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The recent advent of large language models (LLMs), such as ChatGPT, has drawn attention to generative artificial intelligence (AI) in a number of fields. Generative AI can produce different types of data including text, images, and voice, depending on the training methods and datasets used. Additionally, recent advancements in multimodal techniques, which can simultaneously process multiple data types like text and images, have expanded the potential of using multimodal generative AI in the medical environment where various types of clinical and imaging information are used together. This review summarizes the concepts and types of LLMs, image generative AI, and multimodal AI, and it examines the status and future possibilities of generative AI in the field of radiology.

Background and Objectives This study aimed to determine the efficacy of prophylactic desmopressin administered via the intranasal or intravenous route in reducing intraoperative bleeding during nasal surgery. We conducted a meta-analysis of the relevant literature to investigate the role of preoperative desmopressin in minimizing bleeding complications associated with nasal surgery. Methods We screened the relevant literature published before February 2023. Nine articles that compared the perioperative use of desmopressin (treatment) with a placebo or no treatment (control) were included. The analyzed outcomes were intraoperative bleeding during nasal surgery and postoperative morbidity. Results The treatment group showed significant improvements in intraoperative bleeding, the surgical field, and surgeon satisfaction compared to the control group. However, the prophylactic use of desmopressin was associated with elevated blood pressure and decreased serum sodium levels compared to the control group. Nonetheless, no significant adverse effects were reported in the included studies. Subgroup analyses comparing the route of administration (intravenous vs. intranasal) and type of surgery (rhinoplasty vs. endoscopic sinus surgery) showed that desmopressin had a beneficial effect on intraoperative bleeding and the surgical field, regardless of the route of administration or type of surgery. Conclusion The prophylactic use of desmopressin for nasal surgery effectively reduced intraoperative bleeding, improved the surgical field, and increased surgeon satisfaction, with no significant adverse effects. However, caution should be exercised when administering desmopressin as it may cause an elevation in postoperative blood pressure in patients with cardiopulmonary problems.

Cerebrospinal fluid (CSF) rhinorrhea is a rare condition characterized by the leakage of CSF through the nose. The diagnosis is established through comprehensive history taking, brain imaging, and nasal endoscopy. Surgical intervention is considered a secondary option for CSF leakage when conservative treatments, including behavioral therapy, pharmacotherapy, or lumbar puncture, fail to elicit a response. In recent years, endoscopic intranasal surgery has been favored over craniotomy for such surgical treatment. When repairing CSF leakage defects via endoscopic intranasal surgery, autologous fat and muscle flaps are commonly employed. However, these grafts may lead to complications, including donor site infection, edema, and wound dehiscence. Therefore, in this article, we would like to introduce two cases of CSF rhinorrhea repair surgery using TachoComb. While previous studies have employed TachoComb as a supplementary material for the repair of CSF leak defects, in the cases we describe, the primary reconstruction of the defect area was achieved using TachoComb, supported by free grafts such as septal bone or turbinate mucosal flap, which were smaller than the size of the CSF leakage defects.

A HBV infection is a dynamic disease and long-term liver inflammation contributes to the development of liver cirrhosis and hepatocellular carcinoma. Currently available nucleos(t)ide analogues and pegylated interferon are effective in inhibiting HBV replication but rarely achieve HBsAg clearance. The present article introduces a new definition of HBV cure and several emerging therapies for HBV cure, including direct acting antivirals and immune modulatory antivirals.

Acute aortic syndrome including intramural hematoma is a life-threatening disease encountered in the emergency department with high in-hospital mortality even when a timely diagnosis is made. Therefore, accurate differential diagnosis of acute aortic syndrome and its mimics is important to determine the patient’s treatment plan. Until now, a few pathologic diseases mimicking aortic intramural hematoma such as periaortic lymphoma and immunoglobulin G4- related periaoritis have been reported. Here, we report a rare case of granulomatosis with polyangiitis-related periaortitis misdiagnosed as aortic intramural hematoma presenting to the emergency department with chest pain and similar radiologic findings.

High intensity focused ultrasound (HIFU) is a non-surgical and non-invasive treatment option in patients with uterine myoma and adenomyosis. As the use of HIFU increases in the clinical practice, it is important to be aware of imaging findings related to ultrasound (US)-guided HIFU ablation and its potential complications. However, there are few reports on the imaging findings regarding complications of US-guided HIFU ablation. Here, we report a case of acute complication after US-guided HIFU ablation, surgically confirmed as thermal injury with necrosis of skin, subcutaneous tissue, anterior abdominal wall muscles, peritoneum and uterus.

Background: Pulmonary thromboembolism (PTE) is a life-threatening disease with high mortality. This study aimed to assess the outcomes of surgical embolectomy and to clarify the sustained long-term effects of surgery by comparing preoperative, postoperative, and long-term follow-up echocardiography outcomes. Of 22 survivors, 21 were followed up for a mean (median) period of 6.8±5.4 years (4.2 years). Methods: We retrospectively reviewed 27 surgical embolectomy cases for massive or submassive acute PTE from 2003 to 2016. Immediate and long-term follow-up outcomes of surgical embolectomy were assessed on the basis of 30-day mortality, long-term mortality, postoperative complications, right ventricular systolic pressure, and tricuspid regurgitation grade. Results: The 30-day and long-term mortality rates were 14.8% (4 of 27) and 4.3% (1 of 23), respectively. Three patients had major postoperative complications, including hypoxic brain damage, acute kidney injury, and endobronchial b leeding, respectively (3.7% each). Right ventricular systolic pressure (median [range], mm Hg) decreased from 62.0 (45.5–78.5) to 31.0 (25.7–37.0, p＜0.001). The tricuspid valve regurgitation grade (median [range]) decreased from 1.5 (0.63–2.00) to 0.50 (0.50–1.00, p＜0.05). The improvement lasted until the last echocardiographic follow-up. Conclusion: Surgical embolectomy revealed favorable mortality and morbidity rates in patients with acute massive or submassive PTE, with sustained long-term improvements in cardiac function.

The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CAB G). We p resent t he case of a 57-year-old m an w ho u nderwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication.

As the prevalence and life expectancy of type 2 diabetes mellitus (T2DM) continue to increase, the importance of effective detection and intervention for the complications of T2DM, especially neurocognitive complications including cognitive dysfunction and dementia, is receiving greater attention. T2DM is thought to influence cognitive function through an as yet unclear mechanism that involves multiple factors such as hyperglycemia, hypoglycemia, and vascular disease. Recent developments in neuroimaging methods have led to the identification of potential neural correlates of T2DM-related neurocognitive changes, which extend from structural to functional and metabolite alterations in the brain. The evidence indicates various changes in the T2DM brain, including global and regional atrophy, white matter hyperintensity, altered functional connectivity, and changes in neurometabolite levels. Continued neuroimaging research is expected to further elucidate the underpinnings of cognitive decline in T2DM and allow better diagnosis and treatment of the condition.

Thoracic aortic aneurysm (TAA) is the most common pathology of the thoracic aorta. The incidence of TAA is increasing and the true incidence of TAA is likely to be higher than currently reported because of its inherently silent nature. TAAs are an increasingly recognized condition that is diagnosed incidentally on imaging studies performed to evaluate unrelated conditions because most patients with TAA have no symptoms. TAAs normally grow in an indolent manner, but can become rapidly lethal once dissection or rupture occurs. Indeed, aortic aneurysms (both abdominal and thoracic) represent the 15th leading cause of death in individuals older than 55 years, and the 19th leading cause of death in individuals of all ages in the United States. The etiologies underlying TAAs are diverse. Therefore, the evaluation and management of TAAs are complex. The present review summarizes the knowledge of the pathophysiology, natural history and diagnostic modalities, as well as current treatment strategies of TAA on the basis of current literature. [ABSTRACT FROM AUTHOR]

Purpose: In this study, the articles which developed and applied nursing interventions for patients with cancer were reviewed and analyzed. Methods: The analysis was performed in light of 171 pieces of literature on nursing interventions for patients with cancer published between 1991 and 2010. Results: Approximately half of the studies have been published between 2006 and 2010. The quasi-experimental designs using nonequivalent control group and no-synchronized design were the most common form of research design among the 71 papers constituting 41.52% of the total. The most commonly used nursing intervention was education (25.2%), followed by massage (20.4%) and exercise (11.5%). The most common outcome variable was anxiety (11.8%), followed by pain (8.0%) and nausea and vomiting (7.3%). Conclusion: The results of this study can provide useful information for the development of nursing interventions in specialized areas. Systematic literature review or meta-analysis is needed in this area. [ABSTRACT FROM AUTHOR]

Purpose To develop and validate a deep learning-based screening tool for the early diagnosis of scoliosis using chest radiographs with a semi-supervised generative adversarial network (GAN). Materials and Methods Using a semi-supervised learning framework with a GAN, a screening tool for diagnosing scoliosis was developed and validated through the chest PA radiographs of patients at two different tertiary hospitals. Our proposed method used training GAN with mild to severe scoliosis only in a semi-supervised manner, as an upstream task to learn scoliosis representations and a downstream task to perform simple classification for differentiating between normal and scoliosis states sensitively. Results The area under the receiver operating characteristic curve, negative predictive value (NPV), positive predictive value, sensitivity, and specificity were 0.856, 0.950, 0.579, 0.985, and 0.285, respectively. Conclusion Our deep learning-based artificial intelligence software in a semi-supervised manner achieved excellent performance in diagnosing scoliosis using the chest PA radiographs of young individuals; thus, it could be used as a screening tool with high NPV and sensitivity and reduce the burden on radiologists for diagnosing scoliosis through health screening chest radiographs.

A HBV infection is a dynamic disease and long-term liver inflammation contributes to the development of liver cirrhosis and hepatocellular carcinoma. Currently available nucleos(t)ide analogues and pegylated interferon are effective in inhibiting HBV replication but rarely achieve HBsAg clearance. The present article introduces a new definition of HBV cure and several emerging therapies for HBV cure, including direct acting antivirals and immune modulatory antivirals.