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BACKGROUND: Hepatobiliary scintigraphy (HBS) is a useful diagnostic imaging technique that uses radiotracers to evaluate the function of the gallbladder (GB) and biliary system. In segmented GB, some HBS images reveal a discordant GB boundary as compared to anatomical images. AIM: To evaluate the characteristics of HBS in segmented GB and determine the clinical relevance according to HBS characteristics. METHODS: A total of 268 patients with chronic cholecystitis, gallstones, or biliary colic symptoms who underwent HBS between 2011 and 2020 were enrolled. Segmented GB was defined as segmental luminal narrowing of the GB body on computed tomography (CT) or magnetic resonance (MR) images, and HBS was examined 1 mo before or after CT or MR. Segmented GB was classified into 3 types based on the filling and emptying patterns of the proximal and distal segments according to the characteristics of HBS images, and GB ejection fraction (GBEF) was identified: Type 1 was defined as a normal filling and emptying pattern; Type 2 was defined as an emptying defect on the distal segment; and Type 3 was defined as a filling defect in the distal segment. RESULTS: Segmented GB accounted for 63 cases (23.5%), including 36 patients (57.1%) with Type 1, 18 patients (28.6%) with Type 2, and 9 patients (14.3%) with Type 3 emptying pattern. Thus, approximately 43% of HBS images showed a discordant pattern as compared to anatomical imaging of segmented GB. Although there were no significant differences in clinical symptoms, rate of cholecystectomy, or pathological findings based on the type, most gallstones occurred in the distal segment. Reported GBEF was 62.50% ± 24.79% for Type 1, 75.89% ± 17.21% for Type 2, and 88.56% ± 7.20% for Type 3. Type 1 showed no difference in reported GBEF compared to the non-segmented GB group (62.50% ± 24.79% vs 67.40% ± 21.78%). In contrast, the reported GBEF was higher in Types 2 and 3 with defective emptying and filling when compared to Type 1 (80.11% ± 15.70% vs 62.57% ± 24.79%; P = 0.001). CONCLUSION: In segmented GB, discordance in the filling patterns detected by HBS and anatomical imaging could lead to misinterpretation of GBEF. For this reason, clinicians should be cautious when interpreting HBS results in patients with segmented GB.
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Cubic-shaped hematite (C-Fe2O3) functionalized with amine groups was directly prepared via one-pot hydrothermal reaction of Fe3+ with 1,12-diaminododecane (DA-12) in aqueous solution (50% ethanol). Herein, DA-12 (as a Lewis acid) promoted the aggregation of α-FeOOH nanorods with Lewis base sites, leading to the rapid recrystallization and conversion into uniform C-Fe2O3. C-Fe2O3 was subsequently deposited with nanosized Au via sonochemical reduction of 1.0 wt% HAuCl4 (0.1-0.8 mL), hereafter referred to as Au-deposited C-Fe2O3 (C-Fe2O3@Au). X-ray diffraction patterns of C-Fe2O3@Au confirmed the hexagonal crystalline phases of hematite and crystalline Au (111) and showed a weak broad band attributed to the amorphous carbon of DA-12. C-Fe2O3@Au was tested as a visible-light photocatalyst towards the degradation of methylene blue (MB) dye. C-Fe2O3@Au (0.1-0.4 mL of 1.0 wt% HAuCl4) exhibited 6-8 times higher photocatalytic activity than the Au-free counterpart (C-Fe2O3). The enhanced photocatalysis was mainly attributed to the improved separation efficiency of photo-excited charge carriers, i.e., the facilitated transport of electrons from the conduction band to the lower lying Fermi level of Au. However, the photocatalytic activity of C-Fe2O3@Au (0.8 mL of 1.0 wt% HAuCl4) was decreased probably due to the reduction of active sites for MB adsorption by the high coverage of the Au layer. The combined hydrothermal and sonochemical methods provided the direct synthetic route to cubic-shaped hematite decorated with nanosized Au and surface amine functionality as a promising visible-light photocatalyst.
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Accurate and rapid blood-based detection of dopamine levels can aid in the diagnosis and monitoring of diseases related to dopaminergic dysfunction. For the sensitive detection of dopamine levels in human blood plasma (i.e., plasma dopamine levels), a silver-plated Au bimetallic nanocluster (so called plasmonic Au/Ag nanocluster) was prepared as a surface-enhanced Raman scattering (SERS) substrate by the combination of electrodeposition and electroless plating methods. The plasmonic effect of the Au/Ag nanocluster substrate was optimized by controlling the particle morphology, packing density, and interparticle distance, showing the best performance in its SERS activity. The lowest detection limit of dopamine was â¼10-11 M. A linear standard curve was obtained by plotting the log-scale of dopamine concentration (log C) versus Raman intensity at 1152 cm-1. The optimized SERS substrate quantified the plasma dopamine levels of patients with antipsychotic drug-induced Parkinsonism (n = 15) as 3.24 × 10-9 M and healthy control subjects (n = 15) as 2.31 × 10-8 M. Patients with drug-induced Parkinsonism had â¼86% lower plasma dopamine concentration than healthy subjects (two-tailed p-value = 0.000002), indicating a clear separation between the groups. Our study provides the first report on the quantitative SERS detection of dopamine levels in human blood plasma with Parkinsonism. The results highlight the potential clinical utility of the optimized SERS technique in screening clinical populations with dopaminergic dysfunction, i.e., differentiating between healthy subjects and patients with Parkinsonism.
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Intramural esophageal dissection is a rare but clinically important condition in the field of gastroenterology. Classically, intramural esophageal dissection rarely occurs in patients who are anticoagulated or have poor medical condition, and its clinical presentation may include chest pain, dysphagia and hematemesis. Herein, we present a case of intramural esophageal dissection in an alcoholic hepatitis patient that was diagnosed by endoscopy and successfully treated with conservative management.
