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Introduction: Angiolipoleiomyoma (ALLM) is a rare hamartomatous tumor of mesenchymal origin composed of smooth muscle, mature adipose tissue, and blood vessels in various proportions. Because of its histologic similarity to renal angiomyolipoma (AML), it is also called uterine angiomyolipoma. Preoperative diagnosis of uterine ALLM is very challenging due to its uncommon incidence and absence of established characteristic imaging findings. Case Description: A 50-year-old multiparous female patient visited our institution for gynecologic screening. Transvaginal sonography (TVS), Abdominopelvic computed tomography (CT), and pelvic magnetic resonance imaging (MRI) revealed large well-defined masses involving the posterior uterine wall with rectal indentation. The patient underwent a total abdominal hysterectomy for this tumor and the histopathological diagnosis was uterine ALLM. Conclusion: This report would contribute to understanding and establishing the radiologic findings of the uterine ALLM. Considering the benign characteristics and favorable prognosis of this rare tumor, familiarity with its imaging findings by radiologists will guide clinicians in better patient management and prevention of unnecessary radical surgery.

The progression of neurodegenerative disorders can lead to impaired neurotransmission; however, the role of pathogenic factors associated with these diseases and their impact on the structures and functions of neurotransmitters have not been clearly established. Here we report the discovery that conformational and functional changes of a native neuropeptide, somatostatin (SST), occur in the presence of copper ions, metal-free amyloid-β (Aβ) and metal-bound Aβ (metal-Aβ) found as pathological factors in the brains of patients with Alzheimer's disease. These pathological elements induce the self-assembly of SST and, consequently, prevent it from binding to the receptor. In the reverse direction, SST notably modifies the aggregation profiles of Aβ species in the presence of metal ions, attenuating their cytotoxicity and interactions with cell membranes. Our work demonstrates a loss of normal function of SST as a neurotransmitter and a gain of its modulative function against metal-Aβ under pathological conditions.

Introduction: Clear cell hepatocellular carcinoma (HCC) is a rare subtype of HCC. Histologically, clear cell HCC is characterized by the cytoplasmic accumulation of glycogen with a clear cell appearance, constituting > 80% of tumor cells. Radiologically, clear cell HCC demonstrates early enhancement and washout similar to conventional HCC. Occasionally, enhancing capsule and intratumoral fat are accompanied by clear cell HCC. Case description: A 57-year-old male presented to our hospital with right upper quadrant abdominal pain. Ultrasonography, computed tomography, and magnetic resonance imaging revealed a large mass with a well-defined margin in the right hemiliver. The patient underwent a right hemihepatectomy, and the final histopathology revealed clear cell-type HCC. Conclusion: Distinguishing clear cell types from other types of HCC solely based on radiological findings is challenging. If hepatic tumors exhibit encapsulated margins, enhancing rims, intratumoral fat, and arterial phase hyperenhancement/washout pattern despite their large size, consideration of clear cell subtypes in the differential diagnosis list will aid patient management, implying better prognosis than not-otherwise-specified HCC.

BACKGROUND Timely pulmonary tuberculosis (PTB) diagnosis is a global health priority for interrupting transmission and optimising treatment outcomes. The dichotomous time-divided approach for time delay has limited clinical application. OBJECTIVE We aimed to re-evaluate the time delay based on the PTB disease spectrum using a novel scoring system at the national level in the Republic of Korea. METHODS The PTB Spectrum Score (PTBSS) was designed based on previously published proposals for disease spectrum and was validated by mortality. We analysed the data by substituting the PTBSS into the Korea Tuberculosis Cohort Registry, and assessed time delays and related system variables using multivariate regression according to PTBSS. RESULTS Among the 14,031 active PTB Korean patients whose data were analysed from 2018 to 2020, patients with active PTB were diagnosed with mild (37.0%), moderate (38.0%), or severe (25.0%) disease status according to the PTBSS. The time delay patterns differed according to the PTBSS. Healthcare delays showed that greater PTB progression was associated with earlier diagnosis. Presentation delay showed a U-shaped pattern of elapsed time with PTB progression, wherein a remarkable presentation delay in the real-world setting might occur at both apical ends: mild and severe PTB. Independent risk factors for severe PTB pattern were age (adjusted OR, 1.014) and male sex (adjusted OR, 1.422), whereas no remarkable risk factor was found for mild PTB. CONCLUSIONS Timely pulmonary tuberculosis diagnosis should be accomplished. It could be improved with PTBSS, a simple and intuitive scoring system, and more helpful clinical and public applications rather than the traditional dichotomous time-only approach.

Background: Air pollution control is necessary to decrease the burden on older adults with cognitive impairment, especially in low- and middle-income countries (LMICs). Objective: This study retrospectively examined the effect of cumulative exposure to air pollution, including NO2, SO2, CO, fine particulate matter (PM)10, PM2.5, and O3, on cognitive function in older individuals. Methods: Community-dwelling older adults who underwent the Mini-Mental State Examination (MMSE) from 2007 to 2018 were included in the analyses. We excluded older individuals diagnosed with dementia at baseline, while those who had completed more than two MMSE tests were included in the longitudinal analyses. Baseline MMSE and changes in MMSE scores were analyzed according to 5-year average concentrations of the district-level air pollutants, after controlling for covariates associated with cognitive decline in older adults. Results: In total, 884,053 (74.3±7.1 years; 64.1% females) and 398,889 (72.3±6.4 years; 67.0% females) older individuals were included in the cross-sectional and longitudinal analyses, respectively. Older individuals exposed to higher levels of NO2, SO2, CO, and PM10 showed lower baseline MMSE scores. During follow-up, exposure to higher levels of NO2, SO2, CO, and PM10 was associated with greater decreases in MMSE scores in older individuals; for O3, the opposite pattern was observed. Conclusion: Our findings suggest that exposure to high levels of air pollutants can worsen the cognitive performance of older adults without dementia. Efforts to reduce air pollution in LMICs that have similar levels of pollutants to South Korea are necessary to reduce the burden on older adults with cognitive impairment.

Background/Aims: Although the incidence and mortality of tuberculosis are decreasing in South Korea, the number of applications for financial assistance with the cost of tuberculosis treatment made by individuals from vulnerable groups was 3.8 times higher in 2019 compared to 2017 (Tuberculosis Relief Belt Project, 2019).Methods: We analyzed the data of patients who received financial aid for tuberculosis treatment (in the period 2014-2018) from the Tuberculosis Relief Belt Project, which was designed to assist vulnerable groups. This study analyzed 137 subjects, and the independent variables included patient factors (age, gender, nationality, tuberculosis type, number of comorbidities, and place of residence) and treatment type (outpatient or inpatient). The dependent variable was the treatment outcome.Results: The likelihood of treatment success was significantly lower for patients with one (odds ratio [OR] 0.202), two (OR 0.147), or three or more (OR 0.070) comorbidities compared to those with no comorbidities. This was also the case for patients living alone (OR 0.097), and for those classified as homeless (OR 0.053). Korean patients (OR 8.512) had a significantly higher probability of a successful treatment outcome than foreigners.Conclusions: Appropriate community-based management of individuals with tuberculosis from vulnerable groups, including foreigners, people with comorbidities, people living alone, and people with an unstable residential situation or homeless status, is important.

PURPOSE To quantitatively evaluate macular and peripapillary microvascular alterations in patients with indirect traumatic optic neuropathy (TON) compared to normal controls using optical coherence tomography angiography (OCT-A [Topcon DRI OCT; Triton]) and determine their associations with other ocular parameters. METHODS We enrolled 33 eyes of 33 patients with TON and 34 eyes of 34 healthy controls. OCT-A was used to generate microvascular structure images of the superficial retinal capillary plexus (SRCP), deep retinal capillary plexus (DRCP), and radial peripapillary capillary (RPC) segment in the macula and peripapillary area. Age, gender, and spherical equivalent refractive errors were statistically adjusted for the analysis. RESULTS OCT-A revealed a significant reduction of the average vessel density in the RPC segment in TON patients compared to controls (48.5% ± 6.28 vs. 57.88% ± 3.06%, P P P = 0.0253) and visual acuity (P = 0.0369). The temporal sector vessel density of DRCP was also associated with visual field defects (P = 0.0377). The RPC segment in the temporal, superior, and inferior sector vessel density had a significant association with the average pRNFL thickness (P = 0.0092, 0.0171, and

The misfolding and aggregation of amyloid-β (Aβ) peptides are histopathological features found in the brains of Alzheimer's disease (AD). To discover effective therapeutics for AD, numerous efforts have been made to control the aggregation of Aβ species and their interactions with other pathological factors, including metal ions. Metal ions, such as Cu(II) and Zn(II), can bind to Aβ peptides forming metal-bound Aβ (metal–Aβ) complexes and, subsequently, alter their aggregation pathways. In particular, redox-active metal ions bound to Aβ species can produce reactive oxygen species leading to oxidative stress. In this review, we briefly illustrate some experimental approaches for characterizing the coordination and aggregation properties of metal–Aβ complexes.

Recent advances in flexible and stretchable electronics have led to a surge of electronic skin (e-skin)–based health monitoring platforms. Conventional wireless e-skins rely on rigid integrated circuit chips that compromise the overall flexibility and consume considerable power. Chip-less wireless e-skins based on inductor-capacitor resonators are limited to mechanical sensors with low sensitivities. We report a chip-less wireless e-skin based on surface acoustic wave sensors made of freestanding ultrathin single-crystalline piezoelectric gallium nitride membranes. Surface acoustic wave–based e-skin offers highly sensitive, low-power, and long-term sensing of strain, ultraviolet light, and ion concentrations in sweat. We demonstrate weeklong monitoring of pulse. These results present routes to inexpensive and versatile low-power, high-sensitivity platforms for wireless health monitoring devices.

Jee Youn Oh,1 Sung-Soon Lee,2 Hyung Woo Kim,3 Jinsoo Min,4 Yousang Ko,5 Hyeon-Kyoung Koo,2 Yun-Jeong Jeong,6 Hyeon Hui Kang,7 Ji Young Kang,8 Ju Sang Kim,3 Jae Seuk Park,9 Yunhyung Kwon,10 Jiyeon Yang,10 Jiyeon Han,10 You Jin Jang,10 Min Ki Lee,11 Yangjin Jegal,12 Young-Chul Kim,13 Yun Seong Kim14 1Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea; 3Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 4Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 5Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea; 6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang, Republic of Korea; 7Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea; 8Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; 9Division of Pulmonary Medicine, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea; 10Division of Tuberculosis Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea; 11Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Pusan, Republic of Korea; 12Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Republic of Korea; 13Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Republic of Korea; 14Department of Internal Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of KoreaCorrespondence: Sung-Soon Lee, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea, Tel +82-10-7173-6575, Fax +82-2-2626-1166, Email sungsoonlee@gmail.comPurpose: Bronchoscopy is widely used for microbiological diagnosis of patients with minimal sputum production. However, the usefulness of bronchoscopy in patient groups who benefit from subsequent microbiological confirmation has not been established.Patients and Methods: We retrospectively analyzed Korean tuberculosis (TB) cohort data from September 2018 to October 2019 to evaluate the usefulness of bronchoscopy in patients with microbiologically negative pulmonary TB (based on initial sputum polymerase chain reaction and culture results). The primary outcome was the proportion of microbiological diagnoses made after bronchoscopy. Secondary outcomes were the predictors of microbiological confirmation and the percentage of additional resistance detection after bronchoscopy.Results: A total of 5194 patients were diagnosed with pulmonary TB, 937 of whom were microbiologically negative for pulmonary TB based on the initial sputum findings. Of these, 319 patients underwent bronchoscopy, and further microbiological confirmation was achieved in 157 (49.1%) patients. The predictors of microbiological confirmation after bronchoscopy were age > 65 years, female sex, and low body mass index (BMI). The rate of additional resistance detection was 10.5% (multidrug resistant/rifampin-resistant 3.8%; isoniazid-resistant 5.7%).Conclusion: Bronchoscopy can be used for the detection of resistant pathogens. Bronchoscopy should be considered for microbiologically negative pulmonary TB in women aged > 65 years and with low BMI for subsequent microbiological confirmation.Keywords: tuberculosis, pulmonary, bronchoscopy, cohort studies

As coronavirus disease 2019 (COVID-19) continues, the long-term daily use of masks is increasing. A full year includes the four seasons of spring, summer, autumn, and winter. Skin may have been affected by the seasons and further affected by the use of masks. In a previous study, we confirmed the short-term and 6-month effects of wearing face masks. In this study, we investigated how certain characteristics of the skin change when wearing a mask for 1 year. Furthermore, we compared skin covered by the mask (mask-skin zone) to skin that was not covered.The participants were 18 healthy adults (8 men; 10 women) who were asked to wear masks in their daily lives from June 2020 to June 2021. During this period, participants' skin characteristics, such as trans-epidermal water loss, skin hydration, skin elasticity, skin keratin amount, skin pore area, skin temperature, skin redness, and skin color, were measured five times.Trans-epidermal water loss, skin keratin amount, skin pore area, skin color, and skin elasticity changed significantly during the year. Furthermore, trans-epidermal water loss, skin hydration, skin keratin amount, skin pore area, and skin color were significantly different between the mask-wearing and non-mask-wearing areas of the face.The skin characteristics of the mask-skin zone can be affected by long-term wearing of a face mask under lifestyle and environmental conditions. During the COVID-19 pandemic, skin care for the mask-skin zone is also necessary for people who do not wear masks on a daily basis.