PURPOSE: To evaluate the enhancement patterns revealed by dual-phase CT, and other characteristic features of nodular hepatic involvement of malignant lymphoma, and to determine the usefulness of this imaging modality in the differentiatial diagnosis of hepatic masses. MATERIALS AND METHODS: Seven cases that pathologically confirmed as nodular hepatic involvements of malignant lymphoma among patients who underwent dual-phase CT for the staging or follow-up of malignant lymphoma, and two that confirmed as primary lymphoma among patients who underwent dual-phase CT for differential diagnosis of nodular hepatic masses were evaluated. There were eight cases of non-Hodgkin 's lymphoma (NHL) and one of Hodgkin 's disease(HD). The findings were analysed in terms of the number, size, and contour pattern of the masses, the enhancement pattern seen on dual-phase CT, and whether or not the vascular structure of the mass was normal. RESULTS: Primary lymphomas were present in two patients(single mass, n=1; multiple nodules, n=1) and secondary lymphomas in seven (single mass, n=6; multiple nodules, n=1). The maximum size of main masses was mean 5.1(range, 2-12) cm, and the contor was smooth in three cases, ill-defined in three and lobulated in three. During the early phase, five patients showed homogeneous low attenuation, and heterogeneous enhancement was observed in four. During the late phase, three of the five showed peripheral enhancement and the other two showed the same low attenuation, while two of the four showed central low attenuation, one showed iso attenuation, and one showed heterogeneous enhancement. In four of the patients whose main mass was larger than the mean, vascular shadow passed through the mass (left portal vein, n=2; branches of the right portal vein, n=1; and branches of the hepatic artery, n=1). CONCLUSION: Where dual-phase CT demonstrated nodular hepatic involvement of malignant lymphoma, contrast enhancement varied and so differentiation from other hepatic masses such as metastatic adenocarcinoma and hepatocellular carcinoma was therefore difficult. Homogeneity and a lack of necrosis, even though a mass is large and has a smooth well-defined contour, no capsulation and normal vasculature, may suggest the nodular hepatic involvement of malignant lymphoma.
Adenocarcinoma ; Carcinoma, Hepatocellular ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Hepatic Artery ; Humans ; Lymphoma ; Necrosis ; Portal Vein

With technical advances, ultrasonography of musculoskeletal system has been an important imaging modality in variable disorders and has been popular. Real-time imaging and possible dynamic motion study are special advantages of ultrasonography, and particularly helpful in evaluation of tendon or ligament injury. The purpose of this article is to review the basic technique and disorders that dynamic ultrasonography is helpful or essential in diagnosis in upper extremity.
Extremities ; Ligaments ; Musculoskeletal System ; Tendons ; Upper Extremity

BACKGROUND: Hyaluronan (HA) is an unbranched glycosaminoglycan. It has been proposed that HA acts as a vehicle for cytokines due to the strong negative charge on its surface. We hypothesized that HA would function like a cytokine scavenger and reduce the inflammatory signaling cascade and this would lead to improved survival in rats suffering with endotoxemia. METHODS: Endotoxin (Salmonella, 10 mg/kg) or an equal amount of 0.9% NaCl (NS) was injected into the jugular vein of rats. HA (1,600 kDa, 0.35%) or NS was given at 0.1 mL/kg/h for 3 hours. HA or NS infusion was started at 4 hour after endotoxin injection. The rats were divided into the control and HA groups (n=16 for each group). The mean arterial pressure (MAP) was monitored during HA or normal saline infusion. Survival was assessed every 12 hours for 3 days throughout the experiment. RESULTS: The survival rate (%) of the rats treated with HA was higher (60%) than that of the controls (20%) when HA was infused 4 hours after lipopolysaccharide (LPS) injection. The bronchoalveolar lavage (BAL) fluid of the animals surviving HA or NS infusion 4 hours after LPS showed that the total cell counts and number of neutrophils were significantly (p<0.01) reduced in the HA treated groups compared with that of the controls (total cell count, 9.2x10(4)/mL vs. 61x10(4)/mL; neutrophils, 21x10(4)/mL vs. 0.2x10(4)/mL, respectively). There was no significant MAP difference between the HA or control groups either with or without endotoxin. CONCLUSION: Infusion of hyaluronan (1,600 kDa) reduced the BAL total cell count and the number of neutrophils and it improved the survival rate of the endotoxemic rats.
Animals ; Arterial Pressure ; Bronchoalveolar Lavage ; Cell Count ; Cytokines ; Endotoxemia ; Fees and Charges ; Hyaluronic Acid ; Jugular Veins ; Neutrophils ; Rats ; Stress, Psychological ; Survival Rate

A case of adrenogenital syndrome which occurred in a girl of the age of 5 years, having the chief complaint of the abnormal external genitalia such as enlarged clitoris, abnormal urethral meatus and pubic hairs, was herein presented with brief review of literatures.
Adrenogenital Syndrome* ; Clitoris ; Female ; Genitalia ; Hair ; Humans

Performing dynamic ultrasonography in the lower extremity is not so popular as performing dynamic ultrasonography in the upper extremity. However, performing this modality is essential for some diseases and it is very helpful for various other disorders too. The purpose of this article is to describe the basic technique and disorders that dynamic ultrasonography is helpful for or essential for making a diagnosis in the lower extremity and for diagnosing other miscellaneous diseases as well. We also include a review of the relevant medical literature.
Extremities ; Lower Extremity ; Upper Extremity

BACKGROUND: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. METHODS: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. RESULTS: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). CONCLUSION: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.
Blood Pressure ; Hospitals, Teaching ; Humans ; Immobilization ; Multidetector Computed Tomography ; Multivariate Analysis ; Obesity ; Outcome Assessment (Health Care) ; Perfusion ; Prognosis ; Protein C Deficiency ; Protein S Deficiency ; Pulmonary Embolism ; Retrospective Studies ; Risk Factors ; Stroke ; Thrombophilia ; Venous Thrombosis ; Ventilation

An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.
Aneurysm ; Azygos Vein ; Mediastinum ; Pulmonary Embolism ; Rupture ; Thoracic Surgery, Video-Assisted

An azygos vein aneurysm is a very rare cause of a posterior mediastinal mass. Once the diagnosis has been confirmed, no treatment is usually required. However, the aneurysm can thrombose, and this may lead pulmonary thromboembolism, or the aneurysm may rupture. In these instances, the excision of the mass is recommended. Video-assisted thoracic surgery techniques have considerably improved. If it is necessary to remove the aneurysm, video-assisted thoracic surgery may be a good option for surgical treatment. We report a case of an aneurysm of the azygos arch that was successfully resected by video-assisted thoracic surgery.
Aneurysm ; Azygos Vein ; Mediastinum ; Pulmonary Embolism ; Rupture ; Thoracic Surgery, Video-Assisted

BACKGROUND: A tuberculous destroyed lung is sequelae of pulmonary tuberculosis and causes various respiratory symptoms and pulmonary dysfunction. The patients with a tuberculous destroyed lung account for a significant portion of those with chronic lung disease in Korea. However, few reports can be found in the literature. We investigated the computed tomography (CT) findings in a tuberculous destroyed lung and the correlation with lung function. METHODS: A retrospective analysis was carried out for 44 patients who were diagnosed with a tuberculous destroyed lung at the Keimyung University Dongsan Hospital between January 2004 and December 2009. RESULTS: A chest CT scan showed various thoracic sequelae of tuberculosis. In lung parenchymal lesions, there were cicatrization atelectasis in 37 cases (84.1%) and emphysema in 13 cases. Bronchiectasis (n=39, 88.6%) was most commonly found in airway lesions. The mean number of destroyed bronchopulmonary segments was 7.7 (range, 4~14). The most common injured segment was the apicoposterior segment of the left upper lobe (n=36, 81.8%). In the pulmonary function test, obstructive ventilatory defects were observed in 31 cases (70.5%), followed by a mixed (n=7) and restrictive ventilatory defect (n=5). The number of destroyed bronchopulmonary segments showed a significant negative correlation with forced vital capacity (FVC), % predicted (r=-0.379, p=0.001) and forced expiratory volume in one second (FEV1), % predicted (r=-0.349, p=0.020). After adjustment for age and smoking status (pack-years), the number of destroyed segments also showed a significant negative correlation with FVC, % predicted (B=-0.070, p=0.014) and FEV1, % predicted (B=-0.050, p=0.022). CONCLUSION: Tuberculous destroyed lungs commonly showed obstructive ventilatory defects, possibly due to bronchiectasis and emphysema. There was negative correlation between the extent of destruction and lung function.
Bronchiectasis ; Cicatrix ; Emphysema ; Forced Expiratory Volume ; Humans ; Korea ; Lung ; Lung Diseases ; Lung Diseases, Obstructive ; Pulmonary Atelectasis ; Respiratory Function Tests ; Retrospective Studies ; Smoke ; Smoking ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary ; Vital Capacity

We report here a case of Hurthle cell adenoma with eggshell calcification that presented as a thyroid incidentaloma on ultrasonography (US) in a 58-year-old woman. The mass was hypoechoic with continuous eggshell calcification and intranodular vascularity as seen on gray-scale and power Doppler (PD) US. Hurthle cell adenoma should be considered in the differential diagnosis of a thyroid nodule with eggshell calcification.
Adenoma ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Thyroid Gland ; Thyroid Neoplasms ; Thyroid Nodule