Background: and Purpose The accurate prediction of functional outcomes in patients with acute ischemic stroke (AIS) is crucial for informed clinical decision-making and optimal resource utilization. As such, this study aimed to construct an ensemble deep learning model that integrates multimodal imaging and clinical data to predict the 90-day functional outcomes after AIS. Methods: We used data from the Korean Stroke Neuroimaging Initiative database, a prospective multicenter stroke registry to construct an ensemble model integrated individual 3D convolutional neural networks for diffusion-weighted imaging and fluid-attenuated inversion recovery (FLAIR), along with a deep neural network for clinical data, to predict 90-day functional independence after AIS using a modified Rankin Scale (mRS) of 3–6. To evaluate the performance of the ensemble model, we compared the area under the curve (AUC) of the proposed method with that of individual models trained on each modality to identify patients with AIS with an mRS score of 3–6. Results: Of the 2,606 patients with AIS, 993 (38.1%) achieved an mRS score of 3–6 at 90 days post-stroke. Our model achieved AUC values of 0.830 (standard cross-validation [CV]) and 0.779 (time-based CV), which significantly outperformed the other models relying on single modalities: b-value of 1,000 s/mm2 (P<0.001), apparent diffusion coefficient map (P<0.001), FLAIR (P<0.001), and clinical data (P=0.004). Conclusion The integration of multimodal imaging and clinical data resulted in superior prediction of the 90-day functional outcomes in AIS patients compared to the use of a single data modality.

PURPOSE: This study investigated the effect of goji (Lycium chinense Mill.) on erectile dysfunction in old-aged rats. MATERIALS AND METHODS: Twenty-four 18-month-old male Sprague-Dawley rats (defined as old-aged rats) were used. Treatment groups contained eight rats each: a control group, goji extract of 150 mg/kg/day group, and goji extract of 300 mg/kg/day group. Treatment was by orogastric tube once daily for 6 weeks. After 6 weeks of treatment, testes weight, serum testosterone, superoxide dismutase, nitric oxide (NO)-cyclic guanosine monophosphate (cGMP)-related parameters, intracavernous pressure/mean arterial pressure, and histological changes were examined. RESULTS: Treatments with goji extracts increased serum testosterone level, increased the expression of endothelial NO synthase, neuronal NO synthase, and cGMP, improved the oxidative stress marker, and decreased corporal fibrosis. CONCLUSIONS: Our results indicate that goji extract may have a positive effect on erectile dysfunction via its antioxidant effects.
Animals ; Antioxidants ; Arterial Pressure ; Erectile Dysfunction ; Fibrosis ; Guanosine Monophosphate ; Humans ; Infant ; Male ; Models, Animal* ; Neurons ; Nitric Oxide ; Nitric Oxide Synthase ; Oxidative Stress ; Rats* ; Rats, Sprague-Dawley ; Superoxide Dismutase ; Testis ; Testosterone

PURPOSE: Pathogenically, both erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) are closely related to vascular problems, and vascular problems are closely associated with obesity. This study evaluated the relationships between obesity, BPH, and ED. MATERIALS AND METHODS: The medical history of male patients, aged > or =40 years, evaluated at urology outpatient clinics of 11 university hospitals in Korea with chief complaints of lower urinary tract symptoms (LUTS)/BPH and ED were retrospectively evaluated. The correlations of medical history, body mass index (BMI), international prostate symptom score (IPSS), prostate volume, International Index of Erectile Function -5 (IIEF-5), and serum testosterone level were assessed. RESULTS: Body mass index showed significant correlations with IPSS (r=0.087, p=0.003), prostate volume (r=0.384, p<0.001), IIEF (r=-0.072, p=0.015), and serum testosterone concentration (r=-0.303, p<0.001). CONCLUSIONS: Body mass index correlates with testosterone concentration, prostate volume, and markers of LUTS and ED in men with the latter conditions.
Ambulatory Care Facilities ; Body Mass Index ; Erectile Dysfunction* ; Hospitals, University ; Humans ; Korea* ; Lower Urinary Tract Symptoms ; Male ; Obesity* ; Prostate ; Prostatic Hyperplasia* ; Retrospective Studies ; Testosterone ; Urology

PURPOSE: This study took a retrospective approach to investigate patients with catheter-associated urinary tract infection (CAUTI) over 2 years at a single hospital's intensive care unit (ICU) to identify meaningful risk factors and causative organisms. MATERIALS AND METHODS: A retrograde analysis was performed on patients with indwelling catheters between January 2009 and December 2010 in Yeouido St. Mary Hospital medical and surgical ICU. CAUTI was defined as isolated bacterial growth of 100,000 colony-forming units or more either 48 hours after transfer to the ICU if a urinary catheter was placed before the transfer or 48 hours after insertion if the catheter was inserted in the ICU. Only the patients whose culture results were negative before ICU admission were included. RESULTS: There were a total of 1,315 patients with indwelling urinary catheters in our hospital's medical and surgical ICU between January 2009 and December 2010. Of these patients, 241 had positive urine culture results, and 61 had CAUTI. Using multivariate logistic regression analysis, those with diabetes were 4.55 (p<0.001) times as likely to have occurrences of CAUTI than were those without and also had a 1.10-fold (p<0.01) longer duration of an indwelling catheter. Upon urine culture, among the 61 patients with CAUTI, Escherichia coli was the most common bacterium grown; it was identified in 24 patients (38.7%). CONCLUSIONS: The factors and causative organisms contributing to the development of CAUTI in the management of ICU patients must be considered to prevent the occurrence of UTIs in this setting.
Catheters ; Catheters, Indwelling ; Escherichia coli ; Humans ; Critical Care ; Intensive Care Units ; Logistic Models ; Retrospective Studies ; Risk Factors ; Stem Cells ; Urinary Catheters ; Urinary Tract ; Urinary Tract Infections

PURPOSE: The conventional primary therapy for chronic bacterial prostatitis (CBP) is the use of antibiotics. However, the therapy has a low cure rate and long-term use of antibiotics can lead to adverse effects including bacterial resistance. For these reasons, a new therapy for CBP is strongly needed. MATERIALS AND METHODS: To evaluate the anti-inflammatory and antimicrobial effects of selenium-rich hot spring water on CBP, rats were divided into four groups and treatment was administered for four weeks as follows: (1) control (n=8), (2) ciprofloxacin (n=8), (3) selenium-rich hot spring water (n=8), and (4) selenium-rich hot spring water with ciprofloxacin (n=8). Drip infusion of bacterial suspension (E. coli Z17 O2:K1;H-) into Spargue-Dowley rats was then conducted to induce CBP. Four weeks later, the results of prostate tissue and urine culture and histological analysis on the prostate were analyzed in each group. RESULTS: The use of ciprofloxacin, and selenium-rich hot spring water with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (p<0.05). The selenium-rich hot spring water with ciprofloxacin group showed a statistically significantly lower rate of bacterial growth and and greater improvements in prostatic inflammation than the ciprofloxacin group (p<0.05). CONCLUSIONS: These results suggest that spring water may be an effective material in the treatment of CBP. Notably, the combination treatment of selenium-rich hot spring water and ciprofloxacin has synergistic effects. Therefore, we can suggest that the combination of selenium-rich hot spring water and ciprofloxacin may be effective in the treatment of CBP, and with a higher success rate than ciprofloxacin alone.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Hot Springs ; Inflammation ; Infusions, Intravenous ; Prostate ; Prostatitis ; Rats ; Selenium

The aim of this project was to use 3D scanning data collected at incident scenes and various evidence to 1) develop surveying methods based on 3D data consisting of overall and detailed scene evidence, captured by long-range and micros-canner, which can be shared by personnel working in different fields such as forensic medicine, video analysis, physical analysis, traffic engineering, and fire investigation; 2) create digital storage for human skeletons and set the foundation for virtual anthropology; and 3) improve the credibility of 3D evidence by virtual remodeling and simulation of incident scenes and evidence to provide a basis for advanced and high-tech scientific investigation. Two complete skeletons of male and female were scanned using 3D micro-scanner. Each bone was successfully reproduced and assembled in virtual space. In addition, recreating evidence scheduled for invasive examination by creating RP (rapid prototype) was possible. These outcomes could play an important role in setting up the new field of virtual anthropology. Case-specific surveying methods were developed through analysis of 3D scanning data collected by long-range surface scanners at the scenes of vehicular accidents, falls, shootings, and violent crimes. A technique and recording method was also developed for detecting forged seals by micro-scanning the pressure exerted on the seal. Appraisal methods developed in this project could be utilized to secure 3D data of human skeletal remains and incident scenes, create a standard for application, and increase objectivity, reproducibility, and accuracy of scanning methods. We plan to develop case-specific 3D data analysis techniques to improve the credibility of analysis at the NFS and to establish a 3D data collection and analysis team.
Crime ; Data Collection ; Female ; Fires ; Forensic Medicine ; Forensic Sciences ; Humans ; Male ; Skeleton ; Statistics as Topic

A 56-year-old male presented with resting dyspnea and chest discomfort for several years. During transthoracic and transesophageal echocardiography, a spontaneously healed membranous type ventricular septal defect (VSD) with malaligned interventricular septal wall, aneurysmal changes, a subaortic ridge and a double-chambered right ventricle (DCRV) was observed. When combined with DCRV, VSD with malalignment between the outlet and trabecular septa was associated with tetralogy of Fallot. The subaortic ridge was due to turbulent flow caused by the malalignment-type VSD. The VSD with malaligned interventricular septal wall can be developed after aneurismal changes of a perimembranous VSD. We report here in the unusual case of a 56-year-old patient who had a pathology complex comprising DCRV, subaortic ridge, spontaneously healed membranous type VSD with malaligned interventricular septal wall, and survived with surgical treatment.
Aneurysm ; Dyspnea ; Echocardiography, Transesophageal ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Humans ; Male ; Middle Aged ; Tetralogy of Fallot ; Thorax

We report herein a case of subclavian steal syndrome due to occlusive disease in multiple branches of the aortic arch, which was successfully treated by axilloaxillary bypass and subclavian stent insertion. The hemodynamic changes were evaluated using duplex sonography and transcranial Doppler before and after each procedure. The waveform and parameters of blood flow revealed an objective improvement in cerebral perfusion. These findings correlated well with clinical outcome. Neurosonologic evaluation can provide objective evidence for improved hemodynamic status after treatment.
Aorta, Thoracic ; Hemodynamics ; Perfusion ; Stents ; Subclavian Steal Syndrome

PURPOSE: Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for high-risk prostate cancer remains controversial. We investigated the results of patients with high-risk prostate cancer after laparoscopic radical prostatectomy (LRP). MATERIALS AND METHODS: The records of 75 prostate cancer patients undergoing LRP between 2001 and 2008 with preoperative high-risk prostate cancer were reviewed. Patients who underwent radiation therapy for prostate cancer before LRP and patients with lymph node or distant metastases were excluded. High-risk prostate cancer was defined as a prostate-specific antigen (PSA) level of more than 20 ng/ml, a biopsy Gleason score of greater than 7, or a clinical stage greater than T2c. Biochemical recurrence (BCR)-free survival was plotted via the Kaplan-Meier method. RESULTS: After a mean follow-up of 36.1 months, 24 (32%) patients experienced PSA progression with a median time of 17.6 months. Twenty patients received adjuvant hormonal or external beam radiation therapy or both before BCR. The BCR-free survival calculated by the Kaplan-Meier method at 3 and 5 years was 47.4% and 33.8%, respectively. A total of 44.0% of the patients had stage pT2 disease and 56.0% had stage pT3 disease. Surgical margins were positive in 35 patients (46.7%), of whom 11 (31.4%) had positive margins of more than 1. Preoperative PSA, postoperative pathologic Gleason score, and stage were correlated with BCR. CONCLUSIONS: Our results suggest that LRP is a useful tool in the management of high-risk prostate cancer because it provides adequate local control of the prostate and pathological stage. Selection of patients with high-risk prostate cancer who require surgical treatment should be evaluated further in more studies.
Biopsy ; Follow-Up Studies ; Humans ; Laparoscopy ; Lymph Nodes ; Neoplasm Grading ; Neoplasm Metastasis ; Prostate ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence