Two gold-spotted pond frogs (Pelophylax chosenicus) experienced anorexia, buoyancy without diving, and systemic swelling for 1 month and died several days later. On necropsy, the liver had protruding dark gray nodules scattered on its surface, and the kidneys were fat-like beige. Bacteriology showed the presence of Citrobacter braakii, Delftia acidovorans, Elizabethkingia spp., and Chryseobacterium indologenes. On microscopy, the liver showed melanomacrophagic aggregates, inflammatory cell infiltration, and fibrosis. In the case of these frogs, the edema disease is suspected to have been caused by long-term exposure to chlorine and chloramines in tap water rather than infection.

Two gold-spotted pond frogs (Pelophylax chosenicus) experienced anorexia, buoyancy without diving, and systemic swelling for 1 month and died several days later. On necropsy, the liver had protruding dark gray nodules scattered on its surface, and the kidneys were fat-like beige. Bacteriology showed the presence of Citrobacter braakii, Delftia acidovorans, Elizabethkingia spp., and Chryseobacterium indologenes. On microscopy, the liver showed melanomacrophagic aggregates, inflammatory cell infiltration, and fibrosis. In the case of these frogs, the edema disease is suspected to have been caused by long-term exposure to chlorine and chloramines in tap water rather than infection.

Two gold-spotted pond frogs (Pelophylax chosenicus) experienced anorexia, buoyancy without diving, and systemic swelling for 1 month and died several days later. On necropsy, the liver had protruding dark gray nodules scattered on its surface, and the kidneys were fat-like beige. Bacteriology showed the presence of Citrobacter braakii, Delftia acidovorans, Elizabethkingia spp., and Chryseobacterium indologenes. On microscopy, the liver showed melanomacrophagic aggregates, inflammatory cell infiltration, and fibrosis. In the case of these frogs, the edema disease is suspected to have been caused by long-term exposure to chlorine and chloramines in tap water rather than infection.

Two gold-spotted pond frogs (Pelophylax chosenicus) experienced anorexia, buoyancy without diving, and systemic swelling for 1 month and died several days later. On necropsy, the liver had protruding dark gray nodules scattered on its surface, and the kidneys were fat-like beige. Bacteriology showed the presence of Citrobacter braakii, Delftia acidovorans, Elizabethkingia spp., and Chryseobacterium indologenes. On microscopy, the liver showed melanomacrophagic aggregates, inflammatory cell infiltration, and fibrosis. In the case of these frogs, the edema disease is suspected to have been caused by long-term exposure to chlorine and chloramines in tap water rather than infection.

Two gold-spotted pond frogs (Pelophylax chosenicus) experienced anorexia, buoyancy without diving, and systemic swelling for 1 month and died several days later. On necropsy, the liver had protruding dark gray nodules scattered on its surface, and the kidneys were fat-like beige. Bacteriology showed the presence of Citrobacter braakii, Delftia acidovorans, Elizabethkingia spp., and Chryseobacterium indologenes. On microscopy, the liver showed melanomacrophagic aggregates, inflammatory cell infiltration, and fibrosis. In the case of these frogs, the edema disease is suspected to have been caused by long-term exposure to chlorine and chloramines in tap water rather than infection.

Purpose: Gastric cancer (GC) is among the most prevalent and fatal cancers worldwide.National cancer screening programs in countries with high incidences of this disease provide medical aid beneficiaries with free-of-charge screening involving upper endoscopy to detect early-stage GC. However, the coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions to routine healthcare access. Thus, this study aimed to assess the impact of COVID-19 on the diagnosis, overall incidence, and stage distribution of GC. Materials and Methods: We identified patients in our hospital cancer registry who were diagnosed with GC between January 2018 and December 2021 and compared the cancer stage at diagnosis before and during the COVID-19 pandemic. Subgroup analyses were conducted according to age and sex. The years 2018 and 2019 were defined as the “before COVID” period, and the years 2020 and 2021 as the “during COVID” period. Results: Overall, 10,875 patients were evaluated; 6,535 and 4,340 patients were diagnosed before and during the COVID-19 period, respectively. The number of diagnoses was lower during the COVID-19 pandemic (189 patients/month vs. 264 patients/month) than before it.Notably, the proportion of patients with stages 3 or 4 GC in 2021 was higher among men and patients aged ≥40 years. Conclusions During the COVID-19 pandemic, the overall number of GC diagnoses decreased significantly in a single institute. Moreover, GCs were in more advanced stages at the time of diagnosis. Further studies are required to elucidate the relationship between the COVID-19 pandemic and the delay in the detection of GC worldwide.

Objective: This study examined the predictive factors to decide the surgical treatment for clinically suspected pediatric acute appendicitis with equivocal imaging findings. Methods: This study was conducted retrospectively on children who visited local emergency medical centers and outpatients from January 2018 to February 2021. The electronic medical records were reviewed from 811 pediatric patients younger than 16 years of age with the chief complaint of abdominal pain and who underwent an imaging test for the clinical suspicion of appendicitis. Ninety-two patients who showed ambiguous findings on imaging tests but were still suspected of having appendicitis were analyzed. Recursive partitioning analysis and multivariable logistic regression were used to identify the variables associated with appendicitis. Results: Of the 92 enrolled patients, 23 patients were confirmed to have appendicitis, and 69 did not. Patients with the clinical suspicion who had an elevated white blood cell (WBC) count, polymorphonuclear leukocyte differential count (PMN), absolute neutrophil count (ANC), and leukocytosis were more likely to have appendicitis. The PMN (odds ratio=1.175; 95% confidence interval, 1.092-1.265) and ANC (odds ratio=1.00050; 95% confidence interval, 1.00025-1.00075) remained significant after multivariable logistic analysis. Conclusion Elevated PMN and ANC are clinical predictors of pediatric appendicitis when the imaging findings are nondiagnostic, and the clinical suspicion is continuous.

Objective: A retrospective study was performed to evaluate the usefulness of the delta neutrophil index as a prognosticfactor for mortality in intensive care unit patients admitted via the emergency department. Methods: Patients, who presented to the emergency department and were admitted to the intensive care unit fromJanuary 2018 to August 2018, were reviewed retrospectively. The clinical features, inflammatory marker levels, such asC-reactive protein, lactate, simplified acute physiology score 3, length of stay, and in-hospital mortality were obtainedfrom the medical records. Patients, who visited the emergency department because of trauma or suicidal attempts,arrived after out-hospital cardiac arrest, or were diagnosed with cerebrovascular disease, were excluded. Results: Of the 310 patients included, 65 died during their admission, and 245 patients were discharged after treatment.The receiver operating characteristic curve showed that the delta neutrophil index (area under curve [AUC], 0.72), Creactiveprotein (AUC, 0.70), lactate (AUC, 0.64), and simplified acute physiology score 3 (AUC, 0.79) indicated a lowpredictive power for in-hospital mortality. Whole patients were divided into four subgroups (infectious diseases, cardiovasculardiseases, gastrointestinal bleeding diseases, and others). The receiver operating curve of delta neutrophil indexrevealed infectious diseases (AUC, 0.65), in cardiovascular diseases (AUC, 0.70), and gastrointestinal bleeding diseases(AUC, 0.79). Conclusion The role of the delta neutrophil index for predicting the prognosis of in-hospital mortality showed equally lowpredictive power for critically ill patients with the C-reactive protein and lactate.

Sinus pericranii is a rare vascular anomaly characterized by abnormal venous communication betweenthe inner and outer regions of the cranial cavity. Here, we report a case of sinus pericraniiand venous malformations in the right periorbital region of a 2-year-old girl. Radiologic findingsshowed venous malformations in the right parietal region communicating with the superior sagittalsinus in the intracranial region. There were notable improvements following surgical resectionfor the abnormal venous lesions and several sclerotherapies. Presence of a bluish and pulsatingmass on the scalp, which showed bruit on auscultation, may indicate sinus pericranii, whichshould be included in the differential diagnosis.

Objectives: . To investigate the prognostic factors and treatment outcomes of primary parotid carcinoma treated with surgery and postoperative radiotherapy (PORT). Methods: . We reviewed retrospectively 57 patients with primary parotid carcinoma who were treated with surgery and PORT between 2005 and 2014. Superficial parotidectomy was performed in 19 patients, total parotidectomy in 10 patients, and total parotidectomy with lymph node dissection in 28 patients PORT on the tumor bed was performed in 41 patients, while PORT on tumor bed and ipsilateral cervical lymph nodes was performed in 16 patients. Results: . With a median follow-up of 66 months, the 5-year overall survival, disease-free survival, locoregional control, and distant control rates were 77.0%, 60.2%, 77.6%, and 72.8%, respectively. The 5-year overall survival by stage was 100%, 100%, 80.0%, and 46.4% in stage I, II, III, and IV, respectively. Recurrences at primary lesions were found in seven patients, while at cervical nodes in six patients. Distant recurrences were developed in 12 patients. No patient with the low and intermediate histologic grade developed distant failure. As prognostic factors, the histologic grade for overall survival (P=0.005), pathological T-stage (P=0.009) and differentiation grade (P=0.009) for disease-free survival, pathological T-stage for locoregional control (P=0.007), and lympho-vascular invasion (P=0.023) for distant recurrence were significant on multivariate analysis. Conclusion . This study revealed that differentiation grade, histologic grade, pathological T-stage, and lympho-vascular invasion were significant independent prognostic factors on clinical outcomes.