PURPOSE: To report two cases of postoperative endophthalmitis caused by Streptococcus dysgalactiae subspecies equisimilis (SDSE), which appeared as hyperacute presentation and panophthalmitis. CASE SUMMARY: A 68-year-old male was treated with cataract surgery and was evaluated the next day (less than 24 hours after surgery) because of acute loss of vision. There was severe inflammation and the visual acuity was light perception. The patient underwent pars plana vitrectomy (PPV) with intravitreal antibiotic injection. The vitreous culture revealed SDSE. After PPV, regression of inflammation was observed, although the corneal edema had progressed. The cornea evolved to decompensate due to bullous keratopathy and visual acuity of the eye decreased to no light perception after 3 months. A 87-year-old male who underwent phacoemulsification and intraocular lens implantation 2 days previously was hospitalized due to severe ocular pain and visual loss. There was severe inflammation, and the visual acuity was no light perception. The patient received only intravitreal injections of antibiotics due to severe corneal necrosis. The aqueous humor revealed SDSE. Four days after intravitreal injection, erythema and swelling of the eyelid of the affected eye was observed, and diagnosed as panophthalmitis. After treatment with intravenous antibiotics, cellulitis of the eyelid was resolved. The eye progressed as phthisis after 3 months without recurrence. CONCLUSIONS: Postoperative SDSE endophthalmitis showed aggressive and hyperacute presentation, resulting in blindness despite prompt treatment. SDSE is an emerging organism and should be considered a potential cause of postoperative endophthalmitis.
Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; Aqueous Humor ; Blindness ; Cataract ; Cellulitis ; Cornea ; Corneal Edema ; Endophthalmitis ; Erythema ; Eye Infections ; Eyelids ; Humans ; Inflammation ; Intravitreal Injections ; Lens Implantation, Intraocular ; Male ; Necrosis ; Panophthalmitis ; Phacoemulsification ; Recurrence ; Streptococcus ; Visual Acuity ; Vitrectomy

Objectives: This study examined the association between the dietary behavior and weight status of preschool children and their mothers in Daejeon, Korea. Methods: A total of 301 mother–preschool children (aged 3~6 years) dyads were included in this study. The dietary behavior of children and their mothers was assessed using the Nutrition Quotient (NQ) questionnaire for preschoolers and adults, respectively. The NQ questionnaires were completed by the mothers. The overweight/ obesity status of children and their mothers was determined using data on height and body weight reported by the mothers. Multiple logistic regression was performed to examine the relationship between the dietary behavior and weight status of children and their mothers. Results: The mean NQ score was 58.9 ± 9.7 in children and 55.6 ± 9.2 in mothers. The NQ score was higher in boys than girls but did not vary by age. The prevalence of overweight/obesity was 27.5% in children and 46.5% in mothers. The physical activity level of mothers and their NQ scores were positively associated with the NQ scores of the children. After adjustment for covariates, the mothers in the highest tertile of NQ scores showed a lower odds ratio (OR) for the unhealthy dietary behavior of children (OR = 0.24, 95% CI = 0.11~0.53, P< 0.001) compared to those in the lowest tertile.The obese mothers showed a higher OR for children’s overweight/obesity (OR = 3.38, 95% CI = 1.68~6.80, P = 0.001) compared to normal weight mothers. Conclusions The dietary behavior and weight status of young children and their mothers were closely linked. Nutrition education programs targeting mothers are necessary for improving maternal and child nutrition. Specifically, these programs need to be tailored to the socioeconomic characteristics or weight status of mothers.

Objectives: This study examined the association between the dietary behavior and weight status of preschool children and their mothers in Daejeon, Korea. Methods: A total of 301 mother–preschool children (aged 3~6 years) dyads were included in this study. The dietary behavior of children and their mothers was assessed using the Nutrition Quotient (NQ) questionnaire for preschoolers and adults, respectively. The NQ questionnaires were completed by the mothers. The overweight/ obesity status of children and their mothers was determined using data on height and body weight reported by the mothers. Multiple logistic regression was performed to examine the relationship between the dietary behavior and weight status of children and their mothers. Results: The mean NQ score was 58.9 ± 9.7 in children and 55.6 ± 9.2 in mothers. The NQ score was higher in boys than girls but did not vary by age. The prevalence of overweight/obesity was 27.5% in children and 46.5% in mothers. The physical activity level of mothers and their NQ scores were positively associated with the NQ scores of the children. After adjustment for covariates, the mothers in the highest tertile of NQ scores showed a lower odds ratio (OR) for the unhealthy dietary behavior of children (OR = 0.24, 95% CI = 0.11~0.53, P< 0.001) compared to those in the lowest tertile.The obese mothers showed a higher OR for children’s overweight/obesity (OR = 3.38, 95% CI = 1.68~6.80, P = 0.001) compared to normal weight mothers. Conclusions The dietary behavior and weight status of young children and their mothers were closely linked. Nutrition education programs targeting mothers are necessary for improving maternal and child nutrition. Specifically, these programs need to be tailored to the socioeconomic characteristics or weight status of mothers.

OBJECTIVE: To evaluate the feasibility of coronary artery calcium scoring based on three virtual noncontrast-enhanced (VNC) images derived from single-source spectral dual-energy CT (DECT) as compared with true noncontrast-enhanced (TNC) images. MATERIALS AND METHODS: This prospective study was conducted with the approval of our Institutional Review Board. Ninety-seven patients underwent noncontrast CT followed by contrast-enhanced chest CT using single-source spectral DECT. Iodine eliminated VNC images were reconstructed using two kinds of 2-material decomposition algorithms (material density iodine-water pair [MDW], material density iodine-calcium pair [MDC]) and a material suppressed algorithm (material suppressed iodine [MSI]). Two readers independently quantified calcium on VNC and TNC images. The Spearman correlation coefficient test and Bland-Altman method were used for statistical analyses. RESULTS: Coronary artery calcium scores from all three VNC images showed excellent correlation with those from the TNC images (Spearman's correlation coefficient [ρ] = 0.94, 0.88, and 0.89 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Measured coronary calcium volumes from VNC images also correlated well with those from TNC images (ρ = 0.92, 0.87, and 0.91 for MDW, MDC, and MSI, respectively; p < 0.001 for all pairs). Among the three VNC images, coronary calcium from MDW correlated best with that from TNC. The coronary artery calcium scores and volumes were significantly lower from the VNC images than from the TNC images (p < 0.001 for all pairs). CONCLUSION: The use of VNC images from contrast-enhanced CT using dual-energy material decomposition/suppression is feasible for coronary calcium scoring. The absolute value from VNC tends to be smaller than that from TNC.
Calcium* ; Coronary Artery Disease ; Coronary Vessels* ; Ethics Committees, Research ; Humans ; Iodine ; Prospective Studies ; Tomography, X-Ray Computed

The myelination of axons in the vertebrate nervous system through oligodendrocytes promotes efficient axonal conduction, which is required for the normal function of neurons. The central nervous system (CNS) can regenerate damaged myelin sheaths through the process of remyelination, but the failure of remyelination causes neurological disorders such as multiple sclerosis. In mammals, parenchymal oligodendrocyte progenitor cells (OPCs) are known to be the principal cell type responsible for remyelination in demyelinating diseases and traumatic injuries to the adult CNS. However, growing evidence suggests that neural stem cells (NSCs) are implicated in remyelination in animal models of demyelination. We have previously shown that olig2+ + radial glia (RG) have the potential to function as NSCs to produce oligodendrocytes in adult zebrafish. In this study, we developed a zebrafish model of adult telencephalic injury to investigate cellular and molecular mechanisms underlying the regeneration of oligodendrocytes. Using this model, we showed that telencephalic injury induced the proliferation of olig2+ + RG and parenchymal OPCs shortly after injury, which was followed by the regeneration of new oligodendrocytes in the adult zebrafish. We also showed that blocking Notch signaling promoted the proliferation of olig2+ RG and OPCs in the normal and injured telencephalon of adult zebrafish. Taken together, our data suggest that Notch-regulated proliferation of olig2+ RG and parenchymal OPCs is responsible for the regeneration of oligodendrocytes in the injured telencephalon of adult zebrafish.

PURPOSE: To identify altered patterns of retinal mRNA expression in a rat model of oxygen-induced retinopathy (OIR). METHODS: Sprague-Dawley rats from P2 to P14 were exposed to hyperoxia (80% oxygen) to induce OIR and then returned to normoxic conditions. Control rats were sustained in room air. Retinal gene expression between the rats of OIR and the controls was compared using cDNA microarray analysis. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to verify the microarray results. RESULTS: Among a total of 12,731 cDNAs analyzed by mircroarray, 13 genes were strongly up- or down-regulated (>2-fold change over controls) in the OIR rats. We found a significant increase in expression of 10 genes (CaM-kinase II inhibitor; acidic nuclear phosphoprotein 32 family, member A; vascular endothelial growth factor; interferon alpha-inducible protein 27-like; similar to enthoprotin, epsin 4, clathrin interacting protein; nidogen [entactin]; tubulin, beta5; fibrillin-1; spectrin beta2; and stearoyl-coenzyme A desaturase 2) and a significant decrease in expression of 3 genes (myelin-associated oligodendrocytic basic protein, heat shock protein, and decorin) in OIR rats compared to controls. CONCLUSIONS: We confirmed changes in expressions of various retinal genes in a rat model of OIR by microarray and RT-PCR. This study should contribute to the understanding of genetic indicators associeated with OIR.
Animals ; Animals, Newborn ; Down-Regulation ; Gene Expression ; Microarray Analysis ; *Oxygen ; RNA, Messenger/*metabolism ; Rats ; Rats, Sprague-Dawley ; Retina/*metabolism ; Retinal Diseases/*chemically induced/*metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Up-Regulation

BACKGROUND AND OBJECTIVES: The diagnosis of paroxysmal atrial fibrillation (PAF) and the prediction of its recurrence are sometimes difficult. There have been several recent studies attempting to detect patients at risk for PAF while in sinus rhythm by using the P wave signal-averaged ECG. We undertook to define an appropriate technique of P wave signal-averaged ECG and to estimate the reproducibility of the test. Additionally, we estimated the usefulness of P wave signal-averaged ECG in patients at risk for PAF. SUBJECTS AND METHODS: Forty-five patients with PAF were included in the study undertaken between March 1997 and June 1998. Twelve-lead surface ECG and P wave signal-averaged ECG were performed in the patients. The total P wave duration was measured by the P wave signal-averaged ECG using P wave template and least-square fit filter. The same process was followed in forty sex- and age-matched controls. RESULTS: The measurement of P wave duration with P wave signal-averaged ECG was highly reproducible. The measured P wave duration showed significant prolongation in the patient group at cutoff frequencies of 20 Hz and 30 Hz (123.6+/-15.3 vs. 114.8+/-14.5 msec, p=0.009 at 20 Hz, 120.1+/-17.8 vs. 107.5+/-18.8 msec, p=0.002 at 30 Hz). An abnormal P wave duration defined as over 120 msec in duration by P wave signal-averaged ECG was able to detect PAF with a sensitivity of 60%, specificity of 73%, positive predictive value of 71%, and a negative predictive value of 62%. CONCLUSION: A prolonged P wave duration as measured by P wave signal-averaging technique may be a simple noninvasive marker of risk for the development of atrial fibrillation.
Atrial Fibrillation* ; Diagnosis ; Electrocardiography* ; Humans ; Recurrence ; Sensitivity and Specificity

Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.
Advisory Committees ; Biopsy, Fine-Needle ; Biopsy, Large-Core Needle* ; Consensus* ; Diagnosis ; Humans ; Methods ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule

Objective: To investigate whether reader training improves the performance and agreement of radiologists in interpreting unenhanced breast magnetic resonance imaging (MRI) scans using diffusion-weighted imaging (DWI). Materials and Methods: A study of 96 breasts (35 cancers, 24 benign, and 37 negative) in 48 asymptomatic women was performed between June 2019 and October 2020. High-resolution DWI with b-values of 0, 800, and 1200 sec/mm 2 was performed using a 3.0-T system. Sixteen breast radiologists independently reviewed the DWI, apparent diffusion coefficient maps, and T1-weighted MRI scans and recorded the Breast Imaging Reporting and Data System (BI-RADS) category for each breast. After a 2-h training session and a 5-month washout period, they re-evaluated the BI-RADS categories. A BI-RADS category of 4 (lesions with at least two suspicious criteria) or 5 (more than two suspicious criteria) was considered positive.The per-breast diagnostic performance of each reader was compared between the first and second reviews. Inter-reader agreement was evaluated using a multi-rater κ analysis and intraclass correlation coefficient (ICC). Results: Before training, the mean sensitivity, specificity, and accuracy of the 16 readers were 70.7% (95% confidence interval [CI]: 59.4–79.9), 90.8% (95% CI: 85.6–94.2), and 83.5% (95% CI: 78.6–87.4), respectively. After training, significant improvements in specificity (95.2%; 95% CI: 90.8–97.5; P = 0.001) and accuracy (85.9%; 95% CI: 80.9–89.8; P = 0.01) were observed, but no difference in sensitivity (69.8%; 95% CI: 58.1–79.4; P = 0.58) was observed. Regarding inter-reader agreement, the κ values were 0.57 (95% CI: 0.52–0.63) before training and 0.68 (95% CI: 0.62–0.74) after training, with a difference of 0.11 (95% CI: 0.02–0.18; P = 0.01). The ICC was 0.73 (95% CI: 0.69–0.74) before training and 0.79 (95% CI: 0.76–0.80) after training (P = 0.002). Conclusion Brief reader training improved the performance and agreement of interpretations by breast radiologists using unenhanced MRI with DWI.

Thermal ablation using radiofrequency is a new, minimally invasive modality employed as an alternative to surgery in patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology (KSThR) developed recommendations for the optimal use of radiofrequency ablation for thyroid tumors in 2012. As new meaningful evidences have accumulated, KSThR decided to revise the guidelines. The revised guideline is based on a comprehensive analysis of the current literature and expert consensus.
Advisory Committees ; Catheter Ablation* ; Consensus ; Humans ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroid Nodule ; Ultrasonography