Enhancement on CT for preoperative diagnosis of metastatic lymph nodes in thyroid cancer: a comparison across experience levels.

OBJECTIVES: To investigate the diagnostic performance and interobserver agreement of quantitative CT parameters indicating strong lymph node (LN) enhancement in differentiated thyroid cancer (DTC), comparing them with qualitative analysis by radiologists of varying experience. MATERIALS AND METHODS: This study included 463 LNs from 399 patients with DTC. Three radiologists independently analyzed strong LN enhancement on CT. Qualitative analysis of strong enhancement was defined as LN cortex showing greater enhancement than adjacent muscles on the arterial phase. Quantitative analysis included the mean attenuation value (MAV) of LN on arterial phase (LNA) and venous phase (LNV), LNA normalized to the common carotid artery (NAVCCA), internal jugular vein (NAVIJV), and sternocleidomastoid muscle (NAVSCM), attenuation difference [AD; (LNA - MAVSCM)], and relative washout ratio [((LNA - LNV)/LNA) × 100]. The interobserver agreement and diagnostic performance of the quantitative and qualitative analyses were evaluated. RESULTS: Interobserver agreement was excellent for all quantitative CT parameters (ICC, 0.83-0.94) and substantial for qualitative assessment (κ = 0.61). All CT parameters except for LNV showed good diagnostic performance for metastatic LNs (AUC, 0.81-0.85). NAVCCA (0.85, 95% CI: 0.8-0.9) and AD (0.85, 95% CI: 0.81-0.89) had the highest AUCs. All quantitative parameters except for NAVIJV had significantly higher AUCs than qualitative assessments by inexperienced radiologists, with no significant difference from assessments by an experienced radiologist. CONCLUSION: Quantitative assessment of LN enhancement on arterial phase CT showed higher interobserver agreement and AUC values than qualitative analysis by inexperienced radiologists, supporting the need for a standardized quantitative CT parameter-based model for determining strong LN enhancement. CLINICAL RELEVANCE STATEMENT: When assessing strong LN enhancement in DTC, quantitative CT parameters indicating strong enhancement can improve interobserver agreement, regardless of experience level. Therefore, the development of a standardized diagnostic model based on quantitative CT parameters might be necessary. KEY POINTS: Accurate preoperative assessment of LN metastasis in thyroid cancer is crucial. Quantitative CT parameters indicating strong LN enhancement demonstrated excellent interobserver agreement and good diagnostic performance. Quantitative assessment of contrast enhancement offers a more objective model for the identification of metastatic LNs.

Major environmental characteristics of swine husbandry that affect exposure to dust and airborne endotoxins.

Inhalation of organic dust or endotoxin in the dust is considered a major risk factor for occupational respiratory illnesses. Eighteen environmental characteristics associated with animal husbandry were surveyed at 36 swine farms in seven provinces throughout South Korea. Association of these factors with levels of indoor inhalable or respirable dust or endotoxin in each type of dust was analyzed using backward stepwise multiple linear regression models. Mean levels of inhalable and respirable dust were 0.5 ± 0.35 and 0.13 ± 0.12 mg/m3 air, respectively, and mean endotoxin levels were 676 ± 463 and 48.4 ± 68.2 EU/m3, respectively, in each dust. Factors negatively associated with inhalable dust levels included pig age, indoor farm temperature, number of pigs in the building, hr/week of indoor farm work, and partly slatted floor. Factors positively associated with inhalable dust levels included floor cleaning by manual scraping and slurry deposit duration. Factors negatively associated with the level of endotoxin in inhalable dust included pig age, temperature, number of pigs, hr/week of indoor farm work, and partly slatted floor. Factors negatively associated with respirable dust level included area of the confinement building, whereas factors positively associated with respirable dust level included the number of pigs and stocking density. Endotoxin levels in respirable dust were negatively associated with h/week of indoor farm work and partly slatted floor. Overall, data suggest that husbandry variables may be adjusted to control dust and airborne endotoxin levels in swine farms.

Impact of Patient Head Posture on Lens Radiation Exposure During Cerebral Angiography.

BACKGROUND AND PURPOSE: Cerebral angiography remains crucial for detailed characterization and preoperative assessments for intracranial aneurysm. Despite its diagnostic importance, cerebral angiography poses challenges due to its invasiveness, the risk of neurological complications, and radiation exposure. To investigate the impact of head posture on lens radiation exposure during cerebral angiography, this study focused on the correlation between radiation doses to the eye lens, head flexion angles, and head size. MATERIALS AND METHODS: A retrospective analysis was performed on 20 patients who underwent cerebral angiography for unruptured intracranial aneurysms between October and November 2022. Radiation doses to the lens, which were measured in a prior prospective study using photoluminescent glass dosimeters, were analyzed alongside head flexion angles, anteroposterior (AP) head diameters, and kerma-area product (KAP) to evaluate their correlation with lens radiation exposure. The lateral radiation source is located on the left side of the patients. RESULTS: The cohort consisted of 20 patients (60% female, mean age: 62.3 ± 9.9 years). The radiation dose to the left eye (the eye closer to the x-ray source) was 2.8 times higher than that to the right eye (9.18 ± 3.31 mGy vs. 3.3 ± 0.60 mGy, P < 0.001). A strong positive correlation was observed between the left eye lens dose and head flexion angle (R = 0.815, P < 0.001). While the AP head diameter significantly correlated with the flexion angle, it showed no significant correlation with lens dose. The KAP was inversely correlated with both the left lens dose (R = -0.597, P = 0.005) and the flexion angle (R = -0.689, P < 0.001). CONCLUSIONS: Our findings underscore the significant impact of head posture on lens radiation exposure during cerebral angiography. Adjusting head positioning may provide a practical approach to reduce radiation exposure to the lens. Furthermore, it is worth noting that the left lens received more radiation than the right, likely due to the X-ray source being on the left side of the patient. ABBREVIATIONS: AP = anteroposterior; KAP = kerma-area product, PLD = photoluminescent glass dosimeter.

Combination of phytochemicals, including ginsenoside and curcumin, shows a synergistic effect on the recovery of radiation-induced toxicity.

Radiotherapy is commonly used to treat solid cancers located in the pelvis. A considerable number of patients experience proctitis of varying severity, even for a considerable period after radiotherapy. These side effects are often long-lasting or progressively worsen despite multiple therapeutic efforts and are a primary cause of an unexpectedly low quality of life, even after successful cancer treatment. Therefore, this study evaluated the individual and combined efficacy of ginsenoside, curcumin, butyric acid, and sucralfate compounds in treating radiation-induced proctitis. While the candidate compounds did not affect the proliferation and migration of cancer cells, they promoted the recovery of cell activity, including motility. They exhibited anti-inflammatory effects on human dermal fibroblasts or human umbilical vein endothelial cells within in vitro disease models. When each compound was tested, curcumin and ginsenoside were the most effective in cell recovery and promoted the migration of human dermal fibroblasts and cell restoration of human umbilical vein endothelial cells. The combination of ginsenoside and curcumin resulted in cell migration recovery of approximately 54%. In addition, there was a significant improvement in the length of the endothelial tube, with an increase of approximately 25%, suggesting that the ginsenoside-curcumin-containing combination was the most effective against radiation-induced damage. Furthermore, studies evaluating the effects of combined treatments on activated macrophages indicated that the compounds effectively reduced the secretion of inflammatory cytokines, including chemokines, and alleviated radiation-induced inflammation. In conclusion, our study provides valuable insights into using curcumin and ginsenoside as potential compounds for the effective treatment of radiation-induced injuries and highlights the promising therapeutic benefits of combining these two compounds.

Interpretation discrepancies of abdominal imaging by on-call radiology residents: Evaluation of risk factors.

The aim of this study was to determine the rate, important findings, and risk factors related to discrepancies between on-call residents' and attending radiologists' interpretations of abdominal examinations. We identified 1132 eligible patients with abdominal radiology findings that were preliminary interpreted by on-call residents between February 2016 and September 2019. The preliminary interpretations were compared with the final interpretations by abdominal attending radiologists, including clinical data. The preliminary interpretations were analyzed by three radiologists in consensus, who categorized the reports according to organs, important findings (i.e., active bleeding, bowel obstruction, organ ischemia or infarction, and organ rupture), clinical outcomes, and discrepancies with respect to final interpretations. Multiple logistic regression analysis was used to evaluate the risk factors for important discrepant findings. Of 1132 patients, the bowel (n = 567, 50.1%) was the most common organ interpreted by on-call residents, followed by gallbladder/bile duct/pancreas (n = 139, 12.3%) and liver (n = 116, 10.2%). Of 1132, 359 patients (31.7%) had disease with 379 important findings: active bleeding (n = 222), organ rupture (n = 77), bowel obstruction (n = 52), bowel ischemia (n = 24), and organ infarction (n = 4). Sixty-four patients (5.6%) showed discrepancies, and 30 (2.6%) showed 32 important discrepant findings comprising 14 active bleeding, 10 bowel obstructions, 6 organ ruptures, and 2 cases of bowel ischemia. Of the 64 discrepant patients, 33 underwent delayed surgery (n = 18, 28.1%) or interventional treatment (n = 15, 23.4%). In multivariable analysis, bowel obstruction (adjusted odds ratio, 2.52; p = 0.049) was an independent risk factor for determining discrepancy between preliminary and final interpretations. The rate of overall and important discrepancies between on-call residents' and final interpretations was low. However, given that the bowel was the most frequently interpreted organ, bowel obstruction was identified as a risk factor for discrepant interpretations. The identified risk factor and findings may be useful for residents to minimize discrepancies.

Added value of color-coded virtual non-calcium dual-energy CT in the detection of acute knee fractures in non-radiology inexpert readers.

PURPOSE: To evaluated the added value of dual-energy CT (DECT) virtual non-calcium (VNCa) protocol on conventional CT in the detection of acute knee fractures in non-radiology inexpert readers. METHOD: One hundred fifty-six patients (mean age, 51.97 years; age range, 17-86 years) with knee trauma, who underwent DECT and MRI within 3 days between April 2017 and October 2018, were retrospectively analyzed. Three readers (intern, 1st-year general surgery resident, 1st-year emergency medicine resident) independently analyzed CT alone and then with the additional color-coded DECT VNCa for fractures. A board-certified radiologist, analyzed CT and MRI series to define the reference standard. Sensitivity, specificity, and AUC were compared between the two reading sessions. RESULTS: Fifty-seven patients had acute fractures and 99 had no fractures. Thirteen of 57 fractures were nondisplaced. The additional use of VNCa images significantly increased the mean AUC (reader 1: 0.813 vs. 0.919; reader 2: 0.842 vs. 0.930; reader 3: 0.837 vs. 0.921; P < 0.05). When only nondisplaced fractures included, the mean AUC was more increased in the combined analysis of CT and DECT VNCa (reader 1: 0.521 vs. 0.916; reader 2: 0.542 vs. 0.926; reader 3: 0.575 vs. 0.926; P <  .01). Sensitivity increased by 15 %-20 % in total fracture group and by 69 %-77 % in nondisplaced fracture group over that with CT alone when both CT and DECT VNCa were used. Specificity did not differ significantly. CONCLUSIONS: The additional use of color-coded DECT VNCa protocol to conventional CT improved diagnostic performance in detecting acute knee fractures for inexperienced non-radiology readers.

Assessment of the Dynamics of Microbial Community Associated with Tetraselmis suecica Culture under Different LED Lights Using Next-Generation Sequencing.

Tetraselmis is a green algal genus, some of whose species are important in aquaculture as well as biotechnology. In algal culture, fluorescent lamps, traditional light source for culturing algae, are now being replaced by a cost-effective light-emitting diodes (LEDs). In this study, we investigated the effect of LED light of different wavelengths (white, red, yellow, and blue) on the growth of Tetraselmis suecica and its associated microbial community structures using the next-generation sequencing (NGS). The fastest growth rate of T. suecica was shown in the red light, whereas the slowest was in yellow. The highest OTUs (3426) were identified on day 0, whereas the lowest ones (308) were found on day 15 under red light. The top 100 OTUs associated with day 0 and day 5 cultures of T. suecica under the red and yellow LED were compared. Only 26 OTUs were commonly identified among four samples. The highest numbers of unique OTUs were identified at day 0, indicating the high degree of initial microbial diversity of the T. suecica inoculum. The red light-unique OTUs occupied 34.98%, whereas the yellow-specific OTUs accounted for only 2.2%. This result suggested a higher degree of interaction in T. suecica culture under the red light, where stronger photosynthesis occurs. Apparently, the microbial community associated with T. suecica related to the oxygen produced by algal photosynthesis. This result may expand our knowledge about the algaebacteria consortia, which would be useful for various biotechnological applications including wastewater treatment, bioremediation, and sustainable aquaculture.

Characterization of the complete mitochondrial genome of Melibe japonica (Eliot, 1913) collected from Korean water.

Melibe japonica is the rarely identified nudibranch species in Korean and Japanese waters. Total mitochondrial genome of M. japonica collected from the coastal water of Busan, Korea, was determined by the bioinformatic assembly of the contigs generated by Illumina Miseq platform. The circular complete mitochondrial genome of M. japonica was 13, 216 bp in length, which contains 13 proteins, 2 ribosomal RNAs, and 22 tRNAs. Mitochondrial gene order of M. japonica is considerably different from the mitochondrial genome of Melibe leonina in which 6 genes (ND1, COX2, CYTB, ND4L, ND5, and ND6) were differently located. Phylogenetic analysis with COI regions showed that M. japonica is most closely related to Melibe viridis. However, not all Melibe species formed a single clade based on the phylogenetic analysis by COI region and more mitochondrial genomes in this genus should be further studied to have a better knowledge of the evolutional relationship of the nudibranchs.

Evaluation of antimicrobial effects of commercial mouthwashes utilized in South Korea.

Streptococcus mutans is frequently associated with dental caries. Bacterial fermentation of food debris generates an acidic environment on the tooth surface, ultimately resulting in tooth deterioration. Therefore, various mouthwashes have been used to reduce and prevent Streptococcus mutans. The aim of this study was to evaluate the antimicrobial activities of 4 commercial mouthwashes and those of 10% and 20% ethanol solutions (formula A, B, C, D, E and F) against Streptococcus mutans using biofilm and planktonic methods. The range of reduction in the viable cell count of Streptococcus mutans as estimated by the biofilm and planktonic methods was 0.05-5.51 log (P ≤ 0.01) and 1.23-7.51 log (P ≤ 0.001) compared with the negative control, respectively, indicating that the planktonic method had a stronger antibacterial effect against S. mutans. Among the tested formulations, formula A (Garglin regular® mouthwash) was the most effective against Streptococcus mutans (P ≤ 0.001).