PubMed Health⌕ Search

Biomedical subjects

Soon Jin Lee

Publications and source records attributed to Soon Jin Lee.

At least 19 recordsLinked to original sources

Congenic strains confirm aerobic running capacity quantitative trait loci on rat chromosome 16 and identify possible intermediate phenotypes.

We previously identified two inbred rat strains divergent for treadmill aerobic running capacity (ARC), the low-performing Copenhagen (COP) and the high-performing DA rats, and used an F(2)(COPxDA) population to identify ARC quantitative trait loci (QTLs) on rat chromosome 16 (RNO16) and the proximal portion of rat chromosome 3 (RNO3). Two congenic rat strains were bred to further investigate these ARC QTLs by introgressing RNO16 and the proximal portion of RNO3 from DA rats into the genetic background of COP rats and were named COP.DA(chr 16) and COP.DA(chr 3), respectively. COP.DA(chr 16) rats had significantly greater ARC compared with COP rats (696.7 +/- 38.2 m vs. 571.9 +/- 27.5 m, P = 0.03). COP.DA(chr 3) rats had increased, although not significant, ARC compared with COP rats (643.6 +/- 40.9 m vs. 571.9 +/- 27.5 m). COP.DA(chr 16) rats had significantly greater subcutaneous abdominal fat, as well as decreased fasting triglyceride levels, compared with COP rats (P < 0.05), indicating that genes responsible for strain differences in fat metabolism are also located on RNO16. While this colocalization of QTLs may be coincidental, it is also possible that these differences in energy balance may be associated with the superior running performance of COP.DA(chr 16) consomic rats.

Adipose Tissue↗

Substitution mapping in dahl rats identifies two distinct blood pressure quantitative trait loci within 1.12- and 1.25-mb intervals on chromosome 3.

Substitution mapping was used to refine the localization of blood pressure (BP) quantitative trait loci (QTL) within the congenic region of S.R-Edn3 rats located at the q terminus of rat chromosome 3 (RNO3). An F2(SxS.R-Edn3) population (n=173) was screened to identify rats having crossovers within the congenic region of RNO3 and six congenic substrains were developed that carry shorter segments of R-rat-derived RNO3. Five of the six congenic substrains had significantly lower BP compared to the parental S rat. The lack of BP lowering effect demonstrated by the S.R(ET3x5) substrain and the BP lowering effect retained by the S.R(ET3x2) substrain together define the RNO3 BP QTL-containing region as approximately 4.64 Mb. Two nonoverlapping substrains, S.R(ET3x1) and S.R(ET3x6), had significantly lower BP compared to the S strain, indicating the presence of two distinct BP QTL in the RNO3 q terminus. The RNO3 q terminus was fine mapped with newly developed polymorphic markers to characterize the extent of the congenic regions. The two RNO3 BP QTL regions were thus defined as within intervals of 0.05-1.12 and 0.72-1.25 Mb, respectively. Also important was our difficulty in fine mapping and marker placement in this portion of the rat genome (and thus candidate gene identification) using the available genomic data, including the rat genome sequence.

Animals↗

Preoperative staging of rectal cancer: accuracy of 3-Tesla magnetic resonance imaging.

The purpose of this study was to evaluate the accuracy of 3-Tesla magnetic resonance imaging (MRI) for the preoperative staging of rectal cancer. Thirty-five patients with a primary rectal cancer who underwent preoperative 3-T MRI using a phased-array coil and had a surgical resection were enrolled in the study group. Preoperatively, three experienced radiologists independently assessed the T and N staging. A confidence level scoring system was used to determine if there was any perirectal invasion, and receiver operating characteristic (ROC) curves were generated. The interobserver agreement was estimated using kappa statistics. The overall accuracy rate of T staging for rectal cancer was 92%. The diagnostic accuracy was 97% for T1, 89% for T2 and 91% for T3, respectively. The predictive accuracy for perirectal invasion by the three observers was high (Az>0.92). The interobserver agreement for T staging was moderate to substantial. The overall sensitivity, specificity, and accuracy for the detection of mesorectal nodal metastases were 80%, 98%, and 95%, respectively. In conclusion, preoperative 3-T MRI using a phase-array coil accurately indicates the depth of tumor invasion for rectal cancer with a low variability.

Adenocarcinoma↗

Preoperative staging of rectal cancer: comparison of 3-T high-field MRI and endorectal sonography.

OBJECTIVE: The aim of this study was to compare phased-array 3-T MRI and endorectal sonography in the preoperative staging of rectal cancer. MATERIALS AND METHODS: During an 8-month period, 24 patients with rectal cancer underwent both 3-T MRI performed with phased-array coils and 7.5- to 10-MHz endorectal sonography in the 3 weeks before surgical resection. Three radiologists independently reviewed the MR and endorectal sonographic images. The histopathologic findings in resected specimens were used to evaluate the sensitivities and specificities of these techniques for invasion of the muscularis propria and perirectal tissue and for lymph node involvement. Receiver operating characteristic (ROC) analysis was used to compare the diagnostic accuracies of the techniques. RESULTS: For muscularis propria invasion, the mean sensitivities of both MRI and endorectal sonography were 100%, and the mean specificities were 66.7% and 61.1%, respectively. The differences in the mean sensitivities and specificities were not statistically significant (p > 0.05 in each case). For perirectal tissue invasion, MRI and endorectal sonography had comparable sensitivities and specificities (91.1% vs 100%, 92.6% vs 81.5%; p > 0.05 in each case). They also had similar sensitivities and specificities for lymph node involvement (63.6% vs 57.6%, 92.3% vs 82.1%; p > 0.05 in each case). ROC curves for muscularis propria invasion and lymph node involvement showed no differences in diagnostic accuracy. The mean area under the ROC curve for endorectal sonography (A(Z) = 0.996) for perirectal tissue invasion, however, showed higher accuracy than that of MRI (A(Z) = 0.938, p = 0.028). CONCLUSION: The sensitivity, specificity, and accuracy of 3-T MRI were similar to those of endorectal sonography for muscularis propria invasion and lymph node involvement, but for perirectal tissue invasion, 3-T MRI was less accurate than endorectal sonography.

Adenocarcinoma↗

[Virtual CT colonoscopy and virtual CT barium enema using multidetector-row CT].

CT colonography is a promising technique that provides both multiplanar and endoluminal perspective of the air-filled, distended, cleaned colon. "Virtual colonoscopy" refers to computer-simulated 3D endoscopic visualization of the colonic mucosal surface. Unlike barium enema and conventional colonoscopy, CT colonography can give cross- sectional and endoluminal images of the colon and enables to image extracolic abnormality. CT colonography offers potential advantages over colonoscopy in that it causes little discomfort to the patient, and does not need sedation. It is more accurate in spatial location of lesions and creates no complication. To date, most studies assessing CT colonography have focused in technical development, less aggressive bowel preparation, and computer-aided diagnosis of polyp detection. In the future, CT colonography would be a diagnostic and screening tool for the colorectal polyp and cancer.

Barium Sulfate↗

Gene expression profiling of the left ventricles in a rat model of intrinsic aerobic running capacity.

Our previous work found DA rats superior for intrinsic aerobic running capacity (ARC) and several cardiac function indexes compared with Copenhagen (COP) rats, and identified ARC quantitative trait loci (QTLs) on rat chromosomes 16 (RNO16) and 3 (RNO3). The purpose of this study was to use these inbred rat strains as a genetic substrate for differential cardiac gene expression to identify candidate genes for the observed ARC QTLs. RNA expression was examined globally in left ventricles of 15-wk-old DA, F1(COP x DA), and COP rats using microarrays to identify candidate genes for ARC QTLs. We identified 199 differentially expressed probe sets and determined their chromosomal locations. Six differentially expressed genes and expressed sequence tags (ESTs) mapped near ARC QTL regions, including PDZ and LIM domain 3 (Pdlim3). Differential expression of these genes/ESTs was confirmed by quantitative RT-PCR. The Ingenuity Pathways program identified 13 biological networks containing 50 (of the 199) differentially expressed probe sets and 85 additional genes. Four of these eighty-five genes mapped near ARC QTL-containing regions, including insulin receptor substrate 2 (Irs2) and acyl-CoA synthetase long-chain family member 1 (Acsl1). Most (148/199) differentially expressed probe sets showed left ventricular expression patterns consistent with the alleles exerting additive effects, i.e., F1(COP x DA) rat RNA expression was intermediate between DA and COP rats. This study identified several potential ARC QTL candidate genes and molecular networks, one of them related to energy expenditure involving Pik3r1 mRNA expression that may, in part, explain the observed strain differences in ARC and cardiac performance.

Animals↗

Therapeutic response assessment of percutaneous radiofrequency ablation for hepatocellular carcinoma: utility of contrast-enhanced agent detection imaging.

PURPOSE: To assess the utility of contrast-enhanced agent detection imaging (ADI) in the assessment of the therapeutic response to percutaneous radiofrequency (RF) ablation in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Ninety patients with a total of 97 nodular HCCs (mean, 2.1+/-1.3 cm; range, 1.0-5.0 cm) treated with percutaneous RF ablation under the ultrasound guidance were evaluated with contrast-enhanced ADI after receiving an intravenous bolus injection of a microbubble contrast agent (SH U 508A). We obtained serial contrast-enhanced ADI images during the time period from 15 to 90 s after the initiation of the bolus contrast injection. All of the patients underwent a follow-up four-phase helical CT at 1 month after RF ablation, which was then repeated at 2-4 month intervals during a period of at least 12 months. The results of the contrast-enhanced ADI were compared with those of the follow-up CT in terms of the presence or absence of residual unablated tumor and local tumor progression in the treated lesions. RESULTS: On contrast-enhanced ADI, technical success was obtained in 94 (97%) of the 97 HCCs, while residual unablated tumors were found in three HCCs (3%). Two of the three tumors that were suspicious (was not proven) for incomplete ablation were subjected to additional RF ablation. The remaining one enhancing lesion that was suspicious of a residual tumor on contrast-enhanced ADI was revealed to be reactive hyperemia at the 1-month follow-up CT. Therefore; the diagnostic concordance between the contrast-enhanced ADI and 1-month follow-up CT was 99%. Of the 94 ablated HCCs without residual tumors on both the contrast-enhanced ADI and 1-month follow-up CT after the initial RF ablation, five (5%) had CT findings of local tumor progression at a subsequent follow-up CT. CONCLUSION: Despite its limitations in predicting local tumor progression in the treated tumors, contrast-enhanced ADI is potentially useful for evaluating the early therapeutic effect of percutaneous RF ablation for HCCs.

Adult↗

Bronchogenic cyst of the stomach masquerading as benign stromal tumor.

Gastric bronchogenic cyst is an extremely rare lesion. A 62-year-old Korean woman presented with an incidentally found perigastric nodule. An abdominal ultrasonogram and computed tomography showed a 1.5 cm solid, homogeneous, low-density nodule in the hepatogastric ligament near the gastric lesser curvature. At the time of surgery, a soft 1.7 cm nodule was found in the lesser curvature side just below the gastroesophageal junction, and a gelatinous mass was protruded from the nodule during the resection. Microscopically, the gastric subserosa showed cystic structures lined by pseudostratified ciliated columnar epithelium, seromucinous gland, connective tissue and complete layers of smooth muscle bundles. Neither cartilage nor gastrointestinal epithelium was identified. A mucocele was found near the cyst and foamy cells and faintly bluish mucinous substances were found near the cystic structures. All the mucinous substances were stained by alcian blue at pH 2.5 with varying degrees of staining intensity. The present case is the smallest reported cyst among the gastric bronchogenic cysts, and these lesions are unusually located at the lesser curvature side of the stomach. Although these lesions are very rare, gastric bronchogenic cyst should be included in the differential diagnosis of gastric wall mass.

Bronchogenic Cyst↗

Superficial esophageal cancer: esophagographic findings correlated with histopathologic findings.

PURPOSE: To retrospectively determine and evaluate the findings of superficial esophageal cancer at esophagography and to correlate the esophagographic findings with the depth of tumor invasion. MATERIALS AND METHODS: The institutional review boards required neither their approval nor informed patient consent for this retrospective study. One hundred thirteen patients with superficial esophageal cancer who underwent esophagectomy at three institutions were included in this study. Double-contrast esophagograms were reviewed independently by two reviewers. For assessment of histopathologic findings, pathology reports were reviewed. Findings at esophagography, including morphologic type of the lesion, lesion extent, presence or absence of elevated or depressed component, margin and extent of elevated or depressed component, presence or absence of nodularity, extent of nodularity, esophageal luminal narrowing, and esophageal wall rigidity, were compared between mucosal and submucosal cancers by using chi2, Fisher exact, and independent-sample t tests. RESULTS: Of 122 histopathologically proved superficial esophageal cancers in 113 patients, 100 (82%) were detected at esophagography. The most common morphologic type was the plaquelike form; 50 (50%) such lesions were depicted at esophagography. Morphologic types were significantly different between the mucosal and submucosal cancers (P < .001). Protruded and plaquelike lesions were more frequent among submucosal cancers, whereas most flat lesions were mucosal cancers. An elevated component (P < .001), a rigid esophageal wall (P < .001), and a lobulated or irregular margin of the elevated component (P = .023) were significantly more frequent among submucosal cancers. Also, total extent of the lesion (P < .001), size of the largest nodule (P < .001), and extent of nodularity (P = .036) were significantly larger in the submucosal cancers. CONCLUSION: In the evaluation of patients with superficial esophageal cancer, esophagography appears to be helpful for diagnosing the tumor and differentiating mucosal from submucosal cancers.

Adult↗

Ferucarbotran-enhanced MRI versus triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.

OBJECTIVE: We compared ferucarbotran-enhanced MRI with triple-phase MDCT for the preoperative detection of hepatocellular carcinoma. SUBJECTS AND METHODS: Seventy-three consecutive patients with 121 hepatocellular carcinomas underwent ferucarbotran-enhanced MRI, including a dynamic study, and triple-phase MDCT before hepatic resection. The diagnosis of hepatocellular carcinoma was confirmed in all patients by means of pathologic examination after surgical resection. Three experienced radiologists independently reviewed the MR and CT images on a segment-by-segment basis. The accuracy of these techniques for the detection of hepatocellular carcinoma was assessed by conducting a receiver operating characteristic (ROC) analysis of the observations of 88 resected hepatic segments with at least one hepatocellular carcinoma each and 121 resected hepatic segments without hepatocellular carcinoma. RESULTS: The mean values of the area under the ROC curve (A(z)) for ferucarbotran-enhanced MRI and triple-phase MDCT for all observers were 0.947 and 0.949, respectively; the difference between these two values was not statistically significant (p = 0.799). The mean sensitivities of MRI and triple-phase MDCT were 90.2% and 91.3%, respectively, and their mean specificities were 97.0% and 95.3%, respectively. The differences in the mean sensitivities and specificities of these two imaging techniques were not statistically significant (p > 0.05 in each case). CONCLUSION: Ferucarbotran-enhanced MRI seems to be as accurate as triple-phase MDCT for the preoperative detection of hepatocellular carcinoma.

Adult↗

Depiction and local staging of rectal tumors: comparison of transrectal US before and after water instillation.

PURPOSE: To determine whether transrectal ultrasonography (US) with intrarectal water instillation can improve the depiction and accuracy of US in local staging of rectal tumors. MATERIALS AND METHODS: Between October 1999 and February 2002, 63 patients (mean age, 56 years; age range, 23-91 years) with 63 rectal tumors were evaluated with transrectal US before and after intrarectal water instillation. Transrectal US examinations were performed with a 7-10-MHz radial transducer. Immediately after the first transrectal US examination, the rectal lumen was filled with 50-150 mL of degassed water, and a second US examination was performed. All patients underwent surgery within 1 month after transrectal US. Depiction of the tumor was compared between the two methods. The McNemar test was used to compare the accuracy between the two techniques in local staging of the tumor by using pathologic findings in the resected specimen as the standard. RESULTS: The tumors ranged from 0.5 to 8.0 cm (mean, 2.8 cm) as measured at pathologic evaluation. All 63 tumors were clearly depicted at transrectal US after water instillation, while only 42 (67%) of the tumors were depicted at transrectal US before water instillation. In the 42 tumors clearly depicted at transrectal US examinations both before and after water instillation, the accuracy of transrectal US in local tumor staging was significantly higher after water instillation (85.7% [36 of 42]) than before water instillation (57.1% [24 of 42]; P <.001). CONCLUSION: Water instillation during transrectal US examination of rectal tumors improves the depiction and local staging of the tumors.

Adult↗

Changes in bile ducts after radiofrequency ablation of hepatocellular carcinoma: frequency and clinical significance.

OBJECTIVE: The purpose of our study was to determine the frequency of bile duct changes after radiofrequency ablation for hepatocellular carcinoma and to evaluate their clinical significance. MATERIALS AND METHODS: Between April 1999 and August 2003, 389 patients with 521 hepatocellular carcinomas underwent a total of 571 sessions of radiofrequency ablation. The maximum dimension of the tumors measured on sonography was 2.4 +/- 0.9 cm (mean +/- SD) (range, 0.5-5.0 cm). The frequency and type of bile duct changes resulting from radiofrequency ablation, the time interval between radiofrequency ablation and the first appearance of bile duct changes, and the serial changes at follow-up CT were analyzed. Complications related to bile duct changes were also evaluated by reviewing medical records and CT scans. RESULTS: Bile duct changes occurred in 69 (12%) of 571 sessions and 66 (17%) of 389 patients. Bile duct changes seen on CT included mild dilatation of upstream bile ducts surrounding the ablation zone in 57 patients (82.6%), biloma in the ablation zone in four patients (5.8%), and both in eight patients (11.6%). The mean time interval between radiofrequency ablation and the initial appearance of bile duct change was 1.6 months (range, immediate-9 months). Most (87%) of the 69 patients with bile duct changes showed no progression on follow-up CT, and only nine (13%) had slight progression. All patients but one, in whom cholangitis developed, had no major complications requiring specific treatment during the follow-up period. CONCLUSION: Although bile duct changes were frequent after the radiofrequency ablation of hepatocellular carcinoma, most were of no clinical significance, and major complications requiring additional treatment were rare.

Adult↗

Evaluation of hepatic focal nodular hyperplasia with contrast-enhanced gray scale harmonic sonography: initial experience.

OBJECTIVE: To assess the potential of contrast-enhanced gray scale harmonic sonography in the evaluation of the typical vascular and enhancement patterns of hepatic focal nodular hyperplasia. METHODS: Thirteen patients with 13 lesions of hepatic focal nodular hyperplasia underwent contrast-enhanced gray scale harmonic sonography. After the injection of a microbubble contrast agent (SH U 508A), gray scale harmonic sonographic studies using a Coded Harmonic Angio technique were performed with a combination of a period of continuous scanning to assess the vascular pattern (vascular imaging) and interval delay scanning to determine the sequential enhancement pattern (acoustic emission imaging). Each imaging pattern was categorized and analyzed by consensus of 2 experienced radiologists. RESULTS: In 12 (92%) of 13 lesions, vascular imaging during the arterial phase showed central arteries of a spoked wheel pattern, whereas the remaining lesion had stippled vascularity. On acoustic emission imaging, 11 (85%) of 13 lesions were hyperechoic during the early phase, and the remaining 2 (15%) were isoechoic compared with surrounding parenchyma. Ten (77%) of 13 lesions remained either hyperechoic (5 of 13) or isoechoic (5 of 13) during the delay phase, whereas the remaining 3 lesions (23%) were hypoechoic. CONCLUSIONS: Contrast-enhanced gray scale harmonic sonography showed the typical vascularity of a spoked wheel pattern during the vascular phase and persistent enhancement on serial acoustic emission imaging in most cases of hepatic focal nodular hyperplasia, and thereby it can be a promising technique in noninvasive diagnosis of this entity.

Adolescent↗

Poor sensitivity of sonography in detection of hepatocellular carcinoma in advanced liver cirrhosis: accuracy of pretransplantation sonography in 118 patients.

The objective of this study was to assess the detectability of hepatocellular carcinoma by sonography in advanced cirrhotic patients undergoing liver transplantation. We retrospectively reviewed pretransplantation sonography in 118 consecutive patients with advanced liver cirrhosis. We assessed the detectability of hepatocellular carcinoma in relation to tumor size, location, total liver volume, and degree of sonographic heterogeneity of the liver parenchyma. On pathologic examination, 51 hepatocellular carcinomas were identified in 31 patients. Pretransplantation sonography depicted 14 of 51 (27%) hepatocellular carcinomas. Detectability was significantly affected according to tumor size ( p=0.0099), but there was no significant difference according to tumor location, liver volume, or degree of sonographic heterogeneity of the liver parenchyma. Our study suggests that sonography is not sufficiently sensitive to detect hepatocellular carcinoma in patients with advanced liver cirrhosis. Tumor size is the only factor influencing the detectability of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

Bowel wall thickening in patients with Crohn's disease: CT patterns and correlation with inflammatory activity.

AIM: To assess CT patterns of bowel wall thickening in patients with Crohn's disease and to correlate these patterns with inflammatory activity. MATERIALS AND METHODS: We conducted a retrospective review of 58 helical abdominal CT scans of 53 patients with pathologically proven Crohn's disease. CT patterns of thickened bowel wall were divided into four types based on patterns of mural stratification and enhancement: type A, multilayered mural stratification; type B, two layers with strong mucosal enhancement and prominent low-density submucosa; type C, two layers without strong mucosal enhancement; and type D, homogeneous enhancement. We evaluated CT findings of the bowel and adjacent structures. We also reviewed pathologic features and clinical data to determine inflammatory activity. RESULTS: Fifty-five (95%) of 58 CT examinations showed bowel wall thickening. Of these 55 CT scans, type A pattern was found in 33 (60%), type B in 10 (18%), type C in five (9%), and type D in seven (13%). CT scans with type A showed significantly more wall thickening than those with either type C or type D. Histology revealed 43 cases with active disease and 12 with quiescent appearance. Thirty of 33 CT scans with type A and all 10 with type B were classified as acute disease, and three of five with type C and six of seven with type D as quiescent. CONCLUSION: In patients with Crohn's disease, CT patterns of bowel wall thickening correlated with inflammatory activity. Thickened bowel wall with layering enhancement is predictive of acute disease, and that of homogeneous enhancement suggests quiescence.

Adolescent↗

Preoperative depiction of hepatocellular carcinoma: ferumoxides-enhanced MR imaging versus triple-phase helical CT.

PURPOSE: To compare ferumoxides-enhanced magnetic resonance (MR) imaging with triple-phase helical computed tomography (CT) for the preoperative depiction of hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Seventy consecutive patients with a total of 79 HCC nodules underwent ferumoxides-enhanced MR imaging and triple-phase helical CT before surgery. The diagnosis of HCC was established by means of pathologic examination after surgical resection in all patients. MR images obtained with all sequences and triple-phase helical CT images were reviewed independently by three radiologists on a segment-by-segment basis. Accuracy for diagnosis of HCC was assessed by applying receiver operating characteristic (ROC) analysis to observations of 78 hepatic segments with at least one HCC nodule and 70 segments without HCC. RESULTS: The diagnostic accuracy of findings at ferumoxides-enhanced MR imaging (with mean area-under-the-ROC-curve [A(z)] values for the three observers of 0.986, 0.979, and 0.980) was significantly higher (P <.001) than that of findings at triple-phase helical CT (with mean A(z) values for the three observers of 0.945, 0.948, and 0.964). The mean sensitivity of MR imaging (95%, 222 of 234 segments) was also significantly higher than that of triple-phase helical CT (88%, 205 of 234 segments) (P =.001, McNemar test). The mean specificity was 97% (261 of 270 segments) for MR imaging and 98% (264 of 270 segments) for CT, but this difference was not significant (P =.754, McNemar test). CONCLUSION: Ferumoxides-enhanced MR imaging is superior to triple-phase helical CT for the preoperative depiction of HCC.

Adult↗

Correlation between the echogenicity of dysplastic nodules and their histopathologically determined fat content.

OBJECTIVE: To correlate the echogenicity of dysplastic nodules in cirrhotic liver with the difference in fat content between lesions and surrounding liver. METHODS: This retrospective study involved 65 histopathologically proved dysplastic nodules (39 high grade and 26 low grade). Their echogenicity compared with that of surrounding parenchyma was determined sonographically, and differences in the proportions of fat globules contained in the nodules and in surrounding liver tissue were evaluated histopathologically. The sonographic and histopathologic findings were correlated. RESULTS: Among the 65 dysplastic nodules, echogenicity was high in 30 (46%), equal in 5 (8%), and low in 30 (46%). In all cases, there was significant correlation between echogenicity on sonographic imaging and the difference in fat content between nodules and surrounding liver tissue (P < .01). There was, however, no significant correlation between the degree of dysplasia and sonographic echogenicity (P > .05). CONCLUSIONS: The echogenicity of dysplastic nodules correlated with their fat content. Echogenicity did not, however, predict whether the grade of a nodule was high or low.

Adult↗

Clinical diagnosis of primary epiploic appendagitis: differentiation from acute diverticulitis.

BACKGROUND: Primary epiploic appendagitis (PEA) is an uncommon cause of abdominal pain that occurs either from appendageal torsion or spontaneous thrombosis of an appendageal draining vein. Primary epiploic appendagitis is frequently misdiagnosed as either appendicitis or diverticulitis, depending on its location. STUDY: Clinical and radiologic characteristics of 8 patients with PEA were retrospectively reviewed and compared with 18 patients with acute diverticulitis. RESULTS: Patients with PEA presented with lower abdominal pain of recent onset that was localized to the left (seven cases) and right (one case) lower quadrants. Well-localized tenderness without peritoneal irritation sign was usually the only physical finding. Blood tests were not significant. In acute diverticulitis, the pain was more evenly distributed throughout the lower abdomen and findings like nausea, fever, and leukocytosis were more frequently associated than in PEA. Computed tomography findings, such as pedunculated oval fatty mass with streaky densities connected to the serosal surface of the adjacent colon, can lead to the diagnosis of PEA. Symptoms of PEA were resolved within 1 week (mean, 4.7 days) without surgery. CONCLUSIONS: When patients with very localized lower abdominal pain and tenderness do not have associated symptoms or laboratory abnormalities, a high index of suspicion for PEA and early radiologic examinations are required.

Abdominal Pain↗