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Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.
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Abstract Introduction: Traditional meta-analyses on the diagnostic accuracy of oral lesions have been conducted, but they were inherently limited to direct pairwise comparisons between a single method and a single alternative, while multiple diagnostic options and the ranking thereof were methodologically not possible. Objective: To evaluate the diagnostic values of various methods in patients with oral potential malignant disease by performing a network meta-analysis. Methods: Two authors independently searched the databases (MEDLINE, SCOPUS, the Cochrane Register of Controlled Trials, and Google scholar) up to June 2020 for studies comparing the diagnostic accuracy of various tools (autofluorescence, chemiluminescence, cytology, narrow band imaging, and toluidine blue) with visual examination or other tools. The outcomes of interest for this analysis were sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Both a standard pairwise meta-analysis and network meta-analysis were conducted. Results: Treatment networks consisting of six interventions were defined for the network metaanalysis. The results of traditional meta-analysis showed that, among six methods, narrow band imaging showed higher sensitivity, specificity, negative predictive value, positive predictive value, and accuracy compared to visual examination. The results of network meta-analysis showed that autofluorescence, chemiluminescence, and narrow band imaging had higher sensitivity compared with visual examination, and that chemiluminescence and narrow band imaging had higher negative predictive value compared with visual examination. However, autofluorescence and chemiluminescence had lower specificity compared with visual examination. There were no significant differences in positive predictive value and accuracy among the six interventions. Conclusion: This study demonstrated that narrow banding imaging has superiority in terms of sensitivity and negative predictive value compared with the other five tested agents.
Resumo Introdução: Metanálises tradicionais sobre a precisão diagnóstica de lesões orais têm sido conduzidas, mas são inerentemente limitadas a comparações pareadas diretas entre um único método e uma única opção, enquanto múltiplas opções de diagnóstico e suas classificações ainda não foram metodologicamente possíveis. Objetivo: Avaliar os valores diagnósticos de vários métodos em pacientes com doença oral potencialmente maligna e fazer uma metanálise de rede. Método: Dois autores pesquisaram independentemente os bancos de dados (Medline, Scopus, Cochrane Register of Controlled Trials e Google Scholar) até junho de 2020 para estudos que comparassem a precisão diagnóstica de várias ferramentas (autofluorescência, quimioluminescência, citologia, imagem de banda estreita e cloreto de tolônio) com exame visual ou outras ferramentas. Os resultados de interesse para esta análise foram sensibilidade, especificidade, valor preditivo negativo, valor preditivo e precisão. Tanto uma metanálise pareada padrão quanto uma metanálise de rede foram conduzidas. Resultados: Redes de tratamento compostas por seis intervenções foram definidas para a metanálise de rede. Os resultados da metanálise tradicional mostraram que, entre seis métodos, a imagem de banda estreita apresentou maior sensibilidade, especificidade, valor preditivo negativo, valor preditivo e precisão em comparação ao exame visual. Os resultados da metanálise de rede mostraram que a autofluorescência, a quimioluminescência e a imagem de banda estreita obtiveram maior sensibilidade em comparação com o exame visual e que a quimioluminescência e a imagem de banda estreita apresentaram maior valor preditivo negativo em comparação com o exame visual. Entretanto, a autofluorescência e a quimioluminescência mostraram especificidade inferior em comparação com o exame visual. Não houve diferenças significativas no valor preditivo e na precisão entre as seis intervenções. Conclusão: Este estudo demonstrou que a imagem de banda estreita demonstra superioridade em termos de sensibilidade e valor preditivo negativo em comparação com os outros cinco agentes testados.
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Cerebral toxoplasmosis is often life-threatening in an immunocompromised patient due to delayed diagnosis and treatment. Several differential diagnoses could be possible only with preoperative brain images of cerebral toxoplasmosis which show multiple rim-enhancing lesions. Due to the rarity of cerebral toxoplasmosis cases in Korea, the diagnosis and treatment are often delayed. This paper concerns a male patient whose cerebral toxoplasmosis was activated 21 years post kidney transplantation. Brain open biopsy was decided to make an exact diagnosis. Cerebral toxoplasmosis was confirmed by immunohistochemistry and PCR analyses of the tissue samples. Although cerebral toxoplasmosis was under control with medication, the patient did not recover clinically and died due to sepsis and recurrent gastrointestinal bleeding.
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Background@#Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. @*Methods@#From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. @*Results@#The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. @*Conclusions@#The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.
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Objective@#The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer’s disease (AD). @*Methods@#A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI). @*Results@#A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo. @*Conclusion@#The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.
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Background@#Trigeminal neuralgia (TN) is one of the most painful disorder in the orofacial region, and many patients have suffered from this disease. For the effective management of TN, fundamental epidemiologic data related to the target population group are essential. Thus, this study was performed to clarify the epidemiological characteristics of TN in the Korean population. This is the first national study to investigate the prevalence of TN in Korean patients. @*Methods@#From 2014 to 2018, population-based medical data for 51,276,314 subscribers to the National Health Insurance Service of Korea were used for this study. @*Results@#The incidence of TN was 100.21 per 100,000 person-years in the year of 2018 in Korea, and the male to female ratio was 1:2.14. The age group of 51-59 years had the highest prevalence of TN. Constant increases in medical cost, regional imbalance, and differences in prescription patterns by the medical specialties were showed in the management of TN. @*Conclusions@#The results in this study will not only help to study the characteristics of TN, but also serve as an important basis for the effective management of TN in Korea.
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Objective@#The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer’s disease (AD). @*Methods@#A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI). @*Results@#A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo. @*Conclusion@#The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.
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Background/Aims@#We investigated the impact of obesity on the clinical outcomes following percutaneous coronary intervention (PCI). @*Methods@#We included South Koreans aged > 20 years who underwent the Korean National Health Screening assessment between 2009 and 2012. Obesity was defined using the body mass index (BMI), according to the World Health Organization’s recommendations. Abdominal obesity was defined using the waist circumference (WC), as defined by the Korean Society for Obesity. The odds and hazard ratios in all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed up to the end of 2017. @*Results@#Among 130,490 subjects who underwent PCI, the mean age negatively correlated with BMI. WC, hypertension, diabetes, dyslipidemia, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels correlated with the increased BMI. The mortality rates were higher in the lower BMI and WC groups than the higher BMI and WC groups. The non-obese with abdominal obesity group showed a mortality rate of 2.11 per 1,000 person-years. Obese with no abdominal obesity group had the lowest mortality rate (0.88 per 1,000 person-years). The mortality showed U-shaped curve with a cut-off value of 29 in case of BMI and 78 cm of WC. @*Conclusions@#The mortality showed U-shaped curve and the cut-off value of lowest mortality was 29 in case of BMI and 78 cm of WC. The abdominal obesity may be associated with poor prognosis in Korean patients who underwent PCI.
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Additive manufacturing (AM) for dental materials can produce more complex forms than conventional manufacturing methods.Compared to milling processing, AM consumes less equipment and materials, making sustainability an advantage. AM can be categorized into 7 types. Polymers made by vat polymerization are the most suitable material for AM due to superior mechanical properties and internal fit compared to conventional self-polymerizing methods. However, polymers are mainly used as provisional restoration due to their relatively low mechanical strength. Metal AM uses powder bed fusion methods and has higher fracture toughness and density than castings, but has higher residual stress, which requires research on post-processing methods to remove them. AM for ceramic use vat polymerization of materials mixed with ceramic powder and resin polymer. The ceramic materials for AM needs complex post-processing such as debinding of polymer and sintering. The low mechanical strength and volumetric accuracy of the products made by AM must be improved to be commercialized. AM requires more research to find the most suitable fabrication process conditions, as the mechanical properties and surface of any material will vary depending on the processing condition.
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Background@#The aim of this study was to clarify the topographical relationship between the accessory nerve (AN) and transverse cervical artery (TCA) to provide safe and convenient injection points for AN blockade. @*Methods@#This study included 21 and 30 shoulders of 14 embalmed Korean adult cadavers and 15 patients, respectively, for dissection and ultrasound (US) examination. @*Results@#The courses of the TCA and AN in the scapular region were classified into four types based on their positional relationships. Type A indicated the nerve that was medial to the artery and ran parallel without changing its location (38%). In type B (38%), the nerve was lateral to the artery and ran parallel without changing its location. In type C (19%), the nerve or artery traversed each other only once during the whole course. In type D (5%), the nerve or artery traversed each other more than twice forming a twist. At the levels of lines I-IV, the nerve was relatively close to the artery (approximately 10 mm). TCAs were observed in all specimens around the superior angle of the scapula at the level of line II, whereas they were not found below line VI. In US images of the patients, the TCA was commonly observed at the level of line II (93.3%) where all ANs and TCAs were observed in cadaveric dissection. @*Conclusions@#The results expand the current knowledge of the relation between the AN and TCA, and provide helpful information for selective diagnostic nerve blocks in the scapular region.
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Objective@#To evaluate pharmacokinetic variables from contrast-enhancing lesions (CELs) and non-enhancing T2 high signal intensity lesions (NE-T2HSILs) on dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging for predicting progression-free survival (PFS) in glioblastoma (GBM) patients. @*Materials and Methods@#Sixty-four GBM patients who had undergone preoperative DCE MR imaging and received standard treatment were retrospectively included. We analyzed the pharmacokinetic variables of the volume transfer constant (Ktrans) and volume fraction of extravascular extracellular space within the CEL and NE-T2HSIL of the entire tumor. Univariate and multivariate Cox regression analyses were performed using preoperative clinical characteristics, pharmacokinetic variables of DCE MR imaging, and postoperative molecular biomarkers to predict PFS. @*Results@#The increased mean Ktrans of the CEL, increased 95th percentile Ktrans of the CELs, and absence of methylated O6- methylguanine-DNA methyltransferase promoter were relevant adverse variables for PFS in the univariate analysis (p = 0.041, p = 0.032, and p = 0.083, respectively). The Kaplan-Meier survival curves demonstrated that PFS was significantly shorter in patients with a mean Ktrans of the CEL > 0.068 and 95th percentile Ktrans of the CEL > 0.223 (log-rank p = 0.038 and p = 0.041, respectively). However, only mean Ktrans of the CEL was significantly associated with PFS (p = 0.024; hazard ratio, 553.08; 95% confidence interval, 2.27–134756.74) in the multivariate Cox proportional hazard analysis. None of the pharmacokinetic variables from NE-T2HSILs were significantly related to PFS. @*Conclusion@#Among the pharmacokinetic variables extracted from CELs and NE-T2HSILs on preoperative DCE MR imaging, the mean Ktrans of CELs exhibits potential as a useful imaging predictor of PFS in GBM patients.
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Objective@#Proper management of lymph nodes (LNs) with ultrasonographic (US) indeterminate features in thyroid cancerpatients remains elusive. We aimed to evaluate the malignancy risk and US findings predictive of malignancy for USindeterminate LNs in preoperative thyroid cancer patients through node-by-node correlation. @*Materials and Methods@#A total of 348 LNs in 284 thyroid cancer patients, who underwent fine-needle aspiration or coreneedlebiopsy between December 2006 and June 2015, were included. We determined the malignancy risks for US probablybenign, indeterminate, and suspicious categories. For US indeterminate LNs, which had neither echogenic hilum nor hilarvascularity in the absence of any suspicious finding, US findings were compared between benign and metastatic LNs usingMann-Whitney U test and Fisher’s exact test. @*Results@#US imaging diagnoses were probably benign in 20.7% (n = 72) cases, indeterminate in 23.6% (n = 82), andsuspicious in 55.7% (n = 194). Malignancy risk of US indeterminate LNs (19.5% [16/82]) differed from those of the USprobably benign (2.8% [2/72]) (p = 0.002) and US suspicious LNs (78.4% [152/194]) (p < 0.001). Among US indeterminate LNs,there were no significant differences in short, long, and long-to-short diameter (L/S) ratios between benign and metastatic LNs(3.9 vs. 3.8 mm, p = 0.619; 7.3 vs. 7.3 mm, p = 0.590; 1.9 vs. 1.9, p = 0.652). @*Conclusion@#US indeterminate LNs were frequently encountered during preoperative evaluation and had intermediate malignancyrisk. Given the lack of discriminative power of size criteria and L/S ratio, clinical factors such as surgical strategy and nodesize should be considered for proper triage of US indeterminate LNs in thyroid cancer.
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Lumbar facet joints have been implicated in chronic low back pain in up to 45% of patients with low back pain (LBP). Facet joint pain diagnosis and management are always challenging for pain physicians. Facet joint pain is not diagnosed by specific demographic features, pain characteristics, or physical findings, even though electrodiagnostic studies and imaging modalities are available. Although comparative local anesthetics or placebo saline injections can be used, diagnostic blocks are the only reliable diagnostic measures according to the current literature. Treatment of chronic LBP arising due to facet joint includes intraarticular injections, medial branch blocks, and radiofrequency neurotomy. However, the evidence of their clinical efficacy is continuously under scrutiny. Pain physicians must have a detailed understanding of the spinal anatomy in order to perform safe and effective interventional procedures. This review outlines the important aspects of spinal anatomy as they relate to interventional pain management related to facet joint injections. Additionally, we provide a comprehensive review of the procedure and clinical evidence.
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Purpose@#The aim of current study is to verify the efficacy of extracorporeal shock wave therapy (ESWT) in neck and shoulder pain syndrome. @*Methods@#We enrolled 23 patients with neck and shoulder pain syndrome (mean age, 55±16 years; onset, 12.65±8.90 months) who underwent ESWT from July to December 2019. ESWT (4 to 5 bar or 0.23–0.45 mJ/mm 2 , 1,500 to 2,000 times/region, 7 Hz) was performed at least 4 consecutive times per week. Evaluated outcomes were visual analogue scale (VAS) of pain and tenderness, neck disability index (NDI), and shoulder passive range of motion (ROM; forward flexion [FF], external rotation at neutral [ER], internal rotation at back [IR]). Pain and tenderness VAS scores were assessed at every follow-up, while NDI and shoulder ROM were evaluated two times before treatment and at the final follw-up (at 4.52±0.73 weeks). @*Results@#The pain VAS score decreased from 5.5±2.4 at first visit to 4.0±1.8 (p=0.001), 3.3±2.1 (p=0.02), and 3.1±2.2 (p=0.29) at the first, second, and third follow-up visits. The tenderness VAS at first visit was 5.98±1.89, which decreased to 5.17±1.83 (p=0.005), 4.61±1.67 (p=0.05), and 4.09±1.92 (p=0.06) at the first, second, and third follow-up visits. NDI was significantly reduced from 18.04±8.86 to 10.04±6.94 at last follow-up (p=0.001) and shoulder ROM was significantly improved after treatment (FF: 159.6°±28.0° to 177.8°±8.5°, p=0.001; ER: 72.2±15.7° to 79.6±2.1°, p=0.02; IR: 10.2±3.49 [T 10] to 6.9±1.7 [T 7], p=0.001). @*Conclusion@#Consecutive ESWT was effective in treating neck and shoulder pain syndrome with functional improvement and pain reductio
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BACKGROUND: The aim of this study was to clarify the topographical relationships between the dorsal scapular nerve (DSN) and the dorsal scapular artery (DSA) in the interscapular region to identify safe and convenient injection points related to DSN blockade. METHODS: Thirty shoulders of embalmed Korean cadavers and 50 live subjects were used for dissection and ultrasound (US) analysis. RESULTS: The running patterns of the DSA and DSN in the interscapular region were classified into 3 types. Type I was defined as nerves that were medial to the artery and parallel without changing location (80.0% of specimens). In type II (13.3%), the nerve and artery traversed one another only one time over their entire length. In type III (6.7%), the nerve and artery traversed one another, resembling a twist. Above the level of the scapular spine, the nerve was always medial to the artery. Below the scapular spine, the number of arteries was obviously decreased. Most of the arteries were lateral to the medial border of the scapula, except at the level of the superior angle of the scapula artery (SA). The positional tendency of the DSN toward the medial or lateral sides from the medial border of the scapula was similar. In US imaging of live subjects, the DSA was most observed at the level of the SA (94.0%). CONCLUSIONS: Results of this study enhance the current knowledge regarding the pathway of the DSN and DSA and provide helpful information for selective diagnostic nerve blocks in the interscapular region.
Subject(s)
Arteries , Cadaver , Diagnosis , Nerve Block , Running , Scapula , Shoulder , Spine , UltrasonographyABSTRACT
BACKGROUND: Quantitative susceptibility mapping (QSM) has been used to measure iron accumulation in the deep nuclei of patients with Parkinson's disease (PD). This study examined the relationship between non-motor symptoms (NMSs) and iron accumulation in the deep nuclei of patients with PD. METHODS: The QSM data were acquired from 3-Tesla magnetic resonance imaging (MRI) in 29 patients with early PD and 19 normal controls. The Korean version of the NMS scale (K-NMSS) was used for evaluation of NMSs in patients. The patients were divided into high NMS and low NMS groups. The region-of-interest analyses were performed in the following deep nuclei: red nucleus, substantia nigra pars compacta, substantia nigra pars reticulata, dentate nucleus, globus pallidus, putamen, and head of the caudate nucleus. RESULTS: Thirteen patients had high NMS scores (total K-NMSS score, mean = 32.1), and 16 had low NMS scores (10.6). The QSM values in the deep were not different among the patients with high NMS scores, low NMS scores, and controls. The QSM values were not correlated linearly with K-NMSS total score after adjusting the age at acquisition of brain MRI. CONCLUSION: The study demonstrated that the NMS burdens are not associated with iron accumulation in the deep nuclei of patients with PD. These results suggest that future neuroimaging studies on the pathology of NMSs in PD should use more specific and detailed clinical tools and recruit PD patients with severe NMSs.
Subject(s)
Humans , Basal Ganglia , Brain , Caudate Nucleus , Cerebellar Nuclei , Globus Pallidus , Head , Iron , Magnetic Resonance Imaging , Neuroimaging , Parkinson Disease , Pars Compacta , Pars Reticulata , Pathology , Putamen , Red NucleusABSTRACT
BACKGROUND: The purpose of this study was to qualitatively and quantitatively evaluate the effects of a metal artifact reduction for orthopedic implants (O-MAR) for brain computed tomographic angiography (CTA) in patients with aneurysm clips and coils. METHODS: The study included 36 consecutive patients with 47 intracranial metallic implants (42 aneurysm clips, 5 coils) who underwent brain CTA. The computed tomographic images with and without the O-MAR were independently reviewed both quantitatively and qualitatively by two reviewers. For quantitative analysis, image noises near the metallic implants of non-O-MAR and O-MAR images were compared. For qualitative analysis, image quality improvement and the presence of new streak artifacts were assessed. RESULTS: Image noise was significantly reduced near metallic implants (P < 0.01). Improvement of implant-induced streak artifacts was observed in eight objects (17.0%). However, streak artifacts were aggravated in 11 objects (23.4%), and adjacent vessel depiction was worsened in eight objects (17.0%). In addition, new O-MAR-related streak artifacts were observed in 32 objects (68.1%). New streak artifacts were more prevalent in cases with overlapping metallic implants on the same axial plane than in those without (P = 0.018). Qualitative assessment revealed that the overall image quality was not significantly improved in O-MAR images. CONCLUSION: In conclusion, the use of the O-MAR in patients with metallic implants significantly reduces image noise. However, the degree of the streak artifacts and surrounding vessel depiction were not significantly improved on O-MAR images.
Subject(s)
Humans , Aneurysm , Angiography , Artifacts , Brain , Noise , Orthopedics , Quality ImprovementABSTRACT
Surface characteristics and cellular response to titanium surfaces that had been implanted with calcium and magnesium ions using plasma immersion ion implantation and deposition (PIIID) were evaluated. Three different titanium surfaces were analyzed: a resorbable blast media (RBM) surface (blasted with hydroxyapatite grit), a calcium ionimplanted surface, and a magnesium ion-implanted surface. The surface characteristics were investigated by scanning electron microscopy (SEM), surface roughness testing, X-ray diffraction (XRD), and Auger electron spectroscopy (AES). Human bone marrow derived mesenchymal stem cells were cultured on the 3 different surfaces. Initial cell attachment was evaluated by SEM, and cell proliferation was determined using MTT assay. Real-time polymerase chain reaction (PCR) was used to quantify osteoblastic gene expression (i.e., genes encoding RUNX2, type I collagen, alkaline phosphatase, and osteocalcin). Surface analysis did not reveal any changes in surface topography after ion implantation. AES revealed that magnesium ions were present in deeper layers than calcium ions. The calcium ion- and magnesium ion-implanted surfaces showed greater initial cell attachment. Investigation of cell proliferation revealed no significant difference among the groups. After 6 days of cultivation, the expression of RUNX2 was higher in the magnesium ion-implanted surface and the expression of osteocalcin was lower in the calcium ion-implanted surface. In conclusion, ion implantation using the PIIID technique changed the surface chemistry without changing the topography. Calcium ion- and magnesium ion-implanted surfaces showed greater initial cellular attachment.
Subject(s)
Humans , Alkaline Phosphatase , Bone Marrow , Calcium , Cell Proliferation , Chemistry , Collagen Type I , Durapatite , Gene Expression , Immersion , Ions , Magnesium , Mesenchymal Stem Cells , Microscopy, Electron, Scanning , Osteoblasts , Osteocalcin , Osteogenesis , Plasma , Real-Time Polymerase Chain Reaction , Spectrum Analysis , Titanium , X-Ray DiffractionABSTRACT
The rate of detection of thyroid nodules and carcinomas has increased with the widespread use of ultrasonography (US), which is the mainstay for the detection and risk stratification of thyroid nodules as well as for providing guidance for their biopsy and nonsurgical treatment. The Korean Society of Thyroid Radiology (KSThR) published their first recommendations for the US-based diagnosis and management of thyroid nodules in 2011. These recommendations have been used as the standard guidelines for the past several years in Korea. Lately, the application of US has been further emphasized for the personalized management of patients with thyroid nodules. The Task Force on Thyroid Nodules of the KSThR has revised the recommendations for the ultrasound diagnosis and imaging-based management of thyroid nodules. The review and recommendations in this report have been based on a comprehensive analysis of the current literature and the consensus of experts.
Subject(s)
Humans , Ablation Techniques , Advisory Committees , Biopsy , Consensus , Diagnosis , Korea , Lymph Nodes , Multidetector Computed Tomography , Thyroid Gland , Thyroid Neoplasms , Thyroid Nodule , UltrasonographyABSTRACT
OBJECTIVE: To compare computed tomography (CT) and magnetic resonance imaging (MRI) findings between two histological types of nasal hemangiomas (cavernous hemangioma and capillary or lobular capillary hemangioma). MATERIALS AND METHODS: CT (n = 20; six pre-contrast; 20 post-enhancement) and MRI (n = 7) images from 23 patients (16 men and seven women; mean age, 43 years; range, 13-73 years) with a pathologically diagnosed nasal cavity hemangioma (17 capillary and lobular capillary hemangiomas and six cavernous hemangiomas) were reviewed, focusing on lesion location, size, origin, contour, enhancement pattern, attenuation or signal intensity (SI), and bony changes. RESULTS: The 17 capillary and lobular hemangiomas averaged 13 mm (range, 4-37 mm) in size, and most (n = 13) were round. Fourteen capillary hemangiomas had marked or moderate early phase enhancement on CT, which dissipated during the delayed phase. Four capillary hemangiomas on MRI showed marked enhancement. Bony changes were usually not seen on CT or MRI (seen on five cases, 29.4%). Half of the lesions (2/4) had low SI on T1-weighted MRI images and heterogeneously high SI with signal voids on T2-weighted images. The six cavernous hemangiomas were larger than the capillary type (mean, 20.5 mm; range, 10-39 mm) and most had lobulating contours (n = 4), with characteristic enhancement patterns (three centripetal and three multifocal nodular), bony remodeling (n = 4, 66.7%), and mild to moderate heterogeneous enhancement during the early and delayed phases. CONCLUSION: CT and MRI findings are different between the two histological types of nasal hemangiomas, particularly in the enhancement pattern and size, which can assist in preoperative diagnosis and planning of surgical tumor excision.