• 제목/요약/키워드: Abdominal computed tomography

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A Sphaghetti Sign in the Abdominal Radiograph Consistent with Spleno-Systemic Shunts in a Cat

  • Oh, Donghyun;Hwang, Jaewoo;Yoon, Junghee;Choi, Mincheol
    • 한국임상수의학회지
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    • 제37권4호
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    • pp.227-230
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    • 2020
  • A 8-year-old spayed female Korean short-haired cat was presented with respiratory distress. CBC, serum chemistry analysis, plain radiography, and abdominal ultrasonography were performed. Besides hypertrophic cardiomyopathy (HCM) suspected by the thoracic radiograph, a tubular, tortuous soft tissue structure was detected at the region of the left retroperitoneal cavity on the abdominal radiograph. On the abdominal ultrasonography, a shunt vessel is identified caudo-lateral to the left kidney region. These findings are consistent with spleno-systemic shunts in cats. Furthermore, portal hypertension and diffuse hepatic lesion were also identified. Although the cause of a shunt vessel is not easy to diagnose, it is important to include spleno-systemic shunt into differential diagnosis list, when convoluted, tubular soft tissue opacity is seen on the digital radiography (DR). This report will allow clinicians to raise awareness of complications of portosystemic shunt (PSS) and better treat PSS suspected feline patients when the advanced modalities such as computed tomography and magnetic resonance imaging are not available.

한국 중년 남성에서 복부지방 축적이 혈청 지질 및 지단백 농도에 미치는 영향 (Influence of Total Abdominal Fat Accumulation on Serum Lipids and Lipoproteins in Korean middle-aged men)

  • 허갑범;이종호;백인경;안광진;정윤석;김명중;이현철;이영해;이양자
    • Journal of Nutrition and Health
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    • 제26권3호
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    • pp.299-312
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    • 1993
  • Anthropometry, computed tomography(CT) at the umbilical level, nutrient intake, blood pressure, serum levels of lipids and lipoproteins and response of glucose, c-peptide, insulin, and free fatty acid(FFA) during oral glucose tolerance test(OGTT) were estimated on 11 normal-weight controls and 35 overweight and obese middle-agd men. The areas of total abdominal, subcutaneous and visceral were determined by CT scanning technique. Total abdominal fat area correlated the most significantly with the levels of serum lipids, lipoproteins and insulin among several obese indices. Compared with normal-weight controls, overweight and obese men with abdominal fat lower than 29000$\textrm{mm}^2$ showed an increase in waist-hip ratio, areas of total abdominal(35%), visceral and subcutaneous fat and C-peptide response area during OGTT, though age, percent ideal body weight, body mass index, % body fat, and all biochemical indices except C-peptide response area were not different between two groups. Overweight and obese men with abdominal fat greater than 29000$\textrm{mm}^2$ showed a higher values in total abdominal fat(85%), serum levels of triglyceride, total-and LDL-cholesterol, the ratio of LDL-to HDL-cholesterol, and response areas of FFA, insulin and C-peptide during OGTT than normal-weight controls. Overweight and obese men with great abdominal fat showed an increase in alcohol ingestion and percent calorie intake per total energy expenditure, compared with normal-weight controls. Our results indicate that obesity and a certain level of total abdominal fat accumulation is required to observe abnormal levels of serum lipids, lipoproteins and insulin in Korean middle-aged men. In addition, increased alcohol and calorie intake and decreased physical activity could partly explain total abdominal fat accumulation in men.

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복부 둔상 환자에게 간 손상 예측을 위한 Liver Transaminase의 유용성 (The Utility of Liver Transaminase as a Predictor of Liver Injury in Blunt Abdominal Trauma)

  • 이종석;오성찬;김혜진;조석진;이상래;류석용
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.151-156
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    • 2010
  • Purpose: The liver is the second most common organ injured by blunt abdominal trauma. The purpose of this study was to determine the utility of liver transaminase in screening blunt abdominal trauma patients for traumatic liver injury. Methods: We retrospectively reviewed the medical records of 231 patients who sustained blunt trauma and were at risk for traumatic liver injury between June 2009 and August 2010. All of them underwent a focused assessment with sonography for trauma (FAST) and abdominal computed tomography (CT). Based on the diagnosis of abdominal CT, patients were divided into two groups: group I with liver injury and group II without liver injury. We compared the two groups and calculated the sensitivity, the specificity and the predictive values of serum aspartate aminotransferase (AST) and serum alanine aminotransferase (ALT) by using multiple cutoff values. Results: Of 231 patients with no abdominal free fluid in the FAST, 33 had traumatic liver injury on abdominal CT. The mean AST and ALT levels in group I (311.6 IU/L and 228.1 IU/L, respectively) were significantly higher than the values in group II (48.4 IU/L and 35.6 IU/L, respectively). The cutoff to distinguish liver injury is 60 IU/L for AST and 58 IU/L for ALT, with 93.8% sensitivity and 79.8% specificity for AST, and 90.6% sensitivity and 87.4% specificity for ALT. Conclusion: We recommend that all patient with suspected blunt abdominal trauma be evaluated using serum liver transaminase as a screening test for liver injury even though no abdominal free fluid is shown on the FAST. If AST > 60 IU/L and/or ALT > 58 IU/L, abdominal CT was useful to confirm liver injury in this study.

Computed Tomography Assessment of Severity of Acute Pancreatitis in Bangladeshi Children

  • Kaniz Fathema;Bazlul Karim;Salahuddin Al-Azad;Md. Rukunuzzaman;Mizu Ahmed;Tasfia Jannat Rifah;Dipanwita Saha;Md. Benzamin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제27권3호
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    • pp.176-185
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    • 2024
  • Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

미세혈뇨가 있는 소아 둔상 환자에서 콩팥 손상을 감별하기 위한 전산화단층촬영의 기준 (Indications for Computed Tomography (CT) to Detect Renal Injury in Pediatric Blunt Abdominal Trauma Patients with Microscopic Hematuria)

  • 고철곤;김혜진;조석진;오성찬;이상래;류석용
    • Journal of Trauma and Injury
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    • 제23권1호
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    • pp.29-37
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    • 2010
  • Purpose: Controversy exists regarding whether pediatric blunt abdominal trauma patients with microscopic hematuria should undergo radiographic evaluation. Adult patients have indications such as shock and deceleration injury. This study was conducted to suggest indications for the use of CT to detect significant renal injury in pediatric blunt abdominal trauma patients with microscopic hematuria. Methods: From January 2005 to December 2009, patients less than 18 years of age with blunt abdominal trauma and microscopic hematuria who had undergone CT were included in this retrospective study. We analyzed the correlation between microscopic hematuria, shock, deceleration injury, and American Association for the Surgery of Trauma (AAST) renal injury grade. Patients were divided into two groups: the insignificant renal injury group (AAST grade 1) and the significant renal injury group (AAST grades 2-5). We compared age, gender, mechanism of injury, degree of microscopic hematuria, evidence of shock, presence of deceleration injury, and associated injuries between the two groups. We analyzed the effect of each of the above each factors on renal injury by using a logistic regression analysis. Results: Forty-three children were included, and the median age was 15 years. Five children had a significant renal injury. No significant differences, except age and microscopic hematuria (more than 30 red blood cells per high power field (RBC/HPF), p = 0.005) existed between the insignificant and the significant injury groups. A positive correlation existed between renal injury and microscopic hematuria (rho = 0.406, p = 0.007), but renal injury was not correlated with shock and deceleration injury. In the multivariate regression analysis, microscopic hematuria was the only factor correlated with renal injury (p = 0.042). Conclusion: If a microscopic hematuria of more than 30 RBC/HPF exists, the use of CT should be considerd, regardless of shock and deceleration injury to detect significant renal injury in pediatric blunt abdominal trauma patients.

흉복부 방사선 치료 시 압력 기반 복부압박장치 적용에 따른 치료 간 재현성 평가 (Reproducibility evaluation of the use of pressure conserving abdominal compressor in lung and liver volumetric modulated arc therapy)

  • 박가연;김주호;신현경;김민수
    • 대한방사선치료학회지
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    • 제33권
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    • pp.71-78
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    • 2021
  • 목 적: 폐암과 간암 환자에 대해 압력 기반 복부압박장치를 적용하여 입체적 세기변조 회전 방사선치료(VMAT)를 시행하였을 때의 치료 간(interfraction) 위치 재현성과 호흡 재현성을 평가함으로써 그 유용성을 평가하고자 한다. 대상 및 방법: 압력 기반 복부압박장치를 사용해 입체적 세기변조 회전 방사선치료를 받은 6명의 폐암 환자와 3명의 간암 환자를 대상으로 하였다. 치료 간 위치 재현성 평가를 위해 모의치료 CT 영상과 매일 획득한 CBCT 영상 174건을 비교하여 이미지 정합의 이동 값을 비교, 분석하였다. 치료 간 호흡 재현성 평가를 위해 모의치료 4DCT 영상과 매주 획득한 4D CBCT 영상 54건을 비교하여 호흡량 오차를 구하였다. 결 과: 수평수직 세 방향의 3D 벡터값인 전체 위치변화(Overall position variation, Overall VP)값은 폐와 간에서 각각 평균 1.1 ± 1.4 mm, 4.5 ± 2.8 mm로 나타났다. 호흡 변화(respiratory variation, Vr)값은 폐에서 평균 0.7 mm ± 3.4 mm (p=0.195), 간에서 평균 3.6 mm ± 2.6 mm (p<0.05)로 나타났다. 결 론: 흉복부 방사선 치료 시 압력 기반 복부압박장치의 적용은 복부 압박 재현을 통해 치료 간 종양의 호흡 변이뿐만 아니라 위치 변이를 안정적으로 조절하는 데에 유용한 것으로 사료된다. 보다 안정적인 재현성을 위해 치료 계획 시 적절한 PTV 여유가 고려되어야 하고, 매 치료 전 영상 유도에 따른 표적의 위치와 호흡 검증이 필요하다.

한국 비만 여성에서 비만 치료 전 후의 심리적 상관관계 분석 (Relationship between Psychological Factors and Obesity before and after Obesity Treatment in Korean Obese Women)

  • 조유정;이아라;정원석;송미연
    • 한방재활의학과학회지
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    • 제19권1호
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    • pp.155-167
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    • 2009
  • Objectives : Psychological comorbidities are high in patients with obesity and are associated with a variety of medical and dietary problems. This study aims to examine the association between psychological factors and obesity. Methods : This study was performed in pre-menopausal obese($BMI{\geq}25kg/m^2$, waist circumference ${\geq}85cm$) women in Seoul, in 2008 (n=35). Every patient underwent the obesity treatment program. The program included dietary and exercise education, and abdominal mesotherapy for 6 weeks. Simple anthropometry including weight, BMI and Computed Tomography (CT) including Subcutaneous adipose tissue (SAT), Visceral adipose tissue (VAT) and Visceral adipose tissue/Subcutaneous adipose tissue ratio (VSR) were done. To assess psychological factors, the Rosenberg self-esteem scale (SES) questionnaire, Beck depression inventory (BDI) questionnaire and stress response inventory(SRI) questionnaire were administered. Results : 1. All of the obesity indicators (except VSR) decreased significantly after the obesity treatment program. 2. There was a significant relationship between self esteem (SES score) and visceral obesity (VAT and VSR) measured at the end of the program. 3. During the intervention, the more weight, BMI, and subcutaneous adipose tissue decreased, the more self-esteem (SES) increased. There was no relationship between depression (BDI) and obesity. And the change in stress response (SRI) was associated with the change of deep subcutaneous adipose tissue and total abdominal adipose tissue. Conclusions : This study proves that visceral obesity may contribute to low self-esteem, and there is a possibility that the other psychological factors could also be related with obesity in Korean obese women. Individualised antiobesity therapy may be required depending on the patient's psychological characteristics and weight loss could be helpful in order to treat psychological problem in obese patients.

건강검진 수검자에서 비만 지표들과 관상동맥협착증과의 관련성 (Relationship between Some Obesity Indices and Coronary Artery Stenosis in Health-Screen Examinees)

  • 어재은;신새론
    • 대한통합의학회지
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    • 제8권1호
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    • pp.125-135
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    • 2020
  • Purpose : Obesity indices are major predictive markers for coronary artery stenosis, but there are few studies about the relationship between obesity indices and coronary artery stenosis in the Korean population. Therefore, we analyzed the association between obesity indices and coronary artery stenosis among health-screen examinees. Methods : This study included 99 males and females who visited a health-examination center. The obesity indices included body mass index (BMI), waist circumference (WC), visceral adipose tissue (VAT), visceral adipose tissue/subcutaneous adipose tissue ratio (V/S ratio). All subjects had their degree of coronary artery stenosis measured using coronary computed tomography angiography (CCTA). A multiple logistic regression test was conducted to analyze the association between obesity indices and coronary artery stenosis. Results : This study was taken by multiple logistic regression test adjusted by age, sex, smoking status, frequency of alcohol drinking/week and frequency of exercise/week. The adjusted odds ratio for the presence of coronary artery stenosis for subjects with abdominal obesity (abdominal obesity defined as a waist circumference ≥ 90 cm in males; ≥ 85 cm in females) was 6.263 (95 % confidence interval (CI) 1.974-19.869), for subjects with visceral obesity by visceral adipose tissue (visceral obesity defined as a visceral adipose tissue ≥ 100) was 11.430 (95 % CI 3.044-42.928). Conclusion : In this study of adults, WC and VAT were independent predictors of coronary artery stenosis. These results suggest that WC and VAT may be useful markers of coronary artery stenosis.

The Effect of A-3826G Polymorphism of Uncoupling Protein-Ion Visceral Fat Area in Overweight Korean Women

  • Kim, Kil-Soo;Cha, Min-Ho;Kim, Jong-Yeol;Shin, Seung-Uoo;Yoon, Yoo-Sik
    • Preventive Nutrition and Food Science
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    • 제10권3호
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    • pp.279-284
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    • 2005
  • Uncoupling protein-1 (UCP-1) plays a major role in thermogenesis, and has been implicated in the pathogenesis of obesity and metabolic disorders. The aim of this study was to estimate the effects of A-3826G polymorphism of UCP-1 gene on body fat distribution. Two hundred forty eight Korean female overweight subjects with BMI more than 25 kgfm2 participated in this study. The areas of abdominal subcutaneous and visceral fat of all subjects were measured from computed tomography cross sectional pictures of the umbilical region. Subcutaneous fat areas of upper and lower thigh were also measured. Body composition was measured by bio-impedance analysis, and serum concentrations of biochemical parameters, such as glucose, triglyceride, cholesterol etc, were also measured. Genotype of UCP-1 was analyzed by polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) method. The frequencies of UCP-1 genotypes were AA type; $27.8\%,\;AG\;type;\;51.2\%\;and\;GG\;type;\;21.0\%,$ and the frequency of G allele was 0.47. Body weight, BMI, WHR, SBP, DBP and body compositions were not significantly different by UCP-1 genotype. Abdominal visceral fat area was significantly higher in AG and GG type compared with AA type (p=0.009), but subcutaneous fat areas were not significantly different by UCP-1 genotype. Among biochemical parameters, LDL cholesterol level was significantly higher in GG type compared with AA and AG types (p=0.033). Among all subjects, 121 subjects finished 1 month weight loss program containing hypocaloric diet and exercise. The reduction of body weight and BMI were lower in GG type compared with AA/AG type even though statistical significances were not found (p > 0.05). These results suggest that UCP-1 genotype has a significant effect on visceral fat accumulation among Korean female overweight subjects with BMI more than $25\;kg/m^2$.

Leiomyosarcoma of Urinary Bladder in a Yorkshire Terrier Dog

  • Mok, Jinsu;Park, Junghyun;An, Soyon;Kim, Ahreum;Han, Changhee;Hwang, Taesung;Lee, Hee Chun
    • 한국임상수의학회지
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    • 제37권2호
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    • pp.91-95
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    • 2020
  • A 13-year-old, intact male, Yorkshire terrier dog with oliguria and hematuria was presented to the Small Animal Clinic at the Gyeongsang National University animal medical center. There were no remarkable findings on serum chemistry values and complete blood counts. Abdominal radiographs revealed mild elevation of the descending colon at the pelvic level. On the excretory urographic images, a large filling defect was identified in urinary bladder with narrow urinary bladder wall contact and there were no remarkable findings in kidneys and ureters. The abdominal ultrasonography revealed that an irregularly marginated, heterogeneous mass in urinary bladder, central cavitary lesion and mild vascular flow were also observed. Computed tomography showed a heterogeneously attenuated mass within urinary bladder. The mass was surgically excised, and leiomyosarcoma was confirmed by histopathological examination. The patient was followed up for two months and there were no complications. This case is of interest because of the unusual findings of leiomyosarcoma of urinary bladder in a small breed dog.