PURPOSE: To evaluate the usefulness of magnetic resonance imaging (MRI) for assessing fracture types and soft tissue injuries associated with tibial plateau fractures. MATERIALS AND METHODS: MRI was performed in 38 patients with tibial plateau fractures, each of which was classified according to the Schatzker system. We evaluated MR images and assessed the prevalence of each fracture type and accompanying soft tissue injuries. We also assessed whether ligamentous injury correlated with the extent of articular depression, splitting, and comminution. In 24 patients, diagnosis was based on MRI and operative or arthroscopic findings, and in 14 patients, on MRI alone. RESULTS: The totals of fracture types I, II, III, IV, V and VI were 4 (11 %), 15 (39 %), 6 (16 %), 4 (11 %), 4 (11%), and 5 cases (13 %), respectively. In 30 cases (79 %), there were associated ligamentous or meniscal injuries. Medial collateral ligaments and lateral menisci were injured in 17 (45 %) and 14 cases (37 %), respectively. Type II and IV fracture patterns were associated with soft tissue injuries in 14 of 15 cases (93 %) and 4 of 4 cases(100 %), respectively. As the extent of articular depression increased and the extent of bony comminution decreased, there was an increased prevalence of accompanying ligamentous injuries. CONCLUSION: In tibial plateau fractures, MR imaging is a useful diagnostic modality for the evaluation of both fracture type and accompanying ligamentous or meniscal injuries.
Collateral Ligaments ; Depression ; Diagnosis ; Humans ; Ligaments ; Magnetic Resonance Imaging* ; Menisci, Tibial ; Prevalence ; Soft Tissue Injuries*

PURPOSE: To evaluate injury patterns of facet joints and associated soft tissue injuries in patients withacute traumatic cervical facet joint injuries. MATERIALS AND METHODS: From among patients with cervical spinetrauma, 27 with facet joint injuries, as seen on CT and MRI, were chosen for this study. CT scans were analyzedwith regard to the location of facet joint injury, the presence or absence of facet dislocation or fracture, andother associated fractures. MR images were analyzed with regard to ligament injury, intervertebral disc injury,intervertebral disc herniation, and spinal cord injury. RESULTS: The most common location of facet joint injurywas C6-7 level(n=10), followed by C5-6(n=8). Among these 27 patients with facet joint injuries, 12(44%) hadbilateral injuries and 15(56%) unilateral injuries. Facet fractures were present in 17 cases(63%) and the fractureof inferior facet was more frequent than superi-or. Patterns of fracture were vertical, transverse, or comminuted,but vertical fracture was the most common. Various degrees of dislocation were observed in patients with facetfractures. Fractures other than facet includ-ed pillar(n=11), lamina(n=6), transverse process(n=14), body(n=13),and spinous process(n=3). On MR im-ages, anterior longitudinal ligament injury was found in 8 patients(30%),posterior longitudinal ligament injury in 4(15%), and interspinous ligament injury in 20(74%). Twelvepatients(44%) had spinal cord injuries includ-ing edema(n=8) and hemorrhage(n=4). Among patients with discabnormalities, 11(41%) had intervertebral disc injuries, and traumatic disc herniations were found in nine. CONCLUSION: Traumatic cervical facet joint injuries were manifested as various patterns and frequentlyassoci-ated with other fractures or soft tissue injuries. Analysis of CT and MR findings of these injury patternshelped formulate a therapeutic plan and determine of prognosis.
Dislocations ; Humans ; Intervertebral Disc ; Ligaments ; Longitudinal Ligaments ; Magnetic Resonance Imaging* ; Prognosis ; Soft Tissue Injuries ; Spinal Cord Injuries ; Spine* ; Tomography, X-Ray Computed ; Zygapophyseal Joint*

Objectives: This study aimed to develop an accurate pediatric bone age prediction model by utilizing deep learning models and contrast conversion techniques, in order to improve growth assessment and clinical decision-making in clinical practice. Methods: The study employed a variety of deep learning models and contrast conversion techniques to predict bone age. The training dataset consisted of pediatric left-hand X-ray images, each annotated with bone age and sex information. Deep learning models, including a convolutional neural network , Residual Network 50 , Visual Geometry Group 19, Inception V3, and Xception were trained and assessed using the mean absolute error (MAE). For the test data, contrast conversion techniques including fuzzy contrast enhancement, contrast limited adaptive histogram equalization (HE) , and HE were implemented. The quality of the images was evaluated using peak signal-to-noise ratio (SNR), mean squared error, SNR, coefficient of variation, and contrast-to-noise ratio metrics. The bone age prediction results using the test data were evaluated based on the MAE and root mean square error, and the t-test was performed. Results: The Xception model showed the best performance (MAE=41.12). HE exhibited superior image quality, with higher SNR and coefficient of variation values than other methods. Additionally, HE demonstrated the highest contrast among the techniques assessed, with a contrast-to-noise ratio value of 1.29. Improvements in bone age prediction resulted in a decline in MAE from 2.11 to 0.24, along with a decrease in root mean square error from 0.21 to 0.02. Conclusion This study demonstrates that preprocessing the data before model training does not significantly affect the performance of bone age prediction when comparing contrast-converted images with original images.

Intrahepatic portosystemic venous shunt(IPVS) is an uncommon pathologic condition which occurs mostly in adult patients with portal hypertension and cirrhosis of the liver with only scattered reports are on children. However, asymptomatic IPVS have been detected in an increasing number of patients with recent advances in imaging techniques, such as sonography, CT, MR imaging, and color Doppler sonography. The cause of IPVS remains unknown, but two probable origins have been proposed, congenital and acquired origin. In the congenital origin, it has been proposed that the IPVS develops from embryologic vascular remnants. Acquired IPVS can develop into intrahepatic collateral pathway in the presence of portal hypertension and cirrhosis of the liver. We report a case of congenital IPVS with suspicious sepsis in a 6-day-old female patient. An abdominal ultrasonography and color Doppler sonography demonstrated an aneurysmal type of anomalous shunt connecting the right portal vein to the right hepatic vein. The patient continued to be symptomatic after discharge and a follow-up ultrasonography 3 months later revealed the disappearance of the previous IPVS.
Adult ; Aneurysm ; Child ; Female ; Fibrosis ; Follow-Up Studies ; Hepatic Veins ; Humans ; Hypertension, Portal ; Liver ; Magnetic Resonance Imaging ; Portal Vein ; Sepsis ; Ultrasonography

No abstract available.

The energy spectra and dose calculations were performed for secondary neutrons from a 24 MV LINAC using MCNPX code (V2, 4, 0). The energy spectra for neutrons and photons emitted from the LINAC head, and absorbed dose to water were calculated in water phantom. The absorbed doses calculated with Monte Carlo were 0.66~0.35 mGy/photon Gy at the surface to d=5 cm, and calculated with interaction data was 0.52 mGy/photon Gy at the depth of electron equilibrium in water. We have shown that this work can be applied to dose estimation of neutrons from high energy LINAC through the comparison of our results with other results.
Head ; Neutrons* ; Photons ; Water

Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, fever, and variable abnormalities in renal function and mental status. The pathogenesis of TTP is related to an inhibitor or deficiency of the von Willebrand factor (vWF)-cleaving protease (a disintegrin and metalloprotease with thrombospondin type 1 repeats; ADAMTS-13) that cleaves the large vWF multimers. Uncleaved, large vWF molecules are present in TTP and induce thrombosis in small vessels. Even though plasma exchange was proven effective in TTP, 20-40% of the cases showed refractory to plasma exchange. We describe a 41 years old female with plasma exchange refractory TTP who was completely recovered from anemia, thrombocytopenia, and accompanying symptoms following splenectomy.
Adult ; Anemia ; Anemia, Hemolytic ; Female ; Fever ; Humans ; Plasma Exchange* ; Plasma* ; Purpura* ; Purpura, Thrombotic Thrombocytopenic ; Splenectomy* ; Thrombocytopenia* ; Thrombosis ; Thrombospondins ; von Willebrand Factor

BACKGROUND: The inclusion of cardiopulmonary resuscitation (CPR) in formal education has been a useful approach to providing basic life support (BLS) services. However, because not all students have been able to learn directly from certified instructors, we studied the educational efficacy of the use of peer-assisted learning (PAL) to train high-school students to perform BLS services. METHODS: This study consisted of 187 high-school students: 68 participants served as a control group and received a 1-hour BLS training from a school nurse, and 119 were included in a PAL group and received a 1-hour CPR training from a PAL leader. Participants' BLS training was preceded by the completion of questionnaires regarding their background. Three months after the training, the participants were asked to respond to questionnaires about their willingness to perform CPR on bystander CPR and their retention of knowledge of BLS. RESULTS: We found no statistically significant difference between the control and PAL groups in their willingness to perform CPR on bystanders (control: 55.2％, PAL: 64.7％,P=0.202). The PAL group was not significantly different from the control group (control: 60.78±39.77, PAL: 61.76±17.80, P=0.848) in retention of knowledge about BLS services. CONCLUSION: In educating high school students about BLS, there was no significant difference between PAL and traditional education in increasing the willingness to provide CPR to bystanders or the ability to retain knowledge about BLS.

PURPOSE: To evaluate the usefulness of the coaxial technique in US-guided breast core biopsy. Materials andMethods : Using the coaxial technique, US-guided breast core biopsy was performed in 49 breast lesions (40patients). Under US-guidance the 17-gauge, 13 cm long introducer needle was positioned proximal to the lesion.Once the needle was in place, the central trocar was removed and was replaced with the core biopsy needle. We usedan 18-gauge, 16-cm-long core biopsy needle with a 17 mm specimen notch. Four to eight tissue specimens wereobtained from each lesion, and the quality and quantity of specimens, procedure time, and complications and theirrate were evaluated. RESULTS: For 48 of 49 lesions, specimens were adequate for histopathologic diagnosis, andthe findings were as follows : six cases of invasive ductal carcinoma, one of ductal carcinoma in situ, 29 offibrocystic disease, eight of fibroadenoma, two of chronic inflammation, and two of sclerosing lesion. In 12lesions agreement between the pathologic results of needle core biopsy and surgical results was 100%. Theprocedure time was about 15 minutes and no significant complications were noted. CONCLUSION: In breast corebiopsy, the coaxial technique is simple and time-saving, and compared with stan-dard breast core biopsy, may alsobe less traumatic and decrease the potential risk of seeding the biopsy tract with malignant cells.
Biopsy* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Fibroadenoma ; Inflammation ; Needles ; Surgical Instruments

PURPOSE: We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D&E, and to report that transarterial embolization is an exceelent treatment modality. MATERIALS & METHODS: We analyzed gray-scale US, color/duplex Doppler US and angiographic findings inseven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. In one of the AVMs, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. RESULTS: On color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased vascularity, with variable high velocities composed of the pulsatie arterial flow, with ahigh diastoic component. On angiography, the former showed pseudoaneurysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown, following transarterial embolization in all cases. CONCLUSION: Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneurysm.
Aneurysm, False ; Angiography ; Diagnosis* ; Gelatin Sponge, Absorbable ; Humans ; Uterine Artery ; Uterine Hemorrhage*