We present a case of fetal cardiac hemangioma that caused fetal arrhythmia and reduced ventricular contractibility. At 31 weeks and 1 day of gestation, a 29-year-old primiparous mother was referred to our institution due to an abnormal ultrasound finding, suspicious of a fetal cardiac mass occupying the right atrium (RA). The blood flow from the RA to the right ventricle (RV) was decreased. Additional evaluation through FetalHQ (GE Healthcare Korea) revealed diminished RV contractility. At gestational age 35 weeks and 1 day, the fetus had developed paroxysmal supraventricular tachycardia. We decided to perform an emergency cesarean section to prevent further impairment in fetal cardiac circulation. Postnatal echocardiography showed a pedunculated mass on the free wall of the RA, and the cardiac movements were affected with atrial flutter. Immediate mass excision was performed.Pathological analysis confirmed that the mass was a juvenile capillary hemangioma. The newborn stayed admitted for postoperative care and recovered healthy without any signs of cardiac arrhythmia.

We present a case of fetal cardiac hemangioma that caused fetal arrhythmia and reduced ventricular contractibility. At 31 weeks and 1 day of gestation, a 29-year-old primiparous mother was referred to our institution due to an abnormal ultrasound finding, suspicious of a fetal cardiac mass occupying the right atrium (RA). The blood flow from the RA to the right ventricle (RV) was decreased. Additional evaluation through FetalHQ (GE Healthcare Korea) revealed diminished RV contractility. At gestational age 35 weeks and 1 day, the fetus had developed paroxysmal supraventricular tachycardia. We decided to perform an emergency cesarean section to prevent further impairment in fetal cardiac circulation. Postnatal echocardiography showed a pedunculated mass on the free wall of the RA, and the cardiac movements were affected with atrial flutter. Immediate mass excision was performed.Pathological analysis confirmed that the mass was a juvenile capillary hemangioma. The newborn stayed admitted for postoperative care and recovered healthy without any signs of cardiac arrhythmia.

We present a case of fetal cardiac hemangioma that caused fetal arrhythmia and reduced ventricular contractibility. At 31 weeks and 1 day of gestation, a 29-year-old primiparous mother was referred to our institution due to an abnormal ultrasound finding, suspicious of a fetal cardiac mass occupying the right atrium (RA). The blood flow from the RA to the right ventricle (RV) was decreased. Additional evaluation through FetalHQ (GE Healthcare Korea) revealed diminished RV contractility. At gestational age 35 weeks and 1 day, the fetus had developed paroxysmal supraventricular tachycardia. We decided to perform an emergency cesarean section to prevent further impairment in fetal cardiac circulation. Postnatal echocardiography showed a pedunculated mass on the free wall of the RA, and the cardiac movements were affected with atrial flutter. Immediate mass excision was performed.Pathological analysis confirmed that the mass was a juvenile capillary hemangioma. The newborn stayed admitted for postoperative care and recovered healthy without any signs of cardiac arrhythmia.

We present a case of fetal cardiac hemangioma that caused fetal arrhythmia and reduced ventricular contractibility. At 31 weeks and 1 day of gestation, a 29-year-old primiparous mother was referred to our institution due to an abnormal ultrasound finding, suspicious of a fetal cardiac mass occupying the right atrium (RA). The blood flow from the RA to the right ventricle (RV) was decreased. Additional evaluation through FetalHQ (GE Healthcare Korea) revealed diminished RV contractility. At gestational age 35 weeks and 1 day, the fetus had developed paroxysmal supraventricular tachycardia. We decided to perform an emergency cesarean section to prevent further impairment in fetal cardiac circulation. Postnatal echocardiography showed a pedunculated mass on the free wall of the RA, and the cardiac movements were affected with atrial flutter. Immediate mass excision was performed.Pathological analysis confirmed that the mass was a juvenile capillary hemangioma. The newborn stayed admitted for postoperative care and recovered healthy without any signs of cardiac arrhythmia.

We present a case of fetal cardiac hemangioma that caused fetal arrhythmia and reduced ventricular contractibility. At 31 weeks and 1 day of gestation, a 29-year-old primiparous mother was referred to our institution due to an abnormal ultrasound finding, suspicious of a fetal cardiac mass occupying the right atrium (RA). The blood flow from the RA to the right ventricle (RV) was decreased. Additional evaluation through FetalHQ (GE Healthcare Korea) revealed diminished RV contractility. At gestational age 35 weeks and 1 day, the fetus had developed paroxysmal supraventricular tachycardia. We decided to perform an emergency cesarean section to prevent further impairment in fetal cardiac circulation. Postnatal echocardiography showed a pedunculated mass on the free wall of the RA, and the cardiac movements were affected with atrial flutter. Immediate mass excision was performed.Pathological analysis confirmed that the mass was a juvenile capillary hemangioma. The newborn stayed admitted for postoperative care and recovered healthy without any signs of cardiac arrhythmia.

Background/Aims: This study aimed to investigate whether pretransplant frailty can predict postoperative morbidity and mortality after liver transplantation (LT) in patients with cirrhosis. Methods: We retrospectively reviewed 242 patients who underwent LT between 2018 and 2020 at a tertiary hospital in Korea. Results: Among them, 189 patients (78.1%) received LT from a living donor. Physical frailty at baseline was assessed by the Short Physical Performance Battery (SPPB), by which patientswere categorized into two groups: frail (SPPB <10) and non-frail (SPPB ≥10). Among the whole cohort (age, 55.0±9.2 years; male, 165 [68.2%]), 182 patients were classified as non-frail and 60 patients were classified as frail. Posttransplant survival was shorter in the frail group than the non-frail group (9.3 months vs 11.6 months). Postoperative intensive care unit stay was longer in the frail group than in the non-frail group (median, 6 days vs 4 days), and the 30-day complication rate was higher in the frail group than in the non-frail group (78.3% vs 59.3%). Frailty was an independent risk factor for posttransplant mortality (adjusted hazard ratio, 2.38; 95% confidence interval, 1.02 to 5.57). In subgroup analysis, frail patients showed lower posttransplant survival regardless of history of hepatocellular carcinoma and donor type. Conclusions Assessment of pretransplant frailty, as measured by SPPB, provides important prognostic information for clinical outcomes in cirrhotic patients undergoing LT.

Objective: To investigate the effects of long-acting injectable 3-monthly paliperidone palmitate on the clinical and social functioning of patients with schizophrenia. Methods: This study enrolled patients with schizophrenia receiving long-acting injectable 1-monthly paliperidone palmitate for at least 4 months and who subsequently received 3-monthly paliperidone palmitate. Accordingly, 418 patients were followed up for 24 weeks. Their clinical symptoms and social functioning were measured using the Clinical Global Impression-Severity of Illness and Personal and Social Performance scales. Results: The Personal and Social Performance total score was significantly higher after 3-monthly paliperidone palmitate treatment than at baseline (baseline vs. week 24: 54.3 ± 18.0 vs. 61.0 ± 14.5 [mean ± standard deviation]; p ＜ 0.001; Wilcoxon signed-rank test); the proportion of patients in the mildly ill group (scores 71−100) also increased significantly (baseline vs. week 24: 16.5% vs. 20.6%; p＜ 0.001; McNemar-Bowker test). The mean Clinical Global Impression-Severity of Illness score decreased significantly (baseline vs. week 24: 3.7 ± 1.0 vs. 3.4 ± 0.9; p＜ 0.001; Wilcoxon signed-rank test), as did the proportion of patients in the severely ill group (baseline vs. week 24: 4.1% vs. 2.1%; p ＜ 0.001; McNemar-Bowker test). Conclusion Continuous 3-monthly paliperidone palmitate treatment significantly enhances the personal and social performance of patients with schizophrenia and reduces the proportion of those with severe illness. These findings suggest that long-acting injectable antipsychotic administration at intervals longer than 1 month might improve the social functioning of and promote return to activities of daily living in patients with schizophrenia.

Vaginal bleeding is reported among 4%–11% of postmenopausal women. Hematometra is commonly associated with cervical stenosis due to senile atrophy, radiotherapy, or a uterine neoplastic lesion in women of postmenopausal age. Ovarian steroid cell tumor is a rare hormone-secreting tumor subtype accounting for approximately 0.1% of all ovarian tumors. Here we report a case of hematometra in a postmenopausal woman with high estrogen levels who was later diagnosed with a steroid cell tumor.

Background: The purpose of this study is to construct a job-exposure matrix for lead that accounts for industry and work processes within industries using a nationwide exposure database. Methods: We used the work environment measurement data (WEMD) of lead monitored nationwide from 2015 to 2016. Industrial hygienists standardized the work process codes in the database to 37 standard process and extracted key index words for each process. A total of 37 standardized process codes were allocated to each measurement based on an automated key word search based on the degree of agreement between the measurement information and the standard process index. Summary statistics, including the arithmetic mean, geometric mean, and 95th percentile level (X95), was calculated according to industry, process, and industry process. Using statistical parameters of contrast and precision, we compared the similarity of exposure groups by industry, process, and industry process. Results: The exposure intensity of lead was estimated for 583 exposure groups combined with 128 industry and 35 process. The X95 value of the “casting” process of the “manufacture of basic precious and non-ferrous metals” industry was 53.29 μg/m3, exceeding the occupational exposure limit of 50 μg/m3. Regardless of the limitation of the minimum number of samples in the exposure group, higher contrast was observed when the exposure groups were by industry process than by industry or process. Conclusion We evaluated the exposure intensities of lead by combination of industry and process. The results will be helpful in determining more accurate information regarding exposure in lead-related epidemiological studies.

Background: Exclusive enteral nutrition (EEN) induces remission in pediatric Crohn's disease (CD). The exact mechanism of EEN therapy in CD is unknown, but alteration of the intestinal microflora after EEN is thought to affect mucosal healing. To determine the link between EEN therapy and therapeutic efficacy in CD, we established a murine model of dextran sulfate sodium (DSS)-induced colitis and applied EEN therapy. Methods: Eight-week-old C57BL/6 mice were administered DSS for 4 days to induce colitis, and either normal chow (NC) or EEN was administered for the following 4 days. The mice were grouped according to the feeding pattern after DSS administration: DSS/NC and DSS/ EEN groups. The clinical course was confirmed via daily observation of the weight and stool. Fecal samples were collected and 16sRNA sequencing was used. The mice were sacrificed to confirm colonic histopathology. Results: Weight reduction and increase in disease activity were observed as the day progressed for 4 days after DSS administration. There was significant weight recovery and improvement in disease activity in the EEN group compared to that in the NC group. Verrucomicrobia and Proteobacteria abundances tended to increase and Bacteroidetes abundance decreased in the EEN group. In the EEN group, significant changes in the β-diversity of the microbiota were observed. In the analysis of microbiome species, abundances of Akkermansia muciniphila, Clostridium cocleatum, mucin-degrading bacteria, Flintibacter butyricus, and Parabacteroides goldsteinii, which are beneficial microbiota, were significantly increased in the EEN group compared to those in the NC group. More abundant mucins were confirmed in the colonic histopathology of the EEN group. These microbial and histopathological differences suggested that EEN might improve colitis symptoms in a murine colitis model by promoting mucin recycling and subsequently inducing the healing effect of the gut barrier. Conclusion EEN showed clinical efficacy in a murine model of colitis. Based on the increase in mucin-degrading bacteria and the pathological increase in mucin production after EEN administration, it can be observed that mucin plays an important role in the therapeutic effect of EEN.