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1.
Environ Pollut ; 289: 117851, 2021 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-34358869

RESUMO

Heavy metal pollution in soil around abandoned mine sites is one of the most critical environmental issues worldwide. Soil microbes form complex communities and perform ecological functions individually or in cooperation with other organisms to adapt to harsh environments. In this study, we investigated the distribution patterns of bacterial and fungal communities in non-contaminated and heavy metal-contaminated soil of the abandoned Samkwang mine in Korea to explore microbial interaction mechanisms and their modular structures. As expected, the bacterial and fungal community structures showed large differences depending on the degree of heavy metal contamination. The microbial network was divided into three modules based on the levels of heavy metal pollution: heavy metal-tolerant (HM-Tol), heavy metal-mid-tolerant (HM-mTol), and heavy metal-sensitive (HM-Sens) modules. Taxonomically, microbes assigned to Vicinamibacterales, Pedosphaeraceae, Nitrosomonadaceae, and Gemmatimonadales were the major groups constituting the HM-Tol module. Among the detected heavy metals (As, Pb, Cd, Cu, and Zn), copper concentrations played a key role in the formation of the HM-Tol module. In addition, filamentous fungi (Fusarium and Mortierella) showed potential interactions with bacteria (Nitrosomonadaceae) that could contribute to module stability in heavy metal-contaminated areas. Overall, heavy metal contamination was accompanied by distinct microbial communities, which could participate in the bioremediation of heavy metals. Analysis of the microbial interactions among bacteria and fungi in the presence of heavy metals could provide fundamental information for developing bioremediation mechanisms for the recovery of heavy metal-contaminated soil.


Assuntos
Metais Pesados , Poluentes do Solo , Biodegradação Ambiental , Monitoramento Ambiental , Metais Pesados/análise , República da Coreia , Solo , Poluentes do Solo/análise
2.
Artigo em Inglês | MEDLINE | ID: mdl-32894714

RESUMO

Real-time 3-D intracardiac echocardiography (ICE) can enable faster imaging of surfaces orthogonal to the transducer, such as the pulmonary vein (PV) antra and cardiac valve annuli. However, the requirement for a 2-D grid of individually wired elements makes a traditional matrix array challenging to implement within an intravenous catheter. Helicoid array transducers are linear array transducers twisted about their long axis, allowing imaging of different elevation slices using sub-apertures. In this work, we examined the 3-D imaging characteristics of helicoid array transducers through simulations using Field II software and experimental measurements. We report results for varying transducer parameters, such as twist rate and sub-aperture size. We also discuss design considerations for these imaging parameters as they pertain to volumetric imaging of the heart.

3.
J Clin Ultrasound ; 47(5): 255-260, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30820986

RESUMO

PURPOSE: The objective of this study was to compare the false negative rate, sensitivity and false positive rate of ultrasound (US)-guided fine needle aspiration (FNA) with those of US-guided core needle biopsy (CNB) for large thyroid nodules ≥2.0 cm, which reportedly have an increased risk of thyroid malignancy. METHODS: We retrospectively studied surgically confirmed thyroid nodules that had preoperative US-guided FNA or CNB between March 2005 and December 2013. We reviewed nodule size, sonographic features, cytohistologic results, and final surgical pathology. We assessed false negative rates, sensitivity, and false positive rates by biopsy method and nodule size for diagnosis of thyroid malignancy. We assessed complications for procedures. RESULTS: US-guided CNB showed better diagnostic performance, in terms of lower false negative rates and greater sensitivity, than US-guided FNA in large thyroid nodules. There was no significant difference in false positive rate according to biopsy methods in large thyroid nodules. The false negative rates of large thyroid nodules (≥2.0 cm) were higher than those of small nodules (<2.0 cm). There were no major complications, and no significant differences in complication according to biopsy methods. CONCLUSION: US-guided CNB improved the false negative rate and sensitivity for large nodules. Therefore, US-guided CNB can be considered a useful diagnostic method for large thyroid nodules that might reduce the risk of unnecessary diagnostic surgery.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Endossonografia , Nódulo da Glândula Tireoide/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia com Agulha de Grande Calibre , Reações Falso-Negativas , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Adulto Jovem
4.
Ultrasonography ; 38(2): 172-180, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30458606

RESUMO

PURPOSE: The purpose of this study was to record and evaluate interobserver agreement as quality control for the modified categorization of screening breast ultrasound developed by the Alliance for Breast Cancer Screening in Korea (ABCS-K) for the Mammography and Ultrasonography Study for Breast Cancer Screening Effectiveness (MUST-BE) trial. METHODS: Eight breast radiologists with 4-16 years of experience participated in 2 rounds of quality control testing for the MUST-BE trial. Two investigators randomly selected 125 and 100 cases of breast lesions with different ratios of malignant and benign lesions. Two versions of the modified categorization were tested. The initially modified classification was developed after the first quality control workshop, and the re-modified classification was developed after the second workshop. The re-modified categorization established by ABCS-K added size criteria and the anterior-posterior ratio compared with the initially modified classification. After a brief lecture on the modified categorization system prior to each quality control test, the eight radiologists independently categorized the lesions using the modified categorization. Interobserver agreement was measured using kappa statistics. RESULTS: The overall kappa values for the modified categorizations indicated moderate to substantial degrees of agreement (initially modified categorization and re-modified categorization: κ=0.52 and κ=0.63, respectively). The kappa values for the subcategories of category 4 were 0.37 (95% confidence interval [CI], 0.24 to 0.52) and 0.39 (95% CI, 0.31 to 0.49), respectively. The overall kappa values for both the initially modified categorization and the re-modified categorization indicated a substantial degree of agreement when dichotomizing the interpretation as benign or suspicious. CONCLUSION: The preliminary results demonstrated acceptable interobserver agreement for the modified categorization.

5.
Acad Radiol ; 25(5): 643-652, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29339079

RESUMO

PURPOSE: This study aimed to compare the diagnostic values of a combination of diffusion-weighted imaging and T2-weighted imaging (DWI-T2WI) with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and to evaluate the correlation of DWI with the histologic grade in breast cancer. MATERIALS AND METHODS: This study evaluated a total of 169 breast lesions from 136 patients who underwent both DCE-MRI and DWI (b value, 1000s/mm2). Morphologic and kinetic analyses for DCE-MRI were classified according to the Breast Imaging-Reporting and Data System. For the DWI-T2WI set, a DWI-T2WI score for lesion characterization that compared signal intensity of DWI and T2WI (benign: DWI-T2WI score of 1, 2; malignant: DWI-T2WI score of 3, 4, 5) was used. The diagnostic values of DCE-MRI, DWI-T2WI set, and combined assessment of DCE and DWI-T2WI were calculated. RESULTS: Of 169 breast lesions, 48 were benign and 121 were malignant (89 invasive ductal carcinoma, 24 ductal carcinoma in situ, 4 invasive lobular carcinoma, 4 mucinous carcinoma). The mean apparent diffusion coefficient (ADC) of invasive ductal carcinoma (0.92 ± 0.19 × 10-3 mm2/s) and ductal carcinoma in situ (1.11 ± 0.13 × 10-3 mm2/s) was significantly lower than the value seen in benign lesions (1.36 ± 0.22 × 10-3 mm2/s). The specificity, positive predictive value (PPV), and accuracy of DWI-T2WI set and combined assessment of DCE and DWI-T2WI (specificity, 87.5% and 91.7%; PPV, 94.3% and 96.2%; accuracy, Az = 0.876 and 0.922) were significantly higher than those of the DCE-MRI (specificity, 45.8%; PPV, 81.7%; accuracy, Az = 0.854; P < .05). A low ADC value and the presence of rim enhancement were associated with a higher histologic grade cancer (P < .05). CONCLUSION: Combining DWI, T2WI, and ADC values provides increased accuracy for differentiation between benign and malignant lesions, compared with DCE-MRI. A lower ADC value was associated with a higher histologic grade cancer.


Assuntos
Adenocarcinoma Mucinoso/diagnóstico por imagem , Neoplasias da Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Carcinoma Lobular/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética/métodos , Adenocarcinoma Mucinoso/patologia , Adulto , Idoso , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Lobular/patologia , Meios de Contraste , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Valor Preditivo dos Testes
6.
Ultrasound Med Biol ; 44(3): 551-561, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29331356

RESUMO

Shear wave elasticity imaging (SWEI) is a novel ultrasound elastography technique for assessing tissue stiffness. In this study, we investigate the potential of SWEI for providing diastolic functional assessment. In 11 isolated rabbit hearts, pressure-volume (PV) measurements were recorded simultaneously with SWEI recordings from the left ventricle free wall before and after induction of global ischemia. PV-based end diastolic stiffness increased by 100% after ischemia (p <0.05), and SWEI stiffness showed an increase of 103% (p <0.05). The relaxation time constant (τ) before and after ischemia derived from pressure and SWEI curves showed increases of 79% and 76%, respectively (p <0.05). A linear regression between pressure-derived and SWEI-based (τ) showed a slope of 1.164 with R2 = 0.80, indicating the near equivalence of the two assessments. SWEI can be used to derive (τ) values and myocardial end diastolic stiffness. In global conditions, these measurements are consistent with PV measurements of diastolic function.


Assuntos
Diástole , Técnicas de Imagem por Elasticidade/métodos , Isquemia Miocárdica/diagnóstico por imagem , Isquemia Miocárdica/fisiopatologia , Animais , Modelos Animais de Doenças , Coração/diagnóstico por imagem , Coração/fisiopatologia , Coelhos
7.
Korean J Radiol ; 18(4): 624-631, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28670157

RESUMO

OBJECTIVE: To analyze participant factors that affect the diagnostic performance of screening mammography. MATERIALS AND METHODS: We enrolled 128756 cases from 10 hospitals between 2005 and 2010. We analyzed recall rate, cancer detection rate (CDR) per 1000 examinations, positive predictive value (PPV), sensitivity, specificity, false positive rate (FPR), and interval cancer rate (ICR) per 1000 negative examinations according to participant factors including age, breast density, and number of visit to the same institution, and adjusted for confounding variables. RESULTS: Increasing age improved recall rates (27.4% in 40's, 17.5% in 50's, 11.1% in 60's, and 8.6% in 70's), CDR (2.7, 3.2, 2.0, and 2.4), PPV (1.0, 1.8, 1.8, and 2.8%), sensitivity (81.3, 88.8, 90.3, and 94.7%), specificity (72.7, 82.7, 89.0, and 91.7%), and FPR (27.3, 17.3, 11.0, and 8.4%) (p < 0.05). Higher breast density impaired recall rates (4.0% in P1, 9.0% in P2, 28.9% in P3, and 27.8% in P4), PPV (3.3, 2.3, 1.2, and 1.3%), specificity (96.1, 91.2, 71.4, and 72.5%), and FPR (3.9, 8.9, 28.6, and 27.6%) (p < 0.001). It also increased CDR (1.3, 2.1, 3.3, and 3.6) and ICR (0.2, 0.3, 0.6, and 1.6) (p < 0.05). Successive visits to the same institution improved recall rates (20.9% for one visit, 10.7% for two visits, 7.7% for more than three visits), PPV (1.6, 2.8, and 2.7%), specificity (79.4, 89.6, and 92.5%), and FPR (20.6, 10.4, and 7.5%) (p < 0.001). CONCLUSION: Young age and dense breasts negatively affected diagnostic performance in mammography screening, whereas successive visits to the same institution had a positive effect. Examinee education for successive visits to the same institution would improve the diagnostic performance.


Assuntos
Neoplasias da Mama/diagnóstico , Adulto , Idoso , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Bases de Dados Factuais , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Pessoa de Meia-Idade , República da Coreia , Sensibilidade e Especificidade
8.
Sci Total Environ ; 599-600: 198-206, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-28475913

RESUMO

Salinization is one of the most important abiotic stressors in an ecosystem. To examine how exposing a host plant to excess salt affects the consequent performance and metabolism of insects in a food chain, we determined the life history traits and the metabolite profiles in rice (Oryza sativa), the herbivore Sitobion avenae, and its predator Harmonia axyridis. When compared with performance under normal (non-stressed) conditions, exposing plants to 50mM NaCl significantly delayed the timing of development for S. avenae fed on rice and H. axyridis and also reduced the body mass of the latter. Our GC-MS-based analysis revealed clear differences in metabolite profiles between trophic levels or treatment conditions. Salinity apparently increased the levels of main components in rice, but decreased levels of major components in S. avenae and H. axyridis. In addition, 16 metabolites showed salinity-related contrasts in this trophic interaction for our rice-S. avenae-H. axyridis system. Salinity impeded the accumulation of metabolites, especially several sugars, amino acids, organic acids, and fatty acids in both insects, a response that was possibly associated with the negative impacts on their growth and reproduction under stress conditions.


Assuntos
Afídeos/metabolismo , Besouros/metabolismo , Cadeia Alimentar , Metaboloma , Oryza/metabolismo , Salinidade , Animais , Solo/química
9.
Korean J Radiol ; 18(1): 217-237, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28096731

RESUMO

Core needle biopsy (CNB) has been suggested as a complementary diagnostic method to fine-needle aspiration in patients with thyroid nodules. Many recent CNB studies have suggested a more advanced role for CNB, but there are still no guidelines on its use. Therefore, the Task Force Committee of the Korean Society of Thyroid Radiology has developed the present consensus statement and recommendations for the role of CNB in the diagnosis of thyroid nodules. These recommendations are based on evidence from the current literature and expert consensus.


Assuntos
Biópsia com Agulha de Grande Calibre/métodos , Neoplasias da Glândula Tireoide/patologia , Biópsia com Agulha de Grande Calibre/efeitos adversos , Biópsia com Agulha de Grande Calibre/instrumentação , Hematoma/etiologia , Rouquidão/etiologia , Humanos , Biópsia Guiada por Imagem , Assistência ao Paciente , República da Coreia , Sociedades Médicas , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia Doppler
10.
J Am Soc Echocardiogr ; 30(1): 90-96, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27843103

RESUMO

BACKGROUND: Myocardial contractility, a significant determinant of cardiac function, is valuable for diagnosis and evaluation of treatment in cardiovascular disorders including heart failure. Shear wave elasticity imaging (SWEI) is a newly developed ultrasound-based elastographic technique that can directly assess the stiffness of cardiac tissue. The aim of this study was to verify the ability of this technique to quantify contractility changes in the myocardium. METHODS: In 12 isolated rabbit hearts, SWEI measurements were made of systolic stiffness at five different coronary perfusion pressures from 0 to 92 mm Hg. The changes in coronary perfusion were used to induce acute stepwise reversible changes in cardiac contractility via the Gregg effect. The Gregg effect is the dependency of contractility on coronary perfusion. In four of the hearts, the measurements were repeated after delivery of gadolinium, which is known to block the Gregg effect. RESULTS: Systolic stiffness measured by SWEI changed linearly with coronary perfusion pressure, with a slope of 0.27 kPa/mm Hg (mean of 95% CI, R2 = 0.73). As expected, the change in contractility due to the Gregg effect was blocked by gadolinium, with a significant reduction of the slope to 0.08 kPa/mm Hg. CONCLUSIONS: SWEI measurements of systolic stiffness provide an index of contractility in the unloaded isolated rabbit heart. Although this study was done under ideal imaging conditions and with nonphysiologic loading conditions, it reinforces the concept that this ultrasound technique has the potential to provide a direct and noninvasive index of cardiac contractility.


Assuntos
Ecocardiografia/métodos , Técnicas de Imagem por Elasticidade/métodos , Ventrículos do Coração/diagnóstico por imagem , Contração Miocárdica/fisiologia , Volume Sistólico/fisiologia , Função Ventricular Esquerda/fisiologia , Animais , Pressão Sanguínea/fisiologia , Circulação Coronária/fisiologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Coelhos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
11.
Korean J Radiol ; 17(4): 489-96, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27390540

RESUMO

OBJECTIVE: To analyze the diagnostic accuracy and trend in screening mammography in Korea. MATERIALS AND METHODS: We retrospectively linked the information from hospitals participating in the Alliance of Breast Cancer Screening in Korea (ABCS-K) and the database of the National Cancer Screening Program. We calculated performance indicators, including the recall rate, cancer detection rate (CDR), positive predictive value (PPV), sensitivity, specificity, false-positive rate (FPR), and interval cancer rate (ICR). Changes in the performance indicators were calculated as the annual percent change with 95% confidence interval (CI). RESULTS: We enrolled 128756 cases from 10 hospitals from 2005 to 2010. The recall rate was 19.1% with a downward trend over time (-12.1% per year; 95% CI, -15.9 to -8.2). The CDR was 2.69 per 1000 examinations, without a significant trend. The PPV was 1.4% with an upward trend (20.8% per year; 95% CI, 15.2 to 26.7). The sensitivity was 86.5% without a significant trend, whereas the specificity was 81.1% with an upward trend (3.3% per year; 95% CI, 2.1 to 4.5). The FPR was 18.9% with a downward trend (-12.4% per year; 95% CI, -16.2 to -8.4). The ICR was 0.5 per 1000 negative examinations without a significant trend. There were institutional variations in the diagnostic accuracy and trend except for the CDR, sensitivity, and ICR. CONCLUSION: The sensitivity and CDR of screening mammography in the ABCS-K from 2005 to 2010 were compatible with those for Western women. The recall rate, PPV and specificity, however, were suboptimal, although they showed significant improvements over this period. A further analysis is required to explain institutional variations.


Assuntos
Neoplasias da Mama/diagnóstico , Mamografia , Adulto , Idoso , Bases de Dados Factuais , Detecção Precoce de Câncer , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , República da Coreia , Estudos Retrospectivos , Sensibilidade e Especificidade
12.
PLoS One ; 11(4): e0153395, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27055120

RESUMO

Both herbivores that consume transgenic crops and their predators can be exposed to insecticidal proteins expressed in those crops. We conducted a tritrophic bioassay to evaluate the ecotoxicological impacts that Bt cabbage (Brassica oleracea var. capitata) expressing Cry1Ac1 protein might have on the wolf spider (Pardosa astrigera), a non-target generalist predator. Enzyme-Linked Immunosorbent Assays indicated that protein levels were 4.61 ng g(-1) dry weight in fruit flies (Drosophila melanogaster) fed with the transgenic cabbage and 1.86 ng g(-1) dry weight in the wolf spiders that preyed upon them. We also compared the life history traits of spiders collected from Bt versus non-Bt cabbage and found no significant differences in their growth, survival, and developmental rates. Because Bt cabbage did not affect the growth of fruit flies, we conclude that any indirect effects that this crop had on the wolf spider were probably not mediated by prey quality. Therefore, exposure to Cry1Ac1 protein when feeding upon prey containing that substance from transgenic cabbage has only a negligible influence on those non-target predatory spiders.


Assuntos
Brassica/metabolismo , Drosophila melanogaster/crescimento & desenvolvimento , Proteínas de Plantas/metabolismo , Plantas Geneticamente Modificadas/metabolismo , Comportamento Predatório , Aranhas/crescimento & desenvolvimento , Animais , Brassica/crescimento & desenvolvimento , Drosophila melanogaster/metabolismo , Plantas Geneticamente Modificadas/crescimento & desenvolvimento , Aranhas/metabolismo
13.
Endocr Pract ; 21(11): 1219-26, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26214114

RESUMO

OBJECTIVE: Major problems of fine-needle aspiration (FNA) of thyroid nodules arise due to nondiagnostic results caused by inadequately obtained FNA specimens. The purpose of this study was to evaluate the value of visual assessment of liquid-based cytology specimens during FNA of thyroid nodules for predicting sampling adequacy. METHODS: For 3 months, visual assessment of FNA specimens was used for 534 consecutive nodules in 534 patients. The FNA specimens were visually graded immediately following aspiration for each nodule, and the visual grades were classified into 2 categories: inadequate (<6 cell groups) and adequate (>6 cell groups). The cytology results were classified as diagnostic or nondiagnostic based on the Bethesda system. We compared the ultrasound features and FNA characteristics between the diagnostic and nondiagnostic results. Multiple logistic regression analysis was used to determine factors independently predictive of nondiagnostic results. We also evaluated the interobserver agreement regarding the visual assessment. RESULTS: Visual assessment was feasible in all patients, and the nondiagnostic rate was 11.6% (62 of 534). Nondiagnostic results were more frequent in the inadequate visual assessment group (38.1%) than in the adequate visual assessment group (10.5%) (P = .001). Independent predictive factors for nondiagnostic results were inadequate visual assessment (odds ratio, 5.18), >50% vascularity (odds ratio, 3.98), and macrocalcification (odds ratio, 3.60). Interobserver agreement for the prediction of visual assessment was good (κ value, 0.767; P<.001). CONCLUSION: Immediate visual assessment of a specimen during FNA of a thyroid nodule is a feasible method for predicting sampling adequacy.


Assuntos
Citodiagnóstico/métodos , Nódulo da Glândula Tireoide/patologia , Ultrassonografia de Intervenção/métodos , Percepção Visual , Adulto , Idoso , Biópsia por Agulha Fina , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Manejo de Espécimes/métodos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Adulto Jovem
14.
Eur Arch Otorhinolaryngol ; 272(9): 2347-50, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25348340

RESUMO

The objective of the study was to determine the effect of the maxillary sinus on the voice. The prospective study was conducted at an academic secondary referral center. A prospective chart review of 43 patients (17 males, 26 females) who conducted a voice recording and survey before and 3 months after middle meatal antrostomy whose lesion was confined to the maxillary sinus. Subjective voice changes were surveyed using a questionnaire. After phonation [∧m ma: the Korean pronunciation of 'mother'], [Nu Na: the Korean pronunciation of 'sister'], we analyzed the nasal consonant [m] of [∧m ma] and nasalized vowel [a] of [∧m ma] and [a] of [Nu Na]. In the poll conducted, the change rates for males and females were 41.1 % (7/17) and 15.4 % (4/26), respectively; of the male patients, 85.7 % (6/7) felt that the sound quality was better and 14.3 % (1/6) that it was worse. However, all the female patients felt it was better. Among of the patients with an improved voice, reduced nasal sound was the most frequent observation. In an objective analysis, a tendency to lowered frequencies was observed for nasalized vowels after surgery. Significant differences were observed at second formant frequencies of [a] of [∧m ma] and first formant frequencies of [a] of [Nu Na] in female subjects (P < 0.005). Our findings indicated that the maxillary sinus plays a role in the modification of voice quality. Preoperative counseling is important for patients concerning expected changes in the voice after maxillary sinus surgery.


Assuntos
Seio Maxilar/cirurgia , Qualidade da Voz , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fonação , Período Pós-Operatório , Estudos Prospectivos
15.
J Cardiovasc Electrophysiol ; 25(12): 1275-83, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25132292

RESUMO

BACKGROUND: Visual confirmation of radiofrequency ablation (RFA) lesions during clinical cardiac ablation procedures could improve procedure efficacy, safety, and efficiency. It was previously shown that acoustic radiation force impulse (ARFI) imaging can identify RFA lesions in vitro and in vivo in an animal model. This is the "first-in-human" feasibility demonstration of intracardiac ARFI imaging of RFA lesions in patients undergoing catheter ablation for atrial flutter (AFL) or atrial fibrillation (AF). METHODS AND RESULTS: Patients scheduled for right atrial (RA) ablation for AFL or left atrial (LA) ablation for drug refractory AF were eligible for imaging. Diastole-gated intracardiac ARFI images were acquired using one of two equipment configurations: (1) a Siemens ACUSON S2000™ ultrasound scanner and 8/10Fr AcuNav™ ultrasound catheter, or (2) a CARTO 3™ integrated Siemens SC2000™ and 10Fr SoundStar™ ultrasound catheter. A total of 11 patients (AFL = 3; AF = 8) were imaged. ARFI images were acquired of ablation target regions, including the RA cavotricuspid isthmus (CTI), and the LA roof, pulmonary vein ostia, posterior wall, posterior mitral valve annulus, and the ridge between the pulmonary vein and LA appendage. ARFI images revealed increased relative myocardial stiffness at ablation catheter contact sites after RFA and at anatomical mapping-tagged RFA treatment sites. CONCLUSIONS: ARFI images from a pilot group of patients undergoing catheter ablation for AFL and AF demonstrate the ability of this technique to identify intra-procedure RFA lesion formation. The results encourage further refinement of ARFI imaging clinical tools and continued investigation in larger clinical trials.


Assuntos
Fibrilação Atrial/diagnóstico por imagem , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardiovasculares/métodos , Ablação por Cateter/métodos , Técnicas de Imagem por Elasticidade/métodos , Cirurgia Assistida por Computador/métodos , Sistemas Computacionais , Ecocardiografia/métodos , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento
16.
IEEE Trans Biomed Eng ; 61(11): 2779-86, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24951675

RESUMO

No clinical protocols are routinely used to intraoperatively assess surgical margin status during prostate surgery. Instead, margins are evaluated through pathological assessment of the prostate following radical prostatectomy, when it is too late to provide additional surgical intervention. An intraoperative device potentially capable of assessing surgical margin status based on the electrical property contrast between benign and malignant prostate tissue has been developed. Specifically, a microendoscopic electrical impedance tomography (EIT) probe has been constructed to sense and image, at near millimeter resolution, the conductivity contrast within heterogeneous biological tissues with the goal of providing surgeons with real-time assessment of margin pathologies. This device consists of a ring of eight 0.6-mm diameter electrodes embedded in a 5-mm diameter probe tip to enable access through a 12-mm laparoscopic port. Experiments were performed to evaluate the volume of tissue sensed by the probe. The probe was also tested with inclusions in gelatin, as well as on a sample of porcine tissue with clearly defined regions of adipose and muscle. The probe's area of sensitivity consists of a circular area of 9.1 mm(2) and the maximum depth of sensitivity is approximately 1.5 mm. The probe is able to distinguish between high contrast muscle and adipose tissue on a sub-mm scale (∼500 µm). These preliminary results suggest that EIT is possible in a probe designed to fit within a 12-mm laparoscopic access port.


Assuntos
Impedância Elétrica , Endoscopia/métodos , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/cirurgia , Animais , Endoscopia/instrumentação , Masculino , Imagens de Fantasmas , Próstata/diagnóstico por imagem , Próstata/cirurgia , Prostatectomia/métodos , Suínos
17.
Am J Otolaryngol ; 34(6): 626-30, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24011492

RESUMO

PURPOSE: We analyzed site, pattern and degree of obstruction in Korean male obstructive sleep apnea syndrome (OSAS) patients by drug-induced sleep endoscopy (DISE). We also investigated possible links between BMI, AHI and DISE findings. MATERIALS AND METHODS: Sixty-nine male patients underwent DISE. DISE findings were reported using our classification system in which modified 'VOTE classification' - obstruction type, site of obstruction, degree of obstruction and anatomical site contributing obstruction - was reported. Associations were analyzed among the results of the polysomnography, patients' characteristics and DISE finding. RESULTS: Multilevel airway obstruction was found in 84.06% of patients and 15.94% had a unilevel obstruction. Among those with unilevel obstruction, 90.90% had retropalatal level obstruction and 9.10% had retrolingual level obstruction. Palate with lateral pharyngeal wall obstruction (49.28%) is the most common obstruction type of the retropalatal level and tongue with lateral pharyngeal wall (37.68%) is the most common obstruction type of the retrolingual level. Examining the relation between obstruction site according to body mass index (BMI) and severity of OSAS (apnea hypopnea index, AHI), the lateral pharyngeal wall had an increasing tendency associated with higher BMI and higher AHI. But the lateral pharyngeal wall of both levels was statistically significant associated with higher AHI. CONCLUSION: The majority of the Korean male OSAS patients have multilevel obstruction and according to BMI and AHI, the DISE findings indicate that the lateral pharyngeal wall is the most important anatomical site contributing to obstruction regardless of the level at which the obstruction lies.


Assuntos
Obstrução das Vias Respiratórias/patologia , Laringoscopia , Apneia Obstrutiva do Sono/etiologia , Adolescente , Adulto , Idoso , Obstrução das Vias Respiratórias/classificação , Índice de Massa Corporal , Epiglote/patologia , Humanos , Hipnóticos e Sedativos/administração & dosagem , Masculino , Midazolam/administração & dosagem , Pessoa de Meia-Idade , Palato Mole/patologia , Faringe/patologia , Índice de Gravidade de Doença , Língua/patologia , Gravação em Vídeo , Adulto Jovem
18.
Am J Otolaryngol ; 34(5): 600-2, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23562490

RESUMO

This case is a single submandibular gland mumps viral infection patient without parotid gland involvement who developed complications of meningitis and orchitis. Since spontaneous remission is common in mumps viral infection, missing opportunities for exact diagnosis is frequent. As in this case, single submandibular glands infection without parotid gland involvement not only delays diagnosis but also increases risk of developing complications. This case instructs us that despite the atypical manifestation, the clinician should suspect mumps and conduct serologic tests for diagnosis while observing for complications such as meningoencephalitis and orchitis.


Assuntos
Caxumba/diagnóstico , Glândula Submandibular , Adolescente , Diagnóstico Diferencial , Humanos , Masculino , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler
19.
Clin Endosc ; 45(3): 182-8, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22977798

RESUMO

BACKGROUND/AIMS: Three-dimensional (3D) imaging is gaining popularity and has been partly adopted in laparoscopic surgery or robotic surgery but has not been applied to gastrointestinal endoscopy. As a first step, we conducted an experiment to evaluate whether images obtained by conventional gastrointestinal endoscopy could be used to acquire quantitative 3D information. METHODS: Two endoscopes (GIF-H260) were used in a Borrmann type I tumor model made of clay. The endoscopes were calibrated by correcting the barrel distortion and perspective distortion. Obtained images were converted to gray-level image, and the characteristics of the images were obtained by edge detection. Finally, data on 3D parameters were measured by using epipolar geometry, two view geometry, and pinhole camera model. RESULTS: The focal length (f) of endoscope at 30 mm was 258.49 pixels. Two endoscopes were fixed at predetermined distance, 12 mm (d(12)). After matching and calculating disparity (v2-v1), which was 106 pixels, the calculated length between the camera and object (L) was 29.26 mm. The height of the object projected onto the image (h) was then applied to the pinhole camera model, and the result of H (height and width) was 38.21 mm and 41.72 mm, respectively. Measurements were conducted from 2 different locations. The measurement errors ranged from 2.98% to 7.00% with the current Borrmann type I tumor model. CONCLUSIONS: It was feasible to obtain parameters necessary for 3D analysis and to apply the data to epipolar geometry with conventional gastrointestinal endoscope to calculate the size of an object.

20.
Radiology ; 264(3): 834-43, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22771885

RESUMO

PURPOSE: To test the predictive value of skewness and kurtosis changes of normalized cerebral blood volume (nCBV) during the early treatment period for differentiating early tumor progression from pseudoprogression in patients with newly diagnosed glioblastomas. MATERIALS AND METHODS: The institutional review board approved this retrospective study. The authors assessed 135 patients with newly diagnosed glioblastomas who underwent concurrent chemotherapy and radiation therapy (CCRT) after surgical resection. Patients who developed new or enlarged contrast material-enhanced lesions after CCRT were assessed by means of conventional and perfusion magnetic resonance (MR) imaging. The percent change of skewness and kurtosis on nCBV histograms between the first and second post-CCRT follow-up were classified into four categories. Independent predictors of early tumor progression were determined by means of logistic regression analysis. RESULTS: Of 135 patients, 79 had new or enlarged contrast-enhanced lesions after CCRT, subsequently classified as early tumor progression (n = 42, 53.2%) and pseudoprogression (n = 37, 46.8%). Pseudoprogression was observed in 23 of 24 (95.8%) patients in category 1, 10 of 15 (66.7%) in category 2, four of 20 (20.0%) in category 3, and 0 of 20 (0%) in category 4 (χ(2) test, P < .0001). The histographic pattern of nCBV was the best independent predictor (odds ratio, 3.51; P = .0032) for early tumor progression, rather than each percent change of skewness or kurtosis; the histographic pattern of nCBV represented the largest area under the receiver operating characteristic curve (0.934; 95% confidence interval: 0.855, 0.977), with a sensitivity of 85.7% and a specificity of 89.2%. CONCLUSION: The percent change of skewness and kurtosis of nCBV may be a potential imaging biomarker for early treatment response in patients with newly diagnosed glioblastomas.


Assuntos
Neoplasias Encefálicas/patologia , Glioblastoma/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Volume Sanguíneo , Neoplasias Encefálicas/terapia , Circulação Cerebrovascular , Quimiorradioterapia , Distribuição de Qui-Quadrado , Meios de Contraste , Progressão da Doença , Feminino , Glioblastoma/terapia , Humanos , Interpretação de Imagem Assistida por Computador , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
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