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Despite the development of advanced tissue engineering substitutes, inflammation is still a significant problem that can arise from inflamed burn injuries, chronic wounds, or microbial diseases. Although topical wound dressing accelerates healing by minimizing or preventing the consequences of skin inflammation, there remains a need for the development of a novel substitute scaffold that can effectively eliminate immoderate inflammation and infection in the initial phase of the healing meachanism. In this study, an artificial skin substitute scaffold fabricated with asiaticoside (AS) and epsilon-poly-L-lysine (εPLL) was prepared. Upon the release of these bioactive compounds, they accelerate wound healing and inhibit any bacterial infection at the wound site. We determined whether AS and εPLL exhibit anti-inflammatory and bactericidal effects through different mechanisms. Collectively, the collagen-AS/εPLL artificial skin substitute could be a significant therapeutic agent for scar-less rapid wound healing (without infection and inflammation) of initially-inflamed full-thickness wounds.

Background Respiratory infection in children is a major disease that ranks high in outpatient and inpatient cases. In particular, the causes of community acquired pneumonia (CAP) vary depending on the individual susceptibility, epidemiological characteristics of the community, and season, and it is difficult to obtain samples for microbiological diagnosis. This study analysis that laboratory surveillance network of pathogen for pediatric CAP by linking the national community-based hospital and clinics and the Centers for Disease Control and Prevention (KCDC) to identify the distribution trend and prevalence of causative pathogens and to prevent antibiotic resistance of bacterial pathogens. Method The monitoring network was composed of the 28 secondary and tertiary medical institutions based on the national community, and the 24-month prospective study operated a community monitoring network for CAP in children. Results A total of 1023 cases were registered for nasopharyngeal aspirate or sputum in patients with CAP, and 711 cases (69.5%) were isolated by culture, S. aureus 131 cases (12.8%), S. pneumonia 92 cases (9%), H. influenzae 20 cases (2%). PCR of atypical pneumonia revealed 422 cases of M. pneumoniae (41.3%), 5 cases of C. pneumonia (0.5%), and 5 case (0.5%) of B. pertussis. Respiratory virus multiplex PCR test showed positive rates in 65.7%, human rhinovirus 312 (30.5%), RSV(A+B) 212 (20.7%), Adenovirus 123 (12%), Influenza (A+B) 53 (7.8%), CoV (OC43+NL63+229E) 69 (6.7%), HMPV 81 (7.9%), HBoV 51 (5%), PIV (1+2+3+4) 65 (6.4%) and HEV 30 (2.9%) Conclusion It will identify the pathogens that cause respiratory infections, and analyze the current status of antibiotic resistance to provide scientific evidence for management policies of domestic respiratory infection. Also, in preparation for the new epidemic, including COVID19, monitoring of respiratory infections in children and adolescents, especially community pneumonia, has become more important, and research should be continuously conducted in the future. The location and extent of involvement in the medulla were the most important factors associated with the severity of dysphagia after LMI.

Background A national immunization program (NIP) to prevent disease and reduce mortality from vaccine preventable diseases (VPD) is very important. Methods We analyzed only the anaphylaxis cases that occurred between 2001 and 2016 that Korea Centers for Disease Control and Prevention (KCDC) determined had a definite causal relationship with a vaccine. The clinical symptoms were assessed according to the Brighton Collaboration case definition (BCCD) level. Results During the period, there were 13 cases of vaccine-related anaphylaxis. The median age was 9 years (range, 1 month to 59 years). The incidence of anaphylaxis per million doses was 0.090 in 2005, 0.079 in 2012, 0.071 in 2013, 0.188 in 2015, and 0.036 in 2016. Of those cases, 23.1% were influenza vaccines, and 76.9% were BCCD level 2. Epinephrine was used in 46.2%. Conclusion Vaccine-related anaphylaxis seems to have been very rare in the past, but health care professionals must always be aware of anaphylaxis., Graphical Abstract

Background Bronchiectasis is a chronic pulmonary disease characterized by progressive and irreversible bronchial dilatation. The aim of the present study was to investigate the etiologies and clinical features of bronchiectasis in Korean children. Methods We performed a retrospective review of the medical records for children diagnosed with bronchiectasis between 2000 and 2017 at 28 secondary or tertiary hospitals in South Korea. Results A total of 387 cases were enrolled. The mean age at diagnosis was 9.2 ± 5.1 years and 53.5% of the patients were boys. The most common underlying cause of bronchiectasis was preexisting respiratory infection (55.3%), post-infectious bronchiolitis obliterans (14.3%), pulmonary tuberculosis (12.3%), and heart diseases (5.6%). Common initial presenting symptoms included chronic cough (68.0%), recurrent pneumonia (36.4%), fever (31.1%), and dyspnea (19.7%). The most predominantly involved lesions were left lower lobe (53.9%), right lower lobe (47.1%) and right middle lobe (40.2%). No significant difference was observed in the distribution of these involved lesions by etiology. The forced expiratory volume in 1 s (FEV1) levels were lowest in cases with interstitial lung disease-associated bronchiectasis, followed by those with recurrent aspiration and primary immunodeficiency. Conclusions Bronchiectasis should be strongly considered in children with chronic cough and recurrent pneumonia. Long-term follow-up studies on pediatric bronchiectasis are needed to further clarify the prognosis and reduce the disease burden in these patients.

This study compared and analyzed the tooth brushing time per day and dental caries in 1-13-year-old children in the stage of the completion of their permanent teeth based on the 6th primitive at data of objective National Health Nutrition Survey. The results show a meaningful difference between the DMFT and dental caries experience. In particular, the group with a lower toothbrushing rate after lunch generally have a higher incidence of dental caries.

Purpose Croup is a common pediatric respiratory illness with symptoms of varying severity. Moreover, epiglottitis is a rare disease that can rapidly progress to life-threatening airway obstruction. Although the clinical course and treatments differ between croup and epiglottitis, they are difficult to differentiate on presentation. We aimed to compare the clinical characteristics of croup and epiglottitis in Emergency Department patients. Methods The 2012 National Emergency Department Information System database of 146 Korean Emergency Departments was used to investigate patients aged ≤18 years presenting with croup or epiglottitis. Results We analyzed 19,374 croup patients and 236 epiglottitis patients. The male:female sex ratios were 1.9:1 and 2.3:1 and mean ages were 2.2±2.0 and 5.6±5.8 years, respectively. The peak incidence of croup was observed in July and that of epiglottitis was observed in May. The hospitalization rate was lower in croup than in epiglottitis patients, and the proportion of patients treated in the intensive care unit was lower among croup patients. The 3 most common chief complaints in both croup and epiglottitis patients were cough, fever, and dyspnea. Epiglottitis patients experienced dyspnea, sore throat, and vomiting more often than croup patients (P

Purpose: This study evaluated the clinical effects of heated humidified high flow nasal cannula (HHHFNC) treatment in pediatric pa tients with respiratory disease and respiratory insufficiency. Methods: We reviewed the medical records for clinical features and tests performed in patients admitted to Chungnam University Hospital pediatric ward and treated with HHHFNC between July 2014 and December 2018. We evaluated the effects of HHHFNC treatment in patients with bronchiolitis treated with oxygen using a nasal prong. Results: The 136 children were treated with HHHFNC during the study period, and their median age was 8 months. Among the 136 patients, 39 (28.7%) were diagnosed with bronchiolitis and pneumonia, 42 (30.9%) with pneumonia, 28 (20.6%) with bronchiolitis, and 3 (2.2%) with epilepsy. Thirty-five patients (25.7%) had underlying neurological disorders. Fifty-one (37.5%) received invasive ventilator treatment. After HHHFNC treatment, venous blood gas analysis showed a pH increase from 7.32 to 7.37 (P

Purpose The report of adverse events following immunization (AEFI) in Korea has continued since 1994, and the most frequently reported cases of AEFI of Korea Centers for Disease Control and Prevention (KCDC) is bacille Calmette-Guerin (BCG). Meanwhile, various inoculation methods and strains have been used in the past 6 years in Korea. Therefore, we investigated AEFI of BCG by strain types and inoculation methods using immunization safety surveillance of KCDC. Materials and methods We reviewed BCG AEFIs registered in the KCDC from January 2013 to June 2018. Results There were 336 AEFI cases during the period, and average time interval from vaccination to symptom onset was within 2 months. AEFI proportion was 6.4 cases per 100,000 doses for BCG percutaneous Tokyo strain, 41.6 cases per 100,000 doses of BCG intradermal Danish strain, and 25.9 cases per 100,000 doses of BCG intradermal Tokyo strain. Intradermal type was more reported AEFI than percutaneous type in the same strain. The most common adverse events were local reaction like BCG lymphadenitis and severe adverse reactions such as osteomyelitis or disseminated BCG disease were 0.1 to 0.2 cases per 100,000 doses which are correlated with the range of World Health Organization published AEFI rates. Conclusion The AEFI reporting rate does not equal the actual proportion of AEFI occurrence. Because AEFI monitoring is a passive surveillance system, various factors might influence the number of events reported. Nevertheless, it is important to analyze BCG AEFI by vaccine strains and inoculation method using surveillance data of KCDC.

Background Understanding the patterns of emergency department (ED) visits of patients with asthma is important for disease control and prevention of exacerbations. Objective This study aimed to investigate the characteristics of adult patients who visited EDs because of their asthma. Methods Patients with asthma, ages ≥19 years old, who visited 117 EDs throughout Korea between January 2007 and December 2012 were identified in the National Emergency Department Information System (NEDIS) data base using the International Classification of Disease, 10th revision, codes J45 (asthma) and J46 (status asthmaticus). Results A total of 97,835 adult patients with asthma visited 117 EDs throughout Korea during the study period. There was a slight female preponderance (male-to-female ratio, 1:1.09). The number of patients aged 70-79-years-old was 28,031 (28.7%), the highest among the patients with asthma. ED visits showed a seasonal distribution, with most occurring in winter and spring, followed by autumn. The seasonal distribution varied by age; most patients ages 19-49 years presented in autumn (September), whereas those patients ages ≥50 years presented to the ED most often in winter. Overall, 65.5% of patients were admitted to the hospital, including 12.6% admitted to an intensive care unit (ICU). Overall, 209 patients (0.2%) died. The rates of hospital admission to general wards and ICUs were highest in those patients ≥70 years old; this group also had the highest mortality rate. Conclusion In this nationwide study, which spanned 6 years, of adult patients with asthma, we observed an age-specific seasonal pattern of ED visits. Identifying the causes of age-related deterioration and seasonal visits to the ED will help prevent asthma symptoms and reduce medical costs.

The choice of hemostat is determined by the situation and the degree of hemorrhage. One common hemostat, the nonwoven dressing, is easy to handled and controls severe bleeding on wider wounds. In this study, chitosan-based nonwoven dressings with recombinant batroxobin (rBat) were used as efficacious hemostatic dressing agents. Hemostatic agents need to absorb blood quickly in the early stages of blood coagulation cascade to rapidly and effectively control of excessive hemorrhages. To date, most studies of hemostatic agents focused on a single material and hemostats composed of multiple materials have not been studied sufficiently. Thus, we made a chitosan dressing coated with rBat and investigated the microstructure, mechanical properties, hemostatic efficacy, and clotting properties of the coated dressing. Our results showed that the rBat had a synergetic effect on chitosan that improved blood coagulation. Furthermore, the dressing had excellent bleeding control in an Sprague-Dawley (SD) rat femoral artery hemorrhage model. In conclusion, hemostasis can be improved by combining a chitosan-based nonwoven dressing with other agents, and rBat-coated chitosan-based nonwoven dressings have enormous potential to improve blood coagulation.

The regulation of apoptosis, proliferation, and migration of fibroblasts is altered in keloids. The 90-kDa heat shock protein (heat shock protein 90) is known to play a key role in such regulation. Therefore, the authors investigated whether the inhibition of heat shock protein 90 in keloid fibroblasts could induce apoptosis and attenuate keloid fibroblast proliferation and migration.The authors evaluated heat shock protein 90 expression in keloid tissues with immunohistochemistry. The authors used cell viability [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assays and annexin V/propidium iodide staining for apoptosis, a wound healing model and cell tracking system to assess cell migration, and Akt Western blotting analysis in keloid fibroblasts after inhibition of heat shock protein 90 with 17-allylaminodemethoxygeldanamycin (17-AAG).The expression of heat shock protein 90 in keloid tissues was significantly increased compared with normal tissues. The 17-AAG-treated keloid fibroblasts showed significantly decreased proliferation, promotion of apoptosis, and decreased expression of Akt. Furthermore, a dose-dependent decrease in cell migration was noted after 17-AAG treatment of keloid fibroblasts. The 17-AAG-treated keloid fibroblasts had less directionality to the wound center and migrated a shorter distance.The authors confirmed that the inhibition of heat shock protein 90 in keloid fibroblasts could promote apoptosis and attenuate proliferation and migration of keloid fibroblasts. Therefore, the authors think that the inhibition of heat shock protein 90 is a key factor in the regulation of biological processes in keloids. With further preclinical study, the authors will be able to apply these results clinically for keloid treatment.

Background Medical devices inserted into the human body can be divided into single-use devices and reusable medical devices (RMDs) depending on the method of use. RMDs are applied to >1 patient, and users reprocess them prior to repeat use. Therefore, reprocessing of RMDs has become more difficult, and issues related to infection risk have become more prevalent. Methods Research was performed to compare differences in surface alterations between not-aged (NA) samples and accelerated-aging (AA) samples. NA and AA samples were exposed to potential contaminants and treated with the same cleaning conditions. Then the residual contaminants were analyzed, and adhesion characteristics were investigated. Results Significant differences between the 2 sample groups were observed in the pattern of physical surface alterations. Similar to the endoscope for clinical use, a deep crack was found in the surface of the AA sample. According to the binding affinity test, highly likely potential contaminants were found more frequently on AA samples. Conclusion The results suggest the necessity of limiting the duration of time that RMDs may be used, considering the potential risk of infection from repetitive use of RMDs, and also raised the possibility of applying this simulation model of AA. This methodology can be applied to various RMDs, including endoscopes.

Purpose Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. Methods We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. Results Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1-3 years old (48.6%) and the next was less than 12 months of age (17.4%). Based on International Classification of Diseases, 10th revision diagnostic codes, confirmed cases of viral pneumonia comprised 8.4% of all cases, pneumonia due to Mycoplasma pneumoniae comprised 3.8% and confirmed cases of bacterial pneumonia 1.3%. The prevalence of confirmed bacterial pneumonia decreased from 3.07% in 2007 and 4.01% in 2008 to 0.65% in 2014. The yearly rate of pneumococcal pneumonia also decreased from 0.47% in 2007 to 0.08% in 2014. A periodic prevalence of M. pneumoniae pneumonia (MP) was identified. Conclusion The increased number of patients with pneumonia, bacterial pneumonia, pleural effusion, and empyema in 2011 and 2013-2014 resulted from an MP epidemic. We provide evidence that the frequency of confirmed cases of bacterial pneumonia and pneumococcal pneumonia has declined from 2007 to 2014, which can simultaneously reflect the effectiveness of the pneumococcal conjugate vaccine.

본 연구는 객관적인 국가차원의 국민건강영양조사 원시자료를 활용하여 만 14세에서 만 19세까지의 청소년을 추출하고 식품군별로 조사된 섭취빈도조사의 내용을 바탕으로 구강검진 조사의 항목으로 실시된 우식영구치수, 영구치우식유병자여부, 우식경험영구치수, 영구치우식경험여부등의 4가지 항목의 영향력 관계를 조사하였다. 우식영구치수, 영구치우식유병자 여부, 우식경험영구치 수, 영구치우식경험 여부등은 쌀과 배추 김치를 주식으로 하는 우리나라 식생활 문화에 가장 영향을 많이 받았고 쌀과 잡곡, 배추등의 채소와 과일류 등은 치아우식을 낮추는 영향을 주는 인자로 조사되었다. 쌀의 섭취 빈도가 많을수록 치아우식은 감소하는 것으로 나타났으며, 고기 생선 난류의 식품군에서는 멸치의 섭취 빈도가 많을 수록 치아우식은 감소하였고, 돼지고기와 소고기 등의 육류의 섭취 역시 치아우식의 발생을 감소시키는 것으로 나타났다. 특히 탄산음료와 패스트푸드 식품의 일종인 햄버거와 피자등의 섭취 빈도가 클수록 치아우식을 증가시키는 것으로 나타났다. 【This study applied an original survey of an objective National Health Nutriment Research. It picked the youth up from 14 years old to 19 years old and examined an influence relationship of four heads such as DT, DI, DMFT, DMFI which investigated in heads of dental inspections based on an intake frequency questionnaire by food group. It was proved that Korean dietary culture which eats rice and kimchi as staple food had an great effect on DT, DI, DMFT, DMFI And rice and cereals, fruits and vegetables like a cabbage turned out to be factors that can lower dental caries. The dental caries can be reduced by the more intake frequency of rice. And also, intake of fish like anchovy and meats like pork and beef can reduce development of dental caries too. Especially, the larger intake frequency of carbonated drinks and fast food such as hamburger and pizza can make a growth of dental caries.】

In order to overcome the insufficiency of single remote sensing data in change detection, synthetic aperture radar (SAR) and optical image data can be used together for supplementation. However, conventional image fusion methods fail to address the differences in imaging mechanisms and cannot overcome some practical limitations such as usage in change detection or temporal requirement of the optical image. This study proposes a new method to fuse SAR and optical images, which is expected to be visually helpful and minimize the differences between two imaging mechanisms. The algorithm performs the fusion by establishing relationships between SAR and multispectral (MS) images by using a random forest (RF) regression, which creates a fused SAR image containing the surface roughness characteristics of the SAR image and the spectral characteristics of the MS image. The fused SAR image is evaluated by comparing it to those obtained using conventional image fusion methods and the proposed method shows that the spectral qualities and spatial qualities are improved significantly. Furthermore, for verification, other ensemble approaches such as stochastic gradient boosting regression and adaptive boosting regression are compared and overall it is confirmed that the performance of RF regression is superior. Then, change detection between the fused SAR and MS images is performed and compared with the results of change detection between MS images and between SAR images and the result using fused SAR images is similar to the result with MS images and is improved when compared to the result between SAR images. Lastly, the proposed method is confirmed to be applicable to change detection.

OBJECTIVES The purpose of this study was to evaluate the effectiveness of real-time fusion imaging (sonography combined with computed tomography or magnetic resonance imaging) for percutaneous sonographically guided biopsy of focal hepatic lesions with poor sonographic conspicuity. METHODS This study was conducted as a retrospective analysis of a prospective database and was approved by the Institutional Review Board. Patients who had target lesions with poor conspicuity on B-mode sonography for percutaneous biopsy were enrolled in the study. Lesion conspicuity was assessed by conventional B-mode sonography first and then by fusion imaging later in the same session. We compared lesion conspicuity and detection rates between B-mode sonography and fusion imaging and evaluated how many cases of initially invisible lesions on B-mode sonography became visible on fusion imaging. The technical success rate was evaluated on the basis of the final diagnoses, which were established by pathologic examination of the biopsy specimens as well as follow-up clinical and radiologic examinations. RESULTS A total of 22 patients were enrolled in the study. On fusion imaging, lesion conspicuity was increased in 63.6% of focal hepatic lesions (14 of 22). Moreover, 66.7% of lesions (6 of 9) that were invisible on B-mode sonography became visible on fusion imaging. The true-positive detection rate was significantly different between B-mode sonography and fusion imaging (9 of 22 versus 19 of 22; P = .0044). Percutaneous biopsy was performed for all lesions, including 3 target lesions that were invisible even on fusion imaging. The technical success rate was 95.5% (21 of 22). CONCLUSIONS Fusion imaging is effective for percutaneous biopsy of focal hepatic lesions with poor sonographic conspicuity.

Purpose To investigate the characteristic sonographic (US) findings of pure ductal carcinoma in situ (DCIS) in a large series. Methods We retrospectively reviewed the US findings of 126 cases of pure DCIS in 123 consecutive patients who underwent surgery for breast cancer in our hospital. We analyzed the US findings of the lesions according to mass or nonmass abnormality, shape, margin, orientation, echogenicity, echotexture, boundary echo, posterior acoustic features, presence of associated ductal dilatation, presence of intralesional cystic focus, and presence of microcalcifications on US. We compared the US characteristics of pure DCIS with and without mammographic microcalcifications. Results Seventy-eight cases of pure DCIS had microcalcifications and 48 had no microcalcifications on mammography (MG). Overall, 109 cases (86.5%) of pure DCIS were demonstrated on US. DCIS with microcalcifications on MG showed positive US findings in 79.5% of cases. The most common US finding was heterogeneous hyper- or isoechoic parenchyma with intralesional microcalcifications and without posterior acoustic features. DCIS without microcalcifications on MG showed positive US findings in 97.9% of cases. The most common US findings were masses with round or oval shape, microlobulated margin, parallel orientation, heterogeneous mild hypoechogenicity, and without boundary echo or posterior acoustic features. Ductal dilatations and intralesional cystic foci were present in 17.5% (22/126) and 23.8% (30/126) of pure DCIS, respectively. Conclusions Overall, US could demonstrate 85.7% of pure DCIS cases, including 16 (12.7%) cases of clinically and mammographically occult pure DCIS. DCIS with and without microcalcifications on MG showed different US characteristics. © 2013 Wiley Periodicals, Inc. J Clin Ultrasound, 41:465–471, 2013

Background Gadoxetic acid and diffusion-weighted imaging (DWI) is increasingly used for the diagnosis of hepatocellular carcinoma (HCC). It is relevant to refine the diagnostic parameters for HCC, using state-of-the-art imaging techniques. Purpose To validate usefulness of magnetic resonance imaging (MRI) criteria with gadoxetic acid-enhanced MRI and DWI for diagnosis of small HCC by differentiation from dysplastic nodule (DN) or regenerative nodule (RN) in cirrhotic patients with strongly suspected small HCC. Material and Methods One hundred and eight patients with 102 HCCs and 29 benign nodules including 21 DNs and two large RNs (≤ 2.0 cm), and 40 patients with no HCC underwent gadoxetic acid-enhanced MRI and DWI. All patients also underwent MDCT. Index MR criteria for HCC were: (i) arterial hyperenhancement and hypointensity on hepatobiliary phase (HBP) with hyperintensity on DWI; (ii) hypovascular nodule with hyperintensity on DWI; (iii) arterial hyperenhancement and hypointensity on HBP without hyperintensity on DWI; (iv) arterial hyperenhancement and either iso- or hyperintensity on HBP, with hyperintensity on DWI; and (v) hyperintensity only on DWI. According to these criteria, MRI findings for HCCs and benign nodules were independently classified by two reviewers. Results On multidetector-row computed tomography, 64 HCCs (62.7%) showed typical features for HCC while 13 (12.8%) were not identified. On MRI, 84 HCCs (82.4%) showed arterial hyperenhancement and hypointensity on HBP, and hyperintensity on DWI. Eight HCCs were regarded as hypovascular HCCs with hyperintensity DWI (category 2). One HCC (0.6 cm in diameter) was demonstrated only by DWI. For each observer, 101 (99.0%) and 100 HCCs (98.0%) were discernible when applying all MRI criteria for HCC, respectively. Three DNs also fit the HCC criteria, thus the specificity was 90.9% for both observers. Conclusion With the HCC criteria based on combined gadoxetic acid-enhanced MRI and DWI, it is possible to reliably diagnose small HCC including hypovascular HCCs.

Purpose To compare the image quality between T1 high-resolution isotropic volume examination using the multi-echo Dixon technique (mDixon-eTHRIVE) and that using spectrally adiabatic inversion recovery (SPAIR-eTHRIVE) in gadoxetic acid-enhanced liver MRI, and to evaluate the detectability of hepatocellular carcinoma (HCC) on mDixon-eTHRIVE. Materials and Methods Seventy patients with 117 HCCs underwent gadoxetic acid-enhanced liver MRI using mDixon-eTHRIVE. All patients also underwent gadoxetic acid-enhanced MRI using SPAIR-eTHRIVE (mean interval of 96 days). Two radiologists performed a consensus review of MRIs for image quality, homogeneity of fat suppression, artifact, and anatomic sharpness using a four-point scale. The detectability for HCC with mDixon-eTHRIVE was assessed using alternative-free response receiver operating characteristic. Results All mDixon-eTHRIVE images received higher scores for homogeneity of fat suppression and image quality (P 0.05). Diagnostic accuracy (Az) and sensitivity for detecting HCCs with mDixon-eTHRIVE images were mean 0.954 and 93.2%, respectively. Conclusion For gadoxetic acid-enhanced liver MRI, mDixon-eTHRIVE showed improved homogeneity of fat suppression and overall image quality compared with SPAIR-eTHRIVE. J. Magn. Reson. Imaging 2013;38:401–410. © 2013 Wiley Periodicals, Inc.

To evaluate the value of diffusion-weighted (DW) imaging in differentiation of an intrapancreatic accessory spleen (IPAS) from a small (3 cm) solid pancreatic tumor.This retrospective study was approved by the institutional review board, and informed consent was waived. Twenty patients with IPAS and 22 patients with small solid pancreatic tumors were included. All patients underwent abdominal magnetic resonance (MR) imaging with DW and gadoxetic acid-enhanced imaging. Qualitative (signal intensity) and quantitative (signal intensity and apparent diffusion coefficient [ADC]) evaluations were performed by two observers. Fisher exact test and Mann-Whitney U test were used for comparing groups.Compared with the spleen, the IPAS showed isointensity more frequently than did small pancreatic tumors on T2-weighted images (95% [19 of 20] vs 41% [nine of 22]), arterial phase images (100% [20 of 20] vs 18% [four of 22]), portal phase images (100% [20 of 20] vs 23% [five of 22]), late phase images (100% [20 of 20] vs 41% [nine of 22]), and DW images with b value of 0 sec/mm(2) (100% [20 of 20] vs 9% [two of 22]), b value of 100 sec/mm(2) (95% [19 of 20] vs 27% [six of 22]), and b value of 800 sec/mm(2) (100% [20 of 20] vs 27% [six of 22]), with significant differences (P.01). The means of the absolute value of relative signal intensity and ADC ratio on DW images of IPAS were significantly lower and closer to zero than those of pancreatic tumors (P.05). Visual assessment of the similarity between pancreatic lesion and spleen on DW images for diagnosis of IPAS yielded diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 95% (40 of 42), 100% (20 of 20), 91% (20 of 22), 91% (20 of 22), and 100% (20 of 20), respectively, for observer 1 and 90% (38 of 42), 95% (19 of 20), 86% (19 of 22), 86% (19 of 22), and 95% (19of 20), respectively, for observer 2.In addition to conventional morphologic MR imaging, DW imaging can be used as a tool for differentiating IPAS from solid pancreatic tumors.http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.12112765/-/DC1.

The objective was to determine imaging features that distinguish small (≤3cm) solid pancreatic adenocarcinoma, neuroendocrine tumor (NET) and solid pseudopapillary tumor (SPT) on gadoxetic-acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighed imaging (DWI).Twenty-four adenocarcinomas, 10 NETs and 8 SPTs were retrospectively included. Two radiologists analyzed morphologic features, signal intensity of the tumors on MR images including DWI (b=800) and dynamic enhancement pattern with consensus. Tumor-to-parenchyma ratio and tumor apparent diffusion coefficients (ADCs) were quantitatively assessed.All adenocarcinomas had an ill-defined margin and irregular shape, and more frequently had pancreatic duct dilatation compared with other tumors (P.05). All SPTs and all but one of the adenocarcinomas (95.8%) had no arterial enhancement with progressively increased enhancement, whereas seven NETs (70%) had arterial enhancement with progressively decreased enhancement (P.01). The mean value of tumor-to-parenchyma ratio on arterial and portal phases was significantly higher for NETs, and the mean value of tumor ADCs was significantly lower for SPTs than for other tumors (P.05).Gadoxetic-acid-enhanced MRI may aid in differentiation between small adenocarcinomas, NETs and SPTs based on morphologic features with dynamic enhancement pattern in adenocarcinomas, dynamic enhancement pattern with tumor-to-parenchyma ration on arterial and portal phases in NETs, and dynamic enhancement pattern with lower ADC value in SPTs.

A major challenge in the use of electrospun scaffolds for tissue generation is that tightly packed layers of nanofibers can block cell infiltration into the scaffold, resulting in non-homogeneous cell distribution. This can cause incomplete extracellular matrix deposition and failure to generate tissue. In this study, we developed a cell seeding method that supports cell infiltration and distribution within a three-dimensional (3D) flexible and shape-controllable electropun scaffold. Cells were seeded on the scaffold layer-by-layer and cell growth rate 7 days post seeding was compared to cell growth after traditional cell seeding. Scanning electron microscopy demonstrated that the shape-controlled scaffold consist of microfibers with uniform thickness. In using the layer-by-layer seeding method, we observed that the cells were distributed uniformly throughout the 3D scaffold. In contrast, use of the traditional cell seeding method resulted in the cells remaining on the surface of the scaffold. These results suggest that a layer-by-layer cell seeding method can improve cell distribution within a 3D scaffold and effectively facilitate tissue formation. Open image in new window

Background As diffusion-weighted imaging (DWI) is routinely incorporated into the standard clinical protocol, it is clinically relevant to determine whether DWI after gadoxetic acid is comparable to pre-contrast DWI, with regard to the detection and characterization of focal liver lesions. Purpose To compare DWI before and after administration of gadoxetic acid in the detection and characterization of small (≤2.5 cm) focal hepatic lesions. Material and Methods One hundred and fifty-eight patients with 237 focal hepatic lesions (≤2.5 cm) (124 HCCs, 50 metastases, 2 cholangiocarcinomas, 43 hemangiomas, and 18 cysts) were included. DWIs were obtained before and after administration of gadoxetic acid. Non-breath-hold DWI was performed with b values of 0, 100, and 800 s/mm2. Signal-to-noise ratio (SNR), lesion-liver contrast-to-noise ratio (CNR), and apparent diffusion coefficients (ADCs) of the liver and lesion were calculated. Lesion detection with each DWI was evaluated with alternative free-response receiver-operating characteristic analysis by two observers. The sensitivity of the characterization of focal hepatic lesions as solid (malignancy) or non-solid (benignity) with each DWI was calculated using a five-point confidence scale. Inter-observer agreement regarding lesion detection and characterization was evaluated using kappa statistics. Results SNRs of the liver on post-contrast DWI were significantly lower than on unenhanced DWI at b = 800 s/mm2 ( P < 0.05). SNRs, CNRs, and ADCs of focal hepatic lesions were not significantly different between two DWIs ( P > 0.05). The diagnostic accuracy (Az) for lesion detection and the sensitivity for lesion characterization did not show significant difference between two DWIs ( P > 0.05). With regard to the detection and characterization of focal hepatic lesions, the kappa values for two DWIs indicated good and excellent inter-observer agreement, respectively. Conclusion Gadoxetic acid-enhanced DWI showed comparable diagnostic capability to unenhanced DWI for the detection and characterization of small focal hepatic lesions.

To prospectively and intraindividually compare liver magnetic resonance imaging (MRI) using single-source and dual-source parallel radiofrequency (RF) transmissions at 3.0-T for image quality, lesion detectability, and lesion contrast.Ninety-nine patients with 139 liver lesions underwent liver MRI at 3.0-T. Two radiologists performed a consensus review of T2-weighted images (T2WI), heavily T2WI (HT2WI), gadoxetic acid-enhanced hepatobiliary images, and diffusion-weighted imaging using single-source and dual-source RF transmissions with regard to image quality and lesion detectability. Contrast ratios between liver lesions and liver parenchyma were also calculated.Image quality was better with dual-source than with single-source at T2WI and HT2WI (P0.05), but lesion detectabilities were similar for all sequences. There was no significant difference in mean contrast ratios for all sequences (P0.05).Dual-source RF transmission provides a better image quality with T2WI and HT2WI than with single-source. However, 2 techniques showed similar lesion detectability.

RAS-driven tumors are often difficult to treat with conventional therapies and therefore, novel treatment strategies are necessary. The present study describes a promising targeted therapeutic strategy against non-small cell lung cancer (NSCLC) harboring KRAS mutations, which has intrinsic resistance to MEK inhibition. Results showed that intrinsic resistance to MEK inhibition occurred via high AKT expression by PI3K activation as a bypass pathway. The HSP90 inhibitor AUY922 suppressed PI3K-AKT-mTOR and RAF-MEK-ERK, and rendered cells sensitive to trametinib (GSK1120212). Synergy from the combination of the two drugs was observed in only sub-therapeutic concentrations of either drug. Dual inhibition of the HSP90 and MEK signaling pathways with sub-therapeutic doses may represent a potent therapeutic strategy to treat KRAS-mutant NSCLC with intrinsic resistance to MEK inhibition and to resolve the toxicity observed upon dual inhibition of AKT and MEK at therapeutic doses in clinical trials.

The purpose of this article is to evaluate the value of gadoxetic acid-enhanced hepatobiliary phase imaging and high-b-value diffusion-weighted imaging (DWI) for distinguishing well-differentiated hepatocellular carcinomas (HCCs) from benign hepatocellular nodules in patients with chronic liver disease using 3-T MRI.Forty-five patients with 46 well-differentiated HCCs (mean, 2.3 cm) and 21 patients with 24 benign hepatocellular nodules (five large regenerative nodules and 19 dysplastic nodules; mean, 1.8 cm) were included in this study. Diagnosis of well-differentiated HCCs and benign hepatocellular nodules was made histopathologically by percutaneous biopsy (n = 12 and n = 11, respectively) or surgical resection (n = 34 and n = 13, respectively). Gadoxetic acid-enhanced MRI was performed for all patients, and DWI (b values of 0 and 800 s/mm(2)) was performed for 31 well-differentiated HCCs and 11 benign hepatocellular nodules. Two radiologists performed a consensus review of the MRI scans for signal intensity compared with that of the surrounding liver parenchyma on hepatobiliary phase images and DWI (b value, 800 s/mm(2)) for qualitative analysis. The contrast-to-noise ratio (CNR) and relative contrast enhancement of lesions on hepatobiliary phase images and the apparent diffusion coefficient (ADC) values were assessed for quantitative analysis.In the qualitative analysis, 39 well-differentiated HCCs (85%) and 14 benign hepatocellular nodules (58%) were hypointense on hepatobiliary phase images, and seven well-differentiated HCCs (15%) and 10 benign hepatocellular nodules (42%) were iso- or hyperintense (p = 0.04). Twenty-five well-differentiated HCCs (81%) and three benign hepatocellular nodules (27%) were hyperintense on DWI, with b value of 800 s/mm(2), and six well-differentiated HCCs (19%) and eight benign hepatocellular nodules (73%) were iso- or hypointense (p = 0.01). When lesion hypointensity on hepatobiliary phase images or hyperintensity on DWI were considered signs of HCC in cirrhotic liver, our results yielded sensitivities of 85% and 81% and specificities of 42% and 73%, respectively. In the quantitative analysis, the mean (± SD) relative contrast enhancement ratio of the well-differentiated HCCs (0.76 ± 2.30) was significantly higher than that of benign hepatocellular nodules (0.25 ± 0.97) (p = 0.02). The lesion-to-liver CNRs and the mean ADC values were not significantly different between the two groups (p0.05).Hypointensity on gadoxetic acid-enhanced hepatobiliary phase images and hyperintensity on high-b-value DWI to surrounding liver parenchyma suggest well-differentiated HCCs rather than benign hepatocellular nodules in chronic liver disease.

Gastric cancer is a common deadly cancer worldwide. The tumor-node-metastasis (TNM) staging system is one of the most commonly used staging systems, and is accepted and maintained by the International Union against Cancer (UICC) and the American Joint Committee on Cancer (AJCC). The TNM system is well known to effectively predict the prognosis of gastric cancer patients. The latest revision of TNM staging was presented in the 7th edition of the AJCC in 2009. Multi-detector row CT (MDCT) is a powerful test for non-invasive evaluation and can assess metastatic and locoregional staging simultaneously. Current MDCT with isotropic imaging and 3D images has increased the accuracy of T and N staging in patients with gastric cancer. Multi-planar reformatted images permit the radiologist to select the optimal imaging plane to accurately evaluate tumor invasion depth of the gastric wall and perigastric infiltration to identify a fat plane between a tumor and adjacent organs, to avoid partial volume averaging effects, and to differentiate lymph nodes from small perigastric vessels. Thus, MDCT provides a useful all-in-one diagnostic method for the pre-operative evaluation of patients with known, or strongly suspected, gastric cancer according to the 7th AJCC TNM staging system.

To determine the quantitative difference between an intact complete discoid lateral meniscus (CDLM) and a torn CDLM on MR imaging.Between May 2005 to November 2009, 137 patients with a CDLM (107 intact CDLM and 30 torn CDLM) and 92 patients with a normal meniscus were included in this study. The evaluated parameters were the height of the posterior horn of the lateral and medial menisci on the sagittal images and their ratio as assessed by two observers twice at an interval of 1 month. Each parameter was analyzed based on the Kruskal Wallis test, and the analysis using the mixed model. Intraclass correlation coefficient (ICC) was used to determine the interobserver reliabilities at session 2.The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CLDM, and a normal meniscus were 6.5, 7.3, 5.7 and 6.6, 6.4, 6.7 mm at session 1, respectively. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CDLM, and a normal meniscus for both observers were 6.5, 7.2, 5.7 and 6.6, 6.3, 6.8 mm at session 2, respectively. The ratio of the height of the lateral to the height of the medial meniscus for an intact CDLM at both sessions for both observers was 1.0. The ratios were 1.2 and 0.8 for a torn CDLM and for a normal meniscus, respectively, at both sessions for observer 1. The ratios were 1.2 and 0.9 for a torn CDLM and for a normal meniscus, respectively, at session 2 for observer 2. The heights of the posterior horn of the lateral meniscus on the sagittal images and the ratios of the heights of the lateral to the medial menisci in all three groups were statistically significantly different for both sessions (p 0.0001). The interobserver ICCs for each parameter of both an intact CDLM and a torn CDLM at session 2 showed high correlations (p 0.0001).The height of the lateral meniscus and the ratio of the height of the lateral to the height of the medial meniscus for a torn CDLM were significantly higher than those for an intact CDLM.

The quality assurance (QA) is of utmost importance in biobanks when archived biomaterials are distributed to biomedical researchers. For sample authentication and cross-contamination detection, the two fundamental ele-ments of QA, STR genotyping is usually utilized. Howev-er, the incorporated number of STR markers is highly redundant for biobanking purposes, resulting in time and cost inefficiency. An index to measure the cross-con-tamination detection capability of an STR marker, the mixture probability (MP), was developed. MP as well as other forensic parameters for STR markers was vali-dated using STR genotyping data on 2328 normal Koreans with the commercial AmpFlSTR kit. For Koreans, 7 STR marker (D2S1338, FGA, D18S51, D8S1179, D13S317, D21S11, vWA) set was sufficient to provide discrimination power of ∼10 −10 and cross-con-tamination detection probability of ∼1. Interestingly, similar marker sets were obtained from African Ameri-cans, Caucasian Americans, and Hispanic Americans under the same level of discrimination power. Only a small subset of commonly used STR markers is suffi-cient for QA purposes in biobanks. A procedure for se-lecting optimal STR markers is outlined using STR gen-otyping results from normal Korean population.Keywords: Biobank, cross-contamination detection, quali-ty assurance, sample authentication, short tandem re-peat

The objective of our study was to evaluate the feasibility rate and the reasons for infeasibility of percutaneous radiofrequency ablation of hepatocellular carcinomas (HCCs) at planning sonography.We retrospectively evaluated 248 patients who had been referred for planning sonography at our department between October 2005 and February 2006. We reviewed the radiologic reports of 256 planning sonography examinations in terms of the rate of feasible cases and the reasons for infeasibility. The reasons for infeasibility were classified in six categories: an inconspicuous tumor, an inadequate electrode path, an organ vulnerable to collateral thermal damage, a tumor that was too large or too many tumors, and a high risk of the heat sink effect. In addition, we assessed the treatment modality for the patients who were determined to have HCCs for which percutaneous radiofrequency ablation was not feasible.In 141 (55%) of the 256 planning sonography examinations, percutaneous radiofrequency ablation was feasible. The remaining 115 (45%) planning sonography examinations revealed that radiofrequency ablation was not a feasible procedure. The reasons for infeasibility included an inconspicuous tumor in 77 patients (55.8%), an inadequate electrode path in 33 patients (23.9%), an organ vulnerable to collateral thermal damage in 14 patients (10.1%), a tumor that was too large or too many tumors in eight patients (5.8%), a high risk of the heat sink effect in five patients (3.6%), and a portal vein thrombosis in one patient (0.7%). One reason for infeasibility was found in 96 patients, two reasons in 19 patients, and four reasons in one patient. Seventy (61.9%) of 113 patients for whom radiofrequency ablation was not feasible underwent transcatheter arterial chemoembolization as an alternative treatment.In approximately half of the patients for whom percutaneous radiofrequency ablation of HCC is requested, the procedure is not feasible, mainly due to inconspicuous tumors, at planning sonography. Additional objective criteria for assessing the feasibility of radiofrequency ablation and therapeutic strategies according to the reasons for infeasibility should be investigated further.

Purpose – The purpose of this paper is to investigate the effects of perceived product characteristics (i.e. involvement, product type, and switching cost) and consumer value consciousness on private brand purchase intent.Design/methodology/approach – A college student sample was surveyed to measure product characteristic perceptions for six product categories and to evaluate private brand purchase intent. Analysis of covariance was conducted for hypothesis testing.Findings – Support existed for the significant effects of all three product characteristics on the intent to purchase private brands. A moderating effect by value consciousness on the product type (search versus experience) emerged.Practical implications – It is critical that retailers identify appropriate product categories as they develop private brands. Private brand marketing strategies should be designed to reduce the level of product involvement and switching cost, and to increase consumer perception of search properties.Originality/value...

Adhesions are abnormal attachments between tissues, caused by an inflammatory stimulus or trauma. It was generally used physical barriers and various agents to prevent from adhesions formation. In this study, we made an experiment on animals with wound covering material of substance to prevent tissue adhesion. It was performed in sub-acute toxicity, and tested local effects after implantation.

Mycoplasma pneumoniae pneumonia (MP) is responsible for 10-40% of cases of pediatric community-acquired pneumonia. Occasionally, progression to severe pneumonia occurs despite appropriate antibiotic therapy. We retrospectively evaluated the effect of prednisolone in 15 children with MP whose clinical and radiographic course worsened despite broad-spectrum antibiotics, including appropriate macrolides. The mean ( +/- SD) age was 6.1 +/- 1.9 years, and 10 were boys. All children had received macrolides at presentation, but they had persistent fever and progressively worsening radiographic findings. In addition to broad-spectrum antimicrobial therapy, we added prednisolone (1 mg/kg for 3-7 days, then tapered over 7 days) on day 6 (+/-1.5 days) of admission. Fourteen children became afebrile within 24 hr, and their clinical status and radiographic findings improved over several days. The white blood cell count at presentation was 7,500 +/- 2,000/mm3, with a proportion demonstrating lymphopenia (lymphocyte differential, 19.7 +/- 5.7%). In conclusion, corticosteroid treatment appeared to be temporally associated with clinical and radiographic improvement, and may be helpful for reducing morbidity in children with macrolide-nonresponsive severe MP. Further studies may be warranted.

This study analyzed prosthesis condition of the patients according whether they have diabetes or not. It indicates that the patients with diabetes have more prosthesis. For the types of prosthesis of the patients with diabetes, fixed and partial dentures were most common and for the normal patients, most of them do not have prosthesis.

Background Cell migration is an essential activity of the cells in various biological phenomena. The evidence that electrotaxis plays important roles in many physiological phenomena is accumulating. In electrotaxis, cells move with a directional tendency toward the anode or cathode under direct-current electric fields. Indium tin oxide, commonly referred to as ITO has high luminous transmittance, high infrared reflectance, good electrical conductivity, excellent substrate adherence, hardness and chemical inertness and hence, have been widely and intensively studied for many years. Because of these properties of ITO films, the electrotaxis using ITO plate was evaluated. Results Under the 0 V/cm condition, MDA-MB-231 migrated randomly in all directions. When 1 V/cm of dc EF was applied, cells moved toward anode. The y forward migration index was -0.046 ± 0.357 under the 0 V/cm and was 0.273 ± 0.231 under direct-current electric field of 1 V/cm. However, the migration speed of breast cancer cell was not affected by direct-current electric field using ITO plate. Conclusions In this study, we designed a new electrotaxis system using an ITO coated glass and observed the migration of MDA-MB-231 on direct current electric-field of the ITO glass.

To determine the computed tomographic (CT) findings of acute pelvic inflammatory disease (PID).This retrospective, single-institution case-control study was approved by our institutional review board, and the informed consent was waived owing to the retrospective nature of the study. CT images of 32 women with clinically proven acute PID and 32 control subjects with other conditions of similar presentation were retrospectively reviewed. Analysis of CT findings included hepatic capsular enhancement, pelvic fat haziness, complicated ascites, uterine serosal enhancement, tubal thickening, endometritis, and oophoritis. Comparison of CT findings was performed with the Chi square test or the Fisher exact test and logistic regression analysis was used to determine significant CT findings in predicting PID.The CT findings that showed a statistically significant difference were hepatic capsular enhancement on late arterial phase (p = 0.003), pelvic fat haziness (p = 0.045), and tubal thickening (p = 0.001). Subsequent multivariate logistic regression analysis revealed that the presence of hepatic capsular enhancement on late arterial phase and tubal thickening were significant predictors of PID (hepatic capsular enhancement on late arterial phase, p = 0.015, odds ratio [OR] = 4.8; tubal thickening, p = 0.005, OR = 10.5).Diagnostic morphological CT findings in women with clinically proven PID and acute abdominal pain include hepatic capsular enhancement on late arterial phase and tubal thickening.

The objective of this study was to compare aortic (the common carotid to femoral artery) PWV, arm (the brachial to radial artery) PWV, and leg (the femoral to dorsalis pedis artery) PWV in people with or without component of the metabolic syndrome. We analyzed 3345 Korean subjects (1907 men, age 44.6 ± 8.5, 1438 women, age 43.3 ± 8.9). Unpaired t-test was used to compare mean values of various metabolic parameters between subjects with and without Metabolic Syndrome (MetS), and one-way analysis of variance was used to compare these variables among groups satisfying different numbers of the components of MetS. In addition, we compared of Pearson correlation coefficient between age and PWV (arotic PWV, arm PWV and leg PWV) levels of according to whether the subject had components of the metabolic syndrome or not. The present study shows that leg PWV level was found to be significantly associated with the features of the metabolic syndrome in Korean men and women. And, we confirmed that blood pressure is significantly associated with the PWV values at three locations. And, this study shows that Pearson correlation coefficient of arotic PWV and leg PWV were about 10% higher than without diabetes according to age. Further studies need to be performed to evaluate the optimal cut-off value of PWV for diabetes, hypertension, and MetS in Korean.

Purpose: The effective management of atopic dermatitis (AD) adjusted to individual clinical courses and demands can be challenging to both patients and physicians. Understanding of actual situations, experienced and perceived by patients with AD and their caregivers, is essential to improve clinical outcomes and satisfaction in real practice.Methods: This multicenter survey was conducted in patients with AD or their caregivers from 9 centers with questionnaires on diagnosis and management of AD.Results: A total of 324 patients and caregivers participated in the study. Most of the AD cases were initially diagnosed by physicians (80.6%), followed by self-diagnosis. Patients and caregivers thought that allergic substances, such as house dust mites, food, and pollutants, are responsible for AD development; moisturization, environmental control, and improvement of the body constitution are important for AD management. Allergy tests were performed in 194 patients (59.9%), but allergen avoidance strategy was instructed in only 81 subjects (41.8%). Major topical medications were steroids (81.8%) and topical immunomodulators (34.3%), while systemic medications were steroids (42.6%), antihistamines (36.4%), and cyclosporins (2.8%). One hundred eighty-one subjects (55.9%) had received complementary alternative medicine, including Oriental medicine. Many subjects desired to receive individualized management, use of specialized institutions for AD as well as evidence-based, effective, sustainable treatment.Conclusion: Our findings suggest that there may still be an unmet need for patients with AD in real practice. Personalized, evidence-based, and multidisciplinary approaches, including patient education, should be implemented for good outcomes. (Allergy Asthma Respir Dis 2016:4:271-275)

Background As gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) have been widely used for the evaluation of hepatocellular carcinoma (HCC), it is clinically relevant to determine the diagnostic efficacy of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis. Purpose To compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced MRI and DWI for detection of HCCs with respect to the severity of liver cirrhosis. Material and Methods A total of 189 patients with 240 HCCs (≤3.0 cm) (Child-Pugh A, 81 patients with 90 HCCs; Child-Pugh B, 65 patients with 85 HCCs; Child-Pugh C, 43 patients with 65 HCCs) underwent DWI and gadoxetic acid-enhanced MRI at 3.0 T. A gadoxetic acid set (dynamic and hepatobiliary phase plus T2-weighted image) and DWI set (DWI plus unenhanced MRIs) for each Child-Pugh class were analyzed independently by two observers for detecting HCCs using receiver-operating characteristic analysis. The diagnostic accuracy and sensitivity were calculated. Results There was a trend toward decreased diagnostic accuracy for gadoxetic acid and DWI set with respect to the severity of cirrhosis (Child-Pugh A [mean 0.974, 0.961], B [mean 0.904, 0.863], C [mean 0.779, 0.760]). For both observers, the sensitivities of both image sets were highest in Child-Pugh class A (mean 95.6%, 93.9%), followed by class B (mean 83.0%, 77.1%), and class C (mean 60.6%, 60.0%) ( P < 0.05). Conclusion In HCC detection, the diagnostic accuracy and sensitivity for gadoxetic acid-enhanced MRI and DWI were highest in Child-Pugh class A, followed by Child-Pugh class B, and Child-Pugh class C, indicating a tendency toward decreased diagnostic capability with the severity of cirrhosis.

Fabry disease is a lysosomal storage disorder caused by deficiency of α-galactosidase A, which results in deposition of globotriaosylceramide (Gb3) in lysosomes. Patients develop painful neuropathy, vascular occlusions that progressively lead to cardiovascular, cerebrovascular, and renal dysfunction and early death. Since the level of Gb3 and clinical manifestations of Fabry disease have not been correlated, we investigated altered gene expressions in Fabry mouse kidney. Microarray analysis revealed that renal Tsps (Thrombospondins) were significantly up-regulated in Fabry mouse kidney. Tsp-1 and Tsp-2 act as inhibitors of angiogenesis that is an extracellular matrix protein involved in cell adhesion, proliferation and survival. Tsp-1 suppresses tumor growth through transforming growth factor-β (TGF-β) activation. Fibroblast growth factor-2 (FGF-2) induces vascular endothelial growth factor (VEGF) expression. Up-regulation of Tsp-1, VEGF, TGF-β1 and FGF-2 are associated to vascular and renal pathology in ...

Introduction: Mutant KRAS is feature of more than 25% of non-small cell lung cancers (NSCLC) and exemplifies one of the most popular oncogenic drivers. Ras-driven tumors are often hard to cure with conventional therapies and are necessary novel treatment strategies. Experiment: Using the HSP90 inhibitor NVP-AUY922, we investigated the potential of HSP90 inhibition to overcome the resistance to Trametinib, MEK inhibitor, in lung cancers harboring K-RAS mutant cell lines (H23, H358, H647, H1944, and A549). The synergistic effect of AUY-922 and trametinib was determined by analysis of the combination index (CI). After performing western blotting, we underwent following xenograft study with 6-week-old Balb/c-nu/nu female using H649 and H1944 cell lines. The mice were randomized into groups of 5, and NVP-AUY922 (5 mg/kg) was administered 3 days/week and GSK1120212 (300 μg/kg) was administered 5 days/week for up to 21 days in total. Result: NSCLC cells harboring G13D KRAS mutation showed intrinsic MEK inhibitor resistance via PI3K activation by highly expressed AKT as a bypass pathway. And then, HSP90 inhibitor AUY-922 suppresses both PI3K-AKT-mTOR and RAF-MEK-ERK reactivated by MEK inhibitor GSK1120212 and finally AUY-922 renders intrinsic MEK inhibitor resistant NSCLC cells sensitive to GSK1120212 with significant synergy. Furthermore, we showed this synergistic effect is occurred on sub-effective dose of either drug. Conclusion: The dual inhibition of HSP90 and MEK signaling pathways on sub-effective dose may constitute a potent therapeutic strategy to treat intrinsic MEK inhibitor resistant G13DKRAS mutant NSCLCs for resolving toxicity problem of dual inhibition of AKT and MEK in clinical trials. Citation Format: Dae Ho Lee, Kang-Seo Park, Bora Oh, Mi-Hee Lee, Hannah Yang. HSP90 inhibitor NVP-AUY922 sensitizes intrinsic MEK inhibitor Trametinib-resistant NSCLC cells harboring KRAS mutation. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr B90.

Purpose: To examine the differential features of combined hepatocellular and cholangiocarcinoma (HCC-CC) from mass-forming intrahepatic cholangiocarcinoma (ICC) on gadoxetic acid-enhanced MRI. Materials and Methods: Forty patients with pathologically proven combined HCC-CC (n = 20) and ICCs (n = 20) who had undergone gadoxetic acid-enhanced MRI were enrolled in this study. MR images were analyzed for the shape of lesions, hypo- or hyperintense areas on the T2-weighted image (T2WI), rim enhancement during early dynamic phases, and central enhancement with hypointense rim (target appearance) on the 10-min and 20-min hepatobiliary phase (HBP). The significance of these findings was determined by the χ2 test. Results: Irregular shape and strong rim enhancement during early dynamic phases, and absence of target appearance on HBP favored combined HCC-CCs (P < 0.05). Lobulated shape, weak peripheral rim enhancement, and the presence of complete target appearance on the 10-min and 20-min HBP favored ICCs (P < 0.05). However, 10 CC-predominant type of combined HCC-CC showed complete or partial target appearance on 10-min HBP. Conclusion: The shape of tumors, degree of rim enhancement during early dynamic phases, and target appearance on HBP were valuable for differentiating between combined HCC-CC and mass-forming ICC on gadoxetic acid-enhanced MRI. J. Magn. Reson. Imaging 2012;36:881–889. © 2012 Wiley Periodicals, Inc.

Aim The aim was to review the clinical and imaging features of hypervascular hepatic nodule (HHN) in childhood cancer survivors. Materials and methods We retrospectively reviewed 11 pediatric patients (female:male, 7:4; age range, 4.0–12.3 years) who had HHNs detected by surveillance computed tomography (CT) after treatment of a malignant solid tumor and subsequently followed by serial imaging without evidence of recurrent malignancy. The lesions were analyzed in terms of number, size, location, CT and ultrasonographic (US) features, and changes in background liver. In addition, clinical features were investigated along with follow-up changes of HHNs by imaging monitoring. Results Time between initial diagnosis of malignancy and HHN occurrence ranged from 3.2 to 8.5 years (median, 5.8 years). Ten patients had received high-dose chemotherapy and autologous stem cell transplantation for advanced neuroblastoma. A total of 22 nodules were detected, being multiple in six patients and measuring 0.5–3.0 cm in size. At sequential postcontrast CT, nodules demonstrated moderate to strong enhancement during the earlier phase and were isoattenuated during the later phase. On US, they appeared as hypo- or isoechoic lesions. During follow-up, 11 nodules (50%) regressed, 6 (27%) progressed, and 5 (23%) remained stable. Additional HHNs were noted in four patients during follow-up. Conclusion Childhood cancer survivors are at risk of developing HHNs, which are often multiple and small, years after completing chemotherapy. They are nonaggressive and tend to have a benign course, making conservative management reasonable.

OBJECTIVE To determine the most useful findings of gadoxetic acid-enhanced 3.0 Tesla (T) MRI for differentiating focal eosinophilic infiltration (FEI) from hepatic metastasis with verification of their usefulness. MATERIALS AND METHODS Pathologically or clinically proven 39 FEIs from 25 patients and 79 hepatic metastases from 51 patients were included in the study. Gadoxetic acid-enhanced 3.0T MRI was performed in all cancer patients. Size differences measured between T2-weighted and hepatobiliary-phase images for lesions > 1 cm and morphologic findings (margin, shape, signal intensity on T1- and T2-weighted images, enhancement pattern on dynamic images, and target appearance on hepatobiliary-phase images) were compared between two groups via Student's t test as well as univariate and multivariate analyses. Diagnostic predictive values of two observers for differentiating two groups were assessed before (session 1) and after (session 2) recognition of results. RESULTS Mean size difference (2.1 mm) in FEIs between the two images was significantly greater than for metastases (0.7 mm) (p < 0.05). An ill-defined margin and isointensity on T1-weighted images were independently significant morphologic findings (p < 0.05) for differentiating the two groups. All observers achieved a higher diagnostic accuracy in session 2 (97% and 98%) than session 1 (92% and 89%) with statistical significance in observer 2 (p < 0.05). All observers had significantly higher sensitivities (95%) and negative predictive values (NPVs) (98%) in session 2 than in session 1 (sensitivity, 74% in two observers; NPV, 89% and 88%) (p < 0.05). CONCLUSION With the size change, an ill-defined margin and isointensity on T1-weighted images are the most useful findings for differentiating FEI from hepatic metastasis on gadoxetic acid-enhanced 3.0T MRI.

This paper presents a photoplethysmography sensor based on a heart rate monitor for a portable MP3 player. Two major design issues are addressed: one is to acquire the sensor signal with a proper amplitude despite a wide range of variation and the other is to handle the noise contaminated signal which is caused by a motion artifact. A benchmarking test with a professional medical photoplethysmography sensor shows that our device performs very well in calculating heart rate even though our photoplethysmography sensor module was designed to be cost effective.