Enterococcus faecium, particularly in its multidrug-resistant forms, causes invasive nosocomial infections. Given the limited data comparing the effectiveness of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the CLSI clinical breakpoints (CBPs) for quinupristin–dalfopristin (QD) resistance and the need to evaluate their practical application, we retrospectively investigated the susceptibility patterns of 287 E.faecium bloodstream isolates from Korean hospitals to QD using the updated EUCAST and CLSI CBPs and two antimicrobial susceptibility testing methods: disk diffusion (DD) and Sensititre broth microdilution (Sensititre). QD resistance rates were 5.9% (CLSI) and 18.8% (EUCAST) for DD and 22.6% (CLSI) and 28.2% (EUCAST) for Sensititre. The most prevalent QD resistance gene types among QD-resistant isolates were ermB+msrC+ or ermB– msrC+. Categorical agreement between DD and Sensititre ranged from 77.7% to 90.7%, depending on the testing method and CBPs applied. The EUCAST zone diameter CBPs more effectively help identify QD-resistant E. faecium isolates using the DD method than the CLSI zone diameter CBPs. In comparison, the CLSI minimum inhibitory concentration (MIC) CBPs provide more reliable results for resistance classification in the Sensititre method than EUCAST MIC CBPs. These findings would help improve clinical decision-making for treating multidrug-resistant E. faecium infections.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

The global increase in livestock production has correspondingly intensified farm odors due to harmful bacteria, reduced immunity, and disease progression. In this study, we treated feces with Biomagic-Enzyme complex for 4 months to understand the relationship between farm odor, immunity against common viral diseases, immune cytokines, and changes in the microbiota. A gas meter (MultiRAE) was used to measure ammonia (NH3) and hydrogen sulfide (H2S) while odor intensity and offensiveness were characterized by the non-objective scaling method. A complete blood count was performed and plasma was obtained after blood centrifugation at 3,000 rpm for 20 minutes. The cytokine profile was evaluated using commercial kits. Microbial DNA was extracted and purified from fecal samples to analyze the microbiota. Microbial DNA and viral RNA/DNA were obtained from fecal samples and amplified to determine the expression of transmissible gastroenteritis virus (TGEV), porcine reproductive and respiratory syndrome (PRRS), and porcine circovirus type 2 (PCV2). Our results indicated that Biomagic reduced odor nuisance by decreasing ammonia levels, resulting in faint and fairly offensive odor intensity. After the enzyme treatment, Escherichia coli populations significantly reduced across all 3 farms. In contrast, beneficial Lactobacillus spp. levels remained stable, indicating the enzyme selectively targeted harmful bacteria while preserving beneficial ones. The beneficial Lachnospiraceae, Spirochaetaceae, and Bacteroidaceae were found to be higher in the third month of treatment. TGEV was not detected, while PRRS and non-pathogenic PCV2 showed a positive infection rate. In conclusion, Biomagic reduced ammonia, prevented viral infection from pig farms, and improved gut-beneficial bacteria and microbiota.

Background: Major pulmonary resection after neoadjuvant concurrent chemoradiation therapy (nCCRT) is associated with a substantial risk of postoperative complications. This study investigated postoperative complications and associated risk factors to facilitate the selection of suitable surgical candidates following nCCRT in stage IIIA–N2 non-small cell lung cancer (NSCLC). Methods: We conducted a retrospective analysis of patients diagnosed with clinical stage IIIA–N2 NSCLC who underwent surgical resection following nCCRT between 1997 and 2013. Perioperative characteristics and clinical factors associated with morbidity and mortality were analyzed using univariable and multivariable logistic regression. Results: A total of 574 patients underwent major lung resection after induction CCRT.Thirty-day and 90-day postoperative mortality occurred in 8 patients (1.4%) and 41 patients (7.1%), respectively. Acute respiratory distress syndrome (n=6, 4.5%) was the primary cause of in-hospital mortality. Morbidity occurred in 199 patients (34.7%). Multivariable analysis identified significant predictors of morbidity, including patient age exceeding 70 years (odds ratio [OR], 1.8; p=0.04), low body mass index (OR, 2.6; p=0.02), and pneumonectomy (OR, 1.8; p=0.03). Patient age over 70 years (OR, 1.8; p=0.02) and pneumonectomy (OR, 3.26; p<0.01) were independent predictors of mortality in the multivariable analysis. Conclusion In conclusion, the surgical outcomes following nCCRT are less favorable for individuals aged over 70 years or those undergoing pneumonectomy. Special attention is warranted for these patients due to their heightened risks of respiratory complications. In high-risk patients, such as elderly patients with decreased lung function, alternative treatment options like definitive CCRT should be considered instead of surgical resection.

Background: Contralateral pulmonary resection after pneumonectomy presents considerable challenges, and few reports in the literature have described this procedure. Methods: We retrospectively reviewed the medical records of all patients who underwent contralateral lung resection following pneumonectomy for any reason at our institution between November 1994 and December 2020. Results: Thirteen patients (9 men and 4 women) were included in this study. The median age was 57 years (range, 35–77 years), and the median preoperative forced expiratory volume in 1 second was 1.64 L (range, 1.17–2.12 L). Contralateral pulmonary resection was performed at a median interval of 44 months after pneumonectomy (range, 6–564 months). Surgical procedures varied among the patients: 10 underwent single wedge resection, 2 were treated with double wedge resection, and 1 underwent lobectomy. Diagnoses at the time of contralateral lung resection included lung cancer in 7 patients, lung metastasis from other cancers in 3 patients, and tuberculosis in 3 patients. Complications were observed in 4 patients (36%), including acute kidney injury, pneumothorax following chest tube removal, pneumonia, and prolonged air leak. No cases of operative mortality were noted. Conclusion In carefully selected patients, contralateral pulmonary resection after pneumonectomy can be accomplished with acceptable operative morbidity and mortality.

Previous studies have shown that tricuspid regurgitation (TR) can be developed in patients with atrial fibrillation (AF) due to annular dilatation. This study aimed to investigate the incidence and predictors of the progression of TR in patients with persistent AF. A total of 397 patients (66.9±11.4 years, 247 men; 62.2%) with persistent AF were enrolled between 2006 and 2016 in a tertiary hospital, and 287 eligible patients with follow-up echocardiography were analyzed. They were divided into two groups according to TR progression (progression group [n=68, 70.1±10.7 years, 48.5% men] vs. non-progression group [n=219, 66.0±11.3 years, 64.8% men]). Among 287 patients in the analysis, 68 had worsening TR severity (23.7%). Patients in the TR progression group were older and more likely to be female. Patients with left ventricular ejection fraction ＜50% were less frequent in the progression group than those in the non-progression group (7.4% vs. 19.6%, p=0.018). Patients with mitral valve disease were more frequent in the progression group. Multivariate analysis with COX regression demonstrated independent predictors of TR progression, including left atrial (LA) diameter ＞54 mm (HR 4.85, 95%CI 2.23-10.57, p＜0.001), E/e’ (HR 1.05, 95%CI 1.01-1.10, p=0.027), and no use of antiarrhythmic agents (HR 2.20, 95%CI 1.03-4.72, p=0.041). In patients with persistent AF, worsening TR was not uncommon. The independent predictors of TR progression turned out to be greater LA diameter, higher E/e’, and no use of antiarrhythmic agents.

Arachnoid cysts are usually asymptomatic and discovered incidentally. However, cysts may occasionally rupture because of minor head trauma. We describe the radiologic follow-up of 5 patients with ruptured arachnoid cysts featuring spontaneous resolution, subdural hygroma formation, and cystic and subdural hemorrhage. From January 2004 through July 2020, 5 patients (1.3%) with ruptured arachnoid cysts were evaluated out of 388 patients with arachnoid cysts encountered at our institution at that time. The 5 patients were all male, and they ranged in age from 6–17 years (median, 12 years).The median duration of radiologic follow-up was 3.5 years (range, 2.3–10.1 years). All of the ruptured arachnoid cysts were overlying the temporal lobe with Galassi type II. The median cyst diameter was 4.9 cm (range, 4.4–8.9 cm). Four patients had a history of recent minor head trauma. There were no particular neurologic symptoms in their past medical history in all patients. In the follow-up, two patients’ cysts resolved spontaneously without hemorrhage. One patient’s cyst resolved post-burr-hole drainage for chronic subdural hemorrhage. Another patient, whose cyst led to a hemorrhage and chronic subdural hemorrhage, recovered following a craniotomy, hematoma removal, and cyst fenestration. Another patient, presenting with hygroma, cystic hemorrhage, and chronic subdural hemorrhage, was treated with burr-hole drainage. Three patients recovered postoperatively. Arachnoid cysts rarely rupture, and surgical intervention is required for some cases associated with hemorrhage. Postoperatively, all patients had good outcomes without complications in this series.