PURPOSE: To determine the influence of manganese dipyridoxyl diphosphate (Mn-DPDP) on MRI and proton MRS. MATERIALS AND METHODS: In an in-vitro study designed to determine changes in the lipid peak at 1.3 ppm, 4.7T MR equipment was used to obtain proton MR spectrographic images of a lipid solution of varying concentration, with and without Mn-DPDP. Before; at 10, 20, and 30 minutes; and at 1, 2, 4, and 24 hours after the IV injection of Mn-DPDP (10umol, 1ml/kg), the concentration of Mn in liver tissue was measured by atomic absorption spectrometry. At the same intervals, T1-weighted MR images were obtained, the signal intensity ofthe liver was thus determined, and the relative enhancement ratio was calculated. MRS of rabbit liver was performed serially at the same intervals, and the peak areas of metabolites, as well as their peak areas relative to lipids, were calculated. The findings were correlated with tissue Mn concentration. RESULTS: At 1.3 ppm with Mn-DPDP, MRS showed that the peak area of the lipid had decreased. Tissue Mn concentration increased just after Mn-DPDP injection and peaked after 20 minutes, decreasing to a level within the normal range after 24 hours. Serial changes in the signal intensity of the liver, as seen at MRI, showed a similar pattern to that of Mn concentration. There was reverse correlation between serial change in the peak area of lipids at 1.3 ppm and Mn concentration after Mn-DPDP injection. CONCLUSION: At T1-weighted MR imaging, the injection of Mn-DPDP led to the enhancement of liver tissue, and at MRS, the lipid peak at 1.3 ppm decreased. There was close correlation between these effects and tissue Mn concentration.
Absorption ; Liver* ; Magnetic Resonance Imaging* ; Magnetic Resonance Spectroscopy* ; Manganese ; Protons* ; Reference Values ; Spectrum Analysis

PURPOSE: The purpose of this study was to evaluate change in the proton MR spectroscopic (1H-MRS) features of the liver according to changes in the severity of the chronic hepatitis spectrum (normal-chronic hepatitis-liver cirrhosis), and to determine the possibility of replacing liver biopsy by1 H-MRS. MATERIALS AND METHODS: Sixty profiles of 1H-MRS features from 15 normal volunteers, 30 cases of chronic hepatitis, and 15 of liver cirrhosis were evaluated. All cases of chronic hepatitis and liver cirrhosis were confirmed by biopsy, and histopathologic disease severity was categorized according to Ludwig 's classification. Using the STEAM(STimulated Echo-Aquisition Mode) sequence, 1H-MRS was performed. The ratios of peak areas of [glutamate+glutamine]/lipid, phosphomonoesters/lipid, [glycogen+glucose]/lipid, and [3.9-4 . 1ppm unknown peak]/lipid and their mean and standard deviation were calculated in normal, chronic hepatitis stages I and II, and early and late liver cirrhosis groups and the results were compared between these groups. One-way variable analysis was applied to the statistics. RESULTS: Mean and standard deviation of phosphomonoesters/lipid in the normal, chronic hepatitis grades I and II, and early and late liver cirrhosis groups were 0.0146 +/-0.0090, 0.0222 +/-0.0170, 0.0341 +/-0.0276, 0 . 0 6 9 8 +/-0.0360, and 0.0881 +/-0.0276, respectively, and [glycogen+ glucose]/lipid were 0.0403 +/-0.0267, 0.0922 +/-0.0377, 0.1230 +/-0.0364, 0.1853 +/-0.0667, and 0.2325 +/-0.1071, respectively. These results implied that the ra-tio of the above metabolites to lipid content increased according to increasing disease severity (p<0.05). For [g-lutamate+glutamine]/lipid however, the ratios for each group were 0.0204 +/-0.0067, 0.0117 +/-0.0078, 0.0409 +/-0.0167, 0.0212 +/-0.0103, and 0.0693 +/-0.0371, respectively, and there was no correlation with disease severity. In the chonic hepatitis grades I and II, and early and late liver cirrhosis groups, the ratios for [3.9 -4.1 ppm un-known peak]/l ipid were 0.0302 +/-0.0087, 0.0513 +/-0.0167, 0.1112 +/-0.0351, and 0.1504 +/-0 . 0 3 5 5 ,and these also increased according to increasing disease severity (p<0.05). On MR spectra of normal livers, an unknown peak at 3.9 -4.1ppm was not detected. CONCLUSION: Changes in MR spectroscopic features in cases of chronic hepatitic and liver cirrhosis correlated with changes in disease severity, and the sensitivity of the unknown peak at 3.9 -4.1ppm changed according to disease severity. It is therefore possible to differentiate between normal liver, chronic hepatitis and liver cirrhosis by analysis of the 1H-MRS features of the liver. These results indicate that in cases of chronic hepatitis and liver cirrhosis, biopsy of the liver can be replaced by 1H-MRS.
Biopsy ; Classification ; Healthy Volunteers ; Hepatitis ; Hepatitis, Chronic* ; Liver Cirrhosis* ; Liver* ; Protons*

Gynecomastia is an abnormal increase in the volume of the male breast. Surgical techniques include a variety of incisions, excisions, suction-assisted lipopectomy, ultrasound-assisted liposuction, power-assisted liposuction, or some combination of these methods. The purpose of this article is to introduce the authors' method of using power-assisted liposuction and periareolar pull-out technique. Six men were treated from June 2005 through August 2008 for gynecomastia. Fatty breast tissue is removed by power-assisted liposuction. The periareolar pull-out technique is then performed to glandular enlargement. A mean of 120cc of breast tissue was aspirated, and 18.3g of glandular tissue were excised per breast. There were no complications such as skin flap necrosis or hematoma. The cosmetic outcome was good in all and the patients' satisfaction was high. Power-assisted liposuction in combination with periareolar pull-out technique effectively corrects gynecomatia. This combination has little morbidity, minimize scars, and leads to good cosmetic results.
Male ; Humans

BACKGROUND: Recent advances in laboratory information systems have largely been focused on automation. However, the phlebotomy services have not been completely automated. To address this issue, we introduced an automated reception and turnaround time (TAT) management system, for the first time in Korea, whereby the patient's information is transmitted directly to the actual phlebotomy site and the TAT for each phlebotomy step can be monitored at a glance. METHODS: The GNT5 system (Energium Co., Ltd., Korea) was installed in June 2013. The automated reception and TAT management system has been in operation since February 2014. Integration of the automated reception machine with the GNT5 allowed for direct transmission of laboratory order information to the GNT5 without involving any manual reception step. We used the mean TAT from reception to actual phlebotomy as the parameter for evaluating the efficiency of our system. RESULTS: Mean TAT decreased from 5:45 min to 2:42 min after operationalization of the system. The mean number of patients in queue decreased from 2.9 to 1.0. Further, the number of cases taking more than five minutes from reception to phlebotomy, defined as the defect rate, decreased from 20.1% to 9.7%. CONCLUSIONS: The use of automated reception and TAT management system was associated with a decrease of overall TAT and an improved workflow at the phlebotomy room.
Automation, Laboratory ; Efficiency, Organizational/*standards ; Phlebotomy/*statistics & numerical data ; Republic of Korea ; Time Factors ; Workflow

Genitourinary tuberculosis is a disease spread hematogenously from a small tuberculous abscess of the lung. The renal cortex is initially involved, and multiple granulomas form. Ultimately the cortex may cavitate and communicate with the collecting system, allowing downward extension of the infection and subsequent focal caliectasis with infundibular stenosis, ureteral fibrosis, and calcifications of urinary tract organs. The female genitourinary organ is also infected by the hematogenous spread of tuberculosis, the most common lesion be-ing hydrosalpynx with salpingitis. The clinical and radiologic features of genitourinary tuberculosis may mimic other acute abdominal diseases, and the diagnosis of tuberculosis remains difficult. This report describes the ways in which computed tomography and magnetic resonance imaging are valuable aids in the recognition and diagnosis of genitourinary tuberculosis.
Abscess ; Constriction, Pathologic ; Diagnosis ; Female ; Fibrosis ; Granuloma ; Humans ; Lung ; Magnetic Resonance Imaging ; Salpingitis ; Tuberculosis* ; Ureter ; Urinary Tract

PURPOSE: To determine the diagnositic value of multi-shot echo-planar MR imaging (EPI) in focal hepaticlesions by quantitatively comparing this with other standard MR sequences such as FSE(fast spin echo) T2WI,SE(spin echo) T1WI with and without Gd enhancement, FMPSPGR(fast multiplanar spoiled GRASS) with and without Gdenhancement. MATERIALS AND METHODS: Seventeen patients with 18 focal hepatic lesions were retrospectivelyreviewed by two abdominal radiologists. The pathological or clinical results of hepatic lesions were nine cases ofhemangioma, four of hepatocellular carcinoma, one of peripheral cholangiocarcinoma, one of simple cyst, and ofhemangioma. By dividing the data acquisition period into eight interleaved segments, multi-shot EPI images wereobtained. This T2W spin echo eight-shot EPIs of the liver in one 18 second breath hold was compared with otherpulse sequences. The foci of review were lesion detectablity and characterization. For the former, SNR(signal tonoise ratio) of the liver and CNR(contrast to noise ratio) of the lesion to the liver were calculated ;to evaluatethe latter, a separate calculation of lesion to liver CNR for each solid and nonsolid lesion group was performed. RESULTS: Among six pulse sequences, multi-shot EPI provided the poorest liver SNR (p<.01). With regard to lesionto liver CNR, EPI was superior to FMPSPGR, SE, and Gd SE, but inferior to FSE, Gd FMPSPGR(p<.01). For nonsolidlesions(hemangioma, cyst), EPI provided higher liver CNR than FMPSPGR, SE, or Gd-SE, but one that was poorer thanthat provided by FSE and Gd-FMPSPGR(p<.05). Among six pulse sequences, there was no statistically significantdifference in lesion to liver CNR in solid lesions. In the evaluation of liver to lesion CNR, multi-shot EPI wasalways inferior to FSE. CONCLUSION: We concluded that with regard to sensitivity and suseptibility, multi-shotEPI is inferior to T2W FSE. For SNR, EPI was the least satisfactory, though with the exception of FSE, EPIprovided a higher or comparable CNR than other pulse sequences, and this made lesion depiction easy, especially innonsolid lesions. It was, however, difficult to characterize lesions by using EPI alone to determine whether alesion was solid or nonsolid.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Diagnosis* ; Humans ; Liver ; Magnetic Resonance Imaging* ; Noise

Herein, we report on a case of primary torsion of the greater omentum with segmental infarction, which should provide useful information for the preoperative diagnosis of future such cases. Primary torsion of the greater omentum with omental infarction is a rare condition. There are only a few radiological reports of secondary torsion of the greater omentum caused by the hernial sac. During surgical exploration, infarction of the greater omentum was identified, due to the observation of omental torsion without any underlying cause. We describe a patient with characteristic computed tomography (CT) findings of primary omental torsion with segmental infarction, which correlated with the operative and pathologic results.
Diagnosis ; Humans ; Infarction* ; Omentum*

Cholesteatoma of the urinary tract is an extremely rare disease occurring in the bladder and renal pelvis. We report the radiologic findings in two cases of renal cholesteatoma involving the renal pelvis, calyces and ureter, and correlate these with the histopathologic findings.
Cholesteatoma* ; Kidney Pelvis ; Rare Diseases ; Ureter ; Urinary Bladder ; Urinary Tract

This study was performed to investigate the in vitro proliferation and migration of rabbit auricular chondrocytes into the various sized pore of PLLA and PLGA scaffolds. The chondrocytes were harvested, expanded, and seeded onto PLGA(50 : 50, 75 : 25, 85 : 15) and PLLA scaffold having either small(50 - 100 micrometer) or large(300 - 350 micrometer) pores. On the 4th and 8th week after culture, histologic observation and quantitative DNA assay were done. We noted that the largest amount of DNA was found in the 85 : 15 PLGA sponges than others, and in the 4th and 8th week, some amount of DNA was detected in the lower portion of 85 : 15 PLGA sponge only, and DNA amounts were increased during the culture period in the 85 : 15 PLGA, significantly. We also found that the numbers of cells were low in middle portion of scaffolds, and in large pore-sized group of 85 : 15 PLGA, there were many cells in the lower portion of the scaffolds more than that of small pore group. In conclusion, the pore size of the scaffold for chondrocyte culture is important for cell migration and proliferation, and PLGA, especially 85 : 15 PLGA with 300- 350 micrometer sized pore is the more suitable biomatrix for proliferation and migration of the chondrocytes.
Cell Movement ; Chondrocytes* ; DNA ; Porifera

PURPOSE: To evaluate the usefulness of dynamic gadolinium-enhanced MR imaging in the staging of bladder cancer. MATERIALS AND METHODS: Twenty-four patients with histologically proven bladder cancer underwent MR imaging before tumor resection. Pre contrast axial or sagittal T1- and T2-weighted images were obtained in all patients. In 12, dynamic MR imaging was performed using the 3D-EFGRE technique in the axial plane. Images were obtained 30, 90, and 180 sec after a rapid hand injection of Gd-DTPA. T1W1, T2W1, and Gd-enhanced dynamic images were compared on the basis of lesion conspicuity and correlated with histologic specimens. The signal intensity ratio (SIR) of bladder tumors, muscle, and perivesical fat during each phase, and the contrast-to-noise ratio (CNR) of lesion-to-muscle and lesion-to-fat were determined. RESULTS: The accuracy of tumor staging using both T1WI and T2WI was 38% (9/24), and the accuracy of dynamic gadolinium enhanced MR imaging was 58% (7/12). The difference was statistically significant (p<0.05). The SIR of tumors was highest during the capillary phase, and decreased during the venous phase. During all phases i t was significantl y higher than that of bladder muscle and perivesi cal fat ( P < 0.05). The CNR of tumor-to-muscle and tumor-to-perivesical fat increased abruptly during the arterial phase, was highest during the capillary phase and decreased slightly during the venous phase. CONCLUSION: Dynamic gadolinium enhanced MR imaging improves the diagnostic accuracy of both T1WI and T2WI in the preoperative staging of bladder cancer and can be useful in the management and estimation of prognosis. For evalvation of the staging of bladder cancer, the capillary phase is optimal.
Capillaries ; Gadolinium ; Gadolinium DTPA ; Hand ; Humans ; Magnetic Resonance Imaging* ; Neoplasm Staging ; Prognosis ; Urinary Bladder Neoplasms* ; Urinary Bladder*