National Trends in Medical Costs and Prognosis of Acute Ischemic Stroke Patients in Endovascular Thrombectomy Era: Analysis Using Medical Claim Data in Korea

Purpose The purpose of this study was to evaluate trends in medical costs and prognosis in acute ischemic stroke (AIS) patients in Korea from 2008 to 2017 using medical claims data. Materials and Methods All data for the past decade was collected from a big data hub provided by the Health Insurance Review & Assessment Service. Using several Korean Standard Classification of Disease codes, we estimated the number of patients, the costs of medical insurance, and prognosis according to the treatment with or without endovascular thrombectomy (EVT) among in-patients with AIS. Results Since 2014, when EVT was covered by insurance, the number of patients who underwent EVT for AIS has increased significantly. Also, in the past decade, the medical costs following inpatient care for AIS with EVT have increased gradually, and the overall medical costs for the first year post-stroke have also increased. The prognosis of AIS patients with EVT was different according to the time of treatment. Annual trends for both mortality and cerebral hemorrhage after treatment of AIS with EVT have gradually decreased. Conclusion In this study, we found that both inpatient medical costs and 1-year cumulative medical costs have gradually increased, and the prognosis has gradually improved in patients receiving EVT treatment among AIS patients

Tau functions as Widom constants

We define a tau function for a generic Riemann-Hilbert problem posed on a union of non-intersecting smooth closed curves with jump matrices analytic in their neighborhood. The tau function depends on parameters of the jumps and is expressed as the Fredholm determinant of an integral operator with block integrable kernel constructed in terms of elementary parametrices. Its logarithmic derivatives with respect to parameters are given by contour integrals involving these parametrices and the solution of the Riemann-Hilbert problem. In the case of one circle, the tau function coincides with Widom's determinant arising in the asymptotics of block Toeplitz matrices. Our construction gives the Jimbo-Miwa-Ueno tau function for Riemann-Hilbert problems of isomonodromic origin (Painlev\'e VI, V, III, Garnier system, etc) and the Sato-Segal-Wilson tau function for integrable hierarchies such as Gelfand-Dickey and Drinfeld-Sokolov.Comment: 26 pages, 6 figure

Universal convex covering problems under translation and discrete rotations

We consider the smallest-area universal covering of planar objects of perimeter 2 (or equivalently closed curves of length 2) allowing translation and discrete rotations. In particular, we show that the solution is an equilateral triangle of height 1 when translation and discrete rotation of $\pi$ are allowed. Our proof is purely geometric and elementary. We also give convex coverings of closed curves of length 2 under translation and discrete rotations of multiples of $\pi/2$ and $2\pi/3$. We show a minimality of the covering for discrete rotation of multiples of $\pi/2$, which is an equilateral triangle of height smaller than 1, and conjecture that the covering is the smallest-area convex covering. Finally, we give the smallest-area convex coverings of all unit segments under translation and discrete rotations $2\pi/k$ for all integers $k\ge 3$

Two Cases of Herpes Virus Infection of Nose Mimicking Acute Invasive Fungal Infection in Immunocompromised Hosts

Various invasive fungal infections can occur in immunocompromised hosts, and an acute invasive fungal infection (AIFI) can be fatal. Because of its high mortality rate, AIFI must be quickly diagnosed and treated, such as anti-fungal agents or surgical debridement. In an immunocompromised host, nasal herpes simplex infection, usually caused by herpes simplex virus (HSV) type-1, can have various clinical manifestations, some of which can mimic AIFI. However, the management of acute viral infection differs significantly from invasive fungal infections of the nose. A fast and accurate differential diagnosis is mandatory because a delay in the disease-specific treatment of acute invasive infections can lead to mortality. This report describes two immunocompromised patients with mucosal and skin lesions around the nose. We provide clinical clues when mucosal lesions of the nasal cavity and skin lesions around the nose develop in immunocompromised hosts

A New Hardware Correlator in Korea: Performance Evaluation using KVN observations

We report results of the performance evaluation of a new hardware correlator in Korea, the Daejeon correlator, developed by the Korea Astronomy and Space Science Institute (KASI) and the National Astronomical Observatory of Japan (NAOJ). We conducted Very Long Baseline Interferometry (VLBI) observations at 22~GHz with the Korean VLBI Network (KVN) in Korea and the VLBI Exploration of Radio Astrometry (VERA) in Japan, and correlated the aquired data with the Daejeon correlator. For evaluating the performance of the new hardware correlator, we compared the correlation outputs from the Daejeon correlator for KVN observations with those from a software correlator, the Distributed FX (DiFX). We investigated the correlated flux densities and brightness distributions of extragalactic compact radio sources. The comparison of the two correlator outputs show that they are consistent with each other within $<8\%$, which is comparable with the amplitude calibration uncertainties of KVN observations at 22~GHz. We also found that the 8\% difference in flux density is caused mainly by (a) the difference in the way of fringe phase tracking between the DiFX software correlator and the Daejeon hardware correlator, and (b) an unusual pattern (a double-layer pattern) of the amplitude correlation output from the Daejeon correlator. The visibility amplitude loss by the double-layer pattern is as small as 3\%. We conclude that the new hardware correlator produces reasonable correlation outputs for continuum observations, which are consistent with the outputs from the DiFX software correlator.Comment: 13 pagee, 9 figures, 3 tables, to appear in JKAS (received February 9, 2015; accepted March 16, 2015

MicroRNA-150 modulates intracellular Ca2+ levels in naïve CD8+ T cells by targeting TMEM20

Regulation of intracellular Ca2+ signaling is a major determinant of CD8+ T cell responsiveness, but the mechanisms underlying this regulation of Ca2+ levels, especially in naïve CD8+ T cells, are not fully defined. Here, we showed that microRNA-150 (miR-150) controls intracellular Ca2+ levels in naïve CD8+ T cells required for activation by suppressing TMEM20, a negative regulator of Ca2+ extrusion. miR-150 deficiency increased TMEM20 expression, which resulted in increased intracellular Ca2+ levels in naïve CD8+ T cells. The subsequent increase in Ca2+ levels induced expression of anergy-inducing genes, such as Cbl-b, Egr2, and p27, through activation of NFAT1, as well as reduced cell proliferation, cytokine production, and the antitumor activity of CD8+ T cells upon antigenic stimulation. The anergy-promoting molecular milieu and function induced by miR-150 deficiency were rescued by reinstatement of miR-150. Additionally, knockdown of TMEM20 in miR-150-deficient naïve CD8+ T cells reduced intracellular Ca2+ levels. Our findings revealed that miR-150 play essential roles in controlling intracellular Ca2+ level and activation in naïve CD8+ T cells, which suggest a mechanism to overcome anergy induction by the regulation of intracellular Ca2+ levels115Ysciescopu

Dual Therapy with Cidofovir and Mirtazapine for Progressive Multifocal Leukoencephalopathy in a Sarcoidosis Patient

Background: Progressive multifocal leukoencephalopathy (PML) is a demyelinating central nervous system disease caused by JC virus (JCV) reactivation in immunocompromised patients. The disease course of PML is often progressive, fatal and at present, there are few reports on successful treatment outcomes. Case Report: A 45-year-old man with systemic sarcoidosis presented with rapidly progressive dementia and right hemiparesis. The patient was diagnosed with PML as confirmed via brain biopsy and JCV PCR. With a combination treatment of cidofovir and mirtazapine, there was significant improvement of neurological symptoms without measurable functional deficit. Conclusion: This case suggests that dual therapy with cidofovir and mirtazapine might be an effective treatment option in PML patients with sarcoidosis

Real-Time Monitoring of Cancer Cells in Live Mouse Bone Marrow

Disseminated tumor cells in the bone marrow environment are the main cause of systemic metastasis after curative treatment for major solid tumors. However, the detailed biological processes of tumor biology in bone marrow have not been well defined in a real-time manner, because of a lack of a proper in vivo experimental model thereof. In this study, we established intravital imaging models of the bone marrow environment to enable real-time observation of cancer cells in the bone marrow. Using these novel imaging models of intact bone marrow and transplanted bone marrow of mice, respectively, via two-photon microscopy, we could first successfully track and analyze both the distribution and the phenotype of cancer cells in bone marrow of live mouse. Therefore, these novel in vivo imaging models for the bone marrow would provide a valuable tool to identify the biologic processes of cancer cells in a real-time manner in a live animal model