Two Domestic Korean Shorthair cats presented with dyschezia and vomiting. Computed tomography revealed a colonic mass with calcification and lymph node metastasis in case 1, and a small intestinal mass with disseminated mesenteric metastasis and calcification in case 2. Histopathology revealed intestinal adenocarcinoma with osseous metaplasia. Case 1 died two months after surgery from distant metastasis; and case 2 showed no metastasis for five months but presented with anorexia, euthanized seven months after diagnosis. Metastatic intestinal adenocarcinoma with bone formation should be considered as differential diagnosis for calcification on imaging, and lymph node metastasis at diagnosis may indicate poor prognosis.

Background: Mycobacterium tuberculosis (Mtb) is resistant to the β-lactam antibiotics due to a non-classical transpeptidase in the cell wall with β-lactamase activity. A recent study showed that meropenem combined with a β-lactamase inhibitor clavulanate, was effective in MDR and XDR tuberculosis (TB). However, clavulanate can only be used in drugs containing amoxicillin in Korea. In this study, we investigated the susceptibility and genetic mutations of drug-resistant Mtb isolates to amoxicillin-clavulanate and meropenem-clavulanate to improve the diagnosis and treatment of drug-resistant TB patients. Methods: The minimum inhibitory concentration (MIC) of amoxicillin-clavulanate and meropenem-clavulanate was examined by resazurin microtiter assay. We used 82 MDR and 40 XDR strains isolated in Korea and two reference laboratory strains. Mutations of drug targets blaC, blaI, ldtA, ldtB, dacB2, and crfA were analyzed by PCR and DNA sequencing. Results: The MIC90 values of amoxicillin and meropenem with clavulanate in drug-resistant Mtb isolates were 64 and 16, respectively. Gene mutations related to amoxicillin/clavulanate and meropenem/clavulanate resistance could not be identified, but T448G mutation of was found in the blaC gene related to β-lactam antibiotics high susceptibility. Conclusion Our results provide clinical consideration of β-lactams in treating drug-resistant TB and potential molecular markers of amoxicillin-clavulanate and meropenem-clavulanate susceptibility.

Background: Bone scintigraphy is emerging as a confirmatory diagnostic tool for transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to investigate the frequency and clinical characteristics of patients with incidental cardiac uptake and incidental ATTR-CA on bone scintigraphy. Methods: All bone scintigraphic studies performed at a tertiary teaching hospital between 2011 and 2022 were reviewed retrospectively. Patients who underwent bone scintigraphy to confirm ATTR-CA were excluded. Patients with cardiac uptake of grade 2 or 3 were included and divided into two groups: possible ATTR-CA group and noncar‑ diac amyloidosis (non-CA) group. Results: Of the 61,432 bone scintigraphic studies performed on 32,245 patients, 23 (0.07%) had grade 2 or 3 car‑ diac uptake. Nine of 23 patients (39.1%) were assigned to the non-CA group because they showed cardiac uptake from definite other causes or focal uptake that did not match CA. The remaining 14 patients (60.9%) were classified as the possible ATTR-CA group, and five patients were referred to cardiologists and finally diagnosed with ATTR-CA.Two patients were treated with tafamidis. Patients in the ATTR-CA group were significantly older and had a less fre‑ quent history of end-stage renal disease than those in the non-CA group. Other characteristics were comparable in both groups. Conclusions Although incidental ATTR-CA in patients undergoing bone scintigraphy for noncardiac reasons is uncommon, if cardiac uptake is observed in elderly patients without metastatic calcification associated with endstage renal disease, further diagnostic work-up for ATTR-CA as a cause of undiagnosed heart failure should be considered.

Background: Bone scintigraphy is emerging as a confirmatory diagnostic tool for transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to investigate the frequency and clinical characteristics of patients with incidental cardiac uptake and incidental ATTR-CA on bone scintigraphy. Methods: All bone scintigraphic studies performed at a tertiary teaching hospital between 2011 and 2022 were reviewed retrospectively. Patients who underwent bone scintigraphy to confirm ATTR-CA were excluded. Patients with cardiac uptake of grade 2 or 3 were included and divided into two groups: possible ATTR-CA group and noncar‑ diac amyloidosis (non-CA) group. Results: Of the 61,432 bone scintigraphic studies performed on 32,245 patients, 23 (0.07%) had grade 2 or 3 car‑ diac uptake. Nine of 23 patients (39.1%) were assigned to the non-CA group because they showed cardiac uptake from definite other causes or focal uptake that did not match CA. The remaining 14 patients (60.9%) were classified as the possible ATTR-CA group, and five patients were referred to cardiologists and finally diagnosed with ATTR-CA.Two patients were treated with tafamidis. Patients in the ATTR-CA group were significantly older and had a less fre‑ quent history of end-stage renal disease than those in the non-CA group. Other characteristics were comparable in both groups. Conclusions Although incidental ATTR-CA in patients undergoing bone scintigraphy for noncardiac reasons is uncommon, if cardiac uptake is observed in elderly patients without metastatic calcification associated with endstage renal disease, further diagnostic work-up for ATTR-CA as a cause of undiagnosed heart failure should be considered.

Background: Bone scintigraphy is emerging as a confirmatory diagnostic tool for transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to investigate the frequency and clinical characteristics of patients with incidental cardiac uptake and incidental ATTR-CA on bone scintigraphy. Methods: All bone scintigraphic studies performed at a tertiary teaching hospital between 2011 and 2022 were reviewed retrospectively. Patients who underwent bone scintigraphy to confirm ATTR-CA were excluded. Patients with cardiac uptake of grade 2 or 3 were included and divided into two groups: possible ATTR-CA group and noncar‑ diac amyloidosis (non-CA) group. Results: Of the 61,432 bone scintigraphic studies performed on 32,245 patients, 23 (0.07%) had grade 2 or 3 car‑ diac uptake. Nine of 23 patients (39.1%) were assigned to the non-CA group because they showed cardiac uptake from definite other causes or focal uptake that did not match CA. The remaining 14 patients (60.9%) were classified as the possible ATTR-CA group, and five patients were referred to cardiologists and finally diagnosed with ATTR-CA.Two patients were treated with tafamidis. Patients in the ATTR-CA group were significantly older and had a less fre‑ quent history of end-stage renal disease than those in the non-CA group. Other characteristics were comparable in both groups. Conclusions Although incidental ATTR-CA in patients undergoing bone scintigraphy for noncardiac reasons is uncommon, if cardiac uptake is observed in elderly patients without metastatic calcification associated with endstage renal disease, further diagnostic work-up for ATTR-CA as a cause of undiagnosed heart failure should be considered.

Background: Bone scintigraphy is emerging as a confirmatory diagnostic tool for transthyretin cardiac amyloidosis (ATTR-CA). This study aimed to investigate the frequency and clinical characteristics of patients with incidental cardiac uptake and incidental ATTR-CA on bone scintigraphy. Methods: All bone scintigraphic studies performed at a tertiary teaching hospital between 2011 and 2022 were reviewed retrospectively. Patients who underwent bone scintigraphy to confirm ATTR-CA were excluded. Patients with cardiac uptake of grade 2 or 3 were included and divided into two groups: possible ATTR-CA group and noncar‑ diac amyloidosis (non-CA) group. Results: Of the 61,432 bone scintigraphic studies performed on 32,245 patients, 23 (0.07%) had grade 2 or 3 car‑ diac uptake. Nine of 23 patients (39.1%) were assigned to the non-CA group because they showed cardiac uptake from definite other causes or focal uptake that did not match CA. The remaining 14 patients (60.9%) were classified as the possible ATTR-CA group, and five patients were referred to cardiologists and finally diagnosed with ATTR-CA.Two patients were treated with tafamidis. Patients in the ATTR-CA group were significantly older and had a less fre‑ quent history of end-stage renal disease than those in the non-CA group. Other characteristics were comparable in both groups. Conclusions Although incidental ATTR-CA in patients undergoing bone scintigraphy for noncardiac reasons is uncommon, if cardiac uptake is observed in elderly patients without metastatic calcification associated with endstage renal disease, further diagnostic work-up for ATTR-CA as a cause of undiagnosed heart failure should be considered.

BACKGROUND/OBJECTIVES: With the advances in technologies, self-service kiosks at foodservice operations are becoming a new way of service provision. This study examined the relationships among the menu information quality, nutrition information quality, technology acceptance characteristics, and customer behavioral intention toward the kiosks in fast food restaurants.SUBJECTS/METHODS: A survey with a self-administered method was distributed online and offline. The sample consisted of customers who had used the kiosks at fast food restaurants in the last six months prior to the survey. The study hypotheses were tested by applying structural equation modeling.RESULTS: Structural equation modeling revealed the positive impacts of menu information quality and nutrition information quality, technology acceptance characteristics, and behavioral intention toward kiosks at fast food restaurants. On the other hand, one hypothesis (Hypothesis 4) on the impact of nutrition information quality on the perceived usefulness was rejected.CONCLUSION: The study is the first to investigate nutrition and menu information at foodservice kiosks and relate them to technology acceptance. The study is very timely and adequate in the time of the 4th industrial revolution. The critical importance of the presentation of nutrition information and menu information at the kiosks at fast food restaurants was verified. The academic and industrial implications of the study findings were discussed.

BACKGROUND/AIMS: Disturbances of esophageal motility have been reported to be more frequent the aged population. However, the physiology of disturbances in esophageal motility during aging is unclear. The aim of this study was to evaluate the effects of age on esophageal motility using high-resolution esophageal impedance manometry (HRIM). METHODS: Esophageal motor function of 268 subjects were measured using HRIM in 3 age groups, < 40 years (Group A, n = 32), 40–65 years (Group B, n = 185), and > 65 years (Group C, n = 62). Lower esophageal sphincter (LES) and upper esophageal sphincter (UES) pressures, integrated relaxation pressure, distal contractile integral, contractile front velocity, distal latency, and pressures and duration of contraction on 4 positions along the esophagus, and complete bolus transit were measured. RESULTS: Basal UES pressure was lower in Group C (P < 0.001) but there was no significant difference in the LES pressure among groups. Contractile duration on position 3 (10 cm from proximal LES high pressure zone) was longer in Group C (P = 0.001), and the contractile amplitude on position 4 (5 cm from proximal LES high pressure zone) was lower in Group C (P = 0.005). Distal contractile integral was lower in Group C (P = 0.037). Contractile front velocity (P = 0.015) and the onset velocity (P = 0.040) was lower in Group C. There was no significant difference in impedance values. CONCLUSIONS: The decrease of UES pressure, distal esophageal motility, and peristaltic velocity might be related with esophageal symptoms in the aged population.
Aging ; Electric Impedance* ; Esophageal Sphincter, Lower ; Esophageal Sphincter, Upper ; Esophagus ; Humans ; Manometry* ; Physiology ; Relaxation

BACKGROUND/AIMS: Optimized regimen has not yet been established for failures of multiple Helicobacter pylori (H. pylori) eradication. Hence, we aimed to evaluate the efficacy of rifabutin-based rescue therapy, at least after three eradication failures. METHODS: Twelve patients, who failed in the treatment for H. pylori eradication at least three times, were consecutively enrolled between 2007 and 2015 at Seoul National University Bundang Hospital. The rifabutin-based rescue regimen was consisted of proton pump inhibitor (PPI), rifabutin (150 mg b.i.d.), and amoxicillin (1 g b.i.d.), given for 7 or 14 days. MIC concentration test by the agar dilution method was performed on six patients prior to rifabutin-based rescue therapy. RESULTS: One patient did not take this regimen, and per-protocol (PP) analysis was performed in 11 patients. The overall eradication rate by intention-to-treat and PP analysis with rifabutin-based rescue therapy was 50.0% (6/12 patients) and 54.5% (6/11 patients), respectively. There was no difference of the eradication rate depending on the underlying disease, smoking, alcohol, number of previous eradication failures, and CYP2C19 genotype. All of the six patients were susceptible to rifabutin, but only three of them succeeded in eradicating with H. pylori. Side effects occurred in two patients (18.2%), and compliance was 90.9%. CONCLUSIONS: Even the eradication rate of rifabutin-based rescue therapy was not very good. Rifabutin-based rescue therapy could be considered as a rescue therapy, perhaps as the fourth or the fifth-line treatment option. No correlation of rifabutin sensitivity with eradication success rate of H. pylori suggests that frequent administration of high dose PPI and amoxicillin might be important.
Agar ; Amoxicillin ; Compliance ; Cytochrome P-450 CYP2C19 ; Genotype ; Helicobacter pylori* ; Helicobacter* ; Humans ; Methods ; Proton Pumps ; Rifabutin ; Salvage Therapy ; Seoul ; Smoke ; Smoking

Background: In Korea, the actual distribution of cardiac rehabilitation (CR) to the clinical field is insufficient due to the many barriers for cardiovascular patients to participate in CR. Community-based CR is a useful alternative to overcome these obstacles. Through a nationwide survey, we investigated the possibility of regional medical and public health management institutes which can be in charge of community-based CR in Korea. Methods: The questionnaires on recognition of CR and current available resources in health-related institutions were developed with reference to the CR evaluation tools of York University and the International Council of Cardiovascular Prevention and Rehabilitation.The questionnaires were sent to regional public and private medical institutions and public health management institutions. Results: In total, 2,267 questionnaires were sent to 1,186 institutions. There were 241 and 242 responses from 173 and 179 regional private and public medical institutions, respectively. And a total of 244 responses were gathered from 180 public health management institutions. Although many institutions were equipped with the necessary facilities for exercise training, there were few patient-monitoring systems during exercise. Most institutions were aware of the need for CR, but were burdened with the cost of establishing personnel and facilities to operate CR. Conclusion Most regional medical, and public health management institutions in Korea are unprepared for the implementation of community-based CR programs. To encourage the utilization of such, there should be efforts to establish a national consensus.