• Title/Summary/Keyword: liver imaging

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Therapeutic Feasibility Study and Clinical Trial of Intrahepatic $I^{-131}-Lipiodol$ on Patients with Hepatocellular Carcinoma ($Lipiodol-I^{-131}$의 경간동맥 주입에 의한 간암치료의 가능성에 관한 연구)

  • Yoo, Hyung-Sik;Suh, Jung-Ho;Lee, Jong-Tae;Kim, Dong-Ik;Park, Chang-Yun;Kim, Byung-Soo;Park, Chan-H.;Thakur, M.
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.61-71
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    • 1986
  • An iodized oil such as Ethiodol or Lipiodol was selectively retained in the tumor vessels of the large hepatomas as well as in the small daughter hepatomas for long periods following the intra-arterial hepatic injection of such contrast material. The specific aim of the study is to deliver a high internal radiation dose to hepatocellular carcinoma (HCC) in an attempt to control the disease. We were able to replace a small fraction of the stable iodine (I-127) of the 37% iodine in Lipiodol by the $I^{-131}$ with 100% exchange efficiency. $I^{-131}$ labeled Lipiodol was injected through the super-selected tumor feeding artery under superselection or into the proper hepatic arterial level of patients who have malignant hepatomas confirmed by aspiration cytology serum AFP and various imaging modalities. Clinical traial was performed on 43 cases during recent 6 months and follow-up observation was carried out. No severe complications or other adverse reactions were encountered until nowdays. $I^{-131}-Lipiodol$ was stable in vivo and no significant activity was noted in the thyroid, stomach, blood and urine after the injection. Only small fraction of radioisotope activity was noticed in the both side of lungs. Tumor to normal liver radio was very high. Therefore, $I^{-131}-Lipiodol$ (or P-32-Lipiodol) will be effective delivering high internal radiation dose to the tumor while delivering small radiation doses to normal tissues. Labeling, tumor dose calculation and preliminary findings will be presented.

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A Case of Biliary Papillomatosis with Cystic Dilatation of Bile Duct (낭성 담도 확장을 동반한 담도 유두종증 1예)

  • Park, Yoo Mi;Rhee, Kwangwon;Yoon, Sun Och;Ha, Ji Yoon;Park, So Young;Lee, Jung Ho;Jang, Sung Ill
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.136-140
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    • 2012
  • A 61-year-old male who complained of right upper quadrant pain was referred to the authors for evaluation after his computed tomography suggested biliary adenocarcinoma. The lesion consisted of multiple cysts with papillary mass and peri-ampullay mass. The patient underwent an operation due to a clinical suspicion of biliary cystadenocarcinoma, but the pathology confirmed biliary papillomatosis (BP) after diagnosing intrahepatic papillary neoplasm with high-grade dysplasia and invasive adenocarcinoma with papillary neoplasm from the distal common bile duct to the duodenum. BP is a disease characterized by multiple papillary masses. Its cause has yet to be discovered. It commonly manifests as bile duct dilation but rarely as a ductal cystic change. Under computed tomography or magnetic resonance imaging, both the BP and the cystic neoplasm can show bile duct dilation and a papillary mass, which makes their differential diagnosis difficult. A confirmative diagnosis can be made through a pathologic examination. BP is classified as a benign disease that can become malignant and may recur, though rarely. Its treatment of choice is surgical resection. Laser ablation or photodynamic therapy can be used for unresectable lesions. In the case featured in this paper, biliary papillomatosis was difficult to differentiate from cystic adenocarcinoma due to diffusely scattered multiple large cystic lesions in the liver, and it was histologically confirmed to have become malignant with cystic duct dilation after the operation. This case is reported herein with a literature review.

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Tumors Involving Skin, Soft Tissue and Skeletal Muscle: Benign, Primary Malignant or Metastatic?

  • Hsieh, Chi-Ying;Tsai, Huang-Wen;Chang, Chih-Chun;Lin, Tsuo-Wu;Chang, Ke-Chung;Chen, Yo-Shen
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6681-6684
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    • 2015
  • Background: Metastatic cancer with invasion of skin, soft tissue and skeletal muscle is not common. Examples presenting as soft tissue masses could sometimes lead to misdiagnosis with delayed or inappropriate management. The purpose of current study was to investigate clinical characteristics in the involvement of metastatic cancer. Materials and Methods: A total of 1,097 patients complaining of skin or soft tissue masses and/or lesions were retrospectively reviewed from January 2012 to June 2013. Tumors involving skin, soft tissue and skeletal muscle of head and neck, chest wall, abdominal wall, pelvic region, back, upper and lower extremities were included in the study. Results: Fifty-seven (5.2%) patients were recognized as having malignancies on histopathological examination. The most common involvement of malignancy was basal cell carcinoma, followed by cutaneous squamous cell carcinoma, sarcoma and melanoma. The most common anatomical location in skin and soft tissue malignancies was head and neck (52.6% of the malignancies). Four (0.36%) of the malignant group were identified as metastatic cancer with the primary cancer source from lung, liver and tonsil and the most common site was upper extremities. One of them unexpectedly expired during the operation of metastatic tumor excision at the scalp. Conclusions: Discrimination between benign and malignant soft tissue tumors is crucial. Performance of imaging study could assist in the differential diagnosis and the pre-operative risk evaluation of metastatic tumors involving skin, soft tissue and skeletal muscle.

Effects of Ischemic Preconditioning of Different Intraoperative Ischemic Times of Vascularized Bone Graft Rabbit Models

  • Halim, Ahmad Sukari;Wan Ahmad Kamal, Wan Syazli Rodzaian;Noor, Norizal Mohd;Abdullah, Shafie
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.687-696
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    • 2013
  • Background Ischemic preconditioning has been shown to improve the outcomes of hypoxic tolerance of the heart, brain, lung, liver, jejunum, skin, and muscle tissues. However, to date, no report of ischemic preconditioning on vascularized bone grafts has been published. Methods Sixteen rabbits were divided into four groups with ischemic times of 2, 6, 14, and 18 hours. Half of the rabbits in each group underwent ischemic preconditioning. The osteomyocutaneous flaps consisted of the tibia bone, from which the overlying muscle and skin were raised. The technique of ischemic preconditioning involved applying a vascular clamp to the pedicle for 3 cycles of 10 minutes each. The rabbits then underwent serial plain radiography and computed tomography imaging on the first, second, fourth, and sixth postoperative weeks. Following this, all of the rabbits were sacrificed and histological examinations were performed. Results The results showed that for clinical analysis of the skin flaps and bone grafts, the preconditioned groups showed better survivability. In the plain radiographs, except for two non-preconditioned rabbits with intraoperative ischemic times of 6 hours, all began to show early callus formation at the fourth week. The computed tomography findings showed more callus formation in the preconditioned groups for all of the ischemic times except for the 18- hour group. The histological findings correlated with the radiological findings. There was no statistical significance in the difference between the two groups. Conclusions In conclusion, ischemic preconditioning improved the survivability of skin flaps and increased callus formation during the healing process of vascularized bone grafts.

Simultaneous occurrence of an Odontogenic Myxoma and a Squamous Cell Carcinoma of the Mandible (편평세포암종과 병발한 치성점액종)

  • Kim Bong-Su;Lee Sang-Rae;Hwang Eui-Hwan;Lee Byung-Do
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.29 no.1
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    • pp.341-355
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    • 1999
  • Squamous cell carcinoma is the most common type of oral cancer and odontogenic myxoma is relatively uncommon benign tumor of mesenchymal origin. There are, to our knowledge, no prior reports of simultaneously occurring squamous cell carcinoma and odontogenic myxoma of the jaw bones. In this case, at first, the plain films and computed tomograms revealed a large expansile multilocular radiolucent lesion on left mandible and marked expansion of cortical plate. In addition this radiograms revealed also infiltrative bony destruction of anterior and medial border of ascending ramus of left mandible and alveolar bone of left maxilla, floating teeth on left lower molar area and metastatic enlargement of left submandibular, jugular digastric and spinal accessory lymphnodes. Magnetic resonance imaging of this patient revealed infiltrative growth of tumor on alveolar bone of left maxilla, left retromolar fat pad. left masseter and left medial pterygoid muscle. Intraoral presurgical biopsy presented typical features of squamous cell carcinoma. After chemotherapy with radiation therapy during 6 months. this central lesion was diagnosed as odontogenic myxoma by the postsurgical biopsy. After 3 months, this patient presented multiple metastatic signs at lumbar spines, rib and liver. Consequently, our case is simultaneous occurrence of squamous cell carcinoma and odontogenic myxoma.

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Infantile Hepatic Hemangioendothelioma: Seventeen Years of Experience at a Single Center (소아 간 혈관내피종 : 17년간의 치료경험)

  • Kwon, Hyung-Joo;Moon, Suk-Bae;Park, Kwi-Won;Jung, Sung-Eun
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.134-143
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    • 2008
  • Infantile hepatic hemangioendothelioma (IHHE) is the most common benign vascular hepatic tumor in children. We analyzed the 17-year experience of IHHE. The medical records of 16 patients (M:F=8:8) treated at the Department of Pediatric Surgery and the Department of Pediatrics Seoul National University Children's Hospital between January 1991 and January 2008 were reviewed retrospectively. Mean age at presentation was 87 days (1 day - 551 days). Seventy five percent of patients were diagnosed with imaging study and 25 % with biopsy. Major symptoms were hepatomegaly (N=5), palpable abdominal mass (N=4) and congestive heart failure (N=3). Six patients had no symptoms. Kasabach-Merritt syndrome was combined in one patient. Nine patients (56.3 %) underwent operation and 2 patients (12.5 %) underwent only medical treatment. Clinical observation was tried on 5 patients (31.3 %) without any treatment. Operation was performed on the patient with clinical symptoms or on patients where the differentiation between begin and malignant could not be determined. Patients who had clinical symptoms but tumor was unreresectabile were treated medically. Among the 5 patients who had been observed for their clinical course, 2 patients showed complete regression and the tumors of the remaining 3 patients were regressing. Clinical symptoms, the age at presentation, the size of tumor and ${\alpha}$-FP, all had no significant statistical relationship with the time required for complete tumor regression. There was no relationship between the size change of the tumor and the change of ${\alpha}$-FP level. Only the size of tumor was related with clinical symptoms. One patient died of post-operatvie bleeding. Treatment plan was determined by the extent of the tumor and the presence of clinical symptoms. Observation was enough for the patients without clinical symptoms and complete resection was curative for patients with clinical symptoms. Medical treatment is an alternative for the patient whose tumor is unresectable.

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Combined Cytosine Arabinoside and Prednisolone Therapy for Meningoencephalitis of Unknown Etiology in 2 Dogs (원인불명의 수막뇌염을 보인 개에서 Cytosine Arabinoside와 Prednisolone으로 치료한 2례)

  • Kim, Tae-Ho;Seo, Kyoung-Won;Lee, Young-Heun;Hwang, Cheol-Yong;Lee, Young-Won;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.27 no.4
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    • pp.462-467
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    • 2010
  • A Maltese (5-years old, castrated male) and a Yorkshire Terrier (8-years old, intact female) were referred to Seoul National University Hospital for Animals with ataxia, circling, depression and anorexia. It was suspected to meningoencephalitis of unknown etiology (MUE) based on neurological signs, magnetic resonance imaging findings, cerebrospinal fluid analysis and canine distemper virus antigen test. Immunosuppressive dose of corticosteroid was initially chosen to treat in two dogs. However, the clinical signs were relapsed and side effects had arisen including polyuria, polydipsia, calcinosis cutis, liver enzyme elevation, weight gain and abdominal distension. Combination therapy of cytosine arabinoside (CA) and prednisolone (PDS) was tried. With this combination, the clinical signs were resolved and the side effects were alleviated. The dose of PDS was tapered to 0.5 mg/kg q48h in one case and the PDS was discontinued in the other case. These cases suggested that combined CA and PDS therapy may be significantly useful for the treatment of MUE uncontrolled by PDS alone.

Tracking Intravenous Adipose-Derived Mesenchymal Stem Cells in a Model of Elastase-Induced Emphysema

  • Kim, You-Sun;Kim, Ji-Young;Shin, Dong-Myung;Huh, Jin Won;Lee, Sei Won;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.116-123
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    • 2014
  • Background: Mesenchymal stem cells (MSCs) obtained from bone marrow or adipose tissue can successfully repair emphysematous animal lungs, which is a characteristic of chronic obstructive pulmonary disease. Here, we describe the cellular distribution of MSCs that were intravenously injected into mice with elastase-induced emphysema. The distributions were also compared to the distributions in control mice without emphysema. Methods: We used fluorescence optical imaging with quantum dots (QDs) to track intravenously injected MSCs. In addition, we used a human Alu sequence-based real-time polymerase chain reaction method to assess the lungs, liver, kidney, and spleen in mice with elastase-induced emphysema and control mice at 1, 4, 24, 72, and 168 hours after MSCs injection. Results: The injected MSCs were detected with QD fluorescence at 1- and 4-hour postinjection, and the human Alu sequence was detected at 1-, 4- and 24-hour postinjection in control mice (lungs only). Injected MSCs remained more in mice with elastase-induced emphysema at 1, 4, and 24 hours after MSCs injection than the control lungs without emphysema. Conclusion: In conclusion, our results show that injected MSCs were observed at 1 and 4 hours post injection and more MSCs remain in lungs with emphysema.

A Case of Spontaneous Resolution of Bile Plug Syndrome in a 4-year-old Girl (4세 여아에서 자연 완해된 담즙 마개 증후군 1례)

  • Jee, Keum-Bong;Song, Jun-Young;You, Ki-Yang;Min, Ki-Sik;Kim, Deok-Ha;Lee, Kwan-Seop
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.262-266
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    • 1999
  • Obstruction of the extrahepatic bile ducts is the most common cause of conjugated hyperbilirubinemia in early infancy. More than 90% of such obstructive lesions are accounted for by extrahepatic biliary atresia. A rare lesion is obstruction of the common duct by impacted, thickened secretions and bile. Bile plug syndrome is defined as extrahepatic obstruction of the bile ducts by bile sludge in term infants without anatomic abnormalities, congenital chemical defects of bile, or hepatocellular lesions. Obstruction of extrahepatic ducts by plugs of biliary material apperas to be due to the inspissation and precipitation of bile and mucus within the lumen of the ducts. Cholestasis and precipitation of bile develop in association with abnormal composition of bile in cystic fibrosis, hepatocellular damage, prolonged erythroblastic jaundice, altered biliary dynamics with total parenteral nutrition, gut dysfunction, diuretic therapy, exchange transfusions and perinatal hemolysis. In those cases, the term inspissated bile syndrome is used. The clinical and laboratory findings in bile plug syndrome are identical to those observed in biliary atresia and choledochal cyst. The diagnosis can be suspected based on the findings of clinical and laboratory examinations together with hepatobiliary imaging, ultrasonography, radionuclide scan and liver biopsy. We experienced a case of spontaneous resolution of bile plug syndrome in a 4-year-old girl. We report this case with brief review related literatures.

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Evaluation of Physical Correction in Nuclear Medicine Imaging : Normalization Correction (물리적 보정된 핵의학 영상 평가 : 정규화 보정)

  • Park, Chan Rok;Yoon, Seok Hwan;Lee, Hong Jae;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.29-33
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    • 2017
  • Purpose In this study, we evaluated image by applying normalization factor during 30 days to the PET images. Materials and Methods Normalization factor was acquired during 30 days. We compared with 30 normalization factors. We selected 3 clinical case (PNS study). We applied for normalization factor to PET raw data and evaluated SUV and count (kBq/ml) by drawing ROI to liver and lesion. Results There is no significant difference normalization factor. SUV and count are not different for PET image according to normalization factor. Conclusion We can get a lot of information doing the quality assurance such as performance of sinogram and detector. That's why we need to do quality assurance daily.

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