Purpose: To assess patient radiation doses during diagnostic and therapeutic neurointerventional procedures from multiple centers and propose dose reference level (RL). Materials and Methods: Consecutive neurointerventional procedures, performed in 22 hospitals from December 2020 to June 2021, were retrospectively studied. We collected data from a sample of 429 diagnostic and 731 therapeutic procedures. Parameters including dose-area product (DAP), cumulative air kerma (CAK), fluoroscopic time (FT), and total number of image frames (NI) were obtained. RL were calculated as the 3rd quartiles of the distribution. Results: Analysis of 1160 procedures from 22 hospitals confirmed the large variability in patient dose for similar procedures. RLs in terms of DAP, CAK, FT, and NI were 101.6 Gy·cm2, 711.3 mGy, 13.3 minutes, and 637 frames for cerebral angiography, 199.9 Gy·cm2, 3,458.7 mGy, 57.3 minutes, and 1,000 frames for aneurysm coiling, 225.1 Gy·cm2, 1,590 mGy, 44.7 minutes, and 800 frames for stroke thrombolysis, 412.3 Gy·cm2, 4,447.8 mGy, 99.3 minutes, and 1,621.3 frames for arteriovenous malformation (AVM) embolization, respectively. For all procedures, the results were comparable to most of those already published. Statistical analysis showed male and presence of procedural complications were significant factors in aneurysmal coiling. Male, number of passages, and procedural combined technique were significant factors in stroke thrombolysis. In AVM embolization, a significantly higher radiation dose was found in the definitive endovascular cure group. Conclusion Various RLs introduced in this study promote the optimization of patient doses in diagnostic and therapeutic interventional neuroradiology procedures. Proposed 3rd quartile DAP (Gy·cm2) values were 101.6 for diagnostic cerebral angiography, 199.9 for aneurysm coiling, 225.1 for stroke thrombolysis, and 412.3 for AVM embolization. Continual evolution of practices and technologies requires regular updates of RLs.

Background/Aims: Coronavirus disease 2019 (COVID-19) can reportedly cause gastrointestinal symptoms. Therefore, we investigated the clinical characteristics of COVID-19 patients with diarrhea. Methods: We included 118 COVID-19 patients admitted to a single hospital from February 20 to March 31, 2020. Medical records with clinical characteristics, laboratory data, treatment course, and clinical outcomes were compared based on the presence or absence of diarrhea. Prognostic factors for disease severity and mortality in COVID-19 were also assessed. Results: Among patients, 54 (45.8%) had diarrhea, whereas seven (5.9%) had only diarrhea. The median age of patients with diarrhea was 59 years (44 to 64), and 22 (40.7%) were male. Systemic steroid use, intensive care unit admission, septic shock, and acute respiratory distress syndrome were less frequent in the diarrhea group than in the non-diarrhea group. No significant differences were observed in total hospital stay and mortality between groups. On multivariate analysis, age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.01 to 1.12; p = 0.044), diabetes (OR, 3.00; 95% CI, 1.25 to 20.47; p = 0.042), and dyspnea (OR, 41.19; 95% CI, 6.60 to 823.16; p < 0.001) were independent risk factors for septic shock. On Cox regression analysis, diabetes (hazard ratio [HR], 4.82; 95% CI, 0.89 to 26.03; p = 0.043) and chronic obstructive pulmonary disease (HR, 16.58; 95% CI, 3.10 to 88.70; p = 0.044) were risk factors for mortality. Conclusions Diarrhea was present in 45.8% of patients and was a common symptom of COVID-19. Although patients with diarrhea showed less severe clinical features, diarrhea was not associated with disease severity or mortality.

BACKGROUND: Telomere shortening is thought to be involved in the pathophysiology of myeloid malignancies, but telomere lengths (TL) during interphase and metaphase in hematopoietic malignancies have not been analyzed. We aimed to assess the TLs of interphase and metaphase cells of MDS and telomerase activity (TA) and to find out prognostic significances of TL and TA. METHODS: The prognostic significance of TA by quantitative PCR and TL by quantitative fluorescence in situ hybridization (QFISH) of interphase nuclei and metaphase chromosome arms of bone marrow cells from patients with MDS were evaluated. RESULTS: MDS patients had shorter interphase TL than normal healthy donors (P<0.001). Average interphase and metaphase TL were inversely correlated (P=0.013, p arm; P=0.029, q arm), but there was no statistically significant correlation between TA and TL (P=0.258). The progression free survival was significantly shorter in patients with high TA, but the overall survival was not different according to average TA or interphase TL groups. Multivariable Cox analysis showed that old age, higher International Prognostic Scoring System (IPSS) subtypes, transformation to AML, no history of hematopoietic stem cell transplantation and short average interphase TL (<433 TL) as independent prognostic factors for poorer survival (P=0.003, 0.001, 0.005, 0.005, and 0.013, respectively). CONCLUSIONS: The lack of correlation between age and TL, TA, and TL, and the inverse relationship between TL and TA in MDS patients reflect the dysregulation of telomere status and proliferation. As a prognostic marker for leukemia progression, TA may be considered, and since interphase TL has the advantage of automated measurement by QFISH, it may be used as a prognostic marker for survival in MDS.
Arm ; Bone Marrow Cells ; Disease-Free Survival ; Fluorescence ; Hematologic Neoplasms ; Hematopoietic Stem Cell Transplantation ; Humans ; In Situ Hybridization ; Interphase ; Leukemia ; Metaphase ; Myelodysplastic Syndromes* ; Polymerase Chain Reaction ; Prognosis ; Telomerase* ; Telomere Shortening ; Telomere* ; Tissue Donors

This report was designed to investigate a rare case that brachialis tear and hematoma caused by acute elbow posterior dislocation. We studied a 20-year-old male patient with right elbow joint pain after outstretched injury. Physical examination showed instability of hright elbow joint and simple radiography indicated a posterolateral dislocation of right elbow joint. Computed tomography taken after closed reduction using Parvin technique revealed a few small bone fragment located on posterior humerus capitulum. Magnetic resonance imaging showed complete tear of brachialis and anterior articular capsule with hematoma. The patient was managed with long arm splint and hinge brace for an elbow dislocation with brachialis rupture and hematoma. The elbow joint range of motion was recovered to be in a normal range, and pain was diminished. There are few reported cases of acute elbow posterior dislocation combined with brachialis rupture and hematoma. The patient showed good clinical outcome after conservative treatment.
Arm ; Braces ; Dislocations* ; Elbow Joint ; Elbow* ; Hematoma* ; Humans ; Humerus ; Joint Capsule ; Magnetic Resonance Imaging ; Male ; Physical Examination ; Radiography ; Range of Motion, Articular ; Reference Values ; Rupture ; Splints ; Young Adult

OBJECTIVE: To find out the changes of the family structure and familial total income of Korean patients with the brain disorders and associated factors. METHOD: A total of 1,903 patients with brain disorders in Korea were enrolled and drew up the questionnaires about their socioeconomic state and family supports, including pre- and post-disorder family structure, compositions of their family income, and employment of caregivers. RESULTS: A 38.2% of subjects experienced the change in numbers of cohabiting family, decrement in 30.3% and increment in 7.9%. Prior to brain disorders, 48.6% of patients earned their living by themselves, but only 2.8% did after brain disorders. Separation and divorce increased, especially three times more in male patients than in females. A 16.6% of patients employed caregivers, and used them 6.2 days per week, 18 hours a day on average. CONCLUSION: This study reemphasized the worsening socioeconomic state of patients with brain disorders and their families. Increasing tendency of social isolation was also noted.
Brain ; Brain Diseases ; Caregivers ; Divorce ; Employment ; Female ; Humans ; Korea ; Male ; Surveys and Questionnaires ; Social Isolation ; Stroke

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.
Animals ; Baths ; Cacao ; Endothelium ; Humans ; Male ; NG-Nitroarginine Methyl Ester ; Penile Erection ; Phenylephrine ; Rats ; Rats, Sprague-Dawley ; Relaxation

PURPOSE: Cocoa has antihypertensive activity, improves cerebral blood flow, and is an antioxidant. We evaluated the effect of cocoa extract on penile erection using the relaxation of the corpus cavernosal tissue in rat. MATERIALS AND METHODS: We used male 8-week-old Sprague-Dawley rats weighting 250-350 g divided into three groups: corpus cavernosal tissue with the endothelium (group 1), tissue without the endothelium (group 2), and endothelium pretreated with L-NAME (group 3). Changes in isometric tension were examined in an organ bath. Aortic tissues were divided into three groups and treated in similar experiments simultaneously. RESULTS: Cocoa extract dose-dependently relaxed corpus cavernosal tissue pre-contracted by phenylephrine (10-6). In group 1, cocoa extract (10-3g/ml) induced relaxation by 97+/-5% (mean+/-SD). The extract was still effective but less potent tissue without endothelium or pretreated with L-NAME (10-4M). Similar effects were seen in aortic rings. CONCLUSION: Cocoa extract relaxes corpus cavernosal tissue in a dose-dependent manner via NOS and the endothelium. Cocoa extract may therefore be effective for improving erectile function.
Animals ; Baths ; Cacao ; Endothelium ; Humans ; Male ; NG-Nitroarginine Methyl Ester ; Penile Erection ; Phenylephrine ; Rats ; Rats, Sprague-Dawley ; Relaxation

BACKGROUND AND OBJECTIVES: The purpose of this study is to determine the prevalence of abnormalities in the sinuses among the common population, and to correlate this with clinical data. MATERIALS AND METHODS: We retrospectively evaluated a total of five hundred patients who visited the Health Promotion Center, Asan Medical Center, to undergo MRI scan to screen for intracranial pathology from January to April, 2003. Patients who have been treated for nasal or sinus diseases and who had previous history of nasal or sinus operations were excluded. The sinus abnormalities found through the MRI were classified into 2 types as follows; sinusitis group and retention cyst group. RESULTS: Among the five hundred patients studied, ninety-six (19.2%) patients showed abnormality in one or more sinus groups; ninety patients displayed symptoms of sinusitis and nine patients exhibited signs of retention cyst. Three patients showed symptoms of both. Sinus abnormalities were most commonly observed in the maxillary sinus. Seven patients had symptoms of the sinusitis group, and one patient had symptoms of the retention cyst group. CONCLUSION: Incidental sinus abnormalities detected among the common population were relatively common. However, pathologic condition which demanded treatment among these abnormalities were rare. Therefore, it would be important not to overestimate these signs and one should evaluate their clinical correlations carefully through complete physical examinations before applying any treatment for these lesions.
Chungcheongnam-do ; Health Promotion ; Humans ; Magnetic Resonance Imaging* ; Maxillary Sinus ; Pathology ; Physical Examination ; Prevalence* ; Retrospective Studies ; Sinusitis

PURPOSE: The aim of this study was to evaluate the efficacy and safety of a herbal formula that mainly consists of Cornus officinalis for treating erectile dysfunction. MATERIALS AND METHODS: Eighty patients suffering with erectile dysfunction were enrolled in this randomized, double-blinded, placebo-controlled study. The average duration of erectile dysfunction of the herbal formula group(n=40) vs. the placebo group(n=40) were 19.33+/-18.13 months vs. 19.33+/-25.62 months, respectively. The safety variables we examined were the history, physical examination, vital signs, EKG, clinical laboratory tests and hormonal tests. Efficacy assessments included the International Index of Erectile Function(IIEF), the sexual encounter profile(SEP) diary and Global Assessment Questions(GAQ). RESULTS: No significant changes in the laboratory values, hormone tests and blood pressure were observed in both groups. In comparison with the placebo group(6.57+/-11.72), the herbal formula group experienced a significant improvement of the IIEF(11.13+/-11.83)(p<0.05). When the herbal formula and placebo groups were divided by age and the IIEF score (age: 50 years and IIEF: 42) and then compared, the low IIEF group(IIEFor=50) of the herbal formula group significantly improved their IIEF score(p<0.05). The herbal formula group significantly improved their GAQ score(p<0.05). The herbal formula was well tolerated. The common adverse events were headache(2.5%) and nausea(5%). CONCLUSIONS: In conclusion, the herbal formula that mainly consists Cornus officinalis was not only effective at improving erectile function, but it was also safe for the treatment of erectile dysfunction.
Blood Pressure ; Cornus* ; Electrocardiography ; Erectile Dysfunction* ; Humans ; Male ; Physical Examination ; Treatment Outcome ; Vital Signs

OBJECTIVE: To develop a Korean version of Modified Barthel Index (K-MBI) for subjects with stroke and to test the reliability and validity of K-MBI. METHOD: Six senior physiatrists translated the 5th version of MBI into K-MBI and we administered K-MBI to 30 subjects with stroke. Fifteen different examiners working at the 5 different university hospitals evaluated video-recorded examination cases independently to test the reliability and validity of K-MBI. We analyzed intra- and inter-rater reliabilities of the K-MBI by the Kendall's coefficient of concordance and Spearman's correlation coefficients, respectively. Cronbach's alpha coefficient was used for assessing internal consistency of the K-MBI and Spearman's correlation between the K-MBI and Brunnstr?m stage was employed to evaluate the validity of the K-MBI. RESULTS: The intra-rater reliabilities of physiatrists, resident physicians of rehabilitation medicine and occupational therapists were 0.93~1.00, 0.87~0.99, and 0.97~1.00 (p< 0.01), respectively. The inter-rater reliabilities were 0.93~0.98 (p<0.01) and Cronbach's alpha was 0.84 (p<0.01) as the internal consistency reliability of K-MBI. For construct validation study, each item of K-MBI had significant correlation with total score of K-MBI (r=0.54~0.78, p< 0.01). CONCLUSION: The K-MBI is a reliable and valid instrument for measuring functional status of subjects with stroke.
Hospitals, University ; Rehabilitation ; Reproducibility of Results ; Stroke*