Abstract: A 16-year-old cat presented with a 2-week history of anorexia and lethargy. Radiography revealed a soft-tissue opacity, heart-shaped mass between the descending colon and urinary bladder. Ultrasonography showed a large uterine body with a heterogeneously hypoechoic, thickened wall and hypoechoic intraluminal fluid. Computed tomography revealed a large, fluid-filled uterine mass with contrast enhancement, without evidence of regional lymph node or pulmonary metastasis. Ovariohysterectomy was performed and leiomyosarcoma was confirmed by histology. No notable abnormalities were observed during the 1-year postoperative follow-up periods. This report describes the diagnostic imaging and treatment of a rare case of feline uterine leiomyosarcoma.

PURPOSE: Pancreatic body/tail cancer often involves the celiac axis (CA) and it is regarded as an unresectable disease. To treat the disease, we employed distal pancreatectomy with en bloc celiac axis resection (DP-CAR) and reviewed our experiences. METHODS: We performed DP-CAR for seven patients with pancreatic body/tail cancer involving the CA. The indications of DP-CAR initially included tumors with definite invasion of CA and were later expanded to include borderline resectable disease. To determine the efficacy of DP-CAR, the clinico-pathological data of patients who underwent DP-CAR were compared to both distal pancreatectomy (DP) group and no resection (NR) group. RESULTS: The R0 resection rate was 71.4% and was not statistically different compared to DP group. The operative time (P = 0.018) and length of hospital stay (P = 0.022) were significantly longer in DP-CAR group but no significant difference was found in incidence of the postoperative pancreatic fistula compared to DP group. In DP-CAR group, focal hepatic infarction and transient hepatopathy occurred in 1 patient and 3 patients, respectively. No mortality occurred in DP-CAR group. The median survival time (MST) was not statistically different compared to DP group. However, the MST of DP-CAR group was significantly longer than that of NR group (P < 0.001). CONCLUSION: In our experience, DP-CAR was safe and offered high R0 resection rate for patients with pancreatic body/tail cancer with involvement of CA. The effect on survival of DP-CAR is comparable to DP and better than that of NR. However, the benefits need to be verified by further studies in the future.
Axis, Cervical Vertebra* ; Celiac Artery ; Humans ; Incidence ; Infarction ; Length of Stay ; Mortality ; Operative Time ; Pancreatectomy* ; Pancreatic Fistula ; Pancreatic Neoplasms ; Tail*

When cerebral cortical hyperintensities on diffusion-weighted image are seen in patients with suspected acute stroke accompanying seizure, it is necessary to differentiate whether they are caused by infarction or seizure-related change. We report a case of seizure-related cortical hypertensities in a patient with suspected acute infarction. With perfusion MR imaging, we could differentiate from acute infarction.
Humans ; Infarction ; Magnetic Resonance Imaging* ; Perfusion* ; Seizures ; Stroke

OBJECTIVES: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities. METHODS: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women). RESULTS: Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men. CONCLUSIONS: The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Adult* ; Bisexuality* ; Dataset ; Depression ; Drinking ; Female ; Health Status Disparities ; Homosexuality* ; Homosexuality, Female* ; Humans ; Korea* ; Male ; Minority Health ; Musculoskeletal Pain ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicidal Ideation

OBJECTIVES: This study aims to investigate health disparities between lesbian, gay, and bisexual (LGB) adults and the general population in Korea, where there is low public acceptance of sexual minorities and a lack of research on the health of sexual minorities.METHODS: The research team conducted a nationwide survey of 2,335 Korean LGB adults in 2016. Using the dataset, we estimated the age-standardized prevalence ratios (SPRs) for poor self-rated health, musculoskeletal pain, depressive symptoms, suicidal behaviors, smoking, and hazardous drinking. We then compared the SPRs of the LGB adults and the general population which participated in three different nationally representative surveys in Korea. SPRs were estimated for each of the four groups (i.e., gay men, bisexual men, lesbians, and bisexual women).RESULTS: Korean LGB adults exhibited a statistically significantly higher prevalence of depressive symptoms, suicidal ideation and attempts, and musculoskeletal pain than the general population. Lesbian and bisexual women had a higher risk of poor self-rated health and smoking than the general women population, whereas gay and bisexual men showed no differences with the general men population. Higher prevalence of hazardous drinking was observed among lesbians, gay men, and bisexual women compared to the general population, but was not observed in bisexual men.CONCLUSIONS: The findings suggest that LGB adults have poorer health conditions compared to the general population in Korea. These results suggest that interventions are needed to address the health disparities of Korean LGB adults.
Adult ; Bisexuality ; Dataset ; Depression ; Drinking ; Female ; Health Status Disparities ; Homosexuality ; Homosexuality, Female ; Humans ; Korea ; Male ; Minority Health ; Musculoskeletal Pain ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Suicidal Ideation

PURPOSE: The purpose of this study was to evaluate the associated brain parenchymal abnormalities of developmental venous anomalies (DVA) with susceptibility-weighted image (SWI). MATERIALS AND METHODS: Between January 2012 and June 2013, 2356 patients underwent brain MR examinations with contrast enhancement. We retrospectively reviewed their MR examinations and data were collected as per the following criteria: incidence, locations, and associated parenchymal signal abnormalities of DVAs on T2-weighted image, fluid-attenuated inversion recovery (FLAIR), and SWI. Contrast enhanced T1-weighted image was used to diagnose DVA. RESULTS: Of the 2356 patients examined, 57 DVAs were detected in 57 patients (2.4%); 47 (82.4%) were in either lobe of the supratentorial brain, 9 (15.7%) were in the cerebellum, and 1 (1.7%) was in the pons. Of the 57 DVAs identified, 20 (35.1%) had associated parenchymal abnormalities in the drainage area. Among the 20 DVAs which had associated parenchymal abnormalities, 13 showed hemorrhagic foci on SWI, and 7 demonstrated only increased parenchymal signal abnormalities on T2-weighted and FLAIR images. In 5 of the 13 patients (38.5%) who had hemorrhagic foci, the hemorrhagic lesions were demonstrated only on SWI. CONCLUSION: The overall incidence of DVAs was 2.4%. Parenchymal abnormalities were associated with DVAs in 35.1% of the cases. On SWI, hemorrhage was detected in 22.8% of DVAs. Thus, we conclude that SWI might give a potential for understanding of the pathophysiology of parenchymal abnormalities in DVAs.
Brain* ; Cerebellum ; Drainage ; Hemorrhage ; Humans ; Incidence ; Magnetic Resonance Imaging* ; Pons ; Retrospective Studies

PURPOSE: To investigate the value of image post-processing software (FreeSurfer, IBASPM [individual brain atlases using statistical parametric mapping software]) and inversion time (TI) in volumetric analyses of the hippocampus and to identify differences in comparison with manual tracing. MATERIALS AND METHODS: Brain images from 12 normal adults were acquired using magnetization prepared rapid acquisition gradient echo (MPRAGE) with a slice thickness of 1.3 mm and TI of 800, 900, 1000, and 1100 ms. Hippocampal volumes were measured using FreeSurfer, IBASPM and manual tracing. Statistical differences were examined using correlation analyses accounting for spatial interpretations percent volume overlap and percent volume difference. RESULTS: FreeSurfer revealed a maximum percent volume overlap and maximum percent volume difference at TI = 800 ms (77.1 +/- 2.9%) and TI = 1100 ms (13.1 +/- 2.1%), respectively. The respective values for IBASPM were TI = 1100 ms (55.3 +/- 9.1%) and TI = 800 ms (43.1 +/- 10.7%). FreeSurfer presented a higher correlation than IBASPM but it was not statistically significant. CONCLUSIONS: FreeSurfer performed better in volumetric determination than IBASPM. Given the subjective nature of manual tracing, automated image acquisition and analysis image is accurate and preferable.
Adult* ; Brain ; Hippocampus ; Humans

No abstract available.
Endocarditis ; Sinus of Valsalva

PURPOSE: Although heart failure (HF) is recognized as a leading contributor to healthcare costs and a significant economic burden worldwide, studies of HF-related costs in South Korea are limited. This study aimed to estimate HF-related costs per Korean patient per year and per visit. MATERIALS AND METHODS: This retrospective cohort study analyzed data obtained from six hospitals in South Korea. Patients with HF who experienced ≥one hospitalization or ≥two outpatient visits between January 1, 2013 and December 31, 2013 were included. Patients were followed up for 1 year [in Korean won (KRW)]. RESULTS: Among a total of 500 patients (mean age, 66.1 years; male sex, 54.4%), the mean 1-year HF-related cost per patient was KRW 2,607,173, which included both, outpatient care (KRW 952,863) and inpatient care (KRW 1,654,309). During the post-index period, 22.2% of patients had at least one hospitalization, and their 1-year costs per patient (KRW 8,530,290) were higher than those of patients who had only visited a hospital over a 12-month period (77.8%; KRW 917,029). Among 111 hospitalized patients, the 1-year costs were 1.7-fold greater in patients (n=52) who were admitted to the hospital via the emergency department (ED) than in those (n=59) who were not (KRW 11,040,453 vs. KRW 6,317,942; p<0.001). CONCLUSION: The majority of healthcare costs for HF patients in South Korea was related to hospitalization, especially admissions via the ED. Appropriate treatment strategies including modification of risk factors to prevent or decrease hospitalization are needed to reduce the economic burden on HF patients.
Ambulatory Care ; Cohort Studies* ; Delivery of Health Care* ; Emergency Service, Hospital ; Health Care Costs* ; Heart Failure* ; Heart* ; Hospitalization ; Humans ; Inpatients ; Korea* ; Male ; Outpatients ; Retrospective Studies* ; Risk Factors

BACKGROUND: Rheumatoid arthritis (RA) treatment may differ according to hepatitis B state and consequently may bring about different arthritis outcomes. However, whether hepatitis B affects treatment outcome remains unclear. We investigated differences in change in arthritis activity between RA patients according to concomitant hepatitis B virus infection. METHODS: A retrospective medical chart review was performed by two rheumatologic fellows using single center data, from January 2000 to March 2015. Among RA patients older than 18 years, patients with comorbidities that could affect RA treatment aside from hepatitis B were excluded. Using 1:3 propensity score matching, 40 hepatitis B virus surface antigen (HBsAg)-positive patients and 112 HBsAg-negative patients were included in the study. Data were collected longitudinally using standardized electronic forms. The longitudinal relationship between HBsAg-positivity and RA activity was analyzed using generalized estimating equations. RESULTS: RA activity showed time-dependent improvement. Reductions of swollen joint count over time were significantly larger in the HBsAg-negative group. However, changes in disease activity score in 28 joints with three variables (DAS28-3), tender joint count, erythrocyte sedimentation rate and C-reactive protein level did not differ between the groups. There were no differences in alanine aminotransferase level. HBsAg-positive patients were less likely to receive methotrexate (odds ratio [OR], 0.09; 95% confidence interval [CI], 0.04–0.19; P < 0.001) and more likely to receive sulfasalazine (OR, 3.67; 95% CI, 1.94–6.95; P < 0.001). CONCLUSION: RA medication use varied according to HBsAg-positivity. However, improvement in RA activity was not significantly affected by concomitant hepatitis B infection.
Alanine Transaminase ; Antigens, Surface ; Arthritis* ; Arthritis, Rheumatoid* ; C-Reactive Protein ; Comorbidity ; Erythrocyte Count ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Joints ; Methotrexate ; Propensity Score ; Retrospective Studies* ; Sulfasalazine ; Treatment Outcome