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This retrospective study investigated whether the interval change of apparent diffusion coefficient (∆ADC) [baseline and after the first cycle of induction chemotherapy (ICT)] can be used as a valid predictive imaging biomarker of the treatment response to ICT in head and neck cancer (HNC).A total of 19 consecutive patients with HNC who underwent diffusion-weighted magnetic resonance imaging (DWI) at baseline and after the first cycle of ICT were included. Whole-tumor ADC histogram parameters (mean, median, kurtosis, skewness, entropy, minimal, maximum, 25th percentile, and 75th percentile) were obtained. The correlations of ∆ADC histogram parameters, volume, T-stage, N-stage, and age with the treatment response were examined using the Mann-Whitney U test. The predictive value of histogram parameters was examined using receiver operating characteristic (ROC) curves.Responders showed significantly higher values of ∆ADC∆ADC

Background Bet1 Golgi vesicular membrane trafficking protein-like (BET1L) rs2280543 single nucleotide polymorphism (SNP) and diet have been independently associated with uterine leiomyoma (UL). However, whether the SNP and diet could jointly influence the risk of UL is yet to be assessed. Therefore, we investigated the independent and interactive effects of vegetarian diet and BET1L rs2280543 on uterine fibroids in Taiwanese women. Methods We linked participants’ electronic data in the Taiwan Biobank (TWB) database to their medical records in the National Health Insurance Research Database (NHIRD). The TWB had genotypic, lifestyle, and biochemical data between 2008 and 2015 and the NHIRD had data on disease diagnoses between 1998 and 2015. In this study, we included 1997 premenopausal women with complete data. Results Compared to participants with the BET1L rs2280543 CC genotype (wildtype), those with CT/CC genotype had an odds ratio (OR) of 0.69 and a 95% confidence interval (CI) of 0.51–0.93. Vegetarian diet and UL were not significantly associated: OR = 1.09 and 95% CI = 0.77–1.55. However, the test for interaction between rs2280543 and vegetarian diet was significant (p = 0.046). Compared to individuals with the CC genotype, the risk of UL was lower among vegetarians with the CT/TT genotype: OR (95% CI) = 0.15 (0.05–0.47). Conclusion The BET1L rs2280543 CT/TT genotype was associated with a lower risk of UL especially among vegetarians.

Abdominal colic pain or hematuria is suspected to be caused by urinary tract stones. Commonly used X-ray examinations include kidney-ureter-bladder plain radiography (KUB), intravenous urography (IVU), and abdominal computed tomography (CT). In this study, a high-sensitivity thermoluminescent dosimeter (TLD) was embedded in a Rando phantom to directly measure organ dose and evaluate effective dose. During each experiment, 139 TLD measurement points that cover almost all organs (as recommended by the ICRP 103 report) were examined. Red bone-marrow and remainder tissues have a high tissue weighting factor (0.12), and they are widely distributed. In the phantom, 34 TLDs and 31 TLDs were embedded in the red bone-marrow and remainder tissues to improve the accuracy and representativeness of organ doses. The detailed organ dose distributions for KUB, IVU, and abdominal CT are presented. The effective doses for KUB and IVU were 0.22 and 1.51 mSv, respectively, and those for two abdominal CTs were 8.21 and 9.27 mSv. This experiment presents a conversion factor of 0.0177 mSv·mGy

Background: To quantify image quality and radiation doses in regions adjacent to and distant from bismuth shields in computed tomography (CT). Methods: An American College of Radiology accreditation phantom with four solid rods embedded in a water-like background was scanned to verify CT number (CTN) accuracy when using bismuth shields. CTNs, image noise, and contrast-to-noise ratios (CNRs) were determined in the phantom at 80–140 kVp. Image quality was investigated on image portions in the zones adjacent (A zone) to and distant (D zone) from a bismuth shield. Surface radiation doses were measured using thermoluminescent dosimeters. Streak artefacts were graded on a 3-point-scale. Results: Changes in CTN caused by a bismuth shield resulted in changes in X-ray spectra. CTN changes were more apparent in the A zone than in the D zone, particularly for a low tube voltage. The degrees of CTN changes and image noise were proportional to the thickness of the bismuth shields. A 1-ply bismuth shield reduced surface radiation doses by 7.2%–15.5%. The overall CNRs were slightly degraded, and streak artefacts were acceptable. Conclusions: Using a bismuth shield could result in significant CTN changes and perceivable artefacts, particularly for a superficial organ close to the shield, and is not recommended for quantification CT examinations or follow-up CT examinations. Keywords: Computed tomography, Radiation protection, Bismuth shielding, Quantification analysis, Image quality

Thermoluminescent dosemeters (TLDs) were attached to the walls of a plain radiography room and a computed tomography (CT) room, control rooms and corridors to measure the radiation dose. The types of animals scanned and scan parameters were analysed. Dogs and cats accounted for the largest proportion of animals, a combined total of 96.0%. Distributions of tube voltage and tube current-time product are presented. In the CT room, the dose at the angle of the gantry opening was higher than that on either side of the gantry. The study developed equations that may be useful to assess the dose for staff standing in radiography rooms. The personal annual doses for the controlled and uncontrolled areas were lower than the recommended dose limit. The annual doses for personnel and nonworkers were also within the acceptable level for radiation safety.

Androgen deprivation therapy (ADT) is one of the typical treatments used for patients with prostate cancer (PCa). ADT, however, may fail when PCa develops castration-resistance. Fatty acid synthase (FASN), a critical enzyme involved in fatty acid synthesis, is found to be up-regulated in PCa. Since enzalutamide and ADT are frequently used for the treatment of PCa, the present study aimed to unravel the underlying mechanism of combination of orlistat, an FASN inhibitor, and enzalutamide using PC3 cell line; and orlistat and castration in PC3 tumor-bearing animal model. Cytotoxicity was determined by AlamarBlue assay. Drug effects on the cell cycle and protein expressions were assayed by the flow cytometry and Western blot. Electromobility shift assay was used to evaluate the NF-κB activity. The tumor growth delay, expressions of the signaling-related proteins, and histopathology post treatments of orlistat and castration were evaluated in PC3 tumor-bearing mouse model. The results showed that orlistat arrested the PC3 cells at the G1 phase of the cell cycle and enhanced the cytotoxic effects of enzalutamide synergistically. Pretreatment with orlistat combined with castration inhibited the tumor growth significantly compared with those of castration and orlistat treatments alone in PC3 tumor-bearing mice. Combination treatment reduced both FASN and NF-κB activities and their downstream effector proteins. The present study demonstrated the synergistic effects of orlistat combined with enzalutamide in vitro and castration in vivo on human PCa.

Hepatocellular carcinoma (HCC) is difficult to diagnose at an early stage, and its prognosis is generally poor. Sorafenib is the primary treatment for unresectable advanced HCC and targets multiple receptor tyrosine kinases. However, sorafenib only extends the average survival time by 3 months. This observation indicates that sorafenib may need to be combined with other treatments to further improve outcomes. We previously showed that combination of sorafenib with radiotherapy (RT) enhances tumor inhibition in subcutaneous HCC mouse models compared with monotherapy. The present study demonstrated that combining sorafenib and RT could suppress tumor growth in an orthotopic HCC model by regulating apoptosis and NF-κB-related pathways. Moreover, decreased numbers of visible liver tumors and a smaller percentage of spleen metastases were found in the combination group. A transient drop in body weight was initially observed after RT, but progressive recovery of body weight occurred. The current study showed that the combination of sorafenib and RT could be a safe strategy for HCC treatment.

BackgroundParticulate matter (PM) < 2.5 μm (PM2.5) or fine PM is a serious public health concern. It affects DNA methylation and heightens carcinogenesis. Deleted in lung and esophageal cancer 1 (DLEC1) is a tumor suppressor gene. However, aberrant methylation of the gene is associated with several cancers. We evaluated the association between PM2.5and DLEC1 promoter methylation in Taiwanese adults based on regular outdoor exercise.MethodsWe obtained DNA methylation and exercise data of 496 participants (aged between 30 and 70 years) from the Taiwan Biobank (TWB) database. We also extracted PM2.5data from the Air Quality Monitoring Database (AQMD) and estimated participants’ exposure using residential addresses.ResultsDLEC1 methylation and PM2.5were positively associated: beta coefficient (β) = 0.114 × 10−3;pvalue = 0.046. The test for interaction between exercise and PM2.5on DLEC1 methylation was significant (pvalue = 0.036). After stratification by exercise habits, PM2.5and DLEC1 methylation remained significantly associated only among those who exercised regularly (β= 0.237 × 10−3;pvalue = 0.007). PM2.5quartile-stratified analyses revealed an inverse association between regular exercise and DLEC1 methylation at PM2.5< 27.37 μg/m3(β= − 5.280 × 10−3;pvalue = 0.009). After combining exercise habits and PM2.5quartiles, one stratum (i.e., regular exercise and PM2.5< 27.37 μg/m3) was inversely associated with DLEC1 methylation (β= -5.160 × 10−3,pvalue = 0.007).ConclusionsWe found significant positive associations between PM2.5and DLEC1 promoter methylation. Regular exercise at PM2.5< 27.37 μg/m3seemingly regulated DLEC1 promoter methylation.

Background Polycyclic aromatic hydrocarbon (PAH)-rich substances like cigarette smoke and PM2.5 induce aryl hydrocarbon receptor (AHR)-mediated aryl hydrocarbon receptor repressor (AHRR) methylation. AHRR cg05575921 and coagulation factor II (thrombin) receptor-like 3 (F2RL3) cg03636183 methylation patterns are well-established biomarkers for smoking. Even though AHRR cg05575921 methylation has recently been associated with PM2.5, the interaction between smoking and PM2.5 on AHRR methylation is yet to be fully explored. We evaluated AHRR and F2RL3 CpG sites to identify potential significant markers in relation to PM2.5 and smoking in Taiwanese adults. Methods DNA methylation and smoking data of 948 participants aged 30–70 years were obtained from the Taiwan Biobank Database (2008–2015), while PM2.5 data were obtained from the Air Quality Monitoring Database (2006–2011). Results Smoking and PM2.5 were independently associated with hypomethylation (lower levels) of AHRR cg05575921, AHRR cg23576855, F2RL3 cg03636183, and F2LR3 cg21911711 after multiple-comparison correction (Bonferroni P β = − 0.03909, P P smoking P 2.5. After adjusting for F2RL3 cg03636183, smoking and PM2.5 remained significantly associated with cg05575921 hypomethylation: β − 0.02221, P P smoking P = 0.0120 for PM2.5. After stratification by sex, smoking and PM2.5 remained associated (P β = − 0.04274, − 0.17700, and − 0.00163 for former smoking, current smoking, and PM2.5, respectively) and women (β = − 0.01937, − 0.17255, and − 0.00105 for former smoking, current smoking, and PM2.5, respectively). After stratification by residential area, former and current smoking remained associated (P β = − 0.03918 and − 0.17536, respectively (P-trendsmoking P β = − 0.01356 and − 0.01970, respectively (P-trendarea Conclusion Smoking and PM2.5 were independently associated with hypomethylation of cg05575921, cg23576855, cg03636183, and cg21911711. The most hypomethylated CpG site was cg05575921 and its association with smoking and PM2.5 was dose-dependent.

The emergence of the coronavirus disease 2019 (COVID-19) caused a large-scale outbreak and has rapidly spread across China and multiple countries. We reported countermeasures in infection control for diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection and the experiences of point of care diagnostics and medical quarantine for presumed SARS-CoV-2-infected subjects. We conducted a retrospective cohort study on subjects came to Chung Shan Medical University Hospital with suspicion of SARS-CoV-2 infection during January to March, 2020. We performed the real-time reverse-transcription polymerase chain reaction testing (rRT-PCR) for SARS-CoV-2-infection and reported the results of testing and treatment. A total of 212 participants were enrolled due to suspicion of SARS-CoV-2 infection. Five of those were confirmed COVID-19 cases after monitoring for a period of 14 days and were cured. The time to rRT-PCR test conversion after treatment is variate. The infection control measures of home quarantine and mandatory medical quarantine combined with rapid diagnosis seem to postpone the speed of transmission of SARS-CoV-2 infection at once in Taiwan. Due to lack of vaccination and confirmed antiviral therapy, it is important to strictly abide by the infection control measures.

BACKGROUND: The aim of this study was to evaluate early and long-term clinical and laboratory findings in patients with resistant hypertension secondary to aldosterone-producing adenoma (APA) treated with radiofrequency ablation (RFA). METHODS: From July 2009 to September 2017, eight adult patients underwent percutaneous computed tomography (CT)-guided RFA for APA. The safety, efficacy and complications of the procedure were determined. Blood pressure (BP), number of antihypertensive agents, serum potassium, plasma aldosterone and aldosterone-to-renin ratio (ARR) were analyzed before RFA and immediately, short-term and long-term after RFA. RESULTS: The technical success rate was 100%. Two patients developed minor complications but there were no major complications. Clinical improvement was achieved immediately and short-term after RFA. In the long-term (mean follow-up duration of 6.7 ± 2.1 years) there were significant improvements in systolic (from 162.3 mmHg ± 18.6 to 125 mmHg ± 16.1, p = 0.02) and diastolic (from 96.3 mmHg ± 12.7 to 68.5 mmHg ± 6.3, p = 0.02) BP, with a significant reduction in the number of antihypertensive agents (from 3.33 ± 0.82 to 1.33 ± 1.21, p = 0.02). Hypokalemia improved significantly (serum potassium from 2.16 meq/L ± 0.22 to 4.34 meq/L ± 0.54, p = 0.04). Although the plasma aldosterone level decreased significantly, ARR did not (from 100.7 ± 124.4 to 28.7 ± 30.7 ng/dL-per-ng/mL/h, p = 0.13). Hypertension was cured in 33.3% of the patients, and the BP of all patients was more easily controlled regardless of the plasma aldosterone and renin status. CONCLUSIONS: CT-guided percutaneous RFA appears to be effective and safe to treat patients with APA, with clinical improvements in BP, reduced number of antihypertensive agents, and normalization of serum potassium level. These favorable outcomes persisted in short-term and long-term follow-up.

Background: Currently, nine universities and one junior college offer radiologic technologist (RT) programs (RTPs) in Taiwan. The curriculum, certificate examination, and licensing of RTs in RTPs in Taiwan are similar to those for RTPs in Japan and Korea. The present study explored the supply of and demand for RTs over the past 20 years and identified predictive indicators of trends affecting the numbers of RTs supplied and demanded.Methods: The present study involved web-based research. The analyzed data were publicly available information downloaded from the websites of relevant statistical departments in Taiwan. The study employed specific medical devices or examinations used in hospitals to determine the demand for RTs. Long-term (1999–2018) and short-term (2014–2018) trends were analyzed. The change rates were calculated using compound annual growth rate (CAGR). Pearson’s product–moment correlation coefficient or Spearman’s rank correlation coefficient was used to evaluate two groups of continuous variables. Kolmogorov–Smirnov and Shapiro–Wilk tests were used to test normally distributed data.Results: During 1999–2018, the annual numbers of students and graduates in RTPs were 2654 ± 350 and 516 ± 109, respectively, with corresponding CAGRs of 2.2% and 3.7%. During 2014–2018, the annual numbers of students and graduates in the RTPs were 2908 ± 67 and 605 ± 55, respectively, with corresponding CAGRs of −0.7% and 2.4%. During 1999–2018, the annual numbers of examinees and qualified personnel were 1228 ± 174 and 372 ± 62, respectively. The CAGRs for the number of qualified personnel were −1.5% and −4.7% during 1999–2018 and 2014–2018, respectively. The number of specific medical devices increased from 599 in 2000 to 1057 in 2018, whereas that of specific medical examinations increased from 1.7 million in 2000 to 5.3 million in 2018.Conclusion: During 2014–2018, 605 students graduated from RTPs annually, with approximately 375 annually becoming qualified personnel in Taiwan. The increase in the numbers of specific medical devices and examinations resulted in an annual increase of 204 new positions for RTs.

Ultrasonography (US) is believed to be the most available method of detecting hepatic portal venous gas (HPVG) with real-time imaging capability. Hepatic portal venous gas has characteristic image appearances in various ultrasound modes such as bright mode, Doppler mode, and even motion (M) mode. In this article, we give a comprehensive review of the image appearances of HPVG among different modes of US with a special focus on the M mode US. Hepatic portal venous gas was recognized as linear echogenicities in various oblique directions (the meteor shower sign) on the M mode US. This specific sign may expand some potential of HPVG detection by US.

The World Health Organization regards betel quid (BQ) as a human carcinogen. The current study analyzes whether the BQ cues can elicit activity in the chewers' craving-related brain areas. We adopted a cue-reactivity paradigm to examine the changes in the brain activities. The urge intensity was also included to examine whether it can moderate the brain areas stimulated by BQ cues. Sixteen male BQ chewers and 16 healthy male controls were recruited and analyzed. Four types of cues were adopted: BQ cues, matched food cues, visual control cues, and resting crosshair cued. The most direct and important comparison was between the brain activities elicited by the BQ cues versus those by the food cues. Furthermore, to test the current urge intensity effect, we compared BQ chewers with a strong urge versus those with a weak urge. All of the three-dimension anatomical and multi-slice task-based functional images were acquired using 3 T MRI. We found that (1) the BQ chewers and the healthy controls had similar brain activation patterns when comparing any two cue types, (2) the high-urge (not the low-urge) chewers showed craving-related activations (e.g., anterior cingulate cortex, medial orbitofrontal gyrus, and superior frontal gyrus) in the critical BQ cues vs. the food cue comparisons. (3) The high-urge chewers had larger contrast activations (BQ - Food) in many craving-related brain areas than low-urge chewers did (e.g., frontal gyrus). The urge states endorsed by the chewers can moderate the neural responses to BQ cues. Multisensory cues should be considered to elicit more intense and consistent cravings.

The World Health Organization regards betel quid (BQ) as a human carcinogen, and DSM-IV and ICD-10 dependence symptoms may develop with its heavy use. BQ’s possible effects of an enhanced reward system and disrupted inhibitory control may increase the likelihood of habitual substance use. The current study aimed to employ resting-state fMRI to examine the hypothesized enhanced reward system (e.g., the basal forebrain system) and disrupted inhibitory control (e.g., the prefrontal system) in BQ chewers. The current study recruited three groups of 48 male participants: 16 BQ chewers, 15 tobacco- and alcohol-user controls, and 17 healthy controls. We used functional connectivity (FC), mean fractional amplitude of low-frequency fluctuations (mfALFF), and mean regional homogeneity (mReHo) to evaluate functional alternations in BQ chewers. Graph theoretical analysis (GTA) and network-based statistical (NBS) analysis were also performed to identify the functional network differences among the three groups. Our hypothesis was partially supported: the enhanced reward system for the BQ chewers (e.g., habitual drug-seeking behavior) was supported; however, their inhibitory control was relatively preserved. In addition, we reported that the BQ chewers may have enhanced visuospatial processing and decreased local segregation. The current results (showing an enhanced reward system in the chewers) provided the clinicians with important insight for the future development of an effective abstinence treatment.

Rationale and Objectives The purpose of this retrospective study was to evaluate the incidence of totally implantable venous access devices, also called ports, implantation and the associated abnormalities in 2-[18F]-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography-computed tomography (PET-CT) images for patients with cancer, and to determine the percentage of abnormalities identified in the original reports. Materials and Methods The study aimed to perform a retrospective review of all FDG PET-CT imaging in a 3-year period. Cases of port-associated abnormalities found on the FDG PET-CT images were identified and then correlated with X-ray reports and clinical treatment or follow-up. Results In total, 2442 FDG PET-CT scans were retrospectively reviewed. Among them, 897 (897 of 2442, 36.7%) demonstrated port implantation. Abnormalities, including 22 port fractures (22 of 897, 2.45%), 14 malposition (1.56%), one infection (0.11%), and one embraced by a fibrin sheath or tumor (0.11%) were found. Only the infectious one had clinical symptoms. Among the 22 fractured ports, eight fractured catheters migrated and became dislodged. All of the malpositioned ports, except two in the contralateral subclavian vein, were found in the ipsilateral jugular vein. Both the port infection and the port embraced by a fibrin sheath or tumor occurred at the tips of the devices, which demonstrated FDG uptake in the mediastinal region. Only seven of the 38 (18.42%) images of port abnormalities had been identified in the original reports. Conclusions Based on this study, we recommend that the interpretation of FDG PET-CT scans should include a checklist to record all metallic device implantations and to interpret the whole-body X-ray topography as a standard part of PET-CT image report.

Betel quid (BQ) is a common addictive substance in many Asian countries. However, few studies have focused on the influences of BQ on the brain. It remains unclear how BQ can affect structural brain abnormalities in BQ chewers. We aimed to use generalized q-sampling imaging (GQI) to evaluate the impact of the neurological structure of white matter caused by BQ. The study population comprised 16 BQ chewers, 15 tobacco and alcohol controls, and 17 healthy controls. We used GQI with voxel-based statistical analysis (VBA) to evaluate structural brain and connectivity abnormalities in the BQ chewers compared to the tobacco and alcohol controls and the healthy controls. Graph theoretical analysis (GTA) and network-based statistical (NBS) analysis were also performed to identify the structural network differences among the three groups. Using GQI, we found increases in diffusion anisotropy in the right anterior cingulate cortex (ACC), the midbrain, the bilateral angular gyrus, the right superior temporal gyrus (rSTG), the bilateral superior occipital gyrus, the left middle occipital gyrus, the bilateral superior and inferior parietal lobule, and the bilateral postcentral and precentral gyrus in the BQ chewers when compared to the tobacco and alcohol controls and the healthy controls. In GTA and NBS analyses, we found more connections in connectivity among the BQ chewers, particularly in the bilateral anterior cingulum. Our results provided further evidence indicating that BQ chewing may lead to brain structure and connectivity changes in BQ chewers.

Additional file 1: Table S1. AHRR and F2LR3 CpG sites and their association with smoking and PM2.5. Table S2. Multiple linear regression analysis showing the association of smoking and PM2.5 with F2RL3 cg03636183 methylation in the study participants. Table S3. Multiple linear regression analysis showing the association of smoking and PM2.5 with F2RL3 cg03636183 methylation in the study participants stratified by sex. Table S4. Multiple linear regression analysis showing the association of smoking and living in PM2.5 areas with F2RL3 cg03636183 methylation in the study participants. Table S5. Multiple linear regression analysis showing the association of smoking and living in PM2.5 areas and F2RL3 cg03636183 methylation in the study participants stratified by sex.

Purpose To evaluate the effective doses received by donors and recipients, identify effective dose contributions, and make risk assessments. Materials and Methods It was a retrospective study. 100 Donors and 100 recipients were enrolled with an operative day from March 2016 to August 2017. The dose was analyzed for all radiation-related examinations over a period of 2 years, 1 year before and 1 year after the LDLT procedure. The effective doses of plain X-rays, CT, fluoroscopy, and nuclear medicine per patient were simulated by a Monte Carlo software, evaluated by the dose-length product conversion factors, evaluated by the dose-area product conversion factors, and evaluated by the activity conversion factors, respectively. The risks of radiation-induced cancer were assessed on the basis of the ICRP risk model. Results The median effective doses were 71 (range: 30–186) mSv for donors and 147 (32–423) mSv for recipients. The radiation examinations were mainly performed in the last three months of preoperative period to first month of postoperative period for recipients and donors. The HCC recipients received a higher effective dose, 195 (64–423) mSv, than those with other indications. The median radiation-induced cancer risk was 0.38 % in male and 0.48 % in female donors and was 0.50 % in male and 0.58 % in female recipients. Conclusion Donors and recipients received a large effective dose, mainly from the CT scans. To reduce effective doses should be included in future challenges in some living donor liver transplants centers that often use CT examinations.

This study used thermoluminescent dosimeters (TLDs) to measure cumulative radiation doses in a PET/CT center. It covered 18 areas and four personnel groups. Because the isolated lead shielding separated the patients from the nurses, wearing protective clothing when injecting radiopharmaceuticals was unnecessary. Fingertip doses of the dispensing and nurse groups were below the occupational limit. Current radiopharmaceutical transportation and injection operations in this PET/CT center provide considerable radiation protection to medical personnel.

Ming-Chang Ku,1,2 Victor C Kok,3,4 Ming-Yung Lee,5 Soa-Min Hsu,1 Pei-Yu Lee,1 Che-Wei Chang,1 Yeu-Sheng Tyan,6 Chi-Wen Juan7,8 1Department of Radiology, Kuang Tien General Hospital, Taichung, 2Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, 3Department of Internal Medicine, Division of Medical Oncology, Kuang Tien General Hospital, 4Department of Bioinformatics and Medical Engineering, Asia University, 5Department of Statistics and Informatics Science, Providence University, 6Department of Medical Imaging, Chung Shan Medical University Hospital, 7Department of Emergency Medicine, Kuang Tien General Hospital, 8Department of Nursing, HungKuang University, Taichung, Taiwan Objectives: Gallbladder opacification (GBO) on computed tomography (CT) imaging may obscure certain pathological or emergent conditions in the gallbladder, such as neoplasms, stones, and hemorrhagic cholecystitis. This study aimed to investigate the clinical contributing factors that could predict the presence of delayed GBO determined by CT.Methods: This study retrospectively evaluated 243 consecutive patients who received enhanced CT or intravenous pyelography imaging and then underwent abdominal CT imaging within 5days. According to the interval between imaging, the patients were divided into group A (1day), group B (2 or 3days), and group C (4 or 5days). Three radiologists evaluated CT images to determine GBO. Fisher’s exact test and multivariate backward stepwise elimination logistic regression were performed.Results: Positive GBO was significantly associated with the interval between imaging studies, contrast type, contrast volume, renal function, and hypertransaminasemia (P

To retrospectively compare the safety and efficacy of radiofrequency ablation (RFA) with laparoscopic adrenalectomy (LA) in treating aldosterone-producing adenoma (APA) of the adrenal gland. From September 2009 to September 2013, seven patients, diagnosed with unilateral adrenal APA and underwent computed tomography (CT)-guided percutaneous RFA, were recruited in this retrospective study. Eighteen unilateral adrenal APA with the same tumor size (

Paraganglioma is a tumor that originates from neuroendocrine cells of the sympathetic or parasympathetic systems. Patients may suffer from headaches, palpitations, diaphoresis, and hypertension due to catecholamine excess or symptoms from the mass effect of the tumor. In the absence of typical symptoms of catecholamine excess, the diagnosis of a nonfunctional paraganglioma is often delayed. Herein, we report a case of a 63-year-old female patient with a nonfunctional paraganglioma which is an accidental finding during investigation of a fever. Abdominal ultrasonography incidentally detected this lesion as a complex, solid, cystic mass in the left suprarenal retroperitoneum.

Background/aim Gadoxetate disodium (Primovist or Eovist) is extensively used as a hepatospecific contrast agent during magnetic resonance imaging (MRI) examinations. However, there is no information determining whether gadoxetate disodium has a cytotoxic impact and/or affects relative gene expression on liver cells. In the current study, we investigated the effects of gadoxetate disodium on cytotoxicity and the levels of gene expression in human normal Chang Liver cells. Materials and methods The cytotoxic effect was detected via methyl thiazolyl tetrazolium (MTT) assay and 4',6-diamidino-2-phenylindole (DAPI) staining. mRNA expression was monitored by cDNA microarray and quantitative PCR (qPCR) analysis. The protein levels were determined by western blotting. Results Gadoxetate disodium at 5 and 10 mM failed to induce any cell cytotoxicity and morphological changes in Chang Liver cells. Our data demonstrated that gadoxetate disodium significantly enhanced the expression of 29 genes and suppressed that of 27. The SLCO1C1 (solute carrier organic anion transporter family member 1C1) mRNA expression was also increased by 2.62-fold (p-value=0.0006) in gadoxetate disodium-treated cells. Furthermore, we also checked and found that gadoxetate disodium up-regulated organic anion transporter polypeptide 1B1 (OATP1B1) protein level and increased OATP uptake transporter gene SLCO1C1 mRNA expression. Conclusion Our results provide evidence regarding that gadoxetate disodium might be no cytotoxic effects on liver cells.

Major depressive disorder (MDD) is highly prevalent, recurrent, and associated with functional impairment, morbidity, and mortality. Herein, we aimed to identify disruptions in functional connectomics among subjects with MDD by using resting-state functional magnetic resonance imaging (rs-fMRI). Sixteen subjects with MDD and thirty health controls completed resting-state fMRI scans and clinical assessments (e.g., Hamilton Depression Rating Scale (HAMD) and Hospital Anxiety and Depression Scale (HADS)). We found higher amplitude of low frequency fluctuations (ALFF) bilaterally in the hippocampus and amygdala among MDD subjects when compared to healthy controls. Using graph theoretical analysis, we found decreased clustering coefficient, local efficiency, and transitivity in the MDD patients. Our findings suggest a potential biomarker for differentiating individuals with MDD from individuals without MDD.

This study sought to determine the association between twinkling artifacts on color Doppler ultrasound and different types of guidewires.Twenty-two commonly used guidewires were classified into three groups according to decreasing diameter (Group 1, 0.035"; Group 2, 0.018"; and Group 3, 0.014") and testedThe percentages (tips/shafts) of twinkling artifacts were 100%/100% for Group 1; 0%/33.3% for Group 2; and 18.8%/31% for Group 3. The mean scores (tips/shafts) were 2.3/2.7 for Group 1; 0/0.3 for Group 2; and 0.3/0.4 for Group 3. Among them, both two guidewires with strong twinkling artifacts (score = 3) exhibited extensive rough surfaces on microscopic pictures.The twinkling artifacts were more likely to present in guidewires with larger diameters (from 0.014" to 0.035") in our study settings. The surface roughness may be the contribution to the twinkling artifact. Internal heterogeneities, such as types of material, types of coating, tip loading, and spring coil length, do not show influence on the twinkling artifact.

Objective To investigate whether Sjogren’s syndrome would have an influence on the development of Parkinson’s disease. Methods A population-based case-control study was conducted. Participants consisted of 7716 subjects with newly diagnosed Parkinson’s disease and a population of 75129 matched control subjects between 2000 and 2010. We measured the risk of Parkinson’s disease in association with Sjogren’s syndrome by using adjusted odds ratios. Results A total of 143 Parkinson’s disease subjects (1.9%) and 893 control subjects (1.2%) suffered from Sjogren’s syndrome (p < 0.001). The crude odds ratio for Parkinson’s disease among subjects with Sjogren’s syndrome was 1.56 (95% CI 1.30–1.86; p < 0.01). After adjustment for potential confounders which have been proposed that would increase the risk of development of Parkinson’s disease, Sjogren’s syndrome was found to be significantly associated with the risk of Parkinson’s disease with an odds ratio of 1.37 (95% CI 1.15–1.65; p < 0.01). Conclusion This study preliminarily proposed that Sjogren’s syndrome was significant associated with an increased risk of Parkinson’s disease.

Patient: Male, 1 Final Diagnosis: Kasabach-Merritt syndrome with widespread hemangiomas and an infected huge hematoma in the right thigh Symptoms: Gross hematuria Medication: — Clinical Procedure: CT-guided drainage • blood transfusion Specialty: Hematology Objective: Rare disease Background: Kasabach-Merritt syndrome is a potentially fatal disease that consists of hemangioma(s) with thrombocytopenia, microangiopathic hemolytic anemia, and coagulopathy. Extensive hemangiomatosis is rare. We present the radiological features and treatment strategy of a young adult suffering from Kasabach-Merritt syndrome with widespread hemangiomas and an infected huge hematoma in the right thigh. Case Report: A 33-year-old Taiwanese male presented with a painful 20-cm mass over his right thigh and gross hematuria for 2 days. Hemangiomatosis was bioptically proven in infancy and the patient was under regular follow-up. Physical examination revealed normal heart rate, respiratory rate, and body temperature. Multiple palpable lumps with brown and purple areas of skin over the neck, trunk, and right thigh were noted. Laboratory examinations revealed thrombocytopenia anemia and elevated fibrin degradation products. There were no signs of sepsis. Blood transfusion and steroid therapy were executed. Computed tomography showed a huge complicated subcutaneous hematoma in the right thigh. Drainage of the huge hematoma was performed and antibiotics were prescribed. After the local infection in the right thigh and the bleeding tendency were controlled, the patient was discharged in a stable condition two weeks later. Conclusions: A huge infected hematoma and widespread hemangiomas are extremely rare complications of Kasabach-Merritt syndrome. There are no known treatment guidelines currently available. Our patient was successfully treated with steroids, drainage, and antibiotics.

The purpose of this retrospective study was to evaluate the incidence of totally implantable venous access devices, also called ports, implantation and the associated abnormalities in 2-[The study aimed to perform a retrospective review of all FDG PET-CT imaging in a 3-year period. Cases of port-associated abnormalities found on the FDG PET-CT images were identified and then correlated with X-ray reports and clinical treatment or follow-up.In total, 2442 FDG PET-CT scans were retrospectively reviewed. Among them, 897 (897 of 2442, 36.7%) demonstrated port implantation. Abnormalities, including 22 port fractures (22 of 897, 2.45%), 14 malposition (1.56%), one infection (0.11%), and one embraced by a fibrin sheath or tumor (0.11%) were found. Only the infectious one had clinical symptoms. Among the 22 fractured ports, eight fractured catheters migrated and became dislodged. All of the malpositioned ports, except two in the contralateral subclavian vein, were found in the ipsilateral jugular vein. Both the port infection and the port embraced by a fibrin sheath or tumor occurred at the tips of the devices, which demonstrated FDG uptake in the mediastinal region. Only seven of the 38 (18.42%) images of port abnormalities had been identified in the original reports.Based on this study, we recommend that the interpretation of FDG PET-CT scans should include a checklist to record all metallic device implantations and to interpret the whole-body X-ray topography as a standard part of PET-CT image report.