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Wang Q, Ping FY, Pan HB. [Research hotspot in IgG4-related sialadenitis]. Zhonghua Kou Qiang Yi Xue Za Zhi 2016; 51:53-7. [PMID: 26792189 DOI: 10.3760/cma.j.issn.1002-0098.2016.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IgG4-related disease is a novel clinical entity which can affect single or multiple organs. IgG4-related sialadenitis is referred to the salivary gland involvement of IgG4-related disease, with or without other organ involvement. IgG4-related sialadenitis is characterized by painless swelling or enlargement of salivary glands, high serum IgG4 level, abundant IgG4+ plasma cells infiltration with fibrosis histologically, and good response to glucocorticoids. With review of related articles, highlight and provide an overview of the most recent and focused findings and concepts of this disease, including the most significant pathogenic process based on kinds of immunocytes, cytokines, as well as participation of epithelial-mesenchymal transition, the clinical value of elevated serum IgG4 concentration and pathological role of infiltrated IgG4+ plasma cells, the potential relationship with salivary gland malignant tumor, the applying and usefulness of positron emission tomography-CT, the diagnostic utility of lip biopsy, treatment, prognosis, and also future perspectives.
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Affiliation(s)
- Q Wang
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China
| | - F Y Ping
- Department of Oral and Maxillofacial Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, China
| | - H B Pan
- Department of Stomatology, Longsai Hospital, Ningbo Zhejiang 315200, China
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Pan HB, Wong KF, Hsu GC, Liang HL. The type of digital mammography is an influencing factor for the performance of national screening. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv175.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Liu LY, Wang J, Huang Y, Pan HB, Zhang X, Huang ZX, Zhao SM, Gao SZ. The effect of dietary protein levels on the expression of genes coding for four selected protein translation initiation factors in muscle tissue of Wujin pig. J Anim Physiol Anim Nutr (Berl) 2013; 98:310-7. [PMID: 23718228 DOI: 10.1111/jpn.12081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 04/11/2013] [Indexed: 01/11/2023]
Abstract
The objective of this study was to investigate the regulatory mechanism underlying the increased muscle protein accumulation in pigs while were fed a high protein diet. The eukaryotic initiation factors (eIFs) have been reported to involve in muscle protein synthesis. We investigated the mRNA and protein expression levels of eIF2B1, 4A1, 4B and 4E in Wujin pigs fed either a high protein (HP: 18%) or a low protein (LP: 14%) diet at 30, 60 or 100 kg body weight, based on real-time PCR and western blotting analyses. Our results indicated that the expression levels of eIF2B1 mRNA and protein were increased by HP diet at all body weight. The HP diet showed higher mRNA and protein levels of eIF4B gene at 60 and 100 kg. The protein expression of eIF4E phosphorylation was increased by HP diet only at 30 kg. These data suggested that the HP diet promoted porcine muscle protein accumulation mainly by up-regulating eIF2B1, 4B and 4E rather than 4A1 expression along the growth stages.
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Affiliation(s)
- L Y Liu
- College of Life Sciences, Yunnan Normal University, Kunming, Yunnan, China
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Li WZ, Zhao SM, Huang Y, Yang MH, Pan HB, Zhang X, Ge CR, Gao SZ. Expression of lipogenic genes during porcine intramuscular preadipocyte differentiation. Res Vet Sci 2012; 93:1190-4. [PMID: 22795880 DOI: 10.1016/j.rvsc.2012.06.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 06/11/2012] [Accepted: 06/17/2012] [Indexed: 11/30/2022]
Abstract
Intramuscular fat (IMF) content plays an important role in meat quality. Triglyceride (TG) metabolism in intramuscular adipocytes is strongly associated with the intramuscular fat deposition. To better understand the mechanisms leading to IMF deposition we compared the expression levels of genes related to preadipocyte differentiation and lipogenesis in the intramuscular preadipocytes isolated from the longissimus muscle of Wujin and Landrace pigs. The results showed that the intramuscular preadipocytes could differentiate into mature adipocytes in vitro. Triglyceride content in adipocytes isolated from Wujin pigs was higher than Landrace pigs during the middle and later phases of preadipocyte differentiation. The expression levels of genes related to preadipocyte differentiation such as PPARG and CEBPA showed differential expression between Wujin and Landrace porcine adipocytes during the early stage of differentiation. The expression levels of lipogenic genes such as FASN and SREBF1 were significantly higher in Wujin porcine intramuscular preadipocytes than in Landrace intramuscular preadipocytes at the middle and the later stages of differentiation. This suggests that preadipocyte differentiation and lipogenesis exhibited breed-related scheduling.
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Affiliation(s)
- W Z Li
- College of Animal Science and Technology, Yunnan Agricultural University, Kunming 650201, China
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Lai PH, Chang HC, Chuang TC, Chung HW, Li JY, Weng MJ, Fu JH, Wang PC, Li SC, Pan HB. Susceptibility-weighted imaging in patients with pyogenic brain abscesses at 1.5T: characteristics of the abscess capsule. AJNR Am J Neuroradiol 2012; 33:910-4. [PMID: 22282449 DOI: 10.3174/ajnr.a2866] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE SWI is a high-resolution 3D, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. The purpose of this study was to investigate the phase behavior of the capsule of pyogenic brain abscesses with noncontrast SWI. MATERIALS AND METHODS Fourteen patients with pyogenic brain abscesses were studied at 1.5T. In all of the patients, SWI images were obtained and reviewed in addition to conventional MR images. Phase values within the abscess capsule were measured and compared with those from the abscess cavities and contralateral normal white matter using 1-way repeated measures ANOVA with post hoc Bonferroni analysis. RESULTS SWI phase images showed mild hypointesity in 6 patients, isointensity in 3 patients, and mixed iso- to mild hypointensity in 5 patients. The means of phase in the cavity, rim of abscesses, and contralateral normal white matter were -7.552 × 10(-3) ± 0.024, -0.105 ± 0.080, and +0.029 ± 0.011 radians, respectively. Post hoc comparisons showed significant differences between any pair of the 3 regions (abscess cavity, rim capsule, and normal white matter) in SWI (all Ps < .005). CONCLUSIONS SWI phase imaging shows evidence of paramagnetic substances in agreement with the presence of free radicals from phagocytosis. SWI may provide additional information valuable in the characterization of pyogenic brain abscesses.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd., Kaohsiung, Taiwan 813, Republic of China.
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Lam WM, Pan HB, Fong M, Cheung WS, Wong KL, Li ZY, Luk KDK, Chan WK, Wong CT, Yang C, Lu WW. In Vitro characterization of low modulus linoleic acid coated strontium-substituted hydroxyapatite containing PMMA bone cement. J Biomed Mater Res B Appl Biomater 2010; 96:76-83. [DOI: 10.1002/jbm.b.31741] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Pan HB, Zhao XL, Zhang X, Zhang KB, Li LC, Li ZY, Lam WM, Lu WW, Wang DP, Huang WH, Lin KL, Chang J. Strontium borate glass: potential biomaterial for bone regeneration. J R Soc Interface 2009; 7:1025-31. [PMID: 20031984 DOI: 10.1098/rsif.2009.0504] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Boron plays important roles in many life processes including embryogenesis, bone growth and maintenance, immune function and psychomotor skills. Thus, the delivery of boron by the degradation of borate glass is of special interest in biomedical applications. However, the cytotoxicity of borate glass which arises with the rapid release of boron has to be carefully considered. In this study, it was found that the incorporation of strontium into borate glass can not only moderate the rapid release of boron, but also induce the adhesion of osteoblast-like cells, SaOS-2, thus significantly increasing the cyto-compatibility of borate glass. The formation of multilayers of apatite with porous structure indicates that complete degradation is optimistic, and the spread of SaOS-2 covered by apatite to form a sandwich structure may induce bone-like tissue formation at earlier stages. Therefore, such novel strontium-incorporated borosilicate may act as a new generation of biomaterial for bone regeneration, which not only renders boron as a nutritious element for bone health, but also delivers strontium to stimulate formation of new bones.
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Affiliation(s)
- H B Pan
- Department of Orthopeadics & Traumatology, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong
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Lai PH, Weng MJ, Lee KW, Pan HB. Multidetector CT angiography in diagnosing type I and type IVA spinal vascular malformations. AJNR Am J Neuroradiol 2006; 27:813-7. [PMID: 16611770 PMCID: PMC8133994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Multidetector CT (MDCT) angiography is an imaging technique that can provide high-resolution and high-contrast images; however, published reports of MDCT angiography in the evaluation of spinal vascular malformations are limited. We present 2 cases in which MDCT angiography led to diagnosis of a type I (spinal dural arteriovenous fistula) in one and type IVA (perimedullary spinal cord simple arteriovenous fistula fed by a single arterial feeder) spinal vascular malformation, both confirmed by conventional angiography. MDCT angiography can localize the feeding vessel and the fistula, thus greatly reducing the amount of time required for conventional angiography.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming University School of Medicine, Taiwan, ROC
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Lai PH, Ho JT, Lin SL, Hsu SS, Chen C, Yeh LR, Pan HB. Neuromuscular hamartoma arising in the brachial plexus. Neuroradiology 2004; 46:216-8. [PMID: 14991257 DOI: 10.1007/s00234-003-1130-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2003] [Accepted: 08/27/2003] [Indexed: 10/26/2022]
Abstract
We report a case brachial plexus neuromuscular hamartoma (choristoma) in a 28-year-old man who complained of numbness of the left hand and forearm for several years. MRI revealed a circumscribed, rounded mass in the left brachial plexus. The patient is well 2 years after surgery, with no neurological deficit.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, 386 Ta-Chung First Rd, 813 Kaohsiung, Taiwan.
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Lai PH, Wang JS, Chen WL, Pan HB, Yang CF. Intramedullary spinal cryptococcoma: a case report. J Formos Med Assoc 2001; 100:776-8. [PMID: 11802539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Intramedullary spinal cryptococcosis is very rare. We describe a case of intramedullary spinal cryptococcoma at the T12 level in a 60-year-old man who presented with a 3-month history of progressive bilateral lower limb weakness and no obvious immunocompromise. Magnetic resonance (MR) imaging revealed a 1.2 cm diameter mass within the spinal cord at T12 with intermediate signal intensity on T1-weighted images, a slight degree of homogeneous low signal intensity on T2-weighted images, and intense enhancement after infusion of gadopentetate dimeglumine. These findings led to a preoperative diagnosis of intramedullary tumor. After 2 months of postoperative antifungal treatment, the patient's clinical condition had markedly improved. Cryptococcoma should be considered when an enhancing lesion of the spinal cord is found on MR imaging, even in apparently immunocompetent patients. A careful lumbar puncture for cerebrospinal fluid analysis to diagnose cryptococcosis of the central nervous system should be made promptly, as early treatment is associated with a good prognosis.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Kaohsiung, Taiwan
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Lai PH, Chen PC, Chang MH, Pan HB, Yang CF, Wu MT, Li JY, Chen C, Liang HL, Chen WL. In vivo proton MR spectroscopy of chorea-ballismus in diabetes mellitus. Neuroradiology 2001; 43:525-31. [PMID: 11512579 DOI: 10.1007/s002340100538] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The most common cause of chorea-ballismus (CB) is a vascular lesion; it is also associated with nonketotic hyperglycaemia in diabetes mellitus (DM) and may be the first manifestation of this disorder. We describe the CT, MRI and proton MR spectroscopy (1H-MRS) of CB in eight patients. Six had hemichorea-hemiballismus (HC-HB) and two bilateral CB. Single-voxel (SV) 1H-MRS was performed using point-resolved spectroscopy (PRESS). Voxels were positioned in the basal ganglia of the patients and control subjects. PRESS was also used to obtain spectroscopic imaging (1H-MRSI) of the slice of interest in two patients. CT showed a slightly dense striatum in all the patients with CB, and T1-weighted images revealed high signal. The CB correlated well with the neuroimaging findings. SV 1H-MRS showed the mean (+/- SD) N-acetylaspartate (NAA)/ creatine (Cr) ratio to be 1.45 +/- 0.19 in HC-HB and 1.82 +/- 0.06 on the opposite normal side (P = 0.01). The choline (Cho)/ Cr ratio was 1.3 +/- 0.12 in HC-HB and 1.11 +/- 0.13 on the opposite normal side (P = 0.005). A lactate peak was seen in seven patients. The NAA/Cr ratio was 1.44 +/- 0.15 in bilateral CB and 1.74 +/- 0.16 in the controls (P = 0.017); the Cho/Cr ratios were 1.36 +/- 0.1 and 1.19 +/- 0.07 (P = 0.015). The low NAA/Cr suggests neuronal loss or damage and the high Cho/Cr probably indicates gliosis. The presence of lactate may suggest mild ischaemia due to acute vascular events during hyperglycaemia and underlying chronic focal cerebrovascular diseases in DM.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan.
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Lin YT, Lo GH, Lai KH, Tsai CC, Pan HB, Tseng HH, Lo YS. Solitary fibrous tumor of the liver. Zhonghua Yi Xue Za Zhi (Taipei) 2001; 64:305-9. [PMID: 11499341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Solitary fibrous tumor of the liver is a rare neoplasm. So far, 21 cases have been described in the English literature. We reported an additional case. Our patient, a 75-year-old man, suffered from abdominal fullness and body weight loss of 6 kg over 6 months, and chills and fever for 2 months. Hypoglycemia was noted at admission. Both abdominal sonography and CT showed a huge mass occupying the right lobe of liver. Liver biopsy showed fibrous tumor. Right lobectomy was performed and the tumor was resected. Pathological examination showed spindle-shaped and fibroblast-like cells within the collagenous stroma. On immunohistochemical stains, these spindle tumor cells showed CD34 positive reactivity. The post-operative course was uneventful and there was no more hypoglycemia. The patient recovered smoothly, regained his body weight, and was alive without evidence of disease recurrence at the last follow-up visit in November, 2000.
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Affiliation(s)
- Y T Lin
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung 813, Taiwan
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Chen CK, Chung CB, Yeh L, Pan HB, Yang CF, Lai PH, Liang HL, Resnick D. Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients. AJR Am J Roentgenol 2000; 175:655-9. [PMID: 10954446 DOI: 10.2214/ajr.175.3.1750655] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The objective of this study is to describe the CT and MR imaging findings of gouty tophi in the wrist and present this entity as a cause of carpal tunnel syndrome. MATERIALS AND METHODS Retrospective review of the CT (n = 18) and MR imaging (n = 20) studies of the wrist in patients with a documented diagnosis of gout who presented with gout-related carpal tunnel syndrome was performed; images of 24 wrists were collected over a 5-year period. Patient population included 20 men, who ranged in age from 35 to 76 years. All images were reviewed by two musculoskeletal radiologists who reached a consensus opinion. Surgical correlation was available in 12 patients. RESULTS Tophi were found in the floor of the carpal tunnel (n = 18), carpal bones (n = 17), radiocarpal joint (n = 17), and extensor tendons or tendon sheaths (n = 16) of the wrist. All tophi showed similar signal characteristics (from low to intermediate signal intensity on T1-weighted images with heterogeneous signal intensity on T2-weighted images) with the exception of tophi in the floor of the carpal tunnel (low signal intensity on T2-weighted images). Varying degrees of calcification were noted on CT and MR imaging studies. Gadolinium-enhanced MR studies showed heterogeneous enhancement. CONCLUSION Gouty tophi should be entertained as a cause of carpal tunnel syndrome in the appropriate patient population. Familiarity with this entity and its imaging characteristics may prove helpful in diagnosis and preoperative planning.
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Affiliation(s)
- C K Chen
- Department of Radiology, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Rd. Kaohsiung, 813 Taiwan
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Lin CP, Cheng JS, Lai KH, Lo GH, Hsu PI, Chan HH, Hsu JH, Wang YY, Pan HB, Tseng HH. Gastrointestinal metastasis in hepatocellular carcinoma: radiological and endoscopic studies of 11 cases. J Gastroenterol Hepatol 2000; 15:536-41. [PMID: 10847441 DOI: 10.1046/j.1440-1746.2000.02152.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND From October 1990 to January 1999, 11 of 2237 hepatoma patients at our hospital had gastrointestinal tract metastasis. We describe the radiological and endoscopic features, clinical course and prognoses of those patients. METHODS All patients were male. Six patients were hepatitis B carriers, and cirrhosis was noted in eight patients on admission. We reviewed all available radiological, endoscopic and pathological features. RESULTS The commonest clinical presentation was frank gastrointestinal bleeding. Histological proof of gastrointestinal involvement was seen in six patients. Endoscopic features included ulcerative tumours mimicking advanced gastric carcinoma (43%) and submucosal tumours (29%). The sites of organ involvement were stomach (five), duodenum (two), colon (three) and duodenum and colon (one). Direct invasion by a contiguous neoplasm was the major route of gastrointestinal tract metastasis. Portal vein thrombosis may be the key point of haematogenous spread to other sites. CONCLUSIONS The prognosis in these patients was extremely poor. Almost all patients died within 5 months if no further aggressive management was performed. Surgical intervention may be the optimal choice for palliative treatment of HCC with gastrointestinal tract involvement.
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Affiliation(s)
- C P Lin
- Department of Internal Medicine, Veterans General Hospital-Kaohsiung, National Yang-Ming University, Taiwan, Republic of China
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Lai PH, Chang MH, Liang HL, Pan HB, Yang CF. Unusual signs for dural arteriovenous fistulas with diffuse basal ganglia and cerebral calcification. Zhonghua Yi Xue Za Zhi (Taipei) 2000; 63:329-33. [PMID: 10820913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
We present a case of multiple dural arteriovenous fistulas (AVFs) in a 60-year-old man with the chief complaint of worsening headache, altered mental status and progressively unsteady gait over the course of one year. Computerized tomography revealed diffuse, symmetric calcification in the bilateral basal ganglia and bilateral periventricular and subcortical white matter. Magnetic resonance imaging revealed multiple, enhanced, punctate and linear vessels. These images were due to reflux into the parenchymal veins in the dural AVF of the superior sagittal sinus within the basal ganglia and deep white matter of both cerebral hemispheres. Cerebral angiography disclosed multiple dural AVFs. The exact mechanism of basal ganglia and subcortical calcification is proposed to be an arterial steal phenomenon or persistent venous congestion, with calcification occurring in a chronic hypoperfused state or with dystrophic changes in the walls of congested veins.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, ROC
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Lin CP, Cheng JS, Lai KH, Lo GH, Pan HB. Recurrent gastrointestinal bleeding and high output cardiac failure caused by hereditary hemorrhagic telangiectasia. Zhonghua Yi Xue Za Zhi (Taipei) 2000; 63:339-43. [PMID: 10820915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Hereditary hemorrhagic telangiectasia, commonly known as Osler-Weber-Rendu disease, is a systemic autosomal dominant inherited disorder, that occurs in Caucasian populations. We report the case of a 56-year-old housewife who was admitted to the gastrointestinal and cardiovascular ward because she had suffered from recurrent gastrointestinal bleeding and heart failure from 1994 to 1997. Panendoscopy showed vascular ectasia scattered over the tongue, larynx, esophagus, and posterior wall of the gastric body. Colonoscopy showed clusters of telangiectasia over the cecum and ascending colon. Arteriovenous malformations (AVMs) were found in the liver and lungs on computerized tomography. Recurrent gastrointestinal bleeding was controlled by estrogen treatment during the follow-up period. In July 1997, the patient was readmitted to our cardiovascular section due to aggravated dyspnea, orthopnea and bilateral lower leg edema. Cardiac catheterization showed a large fistula from the left pulmonary artery to the left atrium and left ventricle, pulmonary arterial pressure of 37/13 mmHg and cardiac output of 9.61/minute. Other studies excluded the possibility of sepsis, and high-output cardiac failure was suspected. The patient was discharged in a stable condition and scheduled for AVM embolization management. Unfortunately, she died of a suspected heart attack at home two weeks following discharge.
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Affiliation(s)
- C P Lin
- Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taiwan, ROC
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Liang HL, Yang CF, Pan HB, Lai KH, Cheng JS, Lo GH, Chen CK, Lai PH. Small hepatocellular carcinoma: safety and efficacy of single high-dose percutaneous acetic acid injection for treatment. Radiology 2000; 214:769-74. [PMID: 10715044 DOI: 10.1148/radiology.214.3.r00mr06769] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the safety and efficacy of single high-dose percutaneous acetic acid injection (PAI) for treatment of small (<3-cm-diameter) hepatocellular carcinoma (HCC). MATERIALS AND METHODS Eighteen patients with HCC (22 nodules; diameter range, 1.5-3.0 cm) underwent single PAI. With ultrasonographic or computed tomographic (CT) guidance, 4-11 mL of 50% acetic acid was slowly injected into the center of the nodule through a skinny multiple-side-hole needle. Follow-up was performed with helical contrast material-enhanced CT. Complications of high-dose PAI were recorded. RESULTS Seventeen nodules showed no local recurrence (follow-up, 6-29 months) after single PAI. At a mean follow-up of 15.6 months, mean tumor diameter was 2.1 cm and mean injected volume was 6.4 mL. Four nodules showed residual tumor (mean tumor diameter, 2.6 cm; mean injected volume, 5.8 mL). The mean ratio of injected to estimated volume of acetic acid was 1.21 in cases of successful single PAI and 0.72 in cases of local recurrence (P < .001). One patient with preexistent right portal venous thrombosis died of hepatic failure 37 days after PAI. Other complications included severe pain (11%), high fever (4%), and segmental wedge infarction (4%). CONCLUSION Single high-dose PAI is safe and effective for treatment of small HCC.
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Affiliation(s)
- H L Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan
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Liang HL, Pan HB, Lee YH, Huang JS, Wu TD, Chang CT, Liang HL, Yang TL, Yang CF. Small functional adrenal cortical adenoma: treatment with CT-guided percutaneous acetic acid injection--report of three cases. Radiology 1999; 213:612-5. [PMID: 10551251 DOI: 10.1148/radiology.213.2.r99nv10612] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Two patients with Conn syndrome and one patient with Cushing syndrome underwent computed tomography (CT)-guided tumor ablation with a total of 5-11 mL of 50% acetic acid injected into their adrenal nodule (1.3-3.3 cm in diameter). No major complications were encountered during or after the procedure. All patients were symptom free with normal laboratory test results for at least 1-year follow-up. CT images showed complete cystic change with tumor size regression. Our preliminary results suggest that percutaneous acetic acid injection is a safe and effective alternative for treatment of small functional adrenal cortical adenoma.
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Affiliation(s)
- H L Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan, Republic of China.
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Lai PH, Yang CF, Pan HB, Chen C, Ho JT, Hsu SS. Detection and assessment of circle of Willis aneurysms in acute subarachnoid hemorrhage with three-dimensional computed tomographic angiography: correlation with digital substraction angiography findings. J Formos Med Assoc 1999; 98:672-7. [PMID: 10575836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
In this retrospective study, we examined the usefulness of computed tomographic angiography (CTA) for the detection and assessment of circle of Willis aneurysms in patients with acute nontraumatic subarachnoid hemorrhage (SAH), using selective digital substraction angiography (DSA) as the gold standard. Thirty-five patients who presented with acute, nontraumatic SAH, diagnosed on the basis of unenhanced computed tomography or lumbar puncture findings or both, underwent both CTA and DSA. The CTA images were interpreted for the presence, location, size, and shape of the aneurysm, presence of a neck, and relationship of the aneurysm to adjacent arterial branches. The CTA and DSA images were then compared, with the latter images serving as the gold standard. DSA revealed 37 aneurysms in 32 patients and ruled out intracranial aneurysms in the remaining three. The sensitivity and specificity of CTA for aneurysm detection were 97% and 100%, respectively. The size of the smallest aneurysm shown was 4 mm, and the largest aneurysm was 21 mm. The size and lobularity of the aneurysms estimated from CTA images corresponded well with those estimated from DSA images. In addition, CTA provided a three-dimensional representation of the aneurysmal lesion, which was considered useful for surgical planning. Our results confirm the accuracy of CTA in comparison with DSA. Because of its reliability, minimal invasiveness, and rapidity, CTA may become the technique of choice for neuroradiologic work-up of SAH patients. DSA then would be used to diagnose intracranial aneurysms only in selected, questionable cases.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan
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Lai PH, Yang CF, Pan HB, Wu MT, Chu ST, Ger LP, Huang WC, Hsu CC, Lee CN. Recurrent inverted papilloma: diagnosis with pharmacokinetic dynamic gadolinium-enhanced MR imaging. AJNR Am J Neuroradiol 1999; 20:1445-51. [PMID: 10512227 PMCID: PMC7657741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND AND PURPOSE Dynamic gadolinium-enhanced MR imaging has been used successfully to identify post-treatment recurrence or postoperative changes in rectal and cervical carcinoma. Our purpose was to evaluate the usefulness of dynamic gadolinium-enhanced MR imaging for distinguishing recurrent inverted papilloma (IP) from postoperative changes. METHODS Fifteen patients with 20 pathologically proved lesions (recurrent IP, 12; fibrosis or granulation tissue, eight) were enrolled in the study. Three observers, blinded to pathologic results, independently evaluated conventional MR images, including T1-weighted (unenhanced and postcontrast), proton-density-weighted, and T2-weighted spin-echo images. Results then were determined by consensus. Dynamic images were obtained using fast spin-echo sequences at 5, 30, 60, 90, 120, 150, 180, and 300 seconds after the injection of gadolinium-diethylene-triamine penta-acetic acid. Time-signal intensity curves of suspected lesions were analyzed by a pharmacokinetic model. The calculated amplitude and tissue distribution time were used to characterize tissue, and their values were displayed as a color-coded overlay. RESULTS T2-weighted images yielded a sensitivity of 67%, a specificity of 75%, and an accuracy of 70% in the diagnosis of recurrent IP. Contrast-enhanced T1-weighted images yielded a sensitivity of 75%, a specificity of 50%, and an accuracy of 65%. Pharmacokinetic analysis showed that recurrent IP had faster (distribution time, 41 versus 88 seconds) and higher (amplitude, 2.4 versus 1.2 arbitrary units) enhancement than did fibrosis or granulation tissue. A cut-off of 65 seconds for distribution time and 1.6 units for amplitude yielded a sensitivity of 100% and a specificity of 100% for diagnosing recurrent IP. CONCLUSION Dynamic MR imaging can differentiate accurately recurrent IP from postoperative changes and seems to be a valuable diagnostic tool.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang-Ming College, Taiwan, ROC, USA
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Chen CK, Liang HL, Lai PH, Yeh LR, Yang TL, Pan HB, Yang CF. Imaging diagnosis of insufficiency fracture of the sacrum. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62:591-7. [PMID: 10502849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Insufficiency fracture of the sacrum has been recognized as a major cause of lower back pain, especially in elderly osteoporotic patients with or without underlying malignancy and/or prior pelvic radiotherapy. Its diagnosis cannot be readily made from its nonspecific clinical features. Consequently some cases may be mistaken for bone metastases, causing patients to receive inappropriate diagnostic measures and management. Recognition of the spectrum of imaging features is the basis of correct diagnosis and treatment. METHODS The imaging studies of 14 cases (12 women and 2 men; age range, 60-84 years; mean age, 70 years) of sacral insufficiency fracture were reviewed retrospectively. These included 14 radiographs, six bone scintigraphs, eight computerized tomography (CT) scans and 12 magnetic resonance (MR) imaging studies. Six patients had a history of malignancy. Diagnosis was made by characteristic imaging findings, and clinical and radiographic follow-up for one to 3.5 years. RESULTS Five cases of sacral insufficiency fracture were suspected based on radiographic findings of fracture lines (2 cases) and focal sclerosis (3 cases). Seven cases were diagnosed by CT findings of linear fractures (7 cases) and focal sclerosis (2 cases). Nine MR examinations demonstrated characteristic vertical bands of marrow edema. A hypointense fracture line was identified in eight cases. The remaining two MR imaging studies disclosed nonspecific focal marrow edema. An early case, which appeared normal on CT scan, showed marrow edema on MR imaging. The positive and diagnostic rates were both 36% for plain radiographs, 88% for CT scans, and 100% and 83%, respectively, for MR images. CONCLUSIONS Plain radiographs are often unrewarding. Although MR imaging is the most sensitive tool, fracture lines are best demonstrated and diagnosed using CT. Due to the better diagnostic rate, popularity and cost effectiveness, CT is recommended as the definitive modality for confirming diagnosis of insufficiency fracture of the sacrum.
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Affiliation(s)
- C K Chen
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, ROC
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Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, Tsai G, Rosen BR, Kwong KK. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain--preliminary experience. Radiology 1999; 212:133-41. [PMID: 10405732 DOI: 10.1148/radiology.212.1.r99jl04133] [Citation(s) in RCA: 330] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To characterize the central nervous system (CNS) pathway for acupuncture stimulation in the human brain by using functional magnetic resonance (MR) imaging. MATERIALS AND METHODS Functional MR imaging of the whole brain was performed in two groups of nine healthy subjects during four stimulation paradigms: real acupuncture at acupoints ST.36 (on the leg) and LI.4 (on the hand) and control stimulations (minimal acupuncture and superficial pricking on the leg). Stimulations were performed in semirandomized, balanced order nested within two experiments. Psychophysical responses (pain, De-Qi effect [characteristic acupuncture effect of needle-manipulation sensation], anxiety, and unpleasantness) and autonomic responses were assessed. Talairach coordinates-transformed imaging data were averaged for a group analysis. RESULTS Acupuncture at LI.4 and ST.36 resulted in significantly higher scores for De-Qi and in substantial bradycardia. Acupuncture at both acupoints resulted in activation of the hypothalamus and nucleus accumbens and deactivation of the rostral part of the anterior cingulate cortex, amygdala formation, and hippocampal complex; control stimulations did not result in such activations and deactivations. CONCLUSION Functional MR imaging can demonstrate the CNS pathway for acupuncture stimulation. Acupuncture at ST.36 and LI.4 activates structures of descending antinociceptive pathway and deactivates multiple limbic areas subserving pain association. These findings may shed light on the CNS mechanism of acupuncture analgesia and form a basis for future investigations of endogenous pain modulation circuits in the human brain.
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Affiliation(s)
- M T Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan
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Affiliation(s)
- P H Lai
- Veterans General Hospital-Kaohsiung, Taiwan, Republic of China
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, Taiwan, Republic of China
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Affiliation(s)
- P H Lai
- Veterans General Hospital-Kaohsiung, National Yang Ming University, Taiwan, Republic of China
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Abstract
OBJECTIVE To define the imaging characteristics of intra-articular tophi of the knee. DESIGN AND PATIENTS Twelve patients with intra-articular tophi in the knee were studied with routine MR imaging, gadolinium (Gd)-enhanced MR imaging, and CT over a 4-year period. There were 11 men and one woman, 25-82 years of age (mean age 48 years). Four patients did not have a documented history of gout at the time of the MR examination. The diagnosis of intra-articular tophi was provided by arthroscopy and histological examination (5 patients), by microscopic study of joint fluid (5 patients), or by characteristic clinical, laboratory and imaging findings (2 patients). RESULTS In 15 MR examinations the tophi were located purely intra-articularly in 10 knees. In the remaining five MR studies, periarticular soft tissues or bone, or both, were involved. All the intra-articular tophi manifested low to intermediate signal intensity on both T1- and T2-weighted images. All five Gd-enhanced MR examinations demonstrated a heterogeneous peripheral enhancement. All 10 CT scans showed varying degrees of stippled calcifications within the tophi. The nature of the calcifications was confirmed on histological examination in three patients. CONCLUSION Presenting clinical manifestations of gout may relate to intra-articular tophaceous deposits. Such deposits present as masses on MR images with low to intermediate signal intensity on both T1- and T2-weighted images and a characteristic enhancement pattern following intravenous Gd administration. These features relate primarily to internal calcifications, which are most evident on CT images. MR evaluation (including Gd administration) supplemented, in some cases, with CT scanning allows accurate diagnosis of intra-articular tophaceous deposits.
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Affiliation(s)
- C K Chen
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan
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Lai PH, Yang CF, Pan HB, Chen C, Lo YK, Hung KH. Intracranial acute arterial ischemia of the anterior circulation: evaluation with three-dimensional time-of-flight magnetic resonance angiography. Zhonghua Yi Xue Za Zhi (Taipei) 1999; 62:20-7. [PMID: 10063708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
BACKGROUND Stroke has been the second most common cause of death, after cancer, in Taiwan since 1983. The cost of stroke to society in terms of morbidity, mortality and economics is profound. Heightened interest in the early diagnosis and treatment of acute stroke challenges neuroimagers to optimize available modalities and to develop new techniques for the evaluation of cerebrovascular disease. The aim of this study was to investigate the effectiveness of magnetic resonance angiography (MRA) in conjunction with spin-echo imaging in patients with acute brain infarction of the anterior circulation. METHODS Magnetic resonance imaging and three-dimensional Fourier transformed time-of-flight MRA studies, performed on 50 patients within one week after the onset of cerebral ischemia, were retrospectively reviewed and correlated with clinical records. Five of the 50 MRAs were considered nondiagnostic and excluded because of poor patient cooperation. RESULTS In 41 of the 45 cases, the area of infarct corresponding to the clinical deficit at the time of study was identified on T2-weighted spin-echo images. Arterial occlusions or severe stenoses that corresponded to ischemic manifestations were identified with MRA in 37 of the 45 patients. A focal discontinuity with decreased arterial caliber corresponded to stenosis and nonvisualization of distal branches represented arterial occlusion. MRA provided information for 23 cases not obtained from the MR images. CONCLUSIONS Vascular lesions demonstrated on intracranial MRA show a high correlation with infarct distribution. MRA, which provides information adjunctive to conventional MR imaging in a majority of cases, is concluded to be an important component of the complete evaluation of brain infarction.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, ROC
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Lai PH, Hsu SS, Pan HB, Yang CF. Intracranial cystic cavernous angioma: a case report. Kaohsiung J Med Sci 1998; 14:593-8. [PMID: 9796205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
We present a case of cystic cavernous angioma in an 18-year-old woman with the chief complaint of acute onset of seizures. Computed tomography (CT) and magnetic resonance (MR) imaging revealed a tumor with a slightly enhanced solid calcified portion and a large cystic portion. The patient was well without recurrence 6 months after surgery. The importance of MR imaging in the differential diagnoses is emphasized.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, Taipei, Taiwan, Republic of China
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Abstract
We present a case of intracranial parenchymal leiomyoma in a 20-year-old woman with a chief complaint of numbness and a painful sensation over the right limbs for several years. CT and MRI revealed an intensely enhancing calcified mass. The patient was well, without recurrence, 2 years after surgery.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, Taiwan, ROC
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Abstract
OBJECTIVE A retrospective review of the MR images and radiographs of 26 shoulders in 17 patients suffering from contracture of the deltoid muscle was used to establish the characteristic imaging findings. MATERIALS AND METHODS Deltoid muscle contractures in 26 shoulders in 17 patients encountered over a 4-year period are reported. The history of intramuscular injection and clinical symptoms and signs are detailed. Imaging studies including routine radiographs (24 shoulders), MR images (25 shoulders), and computed arthrotomograms (two shoulders) were reviewed. On MR images, the winging angle of the scapula (angle between the axis of the scapular body and the coronal plane of the chest) and the diameter of the lesion were measured and compared with data derived from 24 age-matched control subjects. RESULTS Diagnostic MR features of deltoid muscle contracture include fibrotic cord in the deltoid muscle, especially its middle portion, extending from the superior acromial surface to the deltoid tuberosity, and winging of the scapula (increased winging angle of the scapula). Characteristic radiographic features include abduction contracture, winging of the scapula, lateral down-sloping of the acromial process, and a superior acromial enthesophyte. CONCLUSION MR images are sensitive and accurate in the diagnosis of contracture of the deltoid muscles. Characteristic features also allow accurate routine diagnosis on radiographs.
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Affiliation(s)
- C K Chen
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan
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Lai PH, Lin SM, Pan HB, Yang CF. Disseminated miliary cerebral candidiasis. AJNR Am J Neuroradiol 1997; 18:1303-6. [PMID: 9282859 PMCID: PMC8338024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We present a case of disseminated intracranial infection by Candida albicans in a 5-year-old girl who had fever and a change of consciousness after surgery for complex congenital heart malformation. MR imaging revealed multiple small ring-enhancing hemorrhagic abscesses. One year after antifungal treatment, the abscesses and ventriculomegaly were almost completely resolved. The patient was discharged in a stable but vegetative condition.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, National Defense Medical Center, Taiwan, Republic of China
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Abstract
PURPOSE To evaluate the safety and feasibility of transsplenic portal vein catheterization. MATERIAL AND METHODS Under ultrasonic guidance, percutaneous transsplenic splenic vein catheterization was performed in 17 patients. Two of the patients had minimal and 5 moderate ascites. In 11 patients, the platelet counts were over 50000/mm3 and the coagulation time normal or mildly prolonged, while 6 patients had either platelet counts of less than 50000/mm3 or moderately prolonged coagulation level. RESULTS Transsplenic portal catheterizations were successfully performed in 16 of the 1/patients (one failed because of small splenic size). Procedure-related complications occurred in 3 patients with 2 requiring one unit of packed RBC transfusion. The third patient accumulated minimal fluid in the left pleural space. Imaging studies within one week of the procedure were made in 8 patients. These examinations revealed an intrasplenic hematoma in 2 patients. One patient had a small amount of hemoperitoneum. No major complications occurred. CONCLUSION Transsplenic portal venous catheterization is a safe and feasible procedure.
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Affiliation(s)
- H L Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan, Republic of China
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Yang CF, Wu MT, Chiang AA, Lai RS, Chen C, Tiao WM, McLoud TC, Wang JS, Pan HB. Correlation of high-resolution CT and pulmonary function in bronchiolitis obliterans: a study based on 24 patients associated with consumption of Sauropus androgynus. AJR Am J Roentgenol 1997; 168:1045-50. [PMID: 9124113 DOI: 10.2214/ajr.168.4.9124113] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE An outbreak of Sauropus androgynus-associated bronchiolitis obliterans occurred in Taiwan in the summer of 1995. We undertook a study of the correlation between high-resolution CT findings and pulmonary function testing in patients from this outbreak. MATERIALS AND METHODS We evaluated inspiratory-expiratory high-resolution CT scans of 24 patients with S. androgynus-associated bronchiolitis obliterans. The presence of bronchiectasis was assessed by two visual scores (a bronchial dilatation score and a bronchiectasis extent score). Extent of air-trapping was assessed visually and given a score. We also used computer software to assess the extent of air-trapping and generate scores of dynamic attenuation. Spirometry, plethysmography, and diffusion capacity of each patient were also obtained. RESULTS All four scores had statistically significant correlation with forced expiratory volume in 1 sec (FEV1) (p < .05 for both bronchiectasis scores; p < .001 for both air-trapping scores). The two air-trapping scores had statistically significant correlation with forced vital capacity and diffusion capacity. We found the scores for dynamic attenuation had the greatest correlation with FEV1 (r = .85). We also found that mosaic attenuation was notable on expiratory CT scans alone in nine patients (type 1 air-trapping) and on both inspiratory and expiratory CT scans in 15 patients (type 2 air-trapping). In the latter group, FEV1 was significantly lower (p < .01). CONCLUSION Findings from high-resolution CT of air-trapping were more important than findings of bronchiectasis when correlating pulmonary function with S. androgynus-associated bronchiolitis obliterans. Type 2 air-trapping suggested a more severe air-flow obstruction than did type 1. Scores for quantitative attenuation generated by computer software were helpful in assessing air-trapping and correlating it with pulmonary function. These findings may apply to patients with bronchiolitis obliterans from other causes.
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Affiliation(s)
- C F Yang
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan ROC
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Abstract
PURPOSE To evaluate the safety and feasibility of transsplenic portal vein catheterization. MATERIAL AND METHODS Under ultrasonic guidance, percutaneous transsplenic splenic vein catheterization was performed in 17 patients. Two of the patients had minimal and 5 moderate ascites. In 11 patients, the platelet counts were over 50000/mm3 and the coagulation time normal or mildly prolonged, while 6 patients had either platelet counts of less than 50000/mm3 or moderately prolonged coagulation level. RESULTS Transsplenic portal catheterizations were successfully performed in 16 of the 1/patients (one failed because of small splenic size). Procedure-related complications occurred in 3 patients with 2 requiring one unit of packed RBC transfusion. The third patient accumulated minimal fluid in the left pleural space. Imaging studies within one week of the procedure were made in 8 patients. These examinations revealed an intrasplenic hematoma in 2 patients. One patient had a small amount of hemoperitoneum. No major complications occurred. CONCLUSION Transsplenic portal venous catheterization is a safe and feasible procedure.
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Affiliation(s)
- H L Liang
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan, Republic of China
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Pan HB, Huang JS, Chen CT, Shih MC, Mok KT, Kan YY, Yang CF. Computed tomography in the diagnosis of organic bowel obstruction. Zhonghua Yi Xue Za Zhi (Taipei) 1996; 58:108-113. [PMID: 8915113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND This study examined the usefulness of computed tomography (CT) scan for cases of organic intestinal obstruction, with two simple criteria. METHODS One hundred and thirteen patients with clinical suspicion of bowel obstruction were referred for CT scans. A line was drawn between the dilated proximal, and the collapsed distal bowels. A careful search was conducted on this line for obstructive lesions. The results were reported to be organic obstruction if there was an abrupt change of caliber (Criterion I) or a soft tissue mass around the dilated bowel (Criterion II). The judgement based on the CT findings. RESULTS Eighty-eight cases proved to have bowel obstruction. With Criterion I, the sensitivity was 59.1%, and specificity, 88% with Criterion II, the sensitivity was 56.3% and specificity 100%. If either of them was considered to be a positive sign of organic obstruction, the sensitivity was 100%, the specificity 88% and the accuracy 97.3%. The nature of the obstructions were precisely predicted in 76 patients (86%). CONCLUSIONS With these two simple criteria, CT scan can achieve high accuracy and is a recommendation in virtually every instance when intestinal obstruction is suspected.
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Affiliation(s)
- H B Pan
- Department of Radiology, Veterans General Hospital-Kaohsiung, Kaohsiung, R.O.C
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Lin CH, Lo GH, Lai KH, Mok KT, Pan HB, Teng WB. Obstructive jaundice caused by calcified portal venous thrombosis: a case report. Zhonghua Yi Xue Za Zhi (Taipei) 1996; 58:50-3. [PMID: 8870328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
One case of bile duct obstruction because of calcified thrombosis of the portal vein is described. The patient had received splenectomy 20 years previously. He was admitted for fever, right upper abdominal pain and jaundice. The initial sonography and computed tomography showed dilatation of bilateral intrahepatic ducts and common bile duct with adjacent calcified portal vein mimicking common bile duct stones. Endoscopic retrograde cholangio-pancreatography showed external compression of the common bile duct by the calcified portal vein. Because of the patient's poor liver condition, biliary endoprosthesis was performed to relieve obstruction. This was an indication that the possibility of portal venous thrombosis should be included in the differential diagnosis of patients with obstructive jaundice who had previously received splenectomy.
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Affiliation(s)
- C H Lin
- Department of Medicine, Veterans General Hospital-Kaohsiung, Taiwan, R.O.C
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Yang CF, Tzeng WS, Chang JM, Liang HL, Huang JS, Pan HB, Lo GH, Cheng JS, Lai KH. Experience with transjugular intrahepatic portosystemic shunts for gastroesophageal variceal bleeding. Zhonghua Yi Xue Za Zhi (Taipei) 1996; 57:204-13. [PMID: 8935227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Variceal bleeding is a major life-threatening complication of cirrhosis of the liver. Transjugular intrahepatic portosystemic shunts (TIPS) have been accepted as an effective method for portal decompression. Experiences here with the use of TIPS for control of gastroesophageal variceal bleeding is presented. METHODS Sixteen TIPS procedures were performed for 15 patients who suffered from intractable gastroesophageal variceal bleeding. Nine cases (60%) were hepatitis-related cirrhosis of liver, four (27%) were alcoholic liver cirrhosis and two were cryptogenic in origin. Liver function tests revealed four patients were Child-Pugh's classification A, five were B and six, C. Twelve cases had received failed endoscopic management of varices; and one patient had recurrent variceal bleeding after devascularization. TIPS procedure was performed electively in nine cases and, as an emergency in six cases. RESULTS Fifteen of the 16 TIPS procedures attempted were successfully performed. The technically successful rate was 94% (15/16), but two cases with successful TIPS procedure expired at the end of the procedure from hypovolemic shock and acute respiratory distress, respectively; thus the completely successful rate was 81% (13/16), The initial bleeding control rate was 83% (5/6) for the six patients with active bleeding. Portal venous pressure was significantly decreased from 30.8 +/- 5.8 mmHg before TIPS to 21.7 +/- 6.0 mmHg after the procedure (P < 0.01) and the porto-systemic pressure gradient also significantly decreased from 23.0 +/- 3.6 mmHg to 11.9 +/- 2.7 mmHg after TIPS (P < 0.01). Recurrent variceal bleeding was noted in four patients (33%) and that was managed by percutaneous transluminal angioplasty (PTA) of shunt, placement of additional stent, second TIPS procedure and a devascularization operation. Hepatic encephalopathy was noted in three patients (25%) after TIPS. CONCLUSIONS TIPS is an effective method to control variceal bleeding caused by portal hypertension, especially when endoscopic or surgical management has failed or is contraindicated.
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Affiliation(s)
- C F Yang
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, R.O.C
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Wu MT, Pan HB, Chen C, Chang JM, Lo GH, Wu SS, Yeung HN, Yang CF. Azygos blood flow in cirrhosis: measurement with MR imaging and correlation with variceal hemorrhage. Radiology 1996; 198:457-62. [PMID: 8596849 DOI: 10.1148/radiology.198.2.8596849] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
PURPOSE To evaluate magnetic resonance (MR) measurement of azygos blood flow (ABF) in assessment of risk of variceal hemorrhage in cirrhosis. MATERIALS AND METHODS ABF in 50 patients with cirrhosis and 20 healthy control subjects was evaluated with phase-contrast cine MR imaging at the transaxial subcarinal plane. Group 1 included nine patients with cervical-drainage varices draining into brachiocephalic vein; group 2 included 41 patients with varices draining into azygos vein and was subdivided as group 2A, 15 patients with variceal hemorrhage, and group 2B, 26 without variceal hemorrhage. RESULTS Azygos flow rate and velocity were increased in patients compared with that in control subjects. ABF in group 2A was faster than that in group 2B (cutoff, 15 cm/sec; sensitivity, 80%; specificity, 89%). Group 1 had ABF close to that of group 2B, but variceal hemorrhage occurred in seven of nine patients in group 1 versus 15 of 41 patients in group 2 (78% vs 37%; P = .029). CONCLUSION Patients with cirrhosis with cervical-drainage varices or ABF greater than 15 cm/sec may have higher risk for variceal hemorrhage.
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Affiliation(s)
- M T Wu
- Department of Radiology, Kaohsiung Veterans General Hospital, Taiwan, Republic of China
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Lai PH, Tien RD, Chang MH, Teng MM, Yang CF, Pan HB, Chen C, Lirng JF, Kong KW. Chorea-ballismus with nonketotic hyperglycemia in primary diabetes mellitus. AJNR Am J Neuroradiol 1996; 17:1057-64. [PMID: 8791916 PMCID: PMC8338595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
PURPOSE To describe the neuroimaging (Ct, MR, and single-photon emission CT [SPECT]) findings in a series of patients with chorea-ballismus associated with nonketotic hyperglycemia in primary diabetes mellitus and to correlate the imaging findings with the clinical presentation. METHODS The neuroimaging and clinical data from 10 patients with chorea-ballismus associated with nonketotic hyperglycemia in primary diabetes mellitus were evaluated. Family and drug histories, as well as other causes of chorea, were excluded. All 10 patients had CT, 5 also had MR imaging, and 3 had SPECT examinations. Three had follow-up CT and MR imaging studies, and MR findings were correlated with CT findings in 5 cases. Two experienced neuroradiologists, aware of the diagnosis but blinded to the clinical status of the patients, evaluated all images and reached a consensus as to the final interpretation. RESULTS CT studies in 9 of 10 patients showed a hyperdense putamen and/or caudate nucleus; in 1, the CT findings were normal. T1-weighted MR images in all 5 patients who had MR imaging (including the patient with a normal CT study) showed hyperintense lesions without significant T2 signal alternation at the basal ganglia. In all 3 of the patients who had SPECT studies of the brain, the scans revealed hypoperfusion at corresponding areas. All 3 follow-up studies depicted resolution of the lesions in the abnormal basal ganglia. Increased hypointensity on T2-weighted and gradient-echo T2*-weighted images was also observed in the sequential MR images. In all patients, the initial side of involvement correlated well with the neuroimaging findings. The chorea resolved within 2 days after treatment of the hyperglycemia in 9 patients. CONCLUSION In patients with chorea-ballismus associated with nonketotic hyperglycemia in primary diabetes mellitus, CT and T1-weighted MR images show unilateral or bilateral lesions of the putamen and/or caudate. SPECT scans show hypoperfusion. These findings may be related to petechial hemorrhage and/or myelin destruction. Early recognition of these imaging characteristics may facilitate diagnosis of primary diabetes mellitus with hyperglycemia and prompt appropriate therapy.
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Affiliation(s)
- P H Lai
- Department of Radiology, Veterans General Hospital- Kaohsiung, National Yang Ming University, Taiwan, Republic of China
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40
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Jin X, Chen Y, Dong GS, Zhang M, Xu M, Zhu XG, Wang X, Lu ED, Pan HB, Xu PS, Zhang XY, Fan CY. Synchrotron-radiation study of the electronic structure of fcc Mn thin films grown on a GaAs(001) surface. Phys Rev B Condens Matter 1995; 51:9702-9706. [PMID: 9977636 DOI: 10.1103/physrevb.51.9702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abstract
BACKGROUND This randomized controlled study was objectively designed to evaluate the utility cisplatin (50 mg) in transcatheter arterial embolization (TAE) for treatment of hepatocellular carcinoma (HCC). METHODS From May 1991 to July 1993, 46 patients were included in the study. All had a pathologic verification of HCC. Clinically, all of the patients were considered inoperable. However, these patients satisfied eligibility criteria for TAE. The patients were divided into two groups by random sampling. In group I, 22 patients received TAE with the regimen of cisplatin (50 mg) mixed with Lipiodol 5-15 ml followed by gelfoam pieces. In group II, 24 patients, as a controlled group, used the regimen of Lipiodol and gelfoam (Spongostan Film, Ferrosan, Denmark) pieces only, without adding any anticancer drug. The two groups were evaluated by a series of imaging studies and various clinical examinations before and after TAE. Subsequently, TAE was performed every 2 or 3 months for all patients until there was no visible tumor, or the patient could not sustain further TAE, or the patient died. RESULTS In group I, TAE was administered 61 times (average 28 times for each patient), and in group II, 73 times (average 3 times for each patient). The 1-year and 2-year survival rates of group I were 52.5% and 26.2%, and group II were 72.5% and 39.5%. Statistically, there was no significant difference in survival curves and survival rates between these two groups. Tumor response rate of group I was 68% (15/22) and group II was 67% (16/24). There was no significant difference in tumor response between these two groups. The liver and renal function studies after TAE also showed no significant difference between these two groups. CONCLUSIONS Based on this controlled study, the authors conclude that the addition of cisplatin does not enhance the therapeutic effect of TAE for treatment of HCC.
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Affiliation(s)
- J M Chang
- Department of Radiology, Kaohsiung Veterans General Hospital, Republic of China
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42
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Abstract
BACKGROUND This randomized controlled study was objectively designed to evaluate the utility cisplatin (50 mg) in transcatheter arterial embolization (TAE) for treatment of hepatocellular carcinoma (HCC). METHODS From May 1991 to July 1993, 46 patients were included in the study. All had a pathologic verification of HCC. Clinically, all of the patients were considered inoperable. However, these patients satisfied eligibility criteria for TAE. The patients were divided into two groups by random sampling. In group I, 22 patients received TAE with the regimen of cisplatin (50 mg) mixed with Lipiodol 5-15 ml followed by gelfoam pieces. In group II, 24 patients, as a controlled group, used the regimen of Lipiodol and gelfoam (Spongostan Film, Ferrosan, Denmark) pieces only, without adding any anticancer drug. The two groups were evaluated by a series of imaging studies and various clinical examinations before and after TAE. Subsequently, TAE was performed every 2 or 3 months for all patients until there was no visible tumor, or the patient could not sustain further TAE, or the patient died. RESULTS In group I, TAE was administered 61 times (average 28 times for each patient), and in group II, 73 times (average 3 times for each patient). The 1-year and 2-year survival rates of group I were 52.5% and 26.2%, and group II were 72.5% and 39.5%. Statistically, there was no significant difference in survival curves and survival rates between these two groups. Tumor response rate of group I was 68% (15/22) and group II was 67% (16/24). There was no significant difference in tumor response between these two groups. The liver and renal function studies after TAE also showed no significant difference between these two groups. CONCLUSIONS Based on this controlled study, the authors conclude that the addition of cisplatin does not enhance the therapeutic effect of TAE for treatment of HCC.
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Affiliation(s)
- J M Chang
- Department of Radiology, Kaohsiung Veterans General Hospital, Republic of China
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Jin X, Zhang M, Dong GS, Chen Y, Xu M, Zhu XG, Wang X, Lu ED, Pan HB, Xu PS, Zhang XY, Fan CY. Magnetic ordering of Mn overlayers on GaAs(100). Phys Rev B Condens Matter 1994; 50:9585-9588. [PMID: 9975016 DOI: 10.1103/physrevb.50.9585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Abstract
Gastritis cystica polyposa (GCP) is an uncommon lesion that usually occurs at the gastroenterostomy site, although occasionally it can be found in an unoperated stomach. We present a rare case of GCP which presented as a large polypoid mass in the gastric fundus and contained cystic components demonstrable on preoperative computed tomography.
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Affiliation(s)
- M T Wu
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China
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45
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Hsu SM, Pan HB, Kan YY, Chang JM, Yang CF. [Hematometra in patients with cervical cancer--its CT presentation and clinical significance]. Zhonghua Yi Xue Za Zhi (Taipei) 1993; 51:128-33. [PMID: 8385551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Cervical cancer is the most common gynecologic malignancy in Chinese. Clinical staging has been traditionally used in cervical cancer, according to international Federation of Gynecology and Obstetrics (FIGO) staging classification. Computed tomography was an adjunctive modality for detecting paraaortic lymph nodes in preoperative evaluation. But CT has failed to accurately define the extent of parametrial and vaginal invasion. Here, an attempt has been made to define indirect clues alerting to invasive cervical cancer. Hematometra can be seen in CT as a dilated uterine cavity with retention of significant fluid. The incidence of hematometra was 5% (5/101) in control group, and 26% (22/84) in cervical cancer. Hematometra cannot be more specific for cervical cancer, with an accuracy of 64%, sensitivity of 82% and specificity of 61%. Hematometra was found to have a statistically high relationship with high cancer staging and uterine invasion. The Chi-square values were 14.8 (P < 0.005) in high cancer staging, and 19.8 in uterine invasion. The accuracy of hematometra was 65% in high cancer staging, and 74% in uterine invasion. Hematometra was more common in postmenopause women, with accuracy elevated to 80% for uterine invasion. This is probably related to senile atrophy or endophytic growth of the cervix into the uterus as well as to hormone replacement. These were five false positive instances of hematometra, all unrelated to cervical cancer. They presented with marked fluid and a solid mass in the uterine cavity, and included endometrial adenocarcinoma, uterine myoma and leiomyosarcoma. None of cervical cancer showed a solid mass in a dilated uterine cavity.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S M Hsu
- Department of Radiology, Veterans General Hospital-Kaohisung
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46
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Pan HB, Chiang JH, Huang JS, Chang JM, Yang CF, Lai KH, Mok JT. [Acute abdomen with intraperitoneal bowel perforation-demonstration by CT scan]. Zhonghua Yi Xue Za Zhi (Taipei) 1992; 50:142-8. [PMID: 1327472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Ninety-eight cases of surgically proved bowel perforation in VGH-Kaohsiung within one year were reviewed. Among them, 25 patients received abdominal CT scans before operation. Free gas or fluid could be demonstrated with CT scan in 80% of cases though sometimes the fluid was too scanty to be well recognized. Local abscess formation with or without tumor mass lesion (n = 3), local fluid accumulation (n = 1) and negative CT findings (n = 1) constituted the remaining 20% of cases. The recognition of perforation sites depended on direct evidences of perforation such as ulceration, abscess formation and tumor mass lesion (32%), or indirect evidences including hematoma formation, dependent extraluminal gas accumulation and phlegmonous reaction (12%). An inexplicable localized extraluminal fluid accumulation might also suggest a possibility of hollow organ perforation and lead to the recognition of perforation site in the absence of free gas (4%). Absence of extraluminal fluid or gas can not completely rule out the possibility of hollow organ perforation (4%). Massive free air, especially with an air-fluid level, suggested a possibility of upper abdominal perforation. The perforation hole located at the anterior wall of stomach produced more free gas than that located at posterior wall. Air-fluid levels could never be identified in the cases of lower gastrointestinal perforations. Local bowel wall thickening and the distribution of free gas contributed little to the recognition of perforation site. Extravasation of oral contrast media sometimes led to the diagnosis of gastrointestinal perforation but was not necessary to be noted around the perforation hole and did little contribution to the perforation site recognition.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- H B Pan
- Department of Radiology, Veterans General Hospital-Kaohsiung, Taiwan, R.O.C
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Chou YH, Tiu CM, Hsu CC, Pan HB, Chiang JH, Chang T. Hepatic microabscesses caused by Escherichia coli--US and CT appearance. Zhonghua Yi Xue Za Zhi (Taipei) 1991; 47:280-3. [PMID: 1646678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Hepatic microabscesses have been described in immunosuppressed patients. However, there has been no previous report concerning hepatic microabscesses caused by Escherichia coli (E. coli). Recently, we experienced a 75-year-old male patient who had suffered from fever and upper abdominal pain for 4 days. His laboratory tests revealed an increased erythrocyte sedimentation rate (55 mm/hr), the white cell count was 7500/cumm with 82% segmented leukocytes, minimally elevated serum alkaline phosphatase and serum glutamic-pyruvic transaminase. Ultrasonography (US) showed multiple tiny hypo- or nearly anechoic lesions (3-8mm) diffusely scattered in both hepatic lobes. Some lesions were too small to be demonstrated and only distal acoustic enhancement posterior to the lesions could be noted. Contrast-enhanced computed tomography (CT) scan subsequently demonstrated the tiny hypodense and cystic lesions and confirmed the US diagnosis of microabscesses. Cultures of blood and liver aspirates showed E. coli. Although US and CT appearance of hepatic microabscesses caused by E. coli may be characteristic, it is not specific. Differential diagnosis should include multiple biliary hamartomas, and definite diagnosis should be made by needle aspiration.
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Affiliation(s)
- Y H Chou
- Department of Radiology, Veterans General Hospital-Taipei, R.O.C
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Chou YH, Tiu CM, Pan HB, Yeh CJ, Wei CF, Chang TE. Ultrasonographic demonstration of duplication cyst of the ileum. Zhonghua Yi Xue Za Zhi (Taipei) 1990; 46:237-9. [PMID: 2178058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The enteric duplication cyst is a term applied to an anomaly of the gut which presents as a cystic structure with a mucosal lining predominantly similar to that of the adjacent alimentary tract. It may be either due to an embryologic error in normal canalization or errors in the embryologic connection between the developing gut and neural tube, as a part of the split notochord syndrome. The preoperative diagnosis of a duplication cyst is difficult to make on the basis of conventional radiologic study including barium swallowing gastrointestinal series. With the wide application of ultrasound in the detection and evaluation of pediatric abdominal masses, an intra-abdominal cystic lesion may be encountered and the differential diagnoses may be difficult or impossible. We hereby report a case of duplication cyst of the ileum in which we believe its sonographic appearance is of certain value or even diagnostic in this pathology.
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Affiliation(s)
- Y H Chou
- Department of Radiology, Veterans General Hospital, Taipei, R.O.C
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Lin XZ, Wang SS, Tsai YT, Lee SD, Shiesh SC, Pan HB, Su CH, Lin CY. Serum amylase, isoamylase, and lipase in the acute abdomen. Their diagnostic value for acute pancreatitis. J Clin Gastroenterol 1989; 11:47-52. [PMID: 2466075 DOI: 10.1097/00004836-198902000-00011] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We evaluated the diagnostic value of serum amylase, isoamylase, and lipase for the diagnosis of acute pancreatitis from sera of patients with acute abdominal pain. Comparison was first made in condition A between 32 patients with image-proven pancreatitis and 414 patients with nonpancreatic acute abdomen (the control group), then in condition B, between 62 pancreatitis patients with or without image proof and the control group. We found (a) that patients with image-proven pancreatitis suffer a more severe clinical course than those without; (b) that the sensitivity, positive predictive value, and accuracy in condition B are higher than in condition A at any cutoff level; (c) that none of the enzyme assays is specific at the upper reference limit, but their diagnostic yields are much improved by raising cutoff levels to about three or four times the upper limit; and (d) that at these selected cutoff levels, amylase had a diagnostic value similar to p-isoamylase or lipase in both conditions (sensitivity 84% and 92% for amylase in conditions A and B, respectively; specificity 98% and 98%; positive predictive value 75% and 90%; negative predictive value 99% and 99%; accuracy 91% and 97%). In conclusion, at an appropriately selected cutoff level, amylase can be effectively used as the first-line test and isoamylase or lipase as adjunct tests for acute abdominal conditions.
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Affiliation(s)
- X Z Lin
- Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China
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Tiu CM, Pan HB, Chou YH, Chiang JH, Chang T. Computed tomography of gastric lymphoma. Zhonghua Yi Xue Za Zhi (Taipei) 1988; 42:463-8. [PMID: 3254735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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