Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174,00302841026182,alsfakia@gmail.com
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Δευτέρα 2 Ιουλίου 2018
A Systematic Review of Full-Shift, Noise Exposure Levels Among Construction Workers: Are We Improving?
Correction to: Genetic aberrations of the K-ras proto-oncogene in bladder cancer in relation to pesticide exposure
The original publication of this paper contains a mistake. Line 6 in the abstract, line should read "One hundred patients were diagnosed with bladder cancer and two hundred controls attended the outpatient clinic;"
Biofilm architecture on different substrates of an Oculatella subterranea (Cyanobacteria) strain isolated from Pompeii archaeological site (Italy)
Abstract
The Cyanobacterium Oculatella subterranea Zammit, Billi, Albertano inhabits hypogea and stone caves and is a pioneer of different stone substrata. In this study, a strain isolated from the House of Marco Castricio (Archaeological Park of Pompeii, Italy) was identified by a polyphasic approach and used for an in vitro colonization test to verify the influence of the substrate on the biofilm architecture. Fine structure of O. subterranea microbial mats was revealed as well as filaments orientation toward light source. This aim has been achieved through confocal laser scanner microscope microscopy and computer image analysis. Moreover, bioreceptivity of five different substrates, commonly retrieved in archaeological sites of Campania, was assessed for O. subterranea. Our results show that the three-dimensional structure of O. subterranea microbial mats is poorly affected by physical and geochemical features of substrates: in fact, the porous architecture of its biofilm was preserved, independently of the materials. On the other hand, the area/perimeter ratio relative to the O. subterranea growth on tuff, brick, and porphyry showed significant differences, indicating dissimilar levels of bioreceptivity of the three substrates.
Effects of inorganic ions on the photolysis of propranolol in FA solution
Abstract
Photolysis of the widely used beta-blocker propranolol (PRO) was investigated in the presence of fulvic acid (FA) and inorganic ions under simulated solar irradiation. PRO undergoes direct photolysis proceeding mainly via degradation of the triplet excited state, 3PRO*. FA and inorganic ions inhibited photolysis of PRO in the order of FA > Fe3+ > Cl− > Ca2+ > Mg2+ > NO3− > K+. An antagonistic effect between FA and inorganic ions toward the suppression of PRO photolysis was exhibited. The binding behaviors of PRO, FA, and inorganic ions were examined through fluorescence quenching experiments, which showed that inorganic ions affected the binding between FA and PRO through competing for the binding sites of FA or PRO. The correlation analysis demonstrated a positive correlation between the binding constant (KOC) of FA-PRO and the inhibition rate of FA on PRO photolysis. The observed rate constants of photolysis (kobs) have opposite correlations with the concentration of singlet oxygen (1O2). These findings strongly suggest that inorganic ions decrease the inhibition effect of FA on PRO photolysis via restraining the complexation of FA-PRO and production of 1O2.
Réplica a «Factores de riesgo cardiovascular y grosor de la íntima media carotídea en una población colombiana con psoriasis»
Publication date: Available online 2 July 2018
Source:Actas Dermo-Sifiliográficas
Author(s): Á. González-Cantero, J. González-Cantero, A.I. Sánchez-Moya, C. Pérez-Hortet, C. Schoendorff-Ortega
Nevus epidérmicos y síndromes relacionados. Parte 2: Nevus derivados de estructuras anexiales
Publication date: Available online 2 July 2018
Source:Actas Dermo-Sifiliográficas
Author(s): J. Garcias-Ladaria, M. Cuadrado Rosón, M. Pascual-López
Los nevus epidérmicos son hamartomas originados en la epidermis y/o en las estructuras anexiales de la piel que se han clasificado clásicamente partiendo de la morfología. En los últimos años se han descrito variantes nuevas y se han producido avances en el campo de la genética que han permitido caracterizar mejor estas lesiones y comprender su relación con algunas de las manifestaciones extracutáneas a las que se han asociado. En esta segunda parte revisaremos los nevus derivados de estructuras anexiales de la piel y los síndromes que se asocian.Epidermal nevi are hamartomatous lesions derived from the epidermis and/or adnexal structures of the skin; they have traditionally been classified according to their morphology. New variants have been described in recent years and advances in genetics have contributed to better characterization of these lesions and an improved understanding of their relationship with certain extracutaneous manifestations. In the second part of this review article, we will look at nevi derived from the adnexal structures of the skin and associated syndromes.
Graphical abstract
Tratamiento biológico como primera línea en pacientes con psoriasis: una población no estudiada
Publication date: Available online 2 July 2018
Source:Actas Dermo-Sifiliográficas
Author(s): O. Baniandrés Rodríguez
Inhibidores selectivos de la IL-23: los recién llegados al tratamiento de la psoriasis
Publication date: Available online 2 July 2018
Source:Actas Dermo-Sifiliográficas
Author(s): T. Torres
Abdominal wall herniation after herpes zoster
Indian Dermatology Online Journal 2018 9(4):278-279
Periorbital hyperpigmentation: What lies beneath?
Indian Dermatology Online Journal 2018 9(4):229-230
Clinical training and research opportunities for dermatology residents in India
Indian Dermatology Online Journal 2018 9(4):231-233
Turban tumor: A classical presentation of brooke–Spiegler syndrome
Indian Dermatology Online Journal 2018 9(4):284-285
Immunohistochemistry in dermatopathology and its relevance in clinical practice
Indian Dermatology Online Journal 2018 9(4):234-244
Immunohistochemistry (IHC) is an important diagnostic tool in histopathology. Dermatopathology is a rapidly developing subspecialty of histopathology. Although IHC is not widely used in routine dermatopathology practice, its application is gradually increasing. IHC is used to differentiate two conditions with similar morphology, to confirm a diagnosis as well as to assess prognosis. It is more commonly used for neoplastic conditions like melanocytic, hematolymphoid, and spindle cell tumors, although uses can be very wide. Although IHC can aid in diagnosis, sometimes interpretation can be difficult as there may be overlapping findings. Thus, IHC should not be interpreted in isolation and should be done in the context of clinical and histological findings. In this review, we have discussed the uses of various immunohistochemical markers in dermatopathology in the light of current literature and their clinical relevance.
Basal cell carcinoma with sebaceous differentiation
Indian Dermatology Online Journal 2018 9(4):273-275
A study of clinicopathological correlation of periorbital hyperpigmentation
Indian Dermatology Online Journal 2018 9(4):245-249
Context: "Dark circles" are esthetic concerns that can affect individuals of any age, gender, or race. They can be familial, physiological, or associated with various medical illnesses. Aim: To study the clinicopathological correlation of periorbital hyperpigmentation. Patients and Methods: Fifty patients affected with periorbital melanosis (POM) were enrolled for the study after obtaining informed consent. Details regarding history, demographic data, and physical examination of POM were recorded, and a 2-mm punch skin biopsy was taken from the affected skin under local anesthesia and stained with hematoxylin and eosin (H and E), Fontana Masson (Melanin), Perls Prussian blue (Hemosiderin). Results: Twenty-three (46%) patients with POM had history of chronic illness before developing POM; 18% patients were atopic, 16% had jaundice, 18% had associated pigmentary demarcation lines (PDL) of type F and G, 8% had acanthosis nigricans, 22% patients had anemia, 16% patients gave positive family history of POM, and menstrual irregularity was seen in 16%. Histopathology revealed dermal melanin deposition with melanophages along with predominantly increased epidermal melanin and melanin in vellus follicular epithelium. Prussian blue for hemosiderin was negative in all cases. Conclusions: The study has elicited the multifactorial origin of POM; females are affected more than males. Dermal melanin deposition is a constant feature. Hemosiderin is not found in POM. Increased pigmentation of the vellus follicular epithelium is a feature of POM.
Comment on “Mean platelet volume: A reliable marker of inflammation in recurrent aphthous stomatitis and Behçet's disease?”
Indian Dermatology Online Journal 2018 9(4):281-281
Evaluation of serum Vitamin D levels in patients with systemic sclerosis and healthy controls: Results of a pilot study
Indian Dermatology Online Journal 2018 9(4):250-255
Background: The anti-inflammatory, immunomodulatory, and anti-proliferative effects of vitamin D in pathogenesis of autoimmune diseases have been highlighted in recent years but implications of vitamin D deficiency in systemic sclerosis (SSc) remain understudied. Objectives: To evaluate serum vitamin D levels in SSc patients and matched controls. Materials and Methods: Serum vitamin D levels were estimated in 38 (M:F 5:33) patients aged 23–70 years of untreated SSc and age and gender matched healthy controls. Clinical and investigative evaluation for skin sclerosis by modified Rodnan skin score (mRSS), presence of digital ulcers, Raynaud's phenomenon, type of auto-antibodies, systemic involvement, and serum vitamin D levels were performed. Serum vitamin D levels were defined as normal (30–100 ng/ml), insufficient (10–30 ng/ml), and deficient (<10 ng/ml). Results: Serum vitamin D levels (median ± IQR) were 19.5 ± 77.8 ng/ml in 38 patients and 100 ± 31.3 ng/ml in controls each. Vitamin D deficiency in 13 (34.2%) and insufficiency in 10 (26.3%) patients were identified. Only 2 (5.3%) controls had vitamin D insufficiency and the difference was statistically significant (P = 0.001). An inverse relationship was observed between mRSS and serum vitamin D levels. Conclusions: Patients with SSc have significantly lower serum vitamin D levels than healthy controls. Serum vitamin D levels do not correlate well with age, gender, disease duration or its variants, type of auto antibodies, presence of digital ulceration, or systemic involvement but has inverse correlation with skin sclerosis. Better-designed studies will perhaps resolve issues of potential benefits of vitamin D supplementation in modification of disease activity or severity in SSc.
Dermoscopy of eccrine hidrocystomas
Indian Dermatology Online Journal 2018 9(4):288-289
Polymorphous cutaneous sarcoidosis associated with peripheral vascular disease and its dermatoscopic findings
Indian Dermatology Online Journal 2018 9(4):256-258
Sarcoidosis is a multisystem disorder with cutaneous involvement with myriad of morphological presentations, often leading to diagnostic dilemma. We report a case of 31-year-old male with peripheral arterial disease who presented with three morphological forms of sarcoidosis simultaneously, namely, papular, psoriasiform, and pigmented purpuric dermatosis-like lesions. Dermatoscopy of cutaneous lesions showed yellow-orange globules, red dots, linear vessels, and white crystalline structures depending on the clinical forms. Histopathology of all three morphological types of skin lesions demonstrated sarcoidal naked granulomas.Sarcoid specific lesions of more than one morphological type presenting in a same patient is rare. Association of peripheral vascular disease with sarcoidosis is also seen rarely.
Efficacy and safety of 1% Clotrimazole cream occlusion with the mechanical reduction as an adjuvant therapy for the treatment of onychomycosis
Indian Dermatology Online Journal 2018 9(4):271-272
Multiple eruptive eccrine poromas associated with chemotherapy and autologous bone marrow transplantation
Indian Dermatology Online Journal 2018 9(4):259-261
Eccrine poroma is a benign adnexal tumor that originates from the uppermost portion of the intraepidermal eccrine duct. It usually presents as a solitary tumor. Histopathology shows a monomorphic proliferation of cuboidal cells, which radially extend from the basal layer to the dermis. Here, we present a rare multilesional eruption of eccrine poroma after chemotherapy and bone marrow stem cell transplantation for acute promyelocytic leukemia along with a description of clinical, pathological, and dermoscopic findings.
Risk of atrial fibrillation in pemphigus vulgaris
Indian Dermatology Online Journal 2018 9(4):275-277
Palisaded encapsulated neuroma: An unusual presentation
Indian Dermatology Online Journal 2018 9(4):262-264
Palisaded encapsulated neuroma (PEN) is a distinctive benign neural tumor, which usually presents as a solitary skin-colored papule or a nodule. It is a benign lesion and may clinically mimic a cutaneous neurofibroma, melanocytic nevi, or cutaneous schwannoma. Here we report a rare case of multifocal cutaneous PENs and its differentiation from cutaneous schwannomas, which is possible by histopathology.
In response to “Safety and efficacy of different systemic treatment modalities for acutepain of herpes zoster: A pilot study”
Indian Dermatology Online Journal 2018 9(4):280-280
Clear cell dermatofibroma on the chest wall: A case report and its diagnostic traps
Indian Dermatology Online Journal 2018 9(4):265-267
Dermatofibromas are common lesions of the skin. Although they occur at any part of the body, they are most commonly observed on the lower legs of middle-aged women. The lesion comprises fibroblast-like cells, histiocytes, collagenous tissue, and blood vessels. Many histological variants have been defined based on the ratio of cell components and their location. These variants of dermatofibroma may cause problems during differential diagnosis between benign and malignant mesenchymal lesions of the skin and may lead pathologists to overdiagnose this lesion. Here, we report a case of clear cell dermatofibroma, which is a rare variant of dermatofibroma, together with its diagnostic traps.
SkinIndia Quiz 46: Asymptomatic unilateral inguinal swelling with peripheral eosinophilia
Indian Dermatology Online Journal 2018 9(4):282-283
Unilateral discoid lupus erythematosus over the face: An unusual presentation
Indian Dermatology Online Journal 2018 9(4):268-269
Dermoscopy of topical steroid Damaged/Dependent face
Indian Dermatology Online Journal 2018 9(4):286-287
In vitro inhalation/ingestion bioaccessibility, health risks, and source appointment of airborne particle-bound elements trapped in room air conditioner filters
Abstract
The airborne particle-bound elements (Ca, Fe, Al, Mg, K, Na, Zn, Mn, P, Pb, Cu, Sr, Ti, Ba, Cr, Ni, As, Sb, Cd, Co, and V) trapped in room air conditioners' filters (filter dusts) during recirculating indoor air from different types of rooms were analyzed, and the objectives of this study were to assess the potential sources of those elements and their potential health risks via inhalation/ingestion exposure. Main crustal elements such as Ca, Fe, Al, Mg, and K with an average value of 60.6, 17.9, 11.3, 7.58, and 6.90 mg g−1, respectively, are the preponderant elements, and the mean values of main toxic elements were 2230, 344, 508, 85.7, 71.5, 36.0, 8.02, and 16.9 mg kg−1 for Zn, Cu, Pb, Cr, Ni, As, Cd, and Sb, respectively. The enrichment factors indicated the significant enrichment of Cd, Pb, Cr, Cu, Sb, and Zn in the filter dusts. Four potential sources with the contributions of 33.5, 29.1, 22.6, and 14.8%, respectively, were identified by absolute principal component scores-multiple linear regression analysis (APCS-MLR). Enrichment factor and APCS-MLR model reveal the outdoor input of toxic elements. In vitro inhalation and ingestion bioaccessibility of toxic elements showed elemental and in vitro procedure dependence. There are potential carcinogenic risks via ingestion exposure and no non-carcinogenic risks to both children and adults based on bioaccessible contents of toxic elements. This study reveals the potential health risks posed by the particle-bound elements.
Optimization of preparation of monolithic carbon foam from rice husk char for benzene leakage emergency
Abstract
In the aim of BTEX leakage emergency, monolithic carbon foam (MCF) was designed and prepared via a simple method. Rice husk char (RHC) was chosen as raw material, polyurethane sponge (PUS) was used as sacrificed template to form inner channel, and corn starch and ZnO were employed as binder and reinforcing filler, respectively. The optimized preparation parameter was determined by adopting of Taguchi experimental design method. Both MCF-RHC and MCF-CAC were made from RHC and commercial activated carbon (CAC) under the same condition, and three reported monolithic carbon adsorbents were selected for comparative study with MCFs. The surface and structural properties were characterized by XRD, SEM, and N2 adsorption/desorption isotherm analyses. XRD analysis results reveal that MCF-RHC was the composites of carbon, SiO2, and ZnO, and MCF-RHC and MCF-CAC have good potential in organic adsorption. Hierarchical structure of MCF was constructed by inner macro-channel from burning up of PUS and micro- and meso-pores from resultant carbon composite, and these inner macro-channels play a more important role in benzene rapid adsorption. Specific surface area of MCF-RHC was 465.5 m2 g−1, which included micro- and meso-pores, which mainly come from RHC during the carbonization process. Adsorption kinetics study demonstrated that the benzene equilibrium uptake of MCF-RHC and MCF-CAC was similar, and both of data well fitted the pseudo-second-order kinetic model. However, MCF-RHC has the ability to absorb benzene more quickly, which meets the demand of absorbent utilizing in benzene leakage emergency.
Evaluation and Diagnosis of Salivary Gland Neoplasms
Salivary gland tumors are an uncommon heterogeneous group of neoplasms that vary in their anatomic site, histology and biologic behavior. Pleomorphic adenoma is the most common benign tumor and mucoepidermoid and adenoid cystic carcinoma are the most common malignant tumors. Evaluation and diagnosis of these tumors includes not only a complete history and head and neck exam, but also biopsy and imaging of the tumors. Controversy remains regarding the necessity and type of biopsy to be performed and the usefulness of imaging.
Financial instability and CO 2 emissions: the case of Saudi Arabia
Abstract
This study aims to investigate the nexus between financial instability and CO2 emissions within the multivariate framework in Saudi Arabia's economy over 1971–2016. Autoregressive Distributed Lag (ARDL) model is used to estimate long-run dynamics followed by Vector Error Correction Model (VECM) to detect the direction of causality. The result of the study reveals that financial instability has an insignificant impact on CO2 emissions. However, electricity consumption has an adverse impact on environmental quality by producing a huge amount of CO2 emissions in the atmosphere. The coefficients of oil and non-oil GDPs also suggest that both oil and non-oil GDPs contribute to producing a massive amount of CO2 emissions. Bi-directional causality is observed among all the core variables of the study. Moreover, the reliability and validity are confirmed by applying several diagnostic tests. This study provides novel findings which not only help to advance the existing literature but can be a particular interest to the country's policymakers regarding financial sector and its role in environmental degradation.
Regulation on the toxicity of microcystin-LR target to protein phosphatase 1 by biotransformation pathway: effectiveness and mechanism
Abstract
Biotransformation was an important pathway to regulate the toxicity of microcystins (MCs) targeted to protein phosphatases (PPs). To explore the regulation effectiveness and mechanism, several typical biothiol transformation products originated from MCLR were prepared by nucleophilic addition reaction. The reduced inhibition effect of MCLR transformation products on PP1 was evaluated and compared with their original toxin. Though molecular simulation showed the introduced biothiols enhanced the total combination areas and energies for target complexes, the steric hindrance of introduced biothiols inhibited the combination between the key action sites (Mdha7 and Adda5 residues) and PP1. Furthermore, the introduced biothiols also weakened the hydrogen bonds for some key interaction sites and altered the ion bonds between PP1 and the two Mn2+ ions in the catalytic center. The discrepant regulation effect for biothiols on the toxicity of MCLR was closely related to above indexes and influenced by molecular sides.
Odorous emission reduction from a waste landfill with an optimal protection system based on fuzzy logic
Abstract
Effective landfill management and operation require an accurate evaluation of the occurrence and extent of odour emission events, which are among the main causes of resident complaints and concerns, in particular in densely urbanised areas. This paper proposes a fuzzy optimal protection system (FOPS) based on fuzzy logic to manage odour production from a municipal solid waste (MSW) landfill. The case study is a MSW landfill in an old quarry site located 6 km north-west of Naples city centre (Italy). The aim is to reduce the odour nuisance in the area surrounding the landfill where there are several sensitive receptors. FOPS is based on logical relationships between local atmospheric dynamics, number and intensity of odour pollution events detected by certain fixed receptors and odour emission rate via an optimal fuzzy approach. Such system allows to start, in real time, established mitigation actions required to further reduce the odorous emissions from the landfill itself (e.g. spraying of perfumed substances and activation of extraction wells), especially when weather conditions might not be favourable and cause by causing a higher odour perception. The fuzzy system was coupled with the air pollutant transport software CALPUFF to simulate the odour dispersion in the considered area taking into account both different odour emission rates and local weather conditions. FOPS results show that this approach can be very useful as, by measuring the odour concentrations, a significant reduction of the odour exceedances over the thresholds fixed, to minimise the olfactory harassment, was observed in the whole area studied.
CO 2 emission thresholds for inclusive human development in sub-Saharan Africa
Abstract
We provide policy-relevant critical masses beyond which, increasing CO2 emissions negatively affects inclusive human development. This study examines how increasing CO2 emissions affects inclusive human development in 44 sub-Saharan African countries for the period 2000–2012. The empirical evidence is based on fixed effects and Tobit regressions. In order to increase the policy relevance of this study, the dataset is decomposed into fundamental characteristics of inclusive development and environmental degradation based on income levels (low income versus (vs.) middle income); legal origins (English common law vs. French civil law); religious domination (Christianity vs. Islam); openness to sea (landlocked vs. coastal); resource-wealth (oil-rich vs. oil-poor) and political stability (stable vs. unstable). All computed thresholds are within policy range. Hence, above these thresholds, CO2 emissions negatively affect inclusive human development.
Biomonitoring of atmospheric particulate pollution via chemical composition and magnetic properties of roadside tree leaves
Abstract
Particulate matter (PM) is a main atmospheric pollution which threats human health and well-being. In this research, we chemically and magnetically analysed roadside tree leaves, collected from three tree species in two main roads (from two different cities) and a reference area, for 28 elements and the saturation isothermal remanent magnetisation. Comparison of unwashed and washed leaves revealed that deposited particles on the leaf surface contain various elements including Al, Ca, Fe, Mg, Mn, Na, Si, Ti, Ba, Co, Cr, Cu, Ni, Rb, V, Zn and Zr. Moreover, there was no significant difference between washed/unwashed leaves in Cl, K, P, S, As, Cd, Cs, Pb, Sn and Sr concentrations, which indicates tree leaves may not be a suitable biomonitor for these elements. Our results showed that site and tree species are important factors which affect atmospheric elements deposition. Among the three considered tree species, Chamaecyparis lawsoniana showed the highest potential for atmospheric particle accumulation. The PCA results revealed that Al, Fe, Ti, Co, Cr, Cu, Ni, Rb, Si, V, Zn and Zr indicated emissions from road traffic activities and soil dust; Ca, Mg and Na from sea salts and Mn and Sb from industrial activity. The biplot results showed that the site effect was much stronger than the species effect for all elements and saturation isothermal remanent magnetisation (SIRM) values. Moreover, elements from traffic, industrial activity and soil dust are significantly correlated with leaf SIRM indicating that leaf SIRM can be a suitable bioindicator of exposure to traffic-derived particles and soil dust, and not from sea salts. It is concluded that chemical composition and SIRM of urban tree leaves can serve as a good indicator of atmospheric PM pollution in Iran and anywhere else where the studied trees grow.
Fermented camel milk by Lactococcus lactis subsp. cremoris attenuates erythrocytes oxidative stress-induced hematological and immunological damage in CCl 4 -intoxicated mice
Abstract
Fermented camel by Lactococcus lactis subsp. cremoris has been recently discovered to protect against the toxic effect of carbon tetrachloride (CCl4), but its beneficial effects in the presence of oxidative stress in the erythrocytes have not been established. In the present study, 28 mice were randomly divided into four groups: control group; CCl4 group: intoxicated by a single intraperitoneal injection (ip) of CCl4; group FCM-LLC + CCl4: pretreated with FCM-LLC daily during 14 days, and received a single dose of CCl4. FCM-LLC group received FCM-LLC alone. The occurrence of oxidative stress in erythrocytes was evidenced by an increase in lipid peroxidation, protein carbonyl, and changes in antioxidant enzyme activities and non-enzymatic antioxidant. The oxidative injury induced by CCl4 in the erythrocytes was confirmed by modifications in hematological parameters and decreases in protein, albumin, and globulin content in the serum of intoxicated mice. Therefore, CCl4 caused a significant decrease in immunotoxic indices, including immunoglobulin G (IgG), immunoglobulin M (Ig M), and immunoglobulin A (IgA) levels, and an increase of inflammatory markers such as C-reactive protein (CRP) level. Meanwhile, FCM-LLC effectively restored the parameters cited above to near-normal values. It can be suggested that fermented camel milk could regulate deviant physiological effects induced by CCl4 which is due to its powerful antioxidant and immunomodulatory and anti-inflammatory capacity.
Late gadolinium enhancement of colorectal liver metastases post-chemotherapy is associated with tumour fibrosis and overall survival post-hepatectomy
Abstract
Purpose
To determine whether late gadolinium MRI enhancement of colorectal liver metastases (CRCLM) post-chemotherapy is associated with tumour fibrosis and survival post-hepatectomy.
Materials and methods
The institutional review board approved this retrospective cohort study and waived the requirement for informed consent. A cohort of 121 surgical patients who received preoperative MRI after chemotherapy between 2006-2012 was included in this study. Target tumour enhancement (TTE), defined as the mean contrast-to-noise ratio of up to two target lesions on late-phase gadobutrol-enhanced MRI, was determined by two independent raters. The average TTE was correlated with tumour fibrosis on post-hepatectomy specimens using Spearman correlation and with survival post-hepatectomy using Kaplan-Meier and Cox regression. Inter-rater reliability was determined using relative intra-class correlation coefficients.
Results
In the surgical cohort (mean age: 63.0 years; male: 58%), TTE was associated with tumour fibrosis (r = 0.43, p < 0.001). Strong TTE was associated with improved survival compared to weak TTE (3-year survival: 88.4% vs. 58.8%, p = 0.003) with a hazard ratio of 0.32 (95% CI: 0.14-0.75, p = 0.008), after taking into account known prognostic variables. Inter-rater reliability was very good with a relative intraclass correlation of 0.84 (95% CI: 0.77-0.89).
Conclusion
Late gadolinium MRI enhancement of CRCLM post-chemotherapy is associated with tumour fibrosis and survival.
Key Points
• MRI enhancement of colorectal liver metastases is associated with survival post-hepatectomy
• MRI enhancement of chemotherapy-treated colorectal liver metastases correlates with tumour fibrosis
• Measuring late MRI enhancement using target tumour enhancement is reliable
Forensic age assessment by 3.0T MRI of the knee: proposal of a new MRI classification of ossification stages
Abstract
Purpose
To explore the possibility of determining majority via a morphology-based examination of the epiphyseal-diaphyseal fusion by 3.0 T magnetic resonance imaging (MRI), a prospective cross-sectional study developing and applying a new stage classification was conducted.
Materials and methods
344 male and 350 female volunteers of German nationality between the ages of 12-24 years were scanned between May 2013 and June 2015. A 3.0 T MRI scanner was used, acquiring a T1-weighted (T1-w) turbo spin-echo sequence (TSE) and a T2-weighted (T2-w) TSE sequence with fat suppression by spectral pre-saturation with inversion recovery (SPIR). The gathered information was sifted and a five-stage classification was formulated as a hypothesis. The images were then assessed using this classification. The relevant statistics were defined, the intra- and interobserver agreements were determined, and the differences between the sexes were analysed.
Results
The application of the new classification made it possible to correctly assess majority in both sexes by the examination of the epiphyses of the knee joint. The intra- and interobserver agreement levels were very good (κ > 0.80). The Mann-Whitney-U Test implied significant sex-related differences for most stages.
Conclusion
Applying the presented MRI classification, it is possible to determine the completion of the 18th year of life in either sex by 3.0 T MRI of the knee joint.
Key points
• Based on prospective referential data a new MRI classification was formulated.
• The setting allows assessment of the age of an individual's skeletal development.
• The classification scheme allows the reliable determination of majority in both sexes.
• The staging shows a high reproducibility for instructed and trained professional personnel.
• The proposed classification is likely to be adaptable to other long bone epiphyses.
MRI-based detection of renal artery abnormalities related to renal denervation by catheter-based radiofrequency ablation in drug resistant hypertensive patients
Abstract
Objectives
Endovascular renal denervation (RDN) using catheter-based radiofrequency (RF) ablation has emerged as a potential treatment option for drug-resistant hypertension. Its efficacy is currently under debate. We aimed to evaluate the capability of contrast-enhanced magnetic resonance imaging (MRI) to assess the effects of RDN on the renal arterial wall in patients presenting with drug-resistant hypertension.
Methods
Patients were included prospectively following institutional review board approval and written informed consent. Renal arteries were imaged using a two-dimensional T1-weighted TSE sequence pre- and post-administration of a gadolinium-based contrast agent, before (D0), 2 days (D2) and 6 months (M6) after RDN. Mean enhancement of the wall (mENH) and mean wall thickness (mWT) were compared across time using an ANOVA with repeated measures and post-hoc paired t-test.
Results
Follow-up was completed for 23 patients (median age, 57 years; 16 men). The mENH at D2 (96.3 ± 36.0 %) was significantly higher than at D0 (61.1 ± 26.3%, p < 0.001) and M6 (66.1±22.7%, p < 0.001). Similarly, mWT was significantly higher at D2 (3.1 ± 0.4 m) than at D0 (2.7 ± 0.4mm, p < 0.001) and M6 (2.9 ± 0. 5 mm, p = 0.002).
Conclusions
MRI demonstrated abnormalities of the arterial wall 2 days after RDN that had resolved at 6 months.
Key Points
• Contrast-enhanced MRI provides anatomic evidence of renal artery RF ablation
• Temperature increase related to RF ablation induces transient arterial wall inflammation
• Morphological effects observed 2 days post RF ablation are not visible after 6 months
Imaging complex ventral hernias, their surgical repair, and their complications
Abstract
Complex ventral hernia (CVH) describes large, anterior, ventral hernias. The incidence of CVH is rising rapidly due to increasing laparotomy rates in ever older, obese and co-morbid patients. Surgeons with a specific interest in CVH repair are now frequently referring these patients for imaging, normally computed tomography scanning. This review describes what information is required from preoperative imaging and the surgical options and techniques used for CVH repair, so that radiologists understand the postoperative appearances specific to CVH and are aware of the common complications following surgery.
Key Points
• Complex ventral hernia (CVH) describes large abdominal wall hernias (e.g. width ≥10cm).
• CVH patients are being referred increasingly for preoperative and postoperative imaging.
• Imaging is pivotal to characterise preoperative morphology and quantify loss of domain.
• Postoperative imaging appearances are contingent on the surgical methods used for CVH repair.
• Postoperative complications are depicted easily by imaging.
Magnetic resonance with diffusion-weighted imaging improves assessment of focal liver lesions in patients with potentially resectable pancreatic cancer on CT
Abstract
Purpose
To investigate added value of MRI to preoperative staging MDCT for evaluation of focal liver lesions (FLLs) in potentially resectable pancreatic ductal adenocarcinomas (PDACs).
Materials and methods
In patients with potentially resectable PDACs after staging MDCT (n=167), characteristics of FLLs were scored as benign, indeterminate or metastases on an MDCT set and combined MDCT and MRI set by two readers, independently. Size of hepatic lesions was measured and detection rate of hepatic metastasis unsuspected by MDCT and diagnostic yield of MRI for FLLs were assessed.
Results
Reader-averaged figure-of-merit (FOM) of the combined set was significantly higher than that of MDCT alone (0.94 vs. 0.86, p=.028). In the negative-on-CT group, the diagnostic yield of MRI was 1.5–2.3% (2/133 and 3/133 for readers 1 and 2, respectively). In the indeterminate-on-CT group, MRI yield was 10.5–13.6% (2/19 and 3/22) and in patients with suspicious-metastasis-on-CT, 8.3–26.7% (1/12 and 4/15). All lesions with false-positive and false-negative CT findings were ≤1 cm.
Conclusion
In potentially resectable PDACs, addition of MRI with DWI can provide significantly better diagnostic performance in characterization of focal liver lesions, especially for small-sized (≤ 1 cm) MDCT-indeterminate or suspicious metastasis lesions, aiding in determination of appropriate operation candidates.
Key Points
• Addition of MRI provides better diagnostic performance in characterization of liver lesions.
• Combined interpretation of MRI and MDCT provided less frequent indeterminate liver lesions.
• Diagnostic yield of MRI was high in CT-indeterminate or suspicious metastatic lesions.
• Operation candidates can be determined with greater confidence in potentially resectable PDACs.
Progressive supranuclear palsy and idiopathic Parkinson’s disease are associated with local reduction of in vivo brain viscoelasticity
Abstract
Objectives
To apply three-dimensional multifrequency MR-elastography (3DMRE) for the measurement of local cerebral viscoelasticity changes in patients with Parkinson's disease (PD) and progressive supranuclear palsy (PSP).
Methods
T1-weighted anatomical imaging and 3DMRE were performed in 17 PD and 20 PSP patients as well as 12 controls. Two independent viscoelasticity parameters, |G*| and φ, were reconstructed combining seven harmonic vibration frequencies (30–60 Hz). Spatially averaged values were compared by one-way ANOVA, groups were compared using unpaired t test and Mann-Whitney test, respectively. Correlation between clinical data and parameters of brain elasticity and volume were calculated by Pearson's correlation coefficient.
Results
In patients, |G*| was significantly reduced in the frontal and mesencephalic regions (p < 0.05). Beyond that, reduced mesencephalic |G*| discriminated PSP from PD (p < 0.05). Neurodegeneration causes significant brain atrophy (p < 0.01) and is pronounced in PSP patients (p < 0.05 vs. PD). Reduced brain viscoelasticity is correlated with brain atrophy in PSP (r=0.64, p=0.002) and PD (r=0.65, p=0.005) patients but not in controls.
Conclusions
MRE-measured viscoelasticity reflects local structural changes of brain tissue in PSP and in PD and provides a useful parameter to differentiate neurodegenerative movement disorders based on imaging examinations.
Key points
• 3D multifrequency MR-elastography reveals diffuse regional changes in brain viscoelasticity in neurodegenerative disorders.
• Reduced mesencephalic viscoelasticity separates PD and PSP.
• Reduced brain viscoelasticity and brain atrophy as independent hallmarks of neurodegeneration hypothesized.
Contrast media injection protocol optimization for dual-energy coronary CT angiography: results from a circulation phantom
Abstract
Objectives
To investigate the minimum iodine delivery rate (IDR) required to achieve diagnostic coronary attenuation (300 HU) with dual-energy coronary CTA.
Methods
Acquisitions were performed on a circulation phantom with a third- generation dual-source CT scanner. Contrast media was injected for a fixed time whilst IDRs varied from 1.0 to 0.3 gI/s in 0.1-gI/s intervals. Noise-optimized virtual monoenergetic imaging (VMI+) reconstructions from 40 to 90 keV in 5 keV increments were generated. Contrast-to-noise ratio (CNR) and coronary HU were measured for each injection.
Results
VMI+ from 40–70 keV reached diagnostic attenuation with at least one IDR. The minimum IDR achieving a diagnostic attenuation ranged from 0.4 gI/s at 40 keV (312.8 HU) to 1.0 gI/s at 70 keV (334.1 HU). Attenuation values reached with IDR of 1.0 gI/s were significantly higher at each keV level (p<0.001). CNR showed a near perfect correlation with the IDR (ρ≥0.962; p<0.001), the IDR of 1.0 gI/s provided the highest CNR at each keV level, achieving the highest overall value at 40 keV (54.0±3.1).
Conclusions
IDRs from 0.4–1.0 gI/s associated with VMI+ from 40–70 keV provide diagnostic coronary attenuation with dual-energy coronary CTA.
Key Points
• Iodine delivery rate (IDR) is a major determinant of contrast enhancement.
• Low-keV noise-optimized monoenergetic images (VMI+) maximize iodine attenuation.
• Low-keV VMI+ allows for lower IDRs while maintaining adequate coronary attenuation.
• Lowest IDR to reach 300 HU was 0.4 gI/s, 40 keV VMI+.
Experimental feasibility of spectral photon-counting computed tomography with two contrast agents for the detection of endoleaks following endovascular aortic repair
Abstract
Objectives
After endovascular aortic repair (EVAR), discrimination of endoleaks and intra-aneurysmatic calcifications within the aneurysm often requires multiphase computed tomography (CT). Spectral photon-counting CT (SPCCT) in combination with a two-contrast agent injection protocol may provide reliable detection of endoleaks with a single CT acquisition.
Methods
To evaluate the feasibility of SPCCT, the stent-lined compartment of an abdominal aortic aneurysm phantom was filled with a mixture of iodine and gadolinium mimicking enhanced blood. To represent endoleaks of different flow rates, the adjacent compartments contained either one of the contrast agents or calcium chloride to mimic intra-aneurysmatic calcifications. After data acquisition with a SPCCT prototype scanner with multi-energy bins, material decomposition was performed to generate iodine, gadolinium and calcium maps.
Results
In a conventional CT slice, Hounsfield units (HU) of the compartments were similar ranging from 147 to 168 HU. Material-specific maps differentiate the distributions within the compartments filled with iodine, gadolinium or calcium.
Conclusion
SPCCT may replace multiphase CT to detect endoleaks without sacrificing diagnostic accuracy. It is a unique feature of our method to capture endoleak dynamics and allow reliable distinction from intra-aneurysmatic calcifications in a single scan, thereby enabling a significant reduction of radiation exposure.
Key Points
• SPCCT might enable advanced endoleak detection.
• Material maps derived from SPCCT can differentiate iodine, gadolinium and calcium.
• SPCCT may potentially reduce radiation burden for EVAR patients under post-interventional surveillance.
Prediction of rupture risk in anterior communicating artery aneurysms with a feed-forward artificial neural network
Abstract
Objectives
Anterior communicating artery (ACOM) aneurysms are the most common intracranial aneurysms, and predicting their rupture risk is challenging. We aimed to predict this risk using a two-layer feed-forward artificial neural network (ANN).
Materials and method
594 ACOM aneurysms, 54 unruptured and 540 ruptured, were reviewed. A two-layer feed-forward ANN was designed for ACOM aneurysm rupture-risk analysis. To improve ANN efficiency, an adaptive synthetic (ADASYN) sampling approach was applied to generate more synthetic data for unruptured aneurysms. Seventeen parameters (13 morphological parameters of ACOM aneurysm measured from these patients' CT angiography (CTA) images, two demographic factors, and hypertension and smoking histories) were adopted as ANN input.
Results
Age, vessel size, aneurysm height, perpendicular height, aneurysm neck size, aspect ratio, size ratio, aneurysm angle, vessel angle, aneurysm projection, A1 segment configuration, aneurysm lobulations and hypertension were significantly different between the ruptured and unruptured groups. Areas under the ROC curve for training, validating, testing and overall data sets were 0.953, 0.937, 0.928 and 0.950, respectively. Overall prediction accuracy for raw 594 samples was 94.8 %.
Conclusion
This ANN presents good performance and offers a valuable tool for prediction of rupture risk in ACOM aneurysms, which may facilitate management of unruptured ACOM aneurysms.
Key Points
• A feed-forward ANN was designed for the prediction of rupture risk in ACOM aneurysms.
• Two demographic parameters, 13 morphological aneurysm parameters, and hypertension/smoking history were acquired.
• An ADASYN sampling approach was used to improve ANN quality.
• Overall prediction accuracy of 94.8 % for the raw samples was achieved.
Vessel architecture in human knee cartilage in children: an in vivo susceptibility-weighted imaging study at 7 T
Abstract
Objectives
To evaluate the clinical feasibility of ultrahigh field 7-T SWI to visualize vessels and assess their density in the immature epiphyseal cartilage of human knee joints.
Methods
7-T SWI of 12 knees (six healthy volunteers, six patients with osteochondral abnormalities; mean age 10.7 years; 3 female, 9 male) were analysed by two readers, classifying intracartilaginous vessel densities (IVD) in three grades (no vessels, low IVD and high IVD) in defined femoral, tibial and patellar zones. Differences between patients and volunteers, IVDs in different anatomic locations, differences between cartilage overlying osteochondral abnormalities and corresponding normal zones, and differences in age groups were analysed.
Results
Interrater reliability showed moderate agreement between the two readers (κ = 0.58, p < 0.001). The comparison of IVDs between patients and volunteers revealed no significant difference (p = 0.706). The difference between zones in the cartilage overlying osteochondral abnormalities to corresponding normal zones showed no significant difference (p = 0.564). IVDs were related to anatomic location, with decreased IVDs in loading areas (p = 0.003). IVD was age dependent, with more vessels present in the younger participants (p = 0.001).
Conclusions
The use of SWI in conjunction with ultrahigh field MRI makes the in vivo visualization of vessels in the growing cartilage of humans feasible, providing insights into the role of the vessel network in acquired disturbances.
Key Points
• SWI facilitates in vivo visualization of vessels in the growing human cartilage.
• Interrater reliability of the intracartilaginous vessel grading was moderate.
• Intracartilaginous vessel densities are dependent on anatomical location and age.
Are growth patterns on MRI in small (< 4 cm) solid renal masses useful for predicting benign histology?
Abstract
Purpose
To evaluate previously described growth patterns in < 4 cm solid renal masses.
Materials and Methods
With IRB approval, 63 renal cell carcinomas (RCC; clear cell n = 22, papillary n = 28, chromophobe n = 13) and 36 benign masses [minimal-fat (mf) angiomyolipoma (AML) n = 13, oncocytoma n = 23) from a single institution were independently evaluated by two blinded radiologists (R1/R2) using T2-weighted MRI for (1) the angular interface sign (AIS), (2) bubble-over sign (BOS), (3) percentage (%) exophytic growth and (4) long-to-short axis ratio. Comparisons were performed using ANOVA, chi-square and multi-variate regression.
Results
AIS was present in 11.1% (7/63) -9.5% (6/63) R1/R2 RCC compared to 13.9% (5/36) -19.4% (7/36) R1/R2 benign masses (p = 0.68 and 0.16). BOS was present in 11.1% (7/63) -3.2% (2/63) R1/R2 RCC compared to 16.7% (6/36) -8.3% (3/36) R1/R2 benign masses (p = 0.432 and 0.261). Agreement was moderate (K = 0.50 and 0.55). mf-AML [66 ± 32% (range 0-100%)] and oncocytoma [53 ± 26% (0-90%)] had larger % exophytic growth compared to RCC [32 ± 23% (0-80%)] (p < 0.001). No RCC had 90-100% exophytic growth, present in 38.5% (5/13) mf-AMLs and 17.4% (4/23) oncocytomas. The long-to-short axis did not differ between groups (p = 0.053).
Conclusions
Benign masses show greater % exophytic growth whereas other growth patterns are not useful. Future studies evaluating % exophytic growth using multi-variate MR analysis in renal masses are required.
Key Points
• Greater exophytic growth is associated with benignity among solid renal masses.
• Only minimal fat AMLs and oncocytomas had 90-100% exophytic growth.
• The angular interface sign was not useful to differentiate benign masses from RCC.
• The bubble-over sign was not useful to differentiate benign masses from RCC.
• Subjective analysis of growth patterns had fair-to-moderate agreement.
Sequential high intensity focused ultrasound (HIFU) ablation in the treatment of benign multinodular goitre: an observational retrospective study
Abstract
Objectives
Assessing the efficacy and safety of sequential high-intensity focused ultrasound (HIFU) ablation in a multinodular goitre (MNG) by comparing them with single HIFU ablation.
Methods
One hundred and four (84.6%) patients underwent single ablation of a single nodule (group I), while 19 (15.4%) underwent sequential ablation of two relatively-dominant nodules in a MNG (group II). Extent of shrinkage per nodule [by volume reduction ratio (VRR)], pain scores (by 0-10 visual analogue scale) during and after ablation, and rate of vocal cord palsy (VCP), skin burn and nausea/vomiting were compared between the two groups.
Results
All 19 (100%) sequential ablations completed successfully. The 3- and 6-month VRR of each nodule were comparable between the two groups (p > 0.05) and in group II, the 3- and 6-month VRR between the first and second nodules were comparable (p = 0.710 and p = 0.548, respectively). Pain score was significantly higher in group II in the morning after ablation (2.29 vs 1.15, p = 0.047) and nausea/vomiting occurred significantly more frequently in group II (15.8% vs 0.0%, p = 0.012). However, VCP and skin burn were comparable (p > 0.05).
Conclusions
Sequential ablation had comparable efficacy and safety as single ablation. However, patients undergoing sequential ablation are at higher likelihood of pain in the following morning and nausea/vomiting after ablation.
Key Points
• Sequential HIFU ablation is well-tolerated in patients with two dominant thyroid nodules
• More pain is experienced in the morning following sequential HIFU ablation
• More nausea/vomiting is experienced following sequential HIFU ablation
Diffusion tensor magnetic resonance imaging of breast cancer: associations between diffusion metrics and histological prognostic factors
Abstract
Objectives
To investigate whether quantitative diffusion metrics derived from diffusion tensor imaging (DTI) are associated with histological prognostic factors in breast cancer patients.
Methods
This retrospective study was approved by the institutional review board, and informed consent was waived. Between 2016 and 2017, 251 consecutive women (mean age, 53.8 years) with breast cancer (230 invasive, 21 in situ) who underwent preoperative magnetic resonance (MR) imaging with DTI were identified. Diffusion gradients were applied in 20 directions (b values, 0 and 1,000 s/mm2). DTI metrics – mean diffusivity (MD) and fractional anisotropy (FA) – were measured for breast lesions and contralateral normal breast by two radiologists and were correlated with histological findings using the Mann-Whitney U-test and linear regression analysis.
Results
MD and FA were significantly lower for breast cancers than for normal fibroglandular tissues (1.03 ± 0.25×10−3 mm2/s vs. 1.60 ± 0.19×10−3 mm2/s, p < 0.001 and 0.29 ± 0.09 vs. 0.33 ± 0.06, p < 0.001, respectively). Significant differences were observed in MD between invasive cancer and ductal carcinoma in situ lesions (p < 0.001). Multivariate linear analysis showed that larger size (>2 cm) (p = 0.007), high histological grade (grade 3) (p = 0.045) and axillary node metastasis (p = 0.009) were significantly associated with lower MD in invasive breast cancer patients. Larger size (p < 0.001) and high histological grade (p = 0.025) were significantly associated with lower FA.
Conclusions
DTI-derived diffusion metrics, such as MD and FA, are associated with histological prognostic factors in breast cancer patients.
Key points
• MD was significantly lower for breast cancers than for normal breast tissues.
• FA was significantly lower for breast cancers than for normal breast tissues.
• Reduced DTI metrics were associated with poor prognostic factors of breast cancer.
• DTI may provide valuable information concerning biological aggressiveness in breast cancer.
Correction to: A predictive model for distinguishing radiation necrosis from tumour progression after gamma knife radiosurgery based on radiomic features from MR images
Abstract
The original version of this article, published on 24 November 2017, unfortunately contained a mistake.
Mammographic density changes following discontinuation of tamoxifen in premenopausal women with oestrogen receptor-positive breast cancer
Abstract
Objectives
To evaluate the changes in mammographic density after tamoxifen discontinuation in premenopausal women with oestrogen receptor-positive breast cancers and the underlying factors
Methods
A total of 213 consecutive premenopausal women with breast cancer who received tamoxifen treatment after curative surgery and underwent three mammograms (baseline, after tamoxifen treatment, after tamoxifen discontinuation) were included. Changes in mammographic density after tamoxifen discontinuation were assessed qualitatively (decrease, no change, or increase) by two readers and measured quantitatively by semi-automated software. The association between % density change and clinicopathological factors was evaluated using univariate and multivariate regression analyses.
Results
After tamoxifen discontinuation, a mammographic density increase was observed in 31.9% (68/213, reader 1) to 22.1% (47/213, reader 2) by qualitative assessment, with a mean density increase of 1.8% by quantitative assessment compared to density before tamoxifen discontinuation. In multivariate analysis, younger age (≤ 39 years) and greater % density decline after tamoxifen treatment (≥ 17.0%) were independent factors associated with density change after tamoxifen discontinuation (p < .001 and p = .003, respectively).
Conclusions
Tamoxifen discontinuation was associated with mammographic density change with a mean density increase of 1.8%, which was associated with younger age and greater density change after tamoxifen treatment.
Key Points
• Increased mammographic density after tamoxifen discontinuation can occur in premenopausal women.
• Mean density increase after tamoxifen discontinuation was 1.8%.
• Density increase is associated with age and density decrease after tamoxifen.
Comparison of image quality and radiation dose between split-filter dual-energy images and single-energy images in single-source abdominal CT
Abstract
Objectives
To compare image quality and radiation dose of abdominal split-filter dual-energy CT (SF-DECT) combined with monoenergetic imaging to single-energy CT (SECT) with automatic tube voltage selection (ATVS).
Methods
Two-hundred single-source abdominal CT scans were performed as SECT with ATVS (n = 100) and SF-DECT (n = 100). SF-DECT scans were reconstructed and subdivided into composed images (SF-CI) and monoenergetic images at 55 keV (SF-MI). Objective and subjective image quality were compared among single-energy images (SEI), SF-CI and SF-MI. CNR and FOM were separately calculated for the liver (e.g. CNRliv) and the portal vein (CNRpv). Radiation dose was compared using size-specific dose estimate (SSDE). Results of the three groups were compared using non-parametric tests.
Results
Image noise of SF-CI was 18% lower compared to SEI and 48% lower compared to SF-MI (p < 0.001). Composed images yielded higher CNRliv over single-energy images (23.4 vs. 20.9; p < 0.001), whereas CNRpv was significantly lower (3.5 vs. 5.2; p < 0.001). Monoenergetic images overcame this inferiority in CNRpv and achieved similar results compared to single-energy images (5.1 vs. 5.2; p > 0.628). Subjective sharpness was equal between single-energy and monoenergetic images and diagnostic confidence was equal between single-energy and composed images. FOMliv was highest for SF-CI. FOMpv was equal for SEI and SF-MI (p = 0.78). SSDE was significant lower for SF-DECT compared to SECT (p < 0.022).
Conclusions
The combined use of split-filter dual-energy CT images provides comparable objective and subjective image quality at lower radiation dose compared to single-energy CT with ATVS.
Key points
• Split-filter dual-energy results in 18% lower noise compared to single-energy with ATVS.
• Split-filter dual-energy results in 11% lower SSDE compared to single-energy with ATVS.
• Spectral shaping of split-filter dual-energy leads to an increased dose-efficiency.
MRI-based decision tree model for diagnosis of biliary atresia
Abstract
Objectives
To evaluate MRI findings and to generate a decision tree model for diagnosis of biliary atresia (BA) in infants with jaundice.
Methods
We retrospectively reviewed features of MRI and ultrasonography (US) performed in infants with jaundice between January 2009 and June 2016 under approval of the institutional review board, including the maximum diameter of periportal signal change on MRI (MR triangular cord thickness, MR-TCT) or US (US-TCT), visibility of common bile duct (CBD) and abnormality of gallbladder (GB). Hepatic subcapsular flow was reviewed on Doppler US. We performed conditional inference tree analysis using MRI findings to generate a decision tree model.
Results
A total of 208 infants were included, 112 in the BA group and 96 in the non-BA group. Mean age at the time of MRI was 58.7 ± 36.6 days. Visibility of CBD, abnormality of GB and MR-TCT were good discriminators for the diagnosis of BA and the MRI-based decision tree using these findings with MR-TCT cut-off 5.1 mm showed 97.3 % sensitivity, 94.8 % specificity and 96.2 % accuracy.
Conclusions
MRI-based decision tree model reliably differentiates BA in infants with jaundice. MRI can be an objective imaging modality for the diagnosis of BA.
Key Points
• MRI-based decision tree model reliably differentiates biliary atresia in neonatal cholestasis.
• Common bile duct, gallbladder and periportal signal changes are the discriminators.
• MRI has comparable performance to ultrasonography for diagnosis of biliary atresia.
Have we forgotten imaging prior to and after kidney transplantation?
Key Points
• The number of publications on imaging and kidney transplantation is low.
• These publications are poorly cited, as compared with other fields of imaging.
• Conversely, there is a clinical need for evidence-based recommendations.
• Innovative advances for the use of imaging and kidney transplantation are essential.
• An increased focus and adequate research funding are highly anticipated by clinicians.
The role of breast tomosynthesis in a predominantly dense breast population at a tertiary breast centre: breast density assessment and diagnostic performance in comparison with MRI
Abstract
Objectives
To compare breast density measured on digital breast tomosynthesis (DBT) (BI-RADS-based breast composition and fully-automatic estimation) and magnetic resonance imaging (MRI) (BI-RADS amount of fibroglandular tissue), and to evaluate the diagnostic performance in terms of sensitivity and specificity of DBT and MRI in a predominantly dense breast population.
Methods
Between 2015 and 2016, 152 women with 103 breast malignancies, who underwent 3-T breast MRI and DBT within 2 months' time, were enrolled in this study. Breast composition/fibroglandular tissue and findings on DBT (two readers) and MRI were reported using BI-RADS 5th edition. Digital mammography images were analysed for breast percent density (PD) using the Libra software tool.
Results
A majority of women had dense breasts as categorised by breast composition c (heterogeneously dense) (68%) and d (extremely dense) (15%). The mean PD was 44% (range, 18-89%) and the correlation between breast composition and PD was r = 0.6. The diagnostic performance of MRI was significantly higher compared to DBT for one reader as described by the area under the receiver operating characteristic (ROC) curve (p = 0.004) and of borderline significance for the other reader (p = 0.052).
Conclusions
MRI had higher diagnostic performance than DBT in a dense breast population in the tertiary setting.
Key Points
• MRI had higher diagnostic performance than DBT in a dense breast population
• Diagnostic performance of DBT was comparable to MRI in women with fatty breasts
• MRI was superior to DBT in preoperative breast cancer size assessment
Overall and Sex-specific Associations between Fetal Adversity and Child Development at One Year: Evidence from Brazil
Ixekizumab provides superior efficacy compared to ustekinumab over 52-weeks of treatment: results from IXORA-S, a phase 3 study
The IL-17 antagonist ixekizumab is effective in the clearance of plaque psoriasis. The superior efficacy of ixekizumab over ustekinumab observed at earlier time points is maintained through Week 52 and is associated with greater quality of life improvements. Over 52 weeks, the overall safety of ixekizumab and ustekinumab was comparable.
Natural History of Disease Activity and Damage in Patients with Cutaneous Lupus Erythematosus
There are few longitudinal studies characterizing disease activity and damage of CLE patients. This study utilizes the CLASI to delineate the disease course of CLE patients on standard-of-care treatments. Having high baseline disease activity, minority race, or CLE disease duration <1 year predict CLE activity improvement.
Preliminary Analysis of Pulsed Radiofrequency Therapy Combined with Carpal Tunnel Release for Reducing the Pain in Postoperative Period: Early Outcomes
Carpal tunnel release (CTR) surgery is the main treatment used for moderate and severe CTS. However, despite this treatment, symptoms of pain may continue into the early postoperative period in some cases1.
Reply to the Editor: The pedicled internal pudendal artery perforator (PIPAP) flap for ischial pressure sore reconstruction: Technique and long-term outcome of a cohort study
It is with great interest that we have read the recent publication of Legemate CM et al. on the technique and long-term outcome of the pedicled internal pudendal artery perforator (PIPAP) flap for ischial pressure sore reconstruction.1 First described by Hashimoto et al., this flap is an interesting option due to its rich vascular network, easy dissection, feasible primary closure of the donor site, and the fact that the pudendal artery perforators are close to the location of the ischial defect.
Patients with Abdominal-based Free Flap Breast Reconstruction a Decade after Surgery - A Comprehensive Long-term Follow-up Study
Abdominal-based free flap breast reconstruction has increasingly become the gold standard, however long-term evidence of aesthetic outcome and quality of life is lacking. Our study aims to gain an overview of patients with abdominal-based free flap breast reconstructions in a long-term perspective.
Optimization of the method of the content‐containing interaction evaluation for cosmetic products by gas chromatography–mass spectrometry
International Journal of Cosmetic Science, EarlyView.
Radiomics signature: a biomarker for the preoperative discrimination of lung invasive adenocarcinoma manifesting as a ground-glass nodule
Abstract
Objectives
To identify the radiomics signature allowing preoperative discrimination of lung invasive adenocarcinomas from non-invasive lesions manifesting as ground-glass nodules.
Methods
This retrospective primary cohort study included 160 pathologically confirmed lung adenocarcinomas. Radiomics features were extracted from preoperative non-contrast CT images to build a radiomics signature. The predictive performance and calibration of the radiomics signature were evaluated using intra-cross (n=76), external non-contrast-enhanced CT (n=75) and contrast-enhanced CT (n=84) validation cohorts. The performance of radiomics signature and CT morphological and quantitative indices were compared.
Results
355 three-dimensional radiomics features were extracted, and two features were identified as the best discriminators to build a radiomics signature. The radiomics signature showed a good ability to discriminate between invasive adenocarcinomas and non-invasive lesions with an accuracy of 86.3%, 90.8%, 84.0% and 88.1%, respectively, in the primary and validation cohorts. It remained an independent predictor after adjusting for traditional preoperative factors (odds ratio 1.87, p < 0.001) and demonstrated good calibration in all cohorts. It was a better independent predictor than CT morphology or mean CT value.
Conclusions
The radiomics signature showed good predictive performance in discriminating between invasive adenocarcinomas and non-invasive lesions. Being a non-invasive biomarker, it could assist in determining therapeutic strategies for lung adenocarcinoma.
Key Points
• The radiomics signature was a non-invasive biomarker of lung invasive adenocarcinoma.
• The radiomics signature outweighed CT morphological and quantitative indices.
• A three-centre study showed that radiomics signature had good predictive performance.
Dynamic contrast-enhanced CT for the assessment of tumour response in malignant pleural mesothelioma: a pilot study
Abstract
Objectives
The aim of this pilot study was to investigate the utility of haemodynamic parameters derived from dynamic contrast-enhanced computed tomography (DCE-CT) scans in the assessment of tumour response to treatment in malignant pleural mesothelioma (MPM) patients.
Methods
The patient cohort included nine patients undergoing chemotherapy and five patients on observation. Each patient underwent two DCE-CT scans separated by approximately 2 months. The DCE-CT parameters of tissue blood flow (BF) and tissue blood volume (BV) were obtained within the dynamically imaged tumour. Mean relative changes in tumour DCE-CT parameters between scans were compared between the on-treatment and on-observation cohorts. DCE-CT parameter changes were correlated with relative change in tumour bulk evaluated according to the modified RECIST protocol.
Results
Differing trends in relative change in BF and BV between scans were found between the two patient groups (p = 0.19 and p = 0.06 for BF and BV, respectively). No significant rank correlations were found when comparing relative changes in DCE-CT parameters with relative change in tumour bulk.
Conclusions
Differing trends in the relative change of BF and BV between patients on treatment and on observation indicate the potential of DCE-CT for the assessment of pharmacodynamic endpoints with respect to treatment in MPM. A future study with a larger patient cohort and unified treatment regimens should be undertaken to confirm the results of this pilot study.
Key Points
• CT-derived haemodynamic parameters show differing trends between malignant pleural mesothelioma patients on treatment and patients off treatment
• Changes in haemodynamic parameters do not correlate with changes in tumour bulk as measured according to the modified RECIST protocol
• Differing trends across the two patient groups indicate the potential sensitivity of DCE-CT to assess pharmacodynamic endpoints in the treatment of MPM
Bioadsorption of trivalent and hexavalent chromium from aqueous solutions by sericin-alginate particles produced from Bombyx mori cocoons
Abstract
In this study, particles produced from sericin-alginate blend were used as non-conventional bioadsorbent for removing Cr(III) and Cr(VI) from aqueous solutions. Besides chromium mitigation, the use of sericin-alginate particles as bioadsorbent aims to offer an environmental solution of added value for sericin, which is a by-product from silk industry. Sericin-alginate particles in natura and loaded with Cr(III) and Cr(VI) were characterized using N2 physical adsorption analysis, optical microcopy, mercury porosimetry, helium pycnometry, scanning electron microscope coupled with energy dispersive X-ray spectrometer, Fourier transform infrared spectrometer, and X-ray diffraction. Kinetic studies on the removal of Cr(III) (at pH = 3.5) and Cr(VI) (at pH = 2) indicate the ion exchange mechanism with Ca(II) and the predominance of external mass transfer resistance. Cr(VI) uptake occurs through an adsorption-coupled reduction process, and bioadsorption equilibrium is reached after ~ 1000 min. Cr(III) bioadsorption occurs faster (~ 210 min). The Cr(VI) bioadsorption is endothermic, as bioadsorption capacity increases with temperature: 0.0783 mmol/g (20 °C), 0.1960 mmol/g (30 °C), 0.4570 mmol/g (40 °C), and 0.7577 mmol/g (55 °C). The three-parameter isotherm model of Tóth best represents the equilibrium data of total chromium. From Langmuir isotherm model, the maximum bioadsorption capacity is higher for total chromium, 0.25 mmol/g (30 °C), than for trivalent chromium, 0.023 mmol/g (30 °C). The comparison of bioadsorption capacities with different biomaterials confirms sericin-alginate particles as potential bioadsorbent of chromium.
Magnetic flocculants synthesized by Fe 3 O 4 coated with cationic polyacrylamide for high turbid water flocculation
Abstract
A novel magnetic flocculant (CPAMF) was synthesized by using Fe3O4 coated with cationic polyacrylamide (CPAM) for flocculation of high turbid water. The surface morphology and chemical structures of CPAMF were confirmed by Fourier transform infrared spectroscopy (FTIR) and thermo-gravimetric analysis (TGA). X-ray diffraction (XRD) was employed to verify the crystal structure of CPAMF. The magnetic property of CPAMF was compared with Fe3O4 in this study. The flocculation performance by using flocculants CPAMF was evaluated in high turbid water treatment. The maximum transmittance 92.4% of kaolin suspension was achieved at corresponding optimal flocculation conditions. The result indicated that CPAMF was efficient in high turbid water flocculation. Analysis of FTIR, XRD of flocs, and zeta potential (ZP) of supernatant were accomplished for flocculation mechanism investigation. Because of low recovery factor in reflocculation under the effect of shear force on flocs, the bridging effect was found to be dominant in both acidic and alkaline conditions. Sedimentation experiments under the role of permanent magnet indicated that nano-Fe3O4 could effectively improve the settling property of CPAM.
Graphical abstract
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Publication date: Available online 25 July 2018 Source: Journal of Photochemistry and Photobiology B: Biology Author(s): Marco Ballestr...
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Editorial AJR Reviewers: Heartfelt Thanks From the Editors and Staff Thomas H. Berquist 1 Share + Affiliation: Citation: American Journal...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño