• Childhood Kidney Diseases
• /
• v.13 no.1
• /
• pp.40-48
• /
• 2009

Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.3
• /
• pp.110-122
• /
• 2009

Purpose: Nowadays, A medical institution assesment could get more interest about a quality of medical services from many hospitals that developed the active activities for improving medical services. Also, there is an other additional issue which is the patients risk management. Uijeongbu ST. Mary's hospital Nuclear Medicine department has been changed many work process after PET-CT introduction and renovation of its place since 2008. Therefore, modified structure and the way of existing work process have contained risk factors. The purpose of this study would be the appropriate risk management process while imaging examination process, the removal risk factors and improved activities through the analysis risk factors. Materials and Methods: Nuclear Medicine department new process should analysis through many-sided, Firstly, make and trained risk management manual after then apply an actual work. Result analysis showed the number of risk accident occurrence that comparing the last year and after the improved activities. Secondly, producing risk management public relations film has been showed an applicable patient after then the customer service measurement checked for a hundred patient by questionnaire. Lastly, Risk factors were eliminated through the facilities participation improving activities which could change for the better risk factors. Results: The number of safety accident occurrence(medication error, fall and collision) were checked as zero after the improving activities both PET-CT and gamma camera examination. The results of questionnaire showed as follows; 74% marked as understanding of the test process and 81% checked "satisfaction" after the public relations film showing. The question "Did you consider about the risk factors?", both PET-CT and gamma camera checked as 94% and 89% respectively. Customer risk management could be accomplished effectively through the improving activities at the nuclear medicine department. Conclusions: The study would be an opportunity that spread risk factors were systematically showed and analyzied. Also, It showed the possibility of the minimized safety accident and its feedback, if application of the response manuel that could be a standard of radiology technician's work method to react safety accident. It was the more effective that visual material could be easy to approach as a methodology of risk factors. As far as I have concerned that It could help the safety and convenience through continuous and detailed activities that offer to patients.

• Journal of the Korean Arthroscopy Society
• /
• v.5 no.1
• /
• pp.17-21
• /
• 2001

Purpose : To analyze changes of the anterior translation, MRI findings and associated injuries at scarring of the torn ACL in the chronic ACL rupture. Materials & Method : From Dec. 1996 to May 2000, 19 patients who were diagnosed as the chronic ACL rupture were studied. We analyzed KT-2000 side to side difference of maximal manual anterior displacement(MMAD), MRI findings and associated injuries. Results : There was statistically significant difference in the average MMAD between the 7 cases$(37\%)$ with scar formation$(2.78{\pm}2.41mm)$ and the 12 cases without scarring$(5.75{\pm}2.52mm)$. The chronic ACL rupture without scarring had more meniscal injuries$(67\%)$ than with scarring$(28\%)$. MRI showed that relatively straight bands toward expected insertion site with single large fragment(5 cases) and continuous band with focal angulation(2 cases). Conclusion : If relatively straight bands toward expected insertion site with single large fragment or continuous band with focal angulation on MR imaging is showed in the patient without significant anterior translation at arthrometer, the possibility of the scar formation of the torn ACL should be considered. We think that the chronic ACL rupture with scarring had less meniscal injuries than without scarring will give additional information on the natural history of ACL injuries.

• Investigative Magnetic Resonance Imaging
• /
• v.1 no.1
• /
• pp.94-102
• /
• 1997

Purpose: There have been some efforts to diagnose intracranial aneurysm through a non-invasive method using MRA, although the process may be difficult when the lesion is less than 3mm. The present study prospectively compares the results of high resolution, fast speed slice interpolation MRA and DSA thereby examing the potentiality of primary non-invasive screening test. Materials and Methods: A total of 26 cerebral aneurysm lesions from 14 patients with subarachnoid hemorrhage from ruptured aneurysm (RA) and 5 patients with unruptured aneurysm(UA). In all subjects, MRA was taken to confirm the vessel of origin, definition of aneurysm neck and the relationship of the aneurysm to nearby small vessels, and the results were compared with the results of DSA. The images were obtained with 1.5T superconductive machine (Vision, Siemens, Erlangen, Germany) on 4 slabs of MRA using slice interpolation. The settings include TR/TE/FA=30/6.4/25, matrix $160{\times}512$, FOV $150{\times}200$, 7minutes 42 seconds of scan time, effective thickness of 0.7 mm and an entire thickness of 102. 2mm. The images included structures from foramen magnum to A3 portion of anterior cerebral artery. MIP was used for the image analysis, and multiplanar reconstruction (MPR) technique was used in cases of intracranial aneurysm. Results: A total of 26 intracranial aneurysm lesions from 19 patients with 2 patients having 3 lesion, 3 patients having 2 lesions and the rest of 14 patients having 1 lesion each were examined. Among those, 14 were RA and 12 were UA. Eight lesions were less than 2mm in size, 9 lesions were 3-5mm, 7 were 6-9mm and 2 were larger than IOmm. On initial exams, 25 out of 26 aneurysm lesions were detected in either MRA or DSA showing 96% sensitivity. Specificity cannot be estimated since there was no true negative of false positive findings. When MRA and MPR were used concurrently for the confirmation of size and shape, the results were equivalent to those of DSA, while in the confirmation of aneurysm neck and parent vessels, the concurrent use of MRA and MPR was far superior to the sole use of either MRA or DSA. Conclusion: High resolution MRA using slice interpolation technique showed equal results as those of DSA for the detection of intracranial aneurysm, and may be used as a primary non-invasive screening test in the future.

• Investigative Magnetic Resonance Imaging
• /
• v.8 no.1
• /
• pp.24-31
• /
• 2004

Purpose : To know the differences of proton MR spectroscopic features between recurrent rectal cancer and fibrosis in post-operative period, and to evaluate the possibility to discriminate recurrent rectal cancer from post-operative fibrosis by analysis of proton MR spectra. Materials and Methods : We evaluated the proton MR spectra from 25 soft tissue masses in perirectal area that developed in post-operative period after operation for the resection of rectal cancer. Our series included 11 cases of recurrent rectal cancer and 14 of fibrotic mass. All cases of recurrent rectal cancer and post-operative fibrosis were confirmed by biopsy. We evaluated the spectra with an attention to the differences of pattern of the curves between recurrent rectal cancer and post-operative fibrosis. The ratio of peak area of all peaks at 1.6-4.1ppm to lipid (0.9-1.6ppm) [P (1.6-4.1ppm/P (0.9-1.6ppm)] was calculated in recurrent rectal cancer and post-operative fibrosis groups, and compared the results between these groups. We also evaluated the sensitivity and specificity for discriminating recurrent rectal cancer from post-operative fibrosis by analysis of $^1H-MRS$. Results : Proton MR spectra of post-operative fibrosis showed significantly diminished amount of lipids compared with that of recurrent rectal cancer. The ratio of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis was much higher than that of recurrent rectal cancer with statistical significance (p < .05) due to decreased peak area of lipids. Mean (standard deviations of P (1.6-4.1ppm)/P (0.9-1.6ppm) in post-operative fibrosis and recurrent rectal cancer group were $2.71{\pm}1.48\;and\;0.29{\pm}0.11$, respectively. With a cut-off value of 0.6 for discriminating recurrent rectal cancer from post-operative fibrosis, both the sensitivity and specificity were $100\%$ (11/11, and 14/14). Conclusion : Recurrent rectal cancer and post-operative fibrosis can be distinguished from each other by analysis of proton MR spectroscopic features, and $^1H-MRS$ can be a new method for differential diagnosis between recurrent rectal cancer and post-operative fibrosis.

• Journal of Chest Surgery
• /
• v.42 no.2
• /
• pp.201-205
• /
• 2009

Background: Cryosurgery has been used to treat primary malignant pulmonary tumors at our institute since November 2004. In this study we analyzed our treatment results and complication rates. Material and Method: A retrospective study using medical charts and imaging data was conducted involving 17 patients with a total of 17 malignant pulmonary tumors who were treated between November 2004 and March 2007. Fourteen patients were males and 3 were females. The median age of the patients was 64 years (range, $54{\sim}77$ years). The average size of the tumors was 48.8mm (range, $36{\sim}111mm$) in diameter. The patients were followed with chest CT scans 7 days, 1 month, 3 months, and 6 months postoperatively. PET scans were obtained between 6 and 9 months postoperatively. The treatment response was analyzed according to the Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Result: Six months after treatment, 6 tumors (35.3%) showed a complete response, 4 (23.5%) had a partial response, 3 (17.6%) had stable disease, and 4 (23.5%) showed disease progression. In tumors <4 cm in diameter, a complete response was reported in 50% of the tumors. A $x^2$-test showed that in tumors <4 cm in diameter, the p-value for results better than a partial response was 0.034. With respect to procedural complications, there was 1 case of blood-tinged sputum which resolved spontaneously within 1 or 2 days, a spontaneously relieved case of subcutaneous emphysema, and 1 patient with a fever. There were no mortalities and the average hospital stay was 6.3 days. Conclusion: The effects of cryosurgery on primary lung cancer is greatest in patients with small tumors. Considering the facts that cryosurgery is minimally invasive, has a low complication rate, and can be performed repetitively, we believe that it may play an important role in the treatment of high risk lung cancer patients.

• Journal of Chest Surgery
• /
• v.42 no.1
• /
• pp.63-71
• /
• 2009

Background: The treatment of tracheal stenosis includes less invasive bronchoscopic intervention and more invasive segmental resection & anastomosis. Depending on the patient's clinical features, sometimes all these methods are inappropriate. Silicone T-tube stenting has recently been used as an alternative, safe management of tracheal stenosis. We studied the short term and Intermediate term results of using T-tubes in patients with tracheal stenosis, and this tracheal stenosis was caused by various underlying diseases. Material and Method: We retrospectively reviewed 57 patients with tracheal stenosis and who were treated with T-tubes between Jan 1997 and Apr 2007. Based on the patient's medical records and the imaging studies, we evaluated the clinical findings and status of T-tube removal. Result: There was no T-tube related morbidity or mortality in this series. On follow-up, one patient underwent sleeve resection and end-to-end anastomosis. The T-tube could be successfully removed from 13 patients (13/57, 22.8%) without additional interventions. For another four patients, a T-tube was again inserted after removal of the first T-tube due to tracheomalacia or recurrent stenosis. Four patients died of underlying disease and cancer. The patients' gender and previous tracheostomy significantly affected T-tube removal. By contrast, multiple logistic regression analysis identified gender as a predictor of successfully removing a T-tube. Gender (p=0.033) and previous tracheostomy (p=0.036) were the two factors for success or failure of T-tube removal. Conclusion: A T-tube provided reliable patency of a stenotic airway that was caused by any etiology. We have proven that using a T-tube is safe and effective therapy for patients with tracheal stenosis for the short term or the intermediate term.

• Journal of the Society of Cosmetic Scientists of Korea
• /
• v.38 no.4
• /
• pp.289-296
• /
• 2012

Cosmetic products which might augment the breast have attracted an attention and objective methods for the evaluation of such products are in high demand. This study was conducted to establish a method for assessing the breast-firmming effects of cosmetics. This study included a total of 30 healthy Korean females aged 20-50 years. A cosmetic product was applied by massaging it onto the breast twice a day for 8 weeks. Measurement of breast girth with a tape ruler, 2D and 3D digital image analyses, and Moir$\acute{e}$ topographic analysis were performed before and following the treatment. The application of a cosmetic onto the breast significantly increased breast girth at 2, 4 and 8 weeks without a significant change in underbreast girth, implicating the breast might be augmented. The 2D image analysis indicated that the arc length of the breast which represents the surface distance from the nipple to the periphery of the under-breast was significantly increased at 2, 4 and 8 weeks. The height of the breast which represents the perpendicular distance from the nipple to the periphery of the under-breast was also increased significantly at 4 and 8 weeks. The 3D image analysis of body surface also demonstrated a significant increase of breast volume at 2, 4 and 8 weeks. Moir$\acute{e}$ topographic analysis indicated that breast sagging was significantly reduced at 2, 4 and 8 weeks. The results of this study suggest that Moir$\acute{e}$ topography in combination with 2D and 3D digital image analyses may be useful for evaluating the breast-augmenting effects of cosmetics.

• Journal of Chest Surgery
• /
• v.42 no.4
• /
• pp.502-508
• /
• 2009

Background: Rib fractures are the most common injuries that are caused by blunt chest trauma. However, fractures of the costal cartilage generally go unnoticed on chest X-rays unless they involve a calcified cartilage. For this reason, the sensitivity of conventional radiography for detecting rib fractures is low, and especially those involving the cartilaginous part of the rib. Thus, we have evaluated the usefulness of ultrasonography for detecting fractures of the costal cartilage that were overlooked on the conventional radiographs of patients who suffered minor blunt chest traumas. Material and Method: A total of 45 patients who suffered minor blunt chest trauma and who had no evidence of rib fractures or other major fractures on conventional radiographs were admitted for ultrasonography between April 2008 and March 2009. There were 24 women and 21 men, and the mean age of the patients was 50.4$\pm$15.91 years (range: 17$\sim$76 years). They were examined for the detection of fractures of the costal cartilage by performing ultrasonography with a 7.5-MHz linear transducer. Result: A total of 30 patients (67%) had fractures of the costal cartilage, whereas 15 patients (33%) had no evidence of chondral rib fractures. The mean number of fracture sites of the fractured costal cartilage was 1.6$\pm$0.81 (range: 1$\sim$4 sites) in 30 patients. Periosteal hematoma was the most common finding associated with fractures of the costal cartilage (n=7, 17%), followed by sternum fracture (n=5, 12%). However, periosteal hematoma was noticed in 1 patient (2%) who was without fracture of the costal cartilage, and sternum fracture was noticed in 1 patient (2%) who was without fractures of the costal cartilage. Conclusion: The results of this study suggest that ultrasonography may be a useful imaging modality for detecting fractures of the costal cartilage that are overlooked on the conventional radiographs of patients who suffer minor blunt chest trauma.

• Asian Pacific Journal of Cancer Prevention
• /
• v.17 no.8
• /
• pp.3769-3776
• /
• 2016

Background: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. Materials and Methods: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's ${\chi}^2$ test and ANOVA were applied to examine associations between variables with p < 0.05 being considered significant. Results: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. Conclusions: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.