Shear Wave Liver Elastography with a Propagation Map: Diagnostic Performance and Inter-Observer Correlation for Hepatic Fibrosis in Chronic Hepatitis

The aim of this study was to determine the performance of shear wave elastography (SWE) with a propagation map in the diagnosis of hepatic fibrosis, and to assess its reliability with transient elastography (TE) as the reference standard. Our prospective study included 115 consecutive patients with suspected or alleged chronic hepatitis. Patients underwent SWE by two different operators and TE by sonographers on the same day. The correlation coefficient of the intra-class correlation test between an experienced radiologist and a third-year radiology resident was 0.878. There was a moderate correlation between SWE and TE (r = 0.511) in the diagnosis of hepatic fibrosis. The best cutoff values predicting significant hepatic fibrosis and liver cirrhosis by SWE were >1.78 m/s (area under the receiver operating characteristic curve [AUROC] = 0.777) and >2.24 m/s (AUROC = 0.935), respectively. SWE with a propagation map is a reliable method for predicting hepatic fibrosis regardless of operator experience.     

Efficacy of Superb Microvascular Imaging for Diagnosing Acute Cholecystitis: Comparison with Conventional Ultrasonography

We evaluated the diagnostic performance of ultrasonography (US) plus superb microvascular imaging (SMI) compared with conventional US alone for diagnosing acute cholecystitis. We included 54 patients with suspected biliary disease. The SMI pixel count showing flow signal was measured in the region of interest of the gallbladder bed of the liver. Two radiologists independently evaluated imaging features and rated five-point diagnostic likelihood level before versus after the additional SMI using the cutoff SMI pixel count. The SMI pixel count was significantly higher in acute than in non-acute cholecystitis (169.84 vs. 27.48, p < 0.001). The optimal SMI cutoff pixel count for predicting acute cholecystitis obtained by receiver operating characteristic curve was 56.67(82.8% sensitivity, 92.0% specificity). The area under the curve value was significantly higher after the additional SMI than before (0.798–0.863 vs. 0.701–0.736, p < 0.05). US plus SMI could objectively improve diagnostic performance compared with conventional US for acute cholecystitis.     

Mucosal melanoma arising in the eustachian tube

Mucosal melanoma is a very rare disease. Most cases have their origins in the head and neck region. To date,only three cases of melanoma originating from the eustachian tube have been reported. We present a case of mucosal melanoma of eustachian tube origin in which a complete excision was performed. In this case, the patient underwent adjuvant radiotherapy and the mass size greatly decreased, which aided subsequent surgical excision. Systemic chemotherapy was not utilized in this case; however, it is often used for palliative purposes. A literature review is also presented.     

Prevalence and risk indicators of oral mucosal lesions in an urban population from South Brazil

Oral Diseases (2011) 17 , 171–179 Objective: The objective of the study was to assess the prevalence of oral mucosal lesions (OML) and to perform a multivariable risk assessment of demographic, socioeconomic, behavioral, and oral risk indicators for its occurrence in an urban population in South Brazil. Methods: This cross‐sectional study selected 1586 subjects (719M/867F, age: 14–104 years) using a multistage probability sampling strategy (65.1% response rate). Prevalence, odds ratios (OR), and confidence intervals (95% CI) were calculated accounting for the survey design. Results: Leukoplakia and lichen planus were observed in 1.01% and 1.02% of subjects, respectively. In the multivariable analysis, these lesions were significantly associated with moderate/heavy smoking (OR = 9.0, 95% CI = 2.1–39.1) and heavy drinking (OR = 2.0, 95% CI = 1.1–3.7). Candidiasis and proliferative lesions were observed in 14.09% and 3.80% of the subjects, respectively. These lesions were significantly associated with female gender (OR = 2.2, 95% CI = 1.5–3.2 and OR = 1.7, 95% CI = 1.0–2.8), older age (OR = 22, 95% CI = 8.0–60.8 and OR = 8.9, 95% CI = 3.4–23.7), and low socioeconomic status (OR = 1.9, 95% CI = 1.0–3.5 and OR = 3.0, 95% CI = 1.2–7.2). Conclusions: This population is in need of OML prevention and treatment. Future studies should validate the findings that premalignant lesions are causally related to smoking and alcohol consumption, and that other OML are associated with socioeconomic‐demographic disparities in this and similar populations.     

Microfluidics for Mammalian Cell Chemotaxis

The emerging field of micro-technology has opened up new possibilities for exploring cellular chemotaxis in real space and time, and at single cell resolution. Chemotactic cells sense and move in response to chemical gradients and play important roles in a number of physiological and pathological processes, including development, immune responses, and tumor cell invasions. Due to the size proximity of the microfluidic device to cells, microfluidic chemotaxis devices advance the traditional macro-scale chemotaxis assays in two major directions: one is to build well defined and stable chemical gradients at cellular length scales, and the other is to provide a platform for quantifying cellular responses at both cellular and molecular levels using advanced optical imaging systems. Here, we present a critical review on the designing principles, recent development, and potential capabilities of the microfluidic chemotaxis assay for solving problems that are of importance in the biomedical engineering field.     

Spontaneous diaphragmatic rupture after vomiting: rapid diagnosis on multiplanar reformatted multidetector CT

Spontaneous rupture of the diaphragm is an extremely rare condition. We report a case of spontaneous rupture of the diaphragm that was caused by violent vomiting and immediately diagnosed by the imaging features before the operation. If there is a mass with an air-fluid level adjacent to the diaphragm on the chest radiograph in a patient who presents with sudden chest pain after violent vomiting, spontaneous rupture of the diaphragm should be suspected and multidetector CT with multiplanar reformatted images should be immediately performed.