Search

OBJECTIVES This study aimed to assess multiple factors influencing the outcomes of ultrasound (US)-guided fine-needle aspiration (FNA) of salivary gland lesions. METHODS From 2008 to 2013, a single radiologist performed US-guided FNA of salivary gland lesions in 243 patients. With the exclusion of pure cysts, poor image quality, and insufficient static image cases, 218 salivary gland lesions in 218 patients were included. The composition, size, location, and vascularity of the lesions were retrospectively investigated on the basis of sonographic findings by the same radiologist. The relationship between sampling adequacy and multiple factors was compared, and the diagnostic accuracy of US-guided FNA of salivary gland lesions was calculated by using the final diagnosis as a reference standard. RESULTS The sampling adequacy rate for US-guided FNA of the 218 salivary gland lesions was 96.8% (211 of 218). A significant difference was observed in the composition and vascularity of the lesions (P < .0001), whereas there was no significant difference in the patient age and sex, lesion size, lesion location, and needle size. The rate of inadequate sampling increased in predominantly cystic lesions compared with solid lesions as well as in low-vascularity lesions compared with high-vascularity lesions. Of the 218 lesions, 178 (81.7%) were ultimately diagnosed, and most were benign (162 of 178 [91.0%]). When 3 cases with indeterminate cytologic results were excluded, the sensitivity, specificity, positive and negative predictive values, and accuracy of US-guided FNA of salivary gland lesions were 64.3%, 98.8%, 81.8%, 97.0%, and 96.0%, respectively. CONCLUSIONS When using US-guided FNA to diagnose salivary gland lesions, sampling adequacy depends on the composition or vascularity of the lesions.

OBJECTIVES The purpose of this study was to evaluate the clinical importance and sonographic features of nonpalpable axillary lymphadenopathy identified on breast sonography in patients without malignancy. METHODS Our study included 71 women and 2 men (mean age, 47.5 years; range, 16-69 years) with axillary lymphadenopathy identified on breast sonography. None of the 73 patients had known malignancy or presented with palpable lymph nodes or symptoms of mastitis. The lesions were pathologically diagnosed in 53 patients by surgical biopsy (n = 8), ultrasound-guided core needle biopsy (n = 17), or ultrasound -guided fine needle aspiration (n = 28). Twenty patients underwent follow-up imaging for 6 to 60 months (mean, 17 months). The sonographic features of the axillary lymph nodes were analyzed for all patients. RESULTS The final diagnoses included benign reactive hyperplasia (n = 45), Kikuchi disease (n = 4), tuberculosis (n = 3), and sarcoidosis (n = 1). None of the 20 patients who underwent follow-up imaging developed malignancy. Suspicious sonographic features were frequently observed (loss of the fatty hilum, round shape, abnormal cortical thickening, and marked hypoechogenicity: 79.5%, 75.3%, 82.1%, and 9.6%, respectively) and were mostly complex, with the most common combination being a round shape and loss of the fatty hilum in 61.6% patients. CONCLUSIONS No malignancy was detected in all 73 patients, despite frequent manifestations of complex and extremely suspicious sonographic features. Short-term follow-up imaging rather than immediate biopsy can be recommended for nonpalpable lymphadenopathy in patients without known malignancy.

Background This study aimed to assess solid thyroid nodule (STN) cases with discordant sonographic and cytological diagnoses and to compare the diagnostic indices of these modalities. Methods From January 2013 to December 2013, a single radiologist performed consecutive thyroid ultrasonography (US) and US-guided fine-needle aspiration (US-FNA) to diagnose 347 STNs in 347 patients. Each STN was classified into 1 of 5 categories according to the US diagnosis before US-FNA: “benign,” “probably benign,” “indeterminate,” “suspicious for malignancy,” or “malignant.” We assessed cases where the sonographic and cytological STN diagnoses were discordant, using the final diagnosis as the reference standard. Results Of the 347 STNs, 279 (80.4%) had a final diagnosis confirmed. The “benign,” “probably benign,” and “malignant” US categories showed high concordance with the cytological diagnoses, whereas the “suspicious for malignancy” US category revealed only a 62.2% concordance rate. The prevalence of indeterminate cytology was higher in the “indeterminate” and “suspicious for malignancy” US categories than other US categories. STNs with indeterminate cytology showed a higher malignancy rate in the malignant US categories. When STNs classified into indeterminate categories from the sonographic (n = 49) and cytological (n = 18) diagnoses were excluded, the sensitivity, specificity, and accuracy of the sonographic and cytological diagnoses were 95.5 and 98.8%, 92.1 and 100%, and 93.0 and 99.6%, respectively. Conclusion The “suspicious for malignancy” US category showed higher discordance with cytological diagnoses than other US categories, and the diagnostic value of US was lower than that of cytology. Diagn. Cytopathol. 2015;43:953–959. © 2015 Wiley Periodicals, Inc.

Purpose To investigate gray-scale and color Doppler sonographic (US) features of complex fibroadenoma (FA), according to the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. Methods From 2010 through 2013, 586 women with FAs were seen; 101 (17%) of those lesions were diagnosed as complex FAs on percutaneous needle biopsy or surgery. Among the patients with complex FAs, 67 who had US examination results available were included in this study. In addition, the results from 98 women who had simple FAs were included as controls. US features were retrospectively analyzed by two breast radiologists in consensus for shape, margin, echogenicity, posterior acoustic pattern, boundary, orientation, and associated findings. They also reassessed the BI-RADS category for FAs. Color Doppler US examination results were classified according to the amount of vascularity as absent, moderate, or marked. Results Complex FA were larger than simple FAs were (14.5 cm versus 12.1 cm, p > 0.05). On univariate analysis, a round to irregular shape, an uncircumscribed margin, the presence of associated findings, and BI-RADS categorization as 4a and 4b were more frequently revealed in complex than in simple FAs (p < 0.05). Multivariate analysis revealed that the tumor margin was a predictive factor for complex FA (odds ratio: 6.08; 95% confidence interval: 1.14–32.49, p < 0.05). On color Doppler US, the complex FAs had higher degrees of vascularity than simple FA (p < 0.05). Conclusions Complex FAs, in comparison with simple FAs, tend to have more aggressive features and to be in higher BI-RADS categories on US examination. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 43:556–562, 2015

Aim This study was conducted to explore first experiences of high-fidelity simulation training in Korean nursing students, in order to develop and establish more effective guidelines for future simulation training in Korea. Methods Thirty-three junior nursing students participated in high-fidelity simulation training for the first time. Using both qualitative and quantitative methods, data were collected from reflective journals and questionnaires of simulation effectiveness after simulation training. Descriptive statistics were used to analyze simulation effectiveness and content analysis was performed with the reflective journal data. Results Five dimensions and 31 domains, both positive and negative experiences, emerged from qualitative analysis: (i) machine–human interaction in a safe environment; (ii) perceived learning capability; (iii) observational learning; (iv) reconciling practice with theory; and (v) follow-up debriefing effect. More than 70% of students scored high on increased ability to identify changes in the patient's condition, critical thinking, decision-making, effectiveness of peer observation, and debriefing in effectiveness of simulation. Conclusion This study reported both positive and negative experiences of simulation. The results of this study could be used to set the level of task difficulty in simulation. Future simulation programs can be designed by reinforcing the positive experiences and modifying the negative results.

Objectives The purpose of this study was to evaluate characteristic features of juvenile fibroadenoma of the breast on sonography. Methods Our study included 34 juvenile fibroadenomas confirmed by surgical biopsy or sonographically guided 8-gauge vacuum-assisted biopsy in 23 patients (age range, 15-47 years; mean age, 25 years). Sonographic findings of the lesions were analyzed retrospectively by 2 radiologists in consensus according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) lexicon. The BI-RADS final assessment category was also established. Results On sonography, all fibroadenomas presented as masses. The mean size was 30 mm. Regarding shape, there were 29 oval, 2 round, and 3 irregular masses. The margins were circumscribed in 24, indistinct in 5, microlobulated in 4, and angular in 1. Regarding echogenicity, 16 masses were hypoechoic, 16 isoechoic, and 2 complex echoic. Posterior acoustic characteristics included posterior acoustic enhancement in 22 masses (65%), posterior shadowing in 1, and no posterior acoustic features in 9; this information was not available in 2. The lesion boundary presented as an abrupt interface in 32 and an echogenic halo in 2. The orientation was parallel in 32 and nonparallel in 2. Calcifications were present in 3 cases and absent in 31. On color Doppler sonography, the masses were usually hypervascular with vessel counts of 5 or more (87%). The BI-RADS final assessment categories were 3 in 24 and 4a in 10. Conclusions The dominant sonographic presentation of juvenile fibroadenoma is a circumscribed oval hypoechoic or isoechoic mass, which resembles that of simple fibroadenoma. Juvenile fibroadenomas frequently show posterior acoustic enhancement and hypervascularity on color Doppler sonography.

OBJECTIVES To compare the imaging and clinical features of benign and malignant nonmasslike lesions in the breast. METHODS During a 2-year period at a single institution, 186 nonmasslike lesions in 158 women were pathologically confirmed through surgery or sonographically guided biopsy. The sonographic patterns (mottled, geographic, and indistinct) and distributions (focal and regional) were compared between benign and malignant lesions. The presence of sonographically visible calcifications, amount of color Doppler signals, presence of positive findings on mammography, and presence of symptoms were also compared between the two groups. RESULTS A total of 156 lesions (84%) were confirmed as benign and 30 (16%) as malignant. On sonography, malignant nonmasslike lesions more frequently had mottled and geographic patterns and regional distribution than benign lesions (P < .0001). Malignant lesions also more frequently had sonographically visible calcifications (40% versus 0%; P < 0.0001) and a greater amount of color Doppler signals than benign lesions (P < .0001). On mammography, malignant lesions more frequently had densities and calcifications than benign lesions (30.4% versus 7.1%; P = 0.0052; 73.9% versus 6.1%; P < .0001, respectively). Clinically, malignant lesions were more frequently palpable and accompanied by localized pain than benign lesions (50% versus 2.6%; P< .0001; 13.3% versus 0.6%; P = .0025). CONCLUSIONS The imaging and clinical features of malignant nonmasslike lesions differed significantly from those of benign nonmasslike lesions.

Objective. The purpose of this study was to differentiate between high-grade and non-high-grade ductal carcinoma in situ (DCIS) of the breast on sonography. Methods. From October 2003 to August 2009, 76 DCIS lesions in 73 women who underwent sonography and mammography were included in this study. Lesions were confirmed by mastectomy, breast-conserving surgery, or surgical biopsy. Images were analyzed by 2 radiologists with consensus and were correlated with histologic grades. Results. Of the 76 lesions, 44 were classified as high--grade and 32 as non-high-grade DCIS. Fifty-seven lesions (75.0%) were identified on sonography, which revealed a mass in 30 cases, microcalcifications in 20, ductal changes in 4, and architectural distortion in 3. All cases with false-negative findings on sonography (n = 19) showed microcalcifications on mammography On sonography, masses were more frequently found in non-high-grade (62.5%) than high-grade DCIS (22.7%; P < .01). No significant difference was seen in the sonographic features of masses between high-grade and non-high-grade DCIS. Microcalcifications were more common in high-grade (43.2%) than non-high-grade (3.1 %) DCIS (P= .02). Most sonographically visible microcalcifications had associated findings such as ductal changes (n = 11), a mass (n = 7), or a hypoechoic area (n = 5). The detection rate of microcalcifications on sonography was higher in high-grade (62.9%) than non-high-grade DCIS (25.0%; P=.023). Conclusions. Microcalcifications with associated ductal changes (11 of 31 [35.5%]) were the most common sonographic findings in high-grade DCIS. An irregular hypoechoic mass with an indistinct and microlobulated margin (13 of 26 [50.0%]) was the most frequent finding in non-high-grade DCIS.

To analyze the thermal insulation effect in textiles, waterproof, and breathable nylon fabrics PCMs microcapsules (PCMMcs) were prepared by wet and dry coating processes. The morphology, water vapor permeability (WVP), water penetration resistance (WPR), and peel strength of the PCMMcs-coated fabrics were characterized. At the same time, DSC was used to measure the thermal insulation properties of the PCMMcs-treated fabrics as a means of testing the thermal storage/release capacity according to their phase change temperature. The result showed that the heat storage capacity of the PCMMcs-treated fabrics prepared by wet coating was noticeably better than that of the PCMMcs-untreated samples, whereas the PCMMcs treatment had an insignificant effect on the heat capacity of the fabrics prepared by the dry coating process. From the SEM analysis, it was found that the PCMMcs were physically unstable during the dry coating process, so, they could not be observed. Also, the WVP, WPR, and peel strength were found to decrease with increasing PCMMcs contents. POLYM. ENG. SCI., 2009. © 2009 Society of Plastics Engineers

The effect of a low-temperature plasma and/or chitosan pretreatment as a mordant on the dyeing of poly(ethylene terephthalate) fabrics with an aqueous extract of Caesalpinia sappan L. wood, which showed a remarkably high coloring property in a natural dyeing system, was investigated. After dyeing, scanning electron microscopy, add-on, color measurements, and fastness to washing tests were performed. Dyeing with the C. sappan L. extract led to fair-to-good fastness properties in conventional natural dyeing. The results clearly show that the pretreatment with chitosan and/or plasma is better than a metal mordant in terms of the dye uptake and reduction in the dyeing time, that the proposed pretreatment coloration reaction could be carried out without the need for repetitive dye steps, and that it prevents the excessive use of dye chemicals, thereby resulting in a more ecofriendly process. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008

The fabrication of functional textiles able to provide thermal regulation and comfort for the body has attracted increasing interest in recent years. This research investigated fabric coatings containing energy absorbing, temperature stabilizing, phase-change material microcapsules (PCMMcs), and their methods of application. Specifically, a coated fabric was directly prepared by a dual-type coating method, in which the PCMMcs were dispersed in a polyurethane coating solution with no binder. The thermal performances of the dual-coated samples were evaluated by differential scanning calorimetry, and their physical characteristics were examined by scanning electron microscopy, thermal vision camera, porosity, water vapor transmission rate (WVTR), and water entry pressure (WEP) analyses. Furthermore, the microclimate characteristics of the thermally enhanced fabrics were investigated under experimental conditions using a human-clothing-environment (HCE) simulator system. The study results confirmed the superior performance of the dual-coated fabrics in terms of thermal regulation and body comfort, compared with those coated by the dry or wet coating method, because of the improved WEP, WVTR, and thermal performance. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008

Stoichiometric and nonstoichiometric polyelectrolyte complex (PEC) was prepared with polyethylene glycol-monosuccinate (PEGMS), and chitosan (CS). A series of PEGMS were synthesized by a 1 : 1 mol ratio between PEG and succinic anhydride. Then, the novel PEC was prepared by a various mole reaction of the above synthesized PEGMS and CS. The physicochemical properties of the synthesized PEC was characterized by using elemental analysis, FTIR, 1H, and 13C nuclear magnetic resonance, dissolution behavior, and phase transition phenomenon. Furthermore, some properties of the PEC obtained were analyzed by UV-Visible spectrometry, wide-angle X-ray diffraction, differential scanning calorimeter, scanning electron microscope, and estimated solubility, and cell viability assay, respectively. It was found that the observed FTIR, 1H, and 13C-NMR data was in good agreement with the chemical structure of the prepared PEGMS and PEC. The dissolution behaviors of nonstoichiometric PEC were found to depend on the pH of the solution as well as on the PEGMS/CS composition. The study of MTT assay suggested that the viability of HepG2 human hepatoblastoma cell on PEC were increased significantly in accordance with mole ratio of CS. As the results, the obtained several product is a useful intermediate, which permits further chemical modification for the amino group of CS and may have potential applications in biocompatible or cosmetic systems. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007

In this paper, we report C. agronoma Meyrick for the first time from South Korea. Photographs of adults and genitalia are provided, with brief comments on distribution and biology.