MRI Findings in Tumefactive Demyelinating Lesions: A Systematic Review and Meta-Analysis.

BACKGROUND: Accurate diagnosis of tumefactive demyelinating lesions is clinically important to avoid unnecessary invasive biopsy or inappropriate treatment. PURPOSE: We aimed to evaluate conventional and advanced MR imaging findings of tumefactive demyelinating lesions and determine the diagnostic performance of MR imaging for differentiating tumefactive demyelinating lesions from primary brain tumor. DATA SOURCES: A systematic search of Ovid MEDLINE and EMBASE up to December 6, 2017, was conducted. STUDY SELECTION: Original articles describing MR imaging findings in patients with tumefactive demyelinating lesions were selected. DATA ANALYSIS: The pooled incidences of conventional MR imaging findings of tumefactive demyelinating lesions were obtained with the DerSimonian and Liard random-effects model. The pooled sensitivity and specificity of MR imaging for differentiating tumefactive demyelinating lesions from primary brain tumor were obtained using the bivariate random-effects model. DATA SYNTHESIS: Nineteen eligible studies with 476 patients with tumefactive demyelinating lesions were included. The pooled incidence of open ring or incomplete rim enhancement was 35% (95% CI, 24%-47%), which was significantly higher than the incidence of closed ring or complete rim enhancement (18% [95% CI, 11%-29%]; P = .0281). The pooled incidences of T2 hypointense rim, absent or mild mass effect, and absent or mild perilesional edema were 48%, 67%, and 57%, respectively. On advanced MR imaging, tumefactive demyelinating lesions showed a high apparent diffusion coefficient, peripheral restricted diffusion, and low cerebral blood volume. The pooled sensitivity and specificity of MR imaging for differentiating tumefactive demyelinating lesions from primary brain tumor were 89% (95% CI, 82%-93%) and 94% (95% CI, 89%-97%), respectively. LIMITATIONS: Seventeen of 19 studies were retrospective studies. CONCLUSIONS: Conventional MR imaging findings may help differentiate tumefactive demyelinating lesions from primary brain tumor, though further study is needed to determine the added value of advanced MR imaging.

Clinically Relevant Imaging Features for MGMT Promoter Methylation in Multiple Glioblastoma Studies: A Systematic Review and Meta-Analysis.

BACKGROUND: O6-methylguanine methyltransferase (MGMT) promoter methylation status has been reported as a prognostic biomarker in clinical trials. PURPOSE: Our aim was to systematically evaluate imaging features of MGMT promoter methylated glioblastoma and to determine the diagnostic performance of MR imaging for prediction of MGMT promoter methylation in patients with newly diagnosed glioblastoma. DATA SOURCES: A computerized search of Ovid MEDLINE and EMBASE up to February 27, 2018, was conducted. STUDY SELECTION: We selected studies evaluating imaging features of MGMT promoter methylated glioblastoma and the diagnostic performance of MR imaging for prediction of MGMT promoter methylation. DATA ANALYSIS: Pooled estimates of sensitivity and specificity were calculated using a hierarchic logistic regression model. Meta-regression and sensitivity analysis were performed. DATA SYNTHESIS: Twenty-two articles including 2199 patients were included. MGMT promoter methylated glioblastoma is likely to show less edema, high ADC, and low perfusion. Ten articles including 753 patients were included in the meta-analysis. The summary sensitivity was 79% (95% CI, 72%-85%), and the summary specificity was 78% (95% CI, 71%-84%). In the meta-regression, MGMT promoter methylation and mean age were associated with heterogeneity. Sensitivity analysis excluding 1 study resolved the heterogeneity. LIMITATIONS: Included studies used a variety of different MR imaging techniques to predict MGMT promoter methylation. CONCLUSIONS: MGMT promotor methylated glioblastoma is likely to show less aggressive imaging features than MGMT promotor unmethylated glioblastoma. Despite the variety of different MR imaging techniques used, MR imaging in patients with newly diagnosed glioblastoma was shown to have the potential to predict MGMT promoter methylation noninvasively.

Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Differentiating High-Grade Glioma from Solitary Brain Metastasis: A Systematic Review and Meta-Analysis.

BACKGROUND: Accurate diagnosis of high-grade glioma and solitary brain metastasis is clinically important because it affects the patient's outcome and alters patient management. PURPOSE: To evaluate the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis. DATA SOURCES: A literature search of Ovid MEDLINE and EMBASE was conducted up to November 10, 2017. STUDY SELECTION: Studies evaluating the diagnostic performance of DWI and DTI for differentiating high-grade glioma from solitary brain metastasis were selected. DATA ANALYSIS: Summary sensitivity and specificity were established by hierarchic logistic regression modeling. Multiple subgroup analyses were also performed. DATA SYNTHESIS: Fourteen studies with 1143 patients were included. The individual sensitivities and specificities of the 14 included studies showed a wide variation, ranging from 46.2% to 96.0% for sensitivity and 40.0% to 100.0% for specificity. The pooled sensitivity of both DWI and DTI was 79.8% (95% CI, 70.9%-86.4%), and the pooled specificity was 80.9% (95% CI, 75.1%-85.5%). The area under the hierarchical summary receiver operating characteristic curve was 0.87 (95% CI, 0.84-0.89). The multiple subgroup analyses also demonstrated similar diagnostic performances (sensitivities of 76.8%-84.7% and specificities of 79.7%-84.0%). There was some level of heterogeneity across the included studies (I2 = 36%); however, it did not reach a level of concern. LIMITATIONS: The included studies used various DWI and DTI parameters. CONCLUSIONS: DWI and DTI demonstrated a moderate diagnostic performance for differentiation of high-grade glioma from solitary brain metastasis.

Application of loop-mediated isothermal amplification with propidium monoazide treatment to detect live Salmonella in chicken carcasses.

Raw chicken products are major causes of human foodborne salmonellosis worldwide. In particular, there is a significant risk of human exposure to Salmonella originating from the chicken slaughtering process. Controlling the contamination of chicken carcasses by Salmonella has been a considerable challenge in chicken-slaughtering facilities and involves routine microbiological monitoring using reliable detection methods. Simple and rapid detection methods, particularly those capable of determining cell viability, will significantly facilitate routine monitoring of Salmonella Here, we report an invA-based loop-mediated isothermal amplification method coupled with a simple propidium monoazide treatment (PMA-LAMP) for simple and rapid detection and quantification of viable Salmonella in rinse water of chicken carcasses. In this study, PMA-LAMP consistently gave negative results for isopropanol-killed Salmonella with concentrations up to 8.0 × 106 CFU/reaction. The detection limit of PMA-LAMP was 8.0 × 101 CFU/reaction with viable Salmonella in both pure culture and rinse water of chicken carcasses, and 10-fold lower than a conventional polymerase chain reaction coupled with PMA (PMA-PCR) targeting invA There was a high correlation (R2 = 0.99 to 0.976) between LAMP time threshold (TT) values and viable Salmonella with a quantification range of 1.0 × 103 to 1.0 × 108 CFU/mL in pure culture and rinse water of chicken carcasses. The PMA-LAMP assay took less than 2 h to detect Salmonella contaminated in test samples. Therefore, this simple and rapid method will be a very useful tool to detect live Salmonella contamination of chicken carcasses without pre-enrichment at the slaughterhouse where sanitizing treatments are commonly used.

Comparison of High-Resolution MR Imaging and Digital Subtraction Angiography for the Characterization and Diagnosis of Intracranial Artery Disease.

BACKGROUND AND PURPOSE: High-resolution MR imaging has recently been introduced as a promising diagnostic modality in intracranial artery disease. Our aim was to compare high-resolution MR imaging with digital subtraction angiography for the characterization and diagnosis of various intracranial artery diseases. MATERIALS AND METHODS: Thirty-seven patients who had undergone both high-resolution MR imaging and DSA for intracranial artery disease were enrolled in our study (August 2011 to April 2014). The time interval between the high-resolution MR imaging and DSA was within 1 month. The degree of stenosis and the minimal luminal diameter were independently measured by 2 observers in both DSA and high-resolution MR imaging, and the results were compared. Two observers independently diagnosed intracranial artery diseases on DSA and high-resolution MR imaging. The time interval between the diagnoses on DSA and high-resolution MR imaging was 2 weeks. Interobserver diagnostic agreement for each technique and intermodality diagnostic agreement for each observer were acquired. RESULTS: High-resolution MR imaging showed moderate-to-excellent agreement (interclass correlation coefficient = 0.892-0.949; κ = 0.548-0.614) and significant correlations (R = 0.766-892) with DSA on the degree of stenosis and minimal luminal diameter. The interobserver diagnostic agreement was good for DSA (κ = 0.643) and excellent for high-resolution MR imaging (κ = 0.818). The intermodality diagnostic agreement was good (κ = 0.704) for observer 1 and moderate (κ = 0.579) for observer 2, respectively. CONCLUSIONS: High-resolution MR imaging may be an imaging method comparable with DSA for the characterization and diagnosis of various intracranial artery diseases.

Facile Synthesis of Iron Oxide/Graphene Nanocomposites Using Liquid Phase Plasma Method.

Liquid phase plasma (LPP) method was applied, for the first time, to the impregnation of iron oxide nanoparticles onto graphene sheet. Iron oxide nanoparticles with the size of 50 nm were precipitated with uniform dispersion on the surface of graphene sheet. The amount of iron oxide nanoparticles precipitated on graphene sheets increased with increasing LPP process times. The XPS, Raman and EDX analyses showed that the iron oxide/graphene composites synthesized by the LPP process.

Application of Silver and Silver Oxide Nanoparticles Impregnated on Activated Carbon to the Degradation of Bromate.

Silver and silver oxide nanoparticles were impregnated on the surface of powdered activated carbon (PAC) using a single-step liquid phase plasma (LPP) method. Spherical silver and silver oxide nanoparticles of 20 to 100 nm size were dipersed evenly on the surface of PAC. The impregnated PAC exhibited a higher activity for the decomposition of bromate than bare PAC. The XPS, Raman and EDX analyses showed that the Ag/PAC composites synthesized by the LPP process.

Increased efficacy of inactivated vaccine candidates prepared with Salmonella enterica serovar Typhimurium strains of predominant genotypes in ducks.

Salmonella enterica serovar Typhimurium has been a major causative agent of food-borne human disease, mainly due to consumption of contaminated food animal products. In particular, ducks serve as a reservoir of serovar Typhimurium, and are one of the common sources of human infection. To prevent infection of ducks, and therefore minimize human infection, it is critical to control the persistent epidemic strains in ducks. Here, we analyzed the genetic diversity and virulence of serovar Typhimurium isolates from ducks in Korea to identify the predominant strains that might be used as efficient vaccine candidates for ducks. Among the isolates, 2 representative isolates (ST26 and ST76) of predominant genotypes were selected as vaccine strains on the basis of genotypic analysis by pulsed-field gel electrophoresis and DNA microarrays. Two-week-old ducks were then injected intramuscularly with inactivated vaccine candidates prepared using ST26 or ST76 (10(8) cfu/0.5 mL/duck or 10(9) cfu/0.5 mL/duck), and oral challenge with a highly virulent serovar Typhimurium strain (10(9) cfu/0.5 mL/duck) was carried out 2 wk later. Shedding of the challenge strain was significantly decreased in group 2 after vaccination. The antibody levels by enzyme-linked immunosorbent assay in all vaccinated groups were enhanced significantly (P < 0.05) compared to the unvaccinated control group. Overall, vaccination with ST26 or ST76 reduced bacterial shedding and colonization in internal organs, and induced elevated antibody response. In particular, serovar Typhimurium ST26 (10(8) cfu/0.5 mL/duck) was the most effective vaccine candidate, which can provide efficient protection against serovar Typhimurium in ducks with higher effectiveness compared to a commercial vaccine currently used worldwide.

Development of a highly immunogenic Newcastle disease virus chicken vaccine strain of duck origin.

Newcastle disease virus (NDV) strain NDRL0901 was developed as a live vaccine candidate for control of Newcastle disease. NDV isolate KR/duck/13/07 (DK1307) of duck origin was used as the selected vaccine strain. DK1307 was passaged 6 times in chickens. Then a single clone from the chicken-adapted virus (DK1307C) was finally selected, and the vaccine strain was named NDRL0901. DK1307C and the clone NDRL0901 viruses showed enhanced immunogenicity compared to the DK1307 virus. Principal component analysis based on fusion and hemagglutinin-neuraminidase genes revealed the codon usage pattern in the dataset is distinct separating duck viral sequences and avian sequences, and passage of the duck origin virus into the chicken host causes deviation in the codon usage pattern. The NDRL0901 virus was avirulent and did not acquire viral virulence even after 7 back passages in chickens. When day-old chicks were vaccinated with the NDRL0901 virus via spray, eye drops, and drinking water, the vaccinated birds showed no clinical signs and had significant protection efficacy (>80%) against very virulent NDV (Kr005 strain) infection regardless of the administration route employed. The results indicate that the NDRL0901 strain is safe in chickens and can offer protective immunity.

Single-Stage Coil Embolization of Multiple Intracranial Aneurysms: Technical Feasibility and Clinical Outcomes.

PURPOSE: Not infrequently, intracranial aneurysms may be multifocal. However, strategies conferring open surgical access to opposite sides of the brain are limited. Given the recent advances in protection devices and coiling technique, a study of single-stage coil embolization in patients with multiple intracranial aneurysms was undertaken, assessing procedural safety and efficacy. METHODS: Data prospectively accrued between January 2010 and September 2013 were systematically reviewed, assessing clinical and morphologic outcomes of single-stage coil embolization in 172 patients with multiple aneurysms (≥ 2 aneurysms each; total, 371 aneurysms). RESULTS: Internal carotid artery (n = 132) was the most common site, with progressively fewer aneurysms found elsewhere (middle cerebral artery, 103; anterior communicating artery, 41; posterior communicating artery, 38). In 26 patients, one-stage embolization of three or more aneurysms took place (25 patients with three each; 1 patient with four). Stents were applied in 109 aneurysms, and in 33 lesions, balloons were used. Occlusion was achieved in 326 aneurysms (87.9 %) through coil embolization, and attempted coiling rarely failed (3 of 371, 0.8 %). Mean procedural time was 111.5 ± 37.8 min. Although procedure-related adverse events included three instances of treatment failure, asymptomatic thrombi in four patients, and aneurysmal leakage in one patient, procedural morbidity was low (1 of 172, 0.6 %), and no procedure-related deaths occurred. Postembolization follow-up of 303 aneurysms at > 6 months (mean, 15.4 ± 9.8 months) showed complete occlusion in the vast majority (275 of 303, 90.8 %), with comparatively fewer instances of minor (19 of 303, 6.3 %) and major (9 of 303, 3.0 %) recanalization. Four patients experienced delayed cerebral infarction, but only one suffered permanent neurologic deficit (Glasgow outcome scale 4). CONCLUSION: Single-stage coil embolization of multiple unruptured intracranial aneurysms is technically feasible. The time required for such procedures and the rate of complications observed seem acceptable.

Bioactivity of Several Herbicides on the Nanogram Level Under Different Soil Moisture Conditions.

In this study, a double-tube centrifuge method was employed to determine the effects of soil moisture on the bioactivity of cafenstrole, pretilachlor, benfuresate, oxyfluorfen and simetryn. In general, the available herbicide concentration in soil solution (ACSS) showed little change as soil moisture increased for herbicides. The total available herbicide in soil solution (TASS) typically increased as soil moisture increased for all herbicides. The relationship between TASS and % growth rate based on dry weight showed strong linear relationships for both cafenstrole and pretilachlor, with r2 values of 0.95 and 0.84, respectively. Increasing TASS values were consistent with increasing herbicide water solubility, with the exception of the ionizable herbicide simetryn. Plant absorption and % growth rate exhibited a strong linear relationship with TASS. According to the results suggested that TASS was a better predictor of herbicidal bioactivity than ACSS for all herbicides under unsaturated soil moisture conditions.

Bioavailability of the Nano-Unit 14C-Agrochemicals Under Various Water Potential.

The study was conducted to investigate the effects of water potential on bioavailability of the nano-unit 14C-cafenstrole, 14C-pretilachlor, 14C-benfuresate, 14C-simetryn and 14C-oxyfluorfen applied with or without dimepiperate or daimuron under various water potential conditions. The highest bioavailable concentration in soil solution (BCSS) was found at 60% soil moisture, while the lowest occurred at 50% soil moisture for soil-applied alone or in combination. All water potential conditions differed significantly from each other with variations in total bioavailable amount in soil solution (TBSS) when either dimepiperate or daimuron were added to the soil, and changes were directly proportional to variations in water potential. Across all treatments, TBSS at 80% soil moisture was three to four times greater than that at 50% soil moisture when applied alone or in combination with dimepiperate or daimuron. Cafenstrole and simetryn had distribution coefficient (Kd) values <64 ml g-1 and a TBSS ranging from 10 to 44 ng g-1 soil, regardless of water potential conditions applied alone or in combination. Pretilachlor and benfuresate had Kd values <15 ml g-1 and a TBSS range of 38 to 255 ng g-1 soil when applied with or without dimepiperate or daimuron.

Diagnosis of bovine tuberculosis using a metal oxide-based electronic nose.

Electronic noses (e-noses) have been used for environmental monitoring, standardization of medicinal flavourings, food safety tests and diagnosis of infectious diseases based on the statistical analysis of volatile organic compounds (VOCs). Bovine tuberculosis (bTB) is officially diagnosed using the intradermal skin test (IST), which is time-consuming and labour-intensive. Therefore, a more convenient and rapid test with greater sensitivity would be advantageous as prescreening test. In this study, we used a metal oxide sensor (MOS) type e-nose to analyse VOCs in a bTB-infected (n = 11) and bTB-free (n = 10) sera, from cattle whose health status was confirmed using the IST, and pathological and bacteriological examinations. The differences in VOCs from bTB-infected and bTB-free sera detected by the e-nose were statistically analysed using principal components and discriminant factor analyses. bTB-infected and bTB-free sera could be discriminated by MOS type e-nose, and analysing time per sample was only 20 min. VOC analysis using a MOS e-nose was a rapid and automated prescreening method to diagnose bTB, and can be used to select bTB-suspect cattle for IST confirmation. Further studies are required to estimate test sensitivity and specificity. Significance and impact of the study: Bovine tuberculosis (bTB) in cattle is diagnosed using the intradermal skin test (IST); however, this method is very time-consuming and labour-intensive. We analysed volatile organic compounds that are obtained from serum using a metal oxide sensor type of electronic nose to discriminate between TB-infected and TB-free sera. This simple and automated technique will be useful to prescreen bTB-suspects and reduce the time and labour required to perform the IST.

A cohort study of MFN2 mutations and phenotypic spectrums in Charcot-Marie-Tooth disease 2A patients.

Charcot-Marie-Tooth disease 2A (CMT2A) is the most common axonal form of peripheral neuropathy caused by a defect in the mitofusin 2 (MFN2) gene, which encodes an outer mitochondrial membrane GTPase. MFN2 mutations result in a large range of phenotypes. This study analyzed the prevalence of MFN2 mutation in Korean families with their assorted phenotypes (607 CMT families and 160 CMT2 families). Direct sequencing of the MFN2 coding exons or whole-exome sequencing has been applied to identify causative mutations. A total of 21 mutations were found in 36 CMT2 families. Comparative genotype-phenotype correlations impacting severity, onset age, and specific symptoms were assessed. Most mutations were seen in the GTPase domain (∼86%). A deletion mutation found in the transmembrane helices is reported for the first time, as well as five novel mutations at other domains. MFN2 mutations made up 5.9% of total CMT families, whereas 22.9% in CMT2 families, of which 27.8% occurred de novo. Interestingly, patient phenotypes ranged from mild to severe even for the same mutation, suggesting other factors influenced phenotype and penetrance. This CMT2A cohort study will be useful for molecular diagnosis and treatment of axonal neuropathy.

Posterior Communicating Artery Compromise in Coil Embolization of Posterior Communicating Artery Aneurysms.

PURPOSE: Whether the posterior communicating artery (PcomA) can be safely compromised during endovascular treatment of a PcomA aneurysm is a matter of debate. Here we present clinical and radiologic outcomes, given this scenario. METHODS: From data prospectively accrued between January 2004 and December 2012, records of 44 patients harboring 46 PcomA aneurysms were retrieved. All had suffered PcomA compromise in the course of endovascular coil embolization. Patients/aneurysms were stratified into those with complete (Group A) and incomplete (Group B) compromise depending on the degree of PcomA flow limitation documented by postembolization ipsilateral internal carotid artery angiography. Clinical and radiologic outcomes were accordingly assessed. RESULTS: All affected vessels were hypoplastic PcomA variants (PcomA/P1 ratio, ≤ 1.0), with exception of a single dominant PcomA (PcomA/P1 ratio, 1.1). In Group A (23 patients, 23 aneurysms), no PcomA compromise-related infarction was evident, whereas in Group B (21 patients, 23 aneurysms), two ischemic events occurred. One patient suffered thalamic infarction, although patency of the PcomA was adequate in a follow-up angiogram, and another experienced a transient ischemic attack. CONCLUSION: Our findings suggest that obstructed flow in hypoplastic PcomA variants during coil embolization of PcomA aneurysms carries no major consequence. However, incomplete compromise of the PcomA may be a source of delayed thromboembolic infarction.

Endovascular treatment of ophthalmic artery aneurysms: assessing balloon test occlusion and preservation of vision in coil embolization.

BACKGROUND AND PURPOSE: ICA-ophthalmic artery aneurysms have unique configurations corresponding to relative risks of ophthalmologic morbidities. Presented herein are clinical and radiologic outcomes of coil embolization in ophthalmic artery aneurysms. MATERIALS AND METHODS: From January 2003 to September 2013, endovascular coiling was performed in 43 consecutive patients with ophthalmic artery aneurysms, each classified by the degree to which the ophthalmic artery was incorporated by the aneurysm and the contiguity between the ophthalmic artery entry and parent ICA. Clinical and radiologic outcomes of this approach were investigated, including the technical aspects of treatment and the efficacy of balloon test occlusion. RESULTS: Among 14 patients (32.6%, all ophthalmic artery types) undergoing balloon test occlusion before endovascular coiling, patent collaterals between the external carotid artery and ophthalmic artery were demonstrated in 12 (85.7%) and complete compromise of the ophthalmic artery (without affecting vision) occurred in 4 patients during coiling. Steam-shaped S-configured (67.9%) or straight microcatheters (17.8%) facilitated aneurysm selection in most of the superiorly directed ophthalmic artery aneurysms (n = 28), and steam-shaped pigtail microcatheters (85.7%) were useful in medially directed aneurysms (n = 14). Balloon protection (n = 22) was generally used to facilitate coiling, or a stent (n = 9) was alternatively deployed. Satisfactory aneurysmal occlusion was achieved through coil embolization in 37 lesions (86.1%). During follow-up of 35 patients (mean interval, 12.9 ± 9.4 months), only 1 instance (2.9%) of major recanalization was observed. CONCLUSIONS: If one tailors technical strategies, ophthalmic artery aneurysms are amenable to safe and effective endovascular coil embolization, which tends to be stable in follow-up. Balloon test occlusion may be helpful in devising treatment strategies to preserve vision when coiling ophthalmic artery aneurysms (especially those incorporating an ophthalmic artery origin) is done.

Glioma: Application of histogram analysis of pharmacokinetic parameters from T1-weighted dynamic contrast-enhanced MR imaging to tumor grading.

BACKGROUND AND PURPOSE: The usefulness of pharmacokinetic parameters for glioma grading has been reported based on the perfusion data from parts of entire-tumor volumes. However, the perfusion values may not reflect the entire-tumor characteristics. Our aim was to investigate the feasibility of glioma grading by using histogram analyses of pharmacokinetic parameters including the volume transfer constant, extravascular extracellular space volume per unit volume of tissue, and blood plasma volume per unit volume of tissue from T1-weighted dynamic contrast-enhanced perfusion MR imaging. MATERIALS AND METHODS: Twenty-eight patients (14 men, 14 women; mean age, 49.75 years; age range, 25-72 years) with histopathologically confirmed gliomas (World Health Organization grade II, n = 7; grade III, n = 8; grade IV, n = 13) were examined before surgery or biopsy with conventional MR imaging and T1-weighted dynamic contrast-enhanced perfusion MR imaging at 3T. Volume transfer constant, extravascular extracellular space volume per unit volume of tissue, and blood plasma volume per unit volume of tissue were calculated from the entire-tumor volume. Histogram analyses from these parameters were correlated with glioma grades. The parameters with the best percentile from cumulative histograms were identified by analysis of the area under the curve of the receiver operating characteristic analysis and were compared by using multivariable stepwise logistic regression analysis for distinguishing high- from low-grade gliomas. RESULTS: All parametric values increased with increasing glioma grade. There were significant differences among the 3 grades in all parameters (P < .01). For the differentiation of high- and low-grade gliomas, the highest area under the curve values were found at the 98th percentile of the volume transfer constant (area under the curve, 0.912; cutoff value, 0.277), the 90th percentile of extravascular extracellular space volume per unit volume of tissue (area under the curve, 0.939; cutoff value, 19.70), and the 84th percentile of blood plasma volume per unit volume of tissue (area under the curve, 0.769; cutoff value, 11.71). The 98th percentile volume transfer constant value was the only variable that could be used to independently differentiate high- and low-grade gliomas in multivariable stepwise logistic regression analysis. CONCLUSIONS: Histogram analysis of pharmacokinetic parameters from whole-tumor volume data can be a useful method for glioma grading. The 98th percentile value of the volume transfer constant was the most significant measure.

Short communication: Genetic characterization of antimicrobial resistance in Acinetobacter isolates recovered from bulk tank milk.

A total of 176 Acinetobacter isolates, including 57 Acinetobacter baumannii originally obtained from 2,287 bulk tank milk (BTM) samples in Korea was investigated for the genetic basis of antimicrobial resistance using molecular methods. In addition, the occurrence and cassette content of integrons were examined and the genetic diversity of A. baumannii strains identified was evaluated. Aminoglycoside-modifying enzyme genes were detected in 15 (88.2%) of the 17 aminoglycoside-resistant Acinetobacter isolates tested. The most common aminoglycoside-modifying enzyme gene identified was adenylyltransferase gene aadB (n = 9), followed by phosphotransferase genes aphA6 (n = 7) and aphA1 (n = 5). Of the 31 isolates resistant to tetracycline, tet(39) was detected in 20 of them. The genetic basis of resistance to sulfonamide was identified in 15 (53.6%) of 28 trimethoprim-sulfamethoxazole-resistant isolates and 9 (32.1%) of them carried both sul1 and sul2 genes. A blaADC-7-like gene was detected in 1 ß-lactam-resistant A. baumannii. Furthermore, class 1 integron was identified in 11 Acinetobacter isolates. Two gene cassettes dfrA15, conferring resistance to trimethoprim, and aadA2, conferring resistance to aminoglycosides, were identified in 8 Acinetobacter isolates. None of the isolates was positive for class 2 or class 3 integrons. Pulsed-field gel electrophoresis revealed that most of the A. baumannii strains from BTM samples were genetically diverse, indicating that the occurrence of A. baumannii strains in BTM was not the result of dissemination of a single clone. Elucidation of resistance mechanisms associated with the resistance phenotype and a better understanding of resistance genes may help in the development of strategies to control infections, such as mastitis, and to prevent further dissemination of antibiotic resistance genes. To the best of our knowledge, this is the first report of molecular characterization of antimicrobial-resistant Acinetobacter spp. from milk.