Subclavian Artery Pseudoaneurysm Following Bedside Temporary Hemodialysis Catheter Insertion: A Case Report.

A pseudoaneurysm of the subclavian artery following central venous catheter placement is a rare but potentially fatal complication that often requires surgical intervention. However, surgical repair of the subclavian artery remains challenging. Herein, we report the case of a male patient undergoing hemodialysis who developed a pseudoaneurysm of the subclavian artery after a bedside central vein catheter placement. Hemostasis was successfully achieved by selecting the pseudoaneurysm using a microcatheter. At the 10-month follow-up, the pseudoaneurysm was completely excluded, and the patient was in a stable condition. The patient underwent native arteriovenous fistula creation and hemodialysis. Endovascular treatment could be an effective nonsurgical treatment for subclavian artery pseudoaneurysms and has been attempted as a first-line treatment option.

Added Value of Cone-Beam Computed Tomography for Detecting Hepatocellular Carcinomas and Feeding Arteries during Transcatheter Arterial Chemoembolization Focusing on Radiation Exposure.

Background and Objectives: This study aimed to evaluate the added value of cone-beam computed tomography (CBCT) for detecting hepatocellular carcinomas (HCC) and feeding arteries during transcatheter arterial chemoembolization (TACE). Material and methods: Seventy-six patients underwent TACE and CBCT. We subcategorized patients into groups I (61 patients: possible superselection of tumor/feeding arteries) and II (15 patients: limited superselection of tumor/feeding arteries). We evaluated fluoroscopy time and radiation dose during TACE. Two blinded radiologists independently performed an interval reading based on digital subtraction angiography (DSA) imaging only and DSA combined with CBCT in group I. Result: The mean total fluoroscopy time was 1456.3 ± 605.6 s. The mean dose-area product (DAP), mean DAP of CBCT, and mean ratio of DAP of CBCT to total DAP was 137.1 ± 69.2 Gy cm2, 18.3 ± 7.1 Gy cm2, and 13.3%, respectively. The sensitivity for detecting HCC increased after the additional CBCT reading, from 69.6% to 97.3% and 69.6% to 96.4% for readers 1 and 2, respectively. The sensitivity for detecting feeding arteries increased from 60.3% to 96.6% and 63.8% to 97.4% for readers 1 and 2, respectively. Conclusions: CBCT can increase sensitivity for detecting HCCs and feeding arteries without significantly increasing the radiation exposure.

EEG-Based Identification of Emotional Neural State Evoked by Virtual Environment Interaction.

Classifying emotional states is critical for brain-computer interfaces and psychology-related domains. In previous studies, researchers have tried to identify emotions using neural data such as electroencephalography (EEG) signals or brain functional magnetic resonance imaging (fMRI). In this study, we propose a machine learning framework for emotion state classification using EEG signals in virtual reality (VR) environments. To arouse emotional neural states in brain signals, we provided three VR stimuli scenarios to 15 participants. Fifty-four features were extracted from the collected EEG signals under each scenario. To find the optimal classification in our research design, three machine learning algorithms (XGBoost classifier, support vector classifier, and logistic regression) were applied. Additionally, various class conditions were used in machine learning classifiers to validate the performance of our framework. To evaluate the classification performance, we utilized five evaluation metrics (precision, recall, f1-score, accuracy, and AUROC). Among the three classifiers, the XGBoost classifiers showed the best performance under all experimental conditions. Furthermore, the usability of features, including differential asymmetry and frequency band pass categories, were checked from the feature importance of XGBoost classifiers. We expect that our framework can be applied widely not only to psychological research but also to mental health-related issues.

Diffuse alveolar hemorrhage from metastatic cardiac angiosarcoma of the lung successfully treated with paclitaxel chemotherapy: A case report and brief literature review.

Diffuse alveolar hemorrhage (DAH) is a life-threatening syndrome caused by various etiologies. DAH has rarely been reported to be associated with metastatic angiosarcoma. However, due to the rarity of complications, it may not be well-recognized by most clinicians. Herein, we report the case of a 70-year-old man with newly diagnosed metastatic cardiac angiosarcoma presenting with DAH. After an immediate bronchoalveolar lavage study and bronchoscopic biopsy, the patient was successfully treated with paclitaxel chemotherapy. Although most patients with this phenomenon have an extremely grave prognosis in previous literature, our experience showed that appropriate evaluation and treatment may be beneficial.

Origin and organ-specific bioaccumulation pattern of perfluorinated alkyl substances in crabs.

Consumption of seafood is a major contributor to perfluorinated alkyl substances (PFASs) exposure. Crabs contain high levels of PFASs, and different PFASs are concentrated in their tissues depending on their habitat. Despite South Korea importing huge quantities of crabs, no investigation has been conducted on the effect of PFAS exposure. This study investigated the risk of exposure to PFASs when ingesting crabs. To determine the risk of exposure, 19 different PFAS species were measured in the edible parts (body, legs, offal, and eggs) of crabs originating from South Korea (n = 17), China (n = 14), India (n = 7), and Pakistan (n = 31), which were distributed in the fish markets of South Korea. The results revealed that, in contrast to short-chain PFASs, long-chain PFASs (PFCAs≥8, PFSAs≥6, and perfluorooactane sulfonamidoacetic acids (FOSAAs)≥8) were detected in crab samples from all four countries of origin, and in all the edible parts except for the legs. Perfluorooctanoic acid (PFOA; 16.9 ng/g in South Korea, 9.42 ng/g in China) and perfluoro-n-tridecanoic acid (PFTrDA; 5.35 ng/g in South Korea, 2.40 ng/g in China) were the predominant perfluoroalkyl carboxylic acids (PFCAs) detected in the crabs originating from South Korea and China, and perfluorooctane sulfonic acid (PFOS; 7.02 ng/g in Pakistan, 5.88 ng/g in India) was the predominant perfluoroalkyl sulfonic acids (PFSAs) detected in crabs originating from Pakistan and India. These results indicate that PFASs that are accumulated in crabs differ depending on the ocean from which they originate. The concentrations of PFOA and PFOS were significantly higher in the eggs and offal than in the legs and body of the crab. The average daily intake of PFOA and PFOS in South Koreans ranges from 0.01% to 0.07% based on the tolerable daily intake of EFSA and MFDS. These results establish the PFAS profiles and risk assessment of crabs that are distributed in South Korea.

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging-Part 3: Perfusion, Delayed Enhancement, and T1- and T2 Mapping.

This document is the third part of the guidelines for the protocol, the interpretation and post-processing of cardiac magnetic resonance (CMR) studies. These consensus recommendations have been developed by the Consensus Committee of the Korean Society of Cardiovascular Imaging to standardize the requirements for image interpretation and post-processing of CMR. This third part of the recommendations describes tissue characterization modules, including perfusion, late gadolinium enhancement, and T1- and T2 mapping. Additionally, this document provides guidance for visual and quantitative assessment consisting of "What-to-See," "How-To," and common pitfalls for the analysis of each module. The Consensus Committee hopes that this document will contribute to the standardization of image interpretation and post-processing of CMR studies.

Guidelines for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging-Part 2: Interpretation of Cine, Flow, and Angiography Data.

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technological advances and the expanded national insurance coverage of CMR assessments. For improved patient care, proper acquisition of CMR images as well as their accurate interpretation by well-trained personnel are equally important. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology. KOSCI has also created a formal Committee on CMR guidelines to create updated practices. The members of this committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

Guideline for Cardiovascular Magnetic Resonance Imaging from the Korean Society of Cardiovascular Imaging-Part 1: Standardized Protocol.

Cardiac magnetic resonance (CMR) imaging is widely used in many areas of cardiovascular disease assessment. This is a practical, standard CMR protocol for beginners that is designed to be easy to follow and implement. This protocol guideline is based on previously reported CMR guidelines and includes sequence terminology used by vendors, essential MR physics, imaging planes, field strength considerations, MRI-conditional devices, drugs for stress tests, various CMR modules, and disease/symptom-based protocols based on a survey of cardiologists and various appropriate-use criteria. It will be of considerable help in planning and implementing tests. In addressing CMR usage and creating this protocol guideline, we particularly tried to include useful tips to overcome various practical issues and improve CMR imaging. We hope that this document will continue to standardize and simplify a patient-based approach to clinical CMR and contribute to the promotion of public health.

The Usefulness of Fenestrated Intravenous Catheters Compared With Nonfenestrated Catheter for Cardiac Multidetector Computed Tomography.

PURPOSE: To compare the fenestrated intravenous (IV) catheter and nonfenestrated conventional IV catheter in terms of contrast enhancement and injection pressure for coronary computed tomography angiography. METHODS: Three hundred patients were prospectively and consecutively enrolled to either the 20-gauge nonfenestrated conventional (group 1) IV catheter group or the 20-gauge fenestrated (group 2) or 22-gauge fenestrated (group 3) IV catheter groups. We analyzed mean vascular attenuations in the ascending aorta, left main coronary artery, left ventricular (LV) cavity, and descending aorta. Injection pressure using pound-force per square inch (PSI) and extravasation of contrast media were recorded. RESULTS: Mean attenuations of the left main coronary artery, LV cavity, and descending aorta were significantly higher in group 2 than in group 1 (P ≤ 0.001, P ≤ 0.001, P ≤ 0.001, respectively). Moreover, injection pressure was significantly lower in group 2 than in group 1 (208.3 vs 216.9 PSI, P = 0.006). Mean vascular attenuations of the left main coronary artery, LV cavity, and descending aorta were significantly higher in group 3 than in group 1 (P = 0.016, P = 0.029, P = 0.001, respectively). However, injection pressure was not statistically significant between group 3 and group 1 (213.6 vs 216.9 PSI, P = 0.355). No extravasation occurred in any patient groups during the study. CONCLUSIONS: We suggest that fenestrated IV catheter is useful in terms of higher vascular attenuation and lower injection pressure for coronary computed tomography angiography. It has a potential merit in patients with fragile and small veins.

Diameter of the Solid Component in Subsolid Nodules on Low-Dose Unenhanced Chest Computed Tomography: Measurement Accuracy for the Prediction of Invasive Component in Lung Adenocarcinoma.

Objective: To determine if measurement of the diameter of the solid component in subsolid nodules (SSNs) on low-dose unenhanced chest computed tomography (CT) is as accurate as on standard-dose enhanced CT in prediction of pathological size of invasive component of lung adenocarcinoma. Materials and Methods: From February 2012 to October 2015, 114 SSNs were identified in 105 patients that underwent low-dose unenhanced and standard-dose enhanced CT pre-operatively. Three radiologists independently measured the largest diameter of the solid component. Intraclass correlation coefficients (ICCs) were used to assess inter-reader agreement. We estimated measurement differences between the size of solid component and that of invasive component. We measured diagnostic accuracy of the prediction of invasive adenocarcinoma using a size criterion of a solid component ≥ 6 mm, and compared them using a generalized linear mixed model. Results: Inter-reader agreement was excellent (ICC, 0.84.0.89). The mean ± standard deviation of absolute measurement differences between the solid component and invasive component was 4 ± 4 mm in low-dose unenhanced CT and 5 ± 4 mm in standard-dose enhanced CT. Diagnostic accuracy was 81.3% (95% confidence interval, 76.7.85.3%) in low-dose unenhanced CT and 76.6% (71.8.81.0%) in standard-dose enhanced CT, with no statistically significant difference (p = 0.130). Conclusion: Measurement of the diameter of the solid component of SSNs on low-dose unenhanced chest CT was as accurate as on standard-dose enhanced CT for predicting the invasive component. Thus, low-dose unenhanced CT may be used safely in the evaluation of patients with SSNs.

Phenomena of Nano- and Micro-Pore Formation on Ti-(10~50)Ta Alloys by Plasma Electrolytic Oxidation for Dental Implants.

In this study, the phenomena of nano and micro-pore formation on Ti-(10~50)Ta alloys by plasma electrolytic oxidation for dental implants was investigated using various experimental techniques. The Ti­xTa alloys having Ta contents of 10, 30, and 50 wt.% were prepared using arc-melting vacuum furnace. Micro-pore formation was performed using a potentiostat in 1 M H3PO4 electrolyte by using a potentiostat at various applied voltage (180 V, 210 V, and 240 V). The microstructure of Ti­xTa alloys changed from α' phase to ß + α″ phase with Ta content increased. The applied potential increased, the numbers of micro-pore per unit area decreased, whereas the area ratio of occupied by micro-pores increased. The Ta contents increased, the numbers of micro-pore per unit area decreased, whereas the area ratio of occupied by micro-pores increased at 210 V and 240 V. The thickness of oxide layer and micro-pore size can be controlled by applied potential.

Surface Characteristics of Nano-Structured Silicon/Hydroxyapatite Deposition onto the Ti-Nb-Zr Alloy.

The Ti-Nb-Zr alloy was manufactured with 35 wt% of Nb and 10 wt% of Zr by arc melting furnace to be a beta phase. Electrochemical deposition of Si substituted Ca/P was performed by pulsing the potential with a method of cyclic voltammetry, and changed cyclic time between 10, 30, 70, and 150. The electrolyte was prepared by dissolving the reagent-grade chemicals: Ca(NO3)2, NH4H2PO4, and Na2SiO3 x 9H20 to be 1.67 of Ca/P ratio and silicon contents were controlled to be 1 wt%. The surface characteristics were observed by field-emission scanning electron microscopy, X-ray diffractometer, and electrochemical corrosion as a potentiodynamic test. The Si substituted hydroxyapatite layer was successfully formed on the Ti-35Nb-10Zr alloy substrate by electrochemical deposition. A surface morphologies showed needle like shape at 10 cycles, then changed to be a circular with increment of cycles. The Ca/P ratio was the range between 1.5 and 2.0, the crystalline of hydroxyapatite could be confirmed. The corrosion behavior of Si-HA deposition was related with surface shape and thickness by increment, of cyclic times. Higher cyclic times of deposition had higher corrosion potential and current density than that of lower cyclic surface.