Effects of Low-Intensity Ultrasound on Gramicidin D-Induced Erythrocyte Edema

Lim, Mi Hyun,Seo, A. Rum,Kim, Jiyoung,Min, Byoung-Hyun,Baik, Eun Joo,Park, So Ra,Choi, Byung Hyune American Institute of Ultrasound in Medicine 2014 Journal of ultrasound in medicine Vol.33 No.6

<P><B>Objectives—</B></P><P>To determine whether low-intensity ultrasound (US) can reduce red blood cell (RBC) edema and, if so, whether the US activity is associated with aquaporin 1 (AQP-1), a water channel in the cell membrane.</P><P><B>Methods—</B></P><P>Red blood cell edema was induced by gramicidin D treatment at 40 ng/mL for 20 minutes and evaluated by a hematocrit assay. Low-intensity continuous wave US at 1 MHz was applied to RBCs for the last 10 minutes of gramicidin D treatment. To determine whether US activity was associated with AQP-1, RBCs were treated with 40 μM mercuric chloride (HgCl<SUB>2</SUB>), an AQP-1 inhibitor, for 20 minutes at the time of gramicidin D treatment. Posttreatment morphologic changes in RBCs were observed by actin staining with phalloidin.</P><P><B>Results—</B></P><P>Red blood cell edema increased significantly with gramicidin D at 20 (1.8%), 40 (6.7%), 60 (16.7%), and 80 (11.3%) ng/mL, reaching a peak at 60 ng/mL, compared to the control group (20 ng/mL, <I>P</I> = .019; 40, 60, and 80 ng/mL, <I>P</I> < .001). No significant RBC hemolysis was observed in any group. Edema induced by gramicidin D at 40 ng/mL was significantly reduced by US at 30 (3.4%; <I>P</I> = .003), 70 (4.4%; <I>P</I> = .001), and 100 (2.9%; <I>P</I> = .001) mW/cm<SUP>2</SUP>. Subsequent experiments showed that edema reduction by US ranged from 7% to 10%. Cotreatment with HgCl<SUB>2</SUB> partially reversed the US effect and showed a significantly different level of edema compared to gramicidin D-alone and US-cotreated groups (<I>P</I> = .001). These results were confirmed by microscopic observation of RBC morphologic changes.</P><P><B>Conclusions—</B></P><P>Low-intensity US could reduce gramicidin D–induced RBC edema, and its effect appeared to at least partly involve regulation of AQP-1 activity. These results suggest that low-intensity US can be used as an alternative treatment to control edema and related disorders.</P>

Does Adding Diffuse Optical Tomography to Sonography Improve Differentiation Between Benign and Malignant Breast Lesions? : Observer Performance Study

La Yun, Bo,Kim, Sun Mi,Jang, Mijung,Ahn, Hye Shin,Lyou, Chae Yeon,Kim, Mi Sun,Kim, Sun Ah,Song, Tai-Kyong,Yoo, Yangmo,Chang, Jin Ho,Kim, Youngmi American Institute of Ultrasound in Medicine 2015 Journal of ultrasound in medicine Vol.34 No.5

<P>Objectives-The purpose of this study was to investigate the added value of diffuse optical tomographic categories combined with conventional sonography for differentiating between benign and malignant breast lesions. Methods-In this retrospective database review, we included 145 breast lesions (116 benign and 29 malignant) from 145 women (mean age, 46 years; range, 16-86 years). Five radiologists independently reviewed sonograms with and without a diffuse optical tomographic category. Each lesion was scored on a scale of 0% to 100% for suspicion of malignancy and rated according to the American College of Radiology Breast Imaging Reporting and Data System classification. Diagnostic performance was analyzed by comparing area under receiver operating characteristic curve values. Reader agreement was assessed by intraclass correlation coefficients. Results-In the multireader multicase receiver operating characteristic analysis, adding a diffuse optical tomographic category to sonography improved the diagnostic accuracy of sonography (mean areas under the curve, 0.923 for sonography alone and 0.969 for sonography with diffuse optical tomography; P = .039). The interobserver correlation was also improved (0.798 for sonography alone and 0.904 for sonography with diffuse optical tomography). The specificity increased for 4 reviewers from a mean of 19.5% to 45.8% (P < .001 for reviewers 1-4; P = .238 for reviewer 5) with no significant change in the sensitivity. When the diffuse optical tomographic category was applied strictly, the specificity increased for all reviewers from a mean of 19.5% to 68.3% (P < .001 for all reviewers) with no significant change in the sensitivity. Conclusions-The addition of diffuse optical tomographic categories to sonography may improve diagnostic performance and markedly decrease false-positive biopsy recommendations.</P>

Quality Assurance in Ultrasound Screening for Hepatocellular Carcinoma Using a Standardized Phantom and Standard Clinical Images : A 3-Year National Investigation in Korea

Choi, Joon-Il,Jung, Seung Eun,Kim, Pyo Nyun,Cha, Sang Hoon,Jun, Jae Kwan,Lee, Hoo-Yeon,Park, Eun-Cheol American Institute of Ultrasound in Medicine 2014 Journal of ultrasound in medicine Vol.33 No.6

<P><B>Objectives—</B></P><P>The purpose of this study was to investigate the quality of ultrasound (US) imaging for hepatocellular carcinoma screening.</P><P><B>Methods—</B></P><P>The investigation was performed at all medical institutes participating in the National Cancer Screening Program in Korea. For assessment of personnel, we inquired who was performing the US screenings. For phantom image evaluation, the dead zone, vertical and horizontal measurements, axial and lateral resolution, sensitivity, and gray scale/dynamic range were evaluated. For clinical image evaluation, US images of patients were evaluated in terms of the standard images, technical information, overall image quality, appropriateness of depth, foci, annotations, and the presence of any artifacts.</P><P><B>Results—</B></P><P>Failure rates for phantom and clinical image evaluations at general hospitals, smaller hospitals, and private clinics were 20.9%, 24.5%, 24.1% and 5.5%, and 14.8% and 9.5%, respectively. No statistically significant difference was observed in the failure rates for the phantom images among groups of different years of manufacture. For the clinical image evaluation, the results of radiologists were significantly better than those of other professional groups (<I>P</I> = .0001 and .0004 versus nonradiology physicians and nonphysicians, respectively). The failure rate was also higher when the storage format was analog versus digital (<I>P</I> < .001).</P><P><B>Conclusions—</B></P><P>Approximately 20% of US scanners failed the phantom image evaluation. The year of scanner manufacture was not significantly associated with the results of the phantom image evaluation. The quality of the clinical images obtained by radiologists was the best.</P>

Sparganosis in the Scrotum: Sonographic Findings

Kim, Y. J.,Lee, M. W.,Jeon, H. J.,Yi, J. G.,Paick, S. H.,Kim, H. G.,Lim, S. D.,Hwang, T. S. AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007 Journal of ultrasound in medicine Vol.26 No.1

Evaluation of Screening Whole-Breast Sonography as a Supplemental Tool in Conjunction With Mammography in Women With Dense Breasts

Chae, Eun Young,Kim, Hak Hee,Cha, Joo Hee,Shin, Hee Jung,Kim, Hyunji American Institute of Ultrasound in Medicine 2013 Journal of ultrasound in medicine Vol.32 No.9

<P><B>Objectives—</B></P><P>The purpose of this study was to evaluate the use and performance of supplemental screening whole-breast sonography in conjunction with mammography in asymptomatic women with dense breast tissue.</P><P><B>Methods—</B></P><P>A total of 28,796 asymptomatic women underwent screening mammography. Among 20,864 women with dense breasts (72%), 8359 underwent additional sonography as part of their screening examinations. We classified women with mammographically dense breasts into mammography-only and mammography-plus-sonography groups. The reference standard was a combination of pathologic results and clinical follow-up at 2 years. We compared the recall rate, cancer detection yield, sensitivity, specificity, and positive predictive value in each group.</P><P><B>Results—</B></P><P>Among the 20,864 women with dense breasts, 35 cancers were diagnosed, with a mean size of 13 mm. The cancer detection yield was 0.480 per 1000 women in the mammography-only group and increased to 2.871 in the mammography-plus-sonography group. Of 24 cancers detected in the mammography-plus-sonography group, the mean size was 11 mm, and the axillary lymph nodes were negative in 19 of 20. The sensitivity was significantly higher in the mammography-plus-sonography group than the mammography-only group (100% versus 54.55%; <I>P</I> = .002). The positive predictive values of sonographically prompted biopsy were 11.1% for the mammography-plus-sonography group and 50% for the mammography-only group.</P><P><B>Conclusions—</B></P><P>Supplemental screening whole-breast sonography increases the cancer detection yield by 2.391 cancers per 1000 women with dense breast tissue over that of mammography alone. It is beneficial for increased detection of breast cancers that are predominantly small and node negative; however, it also raises the number of false-positive results.</P>

Olecranon Bursitis Communicating With an Olecranon Cyst in Rheumatoid Arthritis

Jin, W.,Lee, J. H.,Yang, D. M.,Kim, H. C.,Ryu, C. W.,Shin, H. P.,Park, J. S.,Ryu, K. N. AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007 Journal of ultrasound in medicine Vol.26 No.6

Sonographic Evaluation of Anterosuperior Hip Labral Tears With Magnetic Resonance Arthrographic and Surgical Correlation

Jin, W.,Kim, K.I.,Rhyu, K.H.,Park, S.Y.,Kim, H.C.,Yang, D.M.,Park, J.S.,Park, S.J.,Ryu, K.N. AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012 Journal of ultrasound in medicine Vol.31 No.3

Sonographic Quantification of Pronator Quadratus Activity During Gripping Effort

Shin, Won-Jeong,Kim, Jong-Pil,Kim, Jeong-Sang,Park, Hee-Jung American Institute of Ultrasound in Medicine 2015 Journal of ultrasound in medicine Vol.34 No.12

<P><B>Objectives—</B></P><P>The aim of this study was to obtain quantitative data related to the activity of each head of the pronator quadratus based on dynamic sonographic parameters during gripping effort and to assess their relationships with grip and pronation strengths.</P><P><B>Methods—</B></P><P>The forearms of 33 healthy volunteers were evaluated at 5 positions of axial rotation (full supination, 45° supination, neutral, 45° pronation, and full pronation). Echogenic intensity ratios and muscle thicknesses of each head of the pronator quadratus were measured from transverse cross-sectional sonograms obtained during maximal grip and release. Grip strengths and maximal isokinetic pronation torques at 90°/s and 360°/s were evaluated as strength parameters and correlated with sonographic measures.</P><P><B>Results—</B></P><P>Echogenic intensity ratios of both heads significantly decreased during power grip (<I>P</I>≤ .002). Changes in echogenic intensity ratios of the superficial head were greater when the forearm was pronated compared to supination (<I>P</I>< .001), whereas changes in echogenic intensity ratios of the deep head were constant at all forearm positions. Muscle thicknesses of the superficial head maximally increased at the neutral position during power grip (<I>P</I>< .001), whereas muscle thicknesses of the deep head did not change. There were significant negative correlations between grip strength and echogenic intensity ratios of both heads at all respective forearm positions (<I>P</I> ≤ .048). Pronation torque was significantly correlated with echogenic intensity ratios of the superficial head at all forearm positions and the deep head at 45° and full pronation positions (<I>P</I> ≤ .034).</P><P><B>Conclusions—</B></P><P>The data revealed that the superficial head of the pronator quadratus more actively contracts when the forearm is in pronation, whereas the deep head constantly contracts at all positions. This study suggests that both heads of the pronator quadratus also play a role in grip strength, but the superficial head contributes more to pronation strength.</P>

Predictive Factors for Extrathyroidal Extension of Papillary Thyroid Carcinoma Based on Preoperative Sonography

Lee, Chang Yoon,Kim, Soo Jin,Ko, Kyung Ran,Chung, Ki-Wook,Lee, Joo-Hyuk American Institute of Ultrasound in Medicine 2014 Journal of ultrasound in medicine Vol.33 No.2

<P><B>Objectives—</B></P><P>The purpose of this study was to evaluate the diagnostic performance and predictive factors of extrathyroidal extension of papillary thyroid carcinoma based on preoperative sonography.</P><P><B>Methods—</B></P><P>Preoperative sonography was performed for 568 patients who underwent surgery for papillary thyroid cancer between May 2009 and December 2010. Patients’ T stages based on preoperative sonography were compared with their T stages based on pathologic examination, and we statistically analyzed the discriminatory performance of sonography. Among the 568 patients enrolled in this study, we selected 320 patients in whom extrathyroidal extension was suspected on sonography. We analyzed several predictive factors for extrathyroidal extension.</P><P><B>Results—</B></P><P>Two hundred seventy-five of the 568 patients were proven to have pathologic extrathyroidal extension of papillary thyroid cancer after surgery (75.9% diagnostic accuracy, 83.3% sensitivity, 68.9% specificity, 71.6% positive predictive value, and 81.5% negative predictive value). Of 320 patients with sonographically suspected extrathyroidal extension, a larger lesion size (<I>P</I> < .001) and a higher lymph node stage on sonography (<I>P</I> = .004) were the best predictors of extrathyroidal extension among the features that we measured. There were no significant differences in terms of the lesion site or thyroid parenchymal background echogenicity. Thyroid capsular protrusion had a higher predictive value than the abutting ratio (<I>P</I> = .001). However, increasing the abutting ratio enabled the prediction of extrathyroidal extension on sonography (<I>P</I> = .009).</P><P><B>Conclusions—</B></P><P>Preoperative sonography is a helpful tool for predicting pathologic extrathyroidal extension of papillary thyroid cancer. In particular, clinicians should focus on the lesion size, nodal stage, and abutment or capsular protrusion of the lesion while performing sonography because these are the most useful predictive factors for extrathyroidal extension.</P>

Clinical and Radiologic Features of Neuroendocrine Breast Carcinomas

Jeon, Chang Ho,Kim, Sun Mi,Jang, Mijung,Yun, Bo La,Ahn, Hye Shin,Kim, Sung-Won,Kang, Eunyoung,Park, So Yeon American Institute of Ultrasound in Medicine 2014 Journal of ultrasound in medicine Vol.33 No.8

<P>Neuroendocrine breast carcinoma is a rare and distinct type of breast carcinoma, with morphologic features similar to those of pulmonary and gastrointestinal tract neuroendocrine tumors. More than 50% of cells express neuroendocrine markers. We documented the clinical and radiologic features of 11 patients with histologically confirmed neuroendocrine breast carcinomas. Clinical manifestations included nipple discharge (6 patients) and palpable masses (5 patients). Lesions were mainly oval or irregular on mammography (n = 8), sonography (n = 11), and magnetic resonance imaging (n = 9). Understanding the clinical and radiologic features of neuroendocrine breast carcinoma will facilitate the differential diagnosis.</P>