Extracellular vesicles (EVs) are lipid bilayer-enclosed particles that contain diverse molecular components, such as proteins, nucleic acids, and lipids. EVs reflect the state of their cell of origin in intercellular communication. Such characteristics of EVs demonstrate their potential as biomarkers and therapeutic agents in basic and translational research. Research on EV biology and applications has progressed significantly. However, challenges remain in translating their potential into clinical applications because of issues in nomenclature, the separation of EVs from nonvesicular extracellular particles, and methods for characterization and functional analysis. The International Society for Extracellular Vesicles addresses the current standards and challenges in this rapidly evolving field through periodical updates of its Minimal Information for Studies of Extracellular Vesicles (MISEV), which was published in 2014 and revised in 2018. The latest revision, MISEV2023, provides an updated overview of the current methodologies, detailing their strengths and limitations in EV production, separation, and characterization from various sources, including cell cultures, body fluids, and solid tissues. In this review, we summarize the fundamental principles of EV research by referencing the guidelines on EVs published by the Ministry of Food and Drug Safety of the Republic of Korea. Furthermore, we elaborate on the key aspects of MISEV2023, providing information for domestic EV researchers in selecting or developing optimal research methodologies according to their specific objectives and applications.

Extracellular vesicles (EVs) are lipid bilayer-enclosed particles that contain diverse molecular components, such as proteins, nucleic acids, and lipids. EVs reflect the state of their cell of origin in intercellular communication. Such characteristics of EVs demonstrate their potential as biomarkers and therapeutic agents in basic and translational research. Research on EV biology and applications has progressed significantly. However, challenges remain in translating their potential into clinical applications because of issues in nomenclature, the separation of EVs from nonvesicular extracellular particles, and methods for characterization and functional analysis. The International Society for Extracellular Vesicles addresses the current standards and challenges in this rapidly evolving field through periodical updates of its Minimal Information for Studies of Extracellular Vesicles (MISEV), which was published in 2014 and revised in 2018. The latest revision, MISEV2023, provides an updated overview of the current methodologies, detailing their strengths and limitations in EV production, separation, and characterization from various sources, including cell cultures, body fluids, and solid tissues. In this review, we summarize the fundamental principles of EV research by referencing the guidelines on EVs published by the Ministry of Food and Drug Safety of the Republic of Korea. Furthermore, we elaborate on the key aspects of MISEV2023, providing information for domestic EV researchers in selecting or developing optimal research methodologies according to their specific objectives and applications.

Extracellular vesicles (EVs) are lipid bilayer-enclosed particles that contain diverse molecular components, such as proteins, nucleic acids, and lipids. EVs reflect the state of their cell of origin in intercellular communication. Such characteristics of EVs demonstrate their potential as biomarkers and therapeutic agents in basic and translational research. Research on EV biology and applications has progressed significantly. However, challenges remain in translating their potential into clinical applications because of issues in nomenclature, the separation of EVs from nonvesicular extracellular particles, and methods for characterization and functional analysis. The International Society for Extracellular Vesicles addresses the current standards and challenges in this rapidly evolving field through periodical updates of its Minimal Information for Studies of Extracellular Vesicles (MISEV), which was published in 2014 and revised in 2018. The latest revision, MISEV2023, provides an updated overview of the current methodologies, detailing their strengths and limitations in EV production, separation, and characterization from various sources, including cell cultures, body fluids, and solid tissues. In this review, we summarize the fundamental principles of EV research by referencing the guidelines on EVs published by the Ministry of Food and Drug Safety of the Republic of Korea. Furthermore, we elaborate on the key aspects of MISEV2023, providing information for domestic EV researchers in selecting or developing optimal research methodologies according to their specific objectives and applications.

Objective: To compare the diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3-tesla (3T) magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of visceral pleural surface invasion (VPSI). Visceral pleural invasion by non-small-cell lung cancer (NSCLC) can be classified into two types: PL1 (without VPSI), invasion of the elastic layer of the visceral pleura without reaching the visceral pleural surface, and PL2 (with VPSI), full invasion of the visceral pleura. Materials and Methods: Thirty-three patients with pathologically confirmed VPSI by NSCLC were retrospectively reviewed.Multidetector CT and contrast-enhanced 3T MRI with a free-breathing radial three-dimensional fat-suppressed volumetric interpolated breath-hold examination (VIBE) pulse sequence were compared in terms of the length of contact, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. Supplemental evaluation of the tumor-pleura interface (smooth versus irregular) could only be performed with MRI (not discernible on CT). Results: At the tumor-pleura interface, radial VIBE MRI revealed a smooth margin in 20 of 21 patients without VPSI and an irregular margin in 10 of 12 patients with VPSI, yielding an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F-score for VPSI detection of 91%, 83%, 95%, 91%, 91%, and 87%, respectively. The McNemar test and receiver operating characteristics curve analysis revealed no significant differences between the diagnostic accuracies of CT and MRI for evaluating the contact length, angle of mass margin, or arch distance-to-maximum tumor diameter ratio as predictors of VPSI. Conclusion The diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3T MRI and CT were equal in terms of the contact length, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. The advantage of MRI is its clear depiction of the tumor-pleura interface margin, facilitating VPSI detection.

Objective: To compare the diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3-tesla (3T) magnetic resonance imaging (MRI) and computed tomography (CT) for the detection of visceral pleural surface invasion (VPSI). Visceral pleural invasion by non-small-cell lung cancer (NSCLC) can be classified into two types: PL1 (without VPSI), invasion of the elastic layer of the visceral pleura without reaching the visceral pleural surface, and PL2 (with VPSI), full invasion of the visceral pleura. Materials and Methods: Thirty-three patients with pathologically confirmed VPSI by NSCLC were retrospectively reviewed.Multidetector CT and contrast-enhanced 3T MRI with a free-breathing radial three-dimensional fat-suppressed volumetric interpolated breath-hold examination (VIBE) pulse sequence were compared in terms of the length of contact, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. Supplemental evaluation of the tumor-pleura interface (smooth versus irregular) could only be performed with MRI (not discernible on CT). Results: At the tumor-pleura interface, radial VIBE MRI revealed a smooth margin in 20 of 21 patients without VPSI and an irregular margin in 10 of 12 patients with VPSI, yielding an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F-score for VPSI detection of 91%, 83%, 95%, 91%, 91%, and 87%, respectively. The McNemar test and receiver operating characteristics curve analysis revealed no significant differences between the diagnostic accuracies of CT and MRI for evaluating the contact length, angle of mass margin, or arch distance-to-maximum tumor diameter ratio as predictors of VPSI. Conclusion The diagnostic performance of contrast-enhanced radial T1-weighted gradient-echo 3T MRI and CT were equal in terms of the contact length, angle of mass margin, and arch distance-to-maximum tumor diameter ratio. The advantage of MRI is its clear depiction of the tumor-pleura interface margin, facilitating VPSI detection.

Background: The Korean Society of Thoracic Radiology (KSTR) recently constructed a nation-wide coronavirus disease 2019 (COVID-19) database and imaging repository, referred to the Korean imaging cohort of COVID-19 (KICC-19) based on the collaborative efforts of its members. The purpose of this study was to provide a summary of the clinico-epidemiological data and imaging data of the KICC-19. Methods: The KSTR members at 17 COVID-19 referral centers retrospectively collected imaging data and clinical information of consecutive patients with reverse transcription polymerase chain reaction-proven COVID-19 in respiratory specimens from February 2020 through May 2020 who underwent diagnostic chest computed tomography (CT) or radiograph in each participating hospital. Results: The cohort consisted of 239 men and 283 women (mean age, 52.3 years; age range, 11–97 years). Of the 522 subjects, 201 (38.5%) had an underlying disease. The most common symptoms were fever (n = 292) and cough (n = 245). The 151 patients (28.9%) had lymphocytopenia, 86 had (16.5%) thrombocytopenia, and 227 patients (43.5%) had an elevated CRP at admission. The 121 (23.4%) needed nasal oxygen therapy or mechanical ventilation (n = 38; 7.3%), and 49 patients (9.4%) were admitted to an intensive care unit.Although most patients had cured, 21 patients (4.0%) died. The 465 (89.1%) subjects underwent a low to standard-dose chest CT scan at least once during hospitalization, resulting in a total of 658 CT scans. The 497 subjects (95.2%) underwent chest radiography at least once during hospitalization, which resulted in a total of 1,475 chest radiographs. Conclusion The KICC-19 was successfully established and comprised of 658 CT scans and 1,475 chest radiographs of 522 hospitalized Korean COVID-19 patients. The KICC-19 will provide a more comprehensive understanding of the clinical, epidemiological, and radiologic characteristics of patients with COVID-19.

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.
Adult* ; Biopsy ; Cough ; Diabetes Insipidus ; Diabetes Insipidus, Neurogenic* ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Dyspnea ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell* ; Humans ; Lung ; Lung Diseases ; Magnetic Resonance Imaging ; Male* ; Polydipsia ; Smoke ; Smoking ; Smoking Cessation ; Thoracic Surgery, Video-Assisted ; Water Deprivation

OBJECTIVES: This study compared the mechanical properties of various instruments for canal exploration and glide-path preparations. MATERIALS AND METHODS: The buckling resistance, bending stiffness, ultimate torsional strength, and fracture angle under torsional load were compared for C+ file (CP, Dentsply Maillefer), M access K-file (MA, Dentsply Maillefer), Mani K-file (MN, Mani), and NiTiFlex K-file (NT, Dentsply Maillefer). The files of ISO size #15 and a shaft length of 25 mm were selected. For measuring buckling resistance (n = 10), the files were loaded in the axial direction of the shaft, and the maximum load was measured during the files' deflection. The files (n = 10) were fixed at 3-mm from the tip and then bent 45degrees with respect to their long axis, while the bending force was recorded by a load cell. For measuring the torsional properties, the files (n = 10) were also fixed at 3-mm, and clockwise rotations (2-rpm) were applied to the files in a straight state. The torsional load and the distortion angle were recorded until the files succumbed to the torque. RESULTS: The CP was shown to require the highest load to buckle and bend the files, and the NT showed the least. While MA and MN showed similar buckling resistances, MN showed higher bending stiffness than MA. The NT had the lowest bending stiffness and ultimate torsional strength (p < 0.05). CONCLUSIONS: The tested instruments showed different mechanical properties depending on the evaluated parameters. CP and NT files were revealed to be the stiffest and the most flexible instruments, respectively.
Axis, Cervical Vertebra ; Torque

BACKGROUND: Transbronchial lung biopsy (TBLB) is a valuable diagnostic tool for peripheral pulmonary lesions. The diagnostic yield of TBLB reportedly ranges from 41%-60%. Many studies demonstrated the various factors that influence the yield of TBLB, including size, location, and distance from the carina or pleura. However, no study has evaluated the effects of the bronchoscope diameter. We evaluated whether the bronchoscope diameter affected the diagnostic yield of TBLB. METHODS: We reviewed records from 178 patients who underwent TBLB using bronchoscopes of two different diameters (5.7 mm, thick outer diameter, Olympus BF-200; 4.9 mm, thin, BF-260). The fluoroscopic guidance rates, yield of TBLB and flexible bronchoscopy (FB) were compared between the two groups. Additionally, we compared the results of the procedures with respect to diagnosis, distance from the pleura, and size of the lesion. RESULTS: The results of fluoroscopic guidance, TBLB, and FB yield using thin diameter bronchoscope were significantly better than those obtained with a thick diameter bronchoscope (p=0.021, p=0.036, and p=0.010, respectively). Particularly, when the distance from the pleura was < or = 10 mm, success rates for fluoroscopic guidance and FB with thin bronchoscope were higher (p=0.013 and p=0.033, respectively), as compared to with thick bronchoscope. CONCLUSION: A thinner diameter bronchoscope increased the yield of bronchoscopy, and bronchial washing in conjunction with TBLB was useful in the diagnosis of peripheral pulmonary nodules.
Biopsy* ; Biopsy, Fine-Needle ; Bronchoscopes* ; Bronchoscopy ; Diagnosis ; Humans ; Lung Neoplasms ; Lung* ; Pleura