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Association Between Pelvic Bone Computed Tomography-Derived Body Composition and Patient Outcomes in Older Adults With Proximal Femur Fracture

  • Tae Ran Ahn;Young Cheol Yoon;Hyun Su Kim;Kyunga Kim;Ji Hyun Lee
    • Korean Journal of Radiology
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    • v.24 no.5
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    • pp.434-443
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    • 2023
  • Objective: To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. Materials and Methods: We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. Results: A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. Conclusion: In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.

Feasibility of Single-Shot Whole Thoracic Time-Resolved MR Angiography to Evaluate Patients with Multiple Pulmonary Arteriovenous Malformations

  • Jihoon Hong;Sang Yub Lee;Jae-Kwang Lim;Jongmin Lee;Jongmin Park;Jung Guen Cha;Hui Joong Lee;Donghyeon Kim
    • Korean Journal of Radiology
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    • v.23 no.8
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    • pp.794-802
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    • 2022
  • Objective: To evaluate the feasibility of single-shot whole thoracic time-resolved MR angiography (TR-MRA) to identify the feeding arteries of pulmonary arteriovenous malformations (PAVMs) and reperfusion of the lesion after embolization in patients with multiple PAVMs. Materials and Methods: Nine patients (8 females and 1 male; age range, 23-65 years) with a total of 62 PAVMs who underwent percutaneous embolization for multiple PAVMs and were subsequently followed up using TR-MRA and CT obtained within 6 months from each other were retrospectively reviewed. All imaging analyses were performed by two independent readers blinded to clinical information. The visibility of the feeding arteries on maximum intensity projection (MIP) reconstruction and multiplanar reconstruction (MPR) TR-MRA images was evaluated by comparing them to CT as a reference. The accuracy of TR-MRA for diagnosing reperfusion of the PAVM after embolization was assessed in a subgroup with angiographic confirmation. The reliability between the readers in interpreting the TR-MRA results was analyzed using kappa (κ) statistics. Results: Feeding arteries were visible on the original MIP images of TR-MRA in 82.3% (51/62) and 85.5% (53/62) of readers 1 and 2, respectively. Using the MPR, the rates increased to 93.5% (58/62) and 95.2% (59/62), respectively (κ = 0.760 and 0.792, respectively). Factors for invisibility were the course of feeding arteries in the anteroposterior plane, proximity to large enhancing vessels, adjacency to the chest wall, pulsation of the heart, and small feeding arteries. Thirty-seven PAVMs in five patients had angiographic confirmation of reperfusion status after embolization (32 occlusions and 5 reperfusions). TR-MRA showed 100% (5/5) sensitivity and 100% (32/32, including three cases in which the feeding arteries were not visible on TR-MRA) specificity for both readers. Conclusion: Single-shot whole thoracic TR-MRA with MPR showed good visibility of the feeding arteries of PAVMs and high accuracy in diagnosing reperfusion after embolization. Single-shot whole thoracic TR-MRA may be a feasible method for the follow-up of patients with multiple PAVMs.

Diagnostic Accuracy of Percutaneous Transthoracic Needle Lung Biopsies: A Multicenter Study

  • Kyung Hee Lee;Kun Young Lim;Young Joo Suh;Jin Hur;Dae Hee Han;Mi-Jin Kang;Ji Yung Choo;Cherry Kim;Jung Im Kim;Soon Ho Yoon;Woojoo Lee;Chang Min Park
    • Korean Journal of Radiology
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    • v.20 no.8
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    • pp.1300-1310
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    • 2019
  • Objective: To measure the diagnostic accuracy of percutaneous transthoracic needle lung biopsies (PTNBs) on the basis of the intention-to-diagnose principle and identify risk factors for diagnostic failure of PTNBs in a multi-institutional setting. Materials and Methods: A total of 9384 initial PTNBs performed in 9239 patients (mean patient age, 65 years [range, 20-99 years]) from January 2010 to December 2014 were included. The accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PTNBs for diagnosis of malignancy were measured. The proportion of diagnostic failures was measured, and their risk factors were identified. Results: The overall accuracy, sensitivity, specificity, PPV, and NPV were 91.1% (95% confidence interval [CI], 90.6-91.7%), 92.5% (95% CI, 91.9-93.1%), 86.5% (95% CI, 85.0-87.9%), 99.2% (95% CI, 99.0-99.4%), and 84.3% (95% CI, 82.7-85.8%), respectively. The proportion of diagnostic failures was 8.9% (831 of 9384; 95% CI, 8.3-9.4%). The independent risk factors for diagnostic failures were lesions ≤ 1 cm in size (adjusted odds ratio [AOR], 1.86; 95% CI, 1.23-2.81), lesion size 1.1-2 cm (1.75; 1.45-2.11), subsolid lesions (1.81; 1.32-2.49), use of fine needle aspiration only (2.43; 1.80-3.28), final diagnosis of benign lesions (2.18; 1.84-2.58), and final diagnosis of lymphomas (10.66; 6.21-18.30). Use of cone-beam CT (AOR, 0.31; 95% CI, 0.13-0.75) and conventional CT-guidance (0.55; 0.32-0.94) reduced diagnostic failures. Conclusion: The accuracy of PTNB for diagnosis of malignancy was fairly high in our large-scale multi-institutional cohort. The identified risk factors for diagnostic failure may help reduce diagnostic failure and interpret the biopsy results.

Comparison of Monoexponential, Biexponential, Stretched-Exponential, and Kurtosis Models of Diffusion-Weighted Imaging in Differentiation of Renal Solid Masses

  • Jianjian Zhang;Shiteng Suo;Guiqin Liu;Shan Zhang;Zizhou Zhao;Jianrong Xu;Guangyu Wu
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.791-800
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    • 2019
  • Objective: To compare various models of diffusion-weighted imaging including monoexponential apparent diffusion coefficient (ADC), biexponential (fast diffusion coefficient [Df], slow diffusion coefficient [Ds], and fraction of fast diffusion), stretched-exponential (distributed diffusion coefficient and anomalous exponent term [α]), and kurtosis (mean diffusivity and mean kurtosis [MK]) models in the differentiation of renal solid masses. Materials and Methods: A total of 81 patients (56 men and 25 women; mean age, 57 years; age range, 30-69 years) with 18 benign and 63 malignant lesions were imaged using 3T diffusion-weighted MRI. Diffusion model selection was investigated in each lesion using the Akaike information criteria. Mann-Whitney U test and receiver operating characteristic (ROC) analysis were used for statistical evaluations. Results: Goodness-of-fit analysis showed that the stretched-exponential model had the highest voxel percentages in benign and malignant lesions (90.7% and 51.4%, respectively). ADC, Ds, and MK showed significant differences between benign and malignant lesions (p < 0.05) and between low- and high-grade clear cell renal cell carcinoma (ccRCC) (p < 0.05). α was significantly lower in the benign group than in the malignant group (p < 0.05). All diffusion measures showed significant differences between ccRCC and non-ccRCC (p < 0.05) except Df and α (p = 0.143 and 0.112, respectively). α showed the highest diagnostic accuracy in differentiating benign and malignant lesions with an area under the ROC curve of 0.923, but none of the parameters from these advanced models revealed significantly better performance over ADC in discriminating subtypes or grades of renal cell carcinoma (RCC) (p > 0.05). Conclusion: Compared with conventional diffusion parameters, α may provide additional information for differentiating benign and malignant renal masses, while ADC remains the most valuable parameter for differentiation of RCC subtypes and for ccRCC grading.

Preliminary Study on Effect of the Field Correlation Factor for Increasing of the Accuracy in a Direct Reading Instruments on Photoionization Detector for Total Volatile Organic Compounds (총휘발성유기화합물 측정 직독식장비 정확도 향상을 위한 현장보정계수 활용 연구)

  • Sungho Kim;Gwangyong Yi;Sujin Kim;Hae Dong Park
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.34 no.1
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    • pp.67-76
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    • 2024
  • Objectives: Direct reading instruments (DRIs) are widely used by industrial hygienists and other experts for preliminary survey and identifying source locations in many industrial fields. Photoionization detectors (PIDs), which are a form of hand-held portable DRIs, have been used for a variety of airborne vaporized chemicals, especially evaporated hydrocarbon solvents. The benefits of PIDs are high sensitivity between each chemical, competitive price, and portability. With the goal of increasing the accuracy of logged PID concentrations, previous studies have performed tests for the assessment of single chemical compounds, not mixtures. The purpose of this preliminary study was to measure mixtures with a PID and charcoal tube at the same time and compare the accuracy between them. Methods: A chamber test was implemented with different mixtures of hydrocarbon chemicals (acetone, isopropyl alcohol, toluene, m-xylene) and levels in the range of 14 to 864 ppm. Three PIDs and charcoal tubes were connected to the chamber and measured the chemical mixtures simultaneously. A comparison of accuracy and the PID group of concentrations with manufacture correction factor (M_CF) and field correction factor (F_CF) applied was performed. Results: The accuracy of the PID concentrations data-logged from the PID did not meet the accuracy criteria except for the mixture level B and C logged from PID No. 2, which was 18% of all tests for meeting accuracy criteria. The mean and standard deviation (SD) of concentration (ppm) of the charcoal tube followed by each mixtures' level were 10.37±0.26, 155.33±5.28, 300.80±11.65, and 774.93±22.65, respectively. When applying F_CF into the PID concentrations, the accuracy increased by nearly 82%. However, in the case of M_CF, none met the accuracy criterion. Between the PID there were differences of logged concentrations. Conclusions: In this preliminary study, the concentration of a logged PID with F_CF applied was a better way to increase accuracy compared to applying M_CF. We suggest that additional research is necessary to consider environmental factors such as temperature and humidity.

Quantitative T1 Mapping for Detecting Microvascular Obstruction in Reperfused Acute Myocardial Infarction: Comparison with Late Gadolinium Enhancement Imaging

  • Jae Min Shin;Eui-Young Choi;Chul Hwan Park;Kyunghwa Han;Tae Hoon Kim
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.978-986
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    • 2020
  • Objective: To compare native and post-contrast T1 mapping with late gadolinium enhancement (LGE) imaging for detecting and measuring the microvascular obstruction (MVO) area in reperfused acute myocardial infarction (MI). Materials and Methods: This study included 20 patients with acute MI who had undergone 1.5T cardiovascular magnetic resonance imaging (CMR) after reperfusion therapy. CMR included cine imaging, LGE, and T1 mapping (modified look-locker inversion recovery). MI size was calculated from LGE by full-width at half-maximum technique. MVO was defined as an area with low signal intensity (LGE) or as a region of visually distinguishable T1 values (T1 maps) within infarcted myocardium. Regional T1 values were measured in MVO, infarcted, and remote myocardium on T1 maps. MVO area was measured on and compared among LGE, native, and post-contrast T1 maps. Results: The mean MI size was 27.1 ± 9.7% of the left ventricular mass. Of the 20 identified MVOs, 18 (90%) were detected on native T1 maps, while 10 (50%) were recognized on post-contrast T1 maps. The mean native T1 values of MVO, infarcted, and remote myocardium were 1013.5 ± 58.5, 1240.9 ± 55.8 (p < 0.001), and 1062.2 ± 55.8 ms (p = 0.169), respectively, while the mean post-contrast T1 values were 466.7 ± 26.8, 399.1 ± 21.3, and 585.2 ± 21.3 ms, respectively (p < 0.001). The mean MVO areas on LGE, native, and post-contrast T1 maps were 134.1 ± 81.2, 133.7 ± 80.4, and 117.1 ± 53.3 mm2, respectively. The median (interquartile range) MVO areas on LGE, native, and post-contrast T1 maps were 128.0 (58.1-215.4), 110.5 (67.7-227.9), and 143.0 (76.7-155.3) mm2, respectively (p = 0.002). Concordance correlation coefficients for the MVO area between LGE and native T1 maps, LGE and post-contrast T1 maps, and native and post-contrast T1 maps were 0.770, 0.375, and 0.565, respectively. Conclusion: MVO areas were accurately delineated on native T1 maps and showed high concordance with the areas measured on LGE. However, post-contrast T1 maps had low detection rates and underestimated MVO areas. Collectively, native T1 mapping is a useful tool for detecting MVO within the infarcted myocardium.

Current Status and Management of Nanoplastics Exposed in Environment (환경 중 노출되는 나노플라스틱의 현황 및 관리실태)

  • Ha-neul Park;Jeonggue Park;Younghun Kim
    • Clean Technology
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    • v.30 no.1
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    • pp.1-12
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    • 2024
  • Nanoplastics (NP) exhibit distinct material properties compared to microplastics (MP), necessitating their separate recognition. Review of research outcomes and policy documents on NP reveals that most policy frameworks predominantly define MPs as solid synthetic polymer materials measuring 5 mm or less, but do not distinguish them from NP. However, recent revisions in regulations by the EU classify NPs as particles that range in size from 1 to 1,000 nm, as confirmed by some academic studies. Research on NPs often relies on experimental investigations centered around water systems, with a focus on high-concentration experimental conditions using spherical polystyrene-based NPs in behavior and impact studies. Notably, the environmental behavior characteristics of NP show differences in influence depending on the NP type, emphasizing the need for field simulation research. These challenges are mirrored in Korean society, so it is necessary to redefine NP to be distinct from MP in both research and policy. This study aimed to assess the current state of NP management globally and domestically and highlight policy considerations and issues in the existing response to NP. Upon comprehensive review, it becomes apparent that reaching an international agreement on MP faces methodological limitations, which could potentially burden efforts to precisely define NP size. Therefore, referencing the EU's recent regulatory revisions is crucial in domestic policy. Specific adjustments should commence from the MP concept through insights from the domestic industry, guidance from the academic community, and thorough discussions to ensure social acceptance.

Antimicrobial activity of 7,10-epoxy-octadeca-7,9-dienoic acid crude extract against methicillin-resistant Staphylococcus aureus (메티실린 저항성 황색포도상구균에 대한 7,10-epoxy-octadeca-7,9-dienoic acid 조추출물의 항균 활성 연구)

  • Su-Hyeon Son;Ye-Ji Park;Su-Hyeon Lee;Ju-Hyeon Choi;Hak-Ryul Kim
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.98-104
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    • 2023
  • Effective and alternative strategies to control methicillin-resistant Staphylococcus aureus (MRSA) are consistently needed. Previous study presented that 7,10-epoxy-octadeca-7,9-dienoic acid (EODA) was produced from 7,10-dihydroxy-8(E)-octadecenoic acid through one-step heat treatment. Further studies confirmed that EODA was highly active against broad range of pathogenic bacteria including MRSA, promising development of a novel antibacterial agent to control MRSA. However, there are some practical huddles for industrialization of EODA, especially high cost for fine purification. To address this problem, this study was focused on determination of any changes in the antibacterial activities of EODA when used as a crude extract. As a result, any significant changes in the antibacterial activities of EODA was not detected and additional synergistic effect for commercial antibiotics on antibacterial activity was sustained as it was.

Cultivation and use of bottle gourd (Lagenaria siceraria) in ancient Korea (한반도 선·역사시대 박의 재배와 이용)

  • KIM Sebin;KIM Minkoo
    • Korean Journal of Heritage: History & Science
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    • v.57 no.1
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    • pp.38-51
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    • 2024
  • Although the bottle gourd (Lagenaria siceraria) is a crop with a cultivation history of about 10,000 years in the Old and New Worlds, archaeological considerations on the cultivation and use of bottle gourds on the Korean Peninsula are extremely rare. Accordingly, we reviewed previous reports on bottle gourds and examined the morphological characteristics of seeds and rind fragments from the Korean Peninsula. The investigation yielded several conclusions. First, bottle gourd cultivation likely began during the Bronze Age alongside the introduction of so-called southern crops. Evidence suggests that bottle gourd remains were more prevalent during the Three-Kingdoms period, indicating its significance as a crop during the historical era. Second, bottle gourd seeds from the Three-Kingdoms period exhibit characteristics of both African and Asian subspecies, showcasing a high level of morphological diversity. Third, rind thickness indicates that bottle gourds found at the Bongseon-ri site were of varieties with large fruits. Taken together, it is concluded that the bottle gourd was introduced to the Korean Peninsula during the Bronze Age, and people cultivated a range of bottle gourd varieties during the Three-Kingdoms period.

Detection of Monosodium Urate Crystal of Hand and Wrist in Suspected Gouty Arthritis Patients on Dual-Energy CT and Relationship with Serum Urate Level (손과 손목의 통풍관절염에서 이중에너지 CT를 이용한 요산나트륨 결정 검출과 혈중 요산 농도와의 관계)

  • Hana Choi;Jeongah Ryu;Seunghun Lee;Yeo Ju Kim;Soyoung Bang
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.212-225
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    • 2023
  • Purpose We retrospectively investigated the characteristics of patients with monosodium urate (MSU) deposits of the hand and wrist on dual-energy CT (DECT) compared to those without. We also attempted to determine the pattern of MSU distribution in DECT. Materials and Methods In total, 93 patients were included who had undergone DECT for evaluation of the hand or wrist pain under the clinical impression of gouty arthritis. The total volume of MSU deposits on DECT was calculated and the pattern of MSU distribution on DECT was analyzed. Also, the level of the serum urate at the time of DECT and the highest level of the serum urate of the patients were obtained from their records and the relationship between MSU and serum urate level was evaluated. Results The range of the volume of MSU deposits on DECT was 0.01-16.11 cm3 (average: 1.07 cm3). The average level of serum urate was significantly higher in the MSU positive group than that in the MSU negative group. MSU deposits were most frequently observed in the wrists followed by fingers and digitorum tendons. Conclusion On DECT, MSU deposits were most frequently detected in the wrist and related with high serum urate level.