Treatment-related cardiovascular events in patients with non-small cell lung cancer: Evidence from real-world data with a competing risks approach.

BACKGROUND: Understanding cancer treatment-related cardiovascular (CV) events is important for cancer care; however, comprehensive evaluation of CV events in patients with lung cancer is limited. This study aimed to assess the cumulative incidence and associated risks of various CV event types in patients with non-small cell lung cancer (NSCLC). METHODS: A total of 7868 individuals aged 40 years and older, recently diagnosed with NSCLC (2007-2018), were assessed with data obtained from the National Cancer Center, Korea. This study included nine types of CV events. A 2-year cumulative incidence function (CIF) of CV events was estimated, with death as a competing event. The associated risks were assessed by subdistribution hazard ratio (sHR) in the Fine-Gray competing risks model. RESULTS: CV events were observed in 7.8% of patients with NSCLC, with the most frequently observed types being atrial fibrillation and flutter (AF) (2.7%), venous thromboembolic disease (2.0%), and cerebrovascular disease (CeVD) (1.5%). Overall, all CV events were highest in the group treated with systemic therapy (CIF, 10.6%; 95% confidence interval [CI], 9.5%-11.8%), followed by those treated with surgery (CIF, 10.0%; 95% CI, 8.6%-11.6%); the incidence of AF (CIF, 5.7%; 95% CI, 4.6%-7.0%) was highest in patients treated with surgery. Individuals treated with systemic therapy were found to exhibit a higher CeVD risk than those treated with surgery (sHR, 4.12; 95% CI, 1.66-10.23). Among the patients who underwent surgery, those with lobectomy and pneumonectomy had a higher AF risk (vs. wedge resection/segmentectomy; sHR, 7.79; 95% CI, 1.87-32.42; sHR, 8.10; 95% CI, 1.60-40.89). CONCLUSIONS: These findings revealed treatment-related CV event risks in patients with NSCLC, which suggests that the risk of AF in surgery and CeVD in systemic therapy should be paid more attention to achieve a better prognosis and improve cancer survivorship outcomes. PLAIN LANGUAGE SUMMARY: Atrial fibrillation and flutter (AF) is the most common cardiovascular event, particularly at a high risk in patients with non-small cell lung cancer (NSCLC) undergoing surgery. Patients receiving surgery with poor performance status, diagnosed with regional stage, and undergoing lobectomy or pneumonectomy are at a high risk of AF. Systemic/radiotherapy is associated with cerebrovascular and ischemic heart disease in patients with NSCLC.

The Role of Decreased Cortical Thickness and Volume of Medial Temporal Lobe Structures in Predicting Incident Psychosis in Patients With Alzheimer's Disease: A Prospective Longitudinal MRI Study.

OBJECTIVE: To investigate the effect of decreased cortical thickness or volume of medial temporal lobe structures on the risk of incident psychosis in patients with AD. DESIGN, SETTING, AND PARTICIPANTS: This hospital-based prospective longitudinal study enrolled 109 patients with AD. All patients with AD were evaluated at 3-month intervals to investigate the effect of decreased cortical thickness or volume of medial temporal lobe structures on the risk of incident psychosis in patients with AD. OUTCOME MEASURE: The main outcome measure was time-to-progression from AD to incident psychosis. The thickness or volume of medial temporal lobe structures (i.e., the hippocampus, entorhinal cortex, and parahippocampus) were measured using magnetic resonance imaging and the Freesurfer automated segmentation pipeline at baseline. RESULTS: Multivariate Cox proportional hazards regression analysis revealed that a decreased cortical thickness or volume of medial temporal region was associated with a higher risk of incident psychosis in patients with AD. The hazard ratios for decreased cortical thickness of the left entorhinal cortex and decreased cortical volume of the right hippocampus were 4.291 (95% confidence interval [CI], 1.196-15.384) and 2.680 [(CI, 1.003-1.196]), respectively. CONCLUSION: Our study revealed that decreased cortical thickness or volume of medial temporal sub-regions is a risk factor for incident psychosis in patients with AD. A careful assessment of the thickness or volume of the medial temporal lobe structures in AD may improve early detection and intervention of psychosis in AD.

Estimation of Greenhouse Lettuce Growth Indices Based on a Two-Stage CNN Using RGB-D Images.

Growth indices can quantify crop productivity and establish optimal environmental, nutritional, and irrigation control strategies. A convolutional neural network (CNN)-based model is presented for estimating various growth indices (i.e., fresh weight, dry weight, height, leaf area, and diameter) of four varieties of greenhouse lettuce using red, green, blue, and depth (RGB-D) data obtained using a stereo camera. Data from an online autonomous greenhouse challenge (Wageningen University, June 2021) were employed in this study. The data were collected using an Intel RealSense D415 camera. The developed model has a two-stage CNN architecture based on ResNet50V2 layers. The developed model provided coefficients of determination from 0.88 to 0.95, with normalized root mean square errors of 6.09%, 6.30%, 7.65%, 7.92%, and 5.62% for fresh weight, dry weight, height, diameter, and leaf area, respectively, on unknown lettuce images. Using red, green, blue (RGB) and depth data employed in the CNN improved the determination accuracy for all five lettuce growth indices due to the ability of the stereo camera to extract height information on lettuce. The average time for processing each lettuce image using the developed CNN model run on a Jetson SUB mini-PC with a Jetson Xavier NX was 0.83 s, indicating the potential for the model in fast real-time sensing of lettuce growth indices.

Improved Position Estimation Algorithm of Agricultural Mobile Robots Based on Multisensor Fusion and Autoencoder Neural Network.

High-precision position estimations of agricultural mobile robots (AMRs) are crucial for implementing control instructions. Although the global navigation satellite system (GNSS) and real-time kinematic GNSS (RTK-GNSS) provide high-precision positioning, the AMR accuracy decreases when the signals interfere with buildings or trees. An improved position estimation algorithm based on multisensor fusion and autoencoder neural network is proposed. The multisensor, RTK-GNSS, inertial-measurement-unit, and dual-rotary-encoder data are fused with Extended Kalman filter (EKF). To optimize the EKF noise matrix, the autoencoder and radial basis function (ARBF) neural network was used for modeling the state equation noise and EKF measurement equation. A multisensor AMR test platform was constructed for static experiments to estimate the circular error probability and twice-the-distance root-mean-squared criteria. Dynamic experiments were conducted on road, grass, and field environments. To validate the robustness of the proposed algorithm, abnormal working conditions of the sensors were tested on the road. The results showed that the positioning estimation accuracy was improved compared to the RTK-GNSS in all three environments. When the RTK-GNSS signal experienced interference or rotary encoders failed, the system could still improve the position estimation accuracy. The proposed system and optimization algorithm are thus significant for improving AMR position prediction performance.

Cerebral angiography using transauricular access in a rabbit model: a new technique.

BACKGROUND: Cerebral angiography in a rabbit model is widely used in the field of interventional radiology. Conventionally, the femoral artery is used for cerebral angiography in radiology departments. However, angiographic studies require surgical cutdown of the femoral artery, which is technically difficult. PURPOSE: To evaluate a new cerebral angiography technique involving a transauricular approach in a rabbit model. MATERIAL AND METHODS: In each of 10 rabbits, central auricular arteries were punctured in the right or left ear with a 20-gauge i.v. catheter. A microcatheter (2.0 F) with a 0.016-inch guide wire was introduced through the i.v. catheter and advanced to the aortic arch. The microcatheter and guide wire were advanced selectively into cerebral arteries and angiography was performed. RESULTS: Central auricular arteries were successfully punctured with 20-gauge i.v. catheters. After approaching the aortic arch, microcatheter tips and guide wires were advanced manually to cerebral arteries on both sides. Difficulties in selecting the carotid arteries were resolved by using a looping technique within the cardiac chamber. Microcatheter loops within the cardiac chamber disappeared or remained during artery superselection. CONCLUSION: Transauricular cerebral angiography appears to be a feasible technique for brain or carotid intervention studies in rabbits. In addition, vertebral angiography using a transauricular approach is possible using the looping technique. Selection of carotid or vertebral arteries on each side was not difficult when the microcatheter and guide wire were looped within the cardiac chamber. The ear chosen for the initial puncture does not appear to be important.

Water Nitrate Remote Monitoring System with Self-Diagnostic Function for Ion-Selective Electrodes.

The detection of nitrate pollutants is a widely used strategy for protecting water sources. Although ion-selective electrodes (ISEs) have been considered for the determination of ion concentrations in water, the accuracy of ISE technology decreases owing to the signal drift and decreasing sensitivity over time. The objectives of the present study were: (1) to develop an online water monitoring system mainly consisting of an Arduino board-based Internet-of-Things (IoT) device and nitrate ISEs; and (2) to propose a self-diagnostic function for monitoring and reporting the condition of the ISEs. The developed system communicates with the cloud server by using the message queuing telemetry transport (MQTT) protocol and provides monitoring information through the developed cloud-based webpage. In addition, the online monitoring system provides information on the electrode status, which is determined based on a self-diagnostic index (SDI, with a range of 0-100) of the electrode drift and sensitivity. The diagnostic method for monitoring and reporting the electrode status was validated in a one-month-long laboratory test followed by a field test in a stream near an agricultural facility. Moreover, a self-diagnostic index (SDI) was applied in the final field experiments with an accuracy of 0.77.

Genome-wide association study of genetic variants related to anthracycline-induced cardiotoxicity in early breast cancer.

We performed a genome-wide association study to investigate the association between single nucleotide polymorphisms and anthracycline-induced cardiotoxicity (ACT) in patients diagnosed with early breast cancer. From January 2000 to December 2015, 8490 patients underwent breast surgery at the National Cancer Center in Korea. Patients who received doxorubicin (cumulative dose 240 mg/m2 -300 mg/m2 ) with or without trastuzumab as a neoadjuvant/adjuvant therapy were included in our cohort. Sixty-seven patients in our cohort were diagnosed with ACT. Clinical data, including age, body weight, height, cancer stage, trastuzumab treatment, comorbidities, and concomitant medications, were collected retrospectively. Patients were classified as having either persistent or transient ACT based on their clinical course. In total, 346 946 single nucleotide polymorphisms in 42 cases and 215 controls were tested in this study. Body mass index (BMI) ≥25 kg/m2 [odds ratio (OR) = 2.45, 95% confidence interval (CI), 1.23-4.88, P = .011] and trastuzumab use (OR = 2.40, 95% CI, 1.11-5.17, P = .026) were identified as significant risk factors. We found 7 genetic variants for ACT including rs17530621 (SHISA3, P = 3.10E-06), rs11894115 (MPP4, P = 4.71E-06), rs58328254 (RPL7, P = 6.09E-06), and rs117299725 (PRUNE2, P = 8.53E-06), although none of these variants reached the Bonferroni-corrected significance level when adjusted for BMI and trastuzumab use ( = α1.44E-07 based on 0.05/346 946). rs117299725 was a common variant when only the persistent ACT group was analyzed separately. It is meaningful that our study analyzed comprehensively the influence of genetic variation on ACT, along with some clinical factors in Asian breast cancer patients who received anthracycline with or without trastuzumab. Further research will be needed on candidate genetic variants found in this study.

Cumulative incidence of chemotherapy-induced cardiotoxicity during a 2-year follow-up period in breast cancer patients.

PURPOSE: Cardiotoxicities are adverse effects often reported in chemotherapy-treated breast cancer patients. This study evaluated the potential risk factors and cumulative incidence of doxorubicin-induced cardiotoxicity in Korean breast cancer patients. METHODS: We retrospectively analyzed the data of 613 breast cancer patients who underwent a multigated acquisition (MUGA) scan or echocardiography prior to chemotherapy and at least one post-chemotherapy follow-up MUGA scan/echocardiography between 2007 and 2016 at National Cancer Center, Korea. The Cox proportional hazards models were used to evaluate cardiotoxicity risks. Competing risks analyses were performed to estimate cumulative incidence of cardiotoxicity. RESULTS: Risk factors associated with cardiotoxicity within 2 years of doxorubicin administration included age [adjusted hazard ratio (aHR) = 1.02, 95% confidence interval (CI) 1.00-1.04; p = 0.05], metastasis (aHR = 2.66; 95% CI 1.36-5.20; p < 0.01), and concomitant trastuzumab (aHR = 4.08; 95% CI 2.31-7.21; p < 0.01). The cumulative incidence of patients with cardiotoxicity was 6.1% at 2 years (without substantial change from about 9 months)and 20.2% at 2 years (without substantial change from about 15 months) after initiation of doxorubicin-containing therapy without and with trastuzumab, respectively. CONCLUSIONS: Susceptibility to chemotherapy-induced cardiotoxicity within 2 years of doxorubicin initiation in breast cancer patients was elevated with old age, metastasis, and concomitant trastuzumab. Regular imaging monitoring at least up to 9 months after doxorubicin initiation in patients treated without concomitant trastuzumab, and 15 months in patients treated with concomitant trastuzumab, is needed for early detection of chemotherapy-induced cardiotoxicity.

Curcumin Nanocrystal/pH-Responsive Polyelectrolyte Multilayer Core-Shell Nanoparticles for Inflammation-Targeted Alleviation of Ulcerative Colitis.

In this study, we developed oral core-shell nanoparticles composed of curcumin nanocrystals in the core and chitosan/alginate multilayers in the shell for inflammation-targeted alleviation of ulcerative colitis (UC). The release rate of curcumin from the core-shell nanoparticles was low at a pH mimicking the stomach and small intestine, whereas it was higher at a pH mimicking the colon. Further, biodistribution studies in the gastrointestinal tract of mice showed that distribution of nanoparticles was significantly higher in the colon than that in the stomach and small intestine. Quantitative analysis of drugs in colonic tissues and confocal imaging of colons revealed preferential accumulation of nanoparticles in inflamed tissues than that in healthy tissues. In vivo anti-inflammatory studies revealed that nanoparticles exhibit enhanced efficacy in alleviating inflammation-related symptoms in a mouse colitis model. The results suggest that the core-shell nanoparticles presented here can be exploited as efficient colon-targeted drug delivery systems for UC therapy.

Doxorubicin concentration in brain remains high for one day after triolein emulsion infusion induced BBB opening.

Aim: The purpose of this study was to assess changes in doxorubicin concentration in rabbit brain with respect to time after BBB opening induced by triolein emulsion infusion via a carotid artery and the mechanism of BBB opening.Materials and Methods: Doxorubicin (2.4 mg/kg) was infused immediately after triolein emulsion (1%) into rabbit carotid arteries. Bilateral hemispheres were harvested 2, 4, 6 12 and 24 h later and doxorubicin concentrations were measured fluorometrically. Doxorubicin concentration ratios of ipsilateral versus contralateral hemispheres were calculated, and a TEM study was performed to investigate the mechanism responsible for the increased vascular permeability induced by triolein.Results: Doxorubicin concentrations were higher in ipsilateral hemispheres at all time points, and peaked at 2 h after treatment. Doxorubicin was still detected in ipsilateral hemispheres at 24 h after treatment. TEM showed tight junction opening by triolein emulsion with lanthanum tracer spillage into neural interstitium and transcytotic vesicles.Conclusion: Doxorubicin was delivered into neural interstitium because of the increased vascular permeability of the BBB induced by triolein emulsion. Doxorubicin concentrations in brain peaked within 2 h of triolein and doxorubicin administration and remained high for 24 h. The study shows increased vascular permeability induced by triolein emulsion may involve paracellular and transcellular pathways.

Model Predictive Control via Output Feedback Neural Network for Improved Multi-Window Greenhouse Ventilation Control.

Maintaining environmental conditions for proper plant growth in greenhouses requires managing a variety of factors; ventilation is particularly important because inside temperatures can rise rapidly in warm climates. The structure of the window installed in a greenhouse is very diverse, and it is difficult to identify the characteristics that affect the temperature inside the greenhouse when multiple windows are driven, respectively. In this study, a new ventilation control logic using an output feedback neural-network (OFNN) prediction and optimization method was developed, and this approach was tested in multi-window greenhouses used for strawberry production. The developed prediction model used 15 inputs and achieved a highly accurate performance (R2 of 0.94). In addition, the method using an algorithm based on an OFNN was proposed for optimizing considered six window-opening behavior. Three case studies confirmed the optimization performance of OFNN in the nonlinear model and verified the performance through simulations. Finally, a control system based on this logic was used in a field experiment for six days by comparing two greenhouses driven by conventional control logic and the developed control logic; a comparison of the results showed RMSEs of 3.01 °C and 2.45 °C, respectively. It confirmed the improved control performance in comparison to a conventional ventilation control system.

Effect of gastrectomy on blood pressure in early gastric cancer survivors with hypertension.

PURPOSE: We investigated the effect of gastrectomy on blood pressure (BP) in early gastric cancer survivors with hypertension and whether well-controlled BP was due solely to surgery-induced weight loss. METHODS: The study enrolled 66 early gastric cancer patients with hypertension, undergoing endoscopic submucosal dissection (ESD), or gastrectomy. Blood analyses, 24-h ambulatory BP monitoring, brachial ankle pulse wave velocity (baPWV), and echocardiography were measured prior to, 3 months after, and 1 year after ESD or gastrectomy. The primary endpoint was remission of hypertension at 1 year. RESULTS: The remission rate of hypertension was significantly higher in the gastrectomy group than in the ESD group (p = 0.006). Those with remission of hypertension had a significant weight loss (p < 0.001), decrease in body mass index (p < 0.001), 24-h total systolic BP (p = 0.047), baPWV (p = 0.042), triglycerides (p = 0.049) and apolipoprotein B/apolipoprotein A1 (p = 0.004), and an increase in high-density lipoprotein cholesterol (p < 0.001) at 1 year. Upon multivariate logistic regression analysis, gastrectomy [odds ratio (OR) = 7.77, 95% confidence interval (CI) = 2.05-35.89], diuretic use (OR = 3.76, 95% CI = 1.14-13.98), and lower 24-h total diastolic BP before treatment (OR = 0.90, 95% CI = 0.82-0.96) were predictive of remission of hypertension after adjusting for percent weight. CONCLUSIONS: In early gastric cancer survivors with hypertension, gastrectomy resulted in better BP control than did ESD, which may be due to the gastrectomy itself, beyond weight loss. Therefore, it should be remembered that the adequate reduction of antihypertensives may be necessary in early gastric cancer survivors after gastrectomy.

Hybrid Signal-Processing Method Based on Neural Network for Prediction of NO3, K, Ca, and Mg Ions in Hydroponic Solutions Using an Array of Ion-Selective Electrodes.

In closed hydroponics, fast and continuous measurement of individual nutrient concentrations is necessary to improve water- and nutrient-use efficiencies and crop production. Ion-selective electrodes (ISEs) could be one of the most attractive tools for hydroponic applications. However, signal drifts over time and interferences from other ions present in hydroponic solutions make it difficult to use the ISEs in hydroponic solutions. In this study, hybrid signal processing combining a two-point normalization (TPN) method for the effective compensation of the drifts and a back propagation artificial neural network (ANN) algorithm for the interpretation of the interferences was developed. In addition, the ANN-based approach for the prediction of Mg concentration which had no feasible ISE was conducted by interpreting the signals from a sensor array consisting of electrical conductivity (EC) and ion-selective electrodes (NO3, K, and Ca). From the application test using 8 samples from real greenhouses, the hybrid method based on a combination of the TPN and ANN methods showed relatively low root mean square errors of 47.2, 13.2, and 18.9 mg∙L-1 with coefficients of variation (CVs) below 10% for NO3, K, and Ca, respectively, compared to those obtained by separate use of the two methods. Furthermore, the Mg prediction results with a root mean square error (RMSE) of 14.6 mg∙L-1 over the range of 10-60 mg∙L-1 showed potential as an approximate diagnostic tool to measure Mg in hydroponic solutions. These results demonstrate that the hybrid method can improve the accuracy and feasibility of ISEs in hydroponic applications.

Fusion of Spectroscopy and Cobalt Electrochemistry Data for Estimating Phosphate Concentration in Hydroponic Solution.

Phosphate is a key element affecting plant growth. Therefore, the accurate determination of phosphate concentration in hydroponic nutrient solutions is essential for providing a balanced set of nutrients to plants within a suitable range. This study aimed to develop a data fusion approach for determining phosphate concentrations in a paprika nutrient solution. As a conventional multivariate analysis approach using spectral data, partial least squares regression (PLSR) and principal components regression (PCR) models were developed using 56 samples for calibration and 24 samples for evaluation. The R2 values of estimation models using PCR and PLSR ranged from 0.44 to 0.64. Furthermore, an estimation model using raw electromotive force (EMF) data from cobalt electrodes gave R2 values of 0.58-0.71. To improve the model performance, a data fusion method was developed to estimate phosphate concentration using near infrared (NIR) spectral and cobalt electrochemical data. Raw EMF data from cobalt electrodes and principle component values from the spectral data were combined. Results of calibration and evaluation tests using an artificial neural network estimation model showed that R2 = 0.90 and 0.89 and root mean square error (RMSE) = 96.70 and 119.50 mg/L, respectively. These values are sufficiently high for application to measuring phosphate concentration in hydroponic solutions.

Axin2 overexpression promotes the early epithelial disintegration and fusion of facial prominences during avian lip development.

The epithelial disintegration and the mesenchymal bridging are critical steps in the fusion of facial prominences during the upper lip development. These processes of epithelial-mesenchymal transition and programmed cell death are mainly influenced by Wnt signals. Axis inhibition protein2 (Axin2), a major component of the Wnt pathway, has been reported to be involved in lip development and cleft pathogenesis. We wanted to study the involvement of Axin2 in the lip development, especially during the epithelial disintegration of facial prominences. Our results show that Axin2 was expressed mainly in the epithelium of facial prominences and decreased when the prominences were about to contact each other between Hamburger-Hamilton stages 27 and 28 of chicken embryos. The epithelial integrity was destructed or kept intact by the local gain or loss of Axin2 expression, resulting in morphological changes in the facial processes and their skeletal derivatives including the maxilla, nasal, premaxilla bone, and their junctions without cleft formation. These changes were related to expression changes in nuclear ß-catenin, pGSK3ß, Slug, Smad3, E-cadherin, and p63. All these data indicate that Axin2 participates in the regulation of epithelial integrity and fusion by promoting epithelial disassociation, basement membrane breakdown, and seam loss during the fusion of facial prominences in lip development.

Amperometric Detection of Conformational Change of Proteins Using Immobilized-Liposome Sensor System.

An immobilized liposome electrode (ILE)-based sensor was developed to quantify conformational changes of the proteins under various stress conditions. The ILE surface was characterized by using a tapping-mode atomic force microscopy (TM-AFM) to confirm surface immobilization of liposome. The uniform layer of liposome was formed on the electrode. The current deviations generated based on the status of the proteins under different stress were then measured. Bovine carbonic anhydrase (CAB) and lysozyme were tested with three different conditions: native, reduced and partially denatured. For both proteins, a linear dynamic range formed between denatured concentrations and output electric current signals was able to quantify conformational changes of the proteins. The pattern recognition (PARC) technique was integrated with ILE-based sensor to perform data analysis and provided an effective method to improve the prediction of protein structural changes. The ILE-based stress sensor showed potential of leveraging the amperometric technique to manifest activity of proteins based on various external conditions.

Prognostic Value of Computed Tomography-Detected Extramural Venous Invasion to Predict Disease-Free Survival in Patients With Gastric Cancer.

OBJECTIVE: This study aimed to investigate whether there is a correlation between the computed tomography-detected extramural venous invasion (ctEMVI) and disease-free survival (DFS) in patients with gastric cancer using pathologic lymphovascular invasion as a reference standard. METHODS: We retrospectively reviewed 153 patients with gastric cancer who underwent computed tomography during 1 year. Differences in pathological findings between the ctEMVI-positive and ctEMVI-negative groups were analyzed. Disease-free survival was estimated using the Kaplan-Meier method. Factors affecting DFS were analyzed with the Cox proportional hazard model. RESULTS: The ctEMVI-positive group was correlated more with lymphovascular invasion (P = 0.008). The 1- and 2-year DFS rates were 92% and 80%, respectively, in the ctEMVI-negative group, but 77% and 54%, respectively, in the ctEMVI-positive group. A multivariate analysis revealed that tumor size, ctEMVI, and pathological stage remained associated with DFS (Ps = 0.037, 0.015, and 0.002, respectively). CONCLUSIONS: The ctEMVI was an independent prognostic factor for worse DFS in patients with gastric cancer.

Ultrasonography in the diagnosis of nasal bone fractures: a comparison with conventional radiography and computed tomography.

The purpose of this study was to evaluate and compare the diagnostic efficacy of ultrasonography (US) with radiography and multi-detector computed tomography (CT) for the detection of nasal bone fractures. Forty-one patients with a nasal bone fracture who underwent prospective US examinations were included. Plain radiographs and CT images were obtained on the day of trauma. For US examinations, radiologist used a linear array transducer (L17-5 MHz) in 24 patients and hockey-stick probe (L15-7 MHz) in 17. The bony component of the nose was divided into three parts (right and left lateral nasal walls, and midline of nasal bone). Fracture detection by three modalities was subjected to analysis. Furthermore, findings made by each modality were compared with intraoperative findings. Nasal bone fractures were located in the right lateral wall (n = 28), midline of nasal bone (n = 31), or left lateral wall (n = 31). For right and left lateral nasal walls, CT had greater sensitivity and specificity than US or radiography, and better agreed with intraoperative findings. However, for midline fractures of nasal bone, US had higher specificity, positive predictive value, and negative predictive value than CT. Although two US evaluations showed good agreements at all three sites, US findings obtained by the hockey-stick probe showed closer agreement with intraoperative findings for both lateral nasal wall and midline of nasal bone. Although CT showed higher sensitivity and specificity than US or radiography, US found to be helpful for evaluating the midline of nasal bone. Furthermore, for US examinations of the nasal bone, a smaller probe and higher frequency may be required.

Apolipoprotein E genotype modulates effects of vitamin B12 and homocysteine on grey matter volume in Alzheimer's disease.

AIMS: The aim of the present study was to investigate whether the effects of vitamin B12 and homocysteine on brain volume are influenced by apolipoprotein E (APOE) genotype. We examined the effects in each subgroup (APOE ε4 carriers and non-carriers) of Alzheimer's disease (AD) patients and healthy normal controls. METHODS: Forty participants with AD and 20 healthy normal controls were recruited from memory impairment clinics at Pusan National University Hospital in Korea. All participants were APOE genotyped and underwent magnetic resonance imaging, including 3-D volumetric images for grey matter (GM) volume. A multiple regression model integrated into statistical parametric mapping was used to see if there was any correlation between vitamin B12 or homocysteine and GM volume in each subgroup (APOE ε4 carriers and non-carriers) of AD patients and healthy normal controls. RESULTS: There was a significant positive correlation between serum concentrations of vitamin B12 and regional GM volume in APOE ε4 carriers with AD but not in non-carriers. We also found that there was a significant negative correlation between serum concentrations of homocysteine and regional GM volume in APOE ε4 non-carriers with AD but not in carriers (P < 0.001, uncorrected for multiple comparisons; extent threshold = 100 voxel). CONCLUSION: The present findings suggest that the effects of vitamin B12 and homocysteine on GM volume might be influenced by APOE genotype.

Prominent hypointense veins on susceptibility weighted image in the cat brain with acute infarction: DWI, SWI, and PWI.

BACKGROUND: The multiple prominent hypointense veins on susceptibility-weighted imaging (SWI) have been found in the ischemic territory of patients with acute ischemic stroke. Venous side is the unknown area in the hemodynamics of brain infarction. PURPOSE: To evaluate the venous aspect in acute brain infarction through an animal study. MATERIAL AND METHODS: The acute infarction in cat brains was induced with a bolus infusion of 0.25 mL of triolein through one side of the common carotid artery. The magnetic resonance (MR) images, including diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) map, SW, and perfusion-weighted (PWI) images, were obtained serially at 2 h (n = 17), 1 day (n = 11), and 4 days (n = 4) after triolein infusion. The obtained MR images were evaluated qualitatively and quantitatively. For qualitative assessment, the signal intensity of the serial MR images was evaluated. The presence or absence and the location with serial changes of infarction were identified on DWI and ADC map images. The presence or absence of prominent hypointense veins and the serial changes of cortical veins were also evaluated on SWI. Quantitative assessment was performed by comparing the relative cerebral blood volume (rCBV), cerebral blood flow (rCBF), and mean transit times (MTT) of the lesions with those of the contralateral normal side calculated on PWI. The serial changes of rCBV, rCBF, and MTT ratio were also evaluated. RESULTS: Acute infarction in the first and second medial gyrus of lesion hemisphere was found by qualitative evaluation of DWI and ADC map images. On the serial evaluation of SWI, the cortical veins of cat brain with infarction were obscured at 2 h and then re-appeared at 1 day. The hemorrhage transformation and prominent hypointense veins were seen at 4 days on SWI. The quantitative evaluation revealed increased MTT ratios and decreased rCBV and rCBF ratios on PWIs in the acute infarction of cat brain. CONCLUSION: The prominent hypointense veins on SWI were seen in the half of the acute infarction at 4 days. The prominent hypointense veins on SWI may have good agreement with the increased MTT ratio.