Ultrasound-guided thrombin injection for pseudoaneurysms: a case series at a local hospital.

Post-catheterization pseudoaneurysms are increasingly prevalent due to widespread use of endovascular procedures. Ultrasound-guided thrombin injection has emerged as a treatment of choice for these pseudoaneurysms. We review our experience performing this procedure for a series of cases from 2007 to 2010 with different clinical manifestations at a single hospital in Hong Kong. We achieved a high technical success rate with no complications.

Nodular regenerative hyperplasia of the liver associated with systemic lupus erythematosus: three cases.

Nodular regenerative hyperplasia of the liver, characterised by regenerative nodules distributed throughout the liver in the absence of fibrosis, is a rare but important complication of systemic lupus erythematosus. The main consequence of nodular regenerative hyperplasia of the liver is non-cirrhotic portal hypertension. This condition is probably underdiagnosed, as many of these patients may remain asymptomatic. Furthermore, nodular regenerative hyperplasia of the liver may be misdiagnosed as cirrhosis. We describe three female patients with nodular regenerative hyperplasia of the liver associated with systemic lupus erythematosus. All three patients have clinical manifestations of portal hypertension, and all were initially misdiagnosed as having cryptogenic cirrhosis.

Splenic tuberculosis associated with monoclonal gammopathy of undetermined significance and pericarditis.

Tuberculosis usually affects the respiratory system, but it may present atypically involving multiple systems, extrapulmonary systems, and manifest as a protein disorder. Here we report a case of splenic tuberculosis associated with monoclonal gammopathy of undetermined significance, and pericarditis. The diagnosis, confirmed by a plugged biopsy of the spleen, precluded the need for splenectomy in this patient and allowed prompt initiation of treatment, thereby avoiding the complications of tuberculous pericarditis and splenic infection.

Predicting bone scan findings using sPSA in patients newly diagnosed of prostate cancer: feasibility in Asian population.

OBJECTIVE: A number of large-scaled studies done in Western countries have proven a positive relationship between serum prostate-specific antigen (PSA) level and prevalence of positive bone scan findings in newly diagnosed prostate cancer (CaP) patients. The objective of this study is to verify that the tendency occurs as well in Asian population, as well as to establish a possible correlation between PSA level, bone scan result, and Gleason score. METHOD: Records of 116 patients diagnosed to have CaP were reviewed retrospectively for bone scan results, PSA levels, and Gleason score. RESULT: Thirty-four patients were proven to have bone metastases based on positive bone scintigraphy result. None of these patients had a PSA level of less than 10 ng/ml. Two patients had PSA level between 11 and 20, and 15 patients had PSA level between 21 and 200. For patients with PSA level over 201, 17 had bone metastases on bone scintigraphy. CONCLUSION: Based on the PSA level, the likelihood of positive bone scintigraphy result can be postulated. According to PSA levels, staging investigations can be more selective for patients with confirmed CaP. The risk of having positive bone scan is so low that it is not required for patients with PSA level less than 10 ng/ml. On the other hand, on studying the correlation between Gleason score and PSA level or bone scan results, no statistically significant relationship was established.

Pyogenic liver abscesses caused by Klebsiella pneumoniae: US appearance and aspiration findings.

PURPOSE: To retrospectively compare the ultrasonographic (US) appearance and amount of pus obtained at initial aspiration for liver abscesses caused by Klebsiella pneumoniae with those for liver abscesses caused by other bacterial pathogens. MATERIALS AND METHODS: This study had medical ethics committee approval; informed consent was not required. Asian patients with pyogenic liver abscesses in a 5-year period were included. Abscess clinical, laboratory, and microbiologic characteristics and treatment and outcome were analyzed. US images were classified according to the size of the largest liver abscess, the echogenic pattern of the lesion, the presence of any echogenic debris within the lesion, increased through transmission in the posterior aspect of the lesion, and the lesion margin. Clinical and US characteristics of patients with K pneumoniae monomicrobial liver abscesses and those with non-K pneumoniae monomicrobial or polymicrobial liver abscesses were compared. The chi(2) or Fisher exact test was used for categorical variables; the Student t test was used for continuous variables. RESULTS: There were 120 patients with pyogenic liver abscesses. Median patient age was 69 years (range, 13-94 years). Fifty-nine patients were male, and 61 were female. Fifty patients with K pneumoniae monomicrobial and 33 patients with non-K pneumoniae monomicrobial or polymicrobial liver abscesses underwent US. K pneumoniae monomicrobial liver abscesses were associated with diabetes mellitus (P < .001), higher blood glucose levels at admission (P < .05), predominantly solid US appearances (P < .001), irregular or indistinct lesion margins (P < .05), less than 2 mL of pus aspirated (P < .001), and longer duration of antibiotic treatment (P < .05). CONCLUSION: A predominantly solid appearance at US is associated with K pneumoniae monomicrobial liver abscess. K pneumoniae liver abscess is associated with a much smaller quantity of pus at initial aspiration.