Background: To analyze the effects of socioeconomic status (type of insurance and income level) and cancer stage on the survival of patients with liver cancer in Korea. Methods: A retrospective cohort study was constructed using data from the Healthcare Big Data Platform project in Korea between January 1, 2007, and December 31, 2017. A total of 143,511 patients in Korea diagnosed with liver cancer (International Classification of Diseases, 10th Revision [ICD-10] codes C22, C220, and C221) were followed for an average of 11 years. Of these, 110,443 died. The patient’s insurance type and income level were used as indicators of socioeconomic status. Unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using a Cox proportional hazards regression model to analyze the relationship between the effects of sex, age, and cancer stage at first diagnosis (Surveillance, Epidemiology, and the End Results; SEER), type of insurance, and income level on the survival of patients with liver cancer. The interactive effects of the type of insurance, income level, and cancer stage on liver cancer death were also analyzed. Results: The lowest income group (medical aid) showed a higher risk for mortality (HR (95% CI); 1.37 (1.27–1.47) for all patients, 1.44 (1.32–1.57) for men, and 1.16 (1.01–1.34) for women) compared to the highest income group (1–6) among liver cancer (ICD-10 code C22) patients. The risk of liver cancer death was also higher in the lowest income group with a distant cancer stage (SEER = 7) diagnosis than for any other group. Conclusion Liver cancer patients with lower socioeconomic status and more severe cancer stages were at greater risk of death. Reducing social inequalities is needed to improve mortality rates among patients in lower social class groups who present with advanced cancer.

Purpose: This study aimed to gain better understanding of the importance of dental prosthesis order platform services and to identify the essential elements for their enhancement and wider adoption among dental professionals. Materials and Methods: A survey was conducted to assess the perspectives of dentists, dental technicians, dental hygienists, and dental industry professionals toward dental prosthesis ordering and associated platform services (a total of 53 respondents). The questionnaire was devised after an expert review and assessed for reliability using Cronbach’s alpha coefficient. Factor analysis revealed that 57 factors across five categories accounted for 88.417% of the total variance. The survey was administered through an online questionnaire platform, and data analysis was conducted using a statistical software, employing one-way analysis of variance and Tukey’s honestly significant difference test (α = 0.05). Results: The essential elements identified were accurate information input, effective communication, delivery of distortion-free impressions, convenience in data transmission and storage, development of stable and affordable platform services (P < 0.05). Furthermore, significant differences were observed in the importance of these items based on age, dental profession, and career experience (P < 0.05). Conclusion The dental prosthesis ordering platform services, the requirements of dental personnel were stability, economic efficiency, and ease of transmitting and storing prosthesis data. The findings can serve as important indicators for the development and improvement of dental prosthesis order platform services.

Iatrogenic postintubation tracheal injury is a rare but potentially fatal complication associated with anesthesia. However, as signs of tracheal injury including subcutaneous emphysema, pneumomediastinum, pneumothorax, and respiratory distress may also be related to surgical technique, diagnosis may be confused and treatment of tracheal injury can be delayed. We report a case of postintubation tracheal laceration, whose diagnosis was delayed because of symptoms were confused with subcutaneous emphysema after septorhinoplasty including osteotomy. As symptoms deteriorated in spite of conventional management, patient underwent evaluation to determine other causes and eventually postintubation tracheal injury was detected. Therefore, even if there is no problem during tracheal intubation, it is necessary to consider postintubation tracheal injury in patients with subcutaneous emphysema that worsens despite appropriate treatment after septorhinoplasty including osteotomy.
Anesthesia ; Delayed Diagnosis ; Diagnosis ; Humans ; Intubation ; Intubation, Intratracheal ; Lacerations ; Mediastinal Emphysema ; Osteotomy ; Pneumothorax ; Subcutaneous Emphysema

OBJECTIVES: The aim of this study was to evaluate the association between preoperative parameters and extrathyroidal extension (ETE) of papillary thyroid microcarcinoma (PTMC) according to the BRAF mutation and to evaluate the preoperative predictability of ETE. METHODS: We analyzed the medical records of 332 patients with PTMC (140 in the BRAF– group and 192 in the BRAF+ group). The presence of ETE was subjected to a correlation analysis with age, sex, tumor size, clinical nodal status, and ultrasonography (US) findings. Among the US findings, the correlation between tumors and the thyroid capsule was categorized into four groups; US group A, intraparechymal; US group B, tumor abutting the capsule <50% of diameter; US group C, tumor abutting >50% of diameter; and US group D, tumor destroyed the capsule. The predictive value of ETE, including sensitivity, specificity, and positive and negative predictive values were evaluated. RESULTS: Tumor size and US group were significantly correlated with gross ETE in the BRAF– and BRAF+ groups. Tumor size of 0.5 cm and US groups B and C in the BRAF– group were cutoff values for gross ETE, with a negative predictive value of 100%, whereas tumor size of 0.7 cm and US groups A and B in the BRAF+ group had negative predictive values of 92.4% and 100%, respectively. CONCLUSION: Excluding of ETE by US was categorized according to tumor size and US findings. A different categorization to exclude ETE is needed according to the BRAF mutation.
Capsules ; Humans ; Medical Records ; Sensitivity and Specificity ; Thyroid Gland* ; Ultrasonography

A rubber tip disconnection of Arrow-Trerotola percutaneous thrombolytic device (PTD) may occur occasionally. We experienced 5 cases of a rubber tip disconnection among 453 mechanical thrombectomy sessions with the use of PTD. We present a report about these five cases and suggest possible causes for the occurrences.
Aged ; Catheter Obstruction/*etiology ; Equipment Failure Analysis/*methods ; Female ; Humans ; Male ; Middle Aged ; Renal Dialysis/*instrumentation ; Rubber ; Thrombectomy/*instrumentation ; Treatment Outcome

OBJECTIVE: To evaluate the temporal evolution and diagnostic values of the diffusion tensor imaging (DTI) and the high b value diffusion weighted imaging (DWI) in the early permanent and transient cerebral ischemia. MATERIALS AND METHODS: For permanent or 30-minute transient-ischemia induced 30 rats, DTI and DWIs at both high b (b = 3000 s/mm2) and standard b value (b = 1000 s/mm2) were obtained at the following conditions: at 15, 30, 45, 60 minutes after the occlusion of what for hyperacute permanent ischemia; at 1, 3, 5, 7, 9 hours after the occlusion for acute permanent ischemia; and at 15 minutes before reperfusion, 0.5, 2.5, and 24 hours after reperfusion for transient ischemia. The diffusion parameters and their ratios were obtained and compared between different b values, and among different time points and groups, respectively. RESULTS: For both b values, the apparent diffusion coefficient (ADC) ratio decreased for first three hours, and then slightly increased until 9 hours after the occlusion during a gradual continuous increase of DWI signal intensity (SI) ratio, with excellent correlation between ADC ratios and DWI SI ratios. The DWI showed a higher contrast ratio, but the ADC map showed a lower contrast ratio for permanent ischemia at high b value than at standard b value. Fractional anisotropy (FA) increased for 1 hour, then gradually decreased until 9 hours after the occlusion in permanent ischemia and showed transient normalization and secondary decay along with change in ADC in transient ischemia. CONCLUSION: This study presents characteristic initial elevation and secondary decay of FA, higher contrast ratio of DWI, and lower contrast ratio of ADC map at high b value, in addition to the time evolutions of diffusion parameters in early permanent and transient ischemia.
Animals ; Contrast Media/diagnostic use ; Diffusion Magnetic Resonance Imaging/*methods ; Gadolinium DTPA/diagnostic use ; Ischemic Attack, Transient/*diagnosis ; Male ; Rats ; Rats, Sprague-Dawley

Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe

OBJECTIVE: This study was designed to evaluate in vivo MR imaging for the depiction of intraarterially injected superparamagnetic iron oxide (SPIO)-labeled mesenchymal stem cells (MSCs) in an experimental rat model of renal ischemia. MATERIALS AND METHODS: Left renal ischemia was induced in 12 male Sprague-Dawley rats by use of the catheter lodging method. In vivo MR signal intensity variations depicted on T2*-weighted sequences were evaluated in both the left and right kidneys prior to injection (n = 2), two hours (n = 4), 15 hours (n = 2), 30 hours (n = 2) and 72 hours (n = 2) after injection of SPIO-labeled MSCs in both kidneys. Signal intensity variations were correlated with the number of Prussian blue stain-positive cells as visualized in histological specimens. RESULTS: In an in vivo study, it was determined that there was a significant difference in signal intensity variation for both the left and right cortex (40.8 +/- 4.12 and 26.4 +/- 7.92, respectively) and for both the left and right medulla (23.2 +/- 3.32 and 15.2 +/- 3.31, respectively) until two hours after injection (p < 0.05). In addition, signal intensity variation in the left renal cortex was well correlated with the number of Prussian blue stain-positive cells per high power field (r = 0.98, p < 0.05). CONCLUSION: Intraarterial injected SPIO-labeled MSCs in an experimental rat model of renal ischemia can be detected with the use of in vivo MR imaging immediately after injection.
Animals ; Disease Models, Animal ; Ischemia/*diagnosis/*therapy ; Kidney/blood supply/pathology ; Kidney Diseases/*therapy ; Magnetic Resonance Imaging/*methods ; Male ; Mesenchymal Stem Cell Transplantation/*methods ; Mesenchymal Stem Cells/*pathology ; Rats ; Rats, Sprague-Dawley

PURPOSE: Craniospinal neurenteric (NE) cysts are rare developmental non-neoplastic cysts of the central nervous system with diverse MR imaging findings. The purpose of this study was to evaluate various MR imaging findings of intracranial and intraspinal NE cysts. MATERIALS AND METHODS: We retrospectively reviewed the MR imaging findings of six NE cysts that were confirmed by pathology. We evaluated anatomic location, signal intensity, size and enhancement pattern of NE cysts. RESULTS: Two intracranial lesions were located extra-axially in the cerebellopontine angle and quadrigeminal cisterns. Three spinal lesions were intraduralextramedullary cysts, located ventral to the spinal cord, but one thoracic lesion was an intramedullary cyst. The signal intensity of the cysts was hyperintense on T1-weighted images as compared with the cerebrospinal fluid (CSF) for two intracranial lesions and one cervical lesion. In addition, all intracranial lesions showed diffusion restriction. For the remaining three spinal lesions, the signal intensity was nearly the same as the signal intensity of the CSF as seen on both T1- and T2-weighted images. On contrast-enhanced studies, two intracranial cysts showed a small nodular enhancement and one thoracic spinal lesion showed rim enhancement. CONCLUSION: NE cysts have various locations, signal intensities, and possible focal nodular or rim enhancement. Therefore, NE cysts can be included in the differential diagnosis of various craniospinal cystic or tumorous cystic lesions.
Central Nervous System ; Cerebellopontine Angle ; Diagnosis, Differential ; Diffusion ; Neural Tube Defects ; Retrospective Studies ; Spinal Cord