• The Korean Journal of Cytopathology
• /
• v.3 no.2
• /
• pp.100-103
• /
• 1992

We experienced a case of primary hepatic actinomycosis which was initially diagnosed by means of fine needle aspiration. The patient was a 31-year-old emaciated man with a 2-month history of 10 kg weight loss, right upper quadrant pain and flank pain. The liver was palpable and tender on physical examination. Computerized tomography scan of the liver showed two ill-defined hypodense masses in gallbladder fossa and inferior pole of right lobe. Hepatocellular carcinoma was clinically suspected. A CT-guided fine needle aspiration was peformed. Microscopically, smears showed numerous radiating clusters of filamentous bacteria with many neutrophils and monocytes in necrotic background. The symptoms were improved by incision and drainage and massive administration of penicillin.

• 대한핵의학회:학술대회논문집
• /
• 1977.05a
• /
• pp.93.2-94
• /
• 1977

• Tuberculosis and Respiratory Diseases
• /
• v.68 no.5
• /
• pp.298-300
• /
• 2010

Diaphragmatic paralysis can be demonstrated through diaphragmatic elevation on chest X-ray after thoracic lung surgery or the placement of chest tubing. Additional causes of diaphragmatic paralysis are iatrogenic, mass, atelectasis, etc. For the diagnosis of diaphragmatic paralysis, it required some studies (fluoroscopy, computed tomography [CT], magnetic resonance imaging). Diaphragmatic hernia of the liver is a rare clinical entity, usually found after trauma in adults. Congenital diaphragmatic hernia in neonates requires surgery. Non-traumatic diaphragmatic hernia of the liver in an adult is a rare right-sided diaphragmatic hernia. On developing any symptoms, surgery must be performed. When diaphragmatic hernia is incidentally found in adults without trauma, it is placed under observation for a time period. We diagnosed the diaphragmatic herniation of a right hepatic lobe by 16-slice CT scan without surgery.

• Journal of Yeungnam Medical Science
• /
• v.34 no.2
• /
• pp.265-269
• /
• 2017

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

• Journal of Gastric Cancer
• /
• v.16 no.2
• /
• pp.115-119
• /
• 2016

We report the case of a patient with gastric adenocarcinoma with multiple liver metastases. This patient showed complete remission for more than 68 months after S-1/cisplatin combination chemotherapy and radical total gastrectomy. The patient, a 63-year-old man, presented with dyspepsia and difficulty in swallowing. Endoscopic findings showed a huge ulcero-infiltrative mass at the lesser curvature of the mid-body, extending to the distal esophagus. Biopsy revealed a poorly differentiated tubular adenocarcinoma. An abdominal computed tomography scan demonstrated multiple hepatic metastases. S-1/cisplatin combination chemotherapy was initiated, and following completion of six cycles of chemotherapy, the gastric masses and hepatic metastatic lesions had disappeared on abdominal computed tomography. Radical total gastrectomy and D2 lymphadenectomy combined with splenectomy were performed. The patient underwent three cycles of S-1/cisplatin combination chemotherapy followed by tegafur-uracil therapy for 1 year. He remained in complete remission for more than 68 months after surgery.

• Journal of Chest Surgery
• /
• v.18 no.4
• /
• pp.667-672
• /
• 1985

Primary cardiac tumors are uncommon in all age group. In contrast, tumors metastatic to the heart are significantly more common. On rare occasions, tumor may extend into the heart chamber via inferior vena cava from other parts of the body, such as liver, kidney, and uterus cava. With recent advancement in diagnostic imaging modalities and surgical techniques, cardiac tumors are now potentially curably form of heart disease. The most important factor in diagnosing the tumor is a high index of clinical suspicion. Six patients underwent surgical removal of intracardiac tumor during a 5-year period. The mean age of the 4 women and two men was 40 years [range 23 to 60]. All patients were operated on in the last five years of the studied period. All patients had symptoms varying in duration from 1 month to 4 years [average 13 months]. 2-Dimensional echocardiography contributed most to preoperative diagnosis, confirming presence of an intracardiac tumor in all examined patients. Of the six intracardiac tumor, 5 were myxomas [4 left atrial and 1 right ventricular] and one right atrial metastasis from hepatocellular carcinoma of the liver. In all cases, tumor masses were successfully excised. One patient expired after the operation on account of low cardiac out-put syndrome. Remained one patient among six, tumor mass extended into RA and RV with a stalk via IVC. On later follow-up study showed cold area on liver scan [hepatocellular ca.], so she was transferred to internal medicine, department for chemotherapy. Follow up results showed no signs of tumor recurrence in 4 myxoma cases.

• Journal of Radiation Protection and Research
• /
• v.43 no.1
• /
• pp.1-9
• /
• 2018

Background: In this study, we investigate the image quality of virtual monochromatic images synthesized from dual-energy computed tomography (DECT) at voltages of 80/140 kV and 100/140 kV. Materials and Methods: Virtual monochromatic images of a phantom are synthesized from DECT scans from 40 to 70 keV in steps of 1 keV under the two combinations of tube voltages. The dose allocation of dual-energy (DE) scan is 50% for both low- and high-energy tubes. The virtual monochromatic images are compared to single-energy (SE) images at the same radiation dose. In the DE images, noise is reduced using the 100/140 kV scan at the optimal monochromatic energy. Virtual monochromatic images are reconstructed from 40 to 70 keV in 1-keV increments and analyzed using two quality indexes: noise and contrast-to-noise ratio (CNR). Results and Discussion: The DE scan mode with the 100/140 kV protocol achieved a better maximum CNR compared to the 80/140 kV protocol for various materials, except for adipose and brain. Image noise is reduced with the 100/140 kV protocol. The CNR values of DE with the 100/140 kV protocol is similar to or higher than that of SE at 120 kV at the same radiation dose. Furthermore, the maximum CNR with the 100/140 kV protocol is similar to or higher than that of the SE scan at 120 kV. Conclusion: It was found that the CNR achieved with the 100/140 kV protocol was better than that with the 80/140 kV protocol at optimal monochromatic energies. Virtual monochromatic imaging using the 100/140 kV protocol could be considered for application in breast, brain, lung, liver, and bone CT in accordance with the CNR results.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.12 no.1
• /
• pp.33-38
• /
• 2008

Purpose: The Gated cardiac blood pool scan is non-invasive method that a quantitative evaluation of left ventricular function. Also this scan have shown the value of radionuclide ejection fraction measurements during the course of chemotherapy as a predictor of cardiac toxicity. Therefore a reliable method of monitoring its cardiotoxic effects is necessary. the purpose of this study is to minimize the overestimate of left ventricular ejection fraction (LVEF) by modified body position to reduce the influence of scattered rays from surrounding organs of the heart in the background region of interest. Materials and Methods: Gated cardiac blood pool scan using in vivo $^{99m}Tc$-red blood cell (RBC) was carried out in 20 patients (mean $44.8{\pm}8.6$ yr) with chemotherapy for a breast carcinoma. Data acquisition requires about 600 seconds and 24 frames of one heart cycle by the multigated acquisition mode, Synchronization deteriorates toward the end of the cycle and with the distance from the trigger signal (R-wave) by ECG gating. Gated cardiac blood pool scan was studied with conventional method (supine position and the detector head in $30-45^{\circ}$ left anterior oblique position and caudal $10-20^{\circ}$ tilt) and compared with modified method (left lateral flexion position with 360 mL of drinking water). LVEF analysis was performed by using the automatically computer mode. Results: The ROI counts of modified scan method were lower than LV conventional method ($1429{\pm}251$ versus $1853{\pm}243$, <0.01). And LVEF of modified method was also decrease compared with conventional method ($58.3{\pm}5.6%$ versus $65.3{\pm}6.1%$, <0.01). Imaging analysis indicated that stomach was expanded because of water and spleen position was changed to lateral inferior compared with conventional method. Conclusion: This study shows that the modified method in MUGA reduce the influence of scattered rays from surrounding organs. Because after change the body position to left lateral flexion and drinking water, the location of spleen, left lobe of liver and stomach had changed and they could escaped from background ROI. Therefore, modified method could help to minimize the overestimate LVEF (%).

• The Korean Journal of Nuclear Medicine
• /
• v.28 no.3
• /
• pp.377-383
• /
• 1994

Objective : We retrospectively analysed $^{99m}Tc$-MDP bone and $^{67}Ga$ scans to evaluate therapeutic response of bone lymphoma among patients with complete remission. Subjects and Methods : We reviewed 35 cases with an increased uptake finding $^{99m}Tc$-MDP bone scans and 16 $^{67}Ga$ scans that were follow-up studies during and after therapy. The $^{99m}Tc$-MDP bone and $^{67}Ga$ scans were graded visually from 1 to 4 in which grade 3 means same uptake density as that of normal sacroiliac articulation in bone scan and normal liver in $^{67}Ga$ scan, respectively. Results: The improvement findings during and after therapy were found in 66.0% (19/ 29) and 72.7% (24/33) with $^{99m}Tc$-MDP bone scan, 84.6% (l1/13) and 86.7% (13/15) with $^{67}Ga$ scan, respectively. The mean grades of the uptake density in $^{99m}Tc$-MDP bone scan were 3.06 before, 2.34 during, 1.75 after therapy. Those in the $^{67}Ga$ scan were 3.22 before, 1.42 during 1.30 after therapy. Conclusion. $^{67}Ga$ scans appeared more sensitive than bone scans in evaluating therapeutic response of bone lymphoma.

• Progress in Medical Physics
• /
• v.26 no.4
• /
• pp.267-272
• /
• 2015

In this study, the reduction of dose and risk was evaluated from using automatic mA control in 4D CT scan of patients whose organ movement was considered for gated radiotherapy. The organ doses, CTDI, effective doses from 4D CT with and without using automatic mA control were evaluated using CT-Expo program for each 10 patients of liver and lung cancer, and the risk of exposure induced death and loss of life expectancy were evaluated using PCXMC program. It was founded that there were 26.8%, and 15.5% dose reduction in organ doses and CTDI for liver and lung cancer patients and 16.5% and 19.8% risk reduction in liver and lung cancer patients. The organ doses and effective doses were evaluated for the parameter of each patient used in CT scans, and risks considering age and gender could be evaluated. It was founded that there were 21.2% dose reduction and 18.2% risk reduction in 4D CT scan using AEC for liver and lung cancer patients.