Amphiphilic Magnetic Particles Dispersed in Water and Oil for the Removal of Hydrophilic and Hydrophobic Microplastics.

The study explores the synthesis and versatile properties of amphiphilic magnetic particles (AMPs) achieved through sequential coatings. Modulating the hydrophobic content in the synthesis process allows for the formation of hydrophilic, amphiphilic, and hydrophobic magnetic particles, with stable AMPs synthesis achieved at a ratio of hydrophilic to hydrophobic portions of approximately 71 to 29%. These AMPs exhibited outstanding dispersion in both oil and water within an oil/water mixture. Polyethylenimine in the AMP primarily enhances the removal of hydrophilic microparticles and facilitates dispersion in water. On the other hand, octadecylamine is specifically designed for the effective elimination of hydrophobic microparticles and their dispersion in oil. AMPs demonstrated effective removal capabilities for both hydrophilic and hydrophobic microparticles in water as well as hydrophobic microparticles in 100% oil. Our approach is also suited for eliminating hydrophobic microparticles dispersed in small quantities of oil floating on large bodies of water in real-world situations.

Clinical Correlates of Incidental Probable Benign Pulmonary Nodules with Diameters Less than 8 mm in a Healthy Korean Cohort: A Retrospective Study.

Incidental pulmonary nodules detected via computed tomography (CT) are usually small, solid nodules (diameters less than 8 mm) that are likely benign and are difficult to biopsy. Additional features of the benignity of these small nodules may help determine the need and periodicity of further follow-up and should be identified. This study was conducted to examine the clinical factors associated with benign solid pulmonary nodules measuring less than 8 mm in diameter. This retrospective study enrolled participants who underwent low-dose chest CT scans for 3 consecutive years during routine health check-ups at a university hospital in Korea. We chose a 2-year study period to ensure that the nodule(s) were benign, which meant there was no interval change over this period. Participants were stratified into two groups: no nodule (n = 56) and nodule(s) (n = 355). Multivariable logistic regression analyses were performed to explore associations (adjusted odds ratio [aOR], 95% confidence interval [CI], p-value) between variables and nodule(s). In this study cohort, elevated levels of low-density lipoprotein (LDL) cholesterol were positively associated factors with the presence of benign pulmonary nodule(s) (aOR: 1.10, 95% CI:1.00-1.20, p = 0.0488), whereas current cigarette smoking was negatively associated with nodules (aOR: 0.26, 95% CI: 0.08-0.81, p = 0.0202). Therefore, an elevated LDL cholesterol level was the only factor that was positively associated with the presence of benign small pulmonary nodules.

The Impact of Changes in the Intake of Fiber and Antioxidants on the Development of Chronic Obstructive Pulmonary Disease.

Diet is a health-related factor that can modify lung function. This study hypothesized that the change in age-related dietary intake affects lung function. The subjects who undertook a dietary assessment and spirometry in 2012 and 2017, were retrospectively collected in a health screening center. Dietary intakes were directly evaluated using food frequency questionnaires (FFQ) administered by trained dietitians and were compared at the baseline (2012) and 5-year follow-up (2017). A forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) value below 0.70 was defined as airflow limitation. Logistic regression models were used to estimate the odds ratio (ORs) adjusted for potential confounders. A total of 1439 subjects with normal spirometry were enrolled. New airflow limitations were detected in 48 subjects (3.3%) at the 5-year follow-up, including 41 (85.4%) men and 11 (22.9%) current smokers. After adjusting for age, sex, smoking history, and baseline FEV1/FVC, the odd ratios (OR) for new airflow limitation in fiber, vitamin C, and folic acid per 10% decrease in daily recommended requirement were 2.714 (95% confidence interval (CI), 1.538-4.807; p = 0.001), 1.083 (95% CI: 1.020-1.149; p = 0.007), and 1.495 (95% CI: 1.172-1.913; p = 0.001), respectively. A decreased intake of dietary fiber, vitamin C, and folic acid is associated with a newly developed airflow limitation.

Comparison of latent tuberculosis infection screening strategies before tumor necrosis factor inhibitor treatment in inflammatory arthritis: IGRA-alone versus combination of TST and IGRA.

This study aims to compare the latent tuberculosis infection (LTBI) screening strategy of interferon-gamma release assay (IGRA)-alone and in combination with tuberculin skin tests (TSTs) before the initiation of tumor necrosis factor (TNF) inhibitor treatment in patients with inflammatory arthritis. Between January 2011 and June 2017, we enrolled 476 patients who were followed up for ≥1 year after the TNF inhibitor initiation in a tertiary referral center in South Korea. Inflammatory arthritis comprised rheumatoid arthritis in 266 (55.9%) and ankylosing spondylitis in 210 (44.1%) patients. The following strategies were used for LTBI screening during the study period: (i) from January 2011 to October 2014, the combination of TST and QuantiFERON-TB Gold In-Tube (QFT-GIT); (ii) between November 2014 and February 2015, QFT-GIT-alone and (iii) since March 2015, either the combination of TST and QFT-GIT or QFT-GIT-alone depending on the attending physician's choice. We compared the screening strategies of QFT-GIT alone and in combination with TST. Overall, 338 (71.0%) patients received LTBI screening tests using the combination of TST and QFT-GIT, and 138 (29.0%) received QFT-GIT-alone. In addition, the LTBI tests were positive in 159 (47.0%) of 338 patients using the combination tests, and 43.8% (148/338) required LTBI treatment. Meanwhile, the LTBI tests were positive in 32.6% (45/138) of QFT-GIT-alone patients, and 30.4% (42/138) required LTBI treatment. Among 338 patients who received combination tests, 2 patients developed active tuberculosis within 1 year after the TNF inhibitor initiation. Of patients who received QFT-GIT-alone, no patient developed tuberculosis. In conclusion, among patients who received QFT-GIT-alone, the number of patients who required LTBI treatment declined compared to the TST and QFT-GIT combination, and none developed active tuberculosis within 1 year, suggesting that QFT-GIT-alone could be a potential screening strategy for diagnosing LTBI in patients with inflammatory arthritis in South Korea.

Clinical Validation of a Protein Biomarker Panel for Non-Small Cell Lung Cancer.

We validated the diagnostic performance of a previously developed blood-based 7-protein biomarker panel, AptoDetect™-Lung (Aptamer Sciences Inc., Pohang, Korea) using modified aptamer-based proteomic technology for lung cancer detection. Non-small cell lung cancer (NSCLC), 200 patients and benign nodule controls, 200 participants were enrolled. In a high-risk population corresponding to ≥ 55 years of age and ≥ 30 pack-years, the diagnostic performance was improved, showing 73.3% sensitivity and 90.5% specificity with an area under the curve of 0.88. AptoDetect™-Lung (Aptamer Sciences Inc.) offers the best validated performance to discriminate NSCLC from benign nodule controls in a high-risk population and could play a complementary role in lung cancer screening.

Development of a Protein Biomarker Panel to Detect Non-Small-Cell Lung Cancer in Korea.

BACKGROUND: Lung cancer screening using low-dose computed tomography reduces lung cancer mortality. However, the high false-positive rate, cost, and potential harms highlight the need for complementary biomarkers. We compared the diagnostic performance of modified aptamer-based protein biomarkers with Cyfra 21-1. PATIENTS AND METHODS: Participants included 100 patients diagnosed with lung cancer, and 100 control subjects from Asan Medical Center (Seoul, Korea). We investigated candidate biomarkers with new modified aptamer-based proteomic technology and developed a 7-protein panel that discriminates lung cancer from controls. A naive Bayesian classifier was trained using sera from 75 lung cancers and 75 controls. An independent set of 25 cases and 25 controls was used to verify performance of this classifier. The panel results were compared with Cyfra 21-1 to evaluate the diagnostic accuracy for lung nodules detected by computed tomography. RESULTS: We derived a 7-protein biomarker classifier from the initial train set comprising: EGFR1, MMP7, CA6, KIT, CRP, C9, and SERPINA3. This classifier distinguished lung cancer cases from controls with an area under the curve (AUC) of 0.82 in the train set and an AUC of 0.77 in the verification set. The 7-marker naive Bayesian classifier resulted in 91.7% specificity with 75.0% sensitivity for the subset of individuals with lung nodules. The AUC of the classifier for lung nodules was 0.88, whereas Cyfra 21-1 had an AUC of 0.72. CONCLUSION: We have developed a protein biomarker panel to identify lung cancers from controls with a high accuracy. This integrated noninvasive approach to the evaluation of lung nodules deserves further prospective validation among larger cohorts of patients with lung nodules in screening strategy.

Diagnosis of latent tuberculosis infection before initiation of anti-tumor necrosis factor therapy using both tuberculin skin test and QuantiFERON-TB Gold In Tube assay.

BACKGROUND: Reactivation of latent tuberculosis infection (LTBI) is an important complication in patients treated with tumor necrosis factor-alpha (TNF-α) blocking agents. However, the best method for LTBI detection before initiation of anti-TNF therapy remains to be determined. METHODS: From January 2010 to August 2013, anti-TNF therapy was initiated in 426 patients with immune-mediated inflammatory diseases (IMIDs). Tuberculin skin test (TST) and Quantiferon-TB Gold In Tube (QFT-GIT) assay were performed before starting anti-TNF treatment. LTBI was defined as a positive TST (induration ≥ 10 mm) or as a positive QFT-GIT result. Patients were followed up until December 2013. RESULTS: The positive TST and QFT-GIT rates were 22.3% (95/426) and 16.0% (68/426), respectively, yielding a total of 27.0% (115/426) of positive LTBI results. LTBI treatment was initiated in 25.1% (107/426) and was completed in 100% (107/107) of patients. During a median 294 days of follow-up, active TB occurred in 1.4% (6/426) of the patients with negative TST and QFT-GIT results at baseline. CONCLUSION: The either test positive strategy, using both TST and QFT-GIT assay, is acceptable for LTBI screening before commencing anti-TNF therapy in patients with IMIDs.

Association of lung function genes with chronic obstructive pulmonary disease.

BACKGROUND: Spirometric measurements of pulmonary function are important in diagnosing and determining the severity of chronic obstructive pulmonary disease (COPD). We performed this study to determine whether candidate genes identified in genome-wide association studies of spirometric measurements were associated with COPD and if they interacted with smoking intensity. METHODS: The current analysis included 1,000 COPD subjects and 1,000 controls recruited from 24 hospital-based pulmonary clinics. Thirteen SNPs, chosen based on genome-wide association studies of spirometric measurements in the Korean population cohorts, were genotyped. Genetic association tests were performed, adjusting for age, sex, and smoking intensity, using models including a SNP-by-smoking interaction term. RESULTS: PID1 and FAM13A were significantly associated with COPD susceptibility. There were also significant interactions between SNPs in ACN9 and FAM13A and smoking pack-years, and an association of ACN9 with COPD in the lowest smoking tertile. The risk allele of FAM13A was associated with increased expression of FAM13A in the lung. CONCLUSIONS: We have validated associations of FAM13A and PID1 with COPD. ACN9 showed significant interaction with smoking and is a potential candidate gene for COPD. Significant associations of genetic variants of FAM13A with gene expression levels suggest that the associated loci may act as genetic regulatory elements for FAM13A gene expression.

Incidence of tuberculosis among anti-tumor necrosis factor users in patients with a previous history of tuberculosis.

BACKGROUND: We aimed to investigate the results of anti-tumor necrosis factor (TNF) therapy in patients with a previous history of tuberculosis (TB). METHODS: A total of 101 patients with a previous history of TB receiving TNF antagonists between December 2004 and September 2012 at the Asan Medical Center in South Korea were retrospectively analyzed. RESULTS: The mean age of the 101 subjects was 40.4 ± 16.0 years and 51 patients (50.5%) were male. The underlying immune-mediated inflammatory diseases (IMIDs) were Crohn's disease in 55 (54.5%), rheumatoid arthritis in 27 (26.7%), and ankylosing spondylitis in 13 (12.9%) patients. Chest radiography findings were suggestive of previous TB lesions in 33 (32.7%) patients. The rates of positivity in the tuberculin skin test and interferon-gamma release assay were 21.8% (22/101) and 44.6% (45/101), respectively. Latent TB infection (LTBI) treatment was initiated in 11 subjects (10.9%) based on previous inappropriate anti-TB treatments (n = 10) or recent TB contact history (n = 1), irrespective of the LTBI test results. The median follow-up duration after the initiation of TNF antagonist therapy was 31.5 months. Active TB developed, six years after the initiation of TNF antagonist, in one patient (1.0%) who had not received LTBI treatment. The incidence rate of TB was calculated at 336 per 100,000 person-year (PY). CONCLUSIONS: Patients with IMIDs who have a previous history of TB can be treated with TNF antagonists with an acceptable incidence of TB, if LTBI treatment is performed based on clinical judgments including the adequacy of previous anti-TB treatment and recent contact history.

Association between brachial-ankle pulse wave velocity and occult coronary artery disease detected by multi-detector computed tomography.

BACKGROUND: Arterial stiffness, assessed by aortic pulse wave velocity (PWV), has been reported to predict cardiovascular morbidity and mortality. We assessed the association between arterial stiffness, as determined by PWV, and occult coronary artery disease (CAD), as detected by multi-detector computed tomography (MDCT), in asymptomatic individuals. METHOD: We retrospectively enrolled 615 consecutive South Korean individuals who had undergone both brachial-ankle PWV (baPWV) and coronary CT angiography during general routine health evaluations at the Asan Medical Center in 2008. RESULTS: We found that baPWV was positively correlated with age; body mass index; blood pressure; total cholesterol, homocysteine, and fasting blood glucose concentrations; and coronary artery calcium score. When we divided subjects into two groups according to the results of MDCT, we found that baPWV was significantly higher in subjects with (diameter of stenosis >50%) than without CAD (1573.2 ± 275.6 cm/s vs. 1409.6 ± 235.6 cm/s, p<0.01). The optimal baPWV cutoff value for detection of significant coronary arterial stenosis was 1426.0 cm/s, which had a sensitivity of 77% and a specificity of 63% (area under curve=0.71). After adjusting for age, smoking status, hypertension, diabetes, and dyslipidemia, the odds ratio for significant occult CAD was 3.30 (95% CI=1.47-7.41, p<0.01). CONCLUSION: We found that baPWV was associated with risk factors for cardiovascular disease, including CACS, in asymptomatic individuals, and the optimal baPWV cutoff value for occult CAD detected by MDCT was 1426 cm/s. These findings suggest that baPWV may be a useful screening tool for predicting occult CAD.

[A case of pancreaticoportal fistula associated with acute severe pancreatitis].

Pancreatic fistulas are usually caused by the disruption of pancreatic duct. The majority of pancreatic fistulas are external fistulas and common causes of external and internal pancreatic fistulas are trauma and surgery. Internal pancreatic fistulas due to pancreatitis are rare. Internal pancreatic fistulas may communicate with peritoneal cavity, colon, small bowel, biliary system or pleural cavity. Among them, fistula between pancreatic duct and portal vein due to acute pancreatitis is rare. We report a case of 32-year-old male with fistula between pancreatic duct and portal vein as a complication of acute pancreatitis. Pancreaticoportal fistula was diagnosed by endoscopic retrograde cholangiopancreatography. He recovered after distal pancreatectomy with splenectomy and supportive care.