Safety and efficacy of large-bore uncovered stents for treating malignant superior vena cava syndrome.

PURPOSE: To investigate the safety and efficacy of large-bore uncovered stents for treating malignant superior vena cava syndrome. METHODS: This retrospective study included 115 patients (89 men, 26 women; mean age 63.2 years; range 21-83 years) who underwent endovascular large-bore (≥18 mm in diameter) uncovered stent placement between August 2015 and July 2022. One patient was lost to follow-up. Therefore, 114 patients were available for follow-up. RESULTS: Stent placement was technically successful in all 115 patients. Minor procedure-related complications occurred in nine (7.8 %) patients. One hundred eight (93.9 %) patients experienced complete or marked symptomatic relief (Kishi score ≤ 2) at a mean of 3 days after procedure. The cumulative stent patency rates were 98.2 %, 95 %, 93.7 %, 91.5 %, 83.5 %, and 83.5 % at 1, 3, 6, 12, 18, and 24 months, respectively. Stent occlusion occurred in ten (8.8 %) of 114 patients at a mean of 215 days (range 1-732 days) due to thrombosis (n = 7) and tumor ingrowth (n = 3). Stent occlusion did not occur in 21 patients who underwent subsequent central venous catheter insertion. The median patient survival time was 159 days (95 % confidence interval 102-216 days). Univariate and multivariate Cox regression analysis revealed adjuvant anticancer treatment (p = 0.001) and tumor response (p < 0.001) as independent predictors of patient survival. CONCLUSIONS: Endovascular placement of large-bore uncovered stents was a safe and effective treatment for malignant superior vena cava syndrome. Large-bore stent placement can effectively prevent stent occlusion by tumor ingrowth in most cases, and it can provide a sufficient diameter for subsequent insertion of central venous catheters.

Spatial modeling of geogenic indoor radon distribution in Chungcheongnam-do, South Korea using enhanced machine learning algorithms.

Prolonged inhalation of indoor radon and its progenies lead to severe health problems for housing occupants; therefore, housing developments in radon-prone areas are of great concern to local municipalities. Areas with high potential for radon exposure must be identified to implement cost-effective radon mitigation plans successfully or to prevent the construction of unsafe buildings. In this study, an indoor radon potential map of Chungcheongnam-do, South Korea, was generated using a group method of data handling (GMDH) algorithm based on local soil properties, geogenic, geochemical, as well as topographic factors. To optimally tune the hyper-parameters of GMDH and enhance the prediction accuracy of modelling radon distribution, the GMDH model was integrated with two metaheuristic optimization algorithms, namely the bat (BA) and cuckoo optimization (COA) algorithms. The goodness-of-fit and predictive performance of the models was quantified using the area under the receiver operating characteristic (ROC) curve (AUC), mean squared error (MSE), root mean square error (RMSE), and standard deviation (StD). The results indicated that the GMDH-COA model outperformed the other models in the training (AUC = 0.852, MSE = 0.058, RMSE = 0.242, StD = 0.242) and testing (AUC = 0.844, MSE = 0.060, RMSE = 0.246, StD = 0.0242) phases. Additionally, using metaheuristic optimization algorithms improved the predictive ability of the GMDH. The GMDH-COA model showed that approximately 7 % of the total area of Chungcheongnam-do consists of very high radon-prone areas. The information gain ratio method was used to assess the predictive ability of considered factors. As expected, soil properties and local geology significantly affected the spatial distribution of radon potential levels. The radon potential map produced in this study represents the first stage of identifying areas where large proportions of residential buildings are expected to experience significant radon levels due to high concentrations of natural radioisotopes in rocks and derived soils beneath building foundations. The generated map assists local authorities to develop urban plans more wisely towards region with less radon concentrations.

Relationship Between the Presence of Eczema Herpeticum and the Significance of Clinical and Laboratory Tests in Korean Children With Atopic Dermatitis.

BACKGROUND: Eczema herpeticum (EH) is a herpes simplex virus (HSV) infection superimposed on atopic dermatitis (AD). OBJECTIVES: The aim of this study was to evaluate the relationship between clinical features and laboratory tests, including skin cultures, total IgE, eosinophil count, eosinophil cationic protein, and 25-hydroxyvitamin D3 (25-(OH)D3), in Korean children with AD according to the presence of EH. PATIENTS AND METHODS: We enrolled 380 patients aged 6 months to 18 years who were admitted to Busan St. Mary's hospital from January 2012 to December 2014. All 380 subjects were divided into two groups: the control and the AD group. The AD group was further divided into two subgroups: EH+ and EH-. RESULTS: The male gender was related to the presence of EH (odds ratio of 2.56; 95% confidence interval, 1.19 - 5.53, P = 0.01), but age and 25-(OH)D3 levels were not. After adjusting for age, gender, and 25-(OH)D3, no significant relationship was found between total IgE, eosinophil cationic protein or eosinophil count levels and the presence of EH. The relationship between positive skin cultures and the presence of EH was significant (P < 0.001) and the presence of methicillin-resistant Staphylococcus aureus (MRSA) was also related to the development of EH (OR, 0.19; 95% CI, 0.04 - 0.92, P = 0.03). CONCLUSIONS: We conclude that while male gender, positive skin culture results, and the presence of MRSA are factors influencing EH, serum 25-(OH)D3 levels are not associated with EH in Korean AD children.

Case study of a survivor of suicide who lost all family members through parent-child collective suicide.

BACKGROUND: South Korea is characterized by a high percentage of parent-child collective suicide. AIMS: This case study explores one individual's personal experience as an adult survivor of suicide who lost his wife and his only son through parent-child collective suicide in South Korea. METHOD: The study reports data from a semistructured interview, which were analyzed using interpretive phenomenological analysis (IPA). RESULTS: Two themes were identified through the analysis of the narratives of the survivor. The first theme provides a detailed picture of the survivor's explanation of why the parent-child collective suicide occurred. The second theme examines how the participant experienced complicated bereavement after his heart-breaking loss of both wife and son. CONCLUSION: We discuss the importance of support from other people or grief experts for the survivors of suicide who lose family to collective suicide.

Limited efficacy of lamivudine against hepatitis B virus infection in allogeneic hematopoietic stem cell transplant recipients.

BACKGROUND: Reactivation of chronic hepatitis B virus (HBV) infection is a major complication when HBV carriers receive immunosuppressive therapy. Recipients of allogeneic hematopoietic stem cell transplantation (HSCT) carry the highest risk of fatal HBV disease (up to 12%). METHODS: In an attempt to identify a suitable procedure for the prevention and management of HBV reactivation, the administration of lamivudine over the course was tested in two patients. RESULTS: Generally, the patients transplant courses were successfully managed despite their difficult clinical situations: a high HBV load before transplant in one patient and intense steroid therapy for complicated acute graft-versus-host disease (GVHD) in the other patient. However, one patient showed a reactivation of HBV after discontinuing lamivudine and the other showed persistently high DNA polymerase activity despite prolonged administration of lamivudine. CONCLUSIONS: We concluded that lamivudine could have a place in the management of patients who suffer from chronic HBV infection and who are undergoing allogeneic HSCT. However, the efficacy of lamivudine seemed to be limited compared with other settings, including solid organ transplantation and autologous HSCT.

Printing three-dimensional tissue analogues with decellularized extracellular matrix bioink.

The ability to print and pattern all the components that make up a tissue (cells and matrix materials) in three dimensions to generate structures similar to tissues is an exciting prospect of bioprinting. However, the majority of the matrix materials used so far for bioprinting cannot represent the complexity of natural extracellular matrix (ECM) and thus are unable to reconstitute the intrinsic cellular morphologies and functions. Here, we develop a method for the bioprinting of cell-laden constructs with novel decellularized extracellular matrix (dECM) bioink capable of providing an optimized microenvironment conducive to the growth of three-dimensional structured tissue. We show the versatility and flexibility of the developed bioprinting process using tissue-specific dECM bioinks, including adipose, cartilage and heart tissues, capable of providing crucial cues for cells engraftment, survival and long-term function. We achieve high cell viability and functionality of the printed dECM structures using our bioprinting method.