We expirenced multiple hepatocellular adenomatosis, which was proved by pathology, in 38 years old man who had no prior history of predisposing factors. The radiologic findings were different by the size of tumor mass and intratumoral hemorrhage. Ultrasound demonstrated inhomogeneous hyperechoic large mass in segment 5 of right lobe and hyperechoic or isoechoic multiple small nodules in right lobe. Computed tomography demonstrated low density mass without contrast enhacement. Central high density is noted in hemorrhagic portion. Magnetic resonance T1-weighted image demonstrated high signal intensity in mass and hemorrhagic portion. T2-weighted image demonstrated slightly high signal intensity in mass portion, high signal intensity in hemorrhagic portionand double-layered peripheral rim. Gradient echo image well demonstrated inhomogenesity of mass.
Causality ; Hemorrhage ; Pathology ; Ultrasonography

Diarrhea ; Cities ; Epidemiologic Causality

No abstract available.
Arthritis, Rheumatoid* ; Causality* ; Humans ; Methotrexate*

No abstract available.
Causality* ; Humans ; Infant, Newborn* ; Pneumothorax*

Estimating the actual real-world effectiveness of the vaccine is an essential part of the post-marketing evaluation. This regression discontinuity design (RDD) using observational data is designed to quantify the effect of an intervention when eligibility for the intervention is based on a defined cutoff as age, making it suited to estimate vaccine effects. This approach can avoid the high cost and ethical issues; overcome difficulties in the organization and practice process in randomized controlled trials, which leads to a higher level of causal inference evidence and more realistic results. Here, we describe key features of RDD in general, and then specific scenarios, with examples, to illustrate that RDD are an essential tool for advancing our understanding of vaccine effects.
Causality ; Humans ; Vaccine Efficacy ; Vaccines

BACKGROUND: Although secondary cervicothoracic scoliosis frequently occurs in patients with congenital muscular torticollis (CMT), the relationship between scoliosis and CMT has not been evaluated. This study aims to evaluate the effects of surgical release of sternocleidomastoid (SCM) muscle on secondary cervicothoracic scoliosis in patients with CMT and determine factors affecting the improvement of scoliosis after surgical release of SCM muscle. METHODS: Eighty-seven of the 106 patients, confirmed as having secondary cervicothoracic scoliosis with CMT with a minimum 1-year follow-up, were included in this study. Preoperative and last follow-up radiologic outcomes were assessed for the cervicomandibular angle (CMA), Cobb angle of the cervicothoracic scoliosis, and direction of convexity in the scoliosis curve. Patients were divided into two groups to assess the improvement of Cobb angle according to residual growth potential; age ≤ 15 years and > 15 years. The improvement of Cobb angle after surgical release was compared in the two groups. Correlation analysis and multivariable regression analysis were performed to determine the factors affecting the improvement of scoliosis. RESULTS: All the radiologic parameters, such as the Cobb angle and CMA, improved significantly after surgical release (p < 0.001). The improvement of Cobb angle was significantly higher in age ≤ 15 years than in age > 15 years (p < 0.001). The improvement of Cobb angle was significantly correlated with age (r = −0.474, p < 0.001) and the preoperative Cobb angle (r = 0.221, p = 0.036). In multivariable regression analysis, age and preoperative Cobb angle were shown to be predisposing factors affecting the improvement of scoliosis. CONCLUSIONS: The results showed that SCM release can be a beneficial treatment for secondary cervicothoracic scoliosis. The improvement of scoliosis was greater when the SCM release was performed before the patient reached the end of growth.
Causality ; Follow-Up Studies ; Humans ; Scoliosis ; Torticollis

Formation of de novo aneurysm from a junctional dilatation at the origin site of the posterior communicating artery (PcomA) has been rarely reported. In this case report, three females in sixth decades of age developed a de novo aneurysm from the junctional dilatation of the PComA with a tiny bleb-like lesion over 5 years after initial presentation.
Aneurysm* ; Arteries* ; Blister* ; Causality* ; Dilatation* ; Female ; Humans

Epidemiological studies have confirmed that benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes. Although researchers have not yet established a direct causal relationship between the two problems, several pathophysiological factors may serve to explain it, which include the alteration in nitric oxide bioavailability, increased autonomic activity, a1-adrenergic receptor hyperactivity, imbalance of RhoA/Rho-kinase, and metabolic syndrome X. Men seeking care for BPH should always be screened for sexual function and complaints of ED. PDE5 inhibitors show promise as a future treatment for lower urinary tract symptoms secondary to BPH. Further investigation is required for future therapies and possible preventative strategies.
Causality ; Erectile Dysfunction ; Humans ; Male ; Prostatic Hyperplasia

Causality ; Humans ; Occupational Exposure ; Vibration ; adverse effects

BACKGROUND: Human nails bear longitudinal furrows on both upper and lower surface. These furrows are formed as the nails grow and correspond to parallel dermal ridges irregularly distributed on the nail bed. Often there is fungal invasion in a longitudinal narrow band according to the furrows of the nail bed, clinically recognized streak type onychomycosis. OBJECTIVE: Our purpose was to investigate the clinical features, causative organisms, and predisposing factors and to evaluate the treatment responses of oral antifungal agent in streak type onychomycosis. METHODS: The study was conducted with 387 cases of onycomycosis (45 cases of streak type, 342 cases of non-streak type) and 50 normal controls examined at Department of Dermatology, Hanyang University Guri Hospital from June, 2001 to May, 2004. Streak type onychomycosis was devided into three clinical presentations: distal type (20 cases), lateral type (19 cases), and multiple type (6 cases). RESULTS: In the groups of distal and multiple type of streak type onychomycosis, the longitudinal nail furrows were deep compared to the groups of non-streak type onychomycosis and normal control (p< 0.05). In the group of distal type of streak type onychomycosis, the tinea pedis severities were low compared to the group of non-streak type onychomycosis (p< 0.05). There was no statistically significant difference when comparing the nail growth rate of the groups of streak type onychomycosis, non-streak type onychomycosis, and normal control (p> 0.05). In the groups of distal and lateral type of streak type onychomycosis, the treatment responses were poor compared to the group of non-streak type onychomycosis (p< 0.05). CONCLUSION: Treatment response is poor in streak type onychomycosis, therefore, extra treatments in addition to oral antifungal agents should be considered. If the patients who have deep longitudinal nail furrow are affected with tinea pedis, effective therapies in early stage should be considered to prevent to progress to streak type onychomycosis.
Antifungal Agents ; Causality* ; Dermatology ; Humans ; Onychomycosis* ; Tinea Pedis