BACKGROUND: Arterial blood gas analysis are highly susceptible to preanalytic error due to improper method of obtaining or handling the blood sample before analysis. The error in measurement of blood gas analysis are loss of CO2 by exposure to atmospheric air, effect of anticoagulant itself, temperature difference between the experimental subject and the measuring electrode and metabolic change which occur between blood sampling and measurement. METHOD: To study the effect of the delay in estimation of blood gas and drawn blood on values of blood gas partial pressure and pH. Blood sample were divided into 2 groups according to the method of storage, group I stored at 24~25degrees C(room temperature) under anaerobic condition. ;group II stored at 0~4degrees C(refrigerator) under anaerobic condition. The samples were analyzed by time interval through 180 minutes in each group. RESULTS: The result were as follows: 1) PaO2 decreased significantly after 10 mins in group I, whereas it decreased significantly after 20 mins in group II. 2) PaO2 increased significantly after 20 mins in group I, whereas it increased significantly after 120 mins in group II. 3) pH decreased significantly after 60 mins in group I, whereas it decreased significantly after 120 mins in group II. 4) No significant changes of bicarbonate and SaO2 were noted in each group CONCLUSION: From above results, it would be advisable to analyze the sample in a short period of time or to store in a refrigerator when the measuring will be delayed. So we highly recommend that blood gas analysis should be performed as soon as possible after sampling, especially within 10 minutes.
Blood Gas Analysis ; Electrodes ; Hydrogen-Ion Concentration ; Partial Pressure

PURPOSE: To prove whether the arterioportal shunt, especially transvasal shunt is one of the cause of the hypovascular hepatocellular carcinoma. MATERIALS AND METHODS: We evaluated the early phase images of table incremental dynamic CT and hepatic angiography in 20 cases of hepatoceltular carcinomas with transvasal arterioportal shunt. RESULTS: In hepatic arteriography, 18 cases were hypovascular and the remained 2 cases showed hypervascular tumor staining than surrounding normal hepatic parenchyme. In the early phase dynamic CT, 18 cases were hypodense(including 4 cases of focal hyperdensity in hypodense background), one was isodense and remaining one was hyperdense. CONCLUSION: Arterioportal shunt, especially transvasal shunt may make originally hypervasular hepato-cellular carcinoma to hypovascular lesion in the early phase dynamic CT or hepatic arteriography. In attempt to differentiate hepatic masses by tumor vascularity in recently widely used table incremental dynamic CT, the vascular patterns of the mass should be considered by close evaluation of vascular pattern of the liver, such as morphology of perfusion abnormality and arterioportal shunt, etc.
Angiography ; Carcinoma, Hepatocellular* ; Liver ; Perfusion

Desmoid tumor is a type of fibromatosis usually arise in deep musculo-aponeurotic structures, primarily of the trunk and extremities. It is characterized by proliferation of fibroblastic tissue and does not metastasize but may be locally aggressive. Eventhough the surgical margin reveals clean, recurrence often occurs. To analyze the extent of the tumor and homodynamic characteristics exactly, we performed IV bolus CT. Desmoid tumors show peripheral rim enhancement on early phase scan and more strong, central enhancement on late phase IV bolus CT, which reflects abundant fibroblastic components of the tumor. We report two cases of pathologically confirmed desmoid tumor performed IV bolus CT.
Abdominal Wall ; Extremities ; Fibroblasts ; Fibroma ; Fibromatosis, Aggressive* ; Recurrence

Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

BACKGROUND: Although actinic keratosis and Bowens disease ar considered as carcinoma in situ, most of them are biologically benign and dont progress to invasive squamous cell carcinoma. It is little known why they take the benign courses and which factors are involved in the tumorigenesis. Keratoacanthoma, self-regresi;ing benign tumor, may be sometimes or fused morphologically with well-differentiated squamous cell carcinoma. So it is necessary to find a useful marker to help us distinguish them. OBJECTIVES: We performed this study to gain a better understani ling of biologic behaviour and tumerigenesis of epidermal keiatinocytic neoplasms. METHODS: We investigated the expression of p53 protein and priliferating cell nuclear antigen (PCNA) by an immunohistochemical method on the formalin-fixed, araffinembedded tissue specimens of epidermal keratinocytic neoplasms. RESULTS: Fourteen out of 20 cases of squamous cell carcinoma(70.0%), 14 out of 22 cases of actinic keratosis(63.6%), and 13 out of 20 cases of Bowens disease(65.0%) showed p53 protein expression, but keratoacanthoma was negative. All the tumors studied sho ved significantly increased numbers of PCNA-positive eells when compared with normal epidermis and characteristic distribution pattern. of PCNA-positive cells. Most cases of actinic keratosis exhibited the basal dysplastic pattern, but Bo wenoid variants showed diffuse dysplastic pattern. Karatoacanthoma revealed the marginal pattern and Bowens disease showed the diffuse dysplastic pattern. Well-differentiated squamous cell carcinoria showed the basal dysplastic pattern, while poorly differentiated squamous cell carcinoma revealed d ffuse dysplastic pattern. CONCLUSION: Our results suggest that p53 mutation is a common and early genetic change in the epidermal tumorigenesis and may be used as a good marker for malignan transformation, but it does not seem to correlate with the biollagic behavior or prognosis of epidermal neoplasms. PCNA, which is considered as a proliferation-relaited marker, was expressed with chavaceristic distribution patterns according to the type of tumors, but the frequency of PCNA expression is unlikely to reflct the malignant potential of epidermal neoplasms.
Actins ; Bowen's Disease ; Carcinogenesis ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Epidermis ; Keratoacanthoma ; Keratosis, Actinic ; Prognosis ; Proliferating Cell Nuclear Antigen*

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

Authors compared early phase scan of the IV bolus CT (two phase incremental bolus dynamic CT) with late enhanecd scan similar to the conventional contrast enhanced CT for evaluation of the advantages of the IV bolus CT with two viewpoints of the pancreatic or peripancreatic mass and peripancreatic lymphadenopathy in 68 patients-28 cases of the pancreatic cancer, 6 cases of the pancreatitis and 34 cases of the pancreatic or peripancreatic metastasis. On the diagnosis of the pancreatic or peripancreatic mass, IV bolus CT could show the lesion(s) more easily in 41% (Grade II; 13/31) and much more easily in 34% (Grade III; 10/31) when compared with conventional contrast CT scan. The diagnosis of the peripancreatic lymph node involvement was also easy in 51%(Grade II; 20/39) and much easier in 37% (Grade III; 14/39). We thought that these differences were originated from the increase of the contrast between the lesion and normal portion because the early enhanced scans reflected the active blood flow change more exactly. Therefore IV bolus CT had advantages in comparison with the conventional drip infusion contrast CT in the diagnosis of the presence and pathologic extension of the pancreatic and peripancreatic lesion.
Diagnosis ; Infusions, Intravenous ; Lymph Nodes ; Lymphatic Diseases ; Neoplasm Metastasis ; Pancreatic Neoplasms ; Pancreatitis ; Tomography, X-Ray Computed

We performed IV bolus CT scan in 40 patients with final diagnosis of various hepatic masses in order to evaluate hemodynamic changes and differentiating characters of the lesions. Preenhanced, early and late phase post enhanced, and delayed CT scans were obtained with rapid IV bolus injection of contrast materials and table sliding method for pertinent scans. In hepatomas, early enhanced CT scan directly showed hypervascular change and active viable portion of the mass and late phase CT scan showed capsular enhancement. In addition, extracapsular invasion and post-embolization recurrence were more easily visualized. In hemangiomas, early and late enhancing types could be categorized according to the time of maximal enhancement. In metastatic liver malignancies and cholangiocarcinomas, specific findings were seen in early phase and delayed CT scans and not in conventional CT scan. In conclusion, IV bolus CT scan is a very useful CT method in demonstrating the characteristic hemodynamic patterns and in differential diagnosis of the hepatic masses.
Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Liver ; Methods ; Recurrence ; Tomography, X-Ray Computed*

Isolated heaptic tuberculous granuloma with no coexistent tuberculosis elsewhere in the body is extremely rare. We report a case of pathologically proven tuberculous granuloma in the liver followed with both IV bolus and portal CT scans. The lesion on preenhanced CT scan showed undefinable isodensity. After IV bolus injection, it showed poor enhancement with central low-density and surrounding hyperdenity due to compensatory hypervascularity of the left lobe of liver in early phase. It showed peripheral rim enhancement in late phase and in delayed phase showed relatively homogeneous but slightly decreased contract enhancement. On portal CT scan, it showed a hypodense portal defect similar to other hepatic mass lesions. During follow-up studies, it was a slowly growing mass which was more easily detectable by prtal CT scans than bolus CT scans.
Follow-Up Studies ; Granuloma* ; Liver ; Tomography, X-Ray Computed ; Tuberculosis