• Title/Summary/Keyword: CT-scan

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A Case of Henoch-Sch$\"{o}$nlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure (급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Sch$\"{o}$nlein 자반증 1예)

  • Oh, Ki-Won;Park, Sang-Kyu;Kim, Joon-Sung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.2
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    • pp.226-229
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    • 2009
  • Gastrointestinal involvement in Henoch-Sch$\"{o}$nlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.

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Clinical Experience with Vascular Surgery (혈관수술에 대한 임상적 고찰)

  • 김현경
    • Journal of Chest Surgery
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    • v.25 no.12
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    • pp.1570-1577
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    • 1992
  • The vascular surgery is the field that has developed in early 20 century and is progressing nowadays. Recent advance in surgical technique accompanying with excellent medical diagnosis and treatment, prompt angiographic usage, development of variable prosthetic material, and concomitant use of anti-coagulant have made remarkable results of vascular surgery. 83 cases of vascular surgery have been performed at Thoracic and Cardiovascular Surgery Department of Pusan National Unversity Hosaital since 1971 till 1990, for 20 years and their results are followed. Patient ductus arteriosus and Buerger`s disease were omited in this study. 1. The age distribution shows that the fifth and sixth decades are most frequently affected and mean age was 56.1 years old. Male to female ratio is 1: 2.32. 2. Among the 83 cases of all, number of occlusive vascular disease is 46 and that of aneurysmal disease is 33. 3. In clinical manifestation, most common symptom of occlusive disease is pulselessness and pain was next. Mass sensation is most commonly complained by patients of aneurysmal disease. 4. CT scan was more important in diagnosis of aneurysmal diseases and angiogram was more commonly used in occlusive diseases. 5. The common site of arterial occlusion was common iliac artery, femoral artery, aortic bifurcation, and external iliac artery, as its frequency rate. The most commonly affecting portion of aortic aneurysm was abdminal aorta, and descending thoracic aorta and femoral artery were next 6. Preoperative associated diseases were atherosclerosis[41 cases], hypertension[21 cases], valvular heart disease[11 cases], and diabetes mellitus[9 cases], etc, 7. Operative methods in ocllusive diseases were thrombectomy[36.9%], endarterectomy [10.9%], and bypass graft insertion[52.7%]. Among the bypass graft, Y-graft was used in 7 case, straight graft was used in 17 cases, and saphenous venous graft was used in 2 cases. 8. Postoperative complications were developed in 17 cases, and morbidity rate was 36. 9. Eleven patient were died within 1 month after operation, so operative mortality rate was 13.3%. 10. Duration of patency was beteween 7 and 58 months[average 27.5 months] in occlusive diseases and their 5-year patency rate was 56.3%. Duration of patency of aneurysmal disease was 20 months in aveage and their 5-year patency rate was 51.3%. 11. Patients of eleven cases of occlusive disease and two cases of aneurysmal disease required reoperation for variable reason. 12. 35 cases of patient have used anticoagulants: coumadin, ticlid, and persanthin-ASA combination.

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Fatigue Crack Growth Characteristics of 9% Ni Steel Welded Joint for LNG Storage Tank at Low Temperature (LNG 저장탱크용 9% Ni강 용접부의 저온피로균열진전 특성)

  • Kim, Jae-Hoon;Shim, Kyue-Taek;Kim, Young-Kyun;Ahn, Byoung-Wook
    • Journal of Welding and Joining
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    • v.28 no.5
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    • pp.45-50
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    • 2010
  • The fatigue crack growth characteristics of base metal and weld joint of 9% Ni steel for LNG storage tank was carried out using CT specimen at room temperature and $-162^{\circ}C$. Fatigue crack growth rate of base and weld metals at RT and $-162^{\circ}C$ was coincided with a single line independent of the change of stress ratio and temperature. In the region of lower stress intensity factor range, fatigue crack growth rate at $-162^{\circ}C$ was slower than that at RT, and the slop of fatigue crack growth rate at $-162^{\circ}C$ increased sharply with propagating of fatigue crack, fatigue crack growth rate at RT and $-162^{\circ}C$ was intersected near the region of $2{\times}10-4\;mm$/cycle, and after the intersection region, fatigue crack growth rate at $-162^{\circ}C$ was faster than that at RT. The micro-fracture mechanism using SEM shows the ductile striation in the stable crack growth region. Also the defects of weld specimen after fatigue testing were detected using the A scan of ultrasonic apparatus.

Recurrent Malignant Thymoma Detected by Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA Scan (Tc-99m MIBI, Tc-99m Tetrofosmin, 그리고 Tc-99m (V) DMSA 스캔에 의해 발견된 재발성 악성 흉선종)

  • Seok, Ju-Won;Kim, Seong-Jang;Kim, In-Ju;Kim, Yong-Ki
    • The Korean Journal of Nuclear Medicine
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    • v.35 no.4
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    • pp.268-273
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    • 2001
  • Thymoma is the most common primary tumor of anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges 8% to 18%. We reported one patient of recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m Tetrofosmin scintigraphies showed an increased uptake in the mediastinal area. Also, Tc-99m (V) DMSA scintigraphy revealed an increased uptake tn the corresponding area. Coronal SPECT images of Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA revealed increased uptake of each radiopharmaceutical in the tumor lesion corresponding to the mediastinal lesion on the chest CT. However, the normal blood pool activities of the heart and great vessels of Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor seeking agent, we recommend Tc-99m MIBI and Tc-99m Tetrofosmin SPECT rather than Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.

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A Case Report of Synovial Sarcoma of the Face (우측 협부에 발생한 윤활막육종 증례보고)

  • Heo, Jung;Lee, Keun Cheol;Park, Jung Min;Kim, Seok Kwun;Roh, Mee Sook;Lee, Jin Hwa
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.760-762
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    • 2005
  • Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.

The Value of Preoperative Multidetector Computed Tomography for Deep Inferior Epigastric Artery Perforator Free Flap (심하복벽동맥 천공지 유리피판에서 술전 MDCT의 유용성)

  • Heo, Chan Yeong;Hong, Ki Yong;Yoon, Chang Jin;Eun, Seok Chan;Baek, Rong Min;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.140-146
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    • 2009
  • Purpose: Autologous breast reconstruction with abdominal tissue is one of the best options after mastectomy. In a free transverse rectus abdominis myocutaneous(TRAM) or deep inferior epigastric artery perforator(DIEP) flap, a preoperative evaluation of the precise location of perforating vessels and vascular run - off systems is required. The objective of this report is to demonstrate the usefulness of multidetector computed tomography(MDCT) in the preoperative planning of patients undergoing breast reconstruction with abdominal flap. Methods: From June 2006 to January 2008, 28 patients underwent MDCT evaluation before breast reconstruction. All subjects were females with an age range of 30 to 55 years. The CT scan was performed using a 64 - slice MDCT scanner(Brilliance 64; Philips Medical Systems, Best, Netherlands). Results: One perforator or two major perforators were marked on image in good relation with a hand - held Doppler examination and intraoperative findings. All vascular run - off systems were cleared before operation. Conclusion: Preoperative evaluation of perforator arteries with MDCT angiography is beneficial in patients undergoing breast reconstruction. This technique provides a noninvasive approach of the vascular anatomy of the entire anterior abdominal wall.

A case report of Osteochondroma Occuring on the Right Zygoma body (우측 관골체부에 발생한 골연골종의 치험례)

  • Woo, Sang min;Kim, Jin Woo;Shin, Han Kyoung;Jung, Jae Hak;Kim, Young Hwan;Sun, Hook
    • Archives of Plastic Surgery
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    • v.36 no.2
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    • pp.237-241
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    • 2009
  • Purpose: An osteochondroma, also known as osteocartilaginous exostosis, is a common bone tumor, but rarely occurs in the facial bone, especially in the zygoma body. Because most of the craniofacial bones develop from intramembranous ossification, osteochondromas are relatively infrequent in mesenchymal bones of the head and neck. The osteochondroma of the facial bone is a slow growing, painless mass, causes facial asymmetry. In spine and other extremities, it rarely changes malignant, but untill now, there is no evidence of malignant change in facial bone. We herein describe a rare case of osteochondroma occuring on zygoma body with review of the literature. Method: A 50 - year - old male has painless, slowly growing mass on a right cheek for several years. For a diagnosis, CT and whole body bone scan were done and a diagnosis, osteochondroma was made. The tumor was removed with osteotome under general anesthesia. Result: Radiography showed a well - defined calcified mass attatched to the anterior aspect of the right zygoma body. And pathologic exam showed degenerative chondocyte and cancellous bone. As a result, these appearance is that of an osteochondroma. Conclusion: An osteochondroma is a common bone tumor, but rarely occurs in the facial bone. To the authors knowldege, this is the first case of osteochondroma occuring on zygoma in korea, body. For this case, we reviewed literature related to this topic.

Traumatic Organized Hematoma Mimicking Intra-peritoneal Tumor : A Case Report (복강내 종양으로 오인된 외상성 혈종: 증례보고)

  • 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.300-303
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    • 2013
  • Blunt abdominal trauma is commonly encountered in the emergency department. The lack of historical data and the presence of distracting injuries or altered mental status, from head injury or intoxication, can make these injuries difficult to diagnose and manage. We experienced a case of traumatic organized hematoma misdiagnosed as intra-peritoneal tumor with intestinal obstruction. A 52-year-old homeless male patient who have chronic alcoholism was admitted via emergency room with infra-umbilical abdominal pain. At admission, he was drunken status and so we could not be aware of blows to the abdomen. He had a unknown large operation scar on mid abdomen. A computed tomography (CT) scan showed the intestinal obstruction of the ileum level with 5.5cm sized mesenteric tumor. We performed adhesiolysis and widely segmental resection of small bowel including tumor with side-to-side anastomosis due to great discrepancy in size. He stated later that he was a victim of the violence before 3 weeks. A final pathologic report revealed well encapsulated, traumatic mesenteric hematoma with organizing thrombi, ischemia and abscess formation with multiple adhesion bands. Finally, the patient was discharged without complications on postoperative day 14.

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.

SVC Syndrome Caused by Leiomyosarcoma of SVC - A Case Report - (상대정맥에 발생한 평활근육종의 수술 - 1례 보고 -)

  • 손영상;류세민;손호성;조원민;황재준;최영호;김학제;심재정;조성준
    • Journal of Chest Surgery
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    • v.35 no.3
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    • pp.235-238
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    • 2002
  • Among the causes of SVC syndrome, intraluminal tumor, especially the leiomyosarcoma is very rare. We report a 39 year old female patient who had been suffering from headache and facial edema for 6 weeks before admission. On physical examination, facial edema and venous engorgement on upper extermities and upper chast wall were showed. The chest CT scan and SVC cavogram showed a long intraluminal mass lesion resulting in a near total obstruction of the SVC Surgery was performed through median sternotomy. For complete resection of the tumor and thrombus, we used partial and total CPB. The follow up SVC cavogram revealed no abnormality 14 months after the operation.