• Title/Summary/Keyword: abdominal ultrasonography

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A Case of Crigler-Najjar Syndrome Type 2 Diagnosed Using Genetic Mutation Analysis (유전자 검사로 진단된 제2형 Crigler-Najjar 증후군 1예)

  • Kim, Sang-Yee;Lee, Soo-Hyun;Koh, Hong;Lee, Seung-Tae;Ki, Chang-Seok;Kim, Jong-Won;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.219-222
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    • 2008
  • Crigler-Najjar syndrome is a rare inherited disease associated with unconjugated hyperbilirubinemia. It is inherited via an autosomal recessive pattern and is caused by mutation in one of the five exons of the bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (UGT1A1) gene. The synthesis of inactive isoforms of bilirubin uridine-diphosphoglucuronate glucuronosyltransferase (B-UGT) results in unconjugated hyperbilirubinemia. A 13-year-old boy with jaundice for 4 months was admitted to our hospital. He had unconjugated hyperbilirubinemia with no evidence of infection, hemolysis, or structural abnormalities on abdominal ultrasonography or 99mTc-DISIDA scan. The authors identified a missense mutation of Tyr486Asp in the fifth exon of the UGT1A1 gene and diagnosed the patient with Crigler-Najjar syndrome type II. This is the first reported case of Crigler-Najjar syndrome in a Korean child, and it is also the first reported case of a genetic mutation leading to Crigler-Najjar syndrome in Korea.

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Three Cases of Extrahepatic Bile Duct Disorder: Diagnostic Imaging in Perspective (진단 영상을 위주로한 간외 담도계 질환 3례)

  • Lim Chang-yun;Jeong Yu-cheol;Oh Sun-kyoung;Jung Joo-hyun;Kim So-hee;Kim Nam-hyang;Seo Kyeong-won;Hwang Cheol-yong;Byeon Ye-eun;Kweon Oh-kyeong;Choi Min-cheol;Yoon Junghee
    • Journal of Veterinary Clinics
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    • v.22 no.4
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    • pp.412-416
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    • 2005
  • Three cases of extrahepatic bile duct disorder were presented. Two cases, a dog and a cat, were related to the obstruction of the extrhepatic bile duct, the other dog was affected with the gall bladder rupture. The clinical signs included anorexia, abdominal distension and vomiting. The laboratory test represented increased hepatic enzymes. On the radiography, hepatomegaly was seen in the obstructive cases, and ascites could be seen in the ruptured case. On the Ultrasonography, dilated gall bladder and extrahepatic bile duct were found in the obstructive cases, and there were ascites, indistinct gall bladder wall, dilation of gall bladder and extrabiliary tract, increased mesenteric echogenicity in the ruptured case. All presented were taken medication, surgical foreign material removal, or cholecystectomy showed complete recovery.

Diagnosis of Hepatocellular Carcinoma Using C-11 Choline PET/CT: Comparison with F-18 FDG, Contrast-Enhanced MRI and MDCT

  • Chotipanich, Chanisa;Kunawudhi, Anchisa;Promteangtrong, Chetsadaporn;Tungsuppawattanakit, Puntira;Sricharunrat, Thaniya;Wongsa, Paramest
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3569-3573
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    • 2016
  • Purpose: The aim of this study was to compare C-11 choline and F-18 FDG PET/CT, gadoxetic-enhanced 3-T MRI and contrast-enhanced CT for diagnosis of hepatocellular carcinoma (HCC). Materials and Methods: Twelve chronic hepatitis B patients suspected of having HCC by abdominal ultrasonography received all diagnostic modalities performed within a one-week timeslot. PET/CT results were analyzed visually by two independent nuclear medicine physicians and quantitatively by tumor to background ratio (T/B). Nine patients then had histopathological confirmation. Results: Six patients had well differentiated HCC, while two and one patient(s) were noted with moderately and poorly differentiated HCC, respectively. All were detected by both CT and MRI with an average tumor size of $5.7{\pm}3.8cm$. Five patients had positive C-11 choline and F-18 FDG uptake. Of the remaining four patients, three with well differentiated HCC showed negative F-FDG uptake (one of which showed negative results by both tracers) and one patient with moderately differentiated HCC demonstrated no C-11 choline uptake despite intense F-18 FDG avidity. The overall HCC detection rates with C-11 choline and F-18 FDG were 78% and 67%, respectively, while the sensitivity of F-18 FDG for non-well differentiated HCC was 100%, compared with 83% of C-11 choline. The average T/B of C-11 choline in well-differentiated HCC patients was higher than in moderately and poorly differentiated cases (p=0.5) and vice versa with statistical significance for T/B of F-18 FDG (p = 0.02). Conclusions: Our results suggested better detection rate in C-11 choline for well differentiated HCC than F-18 FDG PET. However, the overall detection rate of PET/CT with both tracers could not compare with contrast-enhanced CT and MRI.

An Analysis on Risk Factors of Colon Polyps with Health Examination Examinees (건강검진 대상자에서 대장용종의 위험요인 분석)

  • Park, Yoen-Hwa;Yu, Ji-Hyun;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.15 no.3
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    • pp.1641-1649
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    • 2014
  • This study aimed to analyze the occurrence of colon polyps and also risk factors of colon polyps. Among health examination examinees, 508 people were included who underwent colonoscopy and abdominal ultrasonography at the same time. Physical measurements also performed such as height, weight, blood pressure, waist measurement and BMI. General characteristics including age, sex, smoking, drinking and exercise as a risk factors were checked. At the same time, we analyzed various blood tests and fasting blood sugar through blood-gathering. In the results, regarding risk factors of colon polyps, AST, ALT, TC, fatty liver, obesity and smoking were shown significantly high. As a dependent variable with colon polyps, the highest relation was fatty liver(3.4 times), and then T-C(2.3 times). Smoking factor showed 2.3 times higher relation than non-smokers.

Exogenous Estrogen Toxicity in a Dog (개의 외인성 에스트로겐 중독 증례)

  • Han Jae-Ik;Kim Tae-Hun;Lee Sook-Jin;Kang Ji-Hoon;Cho Sang-Hee;Chang Dong-Woo;Yang Mhan-Pyo;Na Ki-Jeong
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.197-201
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    • 2006
  • A 2-year-old female mongrel dog was referred to the Veterinary Medical Center of Chungbuk National University due to anorexia, depression and weight loss after the administration of exogenous estrogen for contraception in the local hospital. Although the dog was medicated with antibiotics and fluid for two weeks in the local hospital, there was a deterioration in the patient's general condition. Therefore the dog was referred to our Veterinary Medical Center. Hematological and biochemical analysis showed non-regenerative anemia, thrombocytopenia, severely immature leukocytosis, hyperbilirubinemia, hyperglycemia and elevated serum alkaline phosphatase, gamma-glutamyltransferase, and lactate dehydrogenase. Abdominal ultrasonography showed double line of gallbladder and irregular hypertrophic wall of uterus. On the basis of these examination's results and history taking, final diagnosis was exogenous estrogen-induced myelotoxicosis with cholecystitis and endometritis. The symptomatic therapy for estrogen toxicosis was performed for 26 days after the final diagnosis. However, the symptom had no response to therapy except endometritis and anemia. On day 135 after administration of estrogen, platelet and neutrophil count were normalized, but monocytic leukocytosis was occurred.

Long-term Management of Copper-associated Hepatic Cirrhosis with D-penicillamine, SAMe, and DBB in a Dog (개에서 발생한 구리 축적성 간경화에 D-penicillamine, SAMe, DBB로 병용 치료하여 장기간 생존한 1례)

  • Seo, Kyoung-Won;Lee, Young-Heun;Bhang, Dong-Ha;Ahn, Jin-Ok;Coh, Ye-Rin;Hwang, Cheol-Young;Kim, Dea-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.28 no.2
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    • pp.249-253
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    • 2011
  • A 4-year-old intact female American Cocker Spaniel presented with lack of appetite, shivering, and abdominal distension. It was initially diagnosed with chronic hepatitis with cirrhosis, by serum chemistry, radiography, ultrasonography, and histopathologic examination following liver biopsy. Abundant copper granules were detected in most hepatocytes with rhodanine stain, with hepatic copper concentration at 1460 ppm (reference range: <400 ppm). Based on these findings, copper-associated hepatitis with cirrhosis was diagnosed and successfully managed with long-term D-penicillamine, s-adenosylmethionine, biphenyl-dimethyl-dicarboxylate and supportive care. The spaniel died 35 months after diagnosis.

Relationship between Anomalous Pancreaticobiliary Ductal Union and Pathologic Inflammation of Bile Duct in Choledochal Cyst

  • Park, So Won;Koh, Hong;Oh, Jung-Tak;Han, Seok Joo;Kim, Seung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.3
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    • pp.170-177
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    • 2014
  • Purpose: Choledochal cyst is a cystic dilatation of common bile duct. Although the etiology is presently uncertain, anomalous pancreaticobiliary ductal union (APBDU) is thought to be a major etiology of choledochal cyst. In this study, we analyzed the clinical and anatomical characteristics and pathologies of patients diagnosed with choledochal cyst in a single institute for 25 years. Methods: A total of 113 patients, diagnosed with choledochal cyst and who received an operation in Severance Children's Hospital from January 1988 to May 2013, were included. Medical records were reviewed, including clinical and demographic data, surgical procedures. Abdominal ultrasonography, magnetic resonance cholangiopancreatography, and intraoperative cholangiography were used as diagnostic tools for evaluation and classification of choledochal cyst and the presence of anomalous pancreaticobiliary ductal union. Todani's classification, and relationship between APBDU and surgical pathology. Results: Among 113 patients, 77 patients (68.1%) presented symptoms such as hepatitis, pancreatitis and/or cholecystitis. Eighty three patients (73.5%) had APBDU, and 94 patients (83.2%) showed inflammatory pathologic changes. APBDU, pathologic inflammation, and serological abnormalities such as hepatitis or pancreatitis showed a statistically significant correlation to one another. Conclusion: APBDU is thought to be one of the etiologic factors of choledochal cyst. It is related to the inflammatory changes in bile duct that can lead to the cystic dilatation.

A Case of Infantile Nephrotic Syndrome associated with Neuroblastoma

  • Kim, Soo Hyun;Park, Hyun-Min;Lee, Joo Hoon;Kim, Hyery;Go, Heounjeong;Kim, Dae Yeon;Park, Young Seo
    • Childhood Kidney Diseases
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    • v.22 no.2
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    • pp.91-96
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    • 2018
  • Nephrotic syndrome in the first year of life, characterized by renal dysfunction and proteinuria, is associated with a heterogeneous group of disorders. These disorders are often related to genetic mutations, but the syndrome can also be caused by a variety of other diseases. We report an infant with nephrotic syndrome associated with a neuroblastoma. A 6-month-old girl was admitted with a 10% weight loss over 10 days and nephrotic-range proteinuria. She was ill-looking, and her blood pressure was higher than normal for her age. Her cystatin-C glomerular filtration rate was decreased, and levels of plasma renin, aldosterone, and catecholamines were elevated. Renal ultrasonography and abdominal computed tomography showed a retroperitoneal prevertebral mass encasing both renal arteries and the left renal vein. The mass was partially resected laparoscopically, and the pathologic diagnosis was neuroblastoma. Findings on a simultaneous renal biopsy were unremarkable. The patient was treated with chemotherapy and several anti-hypertensive drugs, including an alpha blocker. Two months later, the mass had decreased in size and the proteinuria and hypertension were gradually improving. In an infant with abnormal renin-angiotensin system activation, severe hypertension, and nephrotic-range proteinuria, neuroblastoma can be considered in the differential diagnosis.

Surgical Resection of Renal Cell Carcinoma Extended to the Inferior Vena Cava Using Pump Driven Veno-venous Bypass (정맥-정맥간 우회술을 이용하여 하대정맥까지 확장된 콩팥세포암종의 수술적 치료 1예)

  • Park Han Gyu;Choi Chang Woo;Lee Jae Wook;Her Keun;Shin Hwa Kyun;Won Yong Soon
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.72-75
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    • 2006
  • In a 40 year-old man who has complained of epigastric pain and dyspnea for 10 days including melena for 1 month, abdominal ultrasonography and computerized tomography revealed a large, solid mass in the right kidney and thrombus of inferior vena cava (IVC) that extended to the cavoatrial junction. Renal cell carcinoma was performed by percutaneous needle biopsy. IVC thromboembolectomy was performed using centrifugal pump driven venovenous bypass without cardiac arrest and cardiopulmonary bypass (CPB).

Relationship Between Non-alcoholic Fatty Liver Disease and Decreased Bone Mineral Density: A Retrospective Cohort Study in Korea

  • Sung, Jisun;Ryu, Seungho;Song, Yun-Mi;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.342-352
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    • 2020
  • Objectives: The aim of this retrospective cohort study was to investigate whether non-alcoholic fatty liver disease (NAFLD) was associated with incident bone mineral density (BMD) decrease. Methods: This study included 4536 subjects with normal BMD at baseline. NAFLD was defined as the presence of fatty liver on abdominal ultrasonography without significant alcohol consumption or other causes. Decreased BMD was defined as a diagnosis of osteopenia, osteoporosis, or BMD below the expected range for the patient's age based on dual-energy X-ray absorptiometry. Cox proportional hazards models were used to estimate the hazard ratio of incident BMD decrease in subjects with or without NAFLD. Subgroup analyses were conducted according to the relevant factors. Results: Across 13 354 person-years of total follow-up, decreased BMD was observed in 606 subjects, corresponding to an incidence of 45.4 cases per 1000 person-years (median follow-up duration, 2.1 years). In the model adjusted for age and sex, the hazard ratio was 0.65 (95% confidence interval, 0.51 to 0.82), and statistical significance disappeared after adjustment for body mass index (BMI) and cardiometabolic factors. In the subgroup analyses, NAFLD was associated with a lower risk of incident BMD decrease in females even after adjustment for confounders. The direction of the effect of NAFLD on the risk of BMD decrease changed depending on BMI category and body fat percentage, although the impact was statistically insignificant. Conclusions: NAFLD had a significant protective effect on BMD in females. However, the effects may vary depending on BMI category or body fat percentage.