• 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.

• Korean Journal of Radiology
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• v.23 no.6
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• pp.664-673
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• 2022

Objective: To evaluate the performance of baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping of the extraocular muscles (EOMs) in the prediction of treatment response to intravenous glucocorticoid (IVGC) therapy for active and moderate-to-severe thyroid-associated ophthalmopathy (TAO) and to investigate the effect of fat-suppression (FS) in T2 mapping in this prediction. Materials and Methods: A total of 79 patients clinically diagnosed with active, moderate-to-severe TAO (47 female, 32 male; mean age ± standard deviation, 46.1 ± 10 years), including 43 patients with a total of 86 orbits in the responsive group and 36 patients with a total of 72 orbits in the unresponsive group, were enrolled. Baseline clinical characteristics and pretherapeutic histogram parameters derived from T2 mapping with FS (i.e., FS T2 mapping) or without FS (i.e., conventional T2 mapping) of EOMs were compared between the two groups. Independent predictors of treatment response to IVGC were identified using multivariable analysis. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive performance of the prediction models. Differences between the models were examined using the DeLong test. Results: Compared to the unresponsive group, the responsive group had a shorter disease duration, lower kurtosis (FS-kurtosis), lower standard deviation, larger 75th, 90th, and 95th (FS-95th) T2 relaxation times in FS mapping and lower kurtosis in conventional T2 mapping. Multivariable analysis revealed that disease duration, FS-95th percentile, and FS-kurtosis were independent predictors of treatment response. The combined model, integrating all identified predictors, had an optimized area under the ROC curve of 0.797, 88.4% sensitivity, and 62.5% specificity, which were significantly superior to those of the imaging model (p = 0.013). Conclusion: An integrated combination of disease duration, FS-95th percentile, and FS-kurtosis was a potential predictor of treatment response to IVGC in patients with active and moderate-to-severe TAO. FS T2 mapping was superior to conventional T2 mapping in terms of prediction.

• Korean Journal of Radiology
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• v.23 no.11
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• pp.1067-1077
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• 2022

Objective: To determine whether Sonazoid-enhanced ultrasound (SZUS) was noninferior to SonoVue-enhanced ultrasound (SVUS) in diagnosing hepatocellular carcinoma (HCC) using the same diagnostic criteria. Materials and Methods: This prospective, single-center, noninferiority study (NCT04847726) enrolled 105 at-risk participants (71 male; mean age ± standard deviation, 63 ± 11 years; range, 26-86 years) with treatment-naïve solid hepatic nodules (≥ 1 cm). All participants underwent same-day SZUS (experimental method) and SVUS (control method) for one representative nodule per participant. Images were interpreted by three readers (the operator and two independent readers). All malignancies were diagnosed histopathologically, while the benignity of other lesions was confirmed by follow-up stability or pathology. The primary endpoint was per-lesion diagnostic accuracy for HCC pooled across three readers using the conventional contrast-enhanced ultrasound diagnostic criteria, including arterial phase hyperenhancement followed by mild (assessed within 2 minutes after contrast injection) and late (≥ 60 seconds with a delay of 5 minutes) washout. The noninferiority delta was -10%p. Furthermore, different time delays were compared as washout criteria in SZUS, including delays of 2, 5, and > 10 minutes. Results: A total of 105 lesions (HCCs [n = 61], non-HCC malignancies [n = 19], and benign [n = 25]) were evaluated. Using the 5-minutes washout criterion, per-lesion accuracy of SZUS pooled across the three readers (72.4%; 95% confidence interval [CI], 64.1%-79.3%) was noninferior to that of SVUS (71.4%; 95% CI, 63.1%-78.6%), meeting the statistical criterion for non-inferiority (difference of 0.95%p; 95% CI, -3.8%p-5.7%p). The arterial phase hyperenhancement combined with the 5-minutes washout criterion showed the same sensitivity as that of the > 10-minutes criterion (59.0% vs. 59.0%, p = 0.989), and the specificities were not significantly different (90.9% vs. 86.4%, p = 0.072). Conclusion: SZUS was noninferior to SVUS for diagnosing HCC in at-risk patients using the same diagnostic criteria. No significant improvement in HCC diagnosis was observed by extending the washout time delay from 5 to 10 minutes.

• Korean Journal of Environmental Biology
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• v.41 no.4
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• pp.386-399
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• 2023

Microplastics and nanoplastics (NMPs) are considered one of hazardous contaminants in marine ecosystems due to their toxic effects, such as reproduction disorder and oxidative stress, on marine organisms. Although water temperature is rising due to global climate change, little information on the toxicological interaction between NMPs and temperature is available. Therefore, in this study, we confirmed the toxicity of NMPs (polystyrene [PS] beads; 0.05- and 6-㎛) on brackish water fleas (Diaphanosoma celebensis) depending on increased temperature (30℃ and 35℃) at individual and molecular levels. In the chronic toxicity test, the group exposed to high temperatures showed an earlier first reproduction time compared to the normal temperatures group, but it was delayed by co-exposure to NMPs at 35℃. Notably, the total reproduction decreased significantly only after 0.05-㎛ PS beads exposure at 30℃. Interaction analysis showed that first reproduction time, modulation of the antioxidant-related gene (GSTS1), heat shock gene (Hsp70), and ecdysteroid pathway-related genes (EcR_A, EcR_B, and CYP314A1) were closely related to temperature and PS beads size. These results indicate that microplastics have size-dependent toxicity, and their toxicity can be enhanced at high temperatures. In addition, higher temperatures and PS beads exposure may have negative effects on reproduction. This study suggests that various factors such as water temperature should be considered when evaluating the toxicity of microplastics in marine ecosystems, and provides an understanding of the complex toxic interaction between water temperature and microplastics for marine zooplankton.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.871-881
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• 1996

Objective: In the early short-term therapy of pulmonary tuberculosis, PZA is used for the first two months on 6EHRZ therapy but PZA is not effective in the case of long-tenn use PZA for retreatment in the sensitive relapse or acquired drug resistance for PZA. But in the endemic area as Korea, if we can't use PZA in the retreatment of pulmonary tuberculosis, we can't expect the success for retreatment of pulmonary tuberculosis, therefore we need new drugs substituting for PZA. In these days, 4 - fluoroquinolone derivatives were investigated and only ofloxacin and ciprofloxacin of derivatives were known to be effective but the effectiveness was also not certain because the result was experimental or combined with other bacteriocidal drugs and datas on effectiveness of pulmonary tuberculosis were so little. Therefore these drugs should be use with other two or three strong-acting drugs in the last period of retreatment of pulmonary tuberculosis. The ofloxacin or ciprofloxacin is used in some area in Korea but randomly and needed more study. We did this study for proving the effectiveness of these drugs and establishment of retreatment regimen for pulmonary tuberculosis. Methods: Retrospective cohort study of 83 drug-resistant pulmonary tuberculosis patients at National Masan Tuberculosis Hospital from Jan. 1994 to dec. 1995 was made. All the patients taken medicine for 2nd ami-tuberculosis regimens for the first lime. We separated the patients by two groups.(Group I : OFX+ PTA + CS+PAS + Injection, Group II: PZA + PTA+ CS + PAS + Injection). We compared the difference between two groups and tested the confidence limit about results after treatment by $\chi$2-test and T-test. Results : 1. The age distribution was most frequent in fourth decade(29.2% in Group I, 37.1% in Group II) and the mean age was 43.9 year in Group I, and 39.0 year in Group II, but had no significant difference between two groups. The sex distribution was more frequent in the males(68.8% in Group I, 85.7% in Group II), but had no significant difference. 2. Family history was 29.2% in Group I, 28.6% in Group II, but had no significant difference. 3. In the respect of extent of disease, far-advanced stare was 60.4% in Group I, 74.3% in Group II, but had no significant difference. 4. The side effects for drugs showed in 58.3% in Group I and 65.7% in Group II, and the gastrointestinal trouble showed 25.0% in Group and arthralgia 34.3% in Group II predominantly respectively and had the significant difference(p<0.05). 5. The negative conversion rate on sputum AFB smear was 87.5% in Group I and 80.0% in Group II, but had no significant difference. But the negative conversion rate on sputum AFB culture was 83.3% in Group I and 57.1 % in Group II and had the significant difference(p<0.05). 6. The success rate of treatment was 87.5 % in Group I and 83.3 % in Group II but had no significant difference. Conclusion : In the retreatment of pulmonary tuberculosis, ofloxacin is useful drug for the patients who are not available to use PZA and can be use effectively substituting for PZA.

• Korean Journal of Food Science and Technology
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• v.40 no.4
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• pp.449-454
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• 2008

This research examined whether feeding single extracts or complex extracts of Bulnesia sarmienti, together with a high fat diet, could improve serum lipid levels and reduce fat mass in rats. Test groups were fed the extracts, combined with a high fat diet, for eight weeks, and subdivided into seven groups: normal, control, and five treatment groups (BS: B. sarmienti extracts; BS-S: B. sarmienti and Salvia miltiorrhiza Bunge extracts; BS-M: B. sarmienti and Morus alba Linne extracts; BS-SM1: B. sarmienti, Salvia miltiorrhiza Bunge and Morus alba Linne extracts; and BS-SM2: BS-SM1 extracts at a 2-fold concentration). After feeding the test substance for 8 weeks, no significant differences were found for food intake, water intake, change in body weight, or food efficiency ratios (FER) among the groups. However, serum LDL-cholesterol had increased by 14.1% in the BS-S group. When compared with the control group, total cholesterol levels in the BS, BS-S, BS-M, BS-SM1, and BS-SM2 groups were reduced by 36.0, 14.5, 40.4, 17.5, and 22.5%, respectively, with the greatest change shown in the BS-M group. In terms of triglycerides, levels in BS, BS-S, BS-M, BS-SM1, and BS-SM2 had decreased by 41.9, 8.5, 62.3, 17.7, and 14.5%, respectively. Compared to the control group, the BS group showed a significant decrease in fat mass. In conclusion, the BS and BS-M groups showed significant effects with respect to improved serum lipid profiles and body fat mass when they were fed a high fat diet in combination with the respective extracts.

• Journal of Chest Surgery
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• v.36 no.7
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• pp.497-503
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• 2003

Pulmonary aspergillosis usually results from the colonization of the existing lung lesions by chronic pulmonary diseases, such as tuberculosis. Most cases of pulmonary aspergilloma have been treated surgically for many years because it is a potentially life-threatening disease causing massive hemoptysis. Here we reviewed our results from the last 10 years. Material and Method: We reviewed 31 cases surgically treated from Aug. 1992 to Jul. 2002. retrospectively. This investigation is designed to illustrate the peak age incidence, sex ratio, chief complaints, preoperative study, anatomic location of operative site, postoperative pathologic finding and postoperative complications. Result: The peak age Incidence laid in the 3rd and 4th decade of 20 cases (64.5%). The most common complaint was hemoptysis in 27 cases (87.1%). The 31 cases had a history of treatment with anti-tuberculous drugs under impression of pulmonary tuberculosis. The 19 cases (61.3%) showed the so-called “Air-meniscus sign” on the preoperative chest X-ray. In the 31 cases (100%) on the chest computed tomography. as a preoperative diagnostic modality, positivity was shown in 37.9%, 83.3% was shown on the fungus culture of sputum for Aspergillus, serum immunodiffusion test for A. fumigatus, respectively. The anatomical location of aspergilloma was mainly in the upper lobe in 19 cases (61.3%) and the majority of cases were managed by lobectomy. The postoperative pathologic findings showed that 31 cases (100%) were combined with tuberculosis. The postoperative complications include empyema, prolonged air leakage, remained dead space, postoperative bleeding and these numbers of cases is 3 cases (9.7%), 2 cases (6.45%), 2 cases (6.45%), 1 case (3.23%), respectively. one case was died postoperatively due to massive beeding, and asphyxia. Conclusion: Compared with the previous study, there is no significant difference in results. Preoperative chest computed tomography and immunodiffusion test were more commonly available and showed high positivity. Operations often became technically difficult because of pleural space obliteration, indurated hilar structures, and poor expansion of the remaining lung, which were more prominent in the patients with complex aspergillosis. In such cases, medical treatments and interventional procedures like bronchial artery embolization are preferred. However, cavernostomy is also recommanded with few additional morbidity because of its relatively less invassiveness. Early surgical intervention is the recommended management for patients with simple aspergilloma considering the Row surgical mortality and morbidity in recent days.

• Korean Journal of Materials Research
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• v.4 no.8
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• pp.906-914
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• 1994

Plastic behavior of two-phase intermetallic compounds based on $LI_{2}$-type $(Al, Cr)_3$ Ti was investigated using compression test at R.T. and 77K. $LI_{2}$ single phase alloys and two-phase alloys consisting of mainly $LI_{2}$ phase and a few or 20% second phases were selected from AI-Ti-Cr phase diagram. In general, compared with Llz single phase, two-phase alloys consisting of 20% second phase showed relatively high yield strength and poor ductility. Among the alloys, however, AI-21Ti-23Cr alloy consisting of 20% $Cr_{2}Al$ phase showed available ductility as well as high yield strength. Plastic behavior of $LI_{2}$ single phase alloys and two-phase alloys consisting of a few% $Cr_{2}Al$ was also investigated. Homogenization of arc melted ingots substantially reduced the amount of second phases but introduced extensive pore. When Cr content increased in $Ll_{2}$ single phase alloys after the homogenization, the volume fraction of pore in the alloys decreased, and no residual pore was observed in two-phase alloys consisting of a few% $Cr_{2}Al$ phase. Environmental effect on the ductility of the alloys was investigated using compression test at different strain rates($1.2 \times 10^{-4}/s$ and $1.2 \times 10^{-2}/s$). Environmental embrittlement was least significant in A1-25Ti-10Cr alloy consisting of LIZ single phase among the alloys tested in this study. However, based on the combined estimation of the pore formation, environmental embrittlement and ingot cast structure, AI-21Ti-23Cr alloy consisting of 20% $Cr_{2}Al$ as the second phase is expected to show the best tensile elongation behavior.

• Childhood Kidney Diseases
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• v.2 no.1
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• pp.1-8
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• 1998

Purpose : To evaluate the diagnostic value of dipstick urinalysis($Multistix^{(R)}$) as a screening test for urinary tract infection(UTI) in acute febrile children. Methods : We compared dipstick uinalysis (leukocyte estease(LE) and nitrite) with microscopic urinalysis (WBC and bacteria) and urine culture in 80 children with UTI and 605 children without UTI, who were admitted due to acute fever at EWHA Womans University Hospital between Oct. 1994 and Feb. 1996. Results : 1) In dipstick urinalysis, LE and nitrite were positive in 38.7%, and 13.8% of 80 children with UTI and in 2.1%. and 1.2% of 605 children without UTI. 2) In microscopic urinalysis, WBC and bacteria were positive in 31.2%, and 17.5% of 80 children with UTI and in 4.1%, and 0.6% of 605 children without UTI. 3) Positive rate of LE on dipstick urinalysis was 38.7%, which was significantly higher than 31.5% of WBC on microscopic urinalysis (P<0.05). Positive rate of nitrite was not significantly different to that of bacteria. 4) Sensitivity, specificity, positive predictive value, negative predictive value of dipstick urinalysis were 43.7%, 98.3%, 63.6%, 92.9% which were not significant different to 40.0%, 99.0%, 54.0%, 92.3% of microscopic urinalysis. The sensitivity of combined dipstick and microscopic urinalysis were still low(50%). 5) Additional positive rate of microscopic urinalysis to negative dipstick urinalysis was 6.3%(5/80) in 80 children with UTI. Conclusion : The sensitivity of dipstick urinalysis was low and additional value of microscopic urinalysis was minimal in febrile UTI. So urine culture is mandatory in acute febrile children even though dipstick and microscopic urinalysis are negative.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.218-228
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• 2008

Purpose: Our purpose was to evaluate spinal bony metastasis which could be missed on an F-18 FDG PET/CT (FDG PET/CT) alone, and to characterize discordant metastatic lesions between FDG PET/CT and bone scan. Material and Methods: FDG PET/CT and bone scans of 43 patients with spinal bony metastasis were analyzed retrospectively. A McNemar test was performed comparing the FDG PET/CT alone to the FDG PET/CT plus bone scan in the spinal bony metastases. A one-way chi-square test was performed to characterize the metastases that were missed on the FDG PET/CT alone. To evaluate discordant lesions between FDG PET/CT and bone scan, we performed logistic regression analyses. The independent variables were sites (cervical, thoracic, and lumbar), size (large and small), and maximum SUVs, and the dependant variable was bone scan uptake (positive and negative MDP uptake). Results: A significant difference was found between the FDG PET/CT alone and the FDG PET/CT combined with the bone scan (p < 0.01). Using the FDG PET/CT only, diffuse osteoblastic metastasis was missed with a significantly higher frequency (p = 0.04). In the univariate analysis, cervical vertebra and small size were related to negative MDP uptake, and thoracic vertebra and large size were related to positive MDP uptake. However, in the multivariate analysis, only the large size was related to positive MDP uptake. Conclusion: A bone scan in addition to the FDG PET/CT increased the ability to evaluate spinal bony metastases, especially for diffuse osteoblastic metastasis. Large metastasis was related to positive bone scan uptake in spinal bony metastasis.