The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.

AIMS: In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia. BACKGROUND: Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed. DESIGN: This study used a prospective, randomized, single-blinded, parallel-group design. METHODS: This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009-July 2010. RESULTS: Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up. CONCLUSION: Assertivenss training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols.

CT-guided transthoracic cutting needle biopsy of intrathoracic lesions: comparison between coaxial and single needle technique.

PURPOSE: To evaluate the complication rates and diagnostic accuracy of two different CT-guided transthoracic cutting needle biopsy techniques: coaxial method and single needle method. METHODS: This study involved 198 consecutive subjects with 198 intrathoracic lesions. The first 98 consecutive subjects received a single needle cutting technique and the next 100 consecutive subjects received a coaxial technique. Both groups were compared in relation the diagnostic accuracy and complication rates. RESULTS: No significant difference was found between the two groups concerning patient characteristics, lesions and procedure variables. There was a borderline statistical difference in the incidence of pneumothorax at within 24-h post biopsy between patients in the single needle group (5%) and the coaxial group (13%) (P=0.053). Little difference was found in the pneumothorax rate at immediately post biopsy between the two groups, which was 28% in the single needle group and 31% in the coaxial group. There was no significant difference in the hemoptysis rate between the two groups, which was 9.2% in the single needle group and 11% in the coaxial group. Both techniques yielded an overall diagnostic accuracy of 98% for malignant lesions with similar sensitivity (single needle: 96.9% vs. coaxial: 96.4%) and specificity (single needle: 100% vs. coaxial: 100%). CONCLUSION: There is little difference in the pneumothorax rates and bleeding complications between patients who either received a single needle or a coaxial transthoracic cutting biopsy. Both techniques produce an overall diagnostic accuracy of 98% for malignant lesions.

Hepatic artery infusion catheter implantation without embolization of the gastroduodenal artery in cases of retrograde blood flow.

Between January 2007 and January 2008, a port/catheter system for hepatic arterial infusion chemotherapy was implanted in seven patients with retrograde blood flow in the gastroduodenal artery (GDA). The GDA was not coil-embolized when the catheter tip was positioned in the right gastroepiploic artery. In all cases, implantation of the port/catheter system was successful, and there were no complications. Interventionalists can economize on expensive microcoils by using this simple and time-saving method.

The fabrication of a carbon nanotube array using a catalyst-poisoning layer in the inverse nano-sphere lithography method.

A new method for the fabrication of periodic CNT arrays was developed in this study, which involves the use of the inverse nano-sphere lithography (INSL) process. Mo of a honeycomb pattern, acting as a catalyst-poisoning layer, was produced by the nano-sphere lithography (NSL) process; the Mo poisoned the catalyst and prevented CNT growth where deposited, and as a result, a periodic CNT pattern was obtained. Using this method, the uniformity of the CNT array can be improved by preventing the negative effect of arrangement defects in self-assembled monolayers. The size and the period of the CNT array can be adjusted by careful selection of the polystyrene (PS) sphere diameter. X-ray photoelectron spectroscope (XPS) analysis revealed that the Co catalyst was ineffective on the areas of Mo deposition due to the diffusion of Co into the Mo layer.

A comparison of computed tomography, magnetic resonance imaging, and digital subtraction angiography findings in the diagnosis of infected aortic aneurysm.

PURPOSE: To characterize imaging findings from computed tomography, magnetic resonance imaging, and angiogram in patients with infected aortic aneurysm. METHODS: We retrospectively reviewed the records of 21 patients (men, 17; women, 4) with proven infected aortic aneurysms and compared the imaging findings (computed tomography scans, n = 21; magnetic resonance images, n = 2; and angiograms, n = 2). RESULTS: Aneurysms were located in the descending thoracic aorta (n = 10; 47.6%), abdominal aorta (n = 6; 28.6%), aortic arch (n = 3; 14.3%), and thoracoabdominal aorta (n = 2; 9.5%). Aneurysms were saccular in 19 (90%) and fusiform in 2 (10%). Maximal diameters were greater than 10 cm in 2 patients (10%), 5 to 10 cm in 11 (52%), and less than 5 cm in 8 (38%). Average diameters were 6.5 cm in the aortic arch, 5.3 cm in the descending thoracic aorta, and 5.1 cm in the abdominal aorta. Obvious aortic wall calcification occurred in 19 patients (90%). Other features included disrupted calcification (n = 15; 71%), prominent and irregular wall thickening (n = 17; 81%), periaortic soft tissue mass (n = 15; 71%), rim enhancement (n = 18; 86%), periaortic gas (n = 7; 33%), periaortic stranding and fluid retention (n = 14; 67%), periaortic hematoma (n = 3; 14%), adjacent bone destruction (n = 1; 5%), pleural effusion (n = 12; 57%), and associated dissecting aneurysm (n = 2; 10%). CONCLUSIONS: Saccular aneurysms, adjacent soft tissue masses, rim enhancement, stranding, fluid, gas, and unusual adjacent bony destruction highly suggest infected aneurysm.

Ionic versus nonionic contrast media solvents used with an epirubicin-based agent for transarterial chemoembolization of hepatocellular carcinoma.

PURPOSE: To compare the stability of epirubicin-iodized oil emulsions prepared with ionic or nonionic contrast medium and to compare the efficacy of these emulsions in a prospective, randomized, controlled trial of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Epirubicin-iodized oil emulsions prepared with ionic and nonionic contrast media was evaluated for stability with light microscopy and magnetic resonance imaging. One hundred ninety-seven patients with inoperable HCC were randomized to receive TACE with epirubicin, prepared either with ionic (control group, n = 99) or nonionic (experimental group, n = 98) contrast medium. Tumor response was graded according to iodized oil retention (grade 1 = >90% retention, grade 2 = 50%-90% retention, and grade 3 = <50% retention), as characterized with computed tomography. Survival probabilities were calculated with the Kaplan-Meier method. RESULTS: The epirubicin-iodized oil emulsions prepared with ionic contrast medium were less stable, exhibiting rapid separation of the oil and aqueous phases, compared with emulsions prepared with nonionic medium. Ninety-one patients in the control group and 87 in the experimental group underwent follow-up CT. Thirty-seven of the 91 patients in the control group (41%) had grade 1 tumors, 41 (45%) had grade 2 tumors, and 13 (14%) had grade 3 tumors. Forty-eight of the 87 patients in the experimental group (55%) had grade 1 tumors, 22 (25%) had grade 2 tumors, and 17 (20%) had grade 3 tumors. The number of patients with grade 1 tumors was significantly higher in the experimental group than in the control group (P = .02); however, there was no difference in patient survival (P = .94). CONCLUSIONS: Epirubicin-iodized oil emulsions prepared with nonionic contrast medium are more stable and are associated with lower tumor grade in patients with inoperable HCC. The choice of solvent, however, does not appear to have an effect on patient survival.

Two-dimensional metallic nanobowl array transferred onto thermoplastic substrates by microwave heating of carbon nanotubes.

The unique heating property of microwave irradiation on carbon nanotubes (CNTs) was applied in fabrication of a new architecture of two-dimensional metallic nanobowl array on a thermoplastic substrate. Vertically aligned CNT film was grown on a metal coated polystyrene (PS) submicron sphere array and then transferred onto a polycarbonate (PC) substrate by microwave heating. The back diffracted light spectra of this structure were measured and discrepancies between the spectra and that predicted from a diffraction relationship were studied. It is suggested that the discrepancies were related to the shape and the refractive indices of the materials.

Diffusion-weighted MRI features of brain abscess and cystic or necrotic brain tumors: comparison with conventional MRI.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) can be used to distinguish brain abscesses from cystic or necrotic brain tumors, which are difficult to distinguish by conventional magnetic resonance imaging (MRI) techniques. METHODS: Eleven consecutive patients with brain abscesses [10 pyogenic and 1 toxoplasmosis (in an AIDS patient)] and 15 with cystic or necrotic brain gliomas or metastases were enrolled in this study. None of these lesions had apparent hemorrhage based on T1-weighted image (T1WI). The DWI was performed using a 1.5-T system, single-shot spin-echo echo-planar pulse sequence with b=1000 s/mm(2). The ADC was calculated using a two-point linear regression method at b=0 and b=1000 s/mm(2). The ratio (ADCR) of the lesion ADC to control region ADC was also measured. RESULTS: Increased signal was seen in all of the pyogenic abscess cavities to variable degrees on DWI. In vivo ADC maps showed restricted diffusion in the abscess cavity in all pyogenic abscesses [0.65+/-0.16 x 10(-3) (mean+/-S.D.) mm(2)/s, mean ADCR=0.63]. The case with multiple toxoplasmosis abscesses showed low signal intensity on DWI and high ADC values (mean 1.9 x 10(-3) mm(2)/s, ADCR=2.24). All cystic or necrotic tumors but one showed low signal intensity on DWI and their cystic or necrotic areas had high ADC values (2.70+/-0.31 x 10(-3) mm(2)/s, mean ADCR=3.42). One fibrillary low-grade astrocytoma had a high DWI signal intensity and a low ADC value in its central cystic area (0.44 x 10(-3) mm(2)/s, ADCR=0.49). Postcontrast T1WIs yielded a sensitivity of 60%, a specificity of 27.27%, a positive predictive value (PPV) of 52.94%, and a negative predictive value (NPV) of 33.33% in the diagnosis of necrotic tumors. DWI yielded a sensitivity of 93.33%, a specificity of 90.91%, a PPV of 93.33%, and a NPV of 90.91%. The area under receiver operating characteristic (ROC) curves for postcontrast T1WI was 0.44 and DWI was 0.92. Analysis of these areas under the ROC curves indicates significant difference between postcontrast T1WI and DWI (P<.001). CONCLUSION: With some exceptions, DWI is useful in providing a greater degree of confidence in distinguishing brain abscesses from cystic or necrotic brain tumors than conventional MRI and seems to be a valuable diagnostic tool.