Efficient Collaboration Between Radiologists Using the PACS-Integrated Refer Function to Reduce Communication Times.

The purpose of this study was to assess the utility of a picture archiving and communication systems (PACS)-integrated refer function for improving collaboration between radiologists and radiographers during daily reading sessions. Retrospective analysis was conducted on refers sent by radiologists using a PACS-integrated refer system from March 2020 to December 2021. Refers were categorized according to receiver: radiologists in the same division (intra-division), radiologists in a different division (inter-division), and radiographers. The proportions of answered refers, content of refers, and timing of refer posts were evaluated. Additionally, time intervals in minutes from initial refer post to refer response were assessed to assess the efficiency of the refer system and compared according to receivers using the Mann-Whitney U test. Among a total of 691 refers posted by radiologists, 579 (83.8%) were answered directly using the refer function in PACS. Of the answered refers, 346 refers (59.8%) were made between radiologists, and 173 (50%) were intra-division refers. About the content of refers, about 82.6% of radiologists' refers were about imaging interpretation consultation, and about 98.9% of refers from radiologists to radiographers were for image quality control. The median time interval until refer response was 9 min, and this response time did not differ between intra-division and inter-division refers (p = 0.998). Of the refers that got responses, 74.3% (257/346) were sent among radiologists before official reports were made, and the median time until refer response was 9-10 min. The proportion of refers answered by radiographers was 85.7% (233/272). The median time interval until refer response by radiographers was 87 min for all refers, and 63% were made within 6 h. Therefore, the PACS-integrated refer function can facilitate communication between radiologists for image interpretation and quality control.

Case Study: Improving the Quality of Dairy Cow Reconstruction with a Deep Learning-Based Framework.

Three-dimensional point cloud generation systems from scanning data of a moving camera provide extra information about an object in addition to color. They give access to various prospective study fields for researchers. With applications in animal husbandry, we can analyze the characteristics of the body parts of a dairy cow to improve its fertility and milk production efficiency. However, in the depth image generation from stereo data, previous solutions using traditional stereo matching algorithms have several drawbacks, such as poor-quality depth images and missing information in overexposed regions. Additionally, the use of one camera to reconstruct a comprehensive 3D point cloud of the dairy cow has several challenges. One of these issues is point cloud misalignment when combining two adjacent point clouds with the small overlapping area between them. In addition, another drawback is the difficulty of point cloud generation from objects which have little motion. Therefore, we proposed an integrated system using two cameras to overcome the above disadvantages. Specifically, our framework includes two main parts: data recording part applies state-of-the-art convolutional neural networks to improve the depth image quality, and dairy cow 3D reconstruction part utilizes the simultaneous localization and calibration framework in order to reduce drift and provide a better-quality reconstruction. The experimental results showed that our approach improved the quality of the generated point cloud to some extent. This work provides the input data for dairy cow characteristics analysis with a deep learning approach.

Hepatic arterial damage after transarterial chemoembolization for the treatment of hepatocellular carcinoma: comparison of drug-eluting bead and conventional chemoembolization in a retrospective controlled study.

Background Transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) frequently causes feeding artery stenosis or occlusion that may interfere with repeated treatment. Purpose To investigate the incidence and predictors of hepatic arterial damage (HAD) after drug-eluting bead-TACE (DEB-TACE) in comparison with conventional TACE (Conv-TACE). Material and Methods We retrospectively analyzed 54 patients who underwent DEB-TACE for HCC as an initial treatment with follow-up angiography and 54 patients who underwent Conv-TACE using doxorubicin-lipiodol mixture and gelfoam particles for comparison. HAD was evaluated after a single session of TACE and graded as follows: grade I, no significant wall irregularity; grade II, overt stenosis; grade III, occlusion. Results The incidence of HAD was significantly higher in the DEB-TACE group than the Conv-TACE group when analyzed per branch (odds ratio [OR], 6.36; P < 0.001) and per patient (OR, 3.15; P = 0.005). For each HAD grade, the mean doxorubicin dose was greater in the DEB-TACE group than in the Conv-TACE group ( P < 0.001, P = 0.053, and P = 0.01 for grades I, II, and III, respectively). In multivariate analysis, risk factors of HAD included mean doxorubicin dose and selective embolization in the Conv-TACE group ( P = 0.03 and P < 0.001, respectively) and mean doxorubicin dose in the DEB-TACE group ( P = 0.004). Conclusion The incidence and grade of HAD were higher after DEB-TACE compared to Conv-TACE with doxorubicin dose as a possible risk factor. HAD was independent of overall survival in both groups.

MRI Findings and Prediction of Time to Progression of Patients with Hepatocellular Carcinoma Treated with Drug-eluting Bead Transcatheter Arterial Chemoembolization.

The purpose of this study was to investigate the utility of MRI findings after drug-eluting beads (DEB) - transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma in predicting time to progression (TTP). This study included 48 patients with 60 lesions who underwent liver MRI within 3 months after DEB-TACE. MRI was assessed for arterial enhancement pattern, late washout, arterioportal shunt, signal intensity on T2-weighted image, intratumoral septa, enhancing tissue on subtraction images, and treatment response. Cox-regression analysis was performed to identify independent factors to predict TTP. TTP was calculated using the Kaplan-Meier method with the log-rank test. Per lesion, 30 achieved complete remission, 22 had a partial response, and the remaining 8 lesions displayed stable disease on MRI. Arterial enhancement pattern, washout and enhancing tissue on subtraction images from MRI were associated with viable tumor on the last follow-up computerized tomography. Arterial enhancement, washout and enhancing tissue on subtraction images were significant predictors of TTP, but only enhancing tissue on subtraction images remained a significant predictor of TTP (P=0.018) in the multivariate analysis. TTP was longer in the group without enhancing tissue on subtraction images compared to the group with enhancing tissue (601 days vs. 287 days, P<0.001). Enhancing tissue on subtraction images from MRI after DEB-TACE is predictive for longer TTP.

Ultrasonographic features of fibrous hamartoma of infancy.

OBJECTIVE: To review imaging features of fibrous hamartoma of infancy (FHI), focusing on ultrasonography (US) findings. MATERIALS AND METHODS: We retrospectively reviewed pediatric patients who were diagnosed with pathologically confirmed FHI in two children's hospitals from 2004 to 2013. Imaging features of US, Doppler US, and magnetic resonance imaging (MRI) were evaluated. RESULTS: Thirteen pediatric patients (M:F = 7:6; age 5-22 months, mean 11.3 months) were included. Mean lesion size was 3.2 cm (range, 0.7-8.0 cm). The tumors were located in the back (n = 4), scrotum (n = 2), scalp, shoulder, axilla, forearm, intergluteal cleft, inguinal area, and thigh. US was performed in 11 patients. With the exception of two scrotal masses, all masses were located in the dermal and subcutaneous layer. All masses demonstrated heterogeneous hyperechogenicity with a "serpentine pattern" of intervening hypoechoic portions in the hyperechoic mass. The margins were ill-defined (n = 9) or lobulated (n = 2). Doppler US was performed in nine patients and showed no (n = 6) or minimal (n = 3) vascularity. MRI was performed in five patients and the masses showed heterogeneous signal intensity with the presence of fat on T1- and T2-weighted images. CONCLUSIONS: FHI is a tumor that is typically located in the dermal and subcutaneous layer in young children less than 2 years old and presents as a heterogeneously hyperechoic mass with a "serpentine pattern" and ill-defined or lobulated margin on US and no remarkable vascularity on Doppler US.

The NF-κB transcription factor c-Rel is required for Th17 effector cell development in experimental autoimmune encephalomyelitis.

Experimental autoimmune encephalomyelitis (EAE) is a T cell-mediated autoimmune disease involving effector Th subsets such as Th1 and Th17. In this study, we demonstrate that mice lacking the NF-κB transcription factor family member c-Rel (rel(-/-)), which are known to be resistant to EAE, show impaired Th17 development. Mixed bone marrow chimeras and EAE adoptive transfer experiments show that the deficiency of effector Th17 cells in rel(-/-) mice is T cell intrinsic. Consistent with this finding, c-Rel was activated in response to TCR signaling in the early stages of Th17 development and controlled the expression of Rorc, which encodes the Th17 transcription factor retinoic acid-related orphan receptor γt. CD28, but not IL-2, repression of Th17 development was dependent on c-Rel, implicating a dual role for c-Rel in modulating Th17 development. Adoptive transfer experiments also suggested that c-Rel control of regulatory T cell differentiation and homeostasis influences EAE development and severity by influencing the balance between Th17 and regulatory T cells. Collectively, our findings indicate that in addition to promoting Th1 differentiation, c-Rel regulates the development and severity of EAE via multiple mechanisms that impact on the generation of Th17 cells.

Hospital-wide survey of clinical experience with artificial intelligence applied to daily chest radiographs.

PURPOSE: To assess experience with and perceptions of clinical application of artificial intelligence (AI) to chest radiographs among doctors in a single hospital. MATERIALS AND METHODS: A hospital-wide online survey of the use of commercially available AI-based lesion detection software for chest radiographs was conducted with all clinicians and radiologists at our hospital in this prospective study. In our hospital, version 2 of the abovementioned software was utilized from March 2020 to February 2021 and could detect three types of lesions. Version 3 was utilized for chest radiographs by detecting nine types of lesions from March 2021. The participants of this survey answered questions on their own experience using AI-based software in daily practice. The questionnaires were composed of single choice, multiple choices, and scale bar questions. Answers were analyzed according to the clinicians and radiologists using paired t-test and the Wilcoxon rank-sum test. RESULTS: One hundred twenty-three doctors answered the survey, and 74% completed all questions. The proportion of individuals who utilized AI was higher among radiologists than clinicians (82.5% vs. 45.9%, p = 0.008). AI was perceived as being the most useful in the emergency room, and pneumothorax was considered the most valuable finding. Approximately 21% of clinicians and 16% of radiologists changed their own reading results after referring to AI, and trust levels for AI were 64.9% and 66.5%, respectively. Participants thought AI helped reduce reading times and reading requests. They answered that AI helped increase diagnostic accuracy and were more positive about AI after actual usage. CONCLUSION: Actual adaptation of AI for daily chest radiographs received overall positive feedback from clinicians and radiologists in this hospital-wide survey. Participating doctors preferred to use AI and regarded it more favorably after actual working with the AI-based software in daily clinical practice.

Fast-Embeddable Grooved Microneedles by Shear Actuation for Accurate Transdermal Drug Delivery.

Percutaneous drug delivery using microneedles (MNs) has been extensively exploited to increase the transdermal permeability of therapeutic drugs. However, it is difficult to control the precise dosage with existing MNs and they need to be attached for a long time, so a more simple and scalable method is required for accurate transdermal drug delivery. In this study, we developed grooved MNs that can be embedded into the skin by mechanical fracture following simple shear actuation. Grooved MNs are prepared from hyaluronic acid (HA), which is a highly biocompatible and biodegradable biopolymer. By adjusting the aspect ratio (length:diameter) of the MN and the position of the groove, the MN tip inserted into the skin can be easily broken by shear force. In addition, it was demonstrated that it is possible to deliver the desired amount of triamcinolone acetonide (TCA) for alopecia areata by controlling the position of the groove structure and the concentration of TCA loaded in the MN. It was also confirmed that the tip of the TCA MN can be accurately delivered into the skin with a high probability (98% or more) by fabricating an easy-to-operate applicator to provide adequate shear force. The grooved MN platform has proven to be able to load the desired amount of a drug and deliver it at the correct dose.

Three-dimensional topology-based T-index as an indicator of surgical difficulty of partial nephrectomy in patients with small renal mass.

PURPOSE: To accurately describe the three-dimensional topology of renal tumors, our study suggests a new nephrometry scoring system, the T-index, that combines information about intraparenchymal extension and peripherality of the renal tumor. MATERIALS AND METHODS: This study included 113 patients who underwent partial nephrectomy for small clear cell renal cell carcinoma between 2007 and 2014. Manual segmentation of the renal parenchyma, sinus, and tumor was performed using preoperative computed tomography images. The T-index was calculated by adding the reciprocals of the distances from all points on the tumor-parenchyma interface to the renal sinus. Correlations with perioperative factors and the impact of the T-index on postoperative complications were evaluated and compared with existing nephrometry scoring systems (PADUA, RENAL, contact surface area [CSA], and C-index). RESULTS: The mean value of the T-index among the 113 patients was 116.1±100.5 (1/mm). The T-index showed the strongest correlation with perioperative factors compared with other nephrometry scoring systems. The T-index was able to predict the risk for postoperative complications, either overall (p=0.015) or major complications (p=0.030). A predictive model based on the T-index of the overall postoperative complications presented the best performance (area under the curve, 0.692; 95% CI, 0.599-0.776) compared with other nephrometry scoring systems. CONCLUSIONS: The T-index can be considered as a single value comprising key structural indicators for surgical complexity. Our findings suggest that the T-index can provide a quantitative and objective scoring system associated with surgical difficulty and postoperative complications of partial nephrectomy.

Korean Society of Endourology and Robotics (KSER) recommendation on the diagnosis, treatment, and prevention of urolithiasis.

This article provides evidence-based recommendations and expert opinions to aid urologists in making optimal decisions regarding managing urolithiasis in various clinical scenarios. The most frequently asked questions by urologists in their clinical practice have been collected and answered in the form of FAQs; based on the latest evidence and expert opinions. The natural history of urolithiasis is divided into active treatment and silent phases, with the active treatment stage divided into typical and special situations and peri-treatment management. The authors address 28 key questions, offering practical guidance for the proper diagnosis, treatment, and prevention of urolithiasis in clinical practice. This article is expected to be served as a valuable resource for urologists.

Imaging Patterns of Bacillus Calmette-Guérin-Related Granulomatous Prostatitis Based on Multiparametric MRI.

OBJECTIVE: To categorize multiparametric MRI features of Bacillus Calmette-Guérin (BCG)-related granulomatous prostatitis (GP) and discover potential manifestations for its differential diagnosis from prostate cancer. MATERIALS AND METHODS: The cases of BCG-related GP in 24 male (mean age ± standard deviation, 66.0 ± 9.4 years; range, 50-88 years) pathologically confirmed between January 2011 and April 2019 were retrospectively reviewed. All patients underwent intravesical BCG therapy followed by a MRI scan. Additional follow-up MRI scans, including diffusion-weighted imaging (DWI), were performed in 19 patients. The BCG-related GP cases were categorized into three: A, B, or C. The lesions with diffusion restriction and homogeneous enhancement were classified as type A. The lesions with diffusion restriction and a poorly enhancing component were classified as type B. A low signal intensity on high b-value DWI (b = 1000 s/mm²) was considered characteristic of type C. Two radiologists independently interpreted the MRI scans before making a consensus about the types. RESULTS: The median lesion size was 22 mm with the interquartile range (IQR) of 18-26 mm as measured using the initial MRI scans. The lesion types were A, B, and C in 7, 15, and 2 patients, respectively. Cohen's kappa value for the inter-reader agreement for the interpretation of the lesion types was 0.837. On the last follow-up MRI scans of 19 patients, the size decreased (median, 5.8 mm; IQR, 3.4-8.5 mm), and the type changed from A or B to C in 11 patients. The lesions resolved in four patients. In five patients who underwent prostatectomy, caseous necrosis on histopathology matched with the non-enhancing components of type B lesions and the entire type C lesions. CONCLUSION: BCG-related GP demonstrated three imaging patterns on multiparametric MRI. Contrast-enhanced T1-weighted imaging and DWI may play a role in its differential diagnosis from prostate cancer.

Accuracy and Efficiency of Right-Lobe Graft Weight Estimation Using Deep-Learning-Assisted CT Volumetry for Living-Donor Liver Transplantation.

CT volumetry (CTV) has been widely used for pre-operative graft weight (GW) estimation in living-donor liver transplantation (LDLT), and the use of a deep-learning algorithm (DLA) may further improve its efficiency. However, its accuracy has not been well determined. To evaluate the efficiency and accuracy of DLA-assisted CTV in GW estimation, we performed a retrospective study including 581 consecutive LDLT donors who donated a right-lobe graft. Right-lobe graft volume (GV) was measured on CT using the software implemented with the DLA for automated liver segmentation. In the development group (n = 207), a volume-to-weight conversion formula was constructed by linear regression analysis between the CTV-measured GV and the intraoperative GW. In the validation group (n = 374), the agreement between the estimated and measured GWs was assessed using the Bland-Altman 95% limit-of-agreement (LOA). The mean process time for GV measurement was 1.8 ± 0.6 min (range, 1.3-8.0 min). In the validation group, the GW was estimated using the volume-to-weight conversion formula (estimated GW [g] = 206.3 + 0.653 × CTV-measured GV [mL]), and the Bland-Altman 95% LOA between the estimated and measured GWs was -1.7% ± 17.1%. The DLA-assisted CT volumetry allows for time-efficient and accurate estimation of GW in LDLT.

Minoxidil-loaded hyaluronic acid dissolving microneedles to alleviate hair loss in an alopecia animal model.

Alopecia is defined as hair loss in a part of the head due to various causes, such as drugs, stress and autoimmune disorders. Various therapeutic agents have been suggested depending on the cause of the condition and patient sex, and age. Minoxidil (MXD) is commonly used topically to treat alopecia, but its low absorption rate limits widespread use. To overcome the low absorption, we suggest microneedles (MNs) as controlled drug delivery systems that release MXD. We used hyaluronic acid (HA) to construct MN, as it is biocompatible and safe. We examined the effect of HA on the hair dermal papilla (HDP) cells that control the development of hair follicles. HA enhanced proliferation, migration, and aggregation of HDP cell by increasing cell-cell adhesion and decreasing cell substratum. These effects were mediated by the cluster of differentiation (CD)-44 and phosphorylation of serine­threonine kinase (Akt). In chemotherapy-induced alopecia mice, topical application of HA tended to decrease chemotherapy-induced hair loss. Although the amount of MXD administered by HA-MNs was 10% of topical treatment, the MXD-containing HA-MNs (MXD-HA-MNs) showed better effects on the growth of hair than topical application of MXD. In summary, our results demonstrated that HA reduces hair loss in alopecia mice, and that delivery of MXD and HA using MXD-HA-MNs maximizes therapeutic effects and minimize the side effects of MXD for the treatment of alopecia. STATEMENT OF SIGNIFICANCE: (1) Significance, This work reports a new approach for treatment of alopecia using a dissolving microneedle (MN) prepared with hyaluronic acid (HA). The HA provided a better environment for cellular functions in the hair dermal papilla cells. The HA-MNs containing minoxidil (MXD) exhibited a significant reduction of hair loss, although amount of MXD contained in them was only 10% of topically applied MXD., (2) Scientific impact, This is the first report demonstrating the direct anti-alopecia effects of HA administrated in a transdermal route and the feasibility of novel therapeutics using MXD-containing HA-MNs. We believe that our work will excite interdisciplinary readers of Acta Biomaterialia, those who are interested in the natural polymers, drug delivery, and alopecia.

User-demand fast-curable ocular glues enforced by multilength tunable networks.

Achieving fast and secure wound closure without ocular foreign body sensation is highly desired in ophthalmologic surgery. Sutureless approaches using tissue adhesives are gaining popularity, but their practical use is limited by the difficulty in controlling adhesion time and satisfying safety standards without compromising adhesive performance. Herein, we report user-demand hydrogel-forming ocular glues based on multilength photo-crosslinkable hyaluronic acid (HA), achieving firm tissue adhesion under wet and dynamic conditions and possessing cornea-like optical transparency. The HA-based photocurable glue (HA photoglue) quickly seals wounds upon nontoxic low-energy light exposure (320-500 nm, < 5 s, < 1 J cm-2), and its mechanical and adhesive properties are improved by introducing short and long crosslinkable moieties into HA through one-step synthesis, forming multilength networks. Furthermore, the HA photoglue provides stable sealing in wet environments like ocular mucous surface, a clear vision with a light transmittance of more than 95% over the entire visible range, and a lubricating surface with minimal ocular sensation (generating less than 10% frictional force than suture groups). In a rabbit corneal incision model, the HA photoglue showed improved wound healing efficacy based on histological evaluation compared to control groups.

[Imaging of Scrotal Tumors]. / 음낭 ì¢ ì–‘ì˜ 영상 소견.

Ultrasonography is effective for imaging superficial organs, such as the scrotum. Using a high-frequency transducer, ultrasonography can identify the location and characteristics of scrotal lesions with high accuracy. The primary role of ultrasound (US) in the evaluation of a scrotal mass is to determine if it is intratesticular or extratesticular. Additional clinical information and other imaging options may be needed to diagnose benign tumors and pseudo-tumors. MRI is an effective problem-solving tool in cases with nondiagnostic US findings. CT is helpful for staging testicular cancer and localizing undescended testis. This review covers the imaging features of testicular and extratesticular tumors.

Genetic Analysis of Major Production and Reproduction Traits of Korean Duroc, Landrace and Yorkshire Pigs.

The study aimed to investigate the genetic parameters of the production and reproduction traits of Korean Duroc, Landrace, and Yorkshire pigs. Three production traits, namely average daily gain (ADG), age at 105 kg body weight (DAYS105) and backfat thickness (BFT), and three reproduction traits, namely age at first farrowing (AFF), total number of piglets born (TNB) and number of piglets born alive (NBA), were analyzed. The reproduction dataset was based on first-parity gilts only. However, the production dataset comprised pigs of both sexes. Genetic parameters were estimated from individual datasets using a multiple-trait animal model in AIREMLF90 software. The heritability values of ADG, DAYS105 and BFT were 0.34-0.36, 0.41-0.44 and 0.38-0.48, respectively, across breeds. Heritability values for AFF, TNB and NBA were 0.07-0.14, 0.09-0.11 and 0.09-0.10, respectively. Strong genetic correlations existed between ADG and DAYS105 (-0.97) and between TNB and NBA (0.90 to 0.96). In line with breeding goals, all productive traits in Duroc pigs, and all reproduction traits except AFF in Landrace and Yorkshire pigs, also showed noticeable improvements in recent years. In conclusion, we believe that our findings on economic traits would greatly assist future pig breeding decisions in Korea.

Monitoring the Effective Density of Airborne Nanoparticles in Real Time Using a Microfluidic Nanoparticle Analysis Chip.

Determining the effective density of airborne nanoparticles (NPs; particles smaller than 100 nm in diameter) at a point of interest is essential for toxicology and environmental studies, but it currently requires complex analysis systems comprising several high-precision instruments as well as a specially trained operator. To address these limitations, a field-portable and cost-efficient microfluidic NP analysis device is presented, which provides quantitative information on the effective density and size distribution of NPs in real time. Unlike conventional analysis systems, the device can operate in a standalone mode because of the chip operating principle based on the electrostatic/inertial classification and electrical detection methods. Moreover, the device is both compact (16.0 × 10.9 × 8.6 cm3) and light (950 g) owing to the hardware strip down enabled by integrating the essential functions for effective density analysis on a single chip. Quantitative experiments performed to simulate real-life applications utilizing effective density (i.e., effective density-based morphology analysis on engineered NPs and multi-parametric NP monitoring in ambient air) demonstrate that the developed device can be used as an analysis tool in toxicological studies as an on-site sensor for the monitoring of individual NP exposure and environments, for quality monitoring of engineered NPs via aerosol synthesis, and other applications.

Microfluidic ultrafine particle dosimeter using an electrical detection method with a machine-learning-aided algorithm for real-time monitoring of particle density and size distribution.

Growing concerns related to the adverse health effects of airborne ultrafine particles (UFPs; particles smaller than 300 nm) have highlighted the need for field-portable, cost-efficient, real-time UFP dosimeters to monitor individual exposure. These dosimeters must measure both the particle density and size distribution as these parameters are essential to the determination of where and how many UFPs will be deposited in human lungs. However, though various kinds of laboratory-grade instruments and hand-held monitors have been developed, they are expensive and only capable of measuring particle size distribution. A microfluidic UFP dosimeter is proposed in this study to address these limitations. The proposed sensor, based on an electrical detection method with a machine-learning-aided algorithm, can simultaneously measure the size distribution (number concentration, mean mobility diameter, geometric standard deviation) and particle density, and is compact owing to the microelectromechanical systems (MEMS) technology. In a comparison test using physically synthesised Ag and di-ethyl-hexyl sebacate (DEHS) aerosols, the mean measurement errors of the proposed sensor compared to the reference system were 6.1%, 4.5%, and 7.3% for number concentration, mean mobility diameter, and particle density, respectively. Moreover, when the machine-learning aided algorithm was operated, the geometric standard deviation could be deduced with a 7.6% difference. These results indicate that the proposed device can be successfully used as a field-portable UFP sensor to assess individual exposure, an on-site monitor for ambient air pollution, an analysis tool in toxicological studies of inhaled particles, for quality assurance of nanomaterials engineered via aerosol synthesis, etc.

Stiffness of the Central Corpus Cavernosum on Shear-Wave Elastography Is Inversely Correlated with the Penile Rigidity Score in Patients with Erectile Dysfunction.

PURPOSE: To perform real-time quantitative measurements of penile rigidity for patients with erectile dysfunction (ED) using shear-wave elastography (SWE). MATERIALS AND METHODS: A total of 92 patients with clinically diagnosed ED filled out an abridged five-item version of the International Index of Erectile Function (IIEF-5) questionnaire and underwent SWE as well as penile color Doppler ultrasound (CDUS) after intracavernosal injection for penile erection. Elasticity measurements were repeated on two sites of the corpus cavernosum (central and peripheral elasticity of corpus cavernosum [ECC]) and the glans penis during the erection phase. Correlations between penile elasticity and rigidity scores or IIEF-5 were evaluated statistically. Penile elasticity was also compared with the ED types based on CDUS. RESULTS: The mean age of all patients was 53.5±13.4 years, and the mean IIEF-5 score was 9.78±5.01. The rigidity score and central ECC value demonstrated a significant correlation (r=-0.272; 95% confidence interval: -0.464 to -0.056; p=0.015). The IIEF-5 score was not significantly correlated with penile elasticity. Vascular ED patients showed significantly higher central ECC values than nonvascular ED patients (p<0.001). At a cut-off value of 8.05 kPa, the central ECC had a specificity of 41.5%, a sensitivity of 84.6%, and an area under the ROC curve of 0.720 with a standard error of 0.059 (p=0.019) for predicting vascular ED. CONCLUSIONS: Quantitatively measuring Young's modulus of the corpus cavernosum using SWE could be an objective technique for assessing penile erectile rigidity and the vascular subtype in patients with ED.

Valorization of waste-cooking oil into sophorolipids and application of their methyl hydroxyl branched fatty acid derivatives to produce engineering bioplastics.

Waste-cooking oil (WCO) is defined as vegetable oil that has been used to fry food at high temperatures. The annual global generation of WCO is 41-67 million tons. Without proper treatment, most WCO is abandoned in sinks and the solid residue of WCO is disposed of in landfills, resulting in serious environmental problems. Recycling and valorizing WCO have received considerable attention to reduce its negative impact on ecosystems. To convert WCO into a high value-added compound, we aimed to produce sophorolipids (SLs) that are industrially important biosurfactants, using WCO as a hydrophobic substrate by the fed-batch fermentation of Starmerella bombicola. The SLs concentration was increased ~3.7-fold compared with flask culture (315.6 vs. 84.8 g/L), which is the highest value ever generated from WCO. To expand the applications of SLs, we prepared methyl hydroxy branched fatty acids (MHBFAs) from SLs, which are important chemicals for various industries yet difficult to produce by chemical methods, using a bio-chemical hybrid approach. We synthesized bio-based plastics using MHBFAs as co-monomers. Compared with the control polymer without MHBFAs, even the incorporation of 1 mol% into polymer chains improved mechanical properties (such as ultimate tensile strength, 1.1-fold increase; toughness, 1.3-fold increase). To the best of our knowledge, this is the first attempt to apply MHBFAs from SLs derived from WCO to building blocks of plastics. Thus, we extended the valorization areas of WCO to one of the world's largest industries.