The use of pulmonary artery catheter can be helpful in managing patients after cardiac surgery. Nevertheless, there is a risk of serious complications, such as knotting. A 61 year old man underwent tricuspid valve replacement under cardiopulmonary bypass (CPB). After implantation of a stented tissue valve in the tricuspid valve, repositioning of the catheter was performed. After weaning from CPB, an abnormal pattern of pulmonary artery pressure was suddenly observed on the monitor. Resistance was met when removing the catheter with the balloon deflated, at a 20 cm distance from the tip of the catheter. Chest radiography showed a knot in the catheter within the right brachiocephalic vein. Superior vena cava opened and the distal part of the catheter with the knot was successfully removed.
Brachiocephalic Veins ; Cardiopulmonary Bypass ; Catheters ; Humans ; Organothiophosphorus Compounds ; Pulmonary Artery ; Stents ; Thoracic Surgery ; Thorax ; Tricuspid Valve ; Vena Cava, Superior ; Weaning

Background: Although an inverse association between the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and obesity exists, only few major studies have assessed the association between NT-proBNP levels and skeletal muscle mass in asymptomatic healthy adults. Therefore, this cross-sectional study was conducted. Methods: We assessed participants who underwent health examinations at Kangbuk Samsung Hospital in South Korea from January 2012 to December 2019. Appendicular skeletal muscle mass was measured using a bioelectrical impedance analyzer, and the skeletal muscle mass index (SMI) was calculated. Participants were divided into the control, mildly low skeletal muscle mass (LMM) (−2 standard deviation [SD] < SMI ≤−1 [SD]), and severely LMM groups (SD ≤−2) based on their SMI. The association between elevated NT-proBNP level (≥125 pg/mL) and skeletal muscle mass was assessed using multivariable logistic regression analysis with adjustment for confounding factors. Results: This study enrolled 15,013 participants (mean age, 37.52±9.52; men, 54.24%; control, n=12,827; mildly LMM, n=1,998; severely LMM, n=188). Prevalence of elevated NT-proBNP was higher in mildly and severely LMM groups than in the control group (control, 1.19%; mildly LMM, 1.4%; severely LMM, 4.26%; P=0.001). The adjusted odds ratio (OR) of elevated NT-proBNP was significantly higher in severely LMM (OR, 2.87; 95% confidence interval [CI], 1.3 to 6.37) than in control (OR, 1.00; reference) or mildly LMM groups (OR, 1.24; 95% CI, 0.81 to 1.89). Conclusion Our results showed that NT-proBNP elevation were more prevalent in participants with LMM. In addition, our study showed an association between skeletal muscle mass and NT-proBNP level in a relatively young and healthy adult population.

In order to compare the prognoses of patients with diffuse malignant lymphomas on the basis of histology and immunophenotypes, we retrospectively studied 62 cases of diffuse lymphoma arising in lymph nodes. We also evaluated the reactivity patterns of monoclonal antibodies (MoAb) LN1, LN2 and LN3 to determine the criteria for making a differential diagnosis in B cell lymphomas. The immunologic phenotypes were determined by the avidin biotin peroxidase complex method, using frozen or paraffin fixed tissues. The majority (66.3%) were B cell with the remaining 20.9% being T cell and 12.9% were non-B, non-T cell lineage. Immunological heterogeneity was found especially in the mixed small and large cell and the immunoblastic lymphomas. There was no significant difference between B- and T-cell lymphomas with respect to survival and death (P > 0.05). Histologically 79% (49/62) of the lymphoma was large cell and 21% (13/62), small cell lymphoma. There was a difference in prognosis between low, intermediate and high-grade of lymphomas. However there were no significant differences among the subtypes of the diffuse aggressive lymphomas. Factors associated with poor prognosis were advanced stages (P < 0.025) and histology of the malignant lymphomas. MoAb LN1, LN2 and LN3 gave positive staining in 83.3%, 91.7% and 60% of B cell lymphomas, respectively. The most common phenotypic pattern in B cell lymphomas was LN1+, LN2+, LN3+/-, suggestive of follicular center cell origin. As a panel, phenotypic patterns of MoAb LN1, LN2 and LN3 may be useful in differentiation of follicular center cell lymphoma from others.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD/biosynthesis ; Antigens, Differentiation, B-Lymphocyte/biosynthesis ; Child ; Female ; Follow-Up Studies ; Histocompatibility Antigens Class II/biosynthesis ; Humans ; Immunoenzyme Techniques ; Immunophenotyping ; Lymphoma, B-Cell/immunology ; Lymphoma, Non-Hodgkin/immunology/*pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Sialyltransferases/biosynthesis

PURPOSE: A pertussis patient from an elementary school, in Gyeonggi Province, Korea, was notified to public health authority on July 25, 2017. Epidemiologic investigation was conducted to identify the magnitude, possible source of infection and risk factors for this outbreak on August 17, 2017. MATERIALS AND METHODS: A case was defined as the school student experiencing cough for more than two weeks with or without paroxysmal, whoop, or post-tussive vomiting. Control was defined as the student polymerase chain reaction-negative at the school. School based surveillance was implemented to identify additional cases. RESULTS: From June 29 to August 27, 2017, nine patients of pertussis were identified from an elementary school. Among nine cases, eight were confirmed by polymerase chain reaction positive. All cases had cough, one (11%) had post-tussive vomiting, and one (11%) had fever. Eight cases had macrolide for 7 days in outpatient clinic, and one case admitted in a hospital. There was no significant difference of demographic factors including gender (p=0.49), age group (p=0.97), number of series of vaccination of pertussis (p=0.52), the number of participation of after school activity (p=0.28), and the time elapsed since last vaccination (p=0.42). However, we found the history of contact within the classroom or after-school activity was only the independent risk factor among all the demographic factors collected (odds ratio, 63.61; 95% confidence interval, 4.35 to 930.79). CONCLUSION: The contributing factor for transmission is associated with the case-contact. Immediate identification of pertussis with use of appropriate diagnostic test may help to avoid a large number of cases.
Ambulatory Care Facilities ; Case-Control Studies ; Cough ; Demography ; Diagnostic Tests, Routine ; Disease Outbreaks ; Fever ; Gyeonggi-do ; Humans ; Korea ; Polymerase Chain Reaction ; Public Health ; Risk Factors ; Vaccination ; Vaccines ; Vomiting ; Whooping Cough

Phytochemicals are reported to provide various biological functions leading to the promotion of health as well as the reduced risk of chronic diseases. Fat-soluble plant pigments, carotenoids, are extensively studied micronutrient phytochemicals for their potential health benefits. It is noteworthy that specific carotenoids may be responsible for different protective effects against certain diseases. In addition, each carotenoid can be obtained from different types of plant foods. Considering the fact that the phytochemical content in foods can vary according to, but not limited to, the varieties and culture conditions, it is important to establish a database of phytochemicals in locally produced plant foods. Currently, information on individual carotenoid content in plant foods commonly consumed in Korea is lacking. As the first step to support the production and consumption of sustainable local plant foods, carotenoids and total phenolic contents of plant foods commonly consumed in Korea are presented and their potential biological functions are discussed in this review.
Carotenoids ; Chronic Disease ; Health Promotion ; Insurance Benefits ; Korea ; Micronutrients ; Phenol ; Plants ; Resin Cements

PURPOSE: The aims of this study were to evaluate the change of [18F]fluoromisonidazole ([18F]FMISO) uptake in C3H mouse squamous cell carcinoma-VII (SCC-VII) treated with mild hyperthermia (42oC) and nicotinamide and to assess the biodistribution of the markers in normal tissues under similar conditions. METHODS AND MATERIALS: [18F]FMISO was producedby our hospital. Female C3H mice with a C3H SCC-VII tumor grown on their extremities were used. Tumors were size matched. Non-anaesthetized, tumor-bearing mice underwent control or mild hyperthermia at 42oC for 60 min with nicotinamide (50 mg/kg i.p. injected) and were examined by gamma counter, autoradiography and animal PET scan 3 hours after tracer i.v. injected with breathing room air. The biodistribution of these agents were obtained at 3 h after [18F]FMISO injection. Blood, tumor, muscle, heart, lung, liver, kidney, brain, bone, spleen, and intestine were removed, counted for radioactivity and weighed. The tumor and liver were frozen and cut with a cryomicrotome into 10-micrometer sections. The spatial distribution of radioactivity from the tissue sections was determined with digital autoradiography. RESULTS: The mild hyperthermia with nicotinamide treatment had only slight effects on the biodistribution of either marker in normal tissues. We observed that the whole tumor radioactivity uptake ratios were higher in the control mice than in the mild hyperthermia with nicotinamide treated mice for [18F]FMISO (1.56+/-1.03 vs. 0.67+/-0.30; p=0.063). In addition, autoradiography and animal PET scan demonstrated that the area and intensity of [18F]FMISO uptake was significantly decreased. CONCLUSION: Mild hyperthermia and nicotinamide significantly improved tumor hypoxia using [18F]FMISO and this uptake reflected tumor hypoxic status.
Animals ; Anoxia* ; Autoradiography ; Brain ; Extremities ; Female ; Fever* ; Humans ; Intestines ; Kidney ; Liver ; Lung ; Mice* ; Mice, Inbred C3H ; Myocardium ; Niacinamide ; Positron-Emission Tomography ; Radioactivity ; Respiration ; Spleen

Esophageal achalasia is a primary motility disorder characterized by insufficient lower esophageal sphincter relaxation and loss of esophageal peristalsis. Achalasia is a chronic disease that causes progressive irreversible loss of esophageal motor function. The recent development of high-resolution manometry has facilitated the diagnosis of achalasia, and determining the achalasia subtypes based on high-resolution manometry can be important when deciding on treatment methods. Peroral endoscopic myotomy is less invasive than surgery with comparable efficacy. The present guidelines (the “2019 Seoul Consensus on Esophageal Achalasia Guidelines”) were developed based on evidence-based medicine; the Asian Neurogastroenterology and Motility Association and Korean Society of Neurogastroenterology and Motility served as the operating and development committees, respectively. The development of the guidelines began in June 2018, and a draft consensus based on the Delphi process was achieved in April 2019. The guidelines consist of 18 recommendations: 2 pertaining to the definition and epidemiology of achalasia, 6 pertaining to diagnoses, and 10 pertaining to treatments. The endoscopic treatment section is based on the latest evidence from meta-analyses. Clinicians (including gastroenterologists, upper gastrointestinal tract surgeons, general physicians, nurses, and other hospital workers) and patients could use these guidelines to make an informed decision on the management of achalasia.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.

Gastroesophageal reflux disease (GERD) is a condition in which gastric contents regurgitate into the esophagus or beyond, resulting in either troublesome symptoms or complications. GERD is heterogeneous in terms of varied manifestations, test findings, and treatment responsiveness. GERD diagnosis can be established with symptomatology, pathology, or physiology. Recently the Lyon consensus defined the “proven GERD” with concrete evidence for reflux, including advanced grade erosive esophagitis (Los Angeles classification grades C and or D esophagitis), long-segment Barrett’s mucosa or peptic strictures on endoscopy or distal esophageal acid exposure time > 6% on 24-hour ambulatory pH-impedance monitoring. However, some Asian researchers have different opinions on whether the same standards should be applied to the Asian population. The prevalence of GERD is increasing in Asia. The present evidence-based guidelines were developed using a systematic review and meta-analysis approach. In GERD with typical symptoms, a proton pump inhibitor test can be recommended as a sensitive, cost-effective, and practical test for GERD diagnosis.Based on a meta-analysis of 19 estimated acid-exposure time values in Asians, the reference range upper limit for esophageal acid exposure time was 3.2% (95% confidence interval, 2.7-3.9%) in the Asian countries. Esophageal manometry and novel impedance measurements, including mucosal impedance and a post-reflux swallow-induced peristaltic wave, are promising in discrimination of GERD among different reflux phenotypes, thus increasing its diagnostic yield. We also propose a long-term strategy of evidence-based GERD treatment with proton pump inhibitors and other drugs.