Secondary Omental Infarction Related to Open and Laparoscopic-Assisted Distal Gastrectomy: Report of Two Cases

Omental infarction occurring after open and laparoscopic-assisted distal gastrectomy with partial omentectomy for gastric cancer was a very rare disease in the past, but its incidence has increased as more partial omentectomies are now being performed. But there are few case reports or radiologic studies on its increasing incidence. It is necessary to differentiate omental infarction from carcinomatosis peritonei, since both have similar imaging findings. In this report, we describe two cases of omental infarction; each occurred after open and laparoscopic-assisted distal gastrectomy in early gastric cancer patients. Partial omentectomy was performed in both cases. Omental infarction following distal gastrectomy with partial omentectomy can be discriminated from carcinomatosis peritonei by comparing with different initial and follow up CT findings.

Anthropometry of a Male Child Mummy from a Tomb of Joseon Dynasty Period in Korea / 체질인류학회지

On November 14, 2001, well -preserved male child corpse was excavated at Heapyeong Yoon's family mountain, Gyeonggi -do, in Korea. For one year after the excavation, the researches about this mummified male were made with various aspects including physical anthropology, forensic medicine, histology, radiology, and archaeology. After the researches, the mummy was presumed to be born at A.D. 1680, the middle of Joseon dynasty period and to die at about 5.5 years old by small pox or complications of same disease. This study is for physical anthropological measurement for this mummy and comparison to anthropometric data of mordern Korean 5 years old male child. The ratio of iliocristal height, iliospinal height and total arm length to standing height of the mummy is smaller than the same age group of mordern Korean. In cephalic index, the head of the mummy is hyperbrachycephalic, acrocephalic and hypsicephalic. There is no difference of cephalic index between the mummy and the same age group of mordern Korean. The mummy was taken the whole body computed tomography with 1mm slice distance. After automatic segmentation process of the skull, the model of the skull was reconstructed.

Neuronal Dysfunction in Patients with Chronic Alcoholism Evaluated by In Vivo 1H Magnetic Resonance Spectroscopy

PURPOSE: With the use of localized, water-suppressed in vivo 1H magnetic resonance spectroscopy (MRS), we evaluated the proton metabolic alterations in patients with chronic alcoholism and healthy normal controls. MATERIALS AND METHODS: Patients with chronic alcoholism (N=10) and normal control subjects (N=10) underwent MRS examinations using a stimulated echo acquisition mode (STEAM) pulse sequence with 2X2X2 cm3 volume of interest (VOI) in the left cerebellum and basal ganglia. Proton metabolite ratios relative to creatine (Cr) were obtained using a Marquart algorithm. RESULTS: The specific feature in patients with chronic alcoholism was a significant decrease of N-acetylaspartate (NAA)/Cr ratio in the left cerebellum, compared with normal controls. No clear correlation of other metabolite ratios such as choline (Cho)/Cr and inositols (Ins)/Cr was established. CONCLUSION: Our preliminary study suggests that the reduction of NAA/Cr ratio may indicate neuronal loss in patients with chronic alcoholism. Thus, in vivo 1H MRS may be a useful modality in the clinical evaluation of patients with chronic alcoholism based on the proton metabolite ratios.

Clinical Significance of Hepatic Arterioportal Shunts in Patients with Hepatocellular Carcinoma / 대한내과학회지

Arterioportal (AP) shunt is related to hepatocellular carcinoma (HCC) with variable frequency but its clinical significance is not well known. We retrospectively studied the prevalence and clinical significance including mortality of the AP shunt combined with HCC. METHODS: The clinical data and radiologic features of HCC patients who were performed hepatic angiography from 1992 to 1997 at St. Mary's Hospital in Korea were reviewed. The data of HCC patients with AP shunt were compared with that of randomized samples of HCC patients without AP shunt. RESULTS: The prevalence of AP shunt in HCC was 7.3%(45/616 HCC patients). There was no significant difference in clinical symptoms and signs such as ascites, encephalopathy, or variceal bleeding and laboratory findings between the HCC patients with AP shunt and those without. The AP shunt was more common in diffuse, poorly demarcated, large HCC. Especially, portal vein thrombosis (PVT) was one of the most common causes of AP shunt. Cumulative survival rate of the HCC patients with AP shunt was lower than that of those without. But only the size of HCC was significantly related with poor prognosis. CONCLUSION: AP shunt occurred in some HCC which was large in size or combined with PVT. AP shunt did not increase the severity of symptoms and signs, but decreased the survival because of its relation to tumor size.

Carcinoma of Ampulla of Vater: Emphasis on the CT Technique

PURPOSE: To demonstrate a CT technique by which carcinoma of the ampulla of Vater can be more accurately diagnosed, and to describe the radiologic findings this carcinoma. MATERIALS AND METHODS: We retrospectively reviewed CT findings in 26 patients with pathologically proven carcinoma of the ampulla of Vater. One additional cup of diluted oral contrast medium was ingested immediately before the scan. We analysed the difference in detection rate of the mass in the duodenal lumen with and without duodenal luminal opacification of gastrografin.We also evaluated the size and shape of the mass, dilatation of CBD and the pancreatic duct, and lymph node metastasis. In addition, we analyzed multimodality imaging findings ultrasonogram (US) : 13; hypotonic duodenogram (HTDG): 7; ERCP : 17) of carcinoma of the ampulla of Vater. RESULTS: Nodular soft tissue masses protruding into the duodenal lumen were identified in 21 of 26 cases. In 95% of cases (21/22) with favorable opacification and distension of the duodenum, masses were clearly identified on CT imaging. However, in four caseswith poor opacification and distension of the duodenum, masses could not be observed(P=0.000). The mass on CT scanshowed a well-defined margin, round or lobulated contour, and contrast enhancement similar to that of thepancreas. CBD dilatation was identified in 20 cases and pancreatic duct dilatation in 12. On US, protruding massesin the distal CBD were observed in nine of 13 cases(60%) and on HTDG, in six of seven cases(86%). as well-definedfilling defects. Conclusion : Since the accuracy of CT diagnosis of intestinal lesions is directly proportional tothe degree of intestinal distension and opacification with oral contrast, we believe that adequate ct techniquefor distending and opacitying the duodeual lumen are necessary for early diagnosis of carcinoma of the ampulla ofVater.

Emphysematous Cystitis: 3 Cases Report

Emphysematous cystitis is a rare condition characterized by gas collection in the wall and lumen of the bladder. We experienced three cases of emphysematous cystiris. All patients were female; one was associated with a long term history of diabetes mellitus and another with urinary indwelling catheter. All of the cases were easily diagnosed on plain radiograph and CT scan, and were successfully treated with antibiotic therapy. In one of the cases, however, associated abscess due to perivesical extension of inflammation was treated by combined external drainage.

Stereotactic Radiotherapy by 6MV Linear Accelerator / 대한치료방사선과학회지

Eight patients with intracranial tumors or arteriovenous malformation (AVM)s which were less than 3 cm in diameter were treated by a technique of stereotactic radiotherapy during the 4 months period from July 1988 through October 1988 at the Division of Radiation Therapy, Kang-Nam St. Mary's Hospital, Catholic University Medical College. The patients were diagnosed as AVMs in 3 cases, acoustic neurinoma, craniopharyngioma (recurrent), hemangioblastoma, pineocytoma, and pituitary microadenoma in each case. There are several important factors in this procedure, such as localization system, portal, field size, radiation dose, and perioperative supportive care. It is suggested that stereotactic radiotherapy may be performed safely with a radiation dose of 12-30 gy. So this noninvasive procedure can be used to treat unresectable intracranial tumors or AVMs. Of these, clinical symptoms had been regressed in AVMs in 2 cases at 3 months and 2 months after Stereotactic radiotherapy, one of whom was confirmed slightly regressed on the follow-up angiogram. And also craniopharyngioma and pineocytoma was minimally regressed on 3 month follow-up CT.

Computed Tomography in the Evaluation of Childs with White Pupil

White pupil is one of the most disturbing problems in the pediatric age group and many conditions can cause white pupil, but the differential diagnosis between the retinoblastoma and other conditions simulating it, is the prime importance in the evaluation of the white pupil. The ophthalmoscopy is the most accurate diagnostic method for evaluating intraocular diseases because it is able to see directly. However, its usefulness seems to be limited in the case of extreme lens opacity or vitreous opacity and in the evaluation of orbital diseases extending outside of the globe. Recent advances of high resolution computed tomography(CT), the axial tomographic images of the orbit were markedly improved and represented good anatomic details of the orbit and the topographic relationship with surrounding structures. We reviewed CT findings of 15 children who presented white pupil and had results demonstrating specific findings in the cases of retinoblastoma, persistent hyperplastic primary vitreous and vitreous opacity due to retinal detachment and retrolental fibroplasia. The CT findings of each disease are discussed with detail.

Computed tomographic findings in carcinoma of cervix

Accurate staging as well as diagnosis of cervix carcinoma is of paramount importance in planning treatment. Cervical smear cytologic studies have increased the detection rate of cervix carcinoma, but current radiologictechniques are limited in staging cervix carcinoma and precise visualization of lymphnodal metastasis. The CT scancan display the precise transaxial anatomical structures, permitting us not only to know the tumor size, shape andits extent but also lymphnodal enlargement in the pelvic cavity and around the abdominal aorta and secondarychanges of the kidney. The authors have tested the usefulness of CT in staging cervix carcinoma and detectinglymphatic involvement by analysis of 24 cases diagnosed by CT and confirmed histologically at St. Mary's hospitalduring the period from Oct. 1982 to May 1984. The conclusions are as follows; 1. The accuracy of CT instaging ofcervix carcinoma was 79%. 2. The accuracy of CT diagnosis of lymphatic involvement was 87.5%, sesitivity was85.7%, and speicificity was 88.2%.