No abstract available.
Gamma Cameras* ; Head*

No Abstract Available.

The incidence of acute deep vein thrombosis after multiple trauma has been reported to range from 1.7 to 10%. In general, a thrombus of the calf vein migrates to the proximal vein. An isolated inferior vena cava (IVC) thrombosis without a peripheral venous thrombosis is rare. A 35-year-old woman was admitted as a result of a large subcapsular hematoma in the right hepatic lobe after a blunt injury caused by an automobile accident. The thrombus in the IVC was detected incidentally during a follow up CT scan three weeks after the trauma. A compression of the IVC by the displaced hepatic parenchyme as a result of a large subcapsular hematoma is a possible mechanism for the IVC thrombosis because there was no distal venous thrombosis and no evidence of hypercoagulability. A retrievable caval filter (Gunther-Tulip(TM), Cook Inc. Bloominton, USA) was placed in the suprarenal vena cava via the right internal jugular venous approach. After placing the retrieval caval filter, aspiration thrombectomy was attempted through the right femoral vein. The luminal patency of the IVC was restored immediately after retrieving the thrombus. The subcapsular hematoma in the right hepatic lobe disappeared two months later and there was no evidence of a residual thrombus in the inferior vena cava.
Adult ; Automobiles ; Female ; Femoral Vein ; Follow-Up Studies ; Hematoma ; Humans ; Incidence ; Multiple Trauma ; Phenobarbital ; Thrombectomy ; Thrombophilia ; Thrombosis* ; Tomography, X-Ray Computed ; Veins ; Vena Cava, Inferior* ; Venous Thrombosis ; Wounds, Nonpenetrating

A 66-year-old male with dyspepsia and weight loss was referred to our hospital for evaluation. On laboratory examination, anti-saccharomyces cerevisiae (ASCA)-IgA was positive and iron deficiency anemia was present. PET/CT and abdominal CT scan images showed multiple small bowel segmental wall thickening and inflammation. Capsule endoscopy images showed multiple small bowel ulcerative lesions with exudates. Based on laboratory test results and imaging studies, the patient was diagnosed with Crohn's disease and treated with prednisolone and 5-aminosalicylic acid (5-ASA). However, the patient underwent second operation due to small bowel perforation within 2 month after initiation of treatment. Pathology report of the resected specimen was compatible to primary small bowel diffuse large B cell lymphoma and pertinent treatment was given to the patient after recovery. Herein, we describe a case of primary small bowel diffuse large B cell lymphoma that was mistaken for Crohn's disease.
Aged ; Antibodies/blood ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Capsule Endoscopy ; Crohn Disease/diagnosis/drug therapy ; Diagnostic Errors ; Humans ; Immunoglobulin A/blood ; Intestinal Perforation/surgery ; Lymphoma, Large B-Cell, Diffuse/*diagnosis/drug therapy/pathology ; Male ; Mesalamine/therapeutic use ; Positron-Emission Tomography ; Saccharomyces cerevisiae/immunology ; Tomography, X-Ray Computed

PURPOSE: Hyperlipidemia and diabetes mellitus are common metabolic disorders associated with transplantation and also are risk factors of cardiovascular disease which is leading cause of patient death in kidney transplant recipients. We compared blood lipid and glucose levels of patients receiving tacrolimus (Tac) with those of patients receiving cyclosporine (CyA). METHODS: Patients were grouped as Tac (n=124) or CyA (n=77). Minimal follow up duration was 18 months. Both groups have no difference in age, sex, HLA match, numbers of transplantation and proportion of the patients with pretransplant hypercholesterolemia (>220 mg/dL) or diabetes. Prevalence of hypercholesterolemia and diabetes in Tac and CyA groups were compared at posttransplant 1, 3, 6, and 12 months. RESULTS: Prevalence of diabetes in CyA versus Tac group were 18.9 vs. 13.8% (P=0.348), 8.6% vs. 18.8% (P=0.060), 5.9% vs. 18.6% (P=0.016), and 10.4% vs. 21.1% (P=0.067) at 1, 3, 6 and 12 months after transplantation respectively. Prevalence of hypercholesterolemia in CyA versus Tac group were 52.5% vs. 16.9% (P=0.000), 37.7% vs. 8.3% (P=0.000), 30.3% vs. 7.4% (P= 0.000) and 22.6% vs. 8.3% (P=0.001) at 1, 3, 6, and 12 months after transplantation. CONCLUSION: CyA group was more prone to develop hypercholesterolemia than Tac group, whereas incidence of diabetes in Tac group was not different from CyA group. In terms of cardiovascular risk, there was no significant difference between CyA treated group and Tac treated group in renal allograft recipients.
Allografts* ; Cardiovascular Diseases ; Cyclosporine* ; Diabetes Mellitus ; Follow-Up Studies ; Glucose ; Humans ; Hypercholesterolemia ; Hyperlipidemias ; Incidence ; Kidney ; Prevalence ; Risk Factors ; Tacrolimus* ; Transplantation

An inflammatory abdominal aortic aneurysm (IAAA) is a unique abdominal aortic aneurysm (AAA) subtype, which shows severe inflammatory adhesion to adjacent structures. An IAAA is usually symptomatic; back pain, hydronephrosis, fever and weight loss are common manifestations. Recently, the operative mortality of IAAAs has been reported as being indifferent from that of non-inflammatory AAAs. However, as the technical difficulty of the operation is directly related to the complications and mortality, the operation for an IAAA is usually challenging to the vascular surgeons. Herein, we present our experience of three IAAA patients, who were successfully treated by surgical repairs. Cases: The 1st patient was a 62-year-old male with severe back pain and 8 kg of weight loss over a 3-month period. The IAAA was diagnosed by a CT scan. A Dacron Y graft was successfully placed via a retroperitoneal approach. After the operation, his back pain had been completely resolved. The 2nd and 3rd patients were 71 and 67-year-old males with left flank pain. The preoperative CT scans showed infrarenal IAAAs, with hydronephrosis of left kidney and ureter. After placing a ureteral catheter through the cystoscope, the aneurysms were repaired using Dacron Y-grafts via a transperitoneal approach. After the operations, the symptoms of these two patients completely disappeared. The 2nd patient showed complete resolution of the perianeurysmal inflammation and hydronephrosis on a follow up CT scan four months after surgery. The 3rd patient's hydronephrosis had not resolved on the follow up ultrasonogram two months after the surgery, but he was symptom free. All three patients are doing well at the 16th, 8th and 3rd postoperative months.
Aged ; Aneurysm ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Back Pain ; Cystoscopes ; Fever ; Flank Pain ; Follow-Up Studies ; Humans ; Hydronephrosis ; Inflammation ; Kidney ; Male ; Middle Aged ; Mortality ; Polyethylene Terephthalates ; Tomography, X-Ray Computed ; Transplants ; Ultrasonography ; Ureter ; Urinary Catheters ; Weight Loss

BACKGROUND: There are few comparative studies about the optimal method of pneumatic compression to prevent deep vein thrombosis (DVT). The aim of this prospective randomized study was to compare venous hemodynamic changes and their clinical influences between two graded sequential compression groups (an alternate sequential compression device [ASCD] vs. a simultaneous sequential compression device [SSCD]). METHODS: In total, 34 patients (68 limbs) undergoing knee and spine operations were prospectively randomized into two device groups (ASCD vs. SSCD groups). Duplex ultrasonography examinations were performed on the 4th and 7th postoperative days for the detection of DVT and the evaluation of venous hemodynamics. Continuous data for the two groups were analyzed using a two-tailed, unpaired t-test. Relative frequencies of unpaired samples were compared using Fisher exact test. Mixed effects models that might be viewed as ANCOVA models were also considered. RESULTS: DVT developed in 7 patients (20.6%), all of whom were asymptomatic for isolated calf DVTs. Two of these patients were from the ASCD group (11.8%) and the other five were from the SSCD group (29.4%), but there was no significant difference (p = 0.331). Baseline peak velocity, mean velocity, peak volume flow, and total volume flow were enhanced significantly in both device groups (p < 0.001). However, the degrees of flow and velocity enhancement did not differ significantly between the groups. The accumulated expelled volumes for an hour were in favor of the ASCD group. CONCLUSIONS: Both graded sequential compression devices showed similar results both in clinical and physiological efficacies. Further studies are required to investigate the optimal intermittent pneumatic compression method for enhanced hemodynamic efficacy and better thromboprophylaxis.
Aged ; *Arthroplasty, Replacement, Knee/adverse effects ; *Fracture Fixation/adverse effects ; Hemodynamics ; Humans ; *Intermittent Pneumatic Compression Devices ; Knee/surgery ; Prospective Studies ; Risk Factors ; *Spinal Fusion/adverse effects ; Spine/surgery ; Treatment Outcome ; Venous Thrombosis/etiology/physiopathology/*prevention & control/ultrasonography

PURPOSE: The development of publicized screening methods for breast carcinoma detection has led to a marked increase in the discovery of ductal carcinoma in situ (DCIS) or DCIS with microinvasion (DCIS-MI). Axillary lymph node status has been believed to be not only an indicator of prognosis, but also a direction of adjuvant therapy. But the incidence of axillary metastasis in DCIS or DCIS-MI has diversely found in from 0% to 20%. This study was performed to analyze the incidence of axillary metastasis and the predictive factors associated with axillary lymph node metastasis in DCIS or DCIS-MI. METHODS: Patients with DCIS or DCIS-MI and axillary lymph node dissection from 1987 to 2004 were selected from Korea University Medical Center. We reviewed their medical records for age, palpability and size of the tumor, histolgic subtype, nuclear grade, hormone receptor status, and pathologic slides. RESULTS: Fifty two patients in DCIS and Thirty eight patients in DCIS-MI were included in the study. Axillary lymph node metastases were identified in 2 patients (3.8%) in DCIS and 4 patients (10.5%) in DCIS-MI. Tumor size and nuclear grade in DCIS had a borderline significance in association with microinvasion. We could not be able to find any predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. CONCLUSION: Axillary lymph node metastasis in DCIS or DCIS-MI appeared to be not low and there was no predictive factor associated with axillary lymph node metastasis in DCIS and DCIS-MI. But DCIS patients with large tumor size and poor nuclear grade have the high possibility associated with microinvasion, therefore, in that cases, there is a need to consider the possibility of axillary metastasis.
Academic Medical Centers ; Breast ; Breast Neoplasms ; Carcinoma, Ductal* ; Carcinoma, Intraductal, Noninfiltrating* ; Humans ; Incidence ; Korea ; Lymph Node Excision ; Lymph Nodes* ; Mass Screening ; Medical Records ; Neoplasm Metastasis* ; Prognosis

PURPOSE: In this study, we developed a new software tool for the analysis of renal scintigraphy which can be modified more easily by a user who needs to study new clinical applications, and the appropriateness of the results from our program was studied. MATERIALS AND METHODS: The analysis tool was programmed with IDL5.2 and designed for use on a personal computer running Windows. For testing the developed tool and studying the appropriateness of the calculated glomerular filtration rate (GFR), 99mTc-DTPA was administered to 10 adults in normal condition. In order to study the appropriateness of the calculated mean transit time (MTT), 99mTc-DTPA and 99mTc-MAG3 were administered to 11 adults in normal condition and 22 kidneys were analyzed. All the images were acquired with ORBITOR, the Siemens gamma camera. RESULTS: With the developed tool, we could show dynamic renal images and time activity curve (TAC) in each ROI and calculate clinical parameters of renal function. The results calculated by the developed tool were not different statistically from the results obtained by the Siemens application program (Tmax: p=0.68, Relative Renal Function: p=1.0, GFR: p=0.25) and the developed program proved reasonable. The MTT calculation tool proved to be reasonable by the evaluation of the influence of hydration status on MTT. CONCLUSION: We have obtained reasonable clinical parameters for the evaluation of renal function with the software tool developed in this study. The developed tool could prove more practical than conventional, commercial programs.
Adult ; Gamma Cameras ; Glomerular Filtration Rate ; Humans ; Kidney ; Microcomputers ; Nuclear Medicine* ; Radionuclide Imaging ; Running ; Technetium Tc 99m Mertiatide

Physical evaluations provide the basis for an objective and quantitative analysis of the image quality. Nonetheless, there are limitations in using physical evaluations to judge the utility of the image quality if the observer's subjectivity plays a key role despite its imprecise and variable nature. This study proposes a new method for objective and quantitative evaluation of image quality to compensate for the demerits of both physical and subjective image quality and combine the merits of them. The images of chest phantom were acquired from four digital radiography systems on clinic sites. The physical image quality was derived from an image analysis algorithm in terms of the contrast-to-noise ratio (CNR) of the low-contrast objects in three regions (lung, heart, and diaphragm) of a digital chest phantom radiograph. For image analysis, various image processing techniques were used such as segmentation, and registration, etc. The subjective image quality was assessed by the ability of the human observer to detect low-contrast objects. Fuzzy integral was used to integrate them. The findings of this study showed that the physical evaluation did not agree with the subjective evaluation. The system with the better performance in physical measurement showed the worse result in subjective evaluation compared to the other system. The proposed protocol is an integral evaluation method of image quality, which includes the properties of both physical and subjective measurement. It may be used as a useful tool in image evaluation of various modalities.
Evaluation Studies as Topic ; Heart ; Humans ; Radiographic Image Enhancement ; Thorax