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We develop a non-covalently fused ring acceptor, CPDT–ICMe, to achieve P3HT-based organic solar cells with high-performance (8.17%) and excellent thermal stability.

Small-molecule acceptor (SMA)-based organic solar cells (OSCs) have achieved high power conversion efficiencies (PCEs), while their long-term stabilities remain to be improved to meet the requirements for real applications. Herein, we demonstrate the use of donor-acceptor alternating copolymer-type compatibilizers (DACCs) in high-performance SMA-based OSCs, enhancing their PCE, thermal stability, and mechanical robustness simultaneously. Detailed experimental and computational studies reveal that the addition of DACCs to polymer donor (

Nonfused ring acceptors (NFRAs) have attracted significant attention for nonfullerene organic solar cells (OSCs) owing to their chemical tunability and facile synthesis. In this study, a benzotriazole-based NFRA with chlorinated end groups (Triazole-4Cl) is developed to realize highly efficient and thermally stable NFRA-based OSCs; an analogous NFRA with nonchlorinated end groups (Triazole-H) is synthesized for comparison. Triazole-4Cl film exhibits the high-order packing structure and the near-infrared absorption capability, which are advantageous in charge transport and light harvesting of the resulting OSCs. In particular, the strong crystalline behavior of Triazole-4Cl results in enhanced self-aggregation, leading to high charge carrier mobility. Owing to these properties, a PBDB-T (polymer donor):Triazole-4Cl OSC demonstrates a high short-circuit current, fill factor, and power conversion efficiency (PCE = 10.46%), outperforming a PBDB-T:Triazole-H OSC (PCE = 7.65%). In addition, the thermal stability of a PBDB-T:Triazole-4Cl OSC at an elevated temperature of 120 °C exceeds that of a PBDB-T:Triazole-H OSC. This is mainly attributed to the significantly higher cold crystallization temperature of Triazole-4Cl (205.9 °C). This work provides useful guidelines for the design of NFRAs to achieve efficient and thermally stable NFRA-based OSCs.

Pluronic® triblock copolymers, which spontaneously form nano-sized aggregates in water, have been considered as promising carriers for bioimaging and drug delivery. However, their use for applications in pharmacology and diagnostics is hindered by instability of polymer aggregates which are easily dissociated into unimers. Here we report a general method for stabilizing Pluronic® F127 micelles via semi-interpenetrating network (sIPN). The formation of sIPN within a core stabilizes the micelle upon temperature and concentration changes. We determined optimized methods for the preparation of F127 sIPN in the regime of chemical components. Importantly, F127 sIPNs are able to load various organic fluorescence probes, covering a panchromatic range of photoluminescence (350–850 nm; entire UV–Vis-NIR), without compromising their photophysical properties. Moreover, efficient cellular uptake of the fluorescence probes loaded sIPN is observed in human and mouse cells. After intravenous injection into mice, an infrared dye-loaded sIPNs are incorporated in multiple organs and have longer lifetime than a commercially available imaging probe. With the improvement of stability, Pluronic micelles with sIPN can be a powerful tool for building functional nanoprobes and in vivo fluorescence imaging for cancer cells and live animals.

T cells proliferate vigorously following acute depletion of CD4 + Foxp3 + T regulatory cells [natural Tregs (nTregs)] and also when naive T cells are transferred to syngeneic, nTreg-deficient Rag1 −/− hosts. Here, using mice raised in an antigen-free (AF) environment, we show that proliferation in these two situations is directed to self ligands rather than food or commensal antigens. In both situations, the absence of nTregs elevates B7 expression on host dendritic cells (DCs) and enables a small subset of naive CD4 T cells with high self affinity to respond overtly to host DCs: bidirectional T/DC interaction ensues, leading to progressive DC activation and reciprocal strong proliferation of T cells accompanied by peripheral Treg (pTreg) formation. Likewise, high-affinity CD4 T cells proliferate vigorously and form pTregs when cultured with autologous DCs in vitro in the absence of nTregs: this anti-self response is MHCII/peptide dependent and elicited by the raised level of B7 on cultured DCs. The data support a model in which self tolerance is imposed via modulation of CD28 signaling and explains the pathological effects of superagonistic CD28 antibodies.

This study describes the synthesis and characterization of a series of regioregular dithieno(3,2-b;2′,3′-d)-silole (DTSi)- and dithieno(3,2-b;2′,3′-d)-germole (DTGe)-based small molecules—7,7′-(4,4-bis(2-ethylhexyl)-4H-silolo[3,2-b:4,5-b′]dithiophene-2,6-diyl)bis(5-fluoro-4-(5′-hexyl-[2,2′-bithiophen]-5-yl)benzo[c][1,2,5]thiadiazole) (DTSi(BTFTh2)2), 7,7′-(4,4-bis(2-ethylhexyl)-4H-germolo[3,2-b:4,5-b′]dithiophene-2,6-diyl)bis(5-fluoro-4-(5′-hexyl-[2,2′-bithiophen]-5-yl)benzo[c][1,2,5]thiadiazole) (DTGe(BTFTh2)2), 7,7′-(4,4-bis(2-ethylhexyl)-4H-silolo[3,2-b:4,5-b′]dithiophene-2,6-diyl)bi-s(4-(benzofuran-2-yl)-5-fluorobenzo[c][1,2,5]thiadiazole) (DTSi(BTFBFu)2), and 7,7′-(4,4-bis(2-ethylhexyl)-4H-germolo[3,2-b:4,5-b′]dithiophene-2,6-diyl)bis(4-(benzofuran-2-yl)-5-fluorobenzo[c][1,2,5]thiadiazole) (DTGe(BTFBFu)2) (DTSi(BTFTh2)2, DTGe(BTFTh2)2, DTSi(BTFBFu)2, and DTGe(BTFBFu)2 in which two F atoms are in a symmetric distal/distal configuration relative to the central core units. The optical and electrochemical properties are strongly influenced owing to changes of the terminal units (BFu and Th2) rather than by the tuning of the core units (DTSi and DTGe). In addition to a high fraction of the edge-on orientation in the neat films of all of the molecules, the presence of hexyl side chains in the Th2 terminal units are found to play a critical role in forming high-quality films, leading to homogeneous and smooth surfaces in the films of Th2-containing molecules. When used as donor materials in small-molecule:fullerene solar cells, the best power-conversion efficiency of 3.26% was achieved with the DTSi(BTFTh2)2-based system. Our study herein provides a relevant step toward understanding such isomorphic small molecules.

A new family of naphthalenediimide (NDI)-bithiophene-based random terpolymers (PNDI-Fu10, PNDI-Th10, and PNDI-Se10) was prepared by incorporating a small amount (10 mol%) of different chalcogenophene units, namely furan (Fu), thiophene (Th), and selenophene (Se), into a poly((N,N’-bis(2-octyldodecyl)-naphthalene-1,4,5,8-bis(dicarboximide)-2,6-diyl)-alt-5,5′-(2,2′-bithiophene)) (P(NDI2OD-T2)) backbone. The terpolymers all exhibited negligible optical property and frontier energy level differences. Interestingly, the blend film morphology and photovoltaic performance of all-polymer solar cells (all-PSCs), comprising a random terpolymer series as an acceptor and poly(6-fluoro-2,3-bis-(3-octyloxyphenyl)quinoxaline-5,8-dyl-alt-thiophene-2,5-diyl) (FTQ) as a donor, were strongly dependent on the type of chalcogenophene. Consequently, the all-PSCs revealed a clear variation in short-circuit current density (JSC) and fill factor (FF) while retaining identical open-circuit voltages (VOC). The greatest power-conversion efficiency of 5.88% with a high JSC of 10.77 mA cm−2 was observed for PNDI-Th10:FTQ because of a synergistic contribution from a more preferential π-face-on orientation and suppression of bimolecular/geminate recombination. This was confirmed by a detailed investigation on the morphology and charge dynamic structural properties. In addition to understanding their effects on photovoltaic characteristics, this study demonstrates that introducing a small amount of the chalcogenophenes into a well-performing polymer is a simple and effective method to improve JSC values while maintaining VOCs of the parent polymers.

Food antigens drive spontaneous IgE elevation in the absence of microbiota by inducing IL-4–producing T follicular helper cells., Immunoglobulin E (IgE), a key mediator in allergic diseases, is spontaneously elevated in mice with disrupted commensal microbiota such as germ-free (GF) and antibiotics-treated mice. However, the underlying mechanisms for aberrant IgE elevation are still unclear. Here, we demonstrate that food antigens drive spontaneous IgE elevation in GF and antibiotics-treated mice by generating T helper 2 (TH2)–skewed T follicular helper (TFH) cells in gut-associated lymphoid tissues (GALTs). In these mice, depriving contact with food antigens results in defective IgE elevation as well as impaired generation of TFH cells and IgE-producing cells in GALT. Food antigen–driven TFH cells in GF mice are mostly generated in early life, especially during the weaning period. We also reveal that food antigen–driven TFH cells in GF mice are actively depleted by colonization with commensal microbiota. Thus, our findings provide a possible explanation for why the perturbation of commensal microbiota in early life increases the occurrence of allergic diseases.

CD4 T cells differentiate into RORγt/IL-17A-expressing cells in the small intestine following colonization by segmented filamentous bacteria (SFB). However, it remains unclear whether SFB-specific CD4 T cells can differentiate directly from naïve precursors, and whether their effector differentiation is solely directed towards the Th17 lineage. In this study, we used adoptive T cell transfer experiments and showed that naïve CD4 T cells can migrate to the small intestinal lamina propria (sLP) and differentiate into effector T cells that synthesize IL-17A in response to SFB colonization. Using single cell RT-PCR analysis, we showed that the progenies of SFB responding T cells are not uniform but composed of transcriptionally divergent populations including Th1, Th17 and follicular helper T cells. We further confirmed this finding using in vitro culture of SFB specific intestinal CD4 T cells in the presence of cognate antigens, which also generated heterogeneous population with similar features. Collectively, these findings indicate that a single species of intestinal bacteria can generate a divergent population of antigen-specific effector CD4 T cells, rather than it provides a cytokine milieu for the development of a particular effector T cell subset.

A primary characteristic of autism, which is a neurodevelopmental disorder, is impaired social interaction and communication. Furthermore, patients with autism frequently show abnormal social recognition. In mouse models of autism, social recognition is usually assessed by examining same-sex social behavior using various tests, such as the three-chamber test. However, no studies have examined the ability of male mice with autism to recognize the estrous cycle of female partners. In this study, we investigated the sexual behaviors, especially mounting and ultrasonic vocal communication (USV), of BTBR T+ tf/J (BTBR) mice, which are used as a well-known mouse model of autism, when they encountered estrus or diestrus female mice. As expected, C57BL/6 mice mounted more female mice in the estrus stage compared with the diestrus stage. We found that BTBR mice also mounted more female mice in the estrus stage than female mice in the diestrus stage. Although the USV emission of male mice was not different between estrus and diestrus female mice in both strains, the mounting result implies that BTBR mice distinguish sexual receptivity of females.

Taxi fleets are suitable for the first stage of deployment of electric vehicles (EV) because EV taxis can provide chances for more people to experience EV. However, the lack of charging facilities and limited operation range are barriers to the adoption of EV taxis. As EV taxis can charge when there is no passenger in the vehicle, the conventional origin-destination (OD)-based flow-interception method for the charging station problem is not appropriate. In this study, we present a new EV taxi charging facility planning model that uses the trajectory-interception method with real taxi trajectory data and electric vehicle operation data. Global positioning system (GPS) data from 1,000 vehicles (taxis) and taxi battery performance data from three EVs are used. We developed an optimization algorithm to find optimal charger distribution considering charger installation cost and waiting delay simultaneously based on the evolution algorithm. The results show that the maintenance cost of the chargers and ...

The synthesis and characterization of two new small molecular donor materials, DTGe(ThFBTTh2)2 and DTGe(FBTTh3)2, are presented for application in organic solar cells. These two materials represent structural evolutions of the high-efficiency, dithienogermole (DTGe)-cored small molecule DTGe(FBTTh2)2, in which the conjugation length in the backbone was extended by incorporating additional thiophene units. Using the same molecular framework, we have evaluated how the anchoring sequence of heterocyclic units influences material properties and function in solar cell devices. It was found that incorporating additional thiophene units into the backbone, regardless of the position in the molecular platform, caused a small reduction in band gaps; however, both highest occupied molecular orbitals and lowest unoccupied molecular orbital energy bands were at lower energies when the thiophenes were incorporated near the terminus of the molecule. The film morphologies of both materials could be controlled by either t...

Direct effects of antibiotics in lung DC-mediated immune tolerance, Immune tolerance in the lung is important for preventing hypersensitivity, such as allergic asthma. Maintenance of tolerance in the lung is established by coordinated activities of poorly understood cellular and molecular mechanisms, including participation of dendritic cells (DCs). We have previously identified DC expression of the signaling molecule TRAF6 as a non-redundant requirement for the maintenance of immune tolerance in the small intestine of mice. Because mucosal tissues share similarities in how they interact with exogenous antigens, we examined the role of DC-expressed TRAF6 in the lung. As with the intestine, we found that the absence TRAF6 expression by DCs led to spontaneous generation of Th2-associated immune responses and increased susceptibility to model antigen-induced asthma. To examine the role of commensal microbiota, mice deficient in TRAF6 in DCs were treated with broad-spectrum antibiotics and/or re-derived on a germ-free (GF) background. Interestingly, we found that antibiotics-treated specific pathogen-free, but not GF, mice showed restored immune tolerance in the absence of DC-expressed TRAF6. We further found that antibiotics mediate microbiota-independent effects on lung T cells to promote immune tolerance in the lung. This work provides both a novel tool for studying immune tolerance in the lung and an advance in our conceptual understanding of potentially common molecular mechanisms of immune tolerance in both the intestine and the lung.

Background Although various reconstructive flap surgeries have been successfully performed, there still are difficult wound complications, such as seroma formation, wound margin necrosis, delayed wound healing, and even flap failures. The negative-pressure wound therapy has been described in detail in the literature to assist open chronic/complex wound closure in reconstructive surgery. However, the negative-pressure wound therapy was difficult to be applied under the incisional closed wounds. Methods A total of 23 patients underwent the various reconstructive flap surgeries with continuous high-pressure negative suction drain. Instead of using regular suction units, Barovac (50-90 mm Hg, Sewoon Medical, Seoul, Republic of Korea) drainage tubes were connected to the wall suction unit, providing continuous high-powered negative pressure. In addition, continuous subatmospheric suction pressure (100-300 mm Hg) was applied. Outcome of the measures was obtained from the incidence of seroma, volume of postoperative drainage, hospitalization period, and incidence of other typical wound complications. Dead space was evaluated postoperatively with ultrasonography. Results Using continuous high-pressure negative suction drain, successful management of seroma was obtained without any major complication such as wound infection, flap loss, and wound margin necrosis, except for only 1 case of seroma after discharge from the hospital. The indwelling time of the drain in the latissimus dorsi donor site was significantly reduced in comparison with the authors' previous data (P = 0.047). The volume of drainage and hospitalization period were also reduced; however, these were not statistically significant. The dead space with continuous high-pressure negative suction drain was more reduced than in the control group in the immediate postoperative period and confirmed with ultrasonography. Conclusions Continuous high-pressure negative suction drain might be the simple and powerful solution in the management of challenging closed wounds.

Osteoclast maturation and function primarily depend on receptor activator of NF-κB ligand (RANKL)-mediated induction of nuclear factor of activated T cells c1 (NFATc1), which is further activated via increased intracellular calcium ([Ca(2+)](i)) oscillation. However, the coordination mechanism that mediates Ca(2+) oscillation during osteoclastogenesis remains ill defined. Here, we identified transmembrane protein 64 (Tmem64) as a regulator of Ca(2+) oscillation during osteoclastogenesis. We found that Tmem64-deficient mice exhibit increased bone mass due in part to impaired osteoclast formation. Using in vitro osteoclast culture systems, we show here that Tmem64 interacts with sarcoplasmic endoplasmic reticulum Ca(2+) ATPase 2 (SERCA2) and modulates its activity. Consequently, Tmem64 deficiency significantly diminishes RANKL-induced [Ca(2+)](i) oscillation, which results in reduced Ca(2+)/calmodulin-dependent protein kinases (CaMK) IV and mitochondrial ROS, both of which contribute to achieving the CREB activity necessary for osteoclast formation. These data demonstrate that Tmem64 is a positive modulator of osteoclast differentiation via SERCA2-dependent Ca(2+) signaling.

Backgrounds: In the present study, we aimed to examine the anti-aging properties of human placental hydrolysate (HPE) and dieckol (DE) from Ecklonia cava against free radical scavenging, muscle hypertrophy-related follistatin mRNA expression, amelioration of cognition-related genes and proteins, inhibition of collagenase-regulating genes, and elastinase activity. Methods: The anti-aging effects were examined in human fibroblast (CCD986sk), mouse myoblast (C2C12), and neuroblastoma (N2a) cell models, by employing various assays such as 2,2-diphenyl-1-picrylhydrazyl hydrate (DPPH) scavenging, hydroxyl radical-mediated oxidation, quantitative real-time polymerase chain reaction, enzyme activity, and immunocytochemistry observation. Results: Our results show that HPE combined with DE (HPE: DE) strongly scavenged DPPH radicals and protected proteins against degradation by hydroxyl radical attack. HPE: DE effectively inhibited matrix metalloproteinase-1 expression, protein kinase C alpha expression, and elastinase activity. Furthermore, HPE: DE improved the expression of cognition-related genes (choline acetyltransferase and vesicular acetylcholine transporter). These events may proactively contribute to retard the aging processes and the abrupt physiological changes probably induced by mitochondrial dysfunction with aging. Conclusions: Based on these findings, we conclude that the combined treatment of HPE: DE may be useful for anti-aging therapy in which the accumulation of oxidative damage is the main driving force.

Liposarcoma develops extremely rarely in the oesophagus. Microscopically, it exhibits subtle atypia of H&E-stained features. Accordingly, immunohistochemical features and chromosomal alterations are used for its confirmatory diagnosis. However, cytogenetic analysis has not been performed for oesophageal liposarcoma. We studied chromosomal alterations using array comparative genomic hybridization (CGH), as well as endoscopic, radiological, H&E-stained and immunohistochemical features in the oesophageal well-differentiated liposarcoma of a 67-year-old man. Array CGH analysis revealed the presence of high-level amplifications at chromosomal locations 1p12-1q21.2, 12q13.2-12q15 and 12q21.33-12q23.1. At least 29 genes were highly amplified (log(2) ratio >2), among which CDK4 and MDM2 were the most highly amplified (log(2) ratio >4) and were accepted as major target genes. Moreover, the amplification of AMDHD1, HAL and LTA4H (log(2) ratio = 3.153) was a novel finding. This case suggests the presence of a characteristic profile of gene amplification in well-differentiated liposarcoma of the oesophagus. The amplified genes may be of pathogenic importance for primary oesophageal well-differentiated liposarcoma.

Looking at the application examples related to RFID systems around the world, it is easy to find that RFID systems are introduced in various industries, such as retail and consumer goods sectors, financial and security sectors, automotive and transport sector, leisure and sports sector, logistics, and health-related fields. This is because they can get their operational efficiency and competitiveness by means of product`s visibility and transparency of information through RFID systems. However, it is required that evaluation of effectiveness on introducing RFID systems should be performed to strengthen construction willingness of RFID systems before actual introduction of the RFID systems in the process. This activity affects to introduction of RFID systems in industry-wide and then, will be able to create a synergy effect such as national industrial competitiveness improvement. The purpose of this study is to offer rational method on effectiveness analysis before and after RFID based process. Accordingly, the proposed Choquet fuzzy integral-based model will be allowed rational analysis by integrating quantitative and qualitative analysis. Through the effectiveness analysis of C company`s RFID based process using the proposed evaluation model, we could identify that RFID-based logistics process was more effective than existing process.

The SWI/SNF chromatin-remodeling complex functions as a transcriptional regulator and plays a significant role in cell proliferation, differentiation and embryonic development. SRG3, a homologue of human BAF155, is a core component of the mouse SWI/SNF chromatin remodeling complex. Mutant mice deficient in Srg3 expression are peri-implantation lethal. To investigate the role of SRG3 in the post-implantation stage, we generated SRG3 transgene-rescued (Srg3−/−Tg+) embryos by inducing exogenous gene expression. These Srg3−/−Tg+ embryos overcame early embryonic lethality and extended the life span until mid-gestation. However, the embryos displayed significant defects in blood vessel formation and fetal circulation within the yolk sac around embryonic day 10.5, which led to developmental retardation and death. We found that SRG3 expression was absent in the visceral endoderm of Srg3−/−Tg+ yolk sacs, while SRG3 was normally expressed in wild-type embryos. In addition, expression of angiogenesis-related genes, including Angiopoietin1, Tie2, EphrinB2, Ihh and Notch1, was markedly reduced in Srg3−/−Tg+ yolk sacs. During normal angiogenesis, maturation of the visceral endoderm development is observed in the yolk sac. However, in Srg3−/−Tg+ yolk sacs, the visceral endoderm did not develop normally. Our results indicate that SRG3 is required for angiogenesis and visceral endoderm development in the yolk sac.

Background: The sail sign is a well-known radiographic feature of the pediatric chest. This sign can be observed in an adult population as well, but for a different reason. Purpose: To investigate the sail sign appearing in adult chest radiography. Material and Methods: Based on two anecdotal adult cases in which frontal chest radiographs showed the sail sign, we prospectively screened radiographs of 10,238 patients to determine the incidence of the sail sign found in adults in their 40s or older. The cause of the sail sign was assessed using computed tomography (CT). Results: The sail sign was revealed in 10 (seven males, three females; median age 60.6 years) of 10,238 patients. Of these 10 patients with a sail sign on frontal radiographs, eight underwent CT. The frontal radiographs of these 10 patients showed a concave superior margin toward the lung in nine patients, a concave inferior margin in five, and a double-lined inferior margin in three. Lateral radiographs disclosed a focal opacity over the minor fissure in five of six patients, which was either fuzzy ( n = 4) or sharp ( n = 1) in its upper margin, and was sometimes double lined in the inferior margin ( n = 3). CT revealed the anterior mediastinal fat to be the cause of the radiographic sail sign, which stretched laterally from the mediastinum to insinuate into the minor fissure. Conclusion: The incidence of sail sign on adult chest radiographs is about 0.1%. The sign is specific enough to eliminate the need for more sophisticated imaging.

PURPOSE The aim of this study was to analyze clinical characteristics of skeletal metastasis in epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) and treatment outcomes of continued EGFR tyrosine kinase inhibitor (TKI) therapy in patients presenting with skeletal metastasis progression. MATERIALS AND METHODS Of the 216 patients treated with EGFR-TKI for management of stage III-IV NSCLC between 2006 and 2012 in Seoul St. Mary's Hospital, 76 patients with confirmed EGFR-mutated NSCLC with skeletal metastases during therapy were analyzed retrospectively. RESULTS Of 76 patients with EGFR mutant lung cancer with skeletal metastasis, 37 patients developed first progressive disease (PD) in skeletal regions. EGFR-TKI was continued in these 37 patients after first PD in skeletal regions. Median time to first PD of skeletal regions was 8.9 months (95% confidence interval [CI], 4.8 to 13.0). Median time of continued EGFR-TKI after first PD of skeletal regions was 8.0 months (95% CI, 2.9 to 13.0) in patients with disease progression of preexisting regions, 5.6 months (95% CI, 4.5 to 6.7) in patients showing new localized regions, and 3.3 months (95% CI, 1.1 to 5.5) in patients with multiple new metastatic regions (p=0.006). Median time of postskeletal metastasis progression survival was 23.0 months (95% CI, 13.5 to 32.5), 15.0 months (95% CI, 3 to 34.7), and 7.0 months (95% CI, 6.0 to 8.0) (p=0.004) in the above described patient groups, respectively. Overall, seven patients (18.9%) had more than one episode of skeletal progression of disease without extraskeletal PD. CONCLUSION Continued EGFR-TKI treatment with adequate local treatment after progression of skeletal metastasis may be considered for patients who show disease progression in preexisting regions or local progression.

Keeping immune cells quiet on a diet Over thousands of years, our immune systems has evolved to distinguish self from foreign, perpetrating attacks on microbes but not ourselves. Given this, why do we fail to mount an immune response against most of the food we eat? Kim et al. compared normal mice, mice lacking microbes, and mice lacking microbes that were fed an elemental diet devoid of dietary antigens (see the Perspective by Kuhn and Weiner). Dietary antigens normally induced a population of suppressive immune cells called regulatory T cells in the small intestine. The cells were distinct from regulatory T cells induced by microbial antigens and prevented strong reactions against food. Science , this issue p. 858 ; see also p. 810

OBJECTIVE. The purpose of our study was to evaluate the efficacy of imaging-guided percutaneous radiofrequency ablation of metastatic pulmonary nodules caused by hepatocellular carcinoma.CONCLUSION. Percutaneous radiofrequency ablation is feasible and can be a promising method for the local control of metastatic pulmonary nodules caused by hepatocellular carcinoma, especially when they are limited in number.

The purpose of our prospective study was to assess the image quality with respect to the radiation dose incurred by multidetector CT (MDCT) in patients with suspected bronchiectasis. SUBJECTS AND METHODS. Image clusters, composed of nine images, using MDCT (120 kVp, a 2.5-mm collimation, a pitch of 6, and 2.5-mm reconstruction intervals) were obtained at each of two levels-the azygous arch and the right inferior pulmonary vein-at 170, 100, 70, 40, 20, and 10 mA. Independently, two chest radiologists assessed and compared the quality of the images obtained at the six milliamperage exposures. Image quality was graded using a 5-point scale with lung and mediastinal window settings. Radiation doses were measured at each of the six milliamperage settings while scanning the whole lung of a thoracic phantom using MDCT.The mean image quality scores at exposures of 170, 100, 70, 40, 20, 10 mA were as follows: 3.9, 3.7, 3.8, 3.2, 2.5, 1.6 at lung window settings and 4.1, 4.3, 4.0, 3.4, 2.3, 1.3 at mediastinal window settings, respectively. Images obtained at 70 mA were rated significantly better than those obtained at 40 mA or less (p0.01). The mean radiation dose at 170, 100, 70, 40, 20, 10 mA was 23.72, 14.39, 10.54, 5.41, 2.74, and 1.50 mGy, respectively.With a tube current setting as low as 70 mA, MDCT provides images of acceptable quality and volumetric data sets for the evaluation of bronchiectasis. The trade-off of using MDCT rather than conventional high-resolution CT is that the radiation dose is five times higher with MDCT (10.54 mGy) than with conventional high-resolution CT (2.17 mGy with parameters of 120 kVp, 170 mA, 1-mm collimation, and 10-mm intervals).

OBJECTIVE. The purpose of our study was to describe the radiographic and CT findings in patients with pulmonary infections caused by Mycobacterium abscessus, one of the more common rapidly growing nontuberculous mycobacteria that cause lung disease.CONCLUSION. The main radiologic and CT manifestations of M. abscessus lung infection are bilateral small nodular opacities, bronchiectasis, and cavity formation.

Although various reconstructive flap surgeries have been successfully performed, there still are difficult wound complications, such as seroma formation, wound margin necrosis, delayed wound healing, and even flap failures. The negative-pressure wound therapy has been described in detail in the literature to assist open chronic/complex wound closure in reconstructive surgery. However, the negative-pressure wound therapy was difficult to be applied under the incisional closed wounds.A total of 23 patients underwent the various reconstructive flap surgeries with continuous high-pressure negative suction drain. Instead of using regular suction units, Barovac (50-90 mm Hg, Sewoon Medical, Seoul, Republic of Korea) drainage tubes were connected to the wall suction unit, providing continuous high-powered negative pressure. In addition, continuous subatmospheric suction pressure (100-300 mm Hg) was applied. Outcome of the measures was obtained from the incidence of seroma, volume of postoperative drainage, hospitalization period, and incidence of other typical wound complications. Dead space was evaluated postoperatively with ultrasonography.Using continuous high-pressure negative suction drain, successful management of seroma was obtained without any major complication such as wound infection, flap loss, and wound margin necrosis, except for only 1 case of seroma after discharge from the hospital. The indwelling time of the drain in the latissimus dorsi donor site was significantly reduced in comparison with the authors' previous data (P = 0.047). The volume of drainage and hospitalization period were also reduced; however, these were not statistically significant. The dead space with continuous high-pressure negative suction drain was more reduced than in the control group in the immediate postoperative period and confirmed with ultrasonography.Continuous high-pressure negative suction drain might be the simple and powerful solution in the management of challenging closed wounds.

The purpose of this study was to determine whether color and power Doppler twinkling artifacts could be considered an additional diagnostic sonographic feature of urinary stones.A prospective study was performed in 32 patients with 20 renal stones and 16 ureteral stones to assess how often urinary stones show twinkling artifacts on Doppler sonography. Gray-scale images and color, power, and spectral Doppler images were obtained in all patients. All sonographic examinations were performed with a 3.5- or 5-MHz curvilinear phased array probe. The images were then analyzed for the presence, appearance, and intensity of the artifacts. Phantom experiments were performed with various kinds of urinary stones with high-megahertz linear phased array probes. The effects on the artifacts of the composition of the stones, of the Doppler velocity scale, and of the focal zone were investigated.Thirty (83%) of 36 urinary stones showed color and power Doppler twinkling artifacts, which appeared as a rapidly changing color complex seen persistently behind stones like a comet's tail. Twenty-two of 30 stones with the twinkling artifacts showed strong intensity artifacts. Spectra with saturated amplitude were obtained from all 30 stones showing color Doppler artifacts. In phantom experiments, the artifacts originated from all stones. The velocity range did not affect the artifacts, whereas focal zone did.Color Doppler twinkling artifacts from urinary stones occur frequently and may be considered an additional sonographic feature of urinary stones. The observation of these artifacts may be helpful in determining the presence of urinary stones.

Objective To describe the thin-section CT findings of arc-welders' pneumoconiosis. Materials and Methods Eighty-five arc-welders with a three to 30 (mean, 15)-year history of exposure underwent thin-section CT scanning. The extent of abnormalities detected was correlated with the severity of dyspnea and pulmonary function tests. For comparison, images of 43 smoking males (mean 25 pack-year) who underwent thin-section CT for other reasons (smokers' group) were also analyzed. Results Fifty-four welders (63.5%) and six smokers (14.0%) showed positive findings. Predominant thin-section CT findings were poorly-defined centrilobular micronodules (30/54, 55.6%), branching linear structure (18/54, 33.3%), and ground-glass attenuation (6/54, 11.1%). In the smokers' group, poorly-defined micronodules were found in four patients, branching linear structures in one, and ground-glass attenuation in one. In welders, the extent of abnormalities seen on thin-section CT showed no significant correlation with the severity of dyspnea or the results of pulmonary funotion test. Conclusion Poorly-defined centrilobular micronodules and branching linear structures were the thin-section CT findings most frequently seen in patients with arc-welders' pneumoconiosis. Less commonly, extensive ground-glass attenuation was also seen.

TRAF6 is critical for Toll-like receptor (TLR)-mediated activation of dendritic cells (DCs). Recently, by studying mice DC-specific deletion of TRAF6 (TRAF6ΔDC) we have reported that TRAF6 expression in DCs is important to prevent a spontaneous Th2-associated gut inflammatory disease. To formally demonstrate an involvement of commensal microbiota, we have generated TRAF6ΔDC bone marrow chimeras under germ-free (GF) conditions. Unexpectedly, the Th2-associated disease in GF TRAF6ΔDC chimeras was exacerbated compared with TRAF6ΔDC chimeras generated under conventional conditions. Finally, to test whether the Th2-associate disease is driven by dietary antigens (Ags), we established TRAF6ΔDC bone marrow chimeras in “Ag-free” mice, in which GF mice are raised with a chemically-defined elemental diet devoid of macromolecules. Strikingly, the induction of a spontaneous intestinal Th2-associated inflammatory disease was dramatically averted in “Ag-free” TRAF6ΔDC chimeras, indicating that TRAF6 expression in DCs is essential to establish and/or maintain oral tolerance to dietary Ags.

Superselective intraarterial injections of thiopental sodium solution for evaluation of local brain function were performed before embolization in 38 consecutive patients with supratentorial arteriovenous malformations to evaluate the role of the test using thiopental sodium solution. Thiopental sodium (30–50 mg) was injected in 68 arteries (44 middle cerebral arteries, 13 anterior cerebral arteries, 7 posterior cerebral arteries, 3 external carotid arteries, and 1 thalamo-perforating artery) through superselective microcatheters just before the injection of cyanoacrylate mixture for the embolization. The test was negative in 57 arteries and there were neurologic dysfunctions in 3 of them after embolization. The neurologic deficits in these cases were caused by reflux of embolic material, spasm of the main arterial trunk, or neglected mild sensory change, respectively, and there was no real false-negative test. The embolization could not be performed due to positive test in 9 arteries. Two arteries with positive tests but acceptable symptoms were embolized and the same neurologic deficits developed immediately after embolization. There was no local arterial complication by an injection of the thiopental sodium solution. All neurologic deficits caused by positive tests developed immediately and were completely relieved within 5 min without specific management. Superselective intraarterial injection of thiopental sodium solution is a safe and reliable test for the evaluation of local brain function before embolization of supratentorial arteriovenous malformations.

Pulmonary lymphangioleiomyomatosis (LAM) is a rare, idiopathic disorder that predominantly affects the lung parenchyma of women of childbearing age. While the characteristic radiographic finding of pulmonary LAM consists of multiple well-defined thin-walled cysts, we describe a very unusual case of pulmonary LAM with multiple bilateral large pulmonary nodules and retroperitoneal involvement mimicking metastatic malignancy. A 48-year-old woman who had never smoked with a history of bilateral pneumothorax presented with progressive exertional dyspnea and abdominal discomfort. Imaging studies revealed multiple enlarged retroperitoneal lymph nodes, ascites and bilateral multiple large pulmonary nodules ranging from 3 to 18 mm in diameter. Exploratory laparoscopic surgery for intra-abdominal lesions and video-assisted thoracoscopic wedge resection of lung nodules were carried out to rule out metastatic malignancy. Pathology showed benign looking smooth muscle cell proliferation and immunoreactivity for α-smooth muscle actin and HMB-45 in both specimens. After treatment with GnRH antagonist, the patient was well over a 6-month period without evidence of disease progression.

Transforming growth factor-β (TGF-β) has an essential role in the generation of inducible regulatory T (iTreg) and T helper 17 (Th17) cells. However, little is known about the TGF-β–triggered pathways that drive the early differentiation of these cell populations. Here, we report that CD4+ T cells lacking the molecular adaptor tumor necrosis factor (TNF) receptor-associated factor 6 (TRAF6) exhibit a specific increase in Th17 differentiation in vivo and in vitro. We show that TRAF6 deficiency renders T cells more sensitive to TGF-β–induced Smad2/3 activation and proliferation arrest. Consistent with this, in TRAF6-deficient T cells, TGF-β more effectively down-regulates interleukin-2 (IL-2), a known inhibitor of Th17 differentiation. Remarkably, TRAF6-deficient cells generate normal numbers of Foxp3-expressing cells in iTreg differentiation conditions where exogenous IL-2 is supplied. These findings show an unexpected role for the adaptor molecule TRAF6 in Smad-mediated TGF-β signaling and Th17 differentiation. Importantly, the data also suggest that a main function of TGF-β in early Th17 differentiation may be the inhibition of autocrine and paracrine IL-2–mediated suppression of Th17 cell generation.

The tumor necrosis factor (TNF) superfamily consists of a wide variety of cell-bound and secreted proteins that regulate numerous cellular processes. In particular, TNF-family proteins regulate the proliferation and death of tumor cells, as well as activated immune cells. This overview discusses the mammalian TNF receptor-associated factors (TRAFs), of which TRAF1, 2, 3, 5, and 6 have been shown to interact directly or indirectly with members of the TNF receptor superfamily. Structural features of TRAF proteins are described along with a discussion of TRAF-interacting proteins and the signaling pathways activated by the TRAF proteins. Finally, we examine the phenotypes observed in TRAF-knockout mice.

TRAF6 is critical for Toll-like receptor (TLR)-mediated activation of dendritic cells (DCs). Recently, by studying mice DC-specific deletion of TRAF6 (TRAF6ΔDC) we have reported that TRAF6 expression in DCs is important to prevent a spontaneous Th2-associated gut inflammatory disease. We also found amelioration of TRAF6ΔDC disease by treatment with broad-spectrum antibiotics, suggesting a role for commensal microbiota. To formally demonstrate an involvement of commensal microbiota, we have now generated TRAF6ΔDC bone marrow chimeras under germ-free (GF) conditions. Unexpectedly, the Th2-associated disease in GF TRAF6ΔDC chimeras was exacerbated compared with TRAF6ΔDC chimeras generated under conventional conditions, indicating a beneficial role of commensal microbiota. Moreover, treatment of GF TRAF6ΔDC chimeras with broad-spectrum antibiotics also ameliorated the Th2-associated disease, suggesting a previously unrealized direct immunomodulating effect of antibiotics. Finally, to test whether the Th2-associate disease is driven by dietary antigens (Ags), we established TRAF6ΔDC bone marrow chimeras in “Ag-free” mice, in which GF mice are raised with a chemically-defined elemental diet devoid of macromolecules. Strikingly, the induction of a spontaneous intestinal Th2-associated inflammatory disease was dramatically averted in “Ag-free” TRAF6ΔDC chimeras, indicating that TRAF6 expression in DCs is essential to establish and/or maintain oral tolerance to dietary Ags.

We have previously generated a mouse model of spontaneous Th2-associated disease of the small intestine called TRAF6 Delta DC, in which dendritic cell (DC)-intrinsic expression of the signaling mediator TRAF6 is ablated. Interestingly, broad-spectrum antibiotic treatment ameliorates TRAF6 Delta DC disease, implying a role for commensal microbiota in disease development. However, the relationship between the drug effects and commensal microbiota status remains to be formally demonstrated. To directly assess this relationship, we have now generated TRAF6 Delta DC bone marrow chimera mice under germ-free (GF) conditions lacking commensal microbiota, and found, unexpectedly, that Th2-associated disease is actually exacerbated in GF TRAF6 Delta DC mice compared to specific pathogen-free (SPF) TRAF6 Delta DC mice. At the same time, broad-spectrum antibiotic treatment of GF TRAF6 Delta DC mice has an ameliorative effect similar to that observed in antibiotics-treated SPF TRAF6 Delta DC mice, implying a commensal microbiota-independent effect of broad-spectrum antibiotic treatment. We further found that treatment of GF TRAF6 Delta DC mice with broadspectrum antibiotics increases Foxp3(+) Treg populations in lymphoid organs and the small intestine, pointing to a possible mechanism by which treatment may directly exert an immunomodulatory effect. To investigate links between the exacerbated phenotype of the small intestines of GF TRAF6 Delta DC mice and local microbiota, we performed microbiotic profiling of the luminal contents specifically within the small intestines of diseased TRAF6 Delta DC mice, and, when compared to co-housed control mice, found significantly increased total bacterial content characterized by specific increases in Firmicutes Lactobacillus species. These data suggest a protective effect of Firmicutes Lactobacillus against the spontaneous Th2-related inflammation of the small intestine of the TRAF6 Delta DC model, and may represent a potential mechanism

Insulin plays a critical role in whole-body energy homeostasis by regulating lipid and glucose metabolism. In fat and liver tissues, ADD1/SREBP1c is a key transcription factor to mediate insulin-dependent regulation of gene expression. Although transcriptional and proteolytic activation of ADD1/SREBP1c has been studied intensively, the mechanism by which insulin regulates expression of its target genes with ADD1/SREBP1c at the chromatin level is unclear. Here, we reveal that SWI/SNF chromatin remodeling factors interact with the ADD1/SREBP1c and actively regulate insulin-dependent gene expression. Insulin enhanced recruitment of SWI/SNF chromatin remodeling factors to its target gene promoters with concomitant changes in the chromatin structures as well as gene expression. Furthermore, in vivo overexpression of BAF155/SRG3, a component of the SWI/SNF complex, substantially promoted insulin target gene expression and insulin sensitivity. Taken together, our results suggest that the SWI/SNF chromatin remodeling complexes confer not only insulin-dependent gene expression but also insulin sensitivity in vivo via interaction with ADD1/SREBP1c.

To examine the combined effects of monitor luminance and ambient light on observer performance for detecting abnormalities in a soft-copy interpretation of digital chest radiographs.A total of 254 digital chest radiographs were displayed on a high-resolution cathode ray tube monitor at three luminance levels (25, 50, and 100 foot-lamberts) under three ambient light levels (0, 50, and 460 lux). Six chest radiologists reviewed each image in nine modes of combined luminance and ambient light. The observers were allowed to adjust the window width and level of the soft-copy images. The abnormalities included nodule, pneumothorax, and interstitial disease. Observer performance was analyzed in terms of the receiver operating characteristics. The observers reported their subjective level of visual fatigue with each viewing mode. A statistical test was conducted for each of the abnormalities and for fatigue score by using repeated-measures two-way analysis of variance with an interaction.The detection of nodules was the only reading that was affected by the ambient light with a statistically significant difference (P.05). Otherwise, observer performance for detecting a nodule, pneumothorax, and interstitial disease was not significantly different in the nine-mode comparison. There was no evidence that the luminance of the monitors was related to the ambient light for any of the abnormalities. The fatigue score showed a statistically significant difference due to both the luminance and ambient light.When adequate window width and level are applied to soft-copy images, the primary diagnosis with chest radiographs on the monitor is unlikely to be affected under low ambient light and a monitor luminance of 25 foot-lamberts or more.