Clinical Practice Guidelines for the Management of Atypical Hemolytic Uremic Syndrome in Korea.

Atypical hemolytic uremic syndrome (aHUS) is a rare syndrome characterized by micro-angiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. The major pathogenesis of aHUS involves dysregulation of the complement system. Eculizumab, which blocks complement C5 activation, has recently been proven as an effective agent. Delayed diagnosis and treatment of aHUS can cause death or end-stage renal disease. Therefore, a diagnosis that differentiates aHUS from other forms of thrombotic microangiopathy is very important for appropriate management. These guidelines aim to offer recommendations for the diagnosis and treatment of patients with aHUS in Korea. The guidelines have largely been adopted from the current guidelines due to the lack of evidence concerning the Korean population.

Effect of Stepwise Doping on Lifetime and Efficiency of Blue and White Phosphorescent Organic Light Emitting Diodes.

We investigated a light emission mechanism of blue phosphorescent organic light emitting diodes (PHOLEDs), using a stepwise doping profile of 2, 8, and 14 wt.% within the emitting layer (EML). We fabricated several blue PHOLEDs with phosphorescent blue emitter iridium(III) bis[(4,6-difluorophenyl)-pyridinato-N,C2]picolinate doped in N,N'-dicarbazolyl-3,5-benzene as a p-type host material. A blue PHOLED with the highest doping concentration as part of the EML close to an electron transporting layer showed a maximum luminous efficiency of 20.74 cd/A, and a maximum external quantum efficiency of 10.52%. This can be explained by effective electron injection through a highly doped EML side. Additionally, a white OLED based on the doping profile was fabricated with two thin red EMLs within a blue EML maintaining a thickness of 30 nm for the entire EML. Keywords: Blue Phosphorescent Organic Light Emitting Diodes, Stepwise Doping Structure, Charge Trapping Effect.

Performance improvement of green phosphorescent organic light emitting diodes with partial bulk heterojunctioned emitting layer.

Green phosphorescent organic light emitting diodes (PHOLEDs) were developed using a mixed layer system. They were fabricated with 4,4'-N,N'-dicarbazolyl-biphenyl (CBP) and typical charge transporting materials, which are 4,4'-bis[N-(naphthyl)-N-phenylamino]biphenyl (NPB) as a hole transporting material and 1,3,5-tris(N-phenylbenzimidazole-2-yl)benzene (TPBi) as an electron transporting material, mixed at each interface in a stacked organic layer to reduce the hole injection barrier and extend the recombination zone. We introduced a mixed layer for the hole transporting layer side, the electron transporting layer side, and on both sides to make a bulk heterojunction. This reduced the driving voltage, and the luminous efficiency (LE) was increased to 500 cd/m2. The optimized device showed a maximum LE of 59.87 cd/A and a maximum external quantum efficiency of 17.52%.

Flexible bottom-emitting white organic light-emitting diodes with semitransparent Ni/Ag/Ni anode.

We fabricated a flexible bottom-emitting white organic light-emitting diode (BEWOLED) with a structure of PET/Ni/Ag/Ni (3/6/3 nm)/ NPB (50 nm)/mCP (10 nm)/7% FIrpic:mCP (10 nm)/3% Ir(pq)(2) acac:TPBi (5 nm)/7% FIrpic:TPBi (5 nm)/TPBi (10 nm)/Liq (2 nm)/ Al (100 nm). To improve the performance of the BEWOLED, a multilayered metal stack anode of Ni/Ag/Ni treated with oxygen plasma for 60 sec was introduced into the OLED devices. The Ni/Ag/Ni anode effectively enhanced the probability of hole-electron recombination due to an efficient hole injection into and charge balance in an emitting layer. By comparing with a reference WOLED using ITO on glass, it is verified that the flexible BEWOLED showed a similar or better electroluminescence (EL) performance.

Semi-transparent a-IGZO thin-film transistors with polymeric gate dielectric.

We report the fabrication of semi-transparent a-IGZO-based thin-film transistors (TFTs) with crosslinked poly-4-vinylphenol (PVP) gate dielectric layers on PET substrate and thermally-evaporated Al/Ag/Al source and drain (S&D) electrodes, which showed a transmittance of 64% at a 500-nm wavelength and sheet resistance of 16.8 omega/square. The semi-transparent a-IGZO TFTs with a PVP layer exhibited decent saturation mobilities (maximum approximately 5.8 cm2Ns) and on/off current ratios of approximately 10(6).

Phosphorescence white organic light-emitting diodes with single emitting layer based on isoquinolinefluorene-carbazole containing host.

We have demonstrated a stable phosphorescent white organic light-emitting diodes (WOLEDs) using an orange emitter, Bis(5-benzoyl-2-(4-fluorophenyl)pyridinato-C,N) iridium(III)acetylacetonate [(Bz4Fppy)2Ir(III)acac] doped into a newly synthesized blue host material, 2-(carbazol-9-yl)-7-(isoquinolin-1-yl)-9,9-diethylfluorene (CzFliq). When 1 wt.% (Bz4Fppy)2Ir(III)acac was doped into emitting layer, it was realized an improved EL performance and a pure white color in the OLED. The optimum WOLED showed maximum values as a luminous efficiency of 10.14 cd/A, a power efficiency of 10.24 Im/W, a peak external quantum efficiency 4.07%, and Commission Internationale de L'Eclairage coordinates of (0.34, 0.39) at 8 V.

Efficient green phosphorescent organic light-emitting diodes depending on concentration of lithium quinolate in electron transport layer.

Systematic studies on carrier injection and transport are very important for achieving high efficiency in OLEDs. We demonstrate excellent green phosphorescent organic light-emitting diodes (OLED) with lithium quinolate (Liq) doped in 1,3,5-tris(N-phenylbenzimidazole-2-yl) benzene (TPBi) as the electron transport layer (ETL). The doping concentration of Liq was varied from 0% to 10%. The optimized green phosphorescent OLED with 5% Liq in the ETL showed the best efficiencies, which were maximum luminous efficiency, power efficiency, and quantum efficiency of 65.76 cd/A, 57.39 Im/W, and 20.03%, respectively. Moreover, high triplet energy states of TCTA and TPBi as a triplet exciton-blocking layer (TEBL) played a role in efficient exciton confinement.

Geriatric Nutritional Risk Index as a Prognostic Factor for Renal Progression in Patients with Type 2 Diabetes Mellitus.

The aim of this study was to evaluate whether the geriatric nutritional risk index (GNRI) is associated with chronic kidney disease (CKD) progression in patients with type 2 diabetes mellitus (DM). In total, 1100 patients with type 2 DM with a follow-up duration > 1 year were included in this longitudinal study. The risk of CKD progression was assessed according to GNRI quartiles. Patients in the lowest GNRI quartile exhibited a significantly lower estimated glomerular filtration rate (eGFR), compared with those in quartile four. Moreover, these patients had poorer glycemic control and lower hemoglobin levels, body mass index, and albumin levels. Additionally, they exhibited a greater annual decline in eGFR. Multivariate logistic regression analysis showed that old age (>60 years), baseline eGFR, the presence of proteinuria, the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and low GNRI were significantly associated with CKD progression. GNRI may serve as a valuable predictive tool for identifying the risk of adverse renal outcomes in patients with type 2 DM. It may potentially serve as a more feasible measure for assessing the nutritional status of these patients, as well as for predicting their clinical outcomes.

The malnutrition-inflammation-depression-arteriosclerosis complex is associated with an increased risk of cardiovascular disease and all-cause death in chronic hemodialysis patients.

BACKGROUND: In chronic hemodialysis patients, malnutrition, inflammation, depression and arteriosclerosis are pathogenetically associated suggesting the presence of malnutrition-inflammation-depression-arteriosclerosis (MIDA) complex acting as a risk factor for cardiovascular disease (CVD). METHODS: Nutritional status was assessed by serum albumin, subjective global assessment and normalized protein catabolic rate (nPCR). Inflammation was assessed by serum high-sensitivity C-reactive protein (hsCRP). Depression was assessed with the Beck Depression Inventory and DSM-IV criteria. The severity of arteriosclerosis was measured by pulse wave velocity (PWV). RESULTS: Among 81 hemodialysis patients, 44 (54.3%) had malnutrition (albumin <4.0 mg/dl with subjective global assessment score <6 and/or nPCR <1.0) and 39 (48.1%) had inflammation (hsCRP >1 mg/l). The prevalence of depression was 50.6% (n = 41). Fifty-nine (73.8%) had arteriosclerosis (measured PWV > expected PWV based on age/blood pressure/gender adjustment). The severity of the all four individual MIDA components correlated well with each other. The average number of the MIDA complication (MIDA score) was 2.27 ± 1.33. -During the 5-year follow-up, 40 cases of CVD and 26 cases of all-cause death occurred. In Cox analysis adjusted for -previous CVD, age, diabetes, blood pressure, pulse pressure, intradialytic hypotension, B-type natriuretic peptide, -hemoglobin and hemodialysis incompliance, the MIDA score was an independent predictor of CVD and all-cause death: hazard ratio (95% confidence interval); 1.89 (1.13-3.17) and 3.48 (1.32-9.21) for an increase of 1 MIDA score. CONCLUSIONS: This study suggests the presence of MIDA complex, which is composed of malnutrition, inflammation, depression and arteriosclerosis. The MIDA complex syndrome was an independent risk factor for CVD and all-cause death in chronic hemodialysis patients.

Efficient triplet exciton confinement of blue- and white-organic light emitting diodes using a new host material.

We have demonstrated lower driving voltage and efficient blue phosphorescent organic light emitting diodes (PHOLEDs) using iridium(III) bis[(4,6-di-fluoropheny)-pyridinato-N,C2] picolinate (Flrpic) doped in new host material 9-(4-(triphenylsilyl)phenyl)-9H-carbazole (SPC) and 2,2',2"-(1,3,5-benzenetryl)tris(1-phenyl)-1H-benzimidazol (TPBi) as double-emitting layer (D-EML) system. The D-EML was employed to have good electron transportability and exciton confinement. Additionally, we fabricated white organic light-emitting diode (WOLED) using a phosphorescent red emitter; bis(2-phenylquinolinato)-acetylacetonate iridium III (Ir(pq)2acac) doped in SPC and TPBi as D-EML. The properties of white device exhibited a maximum luminous efficiency of 19.03 cd/A, a maximum external quantum efficiency of 9.91%, and a maximum power efficiency of 12.30 lm/W. It also showed white emission with CIE(x,y) coordinates of (x = 0.38, y = 0.37) at 8 V.

White organic light-emitting diodes for emotion solid-state lighting.

The authors have demonstrated white organic light-emitting diodes for emotion solid-state lighting (ESSL) by using hole modulating layer (HML), N,N'-diphenyl-N,N'-bis-[4-(phenyl-m-tolyl-amino)-phenyl]-biphenyl-4,4'-diamine and N,N'-bis-(1-naphyl)-N,N'-diphenyl-1,1'-biphenyl-4, 4'-diamine, and mixed spacer (MS), 4,4',4"-tris(N-carbazolyl)-triphenylamine and {9,9-dimethyl-7-[10-(naphthalen-2-yl)anthracen-9-yl]-9H-fluoren-2-yl}triphenylsilane, respectively. The HML and MS were used for unbalance of holes and electrons. The ESSL showed various white light chromaticities of Commission Internationale de l'Eclairage coordinates from (0.46,0.42) as warm white emission to (0.29, 0.36) as cold white emission.

Highly efficient blue- and white-organic light-emitting diode based on dual recombination zones with a charge control layer.

Highly efficient blue phosphorescent organic light-emitting diodes are investigated using iridium(Ill) bis[(4,6-di-fluorophenyl)-pyridinato-N,C2']picolinate doped in N,N'-dicarbazolyl-3,5-benzene (mCP) with a charge control layer (CCL) as the dual recombination zone (DRZ) system. DRZ with CCL was used to form a broad recombination zone and exciton confinement within each emission zone. Holes and electrons can be easily transported through the CCL, which were a mixed p-type mCP and n-type 2,2',2"-(1,3,5-benzenetryl) tris(1-phenyl)-1H-benzimidazol, for controlling the carrier movement. The CCL can play a role in triplet exciton blocking as expected from high triplet energy levels as well. Additionally, a white organic light-emitting diode was fabricated using a new phosphorescent orange emitter: bis[2-(2,4-difluorophenyl)pyridinato]iridium 2-(2-hydroxyphenyl)benzothia zolate doped in DRZ. The white device showed a maximum luminous efficiency of 23.15 cd/A, a maximum external quantum efficiency of 9.56%, and a maximum power efficiency of 13.37 lm/W. It also showed white emission with CIEx,y coordinates of (x = 0.33, y = 0.41) at 8 V.

Flexible top-emitting organic light-emitting diodes using semi-transparent multi-metal layers.

In this paper, the improved device performance of top-emitting organic light-emitting diodes (TEOLEDs) with a thin multi-metal layer stack of nickel/silver/nickel (Ni/Ag/Ni) and aluminum/silver/aluminum (Al/Ag/Al) that were used as the anode and cathode on a flexible substrate is discussed. In particular, Indium-Tin-Oxide (ITO) as an anode electrode has been used recently even though it has some problems for flexible devices. Therefore we suggested that a thin multi-metal layer electrode as a new anode is fabricated instead of ITO anode. It was verified that the ITO-free TEOLEDs showed an enhanced probability of the recombination of the electrons and holes through an improved electron/hole charge balance. We also analyzed the optical and electrical characteristics using the current density, luminance, luminance efficiency, external quantum efficiency (EQE), CIE x, y coordinates, and EL spectra of flexible TEOLED devices were characterized. ITO-free, flexible, green-emitting OLEDs with a low cost and a simple process were demonstrated.

Changes in duplex ultrasound parameters during maturation according to arteriovenous access types in incident hemodialysis patients.

BACKGROUND: Little is known about the changes in hemodynamic parameters during arteriovenous (AV) access maturation using duplex ultrasound according to radiocephalic fistula (RCF), brachiocephalic fistula (BCF), and AV graft (AVG) in incident hemodialysis (HD) patient. The objective of this study was to evaluate changes and differences in brachial artery flow rate (BAFR) and related parameters affecting maturation by duplex ultrasound in incident HD patients according to access type. METHODS: This study was an observational study conducted from March 2019 to October 2020. During the study period, 109 incident patients underwent new AV access creation, of which 100 were included in the study. The duplex ultrasound was performed on the day prior to access creation, further, day 1, 2 weeks, and 4 weeks later after access creation in incident HD patients. RESULTS: Among all the patients, 38 (38%) received BCF, while 26 (26%) underwent RCF. Of the patients with AVG, 18 (50%) had a forearm loop AVG. The overall mean age was 62.2 ± 13.8 years (range, 32-89). The BAFR increased about 6.9 times in the RCF, 17.4 times in the BCF, and 19.5 times in the AVG at day 1. The median BAFR measured on day 1 was 580.4 mL/min for RC, 1029.0 mL/min for BC, and 1133.0 mL/min for AVG. Relative to the values measured in week 4, the BAFR on day 1 was 69.5% in RCF, 90.6% in BCF, and 93.9% in AVG. The acceleration decreased most significantly on day 1(p < 0.05). The acceleration time increased significantly on day 1 (p < 0.05) and beyond during maturation in the RCF and BCF. The BAFR of the RCF had a significantly negative correlation with the pulsatility index. The BAFR of the BCF showed a significantly positive correlation with the systolic and diastolic blood pressure but negatively correlated with pulse rate. The BAFR of the AVG showed a significant positive correlation with the diameter of the outflow vein. CONCLUSIONS: There were differences in the clinical and duplex parameters during maturation according to access type. The most dramatic changes of duplex parameters were on the day after AV access creation regardless of AV access types. Though RCF had a lower BAFR rate compared to BCF and AVG, it already had a sufficient BAFR required for adequate HD treatment the day after creation. The BAFR of BCF was not different from that of AVG.

Risk factors for overcorrection of severe hyponatremia: a post hoc analysis of the SALSA trial.

BACKGROUND: Hyponatremia overcorrection can result in irreversible neurologic impairment such as osmotic demyelination syndrome. Few prospective studies have identified patients undergoing hypertonic saline treatment with a high risk of hyponatremia overcorrection. METHODS: We conducted a post hoc analysis of a multicenter, prospective randomized controlled study, the SALSA trial, in 178 patients aged above 18 years with symptomatic hyponatremia (mean age, 73.1 years; mean serum sodium level, 118.2 mEq/L). Overcorrection was defined as an increase in serum sodium levels by >12 or 18 mEq/L within 24 or 48 hours, respectively. RESULTS: Among the 178 patients, 37 experienced hyponatremia overcorrection (20.8%), which was independently associated with initial serum sodium level (≤110, 110-115, 115-120, and 120-125 mEq/L with 7, 4, 2, and 0 points, respectively), chronic alcoholism (7 points), severe symptoms of hyponatremia (3 points), and initial potassium level (<3.0 mEq/L, 3 points). The NASK (hypoNatremia, Alcoholism, Severe symptoms, and hypoKalemia) score was derived from four risk factors for hyponatremia overcorrection and was significantly associated with overcorrection (odds ratio, 1.41; 95% confidence interval, 1.24-1.61; p < 0.01) with good discrimination (area under the receiver-operating characteristic [AUROC] curve, 0.76; 95% CI, 0.66-0.85; p < 0.01). The AUROC curve of the NASK score was statistically better compared with those of each risk factor. CONCLUSION: In treating patients with symptomatic hyponatremia, individuals with high hyponatremia overcorrection risks were predictable using a novel risk score summarizing baseline information.

Efficient organic photovoltaic devices by using PEDOT:PSSs with excellent hole extraction ability.

We have demonstrated the poly(3-hexyl-thiophene-1,5-diyl) (P3HT):[6,6]-phenyl C61-butyric acid methyl ester (PCBM) bulk heterojunction (BHJ) organic photovoltaic (OPV) devices on various poly(3,4-ethylene-dioxythiophene):poly(styrenesulfonate) (PEDOT:PSSs). The device with PEDOT:PSS of PH 500 adding 1% dimethyl sulfoxide (DMSO) showed the best performances in term of the fill factor and power conversion efficiency (PCE) than others. The hole extraction ability of PEDOT:PSS is very important to balance between holes and electrons mobility because the carrier mobility of PCBM (approximately 10(-4) cm2/Vs) is higher than that of P3HT (approximately 10(-6) cm2/Vs) in P3HT:PCBM BHJ structure. The optimized BHJ OPV with PEDOT:PSS of PH 500 adding 1% DMSO showed a short-circuit current density of 8.92 mA/cm2 and a PCE of 2.97%, which was nearly increased to 2.5 times than that of control device with PEDOT:PSS of P VP Al 4083.

Bias stress effects on different dielectric surfaces of pentacene thin-film transistors.

In this paper, it was demonstrated that pentacene thin-film transistors (TFTs) were fabricated with an organic adhesion layer between an organic semiconductor and a gate insulator. In order to form polymeric film as an adhesion layer, a vapor deposition polymerization (VDP) process was introduced to substitute for the usual spin-coating process. Field effect mobility, threshold voltage, and on/off current ratio in pentacene TFTs with a 15 nm thick organic adhesion layer were about 0.4 cm2/Vs, -1 V, and 10(6), respectively. We also demonstrated that threshold voltage strongly depends on the stress time when a gate voltage has been applied for bias stress test. We suggest that a polyimide adhesion layer fabricated by the VDP method can be applied to realize organic TFTs with long-term stability because of lower threshold voltage shifts due to reduced charge trapping at the interface between the pentacene semiconductor and the polyimide layer.

High efficiency phosphorescent blue organic light-emitting diodes using double emitting layer.

We have demonstrated a highly efficient blue phosphorescent organic light emitting diodes (PHOLED) using iridium (111) bis[(4,6-di-fluoropheny)-pyridinato-N,C2] picolinate doped in double emitting layers (D-EML), N,N-dicarbazolyl-3,5-benzene (mCP) and p-bis (triphenylsilyly)benzene (UGH2). D-EML layers were employed to broaden the exciton formation zone and confine excitons. The optimized blue PHOLEDs having mCP/UGH2 as D-EML with a thickness of 200/100 A, exhibited a peak external quantum efficiency of 11.44%, power efficiency of 16.8 Im/W, luminous efficiency of 23.14 cd/A, and Commission Internationale de l'Eclairage coordinates of (0.17, 0.33).

Highly efficient and stable white organic light emitting diode base on double recombination zones of phosphorescent blue/orange emitters.

We demonstrated efficient and stable white phosphorescent organic light-emitting diodes (OLEDs) with double-emitting layers (D-EMLs), which were comprised of two emissive layers with a hole transport-type host of N,N'-dicarbazolyl-3,5-benzene (mCP) and a electron transport-type host of 2,2',2"-(1,3,5-benzenetryl)tris(1-phenyl)-1H-benzimidazol (TPBi) with blue/orange emitters, respectively. We fabricated two type white devices with single emitting layer (S-EML) and D-EML of orange emitter, maintaining double recombination zone of blue emitter. In addition, the device architecture was developed to confine excitons inside the D-EMLs and to manage triplet excitons by controlling the charge injection. As a result, light-emitting performances of white OLED with D-EMLs were improved and showed the steady CIE coordinates compared to that with S-EML of orange emitter, which demonstrated the maximum luminous efficiency and external quantum efficiency were 21.38 cd/A and 11.09%. It also showed the stable white emission with CIE(x,y) coordinates from (x = 0.36, y = 0.37) at 6 V to (x = 0.33, y = 0.38) at 12 V.

Association between copeptin levels and treatment responses to hypertonic saline infusion in patients with symptomatic hyponatremia: a prospective cohort study.

BACKGROUND: Copeptin is secreted in equimolar amounts as arginine vasopressin, main hormone regulating body fluid homeostasis. A recent study reported a copeptin-based classification of osmoregulatory defects in syndromes of inappropriate antidiuresis that may aid in prediction of therapeutic success. We investigated usefulness of copeptin for differentiating etiologies of hyponatremia and predicting efficacy and safety of hypertonic saline treatment in hyponatremic patients. METHODS: We performed a multicenter, prospective cohort study of 100 inpatients with symptomatic hyponatremia (corrected serum sodium [sNa] ≤ 125 mmol/L) treated with hypertonic saline. Copeptin levels were measured at baseline and 24 hours after treatment initiation, and patients were classified as being below or above median of copeptin at baseline or at 24 hours, respectively. Correlations between target, under correction, and overcorrection rates of sNa within 24 hours/24-48 hours and copeptin levels at baseline/24 hours were analyzed. RESULTS: Mean sNa and median copeptin levels were 117.9 and 16.9 pmol/L, respectively. Ratio of copeptin-to-urine sodium allowed for an improved differentiation among some (insufficient effective circulatory volume), but not all hyponatremia etiologic subgroups. Patients with below-median copeptin levels at baseline achieved a higher target correction rate in 6/24 hours (odds ratio [OR], 2.97; p = 0.02/OR, 6.21; p = 0.006). Patients with below-median copeptin levels 24 hours after treatment showed a higher overcorrection rate in next 24 hours (OR, 18.00, p = 0.02). CONCLUSION: There is a limited diagnostic utility of copeptin for differential diagnosis of hyponatremia. However, copeptin might be useful for predicting responses to hypertonic saline treatment in hyponatremic patients.