ABSTRACT The population structure and history of the endangered bagrid catfish Pseudobagrus ichikawai were assessed to provide insights into its conservation through comparative analyses of several traditional genetic markers and genome‐wide SNP data. The species is distributed in the Ise Bay area, located in central Honshu Island, Japan, a biogeographically unique region with endemic freshwater species. Samples were collected across all major populations, and genetic differentiation, population history, and demographic trends were inferred. Genetic analyses were conducted using whole mitochondrial genome sequences (mitogenomes), microsatellite polymorphisms, reduced‐representation genome sequencing (MIG‐seq), and whole‐genome resequencing. For the latter two methods, the newly determined chromosome‐level genome assembly was used as a reference. Genome‐wide data revealed a pattern of population differentiation that could not be detected with mitogenome or microsatellite data. This differentiation pattern, including genetic similarity between populations across the eastern and western sides of Ise Bay (trans‐Ise Bay pattern), appears to reflect population connectivity facilitated by paleo‐river systems during the Last Glacial Period. Genetic diversity indices showed low variability across populations, suggesting historical bottlenecks and, for some populations, recent inbreeding. By utilizing genome‐wide data, this study elucidated the subtle population structure of P. ichikawai in unprecedented detail. This approach provides a deeper understanding of the species' population history under geographic and climatic influences, contributing to conservation strategies for regional biodiversity management. Our results also demonstrate that the absence of detectable population structure using traditional markers does not necessarily preclude its existence, highlighting the critical role of genome‐wide data in uncovering cryptic diversity.

Contrast-enhanced ultrasound (CEUS) plays a pivotal role in the diagnosis of primary breast cancer and in axillary lymph node (ALN) metastasis. However, the imaging features that are clinically crucial for lymph node metastasis have not been fully elucidated. Hence, we developed a bimodal model to predict ALN metastasis in patients with early breast cancer by integrating CEUS images with the annotated imaging features. The model adopted a light-gradient boosting machine to produce feature importance, enabling the extraction of clinically crucial imaging features. In this retrospective study, the diagnostic performance of the model was investigated using 788 CEUS images of ALNs obtained from 788 patients who underwent breast surgery between 2013 and 2021, with the ground truth defined by the pathological diagnosis. The results indicated that the test cohort had an area under the receiver operating characteristic curve (AUC) value of 0.93 (95% confidence interval: 0.88, 0.98). The model had an accuracy of 0.93, which was higher than the radiologist’s diagnosis (accuracy of 0.85). The most important imaging features were heterogeneous enhancement, diffuse cortical thickening, and eccentric cortical thickening. Our model has an excellent diagnostic performance, and the extracted imaging features could be crucial for confirming ALN metastasis in clinical settings.

Sinusoidal obstruction syndrome (SOS)/veno-occlusive disease (VOD) is a serious complication following hematopoietic stem cell transplantation. It is more common in children, with an incidence of approximately 20% compared to 10% in adult patients. While the Hokkaido ultrasonography (US)-based scoring system (HokUS-10 and HokUS-6) has proven effective in diagnosing SOS/VOD in adults, its utility in children remains uncertain. This study evaluated the utility of the HokUS-10/6 scoring systems in diagnosing pediatric SOS/VOD (pSOS/VOD) in a cohort of 99 patients, including 13 diagnosed with pSOS/VOD. Hyperbilirubinemia (> 2 mg/dL) was observed in only three patients (23%), whereas transfusion-refractory thrombocytopenia, hepatomegaly, and ascites were observed in all 13 patients. When the cutoff values for HokUS-10 and HokUS-6 scores were set at 4 and 2, the respective areas under the curve were 0.977 and 0.957. The sensitivity and specificity were 100% and 80% for HokUS-10, and 77% and 97% for HokUS-6, respectively. The simplified HokUS-6 may be a practical tool for diagnosing pSOS/VOD when use of the HokUS-10 scoring system is not feasible. HokUS-10/6 is important for early detection of pSOS/VOD during regular examinations and plays a valuable role in the diagnosis of clinical pSOS/VOD.

Background and Objectives Sinusoidal obstruction syndrome (SOS) / hepatic veno-occlusive disease (VOD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Incidence of SOS/VOD after HSCT varies from 5 to 60%1-4, and mortality rate was 80%2, if it's with multiorgan failure. Difibrotide is only a drug for SOS/VOD treatment, approved by the Ministry of Health, Labour and Welfare in Japan. Early diagnosis, and prompt initiation of defibrotide thought to be successful treatment of SOS/VOD5. The diagnostic criteria of SOS/VOD were based on clinical findings, such as body weight gain and hyperbirilubinemia. Recently, ultrasonography (US) has been suggested as one of modalities to diagnose SOS/VOD. We previously reported the usefulness of original US scoring system, which includes assessing hepatomegaly, ascites, and blood flow alteration. It is called Hokkaido US-based scoring system (HokUS) -106 in diagnosing SOS/VOD. And it has been suggested as one of criteria to diagnose SOS in European federation of bone marrow transplantation (EBMT) guideline 20237. However, 10 findings of HokUS-10 are rather many, and prominent findings are needed for diagnosing SOS/VOD.To identify prominent findings of HokUS-10 for diagnosing SOS. Materials and Methods The patients who underwent HSCT from Jan. 2008 to June 2019 in our institution were retrospectively analyzed. HokUS-10 were applied to the patients before HSCT and on day 14, 28 or when the signs of SOS appeared after HSCT (Fig.1). SOS was clinically diagnosed by the modified Seattle8 or the Baltimore criteria9 or the EBMT criteria10. Patients developed SOS within 21 days after HSCT was categorized as classical SOS, and byond 21 days was as late-onset SOS. HokUS-10 consists of 10 parameters were used SOS/VOD diagnosis (Table 1) US was performed using PVT-375 BT (center frequency, 3.75 MHz), PVT-674 BT (center frequency, 6 MHz), and PVT-704 BT (center frequency, 7.5 MHz) equipped with Aplio™ XV/XG/500/Xario/i800/i700 (Canon Medical Systems Corp., Otawara, Japan), by 5 registered medical sonographers (1∼26 years experiment of US) .To clarify most prominent parameters in HokUS-10, diagnostic performance and Odds ratio were analyzed in classical and late-onset SOS. Results Four hundred and forty-one until day 21 and 421 patients after day 22 of HSCT were enrolled. Of whom, 30 and 22 patients were diagnosed by clinically as classical and late-onset SOS, respectively. Ascites showed highest sensitivity as 100% in both classical and late-onset SOS. Highest positive predictive value as 100% was seen in hepatofugal portal vein blood flow signal. Odds ratio, of classical and late-onset SOS of moderate amount of ascites, appearance of PUV blood flow signal, PUV dilatation, decrease of PV blood flow velocity, and GB wall thickness were 317.3 and 85.5, 41.6 and 32.1, 29.7 and 27.8, 12.6 and 30.6, and 27.4 and 6.6, respectively, in descending order. Summary and Future Perspectives Prominent findings of HokUS-10 for diagnosing both of clinical and late-onset SOS were moderate amount of ascites, PUV dilatation, and appearance of PUV blood flow signal in descending order. Also, in classical SOS, GB wall thickening, and in late-onset SOS decrease of PV blood flow velocity were followed by prominent findings.

Background/Aims: Transabdominal ultrasonography (US) helps evaluate Crohn’s disease (CD) activity. We investigated whether the US could predict subsequent adverse outcomes for patients with CD in clinical remission.Methods: This single-center retrospective study included patients with CD in clinical remission who underwent US between April 2011 and April 2021, focusing on the predictability of subsequent adverse outcomes within 5 years. We used the US-CD, which was calculated using multiple US findings. Predictive variables were assessed using Cox proportional hazards regression analysis, and the predictive value was evaluated using receiver operating characteristic curves.Results: Seventy-three patients were included. During a median follow-up of 1,441 days (range, 41–1,825 days), 16.4% (12/73) experienced clinical relapse, 9.6% (7/73) required endoscopic balloon dilation (EBD), 58.9% (43/73) required enhanced treatment, and 20.5% (15/73) underwent surgery. In the multivariate analysis, US-CD was significantly associated with clinical relapse (P= 0.038) and the need for enhanced treatment (P= 0.005). The area under the receiver operating characteristic curve for predicting clinical relapse and the need for EBD was 0.77 and 0.81, respectively, with US-CD (cutoff value = 11), and that for requiring enhanced treatment was 0.74 with US-CD (cutoff value = 6). Patients with US-CD ≥ 11 demonstrated a significantly higher occurrence of clinical relapse (P= 0.001) and EBD (P= 0.002) within 5 years. Patients with US-CD ≥ 6 experienced a significantly higher likelihood of requiring enhanced treatment (P< 0.001) within 5 years.Conclusions: High US-CD is associated with subsequent adverse outcomes in patients with CD.

BACKGROUND:Pegfilgrastim, a long-acting form of granulocyte-colony stimulating factor, with a convenient single-injection dosage, is being investigated for peripheral blood stem cell (PBSC) mobilization in healthy volunteers. However, data on the adequate dose of pegfilgrastim for PBSC mobilization are limited. This phase 2, single-arm study evaluated the efficacy and safety of pegfilgrastim for PBSC mobilization in healthy volunteers. METHODS:The study comprised 2 phases: pilot (steps 1-3, dose escalation, a single subcutaneous dose of 3.6, 7.2, and 10.8 mg pegfilgrastim, respectively) and evaluation (step 4, efficacy and safety assessments). The primary endpoint was the proportion of subjects who achieved mobilization of ≥20 × 10 6 /L cluster of differentiation 34 positive (CD34 + ) cells. RESULTS:Thirty-five subjects (6 each in steps 1 and 2 and 23 in step 4) were included. In the pilot phase, step 3 with a 10.8 mg dose was not conducted due to favorable outcomes in step 2 (desired CD34 + cell count), at 7.2 mg pegfilgrastim, which was identified as the optimal dose for the evaluation phase. In the evaluation phase, successful CD34 + mobilization was achieved in all 23 subjects. The mean peripheral blood CD34 + cells count peaked on day 5. Back pain, thrombocytopenia, transient elevations of alkaline phosphatase, and lactate dehydrogenase were the most common adverse events. All adverse events were mild, and none led to study discontinuation. CONCLUSIONS:A single-dose pegfilgrastim successfully mobilized an optimal number of CD34 + cells and was well tolerated. Pegfilgrastim could be an alternative option for PBSC mobilization in healthy volunteers. The trial was registered at www.clinicaltrials.gov (NCT03993639).

Background and Objectives Sinusoidal obstruction syndrome (SOS) / hepatic veno-occlusive disease (VOD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Incidence of SOS/VOD after HSCT varies from 5 to 60%1-4, and mortality rate was 80%2, if it's with multiorgan failure. Difibrotide is only a drug for SOS/VOD treatment, approved by the Ministry of Health, Labour and Welfare in Japan. Early diagnosis, and prompt initiation of defibrotide thought to be successful treatment of SOS/VOD5. The diagnostic criteria of SOS/VOD were based on clinical findings, such as body weight gain and hyperbirilubinemia. Recently, ultrasonography (US) has been suggested as one of modalities to diagnose SOS/VOD. We previously reported the usefulness of original US scoring system, which includes assessing hepatomegaly, ascites, and blood flow alteration. It is called Hokkaido US-based scoring system (HokUS) -106 in diagnosing SOS/VOD. And it has been suggested as one of criteria to diagnose SOS in European federation of bone marrow transplantation (EBMT) guideline 20237. However, 10 findings of HokUS-10 are rather many, and prominent findings are needed for diagnosing SOS/VOD. To identify prominent findings of HokUS-10 for diagnosing SOS. Materials and Methods The patients who underwent HSCT from Jan. 2008 to June 2019 in our institution were retrospectively analyzed. HokUS-10 were applied to the patients before HSCT and on day 14, 28 or when the signs of SOS appeared after HSCT (Fig.1). SOS was clinically diagnosed by the modified Seattle8 or the Baltimore criteria9 or the EBMT criteria10. Patients developed SOS within 21 days after HSCT was categorized as classical SOS, and byond 21 days was as late-onset SOS. HokUS-10 consists of 10 parameters were used SOS/VOD diagnosis (Table 1) US was performed using PVT-375 BT (center frequency, 3.75 MHz), PVT-674 BT (center frequency, 6 MHz), and PVT-704 BT (center frequency, 7.5 MHz) equipped with Aplio™ XV/XG/500/Xario/i800/i700 (Canon Medical Systems Corp., Otawara, Japan), by 5 registered medical sonographers (1∼26 years experiment of US) . To clarify most prominent parameters in HokUS-10, diagnostic performance and Odds ratio were analyzed in classical and late-onset SOS. Results Four hundred and forty-one until day 21 and 421 patients after day 22 of HSCT were enrolled. Of whom, 30 and 22 patients were diagnosed by clinically as classical and late-onset SOS, respectively. Ascites showed highest sensitivity as 100% in both classical and late-onset SOS. Highest positive predictive value as 100% was seen in hepatofugal portal vein blood flow signal. Odds ratio, of classical and late-onset SOS of moderate amount of ascites, appearance of PUV blood flow signal, PUV dilatation, decrease of PV blood flow velocity, and GB wall thickness were 317.3 and 85.5, 41.6 and 32.1, 29.7 and 27.8, 12.6 and 30.6, and 27.4 and 6.6, respectively, in descending order. Summary and Future Perspectives Prominent findings of HokUS-10 for diagnosing both of clinical and late-onset SOS were moderate amount of ascites, PUV dilatation, and appearance of PUV blood flow signal in descending order. Also, in classical SOS, GB wall thickening, and in late-onset SOS decrease of PV blood flow velocity were followed by prominent findings. Sinusoidal obstruction syndrome (SOS) / hepatic veno-occlusive disease (VOD) is a serious complication after hematopoietic stem cell transplantation (HSCT). Incidence of SOS/VOD after HSCT varies from 5 to 60%1-4, and mortality rate was 80%2, if it's with multiorgan failure. Difibrotide is only a drug for SOS/VOD treatment, approved by the Ministry of Health, Labour and Welfare in Japan. Early diagnosis, and prompt initiation of defibrotide thought to be successful treatment of SOS/VOD5. The diagnostic criteria of SOS/VOD were based on clinical findings, such as body weight gain and hyperbirilubinemia. Recently, ultrasonography (US) has been suggested as one of modalities to diagnose SOS/VOD. We previously reported the usefulness of original US scoring system, which includes assessing hepatomegaly, ascites, and blood flow alteration. It is called Hokkaido US-based scoring system (HokUS) -106 in diagnosing SOS/VOD. And it has been suggested as one of criteria to diagnose SOS in European federation of bone marrow transplantation (EBMT) guideline 20237. However, 10 findings of HokUS-10 are rather many, and prominent findings are needed for diagnosing SOS/VOD. To identify prominent findings of HokUS-10 for diagnosing SOS. The patients who underwent HSCT from Jan. 2008 to June 2019 in our institution were retrospectively analyzed. HokUS-10 were applied to the patients before HSCT and on day 14, 28 or when the signs of SOS appeared after HSCT (Fig.1). SOS was clinically diagnosed by the modified Seattle8 or the Baltimore criteria9 or the EBMT criteria10. Patients developed SOS within 21 days after HSCT was categorized as classical SOS, and byond 21 days was as late-onset SOS. HokUS-10 consists of 10 parameters were used SOS/VOD diagnosis (Table 1) US was performed using PVT-375 BT (center frequency, 3.75 MHz), PVT-674 BT (center frequency, 6 MHz), and PVT-704 BT (center frequency, 7.5 MHz) equipped with Aplio™ XV/XG/500/Xario/i800/i700 (Canon Medical Systems Corp., Otawara, Japan), by 5 registered medical sonographers (1∼26 years experiment of US) . To clarify most prominent parameters in HokUS-10, diagnostic performance and Odds ratio were analyzed in classical and late-onset SOS. Four hundred and forty-one until day 21 and 421 patients after day 22 of HSCT were enrolled. Of whom, 30 and 22 patients were diagnosed by clinically as classical and late-onset SOS, respectively. Ascites showed highest sensitivity as 100% in both classical and late-onset SOS. Highest positive predictive value as 100% was seen in hepatofugal portal vein blood flow signal. Odds ratio, of classical and late-onset SOS of moderate amount of ascites, appearance of PUV blood flow signal, PUV dilatation, decrease of PV blood flow velocity, and GB wall thickness were 317.3 and 85.5, 41.6 and 32.1, 29.7 and 27.8, 12.6 and 30.6, and 27.4 and 6.6, respectively, in descending order. Prominent findings of HokUS-10 for diagnosing both of clinical and late-onset SOS were moderate amount of ascites, PUV dilatation, and appearance of PUV blood flow signal in descending order. Also, in classical SOS, GB wall thickening, and in late-onset SOS decrease of PV blood flow velocity were followed by prominent findings.

Sinusoidal obstruction syndrome (SOS) is a fatal complication of hematopoietic stem cell transplantation (HSCT). Previously, we established a scoring system (Hokkaido ultrasound-based scoring system-10; HokUS-10) comprising 10 ultrasound parameters for SOS diagnosis. In HokUS-10, the portal vein time-averaged flow velocity (PV TAV) and hepatic artery resistive index (HA RI) are measured using subcostal scanning. However, measurement errors and delineation difficulties occur. Therefore, we aimed to prospectively evaluate PV TAV and HA RI measurements obtained via intercostal scanning as an alternative method to subcostal scanning and determine their cutoff values. HokUS-10 was administered before and after HSCT. PV TAV and HA RI were measured on subcostal and right intercostal scans. We performed 366 scans on 74 patients. The median value (range) of PV TAV in the main and right portal veins was 15.0 cm/s (2.2–49.6 cm/s) and 10.5 cm/s (1.6–22.0 cm/s), respectively. A low correlation was observed between the two values (r = 0.39, p < 0.01). The highest diagnostic value of the right portal vein was less than 8.0 cm/s. The median value (range) of HA RI in the proper and right hepatic arteries was 0.72 (0.52–1.00) and 0.70 (0.51–1.00), respectively. A strong correlation was observed between the two values (r = 0.65, p < 0.01). The highest diagnostic value of the right HA RI was 0.72 or higher. Quantitative measurement of PV TAV and HA RI using intercostal scanning can be appropriately performed as an alternative method to using subcostal scanning.

Abstract The shear wave dispersion (SWD) slope has become available in the clinical practice and is related to tissue viscosity. However, clinical evaluation using SWD was not yet performed for obstructive jaundice. We aimed to evaluate the change of SWD values between before and after biliary drainage in patients with obstructive jaundice. This prospective observational cohort study evaluated 20 patients with obstructive jaundice who underwent biliary drainage. The SWD and liver elasticity values were measured before versus after biliary drainage, comparing between days −5 and 0 (day 0), days 1 and 3 (day 2), and days 6 and 8 (day 7). The mean ± SD values of SWD measured at day 0, day 2, and day 7 were 15.3 ± 2.7, 14.2 ± 3.3, and 13.3 ± 2.4 m/s/kHz, respectively. Dispersion slope values were decreased significantly from day 0 to day 2, from day 2 to day 7, and from day 0 to day 7 (P < 0.05). Liver elasticity levels and serum hepatobiliary enzymes were additionally decreased significantly over time after biliary drainage. The correlations between SWD and liver elasticity values were strong (r = 0.91, P < 0.01). In conclusion, the SWD values decreased significantly over time after biliary drainage concomitant with liver elasticity.

Hepatic sinusoidal obstruction syndrome (SOS) is a severe and life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). We conducted a multi-center retrospective study to evaluate the utility of our ultrasonographic scoring system for the diagnosis of SOS (HokUS-10) in predicting SOS-related mortality (SOS-RM). We analyzed a total of 42 patients who developed SOS after HSCT. The cumulative incidences of SOS-RM, non-relapse mortality (NRM), and overall survival at day 180 after the diagnosis of SOS were 26.4%, 28.8% and 54.5%, respectively. The area under the receiver operating characteristic curve analysis showed that the optimal cut-off value of HokUS-10 total score to predict SOS-RM was 8 points after the treatment of SOS. In the individual HokUS-10 score, ascites and portal vein flow-related scores (PV mean velocity and PV flow direction) after the treatment of SOS were shown as significant risk factors for SOS-RM. Our study suggested that US findings after the treatment can predict the treatment outcomes for SOS.

Background and AimRecently, dispersion imaging by shear wave elastography has been developed to visualize a tissue viscosity-related factor by measuring the dispersion slope. However, clinical significance of dispersion imaging in the field of pancreatic cancer is unknown. This study aimed to investigate the clinical significance of dispersion imaging in the treatment and diagnosis of pancreatic cancer. MethodsWe measured shear wave dispersion slope (SWD) (m/s/kHz) and shear wave elasticity (SWE) (kPa) in patients with pancreatic ductal adenocarcinoma (PDA). The primary endpoint was the relationship between the changes in SWD and SWE values before and after chemotherapy and the response to chemotherapy. Secondary endpoints included SWD and SWE values in relation to differences between PDA and non-PDA sites and histopathological scores of stroma, inflammation, fibrosis, and necrosis in endoscopic ultrasound-guided fine-needle aspiration specimens. ResultsFifty-six patients were included, 30 of whom underwent chemotherapy. There was no relationship between the changes of SWD and SWE values and chemotherapy responses. In 56 patients, the median SWD value was 12.20 m/s/kHz (interquartile range [IQR]: 10.88-13.61) at PDA sites and 13.57 m/s/kHz (IQR: 12.28-16.20) at non-PDA sites (P = 0.005). The median SWE value was 8.18 kPa (IQR: 7.00-9.74) at PDA sites and 6.14 kPa (IQR: 5.40-6.77) at non-PDA sites (P < 0.001). Histopathological evaluation revealed that inflammation scores were correlated with SWD values (r(s) = 0.42, P < 0.001). ConclusionsDispersion imaging in pancreatic cancer would be useful for diagnosis and assessing inflammation.

Background In recent years, contrast-enhanced ultrasonography (CEUS) has been used for various applications in breast diagnosis. The superiority of CEUS over conventional B-mode imaging in the ultrasound diagnosis of the breast lesions in clinical practice has been widely confirmed. On the other hand, there have been many proposals for computer-aided diagnosis of breast lesions on B-mode ultrasound images, but few for CEUS. We propose a semi-automatic classification method based on machine learning in CEUS of breast lesions. Methods The proposed method extracts spatial and temporal features from CEUS videos and breast tumors are classified as benign or malignant using linear support vector machines (SVM) with combination of selected optimal features. In the proposed method, tumor regions are extracted using the guidance information specified by the examiners, then morphological and texture features of tumor regions obtained from B-mode and CEUS images and TIC features obtained from CEUS video are extracted. Then, our method uses SVM classifiers to classify breast tumors as benign or malignant. During SVM training, many features are prepared, and useful features are selected. We name our proposed method "Ceucia-Breast" (Contrast Enhanced UltraSound Image Analysis for BREAST lesions). Results The experimental results on 119 subjects show that the area under the receiver operating curve, accuracy, precision, and recall are 0.893, 0.816, 0.841 and 0.920, respectively. The classification performance is improved by our method over conventional methods using only B-mode images. In addition, we confirm that the selected features are consistent with the CEUS guidelines for breast tumor diagnosis. Furthermore, we conduct an experiment on the operator dependency of specifying guidance information and find that the intra-operator and inter-operator kappa coefficients are 1.0 and 0.798, respectively. Conclusion The experimental results show a significant improvement in classification performance compared to conventional classification methods using only B-mode images. We also confirm that the selected features are related to the findings that are considered important in clinical practice. Furthermore, we verify the intra- and inter-examiner correlation in the guidance input for region extraction and confirm that both correlations are in strong agreement.

This study presents the case of man who underwent ultrasonography (US) for the diagnosis and follow-up of cystitis glandularis with severe intestinal metaplasia. We believe that our study makes a significant contribution to the literature because the findings of cystitis glandularis that forms a mass is relatively rare.

AIM:The aim of this study was to determine the risk factors for household transmission of the omicron variant of SARS-CoV-2.BACKGROUND:The household infection rate has been reported to be higher for the omicron variant than for non-omicron variants of SARS-CoV-2. Determination of the risk factors for household transmission of the omicron variant is therefore important.DESIGN:A Retrospective Cohort Study was conducted.METHODS:When family members of health care workers (HCWs) were found to be infected with SARS-CoV-2, the HCWs had to receive two nucleic acid amplification tests for SARS-CoV-2: immediately after and 5 to 10 days after the onset of COVID-19 in the family members. Risk factors of household transmission were analysed by comparing cases (HCWs infected with SARS-CoV-2) and controls (HCWs not infected with SARS-CoV-2) using multivariable analysis.RESULTS:Unvaccinated status (OR: 3.97), age of index cases (≤6 years) (OR: 1.94) and staying at home with index cases (OR: 10.18) were risk factors for household transmission.CONCLUSION:If there is a strong desire to avoid household infection, family members infected with SARS-CoV-2 should live separately during the period of viral shedding.

We present a case of breast angiosarcoma. Although B-mode ultrasonography did not indicate a tumor, contrast-enhanced ultrasonography (CEUS) was successfully delineated it. CEUS helped identify the tumor and its extent.

The standard diagnostic modalities for gastrointestinal (GI) diseases have long been endoscopy and barium enema. Recently, trans-sectional imaging modalities, such as computed tomography and magnetic resonance imaging, have become increasingly utilized in daily practice. In transabdominal ultrasonography (US), the bowel sometimes interferes with the observation of abdominal organs. Additionally, the thin intestinal walls and internal gas can make structures difficult to identify. However, under optimal US equipment settings, with identification of the sonoanatomy and knowledge of the US findings of GI diseases, US can be used effectively to diagnose GI disorders. Thus, the efficacy of GIUS has been gradually recognized, and GIUS guidelines have been published by the World Federation for Ultrasound in Medicine and Biology and the European Federation of Societies for Ultrasound in Medicine and Biology. Following a systematic scanning method according to the sonoanatomy and precisely estimating the layered wall structures by employing color Doppler make diagnosing disease and evaluating the degree of inflammation possible. This review describes current GIUS practices from an equipment perspective, a procedure for systematic scanning, typical findings of the normal GI tract, and 10 diagnostic items in an attempt to help medical practitioners effectively perform GIUS and promote the use of GIUS globally.

Hepatic sinusoidal obstruction syndrome (SOS)/veno-occlusive disease is a life-threatening complication after hematopoietic stem cell transplantation (HSCT). We previously reported the efficacy of the Hokkaido Ultrasonography (US)-based scoring system (HokUS-10) for US findings. To establish easier-to-use criteria, we retrospectively evaluated US findings from 441 patients, including 30 patients with SOS using the HokUS-10 scoring system. Using logistic regression analysis, we established the novel diagnostic criteria HokUS-6. In the presence of ascites, US diagnosis was made in the presence of two of the following 6 parameters: moderate amount of ascites, the appearance of a paraumbilical vein blood flow signal, gallbladder wall thickening, portal vein dilatation, portal vein velocity decrease, and hepatic artery resistive index increase. The AUC, sensitivity, and specificity of HokUS-6 were 0.974 (95% confidence interval 0.962-0.990), 95.2%, and 96.9%, respectively. The scores were significantly higher in patients with severe SOS than in those with non-severe SOS (p = 0.013). Furthermore, the scores before HSCT were significantly higher in patients who developed SOS than in controls (p = 0.001). The HokUS-6 is an easy and useful way to diagnose and identify the risk of SOS.

Background: The superior vena cava (SVC) flow velocity waveform from the supraclavicular window reflects right atrial pressure (RAP) status. Recent guidelines have stated that the subcostal window is an alternative view for recording SVC flow, but the validity of this approach remains unclear. The aim of this study was to determine the usefulness of SVC flow evaluation from the subcostal window for estimating RAP. Methods: Differences in SVC flow characteristics between opposite approaches were examined in 38 healthy adults. In 115 patients with cardiovascular diseases who underwent cardiac catheterization and echocardiography within 48 hours, the ratio of peak systolic to diastolic forward SVC flow (SVC-S/D) was measured, and the diagnostic ability of SVC-S/D for elevated RAP was tested. A validation cohort was used to confirm the diagnostic ability of SVC-S/D in 48 patients who underwent both cardiac catheterization and echocardiography within 24 hours. In 59 patients in the derivation and validation cohorts, the relationship between SVC flow and RAP was compared between the opposite windows. Results: Both systolic and diastolic SVC flow velocities were higher in the subcostal than in the supraclavicular approach, and effect of position change on subcostal SVC-S/D was smaller than that on supraclavicular SVCS/D in healthy adults. Measurement of SVC-S/D from the subcostal window was feasible in 98 patients (85%). RAP was inversely correlated with SVC-S/D (r = -0.50, P <.001) and was an independent determinant of SVCS/D after adjustment for right ventricular systolic function (beta = -0.48, P <.001). A cutoff value of 1.9 for SVC-S/D showed 85% sensitivity and 74% specificity in identifying elevated RAP. Additionally, SVC-S/D showed an incremental diagnostic value combined with inferior vena cava size and collapsibility (P =.006). When a cutoff value of SVC-S/D < 1.9 was applied to the validation cohort, it showed acceptable accuracy of 72% and incremental diagnostic value combined with inferior vena cava parameters (P =.033). SVC-S/D from the subcostal window correlated better with RAP than that from the supraclavicular window (P <.001, Meng's test). Conclusions: Measurement of SVC flow velocity from the subcostal window was feasible, and SVC-S/D from the subcostal window could be an additive parameter for estimating RAP. (J Am Soc Echocardiogr 2022;35:727-37.)