PURPOSE: The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. MATERIALS AND METHODS: This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm2. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. RESULTS: All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10-3 mm2/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10-3 mm2/sec). CONCLUSION: DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory.
Arachnoid ; Astrocytoma ; Brain ; Brain Abscess ; Diagnosis ; Diagnosis, Differential* ; Diffusion* ; Ependymoma ; Glioblastoma ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Male ; Neoplasm Metastasis ; Neurilemmoma

Acute lymphoblastic leukemia (ALL), in general, can be diagnosed by detecting blasts in peripheral blood or bone marrow. Some of the cases of ALL do not show typical leukemic features, and only manifest as refractory anemia, thrombocytopenia, myelofibrosis and lymphocytic infiltration into bone marrow. Several months after presentation, they may reveal typical leukemic features and are diagnosed as ALL. This kind of leukemia is called ALL with aleukemic prodrome. Although the incidence of ALL with aleukemic prodrome is 1.5~2.2% of childhood ALL cases, it is rarely reported in Korea. We experienced a 6 month-old female infant who presented with refactory anemia and thrombocytopenia, and two serial of bone marrow examination revealed only myelofibrosis. She subsequently developed ALL 3 months later. We report this case with a brief review of related literatures.
Anemia ; Anemia, Refractory ; Bone Marrow ; Bone Marrow Examination ; Female ; Humans ; Incidence ; Infant ; Korea ; Leukemia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Primary Myelofibrosis ; Thrombocytopenia

BACKGROUND: To determine the natural progression of conservatively treated rotator cuff tears, we evaluated changes in radiologic and clinical parameters in patients whose recalcitrant tears were neglected after conservative treatment. METHODS: A total of 73 patients with recalcitrant rotator cuff tears in spite of conservative treatment were included in this study. We measured changes in tear size and in the extent of fatty infiltration of the rotator cuff by comparing the initial and final follow-up magnetic resonance imagings (MRIs). To determine factors influencing the change in tear size, we collected the medical history of patients taken at the time of initial admission. RESULTS: The average follow-up period was 20.1 months, and the average increase in tear size across this period was 6.2 mm. In terms of steroid injection, we found that the increases in tear size of the steroid injection group (p=0.049) and of the sub-group that had received more than three steroid injections (p=0.010) were significantly greater than that of the non-steroid injection group. CONCLUSIONS: We found that the increase in cuff tear size was on average 6.2 mm across the follow-up period, indicating that neglecting cuff tears may cause them to progress into more severe tears. We also observed that a history of steroid injection might be a possible risk factor for a worse prognosis of cuff tears. Therefore, we suggest that patients with rotator cuff tears and a history of steroid injection are recommended aggressive modes of treatment such as surgery.
Follow-Up Studies ; Humans ; Magnetic Resonance Imaging* ; Prognosis ; Retrospective Studies* ; Risk Factors ; Rotator Cuff* ; Tears*

PURPOSE: We wanted to analyze the citation trend and to find a way to improve the impact factor (IF) of the Journal of the Korean Radiological Society (JKRS). MATERIALS AND METHODS: The number of articles and references, the total citations and self-citations, the IF and the IF excluding self-citations (ZIF) were described by an analysis of Korean Medical Citation Index (KoMCI) during 2000-2005. The total and self citations of the JKRS were compared to that of the Top 5 journals. RESULTS: There was a 57% decrease of papers for 6 years. The Korean references/paper ranged from 0.98-0.85. The number of total citations received steadily decreased from 394 in 2000 to 180 in 2005. The IF (ZIF) of the JKRS has been gradually lowered from 0.142 (0.049) in 2000 to 0.063 (0.059) in 2005. Although the total citations that cited all papers published/the annual number of papers was 55% of that of the top 5 journals, the total citations citing papers published within the recent two years was only 24% of that of the top 5 journals. CONCLUSION: The citation status of the JKRS hassteadily decreased for the recent 6 years, and the IF of the JKRS was very low among all the Korean medical journals. To improve the IF, active advertising for the journal members of the importance of the IF is needed to encourage citing JKRS papers that have been published within the recent two years.
Statistics as Topic

PURPOSE: Recently, the clinical performance examination (CPX) using standardized patients has been introduced to several Korean medical schools. The purpose of this paper is to evaluate the correlation of CPX scores with the scores of other clinical clerkship assessments and written examinations. METHODS: We evaluated the correlation of the scores of CPX, which was administered to third-year medical students (n=230) at Seoul National University College of Medicine in January 2005, with the scores of a slide examination in internal medicine, an objective structured clinical examination (OSCE) in pediatrics and obstetrics/gynecology, and the written examinations in internal medicine and general surgery. RESULTS: CPX scores showed a mild correlation with the scores of the slide examination in internal medicine and OSCE in pediatrics and obstetrics/gynecology (r=0.19, 0.28, 0.30). CPX scores were also mildly correlated with written examination scores in internal medicine but not associated with those in general surgery. CONCLUSION: Considering the mild correlation of CPX scores with scores of other clinical clerkship assessments and written examinations, CPX should be affirmatively considered as an examination complementary to previous examinations.
Clinical Clerkship* ; Humans ; Internal Medicine ; Pediatrics ; Schools, Medical ; Seoul ; Students, Medical

BACKGROUND: CELL-DYN Sapphire (Abbott Diagnostics, Santa Clara, CA, USA) hematology analyzer is based on laser multi angle polarized scatter separation, focused flow impedance and fluorescent flow cytometry. In order to assess the usefulness of this newly introduced analyzer, we evaluated the precision and correlation of complete blood count including white blood cell differential count and reticulocyte count of CELL-DYN Sapphire instrument. METHODS: Patient samples ordered for complete blood count and white blood cell differential count and CELL-DYN 29 Plus control samples were used. We evaluated the precision of complete blood count and WBC differential count and analyzed correlation of these parameters for comparison with ADVIA 120 (Bayer corporation, Tarrytown, NY, USA) and manual count. We additionally evaluated reticulocyte parameters for precision and comparison with ADVIA 120. RESULTS: Short term precisions showed low coefficient of variation (CV) values for all CBC parameters including lower than 3% CV values for neutrophil and lymphocyte count. Long term precision showed lower than 4% CV values for all CBC and WBC differential count except for basophils. Comparison with ADVIA 120 showed good correlation for CBC except for MCHC. Good correlation was confirmed in all differential counts except for basophils. Comparison with manual WBC differential count showed good correlation except for monocyte and eosinophil. CONCLUSIONS: CELL-DYN Sapphire has high precision and good correlation with ADVIA 120 and manual count. CELL-DYN Sapphire is an exceptional instrument for CBC with WBC differentials and reticulocyte counting.
Aluminum Oxide ; Basophils ; Blood Cell Count ; Electric Impedance ; Flow Cytometry ; Hematology ; Humans ; Leukocytes ; Lymphocyte Count ; Monocytes ; Neutrophils ; Reticulocyte Count ; Reticulocytes

BACKGROUND: CELL-DYN Sapphire (Abbott Diagnostics, Santa Clara, CA, USA) hematology analyzer is based on laser multi angle polarized scatter separation, focused flow impedance and fluorescent flow cytometry. In order to assess the usefulness of this newly introduced analyzer, we evaluated the precision and correlation of complete blood count including white blood cell differential count and reticulocyte count of CELL-DYN Sapphire instrument. METHODS: Patient samples ordered for complete blood count and white blood cell differential count and CELL-DYN 29 Plus control samples were used. We evaluated the precision of complete blood count and WBC differential count and analyzed correlation of these parameters for comparison with ADVIA 120 (Bayer corporation, Tarrytown, NY, USA) and manual count. We additionally evaluated reticulocyte parameters for precision and comparison with ADVIA 120. RESULTS: Short term precisions showed low coefficient of variation (CV) values for all CBC parameters including lower than 3% CV values for neutrophil and lymphocyte count. Long term precision showed lower than 4% CV values for all CBC and WBC differential count except for basophils. Comparison with ADVIA 120 showed good correlation for CBC except for MCHC. Good correlation was confirmed in all differential counts except for basophils. Comparison with manual WBC differential count showed good correlation except for monocyte and eosinophil. CONCLUSIONS: CELL-DYN Sapphire has high precision and good correlation with ADVIA 120 and manual count. CELL-DYN Sapphire is an exceptional instrument for CBC with WBC differentials and reticulocyte counting.
Aluminum Oxide ; Basophils ; Blood Cell Count ; Electric Impedance ; Flow Cytometry ; Hematology ; Humans ; Leukocytes ; Lymphocyte Count ; Monocytes ; Neutrophils ; Reticulocyte Count ; Reticulocytes

We report an extremely rare case of a diffuse hepatic hemangiomatosis without extrahepatic involvement in an adult. The imaging findings of this tumor were similar to those of a hepatic hemangioma and included contrast enhancement with a centripetal filling pattern of the entire hepatic tumor on the delayed phase of a dynamic CT and inhomogeneous diffuse uptake of the entire tumor on blood-pool images obtained five hours later on a 99mTc-labeled red blood cell scan. Despite its rarity, diffuse hepatic hemangiomatosis can be suggested in adult patients with diffusely involved hepatic tumors showing the radiological findings of a hepatic hemangioma.
Adult ; Female ; Gated Blood-Pool Imaging ; Hemangioma/*diagnosis/pathology/ultrasonography ; Humans ; Liver Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography, X-Ray Computed

Takayasu arteritis (TA) is a chronic systemic inflammatory disease that most commonly affects the aorta and its major branches. TA-induced renal artery stenosis (TARAS) can result in malignant hypertension, severe renal dysfunction, cardiac decompression and premature death. Surgical management for TARAS has been proved to be effective and safe, especially in the medically or interventionally-intractable cases. We report here on a 39-year-old patient with recently deteriorating hypertension and renal function because of a recurred RAS, for which he underwent "y-shaped" aorto-birenal reconstruction surgery 20 years ago. CT angiography showed bilateral diffuse calcified stenosis in the previous renal graft and there was a partial rupture of a pseudoaneurysm in the suprarenal abdominal aorta segment between the celiac axis and the renal graft. We performed descending thoracic aorto-abdominal aortic bypass together with a graft-renal bypass and exclusion of the pseudoaneurysm. The renal function was normalized and the blood pressure became stable without any antihypertensive medication. He recovered and was discharged without any complications.
Adult ; Aneurysm, False ; Angiography ; Aorta ; Aorta, Abdominal ; Axis, Cervical Vertebra ; Blood Pressure ; Constriction, Pathologic ; Decompression ; Humans ; Hypertension ; Hypertension, Malignant ; Hypertension, Renovascular ; Mortality, Premature ; Renal Artery Obstruction ; Rupture ; Takayasu Arteritis ; Transplants

BACKGROUND: Commercial kits of PCR method are widely used in HLA-B27 typing; however, their cost is relatively high. In this study, we evaluated the utility of an in-house PCR method by comparing it with that of a commercial kit. METHODS: HLA-B27 typing was done in 188 patients by using two PCR methods, Absolute(TM) HLAB27 PCR kit (Biosewoom, Korea) and an in-house PCR method. The primers used in the in-house method were prepared by Bioneer (Korea). Both PCR tests were done by Gene Amp PCR System 9600 (Perkin-Elmer Centus Corp., USA). RESULTS: The commercial kit and in-house PCR showed 100% concordance rate with each other in HLA-B27 typing. Of 188 patients tested 72 (38.3%) were positive and 116 (61.7%) were negative by the both tests. Of 62 patients with ankylosing spondylitis, 50 were positive (80.7%). CONCLUSIONS: The in-house PCR is a reliable and cost-effective method and can replace or supplement commercial kits for HLA-B27 typing.
Adult ; Female ; HLA-B27 Antigen/blood/*genetics ; Histocompatibility Testing/*methods ; Humans ; Male ; Polymerase Chain Reaction/*methods ; Reagent Kits, Diagnostic ; Sensitivity and Specificity