Counting small hypointense spots confounds the quantification of functional islet mass based on islet MRI

Iron-containing fragmented islets or free iron released from dying cells could confound the interpretation of MRI of iron nanoparticle-labeled islets. Exclusion of small hypointense spots could be a useful strategy to avoid such artifact. We investigated whether this strategy could improve the estimation of functioning islet mass after islet transplantation. Using a rat syngeneic intraportal islet transplantation model, we quantitatively assessed the relationships between total area, number of hypointense spots on MRI that belong to each size quartile and glycemic control of the recipients. The total area of hypointense spots on MRI was greater in the recipients that achieved diabetes reversal (p = 0.002), whereas the total number of hypointense spots was not different (p = 0.757). Exclusion of small hypointense spots improved the association between the number of hypointense spots and the blood glucose level of the recipients (p < 0.001). Ex-vivo imaging and histologic study confirmed that some small hypointense spots represent the phagocytosed free iron. Exclusion of small hypointense spots improved the quantification of the functional islet mass based on islet MRI. This would be a useful principle in the development of an algorithm to estimate functioning islet mass based on islet MRI.

Measurement of the CP-violation parameter sin2φ1 with a new tagging method at the Υ(5S) resonance

We report a measurement of the CP-violation parameter sin2φ1 at the Υ(5S) resonance using a new tagging method, called "B-π tagging." In Υ(5S) decays containing a neutral B meson, a charged B, and a charged pion, the neutral B is reconstructed in the J/ψK(S)(0) CP-eigenstate decay channel. The initial flavor of the neutral B meson at the moment of the Υ(5S) decay is opposite to that of the charged B and may thus be inferred from the charge of the pion without reconstructing the charged B. From the asymmetry between B-π(+) and B-π(-) tagged J/ψK(S)(0) yields, we determine sin2φ1=0.57±0.58(stat)±0.06(syst). The results are based on 121 fb(-1) of data recorded by the Belle detector at the KEKB e(+)e(-) collider.

Chronic obstructive pulmonary disease and metabolic syndrome: a nationwide survey in Korea

SETTING

Systemic inflammation has been suggested to be involved in the pathogenesis of chronic obstructive pulmonary disease (COPD) and metabolic syndrome. However, the association between these two conditions is not fully understood.

OBJECTIVE

To evaluate the relationship between COPD and metabolic syndrome.

DESIGN

Among subjects aged ≥40 years from the 2001 Korean National Health and Nutrition Examination Survey, 1215 subjects with two or more acceptable spirometry measurements and complete anthropometric/laboratory examinations were analysed.

RESULTS

A total of 133 subjects (11%, 100 men and 33 women) were newly diagnosed with COPD (forced expiratory volume in 1 second/forced vital capacity ≤ 70%). The prevalence of metabolic syndrome, based on the National Cholesterol Education Program Adult Treatment Panel III, was significantly higher in COPD subjects compared with non-COPD subjects in both sexes (33.0% vs. 22.2% in men and 48.5% vs. 29.6% in women). In men, the risk of COPD was higher in subjects with metabolic syndrome than in those without (OR 2.03, 95%CI 1.08-3.80), after adjusting for potential confounders. There was a borderline significant association between COPD and abdominal obesity among the individual component of metabolic syndrome (OR 1.95, 95%CI 0.93-4.11).

CONCLUSION

In the Republic of Korea, metabolic syndrome was associated with COPD in men.

A switch to endoscopic mucosal resection after precutting following gastric perforation during endoscopic submucosal dissection: a simple and useful technique

Endoscopic submucosal dissection (ESD) is safe and effective, but as the number of patients undergoing ESD has increased, so has the number of iatrogenic perforations. We describe the effectiveness and benefits of endoscopic mucosal resection after precutting (EMR-P) in a series of patients who developed a macroperforation during ESD. This was a retrospective, single-center case series from a prospectively maintained database in an academic tertiary care center. The study involved 16 patients with macroperforation out of 1171 patients who underwent ESD between November 2006 and January 2011. En bloc resection by EMR-P was achieved in 12 out of 16 patients (75%) and piecemeal resection in 4 (25%). All patients were discharged after a mean hospital stay of 6.8 days without further complications. There were no recurrences during the median follow-up period of 11.4 months. Macroperforation during ESD can be managed successfully by endoscopic closure, and EMR-P should then be considered.

Chronic obstructive lung disease-related health care utilisation in Korean adults with obstructive lung disease

OBJECTIVES

The numbers of nationwide epidemiological surveys about chronic obstructive pulmonary disease (COPD) prevalence and prospective cohort studies for health care utilisation are limited. We investigated COPD-related health care utilisation in adults with obstructive lung disease in the second Korean National Health and Nutritional Survey (KNHANES II) in 2001 using Korean national medical insurance claim data.

METHODS

Among people aged >40 years, obstructive lung disease (OLD) is defined according to Global Initiative for Chronic Obstructive Lung Disease criteria. Data from a total of 1942 subjects were linked with Korean national medical insurance claims data, and we investigated their COPD-related out-patient visits from 2002 to 2005.

RESULTS

Among the 1942 subjects, 256 (13.2%) had airflow obstruction. COPD-related out-patient visits were reported for 8.2% of patients without airway obstruction, 18.1% of those with mild airway obstruction, and 33.9% of those with moderate to very severe airway obstruction. Multivariate analysis revealed that previous COPD diagnosis by a physician (OR 2.54; P = 0.02) and lower socio-economic status (OR 0.45; P = 0.02) were independent predictors of COPD-related out-patient visits in subjects with OLD.

CONCLUSIONS

Of the subjects with airway obstruction, those with poor financial status utilised COPD-related health care services less frequently, and those previously diagnosed as having COPD by a physician utilised the services more frequently.

The time-dependent alteration of anti-diuretic hormone system in hindlimb unloaded rats

It is important to understand the mechanism on the fluid shift and volume regulation occurring in astronauts after spaceflight for future life in space. In the present study, we examined the time-dependent alteration of anti-diuretic hormone (ADH) concentrating on the water reabsorption system in hindlimb unloaded rats. Male Sprague-Dawley rats were hindlimb unloaded for 1 (HU1), 7(HU7), 14 days (HU14) or rested in the ground for 3 days after HU14 (HU14+3). The plasma ADH and angiotensin II level showed peak value at HU7, and the alterations were restored at HU14. However, several serum electrolytes (Na, K, Cl) were not changed regardless of HU period. In the immunohistochemical study, we examined that ADH and c-Fos immunoreactivities (IR) were maximized at HU7 in the paraventricular nucleus (PVN) and supraoptic nucleus (SON). Aquaporin 2 (AQP2) IR also was increased in the renal collecting duct for water re-absorption at HU7 showing a similar pattern with ADH. These results present a series of physiological ADH system alteration following to period of hindlimb unloading stimulus, indicating that ADH system is activated significantly at HU7. In addition, our results suggest that ADH system activation may be involved in anti-diuretic phenomenon in early spaceflight period. Furthermore, it is speculated that ADH system may require 14 days for adaptation to microgravity.

Safety of protected carotid artery stenting in patients with severe carotid artery stenosis and carotid intraplaque hemorrhage

BACKGROUND AND PURPOSE

Carotid IPH can be detected with MR imaging. The aim of this study was to determine the safety of CAS using an emboli protection device in patients with severe carotid artery stenosis and MR imaging-depicted carotid IPH.

MATERIALS AND METHODS

We retrospectively reviewed a prospective data base that included 91 consecutive patients with severe carotid stenosis and high-risk features who were treated with CAS by using an emboli protection device. Seventy-eight of the included patients underwent prestenting 3D TOF MRA. IPH was defined as the presence of high signal intensity within the carotid plaque, greater than 150% of the signal intensity of the adjacent neck muscle on TOF source images. The primary outcome measure was the combined incidence of stroke, MI, and death within 30 days of CAS. Associations between IPH and the primary outcome were investigated.

RESULTS

IPH was detected on TOF MRA in 30 patients. Symptomatic patients were more common in the IPH group than in the non-IPH group (66.7% vs 41.7%; P = .032). Overall, 30-day stroke, MI, or death rates were 6.6%. There was no significant difference in the primary outcome between the IPH and non-IPH groups (10% and 6.25%, respectively; hazard ratio for IPH, 1.151; 95% CI, 0.035 to 37.500; P = .937). A logistic regression showed there was no independent variable associated with the primary outcome.

CONCLUSIONS

The results of this study indicate that protected CAS seems to be safe in patients with severe carotid stenosis and IPH.

Observation of D+ → K(+)η(') and search for CP violation in D+ → π(+)η(') decays

We report the first observation of the doubly Cabibbo-suppressed decays D(+)→K(+)η((')) using a 791 fb(-1) data sample collected with the Belle detector at the KEKB asymmetric-energy e(+)e(-) collider. The ratio of the branching fractions of doubly Cabibbo-suppressed relative to singly Cabibbo-suppressed D(+)→π(+)η((')) decays are B(D(+)→K(+)η)/B(D(+)→π(+)η)=(3.06±0.43±0.14)% and B(D(+)→K(+)η')/B(D(+)→π(+)η')=(3.77±0.39±0.10)%. From these, we find that the relative final-state phase difference between the tree and annihilation amplitudes in D(+) decays, δ(TA), is (72±9)° or (288±9)°. We also report the most precise measurements of CP asymmetries to date: A(CP)(D(+)→π(+)η)=(+1.74±1.13±0.19)% and A(CP)(D(+)→π(+)η')=(-0.12±1.12±0.17)%.

Prognostic factors for idiopathic pulmonary fibrosis: clinical, physiologic, pathologic, and molecular aspects

BACKGROUND

Previous studies identified clinical and physiologic factors of idiopathic pulmonary fibrosis (IPF) that are related to an increased risk of mortality. But there are few studies about histologic and molecular approach.

OBJECTIVE

We investigated whether the C-reactive protein (CRP), fibroblastic foci, phosphorylated Smad2/3 (p-Smad2/3), tumor growth factor-beta (TGF-beta), TGF-beta receptor II (TbetaRII), and the polymorphism of the TGF-beta1 codon 10 are associated with the progression of IPF patients.

DESIGN

Eighty-six IPF patients who underwent surgical lung biopsies were examined. For each patient, clinical and physiologic parameters were investigated, and we performed immunohistochemical staining for p-Smad2/3 and TbetaRII, and genotyping of the TGF-beta1 codon 10 polymorphism.

RESULTS

Age at diagnosis, gender, symptom duration, and smoking status did not show a significant association. However, the amount of smoking (p = 0.002), severe reduction in the percentages of predicted forced vital capacity (p = 0.013) and diffusion lung capacity of carbon monoxide (p = 0.023), CRP (p = 0.009) at diagnosis, and fibroblastic foci (p = 0.026) were associated with a poor prognosis. Cellularity, fibrosis, expression level of p-Smad2/3 and TbetaRII, and genotype of the TGF-beta1 codon 10 polymorphism did not have a statistically significant association with the prognosis.

CONCLUSION

This study confirmed the amount of smoking, abrupt decrease in follow-up pulmonary function parameters, fibroblastic foci, and increased levels of CRP concentration at diagnosis were significantly associated with poor survival. Larger studies are required to confirm all prognostic factors including CRP.

Observation of X(3872)→J/ψγ and search for X(3872)→ψ'γ in B decays

We report a study of B→(J/ψγ)K and B→(ψ'γ)K decay modes using 772×10⁶ B ̅B events collected at the Υ(4S) resonance with the Belle detector at the KEKB energy-asymmetric e(+)e(-) collider. We observe X(3872)→J/ψγ and report the first evidence for χ(c2)→J/ψγ in B→(X_{c ̅cγ)K decays, while in a search for X(3872)→ψ'γ no significant signal is found. We measure the branching fractions, B(B(±)→X(3872)K(±))B(X(3872)→J/ψγ)=(1.78(-0.44)(+0.48)±0.12)×10(-6), B(B(±)→χ(c2)K(±))=(1.11(-0.34)(+0.36)±0.09)×10(-5), B(B(±)→X(3872)K(±))B(X(3872)→ψ'γ)<3.45×10⁶ (upper limit at 90% C.L.), and also provide upper limits for other searches.

Haemorrhagic low-grade fibromyxoid sarcoma: MR findings in two young women

Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft-tissue sarcoma characterised by a deceptively bland histological appearance and a paradoxically aggressive behaviour. LGFMS usually presents in young-to-middle-aged adults as a painless, slow-growing mass with the potential for local recurrence and metastasis despite low-grade histology. Several case reports have described variable MR findings of LGFMS without haemorrhage or necrosis. We report here on the MR findings in two young women with haemorrhagic LGFMS in the thigh.

Nano-scaled Pt/Ag/Ni/Au contacts on p-type GaN for low contact resistance and high reflectivity

We synthesized the vertical-structured LED (VLED) using nano-scaled Pt between p-type GaN and Ag-based reflector. The metallization scheme on p-type GaN for high reflectance and low was the nano-scaled Pt/Ag/Ni/Au. Nano-scaled Pt (5 A) on Ag/Ni/Au exhibited reasonably high reflectance of 86.2% at the wavelength of 460 nm due to high transmittance of light through nano-scaled Pt (5 A) onto Ag layer. Ohmic behavior of contact metal, Pt/Ag/Ni/Au, to p-type GaN was achieved using surface treatments of p-type GaN prior to the deposition of contact metals and the specific contact resistance was observed with decreasing Pt thickness of 5 A, resulting in 1.5 x 10(-4) ohms cm2. Forward voltages of Pt (5 A)/Ag/Ni contact to p-type GaN showed 4.19 V with the current injection of 350 mA. Output voltages with various thickness of Pt showed the highest value at the smallest thickness of Pt due to its high transmittance of light onto Ag, leading to high reflectance. Our results propose that nano-scaled Pt/Ag/Ni could act as a promising contact metal to p-type GaN for improving the performance of VLEDs.

Performance of GaN vertical light emitting diodes using wafer bonding process with Al-alloyed graphite substrate

We report on the vertical-structure light emitting diodes (VLEDs) fabricated with wafer bonding method using Al-alloyed graphite and Si supporter. VLEDs with Al-alloyed graphite produced no crack during/after laser lift-off (LLO) techniques while the wafer crack took place using Si supporter because of the difference of thermal expansion coefficients between Si and sapphire. The performance of VLEDs with wafer bonding method using Al-alloyed graphite supporter was compared to those fabricated by Cu plating methods. The output power of the chips with wafer bonding method was nearly same as the one with Cu-plating method. However, the forward voltage of VLEDs with wafer bonding method was higher than those with Cu-plating method. In the terms of reliabilities the wafer bonding process is more preferable to Cu-plating and our report proposes that Al-alloyed graphite could be one of promising candidates for the supporters in wafer bonding process.

Overexpression of OsRDCP1, a rice RING domain-containing E3 ubiquitin ligase, increased tolerance to drought stress in rice (Oryza sativa L.)

CaRma1H1 was previously identified as a hot pepper drought-induced RING E3 Ub ligase. We have identified five putative proteins that display a significant sequence identity with CaRma1H1 in the rice genome database (http://signal.salk.edu/cgi-bin/RiceGE). These five rice paralogs possess a single RING motif in their N-terminal regions, consistent with the notion that RING proteins are encoded by a multi-gene family. Therefore, these proteins were named OsRDCPs (Oryza sativa RING domain-containing proteins). Among these paralogs, OsRDCP1 was induced by drought stress, whereas the other OsRDCP members were constitutively expressed, with OsRDCP4 transcripts expressed at the highest level in rice seedlings. osrdcp1 loss-of-function knockout mutant and OsRDCP1-overexpressing transgenic rice plants were developed. Phenotypic analysis showed that wild-type plants and the homozygous osrdcp1 G2 mutant line displayed similar phenotypes under normal growth conditions and in response to drought stress. This may be due to complementation by other OsRDCP paralogs. In contrast, 35S:OsRDCP1 T2 transgenic rice plants exhibited improved tolerance to severe water deficits. Although the physiological function of OsRDCP1 remains unclear, there are several possible mechanisms for its involvement in a subset of physiological responses to counteract dehydration stress in rice plants.

Measurement limits to 134Cs concentration in soil

We investigate the caesium concentrations in soils in mountain areas near Gori nuclear power plant in Korea, focusing on the measurement limits to the (134)Cs. In order to lower the minimum detectable amount (MDA) of activity for the (134)Cs, we have used the ammonium molybdophosphate (AMP) precipitation method to get rid of the (40)K existing in natural radioactivity, which reduces the MDA activity about 10 times smaller than those without the AMP precipitation method. The MDA results for the (134)Cs were found to be in the range between 0.015 and 0.044 Bq/kg-dry weight. In order to diminish the background, we also have measured a part of the soil samples in Yangyang, a small town in the east coast of Korea. However, it turns out that in order to detect the (134)Cs in the samples the MDA should be reduced to the level of mBq/kg-dry weight.

Histiocytic necrotizing lymphadenitis in the context of systemic lupus erythematosus (SLE): Is histiocytic necrotizing lymphadenitis in SLE associated with skin lesions?

Histiocytic necrotizing lymphadenitis (HNL), or Kikuchi's disease, is a benign and self-limiting lymphadenopathy that typically affects young Asian females. It presents with lymphadenopathy, usually cervical, accompanied by fever, chills and leukopenia. Although the association between systemic lupus erythematosus (SLE) and HNL is rare, the number of reports of HNL in SLE patients is increasing. We present nine cases of HNL in patients with SLE. Among the seven patients with diverse skin manifestations, three had skin manifestations that were histologically compatible with SLE. A review of previous reports in the literature showed that cutaneous involvement was commonly found in HNL in association with SLE. In the patients who had simultaneous onset of both diseases, lupus flare-ups were commonly observed. We suggest that HNL in SLE patients is associated with cutaneous manifestations. This report contributes to our understanding of the relationship between these diseases.

Observation of B(s)⁰→J/ψf₀(980) and evidence for B(s)⁰→J/ψf₀(1370)

We report the observation of B(s)⁰→J/ψf₀(980) and evidence for B(s)⁰→J/ψf₀(1370), which are CP eigenstate decay modes. These results are obtained from 121.4 fb⁻¹ of data collected at the Υ(5S) resonance with the Belle detector at the KEKB e(+)e⁻ collider. We measure the branching fractions B(B(s)⁰→J/ψf₀(980); f₀(980)→π(+)π⁻)=(1.16(-0.19)(+0.31)(stat)(-0.17)(+0.15)(syst)(-0.18)(+0.26)(N(B(s)((*))B(s)((*)))))×10⁻⁴ with a significance of 8.4σ, and B(B(s)⁰→J/ψf₀(1370); f₀(1370)→π(+)π⁻)=(0.34(-0.14)(+0.11)(stat)(-0.02)(+0.03)(syst)(-0.05)(+0.08)(N(B(s)((*))B(s)((*)))))×10⁻⁴ with a significance of 4.2σ. The last error listed is due to uncertainty in the number of produced B(s)((*))B(s)((*)) pairs.

An in-mold packaging process for plastic fluidic devices

Micro or nanofluidic devices have many channel shapes to deliver chemical solutions, body fluids or any fluids. The channels in these devices should be covered to prevent the fluids from overflowing or leaking. A typical method to fabricate an enclosed channel is to bond or weld a cover plate to a channel plate. This solid-to-solid bonding process, however, takes a considerable amount of time for mass production. In this study, a new process for molding a cover layer that can enclose open micro or nanochannels without solid-to-solid bonding is proposed and its feasibility is estimated. First, based on the design of a model microchannel, a brass microchannel master core was machined and a plastic microchannel platform was injection-molded. Using this molded platform, a series of experiments was performed for four process or mold design parameters. Some feasible conditions were successfully found to enclosed channels without filling the microchannels for the injection molding of a cover layer over the plastic microchannel platform. In addition, the bond strength and seal performance were estimated in a comparison with those done by conventional bonding or welding processes.

The feasibility of endoscopic submucosal dissection for rectal carcinoid tumors: comparison with endoscopic mucosal resection

BACKGROUND AND STUDY AIMS

Rectal carcinoid tumors are often found incidentally during screening colonoscopy and can be resected using various endoscopic techniques. This study aimed to compare the safety and efficacy of endoscopic submucosal dissection (ESD) with endoscopic mucosal resection (EMR) for rectal carcinoid tumors.

PATIENTS AND METHODS

Between January 2003 and June 2009, 74 patients (74 lesions) underwent either EMR (n = 28) or ESD (n = 46) for rectal carcinoid tumors. The rate of endoscopic complete resection, pathological complete resection, procedure complications, and tumor recurrence were analyzed retrospectively.

RESULTS

The endoscopic complete resection rate was significantly higher in the ESD group (46 lesions, 100 %) compared with the EMR group (25 lesions, 89.3 %) ( P = 0.049). The pathological complete resection rate was higher in the ESD group (38 lesions, 82.6 %) compared with the EMR group (18 lesions, 64.3 %); however, this difference was borderline significant ( P = 0.067). Overall complication rate was not significantly different between the EMR group (3.6 %) and the ESD group (6.3 %). There was one case of remnant lesion in the EMR group, which was managed by ESD, and no recurrence has been detected in either the EMR or ESD groups.

CONCLUSION

This study suggests that ESD might be a feasible treatment technique for small rectal carcinoid tumors. It showed superior efficacy and comparable safety to EMR.

Health behaviour and quality of life in Korean adults with respiratory disease: National Health Survey, 2005

OBJECTIVES

To describe disease management, health behaviour, psychological health and quality of life (QOL) in people with chronic respiratory disease (CRD).

METHODS

We analysed data from 798 adults with CRD drawn from the Korean National Health and Nutrition Examination Survey (KNHANES) 2005: 514 subjects with asthma alone, 258 with chronic obstructive pulmonary disease (COPD) alone, and 56 with asthma and COPD.

RESULTS

Disease management and health behaviour in this cohort were poor. One third of the cohort was not seeking any medical treatment, although many were currently experiencing respiratory symptoms. Twenty-six per cent of the subjects were current smokers who averaged 0.8 packs/day. More than half of the subjects did not exercise, only half of the subjects had regular health examinations and one third of the subjects did not get enough sleep. The study population exhibited poor psychological indices, functional health status and QOL. The combined asthma and COPD group was characterised by an increased frequency of problems related to functional status and QOL.

CONCLUSIONS

People with CRD are at high risk for functional limitations, unhealthy behaviour, poor mental status and poor QOL. A comprehensive disease management programme for people with CRD should be developed using collaborative team efforts.

Intratendinous ganglion cyst of the semimembranosus tendon

Intratendinous ganglion cyst is a very rare lesion with an unknown aetiology that originates within the tendon. We encountered a case of 43-year-old woman who complained of a palpable, non-tender mass in the thigh with increasing swelling. An intratendinous ganglion cyst in the semimembranosus tendon of the lower extremity was diagnosed and located by ultrasound and MRI. Nine months after a surgical excision, there were recurrent ganglion cysts along the semimembranosus tendon. We describe this case with a review of the relevant literature.

Evidence for a new resonance and search for the Y(4140) in the gammagamma-->phiJ/psi process

The process gammagamma-->phiJ/psi is measured using a data sample of 825 fb{-1} collected with the Belle detector. A narrow peak of 8.8{-3.2}{+4.2} events, with a significance of 3.2 standard deviations including systematic uncertainty, is observed. The mass and natural width of the structure [named X(4350)] are measured to be [4350.6{-5.1}{+4.6}(stat)+/-0.7(syst)] MeV/c{2} and [13{-9}{+18}(stat)+/-4(syst)] MeV, respectively. The product of its two-photon decay width and branching fraction to phiJ/psi is [6.7{-2.4}{+3.2}(stat)+/-1.1(syst)] eV for J{P}=0{+}, or [1.5{-0.6}{+0.7}(stat)+/-0.3(syst)] eV for J{P}=2{+}. No signal for the Y(4140)-->phiJ/psi structure reported by the CDF Collaboration in B-->K{+}phiJ/psi decays is observed, and limits of Gamma_{gammagamma}(Y(4140))B(Y(4140)-->phiJ/psi)<41 eV for J{P}=0;{+} or <6.0 eV for J{P}=2{+} are determined at the 90% C.L. This disfavors the scenario in which the Y(4140) is a D{s}{*+}D{s}{*-} molecule.