Objective: Ultrasound is widely used in the clinical field. However, training on use of ultrasound is insufficient. Newer models and techniques cannot be introduced for use by doctors without training and knowledge of its clinical utility. We produced a unique ultrasound education model and investigated if the use of the model could enhance the ability of clinicians to use ultrasound. Methods: A gelatin ultrasound practice model that can be transformed into various shapes was created using a cubeshaped plastic trainer. Residents and interns working in tertiary hospitals were surveyed for their awareness of the use of ultrasound through a questionnaire. Subsequently, ultrasound education was conducted, and a test was administered using a cube-shaped ultrasound education model. After the education and testing, awareness of the use of ultrasound was investigated through a questionnaire once again, and the test results were evaluated. Results: A total of 20 people participated in the evaluation and survey using the practice model. Of these, 11 people (55%) had procedural experience of using ultrasound. The Spearman’s correlation test was performed to compare previous ultrasound procedural experience with the number of correct answers, time spent on the test, and the number of attempts, and the results were 0.278 (P=0.235), -0.513 (P=0.021), and -0.369 (P=0.110), respectively. The correlation coefficients between the previous ultrasound knowledge level and changes in the knowledge level, preference, and confidence about ultrasound examination before and after practice were 0.261 (P=0.281), 0.638 (P=0.003), and 0.705 (P< 0.001), respectively. Conclusion Our cube-shaped ultrasound educational model can spark interest in the use of ultrasound, improve knowledge levels, and increase procedural skills in using ultrasound.

Objective: Cardiac tamponade with hemodynamic collapse requires immediate treatment, and ultrasound-guided pericardiocentesis is the treatment of choice. Although an essential skill for emergency physicians, there is a lack of training. We created a phantom that could practice ultrasound-guided pericardiocentesis using readily available materials. The pros and cons of the materials used were then compared. Methods: Cardiac tamponade phantoms were made from gelatin, and included a heart, liver, and rib cage. We conducted a model-specific satisfaction questionnaire targeting 15 emergency physicians. The questionnaire was designed to be answered on a Likert 5-point scale. Results: Creating the gelatin model took 6 hours. At room temperature, the gelatin model was able to retain its shape for 3 days. Fifteen physicians participated in the questionnaire, comprising five subjects having actual pericardiocentesis experience. In the questionnaire, our model achieved high satisfaction with all questions. Conclusion In our study, the pericardiocentesis phantom made from gelatin could maintain its shape for a long time, there was better recognition of the needle tip, and the model was more similar to the actual cardiac tamponade situation. Considering these positive characteristics, we recommend the phantom as a model for pericardiocentesis training.

In the 2022 series, we summarized the major clinical research advances in gynecologic oncology based on communications at the conference of Asian Society of Gynecologic Oncology Review Course. The review consisted of 1) Ovarian cancer: long-term follow-up data, new poly (ADP-ribose) polymerase (PARP) inhibitors, overall survival (OS) issues with PARP inhibitor monotherapy, hyperthermic intraperitoneal chemotherapy, immunotherapy, and antibody-drug conjugate; 2) Cervical cancer: surgery in early stage disease, therapy for locally advanced stage and advanced, metastatic, or recurrent setting; and 3) Corpus cancer: follow-up regimen, immune checkpoint inhibitor, WEE1 inhibitor, selective inhibitor of nuclear export. A special note was made on the withdrawal of PARP inhibitor from the market for heavily pretreated ovarian cancer patients based on the final OS results of ARIEL-4 and SOLO-3 due to concerns of increased risk of death.

Objective: This study aims to identify significant factors such as sweat that can be used as important predictors of acute coronary syndrome (ACS) in patients visiting the emergency department (ED) complaining of chest pain. Methods: This observational, retrospective, registry-based study conducted from May 2020 to November 2020 evaluated patients who visited the ED due to chest pain. Parameters associated with ACS were investigated, and the clinical characteristics and symptoms were analyzed. Results: A total of 230 patients visited the ED with chest pain. Of these, 94 (40.9%) were diagnosed with ACS. Univariate regression analysis showed that facial sweating (odds ratio [OR], 2.624; 95% confidence interval [CI], 1.241-5.549; P=0.012) and drench sweating (OR, 3.346; 95% CI, 1.602-6.991; P=0.001) were associated with ACS. Hence, we classified these patients as the actual sweating group. However, the sweaty feeling self-reported by patients with no visible sweat did not correlate with ACS. Multivariate logistic regression analysis showed that age (OR, 1.043; 95% CI, 1.016-1.071; P=0.002), quantum of smoking (OR, 1.023; 95% CI, 1.005-1.041; P=0.010), diastolic blood pressure (OR, 1.028; 95% CI, 1.004-1.049; P=0.009), squeezing chest pain (OR, 2.128; 95% CI, 1.000-4.531; P=0.050), and actual sweating (OR, 2.300; 95% CI, 1.209-4.374; P=0.011) were significantly associated with ACS. Conclusion Age, the quantum of smoking, diastolic blood pressure, squeezing chest pain, and actual sweating are useful predictors for ACS diagnosis. Unlike actual sweating, patient-reported sweating is not significantly related to the diagnosis of ACS. The results of this study will be beneficial in predicting ACS to ensure early and emergency medical care in the pre-hospital setting.

Background/Aims: The diagnosis of intestinal tuberculosis (Itbc) is often challenging. Therapeutic anti-tubercular trial (TATT) is sometimes used for the diagnosis of Itbc. We aimed to evaluate the changing pattern of fecal calprotectin (FC) levels during TATT in patients with Itbc. Methods: A retrospective review was performed on the data of 39 patients who underwent TATT between September 2015 and November 2018 in five university hospitals in Daegu, South Korea. The analysis was performed for 33 patients with serial FC measurement reports. Results: The mean age of the participants was 48.8 years. The final diagnosis of Itbc was confirmed in 30 patients based on complete mucosal healing on follow-up colonoscopy performed after 2 months of TATT. Before starting TATT, the mean FC level of the Itbc patients was 170.2 μg/g (range, 11.5-646.5). It dropped to 25.4 μg/g (range, 11.5-75.3) and then 23.3 μg/g (range, 11.5-172.2) after one and two months of TATT, respectively. The difference in mean FC before and one month after TATT was statistically significant (p<0.001), and FC levels decreased to below 100 μg/g in all patients after one month of TATT. Conclusions All Itbc patients showed FC decline after only 1 month of TATT, and this finding correlated with complete mucosal healing in the follow-up colonoscopy after 2 months of TATT.

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.

BACKGROUND: High-fat diet-induced obesity is one of the major cause of chronic renal failure. This obesity-related renal failure is mainly caused by inflammatory processes. However, the role of the major anti-inflammatory cytokine interleukin (IL)-10 has not been researched intensively. METHODS: To evaluate the effect of IL-10 deficiency on obesity-related renal failure, the in vivo study was carried with four animal groups; (1) Low-fat dieted C57BL/6 mice, (2) Low-fat dieted IL-10 knockout (KO) mice, (3) High-fat dieted C57BL/6 mice and (4) High-fat dieted IL-10 KO mice group. The analysis was carried with blood/urine chemistry, H&E, Oil-Red-O, periodic acid-Schiff and Masson’s trichrome staining immunohistochemistry and real-time PCR methods. RESULTS: At week 12, high-fat dieted IL-10 KO mice showed 1) severe lipid accumulation in kidneys, cholesterol elevation (in total, serum kidney) and low-density lipoprotein increasion through the SCAP-SREBP2-LDLr pathway; (2) serious histopathologic alterations showing glomerulosclerosis, tubulointerstitial fibrosis and immune cell infiltration; (3) increased pro-inflammatory cytokines and chemokines expression; (4) enhanced renal fibrosis; and (5) serious functional failure with high serum creatinine and BUN and proteinuria excretion compared to other groups. CONCLUSION IL-10 deficiency aggravates renal inflammation, fibrosis and functional failure in high-fat dieted obese mice, thus IL-10 therapy could be applied to obesity-related chronic renal failure.

BACKGROUND: High-fat diet-induced obesity is one of the major cause of chronic renal failure. This obesity-related renal failure is mainly caused by inflammatory processes. However, the role of the major anti-inflammatory cytokine interleukin (IL)-10 has not been researched intensively. METHODS: To evaluate the effect of IL-10 deficiency on obesity-related renal failure, the in vivo study was carried with four animal groups; (1) Low-fat dieted C57BL/6 mice, (2) Low-fat dieted IL-10 knockout (KO) mice, (3) High-fat dieted C57BL/6 mice and (4) High-fat dieted IL-10 KO mice group. The analysis was carried with blood/urine chemistry, H&E, Oil-Red-O, periodic acid-Schiff and Masson’s trichrome staining immunohistochemistry and real-time PCR methods. RESULTS: At week 12, high-fat dieted IL-10 KO mice showed 1) severe lipid accumulation in kidneys, cholesterol elevation (in total, serum kidney) and low-density lipoprotein increasion through the SCAP-SREBP2-LDLr pathway; (2) serious histopathologic alterations showing glomerulosclerosis, tubulointerstitial fibrosis and immune cell infiltration; (3) increased pro-inflammatory cytokines and chemokines expression; (4) enhanced renal fibrosis; and (5) serious functional failure with high serum creatinine and BUN and proteinuria excretion compared to other groups. CONCLUSION IL-10 deficiency aggravates renal inflammation, fibrosis and functional failure in high-fat dieted obese mice, thus IL-10 therapy could be applied to obesity-related chronic renal failure.

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.