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1.
Article in English | WPRIM | ID: wpr-916901

ABSTRACT

Multilocular cystic renal neoplasm of low malignant potential (MCRNLMP) is a rare subtype of renal cell carcinoma that has a favorable outcome. Most cases of MCRNLMP usually present as distinct multilocular cystic lesions; however, they may appear as small complicated cysts with hemorrhagic components. Herein, we present a case of MCRNLMP and provide a review of the literature.

2.
Article in English | WPRIM | ID: wpr-901384

ABSTRACT

Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.

3.
Article in English | WPRIM | ID: wpr-901351

ABSTRACT

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.

4.
Article in Korean | WPRIM | ID: wpr-901200

ABSTRACT

Objective@#This study aimed at identifying the incidence rate and characteristics of patients who had suffered falls, classifying them by life cycle and factors that affect mortality. @*Methods@#The Korean National Hospital Discharge In-depth Injury Surveys (KNHDIS) from 2007 to 2016 were used to investigate the sex, age, place, season, payment method, underlying disease, and the death of hospitalized patients due to falls. @*Results@#The number of hospitalized patients increased with age. In all life cycles except old age, men were hospitalized more than women. The payment method for treatment was 66.1% through national health insurance, 6.6% through medical aid, and 27.3% through other sources. Falls were most common in winter and occurred frequently at home and on the road. In terms of the number of patients, the compound annual growth rate was 0.9% for men and 3.7% for women. In terms of the number of deaths in hospitals, the compound annual growth rate was -1.9% for men and -7.2% for women. Mortality risk was high in men in middle adulthood and old age, in patients with underlying diseases, and in patients who suffered a fall in their homes. @*Conclusion@#The number of patients from falls is increasing, but the deaths of hospitalized fall patients are decreasing. Mortality risk was high in men in middle adulthood and old age, in patients with underlying diseases, and in patients who suffered falls in their homes.

5.
Article in English | WPRIM | ID: wpr-893680

ABSTRACT

Bladder cancer is a relatively common cancer type, with a high recurrence rate, that can be often encountered in the imaging study. Accurate diagnosis and staging have a significant impact on determining treatment and evaluating prognosis. Bladder cancer has been evaluated by transurethral resection of bladder tumor for clinical staging and treatment, but it is often understaged when compared with final pathologic result by radical cystectomy. If the location, size, presence of muscle invasion, lymph node metastasis, distant metastasis, and presence of upper urinary tract cancer can be accurately diagnosed and evaluated in an imaging study, it can be treated and managed more appropriately. For an accurate diagnosis, radiologists who evaluate the images must be aware of the characteristics of bladder cancer as well as its types, imaging techniques, and limitations of imaging studies. Recent developments in MRI with functional imaging have improved the quality of bladder imaging and the evaluation of cancer. In addition, the Vesical Imaging Reporting and Data System was published to objectively assess the possibility for muscle invasion of cancer. Radiologists need to know the types of bladder cancer treatment and how to evaluate the changes after treatment. In this article, the characteristics of bladder urothelial carcinoma, various imaging studies, and findings are reviewed.

6.
Article in English | WPRIM | ID: wpr-893647

ABSTRACT

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, multi-systemic disease primarily affecting young male adults with a history of smoking. The two patients with PLCH in our report showed relatively early and atypical radiologic presentations at initial evaluation. On chest CT, PLCH presents variable radiologic features depending on the evolutional stage of the disease. Atypical CT features of PLCH may render precise radiologic diagnosis difficult and usually require lung biopsy for a confirmation of the diagnosis. Our case review is aimed at raising the awareness of radiologists on the atypical CT features of PLCH, to help make accurate radiologic diagnosis and prevent unnecessary and invasive diagnostic procedures.

7.
Article in Korean | WPRIM | ID: wpr-893496

ABSTRACT

Objective@#This study aimed at identifying the incidence rate and characteristics of patients who had suffered falls, classifying them by life cycle and factors that affect mortality. @*Methods@#The Korean National Hospital Discharge In-depth Injury Surveys (KNHDIS) from 2007 to 2016 were used to investigate the sex, age, place, season, payment method, underlying disease, and the death of hospitalized patients due to falls. @*Results@#The number of hospitalized patients increased with age. In all life cycles except old age, men were hospitalized more than women. The payment method for treatment was 66.1% through national health insurance, 6.6% through medical aid, and 27.3% through other sources. Falls were most common in winter and occurred frequently at home and on the road. In terms of the number of patients, the compound annual growth rate was 0.9% for men and 3.7% for women. In terms of the number of deaths in hospitals, the compound annual growth rate was -1.9% for men and -7.2% for women. Mortality risk was high in men in middle adulthood and old age, in patients with underlying diseases, and in patients who suffered a fall in their homes. @*Conclusion@#The number of patients from falls is increasing, but the deaths of hospitalized fall patients are decreasing. Mortality risk was high in men in middle adulthood and old age, in patients with underlying diseases, and in patients who suffered falls in their homes.

8.
Article | WPRIM | ID: wpr-834892

ABSTRACT

Objective@#This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospitaltraumatic cardiac arrests (TCA). @*Methods@#The charts of patients with pre-hospital TCA who visited the various emergency department (ED) in Gangwondofrom January 2013 to December 2017 were reviewed retrospectively. @*Results@#TCA patients comprised 0.3% of patients transferred by 119. A total of 367 patients were enrolled in the study.Traffic accidents were the leading cause of the arrest. The initial field and ED rhythm were mostly asystole (field, 79.6%;ED, 82.3%). It took 11.24±9.95 minutes from the call to the field. From the field to ED, it took 22.87±15.37 minutes. Thetotal CPR time before ED arrival was 21.62±15.29 minutes. The causes of TCA were brain injury (35.7%), hypovolemicshock (29.2%), and severe lung injury (16.3%). Seventy TCA patients experienced at least one return of spontaneous circulation(ROSC). Twenty-six patients (7.14%) were admitted to the ward, and their average injury severity score was38.96. Eight patients expired before 12 hours after transient ROSC. Four more patients expired before 24 hours. Fourpatients were discharged alive among patients who lived for more than 24 hours. @*Conclusion@#In this study, 1.5% of patients were discharged alive. The possibility of ROSC was higher as the time to ED,and the cardiopulmonary resuscitation time of 119 was shorter. Pulseless electrical activity rather than asystole tends topromote ROSC. The survival rate increased when ROSC occurred before arriving at the ED.

9.
Article in 0 | WPRIM | ID: wpr-901275

ABSTRACT

Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

10.
Article in 0 | WPRIM | ID: wpr-893571

ABSTRACT

Missed lung cancers on chest radiograph (CXR) may delay the diagnosis and affect the prognosis. CXR is the primary imaging modality to evaluate the lungs and mediastinum in daily practice. The purpose of this article is to review chest radiographs for common blind spots and highlight the importance of various radiologic presentations in primary lung cancer to avoid significant diagnostic errors on CXR.

11.
Article in Korean | WPRIM | ID: wpr-766588

ABSTRACT

The fatality rate of a disaster is associated with the impact of the disaster and the case fatality rate. The severity of the disaster can be reduced by an efficient disaster management system, and the capacity of the trained disaster response system can lower the case mortality rate. The severity of a disaster is determined by the interaction of risk factors and vulnerabilities in a particular area, and the case-fatality rate is determined by a correlation between the capacity of the disaster response team and the survivability of the victims. The disaster management system and the disaster response system are complementary and interconnected, and the efficiency of cooperation and linkage can be improved by developing well organized digitalization. Efforts to increase the survival rate of victims through digitalization has been a continued process and new alternatives are being developed in accordance with the advances in information and communication technology to manage disaster risk factors and to improve disaster response capabilities. However, in case of mass casualty incidents, it is still difficult to reduce the case mortality rate by securing the survival time limit of the victims. Often, sharing the disaster scene information and communicating with the victim is not feasible. A lack of ability to provide real time escape route to exit or safe zone proves fatal. The communication revolution of the next generation wireless wide area network called 5G can overcome the disruption of communication network during the disaster incidents. It can enable real time tracking of the position of victim and linking the victims with its rescuers. Hence, it is possible to increase the survival rate of victims during mass casualty incidents by associating information and communication technologies with appropriate disaster management and response strategies, real-time information exchange and education and training of rescuers and citizens.


Subject(s)
Disasters , Education , Emergencies , Mass Casualty Incidents , Mortality , Risk Factors , Survival Rate , United Nations
12.
Article in Korean | WPRIM | ID: wpr-758487

ABSTRACT

OBJECTIVE: The aim of this study was to identify the latent class, according to the risk factors, of the patients hospitalized due to intentional self-harm by lethal means. METHODS: The risk factors were derived by categorizing the intentional self-harming measures by lethal (hanging, pesticide poisoning, jumping, and drowning) and non-lethal (drug poisoning and stab) measures and comparing the demographics, diseased state, and suicide-related characteristics. Latent class analysis was performed to identify the type of intentional self-harm. RESULTS: Male (sex), elderly (age), rural (residing location), and comorbid diseases were found to be the risk factors for fatal injuries. For this, four latent classes were modeled. Factors, such as the age group between 20 to 40 years, women, and family conflict were included in the first class. The second class included the age group between 30 to 50 years, men, and financial problems. The third class covered the age group between 60 to 70 years and comorbidity. The fourth class contained the age group of 10 to 50 years, women, and mental problems. The rate of suicide and choice of fatal suicide was ranked in the order of 3 (62.7%, 21.5%), 2 (59.8%, 13.9%), 4 (36.8%, 5.7%), and 1 (29.5%, 5.9%). CONCLUSION: A lethal mean access control policy needs to be established for the high-risk group of self-harm. Moreover, establishing an emergency room-community link prevention policy could help reduce the re-suicide attempt among suffering patients.


Subject(s)
Aged , Cluster Analysis , Comorbidity , Demography , Emergencies , Family Conflict , Female , Humans , Inpatients , Male , Methods , Poisoning , Risk Factors , Self-Injurious Behavior , Suicide
13.
Article in Korean | WPRIM | ID: wpr-916825

ABSTRACT

The steady increase in imaging studies has led to the incidental discovery of many renal masses. Although most incidental solid renal masses are asymptomatic and small in size, they are mostly malignant renal cancers necessitating accurate diagnosis. Small-sized masses are more likely to be benign tumors; therefore, access is needed according to size. Because most malignant tumors are renal cell carcinoma, and most benign tumors are angiomyolipoma and oncocytoma. Knowledge of common imaging findings of these tumors is helpful for diagnosis and management. However, imaging techniques are often insufficient to characterize solid renal masses which are discovered incidentally in radiological examinations, especially small-sized masses. Herein, we describe the imaging features characteristic of incidental solid renal masses and discuss their management in cases when an accurate diagnosis could or could not be made.

14.
Article in Korean | WPRIM | ID: wpr-916231

ABSTRACT

The fatality rate of a disaster is associated with the impact of the disaster and the case fatality rate. The severity of the disaster can be reduced by an efficient disaster management system, and the capacity of the trained disaster response system can lower the case mortality rate. The severity of a disaster is determined by the interaction of risk factors and vulnerabilities in a particular area, and the case-fatality rate is determined by a correlation between the capacity of the disaster response team and the survivability of the victims. The disaster management system and the disaster response system are complementary and interconnected, and the efficiency of cooperation and linkage can be improved by developing well organized digitalization. Efforts to increase the survival rate of victims through digitalization has been a continued process and new alternatives are being developed in accordance with the advances in information and communication technology to manage disaster risk factors and to improve disaster response capabilities. However, in case of mass casualty incidents, it is still difficult to reduce the case mortality rate by securing the survival time limit of the victims. Often, sharing the disaster scene information and communicating with the victim is not feasible. A lack of ability to provide real time escape route to exit or safe zone proves fatal. The communication revolution of the next generation wireless wide area network called 5G can overcome the disruption of communication network during the disaster incidents. It can enable real time tracking of the position of victim and linking the victims with its rescuers. Hence, it is possible to increase the survival rate of victims during mass casualty incidents by associating information and communication technologies with appropriate disaster management and response strategies, real-time information exchange and education and training of rescuers and citizens.

15.
Article in English | WPRIM | ID: wpr-717860

ABSTRACT

OBJECTIVE: To evaluate the differences in subjective calcification detection rates and objective calcium volumes in lung nodules according to different reconstruction methods using hybrid kernel (FC13-H) and iterative reconstruction (IR). MATERIALS AND METHODS: Overall, 35 patients with small (< 4 mm) calcified pulmonary nodules on chest CT were included. Raw data were reconstructed using filtered back projection (FBP) or IR algorithm (AIDR-3D; Canon Medical Systems Corporation), with three types of reconstruction kernel: conventional lung kernel (FC55), FC13-H and conventional soft tissue kernel (FC13). The calcium volumes of pulmonary nodules were quantified using the modified Agatston scoring method. Two radiologists independently interpreted the role of each nodule calcification on the six types of reconstructed images (FC55/FBP, FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D). RESULTS: Seventy-eight calcified nodules detected on FC55/FBP images were regarded as reference standards. The calcium detection rates of FC55/AIDR-3D, FC13-H/FBP, FC13-H/AIDR-3D, FC13/FBP, and FC13/AIDR-3D protocols were 80.7%, 15.4%, 6.4%, 52.6%, and 28.2%, respectively, and FC13-H/AIDR-3D showed the smallest calcium detection rate. The calcium volume varied significantly with reconstruction protocols and FC13/AIDR-3D showed the smallest calcium volume (0.04 ± 0.22 mm³), followed by FC13-H/AIDR-3D. CONCLUSION: Hybrid kernel and IR influence subjective detection and objective measurement of calcium in lung nodules, particularly when both techniques (FC13-H/AIDR-3D) are combined.


Subject(s)
Calcium , Humans , Lung , Research Design , Thorax , Tomography, X-Ray Computed
16.
Article in English | WPRIM | ID: wpr-719205

ABSTRACT

PURPOSE: Acute normovolemic hemodilution (ANH) is an autologous transfusion method, using blood collected during surgery, to reduce the need for allogeneic blood transfusion. ANH is controversial because it may lead to various complications. Among the possible complications, anastomotic leakage is one that would have a significant effect on the operation outcome. However, the relationship between ANH and anastomotic site healing requires additional research. Therefore, we conducted this prospective study of ANH, comparing it with standard intraoperative management, undergoing gastric anastomosis in rats. METHODS: Sixteen Sprague-Dawley rats were randomly assigned to three groups: group A, surgery with ANH; group N, surgery with standard intraoperative management; and group C, sham surgery with standard intraoperative management. ANH was performed in group A animals by, removing 5.8–6.6 mL of blood and replacing it with 3 times as much crystalloid. All rats were enthanized on postoperative day 6, and histopathologic analyses were performed. RESULTS: The mean hematocrit values, after hemodilution were 22.0% (range, 18.0%–29.0%), group A; 33.0% (29.0%–35.0%), group N; and 32.5% (29.0%–34.0%), group C. There were significant differences between groups A and N (P = 0.019, P = 0.009, P = 0.004, P = 0.039, and P = 0.027), and between groups N and C (P = 0.006, P = 0.027, P = 0.04, P = 0.008, and P = 0.009) with respect to inflammatory cell numbers, neovascularization, fibroblast numbers, edema and necrosis, respectively; there were no differences between groups A and N. CONCLUSION: In rat model, anastomotic complications did not increase in the ANH group, compared with the standard intraoperative management group.


Subject(s)
Anastomotic Leak , Animals , Blood Transfusion , Cell Count , Edema , Fibroblasts , Hematocrit , Hemodilution , Methods , Models, Animal , Necrosis , Prospective Studies , Rats , Rats, Sprague-Dawley
17.
Korean Journal of Radiology ; : 1119-1129, 2018.
Article in English | WPRIM | ID: wpr-718937

ABSTRACT

OBJECTIVE: To compare the image quality of low-tube-voltage and low-iodine-concentration-contrast-medium (LVLC) computed tomography urography (CTU) with iterative reconstruction (IR) with that of conventional CTU. MATERIALS AND METHODS: This prospective, multi-institutional, randomized controlled trial was performed at 16 hospitals using CT scanners from various vendors. Patients were randomly assigned to the following groups: 1) the LVLC-CTU (80 kVp and 240 mgI/mL) with IR group and 2) the conventional CTU (120 kVp and 350 mgI/mL) with filtered-back projection group. The overall diagnostic acceptability, sharpness, and noise were assessed. Additionally, the mean attenuation, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure of merit (FOM) in the urinary tract were evaluated. RESULTS: The study included 299 patients (LVLC-CTU group: 150 patients; conventional CTU group: 149 patients). The LVLC-CTU group had a significantly lower effective radiation dose (5.73 ± 4.04 vs. 8.43 ± 4.38 mSv) compared to the conventional CTU group. LVLC-CTU showed at least standard diagnostic acceptability (score ≥ 3), but it was non-inferior when compared to conventional CTU. The mean attenuation value, mean SNR, CNR, and FOM in all pre-defined segments of the urinary tract were significantly higher in the LVLC-CTU group than in the conventional CTU group. CONCLUSION: The diagnostic acceptability and quantitative image quality of LVLC-CTU with IR are not inferior to those of conventional CTU. Additionally, LVLC-CTU with IR is beneficial because both radiation exposure and total iodine load are reduced.


Subject(s)
Commerce , Contrast Media , Humans , Iodine , Noise , Prospective Studies , Radiation Exposure , Signal-To-Noise Ratio , Urinary Tract , Urography
18.
Neurology Asia ; : 159-161, 2018.
Article in English | WPRIM | ID: wpr-732549

ABSTRACT

In-stent restenosis occurs in approximately 30% of patients after receiving a Wingspan stent to treat symptomatic intracranial atherosclerosis. This report describes a 55-year-old man with intracranial atherosclerotic internal carotid artery terminus stenosis who developed significant in-stent restenosis. Follow-up angiogram 5 years later demonstrated the regression of restenosis without invasive intervention.

19.
Article in English | WPRIM | ID: wpr-646576

ABSTRACT

Artificial uterus using endometrium implant can be a novel treatment strategy for infertile women with refractory endometrial dysfunction. At early pregnancy, the function of uterine endometrial cells for the communication between the conceptus of pre-implantation period and maternal reproductive system is essential. MicroRNA (miR) expression profile of endometrial cells according to progesterone, a crucial pregnancy-maintaining hormone, provides important data for in vitro endometrial cell culture strategy that is useful for engineering artificial uteri using endometrial implants. The present study aimed to evaluate the miR expression profile of in vitro cultured endometrial cells under hormonal milieu mimicking early pregnancy period in terms of progesterone concentration. We cultured murine uterine endometrial cells, human uterine endometrial carcinoma cells, and immortalized human uterine endometrial cells using different progesterone concentrations, and analyzed the expression of miRs critical for early pregnancy. The expression of miR-20a, -21, -196a, -199a, and -200a was differently regulated according to progesterone concentration in different endometrial cell lines. The analysis of candidate target genes showed that the expression of phosphatase and tensin homolog, mucin 1 (MUC1), progesterone receptor, transforming growth factor β receptor II, matrix metallopeptidase-9 was up-regulated by progesterone treatment in mouse and human endometrial cell lines. These results indicate that physiological concentration range (10⁻⁷ and 10⁻⁹ M) of progesterone affect the survival and target gene expression via modulating miR expression. Taken together, progesterone can be a crucial factor in regulating miR expression on in vitro cultured endometrial cells.


Subject(s)
Animals , Cell Culture Techniques , Cell Line , Endometrial Neoplasms , Endometrium , Female , Gene Expression , Humans , In Vitro Techniques , Mice , MicroRNAs , Mucin-1 , Pregnancy , Progesterone , Receptors, Progesterone , Transforming Growth Factors , Uterus
20.
Hip & Pelvis ; : 44-53, 2017.
Article in English | WPRIM | ID: wpr-147777

ABSTRACT

PURPOSE: Femoral intertrochanteric fractures are common in the elderly. Appropriate surgical fixation of trochanteric fracture fragments can restore normal anatomical structure and ambulation, and can aid in the recovery of biomechanical function of the hip. We evaluated clinical outcomes of bipolar hemiarthroplasty using a wiring technique for trochanteric fracture fragment fixation. MATERIALS AND METHODS: From September 2006 to February 2015, a total of 260 cases underwent simultaneous bipolar hemiarthroplasty and wire fixation. A total of 65 patients (69 hips) with an average age of 78 years and more than one year of follow-up was included in the study. Using pre-, postoperative and follow-up radiograms, we evaluated wire fixation failure and also assessed changes in walking ability. RESULTS: Loosening or osteolysis around the stem was not observed; however, we did observe bone growth around the stem (54 cases), cortical hypertrophy (6 cases), a wide range of sclerotic lines but no stem subsidence (1 case), wire breakage (9 cases), and fracture fragment migration with no significant functional deficiency (2 cases). CONCLUSION: Our study showed that additional wiring for trochanteric fracture fragment fixation following bipolar hemiarthroplasty can help restore normal anatomy. The added stability results in faster rehabilitation, and good clinical and radiographic outcomes. We recommend this procedure in this type of fracture.


Subject(s)
Aged , Bone Development , Bone Wires , Clinical Study , Femur , Follow-Up Studies , Fracture Fixation , Hemiarthroplasty , Hip , Hip Fractures , Humans , Hypertrophy , Osteolysis , Rehabilitation , Walking
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