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Choi G, Ham S, Je BK, Rhie YJ, Ahn KS, Shim E, Lee MJ. Olecranon bone age assessment in puberty using a lateral elbow radiograph and a deep-learning model. Eur Radiol 2024:10.1007/s00330-024-10748-x. [PMID: 38676732 DOI: 10.1007/s00330-024-10748-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/28/2024] [Accepted: 03/21/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVES To improve pubertal bone age (BA) evaluation by developing a precise and practical elbow BA classification using the olecranon, and a deep-learning AI model. MATERIALS AND METHODS Lateral elbow radiographs taken for BA evaluation in children under 18 years were collected from January 2020 to June 2022, retrospectively. A novel classification and the olecranon BA were established based on the morphological changes in the olecranon ossification process during puberty. The olecranon BA was compared with other elbow and hand BA methods, using intraclass correlation coefficients (ICCs), and a deep-learning AI model was developed. RESULTS A total of 3508 lateral elbow radiographs (mean age 9.8 ± 1.8 years) were collected. The olecranon BA showed the highest applicability (100%) and interobserver agreement (ICC 0.993) among elbow BA methods. It showed excellent reliability with Sauvegrain (0.967 in girls, 0.969 in boys) and Dimeglio (0.978 in girls, 0.978 in boys) elbow BA methods, as well as Korean standard (KS) hand BA in boys (0.917), and good reliability with KS in girls (0.896) and Greulich-Pyle (GP)/Tanner-Whitehouse (TW)3 (0.835 in girls, 0.895 in boys) hand BA methods. The AI model for olecranon BA showed an accuracy of 0.96 and a specificity of 0.98 with EfficientDet-b4. External validation showed an accuracy of 0.86 and a specificity of 0.91. CONCLUSION The olecranon BA evaluation for puberty, requiring only a lateral elbow radiograph, showed the highest applicability and interobserver agreement, and excellent reliability with other BA evaluation methods, along with a high performance of the AI model. CLINICAL RELEVANCE STATEMENT This AI model uses a single lateral elbow radiograph to determine bone age for puberty from the olecranon ossification center and can improve pubertal bone age assessment with the highest applicability and excellent reliability compared to previous methods. KEY POINTS Elbow bone age is valuable for pubertal bone age assessment, but conventional methods have limitations. Olecranon bone age and its AI model showed high performances for pubertal bone age assessment. Olecranon bone age system is practical and accurate while requiring only a single lateral elbow radiograph.
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Affiliation(s)
- Gayoung Choi
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sungwon Ham
- Healthcare Readiness Institute for Unified Korea, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Bo-Kyung Je
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Young-Jun Rhie
- Department of Pediatrics, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - Mi-Jung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Kang WY, Hong SJ, Woo OH, Kang CH, Ahn KS, Kim BH, Shim E. T2 Black Synovitis in Musculoskeletal MRI: Disease Spectrum and Imaging Characteristics of Joint Diseases. Curr Med Imaging 2024; 20:e010623217546. [PMID: 37264660 DOI: 10.2174/1573405620666230601114534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 06/03/2023]
Abstract
The synovium may be affected by a wide spectrum of disorders, including inflammatory, infectious, degenerative, traumatic, hemorrhagic, and tumorous conditions. Magnetic resonance imaging (MRI) is a valuable imaging modality to characterize synovial disorders. Most abnormal lesions appear as areas of nonspecific high signal intensity on T2-weighted images (T2-WI) due to high water content or increased perfusion. However, T2 hypointensity can be attributed to blood components of varying ages, calcification, inorganic crystals, fibrosis, caseous necrosis and/or amyloid deposition. Hypointense lesions on T2-WI are infrequent and additional clinical and imaging characteristics can help to limit the list of differential diagnoses, which may include tenosynovial giant cell tumor, synovial chondromatosis, rheumatoid arthritis, tuberculous arthritis, chronic tophaceous gout, amyloid arthropathy, synovial hemangioma, lipoma arborescens and hemosiderotic synovitis. Recently, susceptibility weighted imaging has been developed and may contribute to more accurate diagnosis for deoxygenated blood and calcium. We review the MRI features of hypointense synovial lesions on MRI and emphasize the characteristic findings that suggest a correct diagnosis.
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Affiliation(s)
- Woo Young Kang
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ok Hee Woo
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
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Lee KC, Cho Y, Ahn KS, Park HJ, Kang YS, Lee S, Kim D, Kang CH. Deep-Learning-Based Automated Rotator Cuff Tear Screening in Three Planes of Shoulder MRI. Diagnostics (Basel) 2023; 13:3254. [PMID: 37892075 PMCID: PMC10606560 DOI: 10.3390/diagnostics13203254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to develop a screening model for rotator cuff tear detection in all three planes of routine shoulder MRI using a deep neural network. A total of 794 shoulder MRI scans (374 men and 420 women; aged 59 ± 11 years) were utilized. Three musculoskeletal radiologists labeled the rotator cuff tear. The YOLO v8 rotator cuff tear detection model was then trained; training was performed with all imaging planes simultaneously and with axial, coronal, and sagittal images separately. The performances of the models were evaluated and compared using receiver operating curves and the area under the curve (AUC). The AUC was the highest when using all imaging planes (0.94; p < 0.05). Among a single imaging plane, the axial plane showed the best performance (AUC: 0.71), followed by the sagittal (AUC: 0.70) and coronal (AUC: 0.68) imaging planes. The sensitivity and accuracy were also the highest in the model with all-plane training (0.98 and 0.96, respectively). Thus, deep-learning-based automatic rotator cuff tear detection can be useful for detecting torn areas in various regions of the rotator cuff in all three imaging planes.
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Affiliation(s)
- Kyu-Chong Lee
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea (C.H.K.)
| | - Yongwon Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea (C.H.K.)
- Advanced Medical Imaging Institute, Korea University College of Medicine, Seoul 02841, Republic of Korea
- AI Center, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea (C.H.K.)
- Advanced Medical Imaging Institute, Korea University College of Medicine, Seoul 02841, Republic of Korea
- AI Center, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Hyun-Joon Park
- Institute for Healthcare Service Innovation, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (H.-J.P.); (Y.-S.K.)
| | - Young-Shin Kang
- Institute for Healthcare Service Innovation, College of Medicine, Korea University, Seoul 02841, Republic of Korea; (H.-J.P.); (Y.-S.K.)
| | - Sungshin Lee
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea (C.H.K.)
| | | | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul 02841, Republic of Korea (C.H.K.)
- Advanced Medical Imaging Institute, Korea University College of Medicine, Seoul 02841, Republic of Korea
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Lee KC, Choi IC, Kang CH, Ahn KS, Yoon H, Lee JJ, Kim BH, Shim E. Clinical Validation of an Artificial Intelligence Model for Detecting Distal Radius, Ulnar Styloid, and Scaphoid Fractures on Conventional Wrist Radiographs. Diagnostics (Basel) 2023; 13:diagnostics13091657. [PMID: 37175048 PMCID: PMC10178713 DOI: 10.3390/diagnostics13091657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/02/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
This study aimed to assess the feasibility and performance of an artificial intelligence (AI) model for detecting three common wrist fractures: distal radius, ulnar styloid process, and scaphoid. The AI model was trained with a dataset of 4432 images containing both fractured and non-fractured wrist images. In total, 593 subjects were included in the clinical test. Two human experts independently diagnosed and labeled the fracture sites using bounding boxes to build the ground truth. Two novice radiologists also performed the same task, both with and without model assistance. The sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated for each wrist location. The AUC for detecting distal radius, ulnar styloid, and scaphoid fractures per wrist were 0.903 (95% C.I. 0.887-0.918), 0.925 (95% C.I. 0.911-0.939), and 0.808 (95% C.I. 0.748-0.967), respectively. When assisted by the AI model, the scaphoid fracture AUC of the two novice radiologists significantly increased from 0.75 (95% C.I. 0.66-0.83) to 0.85 (95% C.I. 0.77-0.93) and from 0.71 (95% C.I. 0.62-0.80) to 0.80 (95% C.I. 0.71-0.88), respectively. Overall, the developed AI model was found to be reliable for detecting wrist fractures, particularly for scaphoid fractures, which are commonly missed.
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Affiliation(s)
- Kyu-Chong Lee
- Department of Radiology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - In Cheul Choi
- Department of Orthopedics Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | - Heewon Yoon
- Department of Radiology, Korea University Anam Hospital, Seoul 02841, Republic of Korea
| | | | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea
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Lee KC, Ahn KS, Kang CH, Hong SJ, Kim BH, Shim E. A Systematic Approach to Diagnosing Arthritis Based on Radiological Imaging. Curr Med Imaging 2022; 18:1160-1179. [DOI: 10.2174/1573405618666220428100951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/16/2022] [Accepted: 03/11/2022] [Indexed: 11/22/2022]
Abstract
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Radiology plays key roles in diagnosis of arthritis. We herein suggest an algorithmic approach to diagnosing arthritis. First, the number of joint involvements is reviewed. Monoarticular arthritis includes septic arthritis, pigmented villonodular synovitis, and synovial chondromatosis. Second, polyarticular arthritis can be categorized by its characteristics: erosive, productive and mixed. Erosive disease includes rheumatoid arthritis, hemophilia, and amyloidosis while productive disease includes osteoarthritis, and hemochromatosis. Third, mixed diseases are subcategorized by symmetricity. Ankylosing spondylitis and inflammatory bowel disease related arthritis affect joints symmetrically while psoriatic arthritis, reactive arthritis, and crystalline arthropathy are asymmetric. Adjacent soft tissue density, periostitis, and bone density are ancillary findings that can be used as additional differential diagnostic clues. The final step in identifying the type of arthritis is to check whether the location is a site frequently affected by one particular disease over another. This systematic approach would be helpful for radiologist to diagnose arthritis.
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Affiliation(s)
- Kyu-Chong Lee
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Suk Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
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Hong KT, Cho Y, Kang CH, Ahn KS, Lee H, Kim J, Hong SJ, Kim BH, Shim E. Lumbar Spine Computed Tomography to Magnetic Resonance Imaging Synthesis Using Generative Adversarial Network: Visual Turing Test. Diagnostics (Basel) 2022; 12:diagnostics12020530. [PMID: 35204619 PMCID: PMC8871227 DOI: 10.3390/diagnostics12020530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/11/2022] [Accepted: 02/16/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Introduction: Computed tomography (CT) and magnetic resonance imaging (MRI) play an important role in the diagnosis and evaluation of spinal diseases, especially degenerative spinal diseases. MRI is mainly used to diagnose most spinal diseases because it shows a higher resolution than CT to distinguish lesions of the spinal canals and intervertebral discs. When it is inevitable for CT to be selected instead of MR in evaluating spinal disease, evaluation of spinal disease may be limited. In these cases, it is very helpful to diagnose spinal disease with MR images synthesized with CT images. (2) Objective: To create synthetic lumbar magnetic resonance (MR) images from computed tomography (CT) scans using generative adversarial network (GAN) models and assess how closely the synthetic images resembled the true images using visual Turing tests (VTTs). (3) Material and Methods: Overall, 285 patients aged ≥ 40 years who underwent lumbar CT and MRI were enrolled. Based on axial CT and T2-weighted axial MR images from 285 patients, an image synthesis model using a GAN was trained using three algorithms (unsupervised, semi-supervised, and supervised methods). Furthermore, VTT to determine how similar the synthetic lumbar MR images generated from lumbar CT axial images were to the true lumbar MR axial images were conducted with 59 patients who were not included in the model training. For the VTT, we designed an evaluation form comprising 600 randomly distributed axial images (150 true and 450 synthetic images from unsupervised, semi-supervised, and supervised methods). Four readers judged the authenticity of each image and chose their first- and second-choice candidates for the true image. In addition, for the three models, structural similarities (SSIM) were evaluated and the peak signal to noise ratio (PSNR) was compared among the three methods. (4) Results: The mean accuracy for the selection of true images for all four readers for their first choice was 52.0% (312/600). The accuracies of determining the true image for each reader’s first and first + second choices, respectively, were as follows: reader 1, 51.3% and 78.0%; reader 2, 38.7% and 62.0%, reader 3, 69.3% and 84.0%, and reader 4, 48.7% and 70.7%. In the case of synthetic images chosen as first and second choices, supervised algorithm-derived images were the most often selected (supervised, 118/600 first and 164/600 second; semi-supervised, 90/600 and 144/600; and unsupervised, 80/600 and 114/600). For image quality, the supervised algorithm received the best score (PSNR: 15.987 ± 1.039, SSIM: 0.518 ± 0.042). (5) Conclusion: This was the pilot study to apply GAN to synthesize lumbar spine MR images from CT images and compare training algorithms of the GAN. Based on VTT, the axial MR images synthesized from lumbar CT using GAN were fairly realistic and the supervised training algorithm was found to provide the closest image to true images.
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Affiliation(s)
- Ki-Taek Hong
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
| | - Yongwon Cho
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
- AI Center, Korea University Anam Hospital, Seoul 02841, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
- Correspondence: ; Tel.: +82-29-206-540
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
| | - Heegon Lee
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
| | - Joohui Kim
- Department of Radiology, Korea University College of Medicine, Korea University Anam Hospital, Seoul 02841, Korea; (K.-T.H.); (Y.C.); (K.-S.A.); (H.L.); (J.K.)
| | - Suk Joo Hong
- Korea University Guro Hospital, Seoul 02841, Korea;
| | - Baek Hyun Kim
- Korea University College of Medicine, Korea University Ansan Hospital, Seoul 02841, Korea; (B.H.K.); (E.S.)
| | - Euddeum Shim
- Korea University College of Medicine, Korea University Ansan Hospital, Seoul 02841, Korea; (B.H.K.); (E.S.)
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Shim E, Kim BH, Kang WY, Hong SJ, Kang CH, Ahn KS, Lee H, Kwack TJ. Diagnostic performance of electron-density dual-energy CT in detection of cervical disc herniation in comparison with standard gray-scale CT and virtual non-calcium images. Eur Radiol 2022; 32:2209-2220. [PMID: 35064315 PMCID: PMC8782689 DOI: 10.1007/s00330-021-08374-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/14/2021] [Accepted: 09/30/2021] [Indexed: 01/07/2023]
Abstract
Objectives To assess the diagnostic performance of dual-energy CT (DECT) with electron-density (ED) image reconstruction compared with standard CT (SC) and virtual non-calcium (VNCa) image CT reconstruction for detecting cervical disc herniation. Methods This cross-sectional study was approved by the IRB. We enrolled 64 patients (336 intervertebral discs from C2/3 to C7/T1; mean age, 55 years; 17 women and 47 men) who underwent DECT with spectral reconstruction and 3-T MRI within 2 weeks between January 2018 and June 2020. Four radiologists independently evaluated the first image set of randomized SC, VNCa, and ED images to detect cervical disc herniation. After 8 weeks, the readers re-evaluated the second and the last image sets with an 8-week interval. MRI evaluations performed by two other experienced served as the reference standard. Comparing diagnostic performance between each images set was evaluated by a generalized estimating equation. Results A total of 233 cervical disc herniations were noted on MRI. For detecting cervical disc herniation, electron-density images showed higher sensitivity (94% [219/233; 95% CI, 90–97] vs. 76% [177/233; 70–81] vs. 69% [160/233; 62–76]) (p < 0.001) and similar specificity (90% [93/103; 83–95] vs. 89% [92/103; 82–96] vs. 90% [93/103; 83–95]) (p > 0.05) as SC and VNCa images, respectively. Inter-reader agreement for cervical disc herniation calculated among the four readers was moderate for all image sets (κ = 0.558 for ED, κ = 0.422 for SC, and κ = 0.449 for VNCa). Conclusion DECT with ED reconstruction can improve cervical disc herniation detection and diagnostic confidence compared with SC and VNCa images. Key Points • Intervertebral discs with high material density are well visualized on electron-density images obtained from dual-energy CT. • Electron-density images showed much higher sensitivity and diagnostic accuracy than standard CT and virtual non-calcium images for the detection of cervical disc herniation. • Electron-density images can have false-negative results, especially for disc herniation with high signal intensity on T2W images and can show pseudo-disc extrusion at the lower cervical spine. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08374-y.
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Jang WY, Ahn KS, Oh S, Lee JE, Choi J, Kang CH, Kang WY, Hong SJ, Shim E, Kim BH, Je BK, Jung HW, Lee SH. Difference between bone age at the hand and elbow at the onset of puberty. Medicine (Baltimore) 2022; 101:e28516. [PMID: 35029913 PMCID: PMC8735777 DOI: 10.1097/md.0000000000028516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 12/17/2021] [Indexed: 11/25/2022] Open
Abstract
In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age.A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich-Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset.There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys (P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods (P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls.The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.
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Affiliation(s)
- Woo Young Jang
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Saelin Oh
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Ji Eun Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jimi Choi
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Woo Young Kang
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Eddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Bo-Kyung Je
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Soon Hyuck Lee
- Department of Orthopedic Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
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Lee SH, Ahn KS, Jung HW, Jang WY. The limbus in developmental dysplasia of the hip: An obstacle to reduction and its images changed by the femoral head position. Medicine (Baltimore) 2021; 100:e28198. [PMID: 34941078 PMCID: PMC8702278 DOI: 10.1097/md.0000000000028198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/12/2021] [Accepted: 11/19/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT This study aimed to describe the shape of the limbus arthroscopically and via arthrogram and magnetic resonance imaging (MRI), and to determine whether it prevents concentric reduction of the femoral head in developmental dysplasia of the hip (DDH).Twelve patients (mean age, 10.2 months; range, 3-31 months) who underwent arthroscopic-assisted reduction for DDH were retrospectively reviewed. Limbus shapes were captured on arthrogram before reduction, after closed reduction, and after arthroscopic-assisted reduction and categorized according to the Miyake classification.On arthrogram, the superior limbus was blocked in 2 hips, inverted in 2, intermediate in 5, and everted in 3 after attempted closed reduction. After arthroscopic-assisted reduction, the limbus was everted in 7 hips and normal in 5. On arthroscopy, in all cases, the limbus appeared as a whitish, cartilage-like ring with a variably blunted edge before reduction, without inversion or eversion. On postoperative MRI, 10 of 12 superior limbi showed hypertrophy or globular compression by the femoral head with intermediate or mixed MRI signal intensities and blunted edges. The remaining 2 hips had hypertrophied superior limbi with sharp edges. On transverse plane MRI, the posterior limbus of all hips showed sharp margins with low MRI signal intensity. Residual subluxation was observed in 7 of the 12 hips with interposition of the anteroinferior limbus.The appearance of the limbus varied according to the femoral head position, and it was neither inverted nor everted. Interposed anteroinferior limbi with residual subluxation suggest impeded concentric reduction in DDH.
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Affiliation(s)
- Soon Hyuck Lee
- Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Hospital, Seoul, Republic of Korea
| | - Woo Young Jang
- Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Lee KC, Lee KH, Kang CH, Ahn KS, Chung LY, Lee JJ, Hong SJ, Kim BH, Shim E. Clinical Validation of a Deep Learning-Based Hybrid (Greulich-Pyle and Modified Tanner-Whitehouse) Method for Bone Age Assessment. Korean J Radiol 2021; 22:2017-2025. [PMID: 34668353 PMCID: PMC8628149 DOI: 10.3348/kjr.2020.1468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy and clinical efficacy of a hybrid Greulich-Pyle (GP) and modified Tanner-Whitehouse (TW) artificial intelligence (AI) model for bone age assessment. MATERIALS AND METHODS A deep learning-based model was trained on an open dataset of multiple ethnicities. A total of 102 hand radiographs (51 male and 51 female; mean age ± standard deviation = 10.95 ± 2.37 years) from a single institution were selected for external validation. Three human experts performed bone age assessments based on the GP atlas to develop a reference standard. Two study radiologists performed bone age assessments with and without AI model assistance in two separate sessions, for which the reading time was recorded. The performance of the AI software was assessed by comparing the mean absolute difference between the AI-calculated bone age and the reference standard. The reading time was compared between reading with and without AI using a paired t test. Furthermore, the reliability between the two study radiologists' bone age assessments was assessed using intraclass correlation coefficients (ICCs), and the results were compared between reading with and without AI. RESULTS The bone ages assessed by the experts and the AI model were not significantly different (11.39 ± 2.74 years and 11.35 ± 2.76 years, respectively, p = 0.31). The mean absolute difference was 0.39 years (95% confidence interval, 0.33-0.45 years) between the automated AI assessment and the reference standard. The mean reading time of the two study radiologists was reduced from 54.29 to 35.37 seconds with AI model assistance (p < 0.001). The ICC of the two study radiologists slightly increased with AI model assistance (from 0.945 to 0.990). CONCLUSION The proposed AI model was accurate for assessing bone age. Furthermore, this model appeared to enhance the clinical efficacy by reducing the reading time and improving the inter-observer reliability.
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Affiliation(s)
- Kyu-Chong Lee
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Kee-Hyoung Lee
- Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea.
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Korea
| | | | | | - Suk Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Korea
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11
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Ahn KS, Bae B, Jang WY, Lee JH, Oh S, Kim BH, Lee SW, Jung HW, Lee JW, Sung J, Jung KH, Kang CH, Lee SH. Assessment of rapidly advancing bone age during puberty on elbow radiographs using a deep neural network model. Eur Radiol 2021; 31:8947-8955. [PMID: 34115194 DOI: 10.1007/s00330-021-08096-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Bone age is considered an indicator for the diagnosis of precocious or delayed puberty and a predictor of adult height. We aimed to evaluate the performance of a deep neural network model in assessing rapidly advancing bone age during puberty using elbow radiographs. METHODS In all, 4437 anteroposterior and lateral pairs of elbow radiographs were obtained from pubertal individuals from two institutions to implement and validate a deep neural network model. The reference standard bone age was established by five trained researchers using the Sauvegrain method, a scoring system based on the shapes of the lateral condyle, trochlea, olecranon apophysis, and proximal radial epiphysis. A test set (n = 141) was obtained from an external institution. The differences between the assessment of the model and that of reviewers were compared. RESULTS The mean absolute difference (MAD) in bone age estimation between the model and reviewers was 0.15 years on internal validation. In the test set, the MAD between the model and the five experts ranged from 0.19 to 0.30 years. Compared with the reference standard, the MAD was 0.22 years. Interobserver agreement was excellent among reviewers (ICC: 0.99) and between the model and the reviewers (ICC: 0.98). In the subpart analysis, the olecranon apophysis exhibited the highest accuracy (74.5%), followed by the trochlea (73.7%), lateral condyle (73.7%), and radial epiphysis (63.1%). CONCLUSIONS Assessment of rapidly advancing bone age during puberty on elbow radiographs using our deep neural network model was similar to that of experts. KEY POINTS • Bone age during puberty is particularly important for patients with scoliosis or limb-length discrepancy to determine the phase of the disease, which influences the timing and method of surgery. • The commonly used hand radiographs-based methods have limitations in assessing bone age during puberty due to the less prominent morphological changes of the hand and wrist bones in this period. • A deep neural network model trained with elbow radiographs exhibited similar performance to human experts on estimating rapidly advancing bone age during puberty.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | | | - Woo Young Jang
- Department of Orthopedic Surgery, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - Jin Hyuck Lee
- Department of Sports Medicine, Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Saelin Oh
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Republic of Korea
| | - Si Wook Lee
- Department of Orthopedic Surgery, Keimyung University, School of Medicine, Dongsan Medical Center, Daegu, Republic of Korea
| | - Hae Woon Jung
- Department of Pediatrics, Kyung Hee University Hospital, Seoul, Republic of Korea
| | | | | | | | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Soon Hyuck Lee
- Department of Orthopedic Surgery, Korea University Anam Hospital, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
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12
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Kim HJ, Lee KC, Kang CH, Ahn KS, Kim CH. Characteristic Imaging Features of Merkel Cell Carcinoma: A Case Report. Curr Med Imaging 2021; 17:562-566. [PMID: 33100207 DOI: 10.2174/1573405616666201023142724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/20/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Merkel cell carcinoma (MCC) is a rare primary cutaneous tumor. The standardized imaging guidelines for the diagnosis of MCC have not been established. We report the multimodality imaging features of MCC, including CT, MRI, and ultrasound with grayscale and color Doppler mode as well as the elastography and even a histopathologic confirmation. CASE REPORT We report the case of a 76-year old male patient with MCC on the elbow that was treated by excision. On MRI, prominent T2 low signal voiding was noted with branching or chaotic pattern and marked, branching, or chaotic vascularity was also seen on color doppler ultrasound. Those findings corresponded to histology that showed increased vascularity in stromal tissues of the tumor and in between the tumor cells. CONCLUSION A mass in the dermal and subcutaneous layer with marked and branching or chaotic vascularity may be the unique characteristic that may contribute to early diagnosis of MCC.
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Affiliation(s)
- Hyun Jin Kim
- Departement of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Kyu-Chong Lee
- Department of Radiology, Armed Forces Daejeon Hospital; Daejeon, Korea
| | - Chang Ho Kang
- Departement of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Kyung-Sik Ahn
- Departement of Radiology, Korea University Anam Hospital, Seoul, Korea
| | - Chul Hwan Kim
- Department of Pathology, Korea University Anam Hospital, Seoul, Korea
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13
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Shim E, Kim BH, Choi IY, Hong SJ, Kang CH, Ahn KS. Imaging appearance of post-arthroscopic radiocarpal chondrolysis: comparison with osteoarthritis associated with scapholunate dissociation. Acta Radiol 2021; 62:377-387. [PMID: 32380910 DOI: 10.1177/0284185120922819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Since the diagnosis of post-arthroscopic chondrolysis is very difficult, it can be underdiagnosed and confused with other diseases in clinical practice. PURPOSE To propose imaging features of post-arthroscopic radiocarpal chondrolysis (PRCC) and to compare these with osteoarthritis associated with scapholunate dissociation which are the most common misdiagnoses of PRCC. MATERIAL AND METHODS To identify missed diagnoses of PRCC, 994 magnetic resonance imaging scans performed in 910 patients were retrospectively reviewed. After the identification of 73 patients who exhibited significant radiocarpal cartilage loss, 11 were diagnosed with PRCC. Since scapholunate advanced collapse was the most common incorrect diagnosis of PRCC (4/11), the imaging findings were compared among the 11 patients with PRCC and 14 patients with osteoarthritis caused by scapholunate dissociation who were diagnosed in the same period. The following imaging features were evaluated: scapholunate dissociation; the center of disease and grade of radiocarpal joint destruction; characteristics of bone marrow edema; the presence of radial styloid and distal scaphoid osteophytes; and the extent of joint effusion and synovitis. RESULTS The imaging diagnosis of PRCC was significantly differentiated from osteoarthritis associated with scapholunate dissociation based on occurrence at a younger age, bone marrow edema crossing the joint, center of disease in the proximal radioscaphoid joint, and absence of radial styloid and scaphoid osteophytes (P < 0.05). PRCC occasionally presented with arch-shape bone marrow edema based on the proximal carpal row. CONCLUSION The diagnosis of PRCC can be aided if its characteristic imaging findings are differentiated from other disease entities in patients with a history of arthroscopy.
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Affiliation(s)
- Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - In Young Choi
- Department of Radiology, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Seoul, Republic of Korea
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14
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Ahn KS, Choi IC, Kang CH, Park JW. Ultrasound diagnosis and follow-up of a locked thumb metacarpophalangeal joint caused by radial sesamoid entrapment: a case report. BMC Musculoskelet Disord 2020; 21:509. [PMID: 32736548 PMCID: PMC7395378 DOI: 10.1186/s12891-020-03541-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 11/28/2022] Open
Abstract
Background A locked thumb metacarpophalangeal joint is a rare condition that presents as restricted joint motions with mild hyperextension deformity, usually after a relatively minor hyperextension injury. Owing to the limitations of radiographs, computed tomography is a useful diagnostic imaging modality for assessing sesamoid displacement. However, despite its convenience, ultrasound findings of the locked thumb have rarely been reported. Here, we report a case of a locked thumb metacarpophalangeal joint diagnosed and followed-up using ultrasound. Case presentation A 15-year-old boy with a locked thumb metacarpophalangeal joint presented to our hospital. On physical examination, the 1st metacarpophalangeal joint was found to be hyperextended, and active and passive flexions were not possible. While radiographs were inconclusive, ultrasound revealed radial sesamoid entrapment at the 1st metacarpophalangeal joint causing locking. After closed manual reduction, metacarpophalangeal motions recovered. Success of the reduction was also confirmable by ultrasound. Conclusions Ultrasound can be a feasible modality to diagnose a locked thumb metacarpophalangeal joint and immediately judge the success or failure of the reduction.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - In Cheul Choi
- Division of Hand Surgery & Reconstructive Microsurgery, Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jong Woong Park
- Division of Hand Surgery & Reconstructive Microsurgery, Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
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15
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Ahn KS, Kang CH, Hong SJ, Kim BH, Shim E. The correlation between follow-up MRI findings and laboratory results in pyogenic spondylodiscitis. BMC Musculoskelet Disord 2020; 21:428. [PMID: 32616029 PMCID: PMC7333318 DOI: 10.1186/s12891-020-03446-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although MRI is the gold-standard imaging method in the diagnosis of spondylodiscitis, role of follow-up imaging is debated and there can be discrepancies with regard to the significance of bony or soft tissue responses to treatment. Purpose of our study is to test whether the MRI changes on follow-up imaging correlate with laboratory findings of treatment response. METHODS A total of 48 patients with pyogenic spondylodiscitis who underwent baseline and follow-up MRI were retrospectively reviewed. The extent of bone marrow edema, paravertebral soft tissue inflammation, and disc height were compared on baseline and follow-up MRIs with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels obtained from the medical records at baseline and on follow-up. Relationships between the MRI and laboratory changes were analyzed using the Spearmann correlation test. RESULTS The mean MRI follow-up period was 42.25 days. Based on the CRP (resolved: n = 19, resolving: n = 19, and aggravated: n = 10), there was significant correlation between the laboratory results and the changes in the bone and soft tissues (p < 0.01, both). The correlation was best with soft tissue changes (rho: 0.48) followed by bony changes (rho: 0.41). Based on the ESR (resolved: n = 8, resolving: n = 22, and worsened: n = 18), the correlation was stronger with bone changes (rho: 0.45, p < 0.01) than it was with soft tissue changes (rho: 0.39, p = 0.01). CONCLUSION Follow-up MRI findings of pyogenic spondylodiscitis show variable tissue responses. CRP was best correlated with soft tissue changes, while ESR showed the best association with bony changes.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Korea
| | - Euddeum Shim
- Department of Radiology, Korea University Ansan Hospital, Gyeonggi-do, Korea
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16
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Kwon W, Kim H, Han Y, Hwang YJ, Kim SG, Kwon HJ, Vinuela E, Járufe N, Roa JC, Han IW, Heo JS, Choi SH, Choi DW, Ahn KS, Kang KJ, Lee W, Jeong CY, Hong SC, Troncoso AT, Losada HM, Han SS, Park SJ, Kim SW, Yanagimoto H, Endo I, Kubota K, Wakai T, Ajiki T, Adsay NV, Jang JY. Role of tumour location and surgical extent on prognosis in T2 gallbladder cancer: an international multicentre study. Br J Surg 2020; 107:1334-1343. [PMID: 32452559 DOI: 10.1002/bjs.11618] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 02/29/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In gallbladder cancer, stage T2 is subdivided by tumour location into lesions on the peritoneal side (T2a) or hepatic side (T2b). For tumours on the peritoneal side (T2a), it has been suggested that liver resection may be omitted without compromising the prognosis. However, data to validate this argument are lacking. This study aimed to investigate the prognostic value of tumour location in T2 gallbladder cancer, and to clarify the adequate extent of surgical resection. METHODS Clinical data from patients who underwent surgery for gallbladder cancer were collected from 14 hospitals in Korea, Japan, Chile and the USA. Survival and risk factor analyses were conducted. RESULTS Data from 937 patients were available for evaluation. The overall 5-year disease-free survival rate was 70·6 per cent, 74·5 per cent for those with T2a and 65·5 per cent among those with T2b tumours (P = 0·028). Regarding liver resection, extended cholecystectomy was associated with a better 5-year disease-free survival rate than simple cholecystectomy (73·0 versus 61·5 per cent; P = 0·012). The 5-year disease-free survival rate was marginally better for extended than simple cholecystectomy in both T2a (76·5 versus 66·1 per cent; P = 0·094) and T2b (68·2 versus 56·2 per cent; P = 0·084) disease. Five-year disease-free survival rates were similar for extended cholecystectomies including liver wedge resection versus segment IVb/V segmentectomy (74·1 versus 71·5 per cent; P = 0·720). In multivariable analysis, independent risk factors for recurrence were presence of symptoms (hazard ratio (HR) 1·52; P = 0·002), R1 resection (HR 1·96; P = 0·004) and N1/N2 status (N1: HR 3·40, P < 0·001; N2: HR 9·56, P < 0·001). Among recurrences, 70·8 per cent were metastatic. CONCLUSION Tumour location was not an independent prognostic factor in T2 gallbladder cancer. Extended cholecystectomy was marginally superior to simple cholecystectomy. A radical operation should include liver resection and adequate node dissection.
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Affiliation(s)
- W Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - H Kim
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y Han
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
| | - Y J Hwang
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - S G Kim
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - H J Kwon
- School of Medicine, Kyungpook National University, Daegu, South Korea.,Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - E Vinuela
- Department of Digestive Surgery, Santiago, Chile
| | - N Járufe
- Department of Digestive Surgery, Santiago, Chile
| | - J C Roa
- Pathology, Faculty of Medicine, Catholic University of Chile, Santiago, Chile
| | - I W Han
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - J S Heo
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - S-H Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - D W Choi
- Department of Surgery, Samsung Medical Centre, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - K S Ahn
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - K J Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Keimyung University Dongsan Medical Centre, Daegu, South Korea
| | - W Lee
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - C-Y Jeong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - S-C Hong
- Department of Surgery, Gyeongsang National University College of Medicine, Jinju, South Korea
| | - A T Troncoso
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - H M Losada
- Department of Surgery, Universidad de la Frontera, Temuco, Chile
| | - S-S Han
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-J Park
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - S-W Kim
- Department of Surgery, Centre for Liver Cancer, National Cancer Centre, Goyang, South Korea
| | - H Yanagimoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - I Endo
- Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - K Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - T Wakai
- Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Ajiki
- Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - N V Adsay
- Department of Pathology, Koc University, Istanbul, Turkey.,Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J-Y Jang
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea
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Chung LY, Lee KC, Ahn KS, Lee JJ, Kang CH, Lee KH. MON-LB017 The Effectiveness of Computed Assessment Using GP and TW3 Hybrid System. J Endocr Soc 2020. [PMCID: PMC7209446 DOI: 10.1210/jendso/bvaa046.2074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Bone age assessments (BAAs) is an important clinical modality to investigate endocrine, genetic and growth disorders in children. It is generally performed by radiological examination of the left hand by using either the Greulich-Pyle (GP) or the Tanner-Whitehouse (TW) method. However, both clinical procedures show several limitations, from significant intra- and inter-operator variability to examination effort of clinicians. To address these problems, several automated approaches have been proposed; nevertheless, some disparity still exists between automated BAAs and manual BAAs to be employed in clinical practice. To overcome this disparity, deep learning-based bone age assess software using GP and TW3 hybrid method has been developed. In this study, we evaluate the accuracy and efficiency of the new automated hybrid software system for bone age assessment and validate its feasibility in clinical practice. Materials and Methods: Greulich-Pyle (GP) and Tanner-Whitehouse (TW3) hybrid method-based deep-learning technique was used to develop the automated software system for bone age assessment. Total 102 radiographs from children with the chronological age of 4.9-17.0 years (mean age 10.9±2.3, 51 cases for females and 51 cases for males) were selected and bone age was estimated with this software. For validation of the automated software system, three human experts have manually performed BAAs at expert’s discretion based on GP method for accuracy estimation and one naïve radiologist performed BAAs with automated software system assist and BAAs reading time was recorded in each session for efficiency evaluation. The performance of automated software system was assessed by comparing mean absolute difference (MAD) between the system estimates and the experts manual BAAs.Results: The results of bone age assessment by human experts and automated software system showed no significant difference between the two groups. Each assessed average of bone age were 11.39 ± 2.74 and 11.35 ± 2.76, respectively. MAD was 0.39 years between automated software system BAAs and experts manual BAAs. The 95% confidence interval of the MAD was 0.33 years and 0.45 years. BAAs reading time was reduced from 56.81 sec (95% confidence interval 52.81 - 60.81 sec) in naïve manual BAAs to 31.72 sec (95% confidence interval 29.74 - 33.69 sec) in automated software system assisted BAAs and statistically significant (p < 0.001). MAD showed 0.42 years between naïve manual BAAs and the software-assisted BAAs (95% confidence interval 0.31-0.47 years).Conclusion: The newly developed GP and TW3 hybrid automated software system were reliable for bone age assessments with equivalent accuracy to human experts. Also, the automated system appeared to enhance efficiency by reducing reading times without compromising diagnostic accuracy.
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Affiliation(s)
- Lindsey Yoojin Chung
- Korea University Anam Hospital, Department of Pediatrics, Seoul, Korea, Republic of
| | - Kyu-chong Lee
- Korea University Anam Hospital, Department of Radiology, Seoul, Korea, Republic of
| | - Kyung-Sik Ahn
- Korea University Anam Hospital, Department of Radiology, Seoul, Korea, Republic of
| | | | - Chang Ho Kang
- Korea University Anam Hospital, Department of Radiology, Seoul, Korea, Republic of
| | - Kee-Hyoung Lee
- Korea University Anam Hospital, Department of Pediatrics, Seoul, Korea, Republic of
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18
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Park JH, Ahn KS, Chang A, Kwon YW, Choi IC, Park JW. Changes in the morphology of the triangular fibrocartilage complex (TFCC) on magnetic resonance arthrography related to disruption of ulnar foveal attachment. Skeletal Radiol 2020; 49:249-256. [PMID: 31321453 DOI: 10.1007/s00256-019-03278-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/24/2019] [Accepted: 07/04/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess whether a proximal ligamentous component (PLC) of the triangular fibrocartilage complex (TFCC) with a distally prolapsing morphology is associated with the presence of a TFCC foveal tear on arthroscopy. METHODS One-hundred thirty-two patients (134 wrists) who underwent MR arthrography and subsequent wrist arthroscopy between September 2014 and March 2018 were retrospectively evaluated. The degree of distal PLC prolapse was measured on coronal MR arthrography using the height-to-length ratio (HLR). Subjects' demographics, ulnar variance, presence of a degenerative TFCC tear, and ulnar styloid nonunion were assessed. The association between specific variables and the presence of a foveal tear was investigated. RESULTS A TFCC foveal tear was identified in a total of 101 of 134 wrists examined by arthroscopy. Univariable analysis showed that the HLR of the PLC was significantly greater in the foveal tear group compared with the intact fovea group (44.6 vs. 38.9%, respectively, p < 0.001). Multivariable analysis showed that HLR was positively associated with a foveal tear (odds ratio [OR], 1.211; p < 0.001). The estimated cut-off value of the HLR was 41% (area under the curve [AUC] 0.77). CONCLUSIONS PLCs with a distal prolapse pattern and large HLR are associated with TFCC foveal tears. The HLR of the PLC measured on coronal MR images can therefore be used as an additional predictor of tears of the foveal attachment of the TFCC.
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Affiliation(s)
- Ji Hun Park
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, 73, Inchon-ro, Sungbuk-gu, Seoul, 06334, South Korea
| | - Anseong Chang
- Department of Orthopedic Surgery, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Young Woo Kwon
- Department of Orthopedic Surgery, Korea University Anam Hospital, 73, Inchon-ro, Sungbuk-gu, Seoul, 06334, South Korea
| | - In Cheul Choi
- Department of Orthopedic Surgery, Korea University Anam Hospital, 73, Inchon-ro, Sungbuk-gu, Seoul, 06334, South Korea
| | - Jong Woong Park
- Department of Orthopedic Surgery, Korea University Anam Hospital, 73, Inchon-ro, Sungbuk-gu, Seoul, 06334, South Korea.
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Ahn KS, Kang CH, Cho SB, Cho KH, Han KD, Park YG, Kim YH. Height Loss Was Associated With Osteoporosis in Korean Elderly Men, Not in Women: The Korea National Health and Nutrition Examination Survey 2008-2010. J Clin Densitom 2019; 22:59-66. [PMID: 28781229 DOI: 10.1016/j.jocd.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 07/03/2017] [Accepted: 07/07/2017] [Indexed: 01/28/2023]
Abstract
The degree of height loss varies among individuals, and excessive height loss can be a vertebral fracture or bone loss manifestation. The objective of this study was to examine the relationships between height loss and bone mineral density (BMD) and to assess the prevalence of osteoporosis according to the height loss quartiles. Data from the Korea National Health and Nutrition Examination Survey were analyzed. A total of 2799 participants more than 60 years old were included and subdivided into quartiles according to height loss (Q1-Q4). Height loss was calculated with the difference between the self-reported maximum adult height and the actual measured height. BMD was measured by dual-energy X-ray absorptiometry at the total femur (TF), femoral neck, and lumbar spine. Multivariable linear and logistic regression analyses were conducted to study the height loss-BMD and the height loss-osteoporosis prevalence relationships, respectively. After adjustments for all covariates, height loss was negatively associated with BMD at all the 3 sites (TF and lumbar spine, p < 0.001; femoral neck, p = 0.002) in men, but only at TF (p = 0.008) in women. Men with Q4 height loss had an increased prevalence of osteoporosis compared with those with Q1 (odds ratio = 2.092 and 95% confidence interval = 1.076-4.068). In women, the prevalence of osteoporosis was not associated with height loss. In conclusion, Q4 height loss in elderly men was associated with the increased prevalence of osteoporosis in Korea.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Bum Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yong-Gyu Park
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Kim Y, Giori NJ, Lee D, Ahn KS, Kang CH, Shin CS, Song Y. Role of the acetabular labrum on articular cartilage consolidation patterns. Biomech Model Mechanobiol 2018; 18:479-489. [DOI: 10.1007/s10237-018-1097-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
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Affiliation(s)
- Min A Yoon
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Suk-Joo Hong
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Min Cheol Ku
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Chang Ho Kang
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Kyung-Sik Ahn
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
| | - Baek Hyun Kim
- From the Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea (M.A.Y., S.J.H., M.C.K.); Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea (C.H.K., K.S.A.); Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea (B.H.K.)
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Yoon MA, Hong SJ, Lee CH, Kang CH, Ahn KS, Kim BH. Intravoxel incoherent motion (IVIM) analysis of vertebral bone marrow changes after radiation exposure from diagnostic imaging and interventional procedures. Acta Radiol 2017; 58:1260-1268. [PMID: 28103708 DOI: 10.1177/0284185116688380] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background High cumulative radiation dose in cancer patients warrants systemic examination of possible changes in bone marrow. Purpose To assess retrospectively changes in vertebral bone marrow diffusion and perfusion using intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in hepatocellular carcinoma (HCC) patients after exposure to radiation from diagnostic imaging and interventional procedures. Material and Methods A total of 21 IVIM-DWI sets in 20 HCC patients, consisting of baseline and follow-up liver magnetic resonance imaging (MRI) with an interval less than 100 days, were reviewed after varying levels of radiation exposure from transarterial chemoembolization (TACE), multiphase liver CT, and abdominal radiography. IVIM parameters (apparent diffusion coefficient [ADC], true diffusion coefficient [D], pseudodiffusion coefficient [D*], and perfusion fraction [PF]) of vertebral bone marrow were analyzed for significant differences between baseline and follow-up MRI using Wilcoxon signed-rank test, and for correlations with cumulative effective dose, as well as time interval between last radiation exposure and follow-up MRI using Spearman's correlation. Results Compared to baseline MRI, ADC, D*, and PF significantly decreased on follow-up MRI (ADC: median [interquartile range], 0.405 × 103 mm2/s [0.364-0.477] versus 0.390 [0.348-0.461]; D*: 24.011 [18.141-29.584] versus 20.815 [15.022-28.347]; PF: 10.960% [8.828-12.985] versus 9.125 [8.606-12.803]) ( P < 0.05). There was no significant difference in D ( P = 0.807). Cumulative effective dose was moderately correlated with decrease in D* (r = 0.434). In addition, longer intervals between last exposure and follow-up MRI showed negative correlations with changes in D and ADC (r = -0.352 and -0.333, respectively). Conclusion Vertebral bone marrow diffusion and perfusion parameters were significantly changed after exposure to medical radiation.
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Affiliation(s)
- Min A Yoon
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Hee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
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Kim YH, Ahn KS, Cho KH, Kang CH, Cho SB, Han K, Rho YK, Park YG. Gender differences in the relationship between socioeconomic status and height loss among the elderly in South Korea: Korean National Health and Nutrition Examination Survey 2008-2010. Medicine (Baltimore) 2017; 96:e7131. [PMID: 28834865 PMCID: PMC5571987 DOI: 10.1097/md.0000000000007131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study aimed to examine average height loss and the relationship between height loss and socioeconomic status (SES) among the elderly in South Korea.Data were obtained from the Korean National Health and Nutrition Examination Survey 2008-2010. A total of 5265 subjects (2818 men and 2447 women) were included. Height loss was calculated as the difference between the subject's self-reported maximum adult height and their measured current height. The height loss values were divided into quartiles (Q1-Q4) for men and women. SES was determined using a self-reported questionnaire for education level, family income, and occupation.Height loss was associated with SES in all age groups, and mean height loss increased with age. In the relationship between education level and maximum height loss (Q4), men with ≤6, 7-9, or 10-12 years of education had higher odds ratios for the prevalence of height loss (Q4) than men with the highest education level (≥13 years). With regard to the relationship between the income level and height loss (Q4), the subjects with the lowest income had an increased prevalence of maximum height loss (Q4) than the subjects with the highest income (odds ratios = 2.03 in men and 1.94 in women). Maximum height loss (Q4) was more prevalent in men and women with a low SES and less prevalent in men with a high SES than in men with a middle SES.Height loss (Q4) was associated with education level in men and with income level (especially low income) in men and women. Height loss was also associated with a low SES in men and women.
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Affiliation(s)
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University College of Medicine
| | | | - Chang Ho Kang
- Department of Radiology, Korea University College of Medicine
| | - Sung Bum Cho
- Department of Radiology, Korea University College of Medicine
| | - Kyungdo Han
- Department of Biostatistics, Catholic University College of Medicine, Seoul
| | - Yong-Kyun Rho
- Department of Family Medicine, Hallym University College of Medicine, Chunchon, Republic of Korea
| | - Yong-Gyu Park
- Department of Biostatistics, Catholic University College of Medicine, Seoul
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Kim W, Ahn KS, Kang CH, Kang WY, Yang KS. Comparison of MRI grading for cervical neural foraminal stenosis based on axial and oblique sagittal images: Concordance and reliability study. Clin Imaging 2017; 43:165-169. [DOI: 10.1016/j.clinimag.2017.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/27/2017] [Accepted: 03/10/2017] [Indexed: 10/20/2022]
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Ahn KS, Lee NJ, Kang CH, Lee YH, Jeon HJ. Serial Changes of Tendon Histomorphology and Strain Elastography After Induced Achilles Tendinopathy in Rabbits: An In Vivo Study. J Ultrasound Med 2017; 36:767-774. [PMID: 28150323 DOI: 10.7863/ultra.16.02059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 06/27/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES The purpose of this study was to investigate and compare the serial changes of morphology and strain in the early process of Achilles tendinopathy in a rabbit model. METHODS A total of 10 New Zealand white rabbits underwent ligation of one of their Achilles tendons to induce ischemic injury. Both inflamed and contralateral Achilles tendons were serially evaluated with 3 follow-ups: the first on days 3 to 5, the second on days 9 to 13, and the third and last follow-up on days 15 to 20 after surgery. During each examination, tendon thickness was measured and red, green, and blue pixel intensities of the elastogram were analyzed using color histogram analysis software. Differences between the inflamed and control group were compared. RESULTS The mean thickness of the inflamed tendons increased during consecutive follow-ups and was significantly larger than that of control tendons (P < .01). The mean red pixel intensity ratio of the inflamed tendons was also serially increased and was higher than that in the control tendons, indicating softening. However, the difference was significant only in the second and third follow-ups (P < .01). CONCLUSIONS Tendon thickening and softening developed during the early process of Achilles tendinopathy in a rabbit model. Tendon softening may present later than thickening.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Nam Joon Lee
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Young Hen Lee
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea
| | - Hae Jeong Jeon
- Department of Radiology, Konkuk University School of Medicine, Seoul, Korea
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Lee DK, Ahn KS, Kang CH, Cho SB. Ultrasonography of the lower extremity veins: anatomy and basic approach. Ultrasonography 2017; 36:120-130. [PMID: 28260355 PMCID: PMC5381851 DOI: 10.14366/usg.17001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 01/29/2017] [Accepted: 01/30/2017] [Indexed: 11/29/2022] Open
Abstract
Ultrasonography is an imaging modality widely used to evaluate venous diseases of the lower extremities. It is important to understand the normal venous anatomy of the lower extremities, which has deep, superficial, and perforating venous components, in order to determine the pathophysiology of venous disease. This review provides a basic description of the anatomy of the lower extremity veins and useful techniques for approaching each vein via ultrasonography.
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Affiliation(s)
- Dong-Kyu Lee
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sung Bum Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Na D, Hong SJ, Yoon MA, Ahn KS, Kang CH, Kim BH, Jang Y. Spinal Bone Bruise: Can Computed Tomography (CT) Enable Accurate Diagnosis? Acad Radiol 2016; 23:1376-1383. [PMID: 27432268 DOI: 10.1016/j.acra.2016.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/15/2016] [Accepted: 06/16/2016] [Indexed: 01/15/2023]
Abstract
RATIONALE AND OBJECTIVES The study aimed to evaluate the usefulness of dual-energy computed tomography (DECT) before and after calcium subtraction in the diagnosis of spinal bone bruise. MATERIALS AND METHODS Among the patients who visited our emergency department between January 2013 and July 2014 who underwent both spinal DECT and magnetic resonance imaging, 38 patients (men:women = 25:13; mean age: 55.6 years, range: 28-82) were included. The patients were divided into two groups, those with and without acute spinal compression fracture, based on magnetic resonance imaging findings. In the fracture group (n = 22), the ratio of Hounsfield unit (HU) values was calculated between the fracture level and the next normal inferior vertebra in the DECT before and after calcium subtraction. In the non-fracture group (n = 16), the ratios of HU values were calculated between two normal adjacent vertebrae. The mean HU ratios were compared between the two groups. RESULTS The mean HU ratio was higher in the fracture group (calcium subtraction: before: 1.57 and 1.59; after: 1.74 and 1.76) than the non-fracture group (before: 1.07 and 1.08; after: 1.07 and 1.07) (P < 0.001). The mean HU ratio between before and after calcium subtraction images was different only in the fracture group (P < 0.05). There was no significant difference in the area under the curve, sensitivity, specificity, positive and negative predictive values, and accuracy (before: 0.846, 87.5%, 81.2%, 87.5%, 81.2%, 85%; after: 0.865, 91.7%, 81.2%, 88%, 86.7%, 87.5% in high energy) between the images before and after calcium subtraction. CONCLUSION The HU ratio between the fractured and next normal vertebra was diagnostic for spinal bone bruise on DECT images both before and after calcium subtraction.
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Affiliation(s)
- Domin Na
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea.
| | - Min A Yoon
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, 148, Gurodong-ro, Guro-gu, Seoul 08308, Republic of Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Baek Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Yeonggul Jang
- Severance Biomedical Science Institute, Yonsei University Health System, Seoul, Republic of Korea
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Chung J, Ahn KS, Kang CH, Hong SJ, Kim BH. Hoffmann's disease: MR imaging of hypothyroid myopathy. Skeletal Radiol 2015; 44:1701-4. [PMID: 26250555 DOI: 10.1007/s00256-015-2226-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 02/02/2023]
Abstract
Hoffmann's syndrome is a hypothyroid myopathy presenting as muscle stiffness and hypertrophy. It is a rare complication of hypothyroidism. MRI features of this syndrome have seldom been described in the literature. We present a case of Hoffmann's syndrome in a 34-year-old man who underwent lower extremity contrast-enhanced MRI. MRI can demonstrate the hypertrophic configuration, T2 hyperintensity, and enhancement of the involved muscles in Hoffmann's syndrome. Along with clinical, laboratory, and electromyography findings, MRI may be helpful in distinguishing between inflammatory myopathy, myonecrosis, subacute muscle denervation, and infectious myositis.
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Affiliation(s)
- Jeewon Chung
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea.
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul, 136-705, Korea
| | - Suk-Joo Hong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Beak Hyun Kim
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea
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Ahn KS, Kang CH, Kim Y, Jeong WK. Diagnosis of adhesive capsulitis: comparison of contrast-enhanced MRI with noncontrast-enhanced MRI. Clin Imaging 2015; 39:1061-7. [PMID: 26362354 DOI: 10.1016/j.clinimag.2015.08.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 07/31/2015] [Accepted: 08/12/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the diagnostic performance of contrast-enhanced (CE) magnetic resonance imaging (MRI) and non-CE MRI for adhesive capsulitis (AC). METHODS CE MRI of 50 AC and 53 non-AC patients were reviewed by two radiologists independently. RESULTS Axillary capsular thickening and T2 hyperintensity (sensitivity=92-94%; specificity=53-64%) and enhancement of the axillary capsule and rotator interval (sensitivity=92-98%; specificity=38-64%) were helpful in diagnosing AC. Interobserver reliability was highest with axillary joint capsule enhancement (κ=0.92). CONCLUSION Non-CE and CE MRI are helpful in confirming the clinical diagnosis of AC. CE-MRI may improve assessment of the rotator interval and diagnostic confidence in patients with AC.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea.
| | - Yura Kim
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Woong-Kyo Jeong
- Department of Orthopaedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Cho YH, Ahn KS, Kang CH, Kim CH. Calcifying aponeurotic fibroma of the dorsum of the foot: radiographic and magnetic resonance imaging findings in a four-year-old boy. Iran J Radiol 2015; 12:e23911. [PMID: 25901261 PMCID: PMC4393499 DOI: 10.5812/iranjradiol.23911] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 10/13/2014] [Indexed: 01/25/2023]
Abstract
Calcifying aponeurotic fibroma (CAF) is a rare, benign fibroblastic tumor that typically occurs in the palms of the hands and soles of the feet, in children and adolescents. Due to its infiltrative nature, this tumor can mimic malignancy on preoperative magnetic resonance imaging (MRI) and has a predilection for local recurrence. There are very few reports in the literature that describe features of CAF on MRI, especially those arising in the foot. We present an unusual case of a CAF affecting the dorsum of the foot in a four-year-old boy.
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Affiliation(s)
- Yun Hee Cho
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyung-Sik Ahn
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
- Corresponding author: Kyung-Sik Ahn, Department of Radiology, Anam Hospital, Korea University College of Medicine, 126-1, 5-ga Anam-dong, Seongbuk-gu, Seoul 136-705, Korea. Tel: +82-29206627, Fax: +82-29293796, E-mail:
| | - Chang Ho Kang
- Department of Radiology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Chul Hwan Kim
- Department of Pathology, Anam Hospital, Korea University College of Medicine, Seoul, Korea
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Park HJ, Lee SY, Lee SM, Kim WT, Lee S, Ahn KS. Strain elastography features of epidermoid tumours in superficial soft tissue: differences from other benign soft-tissue tumours and malignant tumours. Br J Radiol 2015; 88:20140797. [PMID: 25827206 DOI: 10.1259/bjr.20140797] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We evaluated ultrasonographic features of superficial epidermoid tumour with a focus on strain elastography (SE) features that will help in the differential diagnosis of epidermoid tumour from other benign and malignant soft-tissue tumours. METHODS We retrospectively evaluated ultrasonographic and SE data of 103 surgically confirmed superficial soft-tissue tumours and tumour-like lesions: 29 cases of epidermoid tumour, 46 cases of other benign tumours and 28 cases of malignant tumour. SE and B-mode imaging were performed at the same time. SE characteristics were assigned into four grades (1-4) according to their elasticity. Interobserver agreement for the four SE scores between the two radiologists was analysed using kappa statistics. We classified each SE finding as a hard lesion (SE Score 3-4) or soft lesion (SE Score 1-2) and compared these findings using the χ(2) test to identify whether a significant difference in mass hardness existed among epidermoid tumour, other benign tumour and malignant tumour. RESULTS Overall interobserver agreement according to the four SE scores was moderate (κ = 0.540), and overall agreement for the hardness [soft (Score 1-2) or hard (Score 3-4)] was almost perfect (κ = 0.825). Malignant tumours showed higher SE scores (3-4, hard nature) than did epidermoid tumour or other benign soft-tissue tumours. There were no differences in SE score between epidermoid tumour and other benign tumours. CONCLUSION Superficial epidermoid tumour exhibits a softer nature than does malignant tumour but does not have a different SE pattern from other benign tumours. ADVANCES IN KNOWLEDGE SE features of epidermoid tumour might be helpful in differentiating from other benign and malignant tumours.
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Affiliation(s)
- H J Park
- 1 Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Siveen KS, Nguyen AH, Lee JH, Li F, Singh SS, Kumar AP, Low G, Jha S, Tergaonkar V, Ahn KS, Sethi G. Negative regulation of signal transducer and activator of transcription-3 signalling cascade by lupeol inhibits growth and induces apoptosis in hepatocellular carcinoma cells. Br J Cancer 2014; 111:1327-37. [PMID: 25101566 PMCID: PMC4183851 DOI: 10.1038/bjc.2014.422] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/23/2014] [Accepted: 07/03/2014] [Indexed: 02/06/2023] Open
Abstract
Background: Constitutive activation of signal transducer and activator of transcription signalling 3 (STAT3) has been linked with survival, proliferation and angiogenesis in a wide variety of malignancies including hepatocellular carcinoma (HCC). Methods: We evaluated the effect of lupeol on STAT3 signalling cascade and its regulated functional responses in HCC cells. Results: Lupeol suppressed constitutive activation of STAT3 phosphorylation at tyrosine 705 residue effectively in a dose- and time-dependent manner. The phosphorylation of Janus-activated kinases (JAKs) 1 and 2 and Src was also suppressed by lupeol. Pervanadate treatment reversed the downregulation of phospho-STAT3 induced by lupeol, thereby indicating the involvement of a phosphatase. Indeed, we observed that treatment with lupeol increased the protein and mRNA levels of SHP-2, and silencing of SHP-2 abolished the inhibitory effects of lupeol on STAT3 activation. Treatment with lupeol also downregulated the expression of diverse STAT3-regulated genes and decreased the binding of STAT3 to VEGF promoter. Moreover, the proliferation of various HCC cells was significantly suppressed by lupeol, being associated with substantial induction of apoptosis. Depletion of SHP-2 reversed the observed antiproliferative and pro-apoptotic effects of lupeol. Conclusions: Lupeol exhibited its potential anticancer effects in HCC through the downregulation of STAT3-induced pro-survival signalling cascade.
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Affiliation(s)
- K S Siveen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - A H Nguyen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - J H Lee
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Republic of Korea
| | - F Li
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - S S Singh
- 1] Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore [2] Cancer Science Institute of Singapore, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore
| | - A P Kumar
- 1] Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore [2] Cancer Science Institute of Singapore, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore [3] Biomedical Sciences, Faculty of Health Sciences, Curtin University, Perth, Western Australia 6009, Australia [4] Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA
| | - G Low
- 1] Cancer Science Institute of Singapore, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore [2] Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - S Jha
- 1] Cancer Science Institute of Singapore, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore [2] Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - V Tergaonkar
- Institute of Molecular and Cell Biology, A*STAR, Biopolis Drive Proteos, Singapore, Singapore
| | - K S Ahn
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul 130-701, Republic of Korea
| | - G Sethi
- 1] Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore [2] Cancer Science Institute of Singapore, Centre for Translational Medicine, 14 Medical Drive, Singapore 117599, Singapore
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Park HJ, Oh Y, Kang HJ, Han EJ, Shin HY, Ahn HS, Ahn KS, Yoon BH, Han BD. A gene-specific primer extension and liquid bead array system for killer-cell immunoglobulin-like receptor genotyping. ACTA ACUST UNITED AC 2011; 77:251-6. [PMID: 21299533 DOI: 10.1111/j.1399-0039.2010.01618.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A simple and accurate method for killer-cell immunoglobulin-like receptor (KIR) genotyping is developed using KIR gene-specific primer extension (GSPE) followed by bead array hybridization (GSPE method). After amplification of exons 4, 5, and 9, KIR GSPE and bead array hybridization were performed to verify the presence or absence of 16 KIR subfamilies. GSPE method was validated with natural killer/KIR reference panel I consisting of 48 cell types provided by 13th International Histocompatibility Working Group (IHWG) and genomic DNA from 17 peripheral blood cells, 8 cell lines, and 8 buccal cells. The results of reference panel from GSPE method were 100% concordant with the IHWG reference typing information. All genomic DNAs except reference panel were typed for KIR genes with sequence-specific primer methods and showed 100% identical typing results using this novel system. In addition, GSPE method can obtain results in 8 h from DNA with 10 ng genomic DNA in a 96-well-based assay format.
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Affiliation(s)
- H J Park
- YeBT Co., Ltd, Mok-dong, Yangchun-gu, Seoul, South Korea
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Park HJ, Oh Y, Kang HJ, Han EJ, Shin HY, Ahn HS, Ahn KS, Yoon BH, Han BD. A gene-specific primer extension and liquid bead array system for killer cell immunoglobulin-like receptor genotyping. ACTA ACUST UNITED AC 2011; 77:535-9. [PMID: 21395560 DOI: 10.1111/j.1399-0039.2010.01622.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Han HS, Cho JY, Yoon YS, Ahn KS, Kim H. Preoperative inflammation is a prognostic factor for gallbladder carcinoma. Br J Surg 2010; 98:111-6. [PMID: 21136565 DOI: 10.1002/bjs.7265] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2010] [Indexed: 12/14/2022]
Abstract
BACKGROUND Inflammation frequently accompanies gallbladder carcinoma (GBC), but its impact on outcome is unclear. The present study investigated the impact of concomitant inflammation on survival of patients with GBC. METHODS All patients undergoing surgery for GBC between October 2003 and May 2009 were identified retrospectively from a prospectively collected database. Patients were classified according to whether preoperative inflammation was present (65 patients) or not (23). RESULTS A total of 88 patients were enrolled. There were no differences in sex, mean age, tumour node metastasis (TNM) stage and radicality of resection between the two groups. The overall 3-year survival rate was lower in patients with preoperative inflammation than in those without (33 versus 73 per cent; P = 0·001). In univariable analysis, preoperative inflammation, T, N and M category, TNM stage, radicality of surgery and tumour differentiation were significant prognostic factors. The presence of preoperative inflammation (hazard ratio (HR) 2·38, 95 per cent confidence interval 1·04 to 5·43), lymph node metastases (HR 5·23, 1·05 to 26·09) and R1 or R2 resection (HR 3·77, 1·47 to 9·72) were independent prognostic factors for poor survival. CONCLUSION The presence of preoperative inflammation is an independent prognostic factor for poor survival in patients with GBC.
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Affiliation(s)
- H-S Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
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Cha HS, Kim TJ, Kim JY, Lee MH, Jeon CH, Kim J, Bae EK, Ahn KS, Koh EM. Autoantibodies to glucose‐6‐phosphate isomerase are elevated in the synovial fluid of rheumatoid arthritis patients. Scand J Rheumatol 2009; 33:179-84. [PMID: 15228189 DOI: 10.1080/03009740310004757] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVE This study investigated whether anti-glucose-6-phosphate isomerase (GPI) antibody in the synovial fluid is specifically related to human rheumatoid arthritis (RA). METHODS Synovial fluid was collected from patients with RA, osteoarthritis (OA), gout, Behcet's disease, or ankylosing spondylitis. GPI-binding activity was measured in the synovial fluid using a surface plasmon resonance (SPR) biosensor. RESULTS The mean level of anti-GPI signal in the synovial fluid of RA patients was significantly elevated compared with that of OA patients (2.84 +/- 1.41 AU versus 1.19 +/- 0.42 AU, respectively; p < 0.0001). Anti-GPI signals in the synovial fluids of patients with non-rheumatoid arthritis, such as gout, Behcet's disease, or ankylosing spondylitis were significantly lower than in the synovial fluid of RA patients (p < 0.005), and were similar to those of OA patients. CONCLUSION Our study indicates that anti-GPI antibody in the synovial fluid is specifically related to RA, and suggests that GPI and its autoantibody might be important in the pathogenesis of human RA.
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Affiliation(s)
- H S Cha
- Department of Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Yoon YS, Lee KH, Han HS, Cho JY, Ahn KS. Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy. Br J Surg 2009; 96:633-40. [DOI: 10.1002/bjs.6609] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abstract
Background
This study evaluated the short- and long-term patency of preserved splenic vessels after laparoscopic spleen-preserving distal pancreatectomy (SPDP) with preservation of the splenic vessels.
Methods
This single-centre retrospective study included all patients who had undergone splenic vessel-preserving laparoscopic SPDP between 2004 and 2007. The patency of the splenic vessels was assessed by abdominal computed tomography and classified into three grades according to the degree of stenosis.
Results
Twenty-two patients were included. The preoperative patency of the splenic artery and vein was normal in 20 and 19 patients respectively. Normal patency of the splenic artery and vein was observed in 16 and five patients respectively within 1 month of surgery, and in 19 and nine patients 6 months or more after operation. Nine of ten patients with complete splenic vein occlusion developed a collateral circulation in the late postoperative phase. Splenic perfusion was well preserved in all patients.
Conclusion
Splenic vessel-preserving laparoscopic SPDP has the short-term benefit of good perfusion to the spleen. In the long term, there is a risk of left-sided portal hypertension if the splenic vein becomes occluded after surgery.
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Affiliation(s)
- Y-S Yoon
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - K H Lee
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - H-S Han
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - J Y Cho
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
| | - K S Ahn
- Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea
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Abstract
Viruses are the most common cause of opportunistic infections, important complications of transplantation. Mumps infection in renal transplant recipients is uncommon. This report focused on a 23-year-old woman who received immunosuppressive therapy based on tacrolimus, prednisolone, and mycophenolate mofetil for renal transplantation. Sixteen months after transplantation, she was admitted with pain and swelling in both infra-auricular areas. Laboratory findings demonstrated positive mumps IgM and IgG antibodies and an increased serum amylase level. Computed tomography revealed both parotid glands to be diffusely enlarged. After the diagnosis of mumps parotitis, the patient's immunosuppression was reduced and the clinical course was satisfactory.
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Affiliation(s)
- S B Park
- Department of Internal Medicine, Kidney Institute, Keimyung University, Dongsan Medical Center, Daegu, Korea.
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Ahn KS, Yoo K, Cha IH, Seo TS. Spontaneously migrated tip of an implantable port catheter into the axillary vein in a patient with severe cough and the subsequent intervention to reposition it. Korean J Radiol 2008; 9 Suppl:S81-4. [PMID: 18607135 PMCID: PMC2627199 DOI: 10.3348/kjr.2008.9.s.s81] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Migration of an implantable port catheter tip is one of the well-known complications of this procedure, but the etiology of this problem is not clear. We describe here a case of migration of the tip of a port catheter from the right atrium to the right axillary vein in a patient with severe cough. Coughing was suggested for this case as the cause of the catheter tip migration. We corrected the position of the catheter tip via transfemoral snaring.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Guro Hospital, Seoul, Korea
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Ahn KS, Yong HS, Lee JW, Woo OH, Kang EY. Right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch. Pediatr Radiol 2007; 37:584-6. [PMID: 17404722 DOI: 10.1007/s00247-007-0452-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 01/31/2007] [Accepted: 03/03/2007] [Indexed: 10/23/2022]
Abstract
We present a rare case of right circumflex retro-oesophageal aortic arch with coarctation of a high-positioned right arch. A 7-month-old boy presented with a cardiac murmur. Cardiac situs was normal and there was no evidence of an intracardiac shunt or patent ductus arteriosus. MR aortography revealed a right aortic arch that was high-positioned, tortuous and narrowed. This right aortic arch crossed the midline behind the oesophagus and continued as a left-sided descending aorta. The left common carotid and subclavian arteries arose from a large branching vascular structure that derived from the top of the left-sided descending aorta. The right common carotid artery arose from the ascending aorta. The proximal portion of the right common carotid artery showed very severe stenosis and poststenotic dilatation. The right subclavian artery originated distal to the narrowed and tortuous segment of the aortic arch.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Guro Hospital, 97 Guro-dong, Guro-gu, Seoul, 152-703 South Korea
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Sethi G, Ahn KS, Chaturvedi MM, Aggarwal BB. Epidermal growth factor (EGF) activates nuclear factor-κB through IκBα kinase-independent but EGF receptor-kinase dependent tyrosine 42 phosphorylation of IκBα. Oncogene 2007; 26:7324-32. [PMID: 17533369 DOI: 10.1038/sj.onc.1210544] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Overexpression of epidermal growth factor (EGF) receptor and constitutive activation of nuclear factor-kappaB (NF-kappaB) are frequently encountered in tumor cells. Although EGF has been shown to induce NF-kappaB activation, the mechanism is poorly understood. EGF activated NF-kappaB DNA binding, induced NF-kappaB reporter activity and the expression of antiapoptotic and cell-proliferative gene products. Interestingly, non-small cell lung adenocarcinoma cell lines (HCC827 and H3255), which exhibit EGFR amplification, showed ligand-independent activation of NF-kappaB. Unlike tumor-necrosis factor (TNF), however, EGF failed to induce IkappaBalpha phosphorylation and ubiquitination and the activation of IkappaBalpha kinase (IKK). Although DN-IKKbeta inhibited TNF-induced NF-kappaB activity, DN-IKKbeta had no effect on EGF-induced NF-kappaB activation, suggesting that EGF-induced NF-kappaB activation is IKK independent. Using dominant-negative plasmids, we also demonstrated the role of TRADD, TRAF2, NIK and Ras in EGF-induced NF-kappaB activation. By using specific antibodies and IkappaBalpha plasmid, which is mutated at tyrosine 42 to phenylalanine, we show that EGF induced the tyrosine phosphorylation of IkappaBalpha at residue 42. Furthermore, EGF receptor kinase inhibitor blocked IkappaBalpha phosphorylation and consequent NF-kappaB activation. Overall, our results indicate that tyrosine phosphorylation of IkappaBalpha at residue 42 is critical for EGF-induced NF-kappaB activation pathway.
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Affiliation(s)
- G Sethi
- Cytokine Research Laboratory, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Abstract
Curcumin has become a focus of interest with regard to its antitumor effects in prostate cancer; however, the effects of this agent on invasion and metastasis remain less well understood. Matrix metalloproteinases (MMPs) are important prerequisite for tumor invasion and metastasis. In this study, we evaluated the effects of curcumin on prostate cancer cells (DU-145) invasion in both in vitro and in vivo. We utilized zymography and ELISA in order to determine the MMP-2 and MMP-9 activity. Matrigel invasion assay was performed to assess cellular invasion. We developed a xenograft model to examine tumorigenicity. Curcumin treatment resulted not only in a significant reduction in the expression of MMP-2 and MMP-9, but also effected the inhibition of invasive ability in vitro. Curcumin was shown to induce a marked reduction of tumor volume, MMP-2, and MMP-9 activity in the tumor-bearing site. The metastatic nodules in vivo were significantly fewer in the curcumin-treated group than untreated group. Curcumin appears to constitute a potential agent for the prevention of cancer progression, or at least of the initial phase of metastasis, in prostate cancer.
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Affiliation(s)
- J H Hong
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Aggarwal BB, Shishodia S, Takada Y, Jackson-Bernitsas D, Ahn KS, Sethi G, Ichikawa H. TNF blockade: an inflammatory issue. Ernst Schering Res Found Workshop 2006:161-86. [PMID: 16331857 DOI: 10.1007/3-540-37673-9_10] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Tumor necrosis factor (TNF), initially discovered as a result of its antitumor activity, has now been shown to mediate tumor initiation, promotion, and metastasis. In addition, dysregulation of TNF has been implicated in a wide variety of inflammatory diseases including rheumatoid arthritis, Crohn's disease, multiple sclerosis, psoriasis, scleroderma, atopic dermatitis, systemic lupus erythematosus, type II diabetes, atherosclerosis, myocardial infarction, osteoporosis, and autoimmune deficiency disease. TNF, however, is a critical component of effective immune surveillance and is required for proper proliferation and function of NK cells, T cells, B cells, macrophages, and dendritic cells. TNF activity can be blocked, either by using antibodies (Remicade and Humira) or soluble TNF receptor (Enbrel), for the symptoms of arthritis and Crohn's disease to be alleviated, but at the same time, such treatment increases the risk of infections, certain type of cancers, and cardiotoxicity. Thus blockers of TNF that are safe and yet efficacious are urgently needed. Some evidence suggests that while the transmembrane form of TNF has beneficial effects, soluble TNF mediates toxicity. In most cells, TNF mediates its effects through activation of caspases, NF-kappaB, AP-1, c-jun N-terminal kinase, p38 MAPK, and p44/p42 MAPK. Agents that can differentially regulate TNF expression or TNF signaling can be pharmacologically safe and effective therapeutics. Our laboratory has identified numerous such agents from natural sources. These are discussed further in detail.
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Affiliation(s)
- B B Aggarwal
- Cytokine Research Laboratory, Department of Experimental Therapeutics, University of Texas, M.D. Anderson Cancer Hospital 77030, USA.
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Cha HS, Ahn KS, Jeon CH, Kim J, Koh EM. Inhibitory effect of cyclo-oxygenase-2 inhibitor on the production of matrix metalloproteinases in rheumatoid fibroblast-like synoviocytes. Rheumatol Int 2004; 24:207-11. [PMID: 12898179 DOI: 10.1007/s00296-003-0359-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2002] [Accepted: 05/30/2003] [Indexed: 10/26/2022]
Abstract
Cyclo-oxygenase (COX)-2 has been associated with inflammation in rheumatoid arthritis (RA), but its role in joint destruction remains unclear. In this study, we investigated the effect on cultured rheumatoid fibroblast-like synoviocytes (FLS) of the selective COX-2 inhibitor celecoxib on the expression of matrix metalloproteinases (MMPs), which play an important role in tissue degradation and angiogenesis in rheumatoid synovium. Treatment with nontoxic doses of celecoxib resulted in dose-dependent inhibition of MMP-1, -2, and -3 secretion from FLS when measured by enzyme-linked immunosorbent assay. Celecoxib suppressed proinflammatory cytokines (tumor necrosis factor-alpha and interleukin-1beta) induced augmentation of the gelatinolytic activity on zymography. These results suggest that COX-2 inhibitors might influence matrix degradation or angiogenesis in RA by downregulating the expression of various MMPs in rheumatoid FLS.
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Affiliation(s)
- H S Cha
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
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Cha HS, Ahn KS, Jeon CH, Kim J, Song YW, Koh EM. Influence of hypoxia on the expression of matrix metalloproteinase-1, -3 and tissue inhibitor of metalloproteinase-1 in rheumatoid synovial fibroblasts. Clin Exp Rheumatol 2003; 21:593-8. [PMID: 14611107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
OBJECTIVE The rheumatoid synovium is a hypoxic environment, and hypoxia has been implicated as a factor in the pathogenesis of rheumatoid arthritis (RA). The purpose of this study was to investigate the effect of hypoxia on the expression of matrix metalloproteinase (MMP)-1, -3 and tissue inhibitor of metalloproteinase (TIMP)-1 in rheumatoid synovial fibroblasts. METHODS Synovial fibroblasts obtained from RA patients were cultured for 48 h under normoxic or hypoxic conditions. Assays included western blot analysis and enzyme-linked immunosorbent assay (ELISA) for MMP-1, -3 and TIMP-1, and northern blot analysis to measure TIMP-1 mRNA levels. RESULTS Compared with normoxic culture, hypoxia increased MMP-1 and MMP-3 expression in rheumatoid synovial fibroblasts. Hypoxia decreased TIMP-1 expression in rheumatoid synovial fibroblasts, as measured by both protein and mRNA levels. CONCLUSION These results suggest that microenvironmental conditions, such as hypoxia, may directly contribute to joint destruction in RA by increasing the ratio of MMP-1, -3 to TIMP-1 production in synovial fibroblasts.
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Affiliation(s)
- H S Cha
- Department of Medicine, Samsung Medical Center, Seoul, Korea.
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46
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Yun YP, Do JH, Ko SR, Ryu SY, Kim JH, Song HC, Park YD, Ahn KS, Kim SH. Effects of Korean red ginseng and its mixed prescription on the high molecular weight dextran-induced blood stasis in rats and human platelet aggregation. J Ethnopharmacol 2001; 77:259-264. [PMID: 11535373 DOI: 10.1016/s0378-8741(01)00303-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study was undertaken to evaluate the antithrombotic effects of Korean Red Ginseng (KRG) and its new prescription (KRGP) consisting of five herbs such as Korean red ginseng, Ganoderma, Cinnamomi Cortex, Glycyrrhizae Radix and Laminaria. In rats with blood stasis induced by high molecular weight dextran, KRG and KRGP significantly restored not only the number of platelets and fibrinogen, but also suppressed the fibrin degradation products (FDP) to normal range. In platelet aggregation assay with human platelet rich plasma (PRP), KRG and KRGP significantly inhibited thrombin and collagen-induced platelet aggregation. The IC(50) values of KRG and KRGP were >2 and 0.23+/-0.01 mg/ml for thrombin, 0.32+/-0.01 and 0.17+/-0.02 mg/ml for collagen and 0.72+/-0.25 and >2 mg/ml for ADP, respectively. In coagulation assay, KRG and KRGP significantly prolonged activated partial prothrombin time (APPT) and prothrombin time (PT) as compared with control data. KRGP was found to be more effective than KRG alone on antithrombotic activity. These results suggest that KRGP may exert its antithrombotic activity due to inhibition of platelet aggregation and coagulation activity more than KRG.
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Affiliation(s)
- Y P Yun
- College of Pharmacy, Chungbuk National University, Cheongju 361-763, South Korea
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47
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Ahn KS, Jung KY, Kim JH, Oh SR, Lee HK. Inhibitory activity of lignan components from the flower buds of Magnoliae fargesii on the expression of cell adhesion molecules. Biol Pharm Bull 2001; 24:1085-7. [PMID: 11558575 DOI: 10.1248/bpb.24.1085] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Inhibitory activity of lignans isolated from Magnoliae fargesii Cheng on cell adhesion molecules on the surface of THP-1 human monocytic cell lines were investigated. Among 16 lignan components tested, six displayed relatively potent inhibitory activity on the expression of both intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1).
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Affiliation(s)
- K S Ahn
- Immunomodulator Research Laboratory, Korea Research Institute of Bioscience and Biotechnology, Taejon
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Abstract
The activation of NF-kappaB induced by kojic acid, an inhibitor of tyrosinase for biosynthesis of melanin in melanocytes, was investigated in human transfectant HaCaT and SCC-13 cells. These two keratinocyte cell lines transfected with pNF-kappaB-SEAP-NPT plasmid were used to determine the activation of NF-kappaB. Transfectant cells release the secretory alkaline phosphatase (SEAP) as a transcription reporter in response to the NF-kappaB activity and contain the neomycin phosphotransferase (NPT) gene for the dominant selective marker of geneticin resistance. NF-kappaB activation was measured in the SEAP reporter gene assay using a fluorescence detection method. Kojic acid showed the inhibition of cellular NF-kappaB activity in both human keratinocyte transfectants. It could also downregulate the ultraviolet ray (UVR)-induced activation of NF-kappaB expression in transfectant HaCaT cells. Moreover, the inhibitory activity of kojic acid in transfectant HaCaT cells was found to be more potent than known antioxidants, e.g., vitamin C and N-acetyl-L-cysteine. These results indicate that kojic acid is a potential inhibitor of NF-kappaB activation in human keratinocytes, and suggest the hypothesis that NF-kappaB activation may be involved in kojic acid induced anti-melanogenic effect.
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Affiliation(s)
- K Y Moon
- Natural Products Research Institute, Seoul National University, Korea
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Yang JM, Ahn KS, Cho MO, Yoneda K, Lee CH, Lee JH, Lee ES, Candi E, Melino G, Ahvazi B, Steinert PM. Novel mutations of the transglutaminase 1 gene in lamellar ichthyosis. J Invest Dermatol 2001; 117:214-8. [PMID: 11511296 DOI: 10.1046/j.0022-202x.2001.01429.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Lamellar ichthyosis, one form of congenital autosomal recessive ichthyosis, is caused by mutations in the gene (TGM1) encoding the transglutaminase 1 enzyme. Mutations, deletions, or insertion of TGM1 have been reported so far. Here we report that three novel mutations of TGM1, D101V, N288T, and R306W, cause lamellar ichthyosis in two different families. The patient in family LI-KD has N288T and R306W mutations, and the patient in family LI-LK has D101V and R306W mutations. The activity of the transglutaminase 1 enzyme of the patient in family LI-LK was only about 15% of normal. Also, three-dimensional structural prediction analyses revealed that the N288T and R306W mutations, and possibly the D101V mutation, cause misfolding in the central catalytic core domain of the transglutaminase 1 enzyme that would probably result in reduced enzyme activity. Our data suggest that the greatly reduced transglutaminase 1 activities are due to disruptions of the native folding of transglutaminase 1, and that these mutations may play a critical role in the pathology of lamellar ichthyosis.
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Affiliation(s)
- J M Yang
- Department of Dermatology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea.
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Yoon SS, Ahn KS, Kim SH, Shim YM, Kim J. In vitro establishment of cis-diammine-dichloroplatinum(II) resistant lung cancer cell line and modulation of apoptotic gene expression as a mechanism of resistant phenotype. Lung Cancer 2001; 33:221-8. [PMID: 11551417 DOI: 10.1016/s0169-5002(01)00205-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
After exposure of H460 cells to an increasing concentrations of cis-diammine-dichloroplatinum(II) (cisplatin, CDDP) for 6 months, cisplatin resistant cells were isolated (H460/CIS). The biologic behaviors of H460 and H460/CIS cells were tested using animal experiments. Only the resistant cells developed lung metastases despite cisplatin treatment. The characteristics of H460/CIS cells are as follows, MTT analyses revealed that H460/CIS cells were markedly resistant to cisplatin compared with their parental cells. Also, H460/CIS cells exhibited cross-resistance to DNA damaging agents such as doxorubicin (DXR) and etoposide. Cisplatin treatment dramatically increased p53 expression in parental cells but not in H460/CIS cells which expressed basal levels of p53. Without cisplatin treatment, Bcl-2 and Bax were expressed in H460/CIS cells, but not in parental cell. Our data suggested that p53, Bax and Bcl-2 were up-regulated in H460/CIS cells. These changes could explain some of the mechanisms of cisplatin resistance. Thus, H460/CIS could be useful to investigate the mechanisms of drug resistance to cisplatin including apoptotic gene expressions conferring drug resistance, thereby making progress in the treatment of cisplatin-resistant tumor cells.
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Affiliation(s)
- S S Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea
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