Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.
Basal Ganglia ; Humans ; Perfusion Imaging ; Perfusion* ; Stroke* ; Tomography, X-Ray Computed

Our objective was to evaluate the clinical feasibility of spatial domain filtering as an alternative to additional image reconstruction using different kernels in CT. Kernels were grouped as H30 (head medium smooth), B30 (body medium smooth), S80 (special) and U95 (ultra sharp). Derived from thin collimated source images, four sets of images were generated using phantom kernels. MTF (50%, 10%, 2%) measured with H30 (3.25, 5.68, 7.45 lp/cm), B30 (3.84, 6.25, 7.72 lp/cm), S80 (4.69, 9.49, 12.34 lp/cm), and U95 (14.19, 20.31, 24.67 lp/cm). Spatial resolution for the U95 kernel (0.6 mm) was 33.3% greater than that of the H30 and B30 (0.8 mm) kernels. Initially scanned kernels images were rated for subjective image quality, using a five-point scale. Image scanned with a convolution kernel led to an increase in noise (U95), whereas the results for CT attenuation coefficient were comparable. CT images increase the diagnostic accuracy in head (H30), abdomen (B30), temporal bone and lung (U95) kernels may be controlled by adjusting CT various algorithms, which should be adjusted to take into account the kernels of the CT undergoing the examination.
Abdomen ; Head ; Image Processing, Computer-Assisted ; Lung ; Noise ; Temporal Bone

PURPOSE: There has been controversy of the lobectomy for well differentiated thyroid cancer (WDTC). Current guidelines recommend total thyroidectomy for the cancer over 1cm, despite previous report suggesting that the lobectomy provides similar excellent outcomes. The purpose of our study is to report our experience of WDTC treated by thyroid lobectomy. METHODS: We retrospectively analyzed 284 patients with WDTC treated by thyroid lobectomy at department of Surgery in Chosun University Hospital from January 2002 to December 2010. Overall survival (OS) and disease-free survival (DFS) were determined by the Kaplan-Meier method. Factors predictive of recurrence by univariate and multivariate analysis were determined using the χ2 test and Cox proportional hazard model respectively. RESULTS: With a mean follow-up of 60.4 months, OS and RFS for all patients were 97.9% and 96.5% respectively. No patient died due to WDTC. Univariate analysis showed statistically significant differences in recurrence by tumor size (P=0.013) and presence of invasion (P=0.039). However, Multivariate analysis showed no significant difference in local recurrence. CONCLUSION: Patients with WDTC confined to one lobe can be safely treated by lobectomy.
Disease-Free Survival ; Follow-Up Studies ; Humans ; Methods ; Multivariate Analysis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy

PURPOSE: The purpose of this study was to investigate expectations regarding aging by middle-aged women in the community, and identify factors contributing to their expectations about aging. METHODS: Participants in the survey for this study were 303 middle-aged women from community health centers and religious facilities in Seoul, Gyeonggi Province, and Chungcheongbuk Province. Data were collected from March 2 to April 17, 2012 using self-report structured questionnaires. The instruments were the Health Perceptions, Rosenberg Self-esteem Scale (RSES), Family APGAR, Expectations Regarding Aging (ERA-12). The data were analyzed using t-test, one-way ANOVA, Scheffe test, Pearson correlation coefficients and hierarchical multiple regression with IBM SPSS/WIN 20.0 program. RESULTS: Perceived health status (beta=0.16, p=.009) and self-esteem (beta=0.20, p=.001) of middle-aged women were identified as significant predictors of expectations regarding aging, after adjusting for age, education, occupation, monthly income and menstrual status. CONCLUSION: These results suggest that nurses should make an effort to improve expectations about aging among middle-aged women. Ultimately, community health programs for middle aged women need to be developed to achieve successful aging.
Adult ; *Aging ; Analysis of Variance ; Demography ; Female ; *Health Status ; Humans ; Income ; Middle Aged ; Perception ; Quality of Life ; Questionnaires ; *Self Concept ; Women/*psychology

PURPOSE: The purpose of this study was to investigate the radiologic and serologic factors related to postoperative union using intramedullary (IM) internal fixation in atypical femoral fractures (AFF), which are closely related to bisphosphonates (BPs) for osteoporosis. MATERIALS AND METHODS: From February 2008 to December 2016, 65 patients (71 cases) who had undergone IM nail fixation after diagnosis of AFF were enrolled in this study. Patients were divided into group A, who experienced union within 6 months and group B, who did not experience union within 6 months. They were evaluated for duration of BPs use, radiologic factors and serological factors. RESULTS: The mean duration of BPs use was 6.17 years in group A and 8.24 years in group B (p=0.039). In the subtrochanteric area, there were 14 cases (27.5%) in group A and 14 cases (70.0%) in group B. In the femoral shaft, there were 37 cases (72.5%) in group A and 6 cases (30.0%) in group B (p=0.001). On the preoperative, the flexion in the coronal plane was 5.9° (2.1°–9.2°) in group A and 8.0° (3.1°–12.1°) in group B (p=0.041). On the postoperative, conversion to valgus was 15 cases (29.4%), 8 cases (40.0%); conversion to neutral was 34 cases (66.7%) and 8 cases (40.0%); conversion to varus was 2 cases (3.9%) and 4 cases (20.0%), each (p=0.037). The fracture site gap was 1.5 mm (0–2.9 mm) on the front side and 1.2 mm (0–2.2 mm) on lateral side and 2.2 mm (0.9–4.7 mm) and 1.9 mm (0.5–3.5 mm), each (p=0.042, p=0.049). Among serological factors, there was no significant difference between the two groups. CONCLUSION: Factors adversely affecting the union should be recognized before surgery, such as longterm BPs use or a severe degree of bending of the femur in the coronal plane. During surgery, proper reduction and spacing of the fracture site on the coronal plane should allow adequate reduction of the anterior and posterior surfaces. Obtaining anatomic reduction would be most beneficial for union, but if that is not possible, obtaining congenital valgus rather than varus on the coronal plane may be helpful for union.
Diagnosis ; Diphosphonates ; Femoral Fractures ; Femur ; Humans ; Osteoporosis

PURPOSE: A papillary thyroid microcarcinoma (PTMC) measures 1 cm or less in diameter. The diagnosis, and thus the apparent incidence, of PTMC has recently increased owing to an increase in the detection of subclinical small and low-risk carcinomas with ultrasonography and fine needle aspiration cytology. However, central neck lymph node metastasis (CLNM) can occur in patients with PTMC. We evaluated the factors influencing CLNM in patients with PTMC. METHODS: We reviewed medical records including clinical information and pathologic reports, and analyzed 622 patients with PTMC who underwent thyroid surgery from January 2002 to December 2012. RESULTS: CLNM was detected in 119 patients (19.1%) of the 622 with PTMC. Lymph node metastasis occurred more frequently in males (P=0.025), and those with bilateral tumors (P=0.016), more than two tumors (P=0.035), tumor size greater than 5 mm (P<0.001), and lymphovascular invasion (P=0.024). There were no statistically significant differences in age and capsular invasion. Multivariate analysis showed that significant factors affecting lymph node metastasis included age at operation (odds ratio [OR]=0.647, 95% confidence interval [CI]=0.422∼0.990, P=0.045), sex (OR=0.489, 95% CI=0.268∼0.891, P=0.020), tumor size (OR=3.034, 95% CI=1.761∼5.224, P<0.001), and lymphovascular invasion (OR=15.036, 95% CI=1.450∼155.911, P=0.023). CONCLUSION: Age less than 45 years, male sex, tumor size greater than 5 mm, and lymphovascular invasion were risk factors associated with CLNM.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Humans ; Incidence ; Lymph Nodes* ; Male ; Medical Records ; Multivariate Analysis ; Neck* ; Neoplasm Metastasis* ; Risk Factors ; Thyroid Gland* ; Ultrasonography

Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.
Axillary Vein ; Catheters, Indwelling/*adverse effects ; Cough/*complications ; Device Removal/*methods ; Foreign-Body Migration/*etiology/radiography ; Heart Atria ; Humans ; Lung Neoplasms/drug therapy ; Male ; Middle Aged

Although halothane is generally anesthetic of choice for asthmatics due to its bronchodilatory action, its combined use with aminophylline should be discouraged. This report is a 43-year-old male who had primary closure and open reduction internal fixation (ORIF) for facial avulsion injury and zygomatic tripod fracture under N2O-O2-halothane anesthesia. About 90 minutes after the procedure, the patient who had aminophylline infusion for an acute bronchospasm developed a sudden cardiac arrest. The immediate cardiopulmonary resuscitation was applied and the patient was recovered without any neurological deficit. At the time, the serum theophylline concentration of the patient was 16 microgram/ml which was in the range of normal therapeutic dose. The cause for this cardiac arrest by halothane is unknown, but possibly a drug interaction between halothane and aminophylline might have contributed, since halothane sensitizes the heart to exogenous catecholamines.
Adult ; Aminophylline* ; Anesthesia ; Bronchial Spasm ; Cardiopulmonary Resuscitation ; Catecholamines ; Death, Sudden, Cardiac ; Drug Interactions* ; Halothane* ; Heart ; Heart Arrest* ; Humans ; Male ; Theophylline

Purpose: Breast cancer is the second most common malignancy in Korean women, and its incidence has increased rapidly. The purpose of this study was to evaluate the treatment outcomes of patients with breast cancer treated at a low volume center. Methods: We retrospectively analyzed 401 patients with stage I-III breast cancer at Chosun University Hospital from January 1998 to December 2013. We reviewed medical records including clinical information and pathologic reports. Results: We found 401 cases of newly diagnosed breast cancer, including 5 (1.2%) male breast cancer patients. According to histological features, there were 43 cases (ductal carcinoma in situ (DCIS): 35 cases [8.7%], lobular carcinoma in situ (LCIS): 8 cases [2.0%]) of non-invasive carcinoma, 350 cases (87.3%) of invasive carcinoma, 2 cases (0.5%) of Paget’s disease, 1 case (0.2%) of malignant phyllodes tumor, 3 cases (0.7%) of sarcoma, and 2 cases (0.5%) of other types. With respect to disease stage, 117 (29.2%) patients were in stage I, 176 (43.9%) in stage II, and 78 (19.4%) in stage III. The type of surgical approaches were breast-conserving surgery (153, 38.2%), modified radical mastectomy (243, 60.6%), wide excision (4, 1.0%), and others (1, 0.2%). Five-year disease-free survival rates were 100% (stage 0), 95.4% (stage I), 91.4% (stage IIa), 75% (stage IIb), 78% (stage IIIa), 50% (stage IIIb), and 59.2% (stage IIIc). Overall survival rates were 100% (stage 0), 96.2% (stage I), 94.3% (stage IIa), 85.4% (stage IIb), 84.8% (stage IIIa), 50% (stage IIIb), and 55.5% (stage IIIc). Conclusion Although the patients were treated at a low-volume center, their favorable survival outcomes are notable. Further multicenter (low-volume centers) research is warranted.

We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.
Adult ; Contrast Media* ; Extravasation of Diagnostic and Therapeutic Materials* ; Hand ; Humans ; Injections, Subcutaneous* ; Tomography, X-Ray Computed