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• GI tract perforation following RFA for liver tumors is rare but potentially fatal. • The small intestine is vulnerable to thermal injury resulting from RFA. • Patients receiving ablation for liver tumors in proximity to the small intestine require careful observation. We analyzed the incidence and mortality rate of gastrointestinal (GI) tract perforation after radiofrequency ablation (RFA) for hepatic tumors and assess its risk factors. This retrospective cohort study included 4799 patients with malignant tumors who underwent RFA (n = 7206). Sixty-nine cases of thermal injury to the GI tract were identified via a search of the electronic medical record system using index terms and divided into two groups according to the thermal injury with (n = 8) or without (n = 61) GI tract perforation based on follow-up CT reports. The risk factors for GI tract perforation were identified via multivariable logistic regression analysis using clinical, technical, and follow-up CT findings. The incidence of thermal injury to the GI tract and GI tract perforation was 0.96 % (69/7206) and 0.11 % (8/7206), respectively. The type of adjacent GI tract and history of diabetes mellitus differed significantly between the two groups (p < 0.05). The index tumor being located around the small intestine was the only significant risk factor for GI tract perforation after ablation (Odds ratio, 22.69; 95 % confidence interval, 2.59–198.34; p = 0.005 [reference standard, stomach]). All perforations were not identified on CT images immediately after RFA. The median time to detection was 20 days (range, 3–41 days). Two patients (25 %, 2/8) died due to perforation-related complications. GI tract perforation after RFA for hepatic tumors is rare; however, it is associated with high mortality. Thus, careful follow-up is required after RFA if the index tumor is located around the small intestine. [ABSTRACT FROM AUTHOR]

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term proposed to replace non-alcoholic fatty liver disease (NAFLD). We analyzed the ultrasonographic findings of MAFLD and NAFLD. We conducted a retrospective cross-sectional study of subjects aged ≥19 years who underwent a health screening examination, including ultrasonography, (n = 17,066). Patients were separated into one of three groups; pure MAFLD (n = 5304), pure NAFLD (n = 579), and both NAFLD & MAFLD (n = 11,183). The outcomes were the degree of fatty liver disease and liver cirrhosis, defined by ultrasonography. In addition, the risk of ultrasonographic cirrhosis was assessed in the MAFLD group based on clinical characteristics. The pure NAFLD group had a lower risk of severe fatty liver disease than the both NAFLD & MAFLD groups (0.9 % vs. 4.4 %, p < 0.001). Cirrhosis was not diagnosed in the NAFLD group. Cirrhosis was more common in the pure MAFLD group than in the both NAFLD & MAFLD group (0.3 % vs. 0.0 %, p < 0.001). In the MAFLD group, multivariable analysis showed that diagnosis by hepatic steatosis index (Odds ratio [OR], 12.39; 95 % confidence interval [CI], 3.40–45.19; p < 0.001) or significant alcohol intake (OR, 9.58, 95 % CI, 1.93–47.61; p = 0.006) was independently associated with risk of liver cirrhosis on ultrasonography. Liver cirrhosis was more frequently identified on ultrasonography in patients with MAFLD than in NAFLD. MAFLD diagnosed using the hepatic steatosis index or significant alcohol intake is a risk factor for liver cirrhosis. • Cirrhosis was more frequently identified when we use MAFLD criteria compared to NAFLD. • Patients with both NAFLD and MAFLD had more severe fatty liver than those with pure NAFLD or MAFLD. • A high-risk group for cirrhosis can be identified using MAFLD criteria: hepatic steatosis index or significant alcohol intake. [ABSTRACT FROM AUTHOR]

The rising demand for sustainable smart buildings is increasing the need to come up with an effective decision-making method for building energy usage management. Simulating energy usage data through advanced technologies like Building Information Modeling (BIM) has become possible of late, and data-mining methods that use various data types (e.g., BIM, energy simulation, sensor, and facility management data) will be needed in the future for decision-making support in BIM-based energy management. Proposed herein is a rule-set-based BIM-based data-mining method for data integration and function extension support that considers functional variability and extensibility. Its work effectiveness was verified through the development and creation of a building-energy-management-related scenario and the analysis of the results thereof. Based on the analysis of work effectiveness, we identified that using the proposed method, the effectiveness improved by 14.4 to 20.5 times. The proposed method enables users to gain intuitive BIM-based decision-making information and allows them customize the flexible workflow for changing of use cases. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the distinctive features of ACLF and chronic liver disease (CLD) on MR images using quantitative and qualitative analyses. Methods Twelve patients with ACLF and 36 patients with CLD who had undergone MR images were included. MR imaging findings from both groups were assessed. Results Gallbladder edema, esophageal varix, and ascites were significantly more prevalent in the ACLF group (all P -values < 0.05). The liver to muscle SI ratio on T2-WI was significantly higher in the ACLF group ( P = 0.002). Conclusion MR imaging findings could be helpful in differentiating between patients with ACLF and those with CLD. [ABSTRACT FROM AUTHOR]

Purpose: To assess the association between non-hypervascular hypointense nodules (NHHNs) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and liver stiffness (LS) in patients with chronic liver disease, and analyzed their progression to overt hepatocellular carcinoma (HCC).Methods: Between August 2012 and March 2016, a total of 714 consecutive patients who had undergone transient elastography for LS measurement and gadoxetic acid-enhanced MRI were investigated. The association between the presence of NHHNs on the hepatobiliary phase and LS, and the patient's HCC status [none, presence of treatment-naïve HCC, or a history of previous HCC treatment] was assessed. In patients with these nodules, cumulative progression rates of nodules to overt HCC were compared with rates of new HCC development in other parts of the liver.Results: The prevalence of NHHNs was 16.8% (120/714). The presence of these nodules was significantly associated with the log LS (Odds ratio [OR], 1.48, p=0.002) and hepatitis B virus infection (OR, 3.14, p=0.017), regardless of the patient's HCC status. The two year cumulative progression rate of overt HCC from corresponding nodules and rate of progression to HCC in other parts of the liver were 34.1% and 18.3%, respectively (p=0.071).Conclusion: The presence of NHHNs on gadoxetic acid-enhanced MRI was associated with higher LS and hepatitis B virus infection. Furthermore, these lesions frequently progressed to overt HCC. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence of severe bleeding and mortality associated with percutaneous biopsy for hepatic angiosarcoma in a multicenter retrospective cohort.Materials and Methods: A retrospective review of 33 patients with biopsy-proven hepatic angiosarcoma (29 male; median age, 57 y; age range, 24-96 y) was performed at seven tertiary academic hospitals between January 1998 and March 2015. The mean maximum tumor size was 5.5 cm (range, 1.7-20 cm). An 18-gauge automated cutting biopsy needle was used with a freehand technique in all patients who underwent ultrasonography-guided percutaneous core needle biopsy on an inpatient basis. The incidences of severe bleeding and procedure-related mortality were evaluated per Society of Interventional Radiology (SIR) guidelines.Results: There was a mean of 2.8 needle passes per patient during the procedure (range, 1-6). The overall incidence of severe bleeding events (SIR grade C/D) was 9.1% (3 of 33). Two patients were managed with blood transfusion, and one patient underwent embolization for bleeding control. No other major complications were encountered. There were no cases of mortality associated with the biopsy.Conclusions: Severe bleeding was not a frequent complication after percutaneous biopsy for hepatic angiosarcoma. The majority of bleeding complications could be controlled with conservative management. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the correlation between grade of pancreatic neuroendocrine tumours (pNETs) based on the 2010 World Health Organization (WHO) classification and the apparent diffusion coefficient (ADC), and to assess whether the ADC value and WHO classification can predict recurrence-free survival (RFS) after surgery for pNETs.Methods: This retrospective study was approved by the Institutional Review Board. The requirement for informed consent was waived. Between March 2009 and November 2014, forty-nine patients who underwent magnetic resonance (MR) imaging with diffusion-weighted image and subsequent surgery for single pNETs were included. Correlations among qualitative MR imaging findings, quantitative ADC values, and WHO classifications were assessed. An ordered logistic regression test was used to control for tumour size as a confounding factor. The association between ADC value (or WHO classification) and RFS was analysed.Results: All tumors (n=49) were classified as low- (n=29, grade 1), intermediate- (n=17, grade 2), and high-grade (n=3, grade 3), respectively. The mean ADC of pNETs was moderately negatively correlated with WHO classification before and after adjustment for tumour size (ρ=-0.64, p<0.001 and ρ=-0.55, p=0.001 respectively). RFS was significantly associated with WHO classification (p=0.007), but not with the ADC value (p=0.569).Conclusion: The ADC value of pNETs is moderately correlated with WHO tumour grade, regardless of tumour size. However, the WHO tumour classification of pNET may be more suitable for predicting RFS than the ADC value. [ABSTRACT FROM AUTHOR]

Purpose: To compare computed tomography (CT) findings in patients with pancreatic metastasis from renal cell carcinoma (pRCC) and patients with hypervascular pancreatic neuroendocrine tumour (pNET) with a focus on the relative percentage washout (RPW).Methods: We evaluated 16 patients with 37 pRCCs and 28 patients with 31 hypervascular pNETs using a protocol consisting of arterial and portal phase CT. Imaging findings were analyzed for comparison between the two groups. The RPW of each tumour using biphasic CT was obtained by two observers for evaluation of diagnostic performance. Interobserver agreement of each value and optimal cut-off level of RPW for discrimination between groups were evaluated.Results: Tumour multiplicity showed significant difference in both groups. The mean RPW of the pRCC group (observer 1, 27.0%; observer 2, 29.4%) was significantly higher than that of the pNET group (observer 1, 0.5%; observer 2, 3.2%) (p<0.001 for each observer). Interobserver agreement for both attenuation values and RPWs was excellent. A RPW value of 19% was selected as the optimal cut-off for pRCC determination, and showed good performance (accuracy 83.8%, sensitivity 83.8%, and specificity 83.9%).Conclusion: With multiplicity, RPW of the tumour on CT could be helpful for differentiating pRCCs from hypervascular pNETs. [ABSTRACT FROM AUTHOR]

The purpose of this research is to suggest and develop a building information modeling (BIM) database based on BIM perspective definition metadata for connecting external facility management (FM) and BIM data, which considers variability and expandability from the user’s perspective. The BIM-based FM system must be able to support different use cases per user role and effectively extract information required by the use cases from various heterogeneous data sources. If the FM system’s user perspective becomes structurally fixed when developing the system, the lack of expandability can cause problems for maintenance and reusability. BIM perspective definition (BPD) metadata helps increase expandability and system reusability because it supports system variability, which allows adding or changing the user perspective even after the system has been developed. The information to be dealt with differs according to the user’s role, which also means that the data model, data conversion rules, and expression methods change per perspective. The perspective should be able to extract only the user-requested data from the heterogeneous system’s data source and format it in the style demanded by the user. In order to solve such issues, we analyzed the practice of FM and the benefits of using BIM-based FM, and we proposed a BPD that supports data extraction and conversion and created a prototype. [ABSTRACT FROM AUTHOR]

Background: The role of computed tomography (CT)/magnetic resonance imaging (MRI) surveillance for hepatocellular carcinoma (HCC) is unclear. We aimed to determine whether the intensity of imaging surveillance using CT and MRI is associated with tumor stage at diagnosis or survival in patients with HCC.Methods: This retrospective cohort study included 529 patients with newly diagnosed HCC under regular surveillance (twice a year testing) at a tertiary academic center. All patients were divided into a standard surveillance group (n = 62; ultrasonography [US] with alpha-fetoprotein) and an intensive imaging surveillance group (US and CT/MRI with alpha-fetoprotein); the latter was divided into a low- (n = 232) and high-intensive (n = 235) imaging surveillance group based on the median percentage of CT/MRI investigations (cut-off, 27%). Relationship between surveillance imaging, stage of HCC at diagnosis, and overall survival (OS) were analyzed.Results: The low- and high-intensive imaging surveillance groups (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.20-0.95; p = 0.034 and OR, 0.40; 95% CI, 0.19-0.86; p = 0.014, respectively) had better performances than the standard surveillance group to detect very early-stage HCC. OS was associated with albumin-bilirubin grade (hazard ratio [HR], 1.98; 95% CI, 1.28-3.07; p < 0.001 for grade 2 and HR, 3.03; 95% CI, 1.11-8.30; p = 0.027 for grade 3) and the applicability of curative treatment (HR, 2.34; 95% CI, 1.63-3.36; p < 0.001). However, surveillance intensity did not affect OS (p > 0.05).Conclusions: Imaging surveillance for HCC using alternative CT/MRI in addition to US compared to standard practice of US only facilitates the diagnosis of very early-stage HCC but may not improve OS. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the incidence and causes of mistargeting after fusion imaging-guided percutaneous radiofrequency (RF) ablation of hepatocellular carcinomas (HCCs). Materials and Methods: Between September 2011 and March 2013, 955 HCCs in 732 patients were treated with percutaneous RF ablation. Among them, ablation of 551 HCCs was accomplished under fusion imaging guidance, and seven mistargetings were noted in seven patients (male-to-female ratio = 6:1; mean age, 60.1 y; range, 47-73 y). The incidence of mistargeting and the cause of liver disease in the patients with mistargeting were evaluated. The causes of mistargeting were assessed according to the following classification: small size of HCC, subcapsular location, subphrenic location, confusion with pseudolesions, poor conspicuity of HCC, poor sonographic window, and poor electrode path. Results: The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3% (7 of 551). All patients with mistargeting were hepatitis B virus carriers. The most common cause of mistargeting was the small size of HCC (100%; 7 of 7), followed by confusion with surrounding pseudolesions (85.7%; 6 of 7), subcapsular (71.4%; 5 of 7) and subphrenic locations (71.4%; 5 of 7), poor conspicuity of the HCC (71.4%; 6 of 7), poor sonographic window (28.6%; 2 of 7), and poor electrode path (28.6%; 2 of 7). Conclusions: The incidence of mistargeting after fusion imaging-guided RF ablation was 1.3%. The most common cause of mistargeting was the small size of HCC, followed by confusion with surrounding pseudolesions, subcapsular and subphrenic locations, and poor conspicuity of the HCC. [ABSTRACT FROM AUTHOR]

Abstract: The human high-mobility group protein A2 (HMGA2) protein is an architectural transcription factor that transforms chromatin structure by binding to DNA. Recently, it has been reported that HMGA2 is highly expressed in fetal neural stem cells and has the capacity to promote stemness. However, there is currently no information available on the functional significance and molecular mechanisms of the cellular in vitro aging and proliferation of human umbilical cord blood-derived stromal cells (hUCBSCs). In the present study, we evaluated the direct effects of HMGA2 on the cellular aging and proliferation of hUCBSCs and investigated potential regulatory mechanisms responsible for the corresponding functions. We found that the overexpression of HMGA2 enhanced proliferation and reduced or even reversed the in vitro aging process of hUCBSCs. This effect was accompanied by the increased expression of cyclin E and CDC25A and the significantly decreased expression of cyclin-dependent kinase inhibitors. Furthermore, HMGA2 inhibition compromised cell proliferation and adipogenic differentiation in early-stage hUCBSCs. From the molecular/cellular functional analysis of microarray data, we found that HMGA2 overexpression induced a PI3K/Akt/mTOR/p70S6K cascade, which in turn suppressed the expression of p16INK4A and p21CIP1/WAF1 in hUCBSCs. These results provide novel insights into the mechanism by which HMGA2 regulates the in vitro aging and proliferation of hUCBSCs. [Copyright &y& Elsevier]

Abstract: In forensic science, identifying a tissue where a forensic specimen was originated is one of the principal challenges. Messenger RNA (mRNA) profile clearly reveals tissue-specific gene expression patterns that many attempts have been made to use RNA for forensic tissue identification. To systematically investigate the body-fluid-specific expression of mRNAs and find novel mRNA markers for forensic body fluid identification, we performed DNA microarray experiment with 24 Korean body fluid samples. Shannon entropy and Q-values were calculated for each gene, and 137 body-fluid-specific candidate genes were selected. By applying more stringent criteria, we further selected 28 candidate genes and validated them by RT-PCR and qRT-PCR. As a result, we suggest a novel combination of four body-fluid-specific mRNA makers: PPBP for blood, FDCSP for saliva, MSMB for semen and MSLN for vaginal secretion. Multiplex qRT-PCR assay was designed using the four mRNA markers and DNA/RNA co-extraction method was tested for forensic use. This study will provide a thorough examination of body-fluid-specifically expressed mRNAs, which will enlarge the possibility of practical use of RNA for forensic purpose. [Copyright &y& Elsevier]

Abstract: Radiosurgery is a noninvasive procedure where spatially accurate and highly conformal doses of radiation are targeted at brain lesions with an ablative intent. Recently, radiosurgery has been established as an effective technique for local treatment of brain metastasis. After radiosurgery, magnetic resonance (MR) imaging plays an important role in the assessment of the therapeutic response and of any complications. The therapeutic approach depends on the imaging findings obtained after radiosurgery, which have a role in the decision making to perform additional invasive modalities (repeat resection, biopsy) to obtain a definite diagnosis and to improve the survival of patients. Conventional MR imaging findings are mainly based on morphological alterations of tumors. However, there are variable imaging findings of radiation-induced changes including radiation necrosis in the brain. Radiologists are sometimes confused by radiation-induced injuries, including radiation necrosis, that are seen on conventional MR imaging. The pattern of abnormal enhancement on follow-up conventional MR imaging closely mimics that of a recurrent brain metastasis. So, classifying newly developed abnormal enhancing lesions in follow-up of treated brain metastasis with correct diagnosis is one of the key goals in neuro-oncologic imaging. To overcome limitations of the use of morphology-based conventional MR imaging, several physiological-based functional MR imaging methods have been used, namely diffusion-weighted imaging, perfusion MR imaging, and proton MR spectroscopy, for the detection of hemodynamic, metabolic, and cellular alterations. These imaging modalities provide additional information to allow clinicians to make proper decisions regarding patient treatment. [Copyright &y& Elsevier]

Background: To investigate the imaging features of gadoxetic acid-enhanced magnetic resonance imaging (MRI) to differentiate hepatic sclerosing hemangioma from malignant tumors.Methods: This retrospective case-control study included 18 patients with sclerosing hemangioma and 54 patients with common hepatic malignant tumor, including hepatocellular carcinoma, metastatic adenocarcinoma, and cholangiocarcinoma, who were examined using gadoxetic acid-enhanced liver MRI from January 2008 to June 2019. Imaging features including signal intensity, tumor margins, enhancement pattern, and presence or absence of diffusion restriction were analyzed. Significant MRI features for predicting sclerosing hemangioma were identified using multivariable logistic regression analysis. Diagnostic performances of each imaging feature and combinations of significant imaging features were summarized.Results: In the multivariable analysis, irregular margins (odds ratio [OR], 10.12; 95 % confidence interval [CI], 1.27-80.94; p = 0.029), centripetal or internal nodular enhancement in the transitional phase (OR, 13.58; 95 % CI, 1.48-124.82; p = 0.021), and absence of diffusion restriction (OR, 39.20; 95 % CI, 4.82-318.49; p = 0.001) were significant imaging features for the diagnosis of sclerosing hemangioma. Presence of at least two significant imaging features had a sensitivity, specificity, and accuracy of 88.9 %, 96.3 %, and 94.4 %, respectively, for diagnosing sclerosing hemangioma.Conclusion: Combinations of two or more of the significant imaging features (irregular margins, centripetal or internal nodular enhancement in the transitional phase, and absence of diffusion restriction) were effective for differentiating hepatic sclerosing hemangioma from malignant tumors using gadoxetic acid-enhanced MRI. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) and magnetic resonance imaging (MRI) are used to detect hepatocellular carcinoma (HCC). We performed a prospective study to compare the diagnostic performance of CT, MRI with extracellular contrast agents (ECA-MRI), and MRI with hepatobiliary agents (HBA-MRI) in the detection of HCC using the liver imaging reporting and data system (LI-RADS). We studied 125 participants (102 men; mean age, 55.3 years) with chronic liver disease who underwent CT, ECA-MRI, or HBA-MRI (with gadoxetic acid) before surgery for a nodule initially detected by ultrasound at a tertiary center in Korea, from November 2016 through February 2019. We collected data on major features and assigned LI-RADS categories (v2018) from CT and MRI examinations. We then compared the diagnostic performance for LR-5 for each modality alone, and in combination. In total, 163 observations (124 HCCs, 13 non-HCC malignancies, and 26 benign lesions; mean size, 20.7 mm) were identified. ECA-MRI detected HCC with 83.1% sensitivity and 86.6% accuracy, compared to 64.4% sensitivity and 71.8% accuracy for CT (P <.001) and 71.2% sensitivity (P =.005) and 76.5% accuracy for HBA-MRI (P =.005); all technologies detected HCC with 97.4% specificity. Adding CT to either ECA-MRI (89.2% sensitivity, 91.4% accuracy; both P <.05) or HBA-MRI (82.8% sensitivity, 86.5% accuracy; both P <.05) significantly increased its diagnostic performance in detection of HCC compared with the MRI technologies alone. ECA-MRI identified arterial phase hyperenhancement in a significantly higher proportion of patients (97.6%) than CT (81.5%; P <.001) or HBA-MRI (89.5%; P =.002). ECA-MRI identified non-peripheral washout in 79.8% of patients, vs 74.2% of patients for CT and 73.4% of patients for HBA-MRI (differences not significant). ECA-MRI identified enhancing capsules in 85.5% of patients, vs 33.9% for CT (P <.001) and 41.4% for HBA-MRI (P <.001). In a prospective study of patients with chronic liver disease and a nodule detected by ultrasound, ECA-MRI detected HCC with higher levels of sensitivity and accuracy than CT or HBA-MRI, based on LI-RADS. Diagnostic performance was best when CT was used in combination with MRI compared with MRI alone. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Yijin-Tang (YJT) is a traditional prescription for the treatment of hyperlipidaemia, atherosclerosis and other ailments related to dampness phlegm, a typical pathological symptom of abnormal body fluid metabolism in Traditional Korean Medicine. However, a holistic network pharmacology approach to understanding the therapeutic mechanisms underlying hyperlipidaemia and atherosclerosis has not been pursued. Aim of the study To examine the network pharmacological potential effects of YJT on hyperlipidaemia and atherosclerosis, we analysed components, performed target prediction and network analysis, and investigated interacting pathways using a network pharmacology approach. Materials and Methods Information on compounds in herbal medicines was obtained from public databases, and oral bioavailability and drug-likeness was screened using absorption, distribution, metabolism, and excretion (ADME) criteria. Correlations between compounds and genes were linked using the STITCH database, and genes related to hyperlipidaemia and atherosclerosis were gathered using the GeneCards database. Human genes were identified and subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Results Network analysis identified 447 compounds in five herbal medicines that were subjected to ADME screening, and 21 compounds and 57 genes formed the main pathways linked to hyperlipidaemia and atherosclerosis. Among them, 10 compounds (naringenin, nobiletin, hesperidin, galangin, glycyrrhizin, homogentisic acid, stigmasterol, 6-gingerol, quercetin and glabridin) were linked to more than four genes, and are bioactive compounds and key chemicals. Core genes in this network were CASP3, CYP1A1, CYP1A2, MMP2 and MMP9. The compound-target gene network revealed close interactions between multiple components and multiple targets, and facilitates a better understanding of the potential therapeutic effects of YJT. Conclusions Pharmacological network analysis can help to explain the potential effects of YJT for treating dampness phlegm-related diseases such as hyperlipidaemia and atherosclerosis. [ABSTRACT FROM AUTHOR]

Factors affecting the registration error (RE) and motion of focal hepatic lesions (FHLs) in image fusion of real-time ultrasonography (US) with computed tomography (CT) images were prospectively assessed by focusing on respiratory movement and FHL location. Real-time US and pre-acquired CT images at end-inspiration were fused with FHLs for 103 patients. Three-dimensional US data containing FHLs were obtained during end-inspiratory/expiratory phases. Multivariate analysis revealed that diaphragm motion (p < 0.001), chronic liver disease (p = 0.02) and the absolute difference in distance between the FHL and the central portal vein (CPV) during respiration (p = 0.03) were the independent factors that revealed the maximum effect on RE. In contrast, diaphragm motion (p < 0.001) and distance between the FHL and CPV at inspiration (p = 0.036) revealed the maximum effect on FHL motion. In conclusion, RE and FHL motion are affected by the degree of respiratory movement and the location of the FHL. Therefore, image fusion with CT images should be used with caution if the degree of respiratory motion is significant or if the FHL is located at the periphery of the liver. [ABSTRACT FROM AUTHOR]

Objectives: Although both clinical and biomechanical studies suggest that cephalomedullary implants have a mechanical advantage over extramedullary implants, a high rate of complications or implant failure remains in elderly patients with osteoporosis. In an attempt to address some of these challenges, new implants with improved designs named proximal femoral nail antirotation II (PFNA II) and Zimmer natural nail (ZNN) were developed for elderly patients. Although the PFNA II reportedly has good clinical outcomes, it is unclear which implant achieves better safety and efficacy for treating intertrochanteric hip fractures. The primary objective of this prospective, randomized trial involved 353 patients was to evaluate Harris Hip Score (HHS). The secondary objective was to compare results associated with clinical outcome such as operation time, fluoroscopy time, lateral hip pain, walking ability, and reoperation rate as well as the incidence of cut-out by using implant position and fracture reduction quality.Methods: 353 patients with an intertrochanteric fracture amenable to either ZNN implant or PFNA II with a mean age of 77.0 years and a mean follow-up period of 12.3 months were included. We analyzed 353 patients with an intertrochanteric fracture treated using a ZNN implant (n=172, group I) or a PFNA II (n=181, group II) between January 2011 and August 2014.Results: There were no significant inter-group differences in HHS, walking ability, and reoperation rate were observed. However, operation and fluoroscopy time were significantly different between the two groups as well as group I showed a higher incidence of lateral hip pain than group II. In addition, no significant inter-group differences in cut-out rate determined by implant position and fracture reduction quality. We also found that cut-out was associated with lag screw position in the femoral head measured by Tip-apex distance (TAD) but not with reduction quality.Conclusions: Although group I had significant longer operation and fluoroscopy time than group II, both implants are useful tools in the treatment of elderly intertrochanteric fractures as well as only TAD, but not Cleveland zone significantly correlated with lag screw cut-out. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to investigate the value of enhancement kinetics and ancillary imaging findings on gadoxetic acid-enhanced and diffusion-weighted (DW) MR imaging for diagnosing hepatocellular carcinomas (HCCs) without the typical enhancement pattern on contrast-enhanced multiphasic MDCT in patients with chronic liver disease. Materials and methods Eighty-two surgically confirmed HCCs without the typical enhancement pattern (hypervascular in the arterial phase, followed by washout on the portal or equilibrium phases) on triple-phase MDCT were enrolled in this study. The patients were classified into four categories based on the CT density pattern of arterial and equilibrium phases (isodense–isodense, hypodense–hypodense, isodense–hypodense, and hyperdense–isodense) compared to liver parenchyma. Signal intensity of HCCs on T2-weighted images (T2WI), arterial phase, 3 min late-phase, hepatobiliary phase (HBP) and DW images with a b value of 800 s/mm 2 were qualitatively evaluated, and ADC values were measured. Fisher's exact test and Chi-square test were used to compare the frequency and trend of hyperintensity on T2WI, hypointensity on HBP images, hyperintensity on DW images, and histopathologic grades between groups with different CT density patterns. Kruskal–Wallis test was used to compare the ADC value between groups. Results Thirty and 52 HCCs were categorized as hypervascular (hyperdense–isodense) and non-hypervascular HCCs (3, isodense–isodense; 37, hypodense–hypodense; 12, isodense–hypodense), respectively. Most HCCs showed hyperintensity on T2WI (77/82, 93.9%) and DW images (81/82, 98.8%) and hypointensity on HBP images (80/82, 97.6%). Thirty-eight HCCs (38/82, 46.3%) showed typical HCC enhancement pattern on dynamic MR images. There were no significant differences in the frequency and trend of signal intensity on T2WI, HBP images, DW images, and histopathologic grades with regard to the four CT density patterns ( p < 0.05). No significant difference in mean ADC values between groups was identified ( p < 0.05). Conclusion Gadoxetic acid-enhanced and DW MR imaging can help diagnose HCCs with atypical enhancement patterns on multiphasic CT in patients with chronic liver disease. [ABSTRACT FROM AUTHOR]

Abstract: Integrated analysis of DNA methylation and gene expression can reveal specific epigenetic patterns that are important during carcinogenesis. We built an integrated database of DNA methylation and gene expression termed MENT (Methylation and Expression database of Normal and Tumor tissues) to provide researchers information on both DNA methylation and gene expression in diverse cancers. It contains integrated data of DNA methylation, gene expression, correlation of DNA methylation and gene expression in paired samples, and clinicopathological conditions gathered from the GEO (Gene Expression Omnibus) and TCGA (The Cancer Genome Atlas). A user-friendly interface allows users to search for differential DNA methylation by either ‘gene search’ or ‘dataset search’. The ‘gene search’ returns which conditions are differentially methylated in a gene of interest, while ‘dataset search’ returns which genes are differentially methylated in a condition of interest based on filtering options such as direction, DM (differential methylation value), and p-value. MENT is the first database which provides both DNA methylation and gene expression information in diverse normal and tumor tissues. Its user-friendly interface allows users to easily search and view both DNA methylation and gene expression patterns. MENT is freely available at http://mgrc.kribb.re.kr:8080/MENT/. [Copyright &y& Elsevier]

Abstract: The fibroblast growth factor-inducible 14 (Fn14) gene encodes a type I transmembrane protein that belongs to the tumor necrosis factor receptor superfamily and regulates multiple cellular processes in diverse physiological and pathological conditions, including cancer. Here, we describe an important role for Fn14 in regulating the growth of gastric cancer cells. Previous gene expression data analysis demonstrated that Fn14 was up-regulated in various tumor tissues, including gastric cancer. Using qRT-PCR, we showed that Fn14 was overexpressed in gastric tumor tissues compared to normal tissues. Furthermore, Fn14 expression levels were inversely correlated with gastric cancer patient survival. Using ectopic overexpression and shRNA-mediated knockdown of Fn14, we demonstrated that the expression level of Fn14 affected cell growth in gastric cancer. The effect of Fn14 on cell growth was mediated by the NF-κB activity and eventually by the transcriptional regulation of the anti-apoptotic Bcl-2 family gene (Bcl-xL). These results suggest that Fn14 may play an important role in gastric tumor growth by regulating NF-κB-mediated anti-apoptosis and that Fn14 may be a useful prognostic marker for gastric cancer. [Copyright &y& Elsevier]

A β-galactoside binding lectin, designated as galectin-2, was identified and characterized from rock bream Oplegnathus fasciatus ( OfGal-2 ). The cDNA of OfGal-2 comprised of 692 bp with a coding sequence of 396 bp, encoding a putative polypeptide of 131 amino acids. Gene structure analysis of OfGal-2 revealed a four exon-three intron organization. A single carbohydrate-binding domain containing all seven important residues for carbohydrate binding was located in the third exon, which formed a carbohydrate-binding pocket. Homology screening and sequence analysis demonstrated that OfGal-2 is an evolutionarily conserved proto-type galectin. OfGal-2 transcripts were detected in several healthy fish tissues, with the highest level observed in the intestine, followed by the liver. The expression of OfGal-2 was elevated upon the injection of various mitogenic stimulants and pathogens in a time-dependent manner. Upregulated expression in the liver after tissue injury suggested its role as a damage-associated molecular pattern. Recombinant OfGal-2 protein had hemagglutinating potential and possessed affinity towards lactose and galactose. Moreover, the recombinant protein agglutinated and bound potential pathogenic bacteria and a ciliate. The results of this study indicate that the galectin-2 from rock bream has a potential role in immunity, particularly in the recognition of invading pathogens. [ABSTRACT FROM AUTHOR]