No abstract available.
Dandy-Walker Syndrome*

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844–930, 931–1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45–49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

Patients with C5 or C6 radiculopathy complain of shoulder area pain or shoulder girdle weakness. Typical idiopathic neuralgic amyotrophy (INA) is also characterized by severe shoulder pain, followed by paresis of shoulder girdle muscles. Recent studies have demonstrated that magnetic resonance neurography (MRN) of the brachial plexus and magnetic resonance imaging (MRI) of the shoulder in patients with INA show high signal intensity (HSI) or thickening of the brachial plexus and changes in intramuscular denervation of the shoulder girdle. We evaluated the value of brachial plexus MRN and shoulder MRI in four patients with typical C5 or C6 radiculopathy. HSI of the brachial plexus was noted in all patients and intramuscular changes were observed in two patients who had symptoms over 4 weeks. Our results suggest that HSI or thickening of the brachial plexus and changes in intramuscular denervation of the shoulder girdle on MRN and MRI may not be specific for INA.
Brachial Plexus Neuritis ; Brachial Plexus* ; Denervation ; Humans ; Magnetic Resonance Imaging ; Muscles ; Paresis ; Radiculopathy* ; Shoulder ; Shoulder Pain

Purpose: This study aimed to gain better understanding of the importance of dental prosthesis order platform services and to identify the essential elements for their enhancement and wider adoption among dental professionals. Materials and Methods: A survey was conducted to assess the perspectives of dentists, dental technicians, dental hygienists, and dental industry professionals toward dental prosthesis ordering and associated platform services (a total of 53 respondents). The questionnaire was devised after an expert review and assessed for reliability using Cronbach’s alpha coefficient. Factor analysis revealed that 57 factors across five categories accounted for 88.417% of the total variance. The survey was administered through an online questionnaire platform, and data analysis was conducted using a statistical software, employing one-way analysis of variance and Tukey’s honestly significant difference test (α = 0.05). Results: The essential elements identified were accurate information input, effective communication, delivery of distortion-free impressions, convenience in data transmission and storage, development of stable and affordable platform services (P < 0.05). Furthermore, significant differences were observed in the importance of these items based on age, dental profession, and career experience (P < 0.05). Conclusion The dental prosthesis ordering platform services, the requirements of dental personnel were stability, economic efficiency, and ease of transmitting and storing prosthesis data. The findings can serve as important indicators for the development and improvement of dental prosthesis order platform services.

OBJECTIVE: To evaluate the temporal evolution and diagnostic values of the diffusion tensor imaging (DTI) and the high b value diffusion weighted imaging (DWI) in the early permanent and transient cerebral ischemia. MATERIALS AND METHODS: For permanent or 30-minute transient-ischemia induced 30 rats, DTI and DWIs at both high b (b = 3000 s/mm2) and standard b value (b = 1000 s/mm2) were obtained at the following conditions: at 15, 30, 45, 60 minutes after the occlusion of what for hyperacute permanent ischemia; at 1, 3, 5, 7, 9 hours after the occlusion for acute permanent ischemia; and at 15 minutes before reperfusion, 0.5, 2.5, and 24 hours after reperfusion for transient ischemia. The diffusion parameters and their ratios were obtained and compared between different b values, and among different time points and groups, respectively. RESULTS: For both b values, the apparent diffusion coefficient (ADC) ratio decreased for first three hours, and then slightly increased until 9 hours after the occlusion during a gradual continuous increase of DWI signal intensity (SI) ratio, with excellent correlation between ADC ratios and DWI SI ratios. The DWI showed a higher contrast ratio, but the ADC map showed a lower contrast ratio for permanent ischemia at high b value than at standard b value. Fractional anisotropy (FA) increased for 1 hour, then gradually decreased until 9 hours after the occlusion in permanent ischemia and showed transient normalization and secondary decay along with change in ADC in transient ischemia. CONCLUSION: This study presents characteristic initial elevation and secondary decay of FA, higher contrast ratio of DWI, and lower contrast ratio of ADC map at high b value, in addition to the time evolutions of diffusion parameters in early permanent and transient ischemia.
Animals ; Contrast Media/diagnostic use ; Diffusion Magnetic Resonance Imaging/*methods ; Gadolinium DTPA/diagnostic use ; Ischemic Attack, Transient/*diagnosis ; Male ; Rats ; Rats, Sprague-Dawley

This study was carried out to examine the proportion of fatty acids and contents of trans fatty acid in commercial processed foods in Jeon-Buk area. Contents of trans fatty acid in bakery products ranged from 0.2% to 1.0% per 100 g food. Especially garlic bread and pastry contained the highest amount. Popcorns contained trans fatty acid from 0.0% to 13.4%. Among them, instant popcorns for microwave contained the highest amount, while trans fatty acid was hardly detected in popcorns for theater. And trans fatty acid detected in popcorns was mostly in the form of 18 : 1 trans. The content of trans fatty acid in pizza was nearly 0.2%. Amounts of saturated fatty acid and unsaturated fatty acid were similar between each type of pizza and frozen pizza. Fritters such as fried chickens and vegetables contained trans fatty acid less than 0.2% per 100 g food.
Bread ; Chickens ; Fatty Acids ; Garlic ; Microwaves ; Vegetables

PURPOSE: The purpose of this study was to investigate the accuracy and reliability of the semi-automated ultrasonographic volume measurement tool, virtual organ computer-aided analysis (VOCAL), for measuring the volume of parathyroid glands. METHODS: Volume measurements for 40 parathyroid glands were performed in patients with secondary hyperparathyroidism caused by chronic renal failure. The volume of the parathyroid glands was measured twice by experienced radiologists by two-dimensional (2D) and three-dimensional (3D) methods using conventional sonograms and the VOCAL with 30°angle increments before parathyroidectomy. The specimen volume was also measured postoperatively. Intraclass correlation coefficients (ICCs) and the absolute percentage error were used for estimating the reproducibility and accuracy of the two different methods. RESULTS: The ICC value between two measurements of the 2D method and the 3D method was 0.956 and 0.999, respectively. The mean absolute percentage error of the 2D method and the 3D VOCAL technique was 29.56% and 5.78%, respectively. For accuracy and reliability, the plots of the 3D method showed a more compact distribution than those of the 2D method on the Bland-Altman graph. CONCLUSION: The rotational VOCAL method for measuring the parathyroid gland is more accurate and reliable than the conventional 2D measurement. This VOCAL method could be used as a more reliable follow-up imaging modality in a patient with hyperparathyroidism.
Follow-Up Studies ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary* ; Imaging, Three-Dimensional ; Kidney Failure, Chronic ; Methods* ; Organ Size ; Parathyroid Glands ; Parathyroidectomy ; Ultrasonography

OBJECTIVE: Our goals were to determine the added value of fine-needle aspiration biopsy (FNAB)-thyroglobulin (Tg) measurements over FNAB-cytology alone for diagnosing metastatic nodes, and to determine whether the ultrasound features of lymph nodes can be used to identify lymph nodes that may benefit from FNAB-Tg measurement in patients with papillary thyroid cancer. MATERIALS AND METHODS: We retrospectively evaluated 76 surgically proven cervical lymph nodes. Twenty-nine patients were awaiting surgery and 18 patients had undergone thyroid surgery for papillary thyroid cancer. Ultrasound-guided FNAB and Tg measurements were performed and the ultrasound features were evaluated. RESULTS: The accuracies, sensitivities, and specificities of FNAB-cytology, FNAB-Tg, and combined FNAB-Tg/cytology were 90%, 80%, and 100%; 92%, 95%, and 90%; and 93%, 96%, and 90%, respectively. The diagnostic sensitivity of FNAB-Tg for metastatic nodes was significantly higher than that of FNAB-cytology (p = 0.011). Furthermore, combined FNAB-Tg/cytology significantly increased sensitivity (p = 0.002) and accuracy (p = 0.03) as compared with FNAB-cytology. CONCLUSION: Combined FNAB-Tg/cytology is significantly more sensitive and accurate at detecting metastatic nodes than FNAB-cytology alone. FNAB-Tg was better at diagnosing metastases in small lymph nodes.
Biopsy, Fine-Needle ; Carcinoma, Papillary/*pathology ; Humans ; Lymph Nodes/*ultrasonography ; Lymphatic Metastasis/*diagnosis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin/*metabolism ; Thyroid Neoplasms/*pathology ; Ultrasonography, Interventional

Background/Aims: Acute-on-chronic liver failure (ACLF) is a widely recognized concept in which acute decompensation (AD) in patients with cirrhosis results in organ failure and high short-term mortality. On the other hand, few studies reflecting the various etiologies of cirrhosis are available. This study examined the clinical features of patients with hepatitis C virus (HCV)-related ACLF. Methods: Between January 2005 and December 2018, 109 HCV-related cirrhosis patients hospitalized for AD (ascites, hepatic encephalopathy, gastrointestinal hemorrhage, and bacterial infection) were enrolled for ACLF defined by the European Association for the Study of the Liver (EASL). Results: ACLF developed in 35 patients (32.1%) on admission. Eight, eight, and 19 patients had ACLF grades 1, 2, and 3, respectively. The 28-day and 90-day mortality rates were very low (2.7% and 5.4%, respectively) in patients without ACLF and very high (60.0% and 74.3%, respectively) in those with ACLF. In patients with HCV-related ACLF, compared to previous studies on hepatitis B virus-related ACLF and alcohol-related ACLF, the prevalence of liver failure was very low (17.1%), whereas that of kidney failure was very high (71.4%). Compared with all other prognostic scores, the Chronic liver failure Consortium Organ Failure score predicted the 90-day mortality most accurately, with an area under the receiver operator characteristic of 0.921. Conclusions HCV-related ACLF has unique clinical characteristics distinct from hepatitis B virus-related and alcohol-related ACLF. ACLF defined by EASL can be useful for predicting the short-term mortality in HCV-related cirrhosis.