Prevalence of complications associated with polymer-based alloplastic materials in nasal dorsal augmentation: a systematic review and meta-analysis / 대한악안면성형재건외과학회지

Background@#Various techniques with different grafts and implants have been proposed to establish a smooth and symmetric nasal dorsum with adequate function. Broadly, two categories of materials have been used in this regard: alloplastic implant materials and autograft materials. The aim of these meta-analyses is to explore the incidence of complications after dorsum augmentation surgery using alloplastic materials. @*Materials and methods@#After duplication removal 491 papers remained that title and abstract were assessed for eligibility. Regarding the study type, 27 observational studies were included, 21 retrospective and 6 prospective case series. A total of 3803 cases were enrolled in this systematic review and meta-analysis.ResultTwenty-seven articles reported on complications and outcomes of dorsal augmentation rhinoplasty with synthetic materials. In a random-effects model, the weighted mean percentage was 2.75% (95% CI 1.61 to 4.17%). the weighted mean percentage were 1.91% (95% CI 0.77 to 3.54%), 0.72% (95% CI 0.316 to 1.31%), and 0.78% (95% CI 0.43 to 1.24%) respectively. @*Conclusion@#The widely used alloplasts were expanded polytetrafluoroethylene (ePTFE), high-density polyethylene, and silicone. The total rates for complications, infection, deviation, irregularity, hematoma, extrusion, and overcorrection were 2.75%, 1.91%, 0.72%, 0.70%, 0.78%, and 0.49%, respectively. The revision rate, based on the random effects model, was 6.40% with 95%CI (3.84 to 9.57).

Erratum: Magnetic Resonance Imaging Features of Adenosis in the Breast / 한국유방암학회지

No abstract available.

Magnetic Resonance Imaging Features of Adenosis in the Breast / 한국유방암학회지

PURPOSE: Adenosis lesions of the breast, including sclerosing adenosis and adenosis tumors, are a group of benign proliferative disorders that may mimic the features of malignancy on imaging. In this study, we aim to describe the features of breast adenosis lesions with suspicious or borderline findings on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). METHODS: In our database, we identified 49 pathologically proven breast adenosis lesions for which the final assessment of the breast MRI report was classified as either category 4 (n=45) or category 5 (n=4), according to the Breast Imaging Reporting and Data System (BI-RADS) published by the American College of Radiology (ACR). The lesions had a final diagnosis of either pure adenosis (n=33, 67.3%) or mixed adenosis associated with other benign pathologies (n=16, 32.7%). RESULTS: Of the 49 adenosis lesions detected on DCE-MRI, 32 (65.3%) appeared as enhancing masses, 16 (32.7%) as nonmass enhancements, and one (2.1%) as a tiny enhancing focus. Analysis of the enhancing masses based on the ACR BI-RADS lexicon revealed that among the mass descriptors, the most common features were irregular shape in 12 (37.5%), noncircumscribed margin in 20 (62.5%), heterogeneous internal pattern in 16 (50.0%), rapid initial enhancement in 32 (100.0%), and wash-out delayed en-hancement pattern in 21 (65.6%). Of the 16 nonmass enhancing lesions, the most common descriptors included focal distribution in seven (43.8%), segmental distribution in six (37.5%), clumped internal pattern in nine (56.3%), rapid initial enhancement in 16 (100.0%), and wash-out delayed enhancement pattern in eight (50.0%). CONCLUSION: Adenosis lesions of the breast may appear suspicious on breast MRI. Awareness of these suspi-cious-appearing features would be helpful in obviating unnecessary breast biopsies.

Efficacy of transarterial chemoembolization on lesion reduction in colorectal liver metastases

Following failure of systemic chemotherapy, transarterial chemoembolization [TACE] is an available method to control unresectable liver metastases from colorectal carcinoma [CRC]. The aim of present study was to evaluate the efficacy of chemoembolization for inoperable metastatic liver lesions from CRC. Forty-five CRC patients with liver metastases resistant to systemic chemotherapy were enrolled in our study. For each patient, three session of TACE were conducted with 45 days interval. A combination of mitomycin, doxorubicin, and lipiodol were used for TACE. A tri-phasic computed tomography scan and biochemical laboratory tests were performed for all patients at baseline and 30 days after each TACE. Image analysis included measurement of lesion diameters as well as contrast enhancement. Eleven patients deceased before completing three session and the final analyses were performed on the remaining 34 patients. Evaluation of a total 93 lesions in all patients after chemoembolization sessions revealed a 25.88% reduction in anteroposterior [AP] diameter, 33.92% transverse [T] diameter, and 42.22% in product of APxT diameter of lesions [P<0.001 for all instances]. CT scan showed a total disappearance of 33% of lesions and evident reduction in contrast enhancement in 16% of them. There were no changes in contrast enhancement in 51% of lesions. Evaluation of single largest lesion in each patient revealed 57.32% reduction in AP diameter, 59.66% in T diameter, and 62.17% in product of APxT diameters [P<0.001 for all diameters]. TACE offers a viable option for CRC patients with unresectable liver metastases by significantly reducing lesion size and contrast enhancement.

Uterine segmentation and volume measurement in uterine fibroid patients' MRI using fuzzy C-mean algorithm and morphological operations

Uterine fibroids are common benign tumors of the female pelvis. Uterine artery embolization [UAE] is an effective treatment of symptomatic uterine fibroids by shrinkage of the size of these tumors. Segmentation of the uterine region is essential for an accurate treatment strategy. In this paper, we will introduce a new method for uterine segmentation in T1W and enhanced T1W magnetic resonance [MR] images in a group of fibroid patients candidated for UAE in order to make a reliable tool for uterine volumetry. Uterine was initially segmented using Fuzzy C-Mean [FCM] method in T1W-enhanced images and some morphological operations were then applied to refine the initial segmentation. Finally redundant parts were removed by masking the segmented region in T1W-enhanced image over the registered T1W image and using histogram thresholding. This method was evaluated using a dataset with ten patients' images [sagittal, axial and coronal views]. We compared manually segmented images with the output of our system and obtained a mean similarity of 80%, mean sensitivity of 75.32% and a mean specificity of 89.5%. The Pearson correlation coefficient between the areas measured by the manual method and the automated method was 0.99. The quantitative results illustrate good performance of this method. By uterine segmentation, fibroids in the uterine may be segmented and their properties may be analyzed

Value of prostate-specific antigen and prostate-specific antigen density in detection of prostate cancer in an Iranian population of men

The objective of this study was to evaluate the value of serum prostate-specific antigen [PSA] and prostate-specific antigen density [PSAD] in the diagnosis of prostate cancer. A total of 330 consecutive patients suspected of having prostate cancer due to either abnormal digital rectal examination or elevated serum PSA levels underwent transrectal ultrasonography-guided sextant biopsy of the prostate. The PSA and PSAD values were assessed based on the biopsy results. One hundred and twenty-one patients [36.7%] had prostate cancer. In this group, the mean PSA was 31.60 +/- 30.85 ng/mL [range, 1.9 ng/mL to 166.0 ng/mL] and the mean PSAD was 0.83 +/- 1.01 [range, 0.04 ng/mL/ cm[3] to 6.38 ng/mL/cm[3]]. In those without prostate cancer the mean PSA and PSAD levels were 13.80 +/- 18.72 ng/mL [range, 0.4 ng/mL to 130.0 ng/mL; P < .001] and 0.24 +/- 0.32 [range of 0.01 ng/mL/cm[3] to 2.29 ng/mL/ cm[3] P < .001]. The receiver operating characteristic curve analysis revealed that the discriminating power of serum PSA for detecting prostate cancer, as estimated by the area under the curve, was 0.74 while that for PSAD was 0.81 [P < .001]. For the PSA range of 3.5 ng/mL to 41 ng/mL [gray zone] the areas under the curve was 0.68 for PSA, while it was 0.78 for PSAD [P < .001]. The use of PSAD instead of PSA in the diagnosis of prostatic cancer improves the diagnostic accuracy

Ultrasonographic screening of the carotid artery in coronary artery bypass surgery

The incidence of stroke after coronary artery bypass grafting [CABG] is between 0.9% and 6.7%, which significantly increases in-hospital and out-hospital costs. This study was designed to evaluate the prevalence of significant carotid stenosis and its risk factors in CABG. In total, 2044 consecutive patients undergoing elective CABG were investigated through a pre-operative duplex scanning of the carotid arteries. The relation of age, sex, smoking, hypertension diabetes, dyslipidemia, and coronary disease with carotid stenosis was evaluated. The prevalence of carotid stenosis was 7.6%. The multivariate analysis showed that age over 55 and left main coronary disease were significant independent risk factors for carotid stenosis. Female gender, smoking hypertension, and diabetes were the risk factors in the univariate logistic regression model. Carotid stenosis is prevalent in CABG candidates. It seems that age >/= 55 years and left main coronary disease are the independent risk factors for carotid stenosis in CABG patients