Search

To compare 10-minute (min) delayed hepatocyte phase imaging (HPI) using a 30° flip angle (FA) (10m-FA30) and 20-min delayed HPI using a 10° FA (20m-FA10) or 30° FA (20m-FA30) in Gd-EOB-DTPA-enhanced MRI in patients with chronic hepatitis or cirrhosis, in terms of lesion-to-liver contrast-to-noise ratio (CNR) for hepatocellular carcinoma (HCC) and detection sensitivity for focal hepatic lesions (FHLs).One hundred and four patients with 168 HCCs and 55 benign FHLs who underwent Gd-EOB-DTPA-enhanced MRI with 10m-FA30, 20m-FA10, and 20m-FA30 were enrolled. Patients were divided into two groups according to the Child-Pugh classification: group A with chronic hepatitis or Child-Pugh A cirrhosis and group B with Child-Pugh B or C cirrhosis. Lesion-to-liver CNR for HCCs was compared between 10m-FA30 and 20m-FA10 or 20m-FA30 for each group. The presence of FHLs was evaluated using a four-point scale by two independent reviewers, and the detection sensitivity was analyzed.In group A, the CNR for HCCs (n = 86) on 10m-FA30 (165.8 ± 99.7) was significantly higher than that on 20m-FA10 (113.4 ± 71.4) and lower than that of 20m-FA30 (210.2 ± 129.3). However, there was no significant difference in the sensitivity of FHL detection between 10m-FA30 (mean 95.0% for two reviewers) and 20m-FA10 (94.7%) or 20m-FA30 (94.7%). In group B, the CNR (54.0 ± 36.4) for HCCs (n = 57) and the sensitivity (94.2%) of FHL detection for 10m-FA30 were significantly higher than those for 20m-FA10 (41.8 ± 36.4 and 80.8%, respectively) and were not different from those for 20m-FA30 (62.7 ± 44.4 and 93.3%, respectively).The diagnostic performance of 10m-FA30 was similar to or higher than 20m-FA10 or 20m-FA30 in both groups A and B. This finding indicates that 10m-FA30 could replace 20-min delayed HPI regardless of patient liver function and reduce the delay time by 10 minutes.

Using multilocus sequence typing (MLST), Candida albicans can be subdivided into 18 different clades. Farnesol, a quorum-sensing molecule secreted by C. albicans, is thought to play an important role in the development of C. albicans biofilms and is also a virulence factor. This study evaluated whether C. albicans bloodstream infection (BSI) strains belonging to different MLST clades secrete different levels of E,E-farnesol (FOH) and whether they have different clinical characteristics. In total, 149 C. albicans BSI isolates from ten Korean hospitals belonging to clades 18 (n = 28), 4 (n = 23), 1 (n = 22), 12 (n = 17), and other clades (n = 59) were assessed. For each isolate, the FOH level in 24-hour biofilms was determined in filtered (0.45 μm) culture supernatant using high-performance liquid chromatography. Marked differences in FOH secretion from biofilms (0.10-6.99 μM) were observed among the 149 BSI isolates. Clade 18 isolates secreted significantly more FOH than did non-clade 18 isolates (mean ± SEM; 2.66 ± 0.22 vs. 1.69 ± 0.10 μM; P < 0.001). Patients with isolates belonging to clade 18 had a lower mean severity of illness than other patients, as measured using the "acute physiology and chronic health evaluation" (APACHE) III score (14.4 ± 1.1 vs. 18.0 ± 0.7; P < 0.05). This study provides evidence that C. albicans BSI isolates belonging to the most prevalent MLST clade (clade 18) in Korea are characterized by increased levels of FOH secretion and less severe illness.

To compare 10-minute delayed hepatocyte phase imaging using a 30° flip angle (10 min-FA30) and 20-minute hepatocyte phase imaging using a 10° FA (20 min-FA10) in gadoxetic acid-enhanced MRI of patients with possible liver metastases, regarding lesion-to-liver contrast-to-noise ratio (CNR) and focal hepatic lesion (FHL) detection to evaluate whether 10 min-FA30 would be superior to 20 min-FA10.Eighty-three patients with 248 liver metastases and 78 benign FHLs who underwent gadoxetic acid-enhanced MRI with 10 min-FA30 and 20 min-FA10 were enrolled. Lesion-to-liver CNRs were compared between the two image groups. Two radiologists independently assessed the presence of FHLs using a four-point scale and detection sensitivity was calculated.The mean CNR for liver metastases on the 10 min-FA30 (248.5 ± 101.6) were significantly higher than that of the 20 min-FA10 (187.4 ± 77.4) (p < 0.001). The mean CNR difference between the two image groups was 61.2 ± 56.8. There was no significant difference in detection sensitivity of FHLs for two readers between 10 min-FA30 (mean 97.7%) and 20 min-FA10 (mean 97.9%), irrespective of the lesion size or malignancy.10 min-FA30 yielded higher CNR with similar sensitivity compared to 20 min-FA10. This finding indicates that 10 min-FA30 can potentially replace 20 min-FA10 with higher diagnostic performance and save 10 minutes of time.

Study Type - Diagnosis (exploratory cohort) Level of Evidence 2b OBJECTIVES To investigate whether there are any differences between preoperative magnetic resonance imaging (MRI) and the final pathology results, based on the time between biopsy and preoperative MRI, as there are reports recommending ≥3 weeks after a prostate biopsy, primarily because haemorrhaging interferes with the interpretation of MRI. PATIENTS AND METHODS Between December 2007 and December 2008, we retrospectively analysed 69 consecutive patients who had biopsy-confirmed prostate cancer. The inclusion criteria for the study were a history of MRI investigation (combined T2-weighted and diffusion-weighted MRI) and robot-assisted laparoscopic radical prostatectomy. The exclusion criteria included an MRI investigation-to-surgery interval of ≥1 week, a biopsy having been taken in another hospital, or other than 12 biopsy cores. The amount of haemorrhaging, number of haemorrhaging sites, and the location of the cancer were determined. For this, the prostate was divided into 12 segments which anatomically corresponded to the sites where the 12 core biopsies were taken. Each haemorrhagic prostate segment was scored according to its diameter. Pathology results were reviewed in the same manner. Finally, we assessed any discordance between the sets of results according to the period between the biopsy and the MRI. The association between the MRI and pathology results, in relation to the period between the biopsy and MRI, was plotted and tested using Pearson's correlation coefficient. RESULTS Five of the 69 patients were excluded because they had a biopsy at another hospital, 12 were excluded because the period between the MRI and the surgery was >7 days. Suspected prostate haemorrhage was detected in 49 of 52 (94%) patients who had MRI. There was a significantly negative correlation with the period between biopsy and MRI (coefficient - 0.285, P= 0.041). There were no significant differences in cancer localization between MRI and pathology results according to the period between the biopsy and MRI (coefficient 0.028, P= 0.874). The rate of matching between MRI results and pathology results was 74%. CONCLUSIONS We found no significant differences in cancer localization between MRI and final pathology according to the period between the biopsy and MRI. Because of this finding, we do not recommend deferring MRI for the purpose of more accurate cancer staging. [ABSTRACT FROM AUTHOR]

Objectives: The overuse of smartphones affects physical, social, and psychological well-being. However, research on smartphone addiction and anxiety disorders is scarce. Therefore, the objective of this study was to investigate the association between anxiety and smartphone addiction risk in Korean adolescents. Methods: This study used a cross-sectional survey method. We used the Revised Children's Manifest Anxiety Scale to assess anxiety symptoms and we used the Korean Smartphone Addiction Proneness Scale index to evaluate the degree of high-risk or at-risk for smartphone addiction. Results: Analyses were performed for 1733 adolescents, including 771 boys and 962 girls. The high-risk or at-risk group for smartphone addiction accounted for 20.1% (p < .0001). Total anxiety scale score, as well as physiological anxiety, oversensitivity, and social concern categories were statistically different among levels of smartphone addiction risk (all p s < .0001). Multivariate analysis showed that poor self-reported health level, higher risk of smartphone addiction, having fewer close friends, caffeine drink consumption, female sex, and alcohol use were associated with greater anxiety. Conclusions: Management of smartphone addiction seems to be essential for proper psychological health. There is an urgent need to develop a way to prevent smartphone addiction on a social level.