• Journal of Chest Surgery
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• v.42 no.2
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• pp.275-278
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• 2009

Leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor. Yet tumors of a smooth muscle origin are the most common primary neoplasms of the major veins, and the inferior vena cava is the most common site of origin. We report here on a 65-year-old female patient who had been suffering from dyspnea and abdominal discomfort for 3 weeks before admission. The abdominal computed tomography (CT) scan and IVC cavogram showed an IVC mass extending from the right atrium to above the level of the right renal vein, obstructing the IVC, and the radiological findings were suggestive of an IVC leiomyosarcoma. We resected the tumor and reconstructed the IVC with a patch PTFE graft. The follow-up abdominal CT revealed no recurrence and obstruction of the IVC for 6 months after the operation.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.36-41
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• 1994

Angiosarcoma is a very rare malignant tumor of endothelial cell origin. We experienced a case of angiosarcoma presented with massive pleural effusion, which was considered as a metastasis from right kidney. A 44-year-old male patient was admitted due to dyspnea for one month. He had a history of transient hematuria 3 months before admission, which disappeared spontaneously. Chest roentgenography showed total haziness in left hemithorax with multiple nodular shadows in right lung. Abdominal ultrasonogram showed a single heterogeneous hyperechoic mass, measuring about $7.3{\times}7.1{\times}6.5cm$ in size in the upper and mid-pole of the right kidney, involving renal sinus. Computed tomography of the chest revealed highly enhanced multiple pulmonary and subpleural nodules with loculated pleurisy. In bronchoscopic finding, a fungating, hypervascular tumor mass was noticed at the orifice of anterior basal segment of left lower lung after removal of tenaceous mucus. Pleural and bronchoscopic biopsies showed findings of angiosarcoma confirmed by immunochemical stains with factor VIII related antigen(+), laminin(+) and vimentin(+), and by characteristic electronmicroscopic findings. Massive pleural effusion was controlled with several times of pleurodesis in both pleural spaces.

• Toxicological Research
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• v.28 no.4
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• pp.235-240
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• 2012

$^{99m}Tc$ tricarbonyl glycine monomers, trimers, and pentamers were synthesized and evaluated for their radiolabeling and in vivo distribution characteristics. We synthesized a $^{99m}Tc$-tricarbonyl precursor with a low oxidation state (I). $^{99m}Tc(CO)_3(H_2O)_3^+$ was then made to react with monomeric and oligomeric glycine for the development of bifunctional chelating sequences for biomolecules. Labeling yields of $^{99m}Tc$-tricarbonyl glycine monomers and oligomers were checked by high-performance liquid chromatography. The labeling yields of $^{99m}Tc$-tricarbonyl glycine and glycine oligomers were more than 95%. We evaluated the characteristics of $^{99m}Tc$-tricarbonyl glycine oligomers by carrying out a lipophilicity test and an imaging study. The octanol-water partition coefficient of $^{99m}Tc$ tricarbonyl glycine oligomers indicated hydrophilic properties. Single-photon emission computed tomography imaging of $^{99m}Tc$-tricarbonyl glycine oligomers showed rapid renal excretion through the kidneys with a low uptake in the liver, especially of $^{99m}Tc$ tricarbonyl triglycine. Furthermore, we verified that the addition of triglycine to prototype biomolecules (AGRGDS and RRPYIL) results in the improvement of radiolabeling yield. From these results, we conclude that triglycine has good characteristics for use as a bifunctional chelating sequence for a $^{99m}Tc$-tricarbonyl-based biomolecular imaging probe.

• Korean Journal of Transplantation
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• v.32 no.4
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• pp.104-107
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• 2018

Mucormycosis is an extremely rare but potentially life-threatening fungal infection. Gastrointestinal (GI) mucormycosis is very rare and occurs primarily in highly malnourished patients, especially in infants and children. A 55-year-old man with end-stage renal disease due to diabetic nephropathy, who had undergone deceased donor kidney transplantation 2 years prior, complained of abdominal pain and distension with a 3-day duration. Computed tomography revealed diffuse gastric wall thickening, and a huge amount of grey colored necrotic debris surrounded by erythematous erosive mucosa was observed at the antrum to upper body by GI endoscopy. The microscopic examination obtained from a GI endoscopic specimen demonstrated peptic detritus with numerous non-septate mucor hyphae in the mucosa and submucosa. Mucormycosis was diagnosed based on the clinical findings and morphological features. A total gastrectomy was performed and an antifungal agent was administered. A microscopic examination of the surgical specimen demonstrated invasive mucormycosis with numerous fungal hyphae with invasion into the mucosa to subserosa. The patient and graft were treated successfully by total gastrectomy and antifungal therapy.

• Korean Journal of Radiology
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• v.25 no.3
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• pp.257-266
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• 2024

Objective: To investigate molecular and functional consequences of additional exposures to iodine- or gadolinium-based contrast agents within 24 hours from the initial intravenous administration of iodine-based contrast agents through an animal study. Materials and Methods: Fifty-six Sprague-Dawley male rats were equally divided into eight groups: negative control, positive control (PC) with single-dose administration of CT contrast agent, and additional administration of either CT or MR contrast agents 2, 4, or 24 hours from initial CT contrast agent injection. A 12 µL/g of iodinated contrast agent or a 0.47 µL/g of gadolinium-based contrast agent were injected into the tail vein. Serum levels of blood urea nitrogen, creatinine, cystatin C (Cys C), and malondialdehyde (MDA) were measured. mRNA and protein levels of kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL) were evaluated. Results: Levels of serum creatinine (SCr) were significantly higher in repeated CT contrast agent injection groups than in PC (0.21 ± 0.02 mg/dL for PC; 0.40 ± 0.02, 0.34 ± 0.03, and 0.41 ± 0.10 mg/dL for 2-, 4-, and 24-hour interval groups, respectively; P < 0.001). There was no significant difference in the average Cys C and MDA levels between PC and repeated CT contrast agent injection groups (Cys C, P = 0.256-0.362; MDA, P > 0.99). Additional doses of MR contrast agent did not make significant changes compared to PC in SCr (P > 0.99), Cys C (P = 0.262), and MDA (P = 0.139-0.771) levels. mRNA and protein levels of KIM-1 and NGAL were not significantly different among additional CT or MR contrast agent groups (P > 0.05). Conclusion: A sufficient time interval, probably more than 24 hours, between repeated contrast-enhanced CT examinations may be necessary to avoid deterioration in renal function. However, conducting contrast-enhanced MRI on the same day as contrast-enhanced CT may not induce clinically significant kidney injury.

• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.519-526
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• 1999

Purpose: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. Materials and Methods: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. Results: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide funker studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. Conclusion: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.923-933
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• 2023

Purpose To evaluate the sensitivity of corticomedullary-phase imaging for detecting urinary stones in patients with renal colic who visited the emergency department. Materials and Methods This retrospective study included 253 patients with suspected renal colic from two tertiary hospitals in South Korea, who visited the emergency department and underwent CT urography. Two radiologists blinded to the clinical history independently reviewed the corticomedullary-phase images. The sensitivity for identifying urinary stones were evaluated for each reviewer. After the initial evaluation, the images were re-evaluated based on patient history. The sensitivity of re-evaluation were recorded. Results Of 253 patients, 150 (59%) had urinary stones. Among them, significant stones were observed in 138 patients (92%), and obstructive changes on CT in 124 patients (82.7%). For identifying significant urinary stones, the sensitivity was 98.6% (136/138) for both the reviewers. For identifying significant urinary stones with urinary obstruction, the sensitivity was 99.2% (123/124) for reviewer 1, and 100% (124/124) for reviewer 2. The sensitivity for identifying significant stones increased from 98.6% to 100% for reviewer 1, and from 98.6% to 99.3% for reviewer 2 in the re-evaluation session. Conclusion The corticomedullary-phase CT urography was sensitive for diagnosing urolithiasis in patients with acute renal colic who visited the emergency department.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.9-13
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• 2016

Purpose PET-CT examinations using $^{18}F-FDG$ to treat urinary system cancer are limited in terms of anatomical structure and excretion route of $^{18}F-FDG$. But one of the ongoing examinations utilizing $^{11}C-Acetate$ can compensate for such defects. We would like to introduce a clinical application of $^{11}C-Acetate$ PET-CT in urinary cancer patients. Materials and Methods We conducted a clinical survey of 22 patients diagnosed with urinary cancer at our hospital, 10 prostate cancer patients, 10 renal cell carcinoma patients, and 2 bladder cancer patients. All patients were performed $^{18}F-FDG$ PET-CT examinations, $^{11}C-Acetate$ examinations were performed after two weeks on average. The equipment used to D-710 PET-CT in GE Company and we performed PET-CT procedures 15 minutes after injecting $^{11}C-Acetate$, and a medical doctor from the department of nuclear medicine appraised and compared images between $^{18}F-FDG$ and $^{11}C-Acetate$. Results According to our survey, prostate cancer patients generally had lower uptake of $^{18}F-FDG$ than other cancer patients did. In 2 out of 10 prostate cancer patients, metastasized cancer showed greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. In renal cell carcinoma cases, 8 out of 10 patients displayed evidently greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. We excluded bladder cancer cases in this study because uptake of $^{18}F-FDG$ in the bladder was too hot, the number of patients was insufficient, and the cases did not meet criteria such as the use of diuretics. Conclusion It is too premature to draw solid conclusions from the survey, since it involved only a small number of participants. However, there are a number of studies conducted abroad that prove the effectiveness of the $^{11}C-Acetate$ PET-CT examinations in treating urinary system cancer, and this study is still ongoing at our hospital. If the tests were to be conducted on a larger number of participants, this study could lead to numerous other potential research topics, such as the correlation between Prostatic specific antigen (PSA) values and $^{11}C-Acetate$ PET-CT, Gleason sum values from biopsy before surgery, Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) between $^{18}F-FDG$ PET-CT examinations and $^{11}C-Acetate$ PET-CT examinations in other urinary system cancers.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.127-131
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• 2013

Urinomas can occur after renal trauma or perforation of the collecting system during an endosurgical procedure. However, spontaneous urinomas are very rare. Here we report a case of a spontaneous perinephric urinoma following the removal of a Foley catheter in an 18-year-old girl with acute kidney injury caused by septic shock. The patient had been treated for septic shock, acute kidney injury, and acute respiratory distress syndrome, and had a Foley catheter in place for seven days. After Foley catheter removal, the patient complained of consistent voiding difficulty. An abdominal computed tomography scan showed a large amount of left perinephric fluid, and the aspirated fluid included urothelial cells, confirming the diagnosis of a urinoma. The urinoma was successfully treated by insertion of a double-J stent into the left ureter. This report discusses the available literature on urinomas, and their clinical features, diagnosis, and treatment.

• Korean Journal of Radiology
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• v.22 no.9
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• pp.1547-1554
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• 2021

Objective: We aimed to investigate whether repeated intravascular administration of iodinated contrast media (ICM) or gadolinium-based contrast agents (GBCAs) within a short interval was associated with an increased risk of post-contrast acute kidney injury (PC-AKI). Materials and Methods: This retrospective study included 300 patients (mean age ± standard deviation, 68.5 ± 8.1 years; 131 male and 169 female) who had undergone at least one ICM-enhanced perfusion brain CT scan, had their baseline and follow-up serum creatinine levels available, and had not undergone additional contrast-enhanced examinations 72 hours before and after a time window of interest were included. The study population was divided into three groups: single-dose group and groups of patients who had received multiple contrast administrations in the time window of interest with the minimum contrast repeat interval either within 4 hours (0-4-hour group) or between 4 to 48 hours (4-48-hour group). Multivariable logistic regression analysis was conducted to evaluate the association between AKI and repeated ICM administrations. A similar supplementary analysis was performed including both ICM and GBCA. Results: When ICM was only considered ignoring GBCA, among 300 patients, 207 patients received a single dose of ICM, 58 had repeated doses within 4 hours (0-4-hour group), and 35 patients had repeated doses between 4 to 48 hours (4-48-hour group). Most patients (> 95%) had a baseline estimated glomerular filtration rate (eGFR) of ≥ 30 mL/min/1.73 m². AKI occurred in 7.2%, 13.8%, and 8.6% of patients in the single-dose, 0-4-hour, and 4-48-hour groups, respectively. In the 0-4-hour and 4-48-hour groups, additional exposure to ICM was not associated with AKI after adjusting for comorbidities and nephrotoxic drugs (all p values > 0.05). Conclusion: Repeated intravascular administrations of ICM within a short interval did not increase the risk of AKI in our study patients suspected of acute stroke with a baseline eGFR of ≥ 30 mL/min/1.73 m².