BACKGROUND/AIMS: We compared the accuracy in the diagnosis of hepatic masses such as hepatocellular carcinoma (HCC), metastasis and hemangioma using enhancing pattern alone with using additional findings, and determined whether the additional findings could improve the diagnostic accuracy. METHODS/MATERIALS: Triphasic spiral CT images were retrospectively analyzed in 83 cases of hepatic lesions,' 40 HCC, 21 metastases, and 22 hemangiomas. Three observers made the diagnosis first by the enhancement pattern of the mass alone, and then, by the whole information. The diagnosis of a lesion was considered correct if the lesion was correctly categorized by at least two observers. Diagnostic accuracies of two sessions were compared with McNemar test. RESULTS: Using enhancing patterns alone, 31/40 HCC (78%), 8/21 metastases (38%), 21/22 hemangiomas (95%) were correctly diagnosed. The frequency of correct diagnosis was significantly improved when all images with additional findings were used: 36/40 (90%) HCC, 20/21 (95%) metastases, 22/22 (100%) hemangiomas (P=0.00006). Metastasis showed most prominent and statistically significant improvement in the diagnostic accuracy (P=0.0004). The number of correct diagnoses for HCC increased without statistical significance (P=0.17). However, the images with additional findings did not significantly contribute to the diagnosis of hemangiomas. The additional finidngs those led to correct diagnosis of metastases were multiple mass (7 cases), coexistence of primary malignancy (6 cases), and metastasis to other organ (1 case). The findings of liver cirrhosis were helpful to diagnose HCC correctly in 5 cases. CONCLUSION: The enhancing pattems of tumors were important in the diagnosis of hepatic masses in spiral CT. However, the additional finidngs were also helpful for the diagnosis of hepatic masses especially for the masses with atypical enhancement pattern. In metastases, the additional findings such as multiple masses or detection of primary malignant focus were useful to diagnose correctly.
Carcinoma, Hepatocellular ; Diagnosis ; Hemangioma ; Liver Cirrhosis ; Liver Neoplasms ; Neoplasm Metastasis ; Retrospective Studies ; Tomography, Spiral Computed*

PURPOSE: To evaluate the incidence of avascular necrosis (AVN), prognostic reliability of the Hawkins sign, and clinical outcomes after operative treatment of fracture and dislocations of the talar neck. MATERIALS AND METHODS: We analysed 16 patients with fracture and dislocations of the talar neck which were treated by open reduction and internal fixation and followed up for more than 2 years. The postoperative radiographs were examined for Hawkins sign and avascular necrosis was confirmed by bone scan. The assessment of clinical results was based on the Hawkins scoring system. RESULTS: AVN was occurred in 2 of 16 cases (12.5%) only in type III. Hawkins sign was found 11 of 16 cases (68.8%), which included 8 cases in type II, 2 cases in type III and 1 case in type IV. The Hawkins sign was not observed in two cases with AVN. In contrast, only 2 of the 5 cases with a negative Hawkins sign developed AVN. According to Hawkins scoring system, 4 patients (25.0%) was in excellent, 7 patients (43.8%) in good, 4 patients (25.0%) in fair and 1 patient (6.3%) in poor. CONCLUSION: Incidence of AVN after operative treatment of fracture and dislocations of the talar neck was lower than that of previous reports. Hawkins sign had a high prognostic reliability, but absence of Hawkins' sign should not be considered a totally reliable indicator of development of avascular necrosis.
Dislocations ; Humans ; Incidence ; Neck ; Necrosis

Dural arteriovenous fistula (DAVF) have been treated by transarterial or transvenous embolization, surgery, and radiosurgery. Besides these treatment options, the external compression technique is a non-invasive, low-cost form of treatment. This article reports that a 60-year-old man with DAVF between multiple arterial branches and transverse/sigmoid sinus was treated by repeated external manual compression method.
Arteriovenous Fistula ; Central Nervous System Vascular Malformations* ; Humans ; Methods ; Middle Aged ; Radiosurgery ; Tinnitus*

Dural arteriovenous fistula (DAVF) have been treated by transarterial or transvenous embolization, surgery, and radiosurgery. Besides these treatment options, the external compression technique is a non-invasive, low-cost form of treatment. This article reports that a 60-year-old man with DAVF between multiple arterial branches and transverse/sigmoid sinus was treated by repeated external manual compression method.
Arteriovenous Fistula ; Central Nervous System Vascular Malformations* ; Humans ; Methods ; Middle Aged ; Radiosurgery ; Tinnitus*

We report a case of rheumatoid nodule of the right knee in a 55-year-old woman which on the basis of MR images was misdiagnosed as soft tissue sarcoma. Rheumatoid nodules occur in up to 20% of adult patients with rheumatoid arthritis and most patients with rheumatoid nodules are rheumatoid factor positive. The nod-ules are most commonly located between the skin and an underlying bony prominence. In this case, the patient had a history of rheumatoid arthritis and a soft tissue mass was present in the lateral aspect of the right knee. T1-weighted images revealed a mass of similar signal intensity to that of muscle, and on T2 weighted im-ages, a central portion of high signal intensity was noted. Enhanced T1 weighted images demonstrated periph-eral rim enhancement. The mass extended to subcutaneous tissue, with penetration of lateral patellar retinacu-lum. Excisional biopsy was performed, and the pathologic diagnosis was rheumatoid nodule. Although its radi-ologic findings are non-specific, rheumatoid nodule should - in appropriate clinical settings - be included in the differential diagnosis of a predominently solid or centrally necrotic periarticular soft tissue.
Adult ; Arthritis, Rheumatoid ; Biopsy ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Knee ; Middle Aged ; Rheumatoid Factor ; Rheumatoid Nodule* ; Sarcoma* ; Skin ; Subcutaneous Tissue

PURPOSE: To compare the radiologic and clinical outcomes of total knee arthroplasty (TKA) performed using a navigation system with those obtained using the conventional technique. MATERIALS AND METHODS: Forty-one TKAs were performed using a navigation system (navigation group) and forty-eight by conventional surgery (conventional group). Radiologic results outside the range defined by +/-3degrees of optimum were classified as outliers. Range of motion and HSS scores at final follow-up were also compared. RESULTS: Mean mechanical axes were 0.3degrees valgus for navigation and 0.5degrees varus for the conventional group, which were not statistically different. However, two outliers occurred in the navigation group, which was significantly less than the 14 that occurred in the conventional group. Mean coronal inclination of the femoral component was significantly different in the two groups as were the outlier numbers. Although outlier numbers significantly differed in sagittal inclination of the femoral or tibial components or coronal inclination of the tibial component, there were no statistical differences in terms of mean values. Differences in ROM and HSS scores were also not observed between the two groups. CONCLUSION: The navigation system helped increase alignment accuracy of the lower extremity, but no significant difference was observed in clinical results between the two study groups.
Arthroplasty* ; Follow-Up Studies ; Knee* ; Lower Extremity ; Range of Motion, Articular

BACKGROUND AND OBJECTIVES: The Tinnitus Handicap Inventory (THI) is a useful measure to evaluate the tinnitus and to quantify the functional and psychosocial consequences of tinnitus. However, it can be difficult for patients to understand the items of questionnaire and may take 10 to 15 minutes for them to complete the questionnaire, which can be problematic. The objective of this study is to develop a simplified version of the Korean type Tinnitus Handicap Inventory (THIS). SUBJECTS AND METHOD: A retrospective clinical study was conducted to analyze the THI-S cutoff score used for referral purpose and the level of predictability between the THI and the THIS. 100 patients participated. The subject samples were drawn from outpatients who reported tinnitus as their primary complaints at the time of the initial audiology and otolaryngology evaluations. The 10-item THI-S, selected by using Cronbach's alpha coefficient, showed a high correlation with the scores of the THI. Based on their clinical experiences, the four otologists developed their own screening versions of THI, which were designated as THI-A, B, C and D. The Pearson product-moment correlation was used to assess the comparability of the scores between the THI and the THI-S, A, B, C and D. RESULTS: The results showed that there is a higher correlation between the THIS and the THI-S. A high comparability was shown in the comparison between the THI and the THI-S. CONCLUSION: Further studies will be needed if the THI-S can be applied for clinical use.
Audiology ; Humans ; Mass Screening ; Otolaryngology ; Outpatients ; Surveys and Questionnaires ; Referral and Consultation ; Retrospective Studies ; Tinnitus

OBJECTIVE: Meningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma. METHODS: In total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3-170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04). RESULTS: Simpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6-71.3) by the log-rank test (p<0.05). CONCLUSION: Chordoid meningiomas are difficult to manage and have a high rate of recurrence. Complete resection of the tumor is a key determinant of better outcomes. Adjuvant radiation therapy is recommended, eparticulary when Simpson grade I resection was not achieved.
Central Nervous System ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Medical Records ; Meningioma* ; Recurrence ; Retrospective Studies ; Treatment Outcome*

The triggering receptor expressed on myeloid cells (TREM) family, which is abundantly expressed in myeloid lineage cells, plays a pivotal role in innate and adaptive immune response. In this study, we aimed to identify a novel receptor expressed on hematopoietic stem cells (HSCs) by using in silico bioinformatics and to characterize the identified receptor. We thus found the TREM-like transcript (TLT)-6, a new member of TREM family. TLT-6 has a single immunoglobulin domain in the extracellular region and a long cytoplasmic region containing 2 immunoreceptor tyrosine-based inhibitory motif-like domains. TLT-6 transcript was expressed in HSCs, monocytes and macrophages. TLT-6 protein was up-regulated on the surface of bone marrow-derived and peritoneal macrophages by lipopolysaccharide stimulation. TLT-6 exerted anti-proliferative effects in macrophages. Our results demonstrate that TLT-6 may regulate the activation and proliferation of macrophages.
Adaptive Immunity ; Computational Biology ; Computer Simulation ; Cytoplasm ; Hematopoietic Stem Cells ; Humans ; Immunoglobulins ; Macrophages* ; Macrophages, Peritoneal ; Monocytes ; Myeloid Cells*

Objectives: . Endoscopic tympanoplasty (ET) provides minimally invasive transcanal access to the middle ear and improves middle ear visibility for the treatment of tympanic membrane (TM) perforations. However, the literature on surgical outcomes for large TM perforations is lacking and limited to small series. This study aimed to evaluate the clinical benefits of ET for large TM perforations. Methods: . This retrospective cohort study was conducted at nine tertiary referral hospitals in South Korea, where 252 patients who underwent ET as primary surgery from September 2019 to August 2021 were included. The outcome measures included the graft success rate and pre- and postoperative audiometric data. Results: . In 239 patients, the graft success rate of ET for large or subtotal perforations was 86.2% (206 patients), while the graft failure rate was 13.8% (33 patients). The graft failure rate was directly correlated with surgical techniques, including overlay and medial or lateral underlay tympanoplasty (P=0.027). Lateral underlay tympanoplasty showed the most favorable results. Sex, laterality, etiology, site and size of perforation, operation time, and graft materials did not vary significantly between the graft success and failure groups (P>0.05). The mean air-bone gap (ABG) improved significantly in both groups (graft success group: 10.0±0.6 dB and graft failure group: 7.7±0.3 dB; P<0.001). However, the ABG improvement did not significantly differ between the groups. Analysis of covariance revealed that the postoperative 500-Hz bone conduction threshold improved after successful ET (adjusted coefficient, –11.351; 95% confidence interval, –21.491 to –1.212; P=0.028). Conclusion . This study involved the largest population to date of large TM perforations treated by ET. The study findings suggest that ET is feasible and effective in treating large TM perforations.