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Efficacy and Safety of a Newly Developed Self-Expanding Open-Cell Type Nitinol Stent for Peripheral Arteries: A Preclinical Study in Minipigs (새로 개발된 말초동맥용 자가팽창성 개방형 니티놀 스텐트의 유효성 및 안전성 평가: 미니피그 전임상실험)

  • Min Uk Kim;Jae Hwan Lee;Chang Jin Yoon;Won Seok Choi;Saebeom Hur;Jin Wook Chung
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.899-911
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    • 2020
  • Purpose To evaluate the safety and efficacy of the newly designed open-cell type self-expandable nitinol stent (NiTi-stent) for peripheral arteries. Materials and Methods Twenty-eight limbs of 14 minipigs were randomly assigned to the NiTistent group or conventional nitinol stent group. Stents were symmetrically implanted into the iliac arteries of each animal using carotid artery approach and were observed for 1 month (n = 5) and 6 months (n = 9). The angiographic lumen diameter (ALD), late lumen loss, angiographic stenosis, histomorphometric lumen area, neointimal area, and area stenosis were analyzed and compared between the groups. Results Stent migration, stent fracture, or thrombus formation were not observed in either group. At the 1-month follow-up, the neointimal area (p = 0.008) and area stenosis (p = 0.016) were significantly smaller in the NiTi-stent group than in the control group. At the 6-months followup, the NiTi-stent group showed significantly larger ALD (p = 0.014), less late lumen loss (p = 0.019), less angiographic stenosis (p = 0.014), larger lumen area (p = 0.040), and smaller neointimal area and area stenosis (p = 0.004 and p = 0.014, respectively) compared with the control group. Conclusion The NiTi-stent is as safe and effective as the conventional nitinol stent and induces less neointimal hyperplasia in a minipig iliac artery model.

Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels (주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성)

  • Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1207-1217
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    • 2021
  • Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.

Light-Chain Cardiac Amyloidosis: Cardiac Magnetic Resonance for Assessing Response to Chemotherapy

  • Yubo Guo;Xiao Li;Yajuan Gao;Kaini Shen;Lu Lin;Jian Wang;Jian Cao;Zhuoli Zhang;Ke Wan;Xi Yang Zhou;Yucheng Chen;Long Jiang Zhang;Jian Li;Yining Wang
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.426-437
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    • 2024
  • Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with light-chain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49-63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At follow-up after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%-1.1%] vs. 1.7% [-5.5%-7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%-1.3%] vs. 2.0% [-3.0%-5.0%]; P = 0.01) compared with those with inferior response. Conclusion: Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

Early Recurrence of Breast Cancer after the Primary Treatment: Analysis of Clinicopathological and Radiological Predictive Factors (유방암 일차치료 후 조기 재발: 임상병리학적 및 영상의학적 예측인자 분석)

  • Sun Geun Yun;Yeong Yi An;Sung Hun Kim;Bong Joo Kang
    • Journal of the Korean Society of Radiology
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    • v.81 no.2
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    • pp.395-408
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    • 2020
  • Purpose To evaluate the value of clinicopathologic factors and imaging features of primary breast cancer in predicting early recurrence after the primary treatment. Materials and Methods We enrolled 480 patients who had been followed-up after breast-conserving surgery and adjuvant therapy from January 2010 to December 2014 at our hospital. Early recurrence was defined as recurrence within 3 years after completion of primary treatment, and univariate and multivariate logistic regression analyses were performed to determine the clinicopathologic and imaging predictive factors of early recurrence. Results In the univariate analysis, among the clinicopathologic factors, advanced stage (p = 0.021), high histologic grade (p < 0.001), estrogen receptor negative (p = 0.002), high Ki-67 proliferation index (p = 0.017), and triple-negative breast cancer (p = 0.019), and among the imaging features, multifocality (p < 0.001), vessels in the rim on Doppler ultrasonography (US) (p = 0.012), and rim enhancement (p < 0.001) on magnetic resonance imaging of the breast were significantly associated with early recurrence. In the multivariate analysis, advanced stage [odds ratio (OR) = 3.47; 95% confidence interval (CI) 1.12-10.73; p = 0.031] and vessels in the rim on Doppler US (OR = 3.32; 95% CI 1.38-8.02; p = 0.008) were the independent predictive factors of early recurrence. Conclusion Vascular findings in the rim of the primary breast cancer on Doppler US before treatment is a radiologic independent predictive factor of early recurrence after the primary treatment.

Single Center Experience of the Balloon-Stent Technique for the Treatment of Unruptured Distal Internal Carotid Artery Aneurysms: Sharing a Simple and Reliable Tip to Use Scepter-Atlas Combination (원위내경동맥에 위치한 비파열성 동맥류의 치료에 있어 풍선-스텐트 테크닉에 대한 단일기관의 경험: Scepter-Atlas 조합을 사용하기 위한 간단하지만 확실한 방법)

  • Yu-jung Park;Jieun Roh;Seung Kug Baik;Jeong A Yeom;Chul-Hoo Kang;Hee Seok Jeong;Sang Won Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1258-1273
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    • 2021
  • Purpose The balloon-stent technique (BST) has certain strengths as an assisted technique for the treatment of complex aneurysms. After Atlas release, the BST can be executed without an exchange maneuver of the balloon to the stent-delivery catheter. The purpose of this article is to share our experience with the BST using the Scepter-Atlas combination. Materials and Methods Device inspection led us to a simple method to avoid failure in loading Atlas to the Scepter. From March 2018 to December 2019, 57 unruptured distal internal carotid artery (dICA) aneurysms were treated with coil embolization; among which, 25 aneurysms in 23 patients were treated with BST. Clinical and angiographic data were retrospectively collected and reviewed. Results The technical success rate of the Scepter-Atlas combination increased from 50% to 100% after careful inspection. BST angiographic results were comparable to the stent-assisted coil (SAC) group treated during the immediately post-embolization same period (modified Raymond-Roy classification [MRRC] 1 & 2 84% in BST, 96.3% in SAC) and during short-term follow-up (MRRC 1 & 2 95.8% in BST, 88.4% in SAC). A small number of patients showed periprocedural complications, but none had clinical consequences. Conclusion BST using the Scepter-Atlas combination can provide an effective and safe method for the treatment of dICA aneurysms. Scepters can be used as delivery catheters for Atlas.

First-Pass Recanalization with EmboTrap II in Acute Ischemic Stroke (FREE-AIS): A Multicenter Prospective Study

  • Jang-Hyun Baek;Byung Moon Kim;Sang Hyun Suh;Hong-Jun Jeon;Eun Hyun Ihm;Hyungjong Park;Chang-Hyun Kim;Sang-Hoon Cha;Chi-Hoon Choi;Kyung Sik Yi;Jun-Hwee Kim;Sangil Suh;Byungjun Kim;Yoonkyung Chang;So Yeon Kim;Jae Sang Oh;Ji Hoe Heo;Dong Joon Kim;Hyo Suk Nam;Young Dae Kim
    • Korean Journal of Radiology
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    • v.24 no.2
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    • pp.145-154
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    • 2023
  • Objective: We aimed to evaluate the efficacy of EmboTrap II in terms of first-pass recanalization and to determine whether it could yield favorable outcomes. Materials and Methods: In this multicenter, prospective study, we consecutively enrolled patients who underwent mechanical thrombectomy using EmboTrap II as a front-line device. The primary outcome was the first pass effect (FPE) rate defined by modified Thrombolysis In Cerebral Infarction (mTICI) grade 2c or 3 by the first pass of EmboTrap II. In addition, modified FPE (mFPE; mTICI grade 2b-3 by the first pass of EmboTrap II), successful recanalization (final mTICI grade 2b-3), and clinical outcomes were assessed. We also analyzed the effect of FPE on a modified Rankin Scale (mRS) score of 0-2 at 3 months. Results: Two hundred-ten patients (mean age ± standard deviation, 73.3 ± 11.4 years; male, 55.7%) were included. Ninety-nine patients (47.1%) had FPE, and mFPE was achieved in 150 (71.4%) patients. Successful recanalization was achieved in 191 (91.0%) patients. Among them, 164 (85.9%) patients underwent successful recanalization by exclusively using EmboTrap II. The time from groin puncture to FPE was 25.0 minutes (interquartile range, 17.0-35.0 minutes). Procedure-related complications were observed in seven (3.3%) patients. Symptomatic intracranial hemorrhage developed in 14 (6.7%) patients. One hundred twenty-three (58.9% of 209 completely followed) patients had an mRS score of 0-2. Sixteen (7.7% of 209) patients died during the follow-up period. Patients who had successful recanalization with FPE were four times more likely to have an mRS score of 0-2 than those who had successful recanalization without FPE (adjusted odds ratio, 4.13; 95% confidence interval, 1.59-10.8; p = 0.004). Conclusion: Mechanical thrombectomy using the front-line EmboTrap II is effective and safe. In particular, FPE rates were high. Achieving FPE was important for an mRS score of 0-2, even in patients with successful recanalization.

CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology (확산강조영상에서 미만성 대뇌 백질의 이상을 보이는 신생아 경련 환자에서 구조적 이상이나 대사와 관련된 원인이 없을 경우 임상적 소견과 영상 소견의 특징)

  • Maeran Kim;Jae-Yeon Hwang;Yeoun Joo Lee;Yong-Woo Kim;Shin Yun Byun;Yun-Jin Lee;Jeong A Yeom;Ung Bae Jeon;Ki Seok Choo;Kyung Jin Nam;Storm Nicholas Shaun Reid
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1412-1423
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    • 2020
  • Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.

A Comparative Study on the Laying Performance and Egg Quality of the Korean Native Commercial Chicken and Hy-Line Brown (산란용 토종닭 실용계와 하이라인 브라운의 산란능력 및 계란분석 비교 연구)

  • Haeeun Park;Myunghwan Yu;Eunsoo Seo;Elijah Ogola Oketch;Shan Randima Nawarathne;Nuwan Chamara Chathuranga;Bernadette Gerpacio Sta. Cruz;Venuste Maniraguha;Jeseok Lee;Hyunji Choi;Jung Min Heo
    • Korean Journal of Poultry Science
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    • v.51 no.2
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    • pp.83-95
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    • 2024
  • This study aimed to assess the performance of laying hens across twelve crossbreed strains (i.e., CFCK, CFYC, CFYD, CKCF, CKYC, CKYD, YCYD, YCCF, YCCK, YDCF, YDCK, and YDYC) of Korean native chicken (KNC) and compare them with Hy-Line Brown layers. A total of 287 18-week-old laying hens were placed in battery cages by strains (2-5 birds per pen). Results indicated that the YCYD and YDYC strains exhibited numerically heavier body weights than Hy-Line Brown at week 18-64. CKYC and YDYC strains demonstrated more than 94% viability by week 64. The CFYC strain had an age of first egg laying of 127 days, and the YDCF strain reached an age of 50% egg production at 140 days, both earlier than their parent stock. The YDCF strain showed over 70% egg production for up to 60 weeks. Regarding egg quality, the CKCF and YCCF strains had numerically higher egg weights among the KNC groups at week 24-64, with the YDYC strain showing a darker (P<0.05) eggshell color compared to CKCF at week 40. Moreover, KNC crossbreeds showed a higher (P<0.05) egg yolk ratio than Hy-Line Brown. In conclusion, the YDCF and YCCF crossbreeds exhibited the most desirable new synthetic Korean native commercial layer based on egg production and quality parameters. Therefore, these strains could be a viable substitute for Hy-Line Brown layers.

The Study on the Effects of Technology Orientation and Market Orientation on Managerial Performance in Innopolis Start-ups: Focusing on the Moderating Effects of Marketing and R&D Expenses (연구소기업의 기술지향성과 시장지향성이 경영성과에 미치는영향: 마케팅 및 연구개발 비용의 조절효과를 중심으로)

  • Kwon, Haram;Yang, Young Seok
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.119-133
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    • 2024
  • As a result of significant investments by the government in promoting public technology commercialization and fostering a venture startup ecosystem, there have been quantitative achievements, such as the registration of over 1,600 Innopolis Start-ups since 2006, generating a total revenue of 1.1 trillion won as of 2021. However, these achievements have been overshadowed by critical qualitative challenges, including a continuous decline in average revenue per Innopolis Start-up. This led to a focus on whether managers' technological and market orientations affect business performance. This study aims to provide insights into improving the qualitative growth of Innopolis Start-ups by analyzing the effects of technological and market orientations on business performance, as well as the moderating effects of adjusting marketing and research and development (R&D) costs on this relationship. Through prior research and empirical analysis, this study derives three main findings. First, technological excellence and innovation significantly influence the business performance of Innopolis Start-ups, while technological intensity does not. Second, customer orientation and competitive orientation significantly impact business performance, whereas entry barriers as a single factor do not. Third, adjusting marketing and R&D costs, as controlled variables obtained through general situations, has no direct impact on other variables. However, it interacts with entry barriers, influencing financial business performance, with R&D costs exhibiting a negative buffering effect and marketing costs showing a positive enhancing effect. This study confirms that both technological and market orientations directly influence the business performance of Innopolis Start-ups, thus being crucial factors affecting their growth. Moreover, it establishes that investments in marketing and R&D play significant roles in alleviating initial entry barriers and enhancing financial performance. Consequently, it underscores the importance of reinforcing technological and market orientations tailored to the characteristics of Innopolis Start-ups. Additionally, it proposes five theoretical contributions: strengthening institutional support systems for technology commercialization and innovation, improving qualitative evaluation criteria during the selection process of Innopolis Start-ups, conducting comprehensive analyses of technological and market aspects during startup selection, enhancing support for marketing education and consulting for smooth market entry, and supporting expenditure strategies and milestone setting tailored to the industrial characteristics of individual Innopolis Start-ups.

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