Although multiphasic CT is an efficient technique for determination of hepatocellular carcinoma (HCC), occasionally, diagnosis of HCC using multiphasic CT can be difficult. Herein we present a case of HCC that was indicative of a typical abscess on CT imaging and compared the image findings with the gross specimen. The patient's body temperature and laboratory results indicated that inflammation were in the normal range. This case emphasizes that not only imaging findings but also clinical presentation should be considered to achieve a correct diagnosis in clinical practice.
Abscess ; Body Temperature ; Carcinoma, Hepatocellular ; Inflammation ; Reference Values

BACKGROUND: There is a clinical need for a simpler measurement of global cardiac function incorporating elements of both systole and diastole. Doppler time index is theoretically regarded as a sensitive index of global left ventricular perfomance and defined as the sum of isovolumetric contraction time (IVCT) and isovolumetric relaxation time (IVRT) divided by ejection time (ET). This study was designed to determine the clinical usefulness of the Doppler time index in patients with left ventricular diastolic dysfunction as well as systolic dysfunction. METHODS: The study population consisted of 23 patients with hypertension as a diastolic dysfunction group, 16 patients with low ejection fraction as a systolic dysfunction group and 31 subjects with normal LV function. The ejection fraction (EF) was measured using M-mode echocardiography. Doppler profiles such as IVCT, IVRT and ET were obtained from Doppler echocardiography. The Doppler time index [ (IVCT+RT)/ET] was calculated from each Doppler velocity profiles. RESULTS: IVRT, IVRT/ET and (IVCT+VRT)/ET were significantly increased in the diastolic dysfunction group (120.5+/-19.5 msec, 0.45+/-0.1, 0.64+/-0.2, respectively:p<0.001, p<0.001, p<0.001, respectively) compared with normal subjects (66.1+/-17.4 msec, 0.25+/-0.0, 0.41+/-0.1). IVCT and IVRT were significantly increased and ET was significantly shortened in systolic dysfunction group (75.4+/-25.7, 144.0+/-39.5 msec, 242.7+/-46.5 msec respectively:p<0.001, p<0.05, p<0.05, respectively) compared with diastolic dysfunction group (50.4+/-23.0 msec, 120.5+/-19.5 msec, 276.8+/-44.6 msec, respectively). IVCT/ET, IVRT/ET and (IVCT+IVRT)/ET also were increased in patients with systolic dysfunction group (0.32+/-0.1, 0.61+/-0.2, 0.93+/-0.2 respectively:p<0.01, p<0.01, p<0.001, res-pectively) compared with diastolic dysfunction group (0.19+/-0.1, 0.45+/-0.1, 0.64+/-0.2). Ejection fraction calculated by M-mode parameters was significantly correlated with (IVCT+IVRT)/ET (correlation coefficient - 0.605, p<0.001). CONCLUSION: The Doppler time index was significantly difficient from normal subjects in patients with isolated LV diastolic dysfunction as well as in those with systolic dysfunction. Thus, this index can be used as a sensitive indicator of myocardial performance.
Diastole ; Echocardiography ; Echocardiography, Doppler ; Humans ; Hypertension ; Relaxation ; Systole ; Ventricular Dysfunction, Left

Ulcerative colitis is an inflammatory bowel disease (IBD) characterized by recurrent episodes of colonic inflammation and tissue degeneration in human or animal models. The contractile force generated by the smooth muscle is significantly attenuated, resulting in altered motility leading to diarrhea or constipation in IBD. The aim of this study is to clarify the altered contractility of circular and longitudinal smooth muscle layers in proximal colon of trinitrobenzen sulfonic acid (TNBS)-induced colitis mouse. Colitis was induced by direct injection of TNBS (120 mg/kg, 50% ethanol) in proximal colon of ICR mouse using a 30 G needle anesthetized with ketamin (50 mg/kg), whereas animals in the control group were injected of 50% ethanol alone. In TNBS-induced colitis, the wall of the proximal colon is diffusely thickened with loss of haustration, and showed mucosal and mucular edema with inflammatory infiltration. The colonic inflammation is significantly induced the reduction of colonic contractile activity including spontaneous contractile activity, depolarization-induced contractility, and muscarinic acetylcholine receptor-mediated contractile response in circular muscle layer compared to the longitudinal muscle layer. The inward rectification of currents, especially, important to Ca2+ and Na+ influx-induced depolarization and contraction, was markedly reduced in the TNBS-induced colitis compared to the control. The muscarinic acetylcholine-mediated contractile responses were significantly attenuated in the circular and longitudinal smooth muscle strips induced by the reduction of membrane expression of canonical transient receptor potential (TRPC) channel isoforms from the proximal colon of the TNBS-induced colitis mouse than the control.
Acetylcholine ; Animals ; Colitis ; Colitis, Ulcerative ; Colon ; Constipation ; Contracts ; Diarrhea ; Edema ; Ethanol ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Membranes ; Mice ; Mice, Inbred ICR ; Models, Animal ; Muscle, Smooth ; Muscles ; Needles ; Protein Isoforms

Veratrum patulum is a perennial plant with toxicity, which grows wild in the high mountain areas of Korea. Various types of steroidal alkaloids contained in Veratrum patulum are known to cause symptoms such as nausea, vomiting, bradycardia and hypotension. Twenty-three patients were admitted to our center with chief complaints of nausea and vomiting after ingesting leaves of Veratrum patulum. The mean age of the group was 44 years old and was comprised of 19 males and 4 females. Some patients showed hypotension and bradycardia with symptoms such as dizziness. Ten patients with severe bradycardia coupled with other symptoms received atropine administration. Nausea and vomiting were improved after the administration of anti-emetics. Blood pressure and the pulse rate were all normalized on the day after admission, and all of the patients were discharged without any symptoms.
Alkaloids ; Antiemetics ; Atropine ; Blood Pressure ; Bradycardia ; Dizziness ; Female ; Heart Rate ; Humans ; Hypotension ; Korea ; Male ; Nausea ; Plants ; Veratrum ; Vomiting

Fundic gland hyperplasia is a hyperplasia of glandular portion on epithelium of gastric fundus or body. The incidence of fundic gland hyperplasia is 1.4% in the general population. Fundic gland hyperplasia is the most common cause of multiple polyposis. Probably the most cause of fundic gland hyperplasia is a hamartomatous origin but some hyperplastic origin because of spontaneous remission. We have experienced and reported a case of atypical fundic gland hyperplasia confirmed by endoscopic mucosal resection.
Epithelium ; Gastric Fundus ; Hyperplasia* ; Incidence ; Remission, Spontaneous

Percutaneous radiologic gastrostomy (PRG) is an enteral nutritional method that can be applied to a patient with dysphagia due to cerebrovascular accident, Parkinsonism, dementia, or head and neck cancer. PRG is a safe and cost-effective method with low morbidity and mortality rates compared with surgical gastrostomy, because it require less sedation and less invasive placement technique. PRG complications include wound infections, peritonitis, tube malfunctions, peristomal leakage, bleeding, ileus, pneumoperitoneum, aspiration pneumonia, and bowel perforation. But, bowel perforation after PRG is rare. We recently experienced a case of transverse colon penetration and tube displacement, which occurred as a PRG complication in a 60-year-old male with a cerebrovascular accident.
Colon, Transverse ; Deglutition Disorders ; Dementia ; Displacement (Psychology) ; Gastrostomy ; Head and Neck Neoplasms ; Hemorrhage ; Humans ; Ileus ; Male ; Middle Aged ; Parkinsonian Disorders ; Peritonitis ; Pneumonia, Aspiration ; Pneumoperitoneum ; Stroke ; Wound Infection

Acute diarrhea is caused by many situations such as infections, drugs, autoimmune diseases, immunodeficiency, ischemia and toxins. In addition, enema induced-colitis also causes acute diarrhea. Damage to the colon has been reported after exposure to a number of rectally administered agents, the better known of which are soaps and detergents used as cleansing enemas. Soap enemas cause corrosive colitis due to the saponification reaction as well as toxic materials. We report two cases of acute colitis induced by soap enemas administered in preparation for cesarean sections.
Autoimmune Diseases ; Cesarean Section ; Colitis ; Colon ; Detergents ; Diarrhea ; Enema ; Female ; Ischemia ; Pregnancy ; Soaps

BACKGROUND/AIMS: Ghrelin has recently been reported as exerting a protective effect in the damaged pancreas in rats. We investigated the correlation between severity of acute pancreatitis and serum ghrelin concentrations. METHODS: Blood samples were collected three times (at admission, after 48 hours, and at discharge) from patients admitted with acute pancreatitis. We divided the patients into nonrisk and risk groups. The risk group was defined as the presence of at least one of following risk factors for severe acute pancreatitis: Ranson's score > or =3, acute physiology and chronic health evaluation (APACHE) II score > or =8, C-reactive protein (CRP) > or =150 mg/L, and CT severity index (CTSI) > or =4. Serum ghrelin concentrations were measured with RIA kit and analyzed based on clinical and biochemical parameters. RESULTS: A total of 53 patients was enrolled in this study: 28 in the nonrisk group and 25 in the risk group. At admission, the ghrelin concentration was significantly higher in the risk group (286.39+/-272.19 vs 175.96+/-138.87 pg/mL [mean+/-SD], p=0.049). However, the ghrelin concentration did not differ significantly between the two groups after 48 hours (p=0.450) and at discharge (p=0.678). The overall ghrelin concentration was significantly lower at admission than at discharge (240.65+/-247.96 vs 369.41+/-254.27 pg/mL, p=0.001). CONCLUSIONS: Patients with risk factors for severe acute pancreatitis have higher serum ghrelin concentrations.
Animals ; APACHE ; C-Reactive Protein ; Ghrelin ; Humans ; Pancreas ; Pancreatitis ; Rats ; Risk Factors

Scrub typhus is an acute febrile illness that results from the destruction of endothelial cells by Orientia tsutsugamushi and subsequent systemic vasculitis. It manifests as fever, headache, myalgia, eschar formation, and lymphadenopathy. Some authors have reported that such vasculitis involves the gastrointestinal tract and that hyperemia, erosion, ulceration, and active bleeding of the gastric mucosa subsequently develop. However, no case of ulcer perforation in a patient with scrub typhus has been reported to date. Here, we report the case of a perforated duodenal ulcer in a 70-year-old female patient with scrub typhus.
Aged ; Duodenal Ulcer ; Endothelial Cells ; Female ; Fever ; Gastric Mucosa ; Gastrointestinal Tract ; Headache ; Hemorrhage ; Humans ; Hyperemia ; Lymphatic Diseases ; Orientia tsutsugamushi ; Scrub Typhus ; Systemic Vasculitis ; Ulcer ; Vasculitis