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ABSTRACT: To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS.
AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification.
The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses.
AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement.
Korean journal of radiology: official journal of the Korean Radiological Society 01/2013; 14(2):154-163. · 1.32 Impact Factor
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ABSTRACT: FDG PET/CT and DWI are both functional modalities that indirectly represent the biological characteristics of cancer, but there are few studies exploring the association between the two modalities and prognostic factors. Our study attempted to evaluate the mutual association by comparing the prognostic factors, SUVmax value of PET/CT, and ADC values associated with diffusion imaging in invasive ductal carcinoma (IDC) patients.
Patients with pathologically confirmed IDC were recruited. There were 118 patients who underwent MRI, including DWI, FDG PET/CT, and immunohistochemical staining of the surgical specimen. Histologic analysis was done on tumor size, lymph node metastasis, expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and epidermal growth factor receptors (EGFR). The relationship among ADC values, SUVmax and prognostic factors were evaluated.
There was significant association between the ADC value and ER-positive and HER2-negative expression. Significant associations were noted between SUVmax and tumor size, lymph node metastasis, histologic grade, ER and PR expression, EGFR and Ki-67. However, there was no significant correlation between the ADC value and SUVmax.
Even though there was no correlation between ADC and SUVmax, both indexes are useful for predicting the prognosis of IDC.
World Journal of Surgical Oncology 06/2012; 10:126. · 1.12 Impact Factor
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ABSTRACT: Murine norovirus-1 (MNV-1) shares many features with human norovirus (HuNoV) and both are classified within the norovirus genus of Caliciviridae family. MNV-1 is used as the surrogate for HuNoV research since it is the only form that can be grown in cell culture. HuNoV and MNV-1 RNA dependent RNA polymerase (RdRp) proteins with the sequence identity of 59% show essentially identical conformations. Here we report the first structural evidence of 2-thiouridine (2TU) or ribavirin binding to MNV-1 RdRp, based on the crystal structures determined at 2.2Å and 2.5Å resolutions, respectively. Cellular and biochemical studies revealed stronger inhibitory effect of 2TU on the replication of MNV-1 in RAW 264.7 cells, compared to that of ribavirin. Our complex structures highlight the key interactions involved in recognition of the nucleoside analogs which block the active site of the viral RNA polymerase.
Virology 05/2012; 426(2):143-51. · 3.35 Impact Factor
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ABSTRACT: The purpose of this study was to compare the diagnostic performance of elastography, conventional ultrasonography (US) and combined conventional US and elastography for differentiation of papillary breast lesions.
A total of 95 papillary lesions (69 benign, 20 atypical and 6 malignant) in 87 patients were examined with conventional US and elastography. We evaluated conventional US images according to the Breast Imaging Reporting and Data System and internal composition (solid vs. cystic) and elastographic images according to elasticity scores. We compared diagnostic performances of elastography, conventional US and the combined method.
Areas under the receiver-operating curve were 0.794 for elastography, 0.875 for conventional US and 0.787 for the combined method. When the elasticity score cutoff was between 2 and 3, the sensitivity, specificity, positive predictive value and negative predictive value were 100, 55.1, 13 and 100 %, respectively. The combined method showed similar sensitivity (100 vs. 100 %) to and higher specificity (57.3 vs. 5.6 %) than conventional US alone. No significant difference was found in the elasticity scores of cystic papillary lesions according to pathology.
Elastography improved the specificity of conventional US in differentiating between benign or atypical and malignant papillary breast lesions when it was combined with conventional US.
Japanese journal of radiology 03/2012; 30(5):422-9. · 0.65 Impact Factor
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ABSTRACT: This report describes Mycoplasma contamination of Lawsonia intracellularis cultures that led to the unintended acquisition of a monoclonal antibody against Mycoplasma spp. during the attempted generation of a monoclonal antibody against L. intracellularis.
Applied and environmental microbiology 03/2012; 78(6):2046-8. · 3.69 Impact Factor
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ABSTRACT: During the routine laboratory cultivation of Lawsonia intracellularis, Mycoplasma contamination has been a frequent problem. When Mycoplasma contamination occurs in laboratories that study L. intracellularis, the cultures must be discarded for 4 reasons: 1) Mycoplasma is inevitably concentrated along with L. intracellularis during the passage of L. intracellularis; 2) Mycoplasma inhibits the growth of L. intracellularis; and 3) it is impossible to selectively eliminate Mycoplasma in L. intracellularis cultures. In this study, we observed the contamination of Mycoplasma species during L. intracellularis cultivation among multiple laboratories.
The presence of a Mycoplasma infection in the L. intracellularis cultures was verified using polymerase chain reaction (PCR), and a sequence analysis of the partial 16S rRNA and 23S rRNA genes was performed. A PCR-based assay using genus-specific universal primers revealed that 29 (85.3%) of the 34 cultures were contaminated with Mycoplasma, including 26 with M. hyorhinis (89.2%), 2 with M. orale (6.9%), and 1 with M. fermentans (3.4%). The Mycoplasma contamination was not the result of infection with material of pig origin. McCoy cells, which are required for the cultivation of L. intracellularis, were also ruled out as the source of the Mycoplasma contamination.
In this study, M. hyorhinis was identified as the most common mollicute that contaminated L. intracellularis cultures. Whether L. intracellularis enhances the biological properties of Mycoplasma to promote infection in McCoy cells is not known. Because the McCoy cell line stocks that were used simultaneously were all negative for Mycoplasma, and the same worker handled both the McCoy cells to maintain the bacteria and the L. intracellularis cultures, it is possible that the L. intracellularis cultures are more vulnerable to Mycoplasma contamination. Taken together, these results suggest that continuous cultures of L. intracellularis must be tested for Mycoplasma contamination at regular intervals.The GenBank accession numbers for the sequences reported in this paper are JN689375 to JN689377.
BMC Research Notes 01/2012; 5:78.
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ABSTRACT: The purpose of this study was to determine the clinical significance of the incidental finding of hypermetabolic foci in the breast at (18)F-FDG PET/CT in patients with malignant disease other than breast cancer or during a screening examination.
The files of 13,897 women who underwent FDG PET/CT from November 2004 to October 2009 were retrospectively reviewed. Forty-eight patients with incidental breast uptake had undergone either tissue confirmation or clinical follow-up with additional sonographic imaging. The following four variables were evaluated: age, maximum standard uptake value (SUV(max)) of breast uptake at FDG PET, findings in the CT portion of PET/CT, and sonographic findings. Malignancy rates were calculated for each variable.
Malignancy was diagnosed in 18 (37.5%) patients and a benign condition in 30 (62.5%) patients. Statistically significant differences in malignancy rate were found between the groups with SUV(max) less than 2 (24.2%) and the group with SUV(max) of 2 or greater (66.7%) and between the group with lesions in a BI-RADS ultrasound category lower than 4 (10.7%) and the group with lesions in category 4 or higher (75.0%) (p < 0.05). There was no significant difference in malignancy rates between the groups younger than 45 years (11.1%) and 45 years and older (53.3%) or between the group with lesions in a BI-RADS category lower than 4 (30.2%) and that with lesions in category 4 or higher (100%) on the CT portion of PET/CT.
Incidental hypermetabolic foci in the breast may represent malignancy in as many as 37.5% of cases. The SUV(max) and sonographic findings can be useful for differentiating benign from malignant lesions.
American Journal of Roentgenology 08/2011; 197(2):341-7. · 2.78 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the diagnostic utility of sonographic elastography in differentiating reactive and metastatic axillary lymph nodes in breast cancer.
A total of 64 lymph nodes (reactive, n = 33; metastatic, n = 31) from 62 patients with breast cancer were examined by both B-mode sonography and elastography from April to July 2009. Two experienced radiologists retrospectively assessed B-mode sonograms by the sum of scores for 4 criteria: short diameter, shape, hilum, and cortical thickening. Elastographic images were given scores of 1 to 4 according to the percentage of high-elasticity areas in the lymph nodes. We compared the diagnostic performance of B-mode sonography, elastography, and combined examinations. We also calculated the strain ratio of the lymph node and subcutaneous fat tissue.
The elasticity score for malignant lymph nodes (mean, 3.1) was higher than the score for benign lymph nodes (mean, 2.2; P < .0001). With a cutoff between elasticity scores of 2 and 3, elastography showed 80.7% sensitivity, 66.7% specificity, and 73.4% accuracy. With a cutoff between B-mode sonographic scores of 1 and 2, B-mode sonography showed 74.2% sensitivity and 78.8% specificity. Combined B-mode and elastographic sonography showed higher sensitivity (87.1%) than B-mode sonography alone. With a strain ratio cutoff point of 2.3, sensitivity was 82.8%, and specificity was 56.3%.
Sonographic elastography may increase the sensitivity of B-mode sonography in the detection of metastatic axillary lymph nodes.
Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 04/2011; 30(4):429-36. · 1.25 Impact Factor
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ABSTRACT: To evaluate the clinical and sonographic (US) features of metastatic tumors from extramammary malignancies to the breast.
This study included 23 patients with pathologically proven metastases in the breast. Two radiologists retrospectively analyzed the images from US (n = 23), mammography (n = 11), and MRI (n = 5) examinations according to BIRADS.
Patients presented with a palpable mass or diffuse breast swelling (21/23) or were asymptomatic (2/23). Eighteen patients had solitary or multiple breast masses on US. The common US finding was an ovoid hypoechoic mass with a noncircumscribed margin. The final assessment categories were BIRADS 3 (probably benign finding) in 6 cases (25%) and BIRADS 4 (suspicious abnormality) in 18 cases (75%). In five patients, US displayed a diffuse infiltrative pattern without a focal lesion, which was categorized as BIRADS 4.
Metastatic tumors in the breast have a wide range of sonographic appearances, with some resembling benign lesions. Any newly developed mass in a patient with a known history of extramammary malignancy, even with a probably benign US appearance, should undergo biopsy for pathologic confirmation.
Journal of Clinical Ultrasound 04/2011; 39(5):248-55. · 0.81 Impact Factor
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ABSTRACT: The aim of this study was to evaluate and compare the diagnostic performance of elastography, B-mode ultrasound (US), and a combination of elastography and B-mode US for the differentiation of small breast masses.
A total of 315 breast masses < 1 cm (267 benign, 48 malignant) in 278 patients were examined with B-mode US and elastography. Histopathologic results were used as a reference standard. Two radiologists retrospectively evaluated the B-mode images according to the American College of Radiology Breast Imaging Reporting and Data System and elastographic images according to the elasticity scoring classification system proposed by Itoh et al and the strain ratio. B-mode US and elastography were combined according to the cutoff value. The diagnostic performance of B-mode US, elastography, and the combination of the two modalities was compared using receiver-operating characteristic curve analysis.
The mean elasticity score for malignant masses (3.02 ± 1.33) was significantly higher than that for benign masses (1.72 ± 0.78) (P < .001). Areas under the receiver-operating characteristic curves were 0.616 for B-mode US, 0.784 for elasticity score, 0.668 for strain ratio, 0.727 for the combination of B-mode US and elasticity score, and 0.701 for the combination of B-mode US, elasticity score, and strain ratio. The sensitivity, specificity, positive predictive value, and negative predictive value were 93.8%, 51.7%, 25.9%, and 97.9%, respectively, when elasticity score and B-mode US were combined as follows: downgrade of B-mode US assessment category in cases with elasticity scores of 1, no change in cases with scores of 2 or 3, and upgrade in cases with scores of 4 or 5.
Elasticity score alone showed the best diagnostic performance, but a combination of B-mode US and elasticity score may have predictive value for the differentiation of benign and malignant lesions <1 cm.
Academic radiology 01/2011; 18(1):74-80. · 2.09 Impact Factor
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ABSTRACT: To describe the clinical and imaging characteristics of Polyimplant Prosthesis (PIP) hydrogel breast implants.
Seven patients with surgically confirmed 8 ruptured and 6 normal PIP hydrogel implants were enrolled in our study. We reviewed retrospectively the medical records and breast ultrasonographic and magnetic resonance imaging (MRI) findings of the patients.
Breast asymmetry was the most common clinical feature of PIP hydrogel implant rupture. The main radiologic finding of ruptured implants was a significant fluid collection around the implant. All 4 intracapsular ruptures showed no significant collapse of the implants despite a large accumulation of fluid surrounding the ruptured implants on ultrasonography and MRI. Three extracapsular ruptures showed variable collapse of the implants, partial collapse in 1 implant and total collapse in 2 implants. One extracapsular rupture showed enlargement of the implant. Ultrasonography and MRI revealed hydrogel extension to the muscles and chest wall in all 4 extracapsular ruptures and extensive inflammation and fibrosis in 3 extracapsular ruptures.
Polyimplant Prosthesis hydrogel implant rupture can be clinically silent. Knowledge of clinical and radiologic findings of the ruptured implants will be helpful in its diagnosis.
Journal of computer assisted tomography 04/2010; 34(3):449-55. · 1.38 Impact Factor
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ABSTRACT: To determine the genetic alterations and chemosensitivity profile of collecting duct carcinoma (CDC) of the kidney, as it is a rare, highly aggressive malignant tumour with frequent distant metastases.
We first established and characterized two human CDC cell lines designated AP3 and AP8, respectively. The CDC cell lines were assessed using microarray-based comparative genomic hybridization and chemosensitivity testing.
The CDC cells grew in vitro as an adherent monolayer with epithelial morphology, but had different growth rates. The cell lines had the characteristic immunophenotype of CDC (high molecular weight cytokeratin-+ve/cytokeratin 7-+ve/vimentin-+ve). Both cell lines shared copy number gains in chromosomes 20 and X. The loci showing a copy number gain were SOX22 at 20p tel, topoisomerse I (TOP1) at 20q12-q13.1, TPD52L2 at 20q tel, 20QTEL14 at 20q tel, KAL at Xp22.3, STS 5' at Xp22.3, OCRL1 at Xq25, AR3'at Xq11-q12, and XIST at Xq13.2, respectively. Immunoblot analysis confirmed that the AP3 and AP8 cell lines showed moderate and high levels of TOP1 expression, respectively. By chemosensitivity testing, the AP8 cells were most sensitive to topoisomerase I and II inhibitors such as topotecan, epirubicin and doxorubicin, but the AP3 cells did not. The chemosensitivity to these drugs was paralleled by cell death via apoptosis.
The results suggest that TOP1 might be one of the molecular targets in AP8 CDC cells. Thus, these novel CDC cell lines will be useful for discovering therapeutic targets and developing effective anticancer drugs against CDC.
BJU International 02/2009; 103(12):1721-8. · 2.84 Impact Factor
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Sanghoon Park,
Hoon Jai Chun,
Yong Dae Kwon,
Bora Keum,
Yeon Seok Seo,
Yong Sik Kim,
Yoon-Tae Jeen,
Soon Ho Um,
Chang Duck Kim,
Ho Sang Ryu, Ji Hye Lee,
Yang-Seok Chae
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ABSTRACT: Endoscopic mucosal resection can cure early gastric cancer. The risk of lymphatic metastasis is related to the depth of submucosal invasion by the mucosal malignancy, with a resection depth of 500 microm generally accepted as a safe cut-off. However, excessive thinning induced by stretching of the resected tissue sometimes preventing a precise diagnosis. We studied the effects of stretching on different layers and sites of gastric tissue.
Porcine stomachs were cut into 2.0x2.0 cm pieces, and pieces from body were stretched to 2.5, 3.0, and 3.5 cm. Pieces from the cardia, body, and antrum were also stretched to 3.0 cm. The thickness of each layer was measured and analyzed statistically.
Whole gastric wall and submucosal layers showed gradual thinning, with stretching to 3.5 cm tearing the tissues and resulting in imperfect extension. The submucosa was thinner in body tissue than in cardia and antrum tissues. Stretching to 3.0 cm induced a consistent decrease in submucosal thickness (30-70%). The change in thickness varied widely between individual samples.
A resection margin of 500 microm might be insufficient for the complete removal of malignancy. Moreover, the thickness of the submucosal layer differs with the gastric site and between individuals. Future studies are needed to confirm the findings in human tissue.
Gut and liver 12/2008; 2(3):199-204. · 0.83 Impact Factor
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ABSTRACT: Extraskeletal Ewing's sarcoma (EES) is a branch of neuroectodermal tumor (PNET), which is very rare soft tissue sarcoma. We report a case of EES/PNET arising is the lung of a 67-yr-old man. Computed tomography, bone scintigraphy, and positron emission tomography confirmed the mass to have a primary pulmonary origin. The mass showed positive reactivity in the Periodic Acid Schiff (PAS) stain and MIC-2 immunoreactivity in immunohistochemical stain. Fluorescence in situ hybridization (FISH) was performed, which revealed an EWSR1 (Ewing sarcoma breakpoint region 1) 22q12 rearrangement. The diagnosis was confirmed both pathologically and genetically. The mass lesion was resected, and the patient is currently undergoing chemotherapy.
Journal of Korean Medical Science 10/2007; 22 Suppl:S159-63. · 0.99 Impact Factor
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ABSTRACT: We report a case of pure red cell aplasia (PRCA), which was initially suspected as a result of bone marrow involvement of diffuse large B cell lymphoma. Persistent anemia without an obvious cause was observed in a 47-yr-old man diagnosed with relapsed diffuse large B cell lymphoma. The bone marrow study showed only erythroid hypoplasia without the evidence of bone marrow involvement with lymphoma cells, thus PRCA was suggested. However, parvovirus infection was excluded as a potential cause of PRCA because of negative IgM anti-parvovirus B19 antibody and negative parvovirus PCR in the serum. Latent Epstein-Barr virus (EBV) infection of bone marrow was suggested by in situ hybridization with EBV-encoded small RNA (EBER) that showed a strong positive expression in bone marrow cells. Thus, PRCA was thought to be associated with latent EBV infection in bone marrow cells. Although the finding of unexplained anemia is a possible predictor of bone marrow involvement with lymphoma cells, PRCA as a result of a viral infection including EBV should be considered in lymphoma patients. This is the first report of the occurrence of PRCA associated with latent EBV infection in a patient with non-Hodgkin's lymphoma.
Journal of Korean Medical Science 10/2007; 22 Suppl:S167-70. · 0.99 Impact Factor
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ABSTRACT: Different combinations of beta-tubulin isotypes contribute to the diverse functions of microtubules (MTs). Class II beta-tubulin (class II tubulin) is up-regulated in differentiated keratinocytes. In contrast, the expression of class II tubulin in follicular differentiation and cutaneous tumors has not been studied.
The immunohistochemical expression of class II tubulin was investigated in 117 cutaneous tumors: 30 squamous cell carcinomas (SCCs), seven keratoacanthomas (KAs), 57 basal cell carcinomas (BCCs), 23 trichoepitheliomas (TEs), and in the adjacent non-neoplastic skin.
Class II tubulin was expressed in the keratinocytes of the granular layer, melanocytes, hair cortical and cuticular cells, inner root sheath (IRS), companion layer (CL) of the outer root sheath (ORS), and mesenchymal cells with Schwannian or myogenic differentiation. Moreover, class II tubulin expression was increased in the areas of squamous or follicular differentiation in cutaneous tumors. On grading the follicular differentiation or myofibroblastic response with anti-class II tubulin, TE showed follicular differentiation more frequently (p < 0.001) with less of a myofibroblastic response (p = 0.001) than BCC.
Class II tubulin expression is closely related to squamous or follicular differentiation and may be helpful in distinguishing most SCCs from KAs and BCC from TE. However, it does not reliably distinguish well-differentiated, crateriform SCC from KA.
Journal of Cutaneous Pathology 03/2007; 34(2):166-73. · 1.56 Impact Factor
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ABSTRACT: The differential diagnosis of salivary gland carcinoma is often difficult because of the confusing histopathological features of the different types of salivary gland carcinomas. The expression of MUC3, MUC5AC, MUC6, cytokeratin (CK)7 and CK20 was studied in 20 mucoepidermoid carcinomas (MEC), 20 adenoid cystic carcinomas (AdCC), and 11 acinic cell carcinomas (ACC). All the cases (51/51, 100%) were positive for CK7, but they were not positive for CK20. All the cases (100%) of the MEC were positive for MUC5AC, while all MEC (100%) were negative for MUC3. Only two cases (10%) were positive for MUC6. All cases (100%) of AdCC were negative for MUC3, MUC5AC and MUC6. Eight cases (73%) of ACC were positive for MUC3, but all the cases (100%) were negative for MUC5AC and MUC6. It is concluded that the positive expression of MUC5AC is very unique to MEC, and that the positive expression of MUC3 is very unique to ACC. These findings will be very useful for the differential diagnosis of the salivary gland carcinomas.
Pathology International 08/2005; 55(7):386-90. · 1.62 Impact Factor
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Burns 12/2004; 30(7):742-5. · 1.96 Impact Factor
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ABSTRACT: A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.
Journal of Korean Medical Science 09/2003; 18(4):614-7. · 0.99 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the ultrasonographic features of benign adenomyoepithelioma of the breast.
Between 2005 and 2009, five patients had histologically confirmed adenomyoepithelioma of the breast. We retrospectively evaluated the ultrasonographic findings of the tumors in correlation with the pathology, and reviewed medical records.
The clinical manifestations included a palpable mass in three patients, while mammographic screening helped detect abnormalities in two patients. Ultrasonograms showed masses with an oval (n = 3) or irregular (n = 2) shape, with uncircumscribed (n = 4) or relatively well-circumscribed (n = 1) margins, as well as with a hypoechoic (n = 3) or a complex echoic (n = 2) internal echo texture. Three patients had focal ductectasia adjacent to the mass. The ultrasonographic assessments were classified as Breast Imaging Reporting and Data System (BI-RADS) category 4A, with low suspicion of malignancy in two cases, and as category 4B, with intermediate suspicion of malignancy in three cases. The pathology revealed benign adenomyoepithelioma in all patients.
Benign adenomyoepitheliomas appear as solid or complex echoic masses with suspicious malignant ultrasonographic features, which may be associated with adjacent ductectasia. Although adenomyoepithelioma is a rare breast tumor, awareness of its sonographic features will be helpful for the differential diagnosis from other tumors.
Korean journal of radiology: official journal of the Korean Radiological Society 11(5):522-7. · 1.32 Impact Factor
