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While histologic response to neoadjuvant chemotherapy (NChT) is the major prognostic factor for osteosarcoma treatment, evaluating that response is difficult.To evaluate the feasibility of the blood oxygen level-dependent (BOLD) technique to assess the response to NChT.Prospective.Twelve patients with osteosarcoma undergoing NChT.3 T; T2*-weighted BOLD, dynamic contrast-enhanced (DCE) and diffusion-weighted (DW) (b values of 0, 400, and 1400 seconds/mmExamination was performed before treatment (first), after each cycle of treatment (second and third). At each time point, spin dephasing rates (R2*) from BOLD magnetic resonance imaging (MRI), parameters from DCE-MRI (volume transfer constant [KWilcoxon's signed rank test, Spearman's correlation coefficient (ρ) were used. A P-value of0.05 was considered statistically significant.The difference and relative difference of the R2* values between the first/third MRIs in the extraosseous portion were statistically significant. Only the differences in the kThe R2* from the BOLD MRI technique could be a useful biomarker for evaluating treatment response in osteosarcoma treated with NchT.5 TECHNICAL EFFICACY: Stage 2.

This study aimed to evaluate the most common primary metastatic location of acral malignant melanoma and to evaluate the usefulness of preoperative ultrasound for sentinel lymph node metastasis. Ninety-eight Korean acral malignant melanoma patients were enrolled. Acral malignant melanoma was present in 76 lower limbs and in 22 upper limbs. The most common origin location was the sole (33.7%). The most common location of primary metastasis was loco-regional recurrence (22/34, 64.7%). The sensitivity, specificity, positive predictive value, and negative predictive value of preoperative sentinel lymph node ultrasound was 29.1%, 94.6%, 63.6%, and 80.5%, respectively. We postulate the unusefulness of preoperative ultrasound for sentinel lymph node metastasis in acral malignant melanoma.

The purpose of this study was to assess the factors associated with high fibular head in symptomatic discoid lateral meniscus (DLM). Eighty-seven patients with complete DLM (discoid group) and 80 normal subjects (control group) were included prospectively. Plain X-rays and MRI were analyzed for level and angle of the fibular head and thickness and type of Wrisberg ligament. Multivariate regression analysis was performed to find the factors associated with levels of the fibular head and DLM. The angle of the fibular head was the only factor associated with level of the fibula in the discoid group (odds ratio : 3.0, p=0.007). The 13.6mm cut off value for fibular level had 70.5% sensitivity and 77.0% specificity for diagnosis of DLM. A high fibular head was associated with larger angle and type of fibular head. Level of evidence : Level II.

Hidradenocarcinoma is an extremely rare cutaneous skin carcinoma which arise from the sweat gland. There are several report about potential targets in this rare disease including estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). A 53-year-old man who presented with a slowly growing mass on the left thumb which was pathologically confirmed of HER2 negative, ER negative hidradenocarcinoma. At the time of presentation, the patient had metastatic lesions to lung and axillary lymph nodes. The patient received several lines of palliative chemotherapy and radiotherapy, but died of the disease progression. We identified TP53 G245S mutation in both primary tumor specimen and cell-free based targeted sequencing. Herein, we report on a very rare case of metastatic hidradenocarcinoma with TP53 G245S mutation but no other treatable targets from clinical sequencing, which pursued an aggressive clinical course.

Overexpression of PD-L1 has been shown to be associated with better clinical responses to PD-1/PD-L1 blockade in melanoma. However, the utility of PD-L1 immunostaining as a predictive biomarker for anti-PD-1 treatment remains unclear, especially in melanoma of acral/mucosal origin. Materials and methods We collected and reviewed the medical records of 37 patients with metastatic melanoma who were treated with the anti-PD-1 antibodies pembrolizumab or nivolumab between January and December 2015. Patients with histologically diagnosed malignant melanoma and whose pretreatment tumor specimens were available for immunohistochemical staining of PD-L1 expression in tumor or immune cells were included. Results Of 37 patients, 26 patients had either acral or mucosal melanoma. The overall response rate was 10.8 % (95 % CI, 0.8-20.8 %). The response rate to PD-1 inhibitor was 11.5 % (95 % CI, 0-23.8 %) in acral/mucosal melanoma and that for cutaneous melanoma was 9.1 % (95 % CI, 0-26.1 %). Of these 37 patients, 18 had pre-treatment tumor specimens available for PD-L1 staining. Of 18 patients, 10 (55.5 %) were of acral/mucosal origin. In all patients with acral melanoma, the overall response rate (ORR) was 16.7 % (1 of 6 patients) and disease control rate (DCR) was 50 % (3 of 6 patients). In the PDL-1(+) melanoma group (1 % cut-off value), ORR was 20 % (2/10) and DCR was 80 %; for PDL-1 (-) group, ORR was 12.5 % (1/8) and DCR of 37.5 %. In the PDL-1 (+) group by 5 % cut-off value, ORR was 33.3 % (2/6) and DCR was 83.3 %; for patients with PDL-1 (-), ORR was 8.3 % (1/12) and DCR was 50 %. The median PFS was 6.8 months in PDL-1(+) group and 1.9 months in PDL-1(-) group (p = 0.149). Anti-PD-1 treatment was very well tolerated without serious adverse events of grade 3 or 4 in all patients. Conclusions The treatment outcome to PD-1 antibody was not different in acral/mucosal melanoma when compared with cutaneous melanoma. The immunohistochemical PD-L1 expression seemed to be correlated with better clinical outcomes of anti-PD-1 treatment in limited cases.

Intravesical BCG therapy after transurethral resection of bladder tumor (TURB) is considered the most effective treatment for prophylaxis against the recurrence of high risk non-muscle invasive bladder cancer, and generally well tolerated and infectious complication are rare. We reported a case of granulomatous prostatitis is a patient who had undergone intravesical BCG therapy due to non-invasive superficial urothelial carcinoma of bladder. This patient was diagnosed by prostate biopsy because of PSA elevation without any other voiding symptoms and abnormal abscess pocket in transrectal ultrasonography.

With the globalization of the construction market and the recession in Korea’s construction economy, construction companies in South Korea are extending their business into new international markets. However, there are still more than a few companies that are not making due profits despite the streams of contracts available outside the country. This is because Korean construction companies are undergoing complications in the resolution process of overseas construction claims and disputes. Therefore, the present study examines research from a construction company’s perspective, based on the FIDIC Red Book, a standard form of contract that is typically used overseas for separate bid-based construction contracts. Disputable items were selected through analysis of contract documents and the final dispute factors were derived through literature reviews and interviews with experts. To determine the priority of the dispute factors suggested by the experts who are practically in charge of overseas construction contract management, an FMEA method survey was performed and feedback was received using the Delphi method. Based on the survey results, the priority of dispute factors was analyzed, and the top 10 factors were selected as preeminent key factors for potential improvement and procedural amendment. In addition, this study analyzes whether individual or company system capabilities should be addressed in order to prevent such dispute factors. Based on the findings of this study, it is expected that Korean construction companies will establish strategies to cope with disputes at a corporate level and gain competitiveness in the overseas construction market.

This study aimed to use a superthin, free superficial circumflex iliac artery perforator (SCIP) flap in functional surgery for treating subungual melanoma and to evaluate its outcomes.Forty-one patients with primary subungual melanoma of less than or equal to 2-mm thickness who were treated with functional surgery were prospectively enrolled. After oncologic resection, a thin SCIP flap was harvested along the trans-superficial fat layer and transferred to the defect with further thinning by primary defatting. Complications and oncologic outcomes were investigated. Postoperative functional status was assessed, using the Quick Disabilities of the Arm, Shoulder and Hand questionnaire for finger cases and the Foot Function Index for toe cases, and was compared with that of patients treated with amputation.The SCIP flap was inset with a final thickness ranging from 1.5 to 4 mm after defatting. Total flap failure occurred in one patient. Complete wound healing was achieved within 3 weeks postoperatively in most cases (90.2 percent). The majority of patients achieved satisfactory contour without needing secondary debulking. Two recurrences developed during a mean follow-up period of 31 months: one local recurrence and one in-transit recurrence. The 3-year disease-free survival was 97.1 percent. Mean scores for the Quick Disabilities of the Arm, Shoulder and Hand questionnaire and the Foot Function Index following functional surgery were significantly lower than those following amputation.The superthin SCIP flap might serve as a valuable reconstruction option, providing aesthetically thin coverage and reliable outcomes, in functional surgery for treating early-stage subungual melanoma.Therapeutic, IV.

We sought to determine the relationship between the mechanical axis-derived and the anatomic landmark-derived femoral rotational axes using three dimensional computed tomographic images of 20 lower extremities. The mechanical axis-derived femoral rotational axis was created on the distal articular surface of the femur using coronal mechanical limb axis and the reconstructed images of the femur. Then, we measured the angular difference between mechanical axis-derived and anatomic landmark-derived femoral rotational axes. The mechanical axis-derived femoral rotational axis was externally rotated with a mean of 2.2° (range, 0 to 4.7°; SD, 1.0) compared with the surgical epicondylar axis. Our findings should be considered to obtain a proper femoral rotational axis in total knee arthroplasty.

As social needs are increasing to minimize the occurrence of external effect due to urban development and to diffuse the benefits of development to surrounding areas, diverse cooperative planning methods are increasingly being discussed. In the long term, laws and systems need to be refined to support cooperative planning, but prior to such development, elements, procedures, and methodologies wherein cooperative planning in U.S.A cases could be implemented were examined to derive the alternative to and implications of cooperative planning that can apply not only to single administrative districts but also to complex boundary new towns being developed by various local governments. This paper surveyed and analyzed the cases of Wisconsin State of the U.S.A, thereby deriving the following implications. First, joint planning areas should be established within the boundary area of various local governments to establish cooperative planning areas in special areas such as complex boundary new towns, and to this end, urban planning means should be prepared. Together with such efforts, to boost the flexibility of cooperative planning, life sphere unit-based planning unit should be established, and a well-organized operation system to activate communities should be prepared. Also, revenues, generated through regional growth, should be distributed to individual local governments through joint tax according to the agreed-upon ratios, and as such, measures to share services and operate joint tax in small-size regions should be secured. Together with such efforts, to establish cooperative governance, measures to manage conflicts through the participation by stakeholders and arbitrators should be prepared from the planning stage, and measures for implementing cooperative planning at the level of basic urban planning should be prepared.Key words: Cooperative Planning, Complex Boundary New Town, Governance, Joint Planning AreaLHI Journal (2014) 5(2):57-68 http://dx.doi.org/10.5804/LHIJ.2014.5.2.057http://lhi.lh.or.kr

최근 도청 이전 신도시, 위례신도시 등 두 개 이상 지자체를 포함하는 신도시(복합경계신도시) 개발이 증가하고 있다. 그러나 현행 도시개발제도는 단일 지자체 신도시를 대상으로 하고 있어, 복합경계 신도시의 개발과 관리를 위한 제도 개선이 필요하다. 다층적 거버넌스(Multi-level governance) 개념은 광역지자체와 기...

About 1,800 villages have released from Greenbelt since Greenbelt-reform-policy for readjustment of the area was promoted after 1997. Even though the government intended to attract planned development & improvement of these lifted villages through District Unit Plan and designating the lifted area as low-rise and low-density zoning considering the characteristics of the Greenbelt region, there are still many problems to be solved: a lack of funds, insufficient capability for self-improvement and unexecuted SOCs in long-term etc. It seems that these problems are caused by focusing on the lifting areas itself instead of researching deeply the condition and characteristics of the villages and searching proper direction/plans of improvement before lifting Greenbelt In addition, the existing plan of village improvement and management was not considering physical and spacial characteristics of the areas, social and economic situation of residents and relationship between the villages and surrounding cities, though these conditions are different among each villages, and the related regulations are applied uniformly across all the villages and those have been causing many civil appeals and environmental problems. In these respects, this study aims to consider the problems of the lifted villages using the existing researches on them and to make typology by characteristics-data of the villages and to establish improvement strategies of each types. In this study, the villages were classified into 5 types as a result of cluster analysis on 424 villages among all 1,800 through variables of locational potentiality : location, accessibility, size and form of village, condition of regulations etc. According to function of the villages, they were divided into 4 types: urban-type, rural-type, industrial-type and neighborhood-centered-type. This study also drew 4 improvement-strategy-types by combination of locational potentiality and village-function : type of improving life-environment, type of improving production-infra, type of inducing-planned-improvement and type of constructing center-of living-circle. Finally, this study suggested the directions of the each 4 types to desirable improvement and management which could be used to make and complement plans for village improvement.

Purpose To determine a new cutoff value that can further distinguish between the incomplete and complete discoid lateral meniscus (DLM). Materials and Methods Twenty-one cases of incomplete DLM and 42 cases of complete DLM without tear were included. In all, 105 patients with normal lateral menisci were included as a control group. We measured the ratio of the shortest width of the lateral meniscus to the longest width of the tibia (ratio 1) and the ratio of the shortest width of the medial meniscus to the shortest width of the lateral meniscus (ratio 2). Results By applying a cutoff value of ratio 1 as 0.32 between two incomplete and complete DLM groups, the proportion of the complete and incomplete DLM diagnosed cases among the true cases were 84% and 94%, respectively. By applying a cutoff value of ratio 2 as 0.40 between two incomplete and complete DLM groups, the proportion of the complete and incomplete DLM diagnosed cases among the true cases were 84% and 75%, respectively. Conclusion A cutoff value of 0.32 using the ratio of the shortest width of the lateral meniscus and the longest width of the tibia are probably useful to help distinguish between complete DLM and incomplete DLM. Additionally, the new ratio using the width of the medial meniscus is also useful to improve distinguishing between the types of DLM. J. Magn. Reson. Imaging 2013;38:417–421. © 2013 Wiley Periodicals, Inc.

Purpose The purpose of this study is to report the clinical course of fatigue-type subchondral fractures of the femoral head in young healthy adults. Materials/Methods We retrospectively reviewed 28 consecutive patients (34 hips) who had a clear history of a sudden increase in physical activity without trauma on the hip and pelvis, and were diagnosed as having a fatigue-type subchondral fracture of the femoral head. The diagnosis was made primarily on the basis of sequential plain radiographs and magnetic resonance images. Results Of the 34 hips, 19 hips with no bony collapse experienced gradual disappearance of subjective pain a few months after onset, and there were no recurrences. Other 2 hips that showed bony collapse, but preserved the articular margin, also experienced no definite deterioration of collapse or arthritic change and did not need surgical intervention. In the remaining13 hips with bony collapse and destroyed articular margin or arthritic change, hip pain gradually worsened necessitating surgery. Conclusions The current findings suggest that a subchondral fatigue fracture of the femoral head could show a different severity of subchondral injury over time. In the collapsed subchondral fatigue fractures, especially when combined with head incongruency, the hip pain was aggravated enough to require surgical intervention.

In France, there are many forms of organizations based on the intercommunal solidarity for city development and management. The purpose of the collaboration among Communes is to achieve high quality and well-equipped service-delivery system through co-operation of public services needed grand finances : water supply and sewage system and waste disposal system etc. The cooperation among French Communes and its effects, even though these were owing to the existing French local administration system, continued throughout regional co-management and social co-development process. This study suggested some characteristics and implications of the collaborative-style French new-town development and management organizations focused on the EPA, SAN and CA. First, the role of developmental corporation like EPA and its collaborative structure of decision-making are meaningful, because in these ways many related Communes could share a goal of new town development. Second, the way of new town corporation (SAN) is important in the sense of enabling the Communes to collaborate with each others while maintaining autonomy, so those are not simply state-directed objects, which was very difficult in the former French local administration system. Finally, transforming to CA (Communautes d'agglomeration:city community), EPA as an intercommunal corporation is possible to extend its purpose to the domain of regional planning including new town and periphery areas and change its position to a subject which can practice Commune’s sustainable development according to stages of city's development and maturity. The most important implication of this study on urban development in Korea is that administrative consultative council or association among local governments and related authorities need to be established and effectively operate because multi-stakeholders could share a goal of urban development and management through that.Key words: French New Town, Collaborative Urban Management, EPA (Etablissement Public d’amenagement), SAN (Syndicat d’agglomeration nouvelle), CA (Communautes d’agglomeration)

Structured abstracts have been regarded as an essential information factor to represent topics of journal articles. This study aims to provide an unconventional view to utilize structured abstracts with the analysis on sub fields of a structured abstract in depth. In this study, a structured abstract was segmented into four fields, namely, purpose, design, findings, and values/implications. Each field was compared in the performance analysis of document clustering. In result, the purpose statement of an abstract affected on the performance of journal article clustering more than any other fields. Furthermore, certain types of keywords were identified to be excluded in the document clustering to improve clustering performance, especially by Within group average clustering method. These keywords had stronger relationship to a specific abstract field such as research design than the topic of an article.

Aim To compare three-dimensional (3D) isotropic T2-weighted magnetic resonance imaging (MRI) sequences and reformation with two-dimensional (2D) T2-weighted sequences regarding image quality of the cervical spine at 3T. Materials and methods A phantom study was performed using a water-filled cylinder. The signal-to-noise and image homogeneity were evaluated. Fourteen ( n =14) volunteers were examined at 3T using 3D isotropic T2-weighted sagittal and conventional 2D T2-weighted sagittal, axial, and oblique sagittal MRI. Multiplanar reformation (MPR) of the 3D T2-weighted sagittal dataset was performed simultaneously with image evaluation. In addition to artefact assessment, the visibility of anatomical structures in the 3D and 2D sequences was qualitatively assessed by two radiologists independently. Cohen's kappa and Wilcoxon signed rank test were used for the statistical analysis. Result The 3D isotropic T2-weighted sequence resulted in the highest signal-to-noise ratio (SNR) and lowest non-uniformity (NU) among the sequences in the phantom study. Quantitative evaluation revealed lower NU values of the cerebrospinal fluid (CSF) and muscles in 2D T2-weighted sagittal sequences compared to the 3D volume isotropic turbo spin-echo acquisition (VISTA) sequence. The other NU values revealed no statistically significant difference between the 2D turbo spin-echo (TSE) and 3D VISTA sequences (0.059 p 0.959). 3D VISTA images showed significantly fewer CSF flow artefacts ( p 0.001) and better delineated intradural nerve rootlets ( p = 0.001) and neural foramina ( p = 0.016) compared to 2D sequences. Conclusion A 3D T2 weighted sequence is superior to conventional 2D sequences for the delineation of intradural nerve rootlets and neural foramina and is less affected by CSF flow artefacts.

The research which it sees is the simulation research for "The Ecological Diversion of Forest Land-Use System". It accomplished the simulation which applies a permission standard, it developed escape it did a model and the basic draft. From the research which it sees in order to investigate the application characteristic of natural intimate mountain district application standard the mountain district whole aspect instance middle actual object a time mountain district use standard about under selecting which it will yell it applied. "Natural intimate mountain district development standard triangular position plan research" from compatibility of the mode of life mountain district whole aspect permission standard which is proposed about under investigating it presented the improvement program and a institutional improvement direction of corresponding standard. About under preserving plan it applies the yearly environment the mountain district to sleep it prepares the foundation for it accomplished the transcendental research for. With the achievement resources which the mountain district has resultantly must preserve a value, limit of the development size it will be able to minimize the effect which it follows in development, the arrangement method back could be proposed, also the case which will use the mountain district where it is damaged induces the development which cabinets to the concept of demobilization, the case which will apply the existing forest resources takes a triangular position with the act it will be able to increase the circulating value of the resources and will do.

The purpose of this study was to examine a developed surgical technique by performing a mid-term evaluation of clinical and stability results and complications.Thirty patients who underwent transtibial posterior cruciate ligament (PCL) reconstruction using a bioabsorbable cross-pin tibial back side fixation method were enrolled in this prospective study. Lysholm and International Knee Documentation Committee (IKDC) knee scales were used to evaluate clinical outcomes. Stability was evaluated using a Telos device with a 150 N force at 90 degrees of knee flexion. Follow-up magnetic resonance imaging (MRI) was also performed in 20 (66.7%) patients, and complications were evaluated. Those with complication by MRI were assigned to an abnormal MRI group.The follow-up period was 47 (range, 25-62) months. On comparing preoperative and final follow-up clinical results, Lysholm and IKDC knee scale scores were found to have improved significantly (P 0.001). The mean side-to-side difference in posterior translation measured using a Telos device was 13.4 ± 3.1 mm (range 10-20 mm) preoperatively and 3.2 ± 1.5 mm (range 1-7 mm) at last follow-up, which represented a significant improvement in stability (P 0.001). Five patients showed cyst formation in the tibial tunnel and two patients showed a significant signal increase at the anterior portion of the tibial tunnel, which was believed to indicate a pro-cystic status. The normal and abnormal MRI groups had similar Lysholm and IKDC knee scale scores and stress radiographs (P 0.05).Single-bundle transtibial PCL reconstruction using a bioabsorbable cross-pin tibial back side fixation was found to produce satisfactory clinical and stability results. However, despite these satisfactory results, a potential complication of tibial cyst formation was observed.Case series, Level IV.

The purpose of this study was to evaluate the accuracy of the characteristic magnetic resonance imaging (MRI) findings of medial meniscal root tear in the coronal, sagittal and axial planes. Thirty arthroscopically diagnosed patients who had undergone preoperative knee MRI were included in this study. They were compared to 30 age-matched patients with medial meniscus tears without root tears. The findings used for imaging analysis were as follows: the radial tear on the meniscal root of the medial meniscus in the axial plane, the presence of the truncation sign in the coronal plane and the ghost meniscus sign in the sagittal plane. Meniscal extrusion in the coronal plane was also evaluated. All the MRI findings of both groups were statistically analyzed. All the findings were more frequently found in the root tear group than those in the control group (P

This study is to derive a project model based on potential demand for Korean-style houses, focusing on new town detached housing sites that LH supplies and to test validity of the derived model and to present the direction and supply methods of the projects. The existing high-class new town Korean-style housing developments that have been considered were found to have little business value due to problems in choice of location and discordance of demand, so 6 types of projects were established through the methods of changes in planned scale, combined use, and subdivision of plot of land based on the results of survey. The type that has the highest business value among the project models was block-type multifamily houses, and this can be interpreted as the increase in total construction area leading to increase inrevenues of allotment sales due to economies of scale. The feasibility of mass housing model in which small-scale Korean-style houses are combined with amenities was found to be high, and if the same project conditions as those of the block-type multifamily houses are applied, the business value of the Korean-style tenement houses was found to be high. Besides, the high-class housing models within block-type detached housing areas are typical projects that the private sector generally promotes, and the construction cost was found to be most expensive with 910 million won per house. In order to enhance the business value of the Korean-style housing development, collectivization such as choice of location, diversification of demand classes, optimization of house sizes, and combination of uses is needed. And in order to adopt Korean-style houses in the detached housing sites, the adjustments and division of the existing planned plots are needed, and the strategies to cope with new demand through supplying Korean-style housing types of sites can be suggested. Also breaking away from the existing uniform residential development methods, the development method through supplying original land that is natural land not yet developed besides basic infrastructures (main roads and water and sewage) can be considered, and as the construction of more than 1~2 stories building is impossible due to the structure of Korean-style house roof and furniture. So it can be suggested that original land in the form of hilly land is considered to be most suitable to large-scale development projects.

Background: The correlation between graft appearance and clinical outcome after double-bundle anterior cruciate ligament (ACL) reconstruction is a major concern. In this study, the graft appearance was assessed with use of second-look arthroscopy and was correlated with the clinical outcome. Overall clinical outcomes after double-bundle ACL reconstruction with use of a single tibial tunnel were analyzed. Methods: Thirty-seven knees that underwent second-look arthroscopy after double-bundle ACL reconstruction and sixty-two knees that underwent double-bundle ACL reconstruction without subsequent second-look arthroscopy were included in this retrospective study. The ninety-nine patients enrolled were followed for thirty-five months (range, twenty-four to fifty-eight months), and the mean duration from ACL reconstruction to second-look arthroscopy was twenty-five months (range, twelve to thirty-six months). Graft thickness, apparent graft tension, and synovial coverage were graded during second-look arthroscopy. Correlations were sought between graft appearance and Lysholm knee scores, International Knee Documentation Committee (IKDC) grades, anterior laxity, and pivot-shift test results. Results: Postoperatively, ninety-four (94.9%) of the ninety-nine knees had an IKDC rating of B or higher, mean anterior laxity was 1.29 mm (range, 0 to 6 mm), and ninety-two knees (92.9%) had a negative pivot-shift result. With regard to graft thickness and tension, anteromedial bundles were graded as A in twenty-eight (75.7%) of the thirty-seven second-look knees and as B in nine knees (24.3%). Posterolateral bundles were graded as A in twenty-five knees (67.6%), B in six knees (16.2%), and C in six knees (16.2%). With regard to synovial coverage, anteromedial bundles were graded as C in only two knees (5.4%) and posterolateral bundles were graded as C in six knees (16.2%). No correlation was found between graft appearance and clinical outcome. Conclusions: In the present study, we observed that clinical outcomes were as satisfactory with a single tibial tunnel as with two tibial tunnels. However, more tears and poorer synovial coverage were observed for posterolateral than for anteromedial bundles during second-look arthroscopy. No significant correlation was found between graft appearance and clinical outcome. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Nontuberculous mycobacterial infections can cause destructive tenosynovitis of the hand. We report on and discuss the clinical course and distinctive radiologic findings of two patients with hand tenosynovitis secondary to M. marinum and intracellulare infection, which are different from those of the nontuberculous mycobacterial infections reported in the previous literature.

The purpose of the paper is to research issues and implications on a large-scale enlargement of urban area in city management plan. This study investigated laws and regulations in force and carried out case study for three cities such as Yangju-si, Gimpo-si, Whaseong-si. As a result of analysis, three points at issue were abstracted and improvement ideas for each of them were suggested as follows. First, to set up adequate size of urban area, it is necessary to consider resonable planning for population, spatial structure, zone of life and land use in city comprehensive plan and city management plan. Second, to decrease arguments about scope and bounds of urban area, it is important to make general and specific guidelines to set up them. Third, to manage new urban area and its surroundings efficiently, it is necessary to subdivide zoning of non-urban area strictly, to restraint individual location of factories or cattle sheds, to make a proper infrastructure plan in advance, to administer strongly the permission of development behavior and to control strictly consecutive and joining development in non-urban area.

To determine the quantitative difference between an intact complete discoid lateral meniscus (CDLM) and a torn CDLM on MR imaging.Between May 2005 to November 2009, 137 patients with a CDLM (107 intact CDLM and 30 torn CDLM) and 92 patients with a normal meniscus were included in this study. The evaluated parameters were the height of the posterior horn of the lateral and medial menisci on the sagittal images and their ratio as assessed by two observers twice at an interval of 1 month. Each parameter was analyzed based on the Kruskal Wallis test, and the analysis using the mixed model. Intraclass correlation coefficient (ICC) was used to determine the interobserver reliabilities at session 2.The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CLDM, and a normal meniscus were 6.5, 7.3, 5.7 and 6.6, 6.4, 6.7 mm at session 1, respectively. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CDLM, and a normal meniscus for both observers were 6.5, 7.2, 5.7 and 6.6, 6.3, 6.8 mm at session 2, respectively. The ratio of the height of the lateral to the height of the medial meniscus for an intact CDLM at both sessions for both observers was 1.0. The ratios were 1.2 and 0.8 for a torn CDLM and for a normal meniscus, respectively, at both sessions for observer 1. The ratios were 1.2 and 0.9 for a torn CDLM and for a normal meniscus, respectively, at session 2 for observer 2. The heights of the posterior horn of the lateral meniscus on the sagittal images and the ratios of the heights of the lateral to the medial menisci in all three groups were statistically significantly different for both sessions (p 0.0001). The interobserver ICCs for each parameter of both an intact CDLM and a torn CDLM at session 2 showed high correlations (p 0.0001).The height of the lateral meniscus and the ratio of the height of the lateral to the height of the medial meniscus for a torn CDLM were significantly higher than those for an intact CDLM.

Kirner deformity is characterized by volar and radial incurvature of the distal phalanx of the 5th finger. A proposed causative mechanism includes abnormal distal insertion of the flexor digitorum profundus tendon along the volar surface of the distal phalanx of the 5th finger. A chronic inflammatory process or altered vascularisation of the soft tissues has also been suggested as the underlying causative mechanism based on MRI findings. We present a teenage boy with Kirner deformity, along with supplementary imaging of his father who also has the deformity, to illustrate MRI findings that dispute the above hypotheses. MRI in both son and father show normal insertion of the deep flexor tendon and no signs of inflammation.

In this study, research topic areas in Korean and American medical schools were analyzed to detect each nation's major research areas. CLINICAL NEUROLOGY was identified as the Korean researchers' major subject area by the total number of journals and 'RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING' was the most major area by the total number of articles. On the other hand. American researchers' top major subject area was the one same area according to all analysis, BIOCHEMISTRY & MOLECULAR BIOLOGY. In addition, Korean researchers showed publishing tendency related to journal preference in several subject areas.

The purpose of this study was to determine whether there are preoperative magnetic resonance imaging (MRI) variables that could predict the repairability of large to massive rotator cuff tears (RCTs), especially in terms of distinguishing between complete repair and incomplete repair.Fifty-one consecutive patients who had large to massive RCTs were treated by arthroscopic repair with suture anchors. The primary repair was subclassified into 4 types. Types I and II were complete repairs with coverage of the lateral end of the greater tuberosity footprint (type I) or to the medial one half or less of the footprint (type II). Types III and IV were incomplete repairs with either small exposure of the humeral head (10 mm) (type III) or moderate exposure of the head with repair of the force couple of the rotator cuff (type IV). Six preoperative MRI measurements (fatty degeneration index [FDI] in all planes, occupational grade, tangent sign, coronal oblique tear distance [COTD], sagittal oblique tear distance [SOTD], and coronal oblique thickness) that were reported in the previous literature were examined. These measurements were correlated with our classification of repair.There were 28 large and 23 massive tears. Interobserver reproducibility was good to excellent. When we compared the completely and incompletely repaired groups, the FDI values for sagittal oblique sections of the supraspinatus and the infraspinatus and the FDI values for COTD and SOTD showed statistically significant differences. The cutoff values for SOTD and COTD were 32 mm and 31 mm, respectively. Regarding FDI, values greater than 3 on sagittal oblique sections of the supraspinatus and greater than 2 on sagittal oblique sections of the infraspinatus can be discouraging findings for complete repair.On preoperative MRI of RCTs, FDI values of greater than 3 on sagittal oblique sections of the supraspinatus and greater than 2 on sagittal oblique sections of the infraspinatus with greater than 31 mm in COTD and 32 mm in SOTD can imply incomplete arthroscopic repair of the torn tendon or type III/IV repair.Level II, development of diagnostic criteria based on consecutive patients with universally applied gold standard.

Background: Ankylosing spondylitis (AS) may affect peripheral joints, with the shoulder, hip, and knee being well known involved sites. However, involvement of the proximal tibiofibular (PTF) joint has not yet been investigated. Purpose: To evaluate PTF joint abnormalities in patients with AS. Material and Methods: From July 1997 to June 2005, 16 patients (15 male, one female; mean age 25 years), who were clinically diagnosed with AS, underwent magnetic resonance imaging (MRI) to evaluate knee pain. All patients also underwent plain radiographs of the knee, lumbar spine, and pelvis. Twenty knee MRIs (bilateral in four patients) and 16 sets of knee, lumbar spine, and pelvic radiographs were retrospectively reviewed in order to evaluate possible AS involvement. The presence of abnormalities suggesting AS involvement were recorded separately in the sacroiliac joints, lumbar spine, hip, and femorotibial and PTF joints. If the PTF joint showed any pathologic findings, the radiologic findings were recorded. Results: Three of 16 patients (18.7%) had pathologic features of the PTF joint observed by plain radiographs or MRI. One of these three patients showed bilateral involvement of the PTF joints on plain radiographs, while the other two patients showed unilateral involvement on MRI. Subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity were identified on MRI. Plain radiographs of two patients revealed subchondral sclerosis and spur formation in the PTF joint. The frequencies of involvement of other joints in the 16 patients were as follows: lumbar spine, n=5 (31%), hip joint, n=1 (6%) (identified by plain radiographs), and femorotibial joints, n=10 (62.5%) (identified by knee MRI). Conclusion: MR imaging of the PTF joint can depict synovial changes and their effect on joint structures in patients with AS. The MRI findings of AS involving the PTF joints are subchondral sclerosis, cartilage abnormality, erosion, and abnormal bone marrow signal intensity.

The purpose of this study was to document the relationship between a discoid lateral meniscus and a thickened Wrisberg ligament with a higher location on the medial femoral condyle.Between July 2002 and February 2006, 100 consecutive patients who had a complete lateral discoid meniscus and another 100 patients without a discoid lateral meniscus (control group) were included. Two radiologists retrospectively reviewed all of the magnetic resonance images, paying particular attention to the presence and thickness of the Wrisberg ligament and the location of the attachment of the Wrisberg ligament to the medial femoral condyle (types I, II, or III). We assumed that type I Wrisberg ligaments had a higher location.All 141 patients had a Wrisberg ligament (71%). There were 73 patients (73%) in the discoid group and 68 patients (68%) in the non-discoid group. The mean thickness of the Wrisberg ligament in the patients in the discoid and non-discoid groups was 2.1 mm (range, 0.4-4.7 mm; median, 2.1 mm) and 1.6 mm (range, 0.4-4.5 mm; median, 1.3 mm), respectively. The Wrisberg ligaments of the discoid group were thicker than the non-discoid group (p = 0.0002). The Wrisberg ligament was attached to the upper part of the medial femoral condyle in the discoid group more often than in the non-discoid group (p0.0001).

Primary liposarcoma of the liver is extremely rare. We report here on a case of primary well-differentiated liposarcoma in the left hepatic lobe of a 63-year-old woman. Abdominal ultrasonography showed a well-defined, echogenic, round mass. Abdominal computed tomography (CT) and magnetic resonance (MR) images showed an almost fatty, lobulated mass with a few, random distributed vascular structures and a small area of nodular enhancement. The resected tumor appeared as a well-defined, round, tan-yellow mass. Histological analysis showed a well-differentiated liposarcoma.

Instruction is an emerging critical factor of library services and the practice of instructional activities has expanded to related various areas. This study analyses librarian job advertisements to identify roles, responsibilities, and job qualifications of instruction librarian. Findings include reference services and collection development are important Parts for instruction librarians` work as well as instructional activities. Knowledge on web and instructional applications are also emphasized in the job description of instruction librarians.

OBJECTIVE. The purpose of this article is to describe the MRI features of giant cell tumors of the spine in 10 patients.CONCLUSION. One of the tumors was located in C7. The other nine tumors were located in the thoracic spine, lumbar spine, and sacrum, three in each site. The characteristic findings included an expansile mass with heterogeneous low to intermediate signal intensity on the T2-weighted images (10/10), a curvilinear area of signal void on T1- and T2-weighted images (9/10), and cystic changes within the mass (4/10). Although no imaging feature was pathognomonic, MRI was found to be valuable in identifying the tumor, revealing its extent, and defining its relationship with the intraspinal structures.

Background Anatomic limb alignment often differs from mechanical limb alignment after total knee arthroplasty (TKA). We sought to assess the accuracy, specificity, and sensitivity for each of three commonly used ranges for anatomic limb alignment (3-9°, 5-10° and 2-10°) in predicting an acceptable range (neutral ± 3°) for mechanical limb alignment after TKA. We also assessed whether the accuracy of anatomic limb alignment was affected by anatomic variation. Methods This retrospective study included 314 primary TKAs. The alignment of the limb was measured with both anatomic and mechanical methods of measurement. We also measured anatomic variation, including the femoral bowing angle, tibial bowing angle, and neck-shaft angle of the femur. All angles were measured on the same full-length standing anteroposterior radiographs. The accuracy, specificity, and sensitivity for each range of anatomic limb alignment were calculated and compared using mechanical limb alignment as the reference standard. The associations between the accuracy of anatomic limb alignment and anatomic variation were also determined. Results The range of 2-10° for anatomic limb alignment showed the highest accuracy, but it was only 73 % (3-9°, 65 %; 5-10°, 67 %). The specificity of the 2-10° range was 81 %, which was higher than that of the other ranges (3-9°, 69 %; 5-10°, 67 %). However, the sensitivity of the 2-10° range to predict varus malalignment was only 16 % (3-9°, 35 %; 5-10°, 68 %). In addition, the sensitivity of the 2-10° range to predict valgus malalignment was only 43 % (3-9°, 71 %; 5-10°, 43 %). The accuracy of anatomical limb alignment was lower for knees with greater femoral (odds ratio = 1.2) and tibial (odds ratio = 1.2) bowing. Conclusions Anatomic limb alignment did not accurately predict mechanical limb alignment after TKA, and its accuracy was affected by anatomic variation. Thus, alignment after TKA should be assessed by measuring mechanical alignment rather than anatomic alignment.

Aim To retrospectively identify signs predictive of malignant intraductal papillary mucinous tumour (IPMT) of the pancreas on computed tomography (CT) images. Materials and methods Thirty-four benign and 21 malignant pancreatic IPMTs were evaluated. Preoperative helical CT images in these 55 cases of pathologically proven pancreatic IPMT were reviewed by two radiologists unaware of the histological grading. Tumour morphological types, locations, numbers and sizes of cystic lesions, maximum main pancreatic duct diameters, the presence of septa, mural nodule, wall thickening, and calcification in cysts, communication with the main pancreatic duct, peripancreatic haziness, protrusion of duodenal papilla, pancreatic atrophy, lymphadenopathy and distant metastasis were analysed using univariate and multivariate analysis. Results Main duct IPMTs were more likely to be malignant (71%) than branch duct (23%) or combined type IPMTs (28%; p = 0.002). Among the branch duct type and combined types, large cystic lesion (p = 0.018), the presence of a mural nodule (p = 0.018), a thickened wall (p = 0.009), and peripancreatic haziness (p = 0.039) were found to predict malignancy. Conclusion CT is helpful in the preoperative differentiation of malignant and benign pancreatic IPMT. The presence of a dilated main pancreatic duct, mural nodules, thickened wall and peripancreatic haziness may be used as independent predictive signs of malignancy.

This study aims to suggest an effective way to enhance question-answer(QA) document retrieval performance by reconstructing queries based on the structural features in the QA documents. QA documents are a structured document which consists of three components : question from a questioner, short description on the question, answers chosen by the questioner. The study proposes the methods to reconstruct a new query using by two major structural parts, question and answer, and examines which component of a QA document could contribute to improve query performance. The major finding in this study is that to use answer document set is the most effective for reconstructing a new query. That is, queries reconstructed based on terms appeared on the answer document set provide the most relevant search results with reducing redundancy of retrieved documents.

PURPOSE: To evaluate quantitative functional ultrasonography (US) in a murine gel model by using microbubble destruction kinetics to determine whether parametric indices provided with US could help assess angiogenesis. MATERIALS AND METHODS: Institutional Animal Subjects Committee approved experiments and procedures. In 36 normal mice, two 0.4-mL gel implants were placed subcutaneously on either side of spine. One implant contained 0.5, 1.0, or 1.5 microg human basic fibroblast growth factor (bFGF) per milliliter of gel. Functional US quantitative analysis of angiogenesis with microbubble contrast agent was performed on days 3, 6, 9, and 12; histologic data were collected. Time-intensity curve of implant was fitted to mathematic decay model to calculate fractional blood volume and fraction of blood replaced per unit of time. Microvascular density (MVD) and percentage of microvascular area (MVA) were measured after anti-CD31 staining. Spearman rank order correlation was used in analyses. RESULTS: bFGF-containing implants induced MVD of eight, 35, 42, and 42 vessels per square millimeter on days 3, 6, 9, and 12, respectively; in controls, MVD was four vessels/mm2 (P

As the number of users who ask and give answers in the query-answer documents retrieval system is growing exponentially, the query-answer document become a crucial information resource, as a new type of information retrieval service. A query-answer document Consists of three structural parts : a query, explanation on query, and answers Chosen by users who asked the query. To identify the role of each structural part in representing the topics of documents, the three structural parts were clustered automatically and the results of several clustering tests were compared in this study.

This experimental study proposes a multi-document summarization method that produces optimal summaries in which users can find answers to their queries. In order to identify the most effective method for this purpose, the performance of the three summarization methods were compared. The investigated methods are sentence clustering, passage extraction through spreading activation, and clustering-passage extraction hybrid methods. The effectiveness of each summarizing method was evaluated by two criteria used to measure the accuracy and the redundancy of a summary. The passage extraction method using the sequential bnb search algorithm proved to be most effective in summarizing multiple documents with regard to summarization precision. This study proposes the passage extraction method as the optimal multi-document summarization method.

Our goal was to develop a reliable technique that has minimal operator dependence for quantifying lymph node enhancement to test and optimize new sonography contrast formulations.Twenty healthy rabbits were studied using five agents, labeled A-G. Agents D and E were the same agent and agents F and G were Imagent, studied blindly to test reproducibility. One milliliter of contrast agent was injected into each hind footpad. A 13-MHz transducer was fixed over the popliteal node, which was imaged at a 4.8-MHz central transmit frequency using phase-inversion technology at 100% power and one frame per second. Immediately after each injection, the footpad was massaged 12 times for 30 sec each time and then imaged after each massage to assess the number of times the node could be refilled from each injection. Lymph node video intensity was measured, and the degree of enhancement was evaluated using analysis of variance with the massage number and the agent used as independent variables.Lymph node enhancement was observed after the first massage with all agents. Degree of enhancement was least with agents A and B, intermediate with agents D and F, and greatest with agent C. Agent A was effective after the first two massages, agent B after the first four, agent C after all 12, agent D after the first eight, and agent F after the first nine. Performance of agents D and F was similar to that of their duplicates, E and G.We established a reproducible technique to quantify lymph node enhancement that can distinguish between different agents. The differences in performance suggest that it is possible to optimize agent formulation for indirect sonographic lymphography.

Rationale and Objectives. To optimize an angiogenesis model for imaging research that is stable and can be imaged several times over the angiogenic time course. Materials and Methods. Mice and rats received two injections of 0.4 mL of extract of basement membrane matrix (Matrigel; Becton Dickinson Labware, Bedford, MA) in the subcutaneous spaces on either side of the spine. One of the two Matrigel plugs in each animal had either 0.1 μg/mL of basic fibroblast growth factor (bFGF) (11 mice), 1.0 μg/mL of bFGF (12 mice, 5 rats), or 1.0 μg/mL of bFGF and 60 U/mL of heparin (11 mice). Three to 12 days after implantation, animals were imaged before and after the administration of up to four injections of 0.1 mL AF0150. Phase inversion imaging was used on a Siemens Elegra (Siemens ultrasound, Issaquah, WA) equipped with a 13 MHz VFX transducer. Three observers subjectively assessed the pattern of enhancement using a four-point scale. The Matrigel plugs were then removed and two observers graded the angiogenic response on a four-point scale. Ten Matrigel plugs, five with 1.0 μg/mL bFGF and five without, were evaluated histologically following immunohistochemical staining with anti-CD31. Results. The angiogenic response was greater in Matrigel plugs with 1.0 than with 0.1 μg/mL of bFGF. Heparin did not increase the angiogenic response. Vessels were predominantly at the periphery of the plugs with variable central penetration. Plugs appeared anechoic and homogeneous on ultrasound. Contrast enhancement within the plug occurred in 44% of mice with an angiogenic response at or after day 6 and the enhancement increased with the angiogenic response. In the others, peripheral enhancement could not be distinguished from the enhancement of surrounding tissues that were also hyperemic. The thicker rat skin interfered with plug assessment. Conclusion. A stable angiogenesis model without the complexity of tumors is described. This model offers the opportunity to image the development and/or inhibition of angiogenesis. Neovasculature in Matrigel was detectable using ultrasound contrast. Quantitative studies correlating the degree of enhancement to microvascular density will be determined in subsequent studies.

The main purpose of this research is to look into not only how users evaluate two major databases(BIST and SATURN) of the scientific and technical literature in Korea, but also what users expect from scientific and technical information services in general. The result of the user evaluation shows that there is a very little difference between two databases in database quality. It was found that BIST is better than SATURN in terms of accuracy, customer support, searching capability, and currency, whereas SATURN is preferred to BIST for completeness and the average number of retrieved items. User expectation for scientific and technical information is also investigated by surveying its user community. Among three user groups, there is notable disagreement in language uses to search non-korean literature. Each group also shows different demands for translation of original literature. This study attempted to evaluate the quality of the scientific and technical information (BIST and SATURN) and simultaneously to investigate users demands in general. By doing so, the specificity implied in quality evaluation of specific information services as well as the generalization of the users behaviors in scientific and technical community were accommodated in this study.

Background Magnetic resonance imaging (MRI) may be useful to diagnose a posterolateral plica syndrome of the elbow joint because this syndrome has less clear clinical features. The purposes of this study were to document mediolateral and sagittal dimensions of a posterolateral synovial fold and to determine the proportion of subjects with the posterolateral plica in asymptomatic elbows. We also aimed to determine whether the dimensions of the posterolateral synovial fold and the prevalence of the plica differ between symptomatic and asymptomatic subjects. Materials and methods This retrospective review of prospectively collected data included 50 asymptomatic elbows (asymptomatic group) and 14 elbows with arthroscopically confirmed posterolateral plicae (plica group). The mediolateral and sagittal dimensions of the posterolateral synovial fold were measured. In addition, the criteria for the prevalence of posterolateral plica was determined with conventional MRI as synovial fold dimension ≥ 3 mm and coverage of radial head by synovial fold ≥ 30%. Results The plica group showed larger posterolateral synovial fold dimensions compared to the asymptomatic group. The median mediolateral and sagittal dimensions of the synovial fold in the asymptomatic group were 3.8 mm and 4.7 mm, respectively. Dimensions in the plica group were 7.0 mm and 7.4 mm, respectively. When the presence of posterolateral plica was determined using the dimension criteria, there was no difference in the prevalence of the plica between the asymptomatic and the plica group. However, using the coverage criteria, the prevalence of posterolateral elbow plica was significantly greater in the plica group than the asymptomatic group (64% vs. 18%; p < 0.001). Conclusions The patients who underwent arthroscopic surgery for posterolateral plica syndrome had larger dimensions of the posterolateral synovial fold and higher prevalence of the posterolateral plica on conventional MRI compared to the asymptomatic subjects.