PURPOSE: Isolated iliac artery aneurysm (IIAA) is uncommon. It is frequently treated by endovascular aneurysm repair (EVAR). This study was to evaluate treatment results of IIAA and survey aortic diameter after EVAR. METHODS: Patients treated for IIAA in Seoul St. Mary's Hospital and Bundang Seoul National University from 2005 to April 2016 were retrospectively enrolled. The inclusion criteria of IIAA was >30 mm of iliac artery aneurysm without abdominal aortic aneurysm, which was treated by open surgical repair (OSR) or EVAR. Patients' clinical characteristics, treatment results, and mortality were obtained from electronic medical records. Diameters of aorta and iliac arteries were measured periodically with scheduled interval based on CT scans. RESULTS: Forty-nine patients (40 males; mean age, 71.9 ± 11.1 years) were enrolled. Five ruptured IIAAs were treated with EVAR (n = 1) or hybrid methods (n = 4). The diameter of ruptured IIAAs was 65 ± 31.4 mm, which was not significantly different from that of elective (44.3 ± 17.0 mm). Forty-four elective IIAA underwent 9 OSR, 31 EVARs, and 3 hybrid treatments (15 bifurcated and 12 straight stent-grafts). Treatment success rate was 93.8% without hospital mortality. There were 4 type I endoleak, 1 type II endoleak, and 1 type III endoleak without aneurysm-related mortality during follow-up. However, the aortic diameter was increased over time though there was no change or decrease in common iliac artery's diameter. CONCLUSION: Treatment of IIAA included various endovascular modalities as well as open surgery. Regular surveillance is still needed due to aortic dilatation after its treatment.
Aneurysm ; Aorta ; Aortic Aneurysm, Abdominal ; Dilatation ; Electronic Health Records ; Endoleak ; Endovascular Procedures ; Follow-Up Studies ; Hospital Mortality ; Humans ; Iliac Aneurysm ; Iliac Artery ; Male ; Mortality ; Retrospective Studies ; Seoul ; Tomography, X-Ray Computed

We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.
Adenocarcinoma ; Carboplatin ; Carcinoma, Non-Small-Cell Lung ; Central Nervous System ; Cerebrospinal Fluid ; Cisplatin ; Drug Therapy ; Epidermal Growth Factor* ; Erlotinib Hydrochloride ; Headache ; Humans ; Lung Neoplasms* ; Lung* ; Methotrexate ; Middle Aged ; Nausea ; Neoplasm Metastasis* ; Paclitaxel ; Phosphotransferases* ; Protein-Tyrosine Kinases ; Receptor, Epidermal Growth Factor* ; Recurrence ; Thorax ; Vomiting

OBJECTIVE: To compare new full-field digital mammography (FFDM) with and without use of an advanced post-processing algorithm to improve image quality, lesion detection, diagnostic performance, and priority rank. MATERIALS AND METHODS: During a 22-month period, we prospectively enrolled 100 cases of specimen FFDM mammography (Brestige(R)), which was performed alone or in combination with a post-processing algorithm developed by the manufacturer: group A (SMA), specimen mammography without application of "Mammogram enhancement ver. 2.0"; group B (SMB), specimen mammography with application of "Mammogram enhancement ver. 2.0". Two sets of specimen mammographies were randomly reviewed by five experienced radiologists. Image quality, lesion detection, diagnostic performance, and priority rank with regard to image preference were evaluated. RESULTS: Three aspects of image quality (overall quality, contrast, and noise) of the SMB were significantly superior to those of SMA (p < 0.05). SMB was significantly superior to SMA for visualizing calcifications (p < 0.05). Diagnostic performance, as evaluated by cancer score, was similar between SMA and SMB. SMB was preferred to SMA by four of the five reviewers. CONCLUSION: The post-processing algorithm may improve image quality with better image preference in FFDM than without use of the software.
Adult ; Aged ; *Algorithms ; Breast Neoplasms/radiography ; Calcinosis/radiography ; Female ; Humans ; Mammography/*methods ; Middle Aged ; Prospective Studies ; Radiographic Image Enhancement/*methods ; Sensitivity and Specificity ; Software

Ultrasound (US) elastography is a valuable imaging technique for tissue characterization. Two main types of elastography, strain and shear-wave, are commonly used to image breast tissue. The use of elastography is expected to increase, particularly with the increased use of US for breast screening. Recently, the US elastographic features of breast masses have been incorporated into the 2nd edition of the Breast Imaging Reporting and Data System (BI-RADS) US lexicon as associated findings. This review suggests practical guidelines for breast US elastography in consensus with the Korean Breast Elastography Study Group, which was formed in August 2013 to perform a multicenter prospective study on the use of elastography for US breast screening. This article is focused on the role of elastography in combination with B-mode US for the evaluation of breast masses. Practical tips for adequate data acquisition and the interpretation of elastography results are also presented.
Breast* ; Consensus ; Elasticity Imaging Techniques* ; Information Systems ; Mass Screening ; Ultrasonography*

OBJECTIVE: To evaluate the additional effect of sonoelastography on the radiologist's ability for distinguishing benign from malignant complex breast masses and to decide whether to perform biopsy by B-mode US. MATERIALS AND METHODS: One hundred eighteen complex breast masses (15 malignant lesions, 103 benign lesions) were included. Five blinded readers independently assessed the likelihood of the malignancy score from 1 to 5 for two data sets (B-mode ultrasound alone and B-mode ultrasound with sonoelastography). Elasticity scores were categorized as 0, 1, or 2 based on the degree and distribution of strain of the echogenic component within complex masses. The readers were asked to downgrade the likelihood of the malignancy score when an elasticity score of 0 was assigned and to upgrade the likelihood of the malignancy score when an elasticity score of 2 was assigned. The likelihood of the malignancy score was maintained as it was for the lesions with an elasticity score of 1. The Az values, sensitivities, and specificities were compared. RESULTS: The Az value of B-mode ultrasound with sonoelastography (mean, 0.863) was greater than that of B-mode ultrasound alone (mean, 0.731; p = 0.001-0.007) for all authors. The specificity of B-mode ultrasound with sonoelastography (mean, 37.1%) was greater than that of B-mode ultrasound alone (mean, 3.8%; p < 0.001) for all readers. The addition of sonoelastography led to changes in decisions. A mean of 33.6% of benign masses were recommended for follow-up instead of biopsy. CONCLUSION: For complex breast masses, sonoelastography allows increase in both the accuracy in distinguishing benign from malignant lesions and the specificity in deciding whether to perform biopsy.
Adult ; Aged ; Biopsy/*methods ; Breast Diseases/pathology/*ultrasonography ; Breast Neoplasms/diagnosis ; Diagnosis, Differential ; Elasticity Imaging Techniques/*methods ; Female ; Humans ; Middle Aged ; Pregnancy ; Reproducibility of Results ; Retrospective Studies ; *Ultrasonography, Mammary ; Young Adult

The purpose of this study was to investigate salinity and sodium content in foods served at industry foodservice operations in selected workplaces in Daegu. The researcher collected 1,142 food items categorized into 22 menu item groups from lunch samples served at 100 industry foodservice operations and measured the salinity of the food items, and calculated sodium and salt contents from the salinity. In terms of salt content of one meal at each workplace, 46% of the meals were 3-<5 g, and only 3.0% of them were 1.7 g or less, which is one third of the daily target intake (5 g) presented by the Dietary Reference Intakes for Koreans. In terms of sodium content, 35.3% of the meals were 1,000-< 1,500 mg (most), and only 2.5% of them were 667 mg or less, which is, again, one third of the daily target intake. As to the salinity of each menu item group, side dishes such as sauces, kimchi, seasoned vegetables, hard-boiled foods, and stir-fried foods were significantly higher, but the sodium content was not higher, because their quantity per serving was small. The salinity of foods with liquid such as stews, noodles, soups, and broths was relatively lower, but the sodium content was higher, because their quantity per serving was large. This indicates that an education program should be developed for foodservice workers who prepare food for the workplace regarding the development and promotion of various menus for reducing sodium content, in order to reduce sodium content in meals served by food service in the workplace.
Food Services ; Lunch ; Meals ; Salinity ; Seasons ; Sodium ; Vegetables

Bisphenol A (BPA) has been reported to possess hepatic toxicity. We investigated the hypothesis that BPA, below the no observed adverse effect level (NOAEL), can induce hepatic damage and mitochondrial dysfunction by increasing oxidative stress in the liver. Two doses of BPA, 0.05 and 1.2 mg/kg body weight/day, were administered intraperitoneally for 5 days to mice. Both treatments impaired the structure of the hepatic mitochondria, although oxygen consumption rate and expression of the respiratory complex decreased only at the higher dose. The hepatic levels of malondialdehyde (MDA), a naturally occurring product of lipid peroxidation, increased, while the expression of glutathione peroxidase 3 (GPx3) decreased, after BPA treatment. The expression levels of proinflammatory cytokines such as interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) also increased. In HepG2 cells, 10 or 100 nM of BPA also decreased the oxygen consumption rate, ATP production, and the mitochondrial membrane potential. In conclusion, doses of BPA below the NOAEL induce mitochondrial dysfunction in the liver, and this is associated with an increase in oxidative stress and inflammation.
Adenosine Triphosphate/metabolism ; Animals ; Glutathione Peroxidase/metabolism ; Hep G2 Cells ; Humans ; Inflammation/chemically induced/metabolism/pathology ; Injections, Intraperitoneal ; Interleukin-6/metabolism ; Lipid Peroxidation/drug effects ; Liver/*drug effects/metabolism/pathology ; Male ; Malondialdehyde/metabolism ; Membrane Potential, Mitochondrial/drug effects ; Mice ; Mice, Inbred C57BL ; Mitochondria/drug effects/*metabolism ; Oxidative Stress/drug effects ; Oxygen Consumption/drug effects ; Phenols/*toxicity ; Tumor Necrosis Factor-alpha/metabolism

This study assesses the sodium intake of adults by 24-hour urine analysis, dietary records review and a food intake questionnaire. Subjects were 236 adult female in Daegu. The results are summarized as follows: Sodium intake as indicated by the 24-hour urine analysis was 5,805.4 +/- 3836.8 mg. This was significantly higher than intake indicated by dietary records (4415.4 +/- 1935.1 mg) and the dish frequency questionnaire (DFQ 55)(4293.5 +/- 1526.5 mg). The results of the 24-hour urine analysis and DFQ 55 showed that sodium intake was higher for the 65-to-74-year-old age group than for other age groups (p < 0.05, p < 0.05). Review of dietary records to examine typical sodium intake by food groups showed that 53.7% of the sodium consumed by subjects in all age groups came from seasonings and spices (2399.0 +/- 1526.5 mg). The analysis of sodium intake by food groups using DFQ 55 showed 34.2% of their sodium came from consumption of kimchi (p < 0.001) and kimch, soup, stew and fish jorim accounted for 57.8% of total sodium intake. The results indicate positive correlation between age and sodium intake, as shown by the 24-hour urine analysis and food intake questionnaire (p < 0.05). Therefore, these results would be valuable as basic data for planning nutrition education for sodium intake reduction.
Adult ; Diet Records ; Eating ; Female ; Humans ; Porphyrins ; Surveys and Questionnaires ; Seasons ; Sodium ; Spices

This study was to develop and evaluate a nutrition education program to reduce dietary sodium. The school children (218 boys, 226 girls), from 8 elementary schools in the city of Daegu, Korea, were involved in this study. This research was based on the data from two groups of elementary school children, the "education" group (n = 240), and "no-education" group (n = 204). Educational media and programs were developed to educate the education group for four weeks and were presented on the web (www.saltdown.com). After education, the preference for a non-salty taste in the education group increased 10%, compared with those who preferred a non-salty taste before education. There was a significant change away from a preference for a salty taste and a rise in the mean score for nutrition knowledge and dietary attitude in the education group compared to the no-education group (p < 0.05). This study indicates that school children can reduce their dependency on preference for a salty taste and change their high-salt dietary behavior after the education.
Child ; Dependency (Psychology) ; Humans ; Korea ; Sodium ; Sodium, Dietary

A 29-year-old man was admitted to hospital with fever, myalgia, and sore throat. Initial laboratory findings were compatible with acute hepatitis; he was positive for the serologic marker for acute hepatitis A. On the 3rd day of admission, in spite of normalization of body temperature and a reduction in serum liver enzyme levels, serum levels of creatinine phosphokinase had increased up to 16,949 U/L. The patient recovered with supportive therapy and was discharged on the 12th day. We report a case of acute hepatitis A complicated by rhabdomyolysis during hospitalization.
Acute Disease ; Adult ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Creatine Kinase/blood ; Hepatitis A/complications/*diagnosis ; Hospitalization ; Humans ; Male ; Rhabdomyolysis/*diagnosis/etiology