M Kim

Relative accuracy of CT and MRI in the differentiation of benign from malignant pancreatic cystic lesions.

AIMS To assess the diagnostic accuracies of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for differentiating benign from malignant lesions and suggesting the specific diagnoses for pancreatic cystic lesions, and to assess whether review of both MDCT and MRI is beneficial. MATERIALS AND METHODS Patients with various neoplastic and non-neoplastic pancreatic cystic lesions that were identifiable by biopsy or surgery, who underwent both MRI and MDCT (n=63), were retrospectively reviewed by three reviewers. The likelihood of malignancy was recorded on a five-point scale, and a specific diagnosis was given. ROC analysis was performed and the sensitivity, specificity for the characterization of malignancy, and the accuracy of specific diagnoses were calculated. RESULTS MDCT and MRI yielded comparable results for the characterization of malignancy (Az: 0.639, 0.735, 0.806 for MDCT and 0.732, 0.753, 0.792 for MRI, for each reviewer). The accuracies of specific diagnosis based on MDCT or MRI were 61.9 versus 55.6% for reviewer 1; 76.2 versus 76.2% for reviewer 2; and 65.1 versus 61.9% for reviewer 3. There was a trend toward better prediction of malignancy (Az: 0.787, 0.745, 0.849 for each reviewer), and better accuracy in suggesting a specific diagnosis (77.8, 73, and 73% for each reviewer) for MDCT+MRI over MDCT or MRI alone, although it was statistically significant for one reviewer in the comparison of MDCT versus MDCT+MRI for the prediction of malignancy, and MRI versus MDCT for suggesting a specific diagnosis. CONCLUSIONS MDCT and MRI have equivalent accuracy for characterizing pancreatic cystic lesions as benign or malignant, and suggesting a specific diagnosis. Combined review of MDCT and MRI was not significantly better but may have the potential to improve diagnostic accuracy in equivocal cases.

Novel cosmetic patches for wrinkle improvement: retinyl retinoate- and ascorbic acid-loaded dissolving microneedles.

To evaluate wrinkle improvement and safety of a novel cosmetic dissolving microneedle patches loaded with two active compounds with different hydrophilicities, namely ascorbic acid and retinyl retinoate.

Gallbladder lymphangioma: MR findings

Intraabdominal lymphangiomas are rare lesions that can be difficult to diagnose. We report ultrasonographic (US), computed tomographic (CT), magnetic resonance (MR) imaging, and pathologic findings in a patient with cavernous lymphangioma originating in the gallbladder. US and CT showed a multiseptated cystic mass in the gallbladder fossa. T2-weighted MR images and MR cholangiopancreatography depicted the lumen of the gallbladder and thin septations of the cystic mass, which originated in the gallbladder. Endoscopic retrograde cholangiopancreatography showed no apparent communication between the cyst and the gallbladder. Histologic findings obtained during the operation were consistent with cavernous lymphangioma. Its characteristic histology was observed in the subserosal layer of the gallbladder. This case is a rare instance of cavernous lymphangioma originating in the gallbladder preoperatively diagnosed by MR and MR cholangiopancreatography.

Hepatocellular carcinoma: contrast-enhanced MRI.

It has been observed that hepatocellular carcinomas (HCCs) can differ in signal intensity on T1and T2weighted images [1–3]. The problem of limited spatial resolution of magnetic resonance imaging (MRI) needs to be solved for assessment of small lesions with low lesionto-liver contrast. To overcome the limitation of static MRI of the liver, various contrast agents have been designed to enhance the lesion-to-liver contrast for lesion detection and detailed characterization of focal lesions. This review briefly describes the recently developed, clinically available, liver-specific, contrast agents in addition to the use of dynamic MRI with nonspecific extracellular fluid space agents for the diagnostic assessment of HCCs.

Evaluation of the anti-wrinkle effect of an ascorbic acid-loaded dissolving microneedle patch via a double-blind, placebo-controlled clinical study.

Although an ascorbic acid‐loaded dissolving microneedle patch has been developed to improve anti‐wrinkle effects, an efficacy evaluation with a control group has not yet been performed. In this study, the anti‐wrinkle effect of an ascorbic acid‐loaded dissolving microneedle patch was evaluated in a double‐blind clinical study with a control group. In addition, a cumulative skin irritation and sensitization potential of the ascorbic acid‐loaded dissolving microneedle patch was performed.

Outcomes of surgery in children with early-onset exotropia

ObjectiveTo evaluate the clinical characteristics and surgical outcomes of early-onset exotropia and to compare differences between constant and intermittent exotropia at presentation.MethodsThe medical records of 45 exotropia patients with a reported onset before 1 year of age who were operated on between 2008 and 2011 were reviewed, and the clinical characteristics and surgical outcomes of these patients were analyzed retrospectively. Patients were then divided into two groups according to type of exotropia at presentation: a constant (XT) group and an intermittent (X(T)) group. Clinical features and surgical results of exotropia were then compared between these two groups.ResultsThe mean age of onset of exodeviation in 45 patients was 9.3±3.8 months. Mean age at surgery was 4.5±2.4 years, and the mean postoperative follow-up period was 17.3 months (range, 6–37 months). Of the 45 patients, 67% showed alignment of less than±10 prism diopters (PD) at final visit. Gross stereopsis was achieved in all 34 testable patients, and bifixation developed in 10 patients (29%). Eleven patients were included in XT group and 34 patients in X(T) group. No significant intergroup difference was found between surgical success rates and binocularities.ConclusionSurgical outcomes, both motor and sensory, were not poor in early-onset exotropia patients, even in patients with constant deviation. Good binocular results following surgery can be achieved in children presenting with apparently constant early-onset exotropia.

Intestinal Behcet's disease: breath-hold MR imaging

AbstractBackground: To determine the feasibility of magnetic resonance (MR) imaging in the evaluation of intestinal Behçets disease. Methods: Eight patients diagnosed to have intestinal Behçets disease prospectively underwent MR imaging. Five patients had previously undergone abdominal surgery for intestinal Behçets disease 27–81 months previously. Breath-hold T2-weighted single-shot fast spin echo, T1-weighted multiplanar spoiled gradient recalled echo, and postgadolinium-enhanced fat-suppressed T1-weighted opposed-phase multiplanar spoiled gradient recalled echo images were obtained. MR findings were analyzed by three independent radiologists in terms of the presence and location of bowel wall thickening and ulcer, maximal bowel wall thickness, grade of bowel wall enhancement, and presence and nature of extraluminal manifestations. K statistics were used to evaluate interobserver variability. Results: Seven cases (88%), including the five cases with previous operations, demonstrated bowel thickening of more than 9 mm and increased enhancement. Ulcer was depicted in four cases (50%) in the terminal ileum or an anastomosis site. Three cases (38%) showed extraluminal manifestation, such as mesenteric infiltration around the involved bowel (two cases) and a sinus tract to subhepatic abscess from perforation (one case). Conclusion: Breath-hold MR imaging is useful for the evaluation of bowel wall thickening, enhancement, mesentery infiltration, and abscess formation. Characteristic ulcerative lesions may be also depicted on T1- and T2-weighted breath-hold images. MR imaging is a useful method for postoperative follow-up study for the evaluation of recurrence.

Estrogen-related receptor γ gene (ESRRG) rs1890552 A>G polymorphism in a Korean population: Association with urinary prostaglandin F2α concentration and impaired fasting glucose or newly diagnosed type 2 diabetes

Diabetes & Metabolism - In Press.Proof corrected by the author Available online since mardi 27 decembre 2016

Effect of intravitreal dexamethasone implant on retinal and choroidal thickness in refractory diabetic macular oedema after multiple anti-VEGF injections

AimsTo investigate the effect of intravitreal dexamethasone implant (IVD) on central foveal thickness (CFT), choroidal thickness (CT) and its correlation with visual acuity in eyes with refractory diabetic macular oedema (DMO).MethodsThis was a retrospective interventional case-series. Thirty-five eyes of 35 patients were treated with a single injection of IVD because of refractory DMO with CFT over 300 μm, and persistent intraretinal and subretinal fluid despite of multiple intravitreal bevacizumab injections. Patients were followed-up for 6 months for the evaluation of CFT and subfoveal CT by spectral-domain optical coherence tomography.ResultsAll eyes (mean age: 59.4±12.35 years; 18 males, 17 females) had been previously treated with multiple bevacizumab injections and showed persistent DMO (mean number of injections 4.08±2.98) The preoperative logMAR BCVA was 0.49±0.24, which gradually improved to 0.46±0.32 at 6 months (P=0.652) and 26% gained two or more lines of Snellen visual acuity. At baseline, the mean CFT was 526.29±123.48 μm, which significantly improved to 316.15±100.09 μm at 3 months (P<0.001). However, CFT deteriorated to 457.07±136.53 μm at 6 months (P=0.051). Similarly, the mean preoperative subfoveal CT was 288.91±36.47 μm and it decreased to 266.85±30.93 μm at 3 months (P<0.01), but increased to 278.63±32.55 μm at 6 months (P=0.137). The reduction of CFT from baseline showed significant correlation with that of subfoveal CT at 3 months (P=0.041) and at 6 months (P=0.008).ConclusionsIn DMO refractory to multiple bevacizumab injections, IVD significantly reduced CFT and subfoveal CT, with BCVA improvement in one-fourth of the patients. The reduction of CFT showed significant correlation with reduction of subfoveal CT.

Effects of Fabrication Errors on the Sensitivity of Nano-Replicated Guided Mode Resonance Protein Sensors

Although an injection molding is a promising method for inexpensive mass production of nanograting substrate for disposable guided mode resonance (GMR) protein sensor, the incomplete filling of nanocavities due to the thick solidified layer in conventional injection molding process may lower the sensitivity of label-free GMR protein sensor. In this study, an instant heating method at the filling stage during the injection molding process was investigated to improve the pattern transcribability of molded nanograting and the sensitivity of fabricated GMR protein sensor. Two types of injection molded nanograting with and without instant heating method were prepared and the effects of pattern fidelity on the performance of fabricated GMR protein sensor were analyzed by theoretical and experimental methods.