• Title/Summary/Keyword: abdominal ultrasonography

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Plasma D-dimer Can Effectively Predict the Prospective Occurrence of Ascites in Advanced Schistosomiasis Japonica Patients

  • Wu, Xiaoying;Ren, Jianwei;Gao, Zulu;Xu, Yun;Xie, Huiqun;Li, Tingfang;Cheng, Yanhua;Hu, Fei;Liu, Hongyun;Gong, Zhihong;Liang, Jinyi;Shen, Jia;Liu, Zhen;Wu, Feng;Sun, Xi;Niu, Zhongzheng;Ning, An
    • Parasites, Hosts and Diseases
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    • v.55 no.2
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    • pp.167-174
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    • 2017
  • China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of $20mm^2$. The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer ($0.71{\pm}2.44{\mu}g/L$ vs $0.48{\pm}2.12{\mu}g/L$, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs $44.50{\mu}g/L$). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54-0.73) and the cutoff value as $0.81{\mu}g/L$. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68-0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.

Clinical Observation of Aortic Dissection (대동맥박리의 임상적 고찰)

  • Jang, Byeong-Ik;Park, Jin-Ho;Shin, Dong-Ku;Kim, Yeoung-Jo;Shim, Bong-Sup;Lee, Hyun-Woo;Kim, Su-Hyen;Han, Sung-Sae
    • Journal of Yeungnam Medical Science
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    • v.9 no.2
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    • pp.334-341
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    • 1992
  • A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows : 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83 : 1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension(79%). 3. The most common presenting symtom was pain(73%), but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnorma aortic conture in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.

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Subsets of Inflammatory Cytokine Gene Polymorphisms are Associated with Risk of Carcinogenic Liver Fluke Opisthorchis viverrini-Associated Advanced Periductal Fibrosis and Cholangiocarcinoma

  • Surapaitoon, Arpa;Suttiprapa, Sutas;Mairiang, Eimorn;Khuntikeo, Narong;Pairojkul, Chawalit;Bethony, Jeffrey;Brindley, Paul J.;Sripa, Banchob
    • Parasites, Hosts and Diseases
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    • v.55 no.3
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    • pp.295-304
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    • 2017
  • Opisthorchis viverrini infection induces chronic inflammation, and a minor proportion of infected individuals develop advanced periductal fibrosis (APF) and cholangiocarcinoma (CCA). Inflammatory cytokines and/or their gene polymorphisms may link to these biliary pathologies. We therefore investigated associations among cytokine gene polymorphisms and cytokine production in 510 Thai cases infected with O. viverrini who presented with APF+ or APF-, as established by abdominal ultrasonography as well as in patients diagnosed with CCA. Levels of pro-inflammatory and anti-inflammatory cytokines were determined in culture supernatants after stimulation of peripheral blood mononuclear cells (PBMCs) with O. viverrini excretory-secretory (ES) products. Pro-inflammatory cytokines, IL-$1{\beta}$, IL-6, IFN-${\gamma}$, LT-${\alpha}$, and TNF-${\alpha}$ were significantly increased in CCA patients compared with non-CCA (APF- and APF+) cases. Polymorphisms in genes encoding IL-$1{\beta}$-511C/T, IL-6-174G/C, IFN-${\gamma}$+874T/A, LT-${\alpha}$+252A/G, and TNF-${\alpha}$-308G/A were then investigated by using PCR-RFLP or allele specific-PCR (AS-PCR) analyses. In the CCA cases, LT-${\alpha}$+252A/G and TNF-${\alpha}$-308G/A heterozygous and homozygous variants showed significantly higher levels of these cytokines than the wild type. By contrast, levels of cytokines in wild type of IFN-${\gamma}$+874T/A were significantly higher than the variants in CCA cases. IFN-${\gamma}$+874T/A polymorphisms were associated with advanced periductal fibrosis, whereas IL-6-174G/C polymorphisms were associated with CCA. To our knowledge, these findings provide the first demonstration that O. viverrini infected individuals carrying several specific cytokine gene polymorphisms are susceptible to develop fibrosis and CCA.

Intestinal Lymphangiectasia in a Yorkshire terrier Dog: Clinical Outcome, Clinicopathological and Histopathological Findings (요크셔테리어견에서 발생한 Intestinal Lymphangiectasia: 임상적 결과와 임상병리학적, 조직병리학적 소견)

  • Hwang Du-Na;Park Chul;Kang Byeong-Teck;Jeong Soon-Wuk;Sur Jung-Hyang;Park Hee-Myung
    • Journal of Veterinary Clinics
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    • v.23 no.2
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    • pp.175-179
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    • 2006
  • A 7-year-old, 3.16 kg intact male Yorkshire terrier had the history of abdominal distension, diarrhea, and weight loss. On the basis of history takings, physical examination, laboratory tests, radiography, ultrasonography, exploratory laparotomy, and histopathological examination, the dog was diagnosed definitely as intestinal lymphangiectasia. In this case, signs and results are consistent with those of other reports, but some clinicopathological findings such as hypocalcemia and hypocholesterolemia are not. This means that the findings were not completely in accord with the typical ones of intestinal lymphangiectasia in this dog. Prednisolone was prescribed to treat. However, it was not effective sufficiently. Thus, azathioprine was added to the regimen used in the first trial, and it was quite efficient in inducing remission in intestinal lymphangiectasia. The clinical signs were improved to the combined therapy. This case report demonstrates that the combined therapy for intestinal lymphangiectasia can be used as an alternative to only glucocorticoid therapy.

Immunohistochemical Diagnosis of Renal Pelvis Transitional Cell Carcinoma in a Dog (개의 신우 이행상피암종의 면역조직화학적 진단)

  • Yang, Hyoung-Seok;Kang, Sang-Chul;Kim, Jae-Hoon
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.292-295
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    • 2013
  • A 9-year-old, male, Doberman pinscher dog with 5-month history of intermittent hematuria, vomiting and glucosuria was referred to local animal hospital. Abdominal ultrasonography showed an irregular and hyperechoic mass in the renal medulla of the enlarged left kidney. Grossly atrophied renal cortex and medulla and marked hydronephrosis were observed on the cut surface of kidney. A single, numerous papillary projected, pedunculated mass 4~5.5 cm in diameter was occupied in renal pelvis, and extended from pelvis to the inlet of ureter. Histopathologically, the mass had numerous papillary structures with arboriform pattern. These papillae were consisted of fibro-vascular stalks that were lined by multiple layers of neoplastic urothelium (transitional epithelium) with marked cellular atypia. Immnohistochemical (IHC) staining demonstrated that the neoplastic cells showed strong positive reactions for cytokeratin (CK) 7, CK 19, CK clone MNF116 and CK high molecular weight, but negative signals for CK 8 low molecular weight. Based on the gross findings, histopathology and CKs profile using IHC staining, this mass was diagnosed as renal pelvis transitional cell carcinoma in a dog.

Gallstones Risk Factor and Prevalence in the Elderly in Jeju Island (제주지역 노인의 담낭결석 유병률 및 위험요인)

  • Sim, Hyun-Sun;Choi, Joon-Lock;Park, Jae-Jin;Lee, Su-Yeon;Lee, Ji-Min;Jung, Hong-Ryang;Lim, Chung-Hwan;Kim, Jung-Gu
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.293-298
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    • 2009
  • Background/aim : Gallbladder stone is the most common disease of biliary tract. It is lead to acute abdominal pain. The cholecystitis which is caused by in gallbladder stone occurs frequently and the possibility of the gallbladder cancer comes to be high. Our study was designed to determine the prevalence and risk factors gallbladder stone in a population who community. Materials and Methods : We enrolled a total of 826 (male : 297, female : 529) persons who 60 or older in Jeju-do 10 places from 2008 July one months. The height, weight, liver function tests, lipid profile, fasting blood sugar, were all measurement. They had their gallbladder examined with using ultrasonography. Statistical significance was defined as a p-value less than 0.05. Results : Among 826 persons, gallbladder stone was found in 49 persons (5.9%). The male is 6.1% and the female is 5.8%, the male 1.03 times appeared more highly the female. The body mass index above of 23.0 kg/$m^2$ with the gallbladder stone was 69.3% (p<0.047). Conclusion : The gallbladder stone appeared highly according to age increases. The obesity is the risk factor of gallbladder stone. The weight management and diet control is a possibility of reducing a gallbladder stone creation.

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Assessment of Aging Effects on Computed Tomographic Glomerular Filtration Rate in Dogs (개에서 연령에 따른 동적 컴퓨터단층촬영을 이용한 사구체여과율의 평가)

  • Chang, Jin-Hwa;Kim, Hwan-Cheol;Choi, Ji-Young;Choi, Ho-Jung;Lee, Hee-Chun;Chang, Dong-Woo;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.130-133
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    • 2012
  • The purpose of this study is to assess the relationship between glomerular filtration rate (GFR) and age by using dynamic computed tomography (CT) and Patlak plot analysis in dogs. Fifteen dogs were used in this study. CT-GFR study was performed under general anesthesia using propofol and isoflurane. 1 ml/kg dosage of 300 mgI/ml iohexol was administered at a rate of 3 ml/s during GFR measurement. CT-GFR was determined with a single-slice dynamic acquisition and Patlak plot analysis. The individual and global GFR values were calculated to plasma clearance per body weight (ml/min/kg). Bodyweight ($mean{\pm}SD$) ranged from 2.0 to 5.7 kg ($3.31{\pm}1.13$ kg). Age ranged from 3 years to 13 years old ($7.14{\pm}3.30$). $Mean{\pm}SD$ creatinine ($0.53{\pm}0.34 $mg/dl), phosphorus ($4.1{\pm}1.2$ mg/dL), and albumin ($3.3{\pm}0.3$ mg/dL) concentrations and urine protein-to-creatinine ratios (all ratios were < 0.5) were within reference ranges. Abdominal ultrasonography revealed small-sized renal calculi, mineralization, or renal cyst at eight dogs. The global CT-GFR ranges shown in this study was 2.57 to 6.60 ml/min/kg. In this study, there was no trend toward weight-adjusted CT-GFR with increasing age. We found no relationships between age-related kidney dysfunction in fifteen dogs. Small-sized renal calculi or cysts did not affect renal function in this study. However, it is thought that a large sample size may have been required to document an age effect.

A CASE OF TYPE II7 MIRIZZI SYNDROME (Type II Mirizzi 증후군 1례)

  • Kim, Hong-Jin;Lee, Joo-Hyeong;Shin, Myeong-Jun;Kwun, Koing-Bo;Chang, Jae-Chun;Chung, Moon-Kwan
    • Journal of Yeungnam Medical Science
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    • v.7 no.2
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    • pp.197-202
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    • 1990
  • Mechanical obstruction of the common hepatic duct includes the following causes ; choledocholithiasis, sclerosis, cholangitis, pancreatic carcinoma, cholangiocarcinoma, postoperative stricture, primary hepatic duct carcinoma, enlarged cystic duct lymph nodes, and metastatic nodal involvement of the porta hepatis. Partial mechanical obstruction of the common hepatic duct caused by impaction of stones and inflammation surrounding the vicinity of the neck of the gallbladder had been reported on the "syndrome del conducto hepatico" in 1948 by Mirizzi. Nowadays, this disease was named by Mirizzi syndrome. Mirizzi syndrome is a rare entity of common hepatic duct obstruction that results from an inflammatory response secondary to a gallstone impacted in the cystic duct or neck of the gallbladder. It results from an almost parallel course and low insertion of the cystic duct into the common hepatic duct. In a varient of Mirizzi's syndrome, the cause of the common hepatic duct obstruction was a primary cystic duct carcinoma rather than gallstone disease. A 71-year-old man was admitted with a four-day history of right upper quadrant abdominal pain. Past medical history was unremarkable. On physical examination, the patient had a temperature of $38^{\circ}C$, icteric sclera and right upper quadrant tenderness. Pertinent laboratory findings included WBC 18,000/$cm^2$;albumin 2.6g/dl(normal 3.9-5.1) ; SGOT 183u/L(normal 0-50) ; SGPT167u/L(normal 0-65) ; bilirubin, 8.2mg/dl(normal 0-1) with the direct bilirubin, 4.4mg/dl(normal 0-0.4). Ultrasonography revealed a dilated extrahepatic biliary tree. ERCP showed that the superior margin was angular and more consistent with a calculus causing partial CHD obstruction(Mirizzi syndrome). At surgery a diseased gallbladder containing calculi was found. In addition, there was two calculi partially eroding through the proximal portion of the cystic duct and compressing the common hepatic duct. A cholecystectomy and excision of common bile duct was performed, with Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful.

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The Study on Risk Factor of Metabolic Diseases in Pancreatic Steatosis (췌장지방증에서 대사성질환의 위험 요인에 관한 연구)

  • Cho, Jin-Young;Ye, Soo-Young;Kim, Dong-Hyun
    • Journal of radiological science and technology
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    • v.39 no.1
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    • pp.81-88
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    • 2016
  • The body of the fat tissue increased in obese represented by risk factors such as cardiovascular diseases, diabetes, metabolic disease and dyslipidemia. Such metabolic diseases and the like of the cardiovascular and cerebrovascular disease, hypertension, dyslipidemia, increase in the adipose tissue of the pancreas is known to be a risk factor of these diseases. Study on the diagnosis and treatment of pancreatic cancer was conducted actively, case studies on pancreatic steatosis is not much. In this study, divided into a control group diagnosed with pancreatic steatosis as a result of ultrasonography to evaluation the physical characteristics and serologic tests and blood pressure and arterial stiffness. The control group and the test pancreas steatosis age and waist circumference, body mass index, total cholesterol, HDL cholesterol, LDL cholesterol, and systolic and diastolic blood pressure, fasting blood glucose, arterial elasticity is higher in pancreatic steatosis. And the lower ankle brachial stenosis and HDL-cholesterol were lower than the normal control group, so the pancreatic steatosis harmful to blood vessels.(P <0.05). The difference between the control group and it was confirmed that the pancreatic jibanggun statistically significant. In conclusion, pancreatic steatosis at abdominal ultrasound can predict the risk of metabolic diseases, and there was a correlation with cardiovascular disease.

Assessment of Systemic Arterial Thromboembolism with Multi-Slice Spiral CT in a Dog (개에서 다중나선형 CT촬영에 의한 동맥혈전색전증의 평가)

  • Shin, Seung-Ho;Lee, Ki-Chang
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.208-213
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    • 2007
  • A 15 kg 6-year-old intact male Jindo dog with a history of a respiratory distress, hindlimb paralysis with necrosed skin of dorsal digit for three weeks was referred to Animal Medical Center, Chonbuk National University. Heartworm infection was identified by kit examination. In plain thoracic radiographs, dilated pulmonary arteries reverse D sign and focal interstitial pattern was compatible with heartworm infection and possible pulmonary thromboembolism. Abdominal radiographs showed poor serosal detail indicating fluid accumulation within peritoneal cavity. No evidence of musculoskeletal abnormalities was found. Ultrasonography presented focal wedge-shaped hyperechogenecity on the both poles of left kidney, weak or absent pulse on the distal to the external iliac artery as well as ascites and irregular liver margin. Multi-organ failure was strongly supposed by blood profile including leukocytosis, anemia, hemoglobinuria bililubinemia, hypoalbuminemia, imbalance of electrolytes, and increased hepatic and renal function values. Interestingly, the glucose level is remarkably lower in pelvic limb compared to thoracic limb. Suspected pulmonary thromboembolism, renal infarction and femoral arterial embolization causing hindlimb paralysis and dermatic necrosis were confirmed by 3D reconstructed CT imaging. Prior to taking a consideration of euthanasia, interventional radiology was experimentally attempted but failed due to not recovered from general anesthesia. Early and accurate diagnosis of thromboembolism is valuable and 3D reconstructed CT images might be very useful to show the correct way to treat effectively.