Sonographic features of axillary lymphadenopathy caused by Kikuchi disease

OBJECTIVE: The purpose of this study was to document the sonographic findings of axillary lymphadenopathy in Kikuchi disease. METHODS: The medical records and sonographic findings of 7 patients with a pathologic diagnosis of Kikuchi disease in the axillary lymph node by sonographically guided core needle biopsy (n=6) or excisional biopsy (n=1) were reviewed. On sonograms, lymph nodes were assessed for their distribution, size, shape, border, echogenicity, and internal architecture, and those sonographic features of each node were evaluated to determine whether the findings favored malignant or benign lymphadenopathy. RESULTS: Of the 7 patients (1 man and 6 women; mean age +/- SD, 34.3+/-7.7 years), 29 affected lymph nodes (5-38 mm; mean, 14.8+/-7.2 mm) were identified on sonograms. The sonographic characteristics were as follows: the shortest axis/longest axis ratio of the node (mean, 0.595) was 0.5 or greater in 22 nodes (76%); the border was sharp in 16 (55%); the cortex was hypoechoic in 20 (69%) and isoechoic in 9 (31%); the hilum was narrow in 1 (4%) and absent in 16 (55%); and cortical thickening was found in 13 (45%, concentric in 6 and eccentric in 7). Nineteen lymph nodes (66%) were classified as having malignant-favoring features, and 10 (34%) were classified as having benign-favoring features. CONCLUSIONS: Many axillary lymph nodes in Kikuchi disease look suspicious sonographically. When lymph nodes in the axilla show suspicious findings on sonograms of relatively young patients, Kikuchi disease can be considered a possible differential diagnosis, and image-guided percutaneous biopsy should be done.ope

Developmental potential of bovine embryos derived from parthenogenesis and somatic cell nuclear transfer with different activation protocols

Thesis(master`s)--서울대학교 대학원 :수의학과대학 수의산과·생물공학전공,2006.Maste

Degree of FDG uptake of hepatocellular carcinoma on FDG-PET : a correlation study with enhancement pattern on CT or MRI. : 전산화단층촬영 또는 자기공명영상에서의 조영 증

의학과/석사[한글] 최근 간세포암의 조기 발견을 높이기 위해 F-18-FDG를 이용한 양전자방출단층촬영 (이하 FDG-PET)을 이용한 기능적 영상이 중요한 검사 방법으로 대두 되었다. 그러나 최근 경험에 의하면 상당 수의 간세포암이 주변 간보다 FDG의 섭취가 높지 않아 FDG-PET상 발견이 되지 않는 경우가 있었다.그러므로, 본 연구에서는 FDG-PET에서의 간세포암의 FDG 섭취 정도와 전산화단층촬영 또는 자기공명영상을 통한 조영증강도와의 상관 관계에 대하여 알아보고자 하였으며 FDG-PET상 간세포암의 FDG 섭취 정도와 기존 영상들의 조영 증강 소견에 영향을 미치는 요인들에 관하여 분석하였다. 2000년 3월부터 2002년 2월까지 세브란스 병원에 내원한 34명의 환자의 37개의 간세포암을 대상으로 하였으며(M:F=30:4, 평균 연령=53세, 연령 분포;38-63), 각각의 간세포암은 Edmonson 및 Steiner의 조직학적인 분류에 따라 grade Ⅰ부터 grade Ⅳ까지 분류하였다. 종양의 FDG 섭취 정도는 주변 간조직의 섭취 정도의 차이에 따라 4등급으로 분류하였으며, (Grade 0; 주변 간조직보다 섭취가 낮은 군, Grade 1; 주변 간조직과 같은 정도의 섭취를 보이는 군, Grade 2; 주변 간조직보다 높은 섭취를 보이는 군, Grade 3; 주변 간조직에 비해 아주 높은 섭취를 보이는 군) 각각의 병변에 대하여 standardized uptake value(SUV)를 구하여 반정량적으로 분석하였다. 전산화단층촬영 및 자기공명영상을 통한 종양의 조영증강도는 동맥기의 문맥과 비교한 음영 혹은 신호 강도에 따라 3개의 group으로 분류하였다(Group Ⅰ : 고음영 혹은 고신호강도, Group Ⅱ : 등음영 혹은 등신호강도, Group Ⅲ : 저음영 혹은 저신호강도). 간세포암의 SUV와 전산화 단층 촬영 및 자기공명영상을 통한 조영 증강 소견과의 상관 관계는 ANOVA를 사용하여 분석하였고 조직학적 분화도와 종양의 크기와 FDG 섭취 정도, 조영증강도와의 상관 관계에 관하여도 분석하였다. 간세포암의 직경은 1.5 cm부터 20 cm까지의 분포를 보였다(평균 표준편차;5 3.9). FDG-PET상 37개의 간세포암 중 19개 (51%)가 Grade 2 혹은 3를 보였고 (Grade 2;12개, Grade 3;7개) 반면에 18개 (49%)가 Grade 0 혹은 1을 보였다 (Grade 0;1개, Grade 1;17개). 37개의 간세포암 중 Edmons on 및 Steiner 분류에 따라 grade Ⅰ인 경우가 8개, grade Ⅱ와 Ⅲ가 각각 14개, grade Ⅳ인 경우가 1개 있었으며 전산화단층촬영을 통한 조영증강도에 따라 Group Ⅰ인 경우는 없었고 Group Ⅱ인 경우가 6개, Group Ⅲ인 경우가 11개였다. 자기공명영상에서는 각각 7, 6, 12개였다. SUV와 전산화단층촬영 및 자기공명영상을 통한 조영증강도 사이에는 유의한 상관관계가 없었다. 종양의 조직학적 분화도와 크기와 FDG 섭취 사이에는 유의한 상관 관계가 있었으나 조영증강도 와는 상관 관계가 없었다. 결론적으로, 전산화단층촬영 또는 자기공명영상에서의 조영증강도는 종양의 FDG 섭취 정도나 조직학적 분화도와 유의한 상관관계를 보이지 않았다. 그러나, FDG-PET상의 간세포암의 대사 정도는 종양의 악성도를 대신할 수 있는 종양의 조직학적 분화도 및 크기와 비례하였다. [영문] The positron emission tomography with F-18-FDG ( FDG-PET ) is useful functional imaging method for early detection of hepatocellular carcinoma. But , according to our experiences, the level of FDG uptake of many hepatocellular carcinomas was not so high to detect the lesion. So, this study was undertaken to correlate the level of FDG uptake of hepatocellular carcinoma with enhancement pattern on CT or MRI and factors affecting the degree of FDG uptake and patterns of contrast enhancement in hepatocellular carcinoma were assessed as well. From March 2000 to February 2002, 37 hepatocellular carcinoma in 34 patients at initial presentation (M:F=30:4, a mean age = 53, age range(38-63)) were included. Histological grade was based on the Edmonson and Steiner''s grading system from grade Ⅰ to Ⅳ. The level of FDG uptake in the tumor was visually assessed compared with the adjacent hepatic parenchyma (Grade 0 : The group that the level of FDG uptake in the tumor was lower compared with the adjacent hepatic parenchyma, Grade 1: The group with equal FDG uptake compared with the adjacent hepatic parenchyma, Grade 2 : The group with higher FDG uptake compared to the adjacent hepatic parenchyma and Grade 3: he group with much higher FDG uptake compared with the adjacent hepatic parenchyma ). The lesions were also semi-quantitatively analyzed using standardized uptake value (SUV). The patterns of enhancement on CT or MRI were classified into 3 groups according to the density or intensity of the lesion compared to that of the portal vein on arterial phase; Group Ⅰ: hyperdense or hyperintense, Group Ⅱ: isodense or isointense, Group Ⅲ: hypodense or hypointense). The SUVs of the tumors were correlated with the enhancement patterns on CT or MRI by ANOVA. The histological grade and size were assessed in relation to the FDG uptake and enhancement patterns. The size of the tumors ranged from 1.5 to 20 cm (meanSD, 53.9). On PET, 19 (51%) of the 37 tumors showed FDG uptake of Grade 2 or 3 while 18 (49%) demonstrated Grade 0 or 1. There were 8 tumors with histologic grade Ⅰ, 14 with grade Ⅱ, 14 with grade Ⅲ, and 1 with grade Ⅳ. The patterns of enhancement on CT were classified into Group Ⅰ in 0, Group Ⅱ in 6 , and Group Ⅲ in 11 lesions. The numbers for MRI were 7, 6, and 12, respectively. The uptake pattern of the F-18-FDG was not correlated with the enhancement pattern on CT or MRI. Only FDG uptake, not the enhancement patterns, was well correlated with the histologic grade and size of the tumors. In conclusion, the patterns of contrast enhancement was not correlated with histologic tumor grade but tumor metabolism on FDG PET was well corresponded to the histologic tumor grade and size of the tumor representing more aggressive biological behavior.ope

Technical Quality Assessment of Breast Ultrasound According to American College of Radiology (ACR) Standards

PURPOSE: To evaluate the technical quality of breast ultrasound based on American College of Radiology(ACR) standards. MATERIALS and METHODS: Between March 2002 and July 2002, ninety three breast sonograms obtained from 73 institutions were evaluated based on ACR standards for the hardware, technical settings, labeling of the images and identification. RESULTS: Of 93 breast sonograms, a satisfactory compliance with all ACR standards in the performance of breast US examinations was documented in 31% while the remaining 69% did not fully meet all ACR standards. 4.3% of breast US examinations were performed with a convex transducers, and the focal zone was inappropriately positioned in 14.2%. Gray-scale gain was subjectively characterized as inappropriate in 26.9%, and the size of lesion was not measured in 7.5%. Anatomic location of lesions was inappropriately described in 9.3%. The orientation of an US tranducer was not properly labeled on any images in 33.3%. Inadequate recording of patient, information was noted in 43.3%. 50% of sonograms at University medical centers and larger general hospitals fully met all ACR standards while 36.8% at radiologic clinics and 12.1% at other private clinics met all ACR standards. CONCLUSION: Overall, 69% of breast sonograms failed to meet the quality criteria of the ACR standards. Therefore, it is essential to educate the basic technical details in performing breast US for the quality control.ope

Analysis of 193 Mammographic Phantom Images

ope

Clinical application of the BI-RADS final assessment to breast sonography in conjunction with mammography

OBJECTIVE: The objective of our study was to report the results of classification of sonographic findings according to BI-RADS and to calculate the positive predictive value (PPV) for each BI-RADS assessment category. SUBJECTS AND METHODS: We prospectively classified 4,668 breast sonograms according to BI-RADS final assessment category. Suspicious sonographic findings were divided into major and minor suspicious findings. Category 1 was normal and category 2 was a benign finding such as cyst or nodule with uniform and intense hyperechogenicity. A nodule neither category 2 nor category 4 or 5 was defined as category 3. A nodule with one or more suspicious findings, not category 5, was defined as category 4. A nodule with two or more major suspicious findings was defined as category 5. RESULTS: Of the 4,668 cases, 321 cases failed to undergo follow-up of at least 1 year. The PPV was 0.1% in category 1 (3/2,191), 0% in category 2 (0/773), 0.8% in category 3 (6/737), 31.1% in category 4 (161/519), and 96.9% in category 5 (123/127). In palpable lesions (n = 751), the PPV was 2.2% in category 1 (2/93), 0.9% in category 3 (2/217), 54% in category 4 (107/198), and 98% in category 5 (98/100). In nonpalpable lesions (n = 3,596), the PPV was 0.05% in category 1 (1/2,098), 0.8% in category 3 (4/520), 16.8% in category 4 (54/321), and 92.6% in category 5 (25/27). CONCLUSION: As with mammography, placing sonographic lesions into BI-RADS categories is useful for predicting the presence of malignancyope

Development and Validation of the Problematic Internet Gaming Scale for Adolescents

본 연구에서는 청소년 게임이용문제 척도의 구성요인을 확인하고, 게임이용문제 척도를 개발 및 타당화하고자 하였다. 이를 위해 초·중·고등학생 15명으로 구성된 청소년 인터뷰와 게임 관련 기관 및 상담 및 학계 교수 9명의 전문가 인터뷰를 실시하였으며, 예비조사 483명, 본조사 870명의 데이터를 분석에 활용하였다. 그 결과는 다음과 같다. 첫째, 예비조사 분석 결과, 게임이용문제의 구성요인으로 현저성, 조절실패, 일상생활문제, 금단의 4개 요인, 24개 문항을 추출하였다. 둘째, 탐색적 요인분석과 전문가 내용타당도 결과를 토대로 3개 하위요인(현저성, 조절실패, 일상생활문제)과 9개 문항을 최종문항으로 선정하였다. 셋째, 본조사 분석 결과, 최종 척도의 신뢰도는 .908이며, 구인타당도 분석 결과 SRMR, TLI, CFI, RMSEA가 각각 .022, .979, .986, .056으로 나타나 적합한 모형임을 확인하였다. 준거타당도 분석 결과, GADIS 척도와의 상관이 .664로 통계적으로도 유의한 정적 상관을 보였다. 본 연구에서 개발한 게임이용문제 척도를 활용하여, 게임으로 인한 부적응적 문제와 어려움을 경험하는 청소년에 대한 이해와 상담 및 교육적 접근에 도움이 될 것으로 기대한다.N

Development and Validation of Adolescent Internet Gaming Literacy Scale

본 연구에서는 청소년 게임리터러시 척도의 구성요인을 확인하고, 게임리터러시 척도를 개발하며 타당화하고자 하였다. 게임 관련 기관 및 상담, 교육 학계 교수 9명을 대상으로 한 전문가 인터뷰와 초․중․고등학생 15명을 대상으로 한 청소년 인터뷰를 실시하였으며, 예비조사 483명, 본조사 870명을 대상으로 분석을 실시하였다. 그 결과는 다음과 같다. 첫째, 전문가와 청소년 인터뷰 결과, 게임리터러시를 구성하는 요인으로 게임윤리, 게임시간조절, 게임비용조절, 게임이해, 게임자기인식, IT흥미의 6개 요인을 추출할 수 있었다. 둘째, 게임리터러시에 관한 선행연구와 전문가, 청소년 인터뷰, 연구진 회의와 전문가 타당도 분석을 바탕으로 최종 6개 하위요인과 18문항(하위요인별 3문항)으로 최종문항을 선정하였다. 셋째, 본조사 분석 결과, 최종 척도 신뢰도가 .821이었으며, 구인타당도 분석 결과, SRMR, TLI, CFI, RMSEA가 .051, .944, .959, .052로 나타나 적합한 모형임을 알 수 있었다. 준거타당도 분석 결과, 미디어 리터러시 인식 검사와 .489, 학교적응 검사와 .358로 통계적으로 유의한 정적 상관을 보였다. 본 연구에서 개발한 청소년 게임리터러시 척도를 활용하여 청소년들이 게임을 조절하면서 잘 사용하는 방법에 대해서 상담 및 교육적 접근이 가능해질 것으로 기대한다. The purpose of this study is to identify variables of Adolescent Internet Gaming Literacy Scale and to develop and validate the scale. Nine experts in game organizations, counseling and education fields and fifteen students in elementary, middle, and high school were interviewed. Then, 483 students in preliminary study and 870 students in main study were selected and analyzed. The results are as follows: first, from experts and students interview, internet gaming literacy were divided into six variables including game ethics, time management, money management, game understanding, self understanding, and IT interests. Second, based on a literature review of internet gaming literacy, expert and youth interviews, research team meetings, and experts validation analysis, total 6 variables and 18 items(3 items per each variable) were selected. Third, reliability(Cronbachs Alpha) of total scale was .821 in main study and the finding of confirmatory factor analysis supported the six factor model of Internet Gaming Literacy Scale, demonstrating the construct validity(SRMR = .051, TLI = .944, CFI = .959, RMSEA = .052). In addition, the developed scale was positively correlated with Media Literacy Awareness scale(r = .489) and School Adjustment scale(r = .358), so the criterion validity was confirmed. Finally, it is expected that counselors and educators can use Adolescent Internet Gaming Literacy Scale developed in the current study to counsel and teach how adolescents to use game well and to regulate game use.N