for a kinematic calibration. A single constraint plane is employed as a mechanical fixture to constrain the movement, and three digital indicators are used as the sensing devices to determine whether the constrained movement is satisfied. This calibration system represents an effective, low cost and feasible technique for a parallel mechanism. A calibration algorithm is developed with a constraint operator and implemented on a parallel manipulator constructed for a machining center tool.

The primary culture of human nasal epithelial cell monolayer was performed on a Transwell. The effect of various factors on the tight junction formation was observed in order to develop an in vitro experimental system for nasal transport studies. Human nasal epithelial cells, collected from human normal inferior turbinates, were plated onto diverse inserts. After 4 days, media of the apical surface was removed for air-liquid interface (ALI) culture. Morphological characteristics was observed by transmission electron microscopy (TEM). A polyester membrane of pore size was determined as the most effective insert based on the change in the transepithelial electric resistance (TEER) value as well as the transport study. The ALI method was effective in developing the tight junction as observed in the further increase in the TEER value and reduction in the permeability coefficient of transport. Results of the transport study of a model drug, budesonide, showed that the primary culture system developed in this study could be further developed and applied for in vitro nasal transport studies.

We present three cases of successful chemical pleurodesis with a liquid solution of mistletoe extract using a spray catheter during medical thoracoscopy. The medical thoracoscopy was performed in all presented cases to remove pleural effusion and conduct chemical pleurodesis to manage symptomatic malignant pleural effusion. A spray catheter was used to instil the mistletoe extract evenly into the pleural cavity, and there were no pleurodesis-related complications. Respiratory symptoms caused by pleural effusion improved after pleurodesis, and successful pleurodesis was maintained for more than 3 months after medical thoracoscopy in all three patients.

Background The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. Methods Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50). The infusion of nicardipine or remifentanil was started before the 1st incision and adjusted to keep mean blood pressure (MBP) within ±20% of the preoperative value. SPI, BIS, end-tidal desflurane concentration (EtDes), MBP, and heart rate were recorded at 2.5 minute intervals from the 1st incision to the end of surgery. Extubation and recovery times, pain score/rescue ketorolac consumption, and adverse events in postanesthesia care unit (PACU) were recorded. Results The trend of SPI during surgery was comparable between the 2 groups (P = 0.804), although the heart rates in group N were significantly higher than those in group R (P = 0.040). The patient characteristics, trends of BIS, EtDes, and MBP during surgery, extubation and recovery times, and incidence of nausea/vomiting were comparable between the groups. Group N had significantly lower pain scores and rescue ketorolac consumption at PACU. Conclusion SPI was comparable between patients receiving nicardipine or remifentanil infusion during thyroidectomy under general anesthesia, which suggests that the administration of nicardipine may confound the interpretation of SPI values during general anesthesia. Clinical trial registration This trial was registered in the UMIN clinical trials registry (unique trial number: UMIN000019058; registration number: R000022028; principal investigator's name: Young Ju Won; date of registration: September 17, 2015).

This research develops an underwater construction robot to level rubbles on the seabed for port construction. The rubble leveling is carried out by an underwater robot equipped with imaging sonars and underwater cameras, LBL and gyroscope sensors. A virtual reality system is developed to visualize the robot"s figure and the topography over the working environment; hence, the robot is virtually tele-operated by an operator. This paper presents the robot’s system and control, and it describes the working process of the rubble leveling carried out by the robot. In addition, the performance of the robot is demonstrated through the experimental results in subsea. The working speed of the robot is faster than that of a human diver, and the robot can work longer than the diver who can work for a limited time to prevent submarine sickness. The robot is expected to have much higher efficiency in deep water where a human diver is unable to work.

This research develops two types of heavy robots to cover breakwater with armour stones. The robots assemble the armour stones weighing over two tons on the surface of the breakwater to protect it from storming waves. For construction above sea level, a robot named Stone Man is developed, whereas for construction below sea level, a robot named Stone Diver is built. In addition, Underwater Filming Device (UFD) is designed to film objects in turbid water. Stone Man is designed by a parallel mechanism which enables to handle heavy armour stones dexterously. Stone Diver is developed to work in subsea by waterproofing Stone Man. UFD films objects through the clean water in a transparent box. Stone Diver works with UFD to assemble armour stones in turbid water. Its efficiency depends on the operator’s skill but Stone Diver is expected to have much higher efficiency in deep water where human divers are unable to work. Furthermore, while the work is being carried out, UFD is capturing a live video of working process which is recorded for supervisory data so that the work quality can be easily managed.

Clinical prediction indicators such as the pneumonia severity index (PSI) and CURB-65 score are useful, but they are complex and often not followed. Therefore, biomarkers that improve hospital outcome predictions are emerging. This study evaluated the prognostic value of a new sepsis biomarker, serum lysophosphatidylcholine (LPC) concentrations, in community-acquired pneumonia (CAP) patients. We prospectively collected blood samples from emergency department CAP patients on days 1 and 7 (post-admission) and analyzed their plasma LPC concentrations. We retrospectively reviewed patient medical records and analyzed correlations between plasma LPC concentrations and clinical parameters and hospital outcomes. A total of 56 CAP patients were included in this study; 24 (42.9 %) required intubation and 15 (26.8 %) died. The mean LPC concentrations on days 1 (p = 0.015) and 7 (p = 0.002) of hospitalization were significantly lower in the non-survivors. Day 1 LPC concentrations were inversely correlated with the PSI (ρ = −269) and CURB-65 scores (ρ = −386). For predicting hospital mortality, the day 1 LPC concentration was comparable with the CURB-65 or PSI scores. Day 1 LPC cut-off levels

Performance management of computer networks is intended to improve a given network performance in order for more efficient information exchange between subsystems of an integrated large-scale system. Importance of perfomance management is growing as many functions of the large- scale system depend on the quality of communication services provided by the network. The role of performance management is to manipulate the adjustable protocol parameters on line so that the network can adapt itself to a dynamic environment. This can be divided into two subtasks : performance evaluation to find how changes in protocol parameters affect the network performance and decision making to determine the magnitude and direction of parameter adjustment. This paper is the first part of the two papers focusing on conceptual design, development, and evaluation of performance management for token bus networks. This paper specifically deals with the task of performance evaluation which utilizes the principle of perturbation analysis of discrete event dynamic systems. The developed algorithm can estimate the network performance under a perturbed protocol parameter setting from observations of the network operations under a nominal parameter setting

A double parallel manipulator (DPM) is composed of two parallel mechanisms with a central aids. The device is expected to have large workspace by reducing interference between links and to avoid singularity by constraining its motion. To prove this, workspace and singularity are analyzed. The workspace of the device is decoupled into a positional and an orientational workspace, each of which is computed and compared with that of a Stewart platform. The singularities occurring outside the workspace are analytically found at the configurations where a Jacobian matrix becomes rank deficient. To ascertain the analytical results, they are geometrically examined at the configurations where the duty for resisting forces and moments is not properly shared by a central axis and linear actuators due to losing static equilibrium. The geometrical results are coincident to the analytical results, which proves the DPM is free from the singularity problem.

For enlarging workspace and avoiding singularities, a double parallel manipulator has been designed by combining two parallel mechanisms with a central axis. The motion of the device is decoupled and constrained by the central axis. This leads to simplicity in geometric constraints but needs a novel strategy for the mechanism analysis. Based on the geometric constraints, the paper develops the formulation for inverse/forward kinematics and Jacobian to be implemented in real time position and velocity controls. These are used for propeller grinding to measure the surface of a casting blade and to grind the removal depth. A dynamic formulation for the parallel mechanism composed of one passive and n-active link trains is derived from motor algebra and a virtual coefficient. The formulation can compute the forces and moments acting at the passive joints as well as the active ones. Workspace and singularities are also analyzed to prove the advantage of the device.

The determination of the direct kinematics of a parallel mechanism is a difficult problem but must be solved for practical application. This paper presents the efficient formulation of the direct kinematics and the Jacobian of a double parallel robot arm for velocity control. The robot arm consists of two parallel mechanisms, and a central axis that generates positional and orientational motions independently. Given a set of lengths for the linear actuators, the direct kinematics computes the position and orientation of the end-effector, and the Jacobian transforms the velocities of the end-effector to those of the linear actuators. The developed formulation is implemented in a real-time control setting and its efficiency is demonstrated.

Gamma-aminobutyric acid (GABA), synthesized by glutamate decarboxylase (GAD), plays an important role in plants. To study the molecular mechanism of GAD regulation and to examine the levels of GABA in Scutellaria baicalensis, we isolated cDNA clones (SbGAD1 and 2) encoding GAD from S. baicalensis. The open reading frames of SbGAD1 and 2 were 1,503 and 1,494 bp long and had 450 and 497 amino acid residues, respectively. Quantitative real-time RT-PCR analysis was performed to show the variation of transcript levels among different organs of S. baicalensis. Transcript levels of SbGAD1 and 2 were highest in the root and flower, respectively. The GABA content of different parts (ranked in descending order) was as follows: leaf > flower > stem > root. We concluded that the expression pattern of SbGAD1 and 2 did not match the accumulation pattern of GABA in different organs. We presume that GABA biosynthesis might be more controlled by SbGAD2 than SbGAD1. These data will aid in future studies that seek to understand the mechanisms underlying GABA biosynthesis, an important amino acid that is synthesized by the GAD enzyme. To explain adequately the GABA biosynthesis mechanisms in S. baicalensis, the enzyme activities of SbGAD1 and 2 should be determined in the near future.

This letter proposes a degradation and cognition model to estimate speech quality impairment because of packet loss concealment (PLC) algorithm implemented in the speech CODEC SILK. By considering the fact that the quality degradation caused by packet loss is highly related to the PLC algorithm, the impact of quality degradation on various types of previous and lost packet classes is analyzed. Then, the PLC effects to the proposed class types are measured by the class conditional expectation of the degradation scores. Finally, the cognition module is derived to estimate the total quality degradation in a mean opinion score (MOS) scale. When assessed for correlation with subject test results, the correlation coefficient of the encoder-based class model is 0.93, and that of the decoder-based model is 0.87.