Deviation of Latitude Cut: A Simple Sign to Differentiate Total Hip Arthroplasty from Hemiarthroplasty in Radiography.

This study aims to propose latitude cut deviation for differentiating hip arthroplasty types and evaluate its diagnostic utility in distinguishing total hip arthroplasty (THA) from hemiarthroplasty using radiography. After assessing various cup designs from top manufacturers for THA and hemiarthroplasty, we conducted a retrospective study on 40 patients (20 THA and 20 hemiarthroplasty). Three readers independently evaluated the radiographs, assessing acetabular sparing, cup-bone interface texture, and latitude cut deviation. Diagnostic performance and inter-observer agreement were compared using receiver operating characteristic curves and the Fleiss kappa coefficient. Latitude cut deviation measured on implant designs ranged from 19% to 42% in hemiarthroplasty and from -12% to 9% in THA. The sensitivity, specificity, and accuracy used to distinguish THA from hemiarthroplasty were 60-85%, 55-95%, and 62.5-77.5% for acetabular sparing; 100%, 50-80%, and 75-90% for cup-bone interface texture; and 100%, 90-100%, and 95-100% for latitude cut deviation. Inter-observer agreement for acetabular sparing, cup-bone interface texture, and latitude cut deviation ranged from moderate to excellent (κ = 0.499, 0.772, and 0.900, respectively). The latitude cut deviation exhibited excellent diagnostic performance and inter-reader agreement in distinguishing hemiarthroplasty from THA on radiographs, offering a concise way to identify hip arthroplasty type.

Colorectal cancer cell-secreted exosomal miRNA N-72 promotes tumor angiogenesis by targeting CLDN18.

Angiogenesis is essential for the growth and metastasis of several malignant tumors including colorectal cancer (CRC). The molecular mechanism underlying CRC angiogenesis has not been fully elucidated. Emerging evidence indicates that secreted microRNAs (miRNAs) may mediate the intercellular communication between tumor cells and neighboring endothelial cells to regulate tumor angiogenesis. In addition, exosomes have been shown to carry and deliver miRNAs to regulate angiogenesis. miRNA N-72 is a novel miRNA that plays a regulatory role in the EGF-induced migration of human amnion mesenchymal stem cells. However, the relation between miRNA N-72 and cancer remains unclear. We here found that CRC cells could secrete miRNA N-72. A high miRNA N-72 level was detected in the serum of CRC patients and the cultured CRC cells. Moreover, the CRC cell-secreted miRNA N-72 could promote the migration, tubulogenesis, and permeability of endothelial cells. In addition, the mouse xenograft model was used to verify the facilitating effects of miRNA N-72 on CRC growth, angiogenesis, and metastasis in vivo. Further mechanism analysis revealed that CRC cell-secreted miRNA N-72 could be delivered into endothelial cells via exosomes, which then inhibited cell junctions of endothelial cells by targeting CLDN18 and consequently promoted angiogenesis. Our findings reveal a novel mechanism of CRC angiogenesis and highlight the potential of secreted miRNA N-72 as a therapeutic target and a biomarker for CRC.

Lymphangiography and lymphatic embolisation for the treatment of chyle leaks after neck surgery: assessment of lymphangiography findings and embolisation techniques.

OBJECTIVE: To assess lymphangiography findings and outcome of lymphatic embolisation to manage chyle leak after neck surgery. METHODS: Consecutive cases of lymphangiography performed between April 2018 and May 2022 for management of chyle leaks related to neck surgery were retrospectively reviewed. Lymphangiography findings, techniques, and outcomes were analysed. RESULTS: Eight patients (mean age: 46.5 years) were included. Six patients had undergone radical neck dissection for thyroid cancer, and two had undergone lymph node excision. Clinical presentations were: chyle drainage through Jackson Pratt catheters in five patients, lymphorrhea through surgical wounds in two, and enlarging lymphocele in one. Lymphangiography techniques included: inguinal lymphangiography in four patients, retrograde lymphangiography in three, and transcervical lymphangiography in one. Lymphangiography revealed leaks in the terminal thoracic duct in two patients, bronchomediastinal trunk in two, jugular trunk in three, and superficial neck channels in one. Embolisation techniques included: non-selective embolisation of terminal thoracic duct (n = 2), selective embolisation of the jugular trunk (n = 3), selective embolisation of the bronchomediastinal trunk (n = 2), and intranodal glue embolisation of superficial neck channels (n = 1). One patient underwent a repeat procedure. Chyle leak resolved in all patients over a mean of 4.6 days. No complication was encountered. CONCLUSION: Lymphatic embolisation seems to be effective and safe in managing chyle leaks after neck surgery. Lymphangiography allowed for the categorisation of chyle leaks according to their location. Post-embolisation patency of the thoracic duct may be preserved in chyle leaks that do not directly involve the thoracic duct. ADVANCES IN KNOWLEDGE: Lymphatic embolisation is safe and effective in managing chyle leaks after neck surgery. On lymphangiography, the location of contrast media extravasation may not be consistent. The technique for embolisation should be based on the location of the leak. Post-embolisation patency of the thoracic duct may be preserved in chyle leaks that do not directly involve the thoracic duct.

Lactate Decreases Bortezomib Sensitivity and Predicts Poor Clinical Outcomes of Multiple Myeloma.

OBJECTIVE: Metabolic disorders are regarded as hallmarks of multiple myeloma (MM) and are responsible for rapid cancer cell proliferation and tumor growth. However, the exact biological roles of metabolites in MM cells have not been fully explored. This study aimed to explore the feasibility and clinical significance of lactate for MM and investigate the molecular mechanism of lactic acid (Lac) in the proliferation of myeloma cells and cell sensitivity to bortezomib (BTZ). METHODS: Metabolomic analysis of the serum was carried out to obtain metabolites expression and clinical characteristics in MM patients. The CCK8 assay and flow cytometry were used to detect cell proliferation, apoptosis, and cell cycle changes. Western blotting was used to detect the potential mechanism and apoptosis- and cycle-related protein changes. RESULTS: Lactate was highly expressed in both the peripheral blood and bone marrow of MM patients. It was significantly correlated with Durie-Salmon Staging (DS Staging) and the International Staging System (ISS Staging) and the serum and urinary involved/uninvolved free light chain ratios. Patients with relatively high lactate levels had a poor treatment response. Moreover, in vitro experiments showed that Lac could promote the proliferation of tumor cells and decrease the proportion of G0/G1-phase cells, which was accompanied by an increased proportion of S-phase cells. In addition, Lac could decrease tumor sensitivity to BTZ by disrupting the expression of nuclear factor kappa B subunit 2 (NFkB2) and RelB. CONCLUSION: Metabolic changes are important in MM cell proliferation and treatment response; lactate could be used as a biomarker in MM and as a therapeutic target to overcome cell resistance to BTZ.

Clinical characteristics of 38 cases of tsutsugamushi disease in Zaozhuang City, Shandong Province / 中华地方病学杂志

Objective:To understand the epidemiological and clinical characteristics of patients with tsutsugamushi disease in Zaozhuang City, Shandong Province, and to provide a basis for formulating effective diagnosis and treatment plan of tsutsugamushi disease. Methods:Retrospective analysis was carried out to collect clinical data of 38 patients with tsutsugamushi disease admitted to Zaozhuang Municipal Hospital of Shandong Province from 2018 to 2020. The epidemiological characteristics, clinical manifestations, laboratory examination results and drug treatment of patients with tsutsugamushi disease were analyzed. Results:Among the 38 patients with tsutsugamushi disease, 15 were males and 23 were females, aged (58.58 ± 14.47) years old; the occupation distribution was mainly farmers, accounting for 92.11% (35/38); the onset time was concentrated in October and November, accounting for 100.00% (38/38); the regional distribution was mainly in Yicheng District, accounting for 34.21% (13/38); 38 patients had a history of grassland/forest contact. All patients had fever, and other main symptoms were eschar (97.37%, 37/38), headache (68.42%, 26/38), fatigue (42.11%, 16/38), and whole body aches (36.84%, 14/38), etc. The results of laboratory examination mainly showed that C-reactive protein increased (89.47%, 34/38), procalcitonin increased (81.58%, 31/38), abnormal liver function (78.95%, 30/38), D-dimer increased (71.05%, 27/38), eosinophils decreased (60.53%, 23/38), and erythrocyte sedimentation rate increased (57.89%, 22/38). All 38 patients were cured after treated with doxycycline or azithromycin. Conclusions:The high incidence time of tsutsugamushi disease in Zaozhuang City is autumn. The clinical symptoms are mainly fever, eschar and headache. Doxycycline and azithromycin are the first choices for treatment of the disease.

Clinical features of 71 patients with acute brucellosis in Zaozhuang City of Shandong Province / 中华地方病学杂志

Objective:To analyze the epidemiological characteristics and clinical manifestations of patients with acute brucellosis in Zaozhuang City of Shandong Province, and to improve the understanding of brucellosis.Methods:The demographic characteristics, epidemiological characteristics, clinical manifestations and laboratory examination results of patients with acute brucellosis diagnosed in Zaozhuang Municipal Hospital from January 2019 to December 2020 were retrospectively analyzed.Results:Most of the 71 patients with acute brucellosis were male, with a male-to-female ratio of 2.2 ∶ 1.0 (49 ∶ 22) and an average age of (53.23 ± 14.12) years old, mainly in Yicheng District (32.39%, 23/71); 80.28% (57/71) of patients had a history of epidemiological contact; the disease occurred throughout the year, mainly from April to October (76.06%, 54/71); the main symptoms were fever (100.00%, 71/71), muscle and joint pain (80.28%, 57/71), fatigue (54.93%, 39/71), hyperhidrosis (39.44%, 28/71), hepatosplenomegaly (18.31%, 13/71) and orchitis (4.23%, 3/71), etc. Laboratory examination results showed that decreased white blood cells accounted for 12.68% (9/71), decreased red blood cells accounted for 21.13% (15/71), thrombocytopenia accounted for 8.45% (6/71), decreased lymphocyte percentage accounted for 12.68% (9/71), increased C-reactive protein accounted for 67.61% (48/71), and accelerated erythrocyte sedimentation rate accounted for 50.70% (36/71). Some patients were accompanied by elevated alanine aminotransferase (50.70%, 36/71) and aspartate aminotransferase (42.25%, 30/71), 57 patients (80.28%) with positive blood culture.Conclusions:The clinical manifestations of acute brucellosis are atypical in Zaozhuang City. Brucellosis screening should be carried out for patients with long-term unexplained fever and an epidemiological exposure history, especially those with muscle joint pain, hepatosplenomegaly and orchitis.

Intralesional triamcinolone injections for the treatment of nail dystrophy: A case series.

Nail dystrophy can be temporary or permanent and affects quality of life for many patients. It can be secondary to an inflammatory condition; however, many cases are idiopathic. Despite many efforts, there is no promising treatment. Local steroid injection is one of the standard therapies offered for nail dystrophy, but there have been few formal open trials or case reports of its efficacy. This study investigated the impact of intralesional triamcinolone injections on the management and safety of nail dystrophy. Overall, 12 patients with 55 nails affected by nail dystrophy were enrolled. All lesions were injected with triamcinolone acetonide (2.5 mg/mL, 0.1 cc) through the proximal nail fold with a 30 g needle. Injections were administered every 4 weeks. Efficacy was retrospectively evaluated using physician's global assessment of clinical photographs graded on a 5-point scale as 0, no improvement; 1, slight improvement; 2, moderate improvement; 3, marked improvement; and 4, almost resolved. All adverse events that occurred during treatment were recorded. All patients presented with slight improvement of nail dystrophy after 1 to 3 months. The treatment durations varied from 6 to 12 months (mean, 8.58 months). The average time to observed therapeutic effect was 1.91 months after first treatment. The mean outcome assessment score was 2.8 points, with two patients each showing slight and moderate improvement and five showing marked improvement; in three, the dystrophy was almost resolved. Side effects of this regimen were minimal. Intralesional triamcinolone injections are an effective and safe method for the treatment of nail dystrophy.

Effect of mesenchymal stem cells on Sjögren-like mice and the microRNA expression profiles of splenic CD4+ T cells.

Mesenchymal stem cells (MSCs) serve immuno-regulatory functions and offer a promising novel treatment for certain autoimmune diseases. The present study investigated the therapeutic effect of mice bone marrow (BM)-MSCs on mice with relatively late stage of Sjögren-like disease and the impact of BM-MSCs on the microRNA (miRNA) expression profiles of splenic CD4+ T cells. Female NOD/Ltj mice were randomized into two groups: The disease group (n=8) and the MSC-treated group (n=8). Female ICR mice served as the healthy control group (n=8). The MSC-treated group received an injection of MSCs when they were 26 weeks old. Water intake, blood glucose and salivary flow rate were measured and submandibular glands were resected and stained with hematoxylin and eosin to calculate the focus score. The concentrations of interleukin (IL)-2, IL-6, hepatocyte growth factor, interferon γ, IL-10, prostaglandin E2, transforming growth factor ß1 and tumor necrosis factor-α in serum were measured using ELISA. The expression of miRNAs in splenic CD4+ T cells were measured using deep sequencing. The results demonstrated that treatment with BM-MSCs prevented a decline in the salivary flow rate and lymphocyte infiltration in the salivary glands of NOD mice, indicating that MSC-treatment had a therapeutic effect on NOD mice with relatively late stage of Sjögren-like disease. ELISA and deep sequencing results showed that the three groups of mice had different serum concentrations of cytokines/growth factors and different miRNA expression profiles of splenic CD4+ T cells. This implies that the alteration in serum levels of cytokines/growth factors and miRNA expression profiles of splenic CD4+ T cells may explain the therapeutic effect MSCs have on Sjögren's syndrome.

Comparison of Virtual Unenhanced Images Derived From Dual-Energy CT With True Unenhanced Images in Evaluation of Gallstone Disease.

OBJECTIVE: The aim of this study was to compare gallstones on virtual unenhanced images and true unenhanced images acquired with dual-energy CT (DECT). MATERIALS AND METHODS: We enrolled 112 patients with right upper quadrant pain and clinically suspected acute cholecystitis or gallstone who underwent DECT--including unenhanced, arterial, and portal phases. Eighty-three gallstones with composition proven by semiquantitative Fourier transform infrared spectroscopy from 45 patients who had undergone cholecystectomy (40 cholesterol gallstones from 21 patients, 43 calcium gallstones from 24 patients) were included. CT images were retrospectively evaluated for stone size, contrast-to-noise ratio (CNR) of gallstone to bile, and visibility and density of gallstones for each image set. The visibility of each type of stone was compared with a paired t test. RESULTS: Both cholesterol and calcium stones measured smaller on virtual unenhanced images than on true unenhanced images, yielding a lower sensitivity of virtual unenhanced images for detecting small gallstones. Mean CNR of cholesterol stones was 2.45 ± 1.32 versus 1.67 ± 1.55 (p < 0.032) and that of calcium stones was 10.59 ± 7.15 and 14.11 ± 9.81 (p < 0.001) for virtual unenhanced and true unenhanced images, respectively. For calcium stones, two readers found 43 of 43 (100%) on true unenhanced images; one reader found 41 of 43 (95%) and the other, 37 of 43 (86%) on virtual unenhanced images. For cholesterol stones, one reader found 20 of 40 (50%) and the other 19 of 40 (47%) on true unenhanced images versus 34 of 40 (85%) and 30 of 40 (75%), respectively, on virtual unenhanced images. The visibility of cholesterol stones was higher on virtual unenhanced images, but that of calcium stones was lower. CONCLUSION: Virtual unenhanced images at DECT allow better visualization of cholesterol gallstones, but true unenhanced images allow better visualization of calcium and small gallstones.

Doppler ultrasonography measurement of hepatic hemodynamics during Valsalva maneuver: healthy volunteer study.

PURPOSE: The aim of our study was to assess the hemodynamic change of liver during the Valsalva maneuver using Doppler ultrasonography. METHODS: Thirty healthy men volunteers were enrolled (mean age, 25.5±3.64 years). The diameter, minimal and maximal velocities, and volume flow of intrahepatic inferior vena cava (IVC), middle hepatic vein (MHV), and right main portal vein (RMPV) was measured during both rest and Valsalva maneuver. These changes were compared using paired t-test. RESULTS: The mean diameters (cm) of the intrahepatic IVC at rest and Valsalva maneuver were 1.94±0.40 versus 0.56±0.66 (P<0.001). The mean diameter (cm), minimal velocity (cm/sec), maximal velocity (cm/sec), and volume flow (mL/min) of MHV at rest and Valsalva maneuver were 0.60±0.15 versus 0.38±0.20 (P<0.001), -7.98±5.47 versus 25.74±13.13 (P<0.001), 21.34±6.89 versus 35.12±19.95 (P=0.002), and 106.94±97.65 versus 153.90±151.80 (P=0.014), respectively. Those of RMPV at rest and Valsalva maneuver were 0.78±0.21 versus 0.76±0.20 (P=0.485), 20.21±8.22 versus 18.73±7.43 (P=0.351), 26.79±8.85 versus 24.93±9.91 (P=0.275), and 391.52±265.63 versus 378.43±239.36 (P=0.315), respectively. CONCLUSION: The blood flow velocity and volume flow of MHV increased significantly during Valsalva maneuver. These findings suggest that hepatic vein might play an important role to maintain venous return to the heart during the maneuver.

Clinical implications of T-wave inversion in an asymptomatic population undergoing annual medical screening (from the Korean Air Forces Electrocardiogram Screening).

This study aimed to determine prevalence, differentiate underlying causes, and identify the benign group in subjects with asymptomatic T-wave inversion (TWI). We retrospectively read 12-lead electrocardiograms from 3,929 consecutive asymptomatic men in the air force (3,929 participants, mean age 39.3 ± 8.7 years) who underwent medical screening at the Aerospace Medical Center, Korea, from September 2010 to August 2012. TWIs other than in right precordial leads (V1 and V2) were present in 23 men (0.6%). All subjects with persistent TWI for 1 year (n = 18) underwent additional study, with the exception of 1 patient who refused further evaluation. Of 17 subjects with investigated persistent TWI, 8 (47.1%) had an apically displaced papillary muscle, 5 (29.4%) exhibited idiopathic TWI, 3 (17.6%) had apical hypertrophic cardiomyopathy, and 1 (5.9%) had Maron type 2 hypertrophic cardiomyopathy with dynamic left ventricular outflow obstruction. The depth of TWI was significantly shallow in the benign group (idiopathic TWI, 1.6 ± 0.5 mm) compared with potentially nonbenign group (the others; 5.5 ± 3.3 mm, p = 0.021). Lateral lead TWI was significantly correlated with potentially nonbenign group (46% vs 0%, p = 0.049). In conclusion, asymptomatic TWI is not rare (0.6%), even in a healthy population such as Korean Air Force society, and at least 29.4% of subjects with TWI are considered to belong to the benign group that does not require aggressive evaluation and criteria of TWI ≤2 mm other than lateral leads without co-morbidity could help to distinguish the benign group from the potentially nonbenign group.

Dual energy CT in patients with acute abdomen; is it possible for virtual non-enhanced images to replace true non-enhanced images?

This study aims to determine whether virtual non-enhanced images derived from dual-energy computed tomography (CT) can replace true non-enhanced images in patients with acute abdomen. Patients with acute abdomen (n = 202) underwent multidetector CT including non-enhanced and contrast-enhanced images obtained at the portal phase using the dual-energy technique. CT attenuation values were measured in abdominal organs. Image quality, noise, artifacts, and acceptability for virtual non-enhanced images compared to true non-enhanced images were rated. Mean sizes of clinically significant stones and mean attenuation values of intraabdominal hemorrhages were compared by means of five-point scales. Effective radiation doses were calculated. Mean CT attenuation values of virtual non-enhanced and true non-enhanced images were similar. Virtual non-enhanced images showed good image quality, mild noise, mild artifacts, and good acceptability compared to true non-enhanced images. A total of 71 clinically significant stones (11 appendicoliths, 33 gallbladder stones, 11 bile duct stones, and 16 urinary stones) and 15 intraabdominal hemorrhages were included in the study. Small stones were detected better on true non-enhanced images than on virtual non-enhanced images. Hemorrhage was similarly detected on both virtual non-enhanced and true non-enhanced images. Mean radiation dose reductions by omitting true non-enhanced images were 33 % in the virtual triple protocol and 47 % in the virtual dual protocol. Image qualities of virtual non-enhanced images are comparable to those of true non-enhanced images. Small stones can be obscured on virtual non-enhanced images. Therefore, tailored application of dual-energy CT is needed for evaluation of patients with acute abdomen.

Lateral topography for reducing effective dose in low-dose chest CT.

OBJECTIVE: The purposes of this study were to assess radiation exposure during low-dose chest CT by using lateral topography and to compare the lateral topographic findings with findings obtained with anteroposterior topography alone and anteroposterior and lateral topography combined. SUBJECTS AND METHODS: From November 2011 to February 2012, 210 male subjects were enrolled in the study. Age, weight, and height of the men were recorded. All subjects were placed into one of three subgroups based on the type of topographic image obtained: anteroposterior topography, lateral topography, and both anteroposterior and lateral topography. Imaging was performed with a 128-MDCT scanner. CT, except for topography, was the same for all subjects. A radiologist analyzed each image, recorded scan length, checked for any insufficiencies in the FOV, and calculated the effective radiation dose. One-way analysis of variance and multiple comparisons were used to compare the effective radiation exposure and scan length between groups. RESULTS: The mean scan length in the anteroposterior topography group was significantly greater than that of the lateral topography group and the combined anteroposterior and lateral topography group (p < 0.001). The mean effective radiation dose for the lateral topography group (0.735 ± 0.033 mSv) was significantly lower than that for the anteroposterior topography group (0.763 ± 0.038 mSv) and the combined anteroposterior and lateral topography group (0.773 ± 0.038) (p < 0.001). CONCLUSION: Lateral topographic low-dose CT was associated with a lower effective radiation dose and scan length than either anteroposterior topographic low-dose chest CT or low-dose chest CT with both anteroposterior and lateral topograms.

iNOS promotes HBx-induced hepatocellular carcinoma via upregulation of JNK activation.

Inducible nitric oxide (iNOS) is closely correlated with chronic inflammation in hepatitis B virus X protein (HBx)-induced hepatocellular carcinoma (HCC). However, the molecular mechanisms through which iNOS contribute to hepatocarcinogenesis remain poorly understood. Therefore, we investigated the role of iNOS in signaling pathways underlying HBx-induced liver tumorigenesis. iNOS deletion showed a marked decrease in the hepatic tumor size and stage of HBx transgenic (Tg) mice, indicating a strong contribution of iNOS signaling pathways to hepatocarcinogenesis. In addition, we found that nitric oxide (NO) increased HBx mRNA by recruiting CREB to the CRE site of HBV enhancer in HepG2 cells, suggesting a positive feedback loop between HBx and iNOS signaling pathway. Moreover, iNOS-modulated JNK activation was associated with sustained upregulation of Cyclin D1 in HBxTg mice and HepG2-HBx cells. These results imply that iNOS may play a key role in HBx-associated HCC development. Taken together, our findings demonstrate that iNOS aligns with HBx to promote tumor progression. These findings provide a better understating of the mechanism involving HBx-mediated hepatic tumorigenesis and selective inhibition of iNOS may have therapeutic applications in HBx-associated HCC.

Asymptomatic brain lesions in pilots: a comparative study with non-flying personnel using brain MRI.

INTRODUCTION: As modern aircraft fly at higher altitudes with rapid velocity, pilots have been put in the environment with a possible increasing risk of brain injury and could sustain cumulative brain damage. However, very few studies have investigated brain lesions using MRI in asymptomatic pilots. We evaluated asymptomatic pilots for the presence of cerebral lesions using MRI. METHODS: Enrolled were 31 healthy pilots of the Republic of Korea Air Force (ROKAF) on active flight duty and 31 healthy nonflying ROKAF personnel with ages of or over 45. We checked for the presence of acute and/or chronic medical conditions, smoking habits, alcohol intake, blood pressure, blood tests including lipid panel, glucose, and liver panel, aircraft type, flight hours, flight altitude, and white matter hyperintensities (WMH) on brain MRI. RESULT: The mean age of both groups was 51.2 yr and the mean total flight hours of the pilots was 3025.0 h. There was no statistical difference between the pilots and non-flying personnel for WMH findings (54.8%/ vs. 32.3%). Of the factors related to flight, only the flying altitude (OR 1.005) was significantly related to the presence of WMH on multivariate analysis. Glucose levels and cholesterol levels were also related to WMH. DISCUSSION: Despite our negative results, there could be the possibility of cumulative brain damage in asymptomatic pilots considering the positive effect of altitude and the positive trend of pilots for the presence of WMH. Additional investigations are surely needed.

Low-dose chest computed tomography as a screening tool: findings in 536 aircrews.

BACKGROUND: Plain chest radiographs and pulmonary function tests have been used for pulmonary screening for flight duties of aircrews of the Republic of Korea Air Force. However, the screening accuracy of plain chest radiographs is controversial. Chest CT imaging with low-dose protocol (LDCT) improves detection of intra-thoracic abnormalities compared to plain chest radiographs. The aim of this study was to assess the influence of LDCT on flight duties of aircrews and to investigate their radiologic findings. METHODS: From June 2009 to May 2011, the Aerospace Medical Center screened asymptomatic subjects 40 yr of age or older to evaluate intra-thoracic abnormalities using LDCT. The abnormal findings, including types and frequency, were recorded and the aircrew's flight duties were also recorded. RESULTS: This study included 536 subjects. No abnormal findings were found in 387 (72.2%) subjects. Abnormal findings related to pulmonary nodules were detected in 123 (23.00%) subjects. Air-trapping lesions were found in 33 (6.1%) subjects. One subject had a mediastinal tumor. Changes of flight duty were made in 26 (4.9%) subjects on the basis of LDCT findings. No subject was permanently disqualified for flight duty. CONCLUSIONS: Pulmonary screening with LDCT could detect many intra-thoracic abnormalities. LDCT was especially useful in the detection of bullae and bleb, and the flight duties of all subjects with bullae and bleb were changed.

Transient sulcal hyperintensities on fluid-attenuated inversion recovery in migraine with aura: transient sulcal hyperintensities in migraine.

Migraine has been found to be associated with patent foramen ovale. However, in practice, it is difficult to show that microemboli via patent foramen ovale can induce a migraine attack. Our patient showed transient sulcal hyperintensities on fluid-attenuated inversion recovery images during a migraine attack. This supports the hypothesis that microemboli via right-to-left shunt may induce migraine attacks through transient occlusion of microcirculation.

The regulatory role of microRNA-1187 in TNF-α-mediated hepatocyte apoptosis in acute liver failure.

In the current study, we aimed at elucidating the regulatory mechanisms through which microR-1187 (miR-1187) participates in hepatocyte apoptosis in acute liver failure (ALF). An ALF model was induced with D-galactosamine (D-GalN) plus lipopolysaccharide (LPS) in BALB/c mice. The hepatic miRNA expression profile was detected by microarray analysis and verified by quantitative real-time PCR (qRT-PCR). The possible underlying mechanism was investigated in vitro using an embryonic murine hepatocyte cell line (BNLCL2) and miR-1187 mimic. Caspase-8 protein was detected by Western blotting and cell apoptosis was assayed by flow cytometry. Hepatic miR-1187 was down-regulated in ALF mice based on microarray data (P<0.001) and verified by qRT-PCR (P<0.01). Target scan revealed that caspase-8 was the putative target of miR-1187. In an in vitro study, miR-1187 showed the highest up-regulation in BNLCL2 cells transfected with the miR-1187 mimic at a 50 nM concentration for 12 h compared with cells transfected with the non-specific mimic (P<0.001). miR-1187 was down-regulated (P<0.01) but caspase-8 mRNA (P<0.01) as well as protein (P<0.05) were up-regulated in the BNLCL2 cells treated with D-GalN/TNF. Furthermore, overexpressed miR-1187 reduced caspase-8 expression at both the mRNA and protein levels significantly (P<0.01 and P<0.05 respectively), and significantly attenuated the apoptotic rate of BNLCL2 cells (P<0.05). We show that miR-1187 regulates hepatocyte apoptosis by targeting caspase-8. miR-1187 may serve as a potential therapeutic target for the treatment of ALF.

Gd-EOB-DTPA enhanced micro-MR imaging of hepatic tumors in H-ras 12V transgenic mice.

RATIONALE AND OBJECTIVES: The aims of this study were to evaluate the morphologic characteristics and growth pattern of hepatic tumors in H-ras 12V transgenic (TG) mice using a micro-magnetic resonance (MR) system and to assess the usefulness of gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) enhancement for the detection of hepatic tumors in these mice. MATERIALS AND METHODS: Hepatocellular carcinoma lines were established to allow insertion of the H-ras 12V transgene under the control of the albumin enhancer/promoter. Seven H-ras 12V TG mice and four wild-type mice were included in this study. The mice underwent various MR imaging examinations, including T1-weighted imaging (repetition time, 300 ms; echo time, 11 ms), Gd-EOB-DTPA-enhanced T1-weighted imaging (dose, 0.025 mmol/kg), and T2-weighted imaging (repetition time, 3500 ms; echo time, 36 ms), with a 4.7-T MR scanner, at 4, 6, 8, and 9 months of age. All mice were euthanized after the final MR imaging procedure, except for one TG mouse and two wild-type mice that were euthanized after MR imaging procedures at 4 months of age. For imaging analysis, the tumor characteristics in each MR sequence, including tumor size, number, and signal intensity (SI), were recorded, and the contrast-to-noise ratio and contrast enhancement ratio were calculated to quantify the SI of the tumor. The MR images were correlated with the findings of histopathologic examinations. RESULTS: No tumors were detected in the four wild-type mice. In the six TG mice, a total of 67 tumors were found in histopathologic specimens obtained at 9 months of age. Of the 67 tumors, 62 were detected on Gd-EOB-DTPA-enhanced T1-weighted images with fat saturation. The majority of hepatic tumors showed high SI on T1-weighted images without fat saturation. The SI diminished on T1-weighted images with fat saturation. The tumor contrast-to-noise ratio for Gd-EOB-DTPA-enhanced T1-weighted imaging was significantly better than that for the other sequences. The tumors were histopathologically confirmed as hepatocellular adenomas (n = 32) and well-differentiated hepatocellular carcinomas (n = 35). CONCLUSIONS: Micro-MR imaging can reveal the characteristics of hepatic tumors in a live murine model. Gd-EOB-DTPA-enhanced T1-weighted imaging is helpful in the detection of hepatic tumors in H-ras 12V TG mice.