Feasibility of Quadruple Arterial Phase of Motion Insensitive Radial Volumetric Imaging Breath-Hold Examination with k-Space Weighted Image Contrast in the Detection of Hepatocellular Carcinoma in Patients with Chronic Liver Disease

PURPOSE@#To evaluate the detection performance of hepatocellular carcinoma and image quality in patients with chronic liver disease with quadruple arterial MR imaging using radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC).@*MATERIALS AND METHODS@#Forty-four patients underwent liver MR examinations with quadruple arterial imaging using radial VIBE-KWIC sequence (full-frame and four sub-frame images). Diagnostic performance was evaluated with receiver operating characteristics (ROC) for detection of hepatocellular carcinoma. The image quality and severity of artifact were scored by using the five-point scale.@*RESULTS@#The area under the ROC curve (Az) value of Hepatocelluar Carcinoma (HCC) detectability was the highest on third sub-frame images, followed by full-frame images. The Az values of third sub-frame and full-frame about the detection of HCC were statistically significantly different from the Az value of first sub-frame images. The full-frame and four sub-frame images showed acceptable image quality and low degree artifact with rating of higher than grade 3.@*CONCLUSION@#Quadruple arterial MRI using radial VIBE-KWIC is a feasible method for detecting hepatocellular carcinoma in patients with chronic liver disease without deterioration of image quality. The third sub-frame and full-frame image are superior to other sub-frame images in detecting hepatocellular carcinoma.

Minimally Invasive Treatment of Falciform Ligament Abscess in a 25-Day-Old Neonate: A Case Report

The falciform ligament is a hepatic suspensory ligament that extends from the umbilicus to the diaphragm, containing the ligamentum teres and a vestigial remnant of the umbilical vein. Among the rarely-occurring pathologies of the falciform ligament, which include ligament cyst, tumor, abnormal vascularization, and congenital ligament defect, a falciform ligament abscess is even more sporadic. Accordingly, the definitive diagnosis of the falciform ligament abscess is rather challenging and may easily be misinterpreted as an infected choledochal cyst or a liver abscess. We present a 25-day-old infant with the falciform ligament abscess, which developed after the umbilical venous catheter insertion and was successfully treated with percutaneous drainage and antibiotic administration.

Red fluorescence of oral bacteria is affected by blood in the growth medium / 대한구강보건학회지

OBJECTIVES: Dental plaque emits red fluorescence under a visible blue light near the ultra-violet end of the light spectrum. The fluorescence characteristics of each microorganism have been reported in several studies. The aim of this study was to evaluate changes in red fluorescence of oral microorganisms that is affected by blood in the culture media. METHODS: The gram-positive Actinomyces naeslundii (AN, KCTC 5525) and Lactobacillus casei (LC, KCTC 3109) and gram negative Prevotella intermedia (PI, KCTC 3692) that are known to emit red fluorescence were used in this study. Each bacterium was activated in broth and cultivated in different agar media at 37℃ for 7 days. Tryptic soy agar with hemin and vitamin K3 (TSA), TSA with sheep blood (TSAB), basal medium mucin (BMM) medium, and BMM with sheep blood (BMMB) were used in this study. Fluorescence due to bacterial growth was observed under 405-nm wavelength blue light using the quantitative light-induced fluorescence-digital (QLF-D) device. The red, green, and blue fluorescence values of colonies were obtained using image-analysis software and the red to green ratio (R/G value) and red to total RGB ratio (R/RGB value) were calculated for quantitative comparison. RESULTS: The QLF-D images of the AN, LC, and PI colonies showed red fluorescence in all media, but the fluorescence of all bacteria was reduced in TSA and BMM media, compared with in TSAB and BMMB media. Both the R/G and the R/RGB values of all bacteria were significantly reduced in growth media without blood (P<0.001). CONCLUSIONS: Based on this in vitro study, it can be concluded that red fluorescence of oral bacteria can be affected by growth components, especially blood. Blood-containing medium could be a significant factor influencing red fluorescence of oral bacteria. It can be further hypothesized that bleeding in the oral cavity can increase the red fluorescence of dental plaque.

Red fluorescence of oral bacteria interacting with Porphyromonas gingivalis / 대한구강보건학회지

OBJECTIVES: Dental plaque is composed of 700 bacterial species. It is known that some oral microorganisms produce porphyrin, and thus, they emit red fluorescence when illuminated with blue light at a specific wavelength of <410 nm. Porphyromonas gingivalis belongs to the genus Porphyromonas, which is characterized by the production of porphyrin. The aim of this study was to evaluate red fluorescence emission of some oral microorganisms interacting with P. gingivalis. METHODS: Five bacterial strains (P. gingivalis, Streptococcus mutans, Lactobacillus casei, Actinomyces naeslundii, and Fusobacterium nucleatum) were used for this study. Tryptic soy agar medium supplemented with hemin, vitamin K3, and sheep blood was used as a growth medium. The fluorescence emission of bacterial colonies was evaluated under 405 nm-wavelength blue light using a Quantitative Light-induced Fluorescence Digital (QLF-D) camera system. Each bacterium was cultured alone and co-cultured in close proximity with P. gingivalis. The red/green (R/G) ratio of fluorescence image was calculated and the differences of R/G ratio according to each growth condition were compared using the Mann-Whitney test (P<0.05). RESULTS: Single cultured S. mutans, L. casei and A. naeslundii colonies emitted red fluorescence (R/G ratio=2.15±0.06, 4.31±0.17, 5.52±1.29, respectively). Fusobacterium nucleatum colonies emitted green fluorescence (R/G ratio=1.36±0.06). The R/G ratios of A. naeslundii and F. nucleatum were increased when P. gingivalis was co-cultured with each bacterium (P<0.05). In contrast, the R/G ratios of S. mutans and L. casei were decreased when P. gingivalis was co-cultured with each bacterium (P=0.002, 0.003). CONCLUSIONS: This study confirmed that P. gingivalis could affect the red fluorescence of other oral bacteria under 405 nm-wavelength blue light. Our findings concluded that P. gingivalis has an important role for red fluorescence emission of dental biofilm.

Total vaginectomy for refractory vaginal intraepithelial neoplasia III of the vaginal vault

Vaginal intraepithelial neoplasia III, is a relatively rare disease. Consequently standard treatments for this disease were not established until recently. Although several convenient methods, such as laser ablation, 5-fluorouracil topical injection, and radiation therapy, have been applied for treating these lesions, surgical treatments, including vaginectomy, have not yet been attempted, as they would likely be accompanied by technical difficulties and various complications. Herein, we report a case of refractory vaginal intraepithelial neoplasia III in the vaginal vault that was successfully treated with a total vaginectomy.

Screening for chromosomal abnormalities using combined test in the first trimester of pregnancy

OBJECTIVE: This study was designed to review the screening performance of combined test at the Ewha Womans University Mokdong hospital. METHODS: All women admitted for routine antenatal care between January 1st 2008 and December 31st 2012 with a known pregnancy outcome were included in this study, totaling 1,156 women with singleton pregnancies presenting at 10 to 13 weeks of gestation. Women were offered screening using a combination of maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and fetal nuchal translucency thickness. Those with an estimated risk of ≥1 in 250 of carrying a fetus with trisomy 21 or ≥1 in 300 risk of trisomy 18 were offered genetic counseling with the option of an invasive diagnostic test. RESULTS: The median of gestational age was 11+3 weeks, the median of crown-rump length was 47.1 mm, and the median age of the women was 31 years. The detection rate was 80% for trisomy 21 (4 of 5) and 100% for trisomy 13 and 18 (all 2). The false-positive rate was 7.73% for trisomy 21 and 1.21% for trisomy 18. CONCLUSION: This study was the first large population study performed with the aim of analyzing the performance of the combined test in Korea. This study demonstrated that the detection rates and other figures of the first trimester combined test are comparable to the results reported in other papers worldwide. Consequently, if strict conditions for good screening outcomes are achieved, the first trimester combined test might well be the earliest detectable screening, improving detection rates without increasing karyotyping or economic and other implications that inevitably ensue.

Screening for chromosomal abnormalities using combined test in the first trimester of pregnancy

OBJECTIVE: This study was designed to review the screening performance of combined test at the Ewha Womans University Mokdong hospital. METHODS: All women admitted for routine antenatal care between January 1st 2008 and December 31st 2012 with a known pregnancy outcome were included in this study, totaling 1,156 women with singleton pregnancies presenting at 10 to 13 weeks of gestation. Women were offered screening using a combination of maternal serum pregnancy-associated plasma protein-A, free β-human chorionic gonadotropin and fetal nuchal translucency thickness. Those with an estimated risk of ≥1 in 250 of carrying a fetus with trisomy 21 or ≥1 in 300 risk of trisomy 18 were offered genetic counseling with the option of an invasive diagnostic test. RESULTS: The median of gestational age was 11+3 weeks, the median of crown-rump length was 47.1 mm, and the median age of the women was 31 years. The detection rate was 80% for trisomy 21 (4 of 5) and 100% for trisomy 13 and 18 (all 2). The false-positive rate was 7.73% for trisomy 21 and 1.21% for trisomy 18. CONCLUSION: This study was the first large population study performed with the aim of analyzing the performance of the combined test in Korea. This study demonstrated that the detection rates and other figures of the first trimester combined test are comparable to the results reported in other papers worldwide. Consequently, if strict conditions for good screening outcomes are achieved, the first trimester combined test might well be the earliest detectable screening, improving detection rates without increasing karyotyping or economic and other implications that inevitably ensue.

Historical control data from 13-week repeated toxicity studies in Crj:CD (SD) rats / 한국실험동물학회지

Reference ranges of standard experimental parameters are useful for comparisons in toxicology. The aim of this study was to collect data from 13-week repeated toxicity studies in Crl:CD (SD) rats, a strain widely used for toxicity and efficacy research, for establishing domestic reference values. Data on body weight, food consumption; urinalysis, hematological, and blood biochemical parameters; and organ weights were collected from 11 toxicity studies in 220 Crl:CD (SD) rats (110 males and 110 females). The studies had been performed at a single testing facility over the last 5 years and involved animals sourced from a single breeder. The findings were collated as means, standard deviations, percentages, and ranges. Urine volume, uterus weight, eosinophil, and basophil counts, and triglyceride, total bilirubin, and gamma-glutamyl transpeptidase levels showed standard deviations of 30% or more. These historical control data would help to interpret the effects of test substances in routine toxicity and efficacy studies.

Long Term Changes of Electrical Stimulation Levels in Children with Cochlear Implant / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The goal of mapping after cochlear implantation (CI) is to find a proper range of acoustic signals for the implantees. In young children or infants, however, it is more difficult to obtain reliable responses during mapping procedure. The purpose of this study was to observe the changes of the proper electrical stimulation levels (threshold levels, comfortable levels and dynamic range) in children with the Nucleus 24 cochlear implant system by analyzing postoperative mapping results. SUBJECTS AND METHOD: The maps of 23 children with normal inner ear who received CI were examined at 7 time intervals (1, 6, 12, 24, 36, 48 and 60 months post-connection). RESULTS: The mean value of C levels and DR of 23 children gradually increased according to time from 1 month to 60 months post-connection. The value of T level increased up to 6 months post-connection and then stabilized. CONCLUSION: This study emphasized the need for frequent mapping in the first 6 months of implant use in children. Protocol for regular mapping schedule from 1 year to 5 year post-connection would be necessary.

Epicanthoplasty with Simple Excision Technique

Epicanthoplasty with or without double-eyelid operation is one of the most commonly performed aesthetic procedure in Korea. Although many techniques have been described for the elimination of epicanthal folds, scarring and complexity in design are still barriers for surgeons to overcome. Epicanthoplasty using Hiraga's method was used to minimize these problems. From September of 1996 to July of 2002, the authors performed epicanthoplasty using Hiraga's method on the eyelids of 117 Asian patients to correct epicanthal folds. Results were satisfactory in almost all patients, with no significant complications. Scarring was acceptable. Mean reduction of intercanthal distance was 3.7 mm and mean operation time was within 10 minutes. Hiraga's method is most effective in patients with mild to moderate epicanthal fold. The advantages of this procedure are simplicity in design and short operation time. Most of all, it's technically simple and easy to perform.

A Novel Method of Dermis Graft for Better Outcome

The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. A new skin graft(dermis graft; deepithelialized split thickness skin graft), was used to minimize these problems. The important aspects of this method involve immediate return of epidermis to the donor site and restoration of the recipient site's epidermis by inducing epithelialization from adjacent skin. From April of 2001 to March of 2004, dermis graft and a conventional split thickness skin graft(STSG) were performed in 53 and 33 patients, respectively. The healing time, the scar condition, and the patients' satisfaction were compared. Regarding the recipient sites, the wounds of the dermis graft(n=53) and STSG(n=33) had reepithelialized after 15.5+/-1.9 and 11.8+/-1.6 days, respectively. The scarring were less severe on the dermis graft in terms of pigmentation, height, and vascularity(p<0.05). No significant difference in pliability was detected. The patients' satisfaction with the dermis graft was also better. Concerning the donor sites, the wounds healed within 7.5+/-0.8 and 12.8+/-1.1 days, respectively. In terms of scar quality and patients' satisfaction, the dermis graft(n=26) showed better results. The dermis graft is superior to conventional STSG both aesthetically and functionally in both the recipient and donor sites.

Effect of Serum Media on Fibroblast Proliferation and Collagen Synthesis

Expanding cells ex-vivo is very important in tissue- engineering. Culture medium is usually supplemented with fetal bovine serum(FBS) in most of the experiments. However, cells grown in bovine serum media may posses the possibilities of disseminating bovine diseases and/or stimulating the patient's immune reactions. To overcome these problems, autologous or homologous serum should be used instead of the FBS. The purpose of this study is to compare cell proliferation and collagen synthesis depending on the kind of sera mixed on media and to provide a guideline on applying established experimental data to clinical cases. Human dermal fibroblasts were obtained from four patients. Five thousand cells per well in 96-well plates were incubated DMEM/F- 12 Nutrient with varying serum mixture; 10% autologous serum, 10% homologous serum, and 10% FBS. Five days after incubation fibroblast proliferation and collagen production were determined by MTT assay and CICP enzyme immunoassay. The mean cell number were; 3.95x104/well, 2.97x104/well and 2.30x104/well, respectively. The average amounts of collagen synthesized were; 238.13ng/ml, 204.88ng/ml, and 163.88ng/ml in each. These results show that the use of human serum mixture may contribute to, not only preventing disseminated infection of bovine diseases. but also increase cell proliferation and collagen synthesis without simulating the patient's immune reactions.

Surgical Management of Ovarian tumors in Pregnancy: Laparoscopy versus Laparotomy / 대한산부인과학회잡지

OBJECTIVE: To evaluate the benefits of laparoscopic surgery compare with laparotomy in the surgical management of adnexal tumors during pregnancy. METHODS: Operating time, hospital stays, complications and pregnancy outcome were analyzed in 18 patients who underwent laparoscopic surgery and 30 patients who underwent laparotomy due to adnexal tumors discovered during pregnancy at Chungnam National University Hospital from January 1993 to June 2000. RESULTS: Mean age of the patients was 27.1 years and mean gestational age was not significantly different between the two groups. Tumor size was larger in laparotomy group (8.4 vs 6.4 cm in diameter). Unilateral salpingo-oophorectomy was most common operative procedures and cystic teratoma was most common histologic findings in both groups. Operating time was not significantly different between the two groups. Blood loss (43.2 vs 18.3 mL) and hospital stay (7.1 vs 5.7 days) was significantly less in laparscopy group. CONCLUSIONS: Laparoscopic surgery may be an effective treatment of adnexal tumors during pregnancy.

Post-Marketing Surveillance of Levocabastin Eye Droups in 1997: A Multicenter Surveillance Study

A multicenter post-marketing surveilance study has been conducted to evaluate the efficacy and safety of levocabastine eye drops(0.5mg/ml). Total 340 patients suffering from allergic conjunctivitis(96%) or other similar ophthalmic disorders were participated. Clinical symptoms(itching, hyperemia, tearing and chemosis) were assessed according to a four point scale before treatment and at every visit. Total symptom severity score before therapy, 6.67(N=340), was remarkably decreased to 3.28(N=252) at 1 week, and to 2.39(N=197) at 2 weeks. The physicians rated the application as `very effective` 1.5% of patients. Adverse reactions(10.3%) were limited to ocular irritation like stinging and burning sensation. These events were even lower in children(age OR =65 yrs) showing 7.0% and 9.5% respectively. Patients with gepatic, renal impairment and hypertension did not experience any special adverse effects. The overall assessment by physicians showed that the application in 80.9% of the patients was evaluated above `useful`(i.e, `very useful`; 17.1%, `useful`; 63.8%, `slighty useful`; `7.1%). therefore, it was conclued that levocabastine eye drops is a a safe and effective treatment for allergic conjnctivitis and other similar ophthalmic disorders.