Associations Between Phthalate, Eosinophil, and Aeroallergen Sensitization in Schoolchildren

Background@#Phthalates and bisphenol A (BPA) are endocrine-disrupting chemicals and may cause immunological disorders in children. Therefore, according to the region, we investigated urinary phthalates and BPA levels and the relationship between urinary phthalate, aeroallergen sensitization, and eosinophil count during the coronavirus disease 2019 pandemic. @*Methods@#In total, 203 schoolchildren (134 residential and 69 industrial) aged 7–10 years were enrolled between July 2021 and July 2022. The BPA, metabolites of four high-molecularweight phthalates (Σ4HMWP) and three low-molecular-weight phthalates (Σ3LMWP), were measured in the urine samples. Total eosinophil count and transepidermal water loss (TEWL) were also measured along with the skin prick test. @*Results@#The two groups had no differences in terms of BPA. The industrial group had significantly more plastic container usage, and there was a difference in the Σ3LMWP (P < 0.001) between the two groups but no difference in the Σ4HMWP (P = 0.234). The quartiles of urinary Σ4HMWP and Σ3LMWP (P < were not associated with the total eosinophil count, vitamin D level, or TEWL. After adjusting for cofactors, the quartiles of urinary Σ4HMWP and Σ3LMWP were significantly associated with total eosinophil count (P < 0.001) but not with aeroallergen sensitization or vitamin D. @*Conclusion@#Exposure to phthalates was significantly associated with eosinophil count but not with aeroallergen sensitization or vitamin D. Therefore, reducing the use of plastic containers may effectively prevent exposure to phthalates and reduce Th2 cell-mediated inflammation in children.

Role of SUMO-Specific Protease 2 in Leptin-Induced Fatty Acid Metabolism in White Adipocytes

Background@#Leptin is a 16-kDa fat-derived hormone with a primary role in controlling adipose tissue levels. Leptin increases fatty acid oxidation (FAO) acutely through adenosine monophosphate-activated protein kinase (AMPK) and on delay through the SUMO-specific protease 2 (SENP2)–peroxisome proliferator-activated receptor δ/γ (PPARδ/γ) pathway in skeletal muscle. Leptin also directly increases FAO and decreases lipogenesis in adipocytes; however, the mechanism behind these effects remains unknown. Here, we investigated the role of SENP2 in the regulation of fatty acid metabolism by leptin in adipocytes and white adipose tissues. @*Methods@#The effects of leptin mediated by SENP2 on fatty acid metabolism were tested by siRNA-mediated knockdown in 3T3-L1 adipocytes. The role of SENP2 was confirmed in vivo using adipocyte-specific Senp2 knockout (Senp2-aKO) mice. We revealed the molecular mechanism involved in the leptin-induced transcriptional regulation of carnitine palmitoyl transferase 1b (Cpt1b) and long-chain acyl-coenzyme A synthetase 1 (Acsl1) using transfection/reporter assays and chromatin immunoprecipitation. @*Results@#SENP2 mediated the increased expression of FAO-associated enzymes, CPT1b and ACSL1, which peaked 24 hours after leptin treatment in adipocytes. In contrast, leptin stimulated FAO through AMPK during the initial several hours after treatment. In white adipose tissues, FAO and mRNA levels of Cpt1b and Acsl1 were increased by 2-fold 24 hours after leptin injection in control mice but not in Senp2-aKO mice. Leptin increased PPARα binding to the Cpt1b and Acsl1 promoters in adipocytes through SENP2. @*Conclusion@#These results suggest that the SENP2-PPARα pathway plays an important role in leptin-induced FAO in white adipocytes.

Feasibility and reliability of various morphologic features on magnetic resonance imaging for iliotibial band friction syndrome

Background@#To evaluate the feasibility, inter-reader reliability, and intra-reader reliability for various morphological features reported to be related to iliotibial band friction syndrome (ITBFS) on knee magnetic resonance imaging (MRI). @*Methods@#A total of 145 patients with a clinical diagnosis and knee MRI findings consistent with ITBFS were included in the “study group” and 232 patients without knee pathology on both physical examination and MRI were included in the “control group”. Various morphologic features on knee MRI were assessed including the patella shape, patella height, lateral epicondyle anterior-posterior (AP) width, lateral epicondyle height, ITB diameter (ITB-d), and ITB area (ITB-a). @*Results@#Patients in the study group had significantly higher lateral epicondyle height (13.9 mm vs. 12.92 mm, P = 0.003), ITB-d (2.9 mm vs. 2.0 mm, P = 0.022), and ITB-a (38.5 mm2 vs. 23.8 mm2 , P < 0.001) than the control group. ITB-a showed higher area under the curve index (0.849 with 74.1% sensitivity and 72.4% specificity at a 30.3 mm2 cutoff) than ITB-d (0.710 with 70.8% sensitivity and 61.2% specificity at 2.4 mm cutoff) and lateral epicondyle height (0.776 with 72.4% sensitivity and 67.8% specificity at 13.4 mm cutoff). However, only the interreader agreement for ITB-a (intraclass correlation coefficient = 0.65) was moderate, while the agreements for other morphologic features were good or excellent. @*Conclusions@#Lateral epicondyle height seems to be a reliable and feasible morphologic feature for diagnosis of ITBFS.

Nutrient Intake and Depression Based on Sleep Duration in Adult Women -Analysis of the Korea National Health and Nutrition Examination Survey, 2016 and 2018 Data-

This study evaluated the nutrient adequacy ratio (NAR) and depression based on the sleep duration of adult women using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018. A total of 4,507 subjects were divided into two groups: sleep hours＜7 (lack of sleep, LS) and 7≤ sleep hours (normal sleep, NS). For a more detailed analysis, the subjects were further divided into normal sleep with no depression (NSND) and lack of sleep with depression (LSWD) groups. When compared with NS group, the nutrient intake of the LS group was observed to be higher in carbohydrates (P＜0.05) and thiamine (P＜0.01), but had a significantly lower mean nutrient adequacy ratio (P＜0.05). Also, the LS group showed a higher frequency of early menopause (P＜0.001) and depression (P＜0.05) than the NS group. In the analysis of anthropometry and blood parameters of the subjects based on their sleep duration, the LS group showed a lower body mass index (BMI, P＜0.05), lower blood creatinine (P＜0.01), glycated hemoglobin (P＜0.05), and high-density lipoprotein (HDL) cholesterol (P＜0.01) levels adjusted by age and menopause than the NS group. When compared to the NSND group, the LSWD group had a lower intake of cholesterol (P＜0.05), vitamin A (P＜0.05), vitamin C (P＜0.05), and folic acid (P＜0.05). There was no variation in the menopausal status, NAR, and mean nutrient adequacy ratio between the NSND and LSWD groups. However, there were differences in total blood cholesterol (P＜0.05) and depression based on sleep duration. Apart from nutritional status, differences in BMI and blood parameters were observed based on sleep duration.

NLRP3 Inflammasome as Therapeutic Targets in Inflammatory Diseases

Innate immunity is a first line defence system in the body which is for sensing signals of danger such as pathogenic microbes or host-derived signals of cellular stress. Pattern recognition receptors (PRR’s), which present in the cell memebrane, are suspect the infection through pathogen-associated molecular patterns (PAMP), and activate innate immunity with response to promote inflammation via inflammatory cells such as macrophages and neutrophils, and cytokines. Inflammasome are protein complexes which are part of innate immunity in inflammation to remove pathogens and repair damaged tissues. What is the important role of inflammation in disease? In this review, we are focused on the action mechanism of NLRP3 inflammasome in inflammatory diseases such as asthma, atopic dermatitis, and sepsis.

Effect of the Computerized Emergency Consultation System on Communication Between Medical Staff for Emergency Care / 의료커뮤니케이션

Purpose@#: In emergency department(ED), emergency consultation is often omitted or delayed, resulting in an increase of the length of stay for patients. The present study investigated the emergency consultation computerized system designed for prompt and accurate communication can shorten the time for consultation care. In addition, we tried to confirm how users’ satisfaction with communication for emergency consultation changed before and after using the system. @*Methods@#: We divided the period from arrival to exit of the emergency department into 4 stages, and the time taken for each stage was measured. In addition, the present study conducted a satisfaction survey on the convenience and accuracy of communication among users. @*Results@#: After using the computerized system, the median value of time for emergency consultation treatment decreased significantly from 78 minutes to 39 minutes (p<0.001). In terms of communication convenience, more than two-thirds of the users responded positively. @*Conclusion@#: The system that computerized the initial communication shortened the time required for emergency consultation and increased satisfaction in terms of convenience of communication between medical staff.

The Association between Serum Uric Acid Levels and the Nutrients Adequacy Ratio among Male Adult Koreans -Based on the 2016∼2019 Korea National Health and Nutrition Examination Survey-

This study evaluated the correlation between serum uric acid level and the nutrients adequacy ratio (NAR) using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016∼2019. This is a cross-sectional study in which 6,579 Korean male adults were divided into quartiles according to their uric acid levels. All analyses were performed with adjusted age. Uric acid decreased as the age increased from the age group 19∼29 years to 30∼49 years and then to 50∼64 years. Interquartile results of serum uric acid levels showed that increases in the serum uric acid levels were associated with decreases in LDL-cholesterol (P＜0.01), triglycerides (P＜0.001), body weight (P＜0.001), waist circumference (P＜0.001), body mass index (P＜0.001), systolic blood pressure (SBP) (P＜0.001), diastolic blood pressure (DBP) (P＜0.001). However, uric acid levels decreased with an increase in HDL cholesterol (P＜0.001). The analysis of the NARs according to the quartiles of serum uric acid levels in men showed that an increase in serum uric acid levels was associated with a decrease in the NAR levels of dietary fiber (P＜0.001), calcium (P＜0.001), and folic acid (P＜0.001).

A systematic review of translation and experimental studies on internal anal sphincter for fecal incontinence

The complexity in the molecular mechanism of the internal anal sphincter (IAS) limits preclinical or clinical outcomes of fecal incontinence (FI) treatment. So far, there are no systematic reviews of IAS translation and experimental studies that have been reported. This systematic review aims to provide a comprehensive understanding of IAS critical role in FI. Previous studies revealed the key pathway for basal tone and relaxation of IAS in different properties as follows; calcium, Rho-associated, coiled-coil containing serine/threonine kinase, aging-associated IAS dysfunction, oxidative stress, renin-angiotensin-aldosterone, cyclooxygenase, and inhibitory neurotransmitters. Previous studies have reported improved functional outcomes of cellular treatment for regeneration of dysfunctional IAS, using various stem cells, but did not demonstrate the interrelationship between those results and basal tone or relaxation-related molecular pathway of IAS. Furthermore, these results have lower specificity for IAS-incontinence due to the included external anal sphincter or nerve injury regardless of the cell type. An acellular approach using bioengineered IAS showed a physiologic response of basal tone and relaxation response similar to human IAS. However, in both cellular and acellular approaches, the lack of human IAS data still hampers clinical application. Therefore, the IAS regeneration presents more challenges and warrants more advances.

A Comparative Study of an Anti-Thrombotic Small-Diameter Vascular Graft with Commercially Available e-PTFE Graft in a Porcine Carotid Model

BACKGROUND@#We have designed a reinforced drug-loaded vascular graft composed of polycaprolactone (PCL) and polydioxanone (PDO) via a combination of electrospinning/3D printing approaches. To evaluate its potential for clinical application, we compared the in vivo blood compatibility and performance of PCL/PDO ? 10%DY grafts doped with an antithrombotic drug (dipyridamole) with a commercial expanded polytetrafluoroethylene (e-PTFE) graft in a porcine model. @*METHODS@#A total of 10 pigs (weight: 25–35 kg) were used in this study. We made a new 5-mm graft with PCL/PDO composite nanofiber via the electrospinning technique. We simultaneously implanted a commercially available e-PTFE graft (n = 5) and our PCL/PDO ? 10%DY graft (n = 5) into the carotid arteries of the pigs. No anticoagulant/antiplatelet agent was administered during the follow-up period, and ultrasonography was performed weekly to confirm the patency of the two grafts in vivo. Four weeks later, we explanted and compared the performance of the two grafts by histological analysis and scanning electron microscopy (SEM). @*RESULTS@#No complications, such as sweating on the graft or significant bleeding from the needle hole site, were seen in the PCL/PDO ? 10%DY graft immediately after implantation. Serial ultrasonographic examination and immunohistochemical analysis demonstrated that PCL/PDO ? 10%DY grafts showed normal physiological blood flow and minimal lumen reduction, and pulsed synchronously with the native artery at 4 weeks after implantation. However, all e-PTFE grafts occluded within the study period. The luminal surface of the PCL/PDO ? 10%DY graft in the transitional zone was fully covered with endothelial cells as observed by SEM. @*CONCLUSION@#The PCL/PDO ? 10%DY graft was well tolerated, and no adverse tissue reaction was observed in porcine carotid models during the short-term follow-up. Colonization of the graft by host endothelial and smooth muscle cells coupled with substantial extracellular matrix production marked the regenerative capability. Thus, this material may be an ideal substitute for vascular reconstruction and bypass surgeries. Long-term observations will be necessary to determine the anti-thrombotic and remodeling potential of this device.

The effects of medical students’ self-oriented perfectionism on academic procrastination: the mediating effect of fear of failure / 한국의학교육

Purpose@#Based on the logic that self-oriented perfectionism (SOP) is one of the most well-established predictors of academic procrastination (AP), we predicted that fear of failure (FF) would mediate the association between SOP and AP. The purpose of this study is to investigate the mediating effect of FF on the influence of SOP on AP in medical students. @*Methods@#A total of 156 undergraduate medical students completed a battery of questionnaires. This study is an analysis of cross-sectional data obtained through an offline survey. The self-report questionnaires assessed demographics and psychological scales, including the Multidimensional Perfectionism Scale, Performance Failure Appraisal Inventory, and Aitken Procrastination Inventory. The data were analyzed by descriptive statistics, correlations analysis, and multiple regression analyses using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA). @*Results@#SOP had a direct negative influence on AP (β=-0.420, p<0.001). Also, SOP had a significant indirect effect on AP through FF (β=0.0393; 95% confidence interval, 0.040–0.0936). These results indicated that the FF partially mediates the relationship between SOP and AP. @*Conclusion@#Although SOP among medical students might play an adaptive role to lessen AP, in cases FF gets higher, SOP could have opposing effects via the mediating effect of FF, leading to an actual increase in AP. Attempts to deal with the FF among medical students should be made for better academic achievements.

Effects of circadian blood pressure patterns on development of microvascular complications in pediatric patients with type 1 diabetes mellitus

Purpose@#The effects of circadian blood pressure (BP) alterations on the development and progression of microvascular complications in type 1 diabetes mellitus (T1DM) patients are unknown. We evaluated the effects of circadian BP alterations with development of microvascular complications during follow-up with patients with childhood-onset T1DM. @*Methods@#We investigated the medical records of 81 pediatric patients with T1DM who underwent 24-hour ambulatory BP monitoring (ABPM) between January 2009 and February 2010. @*Results@#Mean age at diagnosis and ABPM evaluation was 8.0±3.9 and 15.6±2.4 years, respectively. Hypertension (daytime, nighttime, and 24-hour mean hypertension) data were available in 42 patients. During the 8 years of follow-up after ABPM, microvascular complications occurred in 8 patients (diabetic retinopathy [DR] alone in 5, microalbuminuria alone in 2, and both in 1), of whom 7 had nondipper BP. Nighttime diastolic BP, nighttime mean arterial pressure, and glycated hemoglobin A (HbA1c) level were higher in patients with DR than in those without DR (P<0.05 for all). Daytime or nighttime BP and presence of dipper BP were not related to microvascular complications, but diabetic microvascular complications were more likely to occur in patients with an older age at diagnosis and higher HbA1c level. The proportion of patients with DR was higher in those with nondipper hypertension (83.3%) compared with dipper and nondipper normotension (0% and 16.7%, respectively; P=0.021). @*Conclusion@#As a predictor of microvascular complications, nondipper hypertension was not significant. Glycemic control rather than nondipper hypertension is the predominant factor determining DR in T1DM patients.

New conceptual approaches toward dentin regeneration using the drug repositioning strategy with Wnt signaling pathways

This study summarizes the recent cutting-edge approaches for dentin regeneration that still do not offer adequate solutions. Tertiary dentin is formed when odontoblasts are directly affected by various stimuli. Recent preclinical studies have reported that stimulation of the Wnt/β-catenin signaling pathway could facilitate the formation of reparative dentin and thereby aid in the structural and functional development of the tertiary dentin. A range of signaling pathways, including the Wnt/β-catenin pathway, is activated when dental tissues are damaged and the pulp is exposed. The application of small molecules for dentin regeneration has been suggested as a drug repositioning approach. This study reviews the role of Wnt signaling in tooth formation, particularly dentin formation and dentin regeneration. In addition, the application of the drug repositioning strategy to facilitate the development of new drugs for dentin regeneration has been discussed in this study.

Voluntary peer-mentoring program for undergraduate medical students: exploring the experiences of mentors and mentees / 한국의학교육

Purpose@#We aimed to examine the participants’ satisfaction and evaluation of the program’s appropriateness, outcomes and benefits from participants’ perspectives and gather suggestions from students to improve peer mentor programs. @*Methods@#From 2016 to 2018, 67 mentees and mentors participated in the peer mentoring program. All program participants were asked to participate in the survey, and the respondents were invited to focus group interview (FGI). Quantitative data was collected from the survey questionnaire. Qualitative data was gathered from the open-end questions in the survey and supplemented from additional semi-structured FGIs. The interview data were analyzed using qualitative content analysis. @*Results@#Nineteen responded to the survey, and six participated in the further FGI. Qualitative data contained outcomes and mutual benefits, factors for mentoring success, negative experiences, and suggestions for improvement. Especially factors for mentoring success consisted of various methods of studying assistance, motivation, autonomy, responsibility, emotional support, and relational bonding as important topics concerning mentor-mentee experiences. The satisfaction scores about the program appropriateness, others’ attitudes, program implementation, ranged from 3.5 to 3.9 (5-point Likert scores) without significant difference between mentors and mentees. The only negative experience reported by a mentee was feeling the pressure. Specific guidelines on program implementation, pre-education for mentees, appropriate matching, and mentees’ clear purpose and spontaneity were suggested to improve the program. @*Conclusion@#Participants were generally satisfied with the peer mentoring program, gaining academic and non-academic achievements, including emotional support and improved relationships. Furthermore, we expect that this program can be improved with participants’ suggestions in the future.

Comparison of CT Volumetry and RECIST to Predict the Treatment Response and Overall Survival in Gastric Cancer Liver Metastases

Purpose@#The aim of this study was to compare the diameter and volume of liver metastases on CT images in relation to overall survival and tumor response in patients with gastric cancer liver metastases (GCLM) treated with chemotherapy. @*Materials and Methods@#We recruited 43 patients with GCLM who underwent chemotherapy as a first-line treatment. We performed a three-dimensional quantification of the metastases for each patient. An independent survival analysis using the Response Evaluation Criteria in Solid Tumors (RECIST) was performed and compared to volumetric measurements. Overall survival was evaluated using Kaplan-Meier analysis and compared using Cox proportional hazard ratios following univariate analyses. @*Results@#When patients were classified as responders or non-responders based on volumetric criteria, the median overall survival was 23.6 months [95% confidence interval (CI), 8.63–38.57] and 7.6 months (95% CI, 3.78–11.42), respectively (p = 0.039). The volumetric analysis and RECIST of the non-progressing and progressing groups showed similar results based on the Kaplan-Meier method (p = 0.006) and the Cox proportional hazard model (p = 0.008). @*Conclusion@#Volumetric assessment of liver metastases could be an alternative predictor of overall survival for patients with GCLM treated with chemotherapy.

New conceptual approaches toward dentin regeneration using the drug repositioning strategy with Wnt signaling pathways

This study summarizes the recent cutting-edge approaches for dentin regeneration that still do not offer adequate solutions. Tertiary dentin is formed when odontoblasts are directly affected by various stimuli. Recent preclinical studies have reported that stimulation of the Wnt/β-catenin signaling pathway could facilitate the formation of reparative dentin and thereby aid in the structural and functional development of the tertiary dentin. A range of signaling pathways, including the Wnt/β-catenin pathway, is activated when dental tissues are damaged and the pulp is exposed. The application of small molecules for dentin regeneration has been suggested as a drug repositioning approach. This study reviews the role of Wnt signaling in tooth formation, particularly dentin formation and dentin regeneration. In addition, the application of the drug repositioning strategy to facilitate the development of new drugs for dentin regeneration has been discussed in this study.

Effectiveness of Integrated Change Model-based Smoking Cessation Program for High School Students / 기본간호학회지

Purpose@#The purposes of this study were to develop and to evaluate the effectiveness of the I-change model-based smoking cessation program for vocational high school students. @*Methods@#A non-equivalent control group pretest-posttest design was conducted. Fifty seven participants from a vocational high school in U city, South Korea participated in the study which was done during March and April 2019. The I-change model-based smoking cessation programs was developed focusing on enhancing awareness, motivation, and ability to stop smoking for use by high school students. The experimental group completed 8 sessions of the I-change model-based smoking cessation program over 4 weeks, while the control group participated in the general school smoking cessation program. Data were analyzed using x2 test, independent t-test, Mann-Whitney U test and ANCOVA with the IBM SPSS 25.0 program. @*Results@#After the intervention, the experimental group demonstrated significantly higher levels of awareness about smoking cessation and self-efficacy, better attitude toward cons of smoking, and more change in the stage of behavior than the control group. There was no significant difference in attitude toward pros of smoking between the two groups. @*Conclusion@#The I-change model-based smoking cessation program is an effective intervention to improve motivation and change in the stage of behavior for adolescents in vocational high schools. The program will contribute to health education for smoking cessation in vocational high schools.

Penicillium ulleungdoense sp. nov. from Ulleung Island in Korea

In a study of the fungal diversity on Ulleung Island in Korea, three novel strains of Penicillium were isolated. Different sites on Ulleung Island were selected for collecting endophytic fungi, and three endophytic fungal strains showed unique morphological characteristics. DNA sequence of the internal transcribed spacer, β-tubulin, calmodulin, and RNA polymerase II second largest subunit regions of the strains were analyzed and they showed unique taxonomic position from the other species of Penicillium section Sclerotiora. The new strains were named Penicillium ulleungdoense sp. nov. As the novel endophytic Penicillium taxa were discovered in a unique environment, the data could be meaningful for understanding the geographical distribution of Ascomycetes on Ulleung Island.

Impact of Nursing Work Environment on Nurses’ Perception of Just Culture

Background@#The purpose of this study is to identify the factors influencing nurses' perception of just culture, and to provide basic data for the establishment of just culture. @*Methods@#A questionnaire survey was conducted from April 8, 2020 to April 23, 2020 for 168 nurses at hospital in Seoul. The research tools were Petschonek’s JCAT, modified by the researchers and Korean version of practice environment scale of nursing work index (K-PES-NWI). @*Results@#The average age of the participants was 30.5 years, and total clinical career was 7.10 years. The perception of nursing work environment and just culture perception were 2.91±0.50 out of 5 and 4.91±0.72 out of 7, respectively. Through regression analysis with 33.0% of accountability, it was found that the perception of just culture was associated with nursing work environment (β=0.726, P<0.001). @*Conclusions@#Study findings suggest that intervention for the improvement of nursing work environment can be effective to increase the perception of just culture, additionally, the program to improve just culture perception should be developed and applied, and verify its effectiveness.

Nutrient Intake Status of College Students Based on Their Consumption of Black Beans

This study analyzed the intake of calories and nutrients based on the consumption of black beans. The survey was conducted on 124 college students (male: 42, female: 82), of whom 63.7% (79 students) were consumers of black beans. The calorie intake of the black bean intake group (1599.81±555.48 kcal) was significantly higher than that of the non-black bean intake group (1259.99±507.58 kcal) (P＜0.01). The black bean intake group also showed a significantly higher intake of crude protein (P＜0.05), plant protein (P＜0.01), animal protein (P＜0.05), crude fiber (P＜0.001), plant calcium (P＜0.001), plant iron (P＜0.001), zinc (P＜0.01), vitamin B 2 (P＜0.01), vitamin C (P＜0.01), vitamin E (P＜0.01) and folic acid (P＜0.001) compared to the non-black bean intake group. There was a positive correlation between the frequency of black bean intake and crude fiber (P＜0.05), plant calcium (P＜0.05), plant iron (P＜0.05), and folic acid (P＜0.05). Overall, the black bean intake group was more likely to eat black sesame 13.82 times (95% CI=5.37, 35.55), white beans 10.79 times (95% CI=3.53, 33.02), mung beans 7.22 times (95% CI=2.58, 20.23), and brown rice 4.72 times (95% CI=1.88, 11.84), than the non-black bean intake group. In conclusion, we believe that black beans constitute a vital food ingredient that is necessary to provide Korean college students with a well-balanced diet.

Hyperammonemic Encephalopathy Mimicking Ornithine Transcarbamylase Deficiency in Fibrolamellar Hepatocellular Carcinoma: Successful Treatment with Continuous Venovenous Hemofiltration and Ammonia Scavengers / Journal of the Korean Cancer Association, 대한암학회지

Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare liver cancer affecting adolescents and young adults without any pre existing liver disease. Hyperammonemic encephalopathy (HAE) is a serious paraneoplastic syndrome, and several cases of HAE have been reported in patients with FLHCC. This condition is rare; hence, there are currently no management guidelines for cancer-related HAE. Herein, we report a case of an 18-year-old man with advanced FLHCC who developed HAE during the first course of chemotherapy consisting of cisplatin, doxorubicin, 5-fluorouracil, and interferon-α. He was successfully treated with continuous venovenous hemofiltration, sodium benzoate, sodium phenylbutyrate, and amino acid supplementation for HAE. After the second course of chemotherapy, he underwent surgery, and thereafter, his ammonia levels were normal without any ammonia scavenger therapy. Treatments for HAE described here will be helpful for this rare, but serious metabolic complication of FLHCC and could partially applied to HAE related to any malignancies.