Role of Cardiac Computed Tomography in the Diagnosis of Left Ventricular Myocardial Diseases

Multimodality imaging is indicated for the evaluation of left ventricular (LV) myocardial diseases. Cardiac magnetic resonance (CMR) allows morphological and functional assessment of the LV along with soft tissue characterization. Technological advances in cardiac computed tomography (CT) have led to the development of techniques for diagnostic acquisition in LV myocardial disease. Cardiac CT facilitates the characterization of LV myocardial disease based on anatomy, function, and enhancement pattern. LV regional and global functional parameters are evaluated using multi-phasic cine CT images. CT myocardial perfusion facilitates the identification of hemodynamically significant coronary artery stenosis. Cardiac CT with delayed enhancement is used to detect myocardial scarring or fibrosis in myocardial infarction and non-ischemic cardiomyopathy, and for the measurement of extracellular volume fraction in non-ischemic cardiomyopathy. In this review, we review imaging techniques and key imaging features of cardiac CT used for the evaluation of myocardial diseases, along with CMR findings.

Radon and PM10 concentrations in underground parking lots and subway stations with health risks in South Korea

This study examined the environmental factors that affect indoor radon (Rn) and particulate matter (PM₁₀) concentrations in underground public facilities such as subway stations and underground parking lots. Rn and PM₁₀ concentrations from March 2014 to October 2015 were evaluated at 40 subway stations and 19 underground parking lots. Average underground concentrations of Rn and PM₁₀ were 37.3 ± 17.1 Bq/m³ and 78.6 ± 15.1 μg/m³, respectively. There were significant difference in Rn concentration between sampling points, with the highest concentration 41.8 ± 18.1 Bq/m³ on subway platforms, while the highest concentration of PM₁₀ was 83.7 ± 13.8 μg/m³ in transfer pathways. Rn concentration showed positive correlation with PM₁₀ concentration (r = 0.380, p < 0.001). The highest Rn concentration occurred during fall season, followed by summer and spring. At 60-h exposure duration in underground subway stations and parking lots, the hazard quotient (HQ) of Rn exceeded 1 for children less than 1 year old and those between 8 and 10 years old.

Evaluation of PM10, CO2, airborne bacteria, TVOCs, and formaldehyde in facilities for susceptible populations in South Korea

Poor indoor air quality can have adverse effects on human health, especially in susceptible populations; however, few studies have measured multiple pollutants in facilities for susceptible populations at a national scale in South Korea. Therefore, we measured the concentrations of indoor pollutants (fine particulate matter (PM₁₀), CO₂, airborne bacteria (AB), total volatile organic compounds (TVOCs), and formaldehyde) to determine their possible relation to other indoor environmental factors and characteristics of facilities with susceptible populations, such as hospitals, geriatric hospitals, elderly care facilities, and postnatal care centers throughout South Korea. Indoor pollutants were sampled at 82 indoor facilities, including 62 facilities for susceptible populations. Spearman's correlation, Kruskal-Wallis, and Mann-Whitney analyses were used to examine the relationship among and differences between pollutants at indoor facilities and indoor/outdoor differences in PM₁₀ concentration. There were significant correlations between indoor temperature and AB concentration (r = 0.37, p < 0.01), TVOCs, and formaldehyde (r = 0.264, p < 0.01). Indoor PM₁₀ concentrations were higher than outdoor concentrations at all facilities for susceptible populations (p < 0.01). CO₂ might be a good indicator for predicting indoor pollutants when categorized into two levels (≤750 ppm and >750 ppm). The hazard quotient of formaldehyde was higher than the acceptable level of 1 for children under the age of eight in postnatal care centers, indicative of unsafe levels. Therefore, more depth study for exposure characteristics of formaldehyde and indoor air quality (IAQ) in postnatal care facilities as a national scale is needed for finding the children exposure levels.

Meropenem-resistant bacteria in hospital effluents in Seoul, Korea

This study aimed to understand the prevalence, diversity, antibiotic resistance, β-lactamase gene types, and possibility of environmental survival of meropenem-resistant bacteria present in hospital effluents in Seoul, Korea. Water sampling was performed at five general hospitals in Seoul, Korea, in January 2017. Water samples were plated in triplicate on tryptic soy agar plates with 16 mg/L meropenem. Meropenem-resistant bacteria were selected and subjected to 16S rRNA analysis for species determination and PCR for identification of β-lactamase gene types. Resistant bacteria were cultured in sterilized surface water. Meropenem-resistant bacteria exhibited resistance to more than 12 antibiotics and possessed several β-lactamase genes, such as those encoding OXT-M, NDM-1, AmpC, and OXA. They were able to multiply and survive in sterilized surface water for up to 60 days. Multidrug-resistant bacteria represent an environmental health risk, as they can survive in the environment for an extended period of time. Therefore, these bacteria should be monitored before discharge.

Exposure assessment of particulate matter and blood chromium levels in people living near a cement plant

This study evaluates the effect of air pollution caused by cement plants on nearby residential areas and performs an exposure assessment of particulate matter (PM) and total Cr, Cr⁶⁺, Pb, and Al. Further, the blood Cr levels of residents exposed to PM released by cement plants are also assessed. Nine buildings (eight residential and one elementary school building) close to cement plants were selected for this study, which were located in Pyeongtaek port, in west of Gyeonggi Province, South Korea. A total of 51 suspended particulate samples were collected at a flow rate of 2.0 L/min. Total Cr was more widely detected in residents' houses and elementary schools. PM levels were higher at distances of 4.1 and 4.8 km than those at closer distances of 2.7 km. This was due to the influence of wind direction. The estimated mean blood level of Cr for the study participants was 3.80 μg/L, which is higher than levels estimated by other studies on Cr blood levels. Therefore, cement plants could cause an increase in total Cr and blood Cr levels in residential areas, and more continuous monitoring is necessary to better understand their impacts.

Factors affecting ambient endotoxin and particulate matter concentrations around air vents of subway stations in South Korea

Levels of airborne endotoxins and particulate matter less than 10 μm and 2.5 μm in diameter (PM) were measured in the air vents of subway stations in Seoul, South Korea, and factors affecting both pollutants were analyzed. The measurements were completed from March 2016 to February 2017 for eight air vents situated at the ground level around the subway stations. A total of 166 air samples were collected and analyzed using the kinetic limulus amebocyte lysate assay. Endotoxin levels ranged from not detected to 1.986 EU m^-3, with a mean of 0.227 EU m^-3. The results showed significantly different PM levels from the measurements reported by AIRKOREA as part of the comprehensive air quality index. This can be attributed to different sampling sites in the same area. Endotoxin levels tended to be higher in fall compared to summer. Airborne bacteria levels showed a pattern similar to the endotoxin levels, but no significant association was reported between them. The levels of endotoxins around air vents with a glass cover and streets that allowed smoking were significantly higher than those not containing a walled barrier and streets in which smoking was prohibited. Multivariate regression analysis showed that the factors affecting endotoxin levels comprised air vents with a glass cover (coefficient = 0.106, p = 0.014) and season (coefficient = 0.062, p < 0.0001). Therefore, installing barriers on the air vents and prohibiting smoking in streets to which the vents open may be effective ways to lessen exposure to airborne endotoxin levels around air vents.

Dynamic Deflection of a Railroad Sleeper from the Coupled Measurements of Acceleration and Strain

Dynamic deflection of a railroad sleeper works as an indicator of ballast stiffness, reflecting the health conditions of a ballast track. However, difficulty exists in measuring dynamic deflection of a railroad sleeper by conventional deflection transducers such as a linear variable differential transformer (LVDT) or a potentiometer. This is because a fixed reference point is unattainable due to ground vibrations during train passage. In this paper, a patented signal processing technique for evaluation of pseudo-deflection is presented to recover dynamic deflection of a railroad sleeper using a coupled measurement of acceleration and strain at the concrete sleeper. The presented technique combines high-frequency deflections calculated from double integration of acceleration and low-frequency deflections determined from strains. Validity of the combined deflections was shown by the deflections measured with a camera target on a concrete sleeper, captured by a high-resolution DSLR camera with superb video capturing features and processed by computer vision techniques, such as Canny edge detection and Blob analysis.

Spindle epithelial tumor with thymus-like differentiation of the thyroid in a 70-year-old man

Spindle epithelial tumor with thymus-like differentiation (SETTLE) is a very rare tumor of the thyroid gland mostly occurring in young patients. The imaging findings of SETTLE tumors are yet to be defined. However, they are usually described as well-defined heterogeneously enhanced masses on CT scan. The current case has the potential growth as compared with a 2009 chest radiography. We took into account the possibility of SETTLE in the case of a bulky mass in patients over 70 years old, particularly in the lower neck. Herein, we report a case of the oldest patient so far. The patient underwent a right lobectomy of the thyroid and mass excision. Follow-up CT scans after 6 months revealed no local recurrence. Surgery is the gold standard treatment for SETTLE. Chemotherapy and radiotherapy could be another possible option for patients with advanced stage SETTLE.

Different Responses of Left Atrium and Left Atrial Appendage to Radiofrequency Catheter Ablation of Atrial Fibrillation: a Follow Up MRI study

Atrial fibrillation (AF) is known to cause adverse remodeling of left atrium (LA). Radiofrequency catheter ablation (RFCA) of AF is associated with decrease in LA volume. However, the impact of RFCA on left atrial appendage (LAA) volume and hemodynamic function is not fully understood. We analyzed 123 patients who underwent cardiac magnetic resonance imaging (MRI) evaluation before and after RFCA in Korea University Anam Hospital. LA and LAA volume were measured before and after RFCA based on cardiac MRI. Baseline LA volume was 99.5 ± 38.4 cm³ and decreased to 74.6 ± 28.5 cm³ after RFCA (p < 0.001). LA diameter measured with transthoracic echocardiography was also decreased after RFCA (43.3 ± 6.2 mm at baseline and 39.9 ± 5.9 mm at follow up; p < 0.001). However, LAA volume was significantly increased after RFCA (19.4 ± 8.5 cm³ at baseline and 23.7 ± 13.3 cm³ at follow up; p < 0.001). Total ablation time and additional substrate modification was associated with change in LA volume. After RFCA, average LAA velocity measured by transesophageal echocardiography was increased to 51.0 cm/sec from 41.1 cm/sec (p < 0.001). In conclusion, LAA volume was increased after RFCA in contrast to LA volume. Our data raise a concern about worsening hemodynamics of LA and LAA following RFCA and long term clinical significance of enlarged LAA after RFCA needs further evaluation.

Differential Cross Section and Photon-Beam Asymmetry for the γ[over →]p → π^{-}Δ^{++}(1232) Reaction at Forward π^{-} Angles for E_{γ}=1.5-2.95 GeV

Differential cross sections and photon-beam asymmetries for the γ[over →]p→π^{-}Δ^{++}(1232) reaction have been measured for 0.7<cosθ_{π}^{c.m.}<1 and E_{γ}=1.5-2.95  GeV at SPring-8/LEPS. The first-ever high statistics cross-section data are obtained in this kinematical region, and the asymmetry data for 1.5<E_{γ}(GeV)<2.8 are obtained for the first time. This reaction has a unique feature for studying the production mechanisms of a pure uu[over ¯] quark pair in the final state from the proton. Although there is no distinct peak structure in the cross sections, a non-negligible excess over the theoretical predictions is observed at E_{γ}=1.5-1.8  GeV. The asymmetries are found to be negative in most of the present kinematical regions, suggesting the dominance of π exchange in the t channel. The negative asymmetries at forward meson production angles are different from the asymmetries previously measured for the photoproduction reactions producing a dd[over ¯] or an ss[over ¯] quark pair in the final state. Advanced theoretical models introducing nucleon resonances and additional unnatural-parity exchanges are needed to reproduce the present data.

LOGIS (LOcalization of Ground-glass-opacity and pulmonary lesions for mInimal Surgery) registry: Design and Rationale

Background and purpose

An optimal pulmonary localization technique for video-assisted thoracic surgery (VATS) of small lung nodules has not yet been established. The LOcalization of Ground-glass-opacity and pulmonary lesions for mInimal Surgery (LOGIS) registry aims to establish a multicenter database and investigate the usefulness and safety of localization techniques for small pulmonary lesions in individuals undergoing VATS.

Methods/Design

The LOGIS registry is a large-scale, multicenter cohort study, aiming to enroll 825 patients at 10 institutions. Based on the inclusion and exclusion criteria, all study participants with pulmonary lesions indicated for VATS will be screened and enrolled at each site. All study participants will undergo preoperative lesion localization by the hook-wire or lipiodol localization methods according to site-specific methods. Within a few hours of marking, thoracoscopic surgery will be done under general anesthesia by experienced thoracoscopic surgeons. The primary endpoints are the success and complication rates of the two localization techniques. Secondary endpoints include procedure duration, recurrence rate, and all-cause mortality. Study participant enrollment will be completed within 2 years. Procedure success rates and incidence of complications will be analyzed based on computed tomography findings. Procedure duration, recurrence rate, and all-cause mortality will be compared between the two techniques. The study will require 5 years for completion, including 6 months of preparation, 3.5 years for recruitment, and 1 year of follow-up endpoint assessment.

Discussion

The LOGIS registry, once complete, will provide objective comparative results regarding the usefulness and safety of the lipiodol and hook-wire localization techniques.

Evaluation of abundance of artificial radionuclides in food products in South Korea and sources

Food samples are collected nationwide from January 2016 to February 2017 and their contents of artificial radionuclides are measured to address the growing concerns regarding the radioactive contamination of food products in Korea. Specifically, 900 food samples are collected for this study and their contents of representative artificial radionuclides ¹³⁴Cs, ¹³⁷Cs, ^239,240Pu, and ⁹⁰Sr are analyzed. The analysis shows that the activity concentrations of ¹³⁷Cs in fish range from minimum detectable activity (MDA) to 340 mBq/kg of fresh weight. The concentration factor (CF) determined for ¹³⁷Cs as a measure of its bioavailability is calculated to be ca. 74 and found to be very similar to that (100) recommended by the International Atomic Energy Agency. With an MDA of <0.221 mBq/kg, the results reveal that ^239,240Pu values in fish are below the MDA. The activity concentrations of ¹³⁷Cs and ⁹⁰Sr are lower than the MDA in both shellfish and seaweed, while the activity concentrations of ^239,240Pu in shellfish range from 0.26 to 2.18 mBq/kg, and for seaweed samples range from 2.07 to 3.38 mBq/kg. The atom ratios of ²⁴⁰Pu/²³⁹Pu in shellfish caught at the Korean coast vary from 0.209 to 0.237, with a mean of 0.227. The higher ²⁴⁰Pu/²³⁹Pu atom ratio determined in shellfish is thought to be caused by the plutonium transported from the Pacific Proving Grounds rather than other sources such as the Fukushima nuclear power plant accident. The activity concentrations of ¹³⁷Cs in mushrooms are found to vary from 1.0 to 21.4 Bq/kg, with the highest concentrations observed in the Oak (shiitake) and Sarcodon asparatus. ¹³⁴Cs is detected in three mushroom specimens collected from Jeju Island and about 3-3.6% of ¹³⁷Cs present in the wild mushrooms native to the Jeju Island are introduced as a result of the Fukushima nuclear plant accident. The annual effective doses of ¹³⁷Cs received through consumption of mushrooms and fish are 2.0 × 10^-4 mSv yr^-1 and 3.9 × 10^-5 mSv yr^-1, and those values are negligible compared to the annual effective doses limit of 1 mSv yr^-1.

First Determination of the Level Structure of an sd-Shell Hypernucleus, _{Λ}^{19}F

We report on the first observation of γ rays emitted from an sd-shell hypernucleus, _{Λ}^{19}F. The energy spacing between the ground state doublet, 1/2^{+} and 3/2^{+} states, of _{Λ}^{19}F is determined to be 315.5±0.4(stat)_{-0.5}^{+0.6}(syst)  keV by measuring the γ-ray energy of the M1(3/2^{+}→1/2^{+}) transition. In addition, three γ-ray peaks are observed and assigned as E2(5/2^{+}→1/2^{+}), E1(1/2^{-}→1/2^{+}), and E1(1/2^{-}→3/2^{+}) transitions. The excitation energies of the 5/2^{+} and 1/2^{-} states are determined to be 895.2±0.3(stat)±0.5(syst) and 1265.6±1.2(stat)_{-0.5}^{+0.7}(syst)  keV, respectively. It is found that the ground state doublet spacing is well described by theoretical models based on existing s- and p-shell hypernuclear data.

The relationship between depression and periodontal diseases

OBJECTIVE

A cross-sectional study was conducted to investigate whether depression is associated with periodontal diseases in a representative sample of South Korean adults Methods: We used data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI), conducted in 2014. We included in this study 4328 participants aged over 20 years (1768 males and 2560 females). Depression was assessed with the Patient Health Questionnaire (PHQ-9) and history of physician-diagnosed depression. Periodontal diseases were assessed a gingival bleeding, calculus and periodontal pockets. The data were analyzed using the chi-square test and multiple logistic regression.

RESULTS

People with any periodontal diseases tended to be old, male, married, low income, poor education, blue-collar occupation, diabetes mellitus, hypertension, overweight, smoking, not using dental floss or interdental brush in univariate analysis. Neither self-reported nor diagnosed depression was associated with the presence of any or severe periodontal disease in the total sample. In participants aged 20-29 years only, the presence of any periodontal disease was associated with self-reported depression (OR, 2.031; 95% CI, 1.011-4.078). In the same age group, the presence of severe periodontal disease was associated with both self-reported depression (OR, 6.532; 95% CI, 2.190-19.483) and diagnosed depression (OR, 7.729; 95% CI, 1.966-30.389).

CONCLUSION

Self-reported depression was significantly associated with the presence of any or severe periodontal disease, and diagnosed depression was significantly associated with severe periodontal diseases only in participants aged 20-29 years.

Radon and NO2 levels and related environmental factors in 100 underground subway platforms over two-year period

In this study, the environmental factors that affect radon (Rn) and nitrogen dioxide (NO₂) levels in subway-station underground platforms are evaluated, and the outdoor NO₂ levels are compared with those obtained for the underground platforms. The Rn and NO₂ levels from May 2013 to September 2015 are determined for lines 1-4 of the Seoul Metro, via calculation of the arithmetic means of the Rn and NO₂ levels with their standard deviations (SDs). The underground Rn levels in 2013 are found to be significantly higher than those recorded in 2015 for the Seoul Metro. In addition, the Rn levels are related to the station depth and construction year. Further, the underground NO₂ levels are shown to be significantly higher than the outdoor levels for all four Seoul Metro subway lines. The Rn levels are also found to vary significantly between months, and are shown to increase gradually with depth from 8 to 20 m. The Rn levels are also higher for stations constructed in the 1980s. Therefore, stricter monitoring of Rn level may be required for stations constructed in the 1980s and/or having platform depths within the 8-20 m range. Island-type platform stations based on granite areas may also require careful attention.

Post-operative corticosteroid irrigation for chronic rhinosinusitis after endoscopic sinus surgery: A meta-analysis

BACKGROUND

Recently, topical steroid therapy delivery using high-volume sinonasal irrigations has been used more frequently, following endoscopic sinus surgery (ESS), to improve drug delivery into the paranasal sinuses.

OBJECTIVE

The goal of this study was to perform a systematic review with meta-analysis of the efficacy of steroid nasal irrigation on post-operative management of Chronic rhinosinusitis (CRS) following ESS.

METHODS

Five databases (PubMed, SCOPUS, Embase, Web of Science, and the Cochrane database) from inception to March 2017 were independently reviewed by two researchers. Studies that scored CRS endoscopic findings and CRS-related quality of life (QOL) post-operatively before and after steroid nasal irrigation and that compared the effects of steroid nasal irrigation (treatment groups) with saline alone irrigation (control group) were included in the analysis.

RESULTS

Twelve studies (n = 360) met inclusion criteria. Steroid nasal irrigation significantly reduced the endoscopic score compared with pre-treatment values and also improved QOL. Adverse effects following steroid nasal irrigation such as increased intraocular pressure (IOP) and hypothalamus-pituitary-adrenal (HPA) axis disturbance were not significant. However, compared with saline alone irrigation, the additional effects of steroid irrigation were not significant in the view of the endoscopic score and disease-specific QOL.

CONCLUSION

Although steroid nasal irrigation would not induce adverse effects related to systemic steroid absorption, the beneficial effects of additional steroids in saline irrigation were ambiguous in regard to endoscopic score and CRS-related QOL improvement compared with saline alone irrigation. However, further clinical trials with robust research methodologies should be conducted to confirm the results of this study.

Formaldehyde and carbon dioxide air concentrations and their relationship with indoor environmental factors in daycare centers

The aim of this study was to measure the air concentrations of carbon dioxide (CO₂) and formaldehyde (HCHO) in daycare centers to determine relevant influencing factors, including temperature, relative humidity (RH), type of facility, number of children, type of ventilation system, ventilation time, and air cleaning system. The authors measured HCHO, CO₂, temperature, and RH in the center of classrooms in 289 daycare centers. Spearman's correlation and Mann-Whitney analyses were used to examine the relationships and differences in HCHO and CO₂ for varying temperatures, RH values, and categorical indoor environmental factors. There were no significant differences in the HCHO and CO₂ air concentrations with varying numbers of children, ventilation times, or ventilation and air cleaning system types. However, both the HCHO and CO₂ air concentrations were significantly different for varying RH values, which were divided into five categories (p < 0.001). Only the HCHO air concentrations were significantly different for varying temperatures, which were divided into five categories (p < 0.001). Significant correlations were found between HCHO air concentrations and the temperature (r = 0.35, p < 0.0001), RH (r = 0.51, p < 0.0001), and CO₂ (r = 0.36, p < 0.0001). The study results support maintaining an appropriate temperature and RH range for reducing airborne HCHO in daycare centers. Further research is needed to elucidate the precise mechanisms responsible for the relationships observed in this study.

IMPLICATIONS

Data from 289 daycare centers in Seoul, South Korea, indicate that HCHO concentrations show a positive correlation with indoor temperature and relative humidity. This indicates that keeping temperatures low will help keep HCHO concentrations low, by both a direct and an indirect effect, since low temperatures also cause low relative humidity.

Longitudinal trends of blood lead levels before and after leaded gasoline regulation in Korea

The objective of this study was to verify a change in the longitudinal trend of blood lead levels for the Korean population, before and after the regulation of leaded gasoline- which occurred between 1987 and 1993 in Korea. A total of 77 reports on blood lead levels among general Korean population between 1981 and 2014 were selected, and the results were summarized to have the variables of year, number of subjects, the subjects' range in age, gender, and blood lead concentrations (arithmetic mean). The annual average atmospheric lead levels for four major cities (i.e., Seoul, Busan, Daegu and Gwangju) were collected from the Air Pollution Monitoring Database from 1991, and pilot studies from 1985 to 1990 before the national air quality monitoring system was launched in 1991. Blood lead levels were visualized in a bubble plot in which the size of each bubble represented the sample size of each study, and the annual average concentrations in ambient air were depicted on line graphs. Blood lead levels in the Korean population tended to gradually increase from the early 1980s (approximately 15-20 μg/dL) until 1990-1992 (20-25 μg/dL). Blood lead levels then began to rapidly decrease until 2014 (<2 μg/dL). Similar patterns were observed for both adults (≥20 years) and younger children/adolescents. The same longitudinal trend was observed in annual average atmospheric lead concentration, which suggests a significant correlation between air lead concentration and blood lead concentration in the general population. In conclusion, the regulation of leaded gasoline has significantly contributed to the rapid change in blood lead concentrations. And, the regulation of other sources of lead exposure should be considered to further decrease blood lead levels in the Korean population.

Concentrations and identification of culturable airborne fungi in underground stations of the Seoul metro

The purpose of this study was to measure the culturable airborne fungi (CAF) concentrations in the underground subway stations of Seoul, Korea at two time points. This study measured the CAF concentrations in enclosed environments at 16 underground stations of the Seoul Metro in 2006 and 2013 and investigated the effects of various environmental factors, including the presence of platform screen doors, temperature, relative humidity, and number of passengers. CAF concentrations at the stations in 2006 were significantly higher than that at the same stations in 2013 (p < 0.001). Furthermore, there was a significant correlation between CAF concentration and relative humidity (r = 0.311, p < 0.05). Geotrichum and Penicillium were the predominant genera. The CAF concentrations in stations with an operating supply air were significantly higher than that in stations with no supply air (p < 0.001). Therefore, it is recommended that special attention be given to stations with clean supplied air to improve the indoor air quality of these subway stations.

Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients

Purpose

To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications.

Methods

We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume.

Results

Among 92 recipients, the mean volume was 44.53 ± 176.43 cm³ and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm³ was the cutoff, with 83.3% sensitivity and 93.7% specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm³ were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm³, and serum creatinine level at one month were significant factors.

Conclusion

Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early image surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm³ or located inferiorly, early interventions can be considered while carefully observing the changes in symptoms.

Evaluation of asbestos-containing products and released fibers in home appliances

The purpose of this study was to detect asbestos-containing products and released asbestos fibers from home appliances. The authors investigated a total of 414 appliances manufactured between 1986 and 2007. Appliances were divided into three categories: large-sized electric appliances, small-sized electric appliances, and household items. Analysis for asbestos-containing material (ACM) was performed using polarized light microscopy (PLM) and stereoscopic microscopy. Air sampling was performed to measure airborne concentration of asbestos using a phase-contrast microscope (PCM). The results of the analysis for ACM in appliances show that large-sized electric appliances (refrigerators, washing machines, kimchi-refrigerators) and household items (bicycles, motorcycles, gas boilers) contain asbestos material and small-sized electric appliances do not contain asbestos material. All appliances with detected asbestos material showed typical characteristics of chrysotile (7-50%) and tremolite (7-10%). No released fibers of ACM were detected from the tested appliances when the appliances were operating. This study gives the basic information on asbestos risk to people who use home appliances.

IMPLICATIONS

All appliances with detected asbestos material showed typical characteristics of chrysotile (7-50%) and tremolite (7-10%). No released fibers of ACM were detected from the tested appliances when the appliances were operating.