• Journal of radiological science and technology
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• v.38 no.3
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• pp.245-252
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• 2015

To obtain the best SNR (signal to noise ratio) due to changes in CTDI (computed tomography dose index) made for the purpose of setting the optimum image obtained by reducing the dose in abdominal CT. Abdominal CT scans of 59 patients a $400-499cm^2$ (n = 12), $500-599cm^2$ (n = 21), $600-699cm^2$ (n = 17), $700-799cm^2$ (n = 9) were separated by four groups and the effective dose was used in the Excel to get the area of the patient using the ImageJ program. Patients of CTDI, DLP, SNR, the effective dose were analyzed. Abdominal CT area was increased to 13 mGy in CTDI is 7.3 mGy, DLP to 732 in $394.4mGy{\cdot}cm$, also effective dose was 5.9 mSv increase in 11mSv. SNR is 15 dB was maintained at 12.7. CTDI according to the average of the abdominal area of 8.9 mGy, the average of the DLP was $481.54mGy{\cdot}cm$, the effective dose is calculated to be 7.2 mSV. Effective dose was calculated by multiplying the load factor of DLP in the abdomen showed no statistically significant difference of (p < .05), there was a significant difference in SNR (p > . 05). To improve image quality of abdominal CT scan image in consideration of the CTDI according to the volume of the patient it should be able to reduce the radiation exposure of the patients.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.21-28
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• 2010

Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.

• Journal of Yeungnam Medical Science
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• v.13 no.1
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• pp.134-140
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• 1996

Recently many studies have shown the usefulness of computed tomogram in diagnosing abdominal mass when clinical and conventional radiologic examinations fail to reveal the nature of abdominal mass or the cause of abdominal distension. To evaluate the usefulness of CT in diagnosing neuroblastoma, we retrospectively analyzed computed tomographic findings of 16 neuroblastoma patients, who pathologically proved in Yeungnam University Hospital from 1986 to 1995. The age range of the patients studied were from 8months to 18years. The most frequent sith of origin was adrenal gland and the next was retroperitioneum. The presenting symptoms were palpable mass, abdominal distension, and abdominal pain. The viewpoints of this analysis were turnoral calcifications, midline cross, shape, margin, internal structure, contrast enhancement patterns, major vessel involvement, and lymph node involvement. Characteristic CT findings were as follows: Fine dense curvillinear calcification within the tumor(56%), midline cross(50%), lobulation(75%), well-circumscribed margin(56%), cystic degeneration(56%), heterogeneous contrast enhancement(69%). encasement of major vessels such as aorta, IVC and celiac trunk(50%), and paraaortic lymphadenopathy(87%). We conclude that these CT findings were very common and could be helpful in diagnosting and differentiation neuroblastoma in infant and children.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.66-70
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• 2019

Traumatic diaphragmatic injuries (TDIs) are a rare complication in thoraco-abdominal trauma. The diagnosis is difficult and if left untreated, TDI can cause traumatic diaphragmatic hernia (TDH). Through an injured diaphragm, the liver, spleen, stomach, small intestine, and large intestine can be herniated to the thoracic cavity, but pancreatic herniation and pancreatitis are quite rare in TDH. This paper reports a case of pancreatitis developed by additional trauma in a patient with asymptomatic chronic TDH. A 58-year-old male visited the emergency department with a left abdominal injury after a fall 6 hours earlier. The vital signs were stable, but the amylase and lipase levels were elevated to 558 U/L and 1,664 U/L, respectively. Abdominal computed tomography (CT) revealed a left diaphragmatic hernia and an incarceration of the stomach, pancreatic ductal dilatation, and peripancreatic fatty infiltration. Additional history taking showed that he had suffered a fall approximately 20 years ago and had an accidentally diaphragmatic hernia through a chest CT 6 months earlier. A comparison with the previous CT revealed the pancreatitis to be caused by secondary pancreatic ductal obstruction due to the incarcerated stomach. For pancreatitis, gastrointestinal decompression was performed, and after 3 days, the pancreatic enzyme was normalized; hence, a thoracotomy was performed. A small ruptured diaphragm was found and reposition of the organs was performed. This paper reports the experience of successfully treating pancreatitis and pancreatic hernia developed after trauma without complications through a thoracotomy following gastrointestinal decompression.

• Journal of Veterinary Clinics
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• v.36 no.4
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• pp.238-243
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• 2019

A 6-year-old, spayed female Maltese was presented with the condition of a chronic recurrent abscess formation in the left flank region. Despite the antibiotics and drainage therapy given to the dog, the lesion formed a continued serosanguineous to the point that a purulent discharge was evident. In the meantime, an abdominal ultrasound revealed the presence of a well-defined mass with a hypoechoic outer margin, and a hyperechoic inner rim in the cranial of the kidney. A fistula was noted as being present with a connection between the subcutaneous lesion of the left flank and the abdominal mass. It is emphasized that CT scans revealed the existence of a soft tissue dense mass with low attenuation area, as seen in some internal areas and also a peripheral contrast enhancement was noted within a nonenhancing central region. There was additional nonenhancing fluid found dorsal to the inflammatory tract passing under the epaxial muscles and at the peritoneum. Likewise, the tract exited the skin surface in the left flank. A tentative diagnosis of an abdominal abscess with spontaneous cutaneous fistula was made based on the ultrasonographic and CT appearances. A foreign body such as surgical gauze should always be considered a potential cause of draining tract in small animals, as was considered to be the problem in this case.

• Journal of Sasang Constitutional Medicine
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• v.14 no.2
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• pp.147-152
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• 2002

One woman, Sixty three years old, suffered from chest pain, abdominal pain, nausea and vomiting for about three months. Although many examinations, brain magnetic resonance imaging(MRI), chest computed tomography(CT), abdominal CT, gastric endoscope, abdominal ultrasonography, and so forth, was performed from every point of view, those were non-significant. At first, I wrongly diagnosed her case as disease of Soumin and gave Soumin Gwakhyangjeongkisan. But she complained of diarrhea and chest discomfort. I re-diagnosed her case as Soyangin Gyeolhyung and treated with Hyeongbangdojeoksan, herbal medicine, consisted of Rhizoma Rehmanniae(生地黃), Lignum Akebiae(木通), Radix Scrophulariae(玄蔘), Semen Trichosanthis(瓜蔞仁), etc. Three weeks have passed from first visit and she did not suffered from pain. I experienced the excellent effect of Hyeongbangdojeoksan to Soyangin Gyeonlhyung.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.582-587
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• 2009

A 59-year-old woman who was diagnosed with malignant pheochromocytoma underwent $^{18}F$-fluorodeoxyglucose positron emission tomography/computed tomography ($^{18}F$-FDG PET/CT). She had undergone left adrenalectomy for pheochromocytoma 4 years previously. Recent multiple metastatic pulmonary nodules were noted on the chest X-ray. After treatment with $^{131}I$-metaiodobenzylguanidine ($^{131}I$-MIBG) with 7.4 GBq, post-therapy $^{131}I$-MIBG scintigraphy depicted multiple distant metastases including lung, liver, abdominal para-aortic and mesenteric lymph nodes. $^{18}F$-FDG PET/CT also depicted multiple metastases in lung, liver, and abdominal para-aortic lymph nodes, but some lesions were not shown. In this case, $^{131}I$-MIBG scintigraphy found additional lesions in metastatic malignant pheochromocytoma.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.186-187
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• 2006

A 64-year-old female with glioblastoma multiforme (GBM) was assigned to our department for whole body PET/CT scan. She ingested 1 liter of pure water as negative oral contrast just before PET/CT examination. FDG-PET/CT images showed a very intense hypermetabolic, focal lesion in the abdominal cavity around descending colon. The SUVmax of the lesion was 17.2. But there was no abnormal lesion corresponded to the area of PET scan in the combined contrast enhanced CT scan. We suggested considering a malignant lesion due to very intense glycolytic activity. Conventional abdominal CT scan & colonoscopy were accomplished within one week after PET/CT evaluation. There was no abnormality in both examinations. We executed follow-up PET/CT evaluation after 1 month and couldn't find any abnormality around the corresponding area. So we concluded the hypermetabolism was colonic physiologic uptake. A colonic physiologic uptake is a well known cause of false positive finding. Nuclear physicians should be considered the possibility of malignancy when interpret focal colonic uptake, especially incidental finding. There are a few reports that using of negative oral contrast is able to reduce gastrointestinal physiologic uptakes. But as we can see in this case, although we used negative oral contrast, intense physiologic uptake is detected and maxSUV is able to up to 17.2. So, it is important to keep a fact in mind. Even though there is a colonic physiologic uptake in PET/CT image, it may be able to show very intense hypermetabolism regardless of using negative oral contrast.

• Journal of International Society for Simulation Surgery
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• v.1 no.1
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• pp.37-40
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• 2014

Purpose For living donor liver transplantation, liver segmentation is difficult due to the variability of its shape across patients and similarity of the density of neighbor organs such as heart, stomach, kidney, and spleen. In this paper, we propose an automatic segmentation of the liver using multi-planar anatomy and deformable surface model in portal phase of abdominal contrast-enhanced CT images. Method Our method is composed of four main steps. First, the optimal liver volume is extracted by positional information of pelvis and rib and by separating lungs and heart from CT images. Second, anisotropic diffusing filtering and adaptive thresholding are used to segment the initial liver volume. Third, morphological opening and connected component labeling are applied to multiple planes for removing neighbor organs. Finally, deformable surface model and probability summation map are performed to refine a posterior liver surface and missing left robe in previous step. Results All experimental datasets were acquired on ten living donors using a SIEMENS CT system. Each image had a matrix size of $512{\times}512$ pixels with in-plane resolutions ranging from 0.54 to 0.70 mm. The slice spacing was 2.0 mm and the number of images per scan ranged from 136 to 229. For accuracy evaluation, the average symmetric surface distance (ASD) and the volume overlap error (VE) between automatic segmentation and manual segmentation by two radiologists are calculated. The ASD was $0.26{\pm}0.12mm$ for manual1 versus automatic and $0.24{\pm}0.09mm$ for manual2 versus automatic while that of inter-radiologists was $0.23{\pm}0.05mm$. The VE was $0.86{\pm}0.45%$ for manual1 versus automatic and $0.73{\pm}0.33%$ for manaual2 versus automatic while that of inter-radiologist was $0.76{\pm}0.21%$. Conclusion Our method can be used for the liver volumetry for the pre-surgery planning of living donor liver transplantation.

• Physical Therapy Korea
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• v.19 no.4
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• pp.1-7
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• 2012

This present study investigated the effects of the abdominal drawing-in maneuver (ADIM) and chin tuck (CT) on middle thoracic erector spinae, lower thoracic erector spinae, and lumbar erector spinae muscle activity during three prone thoracic extension (PTE) exercises. Twelve healthy subjects performed preferred PTE, ADIM PTE, and ADIM-CT PTE. Surface electromyography was used to collect data on the muscle activity of dominant middle and lower thoracic erector spinae muscles and the lumbar erector spinae. Middle and lower thoracic erector spinae muscle activity significantly increased when ADIM and CT was performed (p<.05). However, lumbar erector spinae muscle activity significantly decreased in ADIM PTE compared to preferred PTE (p=.017) and significantly increased in ADIM-CT PTE compared to ADIM PTE (p=.004). In conclusion, ADIM-CT PTE effectively increased middle and lower thoracic erector spinae muscle activity, and ADIM PTE decreased lumbar erector spinae muscle activity. Hence, ADIM PTE could be a recommended exercise maneuver to strengthen thoracic erector spinae without over activation of lumbar erector spinae.