Current Landscape and Future Perspectives of Abbreviated MRI for Hepatocellular Carcinoma Surveillance

While ultrasound (US) is considered an important tool for hepatocellular carcinoma (HCC) surveillance, it has limited sensitivity for detecting early-stage HCC. Abbreviated MRI (AMRI) has recently gained popularity owing to better sensitivity in its detection of early-stage HCC than US, while also minimizing the time and cost in comparison to complete contrast-enhanced MRI, as AMRI includes only a few essential sequences tailored for detecting HCC. Currently, three AMRI protocols exist, namely gadoxetic acid-enhanced hepatobiliary-phase AMRI, dynamic contrast-enhanced AMRI, and non-enhanced AMRI. In this study, we discussed the rationale and technical details of AMRI techniques for achieving optimal surveillance performance. The strengths, weaknesses, and current issues of each AMRI protocol were also elucidated. Moreover, we scrutinized previously performed AMRI studies regarding clinical and technical factors. Reporting and recall strategies were discussed while considering the differences in AMRI protocols. A risk-stratified approach for the target population should be taken to maximize the benefits of AMRI and the cost-effectiveness should be considered. In the era of multiple HCC surveillance tools, patients need to be fully informed about their choices for better adherence to a surveillance program.     

Effects of deoxynivalenol (vomitoxin) on the humoral and cellular immunity of mice

Sublethal doses (0.00, 0.25, 0.50 and 1.00 mg/kg b.w./day) of vomitoxin (deoxynivalenol; DON) were studied for their effects on humoral and cellular immunity and serum proteins of inbred, male Swiss Webster mice in a series of 4 separate experiments. Vomitoxin was added to basal diet (less than the detection limit, i.e., less than 0.05 micrograms of vomitoxin per g of feed) and administered to mice for 5 weeks beginning at 21 days of age. Mice in experiment 2 were fed the basal diet for 40 days in addition to the 5-week treatment with vomitoxin. The 1.00 mg/kg dose of vomitoxin resulted in a statistically significant reduction in the serum levels of alpha 1 and alpha 2-globulins, an increase in total serum albumin, and a reduction in feed consumption and body weight gain compared to the control group. The 0.50 mg/kg dose of vomitoxin resulted in significantly reduced serum levels of alpha 2- and beta-globulins while a significant reduction of feed consumption was evident only during Week 4. Similarly, body weight gain in this group of mice was significantly reduced during Week 2 but increased to normal levels during Week 3 and remained parallel to the control for Week 4 and 5. Both levels (0.50 and 1.00 mg/kg) of vomitoxin resulted in a reduced, dose-related, time-to-death interval following a challenge with L. monocytogenes and increased proliferative capacity of splenic lymphocyte cultures stimulated with the phytohemagglutinin P (PHA-P) mitogen compared to the control group of mice. The 0.25 mg/kg dose of vomitoxin did not have any significant effects on the parameters studied. A reasonable estimation of a 'no effect' level for immunologic effects in mice based on these and previous immunological studies would seem to be between 0.25 and 0.50 mg/kg b.w./day.     

Phenotype of Asthma-COPD Overlap in COPD and Severe Asthma Cohorts

BackgroundAsthma and chronic obstructive pulmonary disease (COPD) are airway diseases with similar clinical manifestations, despite differences in pathophysiology. Asthma-COPD overlap (ACO) is a condition characterized by overlapping clinical features of both diseases. There have been few reports regarding the prevalence of ACO in COPD and severe asthma cohorts. ACO is heterogeneous; patients can be classified on the basis of phenotype differences. This study was performed to analyze the prevalence of ACO in COPD and severe asthma cohorts. In addition, this study compared baseline characteristics among ACO patients according to phenotype.MethodsPatients with COPD were prospectively enrolled into the Korean COPD subgroup study (KOCOSS) cohort. Patients with severe asthma were prospectively enrolled into the Korean Severe Asthma Registry (KoSAR). ACO was defined in accordance with the updated Spanish criteria. In the COPD cohort, ACO was defined as bronchodilator response (BDR) ≥ 15% and ≥ 400 mL from baseline or blood eosinophil count (BEC) ≥ 300 cells/μL. In the severe asthma cohort, ACO was defined as age ≥ 35 years, smoking ≥ 10 pack-years, and post-bronchodilator forced expiratory volume in 1 s/forced vital capacity < 0.7. Patients with ACO were divided into four groups according to smoking history (threshold: 20 pack-years) and BEC (threshold: 300 cells/μL).ResultsThe prevalence of ACO significantly differed between the COPD and severe asthma cohorts (19.8% [365/1,839] vs. 12.5% [104/832], respectively; P < 0.001). The percentage of patients in each group was as follows: group A (light smoker with high BEC) – 9.1%; group B (light smoker with low BEC) – 3.7%; group C (moderate to heavy smoker with high BEC) – 73.8%; and group D (moderate to heavy smoker with low BEC) – 13.4%. Moderate to heavy smoker with high BEC group was oldest, and showed weak BDR response. Age, sex, BDR, comorbidities, and medications significantly differed among the four groups.ConclusionThe prevalence of ACO differed between COPD and severe asthma cohorts. ACO patients can be classified into four phenotype groups, such that each phenotype exhibits distinct characteristics.     

胸腺瘤合并重症肌无力危象30例围手术期的处理

0引言 胸腺切除是治疗重症肌无力(MG)的有效方法,有效率可达80%[1],但胸腺瘤术后常并发MG危象,导致死亡. 1992 02/2003 02我们共手术治疗89例胸腺瘤合并MG患者,术后发生MG 危象 30例,均抢救成功,无围手术期死亡.     

Effect of Surface Modification for Carbon Cathode Materials on Charge–Discharge Performance of Li-Air Batteries

Li-air batteries have attracted considerable attention as rechargeable secondary batteries with a high theoretical energy density of 11,400 kWh/g. However, the commercial application of Li-air batteries is hindered by issues such as low energy efficiency and a short lifetime (cycle numbers). To overcome these issues, it is important to select appropriate cathode materials that facilitate high battery performance. Carbon materials are expected to be ideal materials for cathodes due to their high electrical conductivity and porosity. The physicochemical properties of carbon materials are known to affect the performance of Li-air batteries because the redox reaction of oxygen, which is an important reaction for determining the performance of Li-air batteries, occurs on the carbon materials. In this study, we evaluated the effect of the surface modification of carbon cathode materials on the charge–discharge performance of Li-air batteries using commercial Ketjenblack (KB) and KB subjected to vacuum ultraviolet (VUV) irradiation as cathodes. The surface wettability of KB changed from hydrophobic to hydrophilic as a result of the VUV irradiation. The ratio of COOH and OH groups on the KB surface increased after VUV irradiation. Raman spectra demonstrated that no structural change in the KB before and after VUV irradiation was observed. The charge and discharge capacities of a Li-air battery using VUV-irradiated KB as the cathode decreased compared to original KB, whereas the cycling performance of the Li-air battery improved considerably. The sizes and shapes of the discharge products formed on the cathodes changed considerably due to the VUV irradiation. The difference in the cycling performance of the Li-air battery was discussed from the viewpoint of the chemical properties of KB and VUV-irradiated KB.     

Association between weight status and recreational drug abuse in Korean adolescents

The purpose of this study was to investigate the relationship between weight status and recreational drug use in Korean adolescents. A total of 72,399 adolescent students (38,152 boys and 34,247 girls) from the middle first to high third grade participated in the 5^th Korea Youth Risk Behaviour Web-based Survey (KYRBWS-V) project in 2009. They were assessed for body mass index (BMI) and recreational drug abuse. The associations between BMI and recreational drug use were examined using multivariable logistic regression analysis after adjusting for the covariate variables of age, smoking frequency and cigarette consumption, frequency of alcohol consumption and severe alcohol intoxication, amount of alcohol consumed, parents’ education level, economic status, sedentary activities during the week, mental stress, sleep duration, frequency of vigorous and moderate physical activities, and muscular strength exercises during the week. For boys, the odds ratio (OR) (95% confidence interval [CI]) between overweight and drug use were 0.990 (0.723–1.356; p = 0.950) for almost none, 0.939 (0.521–1.693; p = 0.834) for past use, and 0.791 (0.385–1.624; p = 0.523) for present use. The OR (95% CI) between obesity and drug use was 0.731(0.508–1.052; p = 0.091) for almost none, 0.755 (0.389–1.465; p = 0.407) for past use, and 0.701 (0.314–1.565; p = 0.386) for present use. For girls, the OR (95% CI) between overweight and drug use was 1.112 (0.702–1.763; p = 0.650) for almost none, 1.103 (0.464–2.619; p = 0.825) for past use, and 0.927 (0.267–3.218; p = 0.905) for present use. The OR (95% CI) between obesity and drug abuse was 0.594 (0.261–1.352; p = 0.215) for almost none, 1.318 (0.462–3.764; p = 606) for past use, and <0.001(<0.001–<0.001; p = 0.998) for present use. We concluded that recreational drug use had no correlation with overweight and obesity in Korean adolescents.