Purpose: To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods: Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results: Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.

Purpose: To design a scoring system to predict malignancy of additional MRI-detected lesions in breast cancer patients. Materials and Methods: Eighty-six lesions (64 benign and 22 malignant) detected on preoperative MRI of 68 breast cancer patients were retrospectively included. The clinico-radiologic features were correlated with the histopathologic results using the Student's t-test, Fisher's exact test, and logistic regression analysis. The scoring system was designed based on the significant predictive features of malignancy, and its diagnostic performance was compared with that of the Breast Imaging-Reporting and Data System (BI-RADS) category. Results: Lesion size ≥ 8 mm (p < 0.001), location in the same quadrant as the primary cancer (p = 0.005), delayed plateau kinetics (p = 0.010), T2 isointense (p = 0.034) and hypointense (p = 0.024) signals, and irregular mass shape (p = 0.028) were associated with malignancy. In comparison with the BI-RADS category, the scoring system based on these features with suspicious non-mass internal enhancement increased the diagnostic performance (area under the receiver operating characteristic curve: 0.918 vs. 0.727) and detected three false-negative cases. With this scoring system, 22 second-look ultrasound examinations (22/66, 33.3%) could have been avoided. Conclusion The scoring system based on the lesion size, location relative to the primary cancer, delayed kinetic features, T2 signal intensity, mass shape, and non-mass internal enhancement can provide a more accurate approach to evaluate MRI-detected lesions in breast cancer patients.

A Statistical observations were done on 587 pediatric patients who were diagnosed as having congenital heart disease by cardiac catheterization angiography and operation at Dong San Hospital Keimyung University, during the period of January 1982 to june 1987. The results were as follows 1) Out of 587 patients, 317 cases were male and 276 cases were female. There were female preponderance in atrial septal defect and patent ductus arteriosus, whille in male tetralogy of Fallot, pulmonary stenosis, and ventricular septal defect. 2) The incidence of congenital heart disease were as folliws;ventricular septal defect 35.7% tetralogy of Fallot 17.5%, patient ductus arteriousus 13.9%, arterial septal defect 7.5% and pulmonary stenosis 2.9%. 3) Most of the patients were visited hospital for the first time between the age of 2 and 10 years. 4) Assosiated anomalies of major congenital heart disease were as follows:the most commonly associated anomaly in ventricular septal defect were pulmonary stenosis and patent ductus arteriosus. Pulmonary stenosis was frequently associated with atrial septal defect. Right sided aortic arch and pentalogy were assosiated with tetralogy of Fallot. The mitral regurgitation was associated with patent ductus arteriosus mostly. 5) The overall surgical mortality was 6.8%. The mortality was high in tetralogy of Fallot(16.1%), transposition of great vessels(28.5%).
Angiography ; Aorta, Thoracic ; Cardiac Catheterization ; Cardiac Catheters ; Ductus Arteriosus, Patent ; Female ; Heart Defects, Congenital* ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Incidence ; Male ; Mitral Valve Insufficiency ; Mortality ; Pulmonary Valve Stenosis ; Statistics as Topic* ; Tetralogy of Fallot

We describe a case of infrarenal aortic hypoplasia in a 52-yr-old woman who presented with claudication. Computed tomographic angiography revealed an abrupt absence of the infrarenal aorta, with collateral flow reconstituting the iliofemoral systems. After a polytetrafluoroethylene graft was interposed between the aortic stump and the iliac bifurcation, the patient's claudication resolved.

PURPOSE: To investigate the clinical characteristics of patients with pseudophakic negative dysphotopsia after cataract surgery and to analyze the risk factors of pseudophakic negative dysphotopsia as well as the postoperative effects on patient's satisfaction. METHODS: This study included 1,020 eyes of 690 patients who underwent phacoemulsification and posterior chamber lens insertion between January 2010 and March 2012. Retrospective chart review was conducted to evaluate the prevalence of negative dysphotopsia according to the site of clear corneal incision during cataract surgery and the type of implanted intraocular lens (IOL). The clinical outcome of Neodymium:yttrium-aluminium-garnet (Nd:YAG) laser anterior capsulotomy in negative dysphotopsia patients was evaluated. Using a telephone survey, patients were asked to subjectively answer 18 questions regarding satisfaction after cataract surgery, the severity of visual symptoms and the effect of negative dysphotopsia in their daily life. RESULTS: Negative dysphotopsia developed in patients who underwent uneventful cataract surgery and successful implantation of IOL in the bag. The patients' vision was corrected up to 20/20 (0.00 log MAR) and HVF P60-4 showed no abnormality in their visual field. There were significantly more patients with the SN60WF IOL who reported negative dysphotopsia but no other factors associated with the prevalence of negative dysphotopsia. During the telephone survey, patients complained of difficulties in their daily life related to the negative dysphotopsia symptoms and reported decreased satisfaction after cataract surgery. CONCLUSIONS: Although negative dysphotopsia can decrease the patient's satisfaction after cataract surgery, the genesis of negative dysphotopsia and an objective method to test for negative dysphotopsia is necessary. Therefore, a prospective large study should be conducted to evaluate the cause and treatment of negative dysphotopsia.
Cataract ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Prevalence ; Pseudophakia ; Retrospective Studies ; Risk Factors ; Telephone ; Visual Fields

PURPOSE: To investigate the clinical characteristics of patients with pseudophakic negative dysphotopsia after cataract surgery and to analyze the risk factors of pseudophakic negative dysphotopsia as well as the postoperative effects on patient's satisfaction. METHODS: This study included 1,020 eyes of 690 patients who underwent phacoemulsification and posterior chamber lens insertion between January 2010 and March 2012. Retrospective chart review was conducted to evaluate the prevalence of negative dysphotopsia according to the site of clear corneal incision during cataract surgery and the type of implanted intraocular lens (IOL). The clinical outcome of Neodymium:yttrium-aluminium-garnet (Nd:YAG) laser anterior capsulotomy in negative dysphotopsia patients was evaluated. Using a telephone survey, patients were asked to subjectively answer 18 questions regarding satisfaction after cataract surgery, the severity of visual symptoms and the effect of negative dysphotopsia in their daily life. RESULTS: Negative dysphotopsia developed in patients who underwent uneventful cataract surgery and successful implantation of IOL in the bag. The patients' vision was corrected up to 20/20 (0.00 log MAR) and HVF P60-4 showed no abnormality in their visual field. There were significantly more patients with the SN60WF IOL who reported negative dysphotopsia but no other factors associated with the prevalence of negative dysphotopsia. During the telephone survey, patients complained of difficulties in their daily life related to the negative dysphotopsia symptoms and reported decreased satisfaction after cataract surgery. CONCLUSIONS: Although negative dysphotopsia can decrease the patient's satisfaction after cataract surgery, the genesis of negative dysphotopsia and an objective method to test for negative dysphotopsia is necessary. Therefore, a prospective large study should be conducted to evaluate the cause and treatment of negative dysphotopsia.
Cataract ; Humans ; Lenses, Intraocular ; Phacoemulsification ; Prevalence ; Pseudophakia ; Retrospective Studies ; Risk Factors ; Telephone ; Visual Fields

PURPOSE: To evaluate the magnetic resonance imaging (MRI) findings to improve the diagnostic accuracy for transverse process fractures and sacral fractures. MATERIALS AND METHODS: The lumbosacral MRI scans of 214 patients (mean age, 60 years; male-to-female ratio, 85:129), who had spine trauma between January and November 2015 were included. Two radiologists evaluated the presence, number, level, and anatomic site of the fractures on MRI with computed tomography as reference standard. Imaging findings were described as cortical disruption, marrow edema, or soft tissue edema on T1-, T2-, and fat-suppressed T2-weighted images. A statistical analysis was performed to compare the diagnostic accuracy of the MRI pulse sequences for the transverse process and sacral fractures. RESULTS: Of 168 fractures, 26 (15.5%) and 13 (4.9%) were in the transverse processes and sacra, respectively. A paravertebral soft tissue edema occurred in the transverse process fractures (80.8%) and presacral soft tissue and marrow edemas occurred in the sacral fractures (46.1%). The sensitivity for the transverse process fractures was 88% on the T2-weighted image. It was 92% on fat-suppressed T2- and T1-weighted images for sacral fractures. CONCLUSION Bone marrow and soft tissue edemas on the MRI could potentially improve the diagnostic accuracy of an MRI for fractures in the transverse process and sacrum.

BACKGROUND: The rheumatoid factor (RF) is the only serological marker in American College of Rheumatology criteria for the diagnosis of rheumatoid arthritis (RA), but its specificity is not satisfactory for the diagnosis of RA. We evaluated the diagnostic performance of a new anti-cyclic citrullinated peptide antibodies (anti-CCP) test with those of RF isotypes for the diagnosis of RA. METHODS: Anti-CCP was determined in 186 serum samples: 110 from RA patients, 30 from non-RA patients(rheumatic diseases other than RA), and 46 normal individuals. IgM RF by latex fixation test and IgA RF by ELISA were also assayed in each samples, and the results were compared to anti-CCP for sensitivity and specificity by the receiver-operating characteristic curve on optimal cut-off values. RESULTS: The sensitivity of anti-CCP was highest (80.0%) and the sensitivities of IgM RF, IgA RF were 71.8%, 45.5%, respectively. The sensitivity increased (from 80.0% to 88.2%) especially in the combination of anti-CCP with IgM RF. The specificity of IgA RF by ELISA were highest (96.0 %) and the specificity of anti-CCP (94.7%) was higher than that of IgM RF (71.4%). Anti-CCP was positive in 58.1% in 31 RA patients with negative IgM RF. CONCLUSIONS: The results said that the combination test of anti-CCP with IgM RF might be useful for the diagnosis of RA because of its higher sensitivity and specificity than IgM RF alone.
Antibodies* ; Arthritis, Rheumatoid* ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunoglobulin A ; Immunoglobulin M ; Latex Fixation Tests ; Rheumatoid Factor* ; Rheumatology ; Sensitivity and Specificity

As a material of metal-ceramic prosthesis, nickel as a form of Ni-Cr alloy has been used for many dental prostheses in many cases. However, several problems in use of the alloy have been revealed (ex ; tissue stimulation, skin allergy, hypersensitivity, cytotoxicity and carcinogenecity). Little is known about nickel with respect to the relationship between Ni-prosthesis and gaining of Ni-resistance in oral microorganisms. The present study was undertaken to check wheather use of Ni-prosthesis leads to occurrence of Ni-resistant microorganisms. So this study may suggest the possible relationships between the oral microorganisms and nickel-resistance in oral enviroment. Bacteria were isolated from the gingival crevicular fluid on the patients wearing Ni-Cr prosthesis. The isolated bacteria were tested for their Ni-resistance in nickel containing media at different concentration from 3mM to 110mM. E. coli HB101 was used as control. The Ni-resistant bacteria were isolated and biochemically identified. The Ni-resistant bacteria were tested several biochemical, molecular-biological tests. Performed tests were ; measuring the growth curve, antibiotic test, growth ability test in liquid media, isolation of the chromosome and plasmid, digestion of DNA by restriction enzyme, electrophoresis of chromosome and plasmid DNA, identification of Ni-resistant genes by the DNA hybridization. The results were as follows: 1) The bacteria isolated from gingival crevicular fluid on the patients wearing Ni-Cr alloy prosthesis showed nickel-resistance. 2) The isolated microorganisms grew at nickel containing media of high concentrations (60mM-110mM). 3) Based on the biochemical tests, the isolated microorganisms were identified as Enterococcus faecalis(13 cases), Klebsiella pneumoniae(1 case) and Enterobacter gergoviae(1 case). 4) Enterococcus faecalis expressed not only nickel resistance but also the multi-drug resistanceto several antibiotics ; chloramphenicol, kanamicin, streptomycin, lincomycin, clindamycin. However all strain showed the sensitivity against the tetracycline. 5) DNA hybridization result suggest that there is no homology between the previousely known gene of nickel resistance in Klebsiella pneumoniae and chromosomal DNA Enterococcus faecalis.
Alloys* ; Anti-Bacterial Agents ; Bacteria* ; Chloramphenicol ; Clindamycin ; Dental Prosthesis ; Digestion ; DNA ; Electrophoresis ; Enterobacter ; Enterococcus ; Enterococcus faecalis ; Gingival Crevicular Fluid* ; Humans ; Hypersensitivity ; Klebsiella ; Klebsiella pneumoniae ; Lincomycin ; Nickel ; Plasmids ; Prostheses and Implants* ; Skin ; Streptomycin ; Tetracycline

Background: The Advanced RBC Application of the CellaVision DM9600 system (CellaVision AB, Lund, Sweden) automatically characterizes and classifies red blood cells (RBCs) into 21 morphological categories based on their size, color, shape, and inclusions. We evaluated the diagnostic performance of the CellaVision Advanced RBC Application with respect to the classification and grading of RBC morphological abnormalities in accordance with the 2015 International Council for Standardization in Haematology (ICSH) guidelines. Methods: A total of 223 samples, including 123 with RBC morphological abnormalities and 100 from healthy controls, were included. Seven RBC morphological abnormalities and their grading obtained with CellaVision DM9600 pre- and post-classification were compared with the results obtained using manual microscopic examination. The grading cut-off percentages were determined in accordance with the 2015 ICSH guidelines. The sensitivity and specificity of the CellaVision DM9600 system were evaluated using the manual microscopic examination results as a true positive. Results: In pre-classification, > 90% sensitivity was observed for target cells, tear drop cells, and schistocytes, while > 90% specificity was observed for acanthocytes, spherocytes, target cells, and tear drop cells. In post-classification, the detection sensitivity and specificity of most RBC morphological abnormalities increased, except for schistocytes (sensitivity) and acanthocytes (specificity). The grade agreement rates ranged from 35.9% (echinocytes) to 89.7% (spherocytes) in pre-classification and from 46.2% (echinocytes) to 90.1% (spherocytes) in post-classification. The agreement rate of samples with withinone grade difference exceeded 90% in most categories, except for schistocytes and echinocytes. Conclusions The Advanced RBC Application of CellaVision DM9600 is a valuable screening tool for detecting RBC morphological abnormalities.