Background: and Purpose Zolpidem is one of the most common hypnotics prescribed to treat insomnia worldwide. However, there are numerous reports of a positive association between zolpidem and mortality, including an association with increased cancer-specific mortality found in a Taiwanese cohort study. This study aimed to determine the association between zolpidem use and brain-cancer-specific mortality in patients with brain cancer. Methods: This population-based, retrospective cohort study analyzed data in the National Health Insurance Service database. All incident cases of brain cancer at an age of ≥18 years at the time of brain cancer diagnosis over a 15-year period (2003–2017) were included. A multivariate Cox regression analysis after adjustment for covariables was performed to evaluate the associations of zolpidem exposure with brain-cancer-specific and all-cause mortality. Results: This study identified 38,037 incident cases of brain cancer, among whom 11,823 (31.1%) patients were exposed to zolpidem. In the multivariate Cox regression model, the brain-cancer-specific mortality rate was significantly higher in patients who were prescribed zolpidem than in those with no zolpidem prescription (adjusted hazard ratio [HR]=1.14, 95% confidence interval [CI]=1.08–1.21, p<0.001). Zolpidem exposure was significantly associated with increased brain-cancer-specific mortality after adjustment in younger adults (age 18– 64 years; adjusted HR=1.37, 95% CI=1.27–1.49) but not in older adults (age ≥65 years; adjusted HR=0.94, 95% CI=0.86–1.02). Conclusions Zolpidem exposure was significantly associated with increased brain-cancerspecific mortality in patients with brain cancer aged 18–64 years. Further prospective studies are warranted to understand the mechanism underlying the effect of zolpidem on mortality in patients with brain cancer.

Objective: To determine hemodynamic changes after surgical treatment for great saphenous vein (GSV) incompetence. Methods: According to clinical, etiological, anatomical, and pathophysiological classification, all patients were classified as C2EpAsPr. A total of 976 limbs of 900 patients with primary varicose veins who underwent surgical treatment at the Samsung Medical Center were retrospectively reviewed. Surgical modalities were high ligation (HL) with stripping, endovenous laser ablation (EVLA), and radiofrequency ablation (RFA) of GSV.Hemodynamic changes were measured using air plethysmography preoperatively and 1 and 6 months postoperatively. Duplex scans were performed to evaluate the GSV status after surgery. Results: Of the 900 patients, 250, 139, and 511 underwent EVLA, RFA, and HL with stripping, respectively. All groups showed a significant increase in the ejection fraction (EF) and a decrease in the venous volume (VV), venous filling index (VFI), and residual volume fraction (RVF) at 1 month postoperatively, compared with the corresponding preoperative values. When the rate of reduction was compared between the treatment modalities, the 1-month postoperative rate of reduction in the VV was higher in the RFA group and those of the VFI, EF, and RVF were higher in the HL with stripping group, compared with the other groups (p<0.05). The GSV occlusion rates at 1 and 6 months were 85.6% and 97.5% in the EVLA group and 95.7% and 99.4% in the RFA group, respectively. Conclusion All three surgical modalities improved the hemodynamic parameters after treatment for GSV incompetence. Thus, appropriate surgical methods can be selected according to the patient’s condition and physician’s preference.

Left-sided inferior vena cava (IVC) is a congenital venous anomaly variant with an incidence of 0.2%–0.5%. Furthermore case of abdominal aortic aneurysm with left-sided IVC is very rare. We reported our experience with two cases of left-sided IVC during open repair of the abdominal aortic aneurysm.

OBJECTIVE: To evaluate the impact of the adaptive iterative dose reduction (AIDR) three-dimensional (3D) algorithm in CT on noise reduction and the image quality compared to the filtered back projection (FBP) algorithm and to compare the effectiveness of AIDR 3D on noise reduction according to the body habitus using phantoms with different sizes. MATERIALS AND METHODS: Three different-sized phantoms with diameters of 24 cm, 30 cm, and 40 cm were built up using the American College of Radiology CT accreditation phantom and layers of pork belly fat. Each phantom was scanned eight times using different mAs. Images were reconstructed using the FBP and three different strengths of the AIDR 3D. The image noise, the contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) of the phantom were assessed. Two radiologists assessed the image quality of the 4 image sets in consensus. The effectiveness of AIDR 3D on noise reduction compared with FBP were also compared according to the phantom sizes. RESULTS: Adaptive iterative dose reduction 3D significantly reduced the image noise compared with FBP and enhanced the SNR and CNR (p < 0.05) with improved image quality (p < 0.05). When a stronger reconstruction algorithm was used, greater increase of SNR and CNR as well as noise reduction was achieved (p < 0.05). The noise reduction effect of AIDR 3D was significantly greater in the 40-cm phantom than in the 24-cm or 30-cm phantoms (p < 0.05). CONCLUSION: The AIDR 3D algorithm is effective to reduce the image noise as well as to improve the image-quality parameters compared by FBP algorithm, and its effectiveness may increase as the phantom size increases.
*Algorithms ; Animals ; Body Size ; Image Processing, Computer-Assisted/*methods ; *Phantoms, Imaging/standards ; Radiation Dosage ; Signal-To-Noise Ratio ; Subcutaneous Fat, Abdominal/*radiography ; Swine ; Tomography, X-Ray Computed/*methods

No abstract available.
Anterior Spinal Artery Syndrome ; Hemiplegia ; Infarction ; Paresis ; Spinal Cord

A 30-year-old male novice golfer was diagnosed with a clay-shoveler’s fracture. During golf practice, he experienced persistent posterior neck and upper back pain for a month. Cervical radiographs and computed tomography revealed a series of sequential spinous process fractures from C7 to T3. The patient was prescribed analgesic medication and fitted with a cervical brace alongside extracorporeal shockwave therapy (ESWT) directed explicitly toward the upper back region, subsequently leading to a notable reduction in pain. Therefore, ESWT could be considered an additional method for pain management in patients with clay-shoveler’s fractures.

Guillain–Barré syndrome (GBS) is an autoimmune-driven condition characterized by acute polyneuropathy, often emerging as a sequel to prior infections or vaccinations. This study presents the first reported cases of GBS emerging after the full recovery from coronavirus disease 2019 (COVID-19) infection in Korea. Despite experiencing mild acute COVID-19 symptoms, these patients faced substantial weakness attributed to GBS, significantly affecting their daily lives. The timely administration of intravenous immunoglobulin treatment halted the progression of symptoms, underscoring the critical importance of early intervention.These cases highlight the potential for neurological complications associated with COVID-19 and underscore the necessity for continuous monitoring and timely medical care.