Antrihabitans stalactiti gen. nov., sp. nov., a new member of the family Nocardiaceae isolated from a cave.

Two Gram-stain-positive, strictly aerobic, non-spore-forming actinobacterial strains, designated YC2-7T and YC5-17, were isolated from the Yongcheondonggul (larva cave) in Jeju, Republic of Korea and their taxonomic ranks were examined by a polyphasic approach. The 16S rRNA gene tree showed that the novel isolates occupied an independent position separated from recognized genera of the family Nocardiaceae. In the 92 core gene-based phylogenomic analysis, strain YC2-7T was loosely associated with the type strain of Aldersonia kummingensis with 66.2 % average amino acid identity. The 16S rRNA gene sequence simairity between the isolate and members of the family Nocardiaceae was below 96.7 %. The cell-wall peptidoglycan was meso-diaminopimelic acid as a diagnostic diamino acid. Whole-cell sugars consisted of arabinose, galactose and glucose. The predominant menaquinone was MK-8(H4, ω-cycl). The major polar lipids consisted of diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol and phosphatidylinositol mannoside. The cellular fatty acids consisted mainly of saturated and unsaturated components with small amounts of tuberculostearic acid. Mycolic acids of 52-58 carbon atoms were present. The DNA G+C content of the genome was 63.8 mol%. On the basis of combination of morphological and chemotaxonomic differences, in addition to phylogenetic distinctness, the novel isolates are considered to constitute members of a novel species of a new genus in the family Nocardiaceae, for which the name Antrihabitans stalactiti gen. nov., sp. nov. is proposed. The type strain is YC2-7T (=KACC 19965T=DSM 108733T).

Paenibacillus cavernae sp. nov., isolated from soil of a natural cave.

A Gram-reaction-variable, strictly aerobic, motile, rod-shaped bacterium, designated strain C4-5T, was isolated from soil of a natural cave. Cells were oxidase- and catalase-positive and formed endospores in sporangia. The 16S rRNA gene sequence comparison showed that the organism formed a distinct clade within the genus Paenibacillus and was most closely related to Paenibacillus contaminans CKOBP-6T ( = KCTC 13623T) (96.85 % 16S rRNA gene sequence similarity) followed by Paenibacillus doosanensis CAU 1005T ( = KCTC 33036T) (94.82 %). The following chemotaxonomic features of strain C4-5T are typical for the genus Paenibacillus: meso-diaminopimelic acid as the diagnostic diamino acid in the cell-wall peptidoglycan, MK-7 as the predominant menaquinone, the major fatty acids of anteiso-C15 : 0, iso-C16 : 0 and C16 : 0 and the DNA G+C content of 54.8 mol%. The major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol and four unidentified aminophospholipids. The phenotypic and phylogenetic data presented support that strain C4-5T represents a novel species of the genus Paenibacillus, for which the name Paenibacillus cavernae sp. nov. is proposed. The type strain is C4-5T ( = KCTC 33652T = DSM 100100T).

The relative survival and cure fraction of gastric cancer estimated through flexible parametric models using data from population-based cancer registration during 2003-2012 in Linzhou, China.

PURPOSE: The proportion of cured gastric cancer patients has drawn the attention of patients, physicians, and healthcare providers after comprehensive prevention and control measures were carried out for several years. Therefore, the relative survival and cure fraction were estimated in our study. METHODS: Population-based cancer registration data were used to estimate survival and cure fraction. A total of 7585 gastric cancer cases (ICD10:C16.0 ~ C16.9) were extracted and included in the final analysis. Cases were diagnosed in 2003-2012 and followed until the end of 2017. Relative survival was calculated as the ratio between the observed survival through the life-table method. The expected survival was estimated by the Ederer II method. The cure fraction was estimated using flexible parametric cure models stratified by age and calendar period when the cases were diagnosed. RESULTS: The 5-year relative survival of cardia gastric cancer increased with the calendar period of 2003-2004, 2005-2006, 2007-2008, 2009-2010, and 2011-2012 (27.5%, 28.3%, 33.5%, 38.2%, and 46.8%, respectively). The increasing trend along with the calendar periods was also observed in cure proportion of cardia gastric cancer (24.8%, 25.2%, 31.7%, 36.0%, and 43.1%, respectively). Notable improvement of cure proportion was observed in the period of 2011-2012, compared with the initial period of 2003-2004. There was an improvement of 79.8% among all gastric cancer subjects, and it was 74.1% and 55.7% in cardia gastric and noncardia gastric cancer subjects, respectively. The median survival of "uncured" patients showed no significant improvement along with the calendar periods in all age groups. CONCLUSIONS: Notable improvement of gastric cancer relative survival and cure proportion was observed in Linzhou during 2003-2012.

Prevalence and natural course of incidental gastric subepithelial tumors

Background/Aims@#Gastric subepithelial tumors (SETs) are often encountered during the upper gastrointestinal endoscopic screening. We assessed the prevalence of gastric SETs and the risk factors for their progression. @*Methods@#We reviewed the electronic medical records of 30,754 patients who underwent upper gastrointestinal endoscopic screening at our medical center between January 2013 and December 2016. @*Results@#Among the 30,754 patients examined, 599 (1.94%) had gastric SETs. The prevalence increased with age and was 9.56% in patients aged ≥70 years. In total, 262 patients underwent serial endoscopy for more than 6 months. The median age was 68 years (interquartile range [IQR], 61–74), and the number of females was 167 (63.7%). During a median follow-up of 58 months (IQR, 38–75), 22 patients (8.4%) showed significant changes in tumor size. An irregular border (odds ratio, 4.623; 95% confidence interval, 1.093–19.558; p=0.037) was a significant risk factor for progression. Seven patients underwent surgical or endoscopic resections. The pathologies of gastric SETs included leiomyomas (n=3), gastrointestinal stromal tumors (n=2), and lipomas (n=2). @*Conclusions@#The prevalence of gastric SETs increases with age. Most gastric SETs do not progress during long-term endoscopic examinations, and the risk of an increase in size is low in asymptomatic small SETs without irregular borders.

Identification of Headspace Volatile Compounds of Blended Coffee and Application to Principal Component Analysis.

Coffee can be blended to create a variety of products to meet consumer's needs. In order to uncover the blending effect of coffee beans, we performed an experiment using principal component analysis (PCA). Twelve varieties of green beans were tested in 11 experimental groups, and the volatile compounds of the beans were analyzed. A total of 41 volatile compounds were identified. PCA was performed on 13 compounds that had a low odor threshold value or a high concentration among the identified compounds. PCA of total volatile compounds showed that principal component (PC) 1 and PC2 were extracted within 80% cumulative dispersion level. In PC1 and PC2, furfuryl alcohol and formic acid ethyl ester showed the greatest positive correlation coefficients among all the volatile compounds. The largest negative correlation coefficients in PC1 and PC2 were 4-hydroxy-2-butanone and 3-(ethylthio)propanal, respectively. Using PCA of the major volatile compounds in coffee, propanal and 1-methylpyrrole were found to have the largest positive correlation coefficients in PC1 and PC2, respectively. In the score plot of the major volatile components, 4 kinds of blended coffee were closely grouped, therefore showing similar aroma qualities. However, 5 kinds of other blended coffees showed a positive correlation with PC2. This is probably due to 3-(ethylthio)propanal acting as a specific value. The application of statistical methods to blended coffee allows for logical and systematic data analysis of data and may be used as a basis for quality evaluation.

Successful Endoscopic Submucosal Dissection Using Open Peroral Endoscopic Myotomy for Duodenal Neuroendocrine Tumor / 대한소화기학회지

Duodenal neuroendocrine tumors (NETs) are subepithelial tumors that are difficult to remove endoscopically, particularly when located just beyond the pylorus. This paper reports a case of a successful endoscopic submucosal dissection (ESD) using open gastric peroral endoscopic myotomy (POEM) for a remnant duodenal NET detected after endoscopic mucosal resection (EMR). A 67-year-old male presented with a 5 mm remnant duodenal NET close to the pylorus after EMR for a duodenal polypoid lesion performed four months earlier. Duodenal ESD was performed under conscious sedation using I-type and IT II knives. The tumor adhered to the fibrotic tissue, and the submucosal cushion was insufficient. Open gastric POEM was performed concurrently during ESD, resulting in the complete resection of the NET. This case suggests that while challenging, open gastric POEM can serve as a valuable technique for endoscopic resection in cases of early gastric cancer or duodenal masses located around the pylorus.

Association between Possible Sarcopenia and Depressive Symptoms in Korean Older Adults: Results from the Korea National Health and Nutrition Examination Survey in 2018 / 가정의학회지

Background@#Despite increased clinical and research interest in sarcopenia, even in Asia, not much is known about the association between sarcopenia and depressive symptoms. Sarcopenia and depressive symptoms are associated with several health problems in older adults; therefore, we investigated the association between sarcopenia and depression in Korean older adults. @*Methods@#The study sample included 1,929 participants aged over 60 years (44.6% men; mean age, 69.7 years) from nationally representative data of the 2018 Korea National Health and Nutrition Examination survey. Possible sarcopenia was defined according to the diagnostic algorithm of the Asian Working Group for Sarcopenia 2019; however, we measured only hand-grip strength (kg) in this study. Patient Health Questionnaire-9 was used for screening for symptoms of depression. A cross-sectional analysis was used to examine the relationship between possible sarcopenia and depressive symptoms. @*Results@#Possible sarcopenia and depressive symptoms were identified in 538 (27.9%) and 97 (5.0%) participants, respectively. After adjusting for age, sex, and other potential covariates, possible sarcopenia was positively associated with higher odds of depressive symptoms (odds ratio, 2.06; 95% confidence interval, 1.36–3.11; P<0.001). @*Conclusion@#Possible sarcopenia was significantly associated with depressive symptoms in Korean older adults. Early interventions for possible sarcopenia and depressive symptoms in routine clinical practice could help Korean older adults to have healthy aging. Future studies are required to explore any causal relationship between possible sarcopenia and depressive symptoms in Korean older adults.

Antioxidant Activity of Vitex rotundifolia Seeds and Phytochemical Analysis Using HPLC-PDA

This study assessed in vitro antioxidant activity (ABTS+ and DPPH) of Vitex rotundifolia seeds collected from two different regions in Korea (Jungjang City and Sindu City). Three extraction methods using ethanol, methanol, and water were prepared separately and subjected to quantification by reverse-phase highperformance liquid chromatography-photodiode array (HPLC-PDA) analysis as well as antioxidant testing.Among them, the water-based extract exhibited superior activity in the ABTS+ compared with the ethanol- and methanol-based extracts, while the DPPH assay analysis, revealed that the methanol-based extract had very low antioxidant activity. The concentrations of vanillic acid (1), luteolin (2), vitexicarpin (3), and artemetin (4) were quantified using HPLC-PDA analysis. Vanillic acid (1) was identified as the main antioxidant in V. rotundifolia seeds. Combining the antioxidant activity and quantitative analysis results, the water-based extract was considered to have the highest antioxidant activity. Furthermore, vanillic acid (1) was detected in the leaves and stems of V. rotundifolia plants from different regions, indicating that this species has the potential for use in future antioxidant-applications.

Pediatric Spinal Trauma at a Single Level 1Trauma Center: Review of 62 Cases

Background@#Traumatic spinal injuries in children are uncommon and result in different patterns of injuries due to the anatomical characteristics of children’s spines. However, there are only a few epidemiological studies of traumatic spinal injury in children. The purpose of this study was to investigate the characteristics of traumatic spinal injury in children. @*Methods@#We retrospectively reviewed the cases of pediatric patients (age < 18 years) with traumatic spinal injury who were treated at a level 1 trauma center between January 2017 and December 2021. We divided them into three groups according to age and analyzed demographics, injury mechanism, level of injury, and injury pattern. @*Results@#A total of 62 patients (255 fractures) were included, and the mean age was 13.8 ± 3.2 years. There were 5 patients (22 fractures) in group I (0–9 years), 24 patients (82 fractures) in group II (10–14 years), and 33 patients (151 fractures) in group III (15–17 years). Both the Injury Severity Score and the Revised Trauma Score were highest in group I, but there was no statistical difference between the age groups. Fall from height was the most common injury mechanism, of which 63% were suicide attempts. The level of spinal injury was different in each age group, T10–L2 injury being the most common. In all age groups, the number of multilevel continuous injury was larger than that of single-level injury or multilevel noncontinuous injury. Surgical intervention was required in 33.9%, and mortality was 3.2%. @*Conclusions@#In our study, fall from height was the most common mechanism of injury, and there were many suicide attempts associated with mental health issues. Thoracolumbar junction injuries were predominant, and the rate of multilevel contiguous injuries was high. The support and interest of the society and families for adolescent children seem crucial in preventing spinal trauma, and image testing of the entire spine is essential when evaluating pediatric spinal injuries.

Analysis of the Total Polyphenol, Flavonoid, and Phenolic Acid Contents in Three Different Leaf Types of Lepidium sativum

Lepidium sativum (LS) is an annual plant that has been used for the treatment of many ailments. The ethanol extracts of pinnately-lobed (PL), pinnately-compound (PC), and pinnately-veined (PV) leaves of LS were examined for their total polyphenol and flavonoid contents, and their phenolic acid (namely caffeic acid (CA), p-coumaric acid (PA), and ferulic acid (FA)) contents were determined using reverse-phase high-performance liquid chromatography-photodiode array (HPLC/PDA) analysis. Among the three leaf types, the highest average total polyphenol content was found in PV (79.87 mg GAE/g extract), whereas PC showed the highest average total flavonoid content (53.35 mg QE/g extract). According to the HPLC/PDA results, PV exhibited a high amount of CA (78.60 µg/g extract) and FA (1,722.85 µg/g extract), whereas a high content of PA (258.72 µg/g extract) was detected in PC. Higher amounts of the phytochemical compounds PV and PC might be indicative of their superior biological activities compared to PL. To the best of our knowledge, this study is the first to quantify and compare the total polyphenol, flavonoid, and phenolic acid contents in three different leaf types of LS.

Chemical Characterization and Oxidative Stability of Medium- and Long-Chain Fatty Acid Profiles in Tree-Borne Seed Oils.

This study was undertaken to evaluate chemical characteristics and oxidative stability of tree-borne seed oils. A total of 15 different fatty acids were identified in six tree-borne seed oils, which included seven types of saturated fatty acids, four types of monounsaturated fatty acids, and four types of polyunsaturated fatty acids. Japanese camphor tree (JCT) had a high content of medium-chain fatty acids (97.94 ± 0.04%), in which fatty acid composition was distinct from those of the other five plant seed oils. Overall, contents of tocopherols, a type of fat-soluble vitamin, ranged between 3.82 ± 0.04 mg/100 g and 101.98 ± 1.34 mg/100 g, respectively. Phytosterol contents ranged from 117.77 ± 1.32 mg/100 g to 479.45 ± 4.27 mg/100 g, respectively. Of all tree-borne seed oils, ß-sitosterol was the phytosterol at the highest concentration. Contents of unsaponifiables were between 0.13 ± 0.08 and 2.01 ± 0.02, and values of acid, peroxide, and p-anisidine were between 0.79 ± 0.01 and 38.94 ± 0.24 mg KOH/g, 3.53 ± 0.21 and 127.67 ± 1.79 meq/kg, and 2.07 ± 0.51 and 9.67 ± 0.25, respectively. Oxidative stability of tree-borne seed oils was assessed through measurement of oxidation-induction periods. These results should serve as a foundation to identify the potential of tree-borne seed oils in industrial application as well as in providing fundamental data.

Development and Validation of Models to Predict Lymph Node Metastasis in Early Gastric Cancer Using Logistic Regression and Gradient Boosting Machine Methods / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#To identify important features of lymph node metastasis (LNM) and develop a prediction model for early gastric cancer (EGC) using a gradient boosting machine (GBM) method. @*Materials and Methods@#The clinicopathologic data of 2556 patients with EGC who underwent gastrectomy were used as training set and the internal validation set (set 1) at a ratio of 8:2. Additionally, 548 patients with EGC who underwent endoscopic submucosal dissection (ESD) as the initial treatment were included in the external validation set (set 2). The GBM model was constructed, and its performance was compared with that of the Japanese guidelines. @*Results@#LNM was identified in 12.6% (321/2556) of the gastrectomy group (training set & set 1) and 4.3% (24/548) of the ESD group (set 2). In the GBM analysis, the top five features that most affected LNM were lymphovascular invasion, depth, differentiation, size, and location. The accuracy, sensitivity, specificity, and the area under the receiver operating characteristics of set 1 were 0.566, 0.922, 0.516, and 0.867, while those of set 2 were 0.810, 0.958, 0.803, and 0.944, respectively. When the sensitivity of GBM was adjusted to that of Japanese guidelines (beyond the expanded criteria in set 1 [0.922] and eCuraC-2 in set 2 [0.958]), the specificities of GBM in sets 1 and 2 were 0.516 (95% confidence interval, 0.502-0.523) and 0.803 (0.795-0.805), while those of the Japanese guidelines were 0.502 (0.488-0.509) and 0.788 (0.780-0.790), respectively. @*Conclusion@#The GBM model showed good performance comparable with the eCura system in predicting LNM risk in EGCs.

Cancer-Related Dysfunctional Beliefs About Sleep Mediate the Influence of Sleep Disturbance on Fear of Progression Among Patients With Surgically Resected Lung Cancer

Background@#Lung cancer is associated with significant psychological distress, including fear of progression (FoP). Because insomnia and depression are highly prevalent and associated with FoP, we examined the association between FoP, insomnia, and depression in cancer patients. Furthermore, we tested the mediation effect of cancer-related dysfunctional beliefs about sleep (C-DBS) on this association. @*Methods@#We analyzed data collected from patients with surgically resected non-small cell lung cancer from a single-center randomized controlled study investigating digital healthcare applications. Baseline demographic and clinical variables were collected. In addition, selfreported questionnaires including the Fear of Progression Questionnaire-Short Form, Patients Health Questionnaire-9 items (PHQ-9), Insomnia Severity Index, and C-DBS were administered. @*Results@#Among the 320 enrolled patients with lung cancer, a regression model showed that FoP was predicted by age (β = −0.13, P = 0.007), PHQ-9 (β = 0.35, P < 0.001), and C-DBS (β = 0.28, P < 0.001). Insomnia did not directly influence FoP, but C-DBS mediated the association. Depression directly influenced FoP, but C-DBS did not mediate this association. @*Conclusion@#Among patients with surgically resected lung cancer, C-DBS mediated the effects of severity of insomnia on FoP. Depression directly influenced FoP, but C-DBS did not influence this association. To reduce FoP among patients with lung cancer, C-DBS should be addressed in the cognitive behavioral therapy module.

The Role of Adjuvant Therapy Following Surgical Resection of Small Cell Lung Cancer: A Multi-Center Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This multi-center, retrospective study was conducted to evaluate the long-term survival in patients who underwent surgical resection for small cell lung cancer (SCLC) and to identify the benefit of adjuvant therapy following surgery. @*Materials and Methods@#The data of 213 patients who underwent surgical resection for SCLC at four institutions were retrospectively reviewed. Patients who received neoadjuvant therapy or an incomplete resection were excluded. @*Results@#The mean patient age was 65.29±8.93 years, and 184 patients (86.4%) were male. Lobectomies and pneumonectomies were performed in 173 patients (81.2%), and 198 (93%) underwent systematic mediastinal lymph node dissections. Overall, 170 patients (79.8%) underwent adjuvant chemotherapy, 42 (19.7%) underwent radiotherapy to the mediastinum, and 23 (10.8%) underwent prophylactic cranial irradiation. The median follow-up period was 31.08 months (interquartile range, 13.79 to 64.52 months). The 5-year overall survival (OS) and disease-free survival were 53.4% and 46.9%, respectively. The 5-year OS significantly improved after adjuvant chemotherapy in all patients (57.4% vs. 40.3%, p=0.007), and the survival benefit of adjuvant chemotherapy was significant in patients with negative node pathology (70.8% vs. 39.7%, p=0.004). Adjuvant radiotherapy did not affect the 5-year OS (54.6% vs. 48.5%, p=0.458). Age (hazard ratio [HR], 1.032; p=0.017), node metastasis (HR, 2.190; p < 0.001), and adjuvant chemotherapy (HR, 0.558; p=0.019) were associated with OS. @*Conclusion@#Adjuvant chemotherapy after surgical resection in patients with SCLC improved the OS, though adjuvant radiotherapy to the mediastinum did not improve the survival or decrease the locoregional recurrence rate.

Optimization of Maillard Reaction between Glucosamine and Other Precursors by Measuring Browning with a Spectrophotometer.

The individual Maillard reactions of glucose, glucosamine, cyclohexylamine, and benzylamine were studied at a fixed temperature of 120°C under different durations by monitoring the absorbance of the final products at 425 nm. Glucosamine was the most individually reactive compound, whereas the reactions of glucose, cyclohexylamine, and benzylamine were not significantly different from each other. Maillard reactions of reaction mixtures consisting of glucosamine-cyclohexylamine, glucosamine-benzylamine, glucose-cyclohexylamine, and glucose-benzylamine were also studied using different concentration ratios under different durations at a fixed temperature of 120°C and pH 9. Maillard reactions in the pairs involving glucosamine were observed to be more intense than those of the pairs involving glucose. Finally, with respect to the concentration ratios, it was observed that in most instances, optimal activity was realized, when the reaction mixtures were in the ratio of 1:1.

Predicting Postoperative Complications and Long-Term Survival After Lung Cancer Surgery Using Eurolung Risk Score

Background@#This study aimed to assess the clinical relevance of the parsimonious Eurolung risk scoring system for predicting postoperative morbidity, mortality, and long-term survival in Korean patients with surgically resected non-small cell lung cancer. @*Methods@#This retrospective analysis used the data of patients who underwent anatomical resection for non-small cell lung cancer between 2004 and 2018 at a single institution. The parsimonious aggregate Eurolung score was calculated for each patient. The Cox regression model was used to determine the ability of the Eurolung scoring system for predicting longterm outcomes. @*Results@#Of the 7,278 patients in the study, cardiopulmonary complications and mortality occurred in 687 (9.4%) and 53 (0.7%) patients, respectively. The rate of cardiopulmonary complications and mortality gradually increased with the increase in the Eurolung risk scores (all P < 0.001). When risk scores were grouped into four categories, the Eurolung scoring system showed a stepwise deterioration of overall survival with the increase in risk scores, and this association was statistically significant (P < 0.001). Multivariate Cox analysis showed that the Eurolung scoring system, classified into four categories, was a significant prognostic factor of overall survival even after adjusting for covariates such as tumor histology and pathological stage (P < 0.001). @*Conclusion@#Stratification based on the parsimonious Eurolung scoring system showed good discriminatory ability for predicting postoperative morbidity, mortality, and long-term survival in South Korean patients with surgically resected non-small cell lung cancer. This might help clinicians to provide a detailed prognosis and decide the appropriate treatment option for high-risk patients with non-small cell lung cancer.

Endoscopic Ultrasonography-guided Gastrojejunostomy for Patients with Gastric Outlet Obstruction and Pyloric Metal Stent Dysfunction / 대한소화기학회지

A 52-year-old woman with a gastric outlet obstruction (GOO) caused by pyloric cancer underwent pyloric endoscopic self-expandable metal stent (SEMS) insertion. She presented with abdominal distension 40 days later. The SEMS was dysfunctional, and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) was performed using an endoscopic nasobiliary drainage tube. A 16 mm×31 mm Niti-S ™ HOT SPAXUS™ (TaeWoong Medical, Gimpo, Korea) was inserted successfully between the stomach and the adjacent jejunum. After the procedure, the patient had a good oral intake for more than seven months. GOO is a mechanical obstructive condition caused by various benign and malignant conditions. Traditionally, surgical GJ and SEMS insertion have been used to treat GOOs. EUS-GJ is a feasible treatment option for patients with GOO and a pyloric metal stent dysfunction.

Natural Progression of Ground-glass Nodules after Curative Resection for Non-small Cell Lung Cancer

Background@#This retrospective study investigated the natural course of synchronous groundglass nodules (GGNs) that remained after curative resection for non-small-cell lung cancer (NSCLC). @*Methods@#Prospectively collected retrospective data were reviewed concerning 2,276 patients who underwent curative resection for NSCLC between 2008 and 2017. High-resolution computed tomography or thin-section computed tomography data of 82 patients were included in the study. Growth in size was considered the most valuable outcome, and patients were grouped according to GGN size change. Patient demographic data (e.g., age, sex, and smoking history), perioperative data (e.g., GGN characteristics, histopathology and pathological stage of the resected tumours), and other medical history were evaluated in a risk factor analysis concerning GGN size change. @*Results@#The median duration of follow-up was 36.0 months (interquartile range, 23.0–59.3 months). GGN size decreased in 6 patients (7.3%), was stationary in 43 patients (52.4%), and increased in 33 patients (40.2%). In univariate analysis, male sex, the GGN size on initial CT, part-solid GGN and smoking history (≥ 10 pack-years) were significant risk factors. Among them, multivariate analysis revealed that lager GGN size, part-solid GGN and smoking history were independent risk factors. @*Conclusion@#During follow-up, 40.2% of GGNs increased in size, emphasising that patients with larger GGNs, part-solid GGN or with a smoking history should be observed.

Cannulation of the Portal Vein during Endoscopic Retrograde Cholangiopancreatography in a Patient with Choledocholithiasis / 대한소화기학회지

Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient.

Cannulation of the Portal Vein during Endoscopic Retrograde Cholangiopancreatography in a Patient with Choledocholithiasis / 대한소화기학회지

Cannulation of the portal vein is a rare complication of ERCP. This paper reports a case of portal vein catheterization during ERCP in a patient with choledocholithiasis. A 62-year-old man was admitted to the Presbyterian Medical Center with right upper quadrant pain and jaundice. ERCP was performed under the suspicion of obstructive jaundice caused by a radiolucent stone. Bile duct cannulation using a pull-type papillotome was attempted, but it failed. After needle-knife fistulotomy, wire-guided cannulation was performed successfully, and 10 mL contrast was injected. On the other hand, the fluoroscopy image showed that the contrast medium disappeared very quickly. Pure blood was collected when the catheter was aspirated to identify the bile reflux, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography showed air in the portal vein. One day after, a follow-up CT scan showed no air in the portal vein. The patient underwent repeated ERCP, and the common bile duct was cannulated. In most cases, isolated portal vein cannulation does not result in severe morbidity. However, it is important to aware of this rare complication so that no further invasive procedure is performed on the patient.