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Purpose@#We aimed to analyze changes in suprascapular nerve (SSN) position within the suprascapular notch during in vivo shoulder abduction. @*Materials and Methods@#Three-dimensional models of the shoulder complex were constructed based on magnetic resonance imaging of the brachial plexus (BP-MR) in a patient diagnosed with SSN dysfunction but normal scapular movement. Using BP-MR in neutral position and computed tomography data on shoulder abduction, shoulder abduction was simulated as the transition between two positions of the shoulder complex with overlapping of a neutral and abducted scapula. SSN movement during abduction was evaluated using the finite element method. Contact stress on the SSN was measured in the presence and absence of the transverse scapular ligament (TSL). @*Results@#In the neutral position, the SSN ran almost parallel to the front of the TSL until entering the suprascapular notch and slightly contacted the anterior-inferior border of the TSL. As shoulder abduction progressed, contact stress decreased due to gradual loss of contact with the TSL. In the TSL-free scapula, there was no contact stress on the SSN in the neutral position. Towards the end of shoulder abduction, contact stress increased again as the SSN began to contact the base of the suprascapular notch in both TSL conditions. @*Conclusion@#We identified changes in the position of the SSN path within the suprascapular notch during shoulder abduction. The SSN starts in contact with the TSL and moves toward the base of the suprascapular notch with secondary contact. These findings may provide rationale for TSL release in SSN entrapment.
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Background@#As the number of large-scale studies involving multiple organizations producing data has steadily increased, an integrated system for a common interoperable format is needed. In response to the coronavirus disease 2019 (COVID-19) pandemic, a number of global efforts are underway to develop vaccines and therapeutics. We are therefore observing an explosion in the proliferation of COVID-19 data, and interoperability is highly requested in multiple institutions participating simultaneously in COVID-19 pandemic research. @*Results@#In this study, a laboratory information management system (LIMS) approach has been adopted to systemically manage various COVID-19 non-clinical trial data, including mortality, clinical signs, body weight, body temperature, organ weights, viral titer (viral replication and viral RNA), and multiorgan histopathology, from multiple institutions based on a web interface. The main aim of the implemented system is to integrate, standardize, and organize data collected from laboratories in multiple institutes for COVID-19 non-clinical efficacy testings. Six animal biosafety level 3 institutions proved the feasibility of our system. Substantial benefits were shown by maximizing collaborative high-quality non-clinical research. @*Conclusions@#This LIMS platform can be used for future outbreaks, leading to accelerated medical product development through the systematic management of extensive data from non-clinical animal studies.
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Paraganglioma is a rare tumor of paraganglia, derived from neural crest cells in sympathetic or parasympathetic ganglions. It can be widely distributed from the skull base to the bottom of the pelvis. The pancreas, however, is a rare location of this neoplasm, and only a limited number of cases have been reported in the English literature, especially with gadoxetic-acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted images (DWI). We herein report a case of pathologically proven paraganglioma in the pancreas head with a literature review on endoscopic ultrasonography (EUS), computed tomography (CT), gadoxetic-acid-enhanced MRI, and DWI sequence.
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Purpose@#To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. @*Materials and Methods@#Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. @*Results@#Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. @*Conclusion@#This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.
ABSTRACT
Paraganglioma is a rare tumor of paraganglia, derived from neural crest cells in sympathetic or parasympathetic ganglions. It can be widely distributed from the skull base to the bottom of the pelvis. The pancreas, however, is a rare location of this neoplasm, and only a limited number of cases have been reported in the English literature, especially with gadoxetic-acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted images (DWI). We herein report a case of pathologically proven paraganglioma in the pancreas head with a literature review on endoscopic ultrasonography (EUS), computed tomography (CT), gadoxetic-acid-enhanced MRI, and DWI sequence.
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Purpose@#To investigate the reliability of CT and MRI for quantitative and qualitative analyses of lumbar paraspinal muscle fatty infiltration (PSFI) and correlation of PSFI with intervertebral disc pathology. @*Materials and Methods@#Lumbar spine CT and MRI of 36 subjects were reviewed retrospectively. Two observers independently outlined lumbar paraspinal muscles at each mid-intervertebral disc level. Paraspinal muscles on CT and MRI were graded according to the Goutallier grading system (GGS). The area, mean value, and standard deviation (SD) of the Hounsfield unit (HU) were obtained. Intervertebral discs were assessed on axial image of T2WI at each level. Correlations between qualitative and quantitative data and intervertebral disc pathology, age, and sex were evaluated. @*Results@#Inter- and intra-observer agreements for results of GGS on MRI were substantial (κ = 0.79) and moderate (κ = 0.59), respectively. Inter- and intra-observer agreements for results of GGS on CT were almost perfect (κ = 0.88) and substantial (κ = 0.66), respectively. Quantitative measurements of HU showed almost perfect inter- and intra-observer reliabilities (κ = 0.82 and κ = 0.99, respectively). There were statistically significant correlations between intervertebral disc pathology and PSFI at L1-2, L2-3, and L4-5 levels on MRI and at L1-2 and L3-4 levels on CT. Age showed significant correlation with results of GGS at all levels on CT and MRI. @*Conclusion@#This study showed that GGS results and HU measurements could be useful for evaluating PSFI because they showed correlations with intervertebral disc pathology results at certain levels.
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Schwannomas originate from Schwann cells, and they are the most common benign neoplasms of the peripheral nerves. They can occur in most parts of the body but have a predilection for the head, the neck, and the flexor aspects of the extremities. Pancreatic schwannomas are uncommon, and only a few cases have been reported in the English literature. Approximately two-thirds of pancreatic schwannomas undergo cystic degeneration, and they should be considered in the differential diagnosis of solid pancreatic tumors with cystic changes to facilitate accurate diagnosis and optimal treatment. We report a case of a pathologically proven schwannoma in the pancreatic tail with multiple cystic and hemorrhagic changes followed by a review of relevant literature.
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Bronchogenic cysts are rare congenital anomalies that are most frequently found in the mediastinum along the tracheobronchial tree, especially in the posterior aspect of the superior mediastinum. Bronchogenic cysts have also been reported in intrapulmonary, intrapericardial, abdominal, and retroperitoneal locations. Herein, we report a case of a retroperitoneal bronchogenic cyst in the presacral space. The patient was diagnosed based on a post-operative histopathological examination.
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Objective@#To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. @*Materials and Methods@#This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1–3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. @*Results@#A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane.The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p 0.05). @*Conclusion@#Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.
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Pulmonary adenofibroma is a rare tumor, with a few reported cases in the literature. Radiologically, the lesion appears as a solitary pulmonary nodule in most cases, and the multiplicity of this disease entity is extremely rare. We present an unusual case of pulmonary adenofibroma in a 71-year-old woman manifested as two nodules in different lobes of the lung on CT. Histopathological and immunohistochemical examinations are needed to establish the definitive diagnosis of pulmonary adenofibroma.
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Objective@#To determine whether ultrasonography at initial presentation can help assess the clinical severity of congenital muscular torticollis (CMT) in infants without a sternocleidomastoid muscle (SCM) mass. @*Materials and Methods@#This retrospective study included 71 infants aged less than 12 months (4.1 ± 2.3 months) with non-mass CMT. The clinical severity was divided into three grades (groups 1–3) based on the degree of lateral head bending or cervical rotation. The difference (SCM-D) and ratio (SCM-R) between the maximal thickness of the affected and non-affected SCMs were obtained using transverse and longitudinal ultrasonography. The sonographic echotexture and echogenicity of the involved SCM were reviewed. @*Results@#A significant difference was observed in the SCM-D (0.42 ± 0.30 mm in group 1; 0.74 ± 0.50 mm in group 2; 1.14 ± 0.85 mm in group 3; p = 0.002) and SCM-R (1.069 ± 0.067 in group 1; 1.129 ± 0.087 in group 2; 1.204 ± 0.150 in group 3; p = 0.001) among the groups when measured along the longitudinal but not along the transverse ultrasonography plane.The areas under the curves of the SCM-R and SCM-D measured by longitudinal ultrasonography were 0.731 (p 0.05). @*Conclusion@#Ultrasonography can aid in assessing the clinical severity of CMT in infants without an SCM mass at the time of initial diagnosis. The SCM-R and SCM-D helped grade the clinical severity when obtained by longitudinal scan.
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Pulmonary adenofibroma is a rare tumor, with a few reported cases in the literature. Radiologically, the lesion appears as a solitary pulmonary nodule in most cases, and the multiplicity of this disease entity is extremely rare. We present an unusual case of pulmonary adenofibroma in a 71-year-old woman manifested as two nodules in different lobes of the lung on CT. Histopathological and immunohistochemical examinations are needed to establish the definitive diagnosis of pulmonary adenofibroma.
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Splenosis refers to autotransplantation of splenic tissue into intraabdominal, intrathoracic or even any other parts of body and occurs after splenic trauma or splenectomy. Hepatic splenosis is usually incidental found during imaging workup. It can mimic other hypervascular mass because it presents vivid and heterogeneous enhancement representing that of splenic tissue. So far, about 20 cases of intrahepatic splenosis have been described in the literature. Herein we report a case of intrahepatic splenosis mimicking hepatocellular carcinoma in a patient with liver cirrhosis. The patient was finally diagnosed on the basis of specific radionuclide imaging.
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Undifferentiated pleomorphic sarcoma (UPS) arising from the descending thoracic aorta is a rare type of tumor. To our knowledge, only a few cases have been reported in the literature. We present computed tomography (CT) and magnetic resonance imaging findings of a 43-year-old male patient with undifferentiated pleomorphic sarcoma of the descending thoracic aorta, which showed enhancement on only magnetic resonance imaging (MRI). MRI with contrast enhancement may be useful in differentiating an aortic tumor from atherosclerotic disease.
Subject(s)
Adult , Humans , Male , Aneurysm, False , Aorta, Thoracic , Hematoma , Magnetic Resonance Imaging , SarcomaABSTRACT
Metronidazole is an antimicrobial agent widely used for the treatment of anaerobic infection or antibiotics-associated diarrhea. It is generally thought to be safe, but can induce reversible toxic encephalopathy in the case of excessive or cumulative over-dose. Metronidazole-induced encephalopathy generally demonstrates the characteristic features of typical lesion location and bilaterality on magnetic resonance imaging (MRI). We report a case of metronidazole-induced encephalopathy with the involvement of asymmetric white matter. To our knowledge, only a few cases have been reported with respect to white matter lesion characteristics on MRI with diffusion-weighted images.
Subject(s)
Brain Diseases , Brain , Diarrhea , Magnetic Resonance Imaging , Metronidazole , Neurotoxicity Syndromes , White MatterABSTRACT
PURPOSE@#To evaluate Metal Artifact Reduction for Orthopedic Implants (O-MAR, Philips Healthcare) technique compared with standard filtered back projection (SFBP) technique on post-operative hip CT regarding image noise reduction and detection of post-operative complications.@*MATERIALS AND METHODS@#Fifty-six hip CT scans after hip replacement with SFBP technique and O-MAR application were retrospectively reviewed. Region of interests (ROIs) were drawn at levels wherein acetabular cup and femoral head were largest at anterior and posterior acetabula, gluteus maximus muscle, subcutaneous fat adjacent to gluteus maximus muscle, and in area adjacent to prosthesis stem wherein lesser trochanter is largest. Hounsfield units (HU) were measured to evaluate artifact quantitatively; mean and standard deviations (SDs) calculated and compared. Periprosthetic complications were evaluated, and visibility rated between two reconstruction techniques; 1-SFBP better, 2–SFBP same as O-MAR, 3–O-MAR better.@*RESULTS@#Average HU was significantly lower in O-MAR at posterior acetabulum, gluteus maximus muscle, and subcutaneous fat (p < 0.05). SD for HU was significantly lower in O-MAR at all ROIs (p < 0.05). Mean visibility of periprosthetic complications was 2.0, so equivalent.@*CONCLUSION@#Reconstruction with O-MAR technique in post-operative hip CT scans after hip replacement yielded statistically significant decrease in image noise. However, visibility of periprosthetic complications was not impacted by reconstruction technique.
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According to the reports presented at the second Asian Radiology Forum (ARF) 2016, organized by the Korean Society of Radiology (KSR) during the Korean Congress of Radiology (KCR) in September 2016 in Seoul, there is an increasing need for the Asian-Oceanian Society of Radiology (AOSR) and its member societies to promote radiology together in the Asian-Oceanian region. In ARF 2016, the national delegates of the Asian-Oceanian radiological partner societies primarily discussed their societies' activities and contributions in international and regional societies including AOSR, expectations for AOSR, recommendations and suggestions for AOSR, and their societies' support of AOSR.
Subject(s)
Humans , Asia , Asian People , International Cooperation , Oceania , SeoulABSTRACT
Acute generalized exanthematous pustulosis (AGEP) is a severe and rare disease usually related to drug eruption. AGEP is induced by drugs in over 90% of cases with antibiotics being the most common. It is characterized by a fever and a pustular eruption on erythematous skin with acute onset and without follicular localization. Acetaminophen is commonly used as an antipyretic and analgesic. Acetaminophen has been reported to be an uncommon cause of AGEP. We report a 79-year-old woman presenting with fever and erythematous maculopapular eruptions on the trunk with sterile pustules arising upon the use of acetaminophen for back pain. Leukocytosis and elevated C-reactive protein levels were noted on the laboratory examination. The histopathological examination of the skin biopsy specimen showed intraepidermal pustule formation with superficial perivascular lymphocytic infiltration, including eosinophils, and extensive red blood cell extravasation. The lesions were resolved with discontinuation of acetaminophen and use of systemic corticosteroid. We report a case of AGEP probably caused by acetaminophen.
Subject(s)
Aged , Female , Humans , Acetaminophen , Acute Generalized Exanthematous Pustulosis , Anti-Bacterial Agents , Back Pain , Biopsy , C-Reactive Protein , Drug Eruptions , Eosinophils , Erythrocytes , Fever , Leukocytosis , Rare Diseases , SkinABSTRACT
PURPOSE: The purpose of this study is to examine the factors associated with neurological outcome and to provide ideas for improving the operation of the emergency medical system in Korea. METHODS: A total of 95,911 out-of-hospital cardiac arrests (OHCAs) with cardiac etiology who were transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea were analyzed. According to these data there is a multilevel structure, so that patient's neurological outcome in the same region is not independent but interrelated, therefore two-level (patient-region) logistic regression analysis was applied to adjust this correlation. RESULTS: The adjusted odds ratio (OR) in the group in which Cardiopulmonary Resuscitation (CPR) was performed by a bystander was 1.27 for good neurological outcome. The adjusted OR in the group with implementation of an automated external defibrillator (AED) before arrival at the hospital was 4.11 for good neurological outcome. The adjusted OR in the numbers of emergency physicians compared with <3 was 2.76 (3-4), 4.24 (≥5) and the adjusted OR in OHCAs volume of each hospital compared with <50 was 2.31 (50-64), 2.51 (65-102), and 2.94 (≥103). The adjusted OR in deprivation level compared with <2 was 0.72 (≥2). CONCLUSION: The neurological outcome was significantly better in the group in which CPR was performed by a bystander and AED was applied early. The neurological outcome tended to be significantly better in hospitals with higher numbers of emergency physicians and higher volume of OHCAs, in less deprived districts.
Subject(s)
Ambulances , Cardiopulmonary Resuscitation , Defibrillators , Emergencies , Korea , Logistic Models , Multilevel Analysis , Odds Ratio , Out-of-Hospital Cardiac ArrestABSTRACT
PURPOSE: The aim of this study was to identify the level of Human papillomavirus (HPV) knowledge, intention of HPV vaccination, and barriers on HPV vaccination among male undergraduate students of Health department and Non-health department. METHODS: A total of 149 male undergraduate students responded to self-administered questionnaires about their HPV knowledge, HPV vaccination intention, and their barriers on HPV vaccination. ANOVA, t-test and χ2 test (Fisher's exact test) were used for data analysis. RESULTS: Mean score of HPV knowledge was 3.39±3.05, and there was significant difference between Health department (4.15±3.08) and Non-health department (2.58±2.82) in HPV knowledge (t=3.241, p=.001). There was no significant difference in HPV vaccination acceptance between the two groups. The barriers on HPV vaccination were 'lack of information about HPV vaccine efficacy' and 'lack of information about HPV vaccination time and strategy', and there were significant differences in barriers on HPV vaccination between the two groups. CONCLUSION: The knowledge on HPV was low, and HPV vaccination was hindered due to lack of information about HPV vaccine despite their intention to obtain HPV vaccine. HPV education to promote HPV vaccination should be targeted among male students.