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Self-screening questionnaire for perianal fistulizing disease in patients with Crohn's disease

  • O Seong Kweon;Ben Kang;Yoo Jin Lee;Eun Soo Kim;Sung Kook Kim;Hyun Seok Lee;Yun Jin Chung;Kyeong Ok Kim;Byung Ik Jang
    • The Korean journal of internal medicine
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    • v.39 no.3
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    • pp.430-438
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    • 2024
  • Background/Aims: A poor prognostic factor for Crohn's disease (CD) includes perianal fistulizing disease, including perianal fistula and/or perianal abscess. Currently, a tool to assess perianal symptoms in patients with CD remains nonexistent. This study aimed to develop a perianal fistulizing disease self-screening questionnaire for patients with CD. Methods: This prospective pilot study was conducted at three tertiary referral centers between January 2019 and May 2020. We formulated questions on perianal symptoms, including tenesmus, anal discharge, bleeding, pain, and heat. A 4-point Likert scale was used to rate each question. Patients with CD completed a questionnaire and underwent pelvic magnetic resonance imaging (MRI). Results: Overall, 93 patients were enrolled, with 51 (54.8%) diagnosed with perianal fistulizing disease, as determined by pelvic MRI. The Spearman correlation findings demonstrated that anal pain (p = 0.450, p < 0.001) and anal discharge (p = 0.556, p < 0.001) were the symptoms that most significantly correlated with perianal disease. For anal pain and discharge, the area under the receiver operating characteristic curve of the scores was significantly higher than that of the combined score for all five symptoms (0.855 vs. 0.794, DeLong's test p = 0.04). For the two symptoms combined, the sensitivity, specificity, and positive predictive and negative predictive values were 88.2, 73.8, 80.4, and 83.8%, respectively, with 81.7% accuracy for detecting perianal fistulizing disease. Conclusions: This study indicates that simple questions regarding anal pain and discharge can help accurately identify the presence of perianal fistulizing disease in patients with CD.

The Results of Arthroscopic Double-Row Rotator Cuff Repairs with Combined Knot-tying and Knotless Suture Anchors (매듭 결속과 비매듭 봉합나사를 이용한 관절경적 이열 회전근개 봉합술의 결과)

  • Ku, Jung-Hoei;Lee, Choon-Key;Cho, Hyung-Lae;Choi, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.172-179
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    • 2008
  • Purpose: To evaluate the functional and structural results of arthroscopic double-row repair using combined knot-tying and knotless suture anchors in rotator cuff tears. Materials and Methods: From March 2006 to June 2007, twenty-one patients (15 males, 6 females; mean age 55.6 years; range 48 to 67) were included who underwent arthroscopic double-row repair for full-thickness tears of the rotator cuff following conservative treatment for a mean of 6.5 months (range 3 to 11). The tear size was carefully inspected arthroscopically and we found 2 small, 13 medium and 6 large-sized rotator cuff tears, with a mean tear size of 2.5cm(range 1.8 to 3.2). The repair constructs were consisted of horizontal mattress sutures using conventional knot-tying suture anchors medially and simple suture at the same level of medial row stitch with Bioknotless RC anchors (DePuy Mitek, Norwood, MA) as lateral row. Clinical and functional evaluations were made according to the range of motion, the ASES, UCLA scale and the isokinetic strength testing. Postoperative cuff integrity was determined through magnetic resonance imaging. The mean follow-up was 15 months (range 13 to 24). Results: The average clinical outcome scores and strength were all improved significantly at the time of the final follow-up (p < 0.01). Nineteen patients (90%) were satisfied with the result of the treatment. In 17 of 21 patients (81%) were judged to reveal healed tendon on magnetic resonance imaging at a mean of 7 months postoperatively. There were no significant functional differences according to the preoperative tear size (p<0.01), but large-sized tear shows less favorable structural results in 3 out of 6 cases(50%). Conclusion: Our results document the usefulness and variability of arthroscopic double-row rotator cuff repairs comparable to the results of the other types of double-row repairs.

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Review on Research Result for Bophi Vum Chrome Mineralized Zone in Northwestern Myanmar (미얀마 북서부 보피붐 크롬광화대 연구결과 리뷰)

  • Heo, Chul-Ho;Ryoo, Chung-Ryul;Park, Gyesoon
    • Economic and Environmental Geology
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    • v.52 no.5
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    • pp.499-508
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    • 2019
  • Based on the preliminary surveys for the occurrences of the Muwellut chrome-nickel mineralized zone ($800km^2$) in northwestern Myanmar, Bophivum area was selected as the detailed exploration area after considering data source, geological potential, metallogenic province, necessity of resource development on target mineral, exploration activity, grade, ore deposit type, nearby operating mine, infrastructure and exploration prediction effect. From 2013 to 2016, KIGAM and DGSE carried out geological and geochemical survey with 1:1,000 scale, magnetic survey(areal extent, $1.672km^2$), trench survey(19 trench, total length 392 m), pitting survey(18 pit, total depth 42.6m), exploration drilling(6holes 600m, 2015; 13holes 617.4m). We analyzed Cr and Ni contents of 77 drill cores with specific gravity in Yangon DGSE analytical center. Considering surface geological survey, geochemical exploration, magnetic survey, trench survey and drilling data, we divided Bophivum area into 8 blocks. Resource estimation are divided into measured and indicated resources. Measured resource is about 9,790t and indicated resource is about 12,080t with the average grade of Cr 11.8% and Ni 0.34%. In case of Bophivum area, if we develop by tying up Webula chrome mineralized zone in the south, it will be possible to upgrade the medium-scale mine. Geologically, the ophiolite belt are distributed in the western and eastern part in Myanmar. So, the exploration technology obtained from exploation in Bophivum area will be helpful to discover the hidden chromitite ore body in Myanmar ophiolite belt in the future.

Risk Factor for Poor Clinical Outcome in Patients with Retear after Repair of the Rotator Cuff (회전근 개 파열 봉합술 후 재파열 환자에서 불량한 임상 결과의 원인 인자)

  • Lee, Hee Jae;Joo, Il Han;Hur, Jeong Min;Oh, Hyun Keun;Lee, Bong Gun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.61-67
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    • 2021
  • Purpose: To evaluate the prognostic factors affecting poor functional outcomes in patients with retear after rotator cuff repair. Materials and Methods: From January 2013 to December 2018, among 631 patients who underwent arthroscopic repair of a rotator cuff tear, 42 patients, who could be followed-up for more than one year and showed a retear of the repaired cuff on magnetic resonance imaging (MRI), were collected retrospectively. The preoperative demographic data, range of motion, American Shoulder and Elbow Surgeons (ASES) score, fatty degeneration, and tear progression on postoperative MRI, as well as other factors that could affect the clinical outcomes, were analyzed. Patients who scored <80 points on the ASES score were allocated to the poor function group. The risk factors for poor clinical outcomes were compared with the group with ASES scores of 80 or above. Results: The postoperative functional results in the group with retear (n=42) after arthroscopic rotator cuff repair showed significant improvement. Univariate analysis revealed the preoperative visual analogue scale (VAS) score and tear progression to have associations with a poor shoulder function. In addition, subscapularis repair was found to be associated with a good shoulder function. The preoperative VAS score and tear progression except for subscapularis repair were independent factors associated with poor clinical outcomes according to multivariate logistic regression analysis. Conclusion: In patients with retear after rotator cuff repair, the preoperative VAS and tear progression in postoperative MRI are factors predicting a poor functional outcome.

A Study on The Measurement of Cerebral Cortical Thickness in Patients with Mood Disorders (기분장애 환자의 대뇌 피질 두께 측정에 관한 연구)

  • Do-Hun Kim;Hyo-Young Lee
    • Journal of the Korean Society of Radiology
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    • v.18 no.2
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    • pp.73-81
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    • 2024
  • This study compared the cortical thickness of patients with mood disorders and a control group to assess structural abnormalities. A retrospective study was conducted from September 2020 to August 2022 at the Department of Psychiatry, P Hospital in Yangsan, Gyeongsangnam-do. The study included 44 individuals diagnosed with mood disorders and 59 healthy individuals without any pathological lesions. The 3D-T1 MPRAGE images obtained from magnetic resonance imaging examinations were utilized, and FreeSurfer software was employed to measure cortical thickness. Statistical analysis involved independent samples t-tests to measure the differences in means between the two groups, and Cohen's d test was used to compare the effect sizes of the differences. Furthermore, the correlation between the measured average cortical thickness and Positive and Negative Syndrome Scale scores was analyzed. The research results revealed that patients with mood disorders exhibited decreased cortical thickness compared to the normal control group in both superior frontal regions, both rostral middle frontal regions, both caudal middle frontal regions, both pars opercularis, pars orbitals, pars triangularis regions, both superior temporal regions, both inferior temporal regions, both lateral orbitofrontal regions, both medial orbitofrontal regions, both fusiform regions, both posterior cingulate regions, both isthmus cingulate regions, both superior parietal regions, both inferior parietal regions, both supramarginal regions, left postcentral region, right bank of the superior temporal sulcus region, right middle temporal region, right rostral anterior cingulate region, and right insula region. Among them, regions that showed differences with effect sizes of 0.8 or higher were left fusiform (d=0.82), pars opercularis (d=0.94), superior frontal (d=0.88), right lateral orbitofrontal (d=0.85), and pars orbitalis (d=0.89). Additionally, there was a weak negative correlation between PANSS scores and average cortical thickness in both the left hemisphere (r=-0.234) and right hemisphere (r=-0.230). These findings are expected to be helpful in identifying areas of cortical thickness reduction in patients with mood disorders compared to healthy individuals and understanding the relationship between symptom severity and cortical thickness changes.

Effect of Reaction Factors on the Properties of Complex Oxide Powder Produced by Spray Roasting Process (분무배소법에 의해 생성되는 복합산화물 분말들의 특성에 미치는 반응인자들의 영향)

  • 유재근;이성수;박희범;안주삼;남용현;손진군
    • Resources Recycling
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    • v.9 no.4
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    • pp.16-27
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    • 2000
  • In order to produce raw material powder of advanced magnetic material by spray roasting process, newly modified spray roasting system was developed in this work. In this spray roasting system, raw material solution was effectively atomized and sprayed into the reaction furnace. Also, uniform temperature distribution inside reaction furnace made thermal decomposition process fully completed, and produced powder was effectively collected in cyclone and bag filter. This system equipped with apparatus which can purify hazard produced gas. In this study complex acid solution was prepared by dissolution of mill scale and ferro-Mn into the acid solution, and the pH of this complex acid solution was controlled about to 4. It was conformed that mill scale and ferro-Mn containing a lot of impurities such as $SiO_2$, P and Al could be used as raw material by reducing the impurities content of complex acid solution below 20 ppm. Complex oxide powder of Fe-Mn system was produced by spraying purified complex acid solution into the spray roaster through nozzle, and the variations of produced powder characters were studied by changing he reaction conditions such as reaction temperature, the injection velocity of solution and air, nozzle tip size and concentration of solution. The morphology of produced powder had spherical shape under the most experimental conditions, and concentration of solution. The morphology of produced powder has spherical shape under the most experimental conditions, and the composition and the particle size distribution were almost uniform, which tells the excellence of this spray roasting system. The grain size of most produced powder was below 100 nm. From the above results, it will be possible to produce ultra fine oxide powder from the chloride of Fe, Mn, Ni, Cu and rare earth by using this spray roasting system, and also to produce ultra fine pure metal powder by changing reaction atmosphere.

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Optimization of the Flip Angle and Scan Timing in Hepatobiliary Phase Imaging Using T1-Weighted, CAIPIRINHA GRE Imaging

  • Kim, Jeongjae;Kim, Bong Soo;Lee, Jeong Sub;Woo, Seung Tae;Choi, Guk Myung;Kim, Seung Hyoung;Lee, Ho Kyu;Lee, Mu Sook;Lee, Kyung Ryeol;Park, Joon Hyuk
    • Investigative Magnetic Resonance Imaging
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    • v.22 no.1
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    • pp.1-9
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    • 2018
  • Purpose: This study was designed to optimize the flip angle (FA) and scan timing of the hepatobiliary phase (HBP) using the 3D T1-weighted, gradient-echo (GRE) imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique on gadoxetic acid-enhanced 3T liver MR imaging. Materials and Methods: Sixty-two patients who underwent gadoxetic acid-enhanced 3T liver MR imaging were included in this study. Four 3D T1-weighted GRE imaging studies using the CAIPIRINHA technique and FAs of $9^{\circ}$ and $13^{\circ}$ were acquired during HBP at 15 and 20 min after intravenous injection of gadoxetic acid. Two abdominal radiologists, who were blinded to the FA and the timing of image acquisition, assessed the sharpness of liver edge, hepatic vessel clarity, lesion conspicuity, artifact severity, and overall image quality using a five-point scale. Quantitative analysis was performed by another radiologist to estimate the relative liver enhancement (RLE) and the signal-to-noise ratio (SNR). Statistical analyses were performed using the Wilcoxon signed rank test and one-way analysis of variance. Results: The scores of the HBP with an FA of $13^{\circ}$ during the same delayed time were significantly higher than those of the HBP with an FA of $9^{\circ}$ in all the assessment items (P < 0.01). In terms of the delay time, images at the same FA obtained with a 20-min-HBP showed better quality than those obtained with a 15-min-HBP. There was no significant difference in qualitative scores between the 20-min-HBP and the 15-min-HBP images in the non-liver cirrhosis (LC) group except for the hepatic vessel clarity score with $9^{\circ}$ FA. In the quantitative analysis, a statistically significant difference was found in the degree of RLE in the four HBP images (P = 0.012). However, in the subgroup analysis, no significant difference in RLE was found in the four HBP images in either the LC or the non-LC groups. The SNR did not differ significantly in the four HBP images. In the subgroup analysis, 20-min-HBP imaging with a $13^{\circ}$ FA showed the highest SNR value in the LC-group, whereas 15-min-HBP imaging with a $13^{\circ}$ FA showed the best value of SNR in the non-LC group. Conclusion: The use of a moderately high FA improves the image quality and lesion conspicuity on 3D, T1-weighted GRE imaging using the CAIPIRINHA technique on gadoxetic acid, 3T liver MR imaging. In patients with normal liver function, the 15-min-HBP with a $13^{\circ}$ FA represents a feasible option without a significant decrease in image quality.

Analysis of Wind Vorticity and Divergence in the High-latitude Lower Thermosphere: Dependence on the Interplanetary Magnetic Field (IMF) (고위도 하부 열권 바람의 소용돌이도와 발산 분석: 행성간 자기장(IMF)에 대한 의존도)

  • Kwak, Young-Sil;Lee, Jae-Jin;Ahn, Byung-Ho;Hwang, Jung-A;Kim, Khan-Hyuk;Cho, Kyung-Seok
    • Journal of Astronomy and Space Sciences
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    • v.25 no.4
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    • pp.405-414
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    • 2008
  • To better understand the physical processes that control the high-latitude lower thermospheric dynamics, we analyze the divergence and vorticity of the high-latitude neutral wind field in the lower thermosphere during the southern summertime for different IMF conditions. For this study the National Center for Atmospheric Research Thermosphere-Ionosphere Electrodynamics General Circulation Model (NCAR-TIEG CM) is used. The analysis of the large-scale vorticity and divergence provides basic understanding flow configurations to help elucidate the momentum sources that ulti-mately determine the total wind field in the lower polar thermosphere and provides insight into the relative strengths of the different sources of momentum responsible for driving winds. The mean neutral wind pattern in the high-latitude lower thermosphere is dominated by rotational flow, imparted primarily through the ion drag force, rather than by divergent flow, imparted primarily through Joule and solar heating. The difference vorticity, obtained by subtracting values with zero IMF from those with non-zero IMF, in the high-latitude lower thermosphere is much larger than the difference divergence for all IMF conditions, indicating that a larger response of the thermospheric wind system to enhancement in the momentum input generating the rotational motion with elevated IMF than the corresponding energy input generating the divergent motion. the difference vorticity in the high-latitude lower thermosphere depends on the direction of the IMF. The difference vorticity for negative and positive $B_y$ shows positive and negative, respectively, at higher magnetic latitudes than $-70^{\circ}$. For negative $B_z$, the difference vorticities have positive in the dusk sector and negative in the dawn sector. The difference vorticities for positive $B_z$ have opposite sign. Negative IMF $B_z$ has a stronger effect on the vorticity than does positive $B_z$.

T1-weighted FLAIR MR Imaging for the Evaluation of Enhancing Brain Tumors: Comparison with Spin Echo Imaging (조영증강을 보이는 뇌종양의 평가에 있어 T1강조 FLAIR 영상과 스핀에코 MR 영상의 비교)

  • Jeong, Boseul;Choi, Dae Seob;Shin, Hwa Seon;Choi, Hye Young;Park, Mi Jung;Jeon, Kyung Nyeo;Na, Jae Beom;Chung, Sung Hoon
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.2
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    • pp.151-156
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    • 2014
  • Purpose : Spin-echo (SE) technique is most commonly used pulse sequence for T1-weighted MR imaging. T1-weighted fluid-attenuated inversion recovery (T1FLAIR) is a relatively new pulse sequence and it provides higher tissue contrast between the gray matter (GM) and white matter (WM) of the brain than T1-weighted SE (T1SE) sequence. However, there has been controversy for the evaluation of enhancing brain tumors with T1FLAIR compared to T1SE. The purpose of this study was to compare T1FLAIR and T1SE sequences for the evaluation of enhancing intracranial tumors. Materials and Methods: Fifty-two patients with enhancing brain tumors were evaluated with contrast-enhanced (CE) T1SE and T1FLAIR imaging. Eight quantitative criteria were calculated: lesion-to-WM contrast ratio (CR) and contrast-to-noise ratio (CNR), lesion-to-GM CR and CNR, lesion-to-CSF CR and CNR, and WM-to-GM CR and CNR. For qualitative evaluation, two radiologists assessed lesion conspicuity on CE T1SE and T1FLAIR sequences with three-scale: 1, T1SE superior; 2, sequence equal; T1FLAIR superior. Results: Seventy-nine tumors (31 primaries, 48 metastases) were assessed. For quantitative measurement, the T1FLAIR lesion-to-GM, lesion-to-CSF, WM-to-GM CR and CNR values were comparable and statistically superior to those of the T1SE images (p < 0.001 in all). However, lesion-to-WM CR and CNR were similar on both two sequences without statistically significant difference (p = 0.661, 0.662, respectively). For qualitative evaluation, both radiologists assessed that T1FLAIR images were superior to T1SE images for the evaluation of lesion conspicuity. Conclusion: For the evaluation of enhancing intracranial tumors, T1FLAIR sequence was superior or comparable to T1SE sequence.

Ferucarbotran-Enhanced Hepatic MRI at 3T Unit: Quantitative and Qualitative Comparison of Fast Breath-hold Imaging Sequences (간의 3T 자기공명영상에서 초상자성산화철 조영증강 급속호흡정지영상기법들간의 양적 및 질적 비교평가)

  • Cho, Kyung-Eun;Yu, Jeong-Sik;Chung, Jae-Joon;Kim, Joo-Hee;Kim, Ki-Whang
    • Investigative Magnetic Resonance Imaging
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    • v.14 no.1
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    • pp.31-40
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    • 2010
  • Purpose : To compare the relative values of various fast breath-hold imaging sequences for superparamagnetic iron-oxide (SPIO)-enhanced hepatic MRI for the assessment of solid focal lesions with a 3T MRI unit. Materials and Methods : 102 consecutive patients with one or more solid malignant hepatic lesions were evaluated by spoiled gradient echo (GRE) sequences with three different echo times (2.4 msec [GRE_2.4], 5.8 msec [GRE_5.8], and 10 msec [GRE_10]) for $T2^*$-weighted imaging in addition to T2-weighted turbo spin echo (TSE) sequence following intravenous SPIO injection. Image qualities of the hepatic contour, vascular landmarks and artifacts were rated by two independent readers using a four-point scale. For quantitative analysis, contrast-to-noise ratio (CNR) was measured in 170 solid focal lesions larger than 1 cm (107 hepatocellular carcinomas, nine cholangiocarcinomas and 54 metastases). Results : GRE_5.8 showed the highest mean points for hepatic contour, vascular anatomy and imaging artifact presence among all of the subjected sequences (p<0.001) and was comparable (p=0.414) with GRE_10 with regard to lesion conspicuity. The mean CNRs were significantly higher (p<0.001) in the following order: GRE_10 ($24.4{\pm}14.5$), GRE_5.8 ($14.8{\pm}9.4$), TSE ($9.7{\pm}6.3$), and GRE_2.4 ($7.9{\pm}6.4$). The mean CNRs of CCCs and metastases were higher than those of HCCs for all imaging sequences (p<0.05). Conclusion : Regarding overall performances, GRE using a moderate echo time of 5.8 msec can provide the most reliable data among the various fast breath-hold SPIO-enhanced hepatic MRI sequences at 3T unit despite the lower CNR of GRE_5.8 compared to that of GRE_10.