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Background/Aims@#Crohn’s disease (CD) with recurrent inflammation can cause intestinal fibrostenosis due to dysregulated deposition of extracellular matrix. However, little is known about the pathogenesis of fibrostenosis. Here, we performed a differential proteomic analysis between normal, inflamed, and fibrostenotic specimens of patients with CD and investigated the roles of the candidate proteins in myofibroblast activation and fibrosis. @*Methods@#We performed two-dimensional difference gel electrophoresis and identified candidate proteins using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and orbitrap liquid chromatography-mass spectrometry. We also verified the levels of candidate proteins in clinical specimens and examined their effects on 18Co myofibroblasts and Caco-2 intestinal epithelial cells. @*Results@#We identified five of 30 proteins (HSP72, HSPA5, KRT8, PEPCK-M, and FABP6) differentially expressed in fibrostenotic CD. Among these proteins, the knockdown of heat shock protein 72 (HSP72) promoted the activation and wound healing of myofibroblasts. Moreover, knockdown of HSP72 induced the epithelial-mesenchymal transition of intestinal epithelial cells by reducing E-cadherin and inducing fibronectin and α-smooth muscle actin, which contribute tofibrosis. @*Conclusions@#HSP72 is an important mediator that regulates myofibroblasts and epithelial-mesenchymal transition in fibrosis of CD, suggesting that HSP72 can serve as a target for antifibrotic therapy.
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Background/Aims@#The purpose of the current study was to examine the anti-inflammatory effects of CKD-506, a novel histone deacetylase 6 inhibitor, on human peripheral blood mononuclear cells (PBMCs) and CD4+ T cells and to explore the relationship between CKD-506 and gut epithelial barrier function. @*Methods@#Lipopolysaccharide-stimulated human PBMCs from inflammatory bowel disease (IBD) patients were treated with CKD-506, and tumor necrosis factor (TNF)-α expression was measured using an enzyme-linked immunosorbent assay. The proliferation of CD4+ T cells from IBD patients was evaluated using flow cytometric analysis. The effects of CKD-506 on gut barrier function in a cell line and colon organoids, based on examinations of mRNA production, goblet cell differentiation, and E-cadherin recovery, were investigated using quantitative reverse transcription polymerase chain reaction, immunofluorescence, and a fluorescein isothiocyanatedextran permeability assay. @*Results@#Secretion of TNF-α, a pivotal pro-inflammatory mediator in IBD, by lipopolysaccharidetriggered PBMCs was markedly decreased by CKD-506 treatment in a dose-dependent manner and to a greater extent than by tofacitinib or tubastatin A treatment. E-cadherin mRNA expression and goblet cell differentiation increased significantly and dose-dependently in HT-29 cells in response to CKD-506, and inhibition of E-cadherin loss after TNF-α stimulation was significantly reduced both in HT-29 cells and gut organoids. Caco-2 cells treated with CKD-506 showed a significant reduction in barrier permeability in a dose-dependent manner. @*Conclusions@#The present study demonstrated that CKD-506 has anti-inflammatory effects on PBMCs and CD4 T cells and improves gut barrier function, suggesting its potential as a smallmolecule therapeutic option for IBD.
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Background@#This retrospective observational matched-cohort study of 2,151,216 individuals from the Korean coronavirus disease 2019 (COVID-19) vaccine effectiveness cohort aimed to evaluate the comparative effectiveness of the COVID-19 bivalent versus monovalent vaccines in providing additional protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, critical infection, and death in Korea. @*Methods@#Among individuals, those vaccinated with COVID-19 bivalent vaccines were matched in a 1:1 ratio with those who were vaccinated with monovalent vaccines (bivalent vaccines non-recipients) during the observation period. We fitted a time-dependent Cox proportional-hazards model to estimate hazard ratios (HRs) of COVID-19 outcomes for infection, critical infection, and death, and we defined vaccine effectiveness (VE) as 1–HR. @*Results@#Compared with the bivalent vaccination group, the incidence proportions in the monovalent vaccination group were approximately three times higher for infection, nine times higher for critical infection, and 11 times higher for death. In the early stage of bivalent vaccination, relative VE of bivalent vaccine against monovalent vaccine was 42.4% against SARS-CoV-2 infection, 81.3% against critical infection, and 85.3% against death. In addition, VE against critical infection and death according to the elapsed period after bivalent vaccination was maintained at > 70%. @*Conclusion@#The bivalent booster dose provided additional protection against SARS-CoV-2 infections, critical infections, and deaths during the omicron variant phase of the COVID-19 pandemic.
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Objectives@#In 2021, the effectiveness of the COVID-19 vaccine was analyzed among people living in the Honam region (Gwangju, Jeollanam-do, Jeollabuk-do, and Jeju) of the Republic of Korea. And we investigated changes in the dominant virus strain. @*Methods@#This study used the data provided by the Korean Ministry of the Interior and Safety for individuals ≥12 years old in the Honam region, and the Integrated Disease and Health Management System of the Korea Centers for Disease Control and Prevention for COVID-19-vaccinated individuals as of December 31, 2021. Statistical analyzes were performed using IBM SPSS ver. 23.0. The occurrence of confirmed cases by vaccination status, the relative risk, and vaccine effectiveness by vaccine type were calculated. @*Results@#In 2021, the COVID-19 vaccination rate in Honam was 88.6%. The overall vaccine effectiveness (after 2 and 3 doses) was 98.7% (p98%, and the effect among persons who received 2 doses was >90% regardless of the vaccine type. Although vaccine effectiveness decreased because of reduced antibody levels over time (as observed in breakthrough infections), receiving a booster dose restored the neutralizing antibody levels.
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This study focuses on the importance of non-face-to-face healthcare, based on the experience with the COVID-19 pandemic, and proposes a model for oral health management services utilizing personal data, known as “my data.” The model aims to develop a comprehensive system that collects and integrates individual health records for easy access. It includes assessing oral health through oral examination records and surveys, creating risk assessment algorithms tailored to various population groups, and standardizing medical terms and data. The goal is to accurately evaluate individual oral health conditions and provide personalized services. However, the success of the model requires considerations such as platform management, user experience enhancement, and medical data security. The research proposes possibilities for further investigation to enhance the oral health service model. This study introduces a novel approach to individual health management, establishing the foundation of effective health management even in non-face-to-face settings.
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Objectives@#This study aims to define the role of the local dental clinic for people with disabilities and the appropriate role of the dental hygienist to resolve oral health inequality with people with disabilities. @*Methods@#From September 12, 2022 to November 11, 2022, 16 experts who voluntarily participated in the research, among the experts recommended by the related institutes, were selected through stratification analysis. The results of this study and improvement plans are as follows. @*Results@#First, as a result of measuring the importance of the role of a regional oral care center for people with disabilities in the analytic hierarchy process (AHP) middle category, check-up was found to be the most important (0.364, C.I=0.01). For examination, a facility visit checkup and regular checkups were required. Second, as a result of measuring the importance of the role of a dedicated dental hygienist in the AHP middle category, the institutional-linked activity was found to be the most important (0.417, C.I=0.02). As for institutional-linked activities, linkage with local community organizations, patient management, and public relations activities were required. @*Conclusions@#Considering these results, the role of a regional oral care center for people with disabilities is to perform examinations and preventive treatments, primary treatments (simple), education and counseling, and establish a smooth medical return system to serve as a base for dental treatment for people with disabilities. Education and counseling are provided through professional patient response and the arrangement of a dedicated dental hygienist, and oral health care is provided to people with disabilities through professional treatment assistance for patients and treatment support and screening, linkage with local community institutions, and patient management. Specialized dental hygienists should play a role in supporting the operation of oral health care for people with disabilities.
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Objectives@#This study aims to verify the effect of the use of a toothpaste containing 0.5% zinc citrate and 1,450 ppm fluoride on oral malodor. @*Methods@#In this study, the experimental group using the experimental toothpaste and the control group using the standard toothpaste control toothpaste were allowed to use each toothpaste for 4 weeks and then a clinical test to measure the change in bad breath was conducted. A study was conducted to evaluate the reduction effect. Efficacy was evaluated by conducting BB checker test and Oralchroma test three times in total before the testing 2 weeks and 4 weeks after the test. @*Results@#As a result of measuring the degree of bad breath using the BB checker, before the start of the test, the experimental group was 46.3 and the control group was 47.2. After 2 weeks of the test, the experimental group was 38.5 and the control group was 44.2 and after 4 weeks the experimental group was 29.6 and the control group was 39.2. There was a significant difference between the experimental group and the control group after 4 weeks of the test (P<0.05). The volatile sulfur compounds measured by Oralchroma were 0.825 ng/10 ml for the experimental group and 0.819 ng/10 ml for the control group after 2 weeks of the test, and they were 0.705 ng/10 ml for the experimental group and 0.860 ng/10ml for the control group after 4 weeks of the test. It was confirmed that a significant index change appeared after 4 weeks of the test compared to before the test (P<0.05). @*Conclusions@#It was confirmed that an improved effect of removing bad breath can be expected when a toothpaste containing 0.5% zinc citrate and 1,450 ppm fluoride is used.
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Objective@#Dysphagia is a common symptom of stroke and affects 23–50% of such patients. In addition, bulbar involvement, which causes dysphagia, is the primary initial symptom in approximately 25–30% of amyotrophic lateral sclerosis (ALS) patients. The purpose of this study was to compare patterns of swallowing difficulties in stroke and ALS patients. @*Methods@#We retrospectively recruited 84 ALS patients with dysphagia and 294 stroke patients with dysphagia between January 2017 and December 2019. Swallowing processes were reviewed by videofluoroscopic swallowing studies (VFSSs). The presence of oral residues and oral transit times (OTTs) were measured in the oral phase, and the presence of penetration and aspiration and residues in valleculae or pyriform sinuses were evaluated. Statistical analysis was performed using SPSS 25.0 and comparisons using the Chi-square test. @*Results@#ALS patients more frequently had delayed OTTs and oral residues than stroke patients, and stroke patients more frequently experienced aspiration and had delayed thin liquid pharyngeal transit times (PTTs). However, no significant intergroup difference was observed for the presence of penetration, residues in valleculae or pyriform sinuses, or thick liquid PTTs. @*Conclusion@#The study shows that ALS patients exhibit slower food processing in the oral cavity and more significant bulbar muscle weakness than stroke patients. On the other hand, stroke patients had greater thin liquid aspiration rates than ALS patients. These findings should be considered when choosing treatments for ALS and stroke.
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Background@#The impact of the coronavirus disease 2019 (COVID-19) pandemic on Kawasaki disease (KD) has not yet been established. We investigated changes in the observed number and severity of KD cases and accompanying coronary artery complications during the COVID-19 pandemic in Korea. @*Methods@#This retrospective observational study included patients aged < 18 years with acute-phase KD diagnosed between March 2018 and February 2021. Data were extracted from the Clinical Data Warehouse that houses data from five affiliated university hospitals in Korea. We analyzed changes in the number of patient admissions and clinical characteristics, including cardiac complications, before and after the onset of the COVID-19 pandemic. @*Results@#A total of 475 admissions were included in the analysis. After March 2020, we observed a significant decrease of 33% in the number of hospitalizations for KD compared with the average number of hospitalizations during the previous 2 years. The number of admissions per month significantly decreased by 7.9 persons/month (95% confidence interval, −13.8 to −2.0; P < 0.05) compared with that before COVID-19. By contrast, the proportion of patients aged < 1 year with KD increased. The proportion of patients with refractory KD and the rate of cardiac complications did not change significantly. @*Conclusion@#Since the onset of the COVID-19 pandemic, the total number of hospital admissions for KD has decreased in Korea. Although the proportion of admissions of infants aged < 1 year increased, no changes were observed in clinical courses and complications.
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Background@#Chronic kidney disease (CKD) is a global health problem, and there is no permanent treatment for reversing kidney failure; thus, early diagnosis and effective treatment are required. Gene therapy has outstanding potential; however, the lack of safe gene delivery vectors, a reasonable transfection rate, and kidney targeting ability limit its application. Nanoparticles can offer innovative ways to diagnose and treat kidney diseases as they facilitate targetability and therapeutic efficacy. @*Methods@#Herein, we developed a proximal renal tubule-targeting gene delivery system based on alternative copolymer (PS) of sorbitol and polyethyleneimine (PEI), modified with vimentin-specific chitobionic acid (CA), producing PS-conjugated CA (PSC) for targeting toward vimentin-expressing cells in the kidneys. In vitro studies were used to determine cell viability, transfection efficiency, serum influence, and specific uptake in the human proximal renal tubular epithelial cell line (HK-2). Finally, the targeting efficiency of the prepared PSC gene carriers was checked in a murine model of Alport syndrome. @*Results@#Our results suggested that the prepared polyplex showed low cytotoxicity, enhanced transfection efficiency, specific uptake toward HK-2 cells, and excellent targeting efficiency toward the kidneys. @*Conclusion@#Collectively, from these results it can be inferred that the PSC can be further evaluated as a potential gene carrier for the kidney-targeted delivery of therapeutic genes for treating diseases.
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Purpose@#This study aimed to investigate and categorize the diverse features of hepatic hemangiomas on superb microvascular imaging (SMI) in a relatively large prospective study. @*Methods@#In this prospective study, 70 patients with 92 hepatic hemangiomas were consecutively enrolled. All nodules were radiologically confirmed with the typical imaging features of hepatic hemangiomas on dynamic computed tomography (CT) or magnetic resonance imaging (MRI). Using SMI, all lesions were evaluated and categorized into subgroups according to the flow pattern on SMI. Differences in the frequencies of SMI patterns according to lesion size and enhancement patterns on dynamic CT or MRI were also compared. @*Results@#In 67.4% (62/92) of hemangiomas, tumor vascularity was detected using SMI, while 32.6% (30/92) did not show any signal on the SMI examination, and the absence of an SMI signal was not shown in rapidly enhancing hemangiomas (0% [0/30] vs. 100% [30/30], P=0.002) and was more frequent in lesions <2 cm than in lesions ≥2 cm (44.0% [22/50] vs. 2.7% [8/42], P=0.011). In hepatic hemangiomas in which vascularity was detected (n=62), the strip rim pattern was the most common SMI pattern of hepatic hemangiomas (48.4%, 30/62), followed by the nodular rim pattern involving spotty dot-like engorged vessels (37.1%, 23/62). @*Conclusion@#The evaluation of the inner vascularity of hepatic hemangiomas with SMI was feasible for most hemangiomas, especially in larger (≥2 cm) or rapidly enhancing hemangiomas. The most frequent SMI patterns of hepatic hemangiomas were the strip rim pattern and nodular rim pattern.
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Objectives@#In order to understand the factors that influence the oral health-related quality of life of older adults, we investigated the quality of life, oral health status, and oral health behavior of older adults in a metropolitan city in Korea. @*Methods@#Data were collected from October 2019 to March 2020, after approval was obtained from the authors’ institutional review board. Oral examinations were administered and a structured questionnaire was distributed to 150 older adults at a public nursing home. Data on sociodemographic factors, oral health behaviors, general health questions, and oral health-related quality of life (assessed with the Oral Health Impact Profile-14 [OHIP-14]) were collected with the questionnaire.To assess the general health condition of the participants, grip strength and upper arm and calf circumference were measured. Multiple logistic regression analysis was used to determine the correlation between oral health-related quality of life and other variables. @*Results@#Whether brushing was performed, the number of remaining teeth, and the presence of periodontal disease were found to correlate with OHIP-14 scores (P<0.05). Oral Health Impact Profile-14 scores and sociodemographic factors in older adults through multiple logistic regression analyses with general health, oral health habits and conditions, and need for assistance with daily oral health care. Correlations between OHIP-14 scores and general health variables, such as thigh circumference and grip strength, revealed a low oral health-related quality of life in participants who needed help during brushing (P<0.05). @*Conclusions@#Results of the study confirmed a relationship between OHIP-14 scores and oral health and habits among older adults in public nursing homes with socioeconomic status, and general health, and oral health, and each variable affects the relationship. Further analysis and additional epidemiological studies are needed to understand the interrelationships.
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Objectives@#This study aimed to determine the relationship between English communication ability and job satisfaction of dental hygienists involved in the process of providing dental health services to foreigners and to analyze factors related to job satisfaction. @*Methods@#Both online and offline surveys were conducted in parallel to measure English communication competency and job satisfaction. Participants were 195 clinical dental hygienists provided dental health services to foreigners. Spearman’s rho analysis was performed on the correlation between English communication ability, and job satisfaction, and a stepwise multiple regression analysis was performed on the factors related to the job satisfaction of the dental hygienist. @*Results@#The job satisfaction of dental hygienists was 2.99 point out of 5 points. There was a strong positive relationship between English communication ability and english communication frequency (r=0.682), and the higher the English communication ability, the higher the job satisfaction (r=0.357).Factors affecting job satisfaction were English communication ability (β=0.378,P<0.001) and foreign medical assistance (β=0.391, P<0.001). The adjusted explanatory power of this model was 34.9%. @*Conclusions@#The job satisfaction of dental hygienists who provided dental health services to foreigners was low. English communication ability and experience in foreign medical assistance were significant influencing factors of job satisfaction. These results suggest that education for improving the English communication skills of dental hygienists should be strengthened.
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Background@#Spinal cord injury (SCI) is a serious clinical condition that impacts a patient's physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients. @*Methods@#Participants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timedup-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale—International and the 36-Item Short-Form Health Survey version 2. @*Results@#Ten participants finished 30 sessions of training and could ambulate independently.No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants. @*Conclusion@#In conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients.
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Objectives@#In order to understand the factors that influence the oral health-related quality of life of older adults, we investigated the quality of life, oral health status, and oral health behavior of older adults in a metropolitan city in Korea. @*Methods@#Data were collected from October 2019 to March 2020, after approval was obtained from the authors’ institutional review board. Oral examinations were administered and a structured questionnaire was distributed to 150 older adults at a public nursing home. Data on sociodemographic factors, oral health behaviors, general health questions, and oral health-related quality of life (assessed with the Oral Health Impact Profile-14 [OHIP-14]) were collected with the questionnaire.To assess the general health condition of the participants, grip strength and upper arm and calf circumference were measured. Multiple logistic regression analysis was used to determine the correlation between oral health-related quality of life and other variables. @*Results@#Whether brushing was performed, the number of remaining teeth, and the presence of periodontal disease were found to correlate with OHIP-14 scores (P<0.05). Oral Health Impact Profile-14 scores and sociodemographic factors in older adults through multiple logistic regression analyses with general health, oral health habits and conditions, and need for assistance with daily oral health care. Correlations between OHIP-14 scores and general health variables, such as thigh circumference and grip strength, revealed a low oral health-related quality of life in participants who needed help during brushing (P<0.05). @*Conclusions@#Results of the study confirmed a relationship between OHIP-14 scores and oral health and habits among older adults in public nursing homes with socioeconomic status, and general health, and oral health, and each variable affects the relationship. Further analysis and additional epidemiological studies are needed to understand the interrelationships.
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Objectives@#This study aimed to determine the relationship between English communication ability and job satisfaction of dental hygienists involved in the process of providing dental health services to foreigners and to analyze factors related to job satisfaction. @*Methods@#Both online and offline surveys were conducted in parallel to measure English communication competency and job satisfaction. Participants were 195 clinical dental hygienists provided dental health services to foreigners. Spearman’s rho analysis was performed on the correlation between English communication ability, and job satisfaction, and a stepwise multiple regression analysis was performed on the factors related to the job satisfaction of the dental hygienist. @*Results@#The job satisfaction of dental hygienists was 2.99 point out of 5 points. There was a strong positive relationship between English communication ability and english communication frequency (r=0.682), and the higher the English communication ability, the higher the job satisfaction (r=0.357).Factors affecting job satisfaction were English communication ability (β=0.378,P<0.001) and foreign medical assistance (β=0.391, P<0.001). The adjusted explanatory power of this model was 34.9%. @*Conclusions@#The job satisfaction of dental hygienists who provided dental health services to foreigners was low. English communication ability and experience in foreign medical assistance were significant influencing factors of job satisfaction. These results suggest that education for improving the English communication skills of dental hygienists should be strengthened.
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Background@#Spinal cord injury (SCI) is a serious clinical condition that impacts a patient's physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients. @*Methods@#Participants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timedup-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale—International and the 36-Item Short-Form Health Survey version 2. @*Results@#Ten participants finished 30 sessions of training and could ambulate independently.No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants. @*Conclusion@#In conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients.
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Purpose@#The aim of this study was to compare the discrepancy of alignment categorization in total knee arthroplasty (TKA) between the anatomical femorotibial angle (aFTA) measured on short knee radiographs and the mechanical hip– knee–ankle axis angle (mHKA) measured on full-length radiographs in knees with and without bowing. @*Methods@#From January 2014 to June 2017, 107 of 526 osteoarthritic knees at our hospital were found to have femoral or tibial bowing. Bowing was defined as a femoral bowing angle (FBA) > 3° or 2° or 7° , mHKA> 3°) alignments. We compared the categorization of alignments between knees with and without bowing using the McNemar test and used logistic regression to find factors for the alignment discordance. @*Results@#Coronal alignment was discordant in 26.2% of the knees with bowing and 13.1% of the knees without bowing (p < 0.001). FBAs were a significant factor affecting the discordance of alignment categorization (OR = 1.152, 95%CI 1.038– 1.279, p = 0.008). @*Conclusion@#Short knee radiographs are insufficient for estimating coronal alignment after TKA, particularly in knees with femoral bowing.Level of evidence: III: Retrospective comparative study.
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Purpose@#The purpose of this study was to prospectively evaluate whether monitoring hepatic steatosis by ultrasonography with acoustic structure quantification (ASQ) is feasible, using magnetic resonance spectroscopy (MRS) as the reference standard. @*Methods@#Thirty-six patients with suspected fatty liver disease underwent both untrasonography with ASQ and MRS on the same day. After a mean follow-up period of 11.4±2.5 months, follow-up ultrasonography with ASQ and MRS were performed on 27 patients to evaluate whether hepatic steatosis had improved. The focal disturbance (FD) ratio, as calculated using ASQ, and the hepatic fat fraction (HFF), estimated by MRS, were obtained at both initial and follow-up examinations. Pearson correlation coefficients were calculated to assess the correlations between ordinal values. @*Results@#The FD ratio showed a strong, negative linear correlation with the HFF after logarithmic transformation of both variables from the initial examinations of 36 patients (ρ=-0.888, P<0.001) and the follow-up examinations of 27 patients (ρ=-0.920, P<0.001). There was also a significant, negative linear correlation between the change in the logarithm of the FD ratio and the change in the logarithm of the HFF by MRS over the follow-up period (ρ=-0.645, P<0.001). In 16 patients with an increased FD ratio on follow-up, the HFF on follow-up MRS significantly decreased, and high-density lipoprotein levels significantly increased, whereas low-density lipoprotein levels tended to decrease. @*Conclusion@#The FD ratio was significantly correlated with the HFF at both the initial and follow-up examinations, and there was also a significant correlation between changes in the FD ratio and changes in the HFF over the follow-up period.
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The first edition of the guidelines for the use of ultrasound contrast agents was published in 2004, dealing with liver applications. The second edition of the guidelines in 2008 reflected changes in the available contrast agents and updated the guidelines for the liver, as well as implementing some nonliver applications. The third edition of the contrast-enhanced ultrasound (CEUS) guidelines was the joint World Federation for Ultrasound in Medicine and Biology-European Federation of Societies for Ultrasound in Medicine and Biology (WFUMB-EFSUMB) venture in conjunction with other regional US societies such as Asian Federation of Societies for Ultrasound in Medicine and Biology, resulting in a simultaneous duplicate on liver CEUS in the official journals of both WFUMB and EFSUMB in 2013. However, no guidelines were described mainly for Sonazoid due to limited clinical experience only in Japan and Korea. The new proposed consensus statements and recommendations provide general advice on the use of Sonazoid and are intended to create standard protocols for the use and administration of Sonazoid in hepatic and pancreatobiliary applications in Asian patients and to improve patient management.