No abstract available.
Cholangiocarcinoma*

PURPOSE: The aim of this study is to evaluate the T2 value of the articular cartilage of the glenohumeral joint in rotator cuff disease displayed on 3.0T MRI and to apply it in clinical practice. MATERIALS AND METHODS: This study involved sixty-two patients who underwent shoulder MRI containing T2 mapping. The mean T2 value was measured by placing a free hand ROI over the glenoid or humeral cartilage from the bone-cartilage interface to the articular surface on three consecutive, oblique coronal images. The drawn ROI was subsequently divided into superior and inferior segments. The assessed mean T2 values of the articular cartilage of the glenohumeral joint were compared and evaluated based on the degree of rotator cuff tear, the degree of fatty atrophy of the rotator cuff, and the acromiohumeral distance. RESULTS: ICC values between two readers indicated moderate or good reproducibility. The mean T2 value for the articular cartilage of the glenoid and humeral head cartilage failed to show any significant difference based on the degree of rotator cuff tear. However, the mean T2 values of articular cartilage, based on fatty atrophy, tended to be higher in fatty atrophy 3 or fatty atrophy 4 groups while some sub-regions displayed significantly higher mean T2 values. There was no correlation between the acromiohumeral distance and the mean T2 values of the articular cartilage of the glenoid and humeral head. CONCLUSION: T2 mapping of the glenohumeral joint failed to show any significant difference in quantitative analysis of the degenerative change of the articular cartilage based on the degree of rotator cuff tear. However, it also offers quantitative information on the degenerative change of cartilage of the glenohumeral joint in patients with rotator cuff tear and severe fatty atrophy of the rotator cuff.
Atrophy ; Cartilage ; Cartilage, Articular ; Hand ; Humans ; Humeral Head ; Magnetic Resonance Imaging ; Rotator Cuff ; Shoulder ; Shoulder Joint ; Tears

A 43-year-old female patient with a congenital right coronary artery to right atrial fistula presented as congestive heart failure and aortic valve infective endocarditis. The diagnosis was made on the basis of echocardiography, especially TEE and confirmed by tight heart catheterization & aortography. She underwent aortic valve replacement due to severe aortic valve regurgitation with vegetations, fistulectomy and coronary aneurysmorrhaphy. The postoperative course was uneventful. She was treated with antibiotics because of infective endocarditis for 6 weeks. At present she remains well and visits out patient clinic regularly for oral anticoagulation without problem.
Adult ; Anti-Bacterial Agents ; Aortic Valve* ; Aortography ; Arteriovenous Fistula* ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Diagnosis ; Echocardiography ; Endocarditis* ; Estrogens, Conjugated (USP)* ; Female ; Fistula ; Heart Failure* ; Humans

Background: Survival and post-cardiac arrest care vary considerably by hospital, region, and country. In the current study, we aimed to analyze mortality in patients who underwent cardiac arrest by hospital level, and to reveal differences in patient characteristics and hospital factors, including post-cardiac arrest care, hospital costs, and adherence to changes in resuscitation guidelines. Methods: We enrolled adult patients (≥ 20 years) who suffered non-traumatic cardiac arrest from 2006 to 2015. Patient demographics, insurance type, admission route, comorbidities, treatments, and hospital costs were extracted from the National Health Insurance Service database. We categorized patients into tertiary hospital, general hospital, and hospital groups according to the level of the hospital where they were treated. We analyzed the patients' characteristics, hospital factors, and mortalities among the three groups. We also analyzed post-cardiac arrest care before and after the 2010 guideline changes. The primary end-point was 30 days and 1 year mortality rates. Results: The tertiary hospital, general hospital, and hospital groups represented 32.6%, 49.6%, and 17.8% of 337,042 patients, respectively. The tertiary and general hospital groups were younger, had a lower proportion of medical aid coverage, and fewer comorbidities, compared to the hospital group. Post-cardiac arrest care, such as percutaneous coronary intervention, targeted temperature management, and extracorporeal membrane oxygenation, were provided more frequently in the tertiary and general hospital groups. After adjusting for age, sex, insurance type, urbanization level, admission route, comorbidities, defibrillation, resuscitation medications, angiography, and guideline changes, the tertiary and general hospital groups showed lower 1-year mortality (tertiary hospital vs. general hospital vs. hospital, adjusted odds ratios, 0.538 vs. 0.604 vs. 1; P < 0.001). After 2010 guideline changes, a marked decline in atropine use and an increase in post-cardiac arrest care were observed in the tertiary and general hospital groups. Conclusion The tertiary and general hospital groups showed lower 30 days and 1 year mortality rates than the hospital group, after adjusting for patient characteristics and hospital factors. Higher-level hospitals provided more post-cardiac arrest care, which led to high hospital costs, and showed good adherence to the guideline change after 2010.

Background: Survival and post-cardiac arrest care vary considerably by hospital, region, and country. In the current study, we aimed to analyze mortality in patients who underwent cardiac arrest by hospital level, and to reveal differences in patient characteristics and hospital factors, including post-cardiac arrest care, hospital costs, and adherence to changes in resuscitation guidelines. Methods: We enrolled adult patients (≥ 20 years) who suffered non-traumatic cardiac arrest from 2006 to 2015. Patient demographics, insurance type, admission route, comorbidities, treatments, and hospital costs were extracted from the National Health Insurance Service database. We categorized patients into tertiary hospital, general hospital, and hospital groups according to the level of the hospital where they were treated. We analyzed the patients' characteristics, hospital factors, and mortalities among the three groups. We also analyzed post-cardiac arrest care before and after the 2010 guideline changes. The primary end-point was 30 days and 1 year mortality rates. Results: The tertiary hospital, general hospital, and hospital groups represented 32.6%, 49.6%, and 17.8% of 337,042 patients, respectively. The tertiary and general hospital groups were younger, had a lower proportion of medical aid coverage, and fewer comorbidities, compared to the hospital group. Post-cardiac arrest care, such as percutaneous coronary intervention, targeted temperature management, and extracorporeal membrane oxygenation, were provided more frequently in the tertiary and general hospital groups. After adjusting for age, sex, insurance type, urbanization level, admission route, comorbidities, defibrillation, resuscitation medications, angiography, and guideline changes, the tertiary and general hospital groups showed lower 1-year mortality (tertiary hospital vs. general hospital vs. hospital, adjusted odds ratios, 0.538 vs. 0.604 vs. 1; P < 0.001). After 2010 guideline changes, a marked decline in atropine use and an increase in post-cardiac arrest care were observed in the tertiary and general hospital groups. Conclusion The tertiary and general hospital groups showed lower 30 days and 1 year mortality rates than the hospital group, after adjusting for patient characteristics and hospital factors. Higher-level hospitals provided more post-cardiac arrest care, which led to high hospital costs, and showed good adherence to the guideline change after 2010.

BACKGROUND AND OBJECTIVES: Practical concerns about transradial approach are increasing in consideration of high procedural success rate, low local complications, and patient's convenience. There was no available data about repeated-use of radial artery for coronary procedures. We evaluate the changes of radial arterial diameter and procedural outcomes of repeated transradial procedure. MATERIALS AND METHOD: Of consecutive 1771 transradial coronary procedures, 117 patients received repeated transradial procedures through the same radial artery. Radial arterial diameter, vascular access time and procedural outcomes were evaluated in between the group of first-use and repeated-use of radial artery. RESULTS: Among 117 patients of second transradial coronary procedure in the repeated-use group, 47 patients (41.6%) underwent coronary intervention and 66 patients (58.4%) underwent coronary angiography. The right radial approach was used in 82.9% of the cases. There was no significant difference in radial artery mean diameter between pre-procedure and 1 day after procedure in patients with first-use and repeated-use group. There was no significant change of radial arterial diameter after first-use depending on the SAR (the ratio of sheath outer diameter to radial artery inner diameter). However, after repeated-use of radial artery, there was significant reduction of radial arterial diameter 1 day after procedure in the patients with SAR more than 0.9 (p<0.05). In repeated-use group, the mean radial arterial diameter was 2.63 +/- 0.35mm mm before the procedure and 2.51 +/- 0.29mm during follow-up (136 +/- 123 days) (p<0.05). There was no significant difference of the vascular access time between the first-use and repeated-use procedures (2.9+/-3.1 vs 3.3+/-3.6 minutes, p<0.05). The procedural success and vascular complication rate of repeated-use of radial artery were as similar to those of the first-use, but total occlusion of radial artery was higher in the repeated-use group (2.6% vs 0.7%, p<0.05). CONCLUSION: The diameter of radial artery after transradial procedures was significantly reduced during follow-up and the incidence of asymptomatic radial artery occlusion was more frequent after repeated-use. However, repeated-use of radial artery was feasible in most patients with high procedural success rate and low vascular complications.
Coronary Angiography ; Follow-Up Studies ; Humans ; Incidence ; Radial Artery*

Myoid hamartoma is an uncommon type of breast hamartoma and its recurrence is very rare. We report the imaging appearance of an unusual case of recurrent myoid hamartoma of the breast mimicking malignancy in a 43-year-old woman. Although the mammographic and ultrasonographic findings have long been described in the literature, MR finding with a dynamic study has not, to the best of our knowledge, been reported previously.
Adult ; Biopsy, Needle ; Breast Neoplasms/*pathology/surgery ; Diagnosis, Differential ; Female ; Fibroadenoma/*pathology ; Hamartoma/*pathology/surgery ; Humans ; Immunohistochemistry ; Magnetic Resonance Imaging/*methods ; Neoplasm Recurrence, Local/pathology

PURPOSE: We evaluated the impact of three automatic optimization of parameters (AOP) modes of digital mammography on the dose and image quality. METHODS: Computerized Imaging Reference Systems phantoms were used. A total of 12 phantoms with different thickness and glandularity were imaged. We analyzed the average glandular dose (AGD) and entrance surface exposure (ESE) of 12 phantoms imaged by digital mammography in three modes of AOP; namely standard mode (STD), contrast mode (CNT), and dose mode (DOSE). Moreover, exposure factors including kVp, mAs, and target/filter combination were evaluated. To evaluate the quality of the obtained digital image, two radiologists independently counted the objects of the phantoms. RESULTS: According to the AOP modes, the score of masses and specks was sorted as CNT>STD=DOSE. There was no difference in the score of fiber among the three modes. The score of image preference was sorted as CNT>STD>DOSE. The AGD, ESE, and mAs were sorted as CNT>STD>DOSE. The kVp was sorted as CNT=STD>DOSE. The score of all test objects in the phantom image was on a downtrend with increasing breast thickness. The score of masses was different among the three groups; 20-21%>30%>50% glandularity. The score of specks was sorted as 20-21%=30%>50% glandularity. The score of fibers was sorted as 30%>20-21%=50% glandularity. The score of image preference was not different among the three glandularity groups. The AGD, ESE, kVp, and mAs were correlated with breast thickness, but not correlated with glandularity. CONCLUSION: The DOSE mode offers significant improvement (19.1-50%) in dose over the other two modes over a range of breast thickness and breast glandularity with acceptable image quality. Owning knowledge of the three AOP modes may reduce unnecessary radiation exposure by utilizing the proper mode according to its purpose.
Breast ; Mammography ; Phantoms, Imaging ; Radiation Dosage

Authors experienced a unique case of craniopharyngioma which had evolved rapidly after 4 years of total resection for supratentorial meningioma. A 58-year-old woman presented with headache and visual deterioration. Previously, she had undertaken surgical removal of frontal convexity meningioma 4 years ago and had been well without any postoperative sequelae thereafter. Brain magnetic resonance imaging demonstrated a newly developed suprasellar mass. Pertinent operative procedure was performed and histological verification was made as an adamantinomatous craniopharyngioma. She has been showing unremarkable clinical course up to date. Possible pathogenic mechanisms of de novo development of craniopharyngioma are disscussed with review of case.
Brain ; Craniopharyngioma* ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Meningioma* ; Middle Aged ; Surgical Procedures, Operative

The roles of TGF-beta1, beta2 and beta3 according to gestational ages and histodifferentiation were studied using immunohistochemistry with rat fetuses. 1. From day 14 to 21 of fetal rat, all the TGF-beta1, beta2 and beta3 were expressed in endocardium, myocardium, bronchiole, tunica intima of blood vessles, mucosa and serosa of intestine, striated muscle, hepatic capsule, hepatic hemopoietic cells, meninges, epidermis and dermis. 2. From day 14 to 21 of fetal rat, TGF-beta1 was not expressed in the smooth muscle of blood vessel and intestinal tract, alveolar cell and renal tubular cell. TGF-beta2 was not expressed in the smooth muscle of blood vessel and intestinal tract and alveolar cell. TGF-beta3 was not expressed in osteocyte, alveolar cell, and basement membrane of renal cuboidal epithelial cell. And TGF-betas expressed especially in early or late gestational age and the degree of expression increased or decreased with gestational age. 3. The TGF-beta1, beta2 and beta3 were expressed in tissues originated from 3 germ layers except several tissues, and those originated from mesoderm exhibited strong expression. The TGF-beta1 was expressed more widely than TGF-beta2 and beta3 during gestation. In summary, TGF-beta1, beta2 and beta3 were considered as important control factors of cell to cell interaction in the morphogenesis of tissues during fetal development.
Animals ; Basement Membrane ; Blood Vessels ; Bronchioles ; Cell Communication ; Dermis ; Endocardium ; Epidermis ; Epithelial Cells ; Fetal Development ; Fetus ; Germ Layers ; Gestational Age ; Immunohistochemistry ; Intestines ; Meninges ; Mesoderm ; Morphogenesis ; Mucous Membrane ; Muscle, Smooth ; Muscle, Striated ; Myocardium ; Osteocytes ; Pregnancy ; Rats* ; Serous Membrane ; Transforming Growth Factor beta ; Transforming Growth Factor beta1 ; Transforming Growth Factor beta2 ; Transforming Growth Factor beta3 ; Transforming Growth Factors* ; Tunica Intima