Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Objective: We aimed to identify the main oncogenic pathway by histological type of ovarian cancer based on Next-generation sequencing (NGS) test and to determine the correlation with clinical prognosis. Methods: We conducted a retrospective review of 420 patients with ovarian cancer who underwent NGS testing at Asan Medical Center from June 1, 2017, to May 31, 2021. Identified mutations were categorized into seven oncogenic pathways that are most frequently associated with ovarian cancer. Results: The average number of oncogenic pathways involved in each cancer patient was 1.76 (range, 0–6). TP53 mutation was the primary oncogenic pathway in patients with high-grade serous carcinoma (HGSC) (92.8%) and carcinosarcoma (87.5%). MAP kinase signaling was the primary oncogenic pathway in low-grade serous carcinoma (58.3%) and mucinous carcinoma (54.5%). The involvement of more diverse oncogenic pathways has been identified in patients with endometrioid carcinoma and clear cell carcinoma and PI3KAKT-mTOR signaling and SWI/SNF family pathways were the most common in both groups.The involvement of the DNA damage response pathway showed an association with better progression free survival (PFS), but not with overall survival (OS) in patients with HGSC. On the other hand, the involvement of the RTK signaling family pathway showed an association with better OS despite no association with PFS in patients with HGSC. Conclusion The clinical prognosis may be improved by implementing targeted treatment tailored to the patient's genetic profile through NGS. Additional research is needed to determine whether the involvement of the RTK signaling family pathway is indeed associated with better OS and to identify the underlying reasons for this association.

Objectives: Unawareness of hyponatremic risks associated with antidepressant use can lead to irreversible consequences, such as syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Numerous previous studies on antidepressant-induced hyponatremia have reported a significant correlation between hyponatremia and the initiation of antidepressants. Although selective serotonin reuptake inhibitors (SSRIs) are most associated with hyponatremia, there is no consensus regarding the relationship between different classes of antidepressants and hyponatremia. The aim of this study is to investigate the correlation between different classes of antidepressants and hyponatremia by analyzing reported incidence rates and odds ratios (ORs). Methods: This study reviewed literature available in both PubMed and Web of Knowledge using a combination of the search terms “antidepressants,” “hyponatremia,” “inappropriate ADH syndrome,” and “SSRI.” Results: This study included 42 cohort and case-control studies, and more than 100 case reports were reviewed individually. Due to differences in study designs, populations, and definitions of hyponatremia, the reported incidence rate of hyponatremia associated with antidepressant use varied widely, ranging from 0.01% to 40%. Among antidepressant classes, serotonin norepinephrine reuptake inhibitors (SNRIs) exhibited the highest incidence rate (70%). Mirtazapine and tricyclic antidepressants (TCAs) were reported to have a comparatively lower risk of hyponatremia. Specifically, the OR ranged from 1.18 to 4.8 for mirtazapine and from 1.2 to 3.3 for TCAs. Many studies have agreed that geriatric age and concurrent use of diuretics, such as thiazides, are probable risk factors for hyponatremia. Conclusions Although awareness of antidepressant-associated hyponatremia has increased among healthcare providers, including clinicians, there is still no consensus on the extent of risk posed by different classes of antidepressants. Based on the reviewed studies, SNRIs appear to carry a higher risk of hyponatremia compared to other classes of antidepressants.Therefore, clinicians may consider prescribing mirtazapine, which has a lower risk of hyponatremia, as an alternative to SNRIs for certain patient populations—particularly elderly patients and those taking diuretics such as thiazides.

Cutaneous adverse drug reactions are well-documented with psychiatric medications, particularly mood stabilizers, antidepressants, and antipsychotics. Although their overall incidence is relatively low, these reactions can significantly affect treatment adherence and, in rare instances, lead to life-threatening conditions such as Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS). Most psychiatric drug-induced skin reactions are unpredictable and idiosyncratic, typically not dose-dependent. Identified risk factors include female sex, older age, genetic predispositions such as specific human leukocyte antigen (HLA) subtypes, high initial dosing, rapid dose escalation, and the presence of certain comorbidities. Mood stabilizers, particularly lamotrigine and carbamazepine, are most frequently implicated, but antidepressants and antipsychotics are also associated with a broad spectrum of cutaneous manifestations, including pruritus, exanthematous eruptions, urticaria, photosensitivity, pigmentary changes, alopecia, hyperhidrosis, and immune-mediated syndromes. Diagnosis requires careful assessment of the temporal relationship between drug initiation and symptom onset. While most reactions are self-limited and resolve with dose reduction or discontinuation of the offending agent, severe cases require immediate cessation and prompt dermatologic consultation. Management is largely supportive and symptomatic, with systemic or topical therapies used as needed. Clinicians should remain vigilant regarding potential cutaneous side effects of psychiatric medications and implement individualized treatment strategies to minimize harm. Advances in personalized medicine and pharmacogenetics may facilitate better prediction and prevention of these adverse effects.

Objectives: The aim of this study is to identify the prevalence of parasuicide and deliberate suicide attempts in the general population of Korea, as well as their associations with sociodemographic risk factors and mental disorders. Methods: This study utilized data from the 2021 National Mental Health Survey of Korea. The survey was conducted between June and August 2021, involving 5,511 respondents aged 18 to 79 years living in communities. The Korean version of the Composite International Diagnostic Interview (K-CIDI) was used as the survey instrument. Logistic regression analysis was employed for statistical analysis. Results: The prevalence of parasuicide was 1.1%, and that of deliberate suicide attempts was 0.9%. The risk of parasuicide increased among younger age, while no significant associations with other sociodemographic factors were found.The risk of deliberate suicide attempts was associated with being divorced, separated or widowed and low income. Both parasuicide and deliberate suicide attempts were associated with depressive disorders, anxiety disorders, alcohol use disorders and nicotine use disorders. Conclusions The sociodemographic risk factors of parasuicide and deliberate suicide attempts are distinct. This study provides valuable insights into the mental disorder-related traits associated with parasuicide and deliberate suicide attempts, which could be useful in developing future suicide prevention programs.