Microvascular flow imaging to differentiate focal hepatic lesions: the spoke-wheel pattern as a specific sign of focal nodular hyperplasia

Microvascular flow imaging (MVFI) is an advanced Doppler ultrasound technique designed to detect slow-velocity blood flow in small-caliber microvessels. This technique is capable of realtime, highly detailed visualization of tumor vessels without using a contrast agent. MVFI has been recently applied for the characterization of focal liver lesions and has revealed typical vascularity distributions in multiple types thereof. Focal nodular hyperplasia (FNH) constitutes an important differential diagnosis of malignant liver tumors. In this essay, we provide iconographic documentation of the MVFI appearance of FNH and other common solid liver lesions. Identifying the typical patterns of vascularity, including the spoke-wheel pattern with MVFI, can expedite the diagnosis, spare patients from unnecessary procedures, and save costs.

Outcome prediction of pediatric drowning

Purpose@#Despite the well-known mortality of pediatric drowning, there is a paucity of evidence on the implications of an initial evaluation on the relevant outcome of drowning. This study aimed to investigate the association of initial clinical findings with outcome of children undergoing drowning. @*Methods@#This retrospective study was conducted using the medical records of 56 children undergoing drowning who visited 3 Korean academic hospitals from January 2000 through May 2020. We analyzed information regarding the prehospital resuscitation, drowning time, a 4-tiered chest radiographic grade, and the baseline characteristics. The grade was defined based on the findings of initial chest radiographs. The poor outcomes were defined as the need for intensive care unit care or death aftercare. We analyzed the association of the prehospital resuscitation, submersion time, and the radiographic grade with the poor outcomes using binary logistic regression. @*Results@#Among the 56 children, 31 (55.4%) were aged 1-4 years. Prehospital resuscitation and 1-5 minutes of submersion time were noted in the 25 (44.6%) and 30 children (53.6%), respectively. The chest radiographic grades 1 through 4 accounted for 17 (30.4%), 20 (35.7%), 12 (21.4%), and 3 children (5.4%), respectively. Poor outcomes occurred in 17 children (30.4%), including 3 deaths (5.4%). The association with the poor outcomes was noted in the submersion time of longer than 5 minutes (adjusted odds ratio, 21.49; 95% confidence interval, 1.11-415.73; compared with < 1 minute) while not in the submersion time and chest radiographic grade. @*Conclusion@#This study confirms that submersion time is an outcome predictor of drowning.

Lentinula edodes extract inhibits matrix metalloproteinase expression and increases typeⅠprocollagen expression via the p38 MAPK/c-Fos signaling pathway in ultraviolet A and B-irradiated HaCaT keratinocytes

Objective:To determine the effect of Lentinula edodes extract on ultraviolet (UV) A and UVB-induced changes in matrix metalloproteinase (MMP) and typeⅠprocollagen expression using human immortalized HaCaT keratinocytes. Methods:Lentinula edodes ethanol extract (LEE) was obtained by extraction with 80％ ethanol for 4 h at 80 ℃. Effect of LEE on UV-induced alteration on the expression and production of MMPs and typeⅠprocollagen in keratinocytes was investigated using ELISA, RT-PCR, and Western blotting assay. To determine the underlying mechanism of LEE-mediated effects, mitogen-activated protein kinase (MAPK) and activator protein 1 signaling pathways were analysed by Western blotting assay. Results:LEE significantly inhibited the expression of MMP-1 and MMP-9 and increased the expression of typeⅠprocollagen in UVA and UVB-irradiated HaCaT keratinocytes. The phosphorylation levels of p38 were significantly inhibited by LEE whereas it did not affect c-Jun N-terminal kinase and extracellular signal-regulated kinase phosphorylation. Suppression of p38 phosphorylation was also accompanied by downregulation of UVA and UVB-induced increase in c-Fos. Conclusions:LEE effectively inhibits the expression of MMP-1 and MMP-9 and increases typeⅠprocollagen production through the p38 MAPK/c-Fos signaling pathway in UVA and UVB-irradiated HaCaT keratinocytes. This findings suggest that Lentinula edodes may be developed as a cosmetic material to suppress UV exposure-mediated skin aging.

Y chromosome microdeletions in infertile men with non-obstructive azoospermia and severe oligozoospermia

Background: The purpose of the study was to investigate the frequencies and types of Y chromosome microdeletions in infertile men and to analyze the relationship between the levels of reproductive hormones and Y microdeletions

Methods: A total of 1,226 infertile men were screened for Y chromosome microdeletions using multiplex PCR assay. Karyotype analysis was performed on peripheral blood lymphocytes with standard G-banding. Serum reproductive hormone levels were measured

Results: Out of 1,226 infertile patients, 134 [10.93%] had Y microdeletions. One hundred seven of 765 [13.99%] non-obstructive azoospermic patients and 27 of 133 [20.30%] severe oligozoospermic patients had Y microdeletions. Among the 134 infertile men with Y microdeletions, the most frequent microdeletions were detected in the AZFc region, followed by AZFbc, AZFb, AZFa, AZFabc[Yq], Yp[SRY]+Yq, and partial AZFc regions. Karyotype analysis was available for 130 of the 134 patients with Y microdeletions. Of them, 36 [27.69%] patients had sex chromosomal abnormalities. Levels of FSH and LH in patients with AZFc microdeletion were significantly lower, while those in patients with Yp[SRY]+Yq were significantly higher than in patients without Y microdeletions. Level of testosterone in patients with AZFabc[Yq] or Yp[SRY]+Yq was significantly lower than that in patients without Y microdeletions. However, there was no significant difference in the levels of reproductive hormones between all patients with and without Y microdeletions

Conclusion: These results highlight the need for Y chromosome microdeletion screening for correct diagnosis of male infertility. Obtaining reliable genetic information for assisted reproductive techniques can prevent unnecessary treatment and vertical transmission of genetic defects to offspring

Necessity and the strategy to establish a national poison center in Korea: through needs survey analysis and database status for Chemical Accident Emergency Respond Information System

This study is to prepare promotional strategies of establishment of the Korea Poison Center based on the chemicals and chemical products and the database (DB) construction status of Chemical Accident Emergency Respond Information System (CEIS) and the DB needs survey of the lay person. The methods of CEIS DB construction and hazard classification are; first, the researchers required material safety data sheet from the manufacturer/distributor and verified its composition/information on ingredients. Second, the researchers conducted the hazard classification of the chemical products by the mixtures classification according to the United Nations Globally Harmonized System of Classification and Labelling of Chemicals (GHS, 3rd edition) guidelines based on the verified composition/information on ingredients. The emergency measures information was established by the Emergency Department healthcare professionals. Health hazards are classified by using 13 reference databases, which include European Chemical Substances Information System (IUCLID) and IARC, and 4 reference books like Emergency Management Guides(ERG). As the result of analyzing the DB construction status of chemical products, it showed in the order of, 180 for vehicle products (15.0%), 162 for printing products (14.0%), 129 for paint (11.0%) and 120 for adhesives (10.0%). Currently in 2013, emergency respond information was established for a total of 2,400 chemicals (includes 1200 chemical products). As the result for conducting a needs survey for the establishment of emergency respond information targeting on the general public and professionals, it showed the highest level of demand for the establishment of emergency respond information on 'household products (2.87 points)' for both lay person and experts. As the result of analyzing the Q&A of the lay person until March 2013, through CEIS, it showed the highest inquiry on disinfectant and germicide products with 11 issues (27.5%). World Health Organization recommends to provide emergency consultation and information on poisoning accidents and operate a 24 hour national poison center able to perform the research functions for every nation. However, there is no such national poison center in Korea, and it can be said fundamental reform of the national poison management system and establishment of national poison center is urgent, considering the fact social demand and citizens from recent consecutive chemical poisoning accidents are increasing.