The Relationship between Types of Os Trigonum and Findings of Conventional Ankle Magnetic Resonance Imaging: A Study Based on Three-Dimensional Magnetic Resonance Imaging.

This study aimed to investigate the dimensions and types of the os trigonum and evaluate their relationship with various pathologic conditions on the posterior ankle using ankle MRI images. A total of 124 non-contrast-enhanced ankle and foot MR images of 123 consecutive patients were included in this retrospective study. The images were presented randomly, and they contained no patient information. The MR images were retrospectively and independently reviewed by two reviewers with a fellowship-trained musculoskeletal radiologist. The images were classified as type I and II based on the ossicle's medial border overlying the talus's posterior process and the groove for the flexor hallucis longus tendon (FHL). The study revealed that patients with type II os trigonum had a longer transverse diameter of the ossicle than type I, and there were statistically significant differences. Detachment status tended to be less in type I than in type II os trigonum, and the differences between the groups were statistically significant. There were no significant differences between type I and II os trigonum regarding posterior talofibular ligament (PTFL) abnormality, bone marrow edema, FHL tenosynovitis, and posterior synovitis. The study concluded that the os trigonum is a common cause of posterior ankle impingement, and type II os trigonum has a longer transverse diameter of the ossicle than type I.

ChatGPT's Accuracy on Magnetic Resonance Imaging Basics: Characteristics and Limitations Depending on the Question Type.

Our study aimed to assess the accuracy and limitations of ChatGPT in the domain of MRI, focused on evaluating ChatGPT's performance in answering simple knowledge questions and specialized multiple-choice questions related to MRI. A two-step approach was used to evaluate ChatGPT. In the first step, 50 simple MRI-related questions were asked, and ChatGPT's answers were categorized as correct, partially correct, or incorrect by independent researchers. In the second step, 75 multiple-choice questions covering various MRI topics were posed, and the answers were similarly categorized. The study utilized Cohen's kappa coefficient for assessing interobserver agreement. ChatGPT demonstrated high accuracy in answering straightforward MRI questions, with over 85% classified as correct. However, its performance varied significantly across multiple-choice questions, with accuracy rates ranging from 40% to 66.7%, depending on the topic. This indicated a notable gap in its ability to handle more complex, specialized questions requiring deeper understanding and context. In conclusion, this study critically evaluates the accuracy of ChatGPT in addressing questions related to Magnetic Resonance Imaging (MRI), highlighting its potential and limitations in the healthcare sector, particularly in radiology. Our findings demonstrate that ChatGPT, while proficient in responding to straightforward MRI-related questions, exhibits variability in its ability to accurately answer complex multiple-choice questions that require more profound, specialized knowledge of MRI. This discrepancy underscores the nuanced role AI can play in medical education and healthcare decision-making, necessitating a balanced approach to its application.

The Development and Validation of an AI Diagnostic Model for Sacroiliitis: A Deep-Learning Approach.

PURPOSE: Sacroiliitis refers to the inflammatory condition of the sacroiliac joints, frequently causing lower back pain. It is often associated with systemic conditions. However, its signs on radiographic images can be subtle, which may result in it being overlooked or underdiagnosed. This study aims to utilize artificial intelligence (AI) to create a diagnostic tool for more accurate sacroiliitis detection in radiological images, with the goal of optimizing treatment plans and improving patient outcomes. MATERIALS AND METHOD: The study included 492 patients who visited our hospital. Right sacroiliac joint films were independently evaluated by two musculoskeletal radiologists using the Modified New York criteria (Normal, Grades 1-4). A consensus reading resolved disagreements. The images were preprocessed with Z-score standardization and histogram equalization. The DenseNet121 algorithm, a convolutional neural network with 201 layers, was used for learning and classification. All steps were performed on the DEEP:PHI platform. RESULT: The AI model exhibited high accuracy across different grades: 94.53% (Grade 1), 95.83% (Grade 2), 98.44% (Grade 3), 96.88% (Grade 4), and 96.09% (Normal cases). Sensitivity peaked at Grade 3 and Normal cases (100%), while Grade 4 achieved perfect specificity (100%). PPVs ranged from 82.61% (Grade 1) to 100% (Grade 4), and NPVs peaked at 100% for Grade 3 and Normal cases. The F1 scores ranged from 64.41% (Grade 1) to 95.38% (Grade 3). CONCLUSIONS: The AI diagnostic model showcased a robust performance in detecting and grading sacroiliitis, reflecting its potential to enhance diagnostic accuracy in clinical settings. By facilitating earlier and more accurate diagnoses, this model could substantially impact treatment strategies and patient outcomes.

Validation of a Deep Learning Chest X-ray Interpretation Model: Integrating Large-Scale AI and Large Language Models for Comparative Analysis with ChatGPT.

This study evaluates the diagnostic accuracy and clinical utility of two artificial intelligence (AI) techniques: Kakao Brain Artificial Neural Network for Chest X-ray Reading (KARA-CXR), an assistive technology developed using large-scale AI and large language models (LLMs), and ChatGPT, a well-known LLM. The study was conducted to validate the performance of the two technologies in chest X-ray reading and explore their potential applications in the medical imaging diagnosis domain. The study methodology consisted of randomly selecting 2000 chest X-ray images from a single institution's patient database, and two radiologists evaluated the readings provided by KARA-CXR and ChatGPT. The study used five qualitative factors to evaluate the readings generated by each model: accuracy, false findings, location inaccuracies, count inaccuracies, and hallucinations. Statistical analysis showed that KARA-CXR achieved significantly higher diagnostic accuracy compared to ChatGPT. In the 'Acceptable' accuracy category, KARA-CXR was rated at 70.50% and 68.00% by two observers, while ChatGPT achieved 40.50% and 47.00%. Interobserver agreement was moderate for both systems, with KARA at 0.74 and GPT4 at 0.73. For 'False Findings', KARA-CXR scored 68.00% and 68.50%, while ChatGPT scored 37.00% for both observers, with high interobserver agreements of 0.96 for KARA and 0.97 for GPT4. In 'Location Inaccuracy' and 'Hallucinations', KARA-CXR outperformed ChatGPT with significant margins. KARA-CXR demonstrated a non-hallucination rate of 75%, which is significantly higher than ChatGPT's 38%. The interobserver agreement was high for KARA (0.91) and moderate to high for GPT4 (0.85) in the hallucination category. In conclusion, this study demonstrates the potential of AI and large-scale language models in medical imaging and diagnostics. It also shows that in the chest X-ray domain, KARA-CXR has relatively higher accuracy than ChatGPT.

Non-Destructive Monitoring via Electrochemical NADH Detection in Murine Cells.

Nicotinamide adenine dinucleotide (NADH) is an important cofactor involved in metabolic redox reactions in living cells. The detection of NADH in living animal cells is a challenge. We developed a one-step monitoring method for NADH via an electrocatalytic reaction that uses a surface-modified, screen-printed electrode (SPE) having a redox active monolayer 4'-mercapto-N-phenlyquinone diamine (NPQD) formed by a self-assembled monolayer (SAM) of an aromatic thiol, 4-aminothiophenol (4-ATP). This electrode has a limit of detection (LOD) of 0.49 µM and a sensitivity of 0.0076 ± 0.0006 µM/µA in cell culture media, which indicates that it retains its selectivity. The applicability of this NADH sensor was demonstrated for the first time by cell viability monitoring via NADH-sensing in cell culture supernatants.

Relationship between Cytotoxicity and Surface Oxidation of Artificial Black Carbon.

The lacking of laboratory black carbon (BC) samples have long challenged the corresponding toxicological research; furthermore, the toxicity tests of engineered carbon nanoparticles were unable to reflect atmospheric BC. As a simplified approach, we have synthesized artificial BC (aBC) for the purpose of representing atmospheric BC. Surface chemical properties of aBC were controlled by thermal treatment, without transforming its physical characteristics; thus, we were able to examine the toxicological effects on A549 human lung cells arising from aBC with varying oxidation surface properties. X-ray photoelectron spectroscopy, as well as Raman and Fourier transform infrared spectroscopy, verified the presence of increased amounts of oxygenated functional groups on the surface of thermally-treated aBC, indicating aBC oxidization at elevated temperatures; aBC with increased oxygen functional group content displayed increased toxicity to A549 cells, specifically by decreasing cell viability to 45% and elevating reactive oxygen species levels up to 294% for samples treated at 800 °C.

Inter-observer reliability and clinical validity of the MRI grading system for cervical central stenosis based on sagittal T2-weighted image.

PURPOSE: The aim was to evaluate the inter-observer reliability of the Kang system among radiologists, residents, and clinicians and examine the correlation between radiologic and clinical findings. METHODS: A total of 133 patients (M:F = 44:89, mean age 56 years) who underwent MRI of the cervical spine at our hospital were included. Two radiologists, two trainees, and two clinicians measured Central cervical spinal stenosis (CCSS) grade at the narrowest point according to the grading system suggested by Kang et al. A different clinician (a neurosurgeon) assessed the associated neurologic manifestations. Kappa statistics were used to analyze the inter-reader agreement among the radiologists, trainees, and clinicians. The clinical correlation (R) between grade and positive clinical manifestations (PCMs) was assessed using nonparametric correlation analysis (Spearman's correlation). RESULTS: We found almost perfect agreement between trainees (k value = 0.890) and between radiologists (k value = 0.912) and substantial agreement between clinicians (k value = 0.691). Clinical correlations for all six readers suggested moderate correlation with R values ranging from 0.380 to 0.566. There was moderate correlation between grade and clinical manifestation within each group (R = 0.562-0.669). CONCLUSION: The Kang MRI grading system of CCSS based on mid-sagittal MRI provides objective, reliable, and reproducible assessment regardless of field proficiency of the reader although the reproducibility of the clinician is slightly lower than radiologist and trainee of the radiology department. There was moderate correlation between image interpretation and clinical findings irrespective of the reader's main field of research.

In vitro model for predicting acute inhalation toxicity by using a Calu-3 epithelium cytotoxicity assay.

INTRODUCTION: As the current methods to predict the inhalation toxicity of chemicals using animal models are limited, alternative methods are required. We present a new in vitro prediction method for acute inhalation toxicity using the Calu-3 epithelial cytotoxicity assay applicable for water-soluble inhalable chemicals. METHOD: To confirm the characteristics of the optimal Calu-3 epithelium, tight-junction formation, morphology, and mucus secretion were verified using scanning electron microscopy, transepithelial electrical resistance analysis, and immunofluorescence after growth in an air-liquid interface (ALI). Sixty chemicals, including 38 positive and 22 negative for acute inhalation toxicity, were selected from the European Chemical Agency chemical database. The cell viability of the exposed cells was assessed using an MTT assay to predict the acute inhalation toxicity by calculating the area under the receiver operating characteristic (ROC) curve and accuracy. RESULTS: When cultivated in an ALI, the epithelium was thicker and secreted more mucin than that under submerged cultivation, characteristic of the in vivo respiratory epithelium. The areas under the ROC curve were 0.75 and 0.78 when exposed to chemicals at concentrations of 2.5 and 5%, respectively. The highest accuracy of the methods was 68 and 78% at cut-off values of 85 and 40% cell viability, respectively. DISCUSSION: The in vitro model was moderately accurate with good prediction. It is replicable because of its advantages, i.e., the use of cultured cells and the simplicity of the method. Overall, the Calu-3 epithelial cytotoxicity assay may be a useful and simple approach to identify substances that cause acute inhalation toxicity.

Interreader Reliability and Clinical Validity of a Magnetic Resonance Imaging Grading System for Cervical Foraminal Stenosis.

OBJECTIVE: Park system is a magnetic resonance imaging (MRI) grading system for cervical neural foraminal stenosis (CNFS) and consists of 4 grades (0-3) based on the foraminal shape of 45-degree T2-weighted oblique sagittal images. The objective of this study was to evaluate the interreader reliability of the Park system among radiologists, residents, and clinicians. This study also assessed the correlations between radiologic and clinical findings. MATERIAL AND METHODS: A total of 289 patients (men:women = 155:134, mean age = 50 years) who underwent oblique sagittal MRI of the cervical spine at our hospital were included. According to the MR grading system suggested by Park et al (Br J Radiol 2013;86:20120515), 2 radiologists, 2 trainees, and 2 clinicians measured CNFS grade at the most narrow point. A neurosurgeon assessed the associated clinical manifestations. κ statistics were used to analyze the interreader agreement among the radiologists and clinicians. The clinical correlations between grade and positive clinical manifestations were assessed with R using nonparametric correlation analysis (Spearman correlation). RESULTS: The overall interreader agreements between radiologists, between trainees, between clinicians, and between radiologists and clinicians were almost perfect (κ = 0.80-0.96). There were moderate correlations between grade and clinical manifestations in each group (R = 0.562-0.669). There were moderate to relatively high correlations between grade and neurologic manifestations based on cervical level (R = 0.570-0.715) (all P < 0.05). CONCLUSIONS: Regardless of reader experience, there was substantial to almost perfect interreader reliability with the Park system for CNFS based on oblique sagittal MRI.

Adhesive Capsulitis of the Shoulder Joint: Value of Glenohumeral Distance on Magnetic Resonance Arthrography.

OBJECTIVE: To evaluate the usefulness of glenohumeral distance (GHD) on axial images of magnetic resonance (MR) arthrography for diagnosis of adhesive capsulitis and to compare this finding with previously reported classic MR arthrographic findings of adhesive capsulitis. MATERIALS AND METHODS: Our study was approved by the institutional ethical review board of our institute. We evaluated 41 patients (M-F, 35:6; mean age, 46 years; adhesive capsulitis, 21; no adhesive capsulitis, 20) who underwent MR arthrography. Two radiologists measured GHD, width of the axillary recess, and capsular thickness in consensus. The GHD was measured from the subchondral bone of the glenoid fossa to the subchondral bone of the humeral head at the level of the midline of the humeral head. Glenohumeral distance (anterior, middle, posterior, and mean), width of the axillary recess, and capsular thickness (anterior, posterior, and mean) were compared in the adhesive capsulitis and no adhesive capsulitis groups using the Mann-Whitney U test. RESULTS: The mean GHD of the no adhesive capsulitis group was longer than that of the adhesive capsulitis group. The length differences were statistically significant (P < 0.05). The mean width of the axillary recess of the no adhesive capsulitis group was significantly wider than that of the adhesive capsulitis group (P < 0.001). The mean capsular thickness of the no adhesive capsulitis group was significantly thinner than that in the adhesive capsulitis group (P = 0.001). CONCLUSIONS: A decreased GHD on MR arthrography can be another useful feature to diagnose adhesive capsulitis in addition to previously presented radiologic features such as capsular thickening and reduced axillary recess capacity.

Nationwide Study of Humidifier Disinfectant Lung Injury in South Korea, 1994-2011. Incidence and Dose-Response Relationships.

RATIONALE: Humidifier disinfectant lung injury is an acute lung disease attributed to recurrent inhalation of certain disinfectant aerosols emitted from room humidifiers. An outbreak of this toxic lung injury occurred in South Korea from 1995 until all humidifier disinfectant products were recalled from the consumer market by the government in 2011. OBJECTIVES: A nationwide study was conducted to ascertain and classify all potential cases of humidifier disinfectant lung injury in Korea and to assess dose-response relationships. METHODS: By several mechanisms, clinicians and the general public were invited to report all suspected cases of humidifier disinfectant lung injury to public health officials in South Korea. A committee was convened to define diagnostic criteria based on pathologic, radiologic, and clinical findings for index cases, combined with assessment of environmental exposure to humidifier disinfectants. Clinical review and environmental assessments were performed and later combined to determine overall likelihood of disease for each study participant, classified as definite, probable, possible, or unlikely. Survival time from exposure to onset of symptoms was analyzed to assess dose-response relationships. Three broad categories of risk factors were examined: (1) biological susceptibility, (2) temporal cycle of exposure and recovery, and (3) spatial conditions and density of disinfectant. MEASUREMENTS AND MAIN RESULTS: Of 374 possible cases identified and reviewed, 329 were unanimously classified by the diagnostic committee, as follows: 117 definite, 34 probable, 38 possible and 140 unlikely cases. A total of 62 individuals with definite or probable disease died. Risk factors examined for polyhexamethyleneguanidine phosphate exposure that were found to be significant in shortening survival included age 4 years or younger at onset, use of disinfectant for 7 days per week, airborne density of 800 µg/m(3) or more of disinfectant, and daily exposure 11 or more hours in duration. CONCLUSIONS: Dose-response analysis indicated that development of humidifier disinfectant lung injury and death were associated strongly with recurrent, intense, acute exposure without sufficient recovery time between exposures, more so than long-term cumulative exposure. These findings may explain some reversible or clinically unapparent cases among coexposed family members.

Anti-inflammatory effects of the Zingiber officinale roscoe constituent 12-dehydrogingerdione in lipopolysaccharide-stimulated Raw 264.7 cells.

Ginger has long been used worldwide as a spice, seasoning, and wine and is also used as a traditional medicine. There have been no previous studies of the potential beneficial effects of the ginger constituent 12-dehydrogingerdione (12-DHGD). We investigated the anti-inflammatory effect of 12-DHGD on lipopolysaccharide (LPS)-stimulated Raw 264.7 cells. The cytotoxicity of 12-DHGD was measured using the MTT assay, and production of prostaglandin E2 (PGE2 ) and the inflammatory cytokines interleukin (IL)-1ß, IL-6, and tumor necrosis factor (TNF)-α was measured by ELISA. Production of nitric oxide (NO) was measured using Griess reagent and expression of cyclooxygenase-2 (COX-2) and inducible NO (iNOS) enzymes was assessed by reverse transcriptase-polymerase chain reaction. Treatment of Raw 264.7 cells with 12-DHGD significantly inhibited LPS-stimulated production of NO (at 12-DHGD concentrations of 150 and 200 ng/ml), IL-6 (at 50, 100, 150, and 200 ng/ml), and PGE2 (at 200 ng/ml). Consistent with the effects on NO and PGE2 production, 12-DHGD treatment also inhibited the LPS-stimulated increase in iNOS and COX-2 mRNA levels. However, 12-DHGD did not affect production of IL-1ß or TNF-α in response to LPS. 12-DHGD, a constituent of ginger, is a potent inhibitor of proinflammatory mediator production in Raw 264.7 macrophage cells.