Analysis of the Factors Affecting Consumer Acceptance of Accredited Online Health Information

With the increasing use of the internet and the spread of smartphones, health information seekers obtain considerable information through the internet. As the amount of online health information increases, the need for quality management of health information has been emphasized. The purpose of this study was to investigate the factors affecting the intention of using accredited online health information by applying the extended technology acceptance model (Extended-TAM). An online survey was conducted from September 15, 2016 to October 3, 2016, on 500 men and women aged 19–69 years. The results showed that the greatest factor influencing the acceptance of the accredited health information was perceived usefulness, and the expectation for the quality of the accreditation system was the most important mediator variable. In order to establish the health information accreditation system as a means to provide easy and useful information to the consumers, it is necessary to carry out quality management and promote the system through the continuous monitoring of the accreditation system.

Utilization, Safety, and Related Factors of Illegal Phosphodiesterase Type 5 Inhibitors in South Korean Men

BACKGROUND: Phosphodiesterase Type 5 Inhibitors (PDE5Is), which are prescription drug in South Korea, have been concerned about misuse, overuse and illegal provision of the drugs. This study was performed to investigate utilization and safety of illegal Phosphodiesterase Type 5 Inhibitors (PDE5Is), and related factors among South Korean men. METHODS: A questionnaire survey was conducted from May to July in 2013 among 1,500 nationally representative general males using computer-assisted telephone interview (CATI). The questionnaire included the characteristics of population, the characteristics of PDE5Is use, the experience with the use of illegally obtained PDE5Is, and adverse events after PDE5Is use. RESULTS: Among study population, the 1,015 (67.7%) men answered that they have used the illegally obtained PDE5Is. Younger age, single, lower frequency of PDE5Is use in a lifetime was associated with an increased use of illegally obtained PDE5Is. The men experienced adverse events after PDE5Is use is 528 (35.2%). The most common adverse event was mild to moderate hot flashes. CONCLUSION: We need to enhance awareness about the risk of illegally obtained PDE5Is use, especially in younger men and single. Proactive educations and public relations on safe use of PDE5Is for proper patients are needed.

Successful Management with Glue Injection of Arterial Rupture Seen during Embolization of an Arteriovenous Malformation Using a Flow-Directed Catheter: A Case Report

We present a case in which an arterial rupture occurring during embolization of an arteriovenous malformation of the left occipital lobe with a flow-directed micro-catheter,was successfully sealed with a small amount of glue. We navigated a 1.8-Fr Magic catheter through the posterior cerebral artery, and during superse-lective test injection, extravasation was observed at the parieto-occipital branch. The catheter was not removed and the perforation site was successfully sealed with a small amount of glue injected through the same catheter. Prompt recogni-tion and closure of the perforation site is essential for good prognosis.

GDC Embolization of Wide-necked Cerebral Aneurysms Using Balloon-Assisted Technique

PURPOSE: The main factor limiting endovascular treatment of intracranial aneurysms is the shape of the a-neurysmal sac, especially the width of the neck. We describe an early experience and technical aspects of treating wide-necked cerebral aneurysm using a Guglielmi detachable coil (GDC) and simultaneous application of a temporary balloon. MATERIALS AND METHODS: Four cases of unruptured wide-necked cerebral aneurysm were treated with GDC, with simultaneous application of a temporary balloon. Patients were aged between 29 and 49 years. On admission, clinical presentation was subarachnoid hemorrhage (SAH) in all cases. Hunt and Hess grade was II in two cases, III in one case, and traumatic SAH in one case. In all patients angiography revealed an asymptomatic a-neurysm after rupture of another aneurysm or traumatic SAH. The aneurysms were occluded with GDC-10, and a Cirrus balloon occlusion system was used simultaneously. All procedures were performed under endo-tracheal general anesthesia and systemic heparinization. RESULTS: All cases were treated successfully, without parent artery compromise. The occlusion rate at the end of the procedure was total in three cases and subtotal in one. In one case a heparin-related hematoma occurred during post-procedural treatment and the patient eventually expired. One patient underwent follow-up angiography after 6 months, and the coil was not changed. CONCLUSION: An aneurysm may not be completely occluded, but with regard to coil compaction and parent artery preservation, the technique is an attractive alternative.

Radiologic Findings of Deep Seated Cere b ral Arteriovenous

PURPOSE: To analyze the radiologic-especially angiographic-findings of deep seated cerebral arteriovenous malformation(AVM) involving nonvisualized straight sinus. MATERIALS AND METHODS: In six patients aged between 15 and 53 years with deep seated cerebral AVM, CT and MR images were retrospectively analyzed with regard to the following features : the presence of straight sinus, the location of AVM, and the occurrence of hemorrhage. Angiograms were analyzed for venous drainage routes of AVM, the appearance of veins, the presence of falcine sinus and venous drainage from normal deep brain parenchyme. In four patients who had undergone intravascular embolization therapy, pre- and post- embolization angiograms were compared. RESULTS: CT and MR images showed neither straight sinus nor thrombosis. AVMs were deeply seated in the brain, and in all cases there was cerebral hemorrhage. Angiograms disclosed that venous drainage of all AVMs occurred via the veins of Galen. In one case, venous flow via the falcine sinus to the superior sagittal sinus was noted, but in others, retrograde flow in the deep venous system was observed. Marked collateral routes followed in response to the obstruction of straight sinus included the basal vein of Rosenthal, the internal occipital, internal cerebral, and cerebellar hemispheric veins (which are Galenic afferents), and the inferior sagittal s-inus. In all patients, contralateral routes were partially involved. Venous drainage from normal deep parenchyme through the transcerebral veins to the superficial venous system was noted, and in one case, s-traight sinus which had been observed on an angiogram five years earlier was no longer present. CONCLUSION: Angiography offers effective evaluation of the dynamic aspect of venous flow in cases involving deep-seated AVM, and of normal deep parenchyme in cases in which AVM involves nonvisualized straight sinus. Before intravascular treatment of AVM, venous flow must be carefully analyzed.

Transarterial Embolization of a Carotid Cavernous Fistula with Guglielmi Detachable Coils: A Case Report

In the management of carotid cavernous fistula, detachable balloon has become the treatment of choice.However, technical difficulties are not uncommon, and transarterial balloon embolization fail in 5% to 10% ofcases. Failure occurs because in some patients, the fistula orifice may be too small to allow entry. Using atracker catheter system with Guglielmi detachable coils, we achieved successful transarterial occlusion of acarotid cavernous fistula with a small fistula.

Tuberculous Pneumonia: CT Findings in 20 Patients

PURPOSE: To evaluate CT findings of tuberculous pneumonia mainly presenting as parenchymal consolidation. MATERIALS & METHODS: CT scans of twenty patients with tuberculous pneumonia were retrospectively reviewed. Analyses included the location, extent, and homogeneity of consolidation, presence of volume loss of involved lung and air-bronchogram, associated lesions suggesting previous tuberculous infection and evidence of bronchogenic spread. RESULTS: The location of consolidation revealed relatively even distribution without any specific predilection site. The areas of consolidation were irregular in margin (95%), inhomogeneous in attenuation (75%) including focal areas of low attenuation and multiple cavities within it. Volume loss (70%) of the involved lobe was associated. There were lesions suggesting previous tuberculous infection (95%) in the surrounding area and evidences of bronchogenic spread (100%) such as poorly-defined nodules and Iobular consolidations in the remote site from main consolidation. CONCLUSION: In tuberculous pneumonia, the areas of consolidation are irregular in margin and inhomogeneous in attenuation on CT scan. The evidences of bronchogenic spread and lesions suggesting previous tuberculous infection are almost always associated in the surrounding or remote site from main consolidation.

Intrahepatic Duct Dilatation Caused by Extrahepatic Billiary Obstruction' Morphologic Differentiation Between Benign and Malignant Disease on CT Scan

PURPOSE: Retrospective studies were carried out to evaluate the usufulness of CT in differentiating benign or malignant intrahepatic duct(IHD) dilatation due to extrahepatic duct(EHD) obstruction. MATERIALS AND METHODS: Among 75 cases of IHD dilatation, 35 cases(47%) which did not show causative lesion on CT were classified into central or peripheral type according to the extent of the dilatation and into pruned or beaded form according to its pattern. We considered central type or pruned form as a benign feature while peripheral type or beaded from as a malignant feature. Predictions of benignancy or malignancy were made according to the pattern and the extent of IHD dilatation. In all 75 cases, maximum caliber of IHD at portal vein bifurcation were examined. RESULTS: In regard to the classification of the extent, 80% (28 out of the 35 cases:11 of 15 cases of benignancy and 17 of 20 cases of malignancy) of our prediction was correct. As to the classification of the pattern, similar results(82% correct prediction) were obtained(14 out of 17 cases):ln 15 cases of benignancy, we observed six cases of pruning and 1 case of beading. Among the 20 cases of malignancy, two cases of pruning and eight cases of beading of IHD dilatation were observed. Mean diameters of IHD at portal vein bifurcation were 10.1ram in benignancy and 15.1mm in malignancy.(Diameters less than 11mm was suggestive of benignancy(alpha =0.05). CONCLUSION: Evaluation of the extent, the pattern, and the degree of IHD dilatation is necessary in differential diagnosis of benignancy and malignancy of EHD obstruction. We conclude that CT is a useful tool for this purpose of differential diagnosis of the benignancy and the malignancy of extrahepatic biliary obstruction.

Correlation Between Displacement of Optic Chiasm on MR and Visual Symptomas and Signs

PURPOSE: MR is the most useful imaging method in evaluating the anatomic changes of the optic chiasm (OC). The purpose of this study is to investigate the relationship between the OC displacement and visual manifestations. MATERIALS AND METHODS: We retrospectively reviewed 44 patients who showed displacement of OC on brain MR. The pattern of OC displacement was classified into 3 groups according to following criteria: group A included the patients with OC displacement only due to empty sella;group B represented the patients with OC displacement by a lesion and the border between the lesion and OC was distinct;and group C was the patients with OC displacement by a lesion and had a indistinct border or thinning of the OC. RESULTS: Visual symptoms and signs were noted in 12 patients and the most common sign was bitemporal hemianopsia. In group A(7 patients), the visual symptoms and signs were seen in only one patient(14%), in whom contracted visual fields persisted since previous pituitary apoplexy had developed. In group B(30 patients), the visual symptoms and signs were seen in 4 patients(13%) who had tumorous conditions except one case of cysticercosis. In group C(7 patients), the visual symptoms and signs were seen in all patients (100%). CONCLUSION: The more OC is compressed, the more the prevalence of visual symptoms and signs increases. However, there was no correlation between the occurrence of visual symptoms and the presence of OC displacement only without compression.

Physiologic AV Valvular Insufficiency in Cine MR Imaging

PURPOSE: To give a help in the interpretation of cardiac cine-MR examination, the extent, shape, and timing of appearance of signal void regions near atrioventricular(A-V) valve prospectively evaluated in the healthy population. MATERIALS AND METHODS: Using an axial gradient-echo technique with small flip angle, repetition time(TR) of 36 msec and echo time(TE) of 22 msec, 20 volunteers without known valvular abnormalities undertook cardiac cine-MR imaging including atrioventricualr valve areas. RESULTS: Transient signal void was observed within the atrium near the tricuspid(13/20 = 65%) and mitral valves(9/20 = 45%), respectively, which is so called "physiologic atrioventricular valvular insufficiency". Eight subjects revealed the signal void areas near both tricuspid and mitral valves but, 5 subjects didnot show any evidences of physiologic insufficiency. This physiologic condition does not extend more than lcm proximal to A-V valve plane and is generally observed only during early systole. Its morphology is semilunar or triangular configuration with the base to the valve plane in most cases of normal tricuspid insufficiency and small globular appearance in most cases of normal mitral insufficiency. CONCLUSION: Awareness of normal signal void areas near the A-V valve and their characteristics is critical in the interpretation of cardiac cine MR examinations and maybe helpfal in the study of the normal cardiac physiology.

Bilateral Hyperintense Basal Ganglia on T1-weighted Image

PURPOSE: Bilateral high signal intensity in basal ganglia on Tl-weighted images is unusual. the purpose of this study is to describe the pattern of high signal intensity and underlying disease. METHODS AND MATERIALS: During the last three years, 8 patients showed bilateral high signal intensity in basal ganglia on Tl-weighted image, as compared with cerebral white matter. Authors analized the images and underlying causes retrospectively. Of 8 patients, 5 were male and 3 were female. The age ranged from 15 days to 79 years. All patient were examined by a 0.5T superconductive MRI. Images were obtained by spin echo multislice technique. RESULTS: Underlying causes were 4 cases of hepatopathy, 2 cases of calcium metabolism disorder, and one case each of neurofibromatosis and hypoxic brain injury. These process were bilateral in all cases and usually symmetric. In all cases the hyperintense areas were generally homogenous without mass effect or edema, although somewhat nodular appearence was seen in neurofibromatosis. Lesions were located in the globus pallidus and internal capsule in hepatopathy and neurofibromatosis, head of the caudate nucleus in disorder of calcum metabolism, and the globus pallidus in hypoxic brain injury. CONCLUSION: Although this study is limited by its patient population, bilateral hyperintense basal ganglia is associated with various disease entities. On analysis of hyperintense basal ganglia lesion, the knowledge of clinical information improved diagnostic accuracy.

Automatic coding method of the ACR code

The authors devdeloped a computer program for automatic coding of ACR (American College of Radiology) code. The automatic coding of the ACR code is essential for computerization of the data in the department of radiology. This program was written in FoxBASE language and has been used for automatic coding of diagnosis in the Deparment of Radiology, Wallace Memorial Baptist Hospital since May 1992. The ACR dictionary files consisted of 11 files, one for the organ code and the others for the pathology code. The organ code was obtained by typing organ name or code number itself among the upper and lower level codes of the selected one that were simultaneously displayed on the screen. According to the first number of the selected organ code. the corresponding pathology code file was chosen augomatically. By the similar fashion of organ code selection, the proper pathologic dode was obtained. An example of obtained ACR code is "131.3661". This procedure was reproducible regardless of the number of fields of data. Bacause this program was written in "User's Defined Function" from, decoding of the stored ACR code was achieved by this same program and incoporation of this program into another data processing program was possible. This program had merits of simple operation, accurate and detail coding, and easy adjustment for another program. Therefore, this program can be used for automation of routine work in the department of radiology.

Focal hepatic lesions:Differential diagnosis with MRI

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.

Focal hepatic lesions:Differential diagnosis with MRI

Differentiation between benign and malignant hepatic lesions was attempted according to the shape of the lesion, internal architecture and characteristics of signal intensity on MR images. MR images. We retrospectively analyzed 20 cases of hemangiomas, 12 cases of hepatomas and 5 cases of cysts which were diagnosed by clinical, radiological and surgical methods (33 patients). On T1-weighted, proton weighted, and T2-weighted images, most hemangiomas (70%) and cysts (100%) had smooth margin and were round or oval in shape, while hepatocellular carcinomas had irregular (67%) or lobulated (33%) borders. Ninety percent of hemangiomas and 100% of cysts had homogeneous signal intensity, but 67% of hepatocellular carcinomas were inhomogeneous. Signal intensities of hepatocellular carcinomas were more variable. However, hemangionmas were isointense or hyperintense on proton weighted images, and markedly hyperintense on T2-weighted images . In conclusion, inhomogenous, irregular border, and variable signal intensity lesions had high likelihood of malignancy, while homogenous and markedly hyperintense lesions were more likely benign.