Multimodality imaging studies of intraductal tubulopapillary neoplasms of the pancreas

PURPOSEWe aimed to investigate multimodality imaging findings of intraductal tubulopapillary neoplasms (ITPN) of the pancreas.METHODSThis study was approved by the institutional review board with waived informed consent. A total of eight patients were histopathologically diagnosed with pancreatic ITPN in a single institution over a 6-year period. The imaging findings of dynamic contrast-enhanced computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and positron emission tomography-computed tomography (PET-CT) were reviewed and correlated with clinicopathologic findings.RESULTSHistopathologically, an invasive carcinoma component was found in 5 of 8 patients (62.5%). The median diameter of the lesions and the main pancreatic ducts were larger in ITPN with invasive carcinoma (19 mm, 13.3–98.0 mm and 13 mm, 5.9–16.3 mm, respectively) than in ITPN without invasive carcinoma (13 mm, 12.7–18.5 mm and 6 mm, 5.6–6.1 mm, respectively), but not significantly (lesions, P = 0.229 and main pancreatic ducts, P = 0.143). Pancreatolithiasis accompanied invasive carcinoma in 3 of 5 patients (60%). Intraductal solid tumors were demonstrated on CT (5/8, 62.5%), MRCP (5/7, 71.4%), and EUS (7/7, 100%). In addition, various imaging findings mimicking chronic autoimmune pancreatitis or pancreatic ductal adenocarcinoma were found in 3 patients (37.5%) on multimodality imaging. The lesion multiplicity and synchronous or metachronous biliary cancer occurred in 3 patients (37.5%), respectively.CONCLUSIONPatients with associated invasive carcinoma from pancreatic ITPN may have presented a trend toward larger tumor size and dilated pancreatic duct with pancreatoliths, but the difference was not statistically significant. Further studies with a larger number of patients are needed to provide better insight into these findings. Pancreatic ITPN can show various atypical imaging findings as well as typical intraductal solid tumor on multimodality imaging. The presence of lesion multiplicity and synchronous or metachronous biliary cancer can be helpful for assisting with the diagnosis of pancreatic ITPN

A case of levocetirizine-induced liver injury

Levocetirizine is a second-generation nonsedative antihistaminic agent that has been demonstrated to be safe and effective for treating allergic disease. There was only one case report of levocetirizine-induced liver toxicity, but a liver biopsy was not performed. In this article, we present the first case of levocetirizine-induced liver injury with histologic findings. A 48-year-old man was hospitalized with jaundice and generalized pruritus that had developed after 2 months of therapy with levocetirizine for prurigo nodularis. Laboratory findings revealed acute hepatitis with cholestasis. A liver biopsy demonstrated portal inflammation and hepatitis with apoptotic hepatocytes. The patient fully recovered 3 weeks after withdrawing levocetirizine. Although levocetirizine is safe and effective, physicians should be aware of its potential hepatotoxicity

Baseline Renal Function Predicts Hyponatremia in Liver Cirrhosis Patients Treated with Terlipressin for Variceal Bleeding

Objectives. Terlipressin is safely used for acute variceal bleeding. However, side effects, such as hyponatremia, although very rare, can occur. We investigated the development of hyponatremia in cirrhotic patients who had acute variceal bleeding treated with terlipressin and the identification of the risk factors associated with the development of hyponatremia. Design and Methods. This retrospective, case-control study investigated 88 cirrhotic patients who developed hyponatremia and 176 controls that did not develop hyponatremia and were matched in terms of age and gender during the same period following terlipressin administration. Results. The overall change in serum sodium concentration and the mean lowest serum sodium concentration were 3.44 ± 9.55 and 132.44 ± 8.78 mEq/L during treatment, respectively. Multivariate analysis revealed that baseline serum sodium was an independent positive predictor, and the presence of baseline serum creatinine, HBV, DM, creatinine, and shock on admission was independent negative predictors of hyponatremia (P<0.05). Conclusion. The presence of HBV, DM, the baseline serum sodium, shock on admission, and especially baseline creatinine may be predictive of the development of hyponatremia after terlipressin treatment. Therefore, physicians conduct vigilant monitoring associated with severe hyponatremia when cirrhotic patients with preserved renal function are treated with terlipressin for variceal bleeding

Radiologic Evaluation and Structured Reporting Form for Extrahepatic Bile Duct Cancer: 2019 Consensus Recommendations from the Korean Society of Abdominal Radiology

Radiologic imaging is important for evaluating extrahepatic bile duct (EHD) cancers; it is used for staging tumors and evaluating the suitability of surgical resection, as surgery may be contraindicated in some cases regardless of tumor stage. However, the published general recommendations for EHD cancer and recommendations guided by the perspectives of radiologists are limited. The Korean Society of Abdominal Radiology (KSAR) study group for EHD cancer developed key questions and corresponding recommendations for the radiologic evaluation of EHD cancer and organized them into 4 sections: nomenclature and definition, imaging technique, cancer evaluation, and tumor response. A structured reporting form was also developed to allow the progressive accumulation of standardized data, which will facilitate multicenter studies and contribute more evidence for the development of recommendations.11Nsciescopu

A scoping review key elements and effects of cardiovascular disease management programs based on community-based participatory research.

BackgroundThis scoping review analyses the literature on community-based participatory research (CBPR)-based cardiovascular disease (CVD) management programmes, examining the key elements of their development and implementation and exploring their effectiveness.MethodsThis scoping review's methodology had six stages: 1) identifying the research question; 2) identifying relevant studies-search strategy; 3) study selection; 4) charting the data; 5) collating, summarising, and reporting the results; and 6) consultation exercise. The databases used were PubMed, Cochrane, and CINAHL, for the period from 4 March to 3 April 2022. We selected studies 1) published after 2000; 2) targeting community residents over 18 years old; and 3) proposed a CBPR-based CVD management programme, described its development, and evaluated its effects based on its application. Data were extracted independently by each of the two researchers, using a standardised form.ResultsAmong the key aspects of such programmes were the many cases where community organisations led establishment of partnerships and cases where a decision-making committee was formed. Regarding application of the CBPR principles, community partners participated only in executing the research, not in analysing and interpreting research results. In addition, among the 21 studies selected were 6 randomised controlled trials, all of which showed a significant positive effect in experimental groups compared to control groups.ConclusionImprovement strategies are needed to allow implementation of CBPR principles in a CBPR-based CVD management programme. Moreover, further verification of programme evaluation research methods is needed.Scoping review registrationThis protocol has been registered to the OSF registries. 0000000204460911. Key Elements and Effects of Cardiovascular Disease Management Programs Based on Community-based Participatory Research: Protocol for a Scoping Review'. OSF, 4 Sept. 2020. Web

Search strategies by electronic databases.

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Regioselective Oxidation of C-H Bonds in Unactivated Alkanes by a Vanadium Superoxo Catalyst Bound to a Supramolecular Host

© 2019 American Chemical Society.A vanadyl ion bound to a cucurbituril (CB) host was reported to oxidize pentane to 2-pentanol in the presence of an oxidizer. DFT calculations suggest that the catalyst selectively reacts with stronger C-H bonds in pentane over weaker C-H bonds in cyclohexane due to size exclusion by the CB host. The active catalyst is an unprecedented vanadium superoxo species bound to the host, and the selectivity toward secondary over the primary C-H bond is the result of a higher degree of charge transfer from the secondary compared to the primary position11sciescopu

Developing and testing a Korean patient classification system for general wards based on nursing intensity

Abstract Aim To develop a new general wards patient classification tool based on the nursing intensity level that reflects patients’ clinical characteristics and indirect nursing activities. Design A cross‐sectional design was adopted. This methodological study developed a patient classification system to sort general ward patients based on the intensity of their nursing needs and verified the validity and reliability of this classification system. Methods Thirteen experts verified the tools’ content validity. Data collectors and head nurses classified 150 patients from two hospitals with four general wards and various nurse staffing levels. Inter‐rater reliability was analysed. Staff nurses classified 846 patients following the Korean patient classification system on nursing intensity scores that reflected patients’ clinical status. Content validity was verified based on the classification results. Using K‐group cluster analysis, score ranges for four groups were identified. Results The developed tool includes 8 domains, (symptom management, infection control, nutrition and medication, personal hygiene and secretion, activity, sleep and rest, guidance in nursing/emotional support, nursing activity planning and coordination, indirect activity), 24 subdomains, 66 nursing activities and 124 criteria. Inter‐rater reliability showed high agreement

Impact of Momentary Cessation Voltage Level in Inverter-Based Resources on Increasing the Short Circuit Current

This study analyzed the impact of varying the momentary cessation (MC) voltage level on the short circuit current of inverter-based resources (IBRs). To analyze the impact of the IBR MC function on the short circuit current, this paper proposes an advanced IBR model for fault current calculation to reflect its fault characteristics and a scheme for analyzing the influence of MC on the short circuit current. Based on the proposed methods, the authors conducted case studies using planning data from the Korea Electric Power Corporation (KEPCO). The influence of MC was investigated on the IBRs located at the southwest side of the KEPCO systems by screening the fault currents while varying the MC voltage. This paper demonstrates that the minimum MC voltage level needed for the fault current not to exceed the circuit breaker (CB) capacity can be proposed through analyzing the impact of MC voltage level on the short circuit current. The test results based on the proposed scheme showed that the short circuit current to power systems could not violate CB capacity if IBRs adjusted the MC voltage level higher than the lowest MC voltage level