Corticospinal Tract Compression by Hematoma in a Patient with Intracerebral Hemorrhage: A Diffusion Tensor Tractography and Functional MRI Study

The purpose of this study was to demonstrate corticospinal tract compression that was due to a hematoma by using diffusion tensor tractography (DTT) and functional MRI (fMRI) in a patient with an intracerebral hemorrhage (ICH). A 23-year-old right-handed woman presented with severe paralysis of her right extremities at the onset of a spontaneous ICH. Over the first three days from onset, the motor function of the affected upper and lower extremities rapidly recovered to the extent that she was able to overcome applied resistance to the affected limbs, and her limbs regained normal function 3 weeks after onset. The tract of the right hemisphere originated from the primary sensori-motor cortex (SM1) and it passed through the known corticospinal tract pathway. However, the tract of the left hemisphere was similar to that of the right hemisphere except that it was displaced to the antero-medial side by the hematoma at the cerebral peduncle. Only the contralateral SM1 area centered on the precentral knob was activated during affected (right) or unaffected (left) hand movements, respectively. In conclusion, fMRI and DTT demonstrated a corticospinal tract compression due to hematoma in this patient. We conclude that the combined use of these two modalities appears to improve the accuracy of investigating the state of the corticospinal tract

Korean Patients with Superwarfarin Intoxication and Their Outcome

This observational study aimed at evaluating recent superwarfarin intoxication of Korean patients. Ten patients were diagnosed as or highly suspicious for superwarfarin intoxication. Case report forms described by attending hematologists of the patients were collected and analyzed. Bleeding symptoms were varied among the patients. Patients uniformly showed prolonged prothrombin time (PT) and activated thromboplastin time (aPTT) with decreased activity of vitamin K dependent coagulation factors. Positive serum brodifacoum test results in 4 of 5 requested patients contributed to confirmatory diagnosis. Psychiatric interview revealed an attempted ingestion in one patient. High dose vitamin K1 therapy promptly corrected prolonged PT and aPTT, but hasty discontinuation caused repeated bleeding diathesis in 6 patients. Route of intoxication was unknown or not definite among 8 of 10 patients. Three patients had a possibility of environmental exposure considering their occupations: there might be intoxication by transdermal absorption or inhalation. Therefore, high dose and prolonged use of vitamin K1 therapy is necessary for effective detoxification. Further detailed investigation on environmental exposure and efforts to improve availability of the blood level test in clinic are requested

Korean Guidelines for the Prevention of Venous Thromboembolism

This guideline focuses on the primary prevention of venous thromboembolism (VTE) in Korea. The guidelines should be individualized and aim at patients scheduled for major surgery, as well as patients with a history of trauma, high-risk pregnancy, cancer, or other severe medical illnesses. Currently, no nation-wide data on the incidence of VTE exist, and randomized controlled trials aiming at the prevention of VTE in Korea have yielded few results. Therefore, these guidelines were based on the second edition of the Japanese Guidelines for the Prevention of VTE and the eighth edition of the American College of Chest Physicians (ACCP) Evidenced-Based Clinical Practice Guidelines. These guidelines establish low-, moderate-, and high-risk groups, and recommend appropriate thromboprophylaxis for each group

Changes in histopathology and tumor necrosis factor-α levels in the hearts of rats following asphyxial cardiac arrest

Objective Post cardiac arrest (CA) syndrome is associated with a low survival rate in patients who initially have return of spontaneous circulation (ROSC) after CA. The aim of this study was to examine the histopathology and inflammatory response in the heart during the post CA syndrome. Methods We induced asphyxial CA in male Sprague-Dawley rats and determined the survival rate of these rats during the post resuscitation phase. Results Survival of the rats decreased after CA: 66.7% at 6 hours, 36.7% at 1 day, and 6.7% at 2 days after ROSC following CA. The rats were sacrificed at 6 hours, 12 hours, 1 day, and 2 days after ROSC, and their heart tissues were examined. Histopathological scores increased at 12 hours post CA and afterwards, histopathological changes were not significant. In addition, levels of tumor necrosis factor-α immunoreactivity gradually increased after CA. Conclusion The survival rate of rats 2 days post CA was very low, even though histopathological and inflammatory changes in the heart were not pronounced in the early stage following CA

Current immunotherapeutic strategies in hepatocellular carcinoma: recent advances and future directions

Hepatocellular carcinoma (HCC) is a common and serious health problem with high mortality. Treatment for HCC remains largely unsatisfactory owing to its high recurrence rates and frequent accompanying cirrhosis. In addition, the unique immune environment of the liver promotes tolerance, which, in conjunction with immune evasion by the disease, makes HCC a less promising target for conventional immunotherapy. However, recent advances in the immunotherapy have led to novel approaches to overcome these obstacles by manipulating and enhancing tumor-specific immune responses against HCC by using various modalities, such as cancer vaccines and immune checkpoint blockade. These treatments have shown both safety and promising outcomes in patients with HCC of various etiologies and tumor stages. Furthermore, combined strategies have been assessed to achieve optimal outcomes, by using immunotherapies with or without conventional treatments. This review briefly covers the background, recent advances, current issues, and future perspectives on immunotherapy in the field of HCC treatment

Surface Polishing of an Inconel 625 Bar by a Super-Fast MAF Process for a Solenoid Valve Stem Used in a Hydrogen Tank

This study explores a super-fast magnetic abrasive finishing (MAF) process for polishing the surface of an Inconel 625 bar workpiece for a hydrogen solenoid valve stem. The Inconel 625 bar was chosen to replace the existing STS 316 bar material, previously used for a hydrogen solenoid valve stem. The cylindrical surface of Inconel 625 bars was polished by a super-fast MAF process with high rotational speeds of 1000, 5000, 15,000, and 25,000 RPM and a super-strong magnetic field of 550 mT. The polishing characteristics of this process were evaluated according to the type of abrasives, rotational speeds of the workpiece and processing time. As a result, a super-smooth Inconel 625 bar was successfully achieved, with a surface roughness (Ra) reduced from 0.31 μm to 0.02 μm under the optimal conditions (15,000 RPM, CNT particles (0.04 μm), PCD diamond abrasive (1 μm), Fe (#200), 0.5 g of light oil, and 16 min of processing time). Also, the Ansys analysis results showed suitable strain, equivalent stress, and safety factor of the Inconel 625 bar. This confirmed that, after a super-fast MAF process, an Inconel 625 bar is feasible for application in Hydrogen (H2) tanks instead of a conventional STS 316 bar