PURPOSE: To analyze and compare ultrasound pachymetry (USP) with a more recently adopted device, the intra ocular lens (IOL) master 700, which are both used to measure central corneal thickness. METHODS: The central corneal thickness was measured in 24 eyes of 12 glaucoma patients and in 83 eyes of 42 normal patients. First, the IOL master 700 was used to measure the central corneal thickness, followed by measurements taken using USP later. The results were analyzed using a paired t-test. We analyzed the agreement and the correlations between the two test devices by using Bland-Altman plots and the Pearson correlation test. To evaluate the reproducibility, measurements with the IOL master 700 were taken twice for a few normal patients within a small time interval. RESULTS: Via the IOL master 700, the thickness of the central cornea showed a high reproducibility and repeatability, demonstrating 2.7 ± 1.7 µm for the test-retest variability, 6.78% for the coefficient of variation, and 0.997 for the intraclass correlation value. The mean measurements using USP and the IOL master 700 are 554.4 ± 37.4 µm and 551.1 ± 37.1 µm, respectively, showing that the IOL master 700 measured significantly smaller values than USP with a p-value < 0.001. The deviations between the two methods are scattered throughout the 95% confidence interval. According to the Pearson correlation test, the measured values of the two test devices were found to have a highly positive correlation (r = 0.977, p < 0.0001). CONCLUSIONS: This study demonstrated that the central corneal thickness (CCT) measured via the IOL master was significantly thinner than that of USP, and the two test devices had a high correlation and good agreement. The CCT value measured via the IOL master 700 also exhibited high reproducibility.
Cornea ; Glaucoma ; Humans ; Tomography, Optical Coherence* ; Ultrasonography*

The dendriform pulmonary ossification (DPO) is a rare condition of unknown origin in which branching mature bony spicules, usually containing marrow, are found within the alveolar septa. DPO manifests slow progression over many years or may remain unchanged; spontaneous regression has not been recorded. Most patients have no symptoms directly attributed to the ossification, although they may have symptoms due to the underlying fibrotic process. We experienced a case of DPO in 38 year-old-man who presented with cough and sputum for a month. The chest X-ray showed marked coarsened interstitial lung markings in both lungs, especially in the lower lobes. Open lung biopsy was done. Grossly, there were significant dendriform osseous structures. Histologically, branching arrays of mature bone were found in the interstitium and occasionally in alveolar spaces. Some bony trabeculae contained fatty or cellular marrow. The alveolar septa showed fibrous thickening with chronic inflammation. The transition between fibrosis and bone tissue was observed. Our case suggests that dendriform pulmonary ossification may be a rare special manifestation of chronic fibrosing interstitial inflammation of the lung. Osseous structures seem to derive from metaplastic bone formation in the vicinity of undergoing fibrous process.
Biopsy ; Bone and Bones ; Bone Marrow ; Cough ; Fibrosis ; Humans ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Osteogenesis ; Sputum ; Thorax

Myofibrosarcoma of the breast is a rare malignant mesenchymal tumor that has been reported in only four well documented cases so far. We report a case of myofibrosarcoma of the breast in an 88-year-old man who complained of a palpable mass for 1 year. Microscopically, the tumor consisted mainly of spindled cells, arranged in irregular fascicles and embedded in broad bands of dense hyalinized collagen. It showed ill-defined border infiltrating the adjacent adipose tissue, moderate cellular pleomorphism, and high mitotic rate (8~9/10 HPF). Immunohistochemical study confirmed myofibroblastic differentiation of the tumor cells with diffuse strong reaction for vimentin, smooth muscle actin, and fibronectin.
Actins ; Adipose Tissue ; Aged, 80 and over ; Breast* ; Collagen ; Fibronectins ; Humans ; Hyalin ; Muscle, Smooth ; Myofibroblasts ; Vimentin

With regard to the indolent clinical characteristics of prostate cancer (PCa), the more selective detection of clinically significant PCa (CSC) has been emphasized in its diagnosis and management. Magnetic resonance imaging (MRI) has advanced technically, and recent international cooperation has provided a standardized imaging and reporting system for prostate MRI. Accordingly, prostate MRI has recently been investigated and utilized as a triage tool before biopsy to guide tissue sampling to increase the detection rate of CSC beyond the staging tool for patients in whom PCa was already confirmed on conventional systematic biopsy. Radiologists must understand the current paradigm shift for better PCa diagnosis and management. This article reviewed the recent literature, demonstrating the diagnostic value of pre-biopsy prostate MRI with targeted biopsy and discussed unsolved issues regarding the paradigm shift in the diagnosis of PCa.

No abstract available.
Incus* ; Malleus*

Gangliocytic paragangliomas are rare benign neuroendocrine tumors that arise mainly in the duodenum. A total of 3 cases of duodenal gangliocytic paraganglioma have been reported in Korea. The authors encountered another case of a gangliocytic paraganglioma in the duodenum. A 48-year old man presented with a mass in the duodenum that had been found incidentally in a medical checkup. The endoscopic examination revealed a 3.5x2.2 cm sized polypoid mass in the second portion of the duodenum. The patient underwent a polypectomy in the form of a wedge resection under general anesthesia. Microscopically, the tumor was composed of epithelial cells forming paraganglioma like patterns, spindle cells and ganglion cells. Gangliocytic paragangliomas are believed to be benign tumors but regional lymph node metastasis and recurrence can occur in rare cases. During the 27-month follow-up after treatment, there was no evidence of recurrence or lymph node metastasis. We report this case to help improve the understanding of this rare disease.
Anesthesia, General ; Duodenum* ; Epithelial Cells ; Follow-Up Studies ; Ganglion Cysts ; Humans ; Korea ; Lymph Nodes ; Middle Aged ; Neoplasm Metastasis ; Neuroendocrine Tumors ; Paraganglioma* ; Rare Diseases ; Recurrence

PURPOSE: In this study we compared the intraocular pressures (IOPs) measured using dynamic contour tonometry (DCT) and Goldmann applanation tonometry (GAT) and investigated the correlation between central corneal thickness (CCT) and IOP. METHODS: In a prospective study, 178 eyes of 91 subjects with glaucoma and glaucoma suspect were enrolled. IOP was measured using DCT and GAT and CCT was measured using ultrasound pachymetry. Each eye was classified into 1 of 3 groups according to their CCT: low CCT (Group A; CCT < 525 microm), normal CCT (Group B; 525 < or = CCT < 561 microm), and high CCT (Group C; CCT > or = 561 microm). In each group, we investigated the correlation between CCT and IOP measurement using GAT and DCT. RESULTS: A significant correlation was found between CCT and IOP measured using GAT (p < 0.001), but not between CCT and IOP measured using DCT (p = 0.108) in all patients. Subgroup analysis showed that CCT affected IOP measured with GAT only in Group A (p = 0.027) and IOP measured with DCT was not affected by CCT in all 3 groups. CONCLUSIONS: IOP measured using GAT and DCT were significantly affected by CCT, especially when the CCT was low. CCT may have no effect on DCT thus, IOP measured using DCT is more reliable than GAT in patients with thin corneas.
Cornea ; Glaucoma ; Humans ; Intraocular Pressure ; Manometry* ; Prospective Studies ; Ultrasonography

Purpose: Joint label fusion (JLF) is a popular multi-atlas-based segmentation algorithm, which compensates for dependent errors that may exist between atlases.However, in order to get good segmentation results, it is very important to set the several free parameters of the algorithm to optimal values. In this study, we first investigate the feasibility of a JLF algorithm for prostate segmentation in MR images, and then suggest the optimal set of parameters for the automatic prostate segmentation by validating the results of each parameter combination. Materials and Methods: We acquired T2-weighted prostate MR images from 20 normal heathy volunteers and did a series of cross validations for every set of parameters of JLF. In each case, the atlases were rigidly registered for the target image. Then, we calculated their voting weights for label fusion from each combination of JLF’s parameters (rpxy , rpz , rsxy , rsz , β). We evaluated the segmentation performances by five validation metrics of the Prostate MR Image Segmentation challenge. Results: As the number of voxels participating in the voting weight calculation and the number of referenced atlases is increased, the overall segmentation performance is gradually improved. The JLF algorithm showed the best results for dice similarity coefficient, 0.8495 ± 0.0392; relative volume difference, 15.2353 ± 17.2350; absolute relative volume difference, 18.8710 ± 13.1546; 95% Hausdorff distance, 7.2366 ± 1.8502; and average boundary distance, 2.2107 ± 0.4972; in parameters of rpxy = 10, rpz = 1, rsxy = 3, rsz = 1, and β = 3. Conclusion The evaluated results showed the feasibility of the JLF algorithm for automatic segmentation of prostate MRI. This empirical analysis of segmentation results by label fusion allows for the appropriate setting of parameters.

Primary aldosteronism is typically characterized by hypertension, hypokalemia, elevated plasma aldosterone concentration, and suppressed plasma renin activity. Surgieal excision of the tumor mostly cures hypertension as well as electrolyte and hormonal abnormalities in patient with aldosterone-producing adenoma. We have experienced the anesthetic management of unilateral adrenalectomy in a 32 years old male, who was diagnosed as aldosterone-producing adenoma, under the general anesthesia with careful monitoring. Postoperative recovery was uncomplicated.
Adenoma ; Adrenalectomy ; Adult ; Aldosterone ; Anesthesia, General ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Male ; Plasma ; Renin

n in 93 of the 112 tumors (83.0%), with pure cystic masses (types I-III) accounted for the remaining 19 tumors (17.1 %). Of the 112 tumors, 68 (67.1%) showed posterior sonic shadowing which was demonstrated only in the hyperechoic area of types IV-VI. CONCLUSION: Any adnexal masses representing a hyperechoic area within a cyst, solid and cystic tumors containing hyperechogenicity or diffusely hyperechoic mass, especially when accompanied by posterior sonic shadowing, should be suspected as indicative of mature cystic teratoma.
Diagnosis* ; Female ; Ovary* ; Shadowing (Histology) ; Teratoma*