Subarachnoid Hemorrhage Misdiagnosed as an Acute ST Elevation Myocardial Infarction

Without significant coronary artery stenosis, ischemic electrocardiographic change including ST segment elevation, segmental wall motion abnormality and elevated serum cardiac-specific markers (creatine kinase-MB, Troponin-T) may develop after central nervous system injuries such as subarachnoid, intracranial or subdural hemorrhage. Misdiagnosing these patients as acute myocardial infarction may result in catastrophic outcomes. By reporting a case of a 55-year old female with subarachnoid hemorrhage mimicking acute ST elevation myocardial infarction, we hope to underline that careful attention of neurologic abnormality is critical in making better prognosis

Elevated red cell distribution width is associated with advanced fibrosis in NAFLD

Background/AimsThe red-blood-cell distribution width (RDW) is a newly recognized risk marker in patients with cardiovascular disease, but its role in nonalcoholic fatty liver disease (NAFLD) has not been well defined. The aim of the present study was to determine the association between RDW values and the level of fibrosis in NAFLD according to BARD and FIB-4 scores.MethodsThis study included 24,547 subjects who had been diagnosed with NAFLD based on abdominal ultrasonography and questionnaires about alcohol consumption. The degree of liver fibrosis was determined according to BARD and FIB-4 scores. The association between RDW values and the degree of fibrosis in NAFLD was analyzed retrospectively.ResultsAfter adjusting for age, hemoglobin level, mean corpuscular volume, history of hypertension, history of diabetes, and high-sensitivity C-reactive protein, the RDW values were 12.61±0.41% (mean±SD), 12.70±0.70%, 12.77±0.62%, 12.87±0.82%, and 13.25±0.90% for those with BARD scores of 0, 1, 2, 3, and 4, respectively, and 12.71±0.72%, 12.79±0.66%, and 13.23±1.52% for those with FIB-4 scores of <1.30, 1.31-2.66, and ≥2.67, respectively (P<0.05). The prevalence of advanced fibrosis (BARD score of 24 and FIB-4 score of ≥1.3) increased with the RDW [BARD score: 51.1% in quartile 1 (Q1) vs. 63.6% in Q4; FIB-4 score: 6.9% in Q1 vs. 10.5% in Q4; P<0.001]. After adjustments, the odds ratio of having advanced fibrosis for those in Q4 compared to Q1 were 1.76 (95%CI=1.55-2.00, P<0.001) relative to BARD score and 1.69 (95%CI=1.52-1.98, P<0.001) relative to FIB-4 score.ConclusionsElevated RDW is independently associated with advanced fibrosis in NAFLD

Strategy for the Prediction of Typhoon Wind and Storm Surge Height Using the Parametric Typhoon Model: Case Study for Hinnamnor in 2022

The parametric typhoon model is a powerful typhoon prediction and reproduction tool with advantages in accuracy, and computational speed. To simulate typhoons’ horizontal features, the longitude and latitude of the typhoon center, central pressure, radius of maximum wind speed (Rmax), and background states (such as surface air pressure and wind speed) are required. When a typhoon approaches or is predicted to affect Korea, the Korea Meteorological Agency (KMA) notifies the above-mentioned parameters, except for the Rmax and background state. The contribution of background wind and pressure is not very significant; however, Rmax is essential for calculating typhoon winds. Therefore, the optimized Rmax for the typhoons over the past five years was estimated at each time step compared with the in situ wind observation record. After that, a fifth-order polynomial fitting was performed between the estimated Rmax and the radius of strong wind (RSW; >15 m/s) provided by the KMA. Finally, the Rmax was calculated from the RSW via the empirical equation, and the horizontal fields of typhoon Hinnamnor (2211) were reproduced using a parametric model. Furthermore, the ocean storm surge height was adequately simulated in the surge model