PURPOSE: The purpose of this study was to evaluate enhancement patterns, as seen on two-phase spiral CT, of hepatic hemangiomas in which atypical features had been seen on sonography (US) MATERIALS AND METHODS: Two-phase spiral CT scanning was performed in 18 patients in whom 24 atypical hemangiomas had been seen on US. Two-phase images were obtained at 25-45 seconds (arterial dominant phase) and 2-5 minutes (equilibrium phase) after the initiation of a bolus injection of contrast material (150 ml, 5 ml/sec). Enhancement patterns of hemangiomas during each phase were classified as homogeneous high, peripheral high, or low attenuation, and were retrospectively analyzed. RESULTS: In the arterial dominant phase of spiral CT, low attenuation was seen in nine hemangiomas (38%), globular or spotty peripheral high attenuation in 14 (58%), and homogeneous high attenuation in one (4%). In the equilibrium phase, enhancement patterns were peripheral high attenuation (partial fill-in) in 18 lesions (75%), and homogeneous high attenuation (complete fill-in) in three (12.5%), In the other three (12.5%) enhancement showed no significant change; in one of these, density was slightly less than in the arterial phase, and two showed subtle peripheral high attenuation. Fourteen hemangiomas (58%) showed globular or spotty peripheral high attenuation in the arterial dominant phase and peripheral or homogeneous high attenuation with progressive centripetal enhancement in the equilibrium phase. CONCLUSION: Our results suggest that two-phase spiral CT during the arterial dominant and equilibrium phase is useful in differentiating hepatic hemangiomas with atypical features seen on US from malignant hepatic tumors.
Hemangioma* ; Humans ; Retrospective Studies ; Tomography, Spiral Computed* ; Ultrasonography*

PURPOSE: To assess the value of dynamic fast infusion of contrast material in the detection and diagnosis of hepatocellular carcinoma(HCC) with spiral CT. MATERIALS AND METHODS: Two-phase dynamic spiral CT was performed in 59 patients with 104 HCCs. 150ml of nonionic contrast material was injected with an automatic injector at the rateof 5 ml/sec. Two-phase images were obtained at 20-45 sec(arterial dominant phase) and 2-5 min(equilibrium phase)after the initiation of bolus injection of contrast material. The tumors were divided into three groups(<3cm,3-5cm, and >5cm) according to the size and the enhancement patterns on two-phase images were compared. RESULTS: Inthe arterial phase, HCCs showed total or partial hyperattenuation in 79% of cases(82/104), isoattenuation in 12%,and hypoattenuation in 9%. In the equilibrium phase, HCCs showed hypoattenuation in 86%(89/104) and isoattenuationin 14%. The most common and characteristic enhancement patterns of HCCs were hyperattenuation in the arterialphase and hypoattenuataion in the equilibrium phase ; in the latter, capsules were demonstrated in 45% of cases. Invasions of the portal and/or hepatic vein were demonstrated in 34% of cases. CONCLUSION: Dynamic fastinfusion(5ml/sec) of contrast material(150ml) is useful in the detection and diagnosis of HCCs with spiral CT.
Capsules ; Carcinoma, Hepatocellular* ; Diagnosis ; Hepatic Veins ; Humans ; Tomography, Spiral Computed*

PURPOSE: Trauma is a leading cause of death, even in previously healthy and disease-free individuals, and the mortality rate is very high in neck trauma patients. On the other hand, there have been few studies related to neck injuries. This study examined the characteristics and treatment results of trauma-related neck injuries using the data from Korean National Emergency Department Information System. METHODS: Neck trauma patients were classified using the 6th Korean Standard Disease Classification system. The patients' demographic factors, number of surgeries, and clinical results were investigated. Statistical analysis was conducted using SPSS to evaluate the annual differences in the demographic factors; mortality according to the site of injury and type of surgery; and mechanisms of injury. RESULTS: From 2011 to 2014, 2,458 neck trauma patients were treated in hospitals in South Korea. The number of patients admitted to regional and local emergency medical centers was 883 (35.9%) and 1,502 (61.1%), respectively. No significant annual differences were observed in age, sex ratio, location of treatment center, mortality, and injury site (vascular, tracheal, or esophageal). In addition, no significant differences in the cause of injury, performed surgery (%), and mortality according to the injured organ were observed. CONCLUSION: This study revealed no annual changes in neck injury patients or differences in mortality according to injured organs. This study can be used as a basis for national research on organ-specific injuries, and may help predict the demand for future support projects for the establishment of regional trauma centers.
Cause of Death ; Classification ; Demography ; Emergencies* ; Emergency Service, Hospital* ; Hand ; Humans ; Information Systems* ; Korea ; Mortality ; Neck Injuries ; Neck* ; Sex Ratio ; Trauma Centers ; Wounds and Injuries

OBJECTIVE: The objective of this systematic review is to evaluate the safety and effectiveness of fiberoptic endoscopic evaluation of swallowing (FEES) for dysphagia patients. METHOD: We performed a systematic review of the literature. We searched Ovid-Medline(R), EMBASE(R) and Cochrane library(R) and Eight domestic databases including KoreaMed up to 19 April 2010. In addition, we added hand search. Searches were conducted without language restriction. We identified ten studies that met our eligibility criteria. Two reviewers independently extracted prespecified data from each study. Also reviewers assessed quality of each study. The qualities of these studies were assessed according to Scottish Intercollegiate Guidelines Network (SIGN) tool. RESULTS: Ten studies (nine diagnostic evaluation studies and one case series) were identified. The complication rate of FEES was 6% which was reported only one study as nose bleeding that did not need further treatment. The effectiveness of FEES was evaluated based on diagnostic accuracy, agreement rate with videofluoroscopy as a reference test. The sensitivities of FEES were 0.87~1.0 (penetration), 0.22~0.96 (aspiration), 0.68~0.91 (pharyngeal residue), and 0.75 (premature spillage) respectively. Specificities of FEES were 0.75~1.0 (penetration), 0.88~1.0 (aspiration), 0.86~1.0 (pharyngeal residue), and 0.56 (premature spillage) respectively. Agreement rate with VFFS were 85~100% (penetration), 82.3~100% (aspiration), 80~89.3% (pharyngeal residues), and 60.7% (premature spillage) respectively. There was no evidence of statistical heterogeneity. The body of evidence as a whole suggests a grade C for FEES. CONCLUSION: FEES is considered as a safe and effective test in patients with dyspahgia and grade C evidence based on existing studies.
Deglutition ; Deglutition Disorders ; Epistaxis ; Fees and Charges ; Hand ; Humans ; Population Characteristics