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This review examined and analyzed clinical research trends in the treatment of compression fractures in traditional Korean medicine using case studies. Accordingly, 5 web databases were searched using relevant Korean and English terms. Based on predefined exclusion and inclusion criteria, 16 case studies were selected, analyzed, and classified according to the journal, publication year, participants, chief complaints, affected vertebrae, treatment and evaluation methods, and improvement. The case studies reported various treatment methods, including acupuncture, herbal medicine, physical therapy, cupping, moxibustion, and band training. All 16 case studies reported the use of combination therapy. All 23 cases reported in these case studies demonstrated improvement in chief complaints, and none reported any side effects.

Background and Objectives Laryngopharyngeal reflux (LPR) is an increasingly common disease, characterized by stomach acid reflux reaching the upper airways. Postnasal drip (PND) is a known consequence of LPR, defined as mucus accumulation perceived in the posterior areas of the nose and throat. PND is among the most common causes of persistent cough, hoarseness, sore throat, and other symptoms, affecting the quality of life. This study aimed to evaluate the effects of a proton-pump inhibitor (PPI) on PND symptoms in patients with LPR. Methods We prospectively enrolled patients diagnosed with LPR at our institution between September 2019 and June 2020. The patients were randomly assigned to either the treatment group (20 mg of ilaprazole daily for 8 weeks) or the control group. The scores for the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and Sino-Nasal Outcome Test (SNOT)-20 were evaluated at baseline and at the end of treatment, focusing on PND symptoms. Results Eighty patients (28 men and 52 women; mean age, 48.8 years, range, 22–78 years) were enrolled, with 43 in the treatment group and 37 in the control group. The initial RSI, RFS, and SNOT-20 scores were similar between the two groups, and they decreased significantly only in the treatment group (p=0.002, p

PURPOSE This study aimed to: 1) compare the differences in static lower-extremity alignment (SLEA) between female ballet dancers (BD) and non-ballet dancers (NBD); 2) investigate the differences among gesture leg (GL) and supporting leg (SL) in BD and dominant leg (DL) in NBD; and 3) compare limb asymmetry between groups. METHODS Twenty-nine female BD and 20 NBD were recruited for this study. The quadriceps, tibiofemoral, rearfoot, and genu-recurvatum angles, tibial torsion and varum, and navicular drop height were measured. An independent t-test was conducted to compare SLEA and limb asymmetry between groups. One-way analysis of variance with Bonferroni post-hoc tests were performed to determine the differences among the GL, SL and DL. RESULTS BD showed lower quadriceps and rearfoot angles, less tibial varum and navicular drop, and greater tibiofemoral angle (p

PURPOSE The purpose of this study was to investigate the characteristics of field and on-ice performances of ice-hockey players and the relationship of performance with subjective joint pain and dysfunction. METHODS A total of 25 male college icehockey players were evaluated for 19 items of performance. Pain and dysfunctions in the lower extremities and lower back were confirmed through the Foot and Ankle Outcome Score, Knee Injury and Osteoarthritis Outcome Score, Hip Dysfunction and Osteoarthritis Outcome Score, and Osweatry Disability Index questionnaire. Players with similar performance characteristics were classified through a cluster analysis, and differences in performance and patient-reported outcomes between clusters were analyzed with a one-way analysis of variance. RESULTS The ice-hockey players were classified into “lower muscular strength and performance (cluster 1),” “lower cardiorespiratory endurance (cluster 2),” and “high muscular strength and performance (cluster 3).” Players in cluster 1 had more frequent ankle and knee joint dysfunctions and pain compared to those in cluster 3. Several performance test items affected the subjective joint score, and the related performance items were more in the proximal joint than in the distal joint. CONCLUSIONS Ice hockey players should perform training to supplement their individual lack of on-ice and field performance. Since performance may be limited because of joint dysfunction and pain, a joint-specific intervention strategy should be applied to improve physical and athletic performances.

Drug-induced dyskinesia is an involuntary muscle movement caused by various dopamine receptor-blocking drug exposure, such as antipsychotics, antidepressants, and antiemetics. Causative drug removal is the main treatment for drug-induced dyskinesia whenever possible because its pathophysiology lacks a universally accepted mechanism; however, the symptoms can persist for years or decades in many patients even after causative drug removal. Herein, we present a case of drug-induced dyskinesia in a 61-year-old female patient who consumed medication for approximately 10 years for her depression, anxiety, and insomnia. Cervical and facial dyskinesia was suggested to be related to perphenazine and levosulpiride administration. The patient received acupuncture, pharmacopuncture, herbal medicine, and chuna treatment for 81 days during hospitalization. The symptoms were evaluated using the Abnormal Involuntary Movement Scale, Toronto Western Spasmodic Torticollis Rating Scale, Tsui’s score, and Numeric Rating Scale, which revealed remarkable improvement, suggesting the effectiveness of combined Korean medicine for drug-induced dyskinesia.

This research was conducted to determine the biodiversity of higher fungi at the supersite of Mt. Jeombong from July to October 2017 during the second long-term ecology research by the National Institute of Ecology under the management of the Ministry of Environment of Korea. Forty-three families, 74 genera, and 130 species of higher fungi were found within the permanent square area of Mt. Jeombong and a 10 m radius of the ecological flux tower. Russulaceae (54 species, 21.9%), Amanitaceae (17 species, 6.9%), and Boletaceae (17 species, 6.9%) were the top three species taxa found in mycorrhizal mushrooms. Mycenaceae (nine species, 8.5%), Polyporaceae (11 species, 4.5%), and Strophariaceae (11 species, 4.5%) were the top three species taxa found in saprophytic mushrooms. These results were analyzed and compared with those of previous fungal mushroom studies.

PURPOSE This study aimed to identify movement pattern differences in the running of youth soccer players with and without lateral ankle sprain (LAS) histories. METHODS A total of 12 participants were recruited and assigned to the LAS group or the control group. All participants were assessed for anthropometric data, and they filled in the subjective ankle function questionnaires. Then, reflective markers were attached to their bodies, and they were instructed to run at the preferred speed on the 9-m runway thrice. 3D joint angles for ankle, knee, and hip joints were exported, and their mean values and 95% confidence intervals were calculated. Ensemble curve analysis was conducted to compare running kinematics between the groups. RESULTS The LAS group exhibited fewer dorsiflexion angles and more inversion angles compared to the control group. Excluding the dorsiflexion deficits and more inverted ankles, there were no significant differences between the groups. CONCLUSIONS Although the ankle kinematic patterns found in this paper are not considered LAS risk factors, it will be able to identify precise LAS risk factors with prospective design (e.g., lower extremity movement patterns) as well as intrinsic risk factors.

Background and Objectives Little is known about studies evaluating positive airway pressure (PAP) compliance after re-prescription. Therefore, the aim of this study was to investigate PAP compliance after re-prescription in obstructive sleep apnea (OSA) patients who failed initial PAP therapy. Methods We retrospectively reviewed OSA patients who had received a re-prescription for PAP from March 2020 to June 2021. We compared the compliance rate between initial prescription and re-prescription for PAP and investigated the reasons for PAP failure after the first prescription. Results A total of 10 consecutive OSA patients (mean age=45.6±13.7 years and male:female=8:2) who received a re-prescription for PAP were included. Of them, 8 patients (80%) met the compliance criteria (i.e., Korean National Health Insurance criteria) for PAP after re-prescription. The compliance rate increased from 36.3±18.2% (initial prescription) to 61.3±28.8% (re-prescription); this was not of statistical significance (p=0.074). PAP/mask-related discomfort was the most common reason for PAP failure, followed by nasal obstruction, unintentional mask removal, and pressure-related discomfort. Conclusion Even if initial PAP therapy fails, the proportion of patients who meet the compliance criteria may be improved through various forms of clinical aid and support after re-prescription of PAP.

Purpose The lifestyle changes during the coronavirus disease 2019 pandemic possibly affected mental health among the pediatric population. We aimed to analyze changes in psychiatric emergency-related visits to the emergency department (ED). Methods We reviewed cases of pediatric patients (≤ 18 years) who visited the ED of a tertiary hospital with psychiatric emergency as a chief complaint from March 2019 through February 2021. The study period was dichotomized by March 2020, starting point of social distancing, into the pandemic and control periods. Clinical data were collected and compared between the 2 periods. Results A total of 246 cases with a mean age of 15.2 years were included. The overall visits to the ED decreased to 43.8% whereas the proportion of psychiatric emergency-related visits increased during the pandemic period, compared to the control period (0.5% vs. 1.0%; P < 0.001). The cases with suicidality, including ideation and attempt, increased in both number and proportion during the pandemic period (51 [38.9%] vs. 63 [54.8%]; P = 0.013). Conclusion Pediatric psychiatric emergency-related visits, particularly suicidality, proportionally increased during the pandemic. This finding may be useful to prepare psychiatric resources in EDs.

Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

Candida is one of the most common causes of bloodstream infections and a leading cause of morbidity and mortality among hospitalized patients. The purpose of this study was to provide important information for formulating empirical treatment plans for candidemia by investigating the antifungal resistance rate of Candida. Among the Candida strains (973 cases) isolated from blood culture tests at the S hospital in 2009~2018, 4.7% (N=44) comprising the Candida spp. (932 strains) showed resistance to fluconazole. The resistant strains included C. albicans, C. parapsilosis, C. tropicalis, and C. glabrata. In addition Candida spp. (947 strains) showed resistance to amphotericin B (N=6, 0.6%), flucytosine (N=23, 2.4%) and voriconazole (N=24, 3.1%). C. albicans was resistant to fluconazole (N=23, 6.9%) and voriconazole (N=21, 6.0%), The statistical analysis showed that C. albicans and non-albicans Candida species were resistant to fluconazole (P=0.039) and voriconazole (P

OBJECTIVES This study examined the immediate effect of unilateral ankle or knee joint cooling on the low-erextremity kinematics and kinetics during two-legged jumping and landing. METHODS Twenty healthy adults randomly completed three data collection sessions for ankle or knee joint cooling, or control. For each session, participants performed two-legged countermovement jumps and lands. For joint cooling, two ice bags were directly placed to the right side and secured with a compression bandage. A three-dimensional motion analysis system (200 Hz) with two floor-embedded force platforms (2000 Hz) was employed to capture the jumping and landing. The cooling effects on kinematical (flight time, and sagittal plane joint angles) and kinetical (peak vertical ground reaction force (vGRF), impulse, and sagittal plane joint moments) variables were examined. A mixed-model analysis of variance was performed for each dependent variable (p≤0.0001 for all tests). RESULTS We did not observe any interactions (flight time: F2,95=0.67, p=0.52; joint angles: F2,209≤2.26, p≥0.10; peak vGRF: F2,209≤1.76, p≥0.20; impulse: F2,209≤2.54, p≥0.10; joint moments: F2,209≤4.80, p≥0.01 for all interactions). Regardless of condition and time (side effect), subjects showed a dominant-leg predominant movement strategy. Specifically, the right side showed a greater peak vGRF (2%), and greater ankle (7%), knee (6%), and hip (11%) joint moments, as compared with the left side during jumping. The same movement pattern was observed during landing that there was greater peak vGRF (11%) and impulse (8%), and greater ankle and knee joint moments (15%). Regardless of time and side (condition effect), subjects with ankle joint cooling showed 5% lesser ankle joint moment during jumping, compared with those who received knee joint cooling (p=0.0001). CONCLUSIONS A 20-min of unilateral ankle or knee joint cooling seems to neither alter vertical jump height nor change movement biomechanics during two-legged jumping and landing.

We report a case of inguinal hernia that contained the entire uterus and both adnexa, presenting with an irreducible soft mass in the left groin and asymmetric labia majora, in a 2-month-old, full-term girl who visited the emergency department. Ultrasonography was performed immediately, and urgent surgical repair was performed without complications. Although inguinal hernia is a common surgical disease, it is rare that the hernia contains the uterus with its adnexa, and presents as a mass of the labia majora. Unlike the bowel herniation, the entity can be complicated by strangulation of the ovary, leading to infertility. To preserve fertility, rapid and accurate diagnosis using ultrasonography should be considered in an infant with an irreducible inguinal mass and asymmetric labia majora.

Button battery ingestion requires emergency endoscopic removal since severe complications, such as esophageal perforation, can develop within 4 hours of the ingestion. Given that guardians do not witness the children’s foreign body ingestion 40% of the time, physicians can only guess what was swallowed based on plain radiography. We report a case of a 45-month-old-boy who visited the emergency department after swallowing an unknown foreign body and whose radiographs showed “circle-within-a-circle appearance” on the anteroposterior view and “step-off appearance” on the lateral view, suggesting button battery ingestion. We conducted emergency endoscopic removal, and found stacked coins mimicking a button battery on the radiographs. The coins were pushed into the stomach and came out through defecation 3 weeks later without further complications. Distinguishing between stacked coins and a button battery through radiography may help avoid unnecessary emergency endoscopy.

Tuberculosis of the cystic duct lymph node is very rare. Only four cases have been reported in the literature. This paper presents the case of a young male patient with a tuberculous cystic duct lymph node and chronic cholecystitis, who was diagnosed with cystic duct stones and a gall bladder polyp preoperatively.

There were 26 Bell’s palsy cases at the Jecheon Hospital of Korean medicine, Semyung University from February 1, 2019, to February 28, 2021 reviewed. One group (A group) was treated with Bamboo salt pharmacopuncture and cervi cornu parvum pharmacopuncture (CC) pharmacopuncture in the paralyzed side of the face, and the other (B group) group was treated with Soyum pharmacopuncture, and hominis placenta (HP) pharmacopuncture. Amid a paucity of studies that have used bamboo salt and CC pharmacopuncture to treat Bell’s palsy, this study aimed to demonstrate possibility of treatment effect on Bell’s palsy. In addition, this study was to see if the effect of determine a change in pharmacopuncture was changed according to the progress of Bell’s palsy symptoms was effective. Bell’s palsy was improved in each group. Altough there were no significant differences in improvement between two groups, Bamboo salt pharmacopuncture and CC pharmacopuncture could be expected to be effective on the paralyzed face. Furthermore, it is effective to switch pharmacopuncture according to the progress of Bell’s palsy.

This study was conducted to find the biodiversity of higher fungi at the supersite of Mt. Jeombong from July to October 2016 during the Second Long Term Ecology Research project. A total of 31 families, 52 genera, and 120 species of higher fungi were found within the permanent 1 ha qaudrat and in a 10 m radius of the ecological flux tower. From a taxonomical and ecological perspcetive, Russulaceae (22 species, 18.0%), Boletaceae (17 species, 13.9%), and Amanitaceae (10 species, 8.2%) were the top 3 taxa with the most species found in mycorrhizal mushrooms. Marasmiaceae (10 species, 9.8%), Mycenaceae (8 species, 6.6%), and Polyporaceae (6 species, 4.9%) were also the top 3 taxa with the most species found in saprophytic mushrooms.

Background Cupping is widely used in Korean medicine, but there is a risk of bacterial infection if the suction pump (used for inducing negative pressure) and the patients’ skin are not separated. This study aimed to investigate the effect of layer cupping by comparing the pressure changes between layer cupping and conventional cupping. Methods To evaluate pressure changes the study was designed with 3 types of conditions applied to a skin model: (1) a Dongbang cup with a manual or motor suction pump (conventional cupping); (2) layer cupping with 2 Dongbang cups; and (3) layer cupping with a cup made by 3D printing and a Dongbang cup. Results When a manual suction pump was used (conventional cupping), the pressure did not decrease steadily, and in 1 section there was an increase in pressure. When layer cupping was used, the pressure in the lower cup (which would be directly applied to the patient’s skin), decreased steadily. Conclusion In the pressure change graph for layer cupping in this skin model, the pressure in the lower cup (which would be placed on the patient’s skin) steadily decreased, and reached equilibrium. Therefore, the layer cupping model may help to reduce the risks of bacterial infection.

The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (> 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future.

MRI has the advantages of having excellent soft-tissue contrast and providing functional information without any harmful ionizing radiation. Although previous technical limitations restricted the use of chest MRI, recent technological advances and expansion of insurance coverage are increasing the demand for chest MRI. Recognizing the need for guidelines on appropriate use of chest MRI in Korean clinical settings, the Korean Society of Radiology has composed a development committee, working committee, and advisory committee to develop Korean chest MRI justification guidelines. Five key questions were selected and recommendations have been made with the evidence-based clinical imaging guideline adaptation methodology. Recommendations are as follows. Chest MRI can be considered in the following circumstances: for patients with incidentally found anterior mediastinal masses to exclude non-neoplastic conditions, for pneumoconiosis patients with lung masses to differentiate progressive massive fibrosis from lung cancer, and when invasion of the chest wall, vertebrae, diaphragm, or major vessels by malignant pleural mesothelioma or non-small cell lung cancer is suspected. Chest MRI without contrast enhancement or with minimal dose low-risk contrast media can be considered for pregnant women with suspected pulmonary embolism. Lastly, chest MRI is recommended for patients with pancoast tumors planned for radical surgery.

Lentinula edodes (Berk.) Pegler, the most produced mushroom in the world, is an edible mushroom with very high nutritional and pharmacological value. Currently, interest in the protection of genetic resources is increasing worldwide, and securing the distinction between new cultivars is very important. Therefore, the development of efficient molecular markers that can discriminate between L. edodes cultivars is required. In this study, we developed cleaved amplified polymorphic sequence (CAPS) markers for the identification of L. edodes cultivars (Sanbaekhyang and Sulbaekhyang). These markers were developed from whole genome sequencing data from L. edodes monokaryon strain B17 and resequencing data from 40 cultivars. A nucleotide deletion existed in scaffold 19 POS 214449 in Sanbaekhyang (GT→G), and a single nucleotide polymorphism changed in scaffold 7 POS 215801 in Sulbaekhyang (G→A). The restriction enzymes HhaⅠ and HpyCH4Ⅳ distinguished Sanbaekhyang and Sulbaekhyang, respectively, from other cultivars. Thus, we developed two CAPS markers for the identification of the L. edodes cultivars Sanbaekhyang and Sulbaekhyang.

Combined Western-Korean medicine treatments were given to a 67-year-old woman with late onset seizures who underwent surgical drainage of a subdural hematoma. Clonazepam and herbal medicine was prescribed. Acupuncture, moxibustion, cupping, chuna, and physical therapy were also performed. The frequency and intensity of seizures was assessed using the Chalfont Seizure Severity Scale. The seizure index score improved from 25 at admission to 0 at discharge. Pain in the right upper extremity reduced from 10 to 0 on the visual analogue scale and muscle strength increased from Grade 3 to 5 in Medical Research Council Scale for the Manual Muscle Test. At the time of hospitalization, the manual muscle strength tests for the affected shoulder, elbow, wrist, and grip strength were 30%, 60%, 10%, 5%, respectively, which improved almost 100% by discharge. Further studies using combined Western-Korean medicine for seizures after strokes are necessary to determine the most effective treatment.

Background Pressure changes related to temperature variation during cupping may lead to dropout. This study aimed to investigate pressure changes related to temperature variations in the cup during the cupping procedure. Methods Changes in temperature and pressure were measured for 15 minutes after the procedure was performed using the alcohol rub method with glass cups and with the addition of infrared irradiation. Changes in temperature and pressure were also measured for 15 minutes after pumping 3 times using the valve suction method, and with the addition of infrared irradiation. Results In a comparison between the alcohol rub method with glass cups and with the addition of infrared irradiation, the negative pressure increased over time in the absence of infrared irradiation, whereas it decreased when performed with infrared irradiation p = 0.094. However, in a comparison between pumping 3 times using the valve suction method, and with the addition of infrared irradiation, the negative pressure decreased in both cases, but this was more significant with infrared irradiation p = 0.172. There was a significantly higher temperature in the glass cups (p = 0.004) and the valve cups (p = 0.001) exposed to infrared radiation, compared with no infrared irradiation. Conclusion The reduction in negative pressure inside the cups exposed to infrared radiation was greater than without infrared irradiation. Temperature increases inside the cup can lead to the risk of dropout.

OBJECTIVES The purpose of this study is to analyze the effect of changes in cervical alignment on balance ability, to correct cervical alignment, and to present effective interventional variables that can improve balance ability. METHODS Group 1 (Deformed cervical alignment group, n = 16) and Group 2 (Normal cervical alignment group, n = 16). The subjects measured their balance ability before and after treatment with chiropractic and shoulder flexibility exercises. Balance ability was measured by static balance and dynamic balance. For Group 1, chiropractic was treated once a week for 15 minutes, and shoulder flexibility exercise was treated three times a week for one hour. The pre- and post-measurement results of Group 1 were compared with Group 2, and differences among groups and groups were analyzed. The test method was tested with the Independent t-test and Paired t-test. RESULTS Group 1 showed a significant reduction (p

The purpose of this study was to evaluate the evidence supporting the effectiveness of moxibustion treatment for osteoarthritis. There were 9 databases used to retrieve randomized controlled trials (RCTs) that used moxibustion as treatment for osteoarthritis. The quality of methodology for the RCTs was assessed using the Cochrane Risk of Bias tool [Review Manager (RevMan) Version 5.3 Windows, The Nordic Cochrane Centre, Copenhagen, Denmark]. The inclusion criteria for this review was met by 27 RCTs. All studies were conducted in China. A 4-week moxibustion treatment period was the most common. EX-LE4 and SP10 and GB34 acupoints were most frequently selected in the treatment of osteoarthritis. The most commonly used evaluation index was the visual analog scale (VAS). All studies, including a meta-analysis showed that moxibustion treatments were statistically significantly effective at treating knee osteoarthritis. However, well-designed randomized RCTs without a high risk of bias should be designed in the future.

PURPOSE We examined the immediate effect on ankle or knee joint cooling on the lower-extremity activation during a single-leg drop jump. METHODS Twenty healthy adults randomly completed three data collection sessions (a 20-minute ankle or knee joint cooling, or control). Two wireless surface electromyography (EMG, 2,000 Hz) electrodes were attached over the vastus medialis (VM) and the medial gastrocnemius (MG) on their right limb. Subjects were asked to drop down from a wooden box (a 30-cm height) on their right foot onto the force platform (2,000 Hz) and then performed an immediate jump as high as they could. Whole EMG signals (normalised by the mean EMG value recorded during a reference position) within the preactivation (100-ms prior to contact) and the ground contact (on the force platform) during the drop jump task were analysed using functional linear models(p=.05, Cohen’s d effect size: ES). RESULTS After knee joint cooling, (1) the VM activation was decreased during the ground contact (6 to 14%, 30 to 45%, 60 to 90% for ES of 0.50, 0.47, and 0.61, respectively) and (2) the MG activation was increased during the preactivation (84- to 29-ms prior to initial contact, ES=1.30) and the ground contact (59 to 100%, ES=1.40). No changes were observed under the condition of ankle joint cooling or control. CONCLUSIONS A 20-minute unilateral knee joint cooling may result in an ipsilateral quadriceps inhibition during a drop jump task. The gastrocnemius appears to increase activation as a compensatory strategy responding to the quadriceps inhibition. The altered neuromuscular activations do not seem to put an individual at risk of injury, resulting from compressive forces in the sagittal plane.

This case study reports the effect of Korean medicine treatments on a 73 year-old female who had a cerebellar infarction. She was hospitalized for 120 days (without visiting Western medicine hospital) where she was treated with acupuncture, herbal decoction, pharmacopuncture, chuna, moxibustion and physiotherapy. Following treatment, her symptoms of dizziness were evaluated using the numeric rating scale and showed pain had reduced (3 to 0). The K-Modified Barthel, showed that life performance had improved (15 to 74), and the Berg balance scale showed an improved balance (2 to 32). Steps per minute and gait posture at stance phase for ataxia also showed improvement. This case report shows that Korean medicine treatment is effective in alleviating dizziness and improved gait instability caused by cerebellar infarction.

The study examined the seasonal pattern of larvae, nymph, and adult life stages for Haemaphysalis longicornis and the rate of infection with severe fever from the thrombocytopenia syndrome virus in ticks collected from 12 sections (Jichukdong), 14 sections (Uldaeri), and 18 sections (Howondong) in Bukhansan dullegil for April–October 2019. Haemaphysalis longicornis ticks have been considered the main vector for severe fever with thrombocytopenia syndrome (SFTS). Haemaphysalis flava and Ixodes nipponensis were collected using the dragging and flagging method. The ratios of Haemaphysalis longicornis of the collected ticks were 91% (Jichukdong), 94% (Uldaeri), and 98% (Howondong). Monthly distributional studies of Haemaphysalis longicornis based on the developmental stage showed that the adults peaked in September while nymphs were collected more frequently from April through June. The larvae peaked in September and October. SFTS virus detection was performed using 2 × OneStep RT-PCR and nested PCR. On the other hand, no SFTS virus-specific gene was detected in 1,158 ticks of Haemaphysalis longicornis. This result provides estimates of the population densities for the life stages of Haemaphysalis longicornis and the associated disease risk in Bukhansan dullegil, where many people have visited since opening in 2010.

Purpose: We investigated the effect of severe calcification of the femoropopliteal artery on intervention outcomes in patients with ischemic tissue loss. Materials and Methods : : A retrospective review of the first endovascular treatment of the femoropopliteal artery for ischemic tissue loss between May 2010 and February 2018 was performed. The calcification of femoropopliteal lesions was estimated by the Compliance 360° score, and lesions with a score of 4 were defined as severe calcification lesions. Results : : Overall, 135 first femoropopliteal endovascular procedures on 135 limbs from 112 patients were included in this study. Among the 135 limbs that received treatement of the femoropopliteal arteries, 74 limbs had Trans-Atlantic Inter Society Consensus (TASC) A or B lesions and 61 limbs had TASC C or D lesions. Among 61 cases of TASC C or D lesions, 21 limbs (34.4%) had severe calcification; there was no statistically significant difference in limb salvage (P=0.75), and amputation-free survival (P=0.11) based on the degree of calcification. However, the survival rate in TASC C or D lesions was significantly different between the two groups (non-severe calcification group vs severe calcification group at 1-year, 2-years, and 3-years: 88.6%, 79.7%, and 61.0% vs 70.0%, 56.0%, and 28.0%, respectively, P=0.01). In multivariate analysis of influencing factors for poor survival in TASC C or D using the Cox proportional hazards model, severe calcification (hazard ratio, 2.362; 95% confidence interval, 1.035-5.391; P=0.041) was a statistically significant risk factor. Conclusion : : Severe femoropopliteal artery calcification was associated with poor survival, especially in TASC C or D lesions.

Metabolic syndrome (MetS) is a group of risk factors that causes cardiovascular and diabetic morbidity and mortality, which is diagnosed by central obesity, dyslipidemia, hyperglycemia, and hypertension. Increasing epidemiological data and experimental results indicate that the presence of MetS increases the incidence of common malignancies and related mortality. Epidemiological studies have previously reported an association of endometrial cancer occurrence with MetS. Aromatization of androstenedione to estrogen, insulin resistance, and diabetes can cause increased levels of free estrogen, and the detrimental effect of elevated estrogen as a carcinogen is well studied in endometrial cancer. Medications used to manage MetS such as metformin and statins are suggested to reduce endometrial cancer risk and improve survival. Some large population-based epidemiological studies have suggested that the MetS is related to an increased risk of cervical carcinoma. MetS may contribute to viral-host interactions, which lead to persistent human papilloma virus (HPV) infection, although limited epidemiological data are available. Specific effects of obesity and diabetes on the occurrence of ovarian cancer have been suggested. However, the direct correlation between MetS and ovarian cancer is still lacking. Previous retrospective studies reported that the use of metformin, statins, and beta-blockers could be associated with cancer prevention or better prognosis. Proper diagnosis and management of the MetS should be a part of the strategies undertaken to prevent and treat gynecologic cancer. So far, only limited data is available on this subject, and further clinical and fundamental research is required to further clarify the effect of these therapies on gynecologic cancer treatment.

Background: The aim of this study was to evaluate the short-term and long-term results of surgical treatment for native valve endocarditis (NVE) and to investigate the risk factors associated with mortality. Methods: Data including patients’ characteristics, operative findings, postoperative results, and survival indices were retrospectively obtained from Hallym University Sacred Heart Hospital. Results: A total of 29 patients underwent surgery for NVE (affecting the mitral valve in 20 patients and the aortic valve in 9) between 2003 and 2017. During the follow-up period (median, 46.9 months; interquartile range, 19.1–107.0 months), the 5-year survival rate was 77.2%. In logistic regression analysis, body mass index (p=0.031; odds ratio [OR], 0.574; 95% confidence interval [CI], 0.346–0.951), end-stage renal disease (ESRD) (p=0.026; OR, 24.0; 95% CI, 1.459–394.8), and urgent surgery (p=0.010; OR, 34.5; 95% CI, 2.353–505.7) were significantly associated with in-hospital mortality. Based on Cox proportional hazard regression analysis, the statistically significant predictors of long-term outcomes were hypertension, ESRD, and urgent surgery. Conclusion: Surgical treatment for NVE is associated with considerable mortality. The in-hospital mortality and 5-year survival rates of this study were 13.8% and 77.2%, respectively. Underlying conditions, including hypertension and ESRD, and urgent surgery were independent risk factors for unfavorable outcomes.

Background: A major complication of peritoneal dialysis (PD) is peritonitis, and bacterial culture of PD effluent in a blood culture bottle is the preferred technique for diagnosis of peritonitis. In this study, we compared dialysate inoculation and culture using the BacT/AlerTⓇ Fastidious Antimicrobial Neutralization Plus blood culture bottles (FAN Plus; bioMérieux, France) to the conventional centrifugation culture method.Methods: A total of 170 PD effluents were simultaneously processed by the conventional centrifugation culture method and by culture using FAN Plus media with two different inoculation procedures: inoculation after centrifugation and direct bedside inoculation.Results: Of the 52 cultures that were positive on at least one of the culture methods, 27 samples were positive on conventional centrifugation. However, 46 samples showed growth following inoculation into the FAN Plus media after centrifugation, and 47 samples were positive on the direct FAN Plus inoculation method. Using the case definition for PD peritonitis to classify samples, sensitivity of the conventional method was 50.0% (95% CI, 33.7-66.3%), whereas the sensitivity of the FAN Plus media was 78.9% (95% CI, 62.2-89.9%) by inoculation after centrifugation and 86.8% (95% CI, 71.1-95.1%) by direct inoculation. Use of both inoculation methods with FAN Plus media resulted in 92.1% sensitivity (95% CI, 89.2-99.9%).Conclusion: Culture using FAN Plus media demonstrated a superior bacterial recovery rate to the conventional centrifugation culture method. A combination of the two inoculation methods with FAN Plus media is recommended for the best diagnostic yield, while direct inoculation alone can be useful due to its simplicity and cost-effectiveness. (Ann Clin Microbiol 2019;22:90-95)

biocontrol agents (BCAs) are widely used to protect plants from diverse biotic and abiotic stresses in agricultural and ecological fields. Among the various microbes, many subspecies of the gram-positive genus, Bacillus, have been successfully industrialized as eco-friendly biological pesticides and fertilizers. In the current study, we demonstrated that Bacillus thuringiensis C25 exhibited antagonistic effects on the mycelial growth of Rosellinia necatrix, a fungal phytopathogen. Scanning electron microscopy analysis revealed that B. thuringiensis C25 degraded the cell wall structures of R. necatrix mycelia. In the functional genomic analysis of B. thuringiensis C25, we annotated 5,683 genes and selected the gene sets that potentially encoded fungal cell wall degrading enzymes (CWDEs). The growth inhibition effects on R. necatrix were highly correlated with the transcriptional activity of the mycelial cell wall degrading genes of B. thuringiensis C25. The transcript levels of CWDEs, including CshiA, B, and Glycos_transf_2 genes in B. thuringiensis C25, were enhanced following co-cultivation with R. necatrix. In conclusion, our study suggested that B. thuringiensis C25 could serve as a suitable candidate for controlling R. necatrix and could facilitate elucidating the mechanisms underlying the antifungal activities of BCAs against phytopathogens.

A common post-harvest disease of sweetpotato tuber is root rot caused by Fusarium solani in Korea as well as the other countries. Storage root rot disease was monitored earlier on sweetpotato (Ipomoea batatas) in storehouses of different locations in Korea. In the present study, an isolate SPL16124 was choosen and collected from Sweetpotato Research Lab., Bioenergy Crop Research Institute, NICS, Muan, Korea, and confirmed the identification as Fusarium solani by conidial and molecular phylogenetic analysis (internal transcribed spacer ITS and translation elongation factor EF 1-α gene sequences). The isolate was cultured on potato dextrose agar, and conidiation was induced. The fungus was screened for Fusarium root rot on tuber of 14 different varieties. Among the tested variety, Yenjami, Singeonmi, Daeyumi, and Sinjami showed resistant to root rot disease. Additionally, the pathogen was tested for pathogenicity on stalks of these varieties. No symptom was observed on the stalk, and it was confirmed that the disease is tissue specific.

Background : Encapsulating peritoneal sclerosis (EPS) is a rare but near-fatal complication of peritoneal dialysis (PD). Despite the high mortality rate of EPS, the surgical treatment strategy of severe EPS is yet to be established.Methods : We retrospectively analyzed outcomes of patients with EPS who underwent enterolysis for intractable EPS at Seoul National University Hospital between 2001 and 2018. EPS was diagnosed based on the clinical symptoms and radiological findings of abdominal computed tomography (CT). CT scans were scored according to an EPS scoring system that assessed peritoneal thickening and calcification as well as bowel thickening, tethering, loculation, and dilatation.Results : Thirteen patients (nine males and four females; age, 48 [29–63] years) underwent enterolysis for severe EPS. PD duration (11 [6–21] years) was not associated with survival. Two patients were newly diagnosed with EPS following kidney transplantation. Five patients died of infectious complications immediately after the surgery. Eight patients survived after the first surgery; however, five of them underwent reoperation but died of persistent infection, fistula formation, or adhesive bowel obstruction. Four young (< 60 years) male patients with relatively low CT scan scores (< 13) survived for > 2 years after the first surgery. Median survival duration from EPS diagnosis was 22 (1.3–184) months and that from the first surgery was 9 (0.3–153) months.Conclusion : The high mortality rate of EPS suggests the importance of appropriate surgical intervention in young symptomatic male EPS patients with relatively low CT scan scores.

A patient with central post-stroke pain was treated for 4 weeks with scalp acupuncture and traditional Korean medicine (following a cerebral infarction in 2013). The patient presented at Chungju hospital in January 2019 with left side weakness and tingling, numbness in the left hemisphere, chronic pain and dysarthria. Initially, herbal medicine, acupuncture, pharmacupunture, indirect moxibustion, and physiotherapy were administered together with Western medicine, with no improvement in the patient’s condition. On Day 5, scalp electroacupuncture (MS1, MS5, MS10, MS11) was introduced. The numbness feeling in the patient’s head resolved, and the pain in his upper body decreased. Grip force difference between the left and right hand improved from 3 kg to 0-0.5 kg. Sleep disturbance was resolved after 4 weeks treatment, and his average numeric rating scale score for pain improved from an admission score of 10, to a discharge score of 5. The patient could walk unaided after treatment.

Background: In the field of urological surgery, robotic surgery continues to develop and increase. This paper is an overview of the present and future of robotic urological surgery. Current Concepts: Robot-assisted surgery has revolutionized minimally invasive surgery and advanced the technical limitations of laparoscopy. Urologists have always been eager to adopt new technological advances to benefit their patients, and they have also been pioneers in the field of robotic surgery. Discussion and Conclusion: Following the first approval by the Food and Drug Administration in 2000, the da Vinci System (Intuitive Surgical, USA) remained the leading robotic surgical system for over 20 years. In 2000, the first robot-assisted laparoscopic radical prostatectomy was performed in urology. Subsequently, applications of the da Vinci System in urology have grown exponentially, including the kidney, urinary bladder, and reconstructive and functional urological surgeries. To date, urology is driving robotic innovation. The first specialist-engineered system for single-site surgery, the da Vinci SP, was initially approved for use in urological surgery. Due to the advantages of robotic surgery, such as excellent visibility and operability, the demand for robotic surgery in the urology department is continuously increasing. Recently, in addition to the da Vinci System, other robot platforms are being developed and commercialized in many countries. In South Korea, robots such as Revo-I (Meere Company Inc., Korea) and Zamenix (Roen Surgical, Korea) are being released and commercialized. Urologists continue to lead the development of domestic robots and robotic surgery. [ABSTRACT FROM AUTHOR]

Purpose: The catheter vein ratio (CVR) is one of control factors related to the incidence of catheter related thrombosis (CRT). This paper reports a practical CVR to reduce the incidence of CRT in patients receiving PICC. Methods: Information on patients with PICC insertion between January 2018 and December 2018 was extracted retrospectively from a single center. The information was composed of age, sex, BMI, access locations, comorbidities, catheter sizes, catheter days, catheter removal cause, and CRT. The incidence of CRT and other factors were analyzed. Results: Of the 164 patients who underwent PICC and 2,697 catheter days in the study, three patients (1.8%) experienced a symptomatic thrombosis. Without significance to other factors, the incidence of thrombosis was relevant only in those with higher CVR vs. those with lower CVR (P = 0.047). In addition, its cut-off value was 36.5% (AUC 0.813, 95% CI: 1.003–1.495). Compared to the higher and lower than 36.5% CVR, the odd ratio was 38.25 in the group with a higher than 36.5% CVR (95% CI: 3.129–467.611, P = 0.010). Conclusion: CVR is one of the factors that can be controlled to reduce the clinical relevance of CRT. A lower than 36.5% CVR should be maintained to be in the safety zone from PICC related thrombosis.

The purpose of this study was to describe the treatment of the clinical symptoms of syringomyelia using Korean medicine. A patient with syringomyelia complained of back and shoulder pain, numbness of the upper right limb, headaches and dyspnea. He was treated with herbal medicine, acupuncture, moxibustion, and physical therapy. The Visual analog scale (VAS) was used to score sensory symptoms (pain, numbness) and Modified Borg scale (mBorg) was used to score dyspnea. After the treatment, his symptoms were relieved. The patient’s chief complaint was back and shoulder pain which was reduced greatly from a VAS score of 6 between 1-2. The results in this study may contribute to the development of the Korean medicine field of syringomyelia in the future.

Background This study was designed to investigate the potential effects of Galgeungyulpitang for whitening and elasticity treatment by examining its effect on melanoma cells. Methods The effects of Galgeungyulpitang on B16/F10 melanoma cell viability, production of melanin, tyrosinase and elastase, were investigated. Cell viability was measured by colorimetric assay that assesses cell metabolic activity (MTT assay). Melanin was measured by Hosei’s method, tyrosinase was measured by Yogi’s method and elastase was measured by James’s method. Results At concentrations higher than 500 μg/mL Galgeungyulpitang, cell viability was significantly reduced (p ≤ 0.05). At concentrations of 500 μg/mL and lower, morphological changes were not observed. The rate of melanin synthesis was significantly reduced to 73.49% ± 2.92% at a concentration of 500 μg/mL Galgeungyulpitang compared with untreated cells (p < 0.05). Extracellular tyrosinase production was not significantly decreased in vitro, however, intracellular tyrosinase production was significantly reduced to 76.06% ± 2.17% when treated with Galgeungyulpitang at a concentration of 500 μg/mL compared with the control (p < 0.05). Elastase Type 1 production was significantly reduced to 74.98% ± 3.24% and 69.62% ± 4.66% at concentrations of 250 and 500 μg/mL Galgeungyulpitang, respectively (p < 0.05). Elastase Type 4 production was significantly reduced to 72.77% ± 3.52% at concentrations of 250 and 500 μg/mL (p < 0.05). Conclusions The results in this study showed that Galgeungyulpitang may inhibit melanin and tyrosinase synthesis, and inhibit elastase production, suggesting that Galgeungyulpitang may be potentially beneficial for skin whitening and loss of skin elasticity treatments.

Background Hypoglycemia is uncommon in people without diabetes. There have been only a few reports of cardiac arrest in conjunction with hypoglycemia in non-diabetic patients. Case Report A 66-year-old man visited the emergency room with dizziness. He was a chronic alcoholic. Laboratory test showed no evidence of diabetes mellitus. Brain magnetic resonance imaging revealed a left cerebellar infarction. Abdomen computed tomography demonstrated liver cirrhosis with minimal ascites. During his hospital stay, he consumed only a small amount of food because of nausea and headache. On hospital day 4, he had a cardiac arrest after two seizure episodes. His blood glucose was 10 mg/dL. The combination of liver cirrhosis, renal failure and poor oral intake was presumed to be the causes of the severe hypoglycemia. Conclusion We report a rare case of cardiac arrest occurring in conjunction with severe hypoglycemia in a non-diabetic patient with cerebral infarction.

Background Chronic placental inflammation (CPI) has been implicated in the pathogenesis of diseases in premature infants, whereas retinopathy of prematurity (ROP) is a major complication primarily affecting preterm and very low-birth-weight (VLBW) infants. This study aims to investigate the association between CPI and ROP in VLBW infants. Methods We performed a retrospective review of clinical records of VLBW infants born between 2013 and 2016. Placental pathology findings including CPI cases were analyzed using logistic regression to study infants’ morbidities and other clinical characteristics. Results A total of 402 infants with a mean (standard deviation) gestational age of 28.5 (2.8) weeks and birth weight of 1,027.2 (304.4) g were included. The incidence of ROP was 24.1%. CPI was found in 90 infants (22.4%), among which 28.9% (26 of 90) developed ROP, and 21.1% (19 of 90) underwent laser photocoagulation. Lower gestational age, lower birth weight, longer duration of oxygen supply, and presence of CPI were associated with the development of ROP. After adjustment for gestational age, birth weight, sex, duration of oxygen supply, and other overlapping placental pathology, CPI was associated with the odds for type 1 ROP that required laser photocoagulation (adjusted odds ratio, 2.739; 95% confidence interval, 1.112 to 6.749; p = .029). Conclusions CPI was associated with severe ROP requiring treatment with laser photocoagulation in VLBW infants.

Background The objective of this study was to determine the effects of Daegangwhal-Tang (DGHT) hot aqueous extract on production of inflammatory mediators and antioxidants in RAW 264.7 macrophage. Methods DGHT was extracted with water, filtered, concentrated and freeze-dried to perform. Cytotoxicity of DGHT extract was performed by MTT assay. Activated macrophages were treated with varying concentrations of DGHT extract (10, 50, 100 and 200 μg/mL), and nitric oxide (NO) and prostaglandin E2(PGE2) concentrations were measured to detect anti-oxidative effects. Interleukin-6 (IL-6), interleukin-1 beta (IL-1ß) and tumor necrosis factor-alpha(TNF-α) concentrations were also measured to detect inflammatory responses to DGHT Results Cytotoxicity of DGHT extract at concentrations of 10, 50, 100 and 200 μg/mL were not observed. NO production was significantly decreased in the DGHT hot aqueous extract 200 μg/mL concentration group. PGE2, IL-6, IL-1ß and TNF-α production was significantly decreased in the DGHT hot aqueous extract 100 and 200 μg/mL concentration groups. DGHT hot aqueous extract appeared to have DPPH free radical scavenging capability at all of concentrations, but did not exceed 50%. Conclusions These results suggest that DGHT hot aqueous extract has concentration-dependent anti-inflammatory and anti-oxidative effect.

Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

A 20-year-old man presented with a femur fracture and epidural hemorrhage (EDH) following a fall. One month after fracture surgery, swelling developed in both legs, and he was diagnosed as having a deep-vein thrombosis and pulmonary embolism. A retrievable inferior vena cava filter (IVCF) was inserted, because EDH is a contraindication to anticoagulants. Four months later, he complained of abdominal pain, and a computed tomography scan showed a fractured IVCF strut. After percutaneous removal failed 3 times, the IVCF was surgically removed by orthopedists using a portable image intensifier without cardiopulmonary bypass.

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was 55±26 months, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.

Background Immunoglobulin G4 (IgG4) related disease is an immune-mediated fibroinflammatory condition that can affect multiple organs. There are only few reports of pachymeningeal involvement by IgG4 related disease in Korea. Case Report A 50-year-old woman was admitted due to generalized seizure and headache. Brain magnetic resonance imaging (MRI) showed nodular dural thickening and enhancement in the right frontal areas. A meningeal biopsy was performed. On pathology, chronic inflammation, fibrosis and plasma cell infiltration were revealed. Immunoglobulin G4 immunohistochemistry showed prominent IgG4+ plasma cell infiltrate. Serum IgG level was normal but IgG4 subclass level was significantly elevated. She was treated with intravenous dexamethasone followed by oral prednisolone. After 1 year of treatment, brain MRI showed marked decrease of dural thickening and enhancement. Conclusion We report a case of IgG4 related pachymeningitis improved with corticosteroid. IgG4 related disease should be included in the differential diagnosis in patients with hypertrophic pachymeningitis.

Background: Despite major advance in surgical techniques from open surgery to robot-assisted surgery, acute kidney injury (AKI) is still major postoperative complication in rectal surgery. The purpose of this study is to compare the incidence of postoperative AKI according to different surgical techniques and also the risk factors, outcomes of AKI in patients undergoing rectal cancer surgery. Methods: A retrospective medical chart review was done in a total of 288 patients who received proctectomy because of rectal cancer from 2011 to 2013. Results: The mean patient age was 62 ± 12 years, and male was 64.2%. Preoperative creatinine was 0.91 ± 0.18 mg/dL. Open surgery was performed in 9%, and laparoscopy assisted surgery or robot assisted surgery were performed in 54.8% or 36.1% of patients, respectively. AKI developed in 11 patients (3.82%), 2 (18%) of them received acute hemodialysis. Incidence of AKI was not different according to the surgical technique, however, the presence of diabetes, intraoperative shock, and postoperative ileus was associated with the development of AKI. In addition, AKI patients showed significantly longer hospital stay and higher mortality than non-AKI patients. Conclusion: Our study demonstrated that despite advances in surgical techniques, incidence of postoperative AKI remains unchanged and also that postoperative AKI is associated with poor outcome. We also found that presence of diabetes, intraoperative shock and postoperative ileus are strongly associated with the development of AKI. More careful attention should be paid on high risk patients for the development of postoperative AKI regardless of surgical techniques.

Spontaneous bleeding from a short gastric artery in the absence of pre-disposing trauma is reported very rarely. To the best of our knowledge, the published literature includes only 14 cases. Young men comprise almost all of the patients, and were induced by vomiting or gagging. The patients usually required emergent surgery. Our patient, a 32-year-old man, was diagnosed with spontaneous hemoperitoneum due to short gastric artery tearing after a few instances of vomiting. We managed him conservatively including fluid, vitamin K and antifibrinolytic agent without surgery. (Korean J Gastroenterol 2016;68:152-155)

Purpose The purpose of this study was to determine a suitable position in which the measured length on ultrasound is close to the true renal length obtained through a multiplanar reconstructed MR image. Materials and Methods A total of 33 individuals (males: 15, females: 18) without any underlying renal disease were included in the present study. Renal length was measured as the longest axis at the level of the renal hilum in three positions–supine, lateral decubitus, and prone, respectively. With a 3.0 T MR scanner, 3D eTHRIVE was acquired. Subsequently, the maximum longitudinal length of both the kidneys was measured through multiplanar reconstructed MR images. Paired t-test was used to compare the renal length obtained from ultrasonographic measurement with the length obtained through multiplanar reconstructed MR images. Results Our study demonstrated significant difference between sonographic renal length in three positions and renal length through MRI (p < 0.001). However, the longest longitudinal length of right kidney among the measured three values by ultrasound was statistically similar to the renal length measured by reconstructed MR image. Among them, the lateral decubitus position showed the strongest correlation with true renal length (right: 0.887; left: 0.849). Conclusion We recommend measurement of the maximum renal longitudinal length in all possible positions on ultrasonography. If not allowed, the best measurement is on the lateral decubitus showing the strongest correlation coefficient with true renal length.