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Choi JY, Kim KW, Jang JK, Choi SH, Kwon HJ, Yoon YI, Song GW, Lee SG. Value of Doppler ultrasonography in predicting clinical outcomes for patients with acute cellular rejection after liver transplantation. Ultrasonography 2023; 42:572-579. [PMID: 37700431 PMCID: PMC10555689 DOI: 10.14366/usg.23112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/21/2023] [Accepted: 08/06/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE This study investigated the value of Doppler ultrasonography in predicting clinical outcomes after antirejection treatment for patients with acute cellular rejection (ACR) following liver transplantation (LT). METHODS This retrospective study included 84 patients who were pathologically diagnosed with ACR and received antirejection treatment within 90 days following LT. Two radiologists searched for abnormal Doppler parameters at ACR diagnosis and within 7 days after antirejection treatment initiation, including portal blood velocity (PBV) <20 cm/s, hepatic artery resistive index <0.5, and a monophasic hepatic vein flow pattern. Interval PBV changes were also evaluated. The frequencies of abnormal Doppler parameters and PBV changes were compared by treatment outcome. RESULTS The frequency of abnormal PBV in the early post-treatment phase (PBVearly post-treatment) was significantly higher among poor responders (50.0% [10/20]) than among good responders (7.8% [5/64]) (P<0.001). The sensitivity, specificity, and accuracy of abnormal PBVearly post-treatment as a predictor of poor response to antirejection treatment were 50.0% (10/20), 92.2% (59/64), and 82.1% (69/84), respectively. A decrease (>10%) from the PBV at event (PBVevent) to PBVearly post-treatment was significantly more common among poor responders (50.0% [10/20]) than among good responders (20.3% [13/64]) (P=0.019). The sensitivity, specificity, and accuracy of this PBV decrease in predicting poor treatment response were 50.0% (10/20), 79.7% (51/64), and 72.6% (61/84), respectively. CONCLUSION Abnormal PBVearly post-treatment and a decrease between PBVevent and PBVearly post-treatment were significantly associated with poor treatment response in patients with ACR after LT. Consequently, Doppler ultrasonography may be useful for predicting clinical outcomes in these patients.
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Affiliation(s)
- Ji Young Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong Keon Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-In Yoon
- Department of Surgery, Division of Hepatobiliary and Liver Transplantation Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Department of Surgery, Division of Hepatobiliary and Liver Transplantation Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Department of Surgery, Division of Hepatobiliary and Liver Transplantation Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Lee S, Kim KW, Kwon HJ, Lee J, Song GW, Lee SG. Impact of the preoperative skeletal muscle index on early remnant liver regeneration in living donors after liver transplantation. Korean J Transplant 2022; 36:259-266. [PMID: 36704805 PMCID: PMC9832594 DOI: 10.4285/kjt.22.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/11/2022] [Accepted: 09/28/2022] [Indexed: 11/15/2022] Open
Abstract
Background We investigated the correlation between the preoperative skeletal muscle index (SMI) and remnant liver regeneration after right hemihepatectomy for living-donor liver transplantation and aimed to identify preoperative predictors of greater early remnant liver regeneration in living donors. Methods This retrospective study included 525 right hemiliver donors (mean age, 28.9±8.3 years; 345 male patients) between 2017 and 2018, who underwent computed tomography before surgery and on postoperative day (POD) 7. Preoperative anthropometry, laboratory parameters, skeletal muscle area at the third lumbar vertebral level, and liver volume before and after surgery were evaluated. Correlations were analyzed using Pearson correlation coefficients, and stepwise multiple regression analysis was performed to identify independent predictors of greater remnant liver regeneration. Results Remnant liver regeneration volume on POD 7 was positively correlated with body mass index (BMI; r=0.280, P<0.001) and SMI (r=0.322, P<0.001), and negatively correlated with age (r=-0.154, P<0.001) and the ratio of future remnant liver volume (FRLV) to total liver volume (TLV; r=-0.261, P<0.001). Stepwise multiple regression analysis showed that high BMI (β=0.146; P=0.001) and SMI (β=0.228, P<0.001), young age (β=-0.091, P=0.025), and a low FRLV/TLV ratio (β=-0.225, P<0.001) were predictors of greater remnant liver regeneration. Conclusions High SMI and BMI, young age, and a low FRLV/TLV ratio may predict greater early remnant liver regeneration in living donors after LDLT.
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Affiliation(s)
- Sunyoung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea,Co-Corresponding author: Sunyoung Lee, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea, Tel: +82-2-2228-7400, Fax: +82-2-2227-8337, E-mail:
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea,Corresponding author: Kyoung Won Kim Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil, Songpa-gu, Seoul 05505, Korea, Tel: +82-2-3010-4400, Fax: +82-2-476-4719, E-mail:
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Gi-Won Song
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Choi J, Kim JY, Kwon HJ, Choi HJ, Kim SH, Kim S, Lee J, Park JE. Association of cerebral white matter hyperintensities with coronary artery calcium in a healthy population: a cross-sectional study. Sci Rep 2022; 12:21562. [PMID: 36513747 PMCID: PMC9747792 DOI: 10.1038/s41598-022-25654-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
In brain magnetic resonance imaging (MRI), white matter hyperintensity (WMH) is a commonly encountered finding and is known to reflect cerebral small vessel disease. The aim of our study was to investigate the association of coronary artery calcium (CAC) with WMH and elucidate the relationship between WMH and atherosclerotic risk factors in a large-scale healthy population. This retrospective study included 1337 individuals who underwent brain MRI and CAC scoring computed tomography at healthcare centers affiliated with a tertiary hospital. Cerebral WMH was defined as Fazekas score greater than 2 on brain MRI. Intracranial artery stenosis (ICAS) was also assessed and determined to be present when stenosis was more than 50% on angiography. The associations of risk factors, CAC score, and ICAS with cerebral WMH were assessed by multivariable regression analysis. In multivariable analysis, categories of higher CAC scores showed increased associations with both periventricular and deep WMHs in a dose-dependent relationship. The presence of ICAS was also significantly related to cerebral WMH, and among the clinical variables, age and hypertension were independent risk factors. In conclusion, CAC showed a significant association with cerebral WMH in a healthy population, which might provide evidence for referring to the CAC score to identify individuals with risk of cerebral WMH.
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Affiliation(s)
- Jinyoung Choi
- grid.264381.a0000 0001 2181 989XDepartment of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 03181 Republic of Korea
| | - Jung Youn Kim
- grid.410886.30000 0004 0647 3511Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-Do 13496 Republic of Korea
| | - Heon-Ju Kwon
- grid.264381.a0000 0001 2181 989XDepartment of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 03181 Republic of Korea
| | - Hye Jeong Choi
- grid.410886.30000 0004 0647 3511Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-Do 13496 Republic of Korea
| | - Sang Heum Kim
- grid.410886.30000 0004 0647 3511Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-Do 13496 Republic of Korea
| | - Sinae Kim
- grid.264381.a0000 0001 2181 989XDivision of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, 03181 Republic of Korea
| | - Jungbin Lee
- grid.412678.e0000 0004 0634 1623Department of Radiology, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-Do 14584 Republic of Korea
| | - Ji Eun Park
- grid.413967.e0000 0001 0842 2126Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, 05505 Republic of Korea
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Kwon HJ, Kim KW, Kang KA, Kim MS, Kim SY, Park T, Lee J. Oral effervescent agent improving magnetic resonance cholangiopancreatography. Quant Imaging Med Surg 2022; 12:4414-4423. [PMID: 36060576 PMCID: PMC9403601 DOI: 10.21037/qims-22-219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022]
Abstract
Background The purpose of our study was to validate the oral effervescent agent improving magnetic resonance cholangiopancreatography (MRCP) in patients with suspicious pancreatobiliary disease. Methods One hundred and eleven consecutive patients with alleged or suspected pancreatobiliary tree problems who had undergone two-dimensional (2D) MRCP imaging both before and after oral effervescent enhancement (conventional-MRCP and enhanced-MRCP) were included. Two radiologists independently scored overall image quality, visualization of ten ductal segments, and gastroduodenal fluid signal intensity score. In consensus, they assessed the presence of gastroduodenal fluids and pancreatobiliary tree overlapping. The data were analyzed using Wilcoxon’s signed-rank test, McNemar test, and paired t-test. Results The grades of overall image quality and individual biliary duct visualization for ten targeted ductal segments, and gastroduodenal fluid signal intensity scores increased significantly on enhanced-MRCP by both readers (P≤0.02), but there was no significant increase for pancreatic duct (PD) at head and tail. On enhanced-MRCP, gastroduodenal fluids except for gastric fundus were less detected rather than those on conventional-MRCP. Anatomic structures of gastroduodenal fluids overlapping extrahepatic bile duct were mainly gastric antrum, duodenal bulb, and 2nd portion on conventional-MRCP. However, these fluids were less overlapped on enhanced-MRCP (P<0.001). Gastric body and antrum were main anatomic structures of gastroduodenal fluids overlapping PD on conventional-MRCP, and fluid in these locations significantly less overlapped PD on enhanced-MRCP (P≤0.02). Conclusions Oral administration of effervescent agent provided effective elimination of gastroduodenal fluid overlapping pancreatobiliary ductal system at MRCP and can improve the quality of the examination in the patients with known or suspected pancreatobiliary disease.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyoung Won Kim
- Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kyung A. Kang
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - So Yeon Kim
- Department of Radiology and the Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Taeyong Park
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
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Choi JY, Kim KW, Jang JK, Kwon HJ, Yoon YI, Song GW, Lee SG. Progression of Portal Hypertension in Acute Cellular Rejection After Liver Transplantation. EXP CLIN TRANSPLANT 2022; 20:742-749. [DOI: 10.6002/ect.2022.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Park J, Kwon HJ, Sohn W, Cho JY, Park SJ, Chang Y, Ryu S, Kim BI, Cho YK. Risk of liver fibrosis in patients with prediabetes and diabetes mellitus. PLoS One 2022; 17:e0269070. [PMID: 35653399 PMCID: PMC9162349 DOI: 10.1371/journal.pone.0269070] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to assess the risk of liver fibrosis in those with no glucose intolerance, prediabetes, or diabetes. A cross-sectional study was conducted based on a cohort from a health examination program which included a magnetic resonance elastography (MRE). Participants were classified into three groups according to glucose tolerance: no glucose intolerance, prediabetes, and diabetes mellitus. Liver fibrosis was evaluated by liver stiffness measurement (LSM) value using two-dimensional real-time MRE. The risk of significant liver fibrosis was compared among three groups. A total of 2,090 subjects were included: no glucose intolerance (n = 889); prediabetes (n = 985); and diabetes (n = 216). Mean values of LSM in those with no glucose intolerance, prediabetes, and diabetes were 2.37 ± 0.43 kPa, 2.41 ± 0.34 kPa, and 2.65 ± 0.70 kPa, respectively (p<0.001). Proportions of significant fibrosis (LSM ≥2.97 kPa) in no glucose intolerance, prediabetes, and diabetes groups were 3.1%, 4.4%, and 16.7%, respectively (p<0.001). Compared with those with no glucose intolerance, those with diabetes had higher risk of significant fibrosis (adjusted odds ratio [aOR]: 3.02, 95% confidence interval [CI]: 1.57–5.81, p<0.001). However, there was no difference between prediabetes and no glucose intolerance (aOR: 1.05, 95% CI: 0.59–1.86, p = 0.876). A subgroup analysis also showed that prediabetes, unlike diabetes, was not associated with significant fibrosis in subjects with or without liver disease. Diabetes, but not prediabetes, is a risk factor for significant liver fibrosis. This finding is consistent regarldess of the pressence of liver disease.
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Affiliation(s)
- Jongsin Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail:
| | - Ju-Yeon Cho
- Department of Internal Medicine, Chosun University Hospital, Gwang-Ju, Republic of Korea
| | - Soo Jin Park
- Department of Surgery, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Byung Ik Kim
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yong Kyun Cho
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Sohn W, Kwon HJ, Chang Y, Ryu S, Cho YK. Liver Fibrosis in Asians With Metabolic Dysfunction-Associated Fatty Liver Disease. Clin Gastroenterol Hepatol 2022; 20:e1135-e1148. [PMID: 34224877 DOI: 10.1016/j.cgh.2021.06.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/17/2021] [Accepted: 06/28/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS This study aimed to evaluate risk factors associated with liver fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD). METHODS A cross-sectional study of 967 Korean patients with MAFLD involved a cohort from a health screening program during the years 2015-2018. The patients were classified into 4 MAFLD subgroups: group 1 (overweight). group 2 (obese), group 3 (lean/normal weight with metabolic abnormalities), and group 4 (diabetes). Liver fibrosis was assessed based on liver stiffness measurement (LSM) value using 2-dimensional real-time magnetic resonance elastography. We investigated differences in liver fibrosis according to MAFLD subgroup classification and determined the risk factors for significant fibrosis. RESULTS The mean age was 50.8 years, and 869 (90%) patients were male. The mean value of LSM in magnetic resonance elastography was 2.48 ± 0.47 kPa. Significant fibrosis (LSM ≥2.97 kPa) was observed in 66 (6.8%) of 967 patients. The proportion of significant fibrosis in MAFLD group 1, group 2, group 3, and group 4 was 1.3%, 5.5%, 6.4%, and 18.9%, respectively (P < .001). Multivariable analysis indicated that the risk factors for significant fibrosis were serum ferritin ≥300 ng/mL (odds ratio [OR], 1.96; 95% confidence interval [CI], 1.10-3.49; P = .023), Fibrosis-4 ≥1.3 (OR, 2.97; 95% CI, 1.68-5.24; P < .001), homeostatic model assessment of insulin resistance ≥2.0 (OR, 2.60; 95% CI, 1.25-5.43; P = .011), metabolic syndrome (OR, 2.53; 95% CI, 1.31-4.88; P = .006), and MAFLD group 4 (OR, 6.93; 95% CI, 1.96-24.51; P = .003). However, the etiology of liver disease was not statistically associated with liver fibrosis. CONCLUSION Liver fibrosis in patients with MAFLD varies according to subgroup classification based on diabetes, body mass index, and metabolic risk factors.
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Affiliation(s)
- Won Sohn
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
| | - Yong Kyun Cho
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Park JY, Yi SY, Baek SH, Lee YH, Kwon HJ, Park HJ. Diagnostic efficacy, performance and safety of side-cut core needle biopsy for thyroid nodules: comparison of automated and semi-automated biopsy needles. Endocrine 2022; 76:341-348. [PMID: 35032314 DOI: 10.1007/s12020-022-02980-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 01/09/2022] [Indexed: 01/20/2023]
Abstract
PURPOSE This study was performed to compare the utility of the semi-automated and automated side-cut core biopsy needles for thyroid nodules. METHODS Between January 2014 and March 2020, biopsy was performed for 278 thyroid nodules using the semi-automated core needle and for 225 nodules using the automated core needle. Nondiagnostic rate, inconclusive rate, diagnostic performance and complication rates were evaluated and compared between two core needle types. RESULTS There were 1.2% (6/503) nondiagnostic results and 15.9% (80/503) inconclusive results. Nondiagnostic rate between two needle types was not significantly different. The semi-automated type (33/278, 11.9%) showed lower inconclusive rate than the automated type (47/225, 20.9%) (p = 0.006). The sensitivity, specificity, PPV, NPV and diagnostic accuracy for diagnosis of malignancy of the semi-automated type were 70.18, 100, 100, 84.96 and 88.89%, respectively; the corresponding rates of automated type were 70.45, 100, 100, 86.6, and 89.84%. There were 12 minor complications: four hematomas (4/278, 1.4%) for the semi-automated type and eight hematomas (8/225, 3.6%) for the automated type, which difference was not statistically significant. CONCLUSION Core needle biopsy for thyroid nodules using either the semi-automated or automated needle is a safe diagnostic tool. Semi-automated needle has lower inconclusive rate than automated needle.
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Affiliation(s)
- Ji Yeon Park
- Department of Radiology, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Seong Yoon Yi
- Division of Hematology-Oncology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
| | - Soo Heui Baek
- Department of Radiology, Daerim St. Mary's Hospital, Seoul, Republic of Korea
| | - Yu Hyun Lee
- Department of Radiology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Lee S, Kim KW, Kwon HJ, Lee J, Koo K, Song GW, Lee SG. Relationship of body mass index and abdominal fat with radiation dose received during preoperative liver CT in potential living liver donors: a cross-sectional study. Quant Imaging Med Surg 2022; 12:2206-2212. [PMID: 35371965 PMCID: PMC8923845 DOI: 10.21037/qims-21-977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 12/31/2021] [Indexed: 10/08/2023]
Abstract
BACKGROUND Although contrast-enhanced computed tomography (CT) is currently the most widely-used imaging modality for the preoperative evaluation of potential living liver donors, radiation exposure remains a major concern. The present study aimed to determine the relationship of body mass index (BMI) and abdominal fat with the effective radiation dose received during liver CT scans as part of a pre-donation work-up in potential living donors. METHODS This retrospective cross-sectional study included 695 potential living donors (mean age, 30.5±9.7 years; 445 men and 250 women) who had undergone preoperative liver CT scans between 2017 and 2018. The following measures were evaluated: BMI, abdominal fat as measured at the level of the third lumbar vertebra, and effective dose based on the dose length product (DLP). Correlations between the effective dose and other variables were evaluated using Pearson's correlation coefficient. RESULTS The mean BMI, total fat area (TFA), and effective dose were 23.6±3.3 kg/m2, 218.7±110.0 cm2, and 9.4±3.3 mSv, respectively. The effective dose during liver CT scans had a strong positive correlation with both BMI (r=0.715; P<0.001) and TFA (r=0.792; P<0.001). As BMI and TFA increased, so did the effective dose. CONCLUSIONS Higher BMI and TFA significantly increased the radiation dose received during liver CT scans in potential living donors.
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Affiliation(s)
- Sunyoung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Kyoyeong Koo
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Gi-Won Song
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sung-Gyu Lee
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Mitchell D, Kwon HJ, Kubica PA, Huff WX, O’Regan R, Dey M. Brain metastases: An update on the multi-disciplinary approach of clinical management. Neurochirurgie 2022; 68:69-85. [PMID: 33864773 PMCID: PMC8514593 DOI: 10.1016/j.neuchi.2021.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/16/2021] [Accepted: 04/03/2021] [Indexed: 01/03/2023]
Abstract
IMPORTANCE Brain metastasis (BM) is the most common malignant intracranial neoplasm in adults with over 100,000 new cases annually in the United States and outnumbering primary brain tumors 10:1. OBSERVATIONS The incidence of BM in adult cancer patients ranges from 10-40%, and is increasing with improved surveillance, effective systemic therapy, and an aging population. The overall prognosis of cancer patients is largely dependent on the presence or absence of brain metastasis, and therefore, a timely and accurate diagnosis is crucial for improving long-term outcomes, especially in the current era of significantly improved systemic therapy for many common cancers. BM should be suspected in any cancer patient who develops new neurological deficits or behavioral abnormalities. Gadolinium enhanced MRI is the preferred imaging technique and BM must be distinguished from other pathologies. Large, symptomatic lesion(s) in patients with good functional status are best treated with surgery and stereotactic radiosurgery (SRS). Due to neurocognitive side effects and improved overall survival of cancer patients, whole brain radiotherapy (WBRT) is reserved as salvage therapy for patients with multiple lesions or as palliation. Newer approaches including multi-lesion stereotactic surgery, targeted therapy, and immunotherapy are also being investigated to improve outcomes while preserving quality of life. CONCLUSION With the significant advancements in the systemic treatment for cancer patients, addressing BM effectively is critical for overall survival. In addition to patient's performance status, therapeutic approach should be based on the type of primary tumor and associated molecular profile as well as the size, number, and location of metastatic lesion(s).
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Affiliation(s)
- D Mitchell
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - HJ Kwon
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - PA Kubica
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - WX Huff
- Department of Neurosurgery, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, IN, USA
| | - R O’Regan
- Department of Medicine/Hematology Oncology, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA
| | - M Dey
- Department of Neurosurgery, University of Wisconsin School of Medicine & Public Health, UW Carbone Cancer Center, Madison, WI, USA,Correspondence Should Be Addressed To: Mahua Dey, MD, University of Wisconsin School of Medicine & Public Health, 600 Highland Ave, Madison, WI 53792; Tel: 317-274-2601;
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11
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Park HJ, Kim KW, Lee J, Park T, Kwon HJ, Song GW, Lee SG. Change in hepatic volume profile in potential live liver donors after lifestyle modification for reduction of hepatic steatosis. Abdom Radiol (NY) 2021; 46:3877-3888. [PMID: 33765175 DOI: 10.1007/s00261-021-03058-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE We aimed to evaluate changes in hepatic volume and hemiliver volume percentage in potential liver donors after hepatic steatosis (HS) reduction through lifestyle modification. METHODS Fifty liver donor candidates with HS (macrovesicular fat [MaF] ≥ 20%) underwent abdominal computed tomography (CT) and liver biopsy before (baseline) and after (follow-up) lifestyle modification. According to the change in MaF, subjects were classified as group A (MaF reduction ≥ 20%, n = 25), and group B (MaF reduction < 20%, n = 25). The hepatic volume and hemiliver volume percentage were measured using CT volumetric analysis. RESULTS Volume percentage of the left hemiliver + S1 (over the whole liver) significantly increased at follow-up in group A (P < 0.001) but not in group B (P = 0.598). The absolute volume change of the right hemiliver and its percentage change from the baseline were significantly greater than those of the left hemiliver + S1 in group A (P < 0.007). There were no significant differences in these values in group B (P = 0.064 and 0.507, respectively). The percentage of subjects that earned the benefit of becoming suitable donors from the change in hepatic volume distribution caused by HS improvement was 52.0% (13/25) and 40.0% (10/25) in group A and group B, respectively. Regarding posthepatectomy liver failure, none was identified in group A after donation, whereas 12% (3/25) was identified in group B. CONCLUSION Hepatic volume profile may change considerably in potential liver donors with HS (MaF ≥ 20%) after HS reduction through lifestyle modification. Reevaluation of the hepatic volume is required before liver procurement after lifestyle modification in these subjects.
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Affiliation(s)
- Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Taeyong Park
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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12
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Kang KA, Kwon HJ, Ham SY, Park HJ, Shin JH, Lee SR, Kim MS. Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered? Ann Surg Treat Res 2020; 99:221-229. [PMID: 33029481 PMCID: PMC7520229 DOI: 10.4174/astr.2020.99.4.221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/05/2020] [Accepted: 07/16/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose We evaluated the impact of preoperative magnetic resonance cholangiopancreatography (MRCP) on patient outcomes, and found which patients should be considered for MRCP before cholecystectomy. Methods We performed retrospective analysis of 2,072 patients that underwent cholecystectomy for benign gallbladder disease from January 2014 to June 2017. Patients were grouped as CT only group (n = 737) and MRCP group (n = 1,335), including both CT and MRCP (n = 1,292) or MRCP only (n = 43). The main outcome measure was associated with complications after cholecystectomy, and the secondary outcomes were hospital stay, readmission, and events that could impact patient management due to addition of MRCP. Results There were no statistical differences in occurrence of intraoperative or postoperative complications or readmission rate between the 2 groups. Hospital stay was about 0.6 days longer in the MRCP group. However, MRCP group was more susceptible to complications due to underlying patient demographics (older age, higher frequency of diabetes, and higher level of the inflammatory markers). MRCP diagnosed common bile duct (CBD) stones in 6.5% of patients (84/1,292) without CBD stones in CT, and bile duct anomalies were identified in 41 patients (3.2%). Elevated γ-GT was the only independent factor for additional detection of CBD stones (adjusted odds ratio [OR], 2.89; P = 0.029) and subsequent biliary procedures (adjusted OR, 3.34; P = 0.018) when additional MRCP was performed. Conclusion MRCP is valuable for identification of bile duct variation and CBD stones. Preoperative MRCP can be considered, particularly in patients with elevated γ-GT, for proper preoperative management and avoidance of complications.
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Affiliation(s)
- Kyung A Kang
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo-Youn Ham
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Ho Shin
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sung Ryol Lee
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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13
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Kim DW, Kwon HJ, Kim KW, Choi SH, Kim SY, Song GW, Lee SG. Importance of Imaging Plane of Gadoxetic Acid--Enhanced Magnetic Resonance Cholangiography for Bile Duct Anatomy in Healthy Liver Donors. Transplant Proc 2020; 53:49-53. [PMID: 32928553 DOI: 10.1016/j.transproceed.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/25/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to compare the image quality and accuracy of axial vs coronal contrast-enhanced magnetic resonance cholangiography (CE-MRC) for assessing bile duct anatomy. METHODS Data from 313 healthy donors who underwent axial and coronal CE-MRC before liver donation were retrospectively analyzed. Motion artifacts and bile duct visibility were assessed using 4-point scales, with scores ≥3 considered interpretable. The sensitivity and specificity of axial and coronal CE-MRC for diagnosing anatomic variations were compared, as were the proportions of correctly categorized biliary anatomic types. RESULTS Axial CE-MRC provided better image quality than coronal CE-MRC in terms of both motion artifacts (3.83 vs 3.17; P < .001) and duct visibility (3.50 vs 3.17, P < .001), resulting in more interpretable images with axial than coronal CE-MRC (92.7% vs 82.1%; P < .001). Among 249 donors with interpretable images, coronal CE-MRC performed significantly better for identifying duct anatomic variation than axial CE-MRC (sensitivity, 96.9% vs 80.4%, P < .001; specificity, 100% vs 96.7%, P = .025). Coronal CE-MRC was significantly better than axial CE-MRC at correctly categorizing anatomic types of right posterior hepatic duct into left hepatic duct and accessory duct with incomplete right hepatic duct. CONCLUSIONS With interpretable image quality, coronal CE-MRC performed better than axial CE-MRC for evaluating bile duct anatomy.
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Affiliation(s)
- Dong Wook Kim
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Heon-Ju Kwon
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyoung Won Kim
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Sang Hyun Choi
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - So Yeon Kim
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Gi-Won Song
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung-Gyu Lee
- (a)Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; (b)Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; (c)Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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14
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Kwon W, Kim H, Han Y, Hwang YJ, Kim SG, Kwon HJ, Vinuela E, Járufe N, Roa JC, Han IW, Heo JS, Choi SH, Choi DW, Ahn KS, Kang KJ, Lee W, Jeong CY, Hong SC, Troncoso AT, Losada HM, Han SS, Park SJ, Kim SW, Yanagimoto H, Endo I, Kubota K, Wakai T, Ajiki T, Adsay NV, Jang JY. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg 2020; 107:1334-1343. [PMID: 32452559 DOI: 10.1002/bjs.11618] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In gallbladder cancer, stage T2 is subdivided by tumour location into lesions on the peritoneal side (T2a) or hepatic side (T2b). For tumours on the peritoneal side (T2a), it has been suggested that liver resection may be omitted without compromising the prognosis. However, data to validate this argument are lacking. This study aimed to investigate the prognostic value of tumour location in T2 gallbladder cancer, and to clarify the adequate extent of surgical resection. METHODS Clinical data from patients who underwent surgery for gallbladder cancer were collected from 14 hospitals in Korea, Japan, Chile and the USA. Survival and risk factor analyses were conducted. RESULTS Data from 937 patients were available for evaluation. The overall 5-year disease-free survival rate was 70·6 per cent, 74·5 per cent for those with T2a and 65·5 per cent among those with T2b tumours (P = 0·028). Regarding liver resection, extended cholecystectomy was associated with a better 5-year disease-free survival rate than simple cholecystectomy (73·0 versus 61·5 per cent; P = 0·012). The 5-year disease-free survival rate was marginally better for extended than simple cholecystectomy in both T2a (76·5 versus 66·1 per cent; P = 0·094) and T2b (68·2 versus 56·2 per cent; P = 0·084) disease. Five-year disease-free survival rates were similar for extended cholecystectomies including liver wedge resection versus segment IVb/V segmentectomy (74·1 versus 71·5 per cent; P = 0·720). In multivariable analysis, independent risk factors for recurrence were presence of symptoms (hazard ratio (HR) 1·52; P = 0·002), R1 resection (HR 1·96; P = 0·004) and N1/N2 status (N1: HR 3·40, P < 0·001; N2: HR 9·56, P < 0·001). Among recurrences, 70·8 per cent were metastatic. CONCLUSION Tumour location was not an independent prognostic factor in T2 gallbladder cancer. Extended cholecystectomy was marginally superior to simple cholecystectomy. A radical operation should include liver resection and adequate node dissection.
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Affiliation(s)
- W Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Hwang
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - S G Kim
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - H J Kwon
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - E Vinuela
- Department of Digestive Surgery, Santiago, Chile
| | - N Járufe
- Department of Digestive Surgery, Santiago, Chile
| | - J C Roa
- Pathology, Faculty of Medicine, Catholic University of Chile, Santiago, Chile
| | - I W Han
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - J S Heo
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - S-H Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - D W Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - K S Ahn
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - K J Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - W Lee
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - C-Y Jeong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - S-C Hong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - A T Troncoso
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - H M Losada
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - S-S Han
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-J Park
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-W Kim
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - K Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - T Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Ajiki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N V Adsay
- Department of Pathology, Koc University, Istanbul, Turkey.,Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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15
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Kwon HJ, Kim KW, Jang JK, Lee J, Song GW, Lee SG. Reproducibility and reliability of computed tomography volumetry in estimation of the right-lobe graft weight in adult-to-adult living donor liver transplantation: Cantlie's line vs portal vein territorialization. J Hepatobiliary Pancreat Sci 2020; 27:541-547. [PMID: 32353894 DOI: 10.1002/jhbp.749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/25/2020] [Accepted: 04/01/2020] [Indexed: 11/12/2022]
Abstract
BACKGROUND/PURPOSE In living-donor liver transplantation (LDLT), liver volume assessment is a mandatory step in determining donor appropriateness. This study aimed to compare reliability and reproducibility between two major methods to define virtual hepatectomy plane, based on Cantlie's line (CTV-Cantlie) and portal vein territorialization (CTV-PVT) for right-lobe graft weight estimation in LDLT. METHODS A total of 188 donors who underwent preoperative CT scans were included. The liver was divided into right and left lobes using CTV-Cantlie and CTV-PTV measurements by two readers. Intraclass correlation coefficient (ICC) was used to determine interreader variability of hepatic weight measured using each CTV method. Intraoperative graft weight (IOW) was used as reference standard of right-lobe graft weight. Pearson correlation test was performed to determine correlation coefficients between presumed graft weight by each CTV method and IOW. RESULTS Intraclass correlation coefficients for total liver weight were roughly equivalent between the two CTV methods (CTV-Cantlie: 0.965 [95% CI, 0.954-0.974], CTV-PVT: 0.977 [0.970-0.983]). However, ICCs of right-and left-lobe weights between two readers were higher with CTV-PVT (0.997 and 0.850) than with CTV-Cantlie (0.829 and 0.668). The IOW was 716.0 ± 162.0 g. Correlation coefficients between presumed graft weight by CTV-Cantlie or CTV-PVT and IOW were 0.722 and 0.807, respectively (both P < .001). CONCLUSIONS For estimation of the right-lobe graft weight in LDLT, CTV-PVT may provide higher reliability and reproducibility than CTV-Cantlie.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Kyoo Jang
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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16
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Park HJ, Kim KW, Kwon JH, Lee J, Park T, Kwon HJ, Song GW, Lee SG. Lifestyle Modification Leads to Spatially Variable Reduction in Hepatic Steatosis in Potential Living Liver Donors. Liver Transpl 2020; 26:487-497. [PMID: 32061052 DOI: 10.1002/lt.25733] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 01/09/2020] [Indexed: 02/07/2023]
Abstract
The spatial variability of hepatic fat reduction in potential living liver donors with hepatic steatosis (HS) who undergo lifestyle modification has not been investigated. Here, we aimed to examine the intrasegmental and intersegmental variability of changes in liver attenuation on computed tomography (CT) in potential living liver donors with HS after diet modification and exercise. A total of 87 living liver donor candidates (30.5 ± 7.0 years; 74 males) with biopsy-proven macrovesicular fat (MaF) ≥10% were included. All underwent diet modification and exercise to improve HS, baseline and follow-up unenhanced CT scans, and liver biopsies. Attenuation and its variability (mean and standard deviation, respectively, in Hounsfield units) in segmental, lobar, superficial, deep, and whole areas of the liver were measured across 32 different regions of interest on both baseline and follow-up CT. At baseline, the right lobe and superficial areas of liver showed significantly lower and more variable attenuation than left lobe and deep areas. Greater variability was noted in patients with more severe HS. Mean interval changes in liver attenuation and variability before and after diet modification and exercise were 13.7 (range, -10.6 to 46.2) and 4.7 (1.6-10.6), respectively. The mean interval change in liver attenuation was significantly higher in the right lobe than in the left (14.7 versus 12.7; P < 0.001), and in superficial areas than in deep areas (14.0 versus 13.4; P = 0.02). Greater variability and larger interval changes in liver attenuation were noted in those who responded (≥20% decrease in MaF) to diet modification and exercise than in those who did not. In conclusion, potential living liver donors with HS show significant intrasegmental and intersegmental variability in hepatic fat reduction on CT before and after diet modification and exercise.
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Affiliation(s)
- Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Taeyong Park
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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17
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Jeong SY, Lee J, Kim KW, Jang JK, Kwon HJ, Song GW, Lee SG. Estimation of the Right Posterior Section Volume in Live Liver Donors: Semiautomated CT Volumetry Using Portal Vein Segmentation. Acad Radiol 2020; 27:210-218. [PMID: 31060982 DOI: 10.1016/j.acra.2019.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/24/2019] [Accepted: 03/25/2019] [Indexed: 12/16/2022]
Abstract
RATIONALE AND OBJECTIVES To determine the accuracy of semiautomated CT volumetry using portal vein (PV) segmentation to estimate volume of the right posterior section (RPS) graft compared to intraoperative measured weight (W) in live liver donors. MATERIALS AND METHODS Among 23 donors who donated RPS grafts for liver transplantation in our institution from April 2003 to August 2016, 17 donors with CT scans within 3 months of liver procurement and PV anatomy of type I-III were included. RPS volumes were retrospectively evaluated by semiautomated CT volumetry (RPSVCTV) and by measurement of standard liver volume (SLV) and PV area ratio (RPSVSLV). RPS volumes were compared to W for correlation coefficients, (absolute) difference, and (absolute) percentage deviation. Linear fitting was performed to identify the method that yielded the greatest correlation with W. RESULTS Mean values of RPSVCTV, RPSVSLV, and W were 503.4 ± 97.8 mL (346.6-686.0), 516.54 ± 146.20 (274.06-776.32), and 518.8 ± 122.4 (370.0-789.0), respectively. RPSVCTV was strongly correlated with W (r = 0.9414; p < 0.0001), whereas RPSVSLV was only moderately did (r = 0.5899; p = 0.0127). RPSVCTV showed a significantly smaller absolute difference (35.20 ± 30.82 vs. 104.79 ± 60.27, p = 0.004) and absolute percentage deviation (6.61 ± 4.90 vs. 19.92 ± 10.37, p < 0.0001) from W. Equation correlating RPSVCTV and W was W = -74.7191 + 1.1791 RPSVCTV (R2 = 0.8862; p < 0.001). CONCLUSION RPSVCTV yields smaller absolute difference than RPSVSLV for estimating intraoperative measured weight of RPS in live liver donors. Semiautomated CT volumetry using PV segmentation is feasible for the estimation of the volume of the RPS of the liver, and RPSVCTV was strongly correlated with W (r = 0.9414; p < 0.0001).
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Koo DH, Hong HP, Oh S, Lee YG, Kang KA, Kwon HJ, Kim MS, Ham SY, Lee H, Jung KU, Kim HO, Kim H, Chun HK, Kang DY, Oh TY. Safety and efficacy of radiofrequency ablation for pulmonary metastases in metastatic colorectal cancer patients: A single center experience. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.4_suppl.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
141 Background: Radiofrequency ablation (RFA) has been increasingly used for the treatment of pulmonary metastases from several types of malignancies. Methods: A retrospective analysis was performed for the safety and efficacy of percutaneous RFA in patients with metastatic colorectal cancer between October 2016 and June 2019 as well as assessing prognostic factors of local tumor control. Results: RFA was carried out for 48 lung metastases in 31 consecutive colorectal cancer patients. Male was 17 patients (55%), and the median age at RFA was 61 years (range, 42-81). The mean diameter of metastases targeted for RFA was 12 mm (range, 4-32), and 17 tumors (35%) were located in a sub-pleural or deep position. Although five cases (10%) were failed due to immediate complications, there was no procedure-related death. In terms of immediate complication, a total of 12 cases (25%) had events including nine pneumothorax (percutaneous drain in four), one pleural effusion, and two hemoptysis (ICU care in one). Delayed complications were lung abscess and diaphragm injury in each one patient, respectively. At the time of analysis, the median follow-up duration from RFA was 12.0 months (interquartile range, 6.5-23.1). Only two patients (6%) died of disease progression, and 3-year overall survival rate was 85.5% (95% CI, 75.5-95.5). RFA site progression was observed in 11 patients (23%), and 1-year and 2-year progression-free survival rates were 71.5% (95% CI, 58.7-84.3) and 56.6% (95% CI, 42.6-70.6), respectively. Multivariate analysis showed that extra-pulmonary progression (hazard ratio 17.49; p = 0.023) was only one independent prognostic factor associated with RFA site progression after adjusting for confounding factors including sex, age, performance, tumor size, location, contact with the vessel, last chemotherapy response, and duration. Conclusions: RFA is a comparatively safe and effective option for the treatment of small-sized lung metastases; however, the control of extra-pulmonary metastases should be accompanied for effective local control.
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Affiliation(s)
- Dong-Hoe Koo
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyun Pyo Hong
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sukjoong Oh
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Yun-Gyoo Lee
- Division of Hematology/Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyung A. Kang
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Soo Youn Ham
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyebin Lee
- Department of Radiation Oncology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyung Uk Jung
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung Ook Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hungdai Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ho-Kyung Chun
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Du-Young Kang
- Department of Cardiovascular and Thoracic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Tae Yun Oh
- Department of Cardiovascular and Thoracic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Kang KA, Jun DW, Kim MS, Kwon HJ, Nguyen MH. Prevalence of significant hepatic fibrosis using magnetic resonance elastography in a health check-up clinic population. Aliment Pharmacol Ther 2020; 51:388-396. [PMID: 31943268 DOI: 10.1111/apt.15626] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 08/09/2019] [Accepted: 12/09/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Significant hepatic fibrosis is associated with higher mortality. However, data on the estimated prevalence of liver fibrosis in the general population are scarce. AIM To use magnetic resonance elastography (MRE) to investigate the prevalence of hepatic fibrosis in a Korean health check-up clinic cohort. METHODS We enrolled 2170 participants at our health check-up clinic between January 2015 and May 2018, all of whom had MR with chemical shift technique and MRE. The primary objective was to estimate the prevalence of liver fibrosis. For generalisation, sex- and age-standardised prevalence was calculated based on the Korean Statistical Information Service (KOSIS) during the period 2015-2018. RESULTS The prevalence of F2 (≥3.0 kPa) and F3 (≥3.6 kPa) in the overall cohort was 5.1% and 1.3% respectively (sex- and age-adjusted prevalence of 3.8% and 1.3%). Non-alcoholic fatty liver disease (NAFLD) prevalence (>5% fat fraction) was 27.7% in the average risk population (after excluding alcohol use and viral hepatitis), and the prevalence of significant and advanced fibrosis in NAFLD participants was 8.0% and 1.5% respectively. In participants with diabetes, 12.5% had ≥F2 and 4.3% ≥F3. In participants with NAFLD plus diabetes, 24.1% had ≥F2 and 6.0% ≥F3. On multivariate analysis, only age, insulin, diabetes and fatty liver on MR were independently associated with significant fibrosis. CONCLUSIONS In a Korean health check-up clinic setting, the prevalence of significant and advanced liver fibrosis was 5.1% and 1.3% (sex- and age-adjusted prevalence of 3.8% and 1.3%). The prevalence of advanced liver fibrosis was five times higher for diabetic participants with NAFLD.
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Affiliation(s)
- Kyung A Kang
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, CA, USA
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Byun J, Kim KW, Lee J, Kwon HJ, Kwon JH, Song GW, Lee SG. The role of multiphase CT in patients with acute postoperative bleeding after liver transplantation. Abdom Radiol (NY) 2020; 45:141-152. [PMID: 31781897 DOI: 10.1007/s00261-019-02347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE The aim of this study was to investigate the role of multiphase computed tomography (CT) in patients with acute postoperative bleeding after liver transplantation(LT). METHODS We retrospectively analyzed multiphase CT images in 270 post-LT bleeding patients between November 2013 and December 2017, with special attention to contrast extravasation (type I, focal or stipple; type II, jet). Patients were classified into conservative management trial and primary therapeutic intervention groups by initial treatment strategy, and then conservative management trial group was subdivided into successful conservative management and conservative management failure groups. On multiphase CT, we evaluated contrast extravasation volume, rate, and patterns (focal or stipple vs. jet). The concordances of the bleeding source determined by multiphase CT to the actual bleeding source were analyzed. RESULTS Of 270 patients, 134 contrast extravasation sites were identified in 116 (43.0%) patients. Most (94.8%, 146/154) of patients without contrast extravasation was successfully managed by conservative management. The mean volume and rate of contrast extravasation significantly increased in order of successful conservative management, conservative management failure, and primary therapeutic intervention groups (all p < 0.01). In subgroup analysis, jet pattern contrast extravasation was more commonly observed with conservative management failure group (p = 0.01). In addition, the change in pattern of contrast extravasation from type I to II was significantly related to the conservative management failure (OR 10.3; 95% CI 1.8-60.4; p = 0.01). There was substantial agreement in localization of bleeding source between multiphase CT and surgery or angiography (Cohen Kappa = 0.78). CONCLUSION Multiphase CT is helpful in the assessment for need of therapeutic intervention and to determine the treatment of choice in recipient with post-LT bleeding.
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Kim JS, Kim KW, Lee J, Kwon HJ, Kwon JH, Song GW, Lee SG. Diagnostic Performance for Hepatic Artery Occlusion After Liver Transplantation: Computed Tomography Angiography Versus Contrast-Enhanced Ultrasound. Liver Transpl 2019; 25:1651-1660. [PMID: 31206222 DOI: 10.1002/lt.25588] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/09/2019] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to compare the diagnostic performance of computed tomography angiography (CTA) and contrast-enhanced ultrasound (CEUS) when used to diagnose significant hepatic artery occlusion (HAO) in patients that was suspected on Doppler ultrasound (US). Among 3465 adult liver transplantations (LTs) performed between January 2010 and February 2018, 329 recipients were suspected of having HAO by Doppler US. In these patients, 139 recipients who had undergone both CTA and CEUS as second-line studies were included. CTA and CEUS were retrospectively reviewed using the criteria for HAO used in previous studies (CTA, ≥50% stenosis at the anastomosis; CEUS, no HA enhancement or delayed and discontinuous enhancement). The diagnostic values of CTA and CEUS were compared using the McNemar test. CEUS showed statistically significant better accuracy and specificity than CTA in patients with Doppler US abnormality seen after LT (accuracy, 99.3% versus 89.2%, P < 0.001; specificity, 100% versus 83.1%, P < 0.001). CTA had 15 false-positive diagnoses, and CEUS had 1 false-negative diagnosis. In conclusion, CEUS showed higher specificity and positive predictive value than CTA for the diagnosis of HAO in selected patients with a Doppler US abnormality. However, even if there is no HAO diagnosed on CEUS, continuous monitoring and follow-up imaging are required when HAO is strongly suspected in the clinical setting and on CTA.
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Affiliation(s)
- Jin Sil Kim
- Department of Radiology and Medical Research Institute, School of Medicine, Ewha Womans University, Seoul, South Korea
| | - Kyoung Won Kim
- Department of Radiology, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, South Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Gi Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sung Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Kwon HJ, Kim KW, Choi SH, Lee J, Kwon JH, Song GW, Lee SG. Visibility of B1 and Right/Left Dissociation Using Gd-EOB-DTPA-enhanced T1-weighted Magnetic Resonance Cholangiography in Live Liver Transplant Donors. Transplant Proc 2019; 51:2735-2739. [DOI: 10.1016/j.transproceed.2019.04.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 04/11/2019] [Indexed: 01/02/2023]
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Choi SH, Kim KW, Kwon HJ, Kim SY, Kwon JH, Song GW, Lee SG. Clinical usefulness of gadoxetic acid–enhanced MRI for evaluating biliary anatomy in living donor liver transplantation. Eur Radiol 2019; 29:6508-6518. [DOI: 10.1007/s00330-019-06292-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 04/24/2019] [Accepted: 05/29/2019] [Indexed: 12/25/2022]
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Park HJ, Kim KW, Choi SH, Lee J, Kwon HJ, Kwon JH, Song GW, Lee SG. Dilatation of left portal vein after right portal vein embolization: a simple estimation for growth of future liver remnant. J Hepatobiliary Pancreat Sci 2019; 26:300-309. [PMID: 31070855 DOI: 10.1002/jhbp.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND To evaluate correlation between growth rate of left portal vein (LPV) and future liver remnant (FLR) after right portal vein embolization (PVE), and to design models predicting FLR growth rate and volume using LPV area measurements on computed tomography (CT). METHODS A total of 134 patients (59.6 ± 10.2 years; 103 men) who underwent right PVE with contrast-enhanced CT before and 3-5 weeks after PVE were retrospectively identified. Kinetic hypertrophy ratio (KHR) and kinetic degree of hypertrophy (KDH) served as growth rate parameters. Correlations between LPV growth rate and FLR growth rate and volume change were evaluated by linear regression analysis. The agreements between actual volumetrically determined growth rates and volume of FLR and those estimated from regression equation using LPV measurements were assessed by Bland-Altman plots. RESULTS Growth rates of LPV and FLR correlated significantly (P < 0.001). The mean difference between actual and estimated value was 0.1% for KHR-FLR (actual, 9.5 ± 6.0%; estimated, 9.4 ± 3.8%), 0.0% for KDH-FLR (actual, 3.3 ± 1.4%; estimated, 3.3 ± 0.7%), -3.8 cm3 for FLR volume (actual, 642.5 ± 167.8 cm3 ; estimated, 646.4 ± 156.5 cm3 ), and -0.1% for proportion of FLR volume (actual, 48.7 ± 7.8%; estimated, 48.9 ± 7.8%). CONCLUSIONS After right PVE, FLR growth rate and volume can be simply estimated from the change in LPV area.
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Affiliation(s)
- Hyo Jung Park
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyun Choi
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Kwon HJ, Jeon J, Kim DH, Jang HR, Sung HH, Han DH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Clinical Impact of a Protocolized Kidney Donor Follow-up System. Transplant Proc 2019; 51:692-700. [PMID: 30979452 DOI: 10.1016/j.transproceed.2018.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Adequate kidney donor management after donation is increasingly emphasized due to concerns of renal function impairment after nephrectomy with increasing life expectancy. In this study, the clinical impact of a protocolized kidney donor follow-up system by nephrologists was evaluated. METHODS A total of 427 living kidney donors underwent nephrectomy from January 2010 to December 2014 and were followed for at least 2 years at the Samsung Medical Center. Donors were followed-up by nephrologists after the establishment of a donor clinic with systemized protocols in January 2013. The primary outcomes were incidence of post-donation low estimated glomerular filtration rate (eGFR) and renal function adaptability. Secondary outcomes were changes in compliance and incidence of hyperuricemia and microalbuminuria. RESULTS The patients were divided into 2 groups according to the time of nephrectomy: the pre-donor clinic period (n = 182) and the donor clinic period (n = 172). Preoperative eGFR in patients in the pre-donor clinic period was higher than that in patients in the donor clinic period. After donation, poor renal adaptation was less frequent in the donor clinic period compared to the pre-donor clinic period. Low eGFR tended to be less common during the donor clinic period. Shorter mean outpatient clinic visit intervals with more visits within 6 months after donation and earlier detection of de novo hyperuricemia were found during the donor clinic period. CONCLUSION A protocolized donor clinic run by nephrologists may improve post-nephrectomy renal outcomes and compliance and facilitate better management of potential risk factors of chronic kidney disease in donors.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J Jeon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Y G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Peng C, de Sousa FB, Gan HY, Kwon HJ, Park S, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Enhanced Delivery of F -, Ca 2+, K +, and Na + Ions into Enamel by Electrokinetic Flows. J Dent Res 2019; 98:430-436. [PMID: 30676839 DOI: 10.1177/0022034518818463] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
As the outermost layer of the tooth crown, dental enamel is the most mineralized tissue in mammals, consisting of hydroxyapatite crystallites separated by long and narrow nanochannels. A major challenge in dentistry is how various molecules can be infiltrated into these nanopores in an efficient and controlled way. Here we show a robust method to transport various ions of interest, such as fluoride (F-), potassium (K+), calcium (Ca++), and sodium (Na+), into these nanopores by electrokinetic flows. It is verified by fluorescence microscopy, laser-scanning confocal microscopy, mass spectrometry, and ion selective electrode technique. Different ions are demonstrated to infiltrate through the entire depth of the enamel layer (~1 mm), which is significantly enhanced penetration compared with diffusion-based infiltration. Meanwhile, transport depth and speed can be controlled by infiltration time and applied voltage. This is the first demonstration of reliably delivering both anions and cations into the enamel nanopores. This technique opens opportunities in caries prevention, remineralization, tooth whitening, and nanomedicine delivery in clinical dentistry, as well as other delivery challenges into various biomaterials such as bones.
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Affiliation(s)
- C Peng
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - F B de Sousa
- 2 Department of Morphology, Health Sciences Center, Fereral University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraiba, Brazil
| | - H Y Gan
- 3 Engineering Cluster, Singapore Institute of Technology, Singapore
| | - H J Kwon
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Park
- 4 Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | | | - W Wang
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Lavender
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - S Pilch
- 5 Colgate-Palmolive Technology Center, Piscataway, NJ, USA
| | - J Han
- 1 Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,6 Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA.,7 Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
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Kim MS, Kwon HJ, Kang KA, Do IG, Park HJ, Kim EY, Hong HP, Choi YJ, Kim YH. Diagnostic performance and useful findings of ultrasound re-evaluation for patients with equivocal CT features of acute appendicitis. Br J Radiol 2018; 91:20170529. [PMID: 29099612 PMCID: PMC5965797 DOI: 10.1259/bjr.20170529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To evaluate the diagnostic performance of ultrasound and to determine which ultrasound findings are useful to differentiate appendicitis from non-appendicitis in patients who underwent ultrasound re-evaluation owing to equivocal CT features of acute appendicitis. METHODS 62 patients who underwent CT examinations for suspected appendicitis followed by ultrasound re-evaluation owing to equivocal CT findings were included. Equivocal CT findings were considered based on the presence of only one or two findings among the CT criteria, and ultrasound re-evaluation was done based on a predefined structured report form. The diagnostic performance of ultrasound and independent variables to discriminate appendicitis from non-appendicitis were assessed. RESULTS There were 27 patients in the appendicitis group. The overall diagnostic performance of ultrasound re-evaluation was sensitivity of 96.3%, specificity of 91.2% and accuracy of 91.9%. In terms of the performance of individual ultrasound findings, probe-induced tenderness showed the highest accuracy (86.7%) with sensitivity of 74% and specificity of 97%, followed by non-compressibility (accuracy 71.7%, sensitivity 85.2% and specificity 60.6%). The independent ultrasound findings for discriminating appendicitis were non-compressibility (p = 0.002) and increased flow on the appendiceal wall (p = 0.001). CONCLUSION Ultrasound re-evaluation can be used to improve diagnostic accuracy in cases with equivocal CT features for diagnosing appendicitis. The presence of non-compressibility and increased vascular flow on the appendix wall are useful ultrasound findings to discriminate appendicitis from non-appendicitis. Advances in knowledge: Ultrasound re-evaluation is useful to discriminate appendicitis from non-appendicitis when CT features are inconclusive.
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Affiliation(s)
- Mi Sung Kim
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Heon-Ju Kwon
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Kyung A Kang
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - In-Gu Do
- 2 Department of Pathology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Hee-Jin Park
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Eun Young Kim
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Hyun Pyo Hong
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Yoon Jung Choi
- 1 Department of Radiology , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
| | - Young Hwan Kim
- 3 Department of Nuclear Medicine , Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine , Seoul, Republic of Korea
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Kwon HJ, Kim DH, Jang HR, Jung SH, Han DH, Sung HH, Park JB, Lee JE, Huh W, Kim SJ, Kim YG, Kim DJ, Oh HY. Predictive Factors of Renal Adaptation After Nephrectomy in Kidney Donors. Transplant Proc 2017; 49:1999-2006. [PMID: 29149951 DOI: 10.1016/j.transproceed.2017.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 08/01/2017] [Accepted: 09/02/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite compensatory hyperfiltration in remaining nephrons following donor nephrectomy, some donors show impaired renal adaptation and low estimated glomerular filtration rate (eGFR). We investigated the factors predicting early renal adaptation after nephrectomy and identified kidney donors at risk of inadequate renal adaptation. METHODS A total of 265 living kidney donors from 2010 to 2013 were retrospectively analyzed. Renal function was serially followed for 6 months after the operation. Regression analyses were performed to identify the independent predictors of low eGFR (eGFR <60 mL/min/1.73 m2) and impaired renal adaptation (%Modification of Diet in Renal Disease [MDRD] <66% of baseline eGFR). RESULTS A total of 148 donors belonged to the low eGFR group, and changes in eGFR (ΔeGFR) at postoperative (PO) 1 day and 1 month were identified as independent predictors of low eGFR. Impaired renal adaptation was related to age, ΔeGFR PO 2-3 days, and ΔeGFR PO 1 month. Early renal adaptation was associated with age, male gender, and residual kidney computerized tomography angiography (CTA) volume. The best sensitivity and specificity were obtained with a cutoff value of ΔeGFR 31 at PO 1 day and 1 month for predicting low eGFR and with a value of ΔeGFR 27 at PO 2-3 days and 1 month for predicting impaired renal adaptation. CONCLUSIONS Our study showed that the degree of early renal adaptation determines subsequent renal function in kidney donors. Closer monitoring and management may be required in old or male donors with small residual CTA kidney volume as well as donors with persistent ΔeGFR >27 within 1 month of nephrectomy.
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Affiliation(s)
- H J Kwon
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H R Jang
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - S-H Jung
- Biostatics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H H Sung
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J B Park
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - J E Lee
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - W Huh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S J Kim
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Y-G Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - D J Kim
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H Y Oh
- Division of Nephrology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim SY, Kim KW, Choi SH, Kwon JH, Song GW, Kwon HJ, Yun YJ, Lee J, Lee SG. Feasibility of UltraFast Doppler in Post-operative Evaluation of Hepatic Artery in Recipients following Liver Transplantation. Ultrasound Med Biol 2017; 43:2611-2618. [PMID: 28843618 DOI: 10.1016/j.ultrasmedbio.2017.07.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 06/19/2017] [Accepted: 07/22/2017] [Indexed: 06/07/2023]
Abstract
To determine the feasibility of using UltraFast Doppler in post-operative evaluation of the hepatic artery (HA) after liver transplantation (LT), we evaluated 283 simultaneous conventional and UltraFast Doppler sessions in 126 recipients over a 2-mo period after LT, using an Aixplorer scanner The Doppler indexes of the HA (peak systolic velocity [PSV], end-diastolic velocity [EDV], resistive index [RI] and systolic acceleration time [SAT]) by retrospective analysis of retrieved waves from UltraFast Doppler clips were compared with those obtained by conventional spectral Doppler. Correlation, performance in diagnosing the pathologic wave, examination time and reproducibility were evaluated. The PSV, EDV, RI and SAT of spectral and UltraFast Doppler measurements exhibited excellent correlation with favorable diagnostic performance. During the bedside examination, the mean time spent for UltraFast clip storing was significantly shorter than that for conventional Doppler US measurements. Both conventional and UltraFast Doppler exhibited good to excellent inter-analysis consistency. In conclusion, compared with conventional spectral Doppler, UltraFast Doppler values correlated excellently and yielded acceptable pathologic wave diagnostic performance with reduced examination time at the bedside and excellent reproducibility.
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Affiliation(s)
- Se-Young Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Sang Hyun Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Ju Yun
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jang HY, Kim KW, Kwon JH, Kwon HJ, Kim B, Seo N, Lee J, Song GW, Lee SG. N-butyl-2 cyanoacrylate (NBCA) embolus in the graft portal vein after portosystemic collateral embolization in liver transplantation recipient: what is the clinical significance? Acta Radiol 2017; 58:1326-1333. [PMID: 28273742 DOI: 10.1177/0284185117693460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background An N-butyl-2 cyanoacrylate (NBCA) embolus in the graft portal vein was frequently observed after an intraoperative embolization of portosystemic collaterals performed to prevent portal steal in liver transplant (LT) recipients. The radiological and clinical features of NBCA emboli have not yet been described. Purpose To describe radiological and clinical features of NBCA embolus in graft portal vein after portosystemic collateral embolization in LT recipients. Material and Methods A total of 165 consecutive LT recipients who had undergone intraoperative NBCA embolization of varix were found in single institution's computerized databases of a clinical cohort of LT. Patients were evaluated for NBCA emboli (categorized into major and minor emboli according to location) on first postoperative computed tomography (CT). All electronic medical records and radiologic studies including follow-up was evaluated to determine any radiological and clinical abnormality associated with NBCA embolus. Results NBCA emboli were found in 24% (39/165) of recipients. Although most patients had minor emboli (77%, 30/39) without remarkable ultrasonography (US) abnormalities, seven (78%) of nine recipients with major emboli showed intraluminal echogenic lesions in graft portal vein on grayscale US, and five of them (71%) showed partial portal flow obstruction, although none exhibited any abnormality on contrast-enhanced US. Recipients with NBCA portal emboli showed no significant clinical abnormalities and were discharged safely. NBCA embolus eventually disappeared mostly within six months (82%, 32/39). Conclusion NBCA emboli are frequently observed after portosystemic collateral embolization in LT recipients and are not associated with poor clinical outcome. They may mimic ordinary thromboemboli on US.
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Affiliation(s)
- Hye Young Jang
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
- Department of Radiology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Republic of Korea
| | - Kyoung Won Kim
- Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery, Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bohyun Kim
- Department of Radiology, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Nieun Seo
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering, Soongsil University, Seoul, Republic of Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery, Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery, Departments of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Kwon HJ, Kim KW, Kim B, Kim SY, Lee CS, Lee J, Song GW, Lee SG. Resection plane-dependent error in computed tomography volumetry of the right hepatic lobe in living liver donors. Clin Mol Hepatol 2017; 24:54-60. [PMID: 28759989 PMCID: PMC5875195 DOI: 10.3350/cmh.2017.0023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 06/24/2017] [Accepted: 06/27/2017] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Computed tomography (CT) hepatic volumetry is currently accepted as the most reliable method for preoperative estimation of graft weight in living donor liver transplantation (LDLT). However, several factors can cause inaccuracies in CT volumetry compared to real graft weight. The purpose of this study was to determine the frequency and degree of resection plane-dependent error in CT volumetry of the right hepatic lobe in LDLT. Methods Forty-six living liver donors underwent CT before donor surgery and on postoperative day 7. Prospective CT volumetry (VP) was measured via the assumptive hepatectomy plane. Retrospective liver volume (VR) was measured using the actual plane by comparing preoperative and postoperative CT. Compared with intraoperatively measured weight (W), errors in percentage (%) VP and VR were evaluated. Plane-dependent error in VP was defined as the absolute difference between VP and VR. % plane-dependent error was defined as follows: |VP–VR|/W∙100. Results Mean VP, VR, and W were 761.9 mL, 755.0 mL, and 696.9 g. Mean and % errors in VP were 73.3 mL and 10.7%. Mean error and % error in VR were 64.4 mL and 9.3%. Mean plane-dependent error in VP was 32.4 mL. Mean % plane-dependent error was 4.7%. Plane-dependent error in VP exceeded 10% of W in approximately 10% of the subjects in our study. Conclusions There was approximately 5% plane-dependent error in liver VP on CT volumetry. Plane-dependent error in VP exceeded 10% of W in approximately 10% of LDLT donors in our study. This error should be considered, especially when CT volumetry is performed by a less experienced operator who is not well acquainted with the donor hepatectomy plane.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bohyun Kim
- Department of Radiology, Ajou University Hospital, Suwon, Korea
| | - So Yeon Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chul Seung Lee
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeongjin Lee
- School of Computer Science & Engineering, Soongsil University, Seoul, Korea
| | - Gi Won Song
- Division of Hepatobiliary and Liver Transplantation Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Gyu Lee
- Division of Hepatobiliary and Liver Transplantation Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Choi SH, Kwon JH, Kim KW, Jang HY, Kim JH, Kwon HJ, Lee J, Song GW, Lee SG. Measurement of liver volumes by portal vein flow by Doppler ultrasound in living donor liver transplantation. Clin Transplant 2017; 31. [DOI: 10.1111/ctr.13050] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Sang Hyun Choi
- Department of Radiology and the Research Institute of Radiology; Seoul Korea
| | - Jae Hyun Kwon
- Division of Liver Transplantation and Hepatobiliary Surgery; Departments of Surgery; University of Ulsan College of Medicine; Asan Medical Center; Seoul Korea
| | - Kyoung Won Kim
- Department of Radiology and the Research Institute of Radiology; Seoul Korea
| | - Hye Young Jang
- Department of Radiology and the Research Institute of Radiology; Seoul Korea
| | - Ji Hye Kim
- Department of Radiology and the Research Institute of Radiology; Seoul Korea
| | - Heon-Ju Kwon
- Department of Radiology; Kangbuk Samsung Hospital; Sungkyunkwan University School of Medicine; Seoul Korea
| | - Jeongjin Lee
- School of Computer Science and Engineering; Soongsil University; Seoul Korea
| | - Gi-Won Song
- Division of Liver Transplantation and Hepatobiliary Surgery; Departments of Surgery; University of Ulsan College of Medicine; Asan Medical Center; Seoul Korea
| | - Sung-Gyu Lee
- Division of Liver Transplantation and Hepatobiliary Surgery; Departments of Surgery; University of Ulsan College of Medicine; Asan Medical Center; Seoul Korea
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Kwon HJ, Brasch HD, Benison S, Marsh RW, Itinteang T, Titchener GW, Evans J, Tan ST. Erratum to "Changing prevalence and treatment outcomes of patients with p16 human papillomavirus related oropharyngeal squamous cell carcinoma in New Zealand" [Br J Oral Maxillofac Surg 54 (8) (2016) 898-903]. Br J Oral Maxillofac Surg 2017; 55:754. [PMID: 28687136 DOI: 10.1016/j.bjoms.2017.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- H J Kwon
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - H D Brasch
- Gillies McIndoe Research Institute, Wellington, New Zealand; Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - S Benison
- Department of Pathology, Hutt Hospital, Wellington, New Zealand
| | - R W Marsh
- Gillies McIndoe Research Institute, Wellington, New Zealand; Auckland University, Auckland, New Zealand
| | - T Itinteang
- Gillies McIndoe Research Institute, Wellington, New Zealand
| | - G W Titchener
- Department of Otolaryngology - Head and Neck Surgery, Wellington Regional Hospital, Wellington, New Zealand
| | - J Evans
- Wellington Blood and Cancer Centre, Wellington Regional Hospital, Wellington, New Zealand
| | - S T Tan
- Gillies McIndoe Research Institute, Wellington, New Zealand; Wellington Regional Plastic, Maxillofacial & Burns Unit, Hutt Hospital, Wellington, New Zealand.
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Kim MS, Kim HJ, Park HW, Kwon HJ, Lee SY, Kook SH, Park HJ, Choi YJ. Impact of high-grade obstruction on outcomes in patients with appendiceal inflammatory masses managed by nonoperative treatment. Ann Surg Treat Res 2017; 92:429-435. [PMID: 28580348 PMCID: PMC5453876 DOI: 10.4174/astr.2017.92.6.429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 11/28/2016] [Accepted: 01/17/2017] [Indexed: 12/26/2022] Open
Abstract
Purpose To retrospectively assess the impact of high-grade obstructions identified on initial CT on outcomes of patients with appendiceal inflammatory masses managed by nonoperative treatment. Methods Institutional Review Boards approved this retrospective study and informed consent was waived. Included were 52 consecutive patients diagnosed with appendiceal inflammatory masses by CT scan and managed by nonoperative treatment. The main outcome measure was treatment failure and secondary outcomes were complications and initial and total hospital stay. Patient demographics, inflammatory markers, and CT findings for presence of an appendiceal inflammatory mass and high-grade obstruction were assessed. Patients with and without high-grade obstruction were compared for patient characteristics and outcomes using Fisher exact test and Student t-test. Results Among 52 patients, 14 (27%) had high-grade obstruction on CT examination at presentation. No significant differences were observed in patient characteristics (P > 0.05), treatment failure (P = 0.33), complications (P = 0.29), or initial (P = 0.73) or total (P = 0.72) hospitalization between patients with and without high-grade obstruction. Conclusion For patients who were managed by nonoperative treatment for appendiceal inflammatory masses, the presence of high-grade obstruction identified on initial CT scan did not significantly affect outcomes of treatment failure, complications, and initial and total hospitalization.
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Affiliation(s)
- Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyuk Jung Kim
- Department of Radiology, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Hae Won Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So-Yeon Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shin Ho Kook
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee-Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Jung Choi
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim YY, Hwang J, Kim HS, Kwon HJ, Kim S, Lee JH, Lee JH. Genetic alterations in mesiodens as revealed by targeted next-generation sequencing and gene co-occurrence network analysis. Oral Dis 2017; 23:966-972. [PMID: 28415132 DOI: 10.1111/odi.12680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/21/2017] [Accepted: 04/06/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Mesiodens is the most common type of supernumerary tooth which includes a population prevalence of 0.15%-1.9%. Alongside evidence that the condition is heritable, mutations in single genes have been reported in few human supernumerary tooth cases. Gene sequencing methods in tradition way are time-consuming and labor-intensive, whereas next-generation sequencing and bioinformatics are cost-effective for large samples and target sizes. MATERIALS AND METHODS We describe the application of a targeted next-generation sequencing (NGS) and bioinformatics approach to samples from 17 mesiodens patients. Subjects were diagnosed on the basis of panoramic radiograph. A total of 101 candidate genes which were captured custom genes were sequenced on the Illumina HiSeq 2500. Multistep bioinformatics processing was performed including variant identification, base calling, and in silico analysis of putative disease-causing variants. RESULTS Targeted capture identified 88 non-synonymous, rare, exonic variants involving 42 of the 101 candidate genes. Moreover, we investigated gene co-occurrence relationships between the genomic alterations and identified 88 significant relationships among 18 most recurrent driver alterations. CONCLUSION Our search for co-occurring genetic alterations revealed that such alterations interact cooperatively to drive mesiodens. We discovered a gene co-occurrence network in mesiodens patients with functionally enriched gene groups in the sonic hedgehog (SHH), bone morphogenetic proteins (BMP), and wingless integrated (WNT) signaling pathways.
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Affiliation(s)
- Y Y Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - J Hwang
- Department of IT Convergence and Engineering, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - H-S Kim
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - H J Kwon
- Institute of Oral Science, Apple Tree Dental Hospital, Ilsansuh-gu, Goyang, Korea
| | - S Kim
- Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - J H Lee
- Department of Clinical Pharmacology and Therapeutics, Kyung Hee University College of Medicine, Dongdaemoon-gu, Seoul, Korea
| | - J H Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, Seodaemoon-gu, Seoul, Korea
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36
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Kwon HJ, Kim KW, Jung JH, Choi SH, Jeong WK, Kim B, Song GW, Lee SG. Noninvasive quantitative estimation of hepatic steatosis by ultrasound: a comparison of the hepato-renal index and ultrasound attenuation index. Med Ultrason 2016; 18:431-437. [PMID: 27981274 DOI: 10.11152/mu-868] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIMS To compare the accuracy of the ultrasound attenuation index (USAI) and hepato-renal index (HRI) for the diagnosis of hepatic steatosis (HS). MATERIAL AND METHODS Two hundred and twenty-four potential living hepatic donors underwent US and subsequent US-guided liver biopsy. The USAI was calculated from US images with an 8 MHz transducer and HRI was measured on sagittal images with a clear visualization of both the liver and kidney. Using histological degrees of HS as the reference standard, we compared the performance of USAI and HRI for diagnosing HS ≥ 5% and ≥ 30% by receiver operating characteristic curve analysis. The interobserver agreement was evaluated by using intraclass correlation coefficients (ICCs) or Bland-Altman statistics. RESULTS Histologic degree of HS was 0-70% (median, 5%). HRI showed a tendency towards higher accuracy than USAI for diagnosing HS ≥ 5% (the area under the ROC curve, 0.856 vs. 0.820; p= 0.279) and ≥ 30% (0.937 vs. 0.909; p = 0.378) without statistical significance. There was an excellent interobserver agreement for both USAI and HRI (ICC = 0.931 and 0.973, respectively). According to the Bland-Altman method, the 95% limits of difference between two readers for HS were -8.5% to 6.6% by USAI and -4.8% to 6.2% by HRI. Most patients would have the difference of calculated HS by USAI (74.0%) and HRI (96.0%) from different operators within a range of ±5%. CONCLUSIONS Although statistically insignificant, HRI was superior to USAI for the diagnosis and quantitative estimation of HS in terms of diagnostic performance, including accuracy and reproducibility.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyoung Won Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Jin-Hee Jung
- Department of Radiology, Dongguk University Ilsan Medical Center, Gyeonggi-do, Korea
| | - Sang Hyun Choi
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Kyoung Jeong
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Bohyun Kim
- Department of Radiology, Ajou University Medical Center, Gyeonggi-do, Korea
| | - Gi-Won Song
- Department of Liver Transplantation Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Gyu Lee
- Department of Liver Transplantation Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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No YA, Kwon HJ, Park KY, Hong SA, Seo SJ, Hong CK. Unilateral, erythematous, swollen, sclerosing patch with nodular progression on the right side of the face. Clin Exp Dermatol 2016; 41:945-947. [PMID: 27766675 DOI: 10.1111/ced.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Y A No
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - K Y Park
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S A Hong
- Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
| | - S J Seo
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
| | - C K Hong
- Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea
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38
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Jeong HS, Lee J, Lim BJ, Kwon HJ, Kim YS, Kim BS, Huh KH, Kim SI, Kim MS, Jeong HJ. Concurrent Post-Transplantation Diabetes Mellitus in Renal Allograft Recipients With Immunoglobulin A Nephropathy. Transplant Proc 2016; 48:887-9. [PMID: 27234759 DOI: 10.1016/j.transproceed.2015.11.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/06/2015] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prevalence of post-transplantation immunoglobulin A nephropathy (PTIgAN) and diabetes mellitus (PTDM) increases with time after transplantation, and recognition and management of these conditions is becoming more important in renal allograft recipients as graft survival increases. METHODS We explored the influence of concurrent PTDM on renal allograft histology and function in 111 cases with PTIgAN diagnosed from 2000 to 2010 at our institution. RESULTS Sixteen patients (14.4%) had PTDM at the time of diagnosis of PTIgAN, which increased to 28 patients (25.2%) at the last follow-up (10.4 years after transplantation). Donor ages were younger in PTIgAN patients with concurrent PTDM. However, other clinical and demographic data were not significantly different between PTIgAN patients with and without PTDM. Histologically, Banff "mm" scores were higher and "M1" of the Oxford classification was more frequent in PTIgAN patients with concurrent PTDM than in patients without PTDM, but the difference did not reach statistical significance. Serum creatinine levels and proteinuria at the time of biopsy and overall graft survival did not vary according to the presence of PTDM both at biopsy and at the last follow-up. CONCLUSIONS Concurrent PTDM does not significantly influence graft function or outcome for 10 years after transplantation in PTIgAN patients.
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Affiliation(s)
- H S Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - J Lee
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - B J Lim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - H J Kwon
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - B S Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - K H Huh
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - S I Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - M S Kim
- Department of Transplantation Surgery, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea
| | - H J Jeong
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea; Institute of Transplantation, Yonsei University College of Medicine, Seoul, Korea.
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Choi SH, Kwon HJ, Lee SY, Park HJ, Kim MS, Sohn JH, Chung EC, Park HW. Focal hepatic solid lesions incidentally detected on initial ultrasonography in 542 asymptomatic patients. Abdom Radiol (NY) 2016; 41:265-72. [PMID: 26867908 DOI: 10.1007/s00261-015-0567-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the clinical significance of focal hepatic solid lesions incidentally detected on initial ultrasonography in asymptomatic patients. METHODS From January 2009 to December 2009, 2670 initial ultrasonographies were performed in asymptomatic population. Of these 2670 initial examinations, 681 focal hepatic solid lesions in 542 patients (mean 39.4 years, range 23-73 years) were detected. Clinical information, ultrasonography features, and the outcome of these lesions were analyzed. RESULTS Six hundred and seventy four lesions (99.0%) in 539 patients (99.4%) were benign, while seven lesions (1.0%) in three patients (0.6%) proved to be malignant. Risk factors significantly associated with malignant focal hepatic solid lesions were known history of malignancy, history of hepatitis, a positive result for the hepatitis B surface antigen, and abnormally elevated tumor markers. No malignancy was identified in patients without any one of these four risk factors. Ultrasonographic features of internal heterogeneous echotexture with peripheral hypoechoic rim showed significant associations with malignancy. CONCLUSIONS Focal hepatic solid lesions incidentally detected on initial ultrasonography were rarely malignant, especially in patients without these risk factors. Therefore, the knowledge of these risk factors and US features is important in order to make a differential diagnosis between benign and malignant focal hepatic lesions.
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Affiliation(s)
- Sang Hyun Choi
- Department of Health Resource Development, Korea Health Promotion Foundation, 173 Toegye-ro, Jung-gu, Seoul, 100-705, Korea.
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap 2-dong, Songpa-ku, Seoul, 138-736, Korea.
| | - Heon-Ju Kwon
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - So-Yeon Lee
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - Hee Jin Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - Jin Hee Sohn
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - Eun Chul Chung
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
| | - Hae Won Park
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea.
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Kim MS, Kim BI, Kwon HJ, Park HW, Park HJ, Bang KB, Hong HP, Rho MH. Discordance between conventional ultrasonography and ElastPQ for assessing hepatic fibrosis in chronic hepatitis B: frequency and independent factors. J Med Ultrason (2001) 2015; 43:201-10. [DOI: 10.1007/s10396-015-0684-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 10/19/2015] [Indexed: 12/17/2022]
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Lee SY, Park HJ, Kwon HJ, Kim MS, Choi SH, Choi YJ, Kim E. T2 relaxation times of the glenohumeral joint at 3.0 T MRI in patients with and without primary and secondary osteoarthritis. Acta Radiol 2015; 56:1388-95. [PMID: 25355791 DOI: 10.1177/0284185114556304] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 09/24/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Quantitative magnetic resonance imaging (MRI) of cartilage has recently been applied to patients with osteoarthritis (OA). T2 mapping is a sensitive method of detecting changes in the chemical composition and structure of cartilage. PURPOSE To establish baseline T2 values of glenohumeral joint cartilage at 3.0 T and compare T2 values among subjects with and without OA. MATERIAL AND METHODS The study involved 30 patients (18 women, 12 men; median age, 67 years; age range, 51-78 years) with primary (n = 7) and secondary OA (n = 23) in the glenohumeral joint and 34 subjects without OA (19 women, 15 men; median age, 49 years; age range, 23-63 years). All subjects were evaluated by radiography and 3.0 T MRI including a multi-echo T2-weighted spin echo pulse sequence. The T2 value of the cartilage was measured by manually drawing the region of interest on the T2 map. Per-zone comparison of T2 values was performed using Mann-Whitney U test. RESULTS Median T2 values differed significantly between subjects without OA (36.00 ms [interquartile range, 33.89-37.31 ms]) and those with primary (37.52 ms [36.84-39.11], P = 0.028), but not secondary (36.87 ms [34.70-41.10], P = 0.160) OA. Glenohumeral cartilage T2 values were higher in different zones between patients with primary and secondary OA than in subjects without OA. CONCLUSION These T2 values can be used for comparison to assess cartilage degeneration in patients with shoulder OA. Significant differences in T2 were observed among subjects without OA and those with primary and secondary OA.
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Affiliation(s)
- So-Yeon Lee
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee-Jin Park
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Heon-Ju Kwon
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Mi Sung Kim
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seon Hyeong Choi
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yoon Jung Choi
- Department of Radiology Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eugene Kim
- Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Kwon HJ, Byun JH, Kim JY, Hong GS, Won HJ, Shin YM, Kim PN. Differentiation of small (≤2 cm) hepatocellular carcinomas from small benign nodules in cirrhotic liver on gadoxetic acid-enhanced and diffusion-weighted magnetic resonance images. ACTA ACUST UNITED AC 2015; 40:64-75. [PMID: 24997560 DOI: 10.1007/s00261-014-0188-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To identify imaging characteristics that differentiate small (≤2 cm) HCCs from small (≤2 cm) benign nodules in cirrhotic liver on gadoxetic acid-enhanced and diffusion-weighted (DW) magnetic resonance (MR) images. MATERIALS AND METHODS On gadoxetic acid-enhanced and DW MR images, we analysed signal intensity of 222 small HCCs and 61 benign nodules (diameter, 0.5-2 cm) at each sequence and rim enhancement during portal or equilibrium phases. Univariate and multivariate logistic regression analyses identified predictors of HCC. Combinations of significant MR findings in multivariate analysis were compared with American Association for the Study of Liver Disease (AASLD) practice guidelines. RESULTS In multivariate analysis, arterial enhancement (adjusted odds ratio [aOR], 8.6), T2 hyperintensity (aOR, 5.8), and hyperintensity on DW images (aOR, 3.8) were significant for differentiating small HCCs from benign nodules (p ≤ 0.004). When two or all three findings were applied as diagnostic criteria for differentiating small HCCs from benign nodules, sensitivity and accuracy were significantly higher compared with AASLD practice guidelines (91% vs. 78% and 89% vs. 81%, respectively; each p < 0.0001). CONCLUSION On gadoxetic acid-enhanced MR imaging, arterial enhancement and hyperintensity on T2-weighted and DW MR images are helpful for differentiating small HCCs from benign nodules in liver cirrhosis.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-ku, Seoul, 138-736, Korea
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Kwon HJ, Shim WH, Cho G, Cho HJ, Jung HS, Lee CK, Lee YS, Baek JH, Kim EJ, Suh JY, Sung YS, Woo DC, Kim YR, Kim JK. Simultaneous evaluation of vascular morphology, blood volume and transvascular permeability using SPION-based, dual-contrast MRI: imaging optimization and feasibility test. NMR Biomed 2015; 28:624-632. [PMID: 25865029 DOI: 10.1002/nbm.3293] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 03/03/2015] [Accepted: 03/04/2015] [Indexed: 06/04/2023]
Abstract
Exploiting ultrashort-T(E) (UTE) MRI, T1-weighted positive contrast can be obtained from superparamagnetic iron oxide nanoparticles (SPIONs), which are widely used as a robust T2-weighted, negative contrast agent on conventional MR images. Our study was designed (a) to optimize the dual-contrast MRI method using SPIONs and (b) to validate the feasibility of simultaneously evaluating the vascular morphology, blood volume and transvascular permeability using the dual-contrast effect of SPIONs. All studies were conducted using 3 T MRI. According to numerical simulation, 0.15 mM was the optimal blood SPION concentration for visualizing the positive contrast effect using UTE MRI (T(E) = 0.09 ms), and a flip angle of 40° could provide sufficient SPION-induced enhancement and acceptable measurement noise for UTE MR angiography. A pharmacokinetic study showed that this concentration can be steadily maintained from 30 to 360 min after the injection of 29 mg/kg of SPIONs. An in vivo study using these settings displayed image quality and CNR of SPION-enhanced UTE MR angiography (image quality score 3.5; CNR 146) comparable to those of the conventional, Gd-enhanced method (image quality score 3.8; CNR 148) (p > 0.05). Using dual-contrast MR images obtained from SPION-enhanced UTE and conventional spin- and gradient-echo methods, the transvascular permeability (water exchange index 1.76-1.77), cerebral blood volume (2.58-2.60%) and vessel caliber index (3.06-3.10) could be consistently quantified (coefficient of variation less than 9.6%; Bland-Altman 95% limits of agreement 0.886-1.111) and were similar to the literature values. Therefore, using the optimized setting of combined SPION-based MRI techniques, the vascular morphology, blood volume and transvascular permeability can be comprehensively evaluated during a single session of MR examination.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Woo Hyun Shim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
| | - Gyunggoo Cho
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
| | - Hyung Joon Cho
- Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Hoe Su Jung
- Ulsan National Institute of Science and Technology, Ulsan, South Korea
| | - Chang Kyung Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
| | - Yong Seok Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
| | - Jin Hee Baek
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
| | | | - Ji-Yeon Suh
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
| | - Yu Sub Sung
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
| | - Dong-Cheol Woo
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
| | - Young Ro Kim
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - Jeong Kon Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Asan Institute for Life Sciences, Seoul, South Korea
- Division of Magnetic Resonance, Korea Basic Science Institute, Cheongwon, Chungbuk, South Korea
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Jeon JS, Kim BH, Lee SH, Kwon HJ, Bae HJ, Kim SK, Park JA, Shim JH, Abd El-Aty AM, Shin HC. Simultaneous determination of arbutin and its decomposed product hydroquinone in whitening creams using high-performance liquid chromatography with photodiode array detection: Effect of temperature and pH on decomposition. Int J Cosmet Sci 2015; 37:567-73. [PMID: 25857400 DOI: 10.1111/ics.12228] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/31/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Arbutin is an effective agent for the treatment of melanin disorders. Arbutin may be converted to hydroquinone under conditions of high temperature, ultraviolet (UV) radiation and dilute acid. The aim of the current study was to develop an analytical method to determine the levels of arbutin and hydroquinone in whitening cosmetic products using high-performance liquid chromatography with photodiode array detection (HPLC-DAD). In addition, we investigated the effects of high temperature and pH on the decomposition of arbutin. METHODS Samples extracted using two-step sonications were separated on a C18 column using a gradient mobile phase consisting of water and methanol. A 60-mm (40 μL) DAD cell was used to enhance the sensitivity of hydroquinone determination. Thermal decomposition of arbutin was evaluated at temperatures ranging from 60 to 120°C for 1-36 h. RESULTS The method showed good linearity (R(2) ≥ 0.9997), precision (relative standard deviation, RSD < 5%) and acceptable extraction recovery (90-102.6%). The limits of quantitation for arbutin and hydroquinone were 0.0085 and 0.0119 μg mL(-1) , respectively. One sample of 21 cosmetic products tested contained arbutin at a concentration 1.61 g 100 g(-1) cream and 0.12 g 100 g(-1) cream of hydroquinone. Arbutin (327.18 ppm) decomposed after 6 h at 120°C and produced 10.73 ppm of hydroquinone. CONCLUSION The developed method is simple to detect both arbutin and hydroquinone simultaneously in cosmetic products, at an adequate level of sensitivity. Notably, temperature and pH did not influence the decomposition of arbutin to hydroquinone in a 2% arbutin cream.
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Affiliation(s)
- J S Jeon
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea.,Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - B H Kim
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - S H Lee
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - H J Kwon
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - H J Bae
- Public Health Research Division, Gyeonggi Province Institute of Health and Environment, 95, Pajang cheon-ro, Jangan-gu, Suwonsi, Gyeonggi Province, 440-290, Korea
| | - S K Kim
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
| | - J A Park
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
| | - J H Shim
- Biotechnology Research Institute, College of Agriculture and Life Sciences, Chonnam National University, 300 Yongbong-dong, Buk-gu, Gwangju, 500-757, Korea
| | - A M Abd El-Aty
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea.,Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
| | - H C Shin
- Department of Veterinary Pharmacology and Toxicology, College of Veterinary Medicine, Konkuk University, Nuengdong-ro, Gwangjin-gu, Seoul, 143-701, Korea
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Kim MS, Park HW, Park JY, Park HJ, Lee SY, Hong HP, Kwag HJ, Kwon HJ. Differentiation of early perforated from nonperforated appendicitis: MDCT findings, MDCT diagnostic performance, and clinical outcome. ACTA ACUST UNITED AC 2015; 39:459-66. [PMID: 24633221 DOI: 10.1007/s00261-014-0117-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To determine the CT findings and assess their diagnostic performance in differentiating early perforated appendicitis from nonperforated appendicitis, and to compare therapeutic approaches and clinical outcomes between two types of appendicitis. Our retrospective study was approved by our institutional review board and informed consent was waived. From July 2012 to July 2013, 339 patients [mean age 40.8 years; age range 19-80 years; 183 male (mean age 40.5 years; age range 19-79 years) and 156 female (mean age 41.2 years; age range 19-80 years)] who underwent appendectomy with preoperative CT examination for suspected acute appendicitis were included, with exclusion of 37 patients with specific CT findings for advanced perforated appendicitis. And they were categorized into nonperforated and early perforated appendicitis groups according to surgical and pathologic reports. The following CT findings were evaluated by two radiologists blinded to pathologic and surgical findings: transverse diameter of the appendix, thickness of the appendiceal wall, the depth of intraluminal appendiceal fluid, appendiceal wall enhancement, presence or absence of focal defect in the appendiceal wall, intraluminal appendiceal air, appendicolith/fecalith, periappendiceal changes, cecal wall thickening, and free fluid. The type of surgical procedures, performance of surgical drainage, and the length of hospital stay were recorded. Univariate and multivariate logistic regression analysis were used to determine the CT findings for differentiating early perforated appendicitis from nonperforated appendicitis, a total of 75 (22%) of the 339 patients was diagnosed with early perforated appendicitis. Focal wall defect [adjusted odds ratio (aOR), 23.40; p < 0.001], circumferential periappendiceal changes (aOR, 5.63; p < 0.001), appendicoliths/fecaliths (aOR, 2.47; p = 0.015), and transverse diameter of the appendix (aOR, 1.22; p = 0.003) were independently differentiating variables for early perforated appendicitis. The transverse diameter of the appendix (≥11 mm) had the highest sensitivity (62.7%) and focal wall defect in the appendiceal wall showed the highest specificity (98.8%). The prevalence of surgical drainage was higher (p = 0.001) and the mean hospital stay was approximately one day longer (p < 0.001) in the early perforated group than nonperforated group. CT can be helpful in differentiating early perforated appendicitis from nonperforated appendicitis, although the sensitivity of the evaluated findings was somewhat limited.
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Affiliation(s)
- Mi Sung Kim
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung dong, Jongno-gu, Seoul, 110-746, Korea
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Oh ST, Zheng L, Kwon HJ, Choo YK, Lee KW, Kang CW, An BK. Effects of Dietary Fermented Chlorella vulgaris (CBT(®)) on Growth Performance, Relative Organ Weights, Cecal Microflora, Tibia Bone Characteristics, and Meat Qualities in Pekin Ducks. Asian-Australas J Anim Sci 2015; 28:95-101. [PMID: 25557680 PMCID: PMC4283193 DOI: 10.5713/ajas.14.0473] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/13/2014] [Accepted: 09/18/2014] [Indexed: 12/24/2022]
Abstract
Fermented Chlorella vulgaris was examined for its effects on growth performance, cecal microflora, tibia bone strength, and meat qualities in commercial Pekin ducks. A total of three hundred, day-old male Pekin ducks were divided into three groups with five replicates (n = 20 ducklings per replicate) and offered diets supplemented with commercial fermented C. vulgaris (CBT(®)) at the level of 0, 1,000 or 2,000 mg/kg, respectively for 6 wks. The final body weight was linearly (p = 0.001) increased as the addition of fermented C. vulgaris into diets increased. Similarly, dietary C. vulgaris linearly increased body weight gain (p = 0.001) and feed intake (p = 0.001) especially at the later days of the feeding trial. However, there was no C. vulgaris effect on feed efficiency. Relative weights of liver were significantly lowered by dietary fermented C. vulgaris (linear effect at p = 0.044). Dietary fermented C. vulgaris did not affect total microbes, lactic acid bacteria, and coliforms in cecal contents. Finally, meat quality parameters such as meat color (i.e., yellowness), shear force, pH, or water holding capacity were altered by adding fermented C. vulgaris into the diet. In our knowledge, this is the first report to show that dietary fermented C. vulgaris enhanced meat qualities of duck meats. In conclusion, our study indicates that dietary fermented C. vulgaris exerted benefits on productivity and can be employed as a novel, nutrition-based strategy to produce value-added duck meats.
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Affiliation(s)
- S T Oh
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - L Zheng
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - H J Kwon
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - Y K Choo
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - K W Lee
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - C W Kang
- Dan Biotech Inc., Cheonan 330-834, Korea
| | - B K An
- Dan Biotech Inc., Cheonan 330-834, Korea
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Choi YJ, Park MI, Park SJ, Moon W, Kim SE, Kwon HJ, Kim JH, Jeon WS. The effect of water bolus temperature on esophageal motor function as measured by high-resolution manometry. Neurogastroenterol Motil 2014; 26:1628-34. [PMID: 25307526 DOI: 10.1111/nmo.12441] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 08/19/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Ingestion of cold fluids may induce pain in patients with esophageal motility disorders. Hot fluids, on the other hand, may help to relieve pain. We studied changes in esophageal motility as a variable of water bolus temperature using high-resolution manometry (HRM) in healthy human. METHODS Thirty-two healthy subjects were recruited at Kosin University Hospital. HRM was performed in a sitting position, with room temperature (RT, 25 °C), hot (45 °C), and cold (2 °C) water swallowed in that order. This exam included single swallowing (10 swallows of 5 mL water, 30 s intervals) and multiple water swallows (MWS; 100 mL water within 30 s). KEY RESULTS In the single swallowing, hot water caused a decrease in lower esophageal sphincter (LES) residual pressure (5.87 ± 4.20 mmHg vs 7.45 ± 4.17 mmHg (RT), p = 0.001) and duration of esophageal body (EB) contraction (3.01 ± 0.80 s vs 3.15 ± 1.16 s (RT), p = 0.009). Cold water caused an increase in the duration of EB contraction (3.52 ± 0.87 s vs 3.15 ± 1.16 s (RT), p = 0.001) and a decrease in contractile front velocity (CFV) (4.43 ± 1.50 cm/s vs 4.90 ± 2.53 cm/s (RT), p = 0.007). Similarly, in the MWS, hot water caused a decrease in the duration of EB contraction (12.95 ± 5.02 s vs 16.33 ± 5.94 s (RT), p = 0.024) and an increase in the amplitude of EB contraction (114.27 ± 83.36 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.007). Cold water caused an increase in the duration of EB contraction (27.38 ± 2.89 s vs 16.33 ± 5.94 s (RT), p = 0.03) and a decrease in the amplitude of EB contraction (51.68 ± 33.94 mmHg vs 82.70 ± 46.77 mmHg (RT), p = 0.001). CONCLUSIONS & INFERENCES This study showed changes in esophageal motility to be dependent on water temperature. Especially, MWS showed clear changes in esophageal motility at different temperatures of water.
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Affiliation(s)
- Y J Choi
- Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea
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Kwon HJ, Kim PN, Byun JH, Kim KW, Won HJ, Shin YM, Lee MG. Various complications of percutaneous radiofrequency ablation for hepatic tumors: radiologic findings and technical tips. Acta Radiol 2014; 55:1082-92. [PMID: 24277883 DOI: 10.1177/0284185113513893] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Radiofrequency ablation is a safe and effective treatment for primary and secondary liver malignancies and has a low complication rate; however, there are various radiofrequency ablation-related complications which can occur from the thorax to the pelvis. Although most of these complications are usually minor and self-limited, they may become fatal if diagnosis and treatment are delayed. It is important for radiologists performing radiofrequency ablation to have a perspective regarding the possible radiofrequency ablation-related complications and their risk factors as well as the radiologic findings for their timely detection and increase of the treatment efficacy, and thereby encouraging the use of the radiofrequency ablation technique. This article illustrates the various imaging features of common and rare radiofrequency ablation-related complications as well as offers technical tips in order to avoid these complications.
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Affiliation(s)
- Heon-Ju Kwon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Pyo Nyun Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Ho Byun
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyoung Won Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyung Jin Won
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Moon Shin
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Moon-Gyu Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Choi SH, Byun JH, Kwon HJ, Ha HI, Lee SJ, Kim SY, Won HJ, Kim PN. The Usefulness of Gadoxetic Acid-Enhanced Dynamic Magnetic Resonance Imaging in Hepatocellular Carcinoma: Toward Improved Staging. Ann Surg Oncol 2014; 22:819-25. [DOI: 10.1245/s10434-014-4074-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Indexed: 12/30/2022]
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Kim EJ, Kwon HJ, Ha M, Lim MH, Oh SY, Kim JH, Yoo SJ, Paik KC. Relationship among attention-deficit hyperactivity disorder, dietary behaviours and obesity. Child Care Health Dev 2014; 40:698-705. [PMID: 24438547 DOI: 10.1111/cch.12129] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Attention-deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders of childhood and can be associated with obesity. The aim of this study was to reveal the connection between ADHD symptoms, food habits and obesity. METHODS We examined 12 350 children (6010 boys, 6340 girls) from 27 elementary schools in Cheonan, the Republic of Korea. The study subjects were 5- to 13-year-old children (9.4 ± 1.7 years). Parents completed the DuPaul ADHD Rating Scale. Food habits were measured by a questionnaire adapted from the Korea Youth Risk Behavior Web-based Survey and a validated mini-dietary assessment tool. The full set of hypothesized associations was tested using covariance structural modelling. RESULTS The prevalence of ADHD was 7.6% and that of obesity was 4.5% in our study population. The data was well fit by the model. ADHD was associated with body mass index (BMI; standardized β = 0.086, P < 0.001). Bulimic dietary behaviours was related to BMI (standardized β = 0.548, P < 0.001). Socio-economic status was associated with BMI (standardized β = -0.017, P = 0.027). CONCLUSION Our analysis suggested that ADHD was a risk factor for obesity through dietary behavioural change and socio-economic status.
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Affiliation(s)
- E J Kim
- The Environmental Health Center (Neurodevelopment), Dankook University Medical Center, Cheonan, Korea
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