PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: With the technical advancement in arterial embolization and subsegmental resection of liver neoplasm, emphasis has been on more detailed knowledge of normal arterial anatomy and its variation. We analysed the patterns of intrahepatic branches of right hepatic artery. MATERIALS AND METHODS: We retrospectively analyzed intrahepatic branching patterns of right hepatic artery in 165 cases. All cases had a single right hepatic artery which could be traced up to tertiary branches, and also performed rapid drip infusion CT scan, hepatic arteriography with antero-posterior and oblique views, superior mesenteric arteriorgraphy and indirect portography. RESULTS: lntrahepatic branching patterns of the right hepatic artery had eight types of variation. The most common intrahepatic branching pattern was type I: 107(64.5%) which represented 5, 8th branch emerging from the anterior segmental artery and 6, 7th branch from the posterior segmental artery. Type VII :26(15.8%) was the next common type which represented 6th branch emerging first from the posterior segmental artery and 7th branch emerging secondly from the posterior segmental artery. Type VII, VI, III were branched from the posterior segmental artery. Type IV, II, V were branched from the anterior segmental artery. CONCLUSION: These result could be helpful to the planning of treatment, such as hepatic subsegmentectomy or transarterial embolization of the hepatic neoplasm.
Angiography* ; Arteries ; Hepatic Artery* ; Infusions, Intravenous ; Liver Neoplasms ; Portography ; Retrospective Studies ; Tomography, X-Ray Computed*

PURPOSE: To determine the value of the CT scan in distinguishing an ischemic and a tumoral segment in coloniccarcinoma complicated by proximal bowel ischemia. MATERIALS AND METHODS: CT scans of twenty patients with ischemic colitis proximal to obstructing colonic carcinoma were reviewed retrospectively. The presence of anischemic segment proximal to colonic carcinoma were patho-logically confirmed in 12 patients, and the remaining eight patients showed typical radiologic findings of bowel ischemia on barium enema but on pathologic review showed only colonic carcinoma. CT scans were analyzed for the location, wall thickness, length, and enhancing pattern of both tumoral and ischemic segments in correlation with barium enema or surgico-pathologic results. Theresults of tumor staging shown on CT scan were compared with those of pathologic findings. RESULTS: On CT scan adistinction between ischemic and tumoral segments could be made in 15 patients (75%). The ischemic segments were contiguously proximal to the tumoral segment in 18 patients. In two patients, however, there was an intervening segment of normal bowel between the two segments and this was confirmed by pathology. Maximvm bowel wall thickness ranged from 0.8 to 4.5cm (mean, 2.0cm) in tumoral segments and from 0.6 to 1.5 cm (mean, 1.0cm) in ischemic segments (p<0.05). Tumoral segments were enhanced heterogeneously in 12 patients (60%) and homogeneously in the remaining eight, while ischemic segments were enhanced homogeneously in 14 patients (70%) and heterogeneously insix. Peripheral rim enhancement was seen only in the ischemic segments of four patients (20%). Comparing TNM tumorstaging of the CT scan with that of pathology, CT scan overstaged in two patients (10%) and understaged in one(5%). CONCLUSION: CT is a valuable tool for distinguishing an ischemic from a tumoral segment in patients with ischemic colitis proximal to colonic carcinoma. An understanding of this pathologic entity could reduce the possibility of over or understaging in cases of colonic carcinoma.
Barium ; Colitis ; Colitis, Ischemic* ; Colon* ; Enema ; Humans ; Ischemia ; Logic ; Neoplasm Staging ; Pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.
Adult ; Coccidioidomycosis* ; Cough ; Fever ; Fungi ; Humans ; Incidence ; Korea ; Lymphatic Diseases ; Male ; New Mexico ; Pleural Effusion ; Radiography ; Solitary Pulmonary Nodule ; Thorax ; Tuberculosis, Miliary

Coccidioidomycosis is a rare systemic fungal infection in Korea. However, the incidence of coccidioidomycosis has recently begun to increase due to the increasing incidence of people traveling overseas to endemic areas. In previously reported cases of coccidioidomycosis in Korea, the radiographic findings usually showed a solitary pulmonary nodule, pleural effusion, cavitation, and hilar lymphadenopathy, but no miliary nodules. We report a case of disseminated coccidioidomycosis with miliary nodules in an immunocompetent patient. A 32 year old male, who had traveled in Corona, New Mexico, USA, was admitted for an evaluation of persistent cough with fever. Chest radiography revealed initially diffuse multiple small nodules that appeared to be miliary tuberculosis. However, a subsequent evaluation revealed that he had disseminated coccidioidomycosis.
Adult ; Coccidioidomycosis* ; Cough ; Fever ; Fungi ; Humans ; Incidence ; Korea ; Lymphatic Diseases ; Male ; New Mexico ; Pleural Effusion ; Radiography ; Solitary Pulmonary Nodule ; Thorax ; Tuberculosis, Miliary

BACKGROUND: Dobutamine stress echocardiography(DSE) is useful detection of coronary artery disease as a noninvasive test. The purpose of this study is to find predicting factors of multivessel disease (MVD) in DSE. METHODS: Sixty-five patients suspicious of coronary artery disease excluding myocardial infarction on clinical base had undergone DSE and coronary arteriography. We divided the patient group into normal group (22 patients), single vessel disease(SVD) group(25 patients) and multivessel disease (MVD) group (18 patients) according to the findings of the findings of coronary angiogram. DSE findings and hemodynamic change during stress were analyzed and compared in these groups. We defined MVD on DSE as findings of new or aggravating regional wall motion abnormalities in 2 or more coronary artery territories, and significant stenosis on coronary angiogram as stenosis of 50% or more. RESULTS: 1) The numbers of diseased vessel evaluated by DSE showed significant correlation with those evaluated by coronary angiogram. 2) Resting, low-dose and peak-dose wall motion scores were significantly different among 3 groups, being higher in MVD group than in SVD and normal group. 3) Total administered dose of dobutamine in MVD group was significantly lower than that of normal group. 4) Heart rate at peak-dose showed significant difference among 3 groups, but product of heart rate and systolic blood pressure at peak-dose was not significantly different. 5) Frequency of ST segment change was significantly higher in multicessel disease group CONCLUSION: DSE reflects severity of coronary artery disease. and frequency of resting regional wall motion abnormally. wall motion score in low-dose and paak stress seems to be useful as a predictor of multivessel disease. Value of total administered dose of dobutamine, hemodynamic changes and ST segment changes as a MVD remains to be proved.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction

BACKGROUND: Dobutamine stress echocardiography(DSE) is useful detection of coronary artery disease as a noninvasive test. The purpose of this study is to find predicting factors of multivessel disease (MVD) in DSE. METHODS: Sixty-five patients suspicious of coronary artery disease excluding myocardial infarction on clinical base had undergone DSE and coronary arteriography. We divided the patient group into normal group (22 patients), single vessel disease(SVD) group(25 patients) and multivessel disease (MVD) group (18 patients) according to the findings of the findings of coronary angiogram. DSE findings and hemodynamic change during stress were analyzed and compared in these groups. We defined MVD on DSE as findings of new or aggravating regional wall motion abnormalities in 2 or more coronary artery territories, and significant stenosis on coronary angiogram as stenosis of 50% or more. RESULTS: 1) The numbers of diseased vessel evaluated by DSE showed significant correlation with those evaluated by coronary angiogram. 2) Resting, low-dose and peak-dose wall motion scores were significantly different among 3 groups, being higher in MVD group than in SVD and normal group. 3) Total administered dose of dobutamine in MVD group was significantly lower than that of normal group. 4) Heart rate at peak-dose showed significant difference among 3 groups, but product of heart rate and systolic blood pressure at peak-dose was not significantly different. 5) Frequency of ST segment change was significantly higher in multicessel disease group CONCLUSION: DSE reflects severity of coronary artery disease. and frequency of resting regional wall motion abnormally. wall motion score in low-dose and paak stress seems to be useful as a predictor of multivessel disease. Value of total administered dose of dobutamine, hemodynamic changes and ST segment changes as a MVD remains to be proved.
Angiography ; Blood Pressure ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Dobutamine* ; Echocardiography, Stress* ; Heart Rate ; Hemodynamics ; Humans ; Myocardial Infarction