• Parasites, Hosts and Diseases
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• v.57 no.4
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• pp.405-409
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• 2019

In malaria, splenic rupture is a serious complication potentially leading to death. Subcapsular hemorrhage of spleen is thought to be an impending sign of splenic rupture; however, the characteristics of subcapsular hemorrhage are not well known. We report 3 cases of subcapsular hemorrhage of the spleen in vivax malaria, with varying degrees of severity. Case 1 showed subcapsular hemorrhage without splenic rupture, was treated by antimalarial drug without any procedure. The healing process of the patient's spleen was monitored through 6 computed tomography follow-up examinations, over 118 days. Case 2 presented subcapsular hemorrhage with splenic rupture, treated only with an antimalarial drug. Case 3 showed subcapsular hemorrhage with splenic rupture and hypotension, treated using splenic artery embolization. They all recovered from subcapsular hemorrhage without any other complications. These 3 cases reveal the process of subcapsular hemorrhage leading to rupture and a potentially fatal outcome. The treatment plan of subcapsular hemorrhage should be determined carefully considering the vital signs, changes in hemoglobin, and bleeding tendency.

• Tuberculosis and Respiratory Diseases
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• v.75 no.5
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• pp.218-221
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• 2013

This report describes a rare case of a patient with splenic tuberculosis (TB) who developed spontaneous splenic rupture after 10 weeks of antituberculous chemotherapy. The patient responded well to the antituberculous regimen prior to the spontaneous splenic rupture. We considered a paradoxical reaction as a cause of the splenic rupture. The patient underwent splenectomy and continuously received initial antituberculous drugs without change. To the best of our knowledge, this is the first report of spontaneous splenic rupture as a paradoxical reaction to antituberculous chemotherapy in an immunocompetent host with splenic TB.

• The Korean Journal of Nuclear Medicine
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• v.16 no.1
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• pp.63-72
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• 1982

Hepatoscintigram has been a useful diagnostic method for the liver diseases since 1953, but reasonable diagnostic criteria for parenchymal liver diseases are not yet accurately established. For the purpose of searching for more advanced diagnostic criteria for various types of live disease by the liver scan, a retrospective study was made of 272 cases who underwent both hepatoscintigram with 198 Au colloid and liver biopsy in Hanynag University Hospital from Jan., 1978 to Dec., 1981. The results were as follows: 1. Fuzzy margin (irregular indentation of the liver margin) in the hepatoscintigram was noted in 226 cases (97.79%). 2. Of 35 cases with fuzzy margin only, 28 cases (80%) revealed mild parenchymal liver disease, such as acute hepatitis or chronic persistent hepatitis by the liver biopsy. 3. Mottling change (209 cases) was always accompanied by fuzzy margin except only one case, and 31 cases (86.1%) of fuzzy and mottling cases (36 cases) showed mild parenchymal liver disease. 4. Configuration change (193 cases) was usually accompanied with other changes and espicially 104 cases had configuration change with fuzzy and mottling changes. 73 cases (88.44%) of 86 cases with severe configuration change revealed advanced parenchymal liver disease on biopsy. If liver scan showed mild configuration change, we could not decide the type of liver disease only liver scan, and so further studies are needed. 5. Splenic uptake was noted in 34 cases (40.48%) of 84 cases with advanced parenchymal liver disease, and the degree of splenic uptake was for the most part morderate or severe; whereas splenic uptake was noted in 18 cases (16.51%) of the mild parenchymal liver disease (109 cases), and the degree of splenic uptake was largely mild.

• Tuberculosis and Respiratory Diseases
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• v.74 no.3
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• pp.134-139
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• 2013

Splenosis is defined as an autotransplantation of the splenic tissue after splenic rupture or splenectomy, and occurs most frequently in the peritoneal cavity. Splenosis is usually asymptomatic and is found incidentally. We report a case of combined intrathoracic and intraperitoneal splenosis in a 54-year-old male who worked as a miner for 10 years in his twenties, and was a current smoker. He was referred to our hospital for further evaluation of an incidental left diaphragmatic mass. Positron emission tomography-computed tomography and bronchoscopy were performed to evaluate the possibility of malignancy. There was no evidence of malignancy, but the spleen was not visualized. Reviewing his medical history revealed previous splenectomy, following a dynamite explosion injury. Therefore, splenosis was suspected and technetium-99m-labeled heat-damaged red blood cell scan confirmed the diagnosis. Radionuclide imaging is a useful diagnostic tool for splenosis, which could avoid unnecessary invasive procedures.

• Parasites, Hosts and Diseases
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• v.56 no.6
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• pp.609-613
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• 2018

Babesiosis, caused by Babesia microti and B. divergens, is transmitted by Ixodid ticks. Symptoms of babesiosis vary from a mild flu-like illness to acute, severe, and sometimes fatal and fulminant disease. In Korea, 7 imported babesiosis cases and 1 endemic case have been reported. We report 2 cases of severe babesiosis initially mistaken as malaria. The first patient was complicated by shock and splenic infarction, the other co-infected with Lyme disease. As the population traveling abroad increases every year, physicians should be aware of babesiosis which mimics malaria, co-infection with other diseases, and its complications.

• The Korean Journal of Nuclear Medicine
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• v.20 no.2
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• pp.53-59
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• 1986

Radionuclide angiography of the liver and spleen with rapid bolus injection of 5 mCi of $^{99m}Tc-Sn-phytate$ was performed for evaluation of dynamic flow change of the liver in 5 normal subjects and 11 patients with diffuse hepatocellular diseases. And quantification of hepatic arterial index (HAI) was generated from those TACs of the liver and compared with HAI generated from hepatic TAC with injection of $^{99m}Tc-TcO_4^-$ as previously reported method by former investigators, 67 patients with diffuse hepatocellular diseases undergoing hepatic scintigraphy were also evaluated by 2 minutes-hepatosplenic scintiangiography with 5 mCi of $^{99m}Tc-phytate$ and followed injection of 7 mCi of $^{99m}Tc-TcO_4^-$. Those heaptic and splenic TACs were analysed and compared with HAIs of 99m Tc-phytate for evaluation of relative change (%) of count at 30 seconds and 1 minuite after peaks of rapid influx phase to the peaks (100%) in T ACs of $^{99m}Tc-phytate$ and at 1 minuite and 3 minuites after in 5 minuite-TAC of $^{99m}Tc-TcO_4^-$. Correlation between HAIs with $^{99m}Tc-phytate$ and $^{99m}Tc-TcO_4^-$ was highly significant (R=0,984, P=0), and there was most significant and useful correlation (R=0,708, p<0.0001) between HAI and splenic TAC generated by $^{99m}Tc-phytate$.

• The Korean Journal of Nuclear Medicine
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• v.17 no.1
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• pp.33-39
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• 1983

Sixty-nine patients with diffuse lung uptake of $^{99m}Tc-tin$ colloid were evaluated to determine the kinds of associated diseases, the incidence of associated liver scan abnormalities, and prognosis. The results were as follows: 1) Diseases associated with diffuse lung uptake included malignancies in 31 patients, infectious diseases in 19, chronic liver diseases in 14, and others in 5. It appeared that the marked degree of lung uptake was associated with severe diseases. 2) Thirty-one of the 69 patients(45%) had abnormal liver size, 43(62%) had space occupying lesions or nonhomogeneity in liver image, 37(54%) had splenomegaly and 45(65%) had increased splenic uptake. Increased bone marrow uptake was found in 48(70%) and renal uptake in 15(22%). As the degree of lung uptake increased, there was a statistically significant (p<0.05) tendency for the incidences of the abnormal liver image and renal uptake to increase. 3) Sixty-two of the 69 patients were followed up for one to 439 days(mean 44 days) after liver scanning. Eleven(18%) were dead, 10(16%) were aggravated, and 13(21%) were improved. Most of improved patients had infectious diseases. It appeared that diffuse lung uptake of $^{99m}Tc-Tn$ colloid was found in the various diseases including malignancies, infections, and chronic liver diseases, and that it was strongly associated with other liver scan abnormalities, but was not necessarily associated with a poor prognosis, particularly when underlying diseases were infections.

• Journal of Microbiology and Biotechnology
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• v.24 no.12
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• pp.1728-1735
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• 2014

Scrub typhus, caused by infection with Orientia tsutsugamushi, is a mite-borne zoonotic disease endemic to the Asian-Pacific region. In Korea, the incidence of this disease has increased with climate changes, and over 10,000 cases of infection were reported in 2013. Although this infection is treatable with antibiotics such as doxycycline and azithromycin, an effective prophylactic vaccine against O. tsutsugamushi would be more desirable for preventing scrub typhus in endemic areas. In this study, we investigated the 56-kDa type-specific antigen (TSA56), which is a major outer membrane protein of O. tsutsugamushi, as a vaccine candidate. Intranasal immunization of recombinant TSA56 (rec56) induced a higher level of TSA56-specific IgG than that induced by intramuscular immunization of tsa56-expressing DNA (p56). Both types of immunization induced a cell-mediated immune response to TSA56, as demonstrated by the splenic cell proliferation assay. Mice immunized with p56, followed by rec56 plus heat-labile enterotoxin B subunit from E. coli, had a stronger protection from a homologous challenge with the O. tsutsugamushi Boryong strain than with other combinations. Our preliminary results suggest that an effective human vaccine for scrub typhus can include either recombinant TSA56 protein or tsa56-expressing DNA, and provide the basis for further studies to optimize vaccine performance using additional antigens or different adjuvants.

• Journal of Korean Medical classics
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• v.31 no.3
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• pp.123-142
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• 2018

Objectives : This paper aims to study the I-Ching perspective in Shanghansuyuanji. Methods : Key words associated with I-Ching was searched in Shanghansuyuanji and analyzed its meaning and categorized thematically. Results & Conclusions : 1. Qianhuang symbolized Shaoyang, The Power of the Great hexagrams, Jueyin Peace hexagrams, Taiyin Gen Earth, Yangming Kun Earth, Shaoyin Return hexagrams, but didn't symbolize Taiyang, making it not uniform. 2. Qianhuang explained physiology focusing the change of YangQi with I-Ching perspective. This is possible because Shanghanlun thought that much of YangQi and I-Ching set a high value on Yang. 3. Qianhuang explained pathology such as insomnia, epigastric fullness, splenic constipation syndrome, Taiyinbing syndrome, somnolence, thirst, YinYang exchange with I-Ching perspective, it is meaningful because it enriches medical YinYanglun. 4. Qianhuang explained prescriptions such as Daqinglongtang, Zhenwutang, Shizaotang, Fuzixiexintang, Dachaihutang, Baihutang, a comparison between Daqinglongtang and Xiaoqinglongtang with I-Ching perspective. This is helpful to grasp the image of prescriptions. 5. Qianhuang explained nature of drugs such as Guizhi, Fuling, Fuzi, Qiandan, Rougui with I-Ching perspective, and it combines well with the features of I-Ching with drugs efficacy. 6. Qianhuang explained diseases of the six Meridians curing time with I-Ching perspective. This shows diseases of the six Meridians recover when Corresponding Qi is vigorous or Conflict Qi appears, and it is persuasive. For reasons mentioned above; Shanghansuyuanji is meaningful as Shanghanlun commentary.

• Tuberculosis and Respiratory Diseases
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• v.50 no.5
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• pp.630-635
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• 2001

Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT findings of splenic tuberculosis are multiple, well-defined, round or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One patient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.