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Background: The ratio of estimated glomerular filtration rate (eGFR) based on cystatin C and creatinine (eGFRcystatin C/eGFRcreatinine ratio) is related to accumulating atherosclerosis-promoting proteins and increased mortality in several cohorts. Methods: We assessed whether the eGFRcystatin C/eGFRcreatinine ratio is a predictor of arterial stiffness and sub-clinical atherosclerosis in type 2 diabetes mellitus (T2DM) patients, who were followed up during 2008 to 2016. GFR was estimated using an equation based on cystatin C and creatinine. Results: A total of 860 patients were stratified according to their eGFRcystatin C/eGFRcreatinine ratio (i.e., <0.9, 0.9-1.1 [a reference group], and >1.1). Intima-media thickness was comparable among the groups; however, presence of carotid plaque was frequent in the <0.9 group (<0.9 group, 38.3%; 0.9-1.1 group, 21.6% vs. >1.1 group, 17.2%, P<0.001). Brachial-ankle pulse wave velocity (baPWV) was faster in the <0.9 group (<0.9 group, 1,656.3±333.0 cm/sec; 0.9-1.1 group, 1,550.5±294.8 cm/sec vs. >1.1 group, 1,494.0±252.2 cm/sec, P<0.001). On comparing the <0.9 group with the 0.9-1.1 group, the multivariate-adjusted odds ratios of prevalence of high baPWV and carotid plaque were 2.54 (P=0.007) and 1.95 (P=0.042), respectively. Cox regression analysis demonstrated near or over 3-fold higher risks of the prevalence of high baPWV and carotid plaque in the <0.9 group without chronic kidney disease (CKD). Conclusion: We concluded that eGFRcystatin C/eGFRcreatinine ratio <0.9 was related to an increased risk of high baPWV and carotid plaque in T2DM patients, especially, those without CKD. Careful monitoring of cardiovascular disease is needed for T2DM patients with low eGFRcystatin C/eGFRcreatinine ratio. [ABSTRACT FROM AUTHOR]

Background: The present study investigated the role of synergistic interaction between hyperuricemia and abdominal obesity as a risk factor for the components of metabolic syndrome. Methods: We performed a cross-sectional study using the data of 16,094 individuals from the seventh Korean National Health and Nutrition Examination Survey (2016 to 2018). The adjusted odds ratios of metabolic syndrome and its components were analyzed by multivariate logistic regression analysis. The presence of synergistic interaction between hyperuricemia and abdominal obesity was evaluated by calculating the additive scales--the relative excess risk due to interaction, attributable proportion due to interaction, and synergy index (SI). Results: There was a synergistic interaction between hyperuricemia and abdominal obesity in hypertriglyceridemia (men: SI, 1.39; 95% confidence interval [CI], 1.01 to 1.98; women: SI, 1.61; 95% CI, 1.02 to 2.69), and low high-density lipoprotein cholesterol (HDL-C) (men: SI, 2.03; 95% CI, 1.41 to 2.91; women: SI, 1.70; 95% CI, 1.05 to 2.95). There was no significant synergistic interaction between hyperuricemia and abdominal obesity for the risk of high blood pressure (men: SI, 1.22; 95% CI, 0.85 to 1.77; women: SI, 1.53; 95% CI, 0.79 to 2.97), and hyperglycemia (men: SI, 1.03; 95% CI, 0.72 to 1.47; women: SI, 1.39; 95% CI, 0.75 to 2.57). Conclusion: Hyperuricemia and abdominal obesity synergistically increased the risk of hypertriglyceridemia and low HDL-C in both sexes. [ABSTRACT FROM AUTHOR]

In this study, agar-based nanocomposite films containing ultra-porous silica aerogel particles were fabricated by gel casting using an aqueous agar/silica aerogel slurry. The silica aerogel particles did not show significant agglomeration and were homogeneously distributed in the agar matrix. Transmission electron microscopy observations demonstrated that the silica aerogel particles had a mesoporous microstructure and their pores were not incorporated into the agar polymer molecules. The thermal conductivities of the agar and agar/5 wt.% silica aerogel nanocomposite films were 0.36 and 0.20 W·m-1·K-1, respectively. The transmittance of the agar films did not decrease upon the addition of silica aerogel particles into them. This can be attributed to the anti-reflection effect of silica aerogel particles. [ABSTRACT FROM AUTHOR]

Background/Aims Functional dyspepsia (FD) is characterized as chronic recurrent upper gastrointestinal symptoms in the absence of any organic disorder. We hypothesized that duodenal low-grade inflammation activates superficial afferent nerve sprouting, thereby contributing to hypersensitivity in patients with FD. Methods A prospective case-control study was conducted in a tertiary referral center. FD was defined using the Rome III criteria. Standardized endoscopic biopsies were performed in the stomach and duodenum. Hematoxylin and eosin staining and immunohistochemical staining for major basic proteins were performed to detect granulated eosinophil-derived granules, and S-100 staining was performed to detect fine nerve fibers. Results A total of 51 patients with FD (82% female; mean age 35.8 ± 13.4 years) and 35 controls were enrolled. Activated eosinophil counts in the duodenum were significantly higher in patients with FD than in controls (41.4% vs 17.1%, P = 0.005). Microscopic duodenitis was more frequently detected in patients with FD than in controls. Fine nerve fibers were more abundant in patients with FD than in controls (45.1% vs 11.4%, P = 0.029). The abundance of fine nerve fibers highly correlated with the degree of activated eosinophils. Conclusion Duodenal low-grade inflammation, such as mucosal eosinophilic accumulation with degranulation, promoted mucosal enteric nerve fiber density and sprouting in patients with FD. [ABSTRACT FROM AUTHOR]

The best management strategy for angiographically intermediated coronary artery diseases remains controversial. Lesions, when coupled with spasm, can lead to catastrophic results and cardiogenic shock. We report a case of a 62-year-old man who had an intermediate coronary artery disease presenting with cardiogenic shock due to coronary spasm during a preoperative period. [ABSTRACT FROM AUTHOR]

Tidal-flats play important roles in oceanic nitrogen (N) cycles. Particularly, N loss in the tidal-flats depends on soil texture and yet the dominant N removal mechanism in relation to soil texture is not clear. Therefore, the objective of this study was to investigate the effect of soil texture on NO3−-N removal and transport in texturally contrasting tidal-flats of the western coast of Korea [Gangwha (GH, silt) and Saemangeum (SMG, loamy sand) sites]. To interpret the experimental results, we compared the time-course patterns of NO3−-N disappearance during incubation under intertidal and subtidal conditions and the patterns of breakthrough curves (BTCs) of NO3−-N with a conservative tracer (Br−) during miscible displacement experiment. Nitrate disappearance by denitrification was negligible for SMG soils, but was 1.6 and 2.3mgNkg−1 soil day−1 under intertidal and subtidal conditions for GH soils, respectively. The BTCs of NO3−-N and Br− were identical and followed Gaussian distributions in SMG tidal-flats, while those obtained for GH tidal-flats were broad and asymmetrical. Calculated Pêclet number of Br− in seawater matrix by fitting the CXTFIT model to the measured BTCs was 45.03 for SMG and 4.93 for GH tidal-flats, indicating dominance of advection over dispersion for the former, and vice versa for the latter. From a mass balance of NO3−-N, nearly all of the added NO3−-N (38.8mg) was recovered in the effluents with a slight unaccounted-for portion (2.8mg) in SMG system, indicating the possibility of an intense off-shore NO3−-N discharge (leaching) from the tidal-flats. In contrast, a considerably large amount (27.0mg) of added NO3−-N was not recovered in GH system but nearly one-third (13.5mg) was recovered in the effluents, suggesting that denitrification dominates over off-shore discharge in NO3−-N removal. Our results showed that the patterns of NO3−-N removal was different depending on soil texture of the tidal-flats and that a dominant mechanism of NO3−-N removal was denitrification in GH tidal-flats and was off-shore discharge in SMG tidal-flats. Therefore, NO3−-N removal characteristics of tidal-flats should be predetermined for site-specific management of waste water N loadings to coastal water systems. [ABSTRACT FROM AUTHOR]

The short story "From Free Food for Millionaires" by Min Jin Lee is presented.

Primary liposarcoma of the liver is extremely rare. We report here on a case of primary well-differentiated liposarcoma in the left hepatic lobe of a 63-year-old woman. Abdominal ultrasonography showed a well-defined, echogenic, round mass. Abdominal computed tomography (CT) and magnetic resonance (MR) images showed an almost fatty, lobulated mass with a few, random distributed vascular structures and a small area of nodular enhancement. The resected tumor appeared as a well-defined, round, tan-yellow mass. Histological analysis showed a well-differentiated liposarcoma. [ABSTRACT FROM AUTHOR]

Background : Antithyroid drugs (ATDs) can lead to the development of agranulocytosis, which is the most serious adverse effect. Characteristics of ATD-induced agranulocytosis (AIA) have seldom been reported due to the rarity. In this study, we characterized the clinical features for AIA in Korean patients. Methods: We retrospectively reviewed data from patients with AIA diagnosed between 1997 and 2014 at four tertiary hospitals. Agranulocytosis was defined as an absolute neutrophil count (ANC) below 500/mm³. Results: The mean age of the patients (11 males, 43 females) was 38.2±14.9 years. Forty-eight patients (88.9%) with AIA had fever and sore throat on initial presentation, 20.4% of patients developed AIA during the second course of treatment, and 75.9% of patients suffered AIA within 3 months after initiation of ATD. The patients taking methimazole (n=39) showed lower levels of ANC and more frequent use of granulocyte-macrophage colony-stimulating factor than propylthiouracil (n= 15) users. The median duration of agranulocytosis was 5.5 days (range, 1 to 20). No differences were observed between the long (≥6 days) and short recovery time (≥ 5 days) groups in terms of age, gender, ATDs, duration of ATDs, or initial ANC levels. Four patients (7.4%) who were taking ATDs for less than 2 months died of sepsis on the first or second day of hospitalization. Conclusion: The majority of AIA incidents occur in the early treatment period. Considering the high fatality rate of AIA, an early aggressive therapeutic approach is critical and patients should be well informed regarding the warning symptoms of the disease. [ABSTRACT FROM AUTHOR]

Background/Aims: As life expectancy has increased, the number of elderly patients who need long-term care has grown rapidly. Mortality in patients with colitis in long-term care facilities (LTCFs) is increasing. We intend to investigate the main causes of colitis in LTCFs compared to those of colitis in local communities, and to identify the clinical features and risk factors of patients with colitis in LTCFs. Methods: We retrospectively analyzed epidemiology, medical conditions, laboratory values, diagnoses, and clinical courses of elderly patients aged ≥65 who were admitted to the Ewha Womans University hospital with colitis between January 2007 and July 2012. Results: Patients with colitis in LTCFs (n=20) were compared with elderly patients with colitis in local communities (n=154). Fifty-five percent of colitis in LTCFs was caused by Clostridium difficile infection (CDI), 30% was due to ischemic colitis, and 15% was due to non-specific colitis. Non-specific colitis was the most common (63%) in the community group. Clinical outcomes were also significantly different between both groups: higher mortality (10.0% vs. 0.64%, P=0.021), higher requirement for intensive care units care (50.0% vs. 18.8%, P<0.01) in LTCFs group. In univariate analysis, the most significant risk factor for death in patients in LTCFs was decreased mental faculties. Conclusions: Patients in LTCFs showed worse clinical outcomes and a much higher prevalence of CDI compared to patients from local communities. We suggest early and active evaluation, such as endoscopic examination, for differential diagnosis in patients in LTCFs. [ABSTRACT FROM AUTHOR]