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Kim SW, Cheon JE, Choi YH, Hwang JY, Shin SM, Cho YJ, Lee S, Lee SB. Feasibility of a deep learning artificial intelligence model for the diagnosis of pediatric ileocolic intussusception with grayscale ultrasonography. Ultrasonography 2024; 43:57-67. [PMID: 38109893 PMCID: PMC10766885 DOI: 10.14366/usg.23153] [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: 08/07/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 12/20/2023] Open
Abstract
PURPOSE This study explored the feasibility of utilizing a deep learning artificial intelligence (AI) model to detect ileocolic intussusception on grayscale ultrasound images. METHODS This retrospective observational study incorporated ultrasound images of children who underwent emergency ultrasonography for suspected ileocolic intussusception. After excluding video clips, Doppler images, and annotated images, 40,765 images from two tertiary hospitals were included (positive-to-negative ratio: hospital A, 2,775:35,373; hospital B, 140:2,477). Images from hospital A were split into a training set, a tuning set, and an internal test set (ITS) at a ratio of 7:1.5:1.5. Images from hospital B comprised an external test set (ETS). For each image indicating intussusception, two radiologists provided a bounding box as the ground-truth label. If intussusception was suspected in the input image, the model generated a bounding box with a confidence score (0-1) at the estimated lesion location. Average precision (AP) was used to evaluate overall model performance. The performance of practical thresholds for the modelgenerated confidence score, as determined from the ITS, was verified using the ETS. RESULTS The AP values for the ITS and ETS were 0.952 and 0.936, respectively. Two confidence thresholds, CTopt and CTprecision, were set at 0.557 and 0.790, respectively. For the ETS, the perimage precision and recall were 95.7% and 80.0% with CTopt, and 98.4% and 44.3% with CTprecision. For per-patient diagnosis, the sensitivity and specificity were 100.0% and 97.1% with CTopt, and 100.0% and 99.0% with CTprecision. The average number of false positives per patient was 0.04 with CTopt and 0.01 for CTprecision. CONCLUSION The feasibility of using an AI model to diagnose ileocolic intussusception on ultrasonography was demonstrated. However, further study involving bias-free data is warranted for robust clinical validation.
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Affiliation(s)
- Se Woo Kim
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Eun Cheon
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
- Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea
| | - Young Hun Choi
- Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su-Mi Shin
- Department of Radiology, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea
| | - Yeon Jin Cho
- Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea
| | - Seunghyun Lee
- Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea
| | - Seul Bi Lee
- Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea
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Nand KN, Jordan TB, Yuan X, Basore DA, Zagorevski D, Clarke C, Werner G, Hwang JY, Wang H, Chung JJ, McKenna A, Jarvis MD, Singh G, Bystroff C. Bacterial production of recombinant contraceptive vaccine antigen from CatSper displayed on a human papilloma virus-like particle. Vaccine 2023; 41:6791-6801. [PMID: 37833124 DOI: 10.1016/j.vaccine.2023.09.044] [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: 11/15/2022] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023]
Abstract
CatSper is a voltage dependent calcium ion channel present in the principal piece of sperm tail. It plays a crucial role in sperm hyperactivated motility and so in fertilization. Extracellular loops of mouse sperm CatSper were used to develop a vaccine to achieve protection from pregnancy. These loops were inserted at one of the three hypervariable regions of Human Papilloma Virus (HPV) capsid protein (L1). Recombinant vaccines were expressed in E.coli as inclusion body (IB), purified, refolded and assembled into virus-like particles (VLP) in vitro, and adsorbed on alum. Four vaccine candidates were tested in Balb/C mice. All the constructs proved immunogenic, one showed contraceptive efficacy. This recombinant contraceptive vaccine is a non-hormonal intervention and is expected to give long-acting protection from undesired pregnancies.
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Affiliation(s)
- K N Nand
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - T B Jordan
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - X Yuan
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - D A Basore
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States; Department of Health and Natural Science, Mercy University, Dobbs Ferry, NY, United States
| | - D Zagorevski
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - C Clarke
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - G Werner
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States
| | - J Y Hwang
- Dept of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, United States
| | - H Wang
- Dept of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, United States
| | - J-J Chung
- Dept of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, CT, United States; Department of Gynecology and Obstetrics, Yale University School of Medicine, New Haven, CT, United States
| | - A McKenna
- Bioresearch Core, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - M D Jarvis
- Bioresearch Core, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - G Singh
- Bioresearch Core, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - C Bystroff
- Dept of Biological Sciences, Rensselaer Polytechnic Institute, Troy NY, United States.
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Ym SC, Choo KS, Nam KJ, Lee K, Hwang JY, Park C, Choi KH. Clinical characteristics of tetralogy of Fallot with left pulmonary artery acute angulation on computed tomography. Heart Vessels 2023; 38:1380-1385. [PMID: 37479869 DOI: 10.1007/s00380-023-02293-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
Left pulmonary artery (LPA) stenosis with acute angulation commonly necessitates surgical revision in the treatment of tetralogy of Fallot (TOF). We investigated the clinical characteristics of acute angulation of the LPA in patients with TOF via computed tomography (CT). Between 2011 and 2022, 160 patients were diagnosed with TOF using CT. After excluding 28 patients due to insufficient records or age, 132 patients were included in the present analysis. The patients were divided into two groups according to the presence or absence of acute angulation of the LPA: group I (TOF with an acute angle of the LPA, n = 53) and group II (TOF without an acute angle of the LPA, n = 79). We retrospectively collected clinical data from electronic medical records. T-tests were used to analyze continuous variables (i.e., age, sex, weight, right ventricular outflow tract [RVOT] pressure on echocardiography, and distance to bifurcation), and Fisher's exact and chi-square tests were used to analyze categorical data (i.e., presence of the right aortic arch, pulmonary arterial atresia/hypoplasia, atrial septal defect [ASD], patent ductus arteriosus [PDA], and pulmonary valve). The groups did not differ significantly in terms of sex, weight, presence of the right aortic arch, pulmonary arterial atresia/hypoplasia, ASD, or distance to the bifurcation. Moreover, there was no significant difference between the presence and absence of PDA (P = 0.057); however, patients in group I were significantly older (143.2 ± 97.8 days) than those in group II (91.1 ± 76.0 days, P = 0.002). Furthermore, RVOT pressure was significantly higher among patients in group I (45.1 ± 22.5 mmHg) than in group II (25.0 ± 12.4 mmHg, P < 0.001). In the current study, acute angulation of the LPA in patients with TOF, as observed on CT, was associated with older age and higher RVOT pressure on echocardiography.
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Affiliation(s)
- Seung Chan Ym
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea.
| | - Kyoung Jin Nam
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
| | - Kyeyoung Lee
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
| | - ChanKue Park
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
| | - Kwang Ho Choi
- Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-Ri, Mulgeum-Eup, Yangsan-Si, 626-770, Gyeongsangnam-Do, Korea
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Kim PH, Yoon HM, Kim JR, Hwang JY, Choi JH, Hwang J, Lee J, Sung J, Jung KH, Bae B, Jung AY, Cho YA, Shim WH, Bak B, Lee JS. Bone Age Assessment Using Artificial Intelligence in Korean Pediatric Population: A Comparison of Deep-Learning Models Trained With Healthy Chronological and Greulich-Pyle Ages as Labels. Korean J Radiol 2023; 24:1151-1163. [PMID: 37899524 PMCID: PMC10613838 DOI: 10.3348/kjr.2023.0092] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/01/2023] [Accepted: 08/06/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE To develop a deep-learning-based bone age prediction model optimized for Korean children and adolescents and evaluate its feasibility by comparing it with a Greulich-Pyle-based deep-learning model. MATERIALS AND METHODS A convolutional neural network was trained to predict age according to the bone development shown on a hand radiograph (bone age) using 21036 hand radiographs of Korean children and adolescents without known bone development-affecting diseases/conditions obtained between 1998 and 2019 (median age [interquartile range {IQR}], 9 [7-12] years; male:female, 11794:9242) and their chronological ages as labels (Korean model). We constructed 2 separate external datasets consisting of Korean children and adolescents with healthy bone development (Institution 1: n = 343; median age [IQR], 10 [4-15] years; male: female, 183:160; Institution 2: n = 321; median age [IQR], 9 [5-14] years; male: female, 164:157) to test the model performance. The mean absolute error (MAE), root mean square error (RMSE), and proportions of bone age predictions within 6, 12, 18, and 24 months of the reference age (chronological age) were compared between the Korean model and a commercial model (VUNO Med-BoneAge version 1.1; VUNO) trained with Greulich-Pyle-based age as the label (GP-based model). RESULTS Compared with the GP-based model, the Korean model showed a lower RMSE (11.2 vs. 13.8 months; P = 0.004) and MAE (8.2 vs. 10.5 months; P = 0.002), a higher proportion of bone age predictions within 18 months of chronological age (88.3% vs. 82.2%; P = 0.031) for Institution 1, and a lower MAE (9.5 vs. 11.0 months; P = 0.022) and higher proportion of bone age predictions within 6 months (44.5% vs. 36.4%; P = 0.044) for Institution 2. CONCLUSION The Korean model trained using the chronological ages of Korean children and adolescents without known bone development-affecting diseases/conditions as labels performed better in bone age assessment than the GP-based model in the Korean pediatric population. Further validation is required to confirm its accuracy.
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Affiliation(s)
- Pyeong Hwa Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Jeong Rye Kim
- Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jin-Ho Choi
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jisun Hwang
- Department of Radiology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea
| | | | | | | | | | - Ah Young Jung
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young Ah Cho
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Hyun Shim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Boram Bak
- University of Ulsan Foundation for Industry Cooperation, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Seong Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Choi JY, Park HJ, Park SM, You KH, Kang MS, Hwang JY, Yoon JH, Kim HJ, Yeom JS. Biportal endoscopic discectomy versus tubular microscopic discectomy for treating single-level lumbar disc herniation in obese patients: a multicenter, retrospective analysis. Acta Neurochir (Wien) 2023; 165:2641-2650. [PMID: 37393400 DOI: 10.1007/s00701-023-05686-4] [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: 03/12/2023] [Accepted: 06/11/2023] [Indexed: 07/03/2023]
Abstract
PURPOSE In microscopic lumbar discectomy in obese patients, a correlation is found between the operation time and increase in estimated blood loss according to the increase in body mass index; however, no studies have investigated the outcomes of biportal endoscopic lumbar discectomy in obese patients. Therefore, this study aimed to compare the clinical and radiographic outcomes of microscopic and endoscopic discectomy in obese patients with lumbar herniated discs. METHODS In this multicenter, retrospective study, clinical and radiological data were compared and analyzed in 73 obese patients with a body mass index of > 30 kg/m2 who underwent microscopic or biportal endoscopic lumbar discectomy. Clinical data on the visual analog scale (VAS), Oswestry disability index (ODI), and EuroQol-5D (EQ-5D) scores were measured, and radiological data were obtained using magnetic resonance imaging (MRI). RESULTS This study enrolled 43 patients who underwent microscopic discectomy and 30 who underwent biportal endoscopic discectomy. The VAS, ODI, and EQ-5D scores in both groups improved after surgery compared with those before surgery, although there was no difference between the two groups. Although there was a difference in the incidence of recurrent disc herniation confirmed by MRI after surgery, no difference was found in the number of patients requiring surgery between the two groups. CONCLUSION In obese patients with lumbar disc herniation that was not improved with conservative treatment, no significant clinical or radiological differences in outcomes were noted between microscopic and biportal endoscopic surgery methods. In contrast, minor complications were less common in the biportal group.
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Affiliation(s)
- Jun-Young Choi
- Department of Orthopaedic Surgery, Dongguk University Ilsan Hospital, Goyang-Si, Gyeonggi-Do, Republic of Korea
| | - Hyun-Jin Park
- Department of Orthopaedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Sang-Min Park
- Department of Orthopaedic Surgery, Spine Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea.
| | - Ki-Han You
- Department of Orthopaedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Min-Seok Kang
- Department of Orthopaedic Surgery, Korea University College of Medicine, Anam Hospital, Seoul, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Orthopaedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Joon-Hyeok Yoon
- Department of Orthopaedic Surgery, Spine Center, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Ho-Joong Kim
- Department of Orthopaedic Surgery, Spine Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
| | - Jin S Yeom
- Department of Orthopaedic Surgery, Spine Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-Ro 173 Beon-Gil, Bundang-Gu, Seongnam-Si, Gyeonggi-Do, 13620, Republic of Korea
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Cho HY, Lee K, Kong HJ, Yang HL, Jung CW, Park HP, Hwang JY, Lee HC. Deep-learning model associating lateral cervical radiographic features with Cormack-Lehane grade 3 or 4 glottic view. Anaesthesia 2023; 78:64-72. [PMID: 36198200 DOI: 10.1111/anae.15874] [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] [Accepted: 08/31/2022] [Indexed: 12/13/2022]
Abstract
Unanticipated difficult laryngoscopy is associated with serious airway-related complications. We aimed to develop and test a convolutional neural network-based deep-learning model that uses lateral cervical spine radiographs to predict Cormack-Lehane grade 3 or 4 direct laryngoscopy views of the glottis. We analysed the radiographs of 5939 thyroid surgery patients at our hospital, 253 (4%) of whom had grade 3 or 4 glottic views. We used 10 randomly sampled datasets to train a model. We compared the new model with six similar models (VGG, ResNet, Xception, ResNext, DenseNet and SENet). The Brier score (95%CI) of the new model, 0.023 (0.021-0.025), was lower ('better') than the other models: VGG, 0.034 (0.034-0.035); ResNet, 0.033 (0.033-0.035); Xception, 0.032 (0.031-0.033); ResNext, 0.033 (0.032-0.033); DenseNet, 0.030 (0.029-0.032); SENet, 0.031 (0.029-0.032), all p < 0.001. We calculated mean (95%CI) of the new model for: R2 , 0.428 (0.388-0.468); mean squared error, 0.023 (0.021-0.025); mean absolute error, 0.048 (0.046-0.049); balanced accuracy, 0.713 (0.684-0.742); and area under the receiver operating characteristic curve, 0.965 (0.962-0.969). Radiographic features around the hyoid bone, pharynx and cervical spine were associated with grade 3 and 4 glottic views.
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Affiliation(s)
- H-Y Cho
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - K Lee
- Department of Electrical Engineering and Computer Science, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea.,Medical Big data Research Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-J Kong
- Transdisciplinary Department of Medicine and Advanced Technology, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-L Yang
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - C-W Jung
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - H-P Park
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - J Y Hwang
- Department of Electrical Engineering and Computer Science, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea.,Department of Interdisciplinary Studies of Artificial Intelligence, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - H-C Lee
- Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Anaesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Hee Kim K, Choo KS, Jin Nam K, Lee K, Hwang JY, Park C, Jung Yang W. Cardiac CTA image quality of adaptive statistical iterative reconstruction-V versus deep learning reconstruction "TrueFidelity" in children with congenital heart disease. Medicine (Baltimore) 2022; 101:e31169. [PMID: 36281124 PMCID: PMC9592454 DOI: 10.1097/md.0000000000031169] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Several recent studies have reported that deep learning reconstruction "TrueFidelity" (TF) improves computed tomography (CT) image quality. However, no study has compared adaptive statistical repeated reconstruction (ASIR-V) using TF in pediatric cardiac CT angiography (CTA) with a low peak kilovoltage. OBJECTIVE This study aimed to determine whether ASIR-V or TF CTA image quality is superior in children with congenital heart disease (CHD). MATERIALS AND METHODS Fifty children (median age, 2 months; interquartile range, 0-5 months; 28 men) with CHD who underwent CTA were enrolled between June and September 2020. Images were reconstructed using 2 ASIR-V blending factors (80% and 100% [AV-100]) and 3 TF settings (low, medium, and high [TF-H] strength levels). For the quantitative analyses, 3 objective image qualities (attenuation, noise, and signal-to-noise ratio [SNR]) were measured of the great vessels and heart chambers. The contrast-to-noise ratio (CNR) was also evaluated between the left ventricle and the dial wall. For the qualitative analyses, the degree of quantum mottle and blurring at the upper level to the first branch of the main pulmonary artery was assessed independently by 2 radiologists. RESULTS When the ASIR-V blending factor level and TF strength were higher, the noise was lower, and the SNR was higher. The image noise and SNR of TF-H were significantly lower and higher than those of AV-100 (P < .01), except for noise in the right atrium and left pulmonary artery and SNR of the right ventricle. Regarding CNR, TF-H was significantly better than AV-100 (P < .01). In addition, in the objective assessment of the degree of quantum mottle and blurring, TF-H had the best score among all examined image sets (P < .01). CONCLUSION TF-H is superior to AV-100 in terms of objective and subjective image quality. Consequently, TF-H was the best image set for cardiac CTA in children with CHD.
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Affiliation(s)
- Kun Hee Kim
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
- *Correspondence: Ki Seok Choo, Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-RI, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 626-770, Korea (e-mail: )
| | - Kyoung Jin Nam
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Kyeyoung Lee
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - ChanKue Park
- Department of Radiology, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, Korea
| | - Woo Jung Yang
- Barunmom Rehabilitation Medicine, Busanjin-gu, Busan, Korea
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Song HG, Ahn JH, Koh JS, Bae JS, Park YW, Hwang SJ, Hwang JY, Jeong YH. Prognostic implication of residual inflammatory risk according to disease status in patients treated with percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1289] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Compared with stable angina, acute myocardial infarction (AMI) phenotype is related with the elevated inflammatory activity. However, time-dependent change of inflammatory level and its prognostic implication has not been fully understood according to the disease entity.
Methods
We enrolled total 4,263 patients who underwent percutaneous coronary intervention (PCI) with serial measurement of high-sensitivity C-reactive protein (hsCRP) at on-admission and 1-month post-PCI. The risks of MACE (a composite of death, MI or stroke), and major bleeding were evaluated up to 4 years after procedure.
Results
Compared with the non-AMI group (n=1,887), the AMI group (n=2,376) showed the significant decrease of hs-CRP during 1 month (∇0.5 vs. ∇0.1 mg/L; P<0.001). However, 1-month hs-CRP value still was higher in the AMI group than in the non-AMI group (median: 1.0 vs. 0.9 mg/L; P=0.001). During 1-month follow-up, high vs. low inflammatory risk (upper vs. lower tertile of hs-CRP) was significantly associated with increased rate of MACE in the AMI group (HR: 7.66; 95% CI: 2.29–25.59; P<0.001), but not in the non-AMI group (HR: 0.74; 95% CI: 0.12–4.40; P=0.736). From 1-month to 4-years, patients with high inflammatory risk showed the greater rate of MACE compared to those with low inflammatory risk, in both the AMI (HR: 2.40; 95% CI: 1.73–3.45; P<0.001) and non-AMI (HR: 2.67; 95% CI: 1.80–3.94; P<0.001) groups.
Conclusion
In PCI-treated patients, patients presented with AMI showed the greater values of inflammatory activity and its prognostic implication during the early phase, but combined inflammatory risk appeared similar across the disease entity during the late phase. This result may support that clinical benefit of post-PCI anti-inflammatory treatment would be constant regardless of the disease entity during the stabilized phase.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H G Song
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
| | - J H Ahn
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - J S Koh
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J S Bae
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - Y W Park
- Cardiovascular Center, Gyeongsang National University Changwon Hospital , Changwon , Korea (Republic of)
| | - S J Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - J Y Hwang
- Cardiovascular Center, Gyeongsang National University Hospital , Jin-Ju , Korea (Republic of)
| | - Y H Jeong
- Department of Cardiology, Heart-Brain Hospital, Chung-Ang University Gwang-Myeong Medical Center , Gwang-Myeong , Korea (Republic of)
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9
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Lee M, Hwang JY, Park SE, Jung S, Jo KJ. A Case Report of Postinfectious Bronchiolitis Obliterans After Coronavirus Disease 2019 in a 10-Year-Old Child. J Korean Med Sci 2022; 37:e246. [PMID: 35942559 PMCID: PMC9359921 DOI: 10.3346/jkms.2022.37.e246] [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: 04/14/2022] [Accepted: 07/19/2022] [Indexed: 11/20/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is usually less severe in children and adolescents than in adults. However, it can cause severe respiratory illness in a small proportion of children with risk factors. Here, we report a rare case of a 10-year-old boy with postinfectious bronchiolitis obliterans that developed after pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This patient was previously healthy apart from a high body mass index (BMI, 30.13; 99.6th percentile for the age bracket), history of preterm birth (35 weeks), and low birth weight (1,850 g). He had persistent exertional dyspnea after recovering from SARS-CoV-2-related pneumonia. Spirometry revealed obstructive lung disease with the following results: predicted forced vital capacity (FVC%pred), 71%; forced expiratory volume in 1 second (FEV1%pred), 63%; FEV1/FVC, 0.81; and forced expiratory flow25-75%pred, 55%. Chest computed tomography showed multifocal areas of parenchymal hyperlucency and mosaic attenuation in both lungs. This case suggests that careful observation of children with obesity and low birth weight is necessary after recovery from SARS-CoV-2-related pneumonia.
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Affiliation(s)
- Miran Lee
- Department of Pediatrics, Division of Pediatric Allergy and Respiratory Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Su Eun Park
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
| | - Sungsu Jung
- Department of Pediatrics, Division of Pediatric Allergy and Respiratory Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
| | - Kyo Jin Jo
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
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10
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Son W, Kim M, Hwang JY, Kim YW, Park C, Choo KS, Kim TU, Jang JY. Comparison of a Deep Learning-Based Reconstruction Algorithm with Filtered Back Projection and Iterative Reconstruction Algorithms for Pediatric Abdominopelvic CT. Korean J Radiol 2022; 23:752-762. [PMID: 35695313 PMCID: PMC9240291 DOI: 10.3348/kjr.2021.0466] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 02/26/2022] [Accepted: 03/29/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To compare a deep learning-based reconstruction (DLR) algorithm for pediatric abdominopelvic computed tomography (CT) with filtered back projection (FBP) and iterative reconstruction (IR) algorithms. Materials and Methods Post-contrast abdominopelvic CT scans obtained from 120 pediatric patients (mean age ± standard deviation, 8.7 ± 5.2 years; 60 males) between May 2020 and October 2020 were evaluated in this retrospective study. Images were reconstructed using FBP, a hybrid IR algorithm (ASiR-V) with blending factors of 50% and 100% (AV50 and AV100, respectively), and a DLR algorithm (TrueFidelity) with three strength levels (low, medium, and high). Noise power spectrum (NPS) and edge rise distance (ERD) were used to evaluate noise characteristics and spatial resolution, respectively. Image noise, edge definition, overall image quality, lesion detectability and conspicuity, and artifacts were qualitatively scored by two pediatric radiologists, and the scores of the two reviewers were averaged. A repeated-measures analysis of variance followed by the Bonferroni post-hoc test was used to compare NPS and ERD among the six reconstruction methods. The Friedman rank sum test followed by the Nemenyi-Wilcoxon-Wilcox all-pairs test was used to compare the results of the qualitative visual analysis among the six reconstruction methods. Results The NPS noise magnitude of AV100 was significantly lower than that of the DLR, whereas the NPS peak of AV100 was significantly higher than that of the high- and medium-strength DLR (p < 0.001). The NPS average spatial frequencies were higher for DLR than for ASiR-V (p < 0.001). ERD was shorter with DLR than with ASiR-V and FBP (p < 0.001). Qualitative visual analysis revealed better overall image quality with high-strength DLR than with ASiR-V (p < 0.001). Conclusion For pediatric abdominopelvic CT, the DLR algorithm may provide improved noise characteristics and better spatial resolution than the hybrid IR algorithm.
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Affiliation(s)
- Wookon Son
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - MinWoo Kim
- School of Biomedical Convergence Engineering, Pusan National University, Busan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chankue Park
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Tae Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Joo Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
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11
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Hwang J, Yoon HM, Hwang JY, Kim PH, Bak B, Bae BU, Sung J, Kim HJ, Jung AY, Cho YA, Lee JS. Re-Assessment of Applicability of Greulich and Pyle-Based Bone Age to Korean Children Using Manual and Deep Learning-Based Automated Method. Yonsei Med J 2022; 63:683-691. [PMID: 35748080 PMCID: PMC9226834 DOI: 10.3349/ymj.2022.63.7.683] [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: 11/15/2021] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the applicability of Greulich-Pyle (GP) standards to bone age (BA) assessment in healthy Korean children using manual and deep learning-based methods. MATERIALS AND METHODS We collected 485 hand radiographs of healthy children aged 2-17 years (262 boys) between 2008 and 2017. Based on GP method, BA was assessed manually by two radiologists and automatically by two deep learning-based BA assessment (DLBAA), which estimated GP-assigned (original model) and optimal (modified model) BAs. Estimated BA was compared to chronological age (CA) using intraclass correlation (ICC), Bland-Altman analysis, linear regression, mean absolute error, and root mean square error. The proportion of children showing a difference >12 months between the estimated BA and CA was calculated. RESULTS CA and all estimated BA showed excellent agreement (ICC ≥0.978, p<0.001) and significant positive linear correlations (R²≥0.935, p<0.001). The estimated BA of all methods showed systematic bias and tended to be lower than CA in younger patients, and higher than CA in older patients (regression slopes ≤-0.11, p<0.001). The mean absolute error of radiologist 1, radiologist 2, original, and modified DLBAA models were 13.09, 13.12, 11.52, and 11.31 months, respectively. The difference between estimated BA and CA was >12 months in 44.3%, 44.5%, 39.2%, and 36.1% for radiologist 1, radiologist 2, original, and modified DLBAA models, respectively. CONCLUSION Contemporary healthy Korean children showed different rates of skeletal development than GP standard-BA, and systemic bias should be considered when determining children's skeletal maturation.
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Affiliation(s)
- Jisun Hwang
- Department of Radiology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea
| | - Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea.
| | - Pyeong Hwa Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Boram Bak
- University of Ulsan Foundation for Industry Cooperation, Ulsan, Korea
| | | | | | - Hwa Jung Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ah Young Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Ah Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jin Seong Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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12
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Kim JH, Jeon UB, Jang JY, Kim YW, Hwang JY, Lim YT, Yang EJ. Radiologic placement of Hickman catheters using intravenous sedation in pediatric patients under 20 kg. Medicine (Baltimore) 2022; 101:e28857. [PMID: 35363188 PMCID: PMC9282005 DOI: 10.1097/md.0000000000028857] [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: 10/29/2021] [Accepted: 01/29/2022] [Indexed: 01/04/2023] Open
Abstract
Surgeons generally perform Hickman catheter insertion in children under general anesthesia. At times, it is difficult to perform procedures with an anesthesiologist for an interventional radiologist. Several diagnostic and therapeutic procedures are efficiently and safely conducted using intravenous (IV) sedation in children with a pediatrician. This study aims to evaluate the efficacy and safety of radiologically placed Hickman catheters using IV sedation in children under 20 kg.Fifty-nine catheters were inserted in 45 children under IV sedation. With continuous monitoring of vital signs, IV midazolam and ketamine were slowly infused by a pediatrician. Mean age and body weights were 3.2 years and 15.2 kg, respectively. Acute leukemia was the most common disease for the procedure (72.9%). The location of the catheter tip was evaluated by measuring the height of the thoracic vertebra.Technical success rate was 100%, and IV sedation-related complications did not occur. The right internal jugular vein was accessed for 51 catheters (86.4%), and the mean procedure time was 21.5 minutes. The 2 vertebral body units below the carina were the cavoatrial junction on a fluoroscopy image. Mean catheter life was 285 days, and catheters were removed post-treatment (35.6%). During follow-up, complications occurred in 29 cases (1.72 per 1000 catheter-days). Catheter-related infections were suspected in 4 patients (6.8%), with 1 positive result.Radiological Hickman catheter placement in children under 20 kg using IV sedation by pediatricians is effective and safe, with minimal complications. The carina is a landmark to estimate the cavoatrial junction in pediatric patients.
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Affiliation(s)
- Jin Hyeok Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Joo Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Tak Lim
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Eu Jeen Yang
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
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13
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Lee YJ, Hwang JY, Ryu H, Kim TU, Kim YW, Park JH, Choo KS, Nam KJ, Roh J. Image quality and diagnostic accuracy of reduced-dose computed tomography enterography with model-based iterative reconstruction in pediatric Crohn's disease patients. Sci Rep 2022; 12:2147. [PMID: 35140296 PMCID: PMC8828853 DOI: 10.1038/s41598-022-06246-z] [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: 07/22/2021] [Accepted: 01/18/2022] [Indexed: 11/09/2022] Open
Abstract
This study assessed the image quality and diagnostic accuracy in determining disease activity of the terminal ileum of the reduced-dose computed tomography enterography using model-based iterative reconstruction in pediatric patients with Crohn's disease (CD). Eighteen patients were prospectively enrolled and allocated to the standard-dose (SD) and reduced-dose (RD) computed tomography enterography (CTE) groups (n = 9 per group). Image quality, reader confidence in interpreting bowel findings, accuracy in determining active CD in the terminal ileum, and radiation dose were evaluated. Objective image quality did not show intergroup differences, except for image sharpness. Although reader confidence in detecting mural stratification, ulcer, and perienteric fat stranding of the RD-CTE were inferior to SD-CTE, RD-CTE correctly diagnosed active disease in all patients. The mean values of radiation dose metrics (SD-CTE vs. RD-CTE) were 4.3 versus 0.74 mGy, 6.1 versus 1.1 mGy, 211.9 versus 34.5 mGy∙cm, and 4.4 versus 0.7 mSv mGy∙cm for CTDIvol, size-specific dose estimation, dose-length product, and effective dose, respectively. RD-CTE showed comparable diagnostic accuracy to SD-CTE in determining active disease of the terminal ileum in pediatric CD patients. However, image quality and reader confidence in detecting ulcer and perienteric fat stranding was compromised.
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Affiliation(s)
- Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea.
| | - Hwaseong Ryu
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Tae Un Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Yong-Woo Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Ki Seok Choo
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Kyung Jin Nam
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
| | - Jieun Roh
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, 50612, Republic of Korea
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14
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Zhao H, Pomicter AD, Eiring AM, Franzini A, Ahmann J, Hwang JY, Senina A, Helton B, Iyer S, Yan D, Khorashad JS, Zabriskie MS, Agarwal A, Redwine HM, Bowler AD, Clair PM, McWeeney SK, Druker BJ, Tyner JW, Stirewalt DL, Oehler VG, Varambally S, Berrett KC, Vahrenkamp JM, Gertz J, Varley KE, Radich JP, Deininger MW. MS4A3 promotes differentiation in chronic myeloid leukemia by enhancing common β-chain cytokine receptor endocytosis. Blood 2022; 139:761-778. [PMID: 34780648 PMCID: PMC8814676 DOI: 10.1182/blood.2021011802] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Received: 03/22/2021] [Accepted: 10/27/2021] [Indexed: 02/05/2023] Open
Abstract
The chronic phase of chronic myeloid leukemia (CP-CML) is characterized by the excessive production of maturating myeloid cells. As CML stem/progenitor cells (LSPCs) are poised to cycle and differentiate, LSPCs must balance conservation and differentiation to avoid exhaustion, similar to normal hematopoiesis under stress. Since BCR-ABL1 tyrosine kinase inhibitors (TKIs) eliminate differentiating cells but spare BCR-ABL1-independent LSPCs, understanding the mechanisms that regulate LSPC differentiation may inform strategies to eliminate LSPCs. Upon performing a meta-analysis of published CML transcriptomes, we discovered that low expression of the MS4A3 transmembrane protein is a universal characteristic of LSPC quiescence, BCR-ABL1 independence, and transformation to blast phase (BP). Several mechanisms are involved in suppressing MS4A3, including aberrant methylation and a MECOM-C/EBPε axis. Contrary to previous reports, we find that MS4A3 does not function as a G1/S phase inhibitor but promotes endocytosis of common β-chain (βc) cytokine receptors upon GM-CSF/IL-3 stimulation, enhancing downstream signaling and cellular differentiation. This suggests that LSPCs downregulate MS4A3 to evade βc cytokine-induced differentiation and maintain a more primitive, TKI-insensitive state. Accordingly, knockdown (KD) or deletion of MS4A3/Ms4a3 promotes TKI resistance and survival of CML cells ex vivo and enhances leukemogenesis in vivo, while targeted delivery of exogenous MS4A3 protein promotes differentiation. These data support a model in which MS4A3 governs response to differentiating myeloid cytokines, providing a unifying mechanism for the differentiation block characteristic of CML quiescence and BP-CML. Promoting MS4A3 reexpression or delivery of ectopic MS4A3 may help eliminate LSPCs in vivo.
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MESH Headings
- Animals
- Cell Cycle Proteins/genetics
- Cell Cycle Proteins/metabolism
- Down-Regulation
- Endocytosis
- Gene Expression Regulation, Leukemic
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Membrane Proteins/genetics
- Membrane Proteins/metabolism
- Mice
- Receptors, Cytokine/metabolism
- Transcriptome
- Tumor Cells, Cultured
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Affiliation(s)
- Helong Zhao
- Versiti Blood Research Institute, Milwaukee, WI
- Medical College of Wisconsin, Milwaukee, WI
- Division of Hematology and Hematologic Malignancies and
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | | | | | - Anca Franzini
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Jonathan Ahmann
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Jae-Yeon Hwang
- Department of Oncological Sciences, The University of Utah, Salt Lake City, UT
| | - Anna Senina
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Bret Helton
- Department of Chemistry, University of Washington, Seattle, WA
| | - Siddharth Iyer
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Dongqing Yan
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Jamshid S Khorashad
- Department of Immunology and Inflammation, Imperial College London, London, United Kingdom
| | | | - Anupriya Agarwal
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR
| | - Hannah M Redwine
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Amber D Bowler
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Phillip M Clair
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
| | - Shannon K McWeeney
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR
| | - Brian J Druker
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR
| | - Jeffrey W Tyner
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR
| | | | | | | | | | | | - Jason Gertz
- Department of Oncological Sciences, The University of Utah, Salt Lake City, UT
| | - Katherine E Varley
- Department of Oncological Sciences, The University of Utah, Salt Lake City, UT
| | | | - Michael W Deininger
- Versiti Blood Research Institute, Milwaukee, WI
- Medical College of Wisconsin, Milwaukee, WI
- Division of Hematology and Hematologic Malignancies and
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
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15
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Kang MG, Kim KH, Park HW, Koh JS, Hwang SJ, Hwang JY, Park JR. Percutaneous coronary intervention in patients with peripheral artery disease and adverse cardiovascular adverse event and bleeding. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1149] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Peripheral artery disease (PAD) increase the risk of comorbidity and mortality in coronary artery disease (CAD).
Objectives
We evaluate influence of PAD on prognosis in patients undergoing percutaneous coronary intervention (PCI).
Methods
We analyzed all consecutive patients included in our dedicated local registry for PCI between January 2011 and December 2016. Presence of PAD was defined by decreased ankle-brachial index (<0.9). Major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, non-fatal myocardial infarct, revascularization, and ischemic stroke. Major bleeding was defined as Bleeding Academic Research Consortium 3 or 5.
Results
Among the 4,747 patients who underwent the PCI, 12.9% (n=610) of PAD were identified. Old age (>60 years), renal dysfunction, reduced ejection fraction, and presence of PAD were predictors with both MACE and major bleeding event. Among them, presence of PAD was an independent risk factor of MACE and major bleeding (MACE, HR 8.26, 95% CI 2.33- 29.41, p=0.036; major bleeding, HR 3.11, 95% CI 1.10–10.63, p=0.040, respectively). The MACE and major bleeding rate at 5-year was significantly increased in patients with PAD (MACE, 30.0% vs. 15.8%, log rank test p<0.001; major bleeding, 6.7 vs. 3.6%, log rank test p=0.003, respectively) (Figure).
Conclusion
Presence of PAD was strongly associated with higher rate of long-term MACE and major bleeding. These findings could have a clinical relevance in requiring individualized pharmacologic strategies to reduce the burden of cardiovascular disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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16
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Kang MG, Kim KH, Park HW, Koh JS, Park JR, Park YH, Hwang SJ, Jeong YH, Kwak CH, Ahn JH, Song HN, Hwang JY. Impact of active and stable cancer on survival in patients undergoing percutaneous coronary intervention. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2858] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
With advances in treatment of ischemic heart disease and cancer treatment, use of percutaneous coronary intervention (PCI) in cancer survivors and patients with active cancer (AC) is expanding.
Objectives
The purpose of this study was to determine the impact of cancer on survival and major cardiovascular events (MACE) in a long-term, single-center cohort of patients treated with PCI.
Methods
Patients treated with PCI between January 2010 and December 2017 were grouped as follows: controls (patients without cancer), stable cancer (SC), and AC. AC was included patients with cancer diagnosed within the past 6 months, patients who had cancer-related therapy within the past 6 months, active metastatic disease, or active recurrence of the cancer. The primary endpoints were 5-year survival and a secondary endpoint was 5-year MACE.
Results
A total of 6,743 patients (age 66±12 years, 68.4% men) treated with PCI were included: 6,404 (95.0%) controls, 245 (3.6%) SC, and 94 (1.4%) AC. Predominant malignancies were gastrointestinal (37.4%), lung (22.7%), and genitourinary cancer (14.7%). No differences were observed between patients with AC, SC and controls regarding 5-year MACE (total MACE, 33.2% vs. 28.1% vs. 17.5%, p=0.072; cardiac death, 13.6% vs. 9.1% vs. 6.7%, p=0.066; non-fatal myocardial infarction, 2.9% vs. 7.5% vs. 7.8%, p=0.820; revascularization, 17.9% vs. 17.6% vs. 11.6%, p=0.794, respectively). Patients with AC and SC had reduced 5-year survival compared with controls (62.0% vs. 81.5% vs. 89.8%, p<0.001) (Figure). AC was associated with a 1.76 (95% CI 1.22 to 2.54, p=0.002) fold increased risk of all-cause 5-year mortality in multivariable adjusted models.
Conclusions
Cumulative incidence of 5-year survival was discriminated by concurrent status of cancer following PCI. Individualized decision making is needed in the routine practice of PCI regarding concurrent cancer-specific treatment and prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M G Kang
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Park
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Changwon, Korea (Republic of)
| | - H N Song
- Gyeongsang National University Hospital, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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Masuda I, Hwang JY, Christian T, Maharjan S, Mohammad F, Gamper H, Buskirk AR, Hou YM. Loss of N1-methylation of G37 in tRNA induces ribosome stalling and reprograms gene expression. eLife 2021; 10:70619. [PMID: 34382933 PMCID: PMC8384417 DOI: 10.7554/elife.70619] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 05/22/2021] [Accepted: 08/09/2021] [Indexed: 01/20/2023] Open
Abstract
N1-methylation of G37 is required for a subset of tRNAs to maintain the translational reading-frame. While loss of m1G37 increases ribosomal +1 frameshifting, whether it incurs additional translational defects is unknown. Here, we address this question by applying ribosome profiling to gain a genome-wide view of the effects of m1G37 deficiency on protein synthesis. Using E coli as a model, we show that m1G37 deficiency induces ribosome stalling at codons that are normally translated by m1G37-containing tRNAs. Stalling occurs during decoding of affected codons at the ribosomal A site, indicating a distinct mechanism than that of +1 frameshifting, which occurs after the affected codons leave the A site. Enzyme- and cell-based assays show that m1G37 deficiency reduces tRNA aminoacylation and in some cases peptide-bond formation. We observe changes of gene expression in m1G37 deficiency similar to those in the stringent response that is typically induced by deficiency of amino acids. This work demonstrates a previously unrecognized function of m1G37 that emphasizes its role throughout the entire elongation cycle of protein synthesis, providing new insight into its essentiality for bacterial growth and survival.
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Affiliation(s)
- Isao Masuda
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, United States
| | - Jae-Yeon Hwang
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Thomas Christian
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, United States
| | - Sunita Maharjan
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, United States
| | - Fuad Mohammad
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Howard Gamper
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, United States
| | - Allen R Buskirk
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, United States
| | - Ya-Ming Hou
- Department of Biochemistry and Molecular Biology, Thomas Jefferson University, Philadelphia, United States
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18
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Ryu H, Hwang JY, Kim YW, Kim TU, Jang JY, Park SE, Yang EJ, Shin DH. Rosai-Dorfman disease in the spleen of a pediatric patient: A case report. World J Clin Cases 2021; 9:6032-6040. [PMID: 34368324 PMCID: PMC8316970 DOI: 10.12998/wjcc.v9.i21.6032] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/14/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rosai–Dorfman disease (RDD) is a rare histiocytic proliferation of unknown etiology commonly found in children and adolescents. The common manifestation of RDD is massive and painless bilateral cervical lymphadenopathy with extranodal disease. While extranodal involvement in RDD is common, the spleen is an infrequent site of disease.
CASE SUMMARY We report a 10-mo-old female infant with RDD presenting multiple splenic masses without cervical lymphadenopathy. She had fever, and blood tests showed leukocytosis, anemia, and elevated erythrocyte sedimentation rate and C-reactive protein. Ultrasound, computed tomography, and magnetic resonance images demonstrated multiple splenic masses. Despite antibiotic therapy, her symptoms were not relived. She underwent diagnostic splenectomy and was discharged with recovery.
CONCLUSION In pediatric patients with refractory infectious symptoms or hematological abnormalities, clinicians should suspect RDD, even in patients without significant lymphadenopathy.
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Affiliation(s)
- Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Tae-Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Joo-Yeon Jang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
| | - Su-Eun Park
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan 50612, South Korea
| | - Eu-Jeen Yang
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan 50612, South Korea
| | - Dong-Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan 50612, South Korea
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19
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Kim GM, Choo KS, Kim JH, Hwang JY, Park CK, Lee JW, Lim SJ. Comparison of noise-optimized linearly blended images and noise-optimized virtual monoenergetic images evaluated by dual-source, dual-energy CT in cardiac vein assessment. Acta Radiol 2021; 62:594-602. [PMID: 32551805 DOI: 10.1177/0284185120933242] [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 The coronary venous system is frequently used as an entry route to the heart and treatment modalities for many cardiac diseases and many procedures. Consequently, evaluation of the coronary venous system and understanding cardiac vein anatomy is crucial. PURPOSE To determine the optimal image set in a comparison of noise-optimized linearly blended images (F_0.6) and noise-optimized virtual monoenergetic images (VMI+) evaluated by dual-energy computed tomography (DECT) for cardiac vein assessment. MATERIAL AND METHODS Thirty-four patients (mean age 58.2 ± 14.2 years) who underwent DECT due to chest pain were enrolled. Images were post-processed with the F_0.6, and VMI+ algorithms at energy levels in the range of 40-100 keV in 10-keV increments. Enhancement (HU), noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were objectively measured at two points in the great cardiac vein by consensus of two radiologists. Two blinded observers evaluated the subjective image quality of the great cardiac vein on a 4-point scale. RESULTS HU, noise, and SNR peaked at 40 keV VMI+ (P < 0.05) among 50-100 keV VMI+. CNR peaked at 100 keV VMI+; however, there were no significant differences compared to CNR images processed at 40-90 keV VMI+. HU and noise were significantly higher in 40 keV VMI+ than F_0.6 images; however, both SNR and CNR were significantly higher in F_0.6 images. An assessment of subjective vein delineation revealed that F_0.6 images had the highest scores. CONCLUSION F_0.6 images were superior to VMI+ and provided the optimal image set for cardiac vein assessment.
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Affiliation(s)
- Gyeong Min Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Ki Seok Choo
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jin Hyeok Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Chan Kyu Park
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Ji Won Lee
- Department of Radiology, Pusan National University Hospital, Busan, Republic of Korea
| | - Soo Jin Lim
- Department of Cardiology, Kim Hae Kangil Hospital, Gimhae, Republic of Korea
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20
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Park YJ, Hwang JY, Kim YW, Lee YJ, Ko A. Radiological manifestation of familial acute necrotizing encephalopathy with RANBP2 mutation in a Far-East Asian family: Case report. Medicine (Baltimore) 2021; 100:e25171. [PMID: 33761695 PMCID: PMC9282079 DOI: 10.1097/md.0000000000025171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/23/2020] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Acute necrotizing encephalopathy (ANE) is a specific type of encephalopathy usually followed by febrile infection. It has an aggressive clinical course; however, it usually does not recur after recovery in cases of spontaneous ANE. Nevertheless, there are several studies reporting recurrences in familial ANE with RAN-binding protein 2 (RANBP2) mutation. There are few cases of familial ANE with RANBP2 mutation in Asian populations. PATIENTS CONCERNS A 21-month-old Korean boy who was previously healthy, presented with seizure following parainfluenza - a virus and bocavirus infection, followed by 2 recurrent seizure episodes and encephalitis after febrile respiratory illnesses. Meanwhile, his 3-year-old sister had focal brain lesions on neuroimaging studies when evaluated for head trauma. The siblings also had an older brother who presented status epilepticus after febrile respiratory illness at the age of 10 months old. DIAGNOSIS Brain magnetic resonance imaging was performed to evaluate the seizure and neurologic symptoms. Imaging findings showed variable spectrum - from non-specific diffuse white matter injury pattern to typical "tricolor pattern" of the ANE on diffusion-weighted images. The other 2 siblings showed focal lesions in both external capsules and severe diffuse brain edema. Genetic tests identified a heterozygous missense mutation in the RANBP2 [c.1754C>T (p.Thr585Met)] in 2 siblings and their mother. INTERVENTIONS Patients were treated conservatively with anticonvulsive agents, intravascular immunoglobulin, and steroids. OUTCOMES Among the 3 siblings, 2 male siblings died from familial ANE, whereas the female sibling was asymptomatic. LESSONS These cases highlight the radiological aspects of familial ANE with incomplete penetrance of the RANBP2 gene in 3 family members, showing variable involvements of the brain and natural history on magnetic resonance images. Radiologists should be aware of the typical and atypical imaging findings of familial ANE for prompt management of affected patients.
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Affiliation(s)
- Yu-Jung Park
- Department of Radiology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University
| | - Yun-Jin Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Ara Ko
- Department of Pediatrics, Pusan National University Children's Hospital, Pusan National University School of Medicine, Yangsan, Korea
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21
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Park C, Choo KS, Jung Y, Jeong HS, Hwang JY, Yun MS. Correction to: CT iterative vs deep learning reconstruction: comparison of noise and sharpness. Eur Radiol 2020; 31:4410-4411. [PMID: 33326052 DOI: 10.1007/s00330-020-07535-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Chankue Park
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Ki Seok Choo
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.
| | - Yunsub Jung
- CT Research Team, GE Healthcare Korea, Seoul, South Korea
| | - Hee Seok Jeong
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Mi Sook Yun
- Division of Biostatistics, Pusan National University Yangsan Hospital, Yangsan, South Korea
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22
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Lee N, Bae MH, Han YM, Park KH, Hwang JY, Hwang CS, Lee JC, Byun SY. Extracerebral choroid plexus papilloma in the pharynx with airway obstruction in a newborn: a case report. BMC Pediatr 2020; 20:336. [PMID: 32635904 PMCID: PMC7339594 DOI: 10.1186/s12887-020-02234-2] [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: 04/21/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022] Open
Abstract
Background Choroid plexus papillomas (CPPs) are rare, usually benign, neoplasms originating in the central nervous system. In this study, we present the first case of a giant airway-obstructing CPP in the pharynx of a newborn. Case presentation A cystic mass located in the pharynx was noted in a fetus at the 29th week of gestation. Elective cesarean section was performed at the 38th week of gestation with successful intubation and ex utero intrapartum treatment. On computed tomography, there was a huge airway-obstructing cystic mass in the choana and pharynx. Elective surgery with total excision was performed, and histological examination confirmed the diagnosis of CPP. Conclusion We report the first case of an extracerebral airway-obstructing CPP in the pharynx of a newborn. Radiologic examinations are not enough for the diagnosis of CPPs, and complete excision of the tumor with histological confirmation is indispensable for accurate diagnosis and treatment.
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Affiliation(s)
- Narae Lee
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Mi Hye Bae
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Young Mi Han
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Kyung Hee Park
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Cheong-Soo Hwang
- Department of Pathology, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Jin-Choon Lee
- Department of Otorhinolaryngology and Head-neck surgery, Pusan National University School of Medicine, Yangsan, Republic of Korea
| | - Shin Yun Byun
- Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Yangsan, 50612, Republic of Korea.
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23
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Kim K, Kim HR, Kang MG, Park HY, Koh JS, Hwang SJ, Hwang JY, Park JR. P1416 Clinical importance of consecutive transthoracic echocardiography in the patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.848] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
nothing
OnBehalf
nothing
Background
prediction of outcomes Hypertrophic cardiomyopathy (HCM) have been robustly analyzed with echocardiography. However, there is limited data of serial follow-up (FU) transthoracic echocardiography (TTE) to predict outcomes in patients with HCM.
Objectives
This study aim is to discover clinical predictors associated with consecutive TTE follow-up in patients with HCM.
Methods
From 2010 to 2016, 162 patients with HCM were enrolled retrospectively. Concentric LVH and others systolic disease related to wall thickness were excluded. Index TTE (baseline) was measured when firstly admitted in our hospital. FU TTE was analyzed at the end of follow-up, defined as the last recorded value in patients who did not develop events or the last recorded value before events developed.
Results
The average of FU TTE and clinical FU period was 3.7 ± 2.0 years. Clinical outcomes were defined as stroke, syncope, heart failure, arrhythmia and death. Interestingly, only baseline TR V max was a predictor for clinical outcome whereas the others echo parameters were not associated with events (Table 1). KM curve showed the TR Vmax ≥2.5m/s was also significant (log rank = 0.008, Fig 1.)
Conclusions Our study showed short-term FU TTE did not bring clinician with clinical benefits in the aspect of prediction for events. Only baseline TR V max was good correlation with cardiovascular outcomes and even in the survival analysis.
Serial TTE and changed values Total N = 162 index TTE (baseline) FU TTE Change of FU per year event no event p-value event no event p-value event no event p-value IVDd, mm 14 ± 4 15 ± 5 0.500 15 ± 5 14 ± 5 0.758 0.23 ± 0.51 -0.07 ± 1.27 0.200 LVIDd, mm 47 ± 5 48 ± 6 0.256 47 ± 7 48 ± 6 0.560 -0.22 ± 2.79 0.10 ± 2.27 0.444 LVEF, % 62 ± 5 61 ± 7 0.379 61 ± 6 61 ± 10 0.927 -0.43 ± 3.10 -0.04 ± 4.94 0.620 LAVI 43 ± 9 43 ± 8 0.879 57 ± 27 58 ± 23 0.849 0.53 ± 14.5 3.11 ± 7.2 0.134 EA ratio 0.9 ± 0.6 0.9 ± 0.6 0.782 1.0 ± 0.8 0.9 ± 0.6 0.595 -0.02 ± 0.76 0.003 ± 0.027 0.594 DT,ms 196 ± 58 201 ± 62 0.603 203 ± 91 217 ± 89 0.370 17 ± 57 5 ± 40 0.154 septal e` 4.4 ± 2.1 4.2 ± 1.6 0.585 4.4 ± 1.6 4.6 ± 1.7 0.438 0.24 ± 0.91 0.05 ± 0.65 0.190 E of e` 17 ± 11 17 ± 23 0.993 15 ± 9 15 ± 6 0.726 -0.48 ± 4.42 -1.66 ± 22.78 0.728 TR velocity 2.6 ± 0.5 2.4 ± 0.4 0.012 2.7 ± 0.6 2.6 ± 0.4 0.604 0.05 ± 0.30 0.04 ± 0.18 0.905 Max wall thickness 17 ± 3 18 ± 3 0.137 17 ± 4 17 ± 3 0.888 -0.01 ± 2.19 -0.18 ± 1.14 0.522
Abstract P1416 Figure. TR Vmax and CV outcomes in the KM curve
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Affiliation(s)
- K Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H R Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - H Y Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea (Republic of)
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24
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Kim M, Hwang JY, Lee YJ, Kim YW, Byun SY, Lee YJ, Yeom JA, Jeon UB, Choo KS, Nam KJ, Reid SNS. Clinical and Imaging Findings of Neonatal Seizures Presenting as Diffuse Cerebral White Matter Abnormality on Diffusion-Weighted Imaging without any Structural or Metabolic Etiology. J Korean Soc Radiol 2020; 81:1412-1423. [PMID: 36237712 PMCID: PMC9431836 DOI: 10.3348/jksr.2019.0071] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 12/06/2019] [Accepted: 02/21/2020] [Indexed: 11/26/2022]
Abstract
Purpose Some patients with neonatal seizures show diffuse, symmetric diffusion-restricted lesions in the cerebral white matter. The aim of this study was to describe clinical and imaging findings of patients with neonatal seizures who had diffuse, symmetric diffusion-restricted lesions without any structural or metabolic etiology. Materials and Methods A total of 56 neonates aged less than 1 week underwent brain magnetic resonance imaging (MRI) for evaluation of seizures from November 2008 to February 2017. After excluding 43 patients, 13 patients showed diffuse white matter abnormality on diffusion-weighted imaging. Initial and follow-up clinical and MRI findings were analyzed retrospectively. Results All 13 patients were born at full term. Among the ten patients who underwent a stool test for viruses, six were positive for rotavirus and one for astrovirus. MRI revealed diffuse, symmetric diffusion-restricted lesions distributed along the cerebral white matter, thalami, and midbrain variably. Conclusion Diffuse, symmetric diffusion-restricted lesions involving the cerebral white matter can be seen in patients with neonatal seizures without any structural or metabolic etiology. Rotavirus is commonly but not exclusively detected in these patients. Nevertheless, viral infection-associated encephalopathy should be considered for patients with characteristic clinical and MRI findings.
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Affiliation(s)
- Maeran Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, School of Medicine, Pusan National University, Yangsan, Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Shin Yun Byun
- Department of Pediatrics, Pusan National University Children's Hospital, School of Medicine, Pusan National University, Yangsan, Korea
| | - Yun-Jin Lee
- Department of Pediatrics, Pusan National University Children's Hospital, School of Medicine, Pusan National University, Yangsan, Korea
| | - Jeong A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kyung Jin Nam
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Storm Nicholas Shaun Reid
- College of Creative Human Resource, School of Liberal Arts Education, Kyungsung University, Busan, Korea
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25
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Hwang JY. Radiological Manifestations of Childhood Fractures. J Korean Soc Radiol 2020; 81:806-831. [PMID: 36238174 PMCID: PMC9432199 DOI: 10.3348/jksr.2020.81.4.806] [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] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/02/2020] [Accepted: 06/23/2020] [Indexed: 11/15/2022]
Abstract
근골격계의 외상은 소아가 응급실로 내원하는 가장 흔한 원인 중에 하나이다. 소아에서 뼈는 아직 완전히 골화가 되지 않았기 때문에 불완전 골절(소성변형, 생나무 골절, 죔쇠 골절)과 같이 성인과는 다른 영상의학적 특성을 보이기도 하며, 성장판의 손상으로 인해 성장 장애를 유발하기도 한다. 소아는 연령에 따라서 활동 범위나 활동 양상이 다르기 때문에 분만 손상에서부터 낙상, 교통사고에 이르기까지 다양한 기전에 의해서 골절이 발생하며, 각각의 손상 기전에 따라 특징적인 골절의 발생 부위 및 골절의 형태를 보이기도 한다. 본 종설에서는 소아의 다양한 근골격계 외상 중 소아에서 흔하게 볼 수 있는 사지 골절의 영상의학적 특성에 대해서 고찰해보고자 한다.
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Affiliation(s)
- Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, College of Medicine, Pusan National University, Yangsan, Korea
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Chung MS, Choi YJ, Hwang JY, Yoon DH, Seo KJ, Lee JH, Baek JH. Feasibility of reduced-dose CT of the head and neck with iterative reconstruction: a phantom and prospective clinical study. Acta Radiol 2019; 60:1457-1464. [PMID: 30776905 DOI: 10.1177/0284185119830276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mi Sun Chung
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Gyeonsangnam-do, Republic of Korea
| | - Dok Hyun Yoon
- Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Kyeong Jin Seo
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Jang JY, Ahn JH, Bae JS, Kang MG, Kim K, Park HW, Koh JS, Park Y, Hwang SJ, Kwak CH, Hwang JY, Jeong YH. P3637Relationship between serial measurements of NT-proBNP and cardiovascular events in patients with acute coronary syndrome. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0494] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Increased level of natriuretic peptides has been known as an important predictors of adverse cardiovascular (CV) outcomes in patients with acute coronary syndrome (ACS). We sought to evaluate clinical implication of N-terminal pro-brain natriuretic peptide (NT-proBNP) measured at initial and follow-up periods.
Methods
Serial NT-proBNP levels (on-admission and one-month post-PCI) were measured in ACS patients undergoing PCI (n=2,290). High NT-proBNP levels were determined according to the predefined age-specific criteria. Patients were stratified into 4 groups according to NT-proBNP levels (on-admission & one-month): (1) normal-normal group (n=1234, 53.9%); (2) high–normal group (n=257, 11.2%); (3) normal-high group (n=376, 16.4%); and (4) high-high group (n=423, 18.5%). Clinical events were defined as all-cause death and MACE (a composite of CV death, non-fatal MI, and ischemic stroke).
Results
With a median follow-up of 35.9 (IQR: 16.8, 54.5) months, all-cause death and MACE were occurred in 4.1% and 7.2%, respectively. NT-proBNP on-admission vs. at one-month did not differ significantly (median 391.6 [IQR: 143.9, 1402.3] vs. median 619.1 [IQR 240.1, 1616.1]; p=0.622), but the prevalence of high NT-proBNP was increased over time (25.3% to 34.9%; p<0.001). The rates of all-cause death and MACE significantly increased only in the high-high group compared with other groups (log-rank test, all p values <0.001, Figure). After adjustment, the high-high group remained significantly risky in terms with the occurrence of all-cause death (HR, 2.99; 95% CI, 1.65 to 5.41; p<0.001) and MACE (HR, 1.96; 95% CI, 1.28 to 3.01; p=0.002).
Figure 1
Conclusion
Serial measurements of NT-proBNP at on-admission and follow-up can help to stratify the risks of all-cause death and adverse CV events following PCI in ACS patients. About two-fifths of patients having high NT-proBNP level during hospitalization can be classified into the low-risk group for all-cause death and adverse CV events.
Acknowledgement/Funding
None
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Affiliation(s)
- J Y Jang
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J H Ahn
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J S Bae
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - M G Kang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - K Kim
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - H W Park
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - J S Koh
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y Park
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - S J Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - C H Kwak
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
| | - J Y Hwang
- Gyeongsang National University Hospital, Internal Medicine, Jinju, Korea (Republic of)
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea (Republic of)
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Kwon BC, Lee JK, Lee SY, Hwang JY. Does use of the 70° arthroscope improve the outcomes of arthroscopic débridement for chronic recalcitrant tennis elbow? J Shoulder Elbow Surg 2019; 28:1750-1757. [PMID: 31326339 DOI: 10.1016/j.jse.2019.04.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/19/2019] [Revised: 04/15/2019] [Accepted: 04/24/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND The use of a 70° arthroscope has been reported to provide better visualization of the extensor carpi radialis brevis origin at the lateral epicondyle. We aimed to compare the surgical outcomes of arthroscopic débridement using an additional 70° arthroscope with those using a 30° arthroscope alone in the treatment of chronic recalcitrant tennis elbow. METHODS A total of 68 consecutive patients who received arthroscopic débridement for chronic recalcitrant tennis elbow were retrospectively reviewed. A 30° scope was used in 41 patients (mean age, 47 years; range, 26-61 years), whereas an additional 70° scope was used in 27 patients (mean age, 50 years; range, 34-61 years). Outcomes were assessed using a visual analog scale for pain and the Quick Disabilities of the Arm, Shoulder and Hand questionnaire at the preoperative visit and at 3 months, 6 months, and 12 or more months after surgery. RESULTS Both groups showed significant and progressive improvements in visual analog scale pain scores and Quick Disabilities of the Arm, Shoulder and Hand scores at 3 months, 6 months, and final follow-up (P < .05). However, no significant differences were found between the groups at all time points of measurement regarding those outcome measures (P > .05). In addition, the proportions of patients with excellent outcomes and those with clinically meaningful improvements were comparable between the groups (P = .397 and P = .558, respectively). CONCLUSION The use of an additional 70° arthroscope did not provide a significant improvement in the outcomes of arthroscopic débridement for chronic recalcitrant tennis elbow.
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Affiliation(s)
- Bong Cheol Kwon
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
| | - Joon-Kyu Lee
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Suk Yoon Lee
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Kim M, Hwang JY, Choo KS, Ryu H, Reid SNS, Kim YW, Kim TU, Kim JH. Comparison of image quality of abdominopelvic CT in paediatric patients: low osmolar contrast media versus less iodine-containing iso-osmolar contrast media at different peak kilovoltages. Clin Radiol 2019; 74:896.e9-896.e16. [PMID: 31431254 DOI: 10.1016/j.crad.2019.06.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
AIM To evaluate the effect of iso-osmolar contrast media (IOCM) at different tube voltages on image quality for abdominal computed tomography (CT) in paediatric patients. MATERIALS AND METHODS The low osmolar contrast media (LOCM) group and IOCM group consisted of 101 and 102 CT examinations, respectively, in patients <18 years old. Images were reviewed retrospectively. Objective measurement of the contrast enhancement and noise were analysed and contrast-to-noise ratios (CNRs) of the abdominal aorta, portal vein, and liver were calculated. Four radiologists participated in subjective analysis using a four-point scale system to evaluate degrees of contrast enhancement, image noise, beam-hardening artefact, and overall image quality. Reader performance for correctly differentiating the two kinds of contrast media was evaluated. RESULTS Regarding the objective measurement, contrast enhancement was significantly higher in the LOCM group (p<0.05). In subjective analysis, only CT using 120 kVp showed significantly stronger enhancement in the LOCM group (p=0.002), and sensitivity to differentiate the IOCM was 80.6%. Overall sensitivity and specificity for correctly differentiating IOCM were 57.1%, and 56.9%, respectively. CONCLUSION The application of IOCM was found to be feasible for performing paediatric abdominopelvic CT with a low tube voltage protocol. Although objective measurements of contrast enhancement were significantly lower in the IOCM group, subjective contrast enhancement and image quality assessments were not statistically different between groups.
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Affiliation(s)
- M Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - J Y Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
| | - K S Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - H Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - S N S Reid
- College of Creative Human Resource, School of Liberal Arts Education, Kyungsung University, Busan, 48434, Republic of Korea
| | - Y W Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - T U Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - J H Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
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Sohn HM, Baik JS, Hwang JY, Kim SY, Han SH, Kim JH. Devising negative pressure within intercuff space reduces microaspiration. BMC Anesthesiol 2018; 18:181. [PMID: 30509183 PMCID: PMC6278018 DOI: 10.1186/s12871-018-0643-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/05/2018] [Accepted: 11/20/2018] [Indexed: 02/07/2023] Open
Abstract
Background Microaspiration past the tracheal tube cuffs causes ventilator-associated pneumonia. The objective of the current study was to evaluate whether creating negative pressure between the tracheal double cuffs could block the fluid passage past the tracheal tube cuffs. Methods A new negative pressure system was devised between the double cuffs through a suction hole in the intercuff space. Blue-dyed water was instilled above the cuff at negative suction pressures of − 54, − 68, − 82, − 95, − 109, − 122, and − 136 cmH2O, and the volume leaked was measured in an underlying water trap after 10 min. Leakage tests were also performed during positive pressure ventilation, and using higher-viscosity materials. The actual negative pressures delivered at the hole of double cuffs were obtained by placing microcatheter tip between the intercuff space and the artificial trachea. Results No leakage occurred past the double cuff at − 136 cmH2O suction pressure at all tracheal tube cuff pressures. The volume leaked decreased significantly as suction pressure increased. When connected to a mechanical ventilator, no leakage was found at − 54 cmH2suction pressure. Volume of the higher-viscosity materials (dynamic viscosity of 63–108 cP <cP> and 370–430 cP) leaked was small compared to that of normal saline (0.9–1.1 cP). The pressures measured in the intercuff space corresponded to 3.8–5.9% of those applied. Conclusions A new prototype double cuff with negative pressure in the intercuff space completely prevented water leakage. The negative pressure transmitted to the tracheal inner wall was a small percentage of that applied.
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Affiliation(s)
- H M Sohn
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - J S Baik
- Department of Anesthesiology and Pain Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - J Y Hwang
- Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - S Y Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea
| | - S H Han
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.,Department of Anesthesiology and Pain Medicine, Seoul National University Medical College, Seoul, Republic of Korea
| | - J H Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea. .,Department of Anesthesiology and Pain Medicine, Seoul National University Medical College, Seoul, Republic of Korea.
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Abstract
The extent of dental tissue destruction during the treatment of white spot lesions (WSLs) increases with the severity of the lesion. If the depth and shape of WSLs can be predicted with a noninvasive diagnostic method before dental caries treatment, more conservative interventions can be planned. Given the superiority of high-frequency ultrasound (HFUS) imaging in observing the internal structures of the body, the present study aimed to verify the possibility of HFUS imaging to examine the depth and shape of WSLs. We prepared tooth samples and developed a biomicroscopic system with a HFUS transducer to obtain images of normal and WSL regions. HFUS images were compared with conventional ultrasound images and micro-computed tomography images. HFUS distinctly differentiated demineralization within WSL and normal regions. WSL depth calculated in the micro-computed tomography image was similar to that in HFUS. This study revealed that HFUS imaging has the potential to detect early dental caries and offer information on the invasion depth of early dental caries quantitatively.
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Affiliation(s)
- J Kim
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - T J Shin
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - H J Kong
- 3 Department of Biomedical Engineering, College of Medicine, Chungnam National University, and Chungnam National University Hospital, Daejeon, Republic of Korea
| | - J Y Hwang
- 1 Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and Technology, Daegu, Republic of Korea
| | - H K Hyun
- 2 Department of Pediatric Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Park YW, Jeong YH, Hwang JY, Kwack CH, Hwang SJ. P1714Risk stratification for ischemic and bleeding events in patients using a potent P2Y12 inhibitor. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y W Park
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - Y H Jeong
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - J Y Hwang
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - C H Kwack
- Gyeongsang National University Hospital, Jinju, Korea Republic of
| | - S J Hwang
- Gyeongsang National University Hospital, Jinju, Korea Republic of
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Kim KH, Jang HG, Kang YM, Kang MG, Park HW, Koh JS, Park JR, Hwang SJ, Hwang JY. P3681Syntax-I score can predict in-hospital mortality among the patients with ST segment elevation myocardial infarction and cardiogenic shock. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- K H Kim
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - H G Jang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - Y M Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - M G Kang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - H W Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J S Koh
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J R Park
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - S J Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
| | - J Y Hwang
- Gyeongsang National University Hospital, Cardiology, Jinju, Korea Republic of
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Park YW, Jeong YH, Kim JH, Sohn SN, Kwack CH, Hwang JY. P810Histologic comparison of intracerebral and intracoronary thrombi. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Y W Park
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea Republic of
| | - Y H Jeong
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea Republic of
| | - J H Kim
- Gyeongsang National University Hospital, Biomedical Research Institute, Jinju, Korea Republic of
| | - S N Sohn
- Hanil Hospital, Neurology, Jinju, Korea Republic of
| | - C H Kwack
- Gyeongsang National University Changwon Hospital, Internal Medicine, Changwon, Korea Republic of
| | - J Y Hwang
- Gyeongsang National University Hospital, Jinju, Korea Republic of
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Lee JM, Hwang JY, Bae J, Kim MR, Kim YW, Park SE, Yeom JA, Roh J. Acoustic radiation force impulse imaging of biopsy-proven Kikuchi disease: initial experiences for evaluating feasibility in pediatric patients. Ultrasonography 2018; 38:58-66. [PMID: 29914233 PMCID: PMC6323305 DOI: 10.14366/usg.17067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 11/27/2017] [Accepted: 04/24/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose This study evaluated the feasibility of acoustic radiation force impulse (ARFI) elastography and characterized the sonographic features of lymph nodes (LNs) with Kikuchi disease in pediatric patients. Methods Seventy-six cervical LN biopsies were performed for the diagnosis of cervical lymphadenopathy. ARFI imaging was performed, and the characteristic ultrasound features of the biopsied LNs and the contralateral LNs were analyzed. We also reviewed clinical and conventional ultrasonographic findings. Results On histology, 56 patients were diagnosed with Kikuchi disease. These LNs were large and elongated, with increased perinodal echogenicity and capsular thickening. In 38 of them, ARFI elastography was performed, and the median shear wave velocity (SWV) of the biopsied LNs with Kikuchi disease (2.19 m/sec; range, 1.45 to 4.57 m/sec) was higher than of the contralateral LNs (1.72 m/sec; range, 0.95 to 2.65 m/sec; P<0.001). In patients with reactive hyperplasia, the mean SWV of the biopsied LNs (2.00 m/sec; range, 1.49 to 2.26 m/sec) was higher than that of the contralateral LNs (1.55 m/sec; range, 1.21 to 2.32 m/sec; P=0.031). Conclusion The SWV of LNs with Kikuchi disease was significantly higher than that of the contralateral LNs. Morphologically, LNs with Kikuchi disease showed an enlarged, elongated, and oval shape, increased perinodal echogenicity, and capsular thickening. In addition to the conventional ultrasonographic findings, the application of ARFI is feasible even in pediatric patients for the evaluation of cervical lymphadenopathy.
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Affiliation(s)
- Jeong-Min Lee
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jihyun Bae
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Mae Ran Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Su Eun Park
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Jeong A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jieun Roh
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Hwang JY, Byun MS, Choe YM, Lee JH, Yi D, Yoon HN, Park IK, Lee YJ, Lee DY. 0249 Association Between Sleep-Wake Cycle And Brain Cortical Thickness In Young Adults. Sleep 2018. [DOI: 10.1093/sleep/zsy061.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Y Hwang
- Seoul National University College of Medicine, Seoul, KOREA, REPUBLIC OF
| | - M S Byun
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, KOREA, REPUBLIC OF
| | - Y M Choe
- Department of Psychiatry, Ulsan University Hospital, Ulsan, KOREA, REPUBLIC OF
| | - J H Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
| | - D Yi
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, KOREA, REPUBLIC OF
| | - H N Yoon
- Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, KOREA, REPUBLIC OF
| | - I K Park
- Center for Sleep and Chronobiology, Department of Psychiatry, Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
| | - Y J Lee
- Center for Sleep and Chronobiology, Department of Psychiatry, Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
| | - D Y Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, KOREA, REPUBLIC OF
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Kim JR, Hwang JY, Yoon HM, Jung AY, Lee JS, Kim JS, Namgoong JM, Kim DY, Oh SH, Kim KM, Cho YA. Risk Estimation for Biliary Atresia in Patients with Neonatal Cholestasis: Development and Validation of a Risk Score. Radiology 2018; 288:262-269. [PMID: 29634437 DOI: 10.1148/radiol.2018172390] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose To develop and validate a scoring system based on clinical and imaging features to predict the risk for biliary atresia in patients with neonatal cholestasis. Materials and Methods Patients with neonatal cholestasis who underwent both ultrasonography (US) and hepatobiliary scintigraphy (n = 480) were retrospectively identified from two tertiary referral hospitals from January 2000 to February 2017. Patients from one hospital were classified as the derivation cohort (n = 371), and those from the other hospital were classified as the validation cohort (n = 109). Clinical and imaging features associated with biliary atresia were assessed. Histopathologic or intraoperative cholangiographic findings served as the reference standard for biliary atresia. A prediction model was developed by using logistic regression and was then transformed into a scoring system. The scoring system was internally and externally validated. Results Among the 371 patients in the derivation cohort, 97 (26.15%) had biliary atresia. A scoring system was constructed with the following variables: full-term birth, presence of the triangular cord sign at US, abnormal gallbladder morphology at US, and failure of radioisotope excretion to the small bowel at hepatobiliary scintigraphy. The maximum possible score with this system is 7 points. This system enabled differentiation of biliary atresia in the derivation cohort (C statistic, 0.981; 95% confidence interval [CI]: 0.970, 0.992) and the validation cohort (C statistic, 0.995; 95% CI: 0.987, 1.000). The risk score also showed good calibration in both the derivation and the validation cohorts (P = .328 and P = .281, respectively). Conclusion A simple scoring system combining clinical and imaging features can help accurately estimate the risk for biliary atresia in patients with neonatal cholestasis.
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Affiliation(s)
- Jeong Rye Kim
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Jae-Yeon Hwang
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Hee Mang Yoon
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Ah Young Jung
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Jin Seong Lee
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Jae Seung Kim
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Jung-Man Namgoong
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Dae Yeon Kim
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Seok Hee Oh
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Kyung Mo Kim
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
| | - Young Ah Cho
- From the Department of Radiology and Research Institute of Radiology (J.R.K., H.M.Y., A.Y.J., J.S.L., Y.A.C.), Department of Nuclear Medicine (J.S.K.), Department of Pediatric Surgery (J.M.N., D.Y.K.), and Department of Pediatrics (S.H.O., K.M.K.), Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea; and Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Gyeongsangnam-do, South Korea (J.Y.H.)
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Yoon HM, Byeon SJ, Hwang JY, Kim JR, Jung AY, Lee JS, Yoon HK, Cho YA. Sacrococcygeal teratomas in newborns: a comprehensive review for the radiologists. Acta Radiol 2018; 59:236-246. [PMID: 28530139 DOI: 10.1177/0284185117710680] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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
Sacrococcygeal teratomas are the most common solid tumor in newborn infants. The diagnosis is not difficult in many cases; however, there should be additional information on imaging studies in order to manage those infants properly. Details include histology, morphologic classification, complications such as rupture, bleeding, and mass effects on the adjacent structures. Although imaging features cannot accurately predict the histologic subtypes of the tumors, thorough evaluation of the imaging features can help distinguish malignant tumors from benign tumors. In this article, pathogenesis, histological characteristics, clinical considerations, and morphologic characteristics will be discussed.
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Affiliation(s)
- Hee Mang Yoon
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Sun-ju Byeon
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Children's Hospital, Yangsan-Si, Republic of Korea
| | - Jeong Rye Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ah Young Jung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jin Seong Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hye-Kyung Yoon
- Department of Radiology, Kangwon National University Hospital, Chuncheon-Si, Republic of Korea
| | - Young Ah Cho
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Zabriskie MS, Antelope O, Verma AR, Draper LR, Eide CA, Pomicter AD, Tran TH, Druker BJ, Tyner JW, Miles RR, Graham JM, Hwang JY, Varley KE, Toydemir RM, Deininger MW, Raetz EA, O'Hare T. A novel AGGF1-PDGFRb fusion in pediatric T-cell acute lymphoblastic leukemia. Haematologica 2017; 103:e87-e91. [PMID: 29284681 DOI: 10.3324/haematol.2017.165282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Orlando Antelope
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anupam R Verma
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Lauren R Draper
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Christopher A Eide
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.,Howard Hughes Medical Institute, Portland, OR, USA
| | | | - Thai Hoa Tran
- Helen Diller Family Cancer Research Center, Benioff Children's Hospital, San Francisco, CA, USA
| | - Brian J Druker
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.,Howard Hughes Medical Institute, Portland, OR, USA
| | - Jeffrey W Tyner
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Rodney R Miles
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - James M Graham
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Jae-Yeon Hwang
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Katherine E Varley
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Department of Oncological Sciences, University of Utah, Salt Lake City, UT, USA
| | - Reha M Toydemir
- Department of Pathology, University of Utah, Salt Lake City, UT, USA.,Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, UT, USA
| | - Michael W Deininger
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.,Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA
| | - Elizabeth A Raetz
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA .,Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
| | - Thomas O'Hare
- Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA .,Department of Pediatrics, Division of Pediatric Hematology/Oncology, University of Utah, Salt Lake City, UT, USA
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Kim YM, Lee YJ, Park JH, Lee HD, Cheon CK, Kim SY, Hwang JY, Jang JH, Yoo HW. High diagnostic yield of clinically unidentifiable syndromic growth disorders by targeted exome sequencing. Clin Genet 2017; 92:594-605. [PMID: 28425089 DOI: 10.1111/cge.13038] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 12/27/2016] [Revised: 04/12/2017] [Accepted: 04/15/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND As syndromic short stature and overgrowth are heterogeneous and the list of causative genes is rapidly expanding, there is an unmet need for identifying genetic causes based on conventional gene testing or karyotyping. Early diagnosis leads to the proper management of the patient and providing genetic counseling for family members at risk in a timely manner. MATERIALS AND METHODS We conducted targeted exome sequencing to identify the genetic causes of undiagnosed syndromic short stature or overgrowth in 15 pediatric patients from 13 families in Korea. We applied targeted exome sequencing using the Next Seq platform and a TruSight One panel. RESULTS Among the 13 families, 6 different disorders in 8 patients with short stature or overgrowth were identified, and the diagnostic yield was 46.2%. One boy with overgrowth had a TGFB3 gene mutation. In the short stature group, Coffin-Lowry syndrome (CLS), trichorhinophalangeal syndrome, DYRK1A haploinsufficiency syndrome, short stature with optic atrophy and Pelger-Huët anomaly syndrome with recurrent hepatitis, and type 4 Meier-Gorlin syndrome were identified. One CLS patient had a co-existing monogenic disease, congenital glaucoma, caused by the compound heterozygote mutations of the CYP1B1 gene. CONCLUSION Targeted exome sequencing is a powerful method for diagnosing syndromic growth disorders. It enables us to understand molecular pathophysiology and investigate new treatments for growth disorders.
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Affiliation(s)
- Yoo-Mi Kim
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Yun-Jin Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Hyoung-Doo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Chong Kun Cheon
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Su-Young Kim
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University College of Medicine, Pusan National University Children's Hospital, Yangsan, Korea
| | - Ja-Hyun Jang
- Laboratory Medicine, Green Cross Genome, Yongin, Korea
| | - Han-Wook Yoo
- Medical Genetics Center, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea
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41
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Song JY, Mun SJ, Sung SK, Hwang JY, Baik SK, Kim JY, Cheon CK, Kim SY, Kim YM. A rare case of multiple pituitary adenomas in an adolescent Cushing disease presenting as a vertebral compression fracture. Ann Pediatr Endocrinol Metab 2017; 22:197-202. [PMID: 29025207 PMCID: PMC5642078 DOI: 10.6065/apem.2017.22.3.197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 02/06/2017] [Revised: 03/16/2017] [Accepted: 03/27/2017] [Indexed: 12/03/2022] Open
Abstract
Cushing disease in children and adolescents, especially with multiple pituitary adenomas (MPAs), is very rare. We report 17-year-old boy with MPAs. He presented with a vertebral compression fracture, weight gain, short stature, headache, and hypertension. On magnetic resonance imaging (MRI), only a left pituitary microadenoma was found. After surgery, transient clinical improvement was observed but headache and hypertension were observed again after 3 months later. Follow-up MRI showed a newly developed right pituitary microadenoma 6 months after the surgery. The need for careful clinical and radiographic follow-up should be emphasized in the search for potential MPAs in patients with persistent Cushing disease.
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Affiliation(s)
- Ji-Yeon Song
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Sue-Jean Mun
- Departments of Otorhinolaryngology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Soon-Ki Sung
- Departments of Neurosergery, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae-Yeon Hwang
- Departments of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Seung-Kug Baik
- Departments of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jee Yeon Kim
- Departments of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Chong-Kun Cheon
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Su-Young Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea
| | - Yoo-Mi Kim
- Department of Pediatrics, Pusan National University Children’s Hospital, Yangsan, Korea,Address for correspondence: Yoo-Mi Kim, MD, PhD https://orcid.org/0000-0002-8440-5069 Department of Pediatrics, Pusan National University Children’s Hospital, 20 Geumo-ro, Mulgeumeup, Yangsan 50612, Korea Tel: +82-55-360-3173 Fax: +82-55-360-2181 E-mail:
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Hwang JY, Choo KS, Choi YY, Kim JH, Ryu H, Han J, Kim YW, Jeon UB, Nam KJ. Subjective and objective image differences in pediatric computed tomography cardiac angiography using lower iodine concentration. Pediatr Radiol 2017; 47:701-709. [PMID: 28236133 DOI: 10.1007/s00247-017-3795-z] [Citation(s) in RCA: 6] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 01/22/2017] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Several recent studies showed the optimal contrast enhancement with a low-concentration and iso-osmolar contrast media in both adult and pediatric patients. However, low contrast media concentrations are not routinely used due to concerns of suboptimal enhancement of cardiac structures and small vessels. OBJECTIVE To evaluate the feasibility of using iso-osmolar contrast media containing a low iodine dose for CT cardiac angiography at 80 kilovolts (kVp) in neonates and infants. MATERIALS AND METHODS The iodixanol 270 group consisted of 79 CT scans and the iopromide 370 group of 62 CT scans in patients ≤1 year old. Objective measurement of the contrast enhancement was analyzed and contrast-to-noise ratios of the ascending aorta and left ventricle were calculated. Regarding subjective measurement, a four-point scale system was devised to evaluate degrees of contrast enhancement, image noise, motion artifact and overall image quality of each image set. Reader performance for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment was evaluated. RESULTS Group objective and subjective measurements were nonsignificantly different. Overall sensitivity, specificity and diagnostic accuracy for correctly differentiating iodixanol 270 and iopromide 370 by visual assessment were 42.8%, 59%, and 50%, respectively. CONCLUSION The application of iodixanol 270 achieved optimal enhancement for performing pediatric cardiac CT angiography at 80 kVp in neonates and infants. Objective measurements of contrast enhancement and subjective image quality assessments were not statistically different in the iodixanol 270 and iopromide 370 groups.
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Affiliation(s)
- Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea.
| | - Yoon Young Choi
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Jin Hyeok Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Junhee Han
- Division of Biostatistics, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Yong-Woo Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
| | - Kyung Jin Nam
- Department of Radiology, Pusan National University Yangsan Hospital, Geumo-ro 20, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, 50612, Republic of Korea
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Kim J, Hwang JY, Oh JK, Park MS, Kim SW, Chang H, Kim TH. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017; 6:337-344. [PMID: 28536117 PMCID: PMC5457638 DOI: 10.1302/2046-3758.65.bjr-2016-0271.r2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 10/11/2016] [Accepted: 03/23/2017] [Indexed: 12/02/2022] Open
Abstract
Objectives The objective of this study was to assess the association between whole body sagittal balance and risk of falls in elderly patients who have sought treatment for back pain. Balanced spinal sagittal alignment is known to be important for the prevention of falls. However, spinal sagittal imbalance can be markedly compensated by the lower extremities, and whole body sagittal balance including the lower extremities should be assessed to evaluate actual imbalances related to falls. Methods Patients over 70 years old who visited an outpatient clinic for back pain treatment and underwent a standing whole-body radiograph were enrolled. Falls were prospectively assessed for 12 months using a monthly fall diary, and patients were divided into fallers and non-fallers according to the history of falls. Radiological parameters from whole-body radiographs and clinical data were compared between the two groups. Results A total of 144 patients (120 female patients and 24 male patients) completed a 12-month follow-up for assessing falls. A total of 31 patients (21.5%) reported at least one fall within the 12-month follow-up. In univariate logistic regression analysis, the risk of falls was significantly increased in older patients and those with more medical comorbidities, decreased lumbar lordosis, increased sagittal vertical axis, and increased horizontal distance between the C7 plumb line and the centre of the ankle (C7A). Increased C7A was significantly associated with increased risk of falls even after multivariate adjustment. Conclusion Whole body sagittal balance, measured by the horizontal distance between the C7 plumb line and the centre of the ankle, was significantly associated with risk of falls among elderly patients with back pain. Cite this article: J. Kim, J. Y. Hwang, J. K. Oh, M. S. Park, S. W. Kim, H. Chang, T-H. Kim. The association between whole body sagittal balance and risk of falls among elderly patients seeking treatment for back pain. Bone Joint Res 2017;6:–344. DOI: 10.1302/2046-3758.65.BJR-2016-0271.R2.
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Affiliation(s)
- J Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - J Y Hwang
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - J K Oh
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - M S Park
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - S W Kim
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - H Chang
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - T-H Kim
- Spine Centre, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Abstract
Cranial nerve disorders are uncommon disease conditions encountered in pediatric patients, and can be categorized as congenital, inflammatory, traumatic, or tumorous conditions that involve the cranial nerve itself or propagation of the disorder from adjacent organs. However, determination of the normal course, as well as abnormalities, of cranial nerves in pediatric patients is challenging because of the small caliber of the cranial nerve, as well as the small intracranial and skull base structures. With the help of recently developed magnetic resonance (MR) imaging techniques that provide higher spatial resolution and fast imaging techniques including three-dimensional MR images with or without the use of gadolinium contrast agent, radiologists can more easily diagnose disease conditions that involve the small cranial nerves, such as the oculomotor, abducens, facial, and hypoglossal nerves, as well as normal radiologic anatomy, even in very young children. If cranial nerve involvement is suspected, careful evaluation of the cranial nerves should include specific MR imaging protocols. Localization is an important consideration in cranial nerve imaging, and should cover entire pathways and target organs as much as possible. Therefore, radiologists should be familiar not only with the various diseases that cause cranial nerve dysfunction, and the entire course of each cranial nerve including the intra-axial nuclei and fibers, but also the technical considerations for optimal imaging of pediatric cranial nerves. In this article, we briefly review normal cranial nerve anatomy and imaging findings of various pediatric cranial nerve dysfunctions, as well as the technical considerations of pediatric cranial nerve imaging. Online supplemental material is available for this article. (©)RSNA, 2016.
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Affiliation(s)
- Jae-Yeon Hwang
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hye-Kyung Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jeong Hyun Lee
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Hee Mang Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Ah Young Jung
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Young Ah Cho
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Jin Seong Lee
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Chong Hyun Yoon
- From the the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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45
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Hwang JY. Emergency ultrasonography of the gastrointestinal tract of children. Ultrasonography 2017; 36:204-221. [PMID: 28228009 PMCID: PMC5494868 DOI: 10.14366/usg.16052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 12/27/2016] [Revised: 01/22/2017] [Accepted: 01/25/2017] [Indexed: 11/18/2022] Open
Abstract
Ultrasonography (US) is widely used to evaluate most body parts in pediatric patients because it is simple, noninvasive, easy to use, and applicable in a wide variety of clinical situations. US is the modality of choice for the initial evaluation of acute abdominal pain in pediatric patients because of their small body habitus and the presence of less fat tissue in the abdominal wall and peritoneal cavity. The most important factor in performing pediatric emergency US is the graded compression technique and selection of the proper transducer. The careful evaluation of bowel wall thickening combined with ancillary findings such as fluid collection, increased echogenicity of the mesenteric fat tissue, enlarged lymph nodes, hyperemic bowel changes, and abnormal bowel peristalsis can increase the diagnostic capability of US.
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Affiliation(s)
- Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea.,Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea
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Hwang JY, Lee YJ, Chun P, Shin DH, Park JH. Esophageal adenocarcinoma and Barrett esophagus in a neurologically impaired teenager. Pediatr Int 2016; 58:1235-1238. [PMID: 27882742 DOI: 10.1111/ped.13114] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/02/2016] [Accepted: 08/08/2016] [Indexed: 11/30/2022]
Abstract
Esophageal adenocarcinoma (EAC) accompanied by Barrett esophagus (BE) is rare in patients younger than 20 years old. EAC in the upper esophagus is also rare. We report a rare case of EAC with BE that developed in the upper esophagus after chronic, untreated gastroesophageal reflux disease in a neurologically impaired teenager. A 19-year-old neurologically impaired man underwent endoscopy for evaluation of dysphagia and vomiting, and was diagnosed with EAC with BE. He underwent transthoracic esophagectomy, extensive lymph node dissection, and cervical esophagogastric anastomosis, but the prognosis was poor. Pathology indicated poorly differentiated adenocarcinoma with BE.
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Affiliation(s)
- Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Peter Chun
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
| | - Dong Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Jae Hong Park
- Department of Pediatrics, Pusan National University Children's Hospital, Yangsan, Korea
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Hwang JY, Buskirk AR. A ribosome profiling study of mRNA cleavage by the endonuclease RelE. Nucleic Acids Res 2016; 45:327-336. [PMID: 27924019 PMCID: PMC5224514 DOI: 10.1093/nar/gkw944] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 08/12/2016] [Revised: 10/05/2016] [Accepted: 10/11/2016] [Indexed: 11/12/2022] Open
Abstract
Implicated in persistence and stress response pathways in bacteria, RelE shuts down protein synthesis by cleaving mRNA within the ribosomal A site. Structural and biochemical studies have shown that RelE cuts with some sequence specificity, which we further characterize here, and that it shows no activity outside the context of the ribosome. We obtained a global view of the effect of RelE on translation by ribosome profiling, observing that ribosomes accumulate on the 5′-end of genes through dynamic cycles of mRNA cleavage, ribosome rescue and initiation. Moreover, the addition of purified RelE to cell lysates shows promise as a method for generating ribosome footprints. In bacteria, profiling studies have suffered from relatively low resolution and have yielded no information on reading frame due to problems inherent to MNase digestion, the method used to degrade unprotected regions of mRNA. In contrast, we find that RelE yields precise 3′-ends that for the first time reveal reading frame in bacteria. Given that RelE has been shown to function in all three domains of life, RelE has potential to improve reading frame and shed light on A-site occupancy in ribosome profiling experiments more broadly.
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Affiliation(s)
- Jae-Yeon Hwang
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Allen R Buskirk
- Department of Molecular Biology and Genetics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
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Nam KJ, Choo KS, Jeon UB, Kim TU, Hwang JY, Yeom JA, Jeong HS, Choi YY, Kim JY, Lee SH, Kim HY, Jung YJ, Cho YH. Comparison of diameters of ipsilateral and contralateral internal mammary arteries by breast MRI in patients with unilateral breast cancer. Jpn J Radiol 2016; 34:409-13. [PMID: 27012963 DOI: 10.1007/s11604-016-0537-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 10/27/2015] [Accepted: 03/14/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE We compared maximal diameters of ipsilateral (IMA) and contralateral (IMA) internal mammary arteries in patients with unilateral breast cancer and analyze the implications of enlargements of ipsilateral or contralateral IMAs in relation to histopathologic factors. MATERIALS AND METHODS Of 568 women who underwent breast magnetic resonance imaging (MRI) examinations from January 2009 to May 2012, 196 had unilateral, histologically proven breast cancer. In 156 women, maximal IMA diameters in the second intercostal space were measured by two blinded radiologists in left and right sides using nonenhanced axial T2-weighted turbo spin-echo sequence images. RESULTS In the 156 study patients, mean maximal diameter of ipsilateral IMAs (2.37 ± 0.60 mm) was significantly larger than that of contralateral IMAs (2.03 ± 0.58 mm) (p = 0.00). Ipsilateral IMA enlargement was present in 66.7 % of the patients (104 of 156). Furthermore, ipsilateral IMA enlargement was found to be significantly associated with human epidermal growth factor receptor-2 (HER-2) expression (p = 0.039). CONCLUSIONS Maximal IMA diameter was significantly greater in ipsilateral sides in breast cancer patients. Findings suggest ipsilateral IMA enlargement detected by MRI might be a useful additional predictor of HER-2 expression in unilateral breast cancer.
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Affiliation(s)
- Kyung Jin Nam
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Ki Seok Choo
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea.
| | - Ung Bae Jeon
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Tae Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Jeong A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Hee Seok Jeong
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Yoon Young Choi
- Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Jin You Kim
- Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan-si, 602-739, Korea
| | - Sang Hyup Lee
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Hyun Yul Kim
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Youn Joo Jung
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
| | - Young Hye Cho
- Department of Family Medicine, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, 20, Geumo-ro, Mulgeum-eup, Yangsan-si, Gyungnam, 626-770, Korea
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Lee YJ, Hwang JY, Cho YH, Kim YW, Kim TU, Shin DH. A long-Segmental Vascular Malformation in the Small Bowel Presenting With Gastrointestinal Bleeding in a Preschool-Aged Child. Iran J Radiol 2016; 13:e29260. [PMID: 27110342 PMCID: PMC4835636 DOI: 10.5812/iranjradiol.29260] [Citation(s) in RCA: 7] [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: 04/16/2015] [Revised: 05/30/2015] [Accepted: 06/05/2015] [Indexed: 11/16/2022]
Abstract
Gastrointestinal (GI) bleeding in pediatric patients has several causes. Vascular malformation of the small bowel is a rare disease leading to pediatric GI bleeding. To our knowledge, few reports describe ultrasound and computed tomography findings of venous malformations involving the small bowel. We present a case of long-segmental and circumferential vascular malformation that led to GI bleeding in a pre-school aged child, focusing on the radiologic findings. Although vascular malformation including of the GI tract is rare in children, it should be considered when GI bleeding occurs in pediatric patients.
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Affiliation(s)
- Yeoun Joo Lee
- Department of Pediatrics, Pusan National University Children’s Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
| | - Jae-Yeon Hwang
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
- Corresponding author: Jae-Yeon Hwang, Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea. Tel: +82-553602778, Fax: +82-553601848, E-mail:
| | - Yong Hoon Cho
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
| | - Yong-Woo Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
| | - Tae Un Kim
- Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
| | - Dong Hoon Shin
- Department of Pathology, Pusan National University Yangsan Hospital, Pusan National University, School of Medicine, Yangsan, Republic of Korea
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50
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Hwang JY, Kim KW, Lee SJ, Kim SY, Lee JS, Kim HJ, Lee J, Song GW, Lee SG. The computed tomographic angiography finding of hepatic artery dissection after living donor liver transplantation; what is the clinical significance? Clin Imaging 2016; 40:130-6. [DOI: 10.1016/j.clinimag.2015.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 06/04/2015] [Accepted: 06/26/2015] [Indexed: 02/07/2023]
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