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Background/Aims@#The incidence and prevalence of inflammatory bowel disease (IBD) is rising in Asia recently. The study aimed to obtain a comprehensive understanding of the current status of drug therapy and monitoring for IBD in Asia. @*Methods@#A questionnaire investigation on drug therapy and monitoring for IBD was conducted right before the 6th Annual Meeting of Asian Organization for Crohn’s & Colitis. Questionnaires were provided to Asian physicians to fill out via emails between March and May 2018. @*Results@#In total, responses of 166 physicians from 129 medical centers were included for analysis. Among the surveyed regions, the most average number of IBD specialist gastroenterologists and nurses was 4.8 per center in Taiwan and 2.5 per center in Mainland China, respectively. 5-Aminosalicylic acid/sulfasalazine (99.4%) was the most preferred first-line choice for mild-moderate ulcerative colitis (UC), meanwhile corticosteroid (83.7%) was widely applied for severe UC. The first-line medication for Crohn’s disease (CD) markedly varied as corticosteroid (68.1%) was the most favored in Mainland China, Japan, and South Korea, followed by infliximab (52.4%) and azathioprine (47.0%). Step-up strategy was preferred in mild-moderate UC (96.4%), while 51.8% of the physicians selected top-down treatment for CD. Only 25.9% and 17.5% of the physicians could test blood concentration of infliximab and antibody to infliximab in their hospitals, respectively. @*Conclusions@#The current status of drug therapy and monitoring for IBD in Asia possesses commonalities as well as differences. Asian recommendations, IBD specialist teams and practice of therapeutic drug monitoring are required to improve IBD management in Asia.
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Objective To observe the display and source of the artery located at anterolateral region next to pancreatic head on en-hanced CT,and to investigate its clinical value.Methods Imaging data of 200 consecutive patients who underwent abdominal CT scan were collected,and their CT images were analyzed.The reconstructed images were obtained at a post-processing workstation. After reconstruction,the display rate,source and branches of the artery located at anterolateral region next to pancreatic head were analyzed,and the diameters of these vessels were measured.Results The arterial vessel located at anterolateral region next to pan-creatic head was found on axial CT image in arterial phase with a display rate of 100%.By using post-reconstruction images,most vessels were gastroduodenal artery with mean diameter of 0.33 cm± 0.05 cm,and other ones were pancreaticoduodenal artery or right gastroomental artery.Conclusion The artery located at anterolateral region next to pancreatic head can be found on axial ab-dominal CT image in the arterial phase.Most vessels are gastroduodenal artery with a fixed position and traveling.
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Objective To investigate perfusion imaging and parameters of normal pancreas by dual-source CT and to evaluate the appropriate perfusion imaging scan.Methods Sixty-six subjects with normal pancreas underwent low-dose pancreatic perfusion and plain scan.CT images were sent to a separate workstation via a network.The blood flow (BF)and blood volume (BV)of pancreas head,body and tail were measured using the VPCT Body software and analyzed by one-way ANOVA.Then the time-density curve of pancreas was drawn,and the enhancement peak time and the corresponding CT value were also measured.Results The average BF values of pancreas head,body and tail were (1 1 6.09 ± 31.83)mL·100 g-1 ·min-1 ,(1 1 9.72±32.50)mL·100 g-1 ·min-1 , (1 14.65±31.42)mL·100 g-1 ·min-1 ,and the mean BV values were (29.83 ±1 9.07)mL/100 g,(30.39 ± 1 9.38)mL/100 g, (28.82±1 9.22)mL/100 g,respectively.The perfusion parameters in different pancreatic parts were not statistically different.The mean enhancement peak time was (27.92 s±4.52)s,(28.02±5.34)s in pancreas head,(27.40±4.36)s in pancreas body,(27.34±4.57)s in pancreas tail.On plain image,the average CT value of pancreas was (41.43±5.88)HU.However,on enhanced image,the mean CT value was (95.96±18.44)HU in normal pancreas [(96.73±19.71)HU in pancreas head,(98.45±17.52)HU in body,(92.69±18.1 7)HU in tail].Conclusion The perfusion parameters including blood flow and blood volume in pancreatic head,body and tail are identical. The mean enhancement peak time is (27.92±4.52)s,and the corresponding enhancement CT value is (95.96±18.44)HU.
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Objective To assess the value of apparent diffusion coefficient (ADC)in clinic ,pathology and prognosis of rectal cancer. Methods The MRI and DWI findings of 109 patients with pathological proved rectal adenocarcinoma were retrospectively analyzed. DWI with b=0 s/mm2 and b= 1 000 s/mm2 were acquired.Mean tumor ADCs were measured and compared between subgroups stratified by histologic differentiation grades,T-stage,N-stage,mesorectal fascia status and presence of lymphangiovascular or peri-neral invasion.Results Mean tumor ADCs were significantly different when comparing groups stratified by histologic differentiation grades,T-stage,mesorectal fascia status and presence of lymphangiovascular invasion.Tukey’s post hoc test showed that the differences of mean ADCs between good-moderate differentiated group and moderate differentiated group(P =0.996),moderate-poor differentiated group and poor differentiated group(P =0.957)were not significant.The differences among other groups of differentia-tion grades differed significantly(P 0.05).There were no sig-nificant differences among N0,N1 and N2 in N-stage groups(P >0.05).Conclusion ADC values can reflect pathologic and prognos-tic features of rectal cancer.
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Objective To investigate the value of dynamic contrast-enhanced quantitative parameters of pancreatic cancer at 3.0T MR.Methods 27 patients with pathologically proved pancreatic cancers were underwent DCE-MR at a 3.0 T scanner.AToft with Vp model was used to quantify K trans ,k ep ,Ve and Vp in the pancreatic cancer and normal pancreatic tissues.All parameters among different tissues were analyzed and compared by SPSS1 7.0.Results The K trans 、k ep 、Ve 、Vp values of pancreatic cancer were(0.303± 0.321)min,(1.387±1.486)min,(25.07±10.98)%and(3.420±4.692)% respectively ,while those values of normal pancreatic tis-sue were (1.235±0.777)min,(9.277 ± 7.996 )min,(1 7.89 ± 8.882 )%,and(7.1 96 ± 6.704)%,respectively.The differences be-tween the four parameters of pancreatic cancer and normal pancreatic tissue were statistically significant(F =33.188,25.414,6.984, 5.78,P <0.05).Conclusion Quantitative parameters of DCE-MRI accurately reflect changes in tumor blood perfusion and microcir-culation,they may be helpful to differentiate the atypical lesion.