A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

A 29 year old woman with unresectable leiomyosarcoma of the inferior vena cave extending into the right atrium of the heart was presented. The upper and middle inferior vena cava involved and there were both intrinsic and extrinsic tumor growth components. The diagnosis was made by a combination of radiological studies including ultrasound, CT, inferior vena cavography and arteriography and the diagnosis was confirmed by ultrasound guided rumor biopsy. The clinical and radiological presenting features were reviewed.
Angiography ; Biopsy ; Diagnosis ; Female ; Heart ; Heart Atria ; Humans ; Leiomyosarcoma* ; Ultrasonography ; Vena Cava, Inferior*

Forty five patients with inferior vena cava (IVC) thrombosis were studied with the use of ultrasonography (US) and computed tomography (CT). Thirty seven cases were cased by tumor extension and the primary neoplasms were hepatocellular Ca. (26cases), renal cell Ca. (6 cases), Wilms' tumor (1 case), IVC leiomyosarcoma (1 case) and retroperitoneal metastatic tumor (3 cases). Non-tumor thrombus were 8 cases which included 5 cases of Budd-Chiari syndrome and 3 cases of thrombophlebitis. US and CT both were good for the diagnosis of IVC thrombosis. Cranial extension was better demonstrated by US whereas CT yielded better delineation of the lower extension. Even though, differentiation of tumor non-tumor thrombi by the echogenecity and density of the thrombus was not possible, the finkdings of adjacent tumor mass, complete obstructive thrombus within dilated lumen with bulging wall, and nontapered acute margin of thrombus made the possibility of tumor thrombus more likely.
Budd-Chiari Syndrome ; Diagnosis ; Humans ; Leiomyosarcoma ; Thrombophlebitis ; Thrombosis* ; Ultrasonography ; Vena Cava, Inferior* ; Wilms Tumor

OBJECTIVE: We developed a Cocoon framework-based device independent electrocardiogram(ECG) Reporting System in order to support such various web devices as desktop Personal Computer(PC), Personal Digital Assistants(PDA) and SmartPhone. METHODS: ECG Reporting System, built in the Cocoon framework, consists of modules of ECG Report Module and ECG Image Module. Two modules publish the applied ECG Report to each different templates according to the requesting device. The method of framework-based development in this paper features a reduction of development costs and the robust stability of system. RESULTS: The medical staff may require patient ECG information in ubiquitous healthcare environment, ECG Reporting System supports their correct judgment and expeditious response by servicing ECG report of the patient according to the requesting device. CONCLUSION: The proposed system and concept in this paper may be a good solution for developing the point of care service system supporting various mobile devices.
Delivery of Health Care ; Electrocardiography* ; Humans ; Judgment ; Medical Staff ; Smartphone

A 21-year-old woman presented with productive cough and hemoptysis. Chest radiograph shows a large thin-walled cystic lesion with an air-fluid level in medial portion of the left lower lung zone and opacity in paravertebral area of the right lower lung zone. Chest CT scan shows a thin-walled cavitary lesion in the posterior basal segment of left lower lobe with an air-fluid level. Area of consolidation containing air-filled cysts was also observed in medial aspect of right lower lobe. Selective angiogram obtained from aberrant artery arising from descending abdominal aorta showed two main branches of the artery supplying bilateral pulmonary lesions.
Aorta, Abdominal ; Arteries ; Bronchopulmonary Sequestration* ; Cough ; Female ; Hemoptysis ; Humans ; Lung ; Radiography, Thoracic ; Tomography, X-Ray Computed ; Young Adult

The vasoactive effecs of ketamine on aortic and pulmonary arteries have not heen clearly characterized. Nevertheless, it has been recommended to avoid ketamine in systemic and pulmonary hypertension because of its tendency to increase systemic and pulmonary vascular resistance. This study was designed to investigate and compare the direct effects of ketamine on isolated rat aortic and pulmonary arteries, with or without intact endothelium. The optimal resting tension (Lmax) of each ring was searched hased on contractile responses to 3.7X10(6)M norepinephrine. Once the Lmax was Obtained, the peak developed tension was recorded as the control. Thereafter, in the second part of the experiments, prior to ketamine exposure, the endothelium was denuded which was confirmed pharmacologically using norepinephrine(3.7X10-6M) and acetylcholine(10(-6)M). In groups with intact endothelium, .3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -10.3+/-5.6%, -17.8+/-4.4%, respectively. In groups without intact endothelium, 3X10(3)M ketamine relaxed aortic and pulmonary artery ring by -9.9+/-3.6%, -14.2+/-3.8%, respectively. It was statistically significant. In groups with or without intact endothelium, 0.1X10(3) M ketamine relaxed aortic and pulmonary artery ring. Hut it was statistically insignificant. We conclude that ketamine is a powerful aortic and pulmonary artery dilator in vitro and that is endothelium independent.
Animals ; Aorta* ; Endothelium ; Hypertension, Pulmonary ; Ketamine* ; Norepinephrine ; Pulmonary Artery* ; Rats* ; Vascular Resistance

Anticancer effect and complications were evaluated after transcatheter arterial embolization(TAE) in 12patients with hepatocellular carcinoma until 2 weeks and 4 weeks after TAE, respectively. The results were asfollows: 1. Serum alpha-fetoprotein value decreased in 7 out of 9 patients wih high value prior to TAE. 2. Loss ofenhancement and better definition on enhanced CT were seen in the tumors in all cases, and low-density areas in9/10 . Gas bubbles were seen in low-density areas in 4/10 and highdensity area caused by lipiodol in 6/10. 3.Post-embolization syndrome was develped in most patients but improved clinically within a week after TAE. 4. Onlaboratory examination, impairment of liver function was developed in most patients but improved within 4 weeksafter TAE. 5. Complications on CT included splenic infarction and thickening of wall of the gallbladder, whichdidn't require specific treatment. The authors conclude that TAE for hepatocellular carcinoma reveals apparentanticancer effect on shortterm evaluation, and resultant complications are transient and improved by conservativetreatment.
alpha-Fetoproteins ; Carcinoma, Hepatocellular ; Ethiodized Oil ; Gallbladder ; Humans ; Liver ; Splenic Infarction

PURPOSE: To evaluate post-ablation syndrome after radiofrequency thermal ablation of malignant hepatic tumors. MATERIALS AND METHODS: Forty-two patients with primary (n=29) or secondary (n=13) hepatic tumors under-went radiofrequency thermal ablation. A total of 65 nodules ranging in size from 1.1 to 5.0 (mean, 3.1) cm were treated percutaneously using a 50W RF generator with 15G expandable needle electrodes. We retrospec-tively evaluated the spectrum of post-ablation syndrome including pain, fever(> or =38 C degrees), nausea, vomiting, right shoulder pain, and chest discomfort according to frequency, intensity and duration, and the findings were cor-related with tumor location and number of ablations. We also evaluated changes in pre-/post-ablation serum aminotransferase(ALT/AST) and prothrombin time, and correlated these findings with the number of abla-tions. RESULTS: Post-ablation syndrome was noted in 29 of 42 patients (69.0%), and most symptoms improved with conservative treatment. The most important of these were abdominal pain (n=20, 47.6%), fever (n=8, 19.0%), and nausea (n=7, 16.7%), and four of 42 (9.5%) patients complained of severe pain. The abdominal pain lasted from 3 hours to 5.5 days (mean; 20.4 hours), the fever from 6 hours to 5 days (mean; 63.0 hours). and the nau-sea from 1 hour to 4 days (mean; 21.0 hours). Other symptoms were right shoulder pain (n=6, 14.3%), chest discomfort (n=3, 7.1%), and headache (n=3, 7.1%). Seventeen of 20 patients (85%) with abdominal pain had a subcapsular tumor of the liver. There was significant correlation between pain, location of the tumor, and number of ablations. After ablation, ALT/AST was elevated more than two-fold in 52.6%/73.7% of patients, respectively but there was no significant correlation with the number of ablation. CONCLUSION: Post-ablation syndrome is a frequent and tolerable post-procedural process after radiofrequency thermal ablation. The spectrum of this syndrome provides a useful guideline for the post-ablation management.
Abdominal Pain ; Electrodes ; Fever ; Headache ; Humans ; Liver ; Nausea ; Needles ; Prothrombin Time ; Shoulder Pain ; Thorax ; Vomiting

PURPOSE: To compare the effect of local injection therapy with absolute ethanol and hot-saline in the normal liver of rat. MATERIALS AND METHODS: An experimental study was performed with the normal liver of 52 rats. The resected livers were pathologically analyzed on three days, one week, two weeks, and four weeks after injection of 0.1 ml absolute ethanol and hot-saline. The assessment was done in view of 1) main pathologic changes on time, 2) pattern of inflammatory cell infiltration, 3) measurement of necrotic area, 4) effect on vascuar and biliary tracts adjacent to necrotic area, and 5) extrahepatic peritoneal adhesion. RESULTS: The main pathologic changes were acute necrosis with inflammation for three days group and secondary regenerative fibrosis in all groups. The degree of necrosis was significantly more severe in absolute ethanol injection group, demonstrating larger necrotic area, than hot-saline injection group. The effect on vessels and bile ducts adjacent to the necrotic area was almost not seen in both groups. The extrahepatic peritoneal adhesion was noted in both groups, but the degree was more prominent in the absolute ethanol injection group than hot-saline injection group. CONCLUSION: Absolute ethanol is superior to hot-saline in the necrotic effect of percutaneous injection therapy. However, hot-saline could be applied in case of the borderline area between mass and adjacent normal liver or the subcapsular mass.
Animals ; Bile Ducts ; Biliary Tract ; Ethanol* ; Fibrosis ; Inflammation ; Liver* ; Necrosis ; Rats*

PURPOSE: To understand the MR findings of extraabdominal desmold tumors by correlation with histopathologic findings. MATERIALS AND METHODS: MR images of histologically proved 12 patients with extraabdominal desmold tumor were retrospectively reviewed. Three types of MR features were defined; type I had signal changes on T1 and T2 weighted images and relatively homogeneous nature, type II had homogeneously low signal intensities on T1 and T2 weighted images and type III was a mixed form of type I and type II. Signal intensity, enhancement pattern and margin of the lesions were analyzed on MR images. Pathologic features were analyzed by three aspects, which were cellularity, amount of collagen and vascularity, and were correlated with MR images. RESULTS: The signal intensities of type I desmolds were intermediate on T1 weighted image and higher on T2 weighted image with localized margin and gadolinium enhancement. Pathologically this type showed predominant cellularity and vascularity. The signal intensities of type II desmold were homogenous low signal intensities on both T1 and T2 weighted images without enhancement. Pathologically this type showed predominant collagen components and hypovascularity. Type III desmolds were mixed form of type I and type II on MR images as well as on pathologic features. Type I and type II desmold tumors had localized margins, however type III had both localized and infiltrative margins. CONCLUSION: The MR findings of extraabdominal desmold tumors would reflect the pathologic background of the tumor.
Collagen ; Gadolinium ; Humans ; Retrospective Studies