• Title/Summary/Keyword: 췌장

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Added Value of the Sliding Sign on Right Down Decubitus CT for Determining Adjacent Organ Invasion in Patients with Advanced Gastric Cancer (진행성 위암 환자에서 인접 장기 침범을 결정하기 위한 우측와위 CT에서의 미끄러짐 징후의 추가적 가치)

  • Kyutae Jeon;Se Hyung Kim;Jeongin Yoo;Se Woo Kim
    • Journal of the Korean Society of Radiology
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    • v.83 no.6
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    • pp.1312-1326
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    • 2022
  • Purpose To investigate the added value of right down decubitus (RDD) CT when determining adjacent organ invasion in cases of advanced gastric cancer (AGC). Materials and Methods A total of 728 patients with pathologically confirmed T4a (pT4a), surgically confirmed T4b (sT4b), or pathologically confirmed T4b (pT4b) AGCs who underwent dedicated stomach-protocol CT, including imaging of the left posterior oblique (LPO) and RDD positions, were included in this study. Two radiologists scored the T stage of AGCs using a 5-point scale on LPO CT with and without RDD CT at 2-week intervals and recorded the presence of "sliding sign" in the tumors and adjacent organs and compared its incidence of appearance. Results A total of 564 patients (77.4%) were diagnosed with pT4a, whereas 65 (8.9%) and 99 (13.6%) patients were diagnosed with pT4b and sT4b, respectively. When RDD CT was performed additionally, both reviewers deemed that the area under the curve (AUC) for differentiating T4b from T4a increased (p < 0.001). According to both reviewers, the AUC for differentiating T4b with pancreatic invasion from T4a increased in the subgroup analysis (p < 0.050). Interobserver agreement improved from fair to moderate (weighted kappa value, 0.296-0.444). Conclusion RDD CT provides additional value compared to LPO CT images alone for determining adjacent organ invasion in patients with AGC due to their increased AUC values and improved interobserver agreement.

Ascariasis Presenting as Hematoma in the Sigmoid Mesocolon: A Case Report (구불창자간막 혈종으로 발현한 회충증: 증례 보고)

  • Ji-Eun Kim;Kyung Eun Bae;Hyun-Jung Kim;Byung-Noe Bae;Ji Hae Lee;Mi-Jin Kang;Ji-Young Kim;Jae Hyung Kim
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.1013-1018
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    • 2020
  • Ascariasis is an intestinal disease caused by Ascaris lumbricoides. Most patients with ascariasis are asymptomatic; however, the presence of many larvae in the bowel can cause gastrointestinal complications, such as intestinal obstruction, obstructive jaundice, cholangitis, cholecystitis, and pancreatitis. Herein, we report a case of ascariasis presenting as hematoma and active bleeding in the sigmoid mesocolon of a 74-year-old man on computed tomography (CT). Sigmoid colon perforation was also detected on follow-up CT. Laparoscopic low anterior resection was performed; there was a large hematoma in the sigmoid mesocolon. Roundworms were microscopically identified in the mesenteric adipose tissue. The clinical and CT findings of this unusual presentation of ascariasis revealed serial complications during parasite migration from the intestinal lumen to the peritoneal cavity.

Percutaneous Transgastric Stent Placement for Malignant Gastroduodenal Obstruction (악성 위십이지장 협착 환자에서의 경피적 위 경유 스텐트 설치)

  • Bumsang Cho;Gyoo-Sik Jung;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.81 no.5
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    • pp.1175-1183
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    • 2020
  • Purpose To evaluate the technical feasibility and clinical efficacy of percutaneous transgastric stent placement after the failure of treatment attempt with the transoral approach in malignant gastroduodenal obstruction patients. Materials and Methods From October 2008 to April 2016, nine patients (M:F = 4:5; mean age = 66 years) with malignant gastroduodenal obstruction underwent stent placement via a gastrostomy tract, which was attributed to the failure of the transoral approach. The primary etiologies of the obstruction were pancreatic (n = 5), gastric (n = 2), and metastatic (n = 2) cancers. Through percutaneous gastrostomy, dual stents (inner bare metal and outer polytetrafluoroethylene-covered) were deployed at the obstruction site. The technical and clinical success rates, as well as complications were evaluated during the follow-up period. Results Stents were successfully inserted in eight patients (88%). We failed to insert stent in one patient due to the presence of a tight obstruction. After stent placement, symptoms improved in seven patients. Gastrostomy tube was removed 9 to 20 days (mean = 12 days) after the stent insertion. During the mean follow-up of 136 days (range, 3-387 days), one patient developed a recurrent symptom due to tumor overgrowth. However, there were no other major complications associated with the procedure. Conclusion Percutaneous transgastric stent placement appeared to be technically feasible and clinically effective in patients who underwent a failed transoral approach.

Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay (복부와 골반의 다양한 장기에서 발생한 황색육아종성 염증 질환의 영상 및 임상 소견: 임상화보)

  • Se Jin Lee;Dal Mo Yang;Hyun Cheol Kim;Sang Won Kim;Kyu Yeoun Won;So Hyun Park;Woo Kyoung Jeong
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.109-123
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    • 2024
  • Xanthogranulomatous (XG) inflammatory disease is a rare benign disease involving various organs, including the gallbladder, bile duct, pancreas, spleen, stomach, small bowel, colon, appendix, kidney, adrenal gland, urachus, urinary bladder, retroperitoneum, and female genital organs. The imaging features of XG inflammatory disease are nonspecific, usually presenting as a heterogeneous solid or cystic mass. The disease may also extend to adjacent structures. Due to its aggressive nature, it is occasionally misdiagnosed as a malignant neoplasm. Herein, we review the radiological features and clinical manifestations of XG inflammatory diseases in various organs of the abdomen and pelvis.

Efficacy and Safety of $Ultracet^{(R)}$ in Ambulatory Patients with Cancer Pain (암환자의 통증치료에 대한 $Ultracet^{(R)}$의 유효성과 안전성)

  • Lee, Hyo-Jin;Jin, Sun-Ah;Yun, Gak-Won;Yang, Yung-Joon;Park, Nam-Whan;Chun, Jae-Min;Park, Nam-Sook;Yun, Hwan-Jung;Jo, Deog-Yeon;Kim, Sam-Yong
    • Journal of Hospice and Palliative Care
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    • v.9 no.2
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    • pp.101-105
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    • 2006
  • Purpose: We aimed to investigate the efficacy and side effects of $Ultracet^{(R)}$ in relieving cancer pain in setting. Methods: Sixty-one cancer patients over 18 years old, who had cancer pain with or without medication, were enrolled. Pain and other variables were evaluated before and after treatment with $Ultracet^{(R)}$ for 2 weeks, using Korean version of Brief Pain Inventory. Results: Of 61 patients with assessable efficacy data, the maximum pain intensity(PI) experienced in a day were $5.18{\pm}1.41\;and\;4.82{\pm}1.94$, before and after treatment with$Ultracet^{(R)}$ respectively (P=0.113). The minimum PI experienced in a day were $1.2{\pm}1.05\;and\;0.87{\pm}1.35$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.038). The average PI experienced in a day were $3.61{\pm}1.01\;and\;3.15{\pm}1.73$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.022). The current PI were $3.63{\pm}1.25\;and\;2.85{\pm}1.94$, before and after treatment with $Ultracet^{(R)}$, respectively (P=0.003). Regarding the quality of life, only mood changed for the better in 49 patients who were treated with $Ultracet^{(R)}$ alone ($1.98{\pm}1.73\;and\;1.35{\pm}1.15$, before and after treatment respectively; P=0.046). There were five (8.2%) adverse events associated with $Ultracet^{(R)}$ treatment. Conclusion: $Ultracet^{(R)}$ seems effective and safe in ambulatory patients with cancer pain.

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An Outbreak of Mumps in Taejon. Korea. 1998 (1998년 대전지역에서 유행한 볼거리의 임상적 연구)

  • Kang, Hee-Dong;Lee, Kyung-Yil;Cha, Sang-Won;Yoon, Kye-Nam;Lee, Dong-Joan;Han, Ji-Whan;Kang, Jin-Han;Whang, Kyung-Tai
    • Pediatric Infection and Vaccine
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    • v.6 no.2
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    • pp.239-244
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    • 1999
  • Purpose : In 1998, there was an outbreak of mumps in Taejon, Korea. We analyzed the monthly incidence, clinical manifestations, and complications during the outbreak and the annual incidence of the recent ten years. Methods : We reviewed the clinical records of 35 mumps patients who had been admitted to Taejon St. Mary's Hospital from January to December, 1998. Results : Mumps was prevalent in summer(from June to August) with 20 cases(57%). Thirthy-three patients(94.3%) received MMR at 15 months of age and no patients received a booster mumps vaccine. The mean age of the mumps patients was 10.5 years-old and the majority of mumps(71%) occurred between 5 and 12 year of age. The male female ratio was 2.2 : 1. The clinical manifestations were swelling of parotid gland(100%), fever (91%), vomiting(77%), abdominal pain(74%) and headache(66%) in order of frequency. Meningitis occurred in 20 cases(57%) and the mean WBC count of CSF was $464{\pm}263/mm^3$. In serology, the mean serum amylase level was $483{\pm}294IU/dL$ and anti-mumps IgM and IgG were positive in 11 and 15 out of 18 cases, respectively. From 1989 to 1997, the mean number of inpatients with mumps was 3.4 per year. Conclusion : We experienced an outbreak of mumps in 1998. It is suggested that there was a primary mumps vaccine failure in Korea and that further studies for vaccine faiure and method of booster mumps vaccine are necessary.

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Association of Serum Vitamin D with Insulin Resistance and Beta Cell Function in Korean Health Checkup Examinees (건강검진 수검자에서 혈청 Vitamin D 수준과 인슐린저항성 및 β-세포 기능과의 관련성)

  • Kim, Han-soo;Ryu, So Yeon;Park, Jong;Han, Mi-Ah;Choi, Seong-Woo;Shin, Min-Ho
    • Journal of agricultural medicine and community health
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    • v.43 no.1
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    • pp.18-30
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    • 2018
  • Objectives: This study was conducted to examine the association of serum Vitamin D with insulin resistance and ${\beta}-cell$ function in Korean health checkup examinees. Methods: This study subjects were 374 healthy adults (199 males, 175 females) over the age of 20, who visited a general hospital medical center located in Haenam-gun, Jeollanam-do. To find the association of Vitamin D with HOMA-IR and $HOMA-{\beta}$, the used statistical analysis were ANOVA and ANCOVA. Results: Of the study subjects, the level of serum Vitamin D defined by deficient group, insufficient group and sufficient group was 38.5%, 48.1% and 13.4%, respectively. According to the level of serum Vitamin D, the mean values of HOMA-IR were $1.92{\pm}1.08$ in sufficient group, $1.99{\pm}1.04$ in the insufficient group and $2.91{\pm}1.05$ in deficient group and there were statistically significant different(p<0.001). The mean values of $HOMA-{\beta}$ were $84.69{\pm}1.07$ in sufficient group, $78.41{\pm}1.04$ in the insufficient group and $80.48{\pm}1.04$ in deficient group, and there were not significant. As a result of ANCOVA, adjusted mean of HOMA-IR were statistically significant different (p<0.001), but those of $HOMA-{\beta}$ were not statistically significant according to the level of serum Vitamin D. Conclusion: The insufficient level of serum Vitamin D was relatively high in healthy adults who live in rural area, and it was found that HOMA-IR significantly increased when Vitamin D was deficient. To prevent insulin resistance or diabetes, it is necessary to provide sufficient information related to sufficient production of Vitamin D such as Vitamin D supplement, sun exposure, food intake and etc.

The Clinical Manifestations of Patients with Severe Alcoholic Ketoacidosis Treated at a Medical Intensive Care Unit (한 내과계 중환자실에서 치료하였던 중증 알코올성 케톤산증 환자들의 임상적 특성)

  • Lee, Kwang Ha;Lee, Sae Hwan;Oh, Yeon-Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Koh, Yoonsuck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang Bum
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.548-553
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    • 2006
  • Background : Alcoholic ketoacidosis(AKA) is a metabolic disturbance that is caused by prolonged and excessive alcohol consumption. Though the prognosis is reportedly good, its outcome is unclear in some cases that are combined with multi-organ failure. There are few reports of an analysis of cases admitted to an intensive care unit(ICU) Method: Cases of AKA admitted to the ICU over the last 5 years were retrospectively analyzed. Severe AKA was characterized by multi-organ failure that required treatment in an ICU Results : All patients were males with a history of excessive alcohol consumption. Five of them (50%) mainly complained of gastrointestinal symptoms (nausea, vomiting, diarrhea), showing metabolic acidosis with an increased asmolar and anion gap. Rhabdomyolysis with acute renal failure was the most common combined organ failure. Mechanical ventilation was performed in 80%. Six patients died and 4 patients survived. In the surviving patients, the arterial blood gas analysis(ABGA) was normalized within 12 hours after admission. Conclusion : In severe AKA patients, rhabdomyolysis with acute renal failure was the most common complication. The mortality rate was high and death from shock occurred within 3 days.

Studies on the Reference Korean 2. Mass of Organs and Size of Brains (표준한국인(標準韓國人)의 최대허용피폭선량(最大許容被曝線量) 설정(設定)에 관한 연구(硏究) 2. 장기질량(臟器質量) 및 뇌(腦)의 크기)

  • Kim, Yung-J.;Lee, Kang-S.;Chun, Ki-J.;Kim, Jong-B.;Kim, Sam-R.;Chung, Gook-H.
    • Journal of Radiation Protection and Research
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    • v.8 no.1
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    • pp.1-14
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    • 1983
  • For the purpose of prediction and protection of radiation effects on the Korean people, we have collected autoptic data from the National Institute of Scientific Investigation. The mass of organs and the size of brains measured is analysed for 1,921 Korean people. The results obtained are as follows; 1. The weight of the kidney in the Reference Korean is 251.6g in male and 227.7g in female. 2. The weight of the lung in the Reference Korean is 1,204.4g in male and 957.4g in female. 3. The weight of the heart in the Reference Korean is 348.8g in male and 301.6g in female. 4. The weight of the liver in the Reference Korean is 1,863.9g in male and 1,610.9g in female. 5. The weight of the pancreas in the Reference Korean is 56.4g in male and 54.0g in female. ,6. The weight of the spleen in the Reference Korean is 67.3g in male and 58.2g in female. 7. The anteroposterior diameter, transverse diameter and vertical diameter of the brain in the Reference Korean are 17.6cm, 15.5cm and 8.6cm in male, respectively, and 17.7cm, 15.4cm and 8.2cm in female, respectively.

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Effects of Cirsium japonicum Powder on Plasma Glucose and Lipid Level in Streptozotocin Induced Diabetic Rats (엉겅퀴 섭취가 Streptozotocin 유발 당뇨 흰쥐의 혈당과 지질수준에 미치는 영향)

  • Han, Hye-Kyoung;Je, Hee-Sun;Kim, Gun-Hee
    • Korean Journal of Food Science and Technology
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    • v.42 no.3
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    • pp.343-349
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    • 2010
  • This investigation was conducted to assess the influence of Cirsium japonicum consumption on the plasma glucose and lipid profiles in streptozotocin (STZ)-induced diabetic rats. Diabetes mellitus was induced in male Sprague-Dawley rats weighing 230 g by injection of STZ into the tail vein at 45 mg/kg body weight. The rats were randomly assigned into four groups: a normal and STZ-control fed an AIN-93 diet group, and diabetic groups whose diets were supplemented with 10% Cirsium japonicum powder containing leaf or root for four weeks. To observe the effects of Cirsium japonicum in the animal model, the levels of glucose, cholesterol, HDL-cholesterol, triglyceride and free fatty acid in the plasma and the levels of glycogen in the tissue were determined after four weeks. Treatment of STZ-induced diabetic rats with leaf consumption significantly lowered the diet intake when compared with STZ-control rats. The relative weights of the liver and kidney differed significantly between the normal and diabetic groups. The weights of the kidneys in the leaf group were significantly lower than those in the STZ-control group. The level of hematocrit was also significantly lower in diabetic rats whose diets were supplemented with leaves when compared to those of STZ-control rats. The plasma glucose level was found to be significantly lower in the leaf group than the STZ-control group. The effect was significant after 2 weeks. The HDL-cholesterol levels increased in all of the diabetic experimental groups when compared to the STZ-control group. These results suggest that supplementation with Circicum japonicum leaves induced considerable hypoglycemic effect in STZ-induced diabetic rats and that these leaves may be useful for the management of diabetes mellitus.