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Son S, Yoo BR, Jeong YM. Digital therapeutics-based lumbar core exercise for patients with low back pain: A prospective exploratory pilot study. Digit Health 2024; 10:20552076231218154. [PMID: 38205039 PMCID: PMC10777809 DOI: 10.1177/20552076231218154] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 11/11/2023] [Indexed: 01/12/2024] Open
Abstract
Objective This study aimed to implement a digital therapeutics-based approach based on motion detection technology and analyze the clinical results for patients with chronic low back pain (LBP). Methods A prospective, single-arm clinical trial was conducted with 22 patients who performed mobile app-based sitting core twist exercise for 12 weeks. Clinical outcomes were assessed using the visual analog scale (VAS) for LBP, Oswestry Disability Index-Korean version (K-ODI), and EuroQol-5 dimension 5-level version (EQ-5D-5L) every 4 weeks after the initiation of treatment. Laboratory tests for factors associated with muscle metabolism, plain X-ray for evaluating sagittal balance, and magnetic resonance imaging for calculating cross-sectional area (CSA) of back muscles were performed at pretreatment and 12 weeks post-treatment. Results The study population included 20 female patients with an average age of 45.77 ± 15.45 years. The clinical outcomes gradually improved throughout the study period in the VAS for LBP (from 6.05 ± 2.27 to 2.86 ± 1.86), K-ODI (from 16.18 ± 6.19 to 8.64 ± 5.58), and EQ-5D-5L (from 11.09 ± 3.24 to 7.23 ± 3.89) (p < 0.001, respectively). The laboratory test results did not show significant changes. Pelvic incidence (from 53.99 ± 9.70° to 50.80 ± 9.20°, p = 0.002) and the mismatch between pelvic incidence and lumbar lordosis (from 8.97± .67° to 5.28 ± 8.57°, p = 0.027) decreased significantly. Additionally, CSA of erector spinae and total back muscles increased by 5.20% (p < 0.001) and 3.08% (p = 0.013), respectively. Conclusions The results of this study suggest that the efficacy of digital therapy-based lumbar core exercise for LBP is favorable. However, further large-scale randomized controlled studies are necessary.
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Affiliation(s)
- Seong Son
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Byung Rhae Yoo
- Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, South Korea
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Oh E, Jang H, Ok S, Eom J, Lee H, Kim SH, Kim JH, Jeong YM, Kim KJ, Yun SP, Kwon HJ, Lee IC, Park JY, Yang S. WGA-M001, a Mixture of Total Extracts of Tagetes erecta and Ocimum basilicum, Synergistically Alleviates Cartilage Destruction by Inhibiting ERK and NF-κB Signaling. Int J Mol Sci 2023; 24:17459. [PMID: 38139287 PMCID: PMC10743532 DOI: 10.3390/ijms242417459] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Tagetes erecta and Ocimum basilicum are medicinal plants that exhibit anti-inflammatory effects against various diseases. However, their individual and combined effects on osteoarthritis (OA) are unknown. Herein, we aimed to demonstrate the effects of T. erecta, O. basilicum, and their mixture, WGA-M001, on OA pathogenesis. The administration of total extracts of T. erecta and O. basilicum reduced cartilage degradation and inflammation without causing cytotoxicity. Although WGA-M001 contained lower concentrations of the individual extracts, it strongly inhibited the expression of pathogenic factors. In vivo OA studies also supported that WGA-M001 had protective effects against cartilage destruction at lower doses than those of T. erecta and O. basilicum. Moreover, its effects were stronger than those observed using Boswellia and Perna canaliculus. WGA-M001 effectively inhibited the interleukin (IL)-1β-induced nuclear factor kappa-light-chain-enhancer of the activated B cell (NF-κB) pathway and ERK phosphorylation. Furthermore, RNA-sequence analysis also showed that WGA-M001 decreased the expression of genes related to the IL-1β-induced NF-κB and ERK signaling pathways. Therefore, WGA-M001 is more effective than the single total extracts of T. erecta and O. basilicum in attenuating OA progression by regulating ERK and NF-κB signaling. Our results open new possibilities for WGA-M001 as a potential therapeutic agent for OA treatment.
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Affiliation(s)
- Eunjeong Oh
- Department of Biological Sciences, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.O.); (H.J.); (S.O.); (J.E.)
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon 16499, Republic of Korea
| | - Hahyeong Jang
- Department of Biological Sciences, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.O.); (H.J.); (S.O.); (J.E.)
| | - Subin Ok
- Department of Biological Sciences, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.O.); (H.J.); (S.O.); (J.E.)
| | - Jiwon Eom
- Department of Biological Sciences, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.O.); (H.J.); (S.O.); (J.E.)
| | - Hyunyong Lee
- Wooree Green Science, Ansan 15409, Republic of Korea; (H.L.); (S.H.K.); (J.H.K.); (Y.M.J.); (K.J.K.)
| | - Sung Hun Kim
- Wooree Green Science, Ansan 15409, Republic of Korea; (H.L.); (S.H.K.); (J.H.K.); (Y.M.J.); (K.J.K.)
| | - Jong Hwa Kim
- Wooree Green Science, Ansan 15409, Republic of Korea; (H.L.); (S.H.K.); (J.H.K.); (Y.M.J.); (K.J.K.)
| | - Yu Mi Jeong
- Wooree Green Science, Ansan 15409, Republic of Korea; (H.L.); (S.H.K.); (J.H.K.); (Y.M.J.); (K.J.K.)
| | - Kyeong Jin Kim
- Wooree Green Science, Ansan 15409, Republic of Korea; (H.L.); (S.H.K.); (J.H.K.); (Y.M.J.); (K.J.K.)
- Department of Horticulture, Chonnam National University, Gwangju 61186, Republic of Korea
| | - Seung Pil Yun
- Department of Pharmacology, Institute of Health Sciences, Gyeongsang National University College of Medicine, Jinju 52727, Republic of Korea;
| | - Hyung-Jun Kwon
- Center for Companion Animal New Drug Development, Jeonbuk Branch, Korea Institute of Toxicology, Jeongeup 53212, Republic of Korea; (H.-J.K.); (I.-C.L.); (J.-Y.P.)
| | - In-Chul Lee
- Center for Companion Animal New Drug Development, Jeonbuk Branch, Korea Institute of Toxicology, Jeongeup 53212, Republic of Korea; (H.-J.K.); (I.-C.L.); (J.-Y.P.)
| | - Ji-Young Park
- Center for Companion Animal New Drug Development, Jeonbuk Branch, Korea Institute of Toxicology, Jeongeup 53212, Republic of Korea; (H.-J.K.); (I.-C.L.); (J.-Y.P.)
| | - Siyoung Yang
- Department of Biological Sciences, Sungkyunkwan University, Suwon 16419, Republic of Korea; (E.O.); (H.J.); (S.O.); (J.E.)
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Yu SH, Jeong YM, Lee SW. Revisiting Kümmell's disease: MRI findings beyond the intraosseous cavity for improved diagnosis. Neuroradiology 2022; 64:1681-1688. [PMID: 35577995 DOI: 10.1007/s00234-022-02976-z] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/05/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The diagnostic tool for Kümmell's disease (KD), including the intravertebral vacuum cavity on imaging, is still limited. The purpose of this study was to find other magnetic resonance imaging (MRI) findings that could help the diagnosis of KD. METHODS A total of 289 patients (103 males and 186 females with a mean age of 69 ± 15 years) with thoracolumbar compression fracture were included. Medical records were reviewed to note symptom duration. MRIs were analyzed for intraosseous cavities (IOC), prevertebral soft-tissue changes (PreSC), posterior wall fracture (PoF), and posterior ligamentous complex tear (PLCT). KD was diagnosed based on surgical findings or clinical report. MRI findings and symptom duration in the presence or absence of KD were compared with chi-squared test, logistic regression, and Student's t-test and area under the curve (AUC) analyses. RESULTS KD was diagnosed in 55 cases. IOC was noted in 33 (60%) cases in the KD group and 82 (35%) cases in non-KD group. Definite PreSC was noted in 44 (80%) cases in the KD group and 94 (40%) cases in the non-KD group. PoF was seen in 36 (65%) and 140 (60%) cases, and PLCT was seen in 7 (13%) and 26 (11%) cases in KD and non-KD groups, respectively. The IOC and PreSC MRI findings were significantly correlated with KD (p < 0.001), but not with PoF (p = 0.539) or PLCT (p = 0.814). AUC of combined IOC and PreSC was 0.72, higher than that of IOC alone (0.63) or PreSC alone (0.69) (both p < 0.001). The average duration of symptom was 64 days in the KD group and 14 days in the non-KD group (p < 0.001). Positive IOC and PreSC findings were associated with longer symptom duration (p < 0.001). CONCLUSIONS Prevertebral soft-tissue changes and intraosseous cavity are associated with KD. Combined findings of prevertebral soft-tissue changes and intraosseous cavity can help the diagnosis of KD.
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Affiliation(s)
- Sung Hyun Yu
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Sheen-Woo Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Tongil-ro, Eunpyeong-gu, Seoul, 1021, Korea.
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Ahn TR, Jeong YM, Park SH, Jeon JY, Lee SW, Shim YS. Analysis of critical report notification from musculoskeletal radiology in a tertiary academic medical institution with a regional trauma center. PLoS One 2022; 17:e0262511. [PMID: 35025970 PMCID: PMC8758081 DOI: 10.1371/journal.pone.0262511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/04/2021] [Accepted: 12/28/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose We aimed to analyze the prevalence, causes, and clinical settings of 4-year critical radiologic reports (CRRs) notified from the musculoskeletal section of the radiology department. Then, we investigated the communication outcomes. Methods This study was approved by our institutional review board. We retrospectively included 175 musculoskeletal CRRs from our database between January 2017 and December 2020. The CRRs were analyzed by two musculoskeletal radiologists, who categorized the CRRs by clinical setting (emergency department(ED) patient, outpatient, and inpatient), body part, type of image modality, reason for CRR, incidental lesion, and clinical outcome. The clinical outcome was retrieved from the electronic medical records. Results The 175 musculoskeletal CRRs accounted for 5.4% of the CRRs (n = 3217) available in the study period. Most CRRs (94.9%, 166/175) corresponded to the musculoskeletal system, while the remaining ones (5.1%, 9/175) corresponded to the non-musculoskeletal system. In addition, the spine, extremities, and thoracic cage accounted for 52.6%, 40.6%, and 1.7% of the musculoskeletal CRRs, respectively. Moreover, most patients presented to the ED (50.3%, 88/175), followed by inpatients (30.9%, 54/175), and outpatients (18.9%, 33/175). The CRR reasons included missed fracture (54.3%), suspected malignancy (16%), clinical emergency (10.3%), unexpected infection/inflammation (11.4%), and others (8%). Furthermore, 11 (6.3%) incidental lesions were not related to the primary imaging purpose. Referring clinicians actively acknowledged 80% of the CRRs. The loss to follow-up action was the highest in the ED patients (35.2%, 31/88; p < 0.001), being significantly higher than that in outpatients (6.1%, 2/33) and inpatients (3.7%, 2/54). Conclusion Missed fractures were the most common cause of musculoskeletal CRRs. ED showed prevalence in musculoskeletal CRRs and reflected the highest loss to follow-up action. ED physicians should pay more attention to CRRs to enhance patient care.
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Affiliation(s)
- Tae Ran Ahn
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
- * E-mail:
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Ji Young Jeon
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Young Sup Shim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Lim HJ, Jeon JY, Jeong YM, Lee BG, Sim JA, Lee SW. Triaging deep vein thrombosis using ultrasonography after lower-extremity orthopedic surgery: analysis of a single-center experience. Ultrasonography 2021; 40:442-448. [PMID: 33775007 PMCID: PMC8217792 DOI: 10.14366/usg.20171] [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: 10/29/2020] [Accepted: 01/12/2021] [Indexed: 11/03/2022] Open
Abstract
PURPOSE This study aimed to stratify risk factors and vein levels for postoperative deep vein thrombosis (DVT) after lower-extremity orthopedic surgery. METHODS Ninety-nine patients who underwent Doppler ultrasonography after lower-extremity orthopedic surgery were enrolled. Medical records were reviewed for anesthesia duration, type of surgery, body weight, height, and cardiovascular risk factors (including history of smoking, diabetes mellitus or hypertension, blood pressure, and total cholesterol and high-density lipoprotein [HDL] cholesterol levels), and the DVT treatment. Ultrasound diagnosis of DVT was made according to a routine protocol. The relationships between selected factors and the presence of DVT were assessed using univariate and multivariate regression analyses. RESULTS Thirty-three (33%) patients were found to have calf DVT. The mean age, weight, and height of the non-DVT and postoperative DVT patients were 55.1 years versus 65.4 years, 70.5 kg versus 61.2 kg, and 163.3 cm versus 157.0 cm, respectively. Total cholesterol/HDL levels in the non-DVT and DVT patients were 70.6/20.7 mg/dL and 90.8/26.0 mg/dL, retrospectively. Systolic and diastolic blood pressure in the non-DVT and DVT patients were 133.6/80.2 mm Hg and 132.2/78.1 mmHg, respectively. The mean duration of anesthesia was 173.9 versus 199.9 minutes, and the operative time was 136.4 minutes versus 161.0 minutes. Older age (P=0.005) and lower body weight (P=0.002) were significantly associated with postoperative DVT. No other significant between-group differences were found (P>0.05). The patients with ultrasound-identified DVT received antithrombotic treatment. None of them had distant thromboembolism. CONCLUSION After lower-extremity orthopedic surgery, the calf veins in elderly patients with low body weight are susceptible to thrombosis; they would most likely benefit from postoperative ultrasonography.
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Affiliation(s)
- Hee Joong Lim
- Department of Radiology, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Ji Young Jeon
- Department of Radiology, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Beom Gu Lee
- Department of Orthopedic Surgery, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jae-Ang Sim
- Department of Orthopedic Surgery, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gachon University Medical Center, Gachon University College of Medicine, Incheon, Korea.,Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Park SH, Jeong YM, Lee HY, Kim EY, Kim JH, Park HK, Ahn HK. Opportunistic use of chest CT for screening osteoporosis and predicting the risk of incidental fracture in breast cancer patients: A retrospective longitudinal study. PLoS One 2020; 15:e0240084. [PMID: 33052943 PMCID: PMC7556442 DOI: 10.1371/journal.pone.0240084] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/19/2020] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the diagnostic performance of chest computed tomography (CT) for opportunistic screening and longitudinal follow-up of osteoporosis in breast cancer patients, compared to dual-energy X-ray absorptiometry (DXA). The association between L1 vertebral attenuation on chest CT and incidental fracture was also evaluated. We retrospectively reviewed 414 consecutive breast cancer patients who underwent both non-enhanced chest CT and DXA within a 3-month interval and had at least two DXA and two chest CT examinations over more than 1 year. The attenuation value of the L1 trabecular bone was measured on an axial CT image and compared to the corresponding DXA T-score. The diagnostic performance of L1 vertebral attenuation on CT for osteoporosis was calculated at different thresholds (90 HU, 100 HU, 110 HU), and the correlation between L1 vertebral attenuation values and DXA T-scores was statistically analyzed. Overall fracture-free survival was estimated and compared with the threshold of 90 HU on CT and -2.5 T-score on DXA. Of 414 patients (median age, 53.0 years), 88 (21.3%) had either vertebral or non-vertebral fractures. The median follow-up duration between initial and final DXA was 902.9 days. There was a moderate correlation between L1 vertebral attenuation value and DXA T-score (ρ = 0.684, CI 0.653–0.712). Fracture-free survival was significantly lower in patients with attenuation values ≤90 HU on CT and T-scores ≤-2.5 on DXA (P < .001). Multivariate analysis revealed that attenuation values ≤90 HU on CT (P < .001), T-scores ≤-2.5 on DXA (P = .003), and age ≥65 years (P = .03) were independent significant prognostic factors associated with overall fracture-free survival. The sensitivities and specificities of L1 attenuation value were 54.9% and 85.8% at 90-HU threshold, 74.0% and78.4% at 100-HU threshold, and 83.9% and 70.1% at 110-HU threshold, respectively. In conclusion, CT can be used for predicting osteoporosis and discriminating incidental fracture risk in breast cancer patients.
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Affiliation(s)
- So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Namdong-gu, Incheon, Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Namdong-gu, Incheon, Korea
| | - Hee Young Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Namdong-gu, Incheon, Korea
- * E-mail:
| | - Eun Young Kim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Namdong-gu, Incheon, Korea
| | - Jeong Ho Kim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Namdong-gu, Incheon, Korea
| | - Heung Kyu Park
- Department of Surgery, Breast Cancer Center, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hee Kyung Ahn
- Department of Oncology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Choi SJ, Ahn SJ, Park SH, Park SH, Pak SY, Choi JW, Shim YS, Jeong YM, Kim B. Dual-source abdominopelvic computed tomography: Comparison of image quality and radiation dose of 80 kVp and 80/150 kVp with tin filter. PLoS One 2020; 15:e0231431. [PMID: 32881876 PMCID: PMC7470424 DOI: 10.1371/journal.pone.0231431] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 08/19/2020] [Indexed: 12/05/2022] Open
Abstract
Objective To compare the radiation dose and the objective and subjective image quality of 80 kVp and 80/150 kVp with tin filter (80/Sn150 kVp) computed tomography (CT) in oncology patients. Methods One-hundred-and-forty-five consecutive oncology patients who underwent third-generation dual-source dual-energy CT of the abdomen for evaluation of malignant visceral, peritoneal, extraperitoneal, and bone tumor were retrospectively recruited. Two radiologists independently reviewed each observation in 80 kVp CT and 80/Sn150 kVp CT. Modified line-density profile of the tumor and contrast-to-noise ratio (CNR) were measured. Diagnostic confidence, lesion conspicuity, and subjective image quality were calculated and compared between image sets. The effective dose and size-specific dose estimate (SSDE) were calculated in the image sets. Results Modified line-density profile analysis revealed higher attenuation differences between the tumor and normal tissue in 80 kVp CT than in 80/Sn150 kVp CT (127 vs. 107, P = 0.05). The 80 kVp CT showed increased CNR in the liver (8.0 vs. 7.6) and the aorta (18.9 vs. 16.3) than the 80/Sn150 kVp CT. The 80 kVp CT yielded higher enhancement of organs (4.9 ± 0.2 vs. 4.7 ± 0.4, P<0.001) and lesion conspicuity (4.9 ± 0.3 vs. 4.8 ± 0.5, P = 0.035) than the 80/Sn150 kVp CT; overall image quality and confidence index were comparable. The effective dose was reduced by 45.2% with 80 kVp CT (2.3 mSv ± 0.9) compared to 80/Sn150 kVp CT (4.1 mSv ± 1.5). The SSDE was 7.4 ± 3.8 mGy on 80/Sn150 kVp CT and 4.1 ± 2.2 mGy on 80 kVp CT. Conclusions The 80 kVp CT reduced the radiation dose by 45.2% in oncology patients while showing comparable or superior image quality to that of 80/Sn150 kVp CT for abdominal tumor evaluation.
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Affiliation(s)
- Seung Joon Choi
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Su Joa Ahn
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
- * E-mail:
| | - Seong Ho Park
- Division of Abdominal Radiology, Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Yong Pak
- Imaging and Computer Vision Division, Siemens Healthcare, Seoul, Korea
| | - Jae Won Choi
- Imaging and Computer Vision Division, Siemens Healthcare, Seoul, Korea
| | - Young Sup Shim
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Bohyun Kim
- Department of Radiology, Seoul Saint Mary's Hospital, Seoul, Korea
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Yang SJ, Jeon JY, Lee SW, Jeong YM. Added value of color-coded virtual non-calcium dual-energy CT in the detection of acute knee fractures in non-radiology inexpert readers. Eur J Radiol 2020; 129:109112. [PMID: 32526668 DOI: 10.1016/j.ejrad.2020.109112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/28/2020] [Revised: 05/12/2020] [Accepted: 05/31/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluated the added value of dual-energy CT (DECT) virtual non-calcium (VNCa) protocol on conventional CT in the detection of acute knee fractures in non-radiology inexpert readers. METHOD One hundred fifty-six patients (mean age, 51.97 years; age range, 17-86 years) with knee trauma, who underwent DECT and MRI within 3 days between April 2017 and October 2018, were retrospectively analyzed. Three readers (intern, 1st-year general surgery resident, 1st-year emergency medicine resident) independently analyzed CT alone and then with the additional color-coded DECT VNCa for fractures. A board-certified radiologist, analyzed CT and MRI series to define the reference standard. Sensitivity, specificity, and AUC were compared between the two reading sessions. RESULTS Fifty-seven patients had acute fractures and 99 had no fractures. Thirteen of 57 fractures were nondisplaced. The additional use of VNCa images significantly increased the mean AUC (reader 1: 0.813 vs. 0.919; reader 2: 0.842 vs. 0.930; reader 3: 0.837 vs. 0.921; P < 0.05). When only nondisplaced fractures included, the mean AUC was more increased in the combined analysis of CT and DECT VNCa (reader 1: 0.521 vs. 0.916; reader 2: 0.542 vs. 0.926; reader 3: 0.575 vs. 0.926; P < .01). Sensitivity increased by 15 %-20 % in total fracture group and by 69 %-77 % in nondisplaced fracture group over that with CT alone when both CT and DECT VNCa were used. Specificity did not differ significantly. CONCLUSIONS The additional use of color-coded DECT VNCa protocol to conventional CT improved diagnostic performance in detecting acute knee fractures for inexperienced non-radiology readers.
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Affiliation(s)
- Su Jeong Yang
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine From the Department of Radiology, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Ji Young Jeon
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine From the Department of Radiology, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon 21565, Republic of Korea.
| | - Sheen-Woo Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine From the Department of Radiology, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon 21565, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine From the Department of Radiology, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon 21565, Republic of Korea
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Shim YS, Park SH, Choi SJ, Ahn SJ, Jeong YM, Kim TB, Jeong J, Kim HJ. Sonographic findings of mass-forming extramammary Paget's disease in the scrotum. BJR Case Rep 2019; 5:20190018. [PMID: 31555478 PMCID: PMC6750622 DOI: 10.1259/bjrcr.20190018] [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: 02/18/2019] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 11/05/2022] Open
Abstract
Extramammary Paget's disease (EMPD) is a rare cutaneous malignancy involving the scrotum and may be confused with other scrotal malignancy. We describe the sonographic findings of an extremely rare case of mass-forming EMPD of the scrotal wall. Ultrasonography, which shows mild heterogeneous hyperechoic masses with a stalk connected to the dermis, can help predict the depth of vertical invasion of the lesion. The lesion extent should be precisely evaluated because the presence of dermal invasion of EMPD is the risk factor in distant metastasis and is known to result in a worse prognosis. Ultrasonography is a primary imaging modality to evaluate the extent and vertical invasion of EMPD. Surgical local wide excision is the treatment of choice for EMPD and histopathology confirmed the diagnosis.
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Affiliation(s)
- Young Sup Shim
- Department of Radiology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Seung Joon Choi
- Department of Radiology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Su-Joa Ahn
- Department of Radiology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Tae Beom Kim
- Department of Urology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Juhyeon Jeong
- Department of Urology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
| | - Hee Joo Kim
- Department of Dermatology, Gil Medical Center, Gachon University College of medicine, Incheon, South Korea
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10
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Jeon JY, Lee SW, Jeong YM, Yu S. The utility of dual-energy CT collagen material decomposition technique for the visualization of tendon grafts after knee ligament reconstruction. Eur J Radiol 2019; 116:225-230. [DOI: 10.1016/j.ejrad.2019.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/29/2018] [Accepted: 03/17/2019] [Indexed: 11/29/2022]
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11
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Lee IS, Park SH, Choi SJ, Shim Y, Ahn SJ, Kim KW, Kim KK, Jeong YM, Choe YH. Diagnostic Performance of Multidetector Computerized Tomography in the Detection of Abdominal Complications Early and Late After Liver Transplantation: A 10-Year Experience. Transplant Proc 2018; 50:3673-3680. [PMID: 30577254 DOI: 10.1016/j.transproceed.2018.09.016] [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: 05/19/2018] [Revised: 08/15/2018] [Accepted: 09/05/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Multidetector computerized tomography (MDCT) is considered to be a fast noninvasive diagnostic technique for the evaluation of postoperative complications in patients with liver transplantation (LT). However, its role has not been fully established in the diagnosis for detecting complications after liver transplantation. The aim of this work was to evaluate the diagnostic performance of MDCT for detecting abdominal complications in the early and late periods after LT. METHODS We retrospectively enrolled 75 patients who had undergone LT from March 2006 to January 2010, followed by MDCT from March 2006 to November 2017. Patients were divided into 2 groups according to the timing after LT: within the first 3 months (early period) or ≥3 months after LT (late period). We evaluated vascular, biliary, and other complications on MDCT. Angiography, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography were used as reference standards. RESULTS We initially found 77 complications in 45 patients (60.0%) with the use of MDCT. After comparison with the reference standards, 83 complications were diagnosed in 49 patients (65.3%). Forty-seven complications (34 vascular, 10 biliary, 3 other complications) were diagnosed in 33 patients (44.0%) during the early period, and 36 complications (6 vascular, 20 biliary, 10 other complications) were detected in 27 patients (36.0%) in the late period. The sensitivity, specificity, and diagnostic accuracy of MDCT for diagnosing overall complications were, respectively, 93.6%, 90.2%, and 92.0% in the early period (for vascular complications: 97.1%, 92.6%, and 94.3%,; for biliary complications: 80.0%, 100%, and 97.7%) and 77.8%, 98.1%, and 89.8% in the late period (for vascular complications: 83.3%, 100%, and 98.9%; for biliary complications: 65.0%, 98.6%, and 90.9%). CONCLUSIONS Although MDCT in the late period should be interpreted with caution in patients with suspected biliary complication, MDCT is a reliable diagnostic technique for the identification of early and late abdominal complications after LT.
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Affiliation(s)
- I S Lee
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea
| | - S H Park
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea.
| | - S J Choi
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea
| | - Y Shim
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea
| | - S-J Ahn
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea
| | - K W Kim
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - K K Kim
- Department of Surgery, Gil Medical Center, Gachon University, Incheon, Korea
| | - Y M Jeong
- Department of Radiology, Gil Medical Center, Gachon University, Incheon, Korea
| | - Y H Choe
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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12
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Jeon JY, Lee SW, Jeong YM, Baek HJ. The effect of tube voltage combination on image artefact and radiation dose in dual-source dual-energy CT: comparison between conventional 80/140 kV and 80/150 kV plus tin filter for gout protocol. Eur Radiol 2018; 29:1248-1257. [PMID: 29987420 DOI: 10.1007/s00330-018-5622-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 05/09/2018] [Revised: 06/08/2018] [Accepted: 06/19/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVES In dual-source CT, dual-energy (DE) performance is affected by various X-ray tube voltage combinations with and without tin filter (Sn). The purpose of this study was to assess the utility of the 80/150 Sn kV voltage combination in terms of image artefact and radiation dose for DECT gout protocol, compared with the conventional 80/140 kV. METHODS Seventy-four patients with suspected gout who underwent dual-source DECT examinations scanned at 80/140 kV (n = 37) and at 80/150 Sn kV (n = 37) were included. Patients' age, sex, and serum uric acid levels were matched between the two groups. The types and incidence of image artefacts and radiation dose were evaluated. RESULTS The 80/150 Sn kV group had significantly fewer patients with artefacts, compared to the 80/140 kV group [11 (30 %) of 37 vs 35 (94.6 %) of 37, p < 0.001]. Except for the motion artefact, the rest of the artefacts-skin, nail bed, submillimetre, motion, vascular, beam-hardening, clumpy artefact along tendon-were significantly less observed in the 80/150 Sn kV acquisitions. The dose-length product (DLP) and effective dose were significantly lower for the 80/150 Sn kV acquisitions compared with the 8s0/140 kV scans (DLP: 104.46 ± 10.66 mGy·cm vs 344.70 ± 56.39 mGy·cm, p < 0.001; effective dose: 1.04 ± 0.11 mSv vs 3.45 ± 0.56 mSv, p < 0.001). CONCLUSIONS The 80/150 Sn kV voltage combination in dual-source DECT system could be used as one of the artefact reduction methods while reducing radiation dose for gout protocol when compared to the conventional 80/140 kV. KEY POINTS • DECT has emerged as the leading modality for non-invasive diagnosis of gout. • Various X-ray tube voltage combinations are now feasible in dual-source DECT. • The 80/150 Sn kV acquisition could facilitate artefact reduction in gout protocol.
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Affiliation(s)
- Ji Young Jeon
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea.
| | - Sheen-Woo Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea
| | - Han Joo Baek
- Division of Rheumatology, Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, 21 Namdong-daero, 774beon-gil, Namdong-gu, Incheon, 21565, Republic of Korea
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Lee KH, Jeong YM, Jeon JY, Im T, Lee SW, Park SH, Kim JH. Sonographic diagnosis of neuritis ossificans of the median nerve. J Clin Ultrasound 2018; 46:358-360. [PMID: 29044622 DOI: 10.1002/jcu.22544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/15/2017] [Revised: 08/23/2017] [Accepted: 08/27/2017] [Indexed: 06/07/2023]
Abstract
We report the sonographic appearance of a rare case of neuritis ossificans of the median nerve at the wrist, which appeared as a hyperechoic lesion around the nerve. Diagnosis was confirmed with magnetic resonance imaging (MRI).
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Affiliation(s)
- Ki Hyun Lee
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Ji Young Jeon
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Taeseong Im
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - So Hyun Park
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University, Gil Medical Center, Incheon, Republic of Korea
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Kim CR, Kim EY, Kim YS, Ahn HK, Kim KW, Jeong YM, Kim JH. Histologic subtypes are not associated with the presence of sarcopenia in lung cancer. PLoS One 2018; 13:e0194626. [PMID: 29590170 PMCID: PMC5874033 DOI: 10.1371/journal.pone.0194626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/06/2018] [Indexed: 01/06/2023] Open
Abstract
Background Sarcopenia is prevalent and a known adverse prognostic effector in lung cancer (LCA). However, the relationship between sarcopenia and histology remains uncertain in LCA. Methods Consecutive patients with newly diagnosed LCA (n = 778) between June 2012 and February 2015 were retrospectively reviewed to identify factors associated with sarcopenia. Sarcopenia was defined as CT-determined L3 muscle index (muscle area at L3/height2) of < 55 cm2/m2 for men and < 39 cm2/m2 for women. Results Mean patient age was 67.7 ± 10.8 years, and most (73.1%) were male. The most prevalent histology was adenocarcinoma (44.0%) and 71.6% of patients had stage III or IV disease. The overall prevalence of sarcopenia was 48.2% (60.3% in men, and 15.3% in women). Univariable analysis showed sarcopenia was significantly associated with male gender, age (≥ 65 years), smoking status, lower BMI (< 23 kg/m2), advanced stage (III and IV), and high comorbidity score (Charlson index ≥ 3). Furthermore, the prevalence of sarcopenia was higher in squamous cell carcinoma (54.9%) and small cell LCA (56.4%) than in adenocarcinoma (39.8%). Multivariable analyses showed sarcopenia was independently associated with a male gender (odds ratio [OR], 11.13), elderly (OR, 2.02) and low BMI (OR, 6.28), stage IV (OR, 1.98), and high comorbidity (OR, 1.93). However, no significant association was found between histologic subtypes and sarcopenia. Conclusions Sarcopenia was found to be significantly associated with old age, male gender, an advanced stage, comorbidities, and low BMI in LCA. However, histology subtype was not an independent factor for the presence of sarcopenia.
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Affiliation(s)
- Chang Rae Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
- * E-mail:
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kun Woo Kim
- Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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15
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Jeong YM. The Termination Level of the Dural Sac Relevant
to Caudal Epidural Block in Lumbosacral
Transitional Vertebrae: A Comparison between
Sacralization and Lumbarization Groups. ACTA ACUST UNITED AC 2018. [DOI: 10.36076/ppj.1.2018.73] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have
been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter
patients with LSTV who require caudal epidural block (CEB) for pain management.
Objective: We investigated the termination level of the dural sac (DS) and anatomical features
of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings
between sacralization and lumbarization groups.
Study Design: A retrospective evaluation.
Setting: A university hospital with inpatient and outpatient LSTV cases presenting low back pain.
Methods: Four hundred ninety-four LSTV patients were included and categorized into sacralization
(n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV
patients were reviewed to determine the level of DS termination, the shortest distance between
the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural
cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and
lower thirds). The MRI findings in both of the groups were compared and analyzed.
Results: The distribution frequency of the levels of DS termination demonstrated a significant
difference between the 2 groups. The mean caudal DS level in the lumbarization group was
significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients]
vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than
19% of the lumbarization group, whereas in only one case of the sacralization group. Although
the incidence of perineural cysts was not significantly different between the 2 groups, the mean
level of caudal margin of perineural cysts in the lumbarization group was significantly lower than
the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2
[11 {44%} of 25 cases]).
Limitations: This study reveals several limitations including the practical challenge of accurate
enumeration of the transitional segment and the constraints on generalizability posed by the
single-country study.
Conclusion: When planning CEB for patients with LSTV, pre-procedural MRI to check the
anatomical structures, including the level of DS termination and caudal margin of perineural cysts,
would be of great use for lowering the risk of unexpected dural puncture during the procedure,
especially in the lumbarization cases.
Key words: Termination of the dural sac, dural sac termination, lumbosacral transitional
vertebrae, transitional vertebra, caudal epidural block
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Affiliation(s)
- Yu Mi Jeong
- 1 Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
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Jeon JY, Jeong YM, Lee SW, Kim JH, Choi HY, Ahn Y. The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups. Pain Physician 2018; 21:73-82. [PMID: 29357336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. OBJECTIVE We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups. STUDY DESIGN A retrospective evaluation. SETTING A university hospital with inpatient and outpatient LSTV cases presenting low back pain. METHODS Four hundred ninety-four LSTV patients were included and categorized into sacralization (n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV patients were reviewed to determine the level of DS termination, the shortest distance between the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and lower thirds). The MRI findings in both of the groups were compared and analyzed. RESULTS The distribution frequency of the levels of DS termination demonstrated a significant difference between the 2 groups. The mean caudal DS level in the lumbarization group was significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients] vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than 19% of the lumbarization group, whereas in only one case of the sacralization group. Although the incidence of perineural cysts was not significantly different between the 2 groups, the mean level of caudal margin of perineural cysts in the lumbarization group was significantly lower than the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2 [11 {44%} of 25 cases]). LIMITATIONS This study reveals several limitations including the practical challenge of accurate enumeration of the transitional segment and the constraints on generalizability posed by the single-country study. CONCLUSION When planning CEB for patients with LSTV, pre-procedural MRI to check the anatomical structures, including the level of DS termination and caudal margin of perineural cysts, would be of great use for lowering the risk of unexpected dural puncture during the procedure, especially in the lumbarization cases. KEY WORDS Termination of the dural sac, dural sac termination, lumbosacral transitional vertebrae, transitional vertebra, caudal epidural block.
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Affiliation(s)
- Ji Young Jeon
- Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University, Gil Medical Center, Republic of Korea
| | - Yong Ahn
- Department of Neurosurgery, Gachon University, Gil Medical Center, Republic of Korea
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Ahn Y, Kim WK, Son S, Lee SG, Jeong YM, Im T. Radiographic Assessment on Magnetic Resonance Imaging after Percutaneous Endoscopic Lumbar Foraminotomy. Neurol Med Chir (Tokyo) 2017; 57:649-657. [PMID: 29046504 PMCID: PMC5735228 DOI: 10.2176/nmc.oa.2016-0249] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Percutaneous endoscopic lumbar foraminotomy (ELF) is a novel minimally invasive technique used to treat lumbar foraminal stenosis. However, the validity of foraminal decompression based on quantitative assessment using magnetic resonance imaging (MRI) has not yet been established. The objective of this study was to investigate the radiographic efficiency of ELF using MRI. Radiographic changes of neuroforamen were measured based on pre- and postoperative MRI findings. Images were blindly analyzed by two observers for foraminal stenosis grade and foraminal dimensions. The intraclass correlation coefficient (ICC) and k statistic were calculated to determine interobserver agreement. Thirty-five patients with 40 neuroforamen were evaluated. The mean visual analog scale (VAS) score improved from 8.4 to 2.1, and the mean Oswestry disability index (ODI) improved from 65.9 to 19.2. Overall, 91.4% of the patients achieved good or excellent outcomes. The mean grade of foraminal stenosis significantly improved from 2.63 to 0.68. There were significant increases in the mean foraminal area (FA) from 50.05 to 92.03 mm2, in mean foraminal height (FH) from 11.36 to 13.47 mm, in mean superior foraminal width (SFW) from 6.43 to 9.27 mm, and in mean middle foraminal width (MFW) from 1.47 to 78 mm (P < 0.001). Interobserver agreements for preoperative and postoperative measurements were good to excellent with the exception of SFW. In conclusion, foraminal dimensions and grades of foraminal stenosis significantly improved after ELF. These findings may enhance the clinical relevance of endoscopic lumbar foraminal decompression.
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Affiliation(s)
- Yong Ahn
- Department of Neurosurgery, Gachon University Gil Medical Center
| | - Woo-Kyung Kim
- Department of Neurosurgery, Gachon University Gil Medical Center
| | - Seong Son
- Department of Neurosurgery, Gachon University Gil Medical Center
| | - Sang-Gu Lee
- Department of Neurosurgery, Gachon University Gil Medical Center
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center
| | - Taeseong Im
- Department of Radiology, Gachon University Gil Medical Center
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Kim EY, Lee HY, Kim YS, Park I, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of cachexia score assessed by CT in male patients with small cell lung cancer. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28426181 DOI: 10.1111/ecc.12695] [Citation(s) in RCA: 16] [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] [Accepted: 03/18/2017] [Indexed: 11/26/2022]
Abstract
To determine the prognostic significance of CT-determined cachexia scores (CSs) in 127 consecutive male small cell lung cancer (SCLC) patients, cross-sectional areas of muscle and fat tissues at the third lumbar vertebra (L3) were retrospectively measured on baseline CT images. CSs were determined based on the presence of sarcopenia and/or adipopenia. According to the presence of sarcopenia (L3 muscle index <55 cm2 /m2 , 86.8%) and adipopenia (L3 fat index <22 cm2 /m2 , 11.8%), CSs were defined as follows: CS2 (sarcopenia and adipopenia, 11.8%), CS1 (sarcopenia only, 74.8%) and CS0 (13.4%). CS2 was significantly related to lower body mass index (p < .001) and poor performance status (p = .002), and patients with CS2 had shorter OS than patients with CS1 or CS0 (median OS, 5.0 months vs. 8.9 months vs. 18.3 months; p = .007). Multivariable analysis revealed that CS was an independent prognostic factor of poor survival (HR, 1.99 for CS1 and 2.59 for CS2, p = .036 and .023, CS0 as a reference), along with extensive stage (p < .001), supportive care only (p < .001) and an elevated lactate dehydrogenase (p = .005). CT-determined CSs, based on the presence of sarcopenia and/or adipopenia, could be used to predict prognosis in male SCLC.
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Affiliation(s)
- E Y Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - H Y Lee
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Y S Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - I Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - H K Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - E K Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Y M Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - J H Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
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Kim EY, Kim K, Kim YS, Ahn HK, Jeong YM, Kim JH, Choi WJ. Prevalence of and Factors Associated with Sarcopenia in Korean Cancer Survivors: Based on Data Obtained by the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2011. Nutr Cancer 2017; 69:394-401. [DOI: 10.1080/01635581.2017.1267776] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Kirang Kim
- Department of Food Science and Nutrition, Dankook University, Cheonan, Chungnam, Republic of Korea
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Kim EY, Kim N, Kim YS, Seo JY, Park I, Ahn HK, Jeong YM, Kim JH. Prognostic Significance of Modified Advanced Lung Cancer Inflammation Index (ALI) in Patients with Small Cell Lung Cancer_ Comparison with Original ALI. PLoS One 2016; 11:e0164056. [PMID: 27706243 PMCID: PMC5051688 DOI: 10.1371/journal.pone.0164056] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [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: 06/13/2016] [Accepted: 09/19/2016] [Indexed: 02/07/2023] Open
Abstract
Background Advanced lung cancer inflammation index (ALI, body mass index [BMI] x serum albumin/neutrophil-lymphocyte ratio [NLR]) has been shown to predict overall survival (OS) in small cell lung cancer (SCLC). CT enables skeletal muscle to be quantified, whereas BMI cannot accurately reflect body composition. The purpose was to evaluate prognostic value of modified ALI (mALI) using CT-determined L3 muscle index (L3MI, muscle area at L3/height2) beyond original ALI. Methods L3MIs were calculated using the CT images of 186 consecutive patients with SCLC taken at diagnosis, and mALI was defined as L3MI x serum albumin/NLR. Using chi-squared test determined maximum cut-offs for low ALI and low mALI, the prognostic values of low ALI and low mALI were tested using Kaplan-Meier method and Cox proportional hazards analysis. Finally, deviance statistics was used to test whether the goodness of fit of the prognostic model is improved by adding mALI as an extra variable. Results Patients with low ALI (cut-off, 31.1, n = 94) had shorter OS than patients with high ALI (median, 6.8 months vs. 15.8 months; p < 0.001), and patients with low mALI (cut-off 67.7, n = 94) had shorter OS than patients with high mALI (median, 6.8 months vs. 16.5 months; p < 0.001). There was no significant difference in estimates of median survival time between low ALI and low mALI (z = 0.000, p = 1.000) and between high ALI and high mALI (z = 0.330, p = 0.740). Multivariable analysis showed that low ALI was an independent prognostic factor for shorter OS (HR, 1.67, p = 0.004), along with advanced age (HR, 1.49, p = 0.045), extensive disease (HR, 2.27, p < 0.001), supportive care only (HR, 7.86, p < 0.001), and elevated LDH (HR, 1.45, p = 0.037). Furthermore, goodness of fit of this prognostic model was not significantly increased by adding mALI as an extra variable (LR difference = 2.220, p = 0.136). Conclusion The present study confirms mALI using CT-determined L3MI has no additional prognostic value beyond original ALI using BMI. ALI is a simple and useful prognostic indicator in SCLC.
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Affiliation(s)
- Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Nambeom Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Ja-Young Seo
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Inkeun Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Ahn SJ, Jeong YM, Lee BG, Sim JA, Choi HY, Kim JH, Lee SW. Using three-dimensional isotropic SPACE MRI to detect posterolateral corner injury of the knee. Acta Radiol 2016; 57:1251-60. [PMID: 26823457 DOI: 10.1177/0284185115626470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 06/10/2015] [Accepted: 11/26/2015] [Indexed: 01/14/2023]
Abstract
BACKGROUND Reliable magnetic resonance imaging (MRI) diagnosis is important in cases of posterolateral corner (PLC) injury due to the limitations of physical examination in patients with multi-ligament injury. PURPOSE To document the appearance of PLC of the knee on three-dimensional (3D) isotropic MR images, and to determine the significance of MRI findings in patients with confirmed posterolateral rotatory instability. MATERIAL AND METHODS Twenty-five patients that underwent surgery for posterolateral instability, and 25 individuals with normal MRI constituted the study cohort. The PLC appearances (popliteofibular, fabellofibular, arcuate ligaments, popliteomeniscal fascicle) were analyzed using 3D isotropic proton density sequence and routine two-dimensional (2D) MRI. In addition, the "fibular cap" sign was evaluated. Statistical analysis was performed using the Chi-square and McNemar's tests. RESULTS Thickening of popliteofibular, fabellofibular, arcuate ligaments, and popliteomeniscal fascicle was significantly more frequent in the PLC injury group than in the control group (P < 0.05). The sensitivity and specificity of 3D MRI for popliteofibular, fabellofibular, arcuate ligaments, and popliteomeniscal fascicle injury were 63/92%, 54/100%, 46/100%, and 58/92%, respectively. On comparing 3D and 2D images with respect to injury detectability (grade 3 or 4), both modalities visualized injuries, but 3D detected grade 3 or grade 1 rather than grade 4 or 0, respectively. The fibular cap sign was observed significantly more frequently in PLC group, with 58% sensitivity and 100% specificity, and was better observed by 3D than 2D (P < 0.05). CONCLUSION 3D MRI is a valid modality for detecting PLC abnormalities as it visualizes pathologies in each component and exhibits the positive fibular cap sign.
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Affiliation(s)
- Su Joa Ahn
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Beom Goo Lee
- Department of Orthopedics, Gachon University, Incheon, Republic of Korea
| | - Jae Ang Sim
- Department of Orthopedics, Gachon University, Incheon, Republic of Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University, Incheon, Republic of Korea
| | - Sheen-Woo Lee
- Department of Radiology, Gachon University, Incheon, Republic of Korea
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Kim YS, Kim EY, Ahn HK, Cho EK, Jeong YM, Kim JH. Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer. J Thorac Dis 2016; 8:1966-73. [PMID: 27621848 DOI: 10.21037/jtd.2016.06.70] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/06/2022]
Abstract
BACKGROUND Although emphysema is a known independent risk factor of lung cancer, no study has addressed the prognostic impact of computed tomography (CT)-emphysema score in advanced stage lung cancer. METHODS For 84 consecutive patients with stage IIIB and IV squamous cell lung cancer that underwent palliative chemotherapy, severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system (possible scores range, 0-24). The cutoff of high CT-emphysema score was determined using the maximum chi-squared test and the prognostic significance of the high CT-emphysema score was evaluated using Kaplan-Meier analysis and Cox proportional hazards analysis. RESULTS The median CT-emphysema score was 5 (range, 0-22). Patients with a high CT-emphysema score (≥4) tended to have poorer overall survival (OS) (median: 6.3 vs. 13.7 months) than those with a score of <4 (P=0.071). Multivariable analysis revealed that a higher CT-emphysema score was a significant independent prognostic factor for poor OS [hazard ratio (HR) =2.06; 95% confidence interval (CI), 1.24-3.41; P=0.005), along with no response to first-line therapy (P=0.009) and no second-line therapy (P<0.001). CONCLUSIONS CT-emphysema score is significantly associated with poor prognosis in patients with advanced squamous cell lung cancer.
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Affiliation(s)
- Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Kim EY, Kim YS, Seo JY, Park I, Ahn HK, Jeong YM, Kim JH, Kim N. The Relationship between Sarcopenia and Systemic Inflammatory Response for Cancer Cachexia in Small Cell Lung Cancer. PLoS One 2016; 11:e0161125. [PMID: 27537502 PMCID: PMC4990336 DOI: 10.1371/journal.pone.0161125] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 03/17/2016] [Accepted: 07/30/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The prognostic significance of sarcopenia, an important component of cancer cachexia, has been demonstrated in oncologic patients. Catabolic drivers have been suggested to be key features of cancer cachexia. OBJECTIVE To determine the relationship between systemic inflammatory markers and CT-determined muscle mass in patients with SCLC. METHODS Cross-sectional muscle areas were evaluated at the level of the third lumbar vertebra (L3) using baseline CT images in 186 SCLC patients. Sarcopenia was defined as a L3 muscle index (L3MI, muscle area at L3/height2) of < 55 cm2/m2 for men and of < 39 cm2/m2 for women. Systemic inflammatory markers investigated included serum white blood cell count (WBC), neutrophil: lymphocyte ratio (NLR), C-reactive protein (CRP), and albumin. RESULTS Mean L3MI was 47.9 ± 9.7 cm2/m2 for men and 41.6 ± 7.0 cm2/m2 for women. Sarcopenia was present in 128 patients (68.8%), and sarcopenic patients had significant serum lymphocyte counts and albumin levels (p = 0.002 and 0.041, respectively), and higher NLRs and CRP levels (p = 0.011 and 0.026) than non-sarcopenic patients. Multivariable analysis revealed that CRP independently predicted L3MI (β = -0.208; 95% CI, -0.415 to -0.002; p = 0.048), along with gender and BMI (p values < 0.001) and performance status (p = 0.010). CONCLUSION The present study confirms a significant linear relationship exists between CT-determined muscle mass and CRP in SCLC patients. This association might provide a better understanding of the mechanism of cancer cachexia.
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Affiliation(s)
- Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- * E-mail:
| | - Ja-Young Seo
- Department of Laboratory Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Inkeun Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Nambeom Kim
- Neuroscience Research Institute, Gachon University, Incheon, South Korea
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Hyung Ann J, Young Kim E, Mi Jeong Y, Ho Kim J, Sik Kim H, Choi HY. Morphologic Evaluation of Ductus Diverticulum Using Multi - Detector Computed Tomography: Comparison with Traumatic Pseudoaneurysm of the Aortic Isthmus. Iran J Radiol 2016; 13:e38016. [PMID: 27895881 PMCID: PMC5118843 DOI: 10.5812/iranjradiol.38016] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/10/2016] [Accepted: 05/19/2016] [Indexed: 11/25/2022]
Abstract
Objectives To evaluate morphologic variations at the aortic isthmus with particular attention to ductus diverticulum, a mimicker of traumatic pseudoaneurysm, and to describe differences using Computed Tomography (CT) images. Patients and Methods From December 2013 to December 2014, patients who underwent a chest CT examination after blunt trauma at our emergency department were included. Aortic isthmus morphologies were evaluated using multiplanar reconstruction (MPR) and maximum intensity projection (MIP) images as follows. Type I -concave contour, type II -convexity without a discrete bulge, or type III -a discrete focal bulge (defined as ductus diverticulum). Results After excluding 11 cases of traumatic pseudoaneurysm of the aortic isthmus, a total of 432 trauma patients (mean age = 47.1 ± 19.1 years, number of males = 318) were evaluated for aortic isthmus morphology, and classified as follows; type I (n = 240, 55.6%), type II (n = 157, 36.3%), and type III (n = 35, 8.1%). As compared with traumatic pseudoaneurysm (n = 11), ductus diverticulum had a smaller vertical diameter (5.5 ± 1.3 mm vs. 11.2 ± 2.7 mm, P < 0.001), a broader base (14.9 ± 4.1 mm vs. 8.8 ± 4.5 mm, P < 0.001), a smoother margin (97.1% vs. 27.3%, P < 0.001), and formed obtuse angle with the aortic wall. Furthermore, ductus diverticulum was not associated with the presence of a dissection flap or hemomediastinum. Conclusion Ductus diverticulum, a mimicker of traumatic pseudoaneurysm of the aortic isthmus, is a frequently observed anatomic variant during CT examinations. Familiarity with its CT imaging findings could avoid it being confused with traumatic pseudoaneurysm in blunt trauma patients.
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Affiliation(s)
- Jun Hyung Ann
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Corresponding author: Eun Young Kim, Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea. Tel: +82-324603060, Fax: +82-324603065, E-mail:
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hyung Sik Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Kim EY, Kim YS, Park I, Ahn HK, Cho EK, Jeong YM, Kim JH. Evaluation of sarcopenia in small-cell lung cancer patients by routine chest CT. Support Care Cancer 2016; 24:4721-6. [PMID: 27364150 DOI: 10.1007/s00520-016-3321-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 06/20/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Single cross-sectional area of muscle at the third lumbar vertebra (L3MA) is gold standard to estimate skeletal muscle mass (SMM), and L3 muscle index (L3MI, L3MA/height(2)) is used to determine sarcopenia. The purposes of this study were to evaluate the relationship between SMM indices determined by routine chest CT and L3MI in patients with small-cell lung cancer (SCLC) and to suggest chest CT-derived diagnostic criteria for sarcopenia. METHODS Area of pectoralis muscles at the aortic arch (PMA) and at L1 (L1MA) was retrospectively measured on chest CT images of 90 consecutive SCLC patients. Pearson's correlation and multiple linear regression analysis were used to assess relationships between L3MI determined by PET/CT and pectoralis muscle index (PMI) and L1 muscle index (L1MI) determined by chest CT. RESULTS The correlation between L1MI and L3MI was stronger than that between PMI and L3MI (r = 0.851 vs. r = 0.447, p < 0.001). Multivariable regression analysis showed that L1MI was the only significant predictor of L3MI; L3MI = 0.963 × L1MI + 10.336 (R (2) = 0.689, p < 0.001) for male and L3MI = 0.772 × L1MI + 16.518 (R (2) = 0.777, p < 0.001) for female. Using this relationship, estimated cutoffs of L1MI for sarcopenia were 46 cm(2)/m(2) for male and 29 cm(2)/m(2) for female (L3MI cutoffs for sarcopenia are 55 cm(2)/m(2) for male and 39 cm(2)/m(2) for female). The sensitivity and specificity of L1MI cutoffs to determine sarcopenia were 98.2 and 100 %, respectively. CONCLUSIONS Chest CT-determined L1MI is highly correlated with L3MI in SCLC patients. L1MI, as determined by chest CT, could be used to determine the presence of sarcopenia with suggested cutoffs of 46 cm(2)/m(2) for men and 29 cm(2)/m(2) for women.
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Affiliation(s)
- Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Young Saing Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
| | - Inkeun Park
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Hee Kyung Ahn
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Eun Kyung Cho
- Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
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Lee MK, Kim EY, Jeong YM, Kim JH, Choi HY. Paratracheal air cysts are uncommon findings in the pediatric population. Jpn J Radiol 2016; 34:579-84. [PMID: 27314683 DOI: 10.1007/s11604-016-0561-3] [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] [Received: 04/14/2016] [Accepted: 06/06/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE To determine the prevalence of paratracheal air cysts (PACs) in the pediatric population. METHODS The chest CT images of pediatric patients between July 2007 and December 2014 were retrospectively reviewed for the presence and imaging findings of PACs. In addition, the association between PACs and the presence of bronchiectasis and air cystic pulmonary lesions were evaluated. RESULTS Among a total of 819 pediatric patients (males = 527, 64.3 %), the overall prevalence of PACs was 1.3 % (n = 11; 1.7 % for infants, 0.4 % for children, and 1.9 % for adolescents). The presence of PACs showed no association with gender, age groups, or the presence of bronchiectasis and air cystic pulmonary lesions (P = 0.56, 0.88, 0.57 and 0.89, respectively). All PACs were located at the right side of the trachea at the thoracic inlet, and the median transverse diameter was 3.7 mm (range 2.0-7.0 mm); one PAC showed septation, and 27.3 % of PACs had communication with the trachea. CONCLUSION In the pediatric population, the prevalence of PACs is 1.3 % as detected by chest CT. Knowledge of the prevalence and imaging findings of PAC would be useful to prevent confusion with pneumomediastinum or other cystic lesions in pediatric patients.
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Affiliation(s)
- Min Kyung Lee
- Department of Radiology, Gachon University Gil Hospital, #1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Hospital, #1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea.
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Hospital, #1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Jeong Ho Kim
- Department of Radiology, Gachon University Gil Hospital, #1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University Gil Hospital, #1198, Guwol-dong, Namdong-gu, Incheon, 405-760, Republic of Korea
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Choi ST, Park HS, Lee YH, Jeong YM, Kim EY, Park JH, Chung DH, Lee SP, Lee SM. A thrombotic primary venous aneurysm of an upper extremity causing pulmonary emboli after it was squeezed. Ann Vasc Surg 2015; 29:836.e9-13. [PMID: 25681173 DOI: 10.1016/j.avsg.2014.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/01/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
Abstract
A 27-year-old Korean male complained of chest pain and dyspnea that began after he had squeezed a mass on the medial side of his right upper arm. Computed tomography angiography and venous Doppler ultrasonography revealed a right basilic vein aneurysm with an organized thrombosis causing pulmonary emboli. After 1 month of anticoagulation, the aneurysm was ligated and resected. During the operation, multiple venous aneurysms filled with organized thrombi were observed. This is the first reported case of a thrombotic primary venous aneurysm of an upper extremity causing pulmonary emboli after it was squeezed.
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Affiliation(s)
- Sang Tae Choi
- Division of Vascular Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Hong Seok Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yeon Hee Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Eun Young Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jae Hyung Park
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Dong Hae Chung
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Sang Pyo Lee
- Division of Pulmonary and Allergy Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Sang Min Lee
- Division of Pulmonary and Allergy Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
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Han SB, Kwon SS, Jeong YM, Yu ER, Park SN. Physical characterization and in vitro skin permeation of solid lipid nanoparticles for transdermal delivery of quercetin. Int J Cosmet Sci 2014; 36:588-97. [PMID: 25220288 DOI: 10.1111/ics.12160] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [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: 06/18/2014] [Accepted: 08/22/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Quercetin, a phenolic compound isolated from plants, can act as an antioxidant to protect the skin from oxidative stress induced by ultraviolet rays. The aims of this work were (i) to compare the physical characterization of quercetin-loaded solid lipid nanoparticles (QSLNs) and (ii) to investigate the enhanced skin permeation of quercetin using QSLNs. METHODS QSLNs were prepared with a certain amount lipid (palmitic acid) and the different ratio of surfactant (Tween(®) 80) by homogenization and ultrasonification method. RESULTS QSLNs showed mono-dispersed particle size distribution in the ranges of 274.0-986.6 nm and zeta potential from -50.4 to -29.4 mV. Entrapment efficiency of QSLN was 15.2-46.2%, and their crystallinity index was low (0-18.2%). In vitro occlusion test showed QSLN-2 has the highest occlusive effect due to its smallest particle size (274.0 nm), and through these result, QSLN-2 was selected as the optimum formulation. Transmission electron microscopy (TEM) analysis further confirmed the uniform spherical shape of QSLN-2 particles. Field emission-scanning electron microscope (FE-SEM) analysis and histological observation of hairless rat skin showed that the lipid particles of QSLN-2 formed a fused lipid film and, subsequently, it hydrated the surface of the rat skin. Franz diffusion cell was used to measure in vitro skin permeation of quercetin dissolved in propylene glycol (QPG), QSLN-2 and QSLN-3. The results showed that QSLN-2 (33.5 μg cm(-2) , 21.9%) exhibited higher skin permeability than QPG (6.6 μg cm(-2) , 4.2%) and QSLN-3 (14.2 μg cm(-2) , 9.1%), which was visually confirmed by confocal laser scanning microscope (CLSM) image analysis as well. CONCLUSION The results suggest that QSLN-2, prepared with a surfactant content of 2%, could be used as useful skin delivery system for transdermal delivery of hydrophobic antioxidants such as quercetin.
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Affiliation(s)
- S B Han
- Department of Fine Chemistry, Nanobiocosmetic Laboratory, and Cosmetic R&D Center, Seoul National University of Science and Technology, 232 Gongneung-ro, Nowon-gu, Seoul, 139-743, Korea
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Park SH, Jeong YM, Cho SH, Jung HK, Kim SJ, Ryu HS. Imaging findings of variable axillary mass and axillary lymphadenopathy. Ultrasound Med Biol 2014; 40:1934-1948. [PMID: 24948395 DOI: 10.1016/j.ultrasmedbio.2014.02.019] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 01/17/2014] [Accepted: 02/12/2014] [Indexed: 06/03/2023]
Abstract
The axilla is a triangular space that contains mesenchymal tissues such as fat, vessels, nerves and lymph nodes, from which various diseases can develop. This article describes axillary masses and axillary lymphadenopathies using imaging findings from techniques such as ultrasonography, mammography, computed tomography and magnetic resonance imaging. Awareness of the characteristic imaging findings of disease entities that cause axillary masses and various axillary lymphadenopathies will help in the accurate diagnosis of axillary lesions.
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Affiliation(s)
- Sung Hee Park
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Hospital, Incheon, Korea
| | - So Hyun Cho
- Department of Radiology, Gachon University Gil Hospital, Incheon, Korea
| | - Hyun Kyung Jung
- Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Soo Jin Kim
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
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Lee HM, Jeong YM, Park SH. Sparganosis of upper extremity in subcutaneous and intramuscular layers. Ultraschall Med 2014; 35:279-281. [PMID: 23860855 DOI: 10.1055/s-0033-1350134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
BACKGROUND Colorectal cancer is a leading cause of cancer morbidity and mortality worldwide. Knowledge of colorectal cancer tumor growth is of importance for basic understanding of tumor biology and for the clinical handling of the disease. PURPOSE To conduct a retrospective evaluation of the growth pattern of colorectal cancer by multidetector computed tomography (MDCT). MATERIAL AND METHODS Pathologically proven adenocarcinomas of the colon and rectum in 44 patients were examined by MDCT on at least two separate occasions with an interval of >1 month in patients not receiving therapy. Maximal longitudinal diameters, wall thicknesses, and volume changes, as determined by serial CT scans, were used in calculation of growth rates. RESULTS Mean longitudinal diameters of tumors at initial and follow-up investigations were 3.8 cm (1.0-9.1 cm) and 5.4 cm (2.5-12.2 cm), respectively. The mean growth rate of longitudinal tumor diameter was 3.4 cm/year (0-13.8 cm/year). Mean axial wall thicknesses at initial and follow-up investigations were 1.4 cm (0.6-6.6 cm) and 1.9 cm (0.8-6.8 cm), respectively. Mean growth rate of tumor axial wall thickness was 1.0 cm/year (0-3.1 cm/year). Mean tumor volumes at initial and follow-up investigations were 1975 cm(3) (172-9756 cm(3); median, 1490) and 3545 cm(3) (442-15211 cm(3); median, 2846), respectively. Mean growth rate of tumor volume was 2912 cm(3)/year (216-12548 cm(3)/year; median, 1698), and volume doubling times varied from 0.05 to 7.1 years (mean, 1.2; median, 0.7). Significant correlations were observed between initial wall thickness and volume growth rate (p = 0.004). No significant difference was observed between other initial tumor size and growth rate. CONCLUSION The tumor growth doubling time of colorectal cancer has a very broad aspect. The initial wall thickness of the tumor on MDCT appears to be the most powerful parameter showing correlation with the volume growth rate.
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Affiliation(s)
- Seung Joon Choi
- Department of Radiology, Gachon University Gil Hospital Incheon, Korea
| | - Hyung-Sik Kim
- Department of Radiology, Gachon University Gil Hospital Incheon, Korea
| | - Su-Joa Ahn
- Department of Radiology, Gachon University Gil Hospital Incheon, Korea
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Hospital Incheon, Korea
| | - Hye-Young Choi
- Department of Radiology, Gachon University Gil Hospital Incheon, Korea
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Jeong YM, Cho HY, Lee SW, Hwang YM, Kim YK. Candida septic arthritis with rice body formation: a case report and review of literature. Korean J Radiol 2013; 14:465-9. [PMID: 23690715 PMCID: PMC3655302 DOI: 10.3348/kjr.2013.14.3.465] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [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: 12/08/2012] [Accepted: 02/06/2013] [Indexed: 11/15/2022] Open
Abstract
Rice body formation in a joint or bursa is a rare condition, and is usually associated with rheumatoid arthritis or tuberculous arthritis. Here we describe a case of multiple rice body formation in a shoulder joint and in adjacent bursae, which was confirmed to be due to septic arthritis by Candida species. To the best of our knowledge, rice body formation in Candida septic arthritis in an immune-competent patient has not been previously reported.
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Affiliation(s)
- Yu Mi Jeong
- Department of Radiology, Gachon University, Gil Hospital, Incheon 405-760, Korea.
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Abstract
The high signal intensities in bilateral mesiotemporal lobes on T2-weighted images are typical findings of herpes encephalitis or paraneoplastic limbic encephalitis. We report a case of neurosyphilis with mesiotemporal involvement on MRI. Positive antibodies in the cerebrospinal fluid confirmed the diagnosis. The results suggest that neurosyphilis should be considered when MRI results indicate mesiotemporal abnormalities.
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Affiliation(s)
- Yu Mi Jeong
- Department of Radiology, Gachon University, Gil Medical Center, Namdong-Gu, Incheon, Korea
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Cha BK, Choi JI, Jost-Brinkmann PG, Jeong YM. Applications of three-dimensionally scanned models in orthodontics. Int J Comput Dent 2007; 10:41-52. [PMID: 17455767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The purpose of this study was to investigate clinical applications of the three-dimensional reverse engineering technologies for the analysis of orthodontic models. The measuring accuracy and the process of the 3D model scanning technique were evaluated with respect to linear, surface and volumetric parameters. Orthodontically induced dentoalveolar changes, which have been traditionally evaluated by cephalometric analysis, were assessed by the registration function of Rapidform 2002, a 3D-reverse modeling software in scanned maxillary casts. Three-dimensional digital models are valuable alternatives to conventional casts for model analysis and also yield information which could previously be gathered only by cephalometric superimposition.
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Affiliation(s)
- B K Cha
- Department of Orthodontics, College of Dentistry, Kangnung National University, Gangneung, South Korea.
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Ghim SY, Choi SK, Shin BS, Jeong YM, Sorokin A, Ehrlich SD, Park SH. Sequence analysis of the Bacillus subtilis 168 chromosome region between the sspC and odhA loci (184 degrees-180 degrees). DNA Res 1998; 5:195-201. [PMID: 9734814 DOI: 10.1093/dnares/5.3.195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The nucleotide sequence of 45,389 bp in the 184 degrees-180 degrees region of the Bacillus subtilis chromosome, containing the cge cluster, which is controlled by the sporulation regulatory protein GerE, was determined. Fifty-four putative ORFs with putative ribosome-binding sites were recognized. Seven of them correspond to previously characterized genes: cgeB, cgeA, cgeC, cgeD, cgeE, ctpA, and odhA. The deduced products of 25 ORFs were found to display significant similarities to proteins in the data banks. We have identified genes involved in detoxification, cell walls, and in the metabolism of biotins, purines, fatty acids, carbohydrates and amino acids. The remaining 22 ORFs showed no similarity to known proteins. Both an attachment site of the SPbeta prophage and 2 new putative DNA replication terminators were identified in this region.
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Affiliation(s)
- S Y Ghim
- Bacterial Molecular Genetics RU, Korea Research Institute of Bioscience and Biotechnology, Yusong, Taejon
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Lim JH, Jeong YM. Sonography of the stomach: an in vitro study to determine the anatomic cause of inner hyperechoic and hypoechoic layers of the gastric wall. AJR Am J Roentgenol 1994; 162:335-8. [PMID: 8310921 DOI: 10.2214/ajr.162.2.8310921] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Sonography of the normal gastric wall delineates five distinct layers: from the luminal side, a first, inner hyperechoic layer; a second, hypoechoic layer; a third, middle hyperechoic layer; a fourth, hypoechoic layer; and a final, outer hyperechoic layer. The anatomic origin of the inner two sonographic layers has been a matter of controversy. To verify the histologic origin of the inner two sonographic layers, we attempted to correlate sonographic and histologic layers of resected gastric specimens. Because we hypothesized that the fluid covering the mucosa and the mucosa may be responsible for the sonographic inner two layers of the stomach, we selected specimens in which the mucosa was sloughed or thickened. MATERIALS AND METHODS We selected five resected gastric specimens with ulcerative carcinoma in which the mucosa was totally sloughed, one specimen with a mucosal polyp, and two specimens with a polypoid lesion and partial surface ulceration. The gastric specimens were immersed in normal saline and examined with 5-MHz high-resolution sonographic equipment. Sonographic findings were correlated with gross and microscopic pathologic findings. Two phantoms were immersed in normal saline and examined with the same technique to evaluate the thickness of the sonographic interface between water and phantoms. RESULTS The inner hyperechoic layer was constant in thickness, measuring 1 mm, and covered the surface of the normal areas and the areas where the mucosa was lost or thickened. The hypoechoic layer underlying the hyperechoic layer was obliterated where the mucosa was defective and thickened where the mucosa was thickened. The sonographic interface between water and phantoms was 1 mm thick. CONCLUSION Our results show that the inner hyperechoic layer of the stomach seen on sonograms is due to echoes arising from the interface between fluid in the gastric lumen and the mucosal surface. The underlying hypoechoic layer is caused by the mucosa itself.
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Affiliation(s)
- J H Lim
- Department of Diagnostic Radiology, Kyung Hee University Hospital, Seoul, Korea
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