Pseudoglandular Formation in Hepatocellular Carcinoma Determines Apparent Diffusion Coefficient in Diffusion-Weighted MRI

PURPOSE: To determine the impact of pseudoglandular formation on apparent diffusion coefficient (ADC) values of hepatocellular carcinoma (HCC) in diffusion-weighted imaging (DWI), and to validate the results using histopathological grades. MATERIALS AND METHODS: We assessed 182 HCCs surgically resected from 169 consecutive patients. Each type of tumor pseudoglandular formation was categorized into “non-,” “mixed-,” or “pure-,” based on official histopathology reports. The ADC for each tumor was independently measured, using the largest region of interest on the ADC map. Data were assessed using the analysis of variance test, with Bonferroni correction for post hoc analysis to stratify the relationship of ADCs with pseudoglandular formation, followed by subgroup analysis according to the histopathological tumor grades. RESULTS: The mean ADC was significantly higher in pure pseudoglandular lesions (n = 5, 1.29 ± 0.08 × 10−3 mm2/s) than in non-pseudoglandular lesions (n = 132, 1.08 ± 0.17 × 10−3 mm2/s; P = 0.003) or mixed-pseudoglandular lesions (n = 45, 1.16 ± 0.24 × 10−3 mm2/s; P = 0.034). The ADC values and pseudoglandular formation were significantly correlated in moderately differentiated HCCs (n = 103; r = 0.307, P = 0.007), while well- (n = 19) and poorly-differentiated HCCs (n = 60) did not show significant correlation (r = 0.105 and 0.068, respectively; P = 0.600 and 0.685, respectively). CONCLUSION: The degree of pseudoglandular formation could be one of the determinants of ADC in DWI of HCCs-especially moderately differentiated HCCs-while its influence does not appear to be significant in well- or poorly differentiated HCCs.

Changes in the bispectral index and cerebral oxygen saturation during neuroendovascular intervention under general anesthesia / 대한마취과학회지

No abstract available.

The Relationships between Enterprise-scale Levels, Safety and Health Information Provisions in the Workplace, and the Consequential Attack Rate of Occupational Disease and Injuries / 대한산업의학회지

OBJECTIVES: We investigated the associations between enterprise-scale levels, the information supplied regarding workplace safety and health, and occupational injury and disease using a nationally representative sample of Korean workers. METHODS: We used data from the '2006 Working Condition Survey' performed by the Korean Occupational Safety & Health Agency. Demographic variables, employment characteristics, workplace hazards, enterprise-scale levels, information supplied regarding workplace safety and health, and occupational injury and disease were included for the study. RESULTS: Subjects who had high incomes, or who were male, full-time workers, or shift workers were more likely to provide safety and health information at work, compared to other workers' groups. The larger the enterprise-scale level, the more likely they would offer information on safety and health at work. Workers who worked in small companies, especially those with less than 10 employees, were the most likely respondents to provide safety and health information. In the corresponding logistic regression, the presence of occupational injuries and disease was significantly associated with the provision of health and safety information, the enterprise-scale level had little correlation. CONCLUSIONS: Our findings suggest that the provision of health and safety information is a critical factor regarding occupational injuries and disease. Proper safety and health education, even in small companies, may contribute to a decrease in occupational disease and injury.

Spinal anesthesia for implantation of a spinal cord stimulator in a patient with failed back surgery syndrome: A case report

Spinal cord stimulation has been applied for some patients with failed back surgery syndrome or neuropathic pain. Tests for the spinal cord stimulation can be performed under local or general anesthesia. However, if this is done during an operation with the patient under general anesthesia, it would be impossible to recognize whether an electrode induces paresthesia in the concordant painful area by the patient's self report. A 79-year-old female patient with failed back surgery syndrome had a spinal cord stimulator implanted under spinal anesthesia and the stimulation led to paresthesia on the most painful area of the patient. We report here on a case that surgical implantation of a spinal cord stimulator was successfully performed under spinal anesthesia.

Ultrasound-guided Pulsed Radiofrequency Lesioning of the Phrenic Nerve in a Patient with Intractable Hiccup

Persistent and intractable hiccups (with respective durations of more than 48 hours and 1 month) can result in depression, fatigue, impaired sleep, dehydration, weight loss, malnutrition, and aspiration syndromes. The conventional treatments for hiccups are either non-pharmacological, pharmacological or a nerve block treatment. Pulsed radiofrequency lesioning (PRFL) has been proposed for the modulation of the excited nervous system pathway of pain as a safe and nondestructive treatment method. As placement of the electrode in close proximity to the targeted nerve is very important for the success of PRFL, ultrasound appears to be well suited for this technique. A 74-year-old man suffering from intractable hiccups that had developed after a coronary artery bypass graft and had continued for 7 years was referred to our pain clinic. He had not been treated with conventional methods or medications. We performed PRFL of the phrenic nerve guided by ultrasound and the hiccups disappeared.