No abstract available.
Tuberculosis, Miliary*

Transrectal Ultrasonography (TRUS) easily provides an accurate assessment of the seminal tract. In Magnetic Resonance Imaging(MRI) of the seminal tract, the anatomic relationships are more clearly seen and the multiplanar imaging is available, so a more definitive diagnosis can be achieved. Although TRUS and MRI have been studied extensively, the findings of TRUS have not been compared with those of MRI. We studied 29 patients who were assessed with TRUS and MRI simultaneously due to disease of the seminal tract. The findings of cystic disease were coincident between TRUS and MRI. But the small size Mullerian duct cysts were not found in TRUS but were found in MRI. Hemorrhage of the ejaculatory duct and seminal vesicle, thickened ampulla portion of vas deferens were found only in MRI. Ejaculatory duct and seminal vesicle calcification were not easily found in TRUS due to their small size. The findings of seminal vesicle atrophy, dilatation and prostatic calcification between TRUS and MRI were discrepant. In conclusion, MRI is more helpful than TRUS in the diagnosis of small Mullerian duct cyst, small ejaculatory duct calculi, small seminal vesicle calculi, hemorrhage of ejaculatory duct and seminal vesicle and thickened ampulla portion of vas eferens.
Atrophy ; Calculi ; Diagnosis* ; Dilatation ; Ejaculatory Ducts ; Hemorrhage ; Humans ; Magnetic Resonance Imaging* ; Male ; Seminal Vesicles ; Ultrasonography* ; Vas Deferens

Purpose: To find diagnostic image features, to compare diagnostic performance of multiphase CT versus gadoxetic acid disodium-enhanced MRI (GAD-MRI), and to evaluate the impact of analyzing Liver Imaging Reporting and Data System (LI-RADS) imaging features, for distinguishing combined hepatocellular-cholangiocarcinoma (CHC) from hepatocellular carcinoma (HCC). Materials and Methods: Ninety-six patients with pathologically proven CHC (n = 48) or HCC (n = 48), diagnosed June 2008 to May 2018 were retrospectively analyzed in random order by three radiologists with different experience levels. In the first analysis, the readers independently determined the probability of CHC based on their own knowledge and experiences. In the second analysis, they evaluated imaging features defined in LI-RADS 2018. Area under the curve (AUC) values for CHC diagnosis were compared between CT and MRI, and between the first and second analyses. Interobserver agreement was assessed using Cohen’s weighted κ values. Results: Targetoid LR-M image features showed better specificities and positive predictive values (PPV) than the others. Among them, rim arterial phase hyperenhancement had the highest specificity and PPV. Average sensitivity, specificity, and AUC values were higher for MRI than for CT in both the first (P = 0.008, 0.005, 0.002, respectively) and second (P = 0.017, 0.026, 0.036) analyses. Interobserver agreements were higher for MRI in both analyses (κ = 0.307 for CT, κ = 0.332 for MRI in the first analysis; κ = 0.467 for CT, κ = 0.531 for MRI in the second analysis), with greater agreement in the second analysis for both CT (P = 0.001) and MRI (P < 0.001). Conclusion Rim arterial phase hyperenhancement on GAD-MRI can be a good indicator suggesting CHC more than HCC. GAD-MRI may provide greater accuracy than CT for distinguishing CHC from HCC. Interobserver agreement can be improved for both CT and MRI by analyzing LI-RADS imaging features.

Pyogenic liver abscess (PLA) can be caused by bacteria entering the liver via the portal vein or primary bacteremia, or it can be cryptogenic. Recently, Klebsiella pneumoniae has been increasingly found as a PLA pathogen. PLA due to this bacterium often leads to formation of extrahepatic abscesses. The treatment of choice is dual therapy with insertion of percutaneous catheter drainage and antibiotic therapy. We report 2 cases of PLA due to K. pneumoniae in immunocompetent children. We successfully treated patient 1 with percutaneous catheter drainage for 18 days and 6-week course of antibiotic therapy. Patient 2 was treated with percutaneous needle aspiration and antibiotic therapy for the same period. In both patients, the PLAs showed the ultrasound-confirmed resolutions after the dual therapy.
Abscess ; Anti-Bacterial Agents ; Bacteremia ; Bacteria ; Catheters ; Child ; Drainage ; Humans ; Immunocompetence ; Klebsiella pneumoniae ; Klebsiella ; Liver ; Liver Abscess, Pyogenic ; Needles ; Pneumonia ; Portal Vein

Objective: This study examined whether the changes in reimbursement coverage of brain magnetic resonance image (MRI) affected practice for patients who visited the emergency department with dizziness as the chief complaint. Methods: Among the 5,423 patients who visited the emergency department for dizziness in 2017, 2019, and 2021, 4,497 patients were included in the study retrospectively and investigated by brain diffusion-weighted MRI and the presence of cerebral infarction on brain diffusion-weighted MRI. This study examined whether there was a significant difference before and after the change. Results: In 2017, 2019, and 2021, 1,489, 1,570, and 1,438 patients with dizziness visited the emergency department, respectively. The number of patients who underwent a brain MRI scan gradually increased from 237 (15.9%) in 2017 to 628 (40.0%) in 2019 and 948 (65.9%) in 2021 (P<0.001). The number of positive findings on brain MRI scan increased gradually from 30 patients (2.0%) in 2017 to 47 patients (3.0%) in 2019 and 53 patients (3.7%) in 2021 (P=0.025). The ratio of positive findings of brain MRI scans to the number of patients who underwent brain MRI scans decreased gradually to 12.7% in 2017, 7.5% in 2019, and 5.6% in 2021 (P=0.001). Conclusion The changes in the reimbursement coverage of brain MRI affect the number of brain MRI scans and the detection of cerebral infarction.

Background/Aims: This study aimed to compare the diagnostic performances of Liver Imaging Reporting and Data System (LI-RADS) 2018 and Korean Liver Cancer Association-National Cancer Center (KLCA-NCC) 2018 criteria on magnetic resonance imaging (MRI) for the noninvasive diagnosis of hepatocellular carcinoma (HCC) in high-risk patients. Methods: This retrospective study included 273 treatment-naïve patients (71 patients with extracellular contrast agent [ECA]-MRI and 202 patients with hepatobiliary agent [HBA]-MRI; 352 lesions including 263 HCCs) with high risk of HCC who underwent contrast-enhanced MRI between 2016 and 2017. Two readers evaluated all lesions according to the criteria of LI-RADS 2018 and KLCA-NCC 2018. The per-lesion diagnostic performances were compared using the generalized estimating equation method. Results: On ECA-MRI, the sensitivity and specificity of LI-RADS 2018 and KLCA-NCC 2018 were not significantly different (LR-5 vs. definite HCC: 75.8% vs. 69.4%, P=0.095 and 95.8% vs. 95.8%, P>0.999; LR-5/4 vs. definite/probable HCC: 87.1% vs.83.9%, P=0.313 and 87.5% vs. 91.7%, P=0.307). On HBA-MRI, definite HCC of KLCA-NCC 2018 showed significantly higher sensitivity (79.1% vs. 68.2%, P<0.001) than LR-5 of LI-RADS 2018 without a significant difference in specificity (93.9% vs. 95.4%, P=0.314). Definite/probable HCC of KLCA-NCC 2018 had higher specificity (92.3% vs. 80.0%, P=0.003) than LR-5/4 of LI-RADS 2018. The sensitivity was lower for definite/probable HCC than for LR-5/4 without statistical significance (85.6% vs. 88.1%, P=0.057). Conclusions On ECA-MRI, LI-RADS 2018 and KLCA-NCC 2018 showed comparable diagnostic performances. On HBA-MRI, definite HCC of KLCA-NCC 2018 provided better sensitivity than LR-5 category of LI-RADS 2018 without compromising the specificity, while definite/probable HCC of KLCA-NCC 2018 revealed higher specificity than LR-5/4 of LI-RADS 2018 for diagnosing HCC.

Malignant mixed mullerian tumors (MMMT) are uncommon neoplasms of the female genital tract that histologically consist of malignant epithelial components and stromal components. Most MMMTs are found in postmenopausal women. The clinical course is very poor due to frequent metastasis and recurrence. Among the carcinogenic epidemiologic predisposing factors, the relationship of previous pelvic irradiation to subsequent development of a malignant mixed mullerian tumor has been reported in recent years. We are reporting a case of MMMT of the uterus which occured in a woman who received radiation therapy for cervical cancer 11 years before the present date.
Causality ; Female ; Humans ; Neoplasm Metastasis ; Recurrence ; Uterine Cervical Neoplasms* ; Uterus

Primary mixed carcinoid with mucinous tumor of borderline malignancy of the ovary is very rare ovarian tumor. Most of them arose in dermoid cyst or in mature solid teratoma. Its diagnosis was based on histological and immunohistochemical findings. We experienced a case of primary mixed carcinoid postoperatively and present with a brief review of literatures.
Carcinoid Tumor* ; Dermoid Cyst ; Diagnosis ; Female ; Mucins* ; Ovary* ; Teratoma

OBJECTIVE: The purpose of this study was to evaluate the incidence, causes and maternal complications in cases of fetal death in utero (FDIU). METHODS: This is a clinical study of 224 cases of FDIU among 10,582 deliveries at 00 University Hospital during January 1990 to December 2004. All the clinical informations were obtained by reviewing medical records retrospectively. RESULTS: The average incidence of FDIU was 2.1%. The mean age of mothers with FDIU was 28.5 years old. The mean gestational age was 30.4 weeks and mean weight of dead fetus was 1442 gm. The causes of FDIU were placenta abuptio (14.3%), severe preeclampsia (13.4%), congenital anomalies (9.4%), severe intrauterine growth restriction (IUGR, 9.4%), nuchal cord (6.7%), chrioamnionitis (5.8%). However the causes of FDIU were largely unknown (18.8%). The modes of delivery were induced labor (65.2%), laparotomy (26.8%), spontaneous labor (8.0%). The most common indication of laparotomy was placenta abuptio (36.7%). There were 66 cases (29.5%) with maternal complications and common complications were hemorrhage (11.2%), fever (8.5%), DIC (5.8%). The incidence of hypofibrinogenemia (<150 mg/dL) was 14.3%. CONCLUSION: The most common suspected causes of FDIU were placenta abruptio, severe preeclampsia and the causes could not be determined in 42 cases (18.8%). The proper prenatal care should be taken of fetuses on the basis of risk factors of antepartum and intrapartum so that unnecessary intrauterine fetal death might be able to be prevented.
Dacarbazine ; Female ; Fetal Death* ; Fetus ; Fever ; Gestational Age ; Hemorrhage ; Humans ; Incidence ; Labor, Induced ; Laparotomy ; Medical Records ; Mothers ; Nuchal Cord ; Placenta ; Pre-Eclampsia ; Pregnancy ; Prenatal Care ; Retrospective Studies ; Risk Factors

Norovirus (NoV) is an etiologic agent of human and animal acute gastroenteritis and is a member of the family Caliciviridae. NoV is classified based on nucleotide sequences of the VP1 gene into at least six genogroups (GI-GVI), among which GI, GII, and GIV are known to infect humans and GII is the most prevalent genogroup. In this study, VP1, the full gene of GII human NoV, was cloned from a human fecal sample and expressed using a baculovirus expression system. Human NoV VP1-specific monoclonal antibodies (MAbs) were produced using expressed recombinant VP1. Expressed VP1 in the recombinant virus was confirmed by polymerase chain reaction (PCR), indirect fluorescence antibody (IFA) test, and Western blot analysis. Eight hybridomas secreting VP1-specific MAbs against human GII NoV were generated and characterized. All of the MAbs produced in this study reacted with human GII NoV VP1-recombinant baculoviruses but not with other non-human calicivirus recombinant baculoviruses. These MAbs reacted specifically with human NoV GII.4-2009 virus-like particles (VLPs), and some MAbs showed cross-reactivity with other GII.4 variant VLPs. Expressed human GII NoV VP1-recombinant protein and MAbs specific to this protein can be used as useful reagents for detecting and characterizing human NoV.
Animals ; Antibodies, Monoclonal* ; Baculoviridae ; Base Sequence ; Blotting, Western ; Caliciviridae ; Clone Cells ; Fluorescence ; Gastroenteritis ; Genotype ; Humans* ; Hybridomas ; Indicators and Reagents ; Norovirus* ; Polymerase Chain Reaction