Difference in F-18 FDG Uptake After Esophagogastroduodenoscopy and Colonoscopy in Healthy Sedated Subjects / 대한핵의학회잡지

PURPOSE: We aimed to evaluate the difference in fluorodeoxyglucose (FDG) uptake in sedated healthy subjects after they underwent esophagogastroduodenoscopy (EGD) and colonoscopy procedures.METHODS: The endoscopy group (n = 29) included healthy subjects who underwent screening via F-18 FDG positron emission tomography/computed tomography (PET/CT) after an EGD and/or colonoscopy under sedation on the same day. The control group (n = 35) included healthy subjects who underwent screening via PET/CT only. FDG uptake in the tongue, uvula, epiglottis, vocal cords, esophagus, stomach, duodenum, liver, cecum, colon, anus, and muscle were compared between the two groups.RESULTS: Maximum standardized uptake value (SUVmax) in the tongue, pharynx, larynx, and esophagus did not significantly differ between the endoscopy and control groups. In contrast, mean SUVmax in the whole stomach was 18 % higher in the endoscopy group than in the control group (SUVmax: 2.96 vs. 2.51, P = 0.010). In the lower gastrointestinal track, SUVmax from the cecum to the rectum was not significantly different between the two groups, whereas SUVmax in the anus was 20% higher in the endoscopy group than in the control group (SUVmax: 4.21 vs. 3.50, P = 0.002). SUVmax in the liver and muscle was not significantly different between the two groups. Mean volume of the stomach and mean cross section of the colon was significantly higher in the endoscopy group than in the control group (stomach: 313.28 cm³ vs. 209.93 cm³, P < 0.001, colon: 8.82 cm² vs. 5.98 cm², P = 0.001).CONCLUSIONS: EGD and colonoscopy under sedation does not lead to significant differences in SUVmax in most parts of the body. Only gastric FDG uptake in the EGD subjects and anal FDG uptake in the colonoscopy subjects was higher than uptake in those regions in the control subjects.

A Case of Papillary Thyroid Carcinoma Coexistent with Thyroid Sarcoidosis / 대한갑상선학회지

Sarcoidosis is a systemic granulomatous disease that primarily affects the lung and lymphatic system of the body. The involvement of thyroid gland with sarcoidosis is uncommon. Moreover, sarcoidosis with thyroid cancer are rarely reported in the world. We encountered papillary thyroid carcinoma (PTC) coexistent with pulmonary sarcoidosis. A 35-year-old female with a medical history of pulmonary sarcoidosis visited the endocrinology department for evaluation of the thyroid nodule. Thyroid ultrasonography showed multiple markedly hypoechoic nodules in the left thyroid lobe. Then ultrasonogram-guided fine needle aspiration of left thyroid nodule was positive for papillary carcinoma. She underwent total thyroidectomy with left complete cervical lymph node dissection. The histopathology was confirmed PTC combined with non-caseating granulomatous inflammation suggesting sarcoidosis on thyroid mass and lymph node. We report here a case of PTC coexistent with thyroid involvement of pulmonary sarcoidosis.

Insulin Autoimmune Syndrome in a Patient with Hashimoto's Thyroiditis / 대한갑상선학회지

Insulin autoimmune syndrome (IAS) is characterized by fasting hypoglycemia, endogenous hyperinsulinemia, and the presence of autoantibodies to insulin or insulin receptor in patients that have never been exposed to exogenous insulin. This syndrome is occasionally accompanied by several autoimmune disorders. There is no reported case of concurrent IAS with Hashimoto's thyroiditis. A 52-year-old female was diagnosed with Hashimoto's thyroiditis and was treated with 25 microg/d levothyroxine for 3 years. Recently, she experienced recurrent fasting hypoglycemic symptoms that disappeared rapidly with a carbohydrate-rich diet, although she had no history of diabetes or insulin use. Blood analysis showed hypoglycemia and elevated serum levels of insulin and C-peptide. Imaging studies did not reveal a mass lesion in the pancreas, and selective calcium-stimulated venous sampling also gave a negative result. However, anti-insulin antibody titer was high and assay for anti-insulin receptor antibody was positive. Here, we report a case of IAS concomitant with Hashimoto's thyroiditis.

Comparison of echocardiography, magnetic resonance imaging, and multidetector CT Images of a Cor Triatriatum / 대한내과학회지

No abstract available.

A Case of Huge Thrombus in the Aortic Arch with Cerebrovascular Embolization

Pedunculated thrombus in the aortic arch that is associated with cerebral infarction is very rare requires prompt diagnosis and treatment to prevent occurrence of another devastating complication. Transesophageal echocardiography is useful for detecting source of embolism including aortic thrombi. The treatment options of aortic thrombi involves anticoagulation, thrombolysis, thromboaspiration, and thrombectomy. Here we report a case of huge thrombus in the aortic arch, resulting in acute multifocal cerebellar embolic infarct in patient without any risk factors for vascular thrombosis. Thrombi in the aortic arch were diagnosed by transesophageal echocardiography and treated with anticoagulants successfully.

A Case of Primary Unclassified Spindle Cell Sarcoma of the Left Atrium / 영남의대학술지

Primary cardiac tumors are very uncommon. Seventy five percent of them are benign tumors and these are mostly myxomas. The malignant cardiac tumors, the majority of which are undifferentiated sarcomas, comprise up to 25% of all cardiac tumors. A primary malignant sarcoma of the myocardium is exceedingly rare. Thus, there have been very few such cases reported in the literature. We present here a case of a 15 year old man who had complaints of orthopnea and increasing exercise intolerance over a one month period. Transthoracic echocardiography demonstrated a well demarcated huge mass with left ventricular inflow obstruction on the posterior wall of the left atrium. The patient's symptoms were relieved by surgery. The histological diagnosis was an unclassified spindle cell sarcoma.

Aberrant right coronary artery from the left coronary sinus with an interarterial course detected using 128-multidetector coronary CT angiography / 대한내과학회지

No abstract available.

A Case of Polyarteritis Nodosa Associated with Pulmonary Tuberculosis / 영남의대학술지

Polyarteritis nodosa (PAN) is a systemic necrotizing vasculitis that typically affects the medium-sized muscular arteries, with occasional involvement of the small muscular arteries. As with other vasculitides, PAN can affect any organ system, including the cardiovascular, gastrointestinal and central nervous systems. The prognosis for patients with untreated PAN is relatively poor, with five-year survival rates of approximately 13 percent. The outcome has improved with proper therapy to approximately 80 percent survival at five years. We report here on a case of a 46 year old man with polyarteritis nodosa and who suffered from pulmonary tuberculosis.

A Case of Exit-Site Infection and Abscess by Mycobacterium Abscessus in a CAPD Patient / 영남의대학술지

Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.

The Difference of Left Atrial Volume Index: Can It Predict the Occurrence of Atrial Fibrillation after Radiofrequency Ablation of Atrial Flutter? / 영남의대학술지

BACKGROUND: The occurrence of atrial fibrillation after ablation of atrial flutter is clinically important. We investigated variables predicting this evolution in ablated patients without a previous atrial fibrillation history. MATERIALS AND METHODS: Thirty-six patients (Male=28) who were diagnosed as atrial flutter without previous atrial fibrillation history were enrolled in this study. Group 1 (n=11) was defined as those who developed atrial fibrillation after atrial flutter ablation during 1 year follow-up. Group 2 (n=25) was defined as those who has not occurred atrial fibrillation during same follow-up term. Echocardiogram was performed to all patients. We measured left atrial size, left ventricle end diastolic and systolic dimension, ejection fraction and left atrial volume index before and after ablation of atrial flutter. The differences of each variables were compared and analyzed between two groups. RESULTS: The preablation left ventricular ejection fraction (preLVEF) and postablation left ventricular ejection fraction (postLVEF) are 54+/-14%, 56+/-13% in group 1 and 47+/-16%, 52+/-13% in group 2. The differences between each two groups are statistically insignificant (2.2+/-1.5 in group 1 vs 5.4+/-9.8 in group 2, p=0.53). The preablation left atrial size (preLA) and postablation left atrial size (postLA) are 40+/-4 mm, 41+/-4 mm in group1 and 44+/-8 mm, 41+/-4 mm in group 2. The atrial sizes of both groups were increased but, the differences of left atrial size between two groups before and after flutter ablation were statistically insignificant (0.6+/-0.9mm in group 1 vs -3.8+/-7.4 mm in group 2, p=0.149). The left atrial volume index before flutter ablation was significantly reduced in group 1 than group 2 (32+/-10 mm3/m2, 35+/-10 mm3/m2 in group 1 and 32+/-10 mm3/m2, 29+/-8 mm3/m2 in group 2, p<0.05). CONCLUSION: The difference between left atrial volume index before and after atrial flutter ablation is the robust predictor of occurrence of atrial fibrillation after atrial flutter ablation without previous atrial fibrillation.