Localized forms of gallbladder adenomyomatosis are rarely polypoid and may mimic gallbladder cancer. Herein, we present a unique case of polypoid gallbladder adenomyomatosis penetrating the colon and preoperatively misdiagnosed as advanced hepatic flexure colon cancer.

PURPOSE: Computational fluid dynamics (CFD) applications for atherosclerotic carotid stenosis have not been widely used due to limited resolution in the severely stenotic lumen as well as small flow dimension in the stenotic channel. MATERIALS AND METHODS: CT data in DICOM format was transformed into 3 dimensional (3D) CFD model of carotid bifurcation. For computational analysis of blood flow in stenosis, commercial finite element software (ADINA Ver. 8.5) was used. The blood flow was assumed to be laminar, viscous, Newtonian, and incompressible. The distribution of wall shear stress (WSS), peak velocity and pressure across the average systolic and diastolic blood pressures permitted construction of a contour map of the velocity in each cardiac cycle. RESULTS: Computer simulation of WSS, flow velocity and wall pressure could be demonstrated three dimensionally according to flow vs. time dimension. Such flow model was correlated with angiographic finding related to maximum degree of stenosis associated with ulceration. Combination of WSS map and catheter angiogram indicated that the highest WSS corresponded to the most severely stenotic segment at systolic phase, whereas ulceration, which is the weakest point of the plaque, appeared at the downstream side of the carotid bulb stenosis. CONCLUSION: Our preliminary study revealed that 3D CFD analysis in carotid stenosis was feasible from CT angiography source image and could reveal WSS, flow velocity and wall pressure in the severe carotid bulb stenosis with ulceration. Further CFD analysis is warranted to apply such hemodynamic information to the atherosclerotic lesion in the more practical way.
Angiography ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Computer Simulation ; Constriction, Pathologic ; Hemodynamics ; Hydrodynamics ; Ulcer

PURPOSE: We analyzed factors related to quality of photographs taken at neuroangiographic suites to optimize exposure condition. MATERIALS AND METHODS: We used a camera (EOS-300D, Canon Inc., Tokyo) with a standard- (EF-S 18-55 mm F3.5-5.6 USM, Canon Inc., Tokyo) and a macro-lens (EF 100 mm f/2.8 Macro USM, Canon Inc., Tokyo). Photographs were taken at a light-booth (1000 lux) and 2 neuroangiographic suites (988 and 856 lux) under ordinary intensity of illumination. We took photographs of a test chart (ColorChecker, X-rite, Michigan) and Kodak Q-13 Grey Scale Card at different values of aperture and shutter speed with fixed ISO of 400 and assessed the quality of photographs by Blade Pro (V1.1, Image group, Seoul). We analyzed photographs of a device at 1/25-1/80 shutter speed and F12 - 20 apertures and compared the result and also made visual assessment. RESULTS: Photographs of test chart and Grey Scale Card revealed that the best images chosen by Blade Pro were distributed in scattered range of quality which could help understand the range of optimum exposure condition but was not suitable for practical usage. We obtained reasonable quality photograph at shutter speed of 1/40 and aperture of F16 that can be used in 3 places. CONCLUSION: The most appropriate exposure condition when taking photographs in neuroangiographic suites could be explored. To get an optimal image in limited illumination, it is mandatory to select a fast enough shutter speed to avoid motion artifacts and a sufficient aperture to actualize the subject depth.
Artifacts ; Lighting

Hand-foot-and-mouth disease (HFMD) is a viral infectious disease that occurs in children under 5 years of age. Its main causes are coxsackievirus (CV) and enterovirus (EV). Since there are no efficient therapeutics for HFMD, vaccines are effective in preventing the disease. To develop broad coverage against CV and EV, the development of a bivalent vaccine form is needed. The Mongolian gerbil is an efficient and suitable animal model of EV71 C4a and CVA16 infection used to investigate vaccine efficacy following direct immunization. In this study, Mongolian gerbils were immunized with a bivalent inactivated EV71 C4a and inactivated CVA16 vaccine to test their effectiveness against viral infection. Bivalent vaccine immunization resulted in increased Ag-specific IgG antibody production; specifically, EV71 C4a-specific IgG was increased with medium and high doses and CVA16-specific IgG was increased with all doses of immunization. When gene expression of T cell-biased cytokines was analysed, Th1, Th2, and Th17 responses were found to be highly activated in the high-dose immunization group. Moreover, bivalent vaccine immunization mitigated paralytic signs and increased the survival rate following lethal viral challenges. When the viral RNA content was determined from various organs, all three doses of bivalent vaccine immunization were found to significantly decrease viral amplification. Upon histologic examination, EV71 C4a and CVA16 induced tissue damage to the heart and muscle. However, bivalent vaccine immunization alleviated this in a dose-dependent manner. These results suggest that the bivalent inactivated EV71 C4a/CVA16 vaccine could be a safe and effective candidate HFMD vaccine.

Background/Aims: Posthepatectomy liver failure (PHLF) is a major complication that increases mortality in patients with hepatocellular carcinoma after surgical resection. The aim of this retrospective study was to evaluate the utility of magnetic resonance elastography-assessed liver stiffness (MRE-LS) for the prediction of PHLF and to develop an MRE-LS-based risk prediction model. Methods: A total of 160 hepatocellular carcinoma patients who underwent surgical resection with available preoperative MRE-LS data were enrolled. Clinical and laboratory parameters were collected from medical records. Logistic regression analyses were conducted to identify the risk factors for PHLF and develop a risk prediction model. Results: PHLF was present in 24 patients (15%). In the multivariate logistic analysis, high MRE-LS (kPa; odds ratio [OR] 1.49, 95% confidence interval [CI] 1.12 to 1.98, p=0.006), low serum albumin (≤3.8 g/dL; OR 15.89, 95% CI 2.41 to 104.82, p=0.004), major hepatic resection (OR 4.16, 95% CI 1.40 to 12.38, p=0.014), higher albumin-bilirubin score (>–0.55; OR 3.72, 95% CI 1.15 to 12.04, p=0.028), and higher serum α-fetoprotein (>100 ng/mL; OR 3.53, 95% CI 1.20 to 10.40, p=0.022) were identified as independent risk factors for PHLF. A risk prediction model for PHLF was established using the multivariate logistic regression equation. The area under the receiver operating characteristic curve (AUC) of the risk prediction model was 0.877 for predicting PHLF and 0.923 for predicting grade B and C PHLF. In leave-one-out cross-validation, the risk model showed good performance, with AUCs of 0.807 for all-grade PHLF and 0. 871 for grade B and C PHLF. Conclusions Our novel MRE-LS-based risk model had excellent performance in predicting PHLF, especially grade B and C PHLF.