| Jeong Hyun Yoo | 9 Articles |
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[English]
[English]
Our purpose was to discuss the current results of renal transplantation at our institute and to document the usefulness of the ultrasonography in the follow-up of renal allograft. Thirty five renal allografts who operated and followed-up at our hospital were included. All patients underwent renal duplex and Doppler sonography. According the clinical course of allograft, the sonographic findings were classified into successful renal transplantation(SRT), acute rejection(AR), chronic rejection(CR), and graft failure(GF). We retrogradely analyzed the sonographic findings as follows : renal size(length, width, thickness), cortex echogenicity, corticomedullary differentiation, renal sinus and pyramid, renal pelvis, resistive index(RI). Results of allografts were as follows : SRT, 24 case(68.6%) ; AR, 6(17.1%) : CR, 3(8.6%) ; and GF, 2(5.7%). The changes of length of allografts were shown no statistically significant changes between the groups, but there is significant increase of thickness of allograft in AC and GF with significance. The mean RI was statistically increased in AR(RI=0.87), and the mean RI's of other groups were 0.65, 0.70, and 0.67 in order to SRT, CR, GF. Parenchymal echogenicities are changed in 66.7% of AC and CR, 25% of SRT, and 50% of GF without clinical significance. There are changes of CMJ, pyramid, sinus echo, renal pelvis of allografts, however, which were shown no statistical significance. Even though we have small cases and short experiences of renal transplantation at our institute, we considered we have relatively good results and it was guessed there were many efforts for the renal transplantation. The duplex and Doppler sonography were useful tools in the follow-up of allograft, especially deciding acute rejection and graft failure, although it is difficult to decide chronic rejection and can not used to differentiate between the main parenchymal causes of graft failure.
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To investigate whether measurements of hepatic metastases before contrast administration are different from measuments after contrast administration. And to gain more effective follow up method by analyzing the difference of contrast between pre- and postcontrast scans. Thirty patients with herpatic metastases were underwent conventional CT. Continuous 10mm thick slices were obtained from liver dome to pelvic inlet, then the patients received IV injection of contrast material, and same method as precontrast CT scan was performed. Additional 5mm thin slice scan was obtained in case of need. Three radiologists performed independent bidimensional measurements of the randomly selected lesion on both pre- and postcontrast images at the same level and analyzed the difference of the size and contrast. The size of hepatic metastases were measured as smaller on postcontrast images ; average 41.4±43.5cm2 on precontrast scan & 35.2±37.5cm2 on postcontrast scan. There was significant difference by paired t-test(p<0.02). 24 of 30 cases(80%) showed better conspicuity on postcontrast images, 5(16.7%), on precontrast images and 1(3.3%) showed similiar conspicuity on both pre- and postcontrast images. The contrast of hepatic metastases was significantly higher on postcontrast scan by chi-square test(p<0.01). Hepatic metastases are significantly smaller on postcontrast images. The contrast between metastatic lesion & liver parenchyme was better on postcontrast scan. Therefore, serial assessment of hepatic metastases size by CT should not be compared mixed pre- and postcontrast image. And postcontrast scan is more effective method than precontrast for follow up of hepatic metastasis.
[English]
To access the changes of cerebral blood flow velocity according to the time after surfactant administration, we prospectively studied in the Hyaline Membrane Disease using Doppler ultrasonography. The patients were 26 infants. The mean gestational age was 3l4wks (range, 184 to 38wk). The ratio of male : female was 16 : 10, mean weight was 1.76±0.88Kg, Apgar score at 5min was 6.9, and type of delivery was C-section : vaginal delivery 19 : 4. Before and after, 10, 30min, 1, 6, l2hr, 1, 3, 5, 7days after surfactant administration, peak systolic and end-diastolic flow velocity(PSFV, EDFV) were estimated by Doppler method measuring MCA flow velocity. The Resistive index was calculated according to the mathematics. For the evaluation of the clinical status, systolic and diastolic systemic BP, PaO2, PaCO2, FiO2, pH, and respiratory rate(RR) were checked. The cerebral blood flow velocity showed initial increase of PSFV just after synthetic surfactant administration, and the increased PSFV continued until the 30 minites and then decreased. PSFV returns to initial level at 6hr, and then increased again. The changes of EDFV was not significant. The changes of RI & PI were no significant changes. The effects of surfactant to the systemic BP had no significance. The changes of PaCO2 and PaO2 were not significant. FiO2 showed steady improvement. Initial tachypnea and acidosis progressively improved without clinical significance. The administration of Surfactant in the HMD patients results in transient increase of cerebral blood flow velocity.
[English]
Ultrasound has been found to be accurate, reliable and noninvasive method in the measurement of spleen. The study was undertaken to obtain standard values of size in three dimensions and normal range of splenic volume by the use of splenic volumetric index(SVI) in normal korean adults. We experienced 100 cases of abdominal ultrasonography of normal korean adults from May 1995 to August 1995. 1) The average size of spleen in adult male was 6.85±1.31cm in breadth, 4.93±1.27cm in thickness, 6.33±1.46cm in height ; in adult females, 6.61±1.23cm, 5.17±1.26cm, 6.33. 42cm, respectively ; total average, 6.73±1,27cm, 5.05±1.27cm, 6.33±1.39cm,respectively. 2) The average splenic volumetric index in adult male was 8.20±3.95; in adult females, 8.41±4.08 ; total average,8.31±4.00. There were no statistical differences of SVI and size between sex and age. Although ultrasonography is less accurate than computed tomography, it is rapid and simple method for splenic measurement.
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Cirrhotic patients may exhibit circulatory derangement and renal dysfunction during the clinical course. Renal dysfunction on cirrhosis can occur without specific causative factors. This functional renal failure in cirrhosis is considered as a consequence of renal vasoconstriction. These alteratons of renal hemodynamics are already present in the early phase of the disease, even in the condition that the conventional kidney function tests are normal. A new method for noninvasive evaluation of arterial tone is duplex Doppler sonography. Among the various sonographic indices proposed, the renal resistive index(RI) is the most widely used for the estimation of intrarenal arteriolar vascular resistence. This study was performed to evaluate the role of Doppler sonography in early detection of renal dysfunction and to assess the clinical significance of RI. In 25 cirrhotic patients without overt kidney failure and ten control subjects, the RI of the acurate artery in both kidneys was measured by Doppler sonography. The mean RI of cirrhotic group was significangly higher than that of control subjects(0,68±0.08 vs -0.62±0.05,p<0). Accordiing to Child class, the RI showed increasing tendency from A to C, through witout statistical significance. In this study, the RI was significantly inversely correlated with 24hr urinary sodium amount(r=-0.39, p<0,05)and correlated with serum creatinine(r=6.60,p<0.01). This study indicates that the measurement of RI is a sensitive method to assess intarenal hemodynamics and to detect early changes of the renal dysfunction in cirrhotic patients.
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Abdominal ultrasound for the health screen was performed in 4610 adults from the Jan. 1993 to Mar. 1995 at Ewha University Hospital Health Clinic. Gross abnormalities were noted in the 33.3% of examined persons. The most common finding was fatty liver(21.6%). And other abnormalities were renal cyst, gallbladder stone, hepatic cyst, and hepatic calcification in the order of frequency. It is concluded that abdominal ultrasound is an important screening modality in the adults.
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There are variable radiological method for breast disease including mammography, breast ultrasound, thermography, CT-mammography and MRI. Among these, mammography is the oldest and the gold standard for diagnosis of breast disease. In mammography, the primary consideration is the demonstration of the absence or presence of the breast lesion and if present, the benignity of malignancy of the lesion. The authors analyzed the mammographic findings in 145 cases pathologically proven cases of various breast disease. The results were as follows: 1) The most prevalent age group of benign lesion was 3rd-4th decade with frequency of 65.3% and that of malignant lesion was 4th-5th decade with frequency of 66.6%. 2) The most frequent site of breast lesion was upper outer quadrant in benignity and malignancy. 3) Pathologic type of breast malignancy was all of ductal carinoma with various type, and the most common benignity is breast tumor(57.8%) and followed fibrocystic disease(27.3%). 4) The detection of abnormal findings of malignant lesion was 87.5% including mass lesion(75%) and benign lesion was 80.1% including mass lesion(54.5%). Conclusively, the authours suggest that mammography is very useful method for the detection & diagnosis of breast disease.
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Although the usefulness of mammography as screening test for breast cancer is still in dispute,its use to patients over 50 years of age is valid. Since Wolfe fisrt classified breast parenchymal pattern of mammography into 4 patterns, N1, Pl, P2, DY, many authors have adopted the clitoris in studing the changes of the parenchymal patterns for certain ages and the risk for breast cancer of certain parenchymal patterns. Authors reviewed 50 cases of breast cancer which diagnosed by radiologic studies including mammography, galactography, and computed tomography, and confirmed by pathologically. The results were as follows : 1) Incidence of breast cancer according to parenchymal pattern was : 9 cases(18%) in N1 type breast 5 cases(10%) in Pl type breast 32 cases(64%) in P2 type breast, 4 cases(8%)in DY type breast. 2) Detection rate of cancer lesion according to parenchymal pattern was : 89% in N1 typebreast, 80% in Pl type breast 63% in P2 type breast 25% in DY type breast. Most frequent age distribution was 5th and 6th decade. In conclusion, mammographic parenchymal pattern is valid indicator for breast cancer.
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, Jeong Soo Suh
