Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

Transcatheter arterial chemoembolization(TACE) is an imperative method for the managment of inoperable hepatocellular carcinoma(HCC). It is well known that primary HCC frequently invades the portal venous system and forms a tumor thrombus obstructing the portal blood flow which makes unfavorable prognosis of patiebt. We retrospetively reviewed 58 patients who reveived TACE(minimum 3 times) of HCC invading into portal venous system. Group 1(n=29) which showed peripheral portal vein invasion had better clinical and laboratory response. Group 2(n=17) which showed first order portal branch invasion had similar response to Group 3(n=12), which had main portal invasion. Group 1 showed no difference in survival time between TAC and TACE, but, in Group 2 and 3, emboliation with chemotherapy made longer survival than chemotherapy only. Clinical level of AFP was meaningful in Group 1 and 2 as decreasing value. Our results provides that careful selection of TACE and case by case Coil/Gelfoam embolization can improve the mean survival and clinical response when HCC evidently invades portal venous system.
Carcinoma, Hepatocellular* ; Drug Therapy ; Humans ; Methods ; Portal Vein* ; Prognosis ; Thrombosis

No abstract available.
Rheumatic Diseases* ; Spondylarthropathies

No abstract available.
Cardiomyopathies*

Septo-optic dysplasia, as first described by de Morsier, is a rare developmental anomaly of absent or hypoplastic septum pellucidum, a primitive optic vesicle, and dysplasia of the optic nerve, chiasm, and optic tracts. It is a common cause of hypopituitarism in children and has variable hypothalamic-pituitary dysfunction. We experienced a case of septo-optic dysplasia in 5 month old female baby who presented with developmental delay and seizure. A magnetic resonance imaging of the brain showed absence of the septum pellucidum and the fundoscopic examination disclosed the absence of left optic disc and atrophy of right optic disc.
Atrophy ; Brain ; Child ; Female ; Humans ; Hypopituitarism ; Infant ; Magnetic Resonance Imaging ; Optic Nerve ; Seizures ; Septo-Optic Dysplasia* ; Septum Pellucidum ; Visual Pathways

PURPOSE: The differentiation between renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) is important due to the different methods of treatment and prognosis. But occasionally it is difficult to draw a distinction between the two diseases when renal parenchyme and renal collecting systems are invaded simultaneously. MATERIAL AND METHOD: We reviewed CT scans of 37 cases of renal cell carcinoma and 12 cases of transitional cell carcinoma which showed involvement of renal parenchyma and renal sinus fat on CT. Retrospective analysis was performed by 3 abdominal radiologists. Check points were renalcontour bulging or reniform shape, location of mass center, intact parenchyme overlying the tumor, cystic change, calcification, LN metastasis, vessel invasion, and perirenal extention. RESULT:There were renal contour bulging due to the tumor mass in 33 out of 37 cases of renal cellcarcinima, wherea and nine of 12 cases of transitional cell carcinoma maintained the reniform appearance. This is significant statiscal difference between the two(p<0.005). Center of all TCCs were located in the renal sinus, and 24 out of 35 cases of RCC were located in the cortex(p<0.005). Thirty-six out of 37 cases of RCC lost the overlying parenchyma, whereas 4 out of 9 cases of well enhanced TCC had intact overlying parenchyma(p<0.005) RCC showed uptic change within the tumor mags in 31 cases which was significanity higher than the 4 cases in TCC(p<0.05). CONCLUSION: CT findings of renal cell carcinoma are contour bulging, peripheral location, obliteration of parenchyma, and cystic change. Findings of transitional cell carcinoma are reniform appearance, central location within the kidney, intact overlying parenchyma, and rare cystic change.
Carcinoma, Renal Cell* ; Carcinoma, Transitional Cell* ; Kidney ; Neoplasm Metastasis ; Pelvis* ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

Corticosteroids has been used in treatment of wide varieties of disease, but there was no report which related to the effects on cardic function with the long term corticosteroids therapy in children. We had been evaluated 18 patients with nephrotic syndrome who were admitted to department of pediatrics, Kyung Hee University Hospital until March 1987. Also we examined interventricular septal thickness, left ventricular posterior wall thickness and all parts of internal dimension of heart, and cardiac output and STI(Systolic Time Interval) by M-mode and Doppler echocardiography, and compared with body surface matched control group. Result are as follows;age and sex distribution were 4 4/12 to 14 6/12(9.11+/-3.55 years) and 15 males and 3 females. The duration of follow up was from 6 to 132 months(39.28+/-36.12 months). The interventricular septal thickness and left ventricular posterior wall thickness were more thickened in corticosteroids group than those of control. Systolic time interval, the index of left ventricular function, was more increased in corticosteroids group than in control group, but there was no differences in cardiac output between two groups. lthough longterm follow up studies are needed to confirm the cardiac effects of long term corticosteroids therapy, we conclude that long term corticosteroids therapy cause significant hypertrophy of cardiac muscle and periodic evaluation of cardiac function such as noninvasive Doppler echocardiographic studies are mandatory in patients with long term corticosteroids therapy.
Adrenal Cortex Hormones* ; Cardiac Output ; Child ; Echocardiography ; Echocardiography, Doppler ; Female ; Follow-Up Studies ; Heart ; Humans ; Hypertrophy ; Male ; Myocardium ; Nephrotic Syndrome* ; Pediatrics ; Sex Distribution ; Systole ; Ventricular Function, Left

No abstract available.
Animals ; Rats* ; Somatotrophs*

Migraine is a common neurologic disorder with recurrent headache and variable accompanying symptoms. Patients with migraine have suffered by an enormous burden on daily life and impairment of quality of life (QoL), but migraine is still underdiagnosed and undertreated. For early and better diagnosis and treatment of migraine, headache education and instruments for evaluation of headache outcomes including QoL and disability are essential. Nonpharmachological treatment like cognitive-behavior therapy, mindfulness-based stress reduction, lifestyle modification and trigger avoidance, biofeedback, relaxation training can reduce frequency of pain, disability, so headache education might be helpful. Headache diary and instruments for evaluation of QoL, disability and comorbidity like Migraine Disability Assessment Scale (MIDAS), Headache Impact Test-6 (HIT-6), Migraine-Specific Quality of Life Questionnaire (MSQ) are useful tools to decide plans of treatment. When nonpharmachological treatment and headache education are well applied and evaluation of the QoL and disability are reflected, it will help improve the quality of life for migraine patients.
J Korean Neurol Assoc 38(3):169-174, 2020

PURPOSE: To evaluate the rates of inter- and intraobserver agreement of the BI-RADS US lexicon. MATERIALS AND METHODS: Two radiologists reviewed 60 sonograms of solid breast masses to evaluate interobserver agreement. After four weeks, the radiologists reinterpreted the series to evaluate the intraobserver agreement. The radiologists described shape, orientation, margin, lesion boundary, echo pattern, posterior acoustic features and microcalcifications. Final assessment categories and management plans were suggested for each case. The rates of inter- and intraobserver agreements were measured by the use of kappa statistics. RESULTS: Interobserver agreement ranged from the highest for orientation (k=0.65) and shape (k=0.61) to the lowest for posterior acoustic features (k=0.42). For the final assessment categories (k=0.46) and management (k=0.49), interobserver agreements were moderate. Intraobserver agreement ranged from the highest for microcalcifications in mass (k=0.90, 0.82) and orientation (k=0.87, 0.83) and the lowest for echo patterns (k=0.62, 0.57) and posterior acoustic features (k=0.59, 0.65). In the final assessment category and management, intraobserver agreements were substantial or nearly complete (k=0.65-0.83). CONCLUSION: There were variable ranged inter- and intraobserver agreements in the description of the BI-RADS US lexicon of solid breast masses. Among them, margin and lesion boundary showed lower agreements. A modification of the BI-RADS US lexicon with more detailed guidelines, followed by continuous education, are suggested.
Acoustics ; Breast* ; Education ; Information Systems*