• Journal of Genetic Medicine
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• v.6 no.2
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• pp.175-178
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• 2009

The 22q11.2 duplication syndrome is an extremely variable disorder with a phenotype ranging from normal to congenital defects and learning disabilities. Recently, the detection rate of 22q11.2 duplication has been increased by molecular techniques, such as array CGH. In this study, we report a familial case of 22q11.2 duplication detected prenatally. Her first pregnancy was terminated because of 22q11.2 duplication detected incidentally by BAC array CGH. The case was referred due to second pregnancy with same 22q11.2 duplication. We perfomed repeat amniocentesis for karyotype and FISH analysis. Karyotype analysis from amniocytes and parental lymphocytes were normal, while FISH analysis of interphase cells presented a duplication of 22q11.2 in the fetus and phenotypically normal mother. The fetal ultrasound showed grossly normal finding. After genetic counseling about variable phenotype with intrafamilial variability with 50% recurrence rate, the couple decided to continue the pregnancy. The newborn had no apparent congenital abnormalities until 2 weeks after birth. We recommend that family members of patients with a 22q11.2 duplication be tested by the interphase FISH analysis. Also, we point out the importance of genetic counseling and an evaluation of the clinical relevance of diagnostic test results.

• Journal of the Korean Society of Radiology
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• v.81 no.1
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• pp.147-156
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• 2020

Purpose The objective of this study was to evaluate the diagnostic value and threshold levels of cytokeratin fragment 21-1 (CYFRA 21-1) in fine-needle aspiration (FNA) washouts for detection of lymph node (LN) recurrence in postoperative breast cancer patients. Materials and Methods FNA cytological assessments and CYFRA 21-1 measurement in FNA washouts were performed for 64 axillary LNs suspicious for recurrence in 64 post-operative breast cancer patients. Final diagnosis was made on the basis of FNA cytology and follow-up data over at least 2 years. The concentration of CYFRA 21-1 was compared between recurrent LNs and benign LNs. Diagnostic performance and cut-off value were evaluated using a receiver operating characteristic curve. Results Regardless of the non-diagnostic results, the median concentration of CYFRA 21-1 in recurrent LNs was significantly higher than that in benign LNs (p < 0.001). The optimal diagnostic cut-off value was 1.6 ng/mL. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CYFRA 21-1 for LN recurrence were 90.9%, 100%, 100%, 98.1%, and 98.4%, respectively. Conclusion Measurement of CYFRA 21-1 concentration from ultrasound-guided FNA biopsy aspirates showed excellent diagnostic performance with a cut-off value of 1.6 ng/mL. These results indicate that measurement of CYFRA 21-1 concentration in FNA washouts is useful for the diagnosis of axillary LN recurrence in post-operative breast cancer patients.

• Journal of Veterinary Clinics
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• v.12 no.1
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• pp.861-876
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• 1995

This study was carried out to get fundamental information about the normal ultrasonogram of the liver and heart in Korean native cattle and calves. The interventricular septum, left ventricular internal diameter, left ventricular free wall thickness, aortic diameter, left atrial diameter, and right ventricular internal diameter of hear in 10 Korean native calves were determined at 4-5 right intercostal spare by use of ultrasonography. The caudal vena cava, portal vein, gallbladder, liver of 9 Korean native cattle and 10 calves were determined at 12, 11 and 10th intercostal spares by use of ultrasonography. Cursor-directed M-mode and gray-scale, B-mode ultrasonograms were obtained with electronic scanning ultrasound equipment with a 3.5 or 5.0-MHz convex transducer. The results obtained through the experiments were summarized as follows: 1. The result of ultrasonographic examination of the korean native calves' heart 1) Interventricular septum in systole and diastole was 1.23 and 0.81 cm, respectively(vc=28.84, 17.4). 2) Ventricular internal diameter in systole and diastole was 2.50 and 4.91 cm, respectively(vc=17.44, 12.73). 3) Left ventricular free was thickness in systole and diastole was 1.44 and 0.92 cm, respectively(vc=26.85, 23.54). 4) Aortic diameter was 2.69.m, .rspectevely(vc=11.29). 5) Left atrial diameter was 1.82 cm(vc=15.31). 6) Right ventricular internal diameter in systole and diastole was 1.12 and 1.9 cm, respectively(vc=33.71, 24.43). 3. Ultrasonographic measurments of caudal vena cava, portal vein, gallbladder of Korean native calves 1) Dorsal margin of caudal vena cava at the 12, 11 and 10th intercostal space was 13.5, 15.3 and 18.1 cm, respectively(p<0.01). 3) Depth of caudal vena cava at the 12, 11 and 10th intercostal space was 4.4, 4.5 and 4.6 cm, respectively. 3) Diameter of caudal vena cava at the 12, 11 and 10th intercostal space was 11.6, 1.7 and 1.6 cm, respectively. 4) Dorsal margin of portal vein at the 12, 11 and 10th intercostal space was 16.2, 18.6 and 21.4 cm, respectively(p<0.01) 5) Depth of portal vein at the 12, 11 and 10th intercostal spare was 4.5, 4.4 and 3.9 cm respectively. 6) Diameter of portal vein at the 13, 11 and 10th intercostal space was 2.1, 2.2 and 1.9 cm respectively. 7) Dorsal margin of gallbladder at the 11 and 10th intercostal space was 23.6 and 23.9 cm, respectively(p<0.01), 8) Longitudinal diameter of gallbladder at the 11 and 10th intercostal space was 7.1 and 5.9 cm, respectively(p<0.05). 9) Transverse diameter of gallbladder at the 11 and 10th intercostal space was 2.4 and 2.1 cm respectively(p<0.01). 3. Ultrasonographic measurments of caudal vena cava, portal vein, gallbladder of Korean native cattle 1) Dorsal margin of caudal vena cava at the 12 and 11th intercostal space was 22.2, and 25.4 cm, respectively(p<0.01). 2) Depth of caudal vena cava at the 12 and 11th intercostal space was 103 and 11.1 cm, respectively(p<0.01). 3) Diameter of caudal vena cava at the 12 and 11th intercostal space was 3.1 and 3.0 cm, respectively. 4) Dorsal margin of portal vein at the 12 and 11th intercostal space was 29.3 and 32.9 cm, respectively(p<0.01). 5) Depth of portal vein at the 12 and 11th intercostal space was 9.6, and 9.2 cm, respectively. 6) Diameter of portal vein at the 12 and lith intercostal space was 3.4 and 3.3 cm, respectively. 7) Dorsal margin of gallbladder at the 11 and 10th intercostal space was 43.1 and 45.5 cm, respectively(p<0.01). 8) Longitudinal diameter of gallbladder at the 11 and 10th intercostal space was 10.1 and 9.4 cm, respectively. 9) Transverse diameter of gallbladder at the 11 and 10th intercostal space was 4.0 and 3.7 cm, respectively. 4, Ultrasonogaphic measurments of dorsal margin, ventral margin, size and angles of the Korean native calves' liver. 1) Dorsal margin of liver at the 12, 11 and 10th intercostal space was 11.0, 9.6, and 12.4 cm, respectively(p<0.01). 2) Ventral margin of liver at the 12, 11 and 10th intercostal spate was 20, 24 and 26.1 cm, respectively(p<0.01). 3) Size of the liver at the 12, 11 and 10th intercostal space was 9.0, 14.6 and 13.8 cm, respectively(p<0.01). 4) Angle of liver at the 12, 11 and 10th intercostal space was 40, 46 and 37, respectively(p<0.01). 5. Ultrasonographic measurmants of dorsal margin, ventral margin, size and anglses of the korean native cattle's liver 1) Dorsal margin of the liver at the 12, 11 and 10th intercostal space was 14.4, 18.2 and 26, 3 cm, respectively. 2) Ventral margin of liver at the 12, 11 and 10th intercostal space was 41.1, 46.4 and 49.3 cm, respectively(p<0.01). 3) Size of the liver at the 12, 11 and 10th intercostal space was 26.8, 28.2 and 23.2 cm, respectively(p<0.01). 4) Angel of liverat the 15, 11 and 10 intercostal space was 41, 40.6 and 35.7, respectively(p<0.05). It was concluded that the ultrasonographic values oletermined in this study can be used as references for the diagnosis of morphologic changes in the hear and liver in korean native calves, and in the liver in korean native rattle.

• Journal of radiological science and technology
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• v.35 no.3
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• pp.237-248
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• 2012

Postpartum depression(PPD) of women with depression increased frequency of thyroid disease, and so the correlations for depression and thyroid disease has been the subject of discussed whether. The purpose of this study was to predict the prevalence of PPD and the correlation between PPD and thyroid disease through ultrasonography. January 2010 to November 2011, Obstetrics & Gynecology in M-clinical center admitted 230 patients within 1 year postpartum were enrolled. EPDS by PPD scale depression screening and general characteristics of subjects were investigated and thyroid was examined that ultrasonography and thyroid blood tests. A total of 230 patients non PPD group were 53.0% and PPD group were 47.0%. In ultrasonography, among 27 patients who changed in size of thyroid, non PPD group were 14.8% and PPD group were 85.2%. Among 124 patients who thyroid nodules were presence, non PPD were 35.8% and PPD group were 64.2%. In ultrasonography, PPD group were higher incidence than non PPD group were changes in size of thyroid and the presence of nodules. There was significant difference between the changed in size of thyroid and thyroid nodules were presence the two group. Definitive histopathological diagnosis was benign in 33 patients (non PPD group were 45.5%, PPD group were 54.5%), malignancy in 5 patients (only PPD group were 100%), thyroiditis in 3 patients (non PPD group were 33.3%, PPD group were 66.7%). The results of thyroid blood tests, abnormal TSH level were 7 patients (non PPD group were 28.6%, PPD group were 71.4%) and abnormal Free T4 level were 9 patients (non PPD group were 44.4%, PPD group were 55.6%). There was no significant difference between the abnormal TSH level and Free T4 level of the two group. 5 patients were diagnosed as thyroid dysfunction. Of these, 2 patients were subclinical hyperthyroidism in non PPD group, 2 patients were subclinical hyperthyroidism and 1 patient was subclinical hyperthyroidism in PPD group. This study was significant the correlation between PPD and thyroid gland disease through ultrasonography. And the objective results of this study might be able to provide guideline that understanding, prevention and treatment for PPD and thyroid disease.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.149-159
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• 2008

The purposes of this study are to analyze abnormal dilatation of the extrahepatic bile ducts by using transabdominal ultrasound, to confirm the existence of bile ducts diseases and their interrelationship, and for it to give a new theoretical basis for the technical access to extrahepatic bile ducts, upon which to analyze the ripple effects of the scan training. After teaching technical access process based on the new theory about extrahepatic bile duct to the thirty students who are studying ultrasonography, we allocated three hours per one student (30 mins ${\times}$ 6 times) to focus on the training of scanning skill. Training has been performed by one-to-one method. For evaluation, all the students have to perform the scans on (1) confluence of the right and left hepatic ducts (extrahepatic bile ducts and cystic duct), (2) the suprapancreatic bile duct, (3) the intrapancreatic bile duct, (4) intrapapilla Duct, based on the clearly divided concept. The existing training and methods have had low confidency about transabdominal ultrasonography of the extrahepatic bile duct and had limitation with which they could image only the suprapancreatic bile duct. The evaluation after finishing the train based on the new theory, however, all the students (30students) can access to (1) confluence of the right and left hepatic ducts(extrahepatic bile ducts and cystic duct), (2) the suprapancreatic bile duct objectively. 24 students can access to (3) the intrapancreatic bile duct and only one student can even make an image for (4) the intrapapilla Duct Though the evaluation on extrahepatic bile duct has to be performed with multi-sided method considering intrahepatic cause, bile duct cause and pathophysiological cause, only if we can image the extrahepatic bile duct to ampular of Vater objectively and confidently, we can greatly reduce invasive procedure such as ERCP, which is for the purpose of simple differential diagnosis and painful to the patients. Therefore if we concentrate on the scanning train based on the new theory to raise the confidency about ultrasonography, the effect will be doubled.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.161-169
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• 2008

Since measuring the size of kidney with sonography becomes an important index for diagnosis, treatment, and prognostic prediction in kidney disease, the accurate measurement and evaluation on this are clinically very important. Accordingly, the purpose of this study was to increase reproducibility and objectivity in measuring the size of kidney by enumerating factors that have an impact for measurement. It targeted 44 adults in Korea at the age of 21-27. It measured in order for both kidneys to be seen most largely while changing a subject-examiner's position in a state of fasting for 8 hours and a transducer's approaching direction. It compared a size of kidney by measuring, respectively, with the same method in 30 minutes and in 1 hour after drinking water in 700-1,000cc. In case of the lateral approach scan in decubitus position, the average length of the kidney both to the right and the left and the deviation of measurement to be the largest. In NPO(None Per Oral) state, the average length in the right kidney was 10.19cm, and the average length in the left kidney was 10.33cm. In 60 minutes after taking moisture, the average length in the right kidney was 10.94cm, and the average length in the left kidney was 11.13cm. In comparing the average length of the kidney in NPO state and its average length in 60 minutes after taking moisture, the size swelled by 7.3% for the length in the right kidney and by 7.7% in the left, thereby having been indicated to be statistically significant(P<0.003). The measurement in a size of kidney by using ultrasound may be measured differently depending on a patient's state of taking moisture and a transducer's approaching direction. It is thought that when the measurement in a size of kidney is especially important clinically, the intake and intake time in moisture need to be considered and that measuring with the posterior approach in prone position is a good method aiming to increase reproducibility in measuring length of the kidney.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.265-270
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• 2003

Purpose : To characterize the infants under 3 months of age with urinary tract infections(UTIs), and especially patients with bacteremia or meningitis Methods : Hospital records of all the infants under 3 months of age discharged from our hospital for 69 consecutive months with the diagnosis of initial episode of UTI were reviewed. UTI was defined when patients had fever with pyuria, and had urine culture results of ${\geq}10^5$ colony forming units/mL from a bag specimen. Patients with previously known urologic abnormality or immunodeficiency were excluded. Nosocomial infections were also excluded from the study. Results : The male:female ratio was 35 : 6. Of the urine cultures, 40(97.6%) yielded single pathogen, one yielded two pathogens. Escherichia coli was the predominant isolate from the urine. Five patients(12%) also had bacteremia. Pathogens isolated from the blood cultures were E. coli(4) and Enterococcus faecalis(1). No patient had culture-positive meningitis or cerebrospinal fluid pleocytosis. Clinical or laboratory findings between patients with and without bacteremia were not different significantly. The rate of vesicoureteral reflux(VUR) was 44%. The sensitivity of ultrasound for detection of VUR was 38%; specificity was 50%. Conclusion : Clinical and laboratory data were not helpful for identifying patients with bacteremia at the time of presentation. Consequently, blood cultures need to be obtained from all febrile infants under 3 months of age with UTIs. A large-scale study including the indication of lumbar puncture for infants with a febrile UTI and study of evaluation and treatment of infants under 3 months of age with UTIs are required.

• Tuberculosis and Respiratory Diseases
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• v.41 no.4
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• pp.397-404
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• 1994

Background: To decide the optimal antibiotics and application of chest tube, examination of pleural fluid is fundamental in the management of empyema. Some criteria for drainage of pleural fluid have been recommended but some controversies have been suggested. Recently, newer radiologic methods including ultrasound and computed tomography scanning, have been applied to the diagnosis and management of pleural effusions. We undertook a retrospective analysis of 30 patients with pleural effusion who had CT scans of the chest in order to apply the criteria of Light et al retrospectively to patients with loculation and to correlate the radiologic appearance of pleural effusions with pleural fluid chemistry. Method: We analyzed the records of 30 out of 147 patients with pleural effusion undergoing chest CT scans. Results: 1) Six of the pleural fluid cultures yielded gram negative organisms and three anaerobic bacterias and one Staphylococcus aureus and one non-hemolytic Streptococci. No organism was cultured in ninteen cases(63.0%). 2) The reasons for taking chest CT scans were to rule out malignancy or parenchymal lung disease(46.7%), poor response to antibiotics(40.0%), hard to aspirate pleural fluid(10.0%) and to decide the site for chest tube insertion(3.3%). 3) There was no significant correlations between ATS stages and loculation but there was a tendency to loculate in stage III. 4) There was a significant inverse relationship between the level of pH and loculation(p<0.05) but there appeared to be no relationship between pleural fluid, LDH, glucose, protein, loculation and pleural thickening. 5) In 12 out of 30, therapeutic measures were changed according to the chest CT scan findings. Conclusion: We were unable to identify any correlations between the plerual fluid chemistry, ATS stages and loculations except pH, and we suggest that tube thoracotomy should be individualized according to the clinical judgement and serial observation. All patients with empyema do not need a chest CT scan but a CT scan can provide determination of loculation, guiding and assessing therapy which should decrease morbidity and hospital stay.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.267-274
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• 2006

The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.