Comparison of hemostatic efficacy and cytotoxicity of three ferric subsulfate- and chitosan-based styptics in different formulations using a rat tail bleeding model

This study was conducted to compare the hemostatic efficacy of three ferric subsulfate- and chitosan-based styptics as a powder and a gel containing ferric subsulfate and chitosan (FSC-PO and FSC-G, respectively) and a soaked pad containing ferric subsulfate and lidocaine (FSL-SP) using a rat tail bleeding model. The cytotoxicity of the styptics against L-929 mouse fibroblasts was also evaluated using a cell counting kit-8 assay. Four groups of 10 rats each were assigned to the three different styptics and a non-treated control groups. Rat tail tips were transected, after which styptics were applied with pressure. The wounds were observed for hemostasis for 3 min, then irrigated with saline to check for recurrent hemorrhage. L-929 mouse fibroblasts were exposed to extracts of the styptics (100 mg/mL) and their dilutions (1:10, 1:100, and 1:1,000). FSC-PO and FSC-G more effectively controlled initial hemorrhage than FSL-SP (p = 0.033). Additionally, FSC-PO and FSC-G more effectively maintained hemostasis than the control group (p = 0.02 and p < 0.01, respectively). However, all styptics showed enhanced cytotoxicity against L-929 cells in a dose-dependent manner. Therefore, although FSC-PO and FSC-G would be recommended to control hemorrhage, the benefits of styptics must be balanced against the clinical significance of their cytotoxicity.

Comparison of hemostatic efficacy and cytotoxicity of three ferric subsulfate- and chitosan-based styptics in different formulations using a rat tail bleeding model / 대한수의학회지

This study was conducted to compare the hemostatic efficacy of three ferric subsulfate- and chitosan-based styptics as a powder and a gel containing ferric subsulfate and chitosan (FSC-PO and FSC-G, respectively) and a soaked pad containing ferric subsulfate and lidocaine (FSL-SP) using a rat tail bleeding model. The cytotoxicity of the styptics against L-929 mouse fibroblasts was also evaluated using a cell counting kit-8 assay. Four groups of 10 rats each were assigned to the three different styptics and a non-treated control groups. Rat tail tips were transected, after which styptics were applied with pressure. The wounds were observed for hemostasis for 3 min, then irrigated with saline to check for recurrent hemorrhage. L-929 mouse fibroblasts were exposed to extracts of the styptics (100 mg/mL) and their dilutions (1:10, 1:100, and 1:1,000). FSC-PO and FSC-G more effectively controlled initial hemorrhage than FSL-SP (p = 0.033). Additionally, FSC-PO and FSC-G more effectively maintained hemostasis than the control group (p = 0.02 and p < 0.01, respectively). However, all styptics showed enhanced cytotoxicity against L-929 cells in a dose-dependent manner. Therefore, although FSC-PO and FSC-G would be recommended to control hemorrhage, the benefits of styptics must be balanced against the clinical significance of their cytotoxicity.

Sterile Pyometra in Two Dogs

Two young dogs were referred to the Veterinary Medical Teaching Hospital of Konkuk University, one for examination of vaginal discharge and the other after being hit by a car. Dog 1 exhibited a high neutrophil count on Gram-stained vaginal smears, marked leukocytosis on a complete blood count, and uterine enlargement on ultrasonography. In dog 2, a markedly enlarged right uterine horn containing echogenic debris was found incidentally on ultrasonography. A tentative diagnosis of pyometra was made in both cases and ovariohysterectomy was performed. Purulent material was collected from each uterine horn and submitted separately for aerobic and anaerobic bacterial culture; all culture results were negative. The white blood cell count revealed normal limits 2 days post operation in dog 1 and 4 days post operation in dog 2. Positive bacterial cultures are usually obtained from dogs with pyometra, and antibiotic selection is based on the results of culture and sensitivity testing in the event of failure of empiric antibiotic therapy. However, in the cases reported here, no bacterial growth was identified from the uterine samples despite the presence of purulent material. A short course of empiric antibiotic therapy was administered. This is the first known report describing sterile pyometra in dogs.

The Imaging Features of Desmoid Tumors: the Usefulness of Diffusion Weighted Imaging to Differentiate between Desmoid and Malignant Soft Tissue Tumors

PURPOSE: To evaluate the imaging findings of desmoid tumors using various imaging modalities and to evaluate whether diffusion-weighted imaging (DWI) can help differentiate between desmoid and malignant tumors. MATERIALS AND METHODS: The study included 27 patients with pathologically confirmed desmoid tumors. Two radiologists reviewed 23 computed tomography (CT), 12 magnetic resonance imaging (MRI) and 8 positron emission tomography-computed tomography (PET-CT) scans of desmoid tumors and recorded data regarding the shape, multiplicity, size, location, degree of enhancement, and presence or absence of calcification or hemorrhage. The signal intensity of masses on T1- and T2-weighted imaging and the presence or absence of whirling or band-like low signal intensity on T2-weighted imaging were recorded. The apparent diffusion coefficient (ADC) values of the desmoid tumors in nine patients with DWIs were compared with the ADC values of 32 malignant tumors. The maximum standardized uptake value (SUV(max)) on PET-CT images was measured in 8 patients who underwent a PET-CT. RESULTS: The mean size of the 27 tumors was 6.77 cm (range, 2.5-26 cm) and four tumors exhibited multiplicity. The desmoid tumors were classified by shape as either mass forming (n = 18), infiltrative (n = 4), or combined (n = 5). The location of the tumors was either intra-abdominal (n = 15), within the abdominal wall (n = 8) or extra-abdominal (n = 4). Among the 27 tumors, 21 showed moderate to marked enhancement and 22 showed homogeneous enhancement. Two tumors showed calcifications and one displayed hemorrhage. Eleven of the 12 MR T2-weighted images showed whirling or band-like low signal intensity areas in the mass. The mean ADC value of the desmoid tumors (1493 × 10⁻⁶ mm²/s) was significantly higher than the mean of the malignant soft tissue tumors (873 × 10⁻⁶ mm²/s, P < 0.001). On the PET-CT images, all tumors exhibited an intermediate SUV(max) (mean, 3.7; range, 2.3–4.5). CONCLUSION: Desmoids tumors showed homogenous, moderate to marked enhancement on CT and MRI scans and a characteristic whirling or band-like pattern on T2-weighted images. DWI can be useful for the differentiation of desmoid tumors from malignant soft tissue tumors.

A standardization model based on image recognition for performance evaluation of an oral scanner

PURPOSE: Accurate information is essential in dentistry. The image information of missing teeth is used in optically based medical equipment in prosthodontic treatment. To evaluate oral scanners, the standardized model was examined from cases of image recognition errors of linear discriminant analysis (LDA), and a model that combines the variables with reference to ISO 12836:2015 was designed. MATERIALS AND METHODS: The basic model was fabricated by applying 4 factors to the tooth profile (chamfer, groove, curve, and square) and the bottom surface. Photo-type and video-type scanners were used to analyze 3D images after image capture. The scans were performed several times according to the prescribed sequence to distinguish the model from the one that did not form, and the results confirmed it to be the best. RESULTS: In the case of the initial basic model, a 3D shape could not be obtained by scanning even if several shots were taken. Subsequently, the recognition rate of the image was improved with every variable factor, and the difference depends on the tooth profile and the pattern of the floor surface. CONCLUSION: Based on the recognition error of the LDA, the recognition rate decreases when the model has a similar pattern. Therefore, to obtain the accurate 3D data, the difference of each class needs to be provided when developing a standardized model.

Factors Related to Radiation Exposure during Lumbar Spine Intervention

Fluoroscopy guidance is useful to confirm anatomical landmark and needle location for spine intervention; however, it can lead to radiation exposure in patients, physicians, and medical staff. Physicians who used fluoroscopy should be cognizant of radiation exposure and intend to minimize radiation dose. We retrospectively reviewed three lumbar spine intervention procedures (nerve root block, medial branch block, and facet joint block) at our institution between June and December, 2014. We performed 268 procedures on 220 patients and found significant difference in radiation dose between two groups classified by performing physicians. The physician who controlled the fluoroscopy unit directly used significantly shorter fluoroscopy (6 seconds) that resulted in a smaller radiation dose (dose area product [DAP] 0.59 Gy.cm2) than the physician supervising the radiographer controlling the fluoroscopy unit (72 seconds, DAP 5.31 Gy.cm2, P < 0.001). The analysis indicates that the difference in fluoroscopy time depends on whether a physician or a radiographer controls the fluoroscopy unit.

Differentiation of benign and malignant thyroid nodules based on the proportion of sponge-like areas on ultrasonography: imaging-pathologic correlation

PURPOSE: The purpose of this study was to determine whether it is possible to differentiate benign from malignant thyroid nodules according to the proportion of sponge-like appearance within the nodules. METHODS: A total of 201 thyroid nodules containing sponge-like appearance from 195 patients (157 women and 38 men) were included this study. Each thyroid nodule was classified into one of three grades by real-time ultrasonography (US) based on the areas with a sponge-like appearance within nodule: grade I had sponge-like areas occupying 75%. We evaluated whether a correlation existed between these grades and cytopathologic diagnoses. RESULTS: Of the 201 nodules, 196 were benign and five were malignant, and according to the US classification, 101 nodules were grade I, 45 were grade II, and 55 were grade III. Of the five malignant nodules, four were grade I, and one was grade II. No statistically significant difference was found in the rate of malignancy between grade III and grades I and II, due to insufficient statistical power. A sponge-like appearance was correlated with follicles filled with colloid and cholesterol granules in benign nodules and with papillary fronds around the dilated cystic spaces in malignant nodules. CONCLUSION: No malignancies were found in thyroid nodules with >75% sponge-like appearance. Due to the overall low incidence of malignancy and the limited number of patients, a statistically significant difference could not be found in the prevalence of malignancy depending on the proportion of sponge-like areas within the nodule.

Intra- and interobserver reliability of gray scale/dynamic range evaluation of ultrasonography using a standardized phantom

PURPOSE: To evaluate intra- and interobserver reliability of the gray scale/dynamic range of the phantom image evaluation of ultrasonography using a standardized phantom, and to assess the effect of interactive education on the reliability. METHODS: Three radiologists (a resident, and two board-certified radiologists with 2 and 7 years of experience in evaluating ultrasound phantom images) performed the gray scale/dynamic range test for an ultrasound machine using a standardized phantom. They scored the number of visible cylindrical structures of varying degrees of brightness and made a 'pass or fail' decision. First, they scored 49 phantom images twice from a 2010 survey with limited knowledge of phantom images. After this, the radiologists underwent two hours of interactive education for the phantom images and scored another 91 phantom images from a 2011 survey twice. Intra- and interobserver reliability before and after the interactive education session were analyzed using K analyses. RESULTS: Before education, the K-value for intraobserver reliability for the radiologist with 7 years of experience, 2 years of experience, and the resident was 0.386, 0.469, and 0.465, respectively. After education, the K-values were improved (0.823, 0.611, and 0.711, respectively). For interobserver reliability, the K-value was also better after the education for the 3 participants (0.067, 0.002, and 0.547 before education; 0.635, 0.667, and 0.616 after education, respectively). CONCLUSION: The intra- and interobserver reliability of the gray scale/dynamic range was fair to substantial. Interactive education can improve reliability. For more reliable results, double-checking of phantom images by multiple reviewers is recommended.

MR Imaging Findings of Extraovarian Endocervical Mucinous Borderline Tumors Arising from Pelvic Endometriosis

We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.

CT and MR Imaging Findings of Lymphangioleiomyomatosis Involving the Uterus and Pelvic Cavity

Lymphangioleiomyomatosis (LAM) is a rare idiopathic disease and this is characterized by a proliferation of abnormal smooth muscle cells in the lungs and in the lymphatic system of the thorax and retroperitoneum. The female genital tract is rarely affected by LAM. We report here on the CT and MR imaging findings of extensive LAM involving the uterus and pelvic cavity, and this was seen as multiple cystic uterine and parauterine masses with internal hemorrhage in a young female with tuberous sclerosis complex.