Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair

Purpose@#This study aimed to investigate the clinical outcomes of internal iliac artery (IIA) interruption during endovascular aneurysm repair (EVAR) and to identify the risk factors for ischemic complications. @*Materials and Methods@#Endovascular treatment was performed in 316 patients with aneurysms or pseudoaneurysms of the abdominal aorta or iliac arteries between March 2006 and January 2022. Medical records and radiological imaging studies were retrospectively reviewed. The incidences of buttock claudication, ischemic colitis, and spinal cord ischemia after IIA interruption were investigated as clinical outcomes. Binary logistic regression analysis were performed to identify the risk factors. @*Results@#IIA embolization was performed in 78 patients. Among the 42 patients who underwent IIA flow preservation procedures, the one-month computed tomography detected early failure in five patients. The origin of the IIA was covered with an endograft in ten patients who did not undergo embolization. Eventually, interruption of the IIA by EVAR was observed in 93 patients. Considering preoperative IIA occlusion, there was a total of six patients who did not have at least one IIA patency. Buttock claudication occurred in 32.6% of the patients, and none of the patients had ischemic colitis or spinal cord ischemia. In multivariable analysis, age ≤80 years and isolated iliac artery aneurysm were associated with the development of postoperative buttock claudication. @*Conclusion@#The most common complication after IIA interruption is buttock claudication; however, critical complications such as ischemic colitis or spinal cord ischemia are rare, even in bilateral IIA occlusion. Adjunctive procedures to preserve bilateral IIA perfusion should be adopted selectively.

Nitrosylation of b2-Tubulin Promotes Microtubule Disassembly and Differentiated Cardiomyocyte Beating in Ischemic Mice

BACKGROUND@#Beating cardiomyocyte regeneration therapies have revealed as alternative therapeutics for heart transplantation. Nonetheless, the importance of nitric oxide (NO) in cardiomyocyte regeneration has been widely suggested, little has been reported concerning endogenous NO during cardiomyocyte differentiation. @*METHODS@#Here, we used P19CL6 cells and a Myocardiac infarction (MI) model to confirm NO-induced protein modification and its role in cardiac beating. Two tyrosine (Tyr) residues of b2-tubulin (Y106 and Y340) underwent nitrosylation (Tyr-NO) by endogenously generated NO during cardiomyocyte differentiation from pre-cardiomyocyte-like P19CL6 cells. @*RESULTS@#Tyr-NO-b2-tubulin mediated the interaction with Stathmin, which promotes microtubule disassembly, and was prominently observed in spontaneously beating cell clusters and mouse embryonic heart (E11.5d). In myocardial infarction mice, Tyr-NO-b2-tubulin in transplanted cells was closely related with cardiac troponin-T expression with their functional recovery, reduced infarct size and thickened left ventricular wall. @*CONCLUSION@#This is the first discovery of a new target molecule of NO, b2-tubulin, that can promote normal cardiac beating and cardiomyocyte regeneration. Taken together, we suggest therapeutic potential of Tyr-NO-b2-tubulin, for ischemic cardiomyocyte, which can reduce unexpected side effect of stem cell transplantation, arrhythmogenesis.

A Rare Case of Methotrexate Induced Pancreatitis in Ectopic Pregnancy / 이화의대지

Ectopic pregnancy (EP) refers to blastocyst implantation outside the uterine endometrium. EP is major cause of maternal morbidity and mortality. Treatment options include surgery, medical therapy with methotrexate, or expectant management. Methotrexate is the primary regimen used in cases of early, unruptured ectopic pregnancies. Most side effects of methotrexate are minor, including nausea, vomiting, abdominal discomfort, and photosensitive skin reaction. Serious side effects, including bone marrow suppression, and pulmonary fibrosis, are invariably observed when methotrexate is administered in high doses with frequent dosing intervals, in chemotherapeutic protocols for malignancy. These side effects are uncommon with the doses used to treat ectopic pregnancies. Since cases of methotrexate-induced pancreatitis are rare, we report a case of pancreatitis in a patient with EP treated with methotrexate and expect to consider pancreatitis as a side effect of methotrexate in a patient with upper abdominal pain undergoing methotrexate chemotherapy.

US features of normal parathyroid glands: a comparison with metastatic lymph nodes in thyroid cancer

Purpose@#This study aimed to determine the ultrasound (US) features of normal parathyroid glands (PTGs) and to evaluate whether normal PTGs can be differentiated from metastatic lymph nodes (LNs) in thyroid cancer. @*Methods@#This retrospective study included 10 normal PTGs and 95 metastatic LNs from thyroid cancer showing suspicious US features. The echogenicity, echotexture, echogenic foci (calcifications), cystic change, abnormal vascularity, size, shape, and location were retrospectively assessed and compared between normal PTGs and metastatic LNs. @*Results@#The echogenicity of normal PTGs was significantly different from that of metastatic LNs (P<0.001). Normal PTGs exhibited marked hyperechogenicity (100%), homogeneous echotexture (80%), focal intraglandular hypoechogenicity (20%), ovoid shape (90%), and focal cystic change in one case (10%). The echogenicity of metastatic LNs was markedly hyperechoic (0%), moderately hyperechoic (15.8%), mildly hyperechoic (53.7%), and hypoechoic (28.4%). The size and long axis/short axis ratios of normal PTGs were significantly smaller and larger than those of metastatic LNs (P<0.01 and P=0.022, respectively). @*Conclusion@#Marked hyperechogenicity was found only in normal PTGs, and small, ovoid, markedly hyperechoic structures in the paramedian central neck characterized normal PTGs. Normal PTGs may be differentiated from metastatic LNs in thyroid cancer.

Influence of Fall-related Perception on Behavioral Intention of Fall Prevention among Hospitalized Older Patients / 기본간호학회지

Purpose@#This study aimed 1) to identify hospitalized older patients' fall-related perceptions (including subjective fall risk assessment, confidence in performing fall risk behavior, fear of falling, and recognition of fall consequences) and behavioral intention for fall prevention, and 2) to investigate the influence of fall-related perceptions on the behavioral intention for fall prevention. @*Methods@#A cross-sectional survey was conducted among 150 hospitalized older patients admitted to a large general hospital. A structured questionnaire was administered from October 1, 2020 to January 31, 2021. Cohen's kappa and multiple linear regression analysis were utilized to analyze the data. @*Results@#The average scores were 1.43±0.65 for the subjective fall risk assessment, 4.08±0.44 for confidence in performing fall risk behavior, and 2.04±0.61 for the behavioral intention for fall prevention, on a 1~5 scale, with higher scores indicating higher levels of the attributes. They had an average of 1.48±0.56 for fear of falling and 2.43±0.35 for the recognition of fall consequences, on a 1~4 scale. Low agreement was found between the subjective fall risk assessment by hospitalized elderly patients and the objective fall risk assessment by nurses using the Morse Fall Scale. The hospitalized elderly patients' subjective fall risk assessment, confidence in performing fall risk behavior, and fear of falling were significant factors influencing behavioral intention for fall prevention. @*Conclusion@#The approach to preventing falls among hospitalized older patients should include assessing fall-related perceptions and providing education to correct inappropriate perceptions about falls.

Isolation and Antimicrobial Susceptibility of Nontuberculous Mycobacteria in a Tertiary Hospital in Korea, 2016 to 2020 / 결핵및호흡기질환

Background@#There is a global increase in isolation of nontuberculous mycobacteria (NTM). The aim of the study was to analyze longitudinal trends of NTM identification and pattern of antimicrobial susceptibility testing. @*Methods@#NTM recovery rates, distribution of NTM species identification, and antimicrobial susceptibility pattern of NTM at Pusan National University Yangsan Hospital between January 2016 and December 2020 were retrospectively analyzed. @*Results@#A total of 52,456 specimens from 21,264 patients were submitted for mycobacterial culture, of which 2,521 from 1,410 patients were NTM positive over five years (January 2016 to December 2020). NTM isolation showed an increasing trend from 2016 to 2020 (p<0.001, test for trend) mainly caused by Mycobacterium avium complex. The vast majority of M. avium complex were susceptible to key agents clarithromycin and amikacin. For Mycobacterium kansasii, resistance to rifampin and clarithromycin is rare. Amikacin was the most effective drug against Mycobacterium abscessus subspecies abscessus and Mycobacterium subspecies massiliense. Most of M. subspecies massiliense were susceptible to clarithromycin, while the majority of M. abscessus subspecies abscessus were resistant to clarithromycin (p<0.001). @*Conclusion@#There was an increasing trend of NTM isolation in our hospital. Resistance to key drugs was uncommon for most NTM species except for M. abscessus subspecies abscessus against clarithromycin.

Differences in Functional Level and Central Symptom of Network Structures in the Patients Seeking Treatment for Panic Disorder Before and During the COVID-19 Pandemic

Objective@#Mental health problems such as anxiety, panic, and depression have been exacerbated by the coronavirus disease-2019 (COVID-19). This study aimed to compare the symptom severities and overall function before and during the COVID-19 pandemic among patients with panic disorder (PD) seeking treatment compared to healthy controls (HCs). @*Methods@#Baseline data were collected from the two groups (patients with PD and HCs) in two separate periods: before COVID-19 (Jan 2016–Dec 2019) and during COVID-19 (Mar 2020–Jul 2022). A total 453 participants (before COVID-19: 246 [139 patients with PD and 107 HCs], during COVID-19: 207 [86 patients with PD and 121 HCs]) was included. Scales for panic and depressive symptoms and overall function were administered. Additionally, network analyses were performed to compare the two groups within the patients with PD. @*Results@#The results of two-way analysis of variance analyses showed that patients with PD enrolled during COVID-19 showed higher levels of interoceptive fear and lower overall functioning. In addition, a network comparison test revealed that a significantly high strength and expected influence for agoraphobia and avoidance in patients with PD during COVID-19. @*Conclusion@#This study suggested that the overall function could have worsened, and the importance of agoraphobia and avoidance as a central symptom may have increased in patients with PD seeking treatment during COVID-19.

Computerized Version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (KSADS-COMP): Development and Validation of the Korean Clinician-Administered Version

Objective@#The purpose of the present study was to develop and validate the Korean version of the clinician-administered KSADSCOMP, which is the recently updated, web-based computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia for school-age children (KSADS). @*Methods@#A total of 71 participants (mean age=12.04±3.86 years, female=29.57%) participated in the study. A child-adolescent psychiatrist established a diagnosis for the participant after a thorough psychiatric interview with the participant and the parent. Researchers who were blind to the diagnoses administered the clinician-administered KSADS-COMP to the parents and participants. The gold-standard diagnoses made by child-adolescent psychiatrists were compared to the current diagnoses generated by the clinician-administered KSADS-COMP. Percent agreement, Cohen’s Kappa, Gwet’s first-order agreement coefficient (AC1), sensitivity, specificity, positive predictive value, and negative predictive value were calculated. @*Results@#Gwet’s AC1, our preferred measure of agreement, showed excellent range between 0.78 and 1. Sensitivity, specificity, positive predicted value and negative predictive value also showed high scores. @*Conclusion@#The current study demonstrated excellent criterion validity of the Korean version of the clinician-administered KSADSCOMP, though the small sample size could be a limitation. The current study was the first study to examine the criterion validity of the KSADS-COMP. Due to its readily usable format and efficient and accurate diagnostic process, widely-use of KSADS-COMP is expected.

A Comparison between Intravitreal Bevacizumab Injection and Placement of a Dexamethasone Implant to Treat Retinal Vein Occlusion Macular Edema

Purpose@#We evaluated the macular, functional and structural features of patients with retinal vein occlusion and macular edema. We measured the best-corrected visual acuity (BCVA), central foveal thickness, and the area of the foveal avascular zone area after intravitreal bevacizumab (IVB) treatment and placement of a dexamethasone implant (IVD). @*Methods@#We retrospectively reviewed 36 eyes of 36 patients with retinal vein occlusion and macular edema who underwent IVB treatment (20 eyes) and IVD placement (16 eyes). The parameters mentioned above were compared between the two treatment groups and the normal contralateral eyes after initial stabilization and 1 year later. @*Results@#The BCVA was significantly higher in the IVB than the IVD group after initial stabilization and 1 year later. The intraocular pressure was lower at initial stabilization in the IVB than the IVD group, but no difference was apparent after 1 year. There was no significant between-group difference in the central foveal thickness at any time, but the IVD group required fewer injections during initial stabilization than the IVB group. In terms of the foveal avascular zone area, both the superficial and deep layers of the IVB group increased significantly during the initial stabilization period and then decreased to 1 year; no changes were seen in the IVD group. @*Conclusions@#IVD treatment is associated with fewer injections than IVB treatment and a more stable retinal vasculature, but visual acuity may possibly decrease (because of cataract formation). Although IVB treatment improves visual acuity and reduces macular edema, this may be associated with an increased risk of macular ischemia given the need for repeated injections.

Development and Application of a Cell-Based Assay for LRP4 Antibody Associated With Myasthenia Gravis

Background@#and Purpose Among patients with double-seronegative myasthenia gravis (dSN-MG) who do not have detectable antibodies against acetylcholine receptor or musclespecific tyrosine kinase, autoantibodies against low-density lipoprotein receptor-related protein 4 (LRP4-Ab) have been detected recently. The purpose of this study was to develop an in-house cell-based assay (CBA) to detect LRP4-Ab and to apply it to samples from patients with MG. @*Methods@#The complementary DNA of LRP4 fused into a vector plasmid containing GFP was transfected into human embryonic kidney 293 (HEK293) cells. LRP4 expression in the transfected HEK293 cells was assessed using the reverse-transcription polymerase chain reaction (RT-PCR), Western blotting, and immunocytochemistry. The CBA included 252 sera collected from 202 patients with MG and 38 with other neuromuscular diseases, and 12 healthy controls. The transfected HEK293 cells were incubated using sera and antihuman immunoglobulin G antibodies conjugated with Alexa Fluor 594. The presence of LRP4-Ab was determined based on the fluorescence intensity and the localization in fluorescence microscopy. @*Results@#The expressions of the mRNA and protein of LRP4 in the transfected HEK293 cells were confirmed using RT-PCR and Western blotting, respectively. Immunocytochemistry indicated LPR4 expression on the cell membrane. Among 202 patients with MG including 53 with dSN-MG, LRP4-Ab were positive in 3 patients who were all double seronegative. LRP4-Ab were not detected in the patients with other neuromuscular diseases or the healthy controls. @*Conclusions@#A CBA for detecting LRP4-Ab associated with MG has been developed, and was used to find LRP4-Ab in the sera of patients with MG.

Suggestions for Escaping the Dark Ages for Pediatric Diffuse Intrinsic Pontine Glioma Treated with Radiotherapy: Analysis of Prognostic Factors from the National Multicenter Study / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#This multicenter retrospective study aimed to investigate clinical, radiologic, and treatment-related factors affecting survival in patients with newly diagnosed diffuse intrinsic pontine glioma (DIPG) treated with radiotherapy. @*Materials and Methods@#Patients aged <30 years who underwent radiotherapy as an initial treatment for DIPG between 2000 and 2018 were included; patients who did not undergo magnetic resonance imaging at diagnosis and those with pathologically diagnosed grade I glioma were excluded. We examined medical records of 162 patients collected from 10 participating centers in Korea. The patients’ clinical, radiological, molecular, and histopathologic characteristics, and treatment responses were evaluated to identify the prognosticators for DIPG and estimate survival outcomes. @*Results@#The median follow-up period was 10.8 months (interquartile range, 7.5 to 18.1). The 1- and 2-year overall survival (OS) rates were 53.5% and 19.0%, respectively, with a median OS of 13.1 months. Long-term survival rate (≥ 2 years) was 16.7%, and median OS was 43.6 months. Age (< 10 years), poor performance status, treatment before 2010, and post-radiotherapy necrosis were independently associated with poor OS in multivariate analysis. In patients with increased post-radiotherapy necrosis, the median OS estimates were 13.3 months and 11.4 months with and without bevacizumab, respectively (p=0.138). @*Conclusion@#Therapeutic strategy for DIPG has remained unchanged over time, and the associated prognosis remains poor. Our findings suggest that appropriate efforts are needed to reduce the occurrence of post-radiotherapy necrosis. Further well-designed clinical trials are recommended to improve the poor prognosis observed in DIPG patients.

Treatment experience in a patient of complex regional pain syndrome combined with secondary lymphedema of lower extremity

Lymphedema is characterized by localized tissue swelling due to excessive interstitial space retention of lymphatic fluid. Lymphedema is easy to be misdiagnosed since itresembles other conditions of extremity swelling. We present a case of complex regionalpain syndrome (CRPS) type I with secondary lymphedema that was successfully managedwith spinal cord stimulation (SCS).Case: A 39-year-old female patient came to our pain clinic with complaints of lower extremity pain and edema. To find out reason of leg edema, computed tomography of extremity angiography and blood test were performed. However, all of evaluations were normal. Lastlyperformed lymphoscintigraphy showed secondary lymphedema. SCS was performed and itshowed dramatic reduction subsequent to implantation of SCS.Conclusions: We could successfully manage the intractable pain and edema in CRPS combined with lymphedema. If a patient presents different nature of edema, coexistence of other disease needs to be considered.

Revealing Joseon period People’s single nucleotide polymorphism associated with lactase gene by ancient DNA analysis of human remains from archaeological sites in Korea / 대한해부학회지

Lactase non-persistence (LNP), one of the causes of lactose intolerance, is related to lactase gene associated single nucleotide polymorphisms (SNPs). Since the frequency of LNP varies by ethnic group and country, the research to reveal the presence or absence of LNP for specific people has been conducted worldwide. However, in East Asia, the study of lactase gene associated SNPs have not been sufficiently examined so far using ancient human specimens from archaeological sites. In our study of Joseon period human remains (n=14), we successfully revealed genetic information of lactase gene associated SNPs (rs1679771596, rs41525747, rs4988236, rs4988235, rs41380347, rs869051967, rs145946881 and rs182549), further confirming that as for eight SNPs, the pre-modern Korean people had a lactase non-persistent genotype. Our report contributes to the establishment of LNP associated SNP analysis technique that can be useful in forthcoming studies on human bones and mummy samples from East Asian archaeological sites.

Sleep Reactivity and Sleep Efforts in Shift Workers

Objective@#The current study aimed to investigate the differences in sleep reactivity and sleep effort differs among late night shift workers (LSWs) and non-late night shift workers (non-LSWs), and non-shift workers (non-SWs). @*Methods@#In total, 6,023 participants (1,613 non-SWs, 3,339 LSWs, and 1,071 non-LSWs) were recruited. Non-SWs was defined as those who works at fixed schedules during standard daylight. LSWs was defined as who work late night hours (10 PM–6 AM), while non-LSWs was SWs who did not work during late night. All completed the Ford Insomnia Response to Stress Test (FIRST), the Glasgow Sleep Effort Scale (GSES), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D) through online survey. @*Results@#LSWs and non-LSWs reported higher FIRST, GSES scores than non-SWs. In addition, LSWs reported higher FIRST, GSES scores than non-LSWs. FIRST scores were correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike. GSES scores were also correlated with CES-D, PSQI, ISI, and ESS for LSWs, non-LSWs, and non-SWs alike. @*Conclusion@#SWs showed higher sleep reactivity and sleep effort than non-SWs. LSWs had higher sleep reactivity and sleep effort than non-LSWs, and these variables are associated with insomnia, daytime sleepiness, and depressive symptoms. Our findings suggests that late night schedule, may increase sleep reactivity and sleep effort, which are associated with sleep and mood disturbances.

Vaccine effectiveness and the epidemiological characteristics of a COVID-19 outbreak in a tertiary hospital in Republic of Korea

Objectives@#Healthcare facilities are high-risk sites for infection. This study analyzed the epidemiological characteristics of a coronavirus disease 2019 (COVID-19) outbreak in a tertiary hospital after COVID-19 vaccination had been introduced in Republic of Korea. Vaccine effectiveness (VE) and shared anti-infection strategies are also assessed. @*Methods@#The risk levels for 4,074 contacts were evaluated. The epidemiological characteristics of confirmed cases were evaluated using the chi-square test. The “1 minus relative risk” method was used to determine VE in preventing infection, progression to severe disease, and death. In the largest affected area (the 8th floor), a separate relative risk analysis was conducted. A multivariate logistic regression analysis (with 95% confidence interval [CIs]) was used to identify transmission risk factors with a significance level <10% via the backward elimination method. @*Results@#In total, 181 cases of COVID-19 were confirmed, with an attack rate of 4.4%. Of those cases, 12.7% progressed to severe disease, and 8.3% died. In the cohort isolation area on the 8th floor, where 79.0% of the confirmed cases occurred, the adjusted odds ratio was 6.55 (95% CI, 2.99–14.33) and 2.19 (95% CI, 1.24–3.88) for caregivers and the unvaccinated group, respectively. VE analysis revealed that 85.8% of the cases that progressed to severe disease and 78.6% of the deaths could be prevented by administering a second vaccine. @*Conclusion@#Caregiver training for infection prevention and control is necessary to reduce infection risk. Vaccination is an important intervention to reduce the risk of progression to severe disease and death.

Serological survey for Getah virus in domestic pigs of South Korea

Several outbreaks of Getah virus (GETV) have been reported in horses and pigs, causing large economic losses. However, there have been no reports describing serological survey for GETV in South Korea pigs. The present study conducted serological survey of GETV in South Korean pigs. A total of 670 whole blood samples were collected from domestic pigs. The overall seropositive rate was 26.4%, higher than the rates observed in racehorses in 2013–2014. Preparations for epidemics of novel diseases caused by climate change should include regular serological survey for these diseases, including GETV, and the development of vaccines against novel pathogens.

Immunogenicity of a new inactivated vaccine against feline panleukopenia virus, calicivirus, and herpesvirus-1 for cats

Feline panleukopenia virus (FPV), feline calicivirus (FCV), and feline herpesvirus type-1 (FHV-1) are major infectious pathogens in cats. We evaluated the immunogenicity of a new vaccine containing inactivated FPV, two FCVs, and FHV-1 in animals. An FPV, two FCVs, and an FHV-1 isolate were continuously passaged 70, 50, 80, and 100 times in CRFK cells. FP70, FC50, FC80, and FH100 were propagated and used as vaccine antigens. Two inactivated feline virus vaccines, Rehydragel-adjuvanted vaccine (FRAV) and Cabopol-adjuvanted vaccine (FCAV) were prepared and inoculated into mice and guinea pigs. Humoral immune responses were measured using hemagglutination inhibition (HI) for FPV and virus-neutralizing antibody (VNA) for two FCVs and FHV-1 tests. Serial passages in CRFK cells resulted in increase in titers of FPV and two FCVs but not FHV-1 The FCAV induced higher mean HI and VNA titers than the FRAV in guinea pigs; therefore, the FCAV was selected. Cats inoculated with FCAV developed a mean HI titer of 259.9 against FPV, and VNA titers of 64, 256, and 3.2 against FCV17D03, FCV17D283, and FHV191071, respectively. Therefore, cats inoculated with the FCAV showed a considerable immune response after receiving a booster vaccination.

Rabies neutralizing antibody titers in Korean dogs and cats intended for overseas travel

Animals imported from abroad are a cause of rabies outbreaks in many countries. Therefore, rabies serology testing for dogs and cats traveling abroad is an important measure to reduce the incidence of rabies. Rabies virus antibodies were measured in sera collected from 2,367 dogs and 894 cats between 2017 and 2021. A serum sample with a value of 0.5 IU/mL or higher was considered a pass. The overall pass rates for rabies virus were 96.4% in dogs and 98.4% in cats. The mean rabies virus neutralization assay titers were higher in cats than in dogs and in female than in male animals. According to age, 6-year-old dogs and 9-year-old cats had the highest virus neutralization assay titers. Of the failure cases, 53.0% (53/100) were dogs or cats less than 1 year old. Although the average failure rates in dogs and cats were low at 3.5% and 1.6%, respectively, the factors influencing failure were age and vaccine manufacturer. Therefore, it is necessary to observe the vaccination interval and timing of blood collection after boosting.

Evaluation of commercial immunochromatography test kits for diagnosing canine parvovirus

Rapid immunochromatography test (RICT) kits are commonly used for the diagnosis of canine parvovirus (CPV) because of their rapid turnaround time, simplicity, and ease of use. However, the potential for cross-reactivity and low sensitivity can yield false-positive or false-negative results. There are 4 genotypes of CPV. Therefore, evaluating the performance and reliability of RICT kits for CPV detection is essential to ensure accurate diagnosis for appropriate treatment. In this study, we evaluated the performance of commercial RICT kits in the diagnosis of all CPV genotypes. The cross-reactivity of 6 commercial RICT kits was evaluated using 8 dog-related viruses and 4 bacterial strains. The limit of detection (LOD) was measured for the 4 genotypes of CPV and feline panleukopenia virus. The tested kits showed no cross-reactivity with the 8 dog-related viruses or 4 bacteria. Most RICT kits showed strong positive results for CPV-2 variants (CPV-2a, CPV-2b, and CPV-2c). However, the 2 kits produced negative results for CPV-2 or CPV-2b at a titer of 105 FAID50/mL, which may result in inaccurate diagnoses. Therefore, some kits need to improve their LOD by increasing their binding efficiency to detect all CPV genotypes.

Comparison of Veno-arterial Extracorporeal Membrane Oxygenation Configurations for Patients Listed for Heart Transplantation

Background and Objectives@#Veno-arterial extracorporeal membrane oxygenation (VAECMO) as a bridge to eventual heart transplantation (HT) is increasingly used worldwide.However, the effect of different VA-ECMO types on HT outcomes remains unclear. @*Methods@#This was a retrospective observational study of 111 patients receiving VA-ECMO and awaiting HT. We assessed 3 ECMO configuration groups: peripheral (n=76), central (n=12), and peripheral to central ECMO conversion (n=23). Cox proportional hazards regression and landmark analysis were conducted to analyze the effect of the ECMO configuration on HT and in-hospital mortality rates. We also evaluated adverse events during ECMO support. @*Results@#HT was performed in the peripheral (n=48, 63.2%), central (n=10, 83.3%), and conversion (n=11, 47.8%) ECMO groups (p=0.133) with a median interval of 10.5, 16, and 30 days, respectively (p<0.001). The cumulative incidence of HT was significantly lower in the conversion group (hazard ratio, 0.292, 95% confidence interval, 0.145–0.586, p=0.001).However, there was no difference in in-hospital mortality (log-rank p=0.433). In the landmark analysis, in-hospital mortality did not differ significantly among the 3 groups.Although we did note a trend toward lower HT in the conversion group, the difference was not statistically significant. Surgical site bleeding occurred mainly in the central, while limb ischemia occurred mainly in the peripheral groups. @*Conclusions@#We suggest that if patients are being stably supported with their initial ECMO configuration, whether it is central or peripheral, it should be maintained, and ECMO conversion should only be cautiously performed when necessary.