Ultrasound evaluation of postsurgical shoulder after rotator cuff repair: comparison of clinical results.

BACKGROUND: The relationship between the imaging parameters on postoperative ultrasound (US) other than repaired tendon integrity with clinical outcome such as postoperative residual pain has not been well defined. PURPOSE: To investigate whether the repaired tendon thickness and subdeltoid fluid collection after rotator cuff repair are correlated with early postoperative clinical outcome. MATERIAL AND METHODS: This retrospective study included 54 patients who underwent repair of the arthroscopic rotator cuff either by suture-bridge or single-row technique and postoperative US. We assessed the relationship between the sonographic parameters, including repaired supraspinatus tendon thickness and subdeltoid fluid collection, with the clinical outcome represented by the Korean Shoulder Scoring system (KSS) score using correlation coefficients (R). Also, the subgroup analysis was done to assess the differences by surgical technique and patients' age. RESULTS: There was a significant inverse relationship between the amount of subdeltoid fluid collection and degree of self-assessed pain improvement of the patients (P < 0.05), although every KSS category showed statistically insignificant tendency of inverse relationship with the fluid thickness. However, there was no statistically significant relationship between the thickness of repaired supraspinatus tendon and KSS scores. In patients aged >60 years, a statistically significant inverse relationship between thickness of subdeltoid fluid collection and difference value of the KSS scores in category of function was observed with both interpreters (P = 0.015 and P = 0.04, respectively). CONCLUSION: Subdeltoid fluid collection measured on US after repair of the arthroscopic rotator cuff in the early postoperative period has significant association with the patients' subjective clinical outcome.

Synthesis of n-type [60]Fullerene Derivatives with Sterically Bulky tert-Butyl Groups for Vacuum Deposition Processes.

[60]Fullerene derivatives with high thermal stability can be used for vacuum deposition under heating to fabricate thin films for organic electronic devices. Here, we investigated the thermal stability of [60]fullerene derivatives with various bulky substituents for thermal evaporation under vacuum by means of thermogravimetric analysis under reduced and normal pressure. We found sterically bulky groups such as tert-butyl groups of [60]fullerene derivatives lowered the vacuum deposition temperature. Also, we performed isothermal thermogravimetric analysis to examine the long-term thermal stability of the designed compounds under heating conditions. Furthermore, we investigated the UV-Vis absorption patterns of the deposited films. Absorption in the blue wavelength range, which was attributed to intermolecular HOMO-LUMO transitions among the molecular orbitals of adjacent [60]fullerenes, was dramatically modified. These results were associated with the prevention of aggregation among neighboring [60]fullerene by the sterically bulky groups. This concept could contribute to expanding the use of evaporable [60]fullerene derivatives in organic thin-film electronics research fields.

Usefulness of strain elastography in the differential diagnosis of ruptured epidermal cyst and superficial abscess.

PURPOSE: The aim of this study was to evaluate the usefulness of strain elastography (SE) in the differential diagnosis of ruptured epidermal cyst and superficial abscess. METHODS: This retrospective study included 34 patients with ruptured epidermal cysts and 17 patients with superficial abscesses who underwent ultrasonography (US) including SE. The SE characteristics were classified into four grades (1 to 4) according to elasticity. The largest length and height of the lesion and their ratio were evaluated on the US images. Involvement of more than half of the depth of the dermis and the presence of the submarine sign were assessed. RESULTS: The inter-reader agreement of US and SE findings showed excellent or almost perfect agreement. The height, length, ratio of height to length, and more-than-half-depth sign did not significantly differ between ruptured epidermal cysts and superficial abscesses for either reader (reader 1, P=0.071, P=0.129, P=0.806, and P=0.102, respectively; reader 2, P=0.173, P=0.053, P=0.669, and P=0.060, respectively). The submarine sign was significantly more frequent in ruptured epidermal cysts than in superficial abscesses (both readers, P<0.001). The difference in SE scores between ruptured epidermal cysts and superficial abscesses, which are harder than ruptured epidermal cysts, was statistically significant (reader 1, P=0.046; reader 2, P=0.028). CONCLUSION: The SE score and submarine sign may be useful characteristics for distinguishing ruptured epidermal cyst from superficial abscess.

Diagnosing thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance cytology with the deep convolutional neural network.

To compare the diagnostic performances of physicians and a deep convolutional neural network (CNN) predicting malignancy with ultrasonography images of thyroid nodules with atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) results on fine-needle aspiration (FNA). This study included 202 patients with 202 nodules ≥ 1 cm AUS/FLUS on FNA, and underwent surgery in one of 3 different institutions. Diagnostic performances were compared between 8 physicians (4 radiologists, 4 endocrinologists) with varying experience levels and CNN, and AUS/FLUS subgroups were analyzed. Interobserver variability was assessed among the 8 physicians. Of the 202 nodules, 158 were AUS, and 44 were FLUS; 86 were benign, and 116 were malignant. The area under the curves (AUCs) of the 8 physicians and CNN were 0.680-0.722 and 0.666, without significant differences (P > 0.05). In the subgroup analysis, the AUCs for the 8 physicians and CNN were 0.657-0.768 and 0.652 for AUS, 0.469-0.674 and 0.622 for FLUS. Interobserver agreements were moderate (k = 0.543), substantial (k = 0.652), and moderate (k = 0.455) among the 8 physicians, 4 radiologists, and 4 endocrinologists. For thyroid nodules with AUS/FLUS cytology, the diagnostic performance of CNN to differentiate malignancy with US images was comparable to that of physicians with variable experience levels.

Diagnostic Value of Contrast-Enhanced Digital Mammography versus Contrast-Enhanced Magnetic Resonance Imaging for the Preoperative Evaluation of Breast Cancer.

PURPOSE: This study aimed to compare the diagnostic performance of contrast-enhanced digital mammography (CEDM) and contrast-enhanced magnetic resonance imaging (CEMRI) in preoperative evaluations, and to evaluate the effect of each modality on the surgical management of women with breast cancer. METHODS: This single-center, prospective study was approved by the Institutional Review Board, and informed consent was obtained from all patients. From November 2016 to October 2017, 84 patients who were diagnosed with invasive carcinoma (69/84) and ductal carcinoma in situ (15/84), and underwent both CEDM and CEMRI, were enrolled. Imaging findings and surgical management were correlated with pathological results and compared. The diagnostic performance of both modalities in the detection of index and secondary cancers (multifocality and multicentricity), and occult cancer in the contralateral breast, was compared. The authors also evaluated whether CEDM or CEMRI resulted in changes in the surgical management of the affected breast due to imaging-detected findings. RESULTS: Eighty-four women were included in the analysis. Compared with CEMRI, CEDM demonstrated a similar sensitivity (92.9% [78/84] vs. 95.2% [80/84]) in detecting index cancer (p=0.563). For the detection of secondary cancers in the ipsilateral breast and occult cancer in the contralateral breast, no significant differences were found between CEDM and CEMRI (p=0.999 and p=0.999, respectively). Regarding changes in surgical management, CEDM resulted in similar changes compared with CEMRI (30.9% [26/84] vs. 29.7% [25/84], p=0.610). Regarding changes in surgical management due to false-positive findings, no significant differences were found between CEDM and CEMRI (34.6% [9/26] vs. 44.0% [11/25], p=0.782). CONCLUSION: CEDM demonstrated a diagnostic performance comparable with CEMRI in depicting index cancers, secondary cancers, and occult cancer in the contralateral breast. CEDM demonstrated similar changes in surgical management compared with CEMRI.