Qualitative Analysis on Magnetic Resonance Imaging for Preoperative Evaluation of Chronic Lateral Ankle Ligament Injury

PURPOSE@#To compare the MRI findings of anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) injuries in chronic lateral ankle instability (CLAI) between surgical treatment groups.@*MATERIALS AND METHODS@#Fifty-two patients with CLAI were divided into the modified Broström procedure (MBP) (n = 31) and lateral ankle ligament reconstruction (LAR) (n = 21) groups. T2-weighted MRI findings between the groups were compared for caliber change, slope, signal intensity, and thickness measurements of the ligaments. Additionally, the talar tilt angles were measured on stress radiographs.@*RESULTS@#The injured ATFL (p = 0.002 vs. p = 0.001) and CFL (p = 0.008 vs. p = 0.039) were more commonly scarce or thin and had decreased slopes in the LAR group. The mean thickness of ATFL (P = 0.002) and CFL (p = 0.002) was 1.1 ± 0.9 mm and 1.3 ± 0.8 mm, respectively, in the LAR group and 2.2 ± 1.3 mm and 2.1 ± 0.9 mm, respectively, in the MBP group. The mean talar tilt angle was greater in the LAR group (13.4 ± 3.9°) than in the MBP group (9.5 ± 3.8°) (p = 0.001).@*CONCLUSION@#A qualitative analysis of the ligaments on MRI is valuable in selecting the surgical method.

Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.

Effects of Self-Assertive Training Applying Reality Therapy Techniques on Self-esteem and Internalized Stigma in Schizophrenia Patients / 정신간호학회지

PURPOSE: The aim of this study was to examine the effect of self-assertive training applying the reality therapy techniques (SATART) on self-esteem and internalized stigma of schizophrenia patients. METHODS: This study was a non-equivalent control group pretest-posttest design and enrolled 55 people with schizophrenia (experimental group=27, control group=28) from two community mental health centers. The SATART was offered twice a week for 6 weeks in a total 12 sessions. Data were collected from February to April, 2017, using the Korean version of the Internalized Stigma of Mental Illness Scale and Rosenberg Self-Esteem Scale. The collected data was analyzed using χ2 test, independent t-test, one-way ANCOVA, and repeated measures ANOVA with using the SPSS/WIN 22.0 program. RESULTS: The experimental group showed significant improvements in self-esteem and recudction of internalized stigma compared to the control group. However, there was no significant improvement on stigma resistance measurement among the subscales of internalized stigma between two groups. CONCLUSION: The findings indicate that the SATART program is effective and could be recommended as a psychosocial intervention for self-esteem enhancement and internalized stigma reduction of people with schizophrenia.

Intramuscular Epidermal Cyst of the Buttock: A Case Report

Epidermal cysts are common benign subcutaneous lesions that occur in or on the skin. It is not very difficult to diagnose subcutaneous epidermal cysts using ultrasound imaging because they exhibit typical sonographic features. However, the differential diagnosis can be confused when epidermal cysts are found in unusual sites. The authors report a case involving a 4-year-old girl who presented with an intramuscular epidermal cyst in the gluteus maximus muscle. Magnetic resonance imaging revealed characteristic internal features of the epidermal cyst, despite being in an uncommon site, and was very useful in the preoperative diagnosis.

Benign Fibrous Histiocytoma with Cystic Change of the Femur: a Case Report

Benign fibrous histiocytoma (BFH) is a rare benign primary skeletal tumor that occurs commonly in the long bones, spine and pelvis. BFH constitutes a diagnostic challenge because it shares clinical background, radiological characteristics, and histological features with other fibrous lesions such as non-ossifying fibroma, giant cell tumor. We present a case of BFH with cystic change that occurred in the distal femur. We did not identify any case of BFH with cystic change involving the majority of the lesion that occurred in the metaepiphysis of the long bone.

Charcoal-Induced Granuloma That Mimicked a Nodal Metastasis on Ultrasonography and FDG-PET/CT after Neck Dissection

Charcoal can be used for preoperative localization of metastatic lymph nodes in the neck. Charcoal remains stable without causing foreign body reactions during as hort period. However, foreign body reactions may develop if charcoal is left in situ for more than 6 months. We reported a case of charcoal granuloma mimicking local recurrence on fluorodeoxyglucose-positron emission tomography/computed tomography and ultrasonography in a 47-year-old woman who had cervical lymph node dissection due to metastatic invasive ductal carcinoma of the breast.

Detection of calcium pyrophosphate dihydrate crystal deposition disease by dual-energy computed tomography

No abstract available.

Time-Resolved 3D Contrast-Enhanced MRA on 3.0T: a Non-Invasive Follow-Up Technique after Stent-Assisted Coil Embolization of the Intracranial Aneurysm

OBJECTIVE: To evaluate the usefulness of time-resolved contrast enhanced magnetic resonance angiography (4D MRA) after stent-assisted coil embolization by comparing it with time of flight (TOF)-MRA. MATERIALS AND METHODS: TOF-MRA and 4D MRA were obtained by 3T MRI in 26 patients treated with stent-assisted coil embolization (Enterprise:Neuroform = 7:19). The qualities of the MRA were rated on a graded scale of 0 to 4. We classified completeness of endovascular treatment into three categories. The degree of quality of visualization of the stented artery was compared between TOF and 4D MRA by the Wilcoxon signed rank test. We used the Mann-Whitney U test for comparing the quality of the visualization of the stented artery according to the stent type in each MRA method. RESULTS: The quality in terms of the visualization of the stented arteries in 4D MRA was significantly superior to that in 3D TOF-MRA, regardless of type of the stent (p < 0.001). The quality of the arteries which were stented with Neuroform was superior to that of the arteries stented with Enterprise in 3D TOF (p < 0.001) and 4D MRA (p = 0.008), respectively. CONCLUSION: 4D MRA provides a higher quality view of the stented parent arteries when compared with TOF.

Satisfaction and Recognition Level of Environment-Friendly Agricultural Products in Cheongju Area / 대한지역사회영양학회지

The purpose of this study was to investigate basic data on the degree of parents' recognition and satisfaction with the use of environment-friendly agricultural products. The conclusions of this study are as follows. The survey on the use of environment-friendly products in households showed that 68.7% of the respondents used environment-friendly products at home. The frequency of purchasing organic products by household consumers showed that 25.1% of the respondents bought organic products one to two times per week. The most popular items of the environment-friendly agricultural products used were vegetables, comprising 63.9%. The households with more than 3,000,000 won of monthly income tended to consume more domestic livestock products (p < 0.05). In comparison to general agricultural products, environment-friendly agricultural products users showed higher satisfaction level with a better quality in term of safety, quality, nutrition, taste, appearance, diversity and price. The degree of satisfaction with safety was the highest (3.8 +/- 0.68), and price showed the lowest (2.76 +/- 0.79). The degree of parents' recognition of the governmental support for environment-friendly agricultural products showed that those who were aware of the supporting policy were 44.5%, but 55.5% of them didn't know about the fact that 46.6% of the respondents agreed that environment-friendly agricultural products should be used in more than 50% of the foods used for school food service. The respondents pointed out that vegetables (45%) sprayed with pesticide are the most urgent food item that need to be replaced by environment-friendly farm products.

Confirmation of Tophi in a Patient of Gout using Dual-Energy CT

No abstract available.

Optimization of the Contrast Mixture Ratio for Simultaneous Direct MR and CT Arthrography: an in Vitro Study

OBJECTIVE: This study was designed to determine the optimal mixture ratio of gadolinium and iodinated contrast agent for simultaneous direct MR arthrography and CT arthrography. MATERIALS AND METHODS: An in vitro study was performed utilizing mixtures of gadolinium at six different concentrations (0.625, 1.25, 2.5, 5.0, 10 and 20 mmol/L) and iodinated contrast agent at seven different concentrations (0, 12.5, 25, 37.5, 50, 75 and 92-99.9%). These mixtures were placed in tissue culture plates, and were then imaged with CT and MR (with T1-weighted sequences, proton-density sequences and T2-weighted sequences). CT numbers and signal intensities were measured. Pearson's correlation coefficients were used to assess the correlations between the gadolinium/iodinated contrast agent mixtures and the CT numbers/MR signal intensities. Scatter diagrams were plotted for all gadolinium/iodinated contrast agent combinations and two radiologists in consensus identified the mixtures that yielded the optimal CT numbers and MR signal intensities. RESULTS: The CT numbers showed significant correlation with iodinated contrast concentrations (r = 0.976, p < 0.001), whereas the signal intensities as measured on MR images showed a significant correlation with both gadolinium and iodinated contrast agent concentrations (r = -484 to -0.719, p < 0.001). A review of the CT and MR images, graphs, and scatter diagram of 42 combinations of the contrast agent showed that a concentration of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was the best combination for simultaneous CT and MR imaging. CONCLUSION: A mixture of 1.25 mmol/L gadolinium and 25% iodinated contrast agent was found to be optimal for simultaneous direct MR arthrography and CT arthrography.

Association Study of Val158Met Polymorphism of Catechol-O-Methyltransferase Gene and Cognitive Markers in Schizophrenia / 신경정신의학

OBJECTIVES: Catechol-O-methyltransferase (COMT) gene has been identified as a positional and functional candidate gene of schizophrenia. Although specific mechanism of increasing schizophrenia susceptibility by this gene has not been well described yet, recent studies suggest that the valine allele of COMT Val158Met polymorphism may contribute to cognitive decline in schizophrenia. The present study investigated the association between this polymorphism of COMT gene and cognitive markers related to schizophrenia in both schizophrenia patients and normal controls. METHODS: The subjects were 78 patients with schizophrenia diagnosed by DSM-IV and 97 normal controls. Comprehensive neurocognitive tests for which performance deficits have been reported in schizophrenia were administered. Genotyping for COMT Val158Met polymorphism was done with SNapShot method. Association analyses between genotype and cognitive functions were performed using ANCOVA and MANCOVA. RESULTS: In the comparison of allele frequencies between patient and control groups, no significant association between the polymorphism and schizophrenia was observed. Significant differences of cognitive performance among genotype groups were not identified in control group. This trend was also observed in the patient group. In the combined analysis of both patient and control groups, there was no significant genotype or genotype-by group effect on any cognitive function measure. CONCLUSION: These findings do not support a major role of COMT gene in the regulation of the cognitive processes of schizophrenia.

A Chondroblastoma Versus a Giant Cell Tumor: Emphasis on the MR Imaging Features

PURPOSE: To assess the MR imaging features in differentiating a chondroblastoma (CB) from a giant cell tumor (GCT), with an emphasis on the accompanying peritumoral bone marrow edema. MATERIALS AND METHODS: MR imaging findings in 20 patients with CB were compared with the imaging features of 22 patients with GCT. The location of the lesion, signal intensity, adjacent cortical change, degree of accompanying bone marrow edema, synovitis in the adjacent joint and cystic change were analyzed. The findings of CB and GCT were examined statistically with use of Fisher's exact test. RESULTS: The incidence ratios of MR imaging findings were as follows (CB:GCT). Metaphyseal dominant involvement (2:21), partial cortical disruption (2:14), extensive bone marrow edema surrounding the tumor (14:0) and synovitis in the adjacent joint (11:2) were statistically different in incidence between CB and GCT (p < 0.01). The inhomogeneous signal intensity (17:17) and cystic change (10:15) were not different in incidence between a CB and a GCT. CONCLUSION: The presence of metaphyseal dominant involvement and cortical disruption favors a diagnosis of a GCT rather than a CB. In contrast, extensive bone marrow edema surrounding the tumor and synovitis in the adjacent joint are highly indicative of a CB.

Therapeutic Effect of Epidural Steroid Injection in Patients Suspected of having an Internal Disc Disruption: A Prospective Case Study

PURPOSE: To assess the effect of the epidural steroid injection for patients suspected of having an internal disc disruption. MATERIALS AND METHODS: Thirteen patients at the pain intervention clinic that received a lumbar interlaminar epidural steroid injection and were suspected of having an internal disc disruption were prospectively enrolled in this study. The treatment outcome was assessed using a 5-point patient satisfaction scale (no pain, much improved, slightly improved, no effect, aggravated) two weeks after injection. A successful outcome required a patient satisfaction scale of "much improved" or "no pain". All patients received follow-up for two months. Two radiologists evaluated the presence of HIZ (high intensity zone), a dark disc by MR (n = 10) and a diffuse bulging disc by CT (n = 3). RESULTS: Nine (69%) of the 13 patients achieved a successful outcome two weeks after injection. These nine patients showed no recurrence during the two months months follow-up. Of the 22 abnormal discs demonstrated by MRI and CT, MRI showed a dark disc in six patients and HIZ in 13 patients. CT showed diffuse bulging in three discs. Nine of 10 patients showed at least one HIZ. CONCLUSION: An lumbar interlaminar epidural steroid injection might be an effective tool for managing patients suspected of having an internal disc disruption.

Usefulness of Fluoroscopy-Guided Intra-articular Injection of the Knee

PURPOSE: To determine the accuracy of the intra-articular location of hyaluroinc acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. MATERIALS AND METHODS: A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). RESULTS: Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injections (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test (p value = 0.14). CONCLUSION: Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee.

Spontaneous Total Necrosis of Hepatocellular Carcinoma

We describe a case of spontaneous total necrosis of hepatocellular carcinoma (HCC). Contrast-enhanced CT scanning revealed a hypoattenuating mass during both the hepatic arterial and portal venous phase. During the latter, subtle capsular enhancement was noted. Ultrasonography demonstrated the presence of a hypoechoic mass with a peripheral hyperechoic rim. The patient underwent tumorectomy, and a totally necrotic mass was found. Microscopic examination revealed necrotic tissue with HCC ghost cells, suggesting spontaneous total necrosis of HCC.