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CT Follow-Up of Postoperative Bronchopleural Fistula: Risk Factors for Progression to Chronic Complicated Infection (수술 후 기관지 흉막루의 전산화단층촬영 추적 검사: 만성 복합성 감염 진행의 위험인자 분석)

  • Ji-Yeon Han;Ki-Nam Lee;Yoo Sang Yoon;Jihyun Lee;Hongyeul Lee;Seok Jin Choi;Hye Jung Choo;Jin Wook Baek;Young Jin Heo;Gi Won Shin;Jinyoung Park;Dasom Kim
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.128-138
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    • 2021
  • Purpose We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. Materials and Methods We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. Results The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2-33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1-545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1-73.5), only in the univariate analysis. Conclusion The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results (외상에 노출된 소방관들의 뇌 구조 및 휴식기 뇌기능 변화: 예비 결과)

  • Yae Won Park;Suhnyoung Jun;Juwhan Noh;Seok Jong Chung;Sanghoon Han;Phil Hyu Lee;Changsoo Kim;Seung-Koo Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.676-687
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    • 2020
  • Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.

Digital Breast Tomosynthesis as a Breast Cancer Screening Tool for Women with Gynecologic Cancer (부인암을 가진 여성에서 유방암의 선별검사로서의 디지털 유방단층 촬영술)

  • Da-hoon Kim;Jin Chung;Eun-Suk Cha;Jee Eun Lee;Jeoung Hyun Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.886-898
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    • 2020
  • Purpose The purpose of our study was to evaluate digital breast tomosynthesis as a breast cancer screening modality for women with gynecologic cancer. Materials and Methods This retrospective study included patients with underlying gynecologic malignancies who underwent screening digital breast tomosynthesis for breast cancer. The cancer detection rate, recall rate, sensitivity, specificity, and positive predictive value (PPV) were calculated. PPV1 was defined as the percentage of all positive screening exams that have a tissue diagnosis of cancer within a year. PPV2 was defined as the percentage of all diagnostic exams (and Breast Imaging Reporting and Data System category 4, 5 from screening setting) with a recommendation for tissue diagnosis that have cancer within a year. PPV3 was defined as the percentage of all known biopsies actually performed that resulted in a tissue diagnosis of cancer within the year. For each case of screen-detected cancer, we analyzed the age, type of underlying gynecologic malignancy, breast density, imaging features, final Breast Imaging Reporting and Data System assessment, histologic type, T and N stages, molecular subtype, and Ki-67 index. Results Among 508 patients, 7 with breast cancer were identified after a positive result. The cancer detection rate was 13.8 per 1000 screening exams, and the recall rate was 17.9%. The sensitivity was 100%, and the specificity was 83.2%. The false negative rate was 0 per 1000 exams. The PPV1, PPV2, and PPV3 were 7.7, 31.8, and 31.8, respectively. Conclusion Digital breast tomosynthesis may be a promising breast cancer screening modality for women with gynecologic cancer, based on the high cancer detection rate, high sensitivity, high PPV, and high detection rate of early-stage cancer observed in our study.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization (흉벽 및 흉곽 내 장기 손상으로 인한 외상성 혈흉: 전신 동맥 색전술의 임상 결과)

  • Chang Mu Lee;Chang Ho Jeon;Rang Lee;Hoon Kwon;Chang Won Kim;Jin Hyeok Kim;Jae Hun Kim;Hohyun Kim;Seon Hee Kim;Chan Kyu Lee;Chan Yong Park;Miju Bae
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.923-935
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    • 2021
  • Purpose We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Anti-inflammatory effect in macrophages according to the mixing ratio of acemannan and aloesin (Acemannan과 aloesin의 혼합 비율에 따른 대식세포에서의 항염증 효과)

  • Hyo-Min Kim;Jeong-Hwan Kim;Dan-Hee Yoo;Se-Yeong Jeon;Hyun-Jin Kim;Seon-Gil Do;In-Chul Lee;Jung-Wook Kang
    • Food Science and Preservation
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    • v.31 no.2
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    • pp.315-323
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    • 2024
  • This study aims to confirm the anti-inflammatory activities of acemannan and aloesin, which have been studied for various efficacies at various mixed sample ratios. The mixed samples were mixed at a ratio of 1:1 (AA-1), 1:2 (AA-2), 1:3 (AA-3), 2:1 (AA-4), and 3:1 (AA-5). Seven samples were evaluated for their cytotoxic ability on macrophages, and the results showed that all cell viability was over 90% at a concentration of 100 ㎍/mL. First, due to the NO production inhibitory activity, a better inhibitory effect was achieved when using a mixed sample rather than a single material. Afterward, the activity of inhibiting the production of PGE2, TNF-α, and IL-6 was confirmed using a mixed sample. It was confirmed that AA-2 had the best inhibitory activity on producing PGE2, TNF-α, and IL-6 rather than AA-1, AA-3, AA-4, and AA-5. For this reason, experiments were conducted using AA-2 to determine the protein expression levels of iNOS and COX-2, which are inflammation-related proteins. It was confirmed that AA-2 inhibited iNOS and COX-2 protein expression by 25.01% and 27.27%, respectively, compared to the LPS-alone treatment group. In conclusion, the mixed sample of acemannan and aloesin is judged to have anti-inflammatory activity and can potentially to be used as a functional material.

Changes in physiologically active ingredients and anti-inflammatory properties of underutilized wild vegetables by complex fermentation using beneficial microorganisms (유용미생물에 의한 저이용 산채류의 복합발효 중 생리활성 성분 및 항염증 변화)

  • Sang-Hyeob Sim;Ha KyoungChoi;Da Eun Lee;Soo Chang Na;Dae Il Hwang;Hyo Bin Oh;Yi Teak Lim;Tae-Young Kim;Dae-Woon Kim
    • Food Science and Preservation
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    • v.31 no.2
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    • pp.287-297
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    • 2024
  • It was confirmed that complex fermentation (CF) was more efficient than single-strain fermentations in inducing changes in the contents of phenolic compounds of Maclura tricuspidate and Pyrus Montana Nakai. A mixture of Maclura tricuspidata, Pyrus montana Nakai, Platycodon grandiflorum and Codonopsis lanceolata were fermented in CF using Aspergillus shirousamii (koji), yeast, and lactic acid bacteria (LAB) for 24 days, and the pH, °Brix, total acidity, anti-oxidant activity, polyphenol content, nitric oxide (NO), and Western blotting of inducible nitric oxide synthase (iNOS), cyclo-oxygenase-2 (COX-2), and tumor necrosis factor-𝛼 (TNF-𝛼) of the sample were determined. There was no significant change in pH and total acidity. °Brix significantly decreased from day 6 onwards. HPLC confirmed that the concentrations of chlorogenic acid, 4-hydrobenzoic acid, vanillic acid, and caffeic acid significantly increased from day 18 during the fermentation. Additionally, DPPH, ABTS radical scavenging activity, total phenol, and total flavonoid were confirmed to be increased until 18 days. NO was significantly inhibited from day 6, along with significant inhibition of iNOS, COX-2, and TNF-a. In conclusion, this study confirmed that CF of low-use (or underutilized) wild vegetables enhances phenolic compounds. It effectively suppresses NO, iNOS, COX-2, and TNF-𝛼, markers of inflammation-related pathogenesis. Altogether, our results suggest that CF of the above plants has a potential anti-inflammatory effect.

Quantitative Evaluation of Liver Fibrosis on T1 Relaxometry in Comparison with Fibroscan (Fibroscan과 비교를 통한 T1 MR Relaxometry를 이용한 간섬유화의 정량적 평가)

  • Byeong Hak Sim;Suk Hee Heo;Sang Soo Shin;Seong Beom Cho;Yong Yeon Jeong
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.365-378
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    • 2020
  • Purpose This study was performed to determine whether the T1 relaxation time of gadoxetic acid-enhanced liver MR imaging is useful for detecting and staging liver fibrosis in patients with chronic liver disease. Materials and Methods One hundred and three patients with suspected focal liver lesion underwent MR imaging and Fibroscan. Fibroscan was chosen as the reference standard for classifying liver fibrosis. T1 relaxation times were acquired before (preT1), 20 minutes after (postT1) contrast administration, and reduction rate of T1 relaxation time (rrT1) on transverse 3D VIBE (volumetric interpolated breath-hold examination) sequence using 3T MR imaging. The optimal cut-off values for the fibrosis staging were determined with ROC analysis. Results PreT1 and postT1 increased and rrT1 decreased constantly with increasing severity of liver fibrosis according to the METAVIR score (F0-F4). There were statistically significant differences between F2 and F3 in preT1 (F2, 836.0 ± 74.7 ms; F3, 888.6 ± 77.5 ms, p < 0.05) and between F3 and F4 in postT1 (F3, 309.0 ± 80.2 ms; F4, 406.6 ± 147.7 ms, p < 0.05) and rrT1 (F3, 65.4 ± 7.7%; F4, 57.3 ± 11.4%, p < 0.05). ROC analysis revealed that combination test (preT1 + postT1) was the best test for predicting liver fibrosis. Conclusion PreT1 and postT1 increased constantly with increasing severity of liver fibrosis. T1 mapping in gadoxetic acid-enhanced liver MR imaging could be a helpful complementary sequence to determine the liver fibrosis stage.

Prediction of Necrotizing Pancreatitis on Early CT Based on the Revised Atlanta Classification (개정된 아틀란타 분류법에 근거한 초기 CT에서의 괴사성 췌장염의 예측)

  • Yeon Seon Song;Hee Sun Park;Mi Hye Yu;Young Jun Kim;Sung Il Jung
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1436-1447
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    • 2020
  • Purpose To investigate the clinical and CT features at admission to predict the progression to necrotizing pancreatitis (NP) in patients initially diagnosed with interstitial edematous pancreatitis (IEP). Materials and Methods Patients with IEP who underwent contrast-enhanced CT at admission and follow-up CT (< 14 days) were included (n = 178). Two radiologists performed a consensus review of follow-up CT scans and diagnosed the type of acute pancreatitis as IEP or NP. Laboratory findings at admission were recorded. Clinical, CT, and laboratory findings were compared between the IEP-IEP group and IEP-NP group using the chi-square test and the t-test. Multivariate analysis was also performed. Results There were 112 and 66 patients in the IEP-IEP and the IEP-NP groups, respectively. The proportion of patients with alcohol etiology was significantly larger in the IEP-NP group. Among the CT findings, the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were more frequently observed in the IEP-NP group. Among the laboratory variables, serum C-reactive protein levels and white blood cell counts were significantly higher in the IEP-NP group. Multivariate analysis revealed that the presence of peripancreatic fluid and heterogeneous parenchymal enhancement were significant findings distinguishing the two groups. Conclusion CT findings, such as the presence of peripancreatic fluid and heterogeneous pancreatic parenchymal enhancement, may be helpful in predicting the progression to NP in patients initially diagnosed with IEP.

Analysis of Micro-Sedimentary Structure Characteristics Using Ultra-High Resolution UAV Imagery: Hwangdo Tidal Flat, South Korea (초고해상도 무인항공기 영상을 이용한 한국 황도 갯벌의 미세 퇴적 구조 특성 분석)

  • Minju Kim;Won-Kyung Baek;Hoi Soo Jung;Joo-Hyung Ryu
    • Korean Journal of Remote Sensing
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    • v.40 no.3
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    • pp.295-305
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    • 2024
  • This study aims to analyze the micro-sedimentary structures of the Hwangdo tidal flats using ultra-high resolution unmanned aerial vehicle (UAV) data. Tidal flats, located in the transitional area between land and sea, constantly change due to tidal activities and provide a unique environment important for understanding sedimentary processes and environmental conditions. Traditional field observation methods are limited in spatial and temporal coverage, and existing satellite imagery does not provide sufficient resolution to study micro-sedimentary structures. To overcome these limitations, high-resolution images of the Hwangdo tidal flats in Chungcheongnam-do were acquired using UAVs. This area has experienced significant changes in its sedimentary environment due to coastal development projects such as sea wall construction. From May 17 to 18, 2022, sediment samples were collected from 91 points during field surveys and 25 in-situ points were intensively analyzed. UAV data with a spatial resolution of approximately 0.9 mm allowed identifying and extracting parameters related to micro-sedimentary structures. For mud cracks, the length of the major axis of the polygons was extracted, and the wavelength and ripple symmetry index were extracted for ripple marks. The results of the study showed that in areas with mud content above 80%, mud cracks formed at an average major axis length of 37.3 cm. In regions with sand content above 60%, ripples with an average wavelength of 8 cm and a ripple symmetry index of 2.0 were formed. This study demonstrated that micro-sedimentary structures of tidal flats can be effectively analyzed using ultra-high resolution UAV data without field surveys. This highlights the potential of UAV technology as an important tool in environmental monitoring and coastal management and shows its usefulness in the study of sedimentary structures. In addition, the results of this study are expected to serve as baseline data for more accurate sedimentary facies classification.

Usefulness of 18F-FDG PET/CT and Multiphase CT in the Differential Diagnosis of Hepatocellular Carcinoma and Combined Hepatocellular Carcinoma-Cholangiocarcinoma (간세포암종과 혼합성 간세포암종-담관암종에서 다위상 전산단층촬영술 소견과 18F-FDG PET/CT에서 섭취율 차이에 대한 분석 )

  • Jae Chun Park; Jung Gu Park;Gyoo-Sik Jung;Hee Kang;Sungmin Jun
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1424-1435
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    • 2020
  • Purpose The purpose of this study was to evaluate the usefulness of multiphasic CT and 18F-fluorodeoxyglucose (FDG) PET/CT for the differentiation of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) from hepatocellular carcinoma (HCC). Materials and Methods From January 2007 to April 2016, 93 patients with pathologically confirmed HCC (n = 84) or cHCC-CCA (n = 9) underwent CT and PET/CT imaging. Contrast enhancement patterns were divided into three types based on the attenuation of the surrounding liver parenchyma: type I (early arterial enhancement with delayed washout), type II (early arterial enhancement without delayed washout), and type III (early hypovascular, infiltrative appearance, or peripheral rim enhancement). Results cHCC-CCAs (89%) had a higher PET/CT positive rate than did HCCs (61%), but the PET/CT positive rate did not differ significantly (p = 0.095). Among the 19 cases of the type II enhancement pattern, 3 (21%) of 14 HCCs and 4 (80%) of 5 cHCC-CCAs were PET/CT positive. cHCC-CCAs had a significantly higher PET/CT positive rate (p = 0.020) in the type II enhancement pattern. Conclusion The PET/CT positive rate of cHCC-CCA was significantly higher than that of HCC in lesions with a type II enhancement pattern. The 18F-FDG PET/CT can be useful for the differentiation of cHCC-CCA from HCC in lesions with a type II enhancement pattern on multiphasic CT.