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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). [ABSTRACT FROM AUTHOR]

Forty existing abdominal CT images, obtained using two different CT scanners, were compressed using two JPEG2000 compression libraries. Three different compression ratios were used with resulting images compared to a nominal compression ratio. Results varied on the compression ratio as the two libraries are different. [ABSTRACT FROM AUTHOR]

To estimate the visually lossless threshold for Joint Photographic Experts Group (JPEG) 2000 compression of contrast-enhanced abdominal computed tomography (CT) images, 100 images were compressed to four different levels: a reversible (as negative control) and irreversible 5:1, 10:1, and 15:1. By alternately displaying the original and the compressed image on the same monitor, six radiologists independently determined if the compressed image was distinguishable from the original image. For each reader, we compared the proportion of the compressed images being rated distinguishable from the original images between the reversible compression and each of the three irreversible compressions using the exact test for paired proportions. For each reader, the proportion was not significantly different between the reversible (0–1%, 0/100 to 1/100) and irreversible 5:1 compression (0–3%). However, the proportion significantly increased with the irreversible 10:1 (95–99%) and 15:1 compressions (100%) versus reversible compression in all readers ( P < 0.001); 100 and 95% of the 5:1 compressed images were rated indistinguishable from the original images by at least five of the six readers and all readers, respectively. Irreversibly 5:1 compressed abdominal CT images are visually lossless and, therefore, potentially acceptable for primary interpretation. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The goal of this study was to determine whether short-term fasting changes in urinary biomarkers related to oxidative stress: malondialdehyde (MDA), 8-isoprostaglandin F2α (8-isoPGF), 8-hydroxydeoxy-guanosine (8-OHdG) and 1,N6-ethenodeoxyadenosine (ɛdA) 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 ɛdA 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 ɛdA. 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Epstein-Barr virus infection in vitro immortalizes 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 Nut77 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. [ABSTRACT FROM AUTHOR]

We report two cases of gastric remnant infarction following laparoscopy-assisted distal gastrectomy for the treatment of early gastric cancer. In both cases, the infarction was diagnosed with contrast-enhanced computer tomography. [ABSTRACT FROM AUTHOR]

Background/Aims: Synchronous multiple gastric cancer (SMGC) accounts for approximately 6% to 14% of gastric cancer (GC) cases. This study aimed to identify risk factors for SMGC. Methods : A total of 14,603 patients diagnosed with GC were prospectively enrolled. Data including age, sex, body mass index, smoking, alcohol consumption, family history, p53 expression, microsatellite instability, cancer classification, lymph node metastasis, and treatment were collected. Risk factors were analyzed using logistic regression analysis between a single GC and SMGC. Results : The incidence of SMGC was 4.04%, and that of early GC (EGC) and advanced GC (AGC) was 5.43% and 3.11%, respectively. Patients with SMGC were older (65.33 years vs 61.75 years, p

The article presents a study which discusses construction of transgene-amplified Chinese hamster ovary (CHO) cell lines by cell cycle checkpoint engineering. Topics discussed include use of Dihydrofolate reductase (DHFR)-mediated gene amplification to establish mammalian cell lines, transfer of small interfering RNA (siRNA) expression vector into CHO, analysis of Green fluorescent protein (GFP) expression level during gene amplification, and comparison of Immunoglobulin G (IgG) productivity.

Background/Aims: There are few reports regarding mixed carcinoma, defined as a mixture of glandular and poorly cohesive components, in patients with gastric cancer (GC). The aim of this study was to evaluate the proportion and characteristics of mixed carcinoma in GC patients. Methods: A total of 7,215 patients diagnosed with GC at Seoul National University Bundang Hospital were enrolled from March 2011 to February 2020. GC was divided into four groups (well-moderately differentiated GC, poorly differentiated GC, poorly cohesive carcinoma, and mixed carcinoma). The proportion of each GC type and the clinicopathological features were analyzed and divided into early GC and advanced GC. Results: The proportion of mixed carcinoma was 10.9% (n=787). In early GC, submucosal invasion was the most common in poorly differentiated (53.7%), and mixed carcinoma ranked second (41.1%). Mixed carcinoma showed the highest proportion of lymph node metastasis in early GC (23.0%) and advanced GC (78.3%). In advanced GC, the rate of distant metastasis was 3.6% and 3.9% in well-moderately differentiated GC and mixed carcinoma, respectively, lower than that in poorly differentiated GC (6.4%) and poorly cohesive carcinoma (5.7%), without statistical significance. Conclusions: Mixed carcinoma was associated with lymph node metastasis compared to other histological GC subtypes. And it showed relatively common submucosal invasion in early GC, but the rates of venous invasion and distant metastasis were lower in advanced GC. Further research is needed to uncover the mechanism underlying these characteristics of mixed carcinoma (Trial registration number: NCT04973631).

Background/Aims: The incidence and prognosis of gastric cancer (GC) shows sex difference. This study aimed to evaluate the effect of body mass index (BMI) on GC survival depending on sex. Methods: The sex, age, location, histology, TNM stages, BMI, and survival were analyzed in GC patients from May 2003 to February 2020 at the Seoul National University Bundang Hospital. Results: Among 14,688 patients, there were twice as many males (66.6%) as females (33.4%). However, under age 40 years, females (8.6%) were more prevalent than males (3.1%). Cardia GC in males showed a U-shaped distribution for underweight (9.6%), normal (6.4%), overweight (6.1%), obesity (5.6%), and severe obesity (9.3%) but not in females (p=0.003). Females showed decreased proportion of diffuse-type GC regarding BMI (underweight [59.9%], normal [56.8%], overweight [49.5%], obesity [44.8%], and severe obesity [41.7%]), but males did not (p

To estimate the prevalence and the related risk factors of low bone mineral density of the calcaneus and the distal radius, a community-based study was conducted in three rural areas of Korea. A total of 1420 women and 732 men aged 40 years and older participated in this study. Information on sociodemographic characteristics and the potential risk factors for osteoporosis were collected by an interviewer-administered standardized questionnaire. Bone mineral density (BMD) of the calcaneus and the distal radius were measured by dual-energy X-ray absorptiometry (DXA). Three hundred and seventeen women and 183 men aged 20?29 years who participated in a regular health check-up were used as a reference population. Osteoporosis was defined using WHO criteria. Odds ratios of the risk factors of osteoporosis were calculated by the unconditional logistic regression model. The standardized prevalence of osteoporosis of the calcaneus was 8.4% for males and 27.3% for females using the Korean population of year 2000 as a standard population. The standardized prevalence of osteoporosis of the distal radius was 4.2% for males and 18.8% for females. Older age and lower body mass index (BMI) were related with low BMD in both the calcaneus and distal radius in males and females. The duration after menopause and the number of live births were an independent risk factor for osteoporosis of the calcaneus (OR=1.1, 95% CI=1.00?1.11; the duration after menopause; OR=2.0, 95% CI=1.20?3.35, the number of live birth) and a familial history of non-traumatic fractures or osteoporosis among the first-degree relatives was significantly related to a increased risk of osteoporosis of the distal radius in females (OR=2.9, 95% CI=1.36?6.31). [ABSTRACT FROM AUTHOR]

Abstract Exosomes are nano-sized cargos with a lipid bilayer structure carrying diverse biomolecules including lipids, proteins, and nucleic acids. These small vesicles are secreted by most types of cells to communicate with each other. Since exosomes circulate through bodily fluids, they can transfer information not only to local cells but also to remote cells. Therefore, exosomes are considered potential biomarkers for various treatments. Recently, studies have shown the efficacy of exosomes in skin defects such as aging, atopic dermatitis, and wounds. Also, exosomes are being studied to be used as ingredients in commercialized skin treatment products. In this review, we discussed the need for exosomes in skin therapy together with the current challenges. Moreover, the functional roles of exosomes in terms of skin treatment and regeneration are overviewed. Finally, we highlighted the major limitations and the future perspective in exosome engineering.

A vast disparity exists between science and practice for CT radiation dose. Despite high-level evidence supporting the use of low-dose CT (LDCT) in diagnosing appendicitis, a recent survey showed that many care providers were still concerned that the low image quality of LDCT may lead to incorrect diagnoses. For successful implementation of LDCT practice, it is important to inform and educate the care providers not only of the scientific discoveries but also of concrete guidelines on how to overcome more practical matters. Here, we discuss CT imaging techniques and other practical issues for implementing LDCT practice.

Abstract Background To develop an algorithm to predict the visually lossless thresholds (VLTs) of CT images solely using the original images by exploiting the image features and DICOM header information for JPEG2000 compression and to evaluate the algorithm in comparison with pre-existing image fidelity metrics. Methods Five radiologists independently determined the VLT for 206 body CT images for JPEG2000 compression using QUEST procedure. The images were divided into training (n = 103) and testing (n = 103) sets. Using the training set, a multiple linear regression (MLR) model was constructed regarding the image features and DICOM header information as independent variables and regarding the VLTs determined with median value of the radiologists’ responses (VLT rad ) as dependent variable, after determining an optimal subset of independent variables by backward stepwise selection in a cross-validation scheme. The performance was evaluated on the testing set by measuring absolute differences and intra-class correlation (ICC) coefficient between the VLT rad and the VLTs predicted by the model (VLT model ). The performance of the model was also compared two metrics, peak signal-to-noise ratio (PSNR) and high-dynamic range visual difference predictor (HDRVDP). The time for computing VLTs between MLR model, PSNR, and HDRVDP were compared using the repeated ANOVA with a post-hoc analysis. P

Summary: Background: The long-term effects of radical resection on quality of life may influence the treatment selection. The objective of this study was to determine whether abdominoperineal resection has a better effect on the quality of life than sphincter preservation surgery at 3 years after surgery Methods: This prospective, cohort study included patients who underwent radical resection for low rectal cancer. The primary outcomes were European Organisation for Research and Treatment of Cancer QLQ-C30 and CR38 quality of life scores 3 years after surgery, which were compared with linear generalised estimating equations, after adjustment for baseline values, a time effect, and an interaction effect between time and treatment. The secondary outcomes included sexual-urinary functions and oncological outcomes. The study was registered with ClinicalTrials.gov (NCT01461525). Findings: Between December 2011 and August 2016, 342 patients were enrolled: 268 (78•4%) underwent sphincter preservation surgery and 74 (21•6%) underwent abdominoperineal resection. The global quality of life scores did not differ between sphincter preservation surgery and abdominoperineal resection groups (adjusted mean difference, 4•2 points on a 100-point scale; 95% confidence interval [CI], −1•3 to 9•7, p = 0•1316). Abdominoperineal resection was associated with a worse body image (9•8 points; 95% CI, 2•9 to 16•6, p = 0•0052), micturition symptoms (−8•0 points; 95% CI, -14•1 to −1•8, p = 0•0108), male sexual problems (−19•9 points; 95% CI, -33•1 to -6•7, p = 0•0032), less confidence in getting and maintaining an erection in males (0•5 points on a 5-point scale; 95% CI, 0•1 to 0•8, p = 0•0155), and worse urinary symptoms (−5•4 points on a 35-point scale; 95% CI, −8•0 to −2•7, p

Background & aimsElastography point quantification is a convenient method for measuring liver stiffness. It can be performed simultaneously with conventional ultrasonography. This study aimed to evaluate its diagnostic performance for assessing hepatic fibrosis in patients with autoimmune liver disease (AILD), including autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC).MethodsThe diagnostic performance of elastography point quantification (ElastPQ) was evaluated and compared with that of serum fibrosis markers, including the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis-4 (FIB-4), using the receiver operating characteristics analysis with histologic evaluation as the reference standard.ResultsIn 49 AIH patients, sensitivity and specificity of ElastPQ were 93.6% and 44.4%, respectively, for significant fibrosis (≥ F2, cutoff 4.47 kPa), and 63.6% and 86.8% for cirrhosis (F4, cutoff 9.28 kPa). In 41 PBC patients, they were 81.8% and 73.3%, respectively, for significant fibrosis (≥ F2, cutoff 5.56 kPa), and 100% and 81.6%, respectively, for advanced fibrosis (≥ F3, cutoff 6.04 kPa). The areas under the receiver operating characteristic curves of ElastPQ for significant fibrosis (0.77, 95% CI 0.67-0.86) and cirrhosis (0.81, 95% CI 0.65-0.96) were higher than those of APRI and FIB-4 in AILD patients. According to the multivariable analysis, histological activity, steatosis, and body max index (BMI) were not significant factors that influenced the result of ElastPQ.ConclusionsElastPQ exhibited better diagnostic performance-without the influence of confounding factors-for assessing hepatic fibrosis in AILD patients than serum fibrosis markers.

Objective Use of computed tomography (CT) continues to increase, but the relatively high radiation doses associated with CT have raised health concerns such as future risk of cancer. We investigated the level of awareness regarding radiation doses and possible risks associated with CT in medical personnel (MP). Methods This study was conducted from April to May 2012 and included physicians and nurses who worked in the emergency department of 17 training hospitals. The questionnaire included measurement of the effect of CT or radiography on health using a 10-point numerical rating scale, estimation of the radiation dose of one abdominal CT scan compared with one chest radiograph, and perception of the increased lifetime risk of cancer associated with CT. Results A total of 354 MP participated in this study: 142 nurses, 87 interns, 86 residents, and 39 specialists. Interns were less aware of the effects of CT or radiography on health than other physicians or nurses (mean±SD of 4.8±2.7, 5.9±2.7, 6.1±2.7, and 6.0±2.2 for interns, residents, specialists, and nurses, respectively; P

Background: Ultrasonography (US) is widely used as a standard surveillance tool for patients who are at a high risk of having hepatocellular carcinoma (HCC); however, conventional B-mode US appears to be insufficient in order to ensure the early detection of HCC. Perfluorobutane allows very stable Kupffer phase imaging for at least 60 min, which is tolerable for examinations of the entire liver. The purpose of our study is to evaluate the added value of contrast-enhanced US using perfluorobutane to that of conventional B-mode US as an HCC surveillance tool for patients with liver cirrhosis.Methods/design: SCAN (Sonazoid-US for surveillance of hepatoCellulArcarciNoma) is a prospective, multi-institutional, diagnostic trial using an intra-individual comparison design in a single arm of patients. This study was approved by our five institutional review board and informed consent was obtained from all participating. We obtained consent for publication of these data (contrast enhanced US images, CT or MRI images, laboratory findings, age, sex) from all participating patients. All patients will undergo conventional B-mode US immediately followed by contrast-enhanced US. The standardized case report forms will be completed by operating radiologists after B-mode US and contrast-enhanced US, respectively. If any lesion(s) is detected, the likelihood of HCC will be recorded. The primary endpoints are a detection rate of early-stage HCC and a false referral rate of HCC. Intra-individual comparison using Mcnemar's test will be performed between B-mode US and contrast-enhanced US. The study will include 523 patients under HCC surveillance in five medical institutions in Korea.Discussion: SCAN is the first study to investigate the efficacy of contrast-enhanced US in surveillance using two reciprocal endpoints specialized for the evaluation of a surveillance test. SCAN will provide evidence regarding whether patients can truly benefit from contrast-enhanced US in terms of the detection of early stage HCC while avoiding additional unnecessary examinations. In addition to the study protocol, we elaborate on potentially debatable components of SCAN, including the design of an intra-individual comparison study, study endpoints, composite reference standards, and indefinite imaging criteria regarding the likelihood of HCC.Trial Registration: The date of trial registration (ClincalTrials.gov: NCT02188901 ) in this study is July 3, 2014. The last patient enrolled in August 30, 2016 and follow up to see the primary end point is still ongoing. All authors have no other relationships/conditions/circumstances that present a potential conflict of interest of relationships. Our study protocol has undergone peer-review by the funding body (GE Healthcare). No other relationships/conditions/circumstances that present a potential conflict of interest. Also, we clearly stated in the 'competing interests' section of my manuscript. [ABSTRACT FROM AUTHOR]

Background: There has been no comparative study of the long-term oncological outcomes of appendiceal cancer and colon cancer. We hypothesized that the oncological outcome is worse in appendiceal cancer because perforation is more frequent than in colon cancer. Methods: Patients with stage IeIII were selected from 5046 patients with appendiceal or colon cancer, between September 2001 and June 2010. The 5-year disease-free survival (DFS) was the primary endpoint. Multivariate analyses with Cox proportional hazards model for DFS and logistic regression model for perforation were conducted. A matching model was used to compensate for the heterogeneity between groups. Results: The perforation rate was 44.7% in appendiceal cancer (n = 47), but 1.1% in colon cancer (n = 2828) (p = 0.001). The 5-year DFS rate was lower in appendiceal cancer than in colon cancer (57.9% vs. 85.2%, p = 0.001; matching model, 54.2% vs. 78.4%, p = 0.038), with a higher rate of peritoneal seeding (25.5% vs. 2.5%, p = 0.001; matching model, 24.0% vs. 4.0%, p = 0.007). Multivariate Cox regression showed that appendiceal cancer was an independent prognostic factor for poor DFS (hazard ratio = 2.602, 95% confidence interval = 1.26e5.35, p = 0.009), and logistic regression confirmed that appendiceal cancer was the risk factor associated with perforation (odds ratio = 66.265, 95% confidence interval = 28.21e155.61, p = 0.001). Conclusions: This study suggested that the long-term oncological outcomes are worse for appendiceal cancer than for colon cancer, attributed to higher perforation rate in appendiceal cancer. [ABSTRACT FROM AUTHOR]

This paper presents a novel method for parallelizing the seeded region growing (SRG) algorithm using Compute Unified Device Architecture (CUDA) technology, with intention to overcome the theoretical weakness of SRG algorithm of its computation time being directly proportional to the size of a segmented region. The segmentation performance of the proposed CUDA-based SRG is compared with SRG implementations on single-core CPUs, quad-core CPUs, and shader language programming, using synthetic datasets and 20 body CT scans. Based on the experimental results, the CUDA-based SRG outperforms the other three implementations, advocating that it can substantially assist the segmentation during massive CT screening tests. [ABSTRACT FROM AUTHOR]