[Show abstract][Hide abstract] ABSTRACT: Purpose: In 2000, the American Heart Association and International Liaison Committee on Resuscitation published guidelines for CPR (Cardiopulmonary Resuscitation), and these guidelines were revised in 2005. Many physicians perform CPR differently than suggested by these guidelines. We investigated guideline conformation rates for CPR by non-emergency physicians. Methods: From 103 in-hospital CPR cases were enrolled. We separated the 103 cases into two groups: 2005 patients and 2007 patients. Fifty-two cases in the 2005 group and 51 cases in the 2007 group were enrolled. The defibrillation method, defibrillation energy, epinephrine use, and atropine use were analyzed. Results: Nineteen cases (82.6%) in the 2005 group and three cases (21.4%) in the 2007 group were performed using the appropriate defibrillation method (p=0.0002). Seventeen cases (73.9%) in the 2005 group and four cases (28.6%) in the 2007 group received the appropriate defibril-lation energy (p=0.0069). Seven cases (14.0%) in the 2005 group and 16 cases (32.0%) in the 2007 group used the appropriate epinephrine dose (p=0.0325). Fourteen cases (28.0%) in the 2005 patient group and 14 cases (29.2%) in the 2007 patient group used the appropriate atropine dose (p=0.8983). Conclusion: Although CPR guidelines were renewed in 2005, many physicians do not follow these guidelines. We suggest that adequate information, education, feedback, and further study are needed for guideline conformation.
[Show abstract][Hide abstract] ABSTRACT: To correlate high resolution dynamic MR features with prognostic factors in breast cancer.
One hundred and ninety-four women with invasive ductal carcinomas underwent dynamic MR imaging using T1-weighted three-dimensional fast low-angle shot (3D-FLASH) sequence within two weeks prior to surgery. Morphological and kinetic MR features were determined based on the breast imaging and reporting data system (BI-RADS) MR imaging lexicon. Histological specimens were analyzed for tumor size, axillary lymph node status, histological grade, expression of estrogen receptor (ER), expression of progesterone receptor (PR), and expression of p53, c-erbB-2, and Ki-67. Correlations between the MR features and prognostic factors were determined using the Pearson chi(2) test, linear-by-linear association, and logistic regression analysis.
By multivariate analysis, a spiculated margin was a significant, independent predictor of a lower histological grade (p < 0.001), and lower expression of Ki-67 (p = 0.007). Rim enhancement was significant, independent predictor of a higher histological grade (p < 0.001), negative expression of ER (p = 0.001), negative expression of PR (p < 0.001) and a larger tumor size (p = 0.006). A washout curve may predict a higher level of Ki-67 (p = 0.05). Most of the parameters of the initial enhancement phase cannot predict the status of the prognostic factors. Only the enhancement ratio may predict a larger tumor size (p = 0.05).
Of the BI-RADS-MR features, a spiculated margin may predict favorable prognosis, whereas rim enhancement or washout may predict unfavorable prognosis of breast cancer.
Korean Journal of Radiology 02/2008; 9(1):10-8. DOI:10.3348/kjr.2008.9.1.10 · 1.81 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: PURPOSE
To correlate high resolution dynamic MR features in invasive breast cancer described in the MR BI-RADS lexicon with prognostic factors.
METHOD AND MATERIALS
194 patients with invasive ductal carcinoma NOS underwent dynamic MR imaging using (1.5 T, Sonata, Siemens) T1-weighted 3D FLASH sequence (fat suppression in the sagittal plane; TR/TE 4.9/1.8ms, FA 12°; FOV 100mm; matrix 224☓448; 1.0mm thickeness with no gap; 0.1mmol/kg Gd-DTPA; acquisition time 84s; 1 pre- and 4 postcontrast phases). Two experienced radiologist blineded to patient information retrospectively analyzed MR data by consensus. Morphologic parameters (mass or nonmass enhancement, shape, margin, and internal enhancement of the mass) and kinetic parameters (enhancement ratio, peak time, initial slope, and shape of the enhancement curve) based on the ACR BI-RADS-MRI lexicon were correlated with classical prognostic factors (tumor size, lymph node status, histologic grade) and immunohistochemically detected biomarkers (ER, PR, p53, c-erbB-2, Ki-67). Univariate and multivariate statistical analysis was performed.
At univariate analysis, spiculated margin was associated with lower grade, positive ER, positive PR, lower P53, and lower Ki-67. Rim enhancement was associated with larger size, higher grade, negative ER, negative PR, and higher Ki-67. Enhancement ratio was showed positive correlation with size, and grade. Initial slope was positively correlated with size, grade, and Ki-67. Peak time was positively correlated with grade and K-67. Washout curve was associated with higher grade, and higher Ki-67. Parameters found to be significant at univariate analysis were selected for logistic regression analysis. Spiculated margin was significant, independent predictor of lower grade (p=<0.001), and lower Ki-67 (p=<0.001). Rim enhancement was predictor of larger size (p=0.007), higher grade (p=<0.001), negative ER (p=0.001), and negative PR (p=<0.001). Washout was predictor of higher grade (p=0.04), and higher Ki-67 (p=0.02).
Some of MR features, i.e., spiculated margin, rim enhancement, and washout were associated with prognostic factors.
MR features of high resolution dynamic MR may predict prognosis of breast cancer.
Radiological Society of North America 2006 Scientific Assembly and Annual Meeting; 11/2006
[Show abstract][Hide abstract] ABSTRACT: LEARNING OBJECTIVES
1. To understand the indication of a larger FOV image in breast US. 2. To understand the principles of five technologies to obtain a larger FOV image in breast US. 3. To understand potential advantages and limitation of five methods used to obtain a larger FOV image in breast US
Several hardware and software approaches have been developed to obtain a larger FOV in breast US. First, the length of the transducers can be increased. A 50-mm long high-frequency linear probe is now commercially available. Second, a lower-frequency curved linear transducer can be used. This is effective for demonstrating the shape of the implant and a mass with great AP dimension. Third way is to phase the beam on either end and to create a trapezoidal image. It is more effective for deeper lesions. Fourth approach is extended FOV technology. It facilitates panoramic images with no loss in resolution by manual movement of a probe in the direction of the transducer array. Final way is to use split-screen imaging and combining the left and right image into a single fused image. Larger FOV image improves the visualization and documentation of large and multiple lesions, thus allowing better assessment of traditional criteria, measurement and comparison of the lesions during follow-up or treatment, and improves preoperative decision making.
Radiological Society of North America 2005 Scientific Assembly and Annual Meeting; 11/2005