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ABSTRACT: Background
Morphologic and kinetic characteristics of breast lesions are regarded as a major criterion for their differential diagnosis in dynamic magnetic resonance imaging (MRI). However, there have not been well-reported MRI findings of microinvasive ductal carcinoma.PurposeTo evaluate MRI characteristics of microinvasive ductal carcinoma of the breast and to compare MRI findings in patients with microinvasive ductal carcinoma and pure ductal carcinoma in situ (DCIS).Material and Methods
Eighty-one patients with pathologically confirmed microinvasive ductal carcinomas (n = 37) or pure DCIS (n = 44) were included in this study. The MRI findings were analyzed without knowledge of the pathologic and conventional imaging findings. For all the lesions detected on MRI, morphologic and kinetic analyses were performed according to the Breast Imaging Reporting and Data System. For the non-mass lesions, the presence of clustered ring enhancement was also analyzed. Statistical analyses were performed using Student's t test, χ(2) test, and Fisher's exact test.ResultsIn total 35 cases of microinvasive ductal carcinoma and 39 cases of DCIS were detected on MRI. The most common and dominant MRI findings of microinvasive ductal carcinoma and DCIS were non-mass lesions with heterogeneous enhancement. However, the spiculated margin of the mass-type lesion (P = 0.022), the segmental distribution (P = 0.023), and clustered ring enhancement (P = 0.006) of the non-mass-type lesion, and the enhancement kinetics showing strong initial enhancement (P = 0.004) with subsequent wash-out (P = 0.001) were significantly more frequent in microinvasive ductal carcinoma than in DCIS.Conclusion
Non-mass lesions with segmental distribution, heterogeneous enhancement, and strong initial enhancement with a wash-out curve were the dominant MRI findings of microinvasive ductal carcinoma. Compared with DCIS, microinvasive ductal carcinoma showed more suspicious imaging characteristics. For the non-mass lesions, clustered ring enhancement was also a characteristic finding of microinvasion on MRI.
Acta Radiologica 04/2013; · 1.37 Impact Factor
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ABSTRACT: BackgroundB1 transmission-field inhomogeneity has been reported at 3.0 Tesla (T) breast imaging. Enhancement measurements of breast cancers at 3.0T may be insufficient for some patients and improvements in imaging protocols are needed.PurposeTo quantify B1 inhomogeneities in normal tissue and malignant masses at 3.0T breast MR imaging and to evaluate effect of an imaging protocol using an interleaved sagittal sequence in dynamic contrast-enhanced MRI (DCE-MRI).Material and MethodsA total of 76 patients were included who underwent DCE-MRI of the breast at 3.0T with an imaging protocol consisting of 1st, 2nd, and 4-6th bilateral axial sequences, and 3rd and 7th unilateral sagittal sequences. Signal intensity (SI) of normal breast tissue was measured at nipple level in four bilateral locations (anterior, posterior, medial, and lateral). Mean whole breast and location specific SI were calculated and compared between right and left breast using a paired t-test. All malignant masses were classified into three groups according to tumor size on MRI (≤2 cm, 2-4 cm, >4 cm). SI of malignant masses was measured independently on axial and sagittal sequences. The axial-sagittal SI gap in each mass was calculated and difference between right and left breast was compared using the t test. Size of each malignant mass was compared with pathologic findings to assess performance of the imaging protocol.ResultsSI of normal breast tissue were lower for the right breast (R-L difference, -91.9; P < 0.0001) and in all four locations (anterior, P < 0.01; posterior, P < 0.01; medial, P < 0.0001; lateral, P < 0.0001). SI of malignant masses were lower for the right breast among same size of the lesions (P < 0.0001), particularly < 4 cm (P < 0.0001). Decreased right to left difference in SI was produced with an interleaved sagittal sequence, as axial-sagittal gap of malignant masses was significant when tumor locates on the right side (P < 0.001). The concordance rate in predicting size of mass in this imaging protocol was 92.2%.Conclusion
The interleaved sagittal sequence is helpful to adjust reduced SI of malignant masses on right breast at 3.0T. This imaging protocol is clinically applicable by adding a single sequence during DCE-MRI of the breast.
Acta Radiologica 03/2013; · 1.37 Impact Factor
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ABSTRACT: Antagonists of CXC chemokine receptor 4 (CXCR4), including AMD3100, induce peripheral mobilization of hematopoietic stem cells and have been approved for clinical use. We explored whether the CXCR4 antagonists affected the survival and proliferation of myeloid leukemia cells in vitro.
The effects of CXCR4 antagonists AMD3100 and T140 on the survival and proliferation of myeloid leukemia cell lines (U937, HL-60, MO7e, KG1a, and K562) as well as CD34(+) cells obtained from patients with AML and CML were analyzed by flow cytometry by using annexin V and a colorimetric cell proliferation assay.
AMD3100, but not T140, stimulated the proliferation of leukemia cells in vitro in a dose-dependent manner for up to 5 days (~2-fold increase at a concentration of 10(-5) M), which was not abrogated by pretreatment of the cells with pertussis toxin, but was attenuated by RNAi knockdown of CXCR7 transcripts. In contrast, AMD3100 induced a marked decrease in the cell numbers after 5-7 days. AMD3100, but not T140, induced phosphorylation of MAPK p44/p42. AMD3100 increased the number and size of leukemia cell colonies and reduced cell apoptosis during the first 5-7 days of incubation, but the phenomena were reversed during the later period of incubation.
The effects of CXCR4 antagonists on the proliferation of myeloid leukemia cells are not uniform. AMD3100, but not T140, exerts dual effects, initially enhancing and subsequently inhibiting the survival and proliferation of the cells in vitro.
The Korean journal of hematology 12/2011; 46(4):244-52.
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ABSTRACT: Green tea extract (GTE) has been reported to have remarkable anti-inflammatory, antioxidant, and anticarcinogenic effects and to prolong allograft survivals. The purpose of the present study is to investigate in vitro the efficacy of GTE as a storage medium for avulsed teeth. We estimated the possibility for storage medium by maintaining the viability of human periodontal ligament (PDL) cells.
Human PDL cells were cultured and stored in the following media: (1) Hank's balanced salt solution (HBSS), (2) tap water, (3) milk, (4) GTE, and (5) commercial green tea. After 1, 3, 6, 12, and 24 hours, cells in different media were examined under the optical microscope, and their viabilities were analyzed by using a nucleocounter and 3-(4,5-dimethylthiazol-2-yl)-5(3-carboxymethonyphenol)-2-(4-sulfophenyl)-2H-tetrazolium assay. The data were statistically analyzed by analysis of variance tests with post analysis using the Duncan method (P < .05).
The result indicates that there was no difference in cell viability between GTE and HBSS media, whereas GTE showed higher cell viability than other media (P < .05).
Our study shows that the efficacy of GTE in maintaining the viability of human PDL cells is similar to that of HBSS and higher than that of milk. Therefore, we conclude that GTE could be a suitable, alternative storage medium for avulsed teeth.
Journal of endodontics 07/2011; 37(7):962-7. · 2.95 Impact Factor
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Hyo Jin Lee,
Song Mei Huang,
Ha Yon Kim,
Yoon Suk Oh, Ji Young Hwang,
Zhe Long Liang,
Jeong Ki Min,
Hwan Jung Yun,
Ji Young Sul,
Samyong Kim,
Deog Yeon Jo,
Jin Man Kim
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ABSTRACT: Chemokine stromal cell-derived factor (SDF)-1α and its receptor CXC chemokine receptor 4 (CXCR4) have been shown to impact cancer progression. Accumulating evidence suggests that CXCR4 and SDF-1α expression is useful for evaluating the risk of gastric cancer progression. Thus, combined analysis of SDF-1α and CXCR4 should have high prognostic potential as a molecular marker for gastric cancer. We investigated the expression of SDF-1α and CXCR4 using immunohistochemistry in relation to prognosis, clinicopathological features and clinical outcomes in 221 cases of primary gastric cancer. Patients were categorized into three groups according to CXCR4 and SDF-1α expression: high CXCR4/high SDF-1α, low CXCR4/low SDF-1α, and high CXCR4/low SDF-1α - low CXCR4/high SDF-1α. No significant differences were noted in age, gender, histology, tumor location, lymphovascular invasion or proportion of tumor size >5 cm among the three groups. However, high CXCR4/high SDF-1α expression in tumor cells was significantly associated with depth of invasion of the tumor, lymph node involvement, and higher tumor stage compared to tumors with low CXCR4/low SDF-1α expression or high CXCR4/low SDF-1α - low CXCR4/high SDF-1α expression. Furthermore, patients with high CXCR4/high SDF-1α expression had the worst patient prognosis, whereas patients who had low CXCR4/low SDF-1α expression showed the most favorable prognosis. In conclusion, CXCR4 and SDF-1α are useful prognostic factors in gastric cancer, and the combination of high CXCR4 protein expression with high SDF-1α expression suggests a dismal prognosis.
Experimental and therapeutic medicine 01/2011; 2(3):499-504.
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Sang Yu Nam,
Boo-Kyung Han,
Eun Young Ko,
Seok Seon Kang,
Soo Yeon Hahn, Ji-Young Hwang,
Mee Young Nam,
Jong-Won Kim,
Jae Hoon Chung,
Young Lyun Oh,
Jung Hee Shin
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ABSTRACT: Proper candidates to improve the effectiveness of molecular testing for thyroid nodules detected on ultrasonography (US) in a clinical setting are not well known. We aimed at evaluating the effective indication and method of BRAF(V600E) mutation analysis of aspiration specimens according to the US features of thyroid nodules in a BRAF(V600E) mutation-prevalent area.
A total of 244 patients with 244 thyroid nodules were prospectively classified as malignant and nonmalignant based on US. Thyroid nodules with any malignant US features including spiculated margin, the presence of microcalcifications or macrocalcifications, marked hypoechogenicity, or a taller-than-wide shape were defined as US-positives and those without these features were defined as US-negatives. All patients underwent US-guided fine-needle aspiration (FNA). The presence of the BRAF(V600E) mutation in FNA specimens was determined by allele-specific polymerase chain reaction (AS-PCR) and direct DNA sequencing. The mutation results were correlated with cytology and either surgical pathology or follow-up.
Of 244 nodules, 66 were US-positive and 178 were US-negative. The malignancy rate was 92% (61/66) for US-positives and 14% (25/178) for US-negatives. The BRAF(V600E) mutation was identified in 67% (44/66) of US-positives and in 10% (17/178) of US-negatives. The BRAF(V600E) mutation for nodules with indeterminate or nondiagnostic cytology was present in 45% (5/11) of US-positives and in 8% (2/26) of US-negatives (p = 0.0168). A false negative cytology with the mutation was found in only one case of the US-negatives. All nodules with the mutation were surgically confirmed as papillary carcinomas. Adding the genetic analysis to the FNA as compared with the FNA alone improved the sensitivity and accuracy for US-positives, whereas there was no significant improvement for US-negatives. With regard to sensitivity and accuracy, the use of the AS-PCR was better than the use of the direct DNA sequencing for US-positives as compared with US-negatives.
The application of BRAF(V600E) mutation analysis in FNA specimens is more effective for thyroid nodules with malignant US features as compared with nodules without malignant US features. The use of the AS-PCR is more valuable as compared with the direct DNA sequencing to refine the diagnosis in a clinical setting.
Thyroid: official journal of the American Thyroid Association 03/2010; 20(3):273-9. · 2.60 Impact Factor
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Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 05/2009; 28(4):545-8. · 1.25 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the value of use of multidetector CT (MDCT) to predict the need for subsequent surgery in patients with small-bowel obstruction (SBO) due to adhesion. During a 3-year period, 128 patients with an SBO due to adhesion were enrolled in this prospective study. Initially, all patients were treated conservatively. Surgery was performed in patients who developed signs of strangulation or did not improve, despite a conservative treatment for at least 5 days. Of the 128 patients, 37 patients eventually underwent surgery. Two radiologists interpreted MDCT findings regarded as predictive indicators for subsequent surgery in consensus. The findings included degree of SBO, presence of transition zone, and an abnormal vascular course. These findings were statistically compared between the group operated on and the group not operated on. A higher degree of SBO, an abnormal vascular course, and the presence of transition zone were more frequently seen in the group of patients operated on (p < 0.001). Sensitivities, specificities, positive and negative predictive values, and risks for the use of MDCT to predict the need for surgery were 100%, 46.1%, 43%, 100%, and 1.9 (1.5 < or = 95% confidence interval (CI) < or = 2.2) for a high-grade obstruction; 100%, 23%, 34.5%, 100%, and 1.3 (1.2 < or = 95% CI < or = 1.5) for the presence of a transition zone; and 70.2%, 90.1%, 74.2%, 88.1%, and 7.1 (3.7 < or = 95% CI < or = 13.7) for the presence of an abnormal course of the mesenteric vessels, respectively. The presence of a high degree of SBO and an abnormal vascular course around transition zone are useful indicators on MDCT to predict the need for surgery in patients with an SBO due to adhesion.
European Radiology 05/2009; 19(10):2425-31. · 3.22 Impact Factor
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ABSTRACT: Due to the low sensitivity of plain radiography, the diagnosis of early stage ankylosing spondylitis (AS) is often difficult since many patients do not meet the radiographic criteria. The objective of our study was to investigate the diagnostic value of performing multidetector computed tomography (MDCT) of the sacroiliac (SI) joint in the evaluation of AS patients.
Thirty seven patients with definite or probable AS were evaluated. Plain radiography and MDCT imaging of the pelvis were performed for evaluating the SI joints. Two radiologists analyzed the images, and they graded the sacroiliitis on a scale of 0-4 according to the modified NY criteria. The clinical variables we analyzed included the disease duration, the treatment duration, the prescribed drugs, peripheral joint involvement, enthesopathy, the functional limitations and the BASDAI.
MDCT detected more bilateral sacroiliitis as compared to the plain radiography (86.5% vs. 75.7%, respectively), and MDCT yielded a higher grade of disease in 32.4% (right SI joint) and 24.3% (left SI joint) of the patients. More patients satisfied the modified NY criteria with using MDCT as compared with that when using the plain radiography (81.1% vs. 54.1%, respectively, p=0.002).
Visualization of the sacroiliac joint by MDCT provided a better diagnosis of AS, and especially during the early stage of the disease.
The Korean Journal of Internal Medicine 10/2007; 22(3):171-7.
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Tae Wook Kang,
Kyu Taek Lee,
Min Kyu Ryu,
Won Moon,
Sang Soo Lee,
Sun-Young Lee, Ji Young Hwang,
Jong Kyun Lee,
Jin Seok Heo,
Seong Heum Choi,
Sang Heum Kim,
Seung Woon Paik,
Jong Chul Rhee
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ABSTRACT: Pancreatic neuroendocrine tumors (PNET) are rare and manifest as functioning tumor (FT) or non-functioning tumor (NFT). Although malignant changes are observed in some cases, its prognosis is better than pancreatic cancer. We evaluated clinicoradiologic features and prognosis of FT and NFT. In addition, we tried to find the predictive factors for the recurrence of NFT after resection.
Between October 1994 and June 2004, we retrospectively evaluated the clinicopathologic features and prognosis of 12 cases of FT and 31 cases of NFT diagnosed by surgical pathology at single medical center in Korea.
PNET included 6 insulinomas, 4 gastrinomas, 1 glucagonoma, 1 somatostatinoma and 31 NFT. The major clinical manifestations were neuroglycopenic symptoms (100%) in insulinoma, abdominal ulcer symptoms (75%) in gastrinoma, dermatitis (100%) in glucagonoma, steatorrhea (100%) in somatostatinoma, and abdominal discomfort or pain (45%) in NFT. NFT was located more proximally when compared to FT (p=0.023). NFT showed more malignant (64.5%) behavior compared to FT (41.7%) despite the lack of statistical significance. Curative resections were done without postoperative death in 38 cases. Six cases of NFT (21.4%) and 1 case of FT (10%) recurred with an average of 26.5 months. In the recurrent NFT, the findings of diabetes mellitus (p=0.010), abnormal pancreatic duct (p=0.026), Whipple's operation (p=0.013) and tumor emboli (p=0.03) were more common than in non-recurrent NFT.
FT and NFT showed different clinicoradiologic features. In addition, NFT should be monitored more carefully because of frequent recurrence.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 09/2006; 48(2):112-8.
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ABSTRACT: The purpose of this series was to describe typical ultrasonographic features of 20 cases of pilomatricoma and to improve its diagnostic rate with the use of an ultrasonographic approach.
For 20 pilomatricomas in 19 patients with preoperative ultrasonography from 1995 to 2004, we reviewed age, sex, symptoms, duration, referring clinician, and tumor sites. The ultrasonographic findings were retrospectively analyzed for tumor location, shape, size, margin, echo texture, echogenicity, presence, amount, and shape of calcification, presence of a hypoechoic rim, and Doppler flow pattern.
The mean age of the 19 patients was 6.9 years (range, 1-21 years), and the female-male ratio was 1.1:1. Patients had a painful palpable mass in 10 cases (50%). Nine lesions occurred in the neck, 5 in the cheek, 2 in the preauricular region, and 4 in the extremity. All tumors were located in the subcutaneous layer. The mean size of the tumors was 13.4 mm. Fourteen pilomatricomas (70%) appeared as well-defined oval masses. Tumors were heterogeneously hyperechoic in 80% of cases. All tumors had internal echogenic foci. A hypoechoic rim was seen in 17 cases (85%). Doppler flow signals were observed in the peripheral region in 14 cases (70%). A correct preoperative diagnosis was made in 33% on the basis of clinical findings and in 76% by ultrasonography.
Diagnosis of pilomatricoma should be considered when a well-defined mass with inner echogenic foci and a peripheral hypoechoic rim or a completely echogenic mass with strong posterior acoustic shadowing in the subcutaneous layer of the head, neck, or extremity is found on ultrasonography.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 11/2005; 24(10):1397-402. · 1.25 Impact Factor
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ABSTRACT: Increased levels of pancreatic enzymes have been reported in patients with renal insufficiency even in the absence of pancreatic diseases. Here, we analyzed serum amylase and lipase levels in chronic renal failure patients according to the degree of azotemia and the treatment modality.
Serum amylase and lipase levels were reviewed in 95 patients on continuous ambulatory peritoneal dialysis, 105 patients on hemodialysis, 71 patients with renal transplantation, and 73 patients without treatment. Age and sex matched 344 normal healthy controls were selected among those who checked their serum amylase and lipase levels during the same study period.
Mean value of amylase level in the patient group (93.7+/-76.5 U/L) was higher than healthy controls (63.8+/-21.4 U/L) (p<0.001) and lipase level in the patient group (212.3+/-195.0 U/L) was higher than healthy control (95.2+/-45.1 U/L) (p<0.001). There was no significant difference in amylase and lipase levels according to the treatment modality in the patient group. The correlations between creatinine clearance and amylase (r=-0.148, p=0.012) or lipase (r=-0.119, p=0.042) were found to be inverse only when the creatinine clearance falls below 50 mL/min.
Serum amylase and lipase levels are about 1.5 times and 2.2 times higher in chronic renal failure patients than healthy controls regardless of treatment modality. The elevations of amylase and lipase levels are inversely correlated with creatinine clearance when it falls below 50 mL/min.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 03/2005; 45(2):125-9.
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ABSTRACT: Isolated pleural effusion, so called primary pleural effusion denotes a pleural effusion without documented etiology such as a cardiac, inflammatory, iatrogenic problem or fetal hydrops. Chromosomal anomaly such as Down syndrome may be associated with isolated pleural effusion. The content of the isolated pleural effusion is mostly chylous, and isolated non-chylous pleural effusion in neonate is rare. We experienced 2 cases of isolated non-chylous pleural effusion. They had neither cardiac problem nor other sign of hydrops fetalis. Imaging diagnosis was done by plain chest radiography and subsequent ultrasonogram. One of them was diagnosed to Down syndrome by karyotyping. They were fared well after diagnostic and therapeutic thoracentesis. We describe 2 cases of non-chylous pleural effusion and review a few English-language case reports of this entity.
Journal of Korean Medical Science 09/2003; 18(4):603-5. · 0.99 Impact Factor
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ABSTRACT: Depletion of phosphatidylinositol 4,5-bisphosphate (PIP(2)) induced by phenylephrine or endothelin causes the inhibition of acetylcholine-activated K(+) current (I(KACh)) in atrial myocytes. In the present study, we have investigated the hypothesis that muscarinic receptor induced PIP(2) depletion also causes inhibition of I(KACh), resulting in desensitization. We confirmed the expression of G(q)-coupled muscarinic receptors in mouse atrial myocytes using reverse transcriptase-polymerase chain reaction. The involvement of M(1) and M(3) receptors in desensitization is examined using specific antagonists, 4-DAMP and pirenzepine, but they significantly reduced peak I(KACh), implying nonspecific M(2) blockade. When ACh-induced phosphoinositide depletion was specifically inhibited using PLCbeta1 knock-out mice, the extent of desensitization during 4 min was 47.5 +/- 3.2%, which was not different from that in wild type (46.8 +/- 2.1%). Phenylephrine-induced phosphoinositide hydrolysis and phenylephrine-induced inhibition of I(KACh) were not affected by PLCbeta1 knock-out. To facilitate PIP(2) depletion, replenishment of PIP(2) was blocked by wortmannin. Wortmannin did not affect the desensitization and the recovery from desensitization. These results suggest that PIP(2) depletion by acetylcholine does not contribute to short-term desensitization of I(KACh). The differential regulation of I(KACh) by different phospholipase C-linked receptors may imply that receptor co-localization is required for PIP(2) to act as a signaling molecule.
Journal of Biological Chemistry 09/2002; 277(31):27742-7. · 4.77 Impact Factor
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ABSTRACT: The authors report two cases with distension of the obturator internus bursa identified on MR images, and describe the location and characteristic features of obturator internus bursitis; the "boomerang"-shaped fluid distension between the obturator internus tendon and the posterior grooved surface of the ischium.
Korean Journal of Radiology 9(4):375-8. · 1.54 Impact Factor
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ABSTRACT: We present a case of an 8-year-old girl with an infected urachal cyst containing an appendicolith found secondary to an appendico-urachal cyst fistula caused by perforated appendicitis. The clinical features and computed tomographic manifestations of this unusual case are discussed.
Clinical imaging 32(6):480-2. · 0.73 Impact Factor
