• Title/Summary/Keyword: Liver, CT

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A Case of Ectopic Peritoneal Paragonimiasis Mimicking Diverticulitis or Abdominal Abscess

  • Kim, Min Jae;Kim, Sung-Han;Lee, Sang-Oh;Choi, Sang-Ho;Kim, Yang Soo;Woo, Jun Hee;Yoon, Yong Sik;Kim, Kyung Won;Cho, Jaeeun;Chai, Jong-Yil;Chong, Yong Pil
    • Parasites, Hosts and Diseases
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    • v.55 no.3
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    • pp.313-317
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    • 2017
  • Paragonimiasis is a parasitic disease caused by Paragnonimus species. The primary site of infection is the lung, and extrapulmonary involvement is also reported. When infected with Paragonimus westermani, which is the dominant species in Korea, the central nervous system is frequently involved along with the liver, intestine, peritoneal cavity, retroperitoneum, and abdominal wall. Ectopic paragonimiasis raises diagnostic challenge since it is uncommon and may be confused with malignancy or other inflammatory diseases. Here, we report an ectopic paragonimiasis case initially presented with recurrent abdominal pain. The patient developed abdominal pain 3 times for the previous 3 years and the computed tomography (CT) of the abdomen revealed fluid collection with wall enhancement. Recurrent diverticulitis was initially suspected and part of the ascending colon was resected. However, the specimen showed intact colon wall without evidence of diverticulitis and multiple parasite eggs and granulomas were found instead. The size of about $70{\mu}m$, the presence of an operculum and relatively thick egg shell suggested eggs of Paragonimus species. With appropriate exposure history and a positive antibody test, the definitive diagnosis was made as peritoneal paragonimiasis.

Successful Treatment with Partial Splenic Embolization in a Case of Post-transplantations Lymphoproliferative Disease with Persistent Hypersplenism (림프세포증식성 질환에서 효과를 보인 부분적 비동맥 색전술 1례)

  • Kim, Mi Jin;Rho, Young Il;Yang, Eun Seok;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.92-97
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    • 2004
  • Posttranplantations lymphoproliferative disease (PTLD) is a common and life-threatening complication for soid organ transplantation associated with the use of chronic immunosuppression and Epstein-Barr virus. There is no standardized treatment algorithm, but numerous management strategies are vaiable. Partial splenic embolization (PSE) had been demonstrated to be an effetive alternatie to splenectomy for patients hypersplenism and portal hypertension. PSE has the advantages of non-invasive intervention and resolution of the complications of hypersplenism. We report the effect of the PSE in a 6-year old male liver transplantation recepient with PTLD who has undergone persistent hypersplenism post-transplant. We reduced immunosuppression agent, started antiviral agent. We started with interferon and IV globulin one month after admission. Hepatosplenomegaly and cervical lymphadenopathy were improved. But fever was not subside. We selectively embolized the lower pole of the spleen to achieve a 50~60% reduction in flow as determined by angiography. After embolization, fever subside and peripheral blood findings were improved. Follow up abdominal CT revealed reduced volume of spleen due to ischemic change and there was no multiple enlarged mesenteric lymphnode compared to preembolization state. We thick that PSE is a safe an effetive treatment modality of PTLD with persistent hypersplenism in patients twho failed to medical treatment.

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Dorsal Cavoatrial Bypass for Congenital Interruption of IVC (선천성 하대정맥 중단 환자의 후방 대정맥-우심방 우회 수술 치료 증례)

  • Choe, Ju-Won;Hong, Joon-Hwa;Sohn, Dong-Suep;Cho, Dai-Yun
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.525-528
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    • 2010
  • Congenital interruption of the inferior vena cava (IVC) can lead to secondary hepatic congestion, portal hypertension, and liver cirrhosis. A 49-year-old woman was admitted to the gynecology department with symptoms of menorrhalgia, known uterine myoma, and anemia. Abdominal computed tomography (CT) and venography performed at our hospital revealed congenital interruption of the IVC. The patient underwent retrohepatic cavoatrial bypass surgery with a polytetrafluoroethylene (PTFE) 16-mm ringed graft via posterolateral thoracotomy, and recovered without major complications. A retroperitoneal approach via posterolateral thoracotomy provides appropriate visualization during dorsal cavoatrial bypass in treating patients with congenital interruption of IVC.

A Case of Intracranial Involvement in Plasma Cell Myeloma (두개 내를 침범한 형질세포골수종 1예)

  • Lee, Su-Hyun;Chung, Yoon-Yung;Lim, Ye-Jee;Ko, Sun-Young;Choi, Yoo-A;Kim, Young-Woon;Lee, Sung-Eun;Park, Chong-Won
    • Journal of Yeungnam Medical Science
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    • v.29 no.1
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    • pp.42-44
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    • 2012
  • Plasma cell myelomas generally manifest as bone or soft-tissue tumors with variable mass effects, pain, and infiltrative behavior. Extramedullary involvement occurs most commonly in the spleen, liver, lymph nodes, and kidneys, but intracranial involvement in plasma cell myeloma is a rare extramedullary manifestation. These authors recently encountered a case of intracranial involvement of plasma cell myeloma. A 69-year-old man was hospitalized for headache and mental changes. Brain CT showed subdural hemorrhage caused by plasma cell myeloma. Plasma cell myeloma with intracranial involvement has poor prognosis, and the patient in this case died from acute complications, such as subdural hemorrhage. Based on this case report, it is suggested that more effective treatment regimens of plasma cell myeloma with intracranial involvement be developed. Moreover, a screening method and decision on the appropriate time for intracranial involvement are needed for plasma cell myeloma patients.

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Role of Radiotherapy in Unresectable Pancreatic Carcinoma (수술 불가능한 췌장암 환자에서 방사선 치료의 역할)

  • Shin Hyun Soo;Seong Jinsil;Oh Won Yong;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.119-126
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    • 1993
  • From 1988 to 1991, nineteen patients with unresectable localized pancreatic carcinoma were treated with radiotherapy and/or hyperthermia or in combination with chemotherapy. Radiation dose of 4500-5000 cGy with or without additional 500-1000 cGy was administered over 5 to 6 weeks to the pancreatic tumor area using 10 MV linear accelerator. Five of 19 patients were given chemotherapy, either neoadjuvant or maintenance setting with FAM regimen (5-FU, adriamycin and mitomycin C), which was repeated every 4 weeks for one year or until progression. Symptomatic palliation was achieved in 17 among 19 patients ($89{\%}$) and objective response (complete or partial response in CT finding) was achieved in 5 among 11 patients ($45{\%}$). The median survival time was 9 months and one-year survival rate, $32{\%}$. Local-regional failure was documented in 10 among 13 patients ($77{\%}$) and distant failures were found in the liver (3 patients) and carcinomatosis (2 patients). Prognostic significance of various factors such as age, sex, performance status, tumor location, stage, etc. were assessed. Any factors did not have the prognostic significance in univariate analysis. Treatment was well tolerated in most of the patients with only mild to moderate toxicity.

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A Case of Successful Endoscopic and Conservative Treatment for Intentional Ingestion of Sharp Foreign Bodies in the Alimentary Tract (고의로 섭취한 커터칼날의 내시경 및 보존적 치료 증례 보고)

  • Park, Jong-Min;Kim, Seong Yup;Chung, Il Yong;Kim, Woo-Shik;Shin, Yong-Chul;Kim, Yeong Cheol;Park, Sei Hyeog
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.304-307
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    • 2013
  • Food bolus impaction is the most common cause of esophageal foreign body obstruction in adults. Other causes include intentional ingestion in psychiatric patients or prison inmates. We experienced successful treatment of a patient with intentional ingestion of multiple sharp foreign bodies(25 cutter and razor fragments). A 47-year-old male patient who was suffering from chronic alcoholism was admitted, via the emergency room, with dysphagia and neck pain. He was suffering from alcoholic liver cirrhosis and psychiatric problems, such as chronic alcoholism, anxiety disorder and insomnia. The patient had intended to leave the hospital after having swallowed the sharp objects. Plain radiographs and computed tomography (CT) scan showed multiple, scattered metal fragments in the esophagus, stomach, and small bowel. We performed emergent endoscopy and successfully removed one impacted blade in the upper esophagus using by a snare with an overtube. The rest of the fragments had already passed through the pylorus, so we could not find them with endoscopy. We checked the patient with simple abdominal radiographs and careful physical examinations every day. All remaining fragments were uneventfully excreted through stool during the patient's 6 day hospital stay. Finally, we were able to confirm the presence of the objects in the stool, and radiographs were negative. The patient was discharged without complications after 14 days hospital stay and then was followed by the Department of Psychiatry.

Clinical Study of Gamitaeeumjowi-tang for Obese Patients (가미태음조위탕(加味太陰調胃湯) 전탕액을 활용한 비만 환자에 대한 임상 연구)

  • Seo, Nam-Jun;Nam, Dong-Woo;Lee, Eun-Ok;Shim, Bum-Sang;Ahn, Kyoo-Seok;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.2
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    • pp.446-452
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    • 2008
  • To evaluate the anti-obesity efficacy of Gamitaeeumjowi-tang consisting of Taeeumjowitang and Daehwang. Eleven male(n=4) and female(n=7), obesity patients were recruited by Tenten Diet Network from November 2005 to February 2006. All the subjects were treated with Gamitaeeumjowi-tang 3 times a day for 12 weeks. Weight, BMI, body fat weight, Total cholesterol, LDL, HDL, Triglycerides, GOT, GPT, and CT results were evaluated before and after the 12 week treatment. Weight, BMI, body fat weight, total cholesterol, triglyceride, and subcutaneous fat in upper and lower abdomen all showed significant decrease after 12 weeks of administration. Also Gamitaeeumjowi-tang showed no toxic effects based on liver function test. Taken together, The potentials of Gamitaeeumjowi-tang as a safe and effective treatment for obesity has been recognized through this study. Further large sample sized and double blinded randomized control trials are needed to fully confirm the findings of this study.

Abdominal Injury by Falls from a Height in Children (소아에서 추락사고에 의한 복부손상)

  • Choi, Kum-Ja
    • Advances in pediatric surgery
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    • v.11 no.2
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    • pp.115-122
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    • 2005
  • Falls from a height are the leading cause of injury and death among urban children. This study describes the incidence, clinical characteristics, and treatment results of children under 15 year of age who fell from a height of more than one meter and were admitted for abdominal injury. The medical records of 585 consecutive patients treated between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. The falling heights were 1 to 31.2 meters, and 28 patients(4.8 %) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The median age of the victims was 5.5 years, and the median height fallen was 3 meters. Fifteen patients (53.6 %) were injured during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3 %) of falls occurred in residential place and 19(67.8 %) of patients arrived at the emergency department within 30 minutes of the accident. Only 16 patients (57.1 %) complained of abdominal pain. Liver injuries were found in 12(42.9 %), spleen injuries in 5(17.9 %), kidney injuries 3(10.7 %), pancreatic injuries in 1(3.6 %) and nonspecific abdominal injuries in 9(32.1 %) cases. Increased SGOT and SGPT were found in 23(82.2 %) and 18(64.3 %) cases. Eleven patients (39.3 %) had associated head injuries. Limb injuries were present in 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3 %) recovered without operation. The median length of hospital stay was 6 days (2 -20 days). Despite the absence of abdominal symptoms or shock, falls from a height in children may carry significant intra-abdominal organ injuries. The height falling could not predict the degree of the abdominal injury. For the evaluation of potential abdominal injuries, CT scan should be utilized.

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Efficacy of Korean Red Ginseng by Single Nucleotide Polymorphism in Obese Women: Randomized, Double-blind, Placebo-controlled Trial

  • Kwon, Dong-Hyun;Bose, Shambhunath;Song, Mi-Young;Lee, Myeong-Jong;Lim, Chi-Yeon;Kwon, Bum-Sun;Kim, Ho-Jun
    • Journal of Ginseng Research
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    • v.36 no.2
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    • pp.176-189
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    • 2012
  • This study examined the effects of Korean red ginseng (KRG) on obese women and aimed to confirm that the effects of KRG on obesity differ dependently on a gene. Fifty obese women were recruited and randomized to receive KRG (n=24) or placebo (n=26) for 8 wk. Measurements of blood pressure, height, weight, waist circumference, waist-hip ratio (WHR), total fat mass, percentage of body fat, resting metabolic rate, basal body temperature, and daily food intake (FI), blood test (serum lipid, liver and renal function), Korean version of obesity-related quality of life scale (KOQOL), and a gene examination were performed. Comparisons of subjects before and after the administration of KRG revealed significant improvements of obesity in terms of weight, body mass index (BMI), WHR, FI, and KOQOL. However, in the comparison between KRG group and placebo group, only KOQOL was significantly different. KRG displayed significant efficacy on BMI and KOQOL in the CT genotype of the G protein beta 3 gene, but not in the CC genotype, on blood sugar test in the Trp64/Arg genotype of the beta 3 adrenergic receptor gene, but not in Trp64/Trp genotype, on KOQOL in the DD genotype of the angiotensin I converting enzyme gene, but not in the ID and DD genotypes. The effects of KRG on obesity were confirmed to some extent. However, a distinct effect compared to placebo was not confirmed. KRG is more effective for improving the secondary issues of the quality of life derived from obesity rather than having direct effects on the obesity-related anthropometric assessment and blood test indices.

The Healing Effect of Jinmu-tang (Zhenwu-tang) in Femur Fractured Rats (진무탕(眞武湯)이 흰쥐의 대퇴골 골절 치유에 미치는 실험적 연구)

  • Park, Jung-Oh;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.19-35
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    • 2020
  • Objectives The aim of this study is to evaluate the fracture healing effect of Jinmu-tang (JM) on femur fractured rats. Methods Rats were randomly divided into 5 groups (normal, control, positive control, JM extract with low concentration and JM extract with high concentration). All group except normal group went through both femur fracture. Normal and control group received no treatment at all. Positive control group were medicated with tramadol (20 mg/kg) once a day for 14 days. Experimental group was orally medicated with JM extract (10 mg/kg for low concentration, 50 mg/kg for high concentration) once a day for 14 days. In order to investigate fracture healing process, plasma and serum were obtained. Also, micro-computed tomography was conducted to see the frature site visually. Immunohistochemistry for transforming growth factor-β1, Ki67, alkaline phosphatase, runt-related transcription factor 2, receptor activator of nuclear factor kappa-β, tartrate resistant acid phosphatase was conducted to observe bone healing progress after 14 days since fracture occured. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured in plasma, for hepatotoxicity and nephrotoxicity of JM extract. Osteocalcin was measured to observe activity of osteoblast. Results Through Micro-CT, more fracture healing was observed on both experimental group than control and positive control group. Through Hematoxylin & Eosin and safranin O staining showed bone cell proliferation and bone formation in the experimental group. RANK was significantly increased in the experimental groups. JM with high concentration showed statistically significant of TGF-β and Osteocalcin. NO, TRAP and ALP were not significantly changed. Liver toxicity was not significantly observed. Creatinine significantly increased in both experimental groups after 28 days. Conclusions As described above, JM extract showed anti-inflammatory effect, promoted fracture healing by stimulating the bone regeneration factor, and showed little hepatotoxicity and nephrotoxicity. In conclusion, JM extract can promote fracture healing and it can be used clinically to patients with fracture.