Background: and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. Methods: Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. Results: Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). Conclusions The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.

Our objective was to investigate whether inflammatory microenvironment induced by Trichomonas vaginalis infection can stimulate proliferation of prostate cancer (PCa) cells in vitro and in vivo mouse experiments. The production of CXCL1 and CCL2 increased when cells of the mouse PCa cells (TRAMP-C2 cell line) were infected with live T. vaginalis. T. vaginalis-conditioned medium (TCM) prepared from co-culture of PCa cells and T. vaginalis increased PCa cells migration, proliferation and invasion. The cytokine receptors (CXCR2, CCR2, gp130) were expressed higher on the PCa cells treated with TCM. Pretreatment of PCa cells with antibodies to these cytokine receptors significantly reduced the proliferation, mobility and invasiveness of PCa cells, indicating that TCM has its effect through cytokine-cytokine receptor signaling. In C57BL/6 mice, the prostates injected with T. vaginalis mixed PCa cells were larger than those injected with PCa cells alone after 4 weeks. Expression of epithelial-mesenchymal transition markers and cyclin D1 in the prostate tissue injected with T. vaginalis mixed PCa cells increased than those of PCa cells alone. Collectively, it was suggested that inflammatory reactions by T. vaginalis-stimulated PCa cells increase the proliferation and invasion of PCa cells through cytokine-cytokine receptor signaling pathways.

Background: and Purpose We aimed to develop a model predicting early recanalization after intravenous tissue plasminogen activator (t-PA) treatment in large-vessel occlusion. Methods: Using data from two different multicenter prospective cohorts, we determined the factors associated with early recanalization immediately after t-PA in stroke patients with large-vessel occlusion, and developed and validated a prediction model for early recanalization. Clot volume was semiautomatically measured on thin-section computed tomography using software, and the degree of collaterals was determined using the Tan score. Follow-up angiographic studies were performed immediately after t-PA treatment to assess early recanalization. Results: Early recanalization, assessed 61.0±44.7 minutes after t-PA bolus, was achieved in 15.5% (15/97) in the derivation cohort and in 10.5% (8/76) in the validation cohort. Clot volume (odds ratio [OR], 0.979; 95% confidence interval [CI], 0.961 to 0.997; P=0.020) and good collaterals (OR, 6.129; 95% CI, 1.592 to 23.594; P=0.008) were significant factors associated with early recanalization. The area under the curve (AUC) of the model including clot volume was 0.819 (95% CI, 0.720 to 0.917) and 0.842 (95% CI, 0.746 to 0.938) in the derivation and validation cohorts, respectively. The AUC improved when good collaterals were added (derivation cohort: AUC, 0.876; 95% CI, 0.802 to 0.950; P=0.164; validation cohort: AUC, 0.949; 95% CI, 0.886 to 1.000; P=0.036). The integrated discrimination improvement also showed significantly improved prediction (0.097; 95% CI, 0.009 to 0.185; P=0.032). Conclusions The model using clot volume and collaterals predicted early recanalization after intravenous t-PA and had a high performance. This model may aid in determining the recanalization treatment strategy in stroke patients with large-vessel occlusion.

The dramatic spread of Coronavirus Disease 2019 (COVID-19) has profound impacts on every continent and life. Due to humanto-human transmission of COVID-19, nuclear medicine staffs also cannot escape the risk of infection from workplaces. Everystaff in the nuclear medicine department must prepare for and respond to COVID-19 pandemic which tailored to the characteristicsof our profession. This article provided the guidance prepared by the Korean Society of Nuclear Medicine (KSNM) incooperation with the Korean Society of Infectious Disease (KSID) and Korean Society for Healthcare-Associated InfectionControl and Prevention (KOSHIC) in managing the COVID-19 pandemic for the nuclear medicine department.We hope that thisguidance will support every practice in nuclear medicine during this chaotic period.

BACKGROUND: Atopic Dermatitis (AD) is a chronic relapsing inflammatory skin disease that is usually observed in patients with an individual or familial history of atopic diseases, and AD is precipitated by environmental factors, including mite antigens. AD is known to be generated by an imbalance of both Th1 and Th2 cytokines. However, the exact etiology of AD is unclear. The leaves of Acer ginnala (AGL) have been demonstrated to have an anti-oxidant effect. OBJECTIVE: We wanted to investigate the effect of AGL on AD-like skin lesions and the other factors related to an immune response. METHODS: The AGL was applied to the AD-like skin lesions on the backs of NC/Nga mice. The efficacy of AGL in the NC/Nga mice was evaluated by the changes of severity of the skin lesions (a modified SCORAD). Blood was collected from the retro-orbital area and the abdominal vena cava. The levels of eosinophils, immunoglobulin (Ig) E and Th2-related cytokines in the blood were measured. RESULTS: The topical application of AGL suppressed the development of AD-like skin lesions. The percent of blood eosinophils was decreased after treatment with AGL. The serum IgE and Th2-related cytokine levels were decreased after treatment with AGL compared with those treated with base cream (the vehicle treated AD group). The IL-4, IL-5 and IL-13 levels were lower than those of the vehicle treated AD group. CONCLUSION: The findings suggest that AGL may exert an inhibitory effect on atopic dermatitis.
Acer ; Animals ; Antioxidants ; Cytokines ; Dermatitis, Atopic ; Eosinophils ; Humans ; Immunoglobulin E ; Immunoglobulins ; Interleukin-13 ; Interleukin-4 ; Interleukin-5 ; Mice ; Mites ; Skin ; Skin Diseases

Growth hormone deficiency is the medical condition of inadequate production of growth hormone. Growth hormone deficiency in adults is not common, but it may feature a diminished, lean body mass, poor bone density and a number of physical and psychological symptoms, including poor memory, social withdrawal and even depression. Abnormally low growth hormone levels in adults typically result in a diminished quality of life and it can even be disabling. The physical symptoms include loss of strength, stamina, and musculature. Growth hormone deficiency can also impair the biological and physiological/functional substrate of penile erection, which can be, at least in part, restored by the normalization of the plasma levels of growth hormone. This is a report on a 63-year-old man who suffered with severe erectile dysfunction and loss of libido due to growth hormone deficiency. Upon growth hormone administration, his erectile function improved dramatically.
Adult ; Bone Density ; Depression ; Erectile Dysfunction ; Growth Hormone ; Humans ; Libido ; Male ; Memory ; Middle Aged ; Penile Erection ; Plasma ; Quality of Life

PURPOSE: We retrospectively evaluated the results and complications of urethroplasty in adult patients with hypospadias. MATERIALS AND METHODS: Between February 1997 and June 2007, 21 adult patients with hypospadias underwent urethroplasty. The types of hypospadias were as follows: megameatus intact prepuce(MIP; n=4), subcoronal(n=5), distal penile(n=3), midshaft(n=2), penile(n=2), penoscrotal(n=2), and scrotal(n=3). Among the 21 patients, 13 were in the primary operative (group A) and 8 were in the re-operative(group B). RESULTS: The mean age of the patients was 32.4+/-6.4 years(group A, 33.1+/-6.0 years; group B, 31.1+/-7.8 years). The mean duration of catheter drainage was 8.0+/-2.4 days(group A, 7.9+/-1.8 days; group B, 8.0+/-2.1 days). The surgical procedures included tubularized incised plate urethroplasty(n=14), Thiersch-Duplay(n=3), pyramid(n=3), and transverse preputial island flap (n=1). The overall success rate was 61.9%(group A, 92.3%; group B, 12.5%). Urethrocutaneous fistulas and a meatal stricture occurred in 6 and 1 patients, respectively, with both occurring in 1 patient(38.1% overall complication rate). Fistula repairs were performed successfully in 4 patients and another fistula resolved spontaneously. The meatal strictures were treated with simple dilatation. CONCLUSIONS: Our data demonstrated a very high success rate in the treatment of primary adult hypospadias. And more careful surgical procedure is needed in patients who had history of previous failure more than 2 times because of significantly high complacation rate.
Adult ; Catheters ; Constriction, Pathologic ; Drainage ; Female ; Fistula ; Humans ; Hypospadias ; Male ; Retrospective Studies

PURPOSE: We evaluated the effect of a topical steroid(0.05% clobetasol propionate[Dermovate(R)]) on phimosis. MATERIALS AND METHODS: Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of Dermovate(R). Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid over the stenotic opening of the prepuce twice daily for 4 weeks then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 1-6. Response to treatment was arbitrarily defined as improvement in the retractibility score(complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis. RESULTS: The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5+/-27.6 months(range, 7-108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age(n=18), the complete response rates were 75% and 72.2%, respectively(p=0.866). In boys with or without an associated concealed penis(n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively(p=0.199). No adverse effect was encountered in all patients. CONCLUSIONS: Our data suggest that the application of topical steroids for 8 weeks as a first line treatment of phimosis may be effective, although further studies are needed to establish the definite efficacy and safety of this procedure.
Child ; Clobetasol ; Female ; Foreskin ; Humans ; Male ; Parents ; Penis ; Phimosis ; Steroids

BACKGROUND: This prospective phase II study assessed the efficacy and toxicity of the combination of carboplatin, ifosfamide and etoposide for previously untreated patients with extensive-disease small cell lung cancer (ED-SCLC). METHODS: Patients with ED-SCLC received a combination chemotherapy with carboplatin AUC 6.0 on day 1, ifosfamide 1200 mg/m2 on day 1-3, and etoposide 100 mg/m2 on day 1-3. RESULTS: Forty-one patients received a median of six cycles of chemotherapy. A complete response was seen in 5 patients and a partial response was seen in 33 patients (overall response 95%). The median duration of the response was 5.1 months (95% CI; 3.4-6.8 months). The median time to progression and overall survival were 7.4 months (95% CI; 6.1-8.6 months) and 10.7 months (95% CI; 6.9-14.6 months), respectively, providing the one-year survival rate of 43.9%. Grade 3~4 anemia, neutropenia and thrombocytopenia occurred in 14%, 7% and 6% in a total of 212 cycles, respectively. Non-hematologic toxicities were generally mild and manageable. No treatment related death was observed. CONCLUSIONS: The combination chemotherapy of carboplatin, etoposide and ifosfamide showed an effective response rate and acceptable toxicity.
Anemia ; Area Under Curve ; Carboplatin* ; Drug Therapy* ; Drug Therapy, Combination ; Etoposide* ; Humans ; Ifosfamide* ; Neutropenia ; Prospective Studies ; Small Cell Lung Carcinoma* ; Survival Rate ; Thrombocytopenia

PURPOSE: To study the outcomes and complications of tension-free vaginal tape(TVT) operations, according to postoperative period, and compare our results with those in the literature. MATERIALS AND METHODS: 340 patients were followed up for at least 3 months, between March 1999 and September 2001. During the postoperative period, the objective and subjective success rate, along with the postoperative complications, were evaluated. The mean age was 50.6+/-10.1 years. Among the 340 patients, 279(81.8%) and 61(19.4%) were diagnosed with stress and mixed incontinences, respectively. The patients were classified according to their symptom grades; grade I(n=66, 19.4%), grade II (n=240, 70.6%) and grade III(n=34, 10.0%). RESULTS: 113, 117, 44 and 66 of the 340 patients were observed postoperatively for 1, 1-2, 2-3 and for over 3 years, respectively. Of these, 137 completed questionnaires for evaluation of the subjective outcome. The objective success rates were high, irrespective of the extent of the postoperative period. The 1, 1-2, 2-3 and over 3 years postoperative period objective success rates were 93.8, 87.5, 89.5 and 93.3%, respectively. The subjective success rates were also high, irrespective of the extent of the postoperative period; 87.5, 75.0, 84.3 and 90.0% 1, 1-2, 2-3 and beyond 3 years, respectively. Postoperative complications occurred in 15 cases, including 12 bladder perforation due to the TVT device, 2 cases of bladder injury due to guide wire and one of vessel injury. 13 cases developed de novo urgency, although, they were cured with anticholinergic medication. Other serious complications, such as wound infection, hemorrhage requiring transfusion and nerve injury, were absent. CONCLUSIONS: Both the short and long term results were excellent, regardless of the extent of the postoperative follow-up period. TVT should play a significant role in treating female urinary incontinence, due to its availability and stability.
Female* ; Follow-Up Studies ; Hemorrhage ; Humans ; Postoperative Complications ; Postoperative Period* ; Surveys and Questionnaires ; Suburethral Slings* ; Surgical Mesh ; Urinary Bladder ; Urinary Incontinence* ; Wound Infection