• Advances in pediatric surgery
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• 제11권2호
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• pp.186-191
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• 2005

A 10-year-old-girl was referred to our hospital due to abdominal pain. She underwent Roux-en-Y cystojejunostomy for a choledochal cyst at another hospital at the age of 3 months. Abdominal ultrasonography (USG) and computed tomography (CT) showed type I choledochal cyst and multiple gallbladder stones. Because of severe inflammation and adhesion, partial resection of the choledochal cyst and Roux-en-Y hepaticojejunostomy was performed. Two and one half years later, intermittent abdominal pain, fever, nausea and vomiting occured. Abdominal CT scan showed a polypoid nodular lesion in the remnant of the choledochal cyst and probable metastasis at segment 7 of the liver. The duodenum was obstructed by the mass. Liver biopsy revealed moderately differentiated adenocarcinoma. A palliative gastrojejunostomy was performed to relieve duodenal obstruction. She died of hepatic insufficiency 4 months later.

• 한국임상수의학회지
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• 제22권3호
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• pp.275-277
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• 2005

A six year old female Shih Tzu was euthanized after having about 2 months history of weakness and convulsion with hypoglycemia. On ultrasonography, several masses in variable sizes were noted in the liver and fine needle aspiration cytology revealed probable neoplasm of pancreatic origin. On necropsy, numerous round firm tan nodules with central depression were noted in the liver and heart. Mesenteric lymph node was enlarged and fused with presumable pancreatic tissue. Based on the histopathology and immunohistochemistry, the tumor was confirmed as malignant metastatic insulinoma.

• Parasites, Hosts and Diseases
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• 제57권4호
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• pp.429-434
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• 2019

A complicated case of echinococcosis with multiple organ involvement is reported in a 53-year-old businessman who frequently traveled overseas, including China, Russia, and Kazakhstan from 2001 to 2007. The patient was first diagnosed with a large liver cyst during a screening abdomen ultrasonography in 2011, but he did not follow up on the lesion afterwards. Six years later, dizziness, dysarthria, and cough developed, and cystic lesions were found in the brain, liver and lungs. The clinical course was complicated when the patient went through multiple surgeries and inadequate treatment with a short duration of albendazole without a definite diagnosis. The patient visited our hospital for the first time in August 2018 due to worsening symptoms; he was finally diagnosed with echinococcosis using imaging and serologic criteria. He is now on prolonged albendazole treatment (400 mg twice a day) with gradual clinical and radiological improvement. A high index of suspicion is warranted to early diagnose echinococcosis in a patient with a travel history to endemic areas of echinococcosis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1789-1794
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• 2015

Background: Non-alcoholic fatty liver disease (NAFLD), the most common liver problem in diabetes, is a risk factor for liver cancer. Diabetes, high body mass index (BMI) and old age can all contribute to NAFLD progression. Transient elastography (TE) is used for non-invasive fibrosis assessment. Objectives: To identify the prevalence of NAFLD and significant hepatic fibrosis in diabetic patients and to assess associated factors. Materials and Methods: One hundred and forty-one diabetic and 60 normal subjects were screened. Fatty liver was diagnosed when increased hepatic echogenicity and vascular blunting were detected by ultrasonography. Liver stiffness measurement (LSM) representing hepatic fibrosis was assessed by TE. LSM ${\geq}7$ kPa was used to define significant hepatic fibrosis. Results: Four cases were excluded due to positive hepatitis B viral markers and failed TE. Diabetic patients had higher BMI, systolic blood pressure, waist circumference and fasting glucose levels than normal subjects. Fatty liver was diagnosed in 82 (60.7%) diabetic patients but in none of the normal group. BMI (OR: 1.31; 95%CI: 1.02-1.69; p=0.038) and alanine aminotransferase (ALT)(OR: 1.14; 95%CI: 1.05-1.23; p=0.002) were associated with NAFLD. Diabetic patients with NAFLD had higher LSM than those without [5.99 (2.4) vs 4.76 (2.7) kPa, p=0.005)]. Significant hepatic fibrosis was more common in diabetic patients than in normal subjects [22 (16.1%) vs 1 (1.7%), p=0.002]. Aspartate aminotransferase (AST)(OR: 1.24; 95%CI: 1.07-1.42; p=0.003) was associated with significant hepatic fibrosis. Conclusions: Sixty and sixteen percent of diabetic patients were found to have NAFLD and significant hepatic fibrosis. High BMI and ALT levels are the predictors of NAFLD, and elevated AST level is associated with significant hepatic fibrosis.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.1097-1102
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• 2016

Background: Liver fluke infection with Opisthorchis viverrini and its associated cholangiocarcinoma constitute a serious problem in Thailand. Healthy behavior can decrease infection, therefore, the investigation of knowledge, attitude, and practice is need required in high risk areas. Objective: This study aimed to investigate the behavior and perceptions regarding liver fluke. Materials and Methods: A cross-sectional descriptive study was conducted in Chum Phuang district of Nakhon Ratchasima province, Thailand during July to November 2015. A total 80 participants who had screened with verbal screening test, stool examination, and ultrasonography, were purposive selected and completed a pre-designed questionnaire (Kruder-Richardon-20=0.80, Cronbach's alpha coefficient=0.82 and 0.79). T-test, ANOVA, and Pearson correlation test were used for analyzed data. Results: The results reveal that O. viverrini infection was 1.25%, and 3 patients had a dilated bile ducts. The participants had a high knowledge, attitude, and practice regarding liver fluke. The education, occupation, and income, were statistical significant to attitude regarding liver fluke. Nurses and television were the main sources of information regarding liver fluke, with statistical significance(p-value <0.05). Knowledge was significantly associated with attitude and practice (p-value<0.05). Conclusions: Participants had good behavior regarding liver fluke. Improvement of knowledge and attitude is influenced to practical change regarding this carcinogenic fluke. In addition, nurse and television are the main information resources for key success in increasing people perception for disease prevention and control in this area.

• 대한영상의학회지
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• 제84권3호
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• pp.666-675
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• 2023

목적 지방간 환자에서 초음파 감쇠영상(attenuation imaging; 이하 ATI)의 감쇠계수(attenuation coefficient; 이하 AC)와 시각적 평가 사이의 상관관계 여부를 파악하고 혈액화학 및 CT 감쇠계수와 AC 사이의 상관관계 여부를 평가하고자 하였다. 대상과 방법 본 후향적 연구에서는 2018년 4월부터 12월까지 ATI를 포함한 간초음파를 시행 받은 환자들 중 만성 간질환 및 간경화증을 제외한 환자들을 대상으로 하였다. AC와 초음파 시각적 평가, 혈액화학, 간 감쇠 및 간 대 비장 비율(liver to spleen ratio; 이하 L/S ratio) 사이의 상관관계를 분석하였다. 분산 분석을 통해 초음파 시각적 등급에 따른 AC 값을 비교하였다. 결과 총 161명의 환자가 포함되었다. 초음파 시각적 평가와 AC 사이의 상관 계수는 0.814였다(p < 0.001). 정상, 경도, 중등도, 고도 지방간의 AC 평균값은 각각 0.56, 0.66, 0.74, 0.85였다(p < 0.001). 알라닌 아미노전이효소는 AC와 유의한 상관관계가 있었다(r = 0.317, p < 0.001). 간 감쇠계수 및 L/S ratio와 AC 사이의 상관계수는 각각 -0.702 와 -0.626이었다(p < 0.001). 결론 초음파 시각적 평가와 AC는 강한 양의 상관관계 및 등급들 사이의 구별되는 AC 값을 보였고, CT 감쇠계수와 AC는 강한 음의 상관관계를 보였다.

• 한국임상수의학회지
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• 제12권1호
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• pp.861-876
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• 1995

This study was carried out to get fundamental information about the normal ultrasonogram of the liver and heart in Korean native cattle and calves. The interventricular septum, left ventricular internal diameter, left ventricular free wall thickness, aortic diameter, left atrial diameter, and right ventricular internal diameter of hear in 10 Korean native calves were determined at 4-5 right intercostal spare by use of ultrasonography. The caudal vena cava, portal vein, gallbladder, liver of 9 Korean native cattle and 10 calves were determined at 12, 11 and 10th intercostal spares by use of ultrasonography. Cursor-directed M-mode and gray-scale, B-mode ultrasonograms were obtained with electronic scanning ultrasound equipment with a 3.5 or 5.0-MHz convex transducer. The results obtained through the experiments were summarized as follows: 1. The result of ultrasonographic examination of the korean native calves' heart 1) Interventricular septum in systole and diastole was 1.23 and 0.81 cm, respectively(vc=28.84, 17.4). 2) Ventricular internal diameter in systole and diastole was 2.50 and 4.91 cm, respectively(vc=17.44, 12.73). 3) Left ventricular free was thickness in systole and diastole was 1.44 and 0.92 cm, respectively(vc=26.85, 23.54). 4) Aortic diameter was 2.69.m, .rspectevely(vc=11.29). 5) Left atrial diameter was 1.82 cm(vc=15.31). 6) Right ventricular internal diameter in systole and diastole was 1.12 and 1.9 cm, respectively(vc=33.71, 24.43). 3. Ultrasonographic measurments of caudal vena cava, portal vein, gallbladder of Korean native calves 1) Dorsal margin of caudal vena cava at the 12, 11 and 10th intercostal space was 13.5, 15.3 and 18.1 cm, respectively(p<0.01). 3) Depth of caudal vena cava at the 12, 11 and 10th intercostal space was 4.4, 4.5 and 4.6 cm, respectively. 3) Diameter of caudal vena cava at the 12, 11 and 10th intercostal space was 11.6, 1.7 and 1.6 cm, respectively. 4) Dorsal margin of portal vein at the 12, 11 and 10th intercostal space was 16.2, 18.6 and 21.4 cm, respectively(p<0.01) 5) Depth of portal vein at the 12, 11 and 10th intercostal spare was 4.5, 4.4 and 3.9 cm respectively. 6) Diameter of portal vein at the 13, 11 and 10th intercostal space was 2.1, 2.2 and 1.9 cm respectively. 7) Dorsal margin of gallbladder at the 11 and 10th intercostal space was 23.6 and 23.9 cm, respectively(p<0.01), 8) Longitudinal diameter of gallbladder at the 11 and 10th intercostal space was 7.1 and 5.9 cm, respectively(p<0.05). 9) Transverse diameter of gallbladder at the 11 and 10th intercostal space was 2.4 and 2.1 cm respectively(p<0.01). 3. Ultrasonographic measurments of caudal vena cava, portal vein, gallbladder of Korean native cattle 1) Dorsal margin of caudal vena cava at the 12 and 11th intercostal space was 22.2, and 25.4 cm, respectively(p<0.01). 2) Depth of caudal vena cava at the 12 and 11th intercostal space was 103 and 11.1 cm, respectively(p<0.01). 3) Diameter of caudal vena cava at the 12 and 11th intercostal space was 3.1 and 3.0 cm, respectively. 4) Dorsal margin of portal vein at the 12 and 11th intercostal space was 29.3 and 32.9 cm, respectively(p<0.01). 5) Depth of portal vein at the 12 and 11th intercostal space was 9.6, and 9.2 cm, respectively. 6) Diameter of portal vein at the 12 and lith intercostal space was 3.4 and 3.3 cm, respectively. 7) Dorsal margin of gallbladder at the 11 and 10th intercostal space was 43.1 and 45.5 cm, respectively(p<0.01). 8) Longitudinal diameter of gallbladder at the 11 and 10th intercostal space was 10.1 and 9.4 cm, respectively. 9) Transverse diameter of gallbladder at the 11 and 10th intercostal space was 4.0 and 3.7 cm, respectively. 4, Ultrasonogaphic measurments of dorsal margin, ventral margin, size and angles of the Korean native calves' liver. 1) Dorsal margin of liver at the 12, 11 and 10th intercostal space was 11.0, 9.6, and 12.4 cm, respectively(p<0.01). 2) Ventral margin of liver at the 12, 11 and 10th intercostal spate was 20, 24 and 26.1 cm, respectively(p<0.01). 3) Size of the liver at the 12, 11 and 10th intercostal space was 9.0, 14.6 and 13.8 cm, respectively(p<0.01). 4) Angle of liver at the 12, 11 and 10th intercostal space was 40, 46 and 37, respectively(p<0.01). 5. Ultrasonographic measurmants of dorsal margin, ventral margin, size and anglses of the korean native cattle's liver 1) Dorsal margin of the liver at the 12, 11 and 10th intercostal space was 14.4, 18.2 and 26, 3 cm, respectively. 2) Ventral margin of liver at the 12, 11 and 10th intercostal space was 41.1, 46.4 and 49.3 cm, respectively(p<0.01). 3) Size of the liver at the 12, 11 and 10th intercostal space was 26.8, 28.2 and 23.2 cm, respectively(p<0.01). 4) Angel of liverat the 15, 11 and 10 intercostal space was 41, 40.6 and 35.7, respectively(p<0.05). It was concluded that the ultrasonographic values oletermined in this study can be used as references for the diagnosis of morphologic changes in the hear and liver in korean native calves, and in the liver in korean native rattle.

• Korean Journal of Radiology
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• 제21권12호
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• pp.1317-1325
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• 2020

Objective: The aim of this study was to prospectively evaluate whether liver stiffness (LS) assessments, obtained by two-dimensional (2D)-shear wave elastography (SWE) with a propagation map, can evaluate liver fibrosis stage using histopathology as the reference standard. Materials and Methods: We prospectively enrolled 123 patients who had undergone percutaneous liver biopsy from two tertiary referral hospitals. All patients underwent 2D-SWE examination prior to biopsy, and LS values (kilopascal [kPa]) were obtained. On histopathologic examination, fibrosis stage (F0-F4) and necroinflammatory activity grade (A0-A4) were assessed. Multivariate linear regression analysis was performed to determine the significant factors affecting the LS value. The diagnostic performance of the LS value for staging fibrosis was assessed using receiver operating characteristic (ROC) analysis, and the optimal cut-off value was determined by the Youden index. Results: Reliable measurements of LS values were obtained in 114 patients (92.7%, 114/123). LS values obtained from 2D-SWE with the propagation map positively correlated with the progression of liver fibrosis reported from histopathology (p < 0.001). According to the multivariate linear regression analysis, fibrosis stage was the only factor significantly associated with LS (p < 0.001). The area under the ROC curve of LS from 2D-SWE with the propagation map was 0.773, 0.865, 0.946, and 0.950 for detecting F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The optimal cut-off LS values were 5.4, 7.8, 9.4, and 12.2 kPa for F ≥ 1, F ≥ 2, F ≥ 3, and F = 4, respectively. The corresponding sensitivity and specificity of the LS value for detecting cirrhosis were 90.9% and 88.4%, respectively. Conclusion: The LS value obtained from 2D-SWE with a propagation map provides excellent diagnostic performance in evaluating liver fibrosis stage, determined by histopathology.

• Clinical and Experimental Pediatrics
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• 제51권1호
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• pp.89-92
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• 2008

신생아의 피막하 간 혈종은 다양한 원인에 의해서 유발되는데 대부분은 출혈의 양이 적어 임상적으로 발견되기 보다는 부검시 발견되는 경우가 많다. 그러나 출혈의 양이 많아 혈종을 싸고 있는 피막이 파열되고 잇따른 출혈이 발생할 경우에는 창백, 혈관 허탈, 빈혈, 복부팽만, 저산소증, 산혈증 등의 증상을 보이므로 조기에 의심하여 정확한 진단을 내리고 적절한 수술적 치료를 실시하지 않으면 사망률이 높다. 저자들은 태변 흡입후 신생아 가사 소견을 보여 심폐소생술을 실시한 신생아에서 출생후 7일에 발현된 대량 피막하 간 혈종 파열 1례를 경험하였기에 보고하는 바이다.

• Clinical and Experimental Pediatrics
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• 제58권2호
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• pp.69-72
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• 2015

Insulinoma, which arises from insulin-producing pancreatic beta cells, is a rare tumor in children. Only 5%-10% of insulinomas are malignant and undergo metastasis. We report a case of an 11-year-old girl who experienced hypoglycemia-related seizures induced by an insulinoma; after resection of the primary tumor, she developed hepatic focal nodular hyperplasia (FNH). Laboratory test results indicated marked hypoglycemia with hyperinsulinemia. Abdominal ultrasonography (US) and computed tomography results were normal; however, magnetic resonance imaging (MRI) showed a solid mass in the pancreatic tail. Therefore, laparoscopic distal pancreatectomy was performed. Two months after the surgery, an abdominal MRI revealed multiple nodular lesions in the liver. An US-guided liver biopsy was then performed, and histological examination revealed FNH without necrosis or mitotic activity. The patient has been free of hypoglycemia for 2 years, and recent MRI studies showed a decrease in the size of FNH lesions, without any evidence of metastasis. Even though no metastatic lesions are noted on imaging, close observation and follow-up imaging studies are required in a child with insulinoma that has malignant potential on histopathologic findings.