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Primary Colonic Epithelioid Angiosarcoma with Hepatic Metastasis: A Case Report (간전이를 동반한 대장 상피모양혈관육종: 증례 보고)

  • Jiyun Lim;Seong Sook Hong;Jiyoung Hwang;Hyun-joo Kim;So-Young Jin
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.432-438
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    • 2022
  • Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.

Clinical Implications of Focal Mineral Deposition in the Globus Pallidus on CT and Quantitative Susceptibility Mapping of MRI

  • Hyojin Kim;Jinhee Jang;Junghwa Kang;Seungun Jang;Yoonho Nam;Yangsean Choi;Na-young Shin;Kook-Jin Ahn;Bum-soo Kim
    • Korean Journal of Radiology
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    • v.23 no.7
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    • pp.742-751
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    • 2022
  • Objective: To assess focal mineral deposition in the globus pallidus (GP) by CT and quantitative susceptibility mapping (QSM) of MRI scans and evaluate its clinical significance, particularly cerebrovascular degeneration. Materials and Methods: This study included 105 patients (66.1 ± 13.7 years; 40 male and 65 female) who underwent both CT and MRI with available QSM data between January 2017 and December 2019. The presence of focal mineral deposition in the GP on QSM (GPQSM) and CT (GPCT) was assessed visually using a three-point scale. Cerebrovascular risk factors and small vessel disease (SVD) imaging markers were also assessed. The clinical and radiological findings were compared between the different grades of GPQSM and GPCT. The relationship between GP grades and cerebrovascular risk factors and SVD imaging markers was assessed using univariable and multivariable linear regression analyses. Results: GPCT and GPQSM were significantly associated (p < 0.001) but were not identical. Higher GPCT and GPQSM grades showed smaller gray matter (p = 0.030 and p = 0.025, respectively) and white matter (p = 0.013 and p = 0.019, respectively) volumes, as well as larger GP volumes (p < 0.001 for both). Among SVD markers, white matter hyperintensity was significantly associated with GPCT (p = 0.006) and brain atrophy was significantly associated with GPQSM (p = 0.032) in at univariable analysis. In multivariable analysis, the normalized volume of the GP was independently positively associated with GPCT (p < 0.001) and GPQSM (p = 0.002), while the normalized volume of the GM was independently negatively associated with GPCT (p = 0.040) and GPQSM (p = 0.035). Conclusion: Focal mineral deposition in the GP on CT and QSM might be a potential imaging marker of cerebral vascular degeneration. Both were associated with increased GP volume.

Simultaneous Estimation of the Fat Fraction and R2* Via T2*-Corrected 6-Echo Dixon Volumetric Interpolated Breath-hold Examination Imaging for Osteopenia and Osteoporosis Detection: Correlations with Sex, Age, and Menopause

  • Donghyun Kim;Sung Kwan Kim;Sun Joo Lee;Hye Jung Choo;Jung Won Park;Kun Yung Kim
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.916-930
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    • 2019
  • Objective: To investigate the relationships of T2*-corrected 6-echo Dixon volumetric interpolated breath-hold examination (VIBE) imaging-based fat fraction (FF) and R2* values with bone mineral density (BMD); determine their associations with sex, age, and menopause; and evaluate the diagnostic performance of the FF and R2* for predicting osteopenia and osteoporosis. Materials and Methods: This study included 153 subjects who had undergone magnetic resonance (MR) imaging, including MR spectroscopy (MRS) and T2*-corrected 6-echo Dixon VIBE imaging. The FF and R2* were measured at the L4 vertebra. The male and female groups were divided into two subgroups according to age or menopause. Lin's concordance and Pearson's correlation coefficients, Bland-Altman 95% limits of agreement, and the area under the curve (AUC) were calculated. Results: The correlation between the spectroscopic and 6-echo Dixon VIBE imaging-based FF values was statistically significant for both readers (pc = 0.940 [reader 1], 0.908 [reader 2]; both p < 0.001). A small measurement bias was observed for the MRS-based FF for both readers (mean difference = -0.3% [reader 1], 0.1% [reader 2]). We found a moderate negative correlation between BMD and the FF (r = -0.411 [reader 1], -0.436 [reader 2]; both p <0.001) with younger men and premenopausal women showing higher correlations. R2* and BMD were more significantly correlated in women than in men, and the highest correlation was observed in postmenopausal women (r = 0.626 [reader 1], 0.644 [reader 2]; both p < 0.001). For predicting osteopenia and osteoporosis, the FF had a higher AUC in men and R2* had a higher AUC in women. The AUC for predicting osteoporosis was highest with a combination of the FF and R2* in postmenopausal women (AUC = 0.872 [reader 1], 0.867 [reader 2]; both p < 0.001). Conclusion: The FF and R2* measured using T2*-corrected 6-echo Dixon VIBE imaging can serve as predictors of osteopenia and osteoporosis. R2* might be useful for predicting osteoporosis, especially in postmenopausal women.

Spatial and temporal trends in food security during the COVID-19 pandemic in Asia Pacific countries: India, Indonesia, Myanmar, and Vietnam

  • Yunhee Kang;Indira Prihartono;Sanghyo Kim;Subin Kim;Soomin Lee;Randall Spadoni;John McCormack;Erica Wetzler
    • Nutrition Research and Practice
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    • v.18 no.1
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    • pp.149-164
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    • 2024
  • BACKGROUND/OBJECTIVES: The economic recession caused by the coronavirus disease 2019 pandemic disproportionately affected poor and vulnerable populations globally. Better uunderstanding of vulnerability to shocks in food supply and demand in the Asia Pacific region is needed. SUBJECTS/METHODS: Using secondary data from rapid assessment surveys during the pandemic response (n = 10,420 in mid-2020; n = 6,004 in mid-2021) in India, Indonesia, Myanmar, and Vietnam, this study examined the risk factors for reported income reduction or job loss in mid-2021 and the temporal trend in food security status (household food availability, and market availability and affordability of essential items) from mid-2020 to mid-2021. RESULTS: The proportion of job loss/reduced household income was highest in India (60.4%) and lowest in Indonesia (39.0%). Urban residence (odds ratio [OR] range, 2.20-4.11; countries with significant results only), female respondents (OR range, 1.40-1.69), engagement in daily waged labor (OR range, 1.54-1.68), and running a small trade/business (OR range, 1.66-2.71) were significantly associated with income reduction or job loss in three out of 4 countries (all P < 0.05). Food stock availability increased significantly in 2021 compared to 2020 in all four countries (OR range, 1.91-4.45) (all P < 0.05). Availability of all essential items at markets increased in India (OR range, 1.45-3.99) but decreased for basic foods, hygiene items, and medicine in Vietnam (OR range, 0.81-0.86) in 2021 compared to 2020 (all P < 0.05). In 2021, the affordability of all essential items significantly improved in India (OR range, 1.18-3.49) while the affordability of rent, health care, and loans deteriorated in Indonesia (OR range, 0.23-0.71) when compared to 2020 (all P < 0.05). CONCLUSIONS: Long-term social protection programs need to be carefully designed and implemented to address food insecurity among vulnerable groups, considering each country's market conditions, consumer food purchasing behaviors, and financial support capacity.

Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay (복부와 골반의 다양한 장기에서 발생한 황색육아종성 염증 질환의 영상 및 임상 소견: 임상화보)

  • Se Jin Lee;Dal Mo Yang;Hyun Cheol Kim;Sang Won Kim;Kyu Yeoun Won;So Hyun Park;Woo Kyoung Jeong
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.109-123
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    • 2024
  • Xanthogranulomatous (XG) inflammatory disease is a rare benign disease involving various organs, including the gallbladder, bile duct, pancreas, spleen, stomach, small bowel, colon, appendix, kidney, adrenal gland, urachus, urinary bladder, retroperitoneum, and female genital organs. The imaging features of XG inflammatory disease are nonspecific, usually presenting as a heterogeneous solid or cystic mass. The disease may also extend to adjacent structures. Due to its aggressive nature, it is occasionally misdiagnosed as a malignant neoplasm. Herein, we review the radiological features and clinical manifestations of XG inflammatory diseases in various organs of the abdomen and pelvis.

Folded-Loop Guidewire Remodeling Technique: Catheterizing Markedly Angulated Branches during Intravascular Embolization (Folded-Loop Guidewire Remodeling Technique: 색전술 시 급격한 분지 각도를 가지는 혈관의 선택적 진입 방법)

  • Dong Hyun Kim;Ung Rae Kang;Young Hwan Kim;Jung Guen Cha
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.418-426
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    • 2023
  • Purpose Practical challenges are encountered in percutaneous intravascular procedures when applied to markedly angulated branching vessels. Herein, we introduced a folded-loop guidewire remodeling technique-the guidewire-shaping technique-to overcome difficult catheterization. Materials and Methods First, the tip of a 0.014-inch micro-guidewire was manually shaped like a pigtail loop. Second, the shaped guidewire was introduced into the microcatheter and was preloaded into the hollow metal introducer for suitability with the microcatheter hub. Gentle rotation of the guidewire after release from the microcatheter can create the preshaped pigtail loop configuration. On pulling back, the loop loosened, the configuration was changed to a small U-shaped tip, and the guidewire tip was easily introduced into the target artery. Results Between December 2019 and January 2022, the described technique was used in 64 patients (male/female, 49/15; mean age, 66.8 ± 9.5 years) for selective arterial embolization, after failed attempts with the conventional selection technique. The technique was successful in 63/64 patients (98%). The indications of embolization include transcatheter arterial chemoembolization, gastrointestinal bleeding, hemoptysis, trauma-induced bleeding, and tumor bleeding. Conclusion The folded-loop guidewire remodeling technique facilitates the catheterization of markedly angulated branching arteries; when usual catheterization method fails.

The Incidences and Characteristics of Malignant Pleural Effusions According to Histologic Types (악성 흉막 삼출증의 조직학적 아형에 따른 빈도와 특성)

  • Yim, Jae-Joon;Kim, U-Jin;Lee, Jae-Ho;Yoo, Chul-Gyu;Chung, Hee-Soon;Han, Sung-Koo;Shim, Young-Soo;Kim, Young-Whan
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.565-573
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    • 1998
  • Malignant pleural effusions are most commonly associated with lung cancers, however, it also can be resulted from breast cancers, ovarian cancers, stomach cancers and so on. According to the their histologic types, adenocarcinoma have been known as the most common cell type of malignant pleural effusions and squamous cell carcinoma is rare. We herein present incidences, clinical characteristics and survivals of malignant pleural effusions according to their cell types and primary diseases. The objects are 84 malignant pleural effusion patients diagnosed by pleural fluid cytologic examination or pleural biopsy from Jan. 1992 to May. 1997 in Seoul National University Hospital. A retrospective chart review on their histologic types, biochemical parameters and survivals is described. Among 84 patients, 52 were males and the other 32 were females with 1.6:1 of male and female ratio and their mean age was 57.6 years old. Common symptoms of them wele dyspnea, cough, sputum and pleuritic chest pain. The proportions of bloody nature of effusion, lymphocyte dominant pleural effusion, exudative effusions were 66%, 39% and 93%, respectively. They consisted of 54 cases of adenocarcinoma(33 cases of them were lung cancers), and 10 cases of squamous cell carcinoma (8 cases of them were lung cancers), 10 cases of malignant lymphoma, 8 cases of small cell lung cancer and a case of mesothelioma and leukemia. There was no differences in characteristics of effusions, clinical features and survivals between each histologic cell types. Analyzing them according to primary diseases, no difference except longer survivals in malignant pleural effusions from breast cancer than from other cancers was observed. In conclusion, considering the incidences of histologic types of lung cancers during same period (squamous cell carcinoma; 47%, adenocarcinoma; 33%, small cell lung cancer; 12% and large cell carcinoma; 2%), malignant pleural effusions more likely occurred in adenocarcinoma than other cell types of lung cancers and there was no significant difference of clinical characteristics between histologic types.

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Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

Wage Differentials between Standard and Non-standard Workers (정규-비정규근로자 임금격차)

  • Kim, Yong-Min;Park, Ki Seong
    • Journal of Labour Economics
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    • v.29 no.3
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    • pp.25-48
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    • 2006
  • In this study, the wage differentials between standard and non-standard workers are estimated using the data from the Establishment Employment Survey of 2003. The estimated wage differentials between standard and non-standard workers become greater controlling for the fixed effects of establishments. The within-establishment wage differential is estimated to be 20.7% between male standard and male non-standard workers in unorganized establishments controlling for establishment heterogeneity. However, the estimated overall wage differential is reduced to 6.8% due to the high wages of non-standard workers in large size establishments and the low wages of standard workers in small size establishments. This difference between 20.7% and 6.8% reflects the between-establishment wage differential. In organized establishments, the wage differential becomes larger, 21.8%, between male standard and male non-standard workers. For the male workers, the greatest wage differential between standard and non-standard workers is found in unorganized large size establishments: it is 35.9%. In organized establishments, it contracts to 25.8%. The additional estimations on the probability of becoming non-standard workers are done. For the male sample, the probability of standard workers to become non-standard workers in unorganized establishments is 6.0 percentage points higher than that in small size organized establishments. The probability is 20.7 percentage points higher for the female sample. However, the signs of the interaction terms of union and large size establishments are all negative. While the effect of large size establishments reduces the effect of union on the probability to 7.3 percentage points for the males, it reduces the probability to 16.0 percentage points for the females.

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Studies on bionomical characteristics of Papilio xuthus (호랑나비(Papilio xuthus)의 생육특성에 관한 연구)

  • Lee, Sang-Hyun;Kim, Se-Gwon;Kim, Nam-Ee;Bae, Kyoung-Sin;Choi, Young-Cheol
    • Journal of Sericultural and Entomological Science
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    • v.51 no.2
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    • pp.173-179
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    • 2013
  • This study was investigation for primary bionomical characteristics, emergence rate of wintering type pupa and oviposition preference, of Papilio xuthus. The emergence rate of wintering type pupa stored at cold chamber($4{\pm}1^{\circ}C$) was 85%, after 10 months. The average emergence rate of wintering type pupa during storage was 89.6%, and the emergence periods were $7.9{\pm}1.9days$ in room temperature. Mating ratio in large oviposition room, $6,000{\times}6,000{\times}3,500$ mm($W{\times}L{\times}H$), was $86.7{\pm}5.8%$ higher than $63.3{\pm}15.3%$ in small room, $2,500{\times}3,000{\times}2,000$ mm($W{\times}L{\times}H$). But the number of eggs in the large room were $137.0{\pm}16.5$ fewer than $141.7{\pm}20.4$ in the small room. As a result of oviposition preference experiment on three different host plants, 10 mated female laid $141.7{\pm}27.8$ on the leaves of Phellodendron amurensew more than $67.7{\pm}20.6$ on Zanthoxylum schinifolium and $77.0{\pm}21.8$ on Citrus unshiu. The egg periods were $4.4{\pm}0.8$ days after oviposition, and the hatchability was 92.2% in $25^{\circ}C$ room condition. The larval period were $19.9{\pm}2.1$ days in the high temperature, long day condition($25^{\circ}C$, 14L : 10D). The headwidth of each developmental larval stage were $0.72{\pm}0.02$(1st), $1.19{\pm}0.02$(2nd), $1.65{\pm}0.05$(3rd), $2.43{\pm}0.07$(4th), $3.21{\pm}0.12$(5th). The pupal ratio was 91.6%. The pupal period were $8.8{\pm}0.9$ days, and the emergence rate was 92.2%.