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This paper presents the evaluation of three different methods for determining zone temperature setpoint variations that limit peak electrical demand in buildings. The methods were developed in a companion paper [Lee K-H, Braun JE. Development of methods for determining demand-limiting setpoint trajectories in buildings using short-term measurements. Building and Environment 2007, in press, doi:10.1016/j.buildenv.2007.11.004] and are evaluated in the current paper through simulation for a small, medium, and large commercial building. Inverse models were employed for the simulation where the parameters were estimated with nonlinear regression techniques using hourly data. Two of the demand-limiting methods are based on the use of simple building models that capture dynamics of the building cooling loads in response to setpoint variations over a short time scale. The third method is data driven and only relies on load data to directly determine setpoint variations that minimize peak cooling demand. All three demand-limiting methods work well in terms of peak demand reduction for individual buildings. However, the data-driven method has slightly better performance than the other methods, is easier to implement, and is directly applicable for peak load reduction of aggregated buildings.

This paper describes the development and evaluation of a model-based approach for minimizing peak cooling demand using energy storage inherent in building structures. On any day where the strategy is invoked, the building is precooled with zone temperature setpoints at the low end of comfort prior to a demand-limiting (DL) period. The zone temperatures are then adjusted upwards during the demand-limiting period following a trajectory that keeps the peak cooling load below a specified target. The cooling demand target and setpoint trajectory are determined using a building model that is trained using field data. The overall approach was demonstrated for a building representative of a small commercial facility. The first step involved training the inverse model using a few weeks of hourly data. The model was then used to study the potential for peak load reduction and to determine setpoint trajectories that were implemented at the site. The demand-limiting strategy resulted in approximately 30% reductions in peak cooling loads compared to night setup control for a 5-h on-peak period of 1 PM to 6 PM.

We present here the radiological findings of a rare case of multiple focal nodular hyperplasia that was associated with portal vein atresia and portopulmonary hypertension in a young woman. This case illustrates and supports the pathophysiological hypotheses that were previously proposed for the coexistence of these three abnormalities.

The purpose of our study was to show the difference of Joint Photographic Experts Group (JPEG) 2000 compression artifacts in the lung between thin- and thick-section CT images.Thirty-five thin-section (1 mm) and 35 corresponding thick-section (5 mm) images were compressed to reversible and irreversible 4:1, 6:1, 8:1, 10:1, and 15:1. In each compressed image, pixels outside the lung were replaced with those from the original image. By comparing the compressed and original images, three radiologists independently rated the compression artifacts using grades of 0 (none, the two images were indistinguishable), 1 (image differences were barely perceptible), 2 (image differences were subtle), or 3 (image differences were significant). At each compression level, thin and thick sections were compared for peak signal-to-noise ratio (PSNR) using paired t tests and for the readers' responses using Wilcoxon's signed rank tests and exact tests for paired proportions.Thin sections had smaller PSNR (p0.0001). Thin sections had higher grades of artifacts than thick sections, showing significant differences at compression levels of 10:1 (mean score, 0.8 vs 0.4, 0.9 vs 0.1, 0.3 vs 0.0; p0.009 for the three readers) and 15:1 (1.9 vs 1.0, 1.9 vs 1.1, 1.5 vs 0.6; p0.0001). The percentages of distinguishable pairs (grades 1-3) were greater for thin sections than for thick sections, showing a statistically significant difference at 10:1 for two readers (31% vs 3% and 74% vs 37%; p0.006).The lung shows more compression artifacts on thin sections than on thick sections. Section thickness should be taken into consideration when adjusting the compression level for lung CT images.

The objective of our study was to assess the effects of compressing source thin-section abdominal CT images on final transverse average-intensity-projection (AIP) images.At reversible, 4:1, 6:1, 8:1, 10:1, and 15:1 Joint Photographic Experts Group (JPEG) 2000 compressions, we compared the artifacts in 20 matching compressed thin sections (0.67 mm), compressed thick sections (5 mm), and AIP images (5 mm) reformatted from the compressed thin sections. The artifacts were quantitatively measured with peak signal-to-noise ratio (PSNR) and a perceptual quality metric (High Dynamic Range Visual Difference Predictor [HDR-VDP]). By comparing the compressed and original images, three radiologists independently graded the artifacts as 0 (none, indistinguishable), 1 (barely perceptible), 2 (subtle), or 3 (significant). Friedman tests and exact tests for paired proportions were used.At irreversible compressions, the artifacts tended to increase in the order of AIP, thick-section, and thin-section images in terms of PSNR (p0.0001), HDR-VDP (p0.0001), and the readers' grading (p0.01 at 6:1 or higher compressions). At 6:1 and 8:1, distinguishable pairs (grades 1-3) tended to increase in the order of AIP, thick-section, and thin-section images. Visually lossless threshold for the compression varied between images but decreased in the order of AIP, thick-section, and thin-section images (p0.0001).Compression artifacts in thin sections are significantly attenuated in AIP images. On the premise that thin sections are typically reviewed using an AIP technique, it is justifiable to compress them to a compression level currently accepted for thick sections.

To test a perceptual quality metric (high-dynamic range visual difference predictor, HDR-VDP) in predicting perceptible artifacts in Joint Photographic Experts Group 2000 compressed thin- and thick-section abdomen computed tomography images.A total of 120 thin (0.67 mm) and corresponding thick (5 mm) sections were compressed to ratios from 4:1 to 15:1. Peak signal-to-noise ratio (PSNR), HDR-VDP results (paired t-tests), and five radiologists' pooled responses for the presence of artifacts (exact tests for paired proportions) were compared between the thin and thick sections. For three subsets of 120 thin- (subset A), 120 thick- (subset B), and 60 thin- and 60 thick-section compressed images (subset C), receiver operating curve analysis was performed to compare PSNR and HDR-VDP in predicting the radiologists' responses. Using the cutoff values where the sum of sensitivity and specificity was the maximum in subset C, visually lossless thresholds (VLTs) were estimated for the 240 original images and the estimation accuracy was compared (McNemar test).Thin sections showed more artifacts in terms of PSNR, HDR-VDP, and radiologists' responses (p.0001). HDR-VDP outperformed PSNR for subset C (area under the curve: 0.97 versus 0.93, p = 0.03), whereas they did not differ significantly for subset A or B. Using the cutoff values, PSNR and HDR-VDP predicted the VLT accurately for 124 (51.7%) and 183 (76.3%) images, respectively (p.0001).HDR-VDP can predict the perceptible compression artifacts, and therefore can be potentially used to estimate the VLT for such compressions.

The objective of our study was to determine whether peak signal-to-noise ratio (PSNR) and a perceptual quality metric (High-Dynamic Range Visual Difference Predictor [HDR-VDP]) can predict the presence of perceptible artifacts in Joint Photographic Experts Group (JPEG) 2000-compressed chest CT images.One hundred chest CT images were compressed to 5:1, 8:1, 10:1, and 15:1. Five radiologists determined if the original and compressed images were identical (negative response) or different (positive response). The correlation between the results for each metric and the number of readers with positive responses was evaluated using Spearman's rank correlation test. Using the pooled readers' responses as the reference standard, we performed receiver operating characteristic (ROC) analysis to determine the cutoff values balancing sensitivity and specificity and yielding 100% sensitivity in each metric. These cutoff values were then used to estimate the visually lossless thresholds for the compressions for the 100 original images, and the accuracy of the estimates of two metrics was compared (McNemar test).The correlation coefficients were -0.918 and 0.925 for PSNR and the HDR-VDP, respectively. The areas under the ROC curves for the two metrics were 0.983 and 0.984, respectively (p = 0.11). The PSNR and HDR-VDP accurately predicted the visually lossless threshold for 69% and 72% of the 100 images (p = 0.68), respectively, at the cutoff values balancing sensitivity and specificity and for 43% and 47% (p = 0.22), respectively, at the cutoff values reaching 100% sensitivity.Both metrics are promising in predicting the perceptible compression artifacts and therefore can potentially be used to estimate the visually lossless threshold.

The non-transition metal spinel MgAl2O4 and the transition metal spinels (NiFe2O4, NiAlFeO4) have been prepared by standard ceramic processing method in the air. The effect of annealing atmosphere on the dielectric properties after sintering has been studied. The annealing atmospheres were N2, O2, and N2–H2 mixture. Dielectric constant ɛ r and tangent loss tanδ have been characterized by varying the measuring temperature and frequency (5 Hz–5 MHz) using the impedance analyzer. The ɛ r and tanδ of the non-transition metal spinel MgAl2O4 remained unchanged even with varying the annealing atmosphere. While the dielectric properties of the transition metal spinels, NiFe2O4 and NiAlFeO4 were critically dependent on the annealing atmosphere. Crystal structural models for the samples manufactured in air have been tested by the Rietveld refinement method for both the centrosymmetric Fd-3m and the noncentrosymmetric F-43m. The electron density distributions were determined by the whole pattern fitting based on the maximum entropy method (MEM). The dielectric properties of the samples have been also discussed in terms of the structure and electron distribution analysis results.

We hypothesized that that the summation or axial slab average intensity projection (AIP) techniques can substitute for the primary reconstruction (PR) from a raw projection data for abdominal applications. To compare with PR datasets (5-mm thick, 20% overlap) in 150 abdominal studies, corresponding summation and AIP datasets were calculated from 2-mm thick images (50% overlap). The root-mean-square error between PR and summation images was significantly greater than that between PR and AIP images (9.55 [median] vs. 7.12, p

The purpose of our study was to compare the tolerance of Joint Photographic Experts Group (JPEG) 2000 compression between thin- and thick-section abdominal CT images.One hundred 0.67-mm-thick and corresponding 5-mm-thick images were compressed to four different levels: reversible and irreversible 6:1, 10:1, and 15:1. Five radiologists determined if the compressed images were distinguishable from the originals. The percentage of distinguishable pairs and peak signal-to-noise ratio (PSNR) were compared between the thin and thick sections. The visually lossless threshold was estimated by comparing the percentages of the distinguishable pairs between each irreversible compression and the reversible compression. Paired Student's t tests and exact tests for paired proportions were used.Thin sections had smaller PSNRs at each compression level (p0.001). According to the pooled responses, the percentages of distinguishable pairs for the thin and thick sections, respectively, were 0% (0/100) and 0% at reversible compression, 27% and 0% at 6:1 (p0.001), 100% and 80% at 10:1 (p0.001), and 100% and 100% at 15:1. Artifacts increased significantly (p0.001) at 6:1 or more for the thin sections and at 10:1 and 15:1 for the thick sections, indicating that the visually lossless thresholds were below 6:1 and between 6:1 and 10:1, respectively.Thin-section abdominal CT images are less tolerant of compression, and a lower compression level should be used for the visually lossless threshold.

To prospectively evaluate the reliability and accuracy of optical colonoscopy and computed tomographic (CT) colonography in polyp measurement, by using direct measurement as the reference standard, and to understand the basis for measurement discrepancy between both modalities.Eighty-six simulated polyps that ranged from 3 to 15 mm were constructed by using pig colons obtained from an abattoir. Approval of the animal care and use committee for the study was not required. CT colonographic measurement was performed by two independent radiologists by using two-dimensional (2D) optimized multiplanar reformatted planes and three-dimensional (3D) endoluminal views. Optical colonoscopic measurement was performed by two independent gastroenterologists by using open biopsy forceps. Interobserver agreement, measurement error, measurement discrepancy defined as the result of subtracting the optical colonoscopic measurement from the CT colonographic measurement, and false-mismatch (ie, designation of matched polyps as mismatched between both modalities) rates according to different matching criteria were analyzed.Intraclass correlation coefficients were 0.879 (95% confidence interval: 0.780, 0.930) for optical colonoscopy, 0.979 (95% confidence interval: 0.956, 0.989) for 2D CT colonography, and 0.985 (95% confidence interval: 0.976, 0.990) for 3D CT colonography. The mean standardized polyp size +/- standard deviation for each observer was 76.3% +/- 14.7 and 85.3% +/- 18.8 for optical colonoscopy, 104.6% +/- 11.6 and 101.6% +/- 10.1 for 2D CT colonography, and 114% +/- 12.4 and 113.4% +/- 13.2 for 3D CT colonography. These values indicated that there was a statistically significant difference among the methods (P.001). Measurement discrepancy was not proportional to polyp size. A percentage-of-error criterion showed increasing false-mismatch rates with decreasing polyp size, whereas a fixed margin-of-error criterion resulted in more uniform false-mismatch rates across polyp size.CT colonography is more reliable and accurate than optical colonoscopy for polyp measurement. A fixed margin-of-error criterion is better than a percentage-of-error criterion for polyp matching between CT colonography and optical colonoscopy with open biopsy forceps.

The aim of the study was to see if there is any differences in urinary 1-hydroxypyrene glucuronide (1-OHPG) and 2-naphthol levels in children ( years old) and their mothers ( years old) living three cities in South Korea (Seoul, Incheon and Pohang) and three in China (Changchun, Datong and Kunming), where the levels of air pollution varies. The factors related with urinary biomarkers levels were also evaluated. The study subjects consisted of 118 Korean (60 children and 58 their mothers) and 120 Chinese (60 children and 60 their mothers). Urinary 1-OHPG was measured by synchronous fluorescence spectroscopy after immuno-affinity purification using monoclonal antibody 8E11 and urinary 2-naphthol concentrations were determined by HPLC with fluorescence detector. Information on recent consumption of diet containing high PAHs, environmental tobacco smoke (ETS), type of cooking and heating fuels, and other life-style characteristics were collected by self-administered questionnaire. The arithmetic mean of urinary 1-OHPG levels (n

We propose a system that automatically generates multiplanar reformation (MPR) images on-the-fly, which is independent of computed tomography (CT) scanner type. Triggered by digital imaging communication in medicine (DICOM) Storage Commitment or in a time threshold manner, this system generates MPR images from received thin-section CT data sets with predefined reformation parameters and then sends MPR images to DICOM stations. Users can specify the reformation parameters and the destination of the resulting MPR images for each CT study description. A pilot system was tested for 3 months. From thin-section data sets received from two 16- and one 64-detector-row CT scanners, this system generated MPR images and sent them to the picture archiving and communication system (PACS) without failure or any additional human operation. For 143 test thin-section CT studies (172-4,761 images in each study), the time to store reformatted images (axial and coronal with 5-mm thicknesses and 4-mm intervals) in PACS after the completion of the CT scan ranged from 92 to 1,772 s (mean +/- SD, 555.1 +/- 509.4).

The objective of our study was to prospectively evaluate the initial diagnostic performance and learning curve of a community of radiologists and residents in interpreting 2-mSv appendiceal CT.We included 46 attending radiologists and 153 radiology residents from 22 hospitals who completed an online training course of 30 2-mSv CT cases. Appendicitis was confirmed in 14 cases. Most of the readers had limited (≤ 10 cases, n = 32) or no (n = 118) prior experience with low-dose appendiceal CT. The order of cases was randomized for each reader. A multireader multicase ROC analysis was performed. Generalized estimating equations were used to model the learning curves in diagnostic performance.Diagnostic performance gradually improved with years of training. The average AUC was 0.94 (95% CI, 0.90-0.98), 0.92 (0.88-0.96), 0.90 (0.85-0.96), and 0.86 (0.80-0.92) for the attending radiologists, senior residents, 2nd-year residents, and 1st-year residents, respectively. We did not observe any notable intrareader learning curves over the training course of the 30 cases except a decrease in reading time. Diagnostic accuracy and sensitivity were significantly affected by the reader training level and prior overall experience with appendiceal CT but not by the prior specific experience with low-dose appendiceal CT.The learning curve is likely prolonged and forms gradually over years by overall radiology training and clinical experience in general rather than by experience with low-dose appendiceal CT specifically.

To retrospectively compare ultrasound (US) and CT as the preoperative first-line imaging modality in terms of negative appendectomy rate (NAR) and appendiceal perforation rate (APR) in adolescents and adults with suspected appendicitis.We included 2,030 patients in 11 sites who underwent appendectomy following US (n = 102) or CT (n = 1,928). Propensity-score (PS) adjusted and matched comparisons were conducted. Matching was performed with 1:1 and 1:3 ratios. Secondary analyses were performed by adding appendiceal perforation to PS model.The unadjusted NAR difference between the unmatched US and CT groups (8% [8/102] versus 3.8% [73/1,928]) was 4.1 percentage points (95% confidence interval, -1.2, -9.3; p = 0.133). The PS adjusted difference was 4.1 percentage points (-1.8, -10.0; p = 0.169). The differences after 1:1 (9% [8/94] versus 5% [5/94]) and 1:3 (9% [8/94] versus 3.0% [8/271]) matching were 3 (-4, -10, p = 0.39) and 5.6 (-0.4, -11.6, p = 0.069) percentage points, respectively. The unadjusted APR difference between the unmatched US and CT groups (22% [22/102] versus 23.8% [459/1,928]) was -2.2 percentage points (-10.4, -6.0; p = 0.59). The PS-adjusted difference was -5.2 percentage points (-13.3, -2.9; p = 0.21). The differences after 1:1 (19% [18/94] versus 24% [23/94]) and 1:3 (19% [18/94] versus 20.7% [56/271]) matching were -5 (-17, -6, p = 0.38) and -1.5 (-10.8, -7.8, p = 0.75) percentage points, respectively.The use of US instead of CT may increase NAR but does not significantly affect APR. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:401-410, 2016.

The purpose of this study is to assess the advantages of additional multiplanar sliding-slab averaging review of 2-mm-thick (thin) sections over stack review of 5-mm-thick (thick) sections in difficult cases of 2-mSv CT in adolescents and young adults with suspected appendicitis.We included 149 patients (mean age, 28.0 years; 61 male patients and 88 female patients) for whom the initial CT reports were inconclusive for the diagnosis of appendicitis. Five independent radiologists retrospectively reviewed the thick sections in the stack mode and then the thin sections using sliding-slab averaging. In each review, they rated the likelihood of appendicitis and the appendix visualization using 5- and 3-point Likert scales, respectively. Diagnostic performance and confidence were compared between the two reviews using ROC analysis, McNemar tests, and Wilcoxon signed-rank tests.The pooled AUCs were 0.90 and 0.93 for the stack and sliding-slab averaging reviews, respectively (90% CI for the difference, 0.002-0.06; p = 0.087). For the individual readers, the sliding-slab averaging review tended to increase the AUC (range, 0.86-0.93 for stack vs 0.87-0.97 for sliding-slab averaging review), improve the confidence in diagnosing (mean score, 3.6-4.7 vs 3.9-4.7) or ruling out (1.6-2.1 vs 1.5-1.9) appendicitis, reduce indeterminate interpretations (0-15% vs 0-11%), and enhance the normal appendix visualization (1.1-1.7 vs 1.1-1.9), although the differences were not always statistically significant.Sliding-slab averaging review of thin sections is helpful when the diagnosis of appendicitis is difficult at 2-mSv CT in adolescents and young adults.

Purpose The aim of this study was to investigate factors that influence arterial Doppler waveforms in an in vitro phantom to provide a more accurate and comprehensive explanation of the Doppler signal. Methods A flow model was created using a pulsatile artificial heart, rubber or polyethylene tubes, a water tank, and a glass tube. Spectral Doppler tracings were obtained in multiple combinations of compliance, resistance, and pulse rate. Peak systolic velocity, minimum diastolic velocity, resistive index (RI), pulsatility index, early systolic acceleration time, and acceleration index were measured. On the basis of these measurements, the influences of the variables on the Doppler waveforms were analyzed. Results With increasing distal resistance, the RI increased in a relatively linear relationship. With increasing proximal resistance, the RI decreased. The pulsus tardus and parvus phenomenon was observed with a small acceleration index in the model with a higher grade of stenosis. An increase in the distal resistance masked the pulsus tardus and parvus phenomenon by increasing the acceleration index. Although this phenomenon occurred independently of compliance, changes in the compliance of proximal or distal tubes caused significant changes in the Doppler waveform. There was a reverse relationship between the RI and the pulse rate. Conclusion Resistance and compliance can alter the Doppler waveforms independently. The pulse rate is an extrinsic factor that also influences the RI. The compliance and distal resistance, as well as proximal resistance, influence the pulsus tardus and parvus phenomenon.

The dihydrofolate reductase gene amplification system is widely used in Chinese hamster ovary (CHO) cells for the industrial production of therapeutic proteins. To enhance the efficiency of conventional gene amplification systems, we previously presented a novel method using cell-cycle checkpoint engineering. Here, we constructed high-producing and stable cells by the conditional expression of mutant cell division cycle 25 homolog B (CDC25B) using the Cre-loxP system. A bispecific antibody-producing CHO DG44-derived cell line was transfected with floxed mutant CDC25B. After inducing gene amplification in the presence of 250 nM methotrexate, mutant CDC25B sequence was removed by Cre recombinase protein expression. Overexpression of the floxed mutant CDC25B significantly enhanced the efficiency of transgene amplification and productivity. Moreover, the specific production rate of the isolated clone CHO Cre-1 and Cre-2 were approximately 11-fold and 15-fold higher than that of mock-transfected clone CHO Mock-S. Chromosomal aneuploidy was increased by mutant CDC25B overexpression, but Cre-1 and Cre-2 did not show any changes in chromosome number during long-term cultivation, as is the case with CHO Mock-S. Our results suggest that high-producing and stable cells can be constructed by conditionally controlling a cell-cycle checkpoint integrated in conventional gene amplification systems.

Objective To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P 1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination.

The preadipocyte-to-adipocyte differentiation (adipogenesis) is a key process in fat mass increase and thus it is regarded as a compelling target for preventing or treating obesity. Of adipogenic hormone receptors, peroxisome proliferator-activated receptor gamma (PPARγ) has crucial roles in adipogenesis and lipid accumulation within adipocytes. Here we demonstrate that the NEDD8 (neuronal precursor cell expressed, developmentally downregulated 8)-based post-translation modification (neddylation) of PPARγ is essential for adipogenesis. During adipogenesis, NEDD8 is robustly induced in preadipocytes and conjugates with PPARγ, leading to PPARγ stabilization. When the neddylation process was blocked by NEDD8-targeting siRNAs (or viral vectors) or an inhibitor MLN4924, adipocyte differentiation and fat tissue development were substantially impaired. We also demonstrate that MLN4924 effectively prevents the high-fat diet-induced obesity and glucose intolerance in mice. This study provides a better understanding of how the PPARγ signaling pathway starts and lasts during adipogenesis and a potential anti-obesity strategy that targets the neddylation of PPARγ.

Background The contribution of the metal components of particulate pollutants to acute respiratory effects has not been adequately evaluated. Moreover, little is known about the effects of genetic polymorphisms of xenobiotic metabolism on pulmonary function. Objectives This study was conducted to assess lung function decrement associated with metal components in particulate pollutants and genetic polymorphisms of glutathione S-transferase M1 and T1. Methods We studied 43 schoolchildren who were in the 3rd to 6th grades. Each student measured peak expiratory flow rate three times a day for 42 days. Particulate air concentrations were monitored every day, and the concentrations of iron, manganese, lead, zinc, and aluminum in the particles were measured. Glutathione S-transferase M1 and T1 genetic polymorphisms were determined using DNA extracted from participant buccal washings. We used a mixed linear regression model to estimate the association between peak expiratory flow rate and particulate air pollutants. Results We found significant reduction in the peak expiratory flow rate after the children’s exposure to particulate pollutants. The effect was shown most significantly 1 day after exposure to the ambient particles. Manganese and lead in the particles also reduced the peak expiratory flow rate. Genetic polymorphisms of glutathione S-transferase M1 and T1 did not significantly affect peak expiratory flow rate. Conclusions This study demonstrated that particulate pollutants and metals such as manganese and lead in the particles are associated with a decrement of peak expiratory flow rate. These effects were robust even with consideration of genetic polymorphisms of glutathione S-transferase.

The objective of our study was to determine useful CT findings for differentiating cholangiocarcinoma from periductal fibrosis in patients with hepatolithiasis.CT images of 30 patients with hepatolithiasis and pathologically proven cholangiocarcinoma (n = 14) or periductal fibrosis (n = 16) were retrospectively reviewed. Helical CT scans were obtained before, 30 seconds after, and 65 seconds after the start of contrast material injection. Analysis of CT findings included evaluation for the presence of periductal soft-tissue density, bile duct wall thickening at the stricture site, ascites, portal vein obliteration, lymph node enlargement, and a duct stone; assessment of the degree of ductal dilatation; and evaluation of the enhancement pattern of periductal lesions, thickened ductal wall, and hepatic parenchyma. The CT attenuation coefficients of the thickened ductal wall and adjacent normal-looking bile duct were measured on images obtained during each phase. Among these findings, statistically significant variables were determined using the Fisher's exact test and Student's t test. Sensitivity and specificity values of the CT criteria were also calculated.The presence of periductal soft-tissue density (p = 0.002), higher enhancement of the duct than adjacent bile duct on portal venous phase images (p = 0.008), ductal wall thickening (p = 0.026), portal vein obliteration (p = 0.031), and lymph node enlargement (p = 0.031) were found to be the significant findings for differentiating cholangiocarcinoma from fibrosis in patients with hepatolithiasis. When any two or more of these five criteria were used in combination, we could identify 100% of the patients with cholangiocarcinoma but only 12.5% of the patients with fibrosis.Cholangiocarcinoma in patients with hepatolithiasis can be diagnosed using specific CT criteria.

Objective To assess the added value of coronal reformation for radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. Materials and Methods Contrast-enhanced CT was performed using 16-detector-row scanners in 110 patients, 46 of whom had appendicitis. Transverse (5-mm thickness, 4-mm increment), coronal (5-mm thickness, 4-mm increment), and combined transverse and coronal sections were interpreted by four radiologists, two surgeons and two emergency physicians. The area under the receiver operating characteristic curve (Az value), sensitivity, specificity (McNemar test), diagnostic confidence and appendiceal visualization (Wilcoxon signed rank test) were compared. Results For radiologists, the additional coronal sections tended to increase the Az value (0.972 vs. 0.986, p = 0.076) and pooled sensitivity (92% [95% CI: 88, 96] vs. 96% [93, 99]), and enhanced appendiceal visualization in true-positive cases (p = 0.031). For non-radiologists, no such enhancement was observed, and the confidence for excluding acute appendicitis declined (p = 0.013). Coronal sections alone were inferior to transverse sections for diagnostic confidence as well as appendiceal visualization for each reader group studied (p < 0.05). Conclusion The added value of coronal reformation is more apparent for radiologists compared to referring physicians or surgeons in the CT diagnosis of acute appendicitis.

The feasibility of applying the single-charge rotational foam molding processing principle to the fabrication of integral skin polypropylene (PP) foams comprising a PP solid skin and a PP foamed core is investigated in this study. A systematic process interruption and sample evaluation approach was used to quantify the experimental results and explore possibilities for improving the process control strategies to ultimately achieve a desired homogeneity and thickness uniformity of the solid PP skin layer that would be fully encapsulating the PP foamed core of a desired cell population density and average cell size. The experimental results revealed that this is quite a challenging task, not only because of the well-known intrinsically poor foaming nature of PP due to its low melt strength at elevated temperatures, but also because, in single-charge rotational molding, the processing parameters are often conflicting with each other and therefore, have to be optimized within a very narrow processing window. However, simultaneous, single-charge, quality PP integral skin and foamed PP core formation in rotational foam molding is feasible. Optimizing the heating profile, heating rate, heating time, and the mold rotational speed as well as careful selection of PP resins (or resin blends), chemical blowing agents (CBA), and their composition formulations is strongly recommended.

Lifestyle modulation of cancer & cancer biomarkersLifestyle element evaluated:short-term fastingOutcome studied (cancer or cancer biomarker ): urinary biomarkers related to oxidative stress: malondialdehyde (MDA), 8-isoprostaglandin F2a (8-isoPGF), 8-hydroxydeoxyguanosine (8-OHdG) and 1,N6-ethenodeoxyadenosine (edA)Method of biomarker analysis: HPLC-UV, HPLC-fluorescence, ELISAStudy type (in vitro, animals, humans): humansStudy design (if human): cross-sectionalStudy size (if human): 52 healthy women Description of cohort(s) studied (if human):women with mean age 28, range 15-48 years old who provided urine samples both before and after the fasting program (average 7.2, range: 3-11 days).Confounders controlled for: BMIImpact on outcome: Urinary MDA levels after fasting (0.18 ± 1.10 mg/g creatinine) were lower than before fasting (0.37 ± 1.11) (n Ό 51, P < 0.01 by paired t-test) Urinary 8-isoPGF also was significantly reduced after fasting (n Ό 47, P < 0.01)The plasma leptin levels after fasting (5.89 ± 1.10 ng/ml) were significantly lower than before fasting (6.91 ± 1.13 ng/ml) (n Ό 27, P Ό 0.05 by paired t-test. KEYWORDS CLASSIFICATION: analogs & derivatives;Adolescent;Adult;blood;Chromatography,High Pressure Liquid;dietary modulation of cancer & cancer biomarkers;Deoxyadenosines;Deoxyguanosine;dietary modulation of carcinogenesis-related pathways;DNA Damage;Enzyme-Linked Immunosorbent Assay;Fasting;Female;history;Humans;Korea;Leptin;Lipid Peroxidation;Malondialdehyde;Middle Aged;Oxidative Stress;physiology;Plasma;Prostaglandins A;Research;Time Factors;urine. The goal of this study was to determine whether short-term fasting changes in urinary biomarkers related to oxidative stress: malondialdehyde (MDA), 8-isoprostaglandin F2alpha (8-isoPGF), 8-hydroxydeoxy-guanosine (8-OHdG) and 1,N6-ethenodeoxyadenosine (epsilondA) among female volunteers participating in the short-term fasting program in South Korea. The study subjects were 52 healthy women (mean age 28, range 15-48 years old) who provided urine samples both before and after the fasting program (average 7.2, range: 3-11 days). Urinary MDA was measured by HPLC-UV and epsilondA levels were measured by immuno-affinity purification followed by HPLC-fluorescence detection. Urinary 8-OHdG and 8-isoPGF concentrations were determined by ELISA. Plasma leptin levels were also measured by radioimmunoassay. Information on demographic characteristics, personal habits (smoking and alcohol consumption) and previous medical history were collected by a self-administered questionnaire. Percent loss of body weight (average 6.3%, 4.28 +/- 0.25 kg) was significantly correlated with fasting duration (r = 0.70, n = 52, P < 0.01). The plasma leptin levels after fasting (5.89 +/- 1.10 ng/ml) were significantly lower than before fasting (6.91 +/- 1.13 ng/ml) (n = 27, P = 0.05). Urinary MDA levels after fasting (0.18 +/- 1.10 mg/g creatinine) were significantly lower than before fasting (0.37 +/- 1.11) (n = 51, P < 0.01). Urinary 8-isoPGF also were significantly reduced after fasting (n = 47, P < 0.01). However, there was no significant difference in 8-OHdG or epsilondA. There was a statistically significant correlation between % change of urinary MDA level with % change of 8-isoPGF level (partial correlation coefficient r = 0.57, n = 46, P = 0.01). The correlations between % change of 8-OHdG and plasma leptin was also significant (partial correlation coefficient r = 0.51, n = 27, P = 0.02). Our results demonstrate that the short-term fasting reduces lipid peroxidation products but does not affect oxidative stress-induced DNA damage.

Tumor necrosis factor (TNF)-alpha induces pleiotropic cellular effects through a 55kDa, type 1 receptor (TNFR1) and a 75kDa type 2 receptor (TNFR2). Moreover, it participates in the pathogenesis of several CNS diseases, including demyelinating diseases. TNF-alpha receptors are differentially expressed and are regulated in many cell types. However, data regarding the TNF-alpha receptor expression and regulation in human astrocytes is limited to date. We investigated TNF- receptor expression, its regulation by cytokines, and its functional role in primary cultured human fetal astrocytes, which are the most abundant cellular population in the central nervous system and are known to be immunologically active. In this study, astrocytes were found to constitutively and predominantly transcribe, translate and shed TNFR1 rather than TNFR2, but TNFR2 expression was increased by adding TNF-alpha, IL-1, and IFN-gamma, but not by adding LPS. To determine the functional roles of TNFR1 and TNFR2 on TNF induction, we investigated NF-kappaB activation and TNF-alpha induction after neutralizing TNFR1 and TNFR2 by an antibody treatment. We found that NF-kappaB activation and TNF-alpha induction are blocked by TNFR1 neutralizing antibody treatments.

The purpose of our study was to determine the nature of the association between the attenuation difference of the hepatic parenchyma surrounding an abscess and obstruction of the regional portal vein or of the hepatic vein.Helical CT scans of 60 patients with hepatic abscess were analyzed for the presence of complete or partial obstruction of the portal or hepatic veins and for attenuation differences in the surrounding parenchyma. Clinical (age, sex, underlying disease, and microorganism) and CT (obstruction of the portal or hepatic vein and number, location, and size of abscesses) findings were analyzed statistically for possible associations with each of regional parenchymal hyper- and hypoattenuation by using the chi-square test and multivariate logistic regression analysis.Regional parenchymal hyperattenuation was identified in 40 patients (67%). More patients with portal vein obstruction showed regional parenchymal hyperattenuation than patients without portal vein obstruction (22/27 patients vs 18/33, p = 0.028), and more patients with hepatic vein obstruction showed regional parenchymal hypoattenuation than those without hepatic vein obstruction (11/21 vs 3/39, p = 0.0003). Multivariate logistic regression analysis showed that portal venous obstruction was the only statistically significant predictor of regional parenchymal hyperattenuation (p = 0.032; odds ratio, 3.7) and that parenchymal hypoattenuation was associated with hepatic venous obstruction (p = 0.001; odds ratio, 44.9).Parenchymal hypo- and hyperattenuation are frequently observed in the hepatic region surrounding an abscess on dynamic CT. Moreover, these parenchymal attenuation differences are associated with regional portal or hepatic vein obstruction.

To evaluate retrospectively the use of multiphasic helical computed tomography (CT) to differentiate malignant and benign common bile duct (CBD) strictures in patients with only a focal CBD stricture and to determine predictors for this differentiation.Institutional review board approval and informed patient consent were not required. Fifty patients (35 men, 15 women; age range, 35-87 years; mean age, 61.6 years) with only a focal CBD stricture comprised the sample for this study (32 malignant and 18 benign strictures). The diagnosis of all malignant and five benign CBD strictures was confirmed by reviewing patients' surgical and pathology records; in 13 benign CBD strictures, the diagnosis was confirmed by means of clinical features. Multiphasic CT findings were analyzed with regard to the wall thickness, location, length, and enhancement pattern of the involved CBD, the upstream CBD diameter, and other findings. CT features to identify benign and malignant CBD strictures were compared by means of univariate analysis and multivariable stepwise logistic regression analysis.Malignant strictures were longer (17.9 mm +/- 6.6 [+/- standard deviation]) than benign strictures (8.9 mm +/- 6.8) (P.0001), and upstream CBD diameters were larger in malignant cases (22.0 mm +/- 5.4) than in benign cases (17.8 mm +/- 4.6) (P = .033). The involved wall thickness was more than 1.5 mm in 26 malignant cases and three benign cases (P.0001). During both hepatic arterial and portal venous phases, greater enhancement than that in the normal CBD were more frequently observed in malignant cases (in 27 and 30 patients for hepatic arterial and portal venous phase scans, respectively) than in benign cases (in two and three patients, respectively) (P.0001). Results of multivariable stepwise logistic regression analysis showed that hyperenhancement of the involved CBD during the portal venous phase was the only variable that could be used to independently differentiate malignant from benign strictures.Hyperenhancement of the involved CBD during the portal venous phase is the main factor distinguishing malignant from benign CBD strictures.

To describe in vitro CT features of intrahepatic stones and to correlate CT attenuation with chemical composition.Of the patients who underwent choledochoscopic intrahepatic stone removal between 1998 and 2001, 54 patients with stones larger than 3 mm were enrolled in this study. In each case, a chemical compositional analysis was performed to determine calcium, cholesterol, total bilirubin, and inorganic phosphorus compositions. The three largest stones obtained from each patient were imaged by CT. CT attenuation numbers were measured in the center images of each stone by drawing free-hand region of interest (ROI). The measured CT attenuation numbers were correlated with their chemical composition. Also, CT attenuation numbers of stones were compared with that of the liver on non-contrast CT (50-70 HU).Stone size ranged from 3.1 to 10.5 mm (mean +/- S.D.: 6.0 +/- 1.4). The CT attenuation numbers (HU) of stones ranged from 36.4 to 410.19 (mean +/- S.D.: 94.6 +/- 49.9). CT numbers of stones were below 70 HU in 11 patients (20.4%), and below 90 HU in 33 patients (59.3%). The chemical analysis data of the stones were as follows: calcium (0.5-6.5 wt.%; mean +/- S.D., 2.6 +/- 1.4), total bilirubin (0.45-24.4 wt.%; 13.1 +/- 6.2), cholesterol (5.4-73.9 wt.%; 29.3 +/- 17.4), phosphorus (0.1-1.2 wt.%; 0.6 +/- 0.3), and non-soluble residue (17.6-85.4 wt.%; 57.0 +/- 22.6). There was a weak but significant correlation between calcium composition and CT attenuation (r = 0.38, P0.01) and no significant correlation between other chemical compositions and the CT attenuation (cholesterol, r = 0.01, P0.01; total bilirubin, r = 0.05, P0.01; phosphorus, r = 0.01, P0.01).On non-contrast CT, intrahepatic stones would not be hyperattenuating with respect to liver parenchyma in about one fifth of patients. The CT attenuation of stones correlates with calcium and does not correlate with any other chemical composition.

A whisker-reinforced glass-ceramic composite in the Li2O-Al2O3-SiO2-P2O5 system has been fabricated by a single-stage process that simultaneously forms the glass-ceramic material and whiskers of TiO2in situ. The method utilizes typical glass-ceramic processing techniques and requires precise addition of a TiO2 nucleation agent during the glass-melting operation, followed by controlled nucleation and crystallization. The maximum nucleation temperature, 740°C, was determined by differential thermal analysis (DTA), and the result was confirmed by scanning electron microscopy (SEM) of the microstructures formed by nucleation/isothermal crystallization heat treatments. The apparent activation energy for crystallization of the material was determined to be 285 ± 3 kj/mol. The average aspect ratio of the TiO2 whiskers depends on temperature and time during crystallization. The X-ray diffraction patterns of the in situ composite show that eucryptite(ss) and rutile exist as two different phases; no additional phases were observed. Elemental X-ray mapping by electron microprobe indicates that these highly crystallized composites consist of modified β-eucryptite glass-ceramic matrix and acicular grains of TiO2.

Background: The diagnosis of squalene aspiration pneumonia in children is often difficult because of minimal non-specific symptoms. Objective: To investigate the radiological findings of squalene aspiration pneumonia in children. Materials and methods: We reviewed the chest radiographs (n = 8) and CT scans (n = 7), including high-resolution CT (n = 3), of eight patients (four boys, four girls; age 3 months to 6 years) with squalene aspiration pneumonia. All patients presented minimal symptoms. Results: Chest radiographs showed right-sided predominantly parahilar infiltrations. The extent and the opacity of the lesions decreased slowly during the follow-up period (mean 5.4 months) after halting the exposure. On CT, affected areas appeared as dense consolidations surrounded by ground-glass opacities showing a crazy-paving pattern in a geographic lobular distribution in all patients. The lesions were predominantly in the right lung and dependent areas in all patients and extensively involved all pulmonary lobes in five patients. Conclusions: These radiological findings, although non-specific, can lead to an appropriate diagnosis, particularly when patients present few symptoms.

In addition to functioning as a transcriptional transactivator, Epstein-Barr virus EBNA2 interacts with Nur77 to protect against Nur77-mediated apoptosis. Estrogen-regulated EBNA2 in EREB2-5 cells was replaced by either EBNA2 or EBNA2 with a deletion of conserved region 4 (EBNA2ΔCR4). Both EBNA2-converted and EBNA2ΔCR4-converted EREB2-5 cells grew in the absence of estrogen and expressed LMP1. Treatment with tumor necrosis factor alpha did not induce apoptosis of EBNA2- or EBNA2ΔCR4-expressing cells, but EBNA2ΔCR4 cells were susceptible to etoposide and 5-fluorouracil, Nur77-mediated inducers of apoptosis. Thus, EBNA2 protects B cells against specific apoptotic agents against which LMP1 is not effective.

Objective. To identify laboratory and sonographic features capable of differentiating hepatocellular carcinoma (HCC) invading the bile duct from intraductal cholangiocarcinoma (IDCCC). Methods. Nine patients with HCC invading the bile duct and 8 patients with IDCCC were found in our radiologic and pathologic database. Laboratory (α-fetoprotein, cancer antigen 19-9, total bilirubin, and alkaline phosphatase) and sonographic findings were retrospectively reviewed by 2 reviewers by consensus. Sonographic findings included the presence and echo texture of parenchymal masses, the margin and echo texture of intraductal masses, continuity between parenchymal and intraductal masses, cystic ductal dilatation or wall thickening of the bile duct, and the presence of associated chronic liver disease. Results. Significant differences were found in the levels of total bilirubin (14 versus 3.5 mg/dL), α-fetoprotein (2984 versus 5 ng/mL), and cancer antigen 19-9 (8574 versus 1861 U/mL) in HCC and IDCCC (P < .05). Echogenicity of the intraductal masses was iso or low in 8 (88.9%) of 9 HCCs and 3 (37.5%) of 8 IDCCCs (P < .05). In all 7 patients with HCC but in no patient with IDCCC, the parenchymal masses were contiguous with the intraductal masses (P < .05). Cystic ductal dilatation of bile duct was seen in 8 (88.9%) of 9 HCCs and 3 (37.5%) of 8 IDCCCs (P < .05). All 9 (100%) of 9 HCCs and 3 (37.5%) of 8 IDCCCs were associated with chronic liver disease (P < .05). Parenchymal masses occurred in 7 patients with HCC (77.8%) and in 3 patients with IDCCC (37.5%), but the difference was not statistically significant (P = .153). The margins of the intraductal masses were smooth in all 9 (100%) of 9 HCCs and lobulated in 3 (37.5%) of 8 IDCCCs (P = .082). Conclusions. Combined interpretation of laboratory and sonographic features may help in the differentiation of HCC with bile

OBJECTIVE. The purpose of this study was to describe the CT and radiographic features of gastrointestinal stromal tumors of the duodenum.CONCLUSION. Gastrointestinal stromal tumors of the duodenum appear on barium studies as extrinsically compressing or submucosal masses with or without ulceration. These tumors usually appear on contrast-enhanced CT as well-defined masses with an exoenteric growth pattern and relatively good heterogeneous enhancement.

To evaluate the safety and diagnostic yield of percutaneous 18-gauge core biopsy for an experimentally induced small-bowel tumor in a rabbit model.Small-bowel tumors were induced by injecting VX2 tumor into 20 rabbits. After 3 weeks, the small bowel was filled with 100 mL of 2% diluted contrast agent containing methylene blue by using a 5-F catheter. Fifty biopsy firings for small-bowel tumor were performed with ultrasonographic (US) guidance by using an 18-gauge automatic gun. Computed tomography (CT) was performed before and immediately after biopsy. Any procedure-related complications, including leakage of air or fluid, hematoma, and perforation as seen at CT and identified at laparotomy, which was performed 48 hours after biopsy, were evaluated. White blood cell (WBC), red blood cell, and platelet counts; hemoglobin and hematocrit levels; and erythrocyte sedimentation rate were also obtained before and 48 hours after biopsy. Comparison was performed with paired t test. The diagnostic yield was calculated, and the specimen was evaluated whether fragments of mucosa were included or not.No contrast agent leakage or pneumoperitoneum suggesting perforation was identified at CT or laparotomy. Fluid leakage was observed with manual squeezing at two biopsy sites (4%). In two rabbits, hemoperitoneum was observed at CT or laparotomy. Hematoma larger than 3 cm was observed in six rabbits. WBC count and erythrocyte sedimentation rate slightly increased, and red blood cells, hemoglobin, hematocrit, and platelets counts had decreased slightly after biopsy but were not significant (P.05). Definitive histologic diagnosis of tumor was obtained in 44 (88%) of 50 biopsy sites. Fragments of mucosa were observed in 13 (28%) specimens of 10 rabbits.Core biopsies of small-bowel tumor can be performed safely with an 18-gauge gun without severe complications and allow histologic diagnosis of small-bowel tumor with a good diagnostic yield.

We reviewed the computed tomographic (CT) findings of afferent loop obstruction and assessed the value of helical CT in determining the underlying cause.Helical CT scans of 18 patients (12 men and six women; age range = 35-67, mean age = 50 years) with afferent loop obstruction were reviewed. All patients had gastric cancer. Ten patients had undergone radical subtotal gastrectomy with Billroth II gastrojejunostomy, and eight had undergone total gastrectomy with Roux-en-Y esophagojejunostomy. CT images were analyzed retrospectively, and the presumed cause of obstruction on CT was compared with surgical findings (n = 8) and clinical courses (n = 10).Local recurrence (n = 15), peritoneal seeding (n = 1), internal hernia (n = 1), and adhesion (n = 1) were the presumed causes of obstruction on CT. In all eight patients who underwent a second operation, the cause of afferent loop obstruction was correctly suggested on CT (local recurrence in six patients and adhesion and internal hernia in one patient). In 10 patients who were not re-explored, the clinical findings or biopsy indicated recurrent tumor as suggested on CT.Recurrent tumors and other potential causes of afferent loop obstruction can be correctly predicted with CT in most cases.

OBJECTIVE To compare the in-vitro efficiency of a hypertonic saline (HS)-enhanced bipolar radiofrequency (RF) system with monopolar RF applications by assessing the temperature profile and dimensions of RF-created coagulation necrosis in bovine liver. MATERIALS AND METHODS A total of 27 ablations were performed in explanted bovine livers. After placement of two 16-gauge open-perfused electrodes at an interelectrode distance of 3 cm, 5% HS was instilled into tissue at a rate of 1 mL/min through the electrode. Seventeen thermal ablation zones were created in the monopolar mode (groups A, B), and ten more were created using the two open-perfused electrodes in the bipolar mode (group C). RF was applied to each electrode for 5 mins (for a total of 10 mins, group A) or 10 mins (for a total of 20 mins, group B) at 50W in the sequential monopolar mode, or to both electrodes for 10 min in the bipolar mode (group C). During RF instillation, we measured tissue temperature at the midpoint between the two electrodes. The dimensions of the thermal ablation zones and changes in impedance and wattage during RFA were compared between the groups. RESULTS With open-perfusion electrodes, the mean accumulated energy output value was lower in the bipolar mode (group C: 26675+/-3047 Watt s) than in the monopolar mode (group A: 28778+/-1300 Watt s) but the difference was not statistically significant (p > 0.05). In the bipolar mode, there were impedance rises of more than 700 ohm during RF energy application, but in the monopolar modes, impedance did not changed markedly. In the bipolar mode, however, the temperature at the mid-point between the two probes was higher (85 degrees C) than in the monopolar modes (65 degrees C, 80 degrees C for group A, B, respectively) (p < 0.05). In addition, in HS-enhanced bipolar RFA (group C), the shortest diameter at the midpoint between the two electrodes was greater than in either of the monopolar modes: 5.4+/-5.6 mm (group A); 28.8+/-8.2 mm (group B); 31.2+/-7.6 mm (group C) (p < 0.05) CONCLUSION Using an open perfusion system, HS-enhanced bipolar RFA more efficiently created larger areas of thermal ablation and higher tissue temperatures than monopolar RFA.

Shipbuilding workers are exposed to a variety of genotoxic compounds including polycyclic aromatic hydrocarbons (PAHs). A limited number of studies have been conducted to evaluate biomarkers related to PAH exposure in painters in the shipyard industry. We examined this in 208 workers recruited from a shipyard located in South Korea. Employees were grouped into three exposure groups: (1) 111 painters using coal tar paints, (2) 70 painters using general paints, and (3) 27 on-site controls using no paints. Levels of urinary 1-hydroxypyrene glucuronide (1-OHPG), as internal dose of PAH exposure, were measured by synchronous fluorescence spectroscopy. Glutathione S-transferase (GST) M1 and T1 genotypes were assessed by a multiplex polymerase chain reaction (PCR)-based method, aromatic-DNA adducts in peripheral white blood cells were measured by 32P-postlabeling, and glycophorin A (GPA) variant frequencies in red blood cells were assessed by flow cytometry. Information on demographic characteristics, smoking habits, diet, job title and use of personal protective equipment (e.g. respiratory and dermal) were collected by self-administered questionnaire. Average urinary 1-OHPG levels in coal tar paint (2.24 micromol/mol creatinine) and general paint (1.38 micromol/mol creatinine) users were significantly higher than in on-site controls (0.62 micromol/mol creatinine) (P

Purpose: To compare contrast-enhanced CT angiography (CTA) and gadolinium-enhanced MR angiography (MRA) for the detection of subsegmental-sized pulmonary emboli in a pig model. Material and Methods: In 5 anesthetized pigs, 3-mm diameter embolic materials made of Konjac, a semisolid food, were introduced through the internal jugular vein into pulmonary arteries. After embolization, CTA and MRA images were obtained. Respiration was suspended during CTA and MRA image acquisition. Two readers reviewed the CTA and MRA images to detect emboli. The pigs were sacrificed, and sliced specimens of inflated lung served as the gold standard. Results: Thirty-six emboli were detected within peripheral arteries. The sensitivity (and 95% confidence intervals) of CTA for the two readers were 57% (39–74%) and 66% (48–81%), and 88% (69–98%) and 92% (74–94%) for MRA. The specificity of CTA was 95% (91–97%) and 98% (96–99%), and that of MRA was 85% (74–93%) and 90% (80–96%). Interobserver agreement was higher for M...

This study was designed to evaluate the effect of autologous fibroblast-attached platinum coils on the promotion of intra-aneurysmal thrombus organization.Sidewall aneurysms were surgically created at common carotid arteries bilaterally in 5 dogs. Fibroblasts were obtained from the skins of the dogs and cultured and attached to unmodified platinum coils in a 5-day coculture. In each animal, one aneurysm was embolized with fibroblast-attached platinum coils (study group) and the other with plain platinum coils of the same size (control group).All aneurysms were partially occluded; the mean occlusion rate was 67%. The histologic analyses performed 2 weeks after the embolization showed more advanced organization of intra-aneurysmal thrombus in the study group than in the control group (80% versus 53%, P = 0.02). Overgrowth of the organizing tissue and parent artery stenosis did not occur.Our results suggest that autologous fibroblasts delivered with platinum coils could promote the organization of intra-aneurysmal thrombus. Although further research is needed, especially on the potential complications, endovascular treatment using autologous fibroblasts may be applied to aneurysm treatment.

Epstein–Barr virus infectionin vitroimmortalizes primary B cells. EBNA2 is an Epstein–Barr virus-encoded transcriptional transactivator that mimics the effects of activated Notch signaling and is essential for this proliferative response. An assay using Sindbis virus (SV) as a cell death inducer revealed that, like Notch, EBNA2 also has antiapoptotic activity. We show that Nur77 is a mediator of SV-induced cell death and that EBNA2 antiapoptotic activity results from interaction with Nur77. EBNA2 colocalized with Nur77 in transfected cells and coprecipitated with Nur77 in IB4 B cells. EBNA2 binds to Nur77 through sequences in the EBNA2 amino acid 123–147 conserved domain and an EBNA2 mutant unable to bind Nur77 also lost the ability to protect cells from SV-induced apoptosis. EBNA2 exerted its antideath function by retaining Nur77 in the nucleus and preventing Nur77 from targeting mitochondria in response to apoptotic stimuli. Thus, targeting of Nur77 can be added to the list of strategies used by viruses to counter apoptosis.

The purpose of this study was to investigate the clinical effectiveness of percutaneous tube enterostomy in afferent loop syndrome presenting as jaundice. Tube enterostomy was successfully performed in seven patients without procedural complications. The serum bilirubin level normalized in five patients but remained elevated in the other two, presumably related to more proximal bile duct obstruction. Percutaneous tube enterostomy is an effective palliative treatment in afferent loop syndrome presenting as an obstructing jaundice. However, coexisting biliary obstruction might be problematic for relieving jaundice with tube enterostomy.

In this study, we found that no Candida species other than C. albicans is able to form germ tubes at 39 degrees C in serum-free YEPD (1% (w/v) yeast extract, 2% (w/v) peptone and 2% (w/v) dextrose) media, which makes it easy to identify C. albicans from other Candida species. When cultivated in rabbit serum for at least 2 h at 37 degrees C, more than 60% of C. albicans cells generated germ tubes. In YEPD, however, germ tubes began to appear from C. albicans cells within 30 min at 39 degrees C, and more than 60% of C. albicans cells formed the germ tubes after 1 h at 39 degrees C. Standard Candida strains (ATCC, CBS), three C. albicans and two C. dubliniensis strains were cultured in serum at 37 degrees C for 2 h and in YEPD at 39 degrees C for 1 h. All of the three C. albicans formed germ tubes at 39 degrees C. The two C. dubliniensis strains formed germ tubes in serum at 37 degrees C, but grew as a yeast form in YEPD at 39 degrees C. All of the clinically isolated C. albicans strains in our laboratory formed germ tubes in YEPD at 39 degrees C for 1 h, and none of the clinically isolated Candida species other than C. albicans generated germ tubes in YEPD at 39 degrees C. Thus, the unique germ tube formation of C. albicans induced by high temperature (39 degrees C) in YEPD could be applied to a protocol for the rapid and convenient identification of C. albicans in clinical laboratories.

To compare diagnostic accuracy of soft-copy selenium-based digital radiographic images and soft-copy computed radiographic images obtained for detection of pulmonary edema in pigs.Oleic acid was injected intraatrially into three pigs (weight, 20-25 kg) at doses of 0.04, 0.05, and 0.06 mL/kg to induce pulmonary edema. Thirty-seven sets of computed radiographic, digital radiographic, and thin-section computed tomographic (CT) scans were obtained every 20-30 minutes in three pigs over 4-6 hours. Images were masked for identity, randomly sorted, and displayed on a monitor. Four radiologists rated each image for presence of parenchymal opacities by using a dichotomous scoring system in two sessions. Presence of pulmonary edema was determined with thin-section CT and a severity scale. Intra- and interobserver variations were determined with the kappa statistic and the Z test and with the Cochran Q test and the McNemar test, respectively. True-positive, true-negative, false-positive, and false-negative rates were determined. McNemar test was used to determine statistical significance of differences in detection between computed and digital radiographic images.There was no significant intra- or interobserver variation, except for one pair of observers during the first interpretative session with computed radiographic images (P =.016, McNemar test). Overall sensitivity (92.1%) and diagnostic accuracy (90.2%) of digital radiography were significantly higher than those of computed radiography (79.6% and 83.4%, respectively) (P.001 for sensitivity, P =.01 for diagnostic accuracy, McNemar test). In detection of minimal and mild pulmonary edema, sensitivity of digital radiography (84%) was significantly higher than that of computed radiography (58%) (P.001).Soft-copy digital radiographic images are superior to soft-copy computed radiographic images obtained for detection of mild pulmonary edema in pigs.

The association between urinary 1-hydroxypyrene glucuronide (1-OHPG) levels, as an internal measure of polycyclic aromatic hydrocarbon (PAH) exposure, and glycophorin A (GPA) mutation frequency, as an early biologic effect indicator, was determined to establish whether genetic polymorphisms of glutathione S-transferase (GST) isoforms GSTM1 and GSTT1 play a role. Eighty-one workers including 38 employees directly involved in incinerating industry wastes were recruited from a company located in South Korea. Urinary 1-OHPG levels were measured by synchronous fluorescence spectroscopy after immunoaffinity purification using monoclonal antibody 8E11. Erythrocyte GPA variant frequency (NN or NO) was assessed in MN heterozygotes with a flow cytometric assay. The GSTM1 and GSTT1 genotypes were assessed by a multiplex polymerase chain reaction (PCR) method. Urinary 1-OHPG levels were higher in workers handling industrial wastes than in those with presumed lower exposure to PAHs. An increase was seen in GPA variant frequency levels with increase in urinary 1-OHPG levels. When this association was evaluated by GSTM1 genotype status, the association between GPA mutation and urinary 1-OHPG levels was stronger in individuals with GSTM1 genotype. These results suggest that the association between urinary 1-OHPG and GPA mutation might be modulated by the GSTM1 genotype.

Objective. To present the sonographic appearance of hepatocellular carcinoma imaged with the intravenous contrast agent Levovist. Methods. We reviewed our experience using Levovist (Schering AG, Berlin, Germany) for the sonographic diagnosis of hepatocellular carcinoma. Results. Contrast-enhanced sonography with Levovist facilitated detailed evaluation of tumor vascularity in hepatocellular carcinoma. Conclusions. Contrast-enhanced sonography with Levovist enhances the role of sonography in the diagnosis of hepatocellular carcinoma. It provides detailed information about tumor vascularity and the contrast enhancement pattern.

90 Background: The aim of this study was to evaluate the feasibility and safety of laparoscopic limited gastrectomy with sentinel basin (SB) dissection for gastric cancer using simultaneous indocyanine green and 99mTc-antimony sulfur colloid injections. Methods: The primary end point was the 3-year relapse-free survival rate of the patients who underwent laparoscopic sentinel node navigation surgery (SNNS). Secondary end points included sentinel node (SN) detection rate, false negative rate of intraoperative pathologic examinations for metastatic SN detection, postoperative morbidity and mortality, quality of life (QOL), and overall survival. Results: From July 2010 to April 2013, 100 patients were enrolled to this study. The SBs were identified in all patients (100%) by dual method. The mean number of SN and non-SN was 6.07 ± 3.84 [range 0-17] and 4.60 ± 4.76 [range 0-25]. Eleven patients had SN metastasis and they were converted to conventional laparoscopic gastrectomy with radical lymphadenectomy. Among 89 patients with negative SNs, 3 patients were considered as false negative of intraoperative pathological examination (3.37%). There was no significant difference between SN negative (n = 89) and positive (n = 11) groups in estimated blood loss, postoperative hospital stays and complication rate. Overall, QOL scores are more likely to be better in SNNS group than in conventional laparoscopic distal gastrectomy group. After median follow-up periods of 47.5 months in all patients, 4 patients who underwent SNNS died, and 2 patients who underwent SNNS had recurrences of cancer. The 3-year relapse-free survival rate for all patients (n = 100) was 97.0 %. In the subgroup analysis, the 3-year relapse-free for the SN negative group was 96.6%, and 100% for the SN positive group (P = 0.374). The 3-year overall survival rate was 98.0% for all patients; 97.7% for the SN negative group and 100% for the SN positive group (P = 0.418). Conclusions: Laparoscopic SNNS was feasible and safe in early gastric cancer. Phase III randomized controlled trial on comparing laparoscopic SNNS and conventional laparoscopic gastrectomy will be needed based on the present study. Clinical trial information: NCT01441310.