To evaluate the correlations between prostate volumes estimated by transabdominal, transrectal, and three-dimensional US and the factors affecting the differences.
Materials and Methods
The prostate volumes of 94 consecutive patients were measured by both transabdominal and transrectal US. Next, the prostate volumes of 58 other patients was measured by both transrectal and three-dimensional US. We evaluated the degree of correlation and mean difference in each comparison. We also analyzed possible factors affecting the differences, such as the experiences of examiners in transrectal US, bladder volume, and prostate volume.
In the comparison of transabdominal and transrectal US methods, the mean difference was 8.4 ± 10.5 mL and correlation coefficient (r) was 0.775 (p < 0.01). The experienced examiner for the transrectal US method had the highest correlation (r = 0.967) and the significantly smallest difference (5.4 ± 3.9 mL) compared to the other examiners (the beginner and the trained; p < 0.05). Prostate volume measured by transrectal US showed a weak correlation with the difference (r = 0.360, p < 0.05). Bladder volume did not show significant correlation with the difference (r = -0.043, p > 0.05). The comparison between the transrectal and three-dimensional US methods revealed a mean difference of 3.7 ± 3.4 mL and the correlation coefficient was 0.924 for the experienced examiner. Furthermore, no significant difference existed between examiners (p > 0.05). Prostate volume measured by transrectal US showed a positive correlation with the difference for the beginner only (r = 0.405, p < 0.05).
In the prostate volume estimation by US, experience in transrectal US is important in the correlation with transabdominal US, but not with three-dimensional US. Also, less experienced examiners' assessment of the prostate volume can be affected by prostate volume itself.
Prostate, US; Ultrasound (US), three-dimensional; Ultrasound (US), technology
To assess the usefulness of pulsatile flow detection (PFD), a newly developed function of color Doppler US, in measuring resistive index (RI) in renal Doppler US and to compare it with conventional color Doppler (CCD).
Materials and Methods
Fifty-six kidneys in 31 patients were randomly selected and divided into two groups. In group A, RI was measured first with the aid of CCD, and then with PFD. In group B, data were obtained in the reverse order. The time required for each RI measurement was recorded in seconds. The quality of the Doppler spectral waveform was subjectively graded as 0, 1, or 2 and examination time and waveform quality were compared between PFD and CCD.
The time required to measure RI with PFD (PFD time) was less than with CCD (CCD time) (mean 42.7 secs vs. mean 70.3 secs; p = 0.031). There was no significant difference in PFD time between group A and B, but CCD time was shorter in group B (70.3 secs vs. 24.6 secs; p = 0.0004). Spectral waveform quality was not significantly different between PFD and CCD.
The time required to measure RI in kidneys can be shortened with the aid of the PFD function in color Doppler US without affecting the quality of the examination.
Kidney, US; Ultrasound (US), technology; Ultrasound (US), Doppler studies
Transcriptional repression of pathogen defense-related genes is essential for plant growth and development. Several proteins are known to be involved in the transcriptional regulation of plant defense responses. However, mechanisms by which expression of defense-related genes are regulated by repressor proteins are poorly characterized. Here, we describe the in planta function of CBNAC, a calmodulin-regulated NAC transcriptional repressor in Arabidopsis. A T-DNA insertional mutant (cbnac1) displayed enhanced resistance to a virulent strain of the bacterial pathogen Pseudomonas syringae DC3000 (PstDC3000), whereas resistance was reduced in transgenic CBNAC overexpression lines. The observed changes in disease resistance were correlated with alterations in pathogenesis-related protein 1 (PR1) gene expression. CBNAC bound directly to the PR1 promoter. SNI1 (suppressor of nonexpressor of PR genes1, inducible 1) was identified as a CBNAC-binding protein. Basal resistance to PstDC3000 and derepression of PR1 expression was greater in the cbnac1 sni1 double mutant than in either cbnac1 or sni1 mutants. SNI1 enhanced binding of CBNAC to its cognate PR1 promoter element. CBNAC and SNI1 are hypothesized to work as repressor proteins in the cooperative suppression of plant basal defense.
Approximately two thirds of the ovarian cancer is diagnosed at late stage with peritoneal seeding. The most important prognostic factor is the residual tumor size after surgery. The better survival outcome from minimizing tumor has been established well from several institutional reports, clinical trials for chemotherapy, and meta-analyses. The current standard treatment for such advanced ovarian cancer is to resect all visible and palpable ovarian cancer as much as possible and postoperative chemotherapy. But, even after complete resection of all visible and palpable tumors, a significant percentage of the patients have recurrence usually in the peritoneal cavity in advanced ovarian cancer. Recurrence likely stems from microscopic residual tumor not resected at time of the initial surgery. Currently, advanced technology for intraoperative tumor detection has been reported. Although the current clinical outcome is at an early stage definitively, clinical benefit could be expected from the future in-depth basic research and clinical trials in this area. If all residual microscopic disease, especially chemotherapy-resistant cancer cells, could be removed or treated using new technology, groundbreaking advance for treating ovarian cancer will be realized.
Ovarian cancer; surgery; cytoreductive surgery; image; fluorescent
Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.
Florid Cemento-Osseous Dysplasia; Cone-Beam Computed Tomography; Cementoma
Diets high in calories and sweetened foods with disaccharides frequently lead to exaggerated postprandial spikes in blood glucose. This state induces immediate oxidant stress and free radicals which trigger oxidative stress-linked diabetic complications. One of the therapeutic approaches for decreasing postprandial hyperglycemia is to retard absorption of glucose by the inhibition of carbohydrate hydrolyzing enzymes, α-amylase and α-glucosidases, in the digestive organs. Therefore, the inhibitory activity of Korean onion (Allium cepa L.) extract against rat intestinal α-glucosidases, such as sucrase, maltase, and porcine pancreatic α-amylase were investigated in vitro and in vivo. The content of quercetin in ethyl alcohol extract of onion skin (EOS) was 6.04 g/100 g dried weight of onion skin. The in vitro half-maximal inhibitory concentrations (IC50) of EOS and quercetin, a major phenolic in onion, on rat intestinal sucrase were 0.40 and 0.11 mg/mL, respectively. The postprandial blood glucose lowering effects of EOS and quercetin were compared to a known type 2 diabetes drug (Acarbose), a strong α-glucosidase inhibitor in the Sprague-Dawley (SD) rat model. In rats fed on sucrose, EOS significantly reduced the blood glucose spike after sucrose loading. The area under the blood glucose-time curve (AUClast) in EOS-treated SD rats (0.5 g-EOS/kg) was significantly lower than in untreated SD rats (259.6 ± 5.1 vs. 283.1 ± 19.2 h·mg/dL). The AUClast in quercetin-treated SD rats (0.5 g-quercetin/kg) was similar to in EOS-treated group (256.1 ± 3.2 vs. 259.6 ± 5.1 h·mg/dL). Results from this study indicates that although quercetin does have blood glucose lowering potential via α-glucosidase inhibition, there are other bioactive compounds present in onion skin. Furthermore, the effects of two weeks administration of EOS in a high carbohydrate-dietary mixture (Pico 5053) on sucrase and maltase activities in intestine were evaluated in SD rat model. Compared to the upper and middle parts of intestine, the activities of sucrase in the lower parts of intestine remained significantly higher after two weeks of EOS treatment. These results indicate that EOS may improve exaggerated postprandial spikes in blood glucose and glucose homeostasis since it inhibits intestinal sucrase and thus delays carbohydrate absorption, although clinical trials are needed.
α-glucosidase; hyperglycemia; sucrase; postprandial spikes; Allium cepa
The objective of this study was to review our experience in the surgical management of carotid body paragangliomas and evaluate the outcomes and complications according to the Shamblin classification.
Thirteen patients who had been diagnosed and surgically treated for carotid body tumors (CBTs) were enrolled in this study. We reviewed patient demographics, radiographic findings, and surgical outcomes collected from medical records.
Fifteen CBTs were found in 13 patients and 13 tumors were resected. Selective preoperative tumor embolization was performed on six patients. The median blood loss, operation time, and hospital stay for these patients were not significantly reduced compared to those without embolization. The median tumor size was 2.3 cm in Shamblin I and II and 4 cm in Shamblin III. The median intraoperative blood loss was 280 mL and 700 mL, respectively (P<0.05). Internal carotid artery ligation with reconstruction was accomplished on three patients (23%), and they all belonged to Shamblin III (38%). One Shamblin III patient (8%) developed transient cerebral ischemia, and postoperative stroke with death occurred in another Shamblin III patient. Postoperative permanent cranial nerve deficit occurred in three patients (23%) who were all in Shamblin III (P=0.03). There were no recurrences or delayed complications at the median follow up of 29 months.
Shamblin III had a high risk of postoperative neurovascular complications. Therefore, early detection and prompt surgical resection of CBTs will decrease surgical morbidity.
Carotid body tumor; Paraganglioma
Remote teleconsultation by specialists is important for timely, correct, and specialized emergency surgical and medical decision making. In this paper, we designed a new personal digital assistant (PDA)–phone-based emergency teleradiology system by combining cellular communication with Bluetooth-interfaced local wireless links. The mobility and portability resulting from the use of PDAs and wireless communication can provide a more effective means of emergency teleconsultation without requiring the user to be limited to a fixed location. Moreover, it enables synchronized radiological image sharing between the attending physician in the emergency room and the remote specialist on picture archiving and communication system terminals without distorted image acquisition. To enable rapid and fine-quality radiological image transmission over a cellular network in a secure manner, progressive compression and security mechanisms have been incorporated. The proposed system is tested over a code division Multiple Access 1×-Evolution Data-Only network to evaluate the performance and to demonstrate the feasibility of this system in a real-world setting.
PDA; teleradiology; image transmission; Bluetooth; CDMA 1× EV-DO; WLAN
To evaluate the effect of thin overlapping reconstruction on the attenuation of small (≤ 3 cm) renal cysts in the nephrographic phase of multidetector CT (MDCT).
Materials and Methods
We scanned a phantom kidney containing spheres of various sizes (10, 20, and 30 mm) using both 4- and 16-channel MDCT scanners, and reconstructed images with various slice thickness (T, mm) and intervals (I, mm). The attenuation increase (AI) was measured for each sphere in 240-HU diluted solution of contrast material and compared with the attenuation in 35-HU solution.
On the 4-channel MDCT, thin overlapping reconstruction (T/I = 3/1, compared with 5/5) lowered the AI as much as 17 HU in the 10 mm-sphere and 6 HU in the 20 mm-sphere (p < 0.05). Thin slicing alone was also effective; however overlapping alone was not. On the 16-channel MDCT, AI in the 10 mm-sphere was significantly lower than on the 4-channel MDCT with T/I = 5/5 (p < 0.05), however thinner slicing or overlapping did not affect the attenuation significantly in all of the spheres.
The effect of thin overlapping reconstruction on minimizing falsely elevated attenuation in the nephrographic phase was significant only in cysts ≤ 20 mm on the 4-channel MDCT.
Kidney; Cyst; Computed tomography (CT); Pseudoenhancement
We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them.
Materials and Methods
The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement.
All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2-dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas.
Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.
Cystadenofibroma; Ovary; Magnetic resonance (MR)
To evaluate the CT findings of ruptured corpus luteal cysts.
Materials and Methods
Six patients with a surgically proven ruptured corpus luteal cyst were included in this series. The prospective CT findings were retrospectively analyzed in terms of the size and shape of the cyst, the thickness and enhancement pattern of its wall, the attenuation of its contents, and peritoneal fluid.
The mean diameter of the cysts was 2.8 (range, 1.5-4.8) cm; three were round and three were oval. The mean thickness of the cyst wall was 4.7 (range, 1-10) mm; in all six cases it showed strong enhancement, and in three was discontinuous. In five of six cases, the cystic contents showed high attenuation. Peritoneal fluid was present in all cases, and its attenuation was higher, especially around the uterus and adnexa, than that of urine present in the bladder.
In a woman in whom CT reveals the presence of an ovarian cyst with an enhancing rim and highly attenuated contents, as well as highly attenuated peritoneal fluid, a ruptured corpus luteal cyst should be suspected. Other possible evidence of this is focal interruption of the cyst wall and the presence of peritoneal fluid around the adnexa.
Computed tomography (CT); Cysts; Hemorrhage; Ovary