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Current Practices in Breast Magnetic Resonance Imaging: a Survey Involving the Korean Society of Breast Imaging

  • Yun, Bo La;Kim, Sun Mi;Jang, Mijung;Kang, Bong Joo;Cho, Nariya;Kim, Sung Hun;Koo, Hye Ryoung;Chae, Eun Young;Ko, Eun Sook;Han, Boo-Kyung
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.4
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    • pp.233-241
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    • 2017
  • Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.

Anti-oxidative Effect of Chungsimyeonja-um (CSYJE) via Nrf2/HO-1 Pathway Activity in Lipopolysaccharide (LPS) Induced RAW 264.7 Macrophages (대식세포에서 Nrf2/HO-1경로를 통한 청심연자음의 항산화효과)

  • Jeon, Seon Hong;Oh, Sol La;Kim, So Jeong;Jeon, Bo Hee;Sung, Jin Young;Kim, Yong Min
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.46 no.3
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    • pp.253-263
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    • 2020
  • Reactive oxygen species (ROS) plays an important role in maintaining homeostasis. However, excessive ROS production damages cellular components such as proteins, lipids, and nucleic acids and promotes skin aging. In this study, we confirmed the antioxidant effect of CSYJE to prevent excessive oxidative stress. First, DPPH and ABTS assays were performed to confirm the antioxidant effect of CSYJE and the radical scavenging activity was confirmed depending on the concentration. As a result of performing the MTT assay to confirm the cell viability, it was confirmed that there was no cytotoxicity at a concentration of 1,000 ㎍/mL. As a result of western blotting to confirm the expression levels of the antioxidant-related proteins nuclear-E2-related factor 2 (Nrf2) and Heme oxygenase-1 (HO-1), it was confirmed that the expression was increased in a concentration-dependent manner. After inducing ROS with lipopolysaccharide (LPS), an intracellular ROS-causing substance, DCF-DA was performed to confirm the inhibitory effect of ROS production, and the inhibition of ROS production was confirmed to concentration-dependent. Real-time RT-PCR was performed to confirm the mRNA expression level of inflammatory cytokines and inflammatory mediator caused by ROS generation, mRNA expression was reduced in a dose dependent manner. Therefore, this study confirmed the antioxidant effect of CSYJE through the Nrf2/HO-1 signaling pathway, which suggests that CSYJE can be used as an antioxidant cosmetic material by inhibiting free radicals.

Determination of the Origin in both Dissolved Inorganic Nitrogen and Phytoplankton at the Lake Paldang using Stable Isotope Ratios (δ13C, δ15N, δ15N-NO3 and δ15N-NH4) (질산염 및 식물플랑크톤의 안정동위원소비를 이용한 팔당호 수계내의 질소원 기원 연구)

  • Kim, Min-Seob;Lee, Eun-Jeong;Yoon, Suk-Hee;Lim, Bo-La;Park, Jaeseon;Park, Hyunwoo;Chung, Hyen-Mi;Choi, Jong-Woo
    • Korean Journal of Ecology and Environment
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    • v.50 no.4
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    • pp.452-458
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    • 2017
  • The nitrogen isotope value in both ammonium and nitrate ion were determined at 9 stations during both June and August 2016, in order to understand the origin of DIN at the Han river. ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values in 8 stations (CP, SB, MHC, P4, SJ, SBC, P2, SC) were no significant variation. However ${\delta}^{15}N-NO_3$ and ${\delta}^{15}N-NH_4$ values in KK (Kyeongan stream) showed significant different in comparison with 8 stations, with an apparent increase of nitrogen isotope values. These results indicate that antropogenic nitrogen source influence on KK station. Also the ${\delta}^{13}C$ and ${\delta}^{15}N$ isotope ratio of phytoplankton (Diatom and Cyanobacteria) in KK (Kyeongan stream) showed heavier values, compared to other study stations. These results indicate that nitrogen isotope value in phytoplankton effects by different nitrogen source in study sites. These results suggest that the analysis of stable isotope ratios is a simple but useful tool for the identification of dissolved inorganic nitrogen origin in aquatic environments.

Anti-CD3 Antibody Induces IL-10-producing $CD4^+CD25^+$ Regulatory T Cells, Which Suppress T Cell Response in Rheumatoid Arthritis Patients

  • Yoon, Bo-Young;Cho, Mi-La;Hong, Yeon-Sik;Jhun, Joo-Yeon;Park, Mi-Kyung;Park, Kyung-Su;Park, Sung-Hwan;Kim, Ho-Youn
    • IMMUNE NETWORK
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    • v.7 no.3
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    • pp.124-132
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    • 2007
  • Background: Regulatory T cells (Tregs) have been investigated intensively for some decades. These cells regulate the immune system, prevent overactivated immune responses and can be used therapeutically. For rheumatoid arthritis (RA), understanding the functions and status of Tregs is an important step for understanding immune regulation in this autoimmune disease. Methods: We investigated the percentages, phenotypes and suppressive functions of $CD4^+CD25^+$ Tregs in peripheral blood (PB) of patients with RA. Results: The percentages were higher in the patients (n=12) than in healthy controls (n=10), and the cells expressed the $CD45RB^{low}$, CTLA-4 and CCR7 phenotypes. We also investigated the expression of Foxp3 and secretion of interleukin (IL)-10 induced $CD4^+CD25^+$ Tcells by anti-CD3 antibody treatment. A suppressive function of the patients' cells was shown through coculture with $CD4^+CD25^-$ T cells in vitro. Conclusion: We suggest that, despite their increased numbers and suppressive function, they manage the ongoing inflammation ineffectively. It might be possible to apply IL-10 to induce the proliferation of IL-10-producing Tregs as therapy for RA.

A Study of Facial Deformity in the Patient with Bilateral Cleft Lip before the Primary Cheiolplasty (양측성 구순열 환자의 안모 변형에 대한 연구)

  • Yoon Bo-Keun;Soh Byung-Soo;Baik Jin-Ah;Shin Hyo-Keun
    • Korean Journal of Cleft Lip And Palate
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    • v.4 no.2
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    • pp.51-68
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    • 2001
  • Midfacial hypoplasia in patients with clefts of the lip and palate is considered to be the result of congenital dysmorphogenesis. And cleft lip and palate developes facial deformity, jaw abnormality, speech problem, which is most frequent hereditary deformity in maxillofacial region. So cleft lip and palate is characterized by midface deformity which shaws maxillary anterior nasal septal deviation and deformity. Our study describes congenital correlates of midfacial hypoplasia by examining the displacement of a normal complement of parts, a triangular tissue deficiency low on the lip border on the columellar side, and a linear deficiency and displacement in the line of the bilateral cleft lip. 15 patients with bilateral cleft lip and palate were taken impression before operation, but the patient who had other abnormalities and complications were excluded. Average age is 3.4 months and they were classified into both complete, both incomplete and complete & incomplete group. The obtained results were as follows 1. There were no differences on intercanthal width and canthal width between each of the groups. 2. Both complete group had longer lateral ala length than both incomplete group, but there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 3. Columella length was greater in both incomplete group than in both complete group, but there was no difference between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 4. Both complete group had longer ala width & ala base width than both incomplete group had. But there were no differences between both complete group and complete side of com. & incom. group and both incomplete group and incomplete side of com. & incom. group. 5. There were no differences between each of the groups on upper lip length, but nose/mouth width ratio was greater in both complete group than in both incomplete group. 6. Pronasale(pm), subnasle(sn), la~rale superioris(ls), stomion(sto) points were located around the central vertical line of face but deviated to incomplete side in com. & incom. group. 7. Nasal tip protrusion was greater in both incomplete group and com. & incom. group than both complete group, but there was no difference between both incomplete group and com. & incom. group.

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Port Performance of Fully Automated Container Terminal on the COVID Pandemic (코로나 팬데믹에서 완전자동화항만의 성과 비교 연구)

  • BoKyung Kim;GeunSub Kim
    • Proceedings of the Korean Institute of Navigation and Port Research Conference
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    • 2022.06a
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    • pp.327-328
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    • 2022
  • The recent spread of the corona pandemic and a temporary surge in demand for consumer goods have resulted in an increase in port cargo volume, and the resulting port congestion is coupled with a shortage of labor in the port, exacerbating the global supply chain chaos. Supply chain disruptions will increase logistics costs and ultimately increase global inflationary pressures. In this situation, the role of the port, which is the nodal point between land and sea, is gradually becoming more important. And fully automated ports that are operated unmanned are evaluated as being able to respond stably and flexibly by reducing operational risks in situations such as COVID-19. Therefore, this study compared the operational performance of fully automated and non-fully automated terminals within the same port before and after the corona outbreak, and analyzed the fully automated terminal was stable in actual operation. As a result of the analysis, the fully automated terminal showed stable operating efficiency in all aspects of operational performance compared to the non-fully automated terminal even under severe port congestion due to COVID-19.

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Automated Versus Handheld Breast Ultrasound for Evaluating Axillary Lymph Nodes in Patients With Breast Cancer

  • Sun Mi Kim;Mijung Jang;Bo La Yun;Sung Ui Shin;Jiwon Rim;Eunyoung Kang;Eun-Kyu Kim;Hee-Chul Shin;So Yeon Park;Bohyoung Kim
    • Korean Journal of Radiology
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    • v.25 no.2
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    • pp.146-156
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    • 2024
  • Objective: Automated breast ultrasound (ABUS) is a relevant imaging technique for early breast cancer diagnosis and is increasingly being used as a supplementary tool for mammography. This study compared the performance of ABUS and handheld ultrasound (HHUS) in detecting and characterizing the axillary lymph nodes (LNs) in patients with breast cancer. Materials and Methods: We retrospectively reviewed the medical records of women with recently diagnosed early breast cancer (≤ T2) who underwent both ABUS and HHUS examinations for axilla (September 2017-May 2018). ABUS and HHUS findings were compared using pathological outcomes as reference standards. Diagnostic performance in predicting any axillary LN metastasis and heavy nodal-burden metastases (i.e., ≥ 3 LNs) was evaluated. The ABUS-HHUS agreement for visibility and US findings was calculated. Results: The study included 377 women (53.1 ± 11.1 years). Among 385 breast cancers in 377 patients, 101 had axillary LN metastases and 30 had heavy nodal burden metastases. ABUS identified benign-looking or suspicious axillary LNs (average, 1.4 ± 0.8) in 246 axillae (63.9%, 246/385). According to the per-breast analysis, the sensitivity, specificity, positive and negative predictive values, and accuracy of ABUS in predicting axillary LN metastases were 43.6% (44/101), 95.1% (270/284), 75.9% (44/58), 82.6% (270/327), and 81.6% (314/385), respectively. The corresponding results for HHUS were 41.6% (42/101), 95.1% (270/284), 75.0% (42/56), 82.1% (270/329), and 81.0% (312/385), respectively, which were not significantly different from those of ABUS (P ≥ 0.53). The performance results for heavy nodal-burden metastases were 70.0% (21/30), 89.6% (318/355), 36.2% (21/58), 97.3% (318/327), and 88.1% (339/385), respectively, for ABUS and 66.7% (20/30), 89.9% (319/355), 35.7% (20/56), 97.0% (319/329), and 88.1% (339/385), respectively, for HHUS, also not showing significant difference (P ≥ 0.57). The ABUS-HHUS agreement was 95.9% (236/246; Cohen's kappa = 0.883). Conclusion: Although ABUS showed limited sensitivity in diagnosing axillary LN metastasis in early breast cancer, it was still useful as the performance was comparable to that of HHUS.

Background Breast Parenchymal Signal During Menstrual Cycle on Diffusion-Weighted MRI: A Prospective Study in Healthy Premenopausal Women

  • Yeon Soo Kim;Bo La Yun;A Jung Chu;Su Hyun Lee;Hee Jung Shin;Sun Mi Kim;Mijung Jang;Sung Ui Shin;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.511-517
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    • 2024
  • Objective: To prospectively investigate the influence of the menstrual cycle on the background parenchymal signal (BPS) and apparent diffusion coefficient (ADC) of the breast on diffusion-weighted MRI (DW-MRI) in healthy premenopausal women. Materials and Methods: Seven healthy premenopausal women (median age, 37 years; range, 33-49 years) with regular menstrual cycles participated in this study. DW-MRI was performed during each of the four phases of the menstrual cycle (four examinations in total). Three radiologists independently assessed the BPS visual grade on images with b-values of 800 sec/mm2 (b800), 1200 sec/mm2 (b1200), and a synthetic 1500 sec/mm2 (sb1500). Additionally, one radiologist conducted a quantitative analysis to measure the BPS volume (%) and ADC values of the BPS (ADCBPS) and fibroglandular tissue (ADCFGT). Changes in the visual grade, BPS volume (%), ADCBPS, and ADCFGT during the menstrual cycle were descriptively analyzed. Results: The visual grade of BPS in seven women varied from mild to marked on b800 and from minimal to moderate on b1200 and sb1500. As the b-value increased, the visual grade of BPS decreased. On b800 and sb1500, two of the seven volunteers showed the highest visual grade in the early follicular phase (EFP). On b1200, three of the seven volunteers showed the highest visual grades in EFP. The BPS volume (%) on b800 and b1200 showed the highest value in three of the six volunteers with dense breasts in EFP. Three of the seven volunteers showed the lowest ADCBPS in the EFP. Four of the seven volunteers showed the highest ADCBPS in the early luteal phase (ELP) and the lowest ADCFGT in the late follicular phase (LFP). Conclusion: Most volunteers did not exhibit specific BPS patterns during their menstrual cycles. However, the highest BPS and lowest ADCBPS were more frequently observed in EFP than in the other menstrual cycle phases, whereas the highest ADCBPS was more common in ELP. The lowest ADCFGT was more frequent in LFP.

The Value of Adding Ductography to Ultrasonography for the Evaluation of Pathologic Nipple Discharge in Women with Negative Mammography

  • Younjung Choi;Sun Mi Kim;Mijung Jang;Bo La Yun;Eunyoung Kang;Eun-Kyu Kim;So Yeon Park;Bohyoung Kim;Nariya Cho;Woo Kyung Moon
    • Korean Journal of Radiology
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    • v.23 no.9
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    • pp.866-877
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    • 2022
  • Objective: The optimal imaging approach for evaluating pathological nipple discharge remains unclear. We investigated the value of adding ductography to ultrasound (US) for evaluating pathologic nipple discharge in patients with negative mammography findings. Materials and Methods: From July 2003 to December 2018, 101 women (mean age, 46.3 ± 12.2 years; range, 23-75 years) with pathologic nipple discharge were evaluated using pre-ductography (initial) US, ductography, and post-ductography US. The imaging findings were reviewed retrospectively. The standard reference was surgery (70 patients) or > 2 years of follow-up with US (31 patients). The diagnostic performances of initial US, ductography, and post-ductography US for detecting malignancy were compared using the McNemar's test or a generalized estimating equation. Results: In total, 47 papillomas, 30 other benign lesions, seven high-risk lesions, and 17 malignant lesions were identified as underlying causes of pathologic nipple discharge. Only eight of the 17 malignancies were detected on the initial US, while the remaining nine malignancies were detected by ductography. Among the nine malignancies detected by ductography, eight were detected on post-ductography US and could be localized for US-guided intervention. The sensitivities of ductography (94.1% [16/17]) and post-ductography US (94.1% [16/17]) were significantly higher than those of initial US (47.1% [8/17]; p = 0.027 and 0.013, respectively). The negative predictive value of post-ductography US (96.9% [31/32]) was significantly higher than that of the initial US (83.3% [45/54]; p = 0.006). Specificity was significantly higher for initial US than for ductography and post-ductography US (p = 0.001 for all). Conclusion: The combined use of ductography and US has a high sensitivity for detecting malignancy in patients with pathologic nipple discharge and negative mammography. Ductography findings enable lesion localization on second-look post-ductography US, thus facilitating the selection of optimal treatment plans.

Comparison of One- and Two-Region of Interest Strain Elastography Measurements in the Differential Diagnosis of Breast Masses

  • Hee Jeong Park;Sun Mi Kim;Bo La Yun;Mijung Jang;Bohyoung Kim;Soo Hyun Lee;Hye Shin Ahn
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.431-441
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    • 2020
  • Objective: To compare the diagnostic performance and interobserver variability of strain ratio obtained from one or two regions of interest (ROI) on breast elastography. Materials and Methods: From April to May 2016, 140 breast masses in 140 patients who underwent conventional ultrasonography (US) with strain elastography followed by US-guided biopsy were evaluated. Three experienced breast radiologists reviewed recorded US and elastography images, measured strain ratios, and categorized them according to the American College of Radiology breast imaging reporting and data system lexicon. Strain ratio was obtained using the 1-ROI method (one ROI drawn on the target mass), and the 2-ROI method (one ROI in the target mass and another in reference fat tissue). The diagnostic performance of the three radiologists among datasets and optimal cut-off values for strain ratios were evaluated. Interobserver variability of strain ratio for each ROI method was assessed using intraclass correlation coefficient values, Bland-Altman plots, and coefficients of variation. Results: Compared to US alone, US combined with the strain ratio measured using either ROI method significantly improved specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve (AUC) (all p values < 0.05). Strain ratio obtained using the 1-ROI method showed higher interobserver agreement between the three radiologists without a significant difference in AUC for differentiating breast cancer when the optimal strain ratio cut-off value was used, compared with the 2-ROI method (AUC: 0.788 vs. 0.783, 0.693 vs. 0.715, and 0.691 vs. 0.686, respectively, all p values > 0.05). Conclusion: Strain ratios obtained using the 1-ROI method showed higher interobserver agreement without a significant difference in AUC, compared to those obtained using the 2-ROI method. Considering that the 1-ROI method can reduce performers' efforts, it could have an important role in improving the diagnostic performance of breast US by enabling consistent management of breast lesions.