1.The Usefulness of Diffusion Weighted Imaging in the Differential Diagnosis of Various Intracranial Cystic Lesions.
Yon Kwon IHN ; Jeong Su JUN ; Seong Su HWANG ; Jun Hyun BAIK ; Young Ha PARK
Journal of the Korean Radiological Society 2004;50(6):415-421
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
2.Acute Marchiafava-Bignami Disease: Diffusion-Weighted MRI in Cortical and Callosal Involvement.
Yon Kwon IHN ; Seong Su HWANG ; Young Ha PARK
Yonsei Medical Journal 2007;48(2):321-324
Marchiafava-Bignami disease (MBD) is a fatal disorder characterized by demyelination of the corpus callosum. MRI, suggestive of corpus callosum demyelination with associated white matter involvement in both cerebral hemispheres, indicates a diagnosis of MBD. In this case, MR diffusion-weighted findings taken at an acute stage of MBD revealed lesions not only in the corpus callosum but also in the cerebral cortex. Lower apparent diffusion coefficient values of the corpus callosum and cortical lesions were associated with poor clinical outcome.
Middle Aged
;
Male
;
Humans
;
Demyelinating Diseases/*pathology
;
Corpus Callosum/*pathology
;
Brain/*pathology
;
Alcoholism/complications
3.Correction: Comparison of Multilocus Sequence Typing Change Patterns of Vancomycin-Resistant Enterococcus faecium from 2015 to 2017.
Joon KIM ; Young Ihn KWON ; Wee Gyo LEE
Annals of Clinical Microbiology 2017;20(4):109-109
The period of study in title should have been listed as ‘in the Past Nine Years’. Therefore, we ask to correct ‘from 2015 to 2017’ with ‘from 2007 to 2015’.
4.Comparison of Multilocus Sequence Typing Change Patterns of Vancomycin-Resistant Enterococcus faecium from 2015 to 2017.
Joon KIM ; Young Ihn KWON ; Wee Gyo LEE
Annals of Clinical Microbiology 2017;20(3):67-73
BACKGROUND: Multilocus sequence typing (MLST) is useful in determining the long-term evolutionary process and minimizes differences in experimental results across individuals and laboratories. It is also useful in determining evolutionary origins and backgrounds of bacterial species. This study carries out MLST analysis on VanA-type vancomycin-resistant Enterococcus faecium isolated from patient specimens in a single university hospital over nine years in order to observe changes in genetic evolution over time. METHODS: During the years from 2007 to 2015, 44 clinical isolates of vanA-containing E. faecium were collected from Ajou University Hospital in Korea. Species were identified by the VitekII system (bio-Merieux, USA), and antibiotic susceptibility testing was performed by disk diffusion and E-test according to Clinical and Laboratory Standards Institute (CLSI) guidelines. To determine genetic relatedness, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF M/S) was employed. To characterize clonal diversity, MLST analysis was used. RESULTS: All isolates were highly resistant to ampicillin, ciprofloxacin, and vancomycin but showed variable levels of resistance to teicoplanin. The 44 clinical isolates were genetically unrelated according to MALDI-TOF M/S analysis. MLST showed that the clinical isolates harbored 6 sequence types (ST), with ST17 (n=19) being the most common, followed by ST78 (n=13), ST192 (n=6), ST64 (n=4), ST262 (n=1), and ST414 (n=1). CONCLUSION: The MLST analysis showed that the sequence types of most isolates belonged to clonal complex 17 This is consistent with outbreaks in hospitals. We had single observations for ST262 and ST414, suggesting that they were random occurrences. MLST can be useful for speculating the genetic evolution of VanA-containing E. faecium isolates.
Ampicillin
;
Ciprofloxacin
;
Diffusion
;
Disease Outbreaks
;
Enterococcus faecium*
;
Enterococcus*
;
Evolution, Molecular
;
Humans
;
Korea
;
Mass Spectrometry
;
Multilocus Sequence Typing*
;
Teicoplanin
;
Vancomycin
5.Expanding Hematoma of the Abdominal Wall Caused by Spontaneous Rupture of a Deep Circumflex Iliac Artery:Report of A Case Treated by Coil Embolization.
Jun Hyun BAIK ; Young Ha PARK ; Jung Soo JEON ; Sung Soo HWANG ; Yon Kwon IHN
Journal of the Korean Radiological Society 2004;50(6):423-426
Abdominal wall hematoma is a rare but well-known disease, usually caused by trauma or, on rare occasions, occurring spontaneously. Hematomas of the rectus sheath and the anterolateral abdominal wall are commonly associated with injury to the inferior epigastric artery and the deep circumflex iliac artery, respectively. The diagnosis of spontaneously developed abdominal wall hematoma is sometimes delayed, due its clinical manifestations being similar to those of other causes of the acute abdomen. CT and angiography can be helpful in the diagnosis of the hematoma and the injured vessel. Herein, we report on a rare case of a spontaneously developed anterolateral abdominal wall hematoma treated with microcoil embolization of the left deep circumflex iliac artery.
Abdomen, Acute
;
Abdominal Wall*
;
Angiography
;
Diagnosis
;
Embolization, Therapeutic*
;
Epigastric Arteries
;
Hematoma*
;
Iliac Artery
;
Rupture, Spontaneous*
6.Key imaging features for differentiating cystic biliary atresia from choledochal cyst: prenatal ultrasonography and postnatal ultrasonography and MRI
Hyun Joo SHIN ; Haesung YOON ; Seok Joo HAN ; Kyong IHN ; Hong KOH ; Ja-Young KWON ; Mi-Jung LEE
Ultrasonography 2021;40(2):301-311
Purpose:
This study compared clinical and radiologic differences between cystic biliary atresia (cBA) and choledochal cyst (CC) type Ia/b.
Methods:
Infants (≤12 months old) who were diagnosed with cBA or CC type Ia/b from 2005 to 2019 were retrospectively reviewed. Imaging features on preoperative ultrasonography (US) and magnetic resonance imaging (MRI) were compared between the cBA and CC groups. Logistic regression and area under the receiver operating characteristic curve (AUC) analyses were performed for the diagnosis of cBA. Changes in cyst size were also evaluated when prenatal US exams were available.
Results:
Ten patients (5.5% of biliary atresia cases) with cBA (median age, 48 days) and 11 infants with CC type Ia/b (Ia:Ib=10:1; median age, 20 days) were included. Triangular cord thickness on US (cutoff, 4 mm) showed 100% sensitivity and 90.9% specificity (AUC, 0.964; 95% confidence interval [CI], 0.779 to 1.000) and cyst size on MRI (cutoff, 2.2 cm) had 70% sensitivity and 100% specificity (AUC, 0.900; 95% CI, 0.690 to 0.987) for diagnosing cBA. Gallbladder mucosal irregularity on US and an invisible distal common bile duct on MRI were only seen in the cBA group (10 of 10). Only the CC group showed prenatal cysts exceeding 1 cm with postnatal enlargement.
Conclusion
Small cyst size (<1 cm) on prenatal US, triangular cord thickening (≥4 mm) and gallbladder mucosal irregularity on postnatal US, and small cyst size (≤2.2 cm) and an invisible distal common bile duct on MRI can discriminate cBA from CC type Ia/b in infancy.
7.Setting Priority Criteria for Classification of Self-Testing In Vitro Diagnostic Medical Devices Using Analytic Hierarchy Process Technique
Seol-Ihn KIM ; Do-Yun PYEON ; Yong-Ik JEONG ; Jahyun CHO ; Gaya NOH ; Green BAE ; Hye-Young KWON
Health Policy and Management 2023;33(2):173-184
Background:
The coronavirus disease 2019 pandemic has been challenging the healthcare service, i.e., the vitalization of the point of care accompanying self-testing in vitro diagnostic medical devices (IVDs). This study aims to suggest priority criteria to classify self-testing IVDs using the analytic hierarchy process technique.
Methods:
Two dimensions of the characteristics embedded in the IVDs and the diseases to be diagnosed with self-testing IVDs were parallelly considered and independently investigated. In addition, three expert panels consisting of laboratory medical doctors (n=11), clinicians (n=10), and citizens (n=11) who have an interest in the selection of self-testing IVDs were asked to answer to questionnaires. Priorities were derived and compared among each expert panel.
Results:
First of all, ease of specimen collection (0.241), urgency of the situation (0.224), and simplicity of device operation (0.214) were found to be the most important criteria in light of the functional characteristics of self-testing IVDs. Medical doctors valued the ease of specimen collection, but the citizen’s panel valued self-management of the disease more. Second, considering the characteristics of the diseases, the priority criteria were shown in the order of prevalence of diseases (0.421), fatality of disease (0.378), and disease with stigma (0.201). Third, medical doctors responded that self-testing IVDs were more than twice as suitable for non-communicable diseases as compared to communicable diseases (0.688 vs. 0.312), but the citizen’s group responded that self-testing IVDs were slightly more suitable for infectious diseases (0.511 vs. 0.489).
Conclusion
Our findings suggested that self-testing IVDs could be primarily classified as the items for diagnosis of non-communicable diseases for the purpose of self-management with easy specimen collection and simple operation of devices, taking into account the urgency of the situation as well as prevalence and fatality of the disease.
8.Detection of Saliva Aspiration Using Salivagram in Bedridden Patients with Brain Lesion.
In Soon KANG ; Jung Gu KWON ; Sung Uk LEE ; Zee Ihn LEE ; Gi Young PARK ; Hea Woon PARK
Journal of the Korean Academy of Rehabilitation Medicine 2010;34(5):503-507
OBJECTIVE: To investigate the aspiration of saliva itself in bedridden patients with brain lesion using the response of radionuclide salivagram, and its association with patient characteristics and clinical factors. METHOD: Thirty two patients (21 men and 11 women) in bedridden state with brain lesion were performed the radionuclide salivagram. (99m)Tc sulfur colloid (1.0 mCi in a drop of saline) was instilled into patients' tongue with supine position. The sequential images were obtained at first 5 minutes and 10 minutes interval for 1 hour, and evaluated the presence of saliva aspiration as the entrance of tracer into major airways or lung parenchyma. The characteristics of patients and the states of cooperation, drooling, tracheostomy, and method of feed were also assessed. RESULTS: Seven out of 32 subjects exhibited positive response of saliva aspiration by radionuclide salivagram. Men, uncooperative, and anterior drooling was significantly associated with positive finding of salivagram (p<0.05). CONCLUSION: In bedridden patients with brain lesion, it seems that radionuclide salivagram may be one of methods for detection of the aspiration of saliva itself.
Brain
;
Colloids
;
Humans
;
Lung
;
Male
;
Saliva
;
Sialorrhea
;
Sulfur
;
Supine Position
;
Tongue
;
Tracheostomy
9.A Clinical Study of Tissue Valve Failure.
Duk Hyun KANG ; Ihn Ho CHAI ; Myoung Chan CHO ; Young Kwon KIM ; Duk Kyung KIM ; Dae Won SOHN ; Myoung Mook LEE ; Young Bae PARK ; Yun Shik CHOI ; Jung Don SEO ; Young Woo LEE
Korean Circulation Journal 1990;20(4):679-686
On reoperations for tissue valve failure from December 1981 to December 1989, we had diagnosed 71 cases as primary tissue failure. In those cases we found out risk factors of accelerated primary tissue failure and increased thrombogenecity. We reviewed also long-term follow-ups of 542 patients after tissue valve replacement from 1978 to 1982, and durability of tissue valve was evaluated with the freedom rate from primary tissue failure. The results were as follows. 1) Eight patients had undergone reoperation by Dec. 1989 ; 71 cases(80.7%) for primary tissue failure, 11 cases(12.5%) for prosthetic valve endocarditis, 4 cases(4.5%) for thromboembolism, and 2 cases(2.3%) for paravalvular leakage. primary tissue failure was the main cause(80.7%) of tissue valve failure. 2) Primary tissue failure occurred at a mean postoperative interval of 89.7 months(range : 19.9-143.2 months). 3)In children under the age of 18, mean implantation time was 62 months, and in adults mean implantation time was 96 months. In the child group primary tissue failure occurred earlier than in the adult group by 34 months(p<0.01) 4) Actuarial freedom from primary tissue failure was 97.6%+/-0.6% at 5 years and 84.4%+/-2.2% at 10 years. 5) The types and locations of prosthetic tissue valves resulted in no significant difference in durability. 6) Primary tissue failure was mainly caused by calcification of the cusps(76%) 7) In atrial fibrillation the incidence of atrial thrombi was 31.3% and left atrial thrombi was the most common finding(60%) In conclusion, 1) Durability of tissue valve for 10 years is acceptable, but the limited durability of tissue may be a major concern after 10 years. 2) In children under the age of 18, tissue valve should be avoided due to accelerated tissue failure. 3) Atrial fibrillation clearly increases the risk of thromboembolism and anticoagulation is considered to be required in patients with atrial fibrillation.
Adult
;
Atrial Fibrillation
;
Child
;
Endocarditis
;
Follow-Up Studies
;
Freedom
;
Humans
;
Incidence
;
Reoperation
;
Risk Factors
;
Thromboembolism
10.Osteoporotic Vertebral Fractures: SPECT findings.
Jun Hyun BAIK ; Young Ha PARK ; Yon Kwon IHN ; Sung Hoon KIM ; Yong An CHUNG ; le Ryung YOO ; Jee Young KIM ; Hyun Seok JUNG ; Hyung Seon SOHN ; Soo Kyo CHUNG
Korean Journal of Nuclear Medicine 2004;38(6):522-527
PURPOSE: The purpose of this study was to evaluate the usefulness of single photon emission computed tomography (SPECT) of bone using Tc-99m MDP in the diagnosis of osteoporotic vertebral fractures. MATERIALS AND METHODS: Thirty two patients with osteoporotic vertebral fracture were included in this study (mean age: 67 +/- 8, male: 5, female: 27). Seventy nine vertebral fractures were detected (38 thoracic/thoracolumbar lesions and 41 lumbar lesions), which were classified by type of deformity (wedge, biconcave or compression). The patterns and locations of increased uptakes were examined and analyzed. RESULTS: Forty seven wedge fractures, 20 biconcave fractures and 12 compression fractures were found. Diffuse and asymmetric uptakes were common in fractured bodies. More than one uptake were examined in 69 posterior elements of fractured vertebrae (87.3%) including 40 of 47 wedge fractures (85.1%), 17 of 20 biconcave fractures (85.0%) and 12 of 12 compression fractures (100%). Wedge fractures were predominant fracture in thoracic/thoracolumbar spine whereas incidence of biconcave or compression type was similar to that of wedge fracture in lumbar spine (p=0.04). Spinous process uptake was more frequently seen in lumbar lesions than thoracic/thoracolumbar lesions (p=0.009). Facet joint uptake in biconcave fracture was more common in lumbar spine (92.3%) than thoracic/thoracolumbar spine (57.1%). Spinous process uptake in biconcave fracture was also more frequently detected in lumbar spine (p=0.043). CONCLUSION: Bone SPECT was useful in the evaluation of osteoporotic vertebral fracture, especially posterior elements of vertebrae.
Congenital Abnormalities
;
Diagnosis
;
Female
;
Fractures, Compression
;
Humans
;
Incidence
;
Male
;
Osteoporosis
;
Spine
;
Technetium Tc 99m Medronate
;
Tomography, Emission-Computed, Single-Photon*
;
Zygapophyseal Joint