Leiomyosarcoma of the Inferior Vena Cava Mimicking Right Adrenal Tumor

The most frequent tumor arising from retroperitoneum is sarcoma. Most sarcomas of retroperitoneal origin have no symptoms and comprise 15% of all sarcomas. However, they can grow so great as to cause pain, which implies the possibility of invasion to adjacent organs. Moreover, if its location is between right adrenal gland and inferior vena cava (IVC) ambiguity of its origin can arise. Leiomyosarcoma of IVC is so rare that it can be seen to mimic right adrenal tumor. This 56-year-old female patient with back pain since approximately 4 months prior was transferred to our hospital via local clinic. We performed radical resection of tumor including segmental resection of IVC. Final diagnosis was leiomyosarcoma of IVC. We report this case with a review of literature.

Surgical Clip Moved into the Extrahepatic Bile Duct after Laparoscopic Hepatectomy / 대한내시경복강경외과학회지

In the case of using surgical clips for division of the cystic duct during laparoscopiccholecystectomy, surgical clip migration into the common bile duct is known to be an extremely rare complication. However, its mechanism is currently unclear. The incidence of performing laparoscopic hepatectomy has significantly increased in the laparoscopic center of hospitals. Accordingly, the complications associated with using clips in laparoscopic cholecystectomy have increase as well. A 49 year-old female patient underwent laparoscopic left hepatectomy due to left intrahepatic duct stones with cholangitis. We report here on a case of a clip that migrated into the common bile duct and the duct had bile stones. We also review the relevant literature.

A Study on Middle School Students' Recognition of Food and Nutrition Part in Home Economics / 대한지역사회영양학회지

The purpose of this study was to investigate the differences of middle school students' recognition of food and nutrition part in Home Economics by gender, school location and school type. The study was carried out through questionnaire about three category: perception (interests, practical usefulness, attitude change in food behavior), difficulty (nutrition and health in adolescence, balanced diet, principle of cooking and preparing food), necessity (nutrition and health in adolescence, balanced diet, principle of cooking and preparing food). The subjects were 1014 middle school students of 1st grade in Jeonbuk area; urban 334, suburban 339 and rural 341. The results of this study were as follows. 1) There was difference in 'interests' by gender (girls > boys), school location (urban, suburban > rural) and school type (coeducation > boys, girls). There were differences in 'practical usefulness' by school location (urban > rural) and in 'attitude change in food behavior' by school location (urban > suburban > rural) and school type (boys, girls > coeducation). 2) There was difference in difficulty in section of 'nutrition and health in adolescence' by school location (suburban > rural). There were no differences in section of 'balanced diet' by gender, school location and school type. But there were differences in section of 'principle of cooking and preparing food' by school location (urban, rural > suburban)and school type (coeducation > boys). 3) There were differences in necessity for 'balanced diet' and for 'principle of cooking and preparing food' by school location (urban, suburban > rural) and school type (coeducation > boys, girls). Characteristically, the boys had more necessity for 'nutrition and health in adolescence' and for 'balanced diet' than girls but girls had more necessity for 'principle of cooking and preparing food' than boys. It suggests that gender, school type and school location should be considered for an effective and practical curriculum of food and nutrition part in Home Economics.

Effect of Oral Nutritional Support During Radiation Therapy in Patients with Thoracic and Gead/Neck Cancer / 대한암학회지

PURPOSE: This study was designed to evaluate the role of oral nutritional support and nutritional counseling by dietician during radiation therapy. MATERIALS AND METHODS: This study included total 58 patients with head/neck, lung, or esophageal cancers who received radiation therapy with radical purpose between February and December, 1996. They were randomized either into nutrient supplement group (Group I) or control group (Group II). In Group I, the dietician advised patients to take high density nutrient supplement (NuCare, 250 kcal/can, Miwon co., LTD) based on dieticians initial evaluation for oral intake from initiation to completion of radiation therapy. In Group II, patients received nutritional support other than high density nutrient supplement only when patients lose weight more than 2 Kg during radiation treatment. All patients were evaluated for nutritional status and diet pattern and received nutritional counseling before radiation therapy and then weekly during treatment. RESULTS: Total 45 patients (22 patients in group I, 23 patients in group II) were available. In group I, all patients received average 3 cans (2~4 cans) a day. The calory from nutrient supplement was 43.9% of their daily energy intake (25.9~68.7%). About 72.7% of patients in Group I could keep up with their oral intake over 80% of daily requirement energy comparing to only 12.3% for patients in Group II(p0.05). CONCLUSION: There was less significant weight loss in patients who started oral nutritional supplement based on the daily requirement energy early in radiation therapy. We think it is better to recommend nutritional supplement before weight loss started because radiation induced side effects such as esophagitis and oral mucositis prohibited patients to continue to take nutrient supplement.

Single breath-hold MR imaging of liver

Single breath-hold gradient echo images with Small Tip. Angle Gradient Echo(STAGE) were evaluated in the study of liver in 16 patients(4 normal liver, 5 hepatoma, 5 cholangiocarcinoma, 1 hemangioma, 1 cavernous transformation of portal vein). We obtained one slice of gradient echo during single breath-hold at the level of pathology defined on conventional spin echo inage. Single breath-hold gradient echo images were compared with spin echo images for image quality and artifacts. Single breath-hold gradient image showed improved resolution of vascular detail and excellent contrast between lesion and adjacent normal liver in hepatoma. Cholangiocarcinoma showed decreased contrast between lesion and biliary trees but improved contrast between lesion and blood vessel. Cavernous transformation of porta vein was noted as tortuous vessel of high signal intensity. Single breath-hold gradient echo scan increased vascular artifact, but decreased respiratory artifact leading to improved image quality. Single breath-hold technique can reduce can reduce imaging time and improve image quality and may be used as complementary method to the spin echo scan.

High signal intensity lesion in basal ganglia on MR imaging: Correlation with portal-systemic encephalopathy in liver cirrhosis

To evaluate of the relationship between basal ganglia lesion and portal-systemic encephalopathy, eleven patients who had clinically proved liver cirrhosis with superior mesenteric vein larger than 10mm in diameter on ultrasonogram underwent brain MR imaging. No evidence of clinical or neuropsychiatric disturbance was observed in any patient at the time of the MR examination. Brain MR imaging revealed basal ganglia lesion characterized by bilateral, symmetric, high signal intensity without edema or mass effect on spin echo T1-weighted images in nine patients which included three patients with the past history of portal-systemic encephalopathy. It was concluded that excepted in the circumstances of other causes of the high signal intensity in basal ganglia on T1-weighted images such as fat, methemoglobin, melanin, neurofibromatosis, dense calcification, and parenteral nutrition, bilateral and symmetric high signal intensity lesion, in basal ganglia would be a useful MR finding of subclinical portal-systemic encephalopathy in liver cirrhosis patients with no clinical or neuropsychiatric symptoms and larger than 10mm diameter of superior mesenteric vein in ultrasonography.

Comparison of MR angiography and conventional angiography in intracranial arteriovenous malformations

In 10 cases with intracranial arterivenous malformation (AVMs) diagnosed by MR spin echo images, MR angiography was evaluated and compared with conventional angiography in regard to depiction of nidus, arterial feeders, and draining veins. Spin echo images demonstrated the nidus of the AVM in all cases, but displayed the feeding vassels inadequately. These vessels were directly visualized with 3 dimensional STAGE(small tip angle gradient echo) MR angiography using rephasing/dephasing pulse sequences. In 5 cases MR angiography and conventional angiography showed the same results. However, in the others, MR angiography showed lower resolution than conventional angiography. MR angiography is useful in preangiographic evaluation of intracranial AVM but improvement in image resolution, which is dependent on MR hard ware and pulse sequence, is still to be desired.