Arterial thrombosis remains a leading cause of cardiovascular morbidity and mortality despite widespread use of dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors. Although these agents reduce ischemic events, their efficacy is counterbalanced by dose-dependent bleeding and their inability to distinguish pathological platelet activation from physiological hemostasis.Recent advances in platelet biology have shifted therapeutic development toward hemostasis-sparing antiplatelet strategies— approaches designed to selectively inhibit thrombosis while preserving baseline hemostatic function. These strategies target upstream adhesion receptors (GPVI, GPIb–vWF, CLEC-2) and receptor-proximal intracellular signaling nodes (SYK, BTK, PI3Kβ, PLCγ2, NADPH oxidases) that are preferentially engaged under high-shear or strongly prothrombotic conditions. Early-phase clinical and translational studies of such agents demonstrate antithrombotic efficacy with minimal impact on bleeding time, supporting their mechanistic selectivity. In parallel, contemporary clinical practice increasingly utilizes individualized risk assessment, platelet function testing, and genetic profiling to tailor treatment intensity. This integration of mechanism-selective agents with patient-specific risk evaluation forms the basis of precision-based thrombosis prevention, a framework aimed at aligning the duration and depth of platelet inhibition with the dynamic balance between ischemic and bleeding risk. Together, these developments mark a paradigm shift from broad platelet suppression toward rational, context-adaptive, and safer antiplatelet therapy.

Activation of osteoclast and inactivation of osteoblast result in loss of bone mass with bone resorption, leading to the pathological progression of osteoporosis. The receptor activator of NF-κB ligand (RANKL) is a member of the TNF superfamily, and is a key mediator of osteoclast differentiation. A flavanone glycoside isolated from the fruit of Poncirus trifoliata, poncirin has anti-allergic, hypocholesterolemic, anti-inflammatory and anti-platelet activities. The present study investigates the effect of poncirin on osteoclast differentiation of RANKL-stimulated RAW264.7 cells. We observed reduced formation of RANKL-stimulated TRAP-positive multinucleated cells (a morphological feature of osteoclasts) after poncirin exposure. Real-time qPCR analysis showed suppression of the RANKL-mediated induction of key osteoclastogenic molecules such as NFATc1, TRAP, c-Fos, MMP9 and cathepsin K after poncirin treatment. Poncirin also inhibited the RANKL-mediated activation of NF-κB and, notably, JNK, without changes in ERK and p38 expression in RAW264.7 cells. Furthermore, we assessed the in vivo efficacy of poncirin in the lipopolysaccharide (LPS)-induced bone erosion model. Evaluating the micro-CT of femurs revealed that bone erosion in poncirin treated mice was markedly attenuated. Our results indicate that poncirin exerts anti-osteoclastic effects in vitro and in vivo by suppressing osteoclast differentiation. We believe that poncirin is a promising candidate for inflammatory bone loss therapeutics.

A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.
Abdominal Abscess/complications/radiography ; Adult ; Aged ; Aged, 80 and over ; Appendicitis/complications/radiography ; Colitis, Ischemic/complications/radiography ; Colon/*radiography ; Colonic Diseases/complications/radiography ; Colonic Neoplasms/*complications/*radiography ; Female ; Humans ; Intestinal Diseases/*complications/*radiography ; Intestinal Obstruction/complications/radiography ; Intussusception/complications/radiography ; Male ; Middle Aged ; Tomography, X-Ray Computed/*methods

Aged ; Breast Neoplasms ; diagnosis ; Colonic Neoplasms ; diagnosis ; Female ; Humans ; Liver Neoplasms ; diagnosis ; Lung Neoplasms ; diagnosis ; Neoplasms, Multiple Primary ; diagnosis ; Stomach Neoplasms ; diagnosis

In order to determine the current infection status of pond smelts, Hypomesus olidus, and other freshwater fishes with trematode metacercariae, a total of 4,861 pond smelts and 18 other freshwater fishes, collected from the Soyang and Uiam Lakes in Gangwon-do, the Unam Lake in Jeollabuk-do, the Jangseong Lake in Jeollanam-do, the Uirim-ji (lake) in Chungcheongbuk-do, and the Andong Lake in Gyeongsangbuk-do, were individually digested with 1% pepsin-HCl and examined under a dissecting microscope. In all pond smelts caught from the 6 lakes, we were unable to detect any known human infectious trematode metacercariae in Korea. However, in other freshwater fishes, such as, Squalidus japonicus coreanus (Unam Lake), and Zacco platypus (Jangseong Lake) and Opsariichthys uncirostris amurensis (Jangseong Lake), metacercariae of human-infecting trematodes, i.e., Clonorchis sinensis and Metagonimus sp. were detected, respectively.
Trematode Infections/*veterinary ; Osmeriformes/*parasitology ; Korea ; Humans ; Fresh Water ; Fish Diseases/*parasitology ; Animals

BACKGROUND: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: From January 1998 to December1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication, success rate and patient's satisfaction were evaluated. RESULTS: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication, bladder perforation occurred in one patient(2.4%), residual urine sensation developed in seven patients(16.7%). and suprapubic pain was complained in five patients(11.9%). which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instablility were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. CONCLUSION: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence. but a longer follow-up is necessary to determine long term effect.
Catheters ; Cholinergic Antagonists ; Drainage ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Sensation ; Urinary Bladder ; Urinary Incontinence*

The fibroepithelial polyp of the ureter is a rare, benign tumor. Its pathogenesis is unclear, but most investigators agree that it arises from elements of mesodermal origin within the ureteral wall. Symptoms include hematuria and intermittent flank pain secondary to partial ureteral obstruction. Correct radiologic assessment is crucial to direct surgical management. We report a case of a fibroepithelial polyp of the ureter in a child in whom correct preoperative diagnosis was made by correlating the results of excretory urography, sonography, CT and urine cytology.
Child* ; Diagnosis ; Flank Pain ; Hematuria ; Humans ; Mesoderm ; Polyps* ; Research Personnel ; Ureter* ; Ureteral Obstruction ; Urography

PURPOSE: Korean ginseng (KG) has been used as a general tonic in oriental society. The present study was undertaken to investigate the effect of total saponin (TS), a major extract of KG, and non-saponin components of KG on penile erection for evaluation of the possibility of developing KG as an pharmacological agent. MATERIALS AND METHODS: Strips of rabbit corpus cavernosum were mounted in organ chambers to measure isometric tension, with the treatment of TS and non-saponin components including methanol extracts, ethylacetate extract and H2O extract. We observed the relaxing effect of TS and non-saponin components, which were represented by % relaxation compared to 10-3M sodium nitroprusside-induced relaxation. In adult Sprague Dawley rats, we observed the increase of intracavernous pressure (delta ICP) and duration of tumescence (DT) by intracavernosal injection of TS. RESULTS: TS (1-4mg/cc) significantly relaxed the strips precontracted with phenylephrine (10(-5)M) in dose dependent manner (%relaxation: 5.8-36.7%). Intracavernous injections of TS (0.05mg-3.2mg/0.1cc) induced penile erection (delta ICP: 1.3-21.3mmHg, DT: 0.3-5.2min) in dose dependent manner. The cumulative additions of all non-saponin components at concentrations from 0.5mg/cc to 4mg/cc relaxed the strips in concentration-dependent manner. The maximal relaxing effect were 14.7% in methanol extract, 16.9% in H2O extract, 18.2% in ethylacetate extract. CONCLUSIONS: With the results, ginseng induces penile erection by relaxing corpus cavernosum and suggest that ginseng is not doing its action as a single component but ginseng is doing rather its action as complexes with saponin and non-saponin components.
Adult ; Humans ; Male ; Methanol ; Panax* ; Penile Erection* ; Phenylephrine ; Rats, Sprague-Dawley ; Relaxation ; Saponins ; Sodium

PURPOSE: The present study was undertaken to compare the function of the urinary bladder, reflex changes of the urinary bladder, and bladder outlet, during micturition between mature male and female rats. MATERIALS AND METHODS: Mature male(n=6) and female(n=6) Sprague-Dawley rats weighing 250 to 300gm were used. After each rat was anesthetized with urethane(1g/kga simultaneous recording of the intravesical pressure and voided urinary volume during micturition were recorded. And then, the urethra was ligated placing 4-0 silk tie just distal to the bladder neck. Isovolumetric bladder contractions and urethral pressure were recorded independently. RESULTS: The voided volume and intravesical pressure during micturltion showed no significant differences between mature fema1e and male rats. During reflex bladder contraction, isovolumetric bladder contractions and urethral pressure also showed no significant differences between mature female and male rats. Administration of N-nitro-L-arginine(L-NOARG, 15mg/kg), a nitric oxide synthase inhibitor, intravenously in female rats, reversibly decreased the magnitude(42.5%, p<0.05) and duration(35.4%, p<0.05) of reflex urethral relaxation. There was no effect on reflex urethral relaxation in male rats. Administration of L-NOARG 20mg/kgintravenously in male rats reversibly decreased the magnitude(49.8%, p<0.05) and duration(38.7%, p<0.05) of reflex urethral relaxation. CONCLUSIONS: From the results, it appears that the function of the urinary bladder and the reflex change of the urinary bladder and bladder outlet during micturition showed no significant difference between male and female rats of similar weight. Howerever, the dosage of L-NOARG showed difference of the decreasing level of the magnitude and duration of the urethral relaxation.
Animals ; Female* ; Humans ; Male* ; Neck ; Nitric Oxide Synthase* ; Nitric Oxide* ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Relaxation ; Silk ; Urethra ; Urinary Bladder* ; Urination