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Objectives In the context where the greenhouse gas (GHG) emissions from livestock manure (LSM) account for more than half of the GHG emissions in the livestock sector, it is necessary to find alternatives to composting due to the decrease in agricultural land. This study aims to calculate the GHG reduction contribution and economic benefits when converting LSM into solid fuel as an alternative to traditional composting. Methods The study compares the results of converting the entire LSM generated domestically into solid fuel replacing it with hard coal for fuel (HC-F), bituminous coal for raw materials (BC-R), bituminous coal for fuel (BC-F). The GHG reduction contribution is calculated following the domestic GHG inventory methodology, using the IPCC guidelines and the method for calculating carbon emission reduction effects. For the assessment of economic benefits, were evaluated by aggregating the impacts of reducing coal imports and GHG reduction benefits in line with EU-ETS standards. Economic benefits are assessed by combining the effects of avoiding coal imports and the GHG reduction benefits according to the EU-ETS. Results and Discussion The GHG reduction effect was found to be highest when replacing with HC-F, and this is attributed to the lower heating value and higher GHG emission coefficient of HC-F compared to BC-R, and BC-F, indicating that the substitution with HC-F is most effective in terms of import avoidance. If 20% of the annual coal consumption in 2022 is replaced with solid fuel from LSM, the GHG reduction effects for coal substitution are 1.4% for HC-F, 2.1% for BC-R, and 1.9% for BC-F based on the LSM generation CO2 emissions from biomass fuel are considered climate-neutral and are excluded from the national total emissions. Solid fuel from LSM serves as an alternative in addressing the GHG generated during the LSM treatment process, contributing to potential reduction. If all generated LSM is replaced with HC-F, BC-R, or BC-F, there are respective GHG reduction effects of 13,193,591 tGHG, 11,320,572 tGHG, and 11,226,331 tGHG. Conclusion In 2018, the livestock sector accounted for approximately 42% of the GHG emissions in the agricultural sector, totaling 9.4 million tCO2 eq. Assuming the complete conversion of LSM into solid fuel for coal substitution, regardless of the type of coal replaced, it offsets the entire GHG emissions from the agricultural sector. Currently, there is limited demand for the conversion of LSM into solid fuel due to a lack of proof and awareness, but with some coal-fired power plants scheduled for partial shutdown and the government considering energy options for LSM, a promising stage is anticipated in the future for the substitution and expanded use of solid fuel from LSM in place of coal in the coal fuel. Although it may not be possible to entirely replace the coal used in power plants and steel mills with solid fuel from LSM, it can be utilized by increasing the proportion of coal blending. However, even if not reported in the national GHG inventory, the treatment of pollutants generated by solid fuel combustion remains an ongoing challenge. As solid fuel becomes more commonplace in the future, a comprehensive assessment of the entire process, including potential environmental impacts throughout the life cycle, will be necessary to establish a basis for GHG reduction measures.

Background Despite the widespread impact of the severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019, COVID-19) and vaccination in South Korea, our understanding of kidney diseases following these events remains limited. We aimed to address this gap by investigating the characteristics of glomerular diseases following the COVID-19 infection and vaccination in South Korea. Methods Data from multiple centers were used to identify de novo glomerulonephritis (GN) cases with suspected onset following COVID-19 infection or vaccination. Retrospective surveys were used to determine the COVID-19–related histories of patients who were initially not implicated. Bayesian structural time series and autoregressive integrated moving average models were used to determine causality. Results Glomerular diseases occurred shortly after the infection or vaccination. The most prevalent postinfection GN was podocytopathy (42.9%), comprising primary focal segmental glomerulosclerosis and minimal change disease, whereas postvaccination GN mainly included immunoglobulin A nephropathy (IgAN; 57.9%) and Henoch-Schönlein purpura nephritis (HSP; 15.8%). No patient progressed to end-stage kidney disease. Among the patients who were initially not implicated, nine patients with IgAN/HSP were recently vaccinated against COVID-19. The proportion of glomerular diseases changed during the pandemic in South Korea, with an increase in acute interstitial nephritis and a decrease in pauci-immune crescentic GN. Conclusion This study showed the characteristics of GNs following COVID-19 infection or vaccination in South Korea. Understanding these associations is crucial for developing effective patient management and vaccination strategies. Further investigation is required to fully comprehend COVID-19’s impact on GN.

Objectives This study examined the association between ultra-processed food (UPF) consumption and chronic diseases in elderly Koreans. Methods Data from the 2019–2021 Korea National Health and Nutrition Examination Survey were analyzed. Dietary intake and UPF consumption were assessed using the NOVA food classification based on 24-hour recall data from 3,790 participants (aged 65+ years). Participants were divided into 4 groups based on the quartile of energy intake from UPFs. Regions were classified as urban or rural. Multivariable logistic regression was employed to estimate the adjusted odds ratios (AORs) with 95% confidence intervals (CIs) after controlling for potential confounders. Results Among the participants, 71.3% resided in urban and 28.7% in rural areas. Compared to the urban elderly, rural participants tended to be older, have lower education and income levels, be more likely to live in single-person households, and have a higher smoking rate (P < 0.05). Urban elderly consumed more UPFs daily (146.1 g) compared to rural residents (126.6 g; P < 0.05). “Sugar-sweetened beverages” were the most consumed category in both regions. “Sweetened milk and its products” and “traditional sauces” were prominent in urban areas, while rural elderly consumed more “traditional sauces” and “distilled alcoholic beverages.” Rural areas also had a higher carbohydrate-to-calorie ratio than urban areas. Compared to the lowest quartile of UPF intake, the highest quartile was significantly associated with impaired fasting glucose only in rural areas (AOR, 1.48; 95% CI, 1.00–2.19; P for trend = 0.0014). No significant associations were observed for diabetes in either urban or rural areas. Conclusions This study suggests that high intake of UPFs is associated with increased odds of impaired fasting glucose in rural elderly. Further research is needed to elucidate the specific negative health effects of UPFs in different populations, and targeted efforts should promote healthy diets in both urban and rural areas.

Tuberculous pericarditis is an extrapulmonary manifestation of tuberculosis that is most commonly associated with pericardial thickening, effusion, and calcification. We present a case of tuberculous pericarditis mimicking a malignant pericardial tumor in a 77-year-old male. CT revealed an irregular and nodular pericardial thickening. MRI revealed high signal intensity on T1-weighted fat-suppressed images and peripheral rim enhancement after gadolinium administration. MRI can be helpful in determining the differential diagnoses in cases of tuberculous pericarditis with nonspecific imaging findings.

Mediastinal vascular malformations are rare and their diagnosis can be challenging. Imaging is vital for diagnosing mediastinal vascular malformations and can help avoid unnecessary invasive procedures. Herein, we report the detailed CT and MRI findings of a rare low-flow mediastinal vascular malformation in an asymptomatic 63-year-old male.

The purpose of this study was to analyze acupuncture treatment methods and acupoints used to treat obstructive sleep apnea (OSA) or obstructive sleep apnea-hypoapnea syndrome (OSAHS). The data were retrieved from January 2010 to May 2022 from the China National Knowledge Infrastructure database. The search terms included “adult,” “obstructive sleep apnea,” “obstructive sleep apnea hypoapnea syndrome,” “acupuncture,” and “electro-acupuncture.” Clinical trials for acupuncture treatment of OSA or OSAHS were included in this review (4 non-randomized controlled studies, 1 was a case report, and 10 randomized controlled studies). For OSA and OSAHS treatment, the acupoints that were most frequently used included REN23, LU7, ST40, EX9, LI11, and DU20. Compared with the control or Western treatment group, the treatment outcome measures of participants in the acupuncture treatment group significantly improved. In some studies, participants in the acupuncture group did not have side effects and the treatment was cost-effective. The data analyzed in this review suggest that acupuncture is an effective treatment for OSA or OSAHS.

Purpose Despite the well-known mortality of pediatric drowning, there is a paucity of evidence on the implications of an initial evaluation on the relevant outcome of drowning. This study aimed to investigate the association of initial clinical findings with outcome of children undergoing drowning. Methods This retrospective study was conducted using the medical records of 56 children undergoing drowning who visited 3 Korean academic hospitals from January 2000 through May 2020. We analyzed information regarding the prehospital resuscitation, drowning time, a 4-tiered chest radiographic grade, and the baseline characteristics. The grade was defined based on the findings of initial chest radiographs. The poor outcomes were defined as the need for intensive care unit care or death aftercare. We analyzed the association of the prehospital resuscitation, submersion time, and the radiographic grade with the poor outcomes using binary logistic regression. Results Among the 56 children, 31 (55.4%) were aged 1-4 years. Prehospital resuscitation and 1-5 minutes of submersion time were noted in the 25 (44.6%) and 30 children (53.6%), respectively. The chest radiographic grades 1 through 4 accounted for 17 (30.4%), 20 (35.7%), 12 (21.4%), and 3 children (5.4%), respectively. Poor outcomes occurred in 17 children (30.4%), including 3 deaths (5.4%). The association with the poor outcomes was noted in the submersion time of longer than 5 minutes (adjusted odds ratio, 21.49; 95% confidence interval, 1.11-415.73; compared with < 1 minute) while not in the submersion time and chest radiographic grade. Conclusion This study confirms that submersion time is an outcome predictor of drowning.

The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

Brainstem infarction due to vertebrobasilar insufficiency is a rare initial presentation of systemic lupus erythematosus (SLE) patients and small-vessel dissection as the direct cause of infarction has not been reported. We report the case of a 20-year-old female with acute infarction on the right side of the pons due to a small artery (pontine perforator) dissection, identified on digital subtraction angiography and high-resolution vessel wall MRI (vwMRI). She was diagnosed with SLE based on the presence of neurologic disorders and relevant laboratory findings. The pontine perforator-dissecting aneurysm had occluded and the right distal vertebral artery had resolved on subsequent vwMRI. She had a modified Rankin Scale (mRS) score of 1 at discharge with mild symptom improvement, and exhibited no further aggravation of symptoms at 3 or 12 months, maintaining an mRS score of 1.

This study aimed to show the effects of Korean medicine treatment (particularly bee-venom pharmacopunture) on a patient with brachial plexus palsy. A 64-year-old woman was diagnosed with brachial plexus palsy on the right upper extremity and was treated with Korean and Western medicine from September 30th to November 6th, 2019. Improvement of the patient’s symptoms was evaluated using the Manual Muscle Test, Range of Motion and visual analogue scale. After treatment, the patient’s Manual Muscle Test grade and Range of Motion were improved, and the Visual Analogue Scale score indicated the intensity of her right hand numbness had decreased. These results suggested that improper use of crutches can result in brachial plexus palsy and a Korean-Western medicine treatment regimen primarily focused on bee-venom pharmacopunture, may be effective in reducing the symptoms of brachial plexus palsy.

Purpose We aimed to compare two different sedation protocols for brain magnetic resonance imaging (MRI) in preterm infants. One protocol used chloral hydrate (CH) with monitoring conducted by non-anesthesiologists, and the other used a continuous infusion of propofol (PF) with monitoring by anesthesiologists. Methods A total of 250 preterm infants born between January 2011 and December 2015 who received brain MRI during hospitalization in our neonatal intensive care unit (NICU) were included in this retrospective study. In period 1, sedation for brain MRI was done using a single dose or multiple doses of CH with monitoring conducted by NICU medical staff. In period 2, an anesthesiologist prescribed a continuous infusion of PF and titrated the dosage for minimal and adequate sedation. Data on the adverse events, including desaturation and bradycardia, were collected and compared between periods 1 and 2. Results Despite similar gestational ages of the patients in periods 1 and 2, the infants in period 1 showed a higher risk of developing bradycardia after sedation compared to those in period 2 (30.2% vs. 14.8%; an adjusted odds ratio of 2.35; 95% confidence interval of 1.12 to 4.91). Infants who had an adverse event after sedation had a lower gestational age and corrected age at the time of MRI (26.8 weeks vs. 27.9 weeks, P=0.004; 37.3 weeks vs. 38.3 weeks, P=0.023). The duration of MRI was significantly longer in infants that had an adverse event than those that did not (70.9 minutes vs. 64.3 minutes). After adjusting for various clinical factors, lower gestational age, lower corrected age at the time of MRI, and period 1 increased the risk of developing adverse events after sedation for MRI. Conclusion The use of a continuous PF infusion with dose titration and monitoring by an anesthesiologist is safe and feasible as a sedation protocol for brain MRI in prematurely born infants.

Fibromuscular dysplasia is a nonatheromatous, noninflammatory arterial disorder that results in stenosis and/or aneurysm formation and rarely involves the mesenteric arteries. Herein, we report a case of fibromuscular dysplasia limited to the inferior mesenteric artery, which manifested with arterial aneurysms and ischemic colitis.

Purpose The purpose of this study was to examine the effects of a video education program in women receiving high-intensity focused ultrasound (HIFU) treatment. Methods This was a quasi-experimental study with a nonequivalent control group non-synchronized design. The participants were 54 patients who had benign uterine tumors and adenomyosis. The data were collected from June to August 2018. A 10-minute video education program on HIFU and post-procedural care was developed based on the literature. The experimental group was provided the video education program with a question-and-answer session for 10 minutes after viewing the video. The control group received usual care (i.e., verbal instructions on post-procedural self-care). The questionnaire survey was conducted twice: before the educational program and before being discharged from the hospital. Differences in uncertainty, emotions, and self-efficacy among patients were analyzed. Data were analyzed using the chi-square test, Shapiro-Wilk test, paired t-test, and t-test with SPSS version 23.0. Results The participants in the experimental group showed a decrease in uncertainty(t=4.33, p

Background : : Abnormal chest radiographs are frequently encountered in patients with scrub typhus. This study aimed to investigate whether chest radiography on admission is significant as a predictive factor for acute kidney injury (AKI) in patients with scrub typhus. Methods : : From 2010 to 2016, 467 patients were diagnosed with scrub typhus in our hospital. We divided the patients into two groups: normal chest radiograph (NCR) and abnormal chest radiograph (AbNCR), based on chest radiography findings. The incidence, clinical characteristics, and severity of AKI were compared between AKI and non-AKI groups according to the RIFLE classification. Results : : Of the 467 patients, 96 (20.6%) constituted the AbNCR group. Compared with NCR patients, AbNCR patients were older (71 ± 11 vs. 62 ± 13 years, P < 0.001) and had higher total leukocyte counts (9.43 × 103/mL vs. 6.98 × 103/mL, P < 0.001). The AbNCR group had significantly longer duration of hospital stay (8.9 ± 5.5 vs. 6.3 ± 2.8 days, P < 0.001) and higher incidence of AKI (46.9% vs. 15.1%, P < 0.001). The common abnormal chest radiographic findings were pulmonary abnormalities, such as pulmonary congestion and pleural effusion. The overall AKI incidence was 21.6%, of which 12.4%, 7.9%, and 1.3% cases were classified as risk, injury, and failure, respectively. In a multivariable logistic regression analysis for association with AKI, old age, presence of chronic kidney disease or hypertension, leukocytosis, hypoalbuminemia, and chest radiographic abnormalities on admission were significant predictors of AKI. Conclusion : : Chest radiographic abnormalities on admission were independently associated with AKI in patients with scrub typhus.

Serous cystic neoplasms of the pancreas are usually benign, with a low malignant potential. Herein, we report a case of malignant serous cystic neoplasm of the pancreas treated with subtotal pancreatectomy, which progressed to local recurrence and metachronous hepatic metastasis during the regular follow-up period.

An osteoma of the tongue is a rare benign tumor, typically located in the posterior one-third of the tongue. Several etiological hypotheses have been proposed in previous literature reviews. Herein, we report the case of a lingual osteoma in a 39-year-old woman, who complained of a lump in the throat. The lesion presented as a homogeneously hyperdense submucosal mass without any enhancement in the base of the tongue on CT, consistent with previous image findings of lingual osteoma. After surgical resection, the mass was pathologically proven to be a lingual osteoma. The patient no longer complained of the sensation of a lump. Typical CT findings of a lingual osteoma—a well-circumscribed hyperdense submucosal mass seen around the foramen cecum—could be helpful in the diagnosis of lingual osteoma and the prevention of further unnecessary work-up.

Primary effusion lymphoma is a large cell non-Hodgkin lymphoma exclusively presenting with effusions in body cavities in absence of solid tumor masses. It is typically associated with human herpesvirus 8 infection in immunocompromised patients with human immunodeficiency virus (HIV) infection. We report herein a case of primary effusion lymphoma in a HIV-negative patient.

Parkinson’s disease (PD) is a neurodegenerative disease, where treatment with medication may lead to gastrointestinal (GI) symptoms. The objective of this case study was to investigate the effectiveness of Korean medicine (KM) in treating PD with drug-induced GI dysfunction. A 70-year-old female participant was diagnosed with PD in 2010 and drug-induced gastritis in 2016. Her major symptoms were related to GI, PD, and overall feeling of weakness. She was treated with KM including pharmacopuncture, acupuncture, moxibustion, and herbal medicines, in combination with Western medicines during 46 days of in-patient care. This study showed an improvement in symptoms and scores on the GI symptom scale, Unified Parkinson’s disease rating scale, Hoehn and Yahr staging, Berg balance scale, PD quality of life, and stress index at discharge. This case demonstrated that the symptoms of drug-induced GI dysfunctions in PD was improved by treatment with KM.

We report a case of clinically occult diffuse large B-cell lymphoma (DLBCL) of the middle turbinate (MT) identified by 18F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18F-FDG PET/CT) in a 71-year-old man along with imaging findings. DLBCL was presented with a hypermetabolic right MT [maximum standardized uptake values (SUVmax) = 8.8 gm/dL] on 18F-FDG PET/CT, while rhinologic examination was normal. CT showed nothing but slightly more intense enhancement of the right MT compared with the opposite side. The disease progressed during next 7 months until follow-up CT demonstrated solidly enhancing mass occupying entire right nasal cavity which was intensely hypermetabolic (SUVmax = 12.8 gm/dL). Surgical biopsy confirmed the diagnosis. Follow-up CT and 18F-FDG PET/CT performed after chemotherapy demonstrated complete resolution of DLBCL of the right nasal cavity including the right MT. This is thought to be the first case report in the literature concerning clinically occult DLBCL presenting as a hypermetabolic MT on 18F-FDG PET/CT.

ObjectiveThis study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL).MethodsWe analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20–60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing.ResultsOf the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08–2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P

Objectives:We investigated the efficacy and safety of miniscalpel acupuncture (MA) for knee osteoarthritis (KOA) in an assessor-blinded randomized controlled pilot trial; this would provide information for a largescale randomized controlled trial.Methods:Participants (n = 24) were recruited and randomly allocated to the MA group (experimental) or acupuncture group (control). The MA group received treatment once a week for 3 weeks (total of 3 treatments), while the acupuncture group received treatment two times per week for 3 weeks (total of 6 treatments). The primary outcome was pain as assessed by a visual analogue scale (VAS). The secondary outcomes (intensity of current pain, stiffness, and physical function) were assessed using the short-form McGill Pain Questionnaire (SF-MPQ) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Assessments were performed at baseline, 1, 2, and 3 during treatment and at week 5 (2 weeks after the end of treatment).Results:Of the 24 participants, 23 completed the study. Both groups showed significant improvements in VAS, SF-MPQ, and WOMAC. However, there were no significant differences between the MA and acupuncture groups. No serious adverse event occurred and blood test results were within normal limits.Conclusion:Our results suggest that although both MA and acupuncture provide similar effects with regard to pain control in patients with KOA, MA may be more effective in providing pain relief because the same relief was obtained with fewer treatments. A large-scale clinical study is warranted to further clarify these findings.

Small cell carcinoma of the ovary, hypercalcemic type is a rare ovarian tumor. This tumor has three distinctive clinical features: i) an occurrence in young women, ii) the presence of hypercalcemia in 62% of cases, and iii) a high degree of malignancy. The radiologic findings of the tumors are usually large and a predominantly solid mass with internal necrosis, hemorrhage and cystic degeneration. We report on the CT and MRI findings of an ovarian small cell carcinoma, hypercalcemic type in a 17-year-old female who presented 1 month abdominal discomfort with weight loss.

During 2015-2017, we surveyed the incidence of viral infections of tomato and paprika growing in greenhouses in Cherwon province, Korea. In 2015 and 2016, we collected leaves and fruits from tomato and paprika plants growing in greenhouses. We detected viruses in the samples collected using specific primer sets for Broad bean wilt virus 2 (BBWV2), Cucumber mosaic virus (CMV), Pepper mild mottle virus (PMMoV), Pepper mottle mosaic virus (PepMoV), and Tomato spotted wilt virus (TSWV). We detected PMMoV, CMV, and TSWV in the samples, and CMV and TSWV were the most prevalent. For the prevention of future viral diseases, we then surveyed the routes of infection by these viruses in tomato and paprika plants growing in greenhouses in Cherwon province in 2017. Leaf and fruit samples were collected from seedlings and crops two and four months after transplanting into greenhouses. As a result, we found that TSWV was transferred from seedlings to plants, and outbreaks of the virus occurred at the early stage of cultivation. On the other hand, we found that CMV was a virus indigenous to the soil of some towns in Cherwon province, and thus outbreaks of this virus occurred at the middle stage of cultivation.

Background The purpose of this study was to survey the anatomical angiographic finding of the aneurysm and identify parameters associated with visual recovery of the patients with Terson syndrome (TS). Methods This retrospective study was conducted on 494 patients with aneurysmal subarachnoid hemorrhage (SAH) from 2008 to 2015. Radiologists independently reviewed findings on computed tomography scans and cerebral digital subtraction angiography. Ophthalmologists conducted ophthalmological examinations for patients who had no communication problem. The degree of visual acuity recovery (DVAR) was measured based on the visual acuity difference between the initial and sixth-month follow-up. Favorable visual recovery was defined as DVAR >0.4. Results A total of 494 patients diagnosed with aneurysmal SAH were given admission to a single institute, of whom 171 received ophthalmological examinations. Of the total, 40 patients were diagnosed with TS and 54 eyeballs were affected by vitreous or retinal hemorrhage. In the multivariable analysis, male sex (odds ratio [OR] 9.530; 95% confidence interval [CI] 1.824-49.801), favorable Glasgow coma scale (GCS) (≥13 points) (OR 8.073; 95% CI 1.226-53.148), and anterior orientation of aneurysm (OR 5.006; 95% CI 1.842-29.751) were identified as independent factors predicting favorable visual recovery after adjusting covariables. Conclusion TS was identified in 23.4% of patients with aneurysmal SAH. Male sex, favorable GCS at admission, and anterior orientation of the aneurysm were identified as prognostic factors for favorable visual recovery. It is proposed that positive ophthalmologic consultation and treatment can be helpful in improving vision and quality of life of TS patients.

Background: Volume overload results in higher mortality rates in patients on continuous ambulatory peritoneal dialysis (CAPD). The ratio of bioimpedance (RBI) might be a helpful parameter in adjusting dry body weight in CAPD patients. This study examined whether it is possible to distinguish between non-hypervolemic status and hypervolemic status in CAPD patients by using only RBI. Methods: RBI was calculated as follows: RBI = impedance at 50 kHz/impedance at 500 kHz. Based on the experts’ judgements, a total of 64 CAPD patients were divided into two groups, a non-hypervolemic group and a hypervolemic group. The RBI was measured from right wrist to right ankle (rw-raRBI) by bioimpedance spectroscopy (BCM®, Fresenius Medical Care) before and after the peritosol was emptied. Other RBIs were measured from the right side of the anterior superior iliac spine to the ipsilateral ankle (rasis-raRBI) to control for the electro-physiological effects of peritoneal dialysate. Results: The mean rw-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients in the presence (1.141 ± 0.022 vs. 1.121 ± 0.021, P < 0.001) of a peritosol. Likewise, the mean rasis-raRBI of non-hypervolemic patients was higher than that of hypervolemic patients (presence of peritosol: 1.136 ± 0.026 vs. 1.109 ± 0.022, P < 0.001; absence of peritosol: 1.131 ± 0.022 vs. 1.107 ± 0.022, P < 0.001). Conclusion: The volume status of CAPD patients was able to be simply expressed by RBI. Therefore, this study suggests that when patients cannot be analyzed using BCM, RBI could be an alternative.

Background Glanzmann thrombasthenia (GT) is a rare disease with severe insufficiency of platelet function. There are no reports of GT associated with a cerebral hemorrhage. Case report A 45-year-old woman had a stuporous mentality. Her computed tomographic (CT) angiography revealed a rupture of the posterior cerebral artery aneurysm. Hunt-Hess grade was 4 points and Fisher grade was 3 points. A clipping of the aneurysm was performed and proceeded to external ventricular drainage for hydrocephalus after 6 days. But, a new hemorrhage was detected several times via a follow-up brain CT. Various blood tests were conducted to evaluate the bleeding tendency, and the GT was diagnosed with PFA-200. The ventriculoperitoneal shunt was performed after the platelets transfusion, and she was discharged without other complications. Conclusion With nonspecific and recurrent intracranial hemorrhage, a GT should be included in the differential diagnosis, which is important in controlling bleeding during the surgery.

Background: Colistin (polymyxin E) is active against multidrug-resistant Gram-negative bacteria (MDR-GNB). However, the effectiveness of inhaled colistin is unclear. This study was designed to assess the effectiveness and safety of aerosolized colistin for the treatment of ventilator-associated pneumonia (VAP) caused by MDR-GNB. Methods: In this retrospective longitudinal study, we evaluated the medical records of 63 patients who received aerosolized colistin treatment for VAP caused by MDR-GNB in the medical intensive care unit (MICU) from February 2012 to March 2014. Results: A total of 25 patients with VAP caused by MDR-GNB were included in this study. The negative conversion rate was 84.6% after treatment, and acute kidney injury (AKI) occurred in 11 patients (44%, AKI group). The average length of MICU stay and colistin treatment-related factors, such as daily and total cumulative doses and administration period, were not significantly different between groups. In-hospital mortality tended to be higher in the AKI group (p = 0.07). Multivariate analysis showed that a body mass index less than 18 was an independent risk factor of mortality (odds ratio [OR] = 21.95, 95% confidence interval [CI] 1.59-302.23; p = 0.02). Notably, AKI occurrence was closely related to the administration of more than two nephrotoxic drugs combined with aerosolized colistin (OR = 15.03, 95% CI 1.40-161.76; p = 0.025) and septic shock (OR = 8.10, 95% CI 1.40-161.76; p = 0.04). Conclusions: The use of adjunctive aerosolized colistin treatment appears to be a relatively safe and effective option for the treatment of VAP caused by MDR-GNB. However, more research on the concomitant use of nephrotoxic drugs with aerosolized colistin will be necessary, as this can be an important risk factor of development of AKI.

Periampullary diverticulum is commonly found during endoscopy and can occur at any age although its prevalence increases with age. Periampullary diverticular bleeding is a rare and difficult to diagnose during clinical practice because of its unique appearance and location. This often can lead to massive bleeding and interfere with adequate bleeding control. Endoscopic management on duodenal diverticular bleeding is limited compared to colonic diverticular bleeding due to lack of experience. Herein, we report a case of active bleeding from a periampullary diverticulum during bile duct stone extraction diagnosed by side-viewing endoscope and successfully controlled using hemoclips without any complications. (Korean J Gastroenterol 2016;67:146-149)

Multiple enchondromas are well described in the literature, however, the associated spectrum of MR imaging findings remains unclear. Secondary chondrosarcoma of the hand and feet associated with multiple enchondromas is extremely rare. Herein, we reported a case of multiple enchondromas of intramedullary, intracortical, and periosteal location with associated low-grade chondrosarcomas in the lower extremities on MR imaging in a 57-year-old woman.

Purpose To describe the chest radiographic findings of acute paraquat poisoning. Materials and Methods 691 patients visited the emergency department of our hospital between January 2006 and October 2012 for paraquat poisoning. Of these 691, we identified 56 patients whose initial chest radiographs were normal but who developed radiographic abnormalities within one week. We evaluated their radiographic findings and the differences in imaging features based on mortality. Results The most common finding was diffuse consolidation (29/56, 52%), followed by consolidation with linear and nodular opacities (18/56, 32%), and combined consolidation and pneumomediastinum (7/56, 13%). Pleural effusion was noted in 17 patients (30%). The two survivors (4%) showed peripheral consolidations, while the 54 patients (96%) who died demonstrated bilateral (42/54, 78%) or unilateral (12/54, 22%) diffuse consolidations. Conclusion Rapidly progressing diffuse pulmonary consolidation was observed within one week on follow-up radiographs after paraquat ingestion in the deceased, but the survivors demonstrated peripheral consolidation.