This retrospective study was performed to assess CT scan findings of pancratic cancer and its ability todetermine resectability. CT scans of 41 patients, who were diagnosed to have pancreatic cancer on histological orclinical base, were reviewed. Most common findings were; focal pancreatic enlargement, diffuse pancreaticenlargement, loss of distinct contour, peripancretic fat obliteration, bile duct or pancreatic duct dilatation,vascular invasion, lymph node involvement, direct invasion of adjacent organs and distant metastasis.Resectability was assessed according to generally accepted CT findings such as small pancreatic mass lesion havingnormal lobulated contour of pancreas, no evidence of vascular invasion, no evidence lymph node involvement andfree of distant metastasis. With the criteria, 5 cases among 41 cases deemed to be resectable. However onoperation all cases were found unresectable indicating prediction of tumor resectability is difficult even withhelp of CT. Nonetheless CT would be very helpful in management of patients having pancreatic cancer since CT wouldshorten the diagnostic procedures of pancreatic cancer.
Bile Ducts ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Retrospective Studies ; Tomography, X-Ray Computed

CHARGE syndrome has been estimated to occur in 1:10,000 births worldwide and shows various clinical manifestations. It is a genetic disorder characterized by a specific and a recognizable pattern of anomalies. The major clinical features are ocular coloboma, heart malformations, atresia of the choanae, growth retardation, genital hypoplasia, and ear abnormalities. The chromodomain helicase DNA-binding protein 7 (CHD7) gene, located on chromosome 8q12.1, causes CHARGE syndrome. The CHD7 protein is an adenosine triphosphate (ATP)-dependent chromatin remodeling protein. A total of 67% of patients clinically diagnosed with CHARGE syndrome have CHD7 mutations. Five hundred twenty-eight pathogenic and unique CHD7 alterations have been identified so far. We describe a patient with a CHARGE syndrome diagnosis who carried a novel de novo mutation, a c.3896T>C (p. leu1299Pro) missense mutation, in the CHD7 gene. This finding will provide more information for genetic counseling and expand our understanding of the pathogenesis and development of CHARGE syndrome.
Adenosine Triphosphate ; CHARGE Syndrome* ; Chromatin Assembly and Disassembly ; Coloboma ; Diagnosis ; Ear ; Genetic Counseling ; Heart ; Humans ; Mutation, Missense ; Nasopharynx ; Parturition

This study was performed to investigate the effect of dietary intakes and nutritional status for fatty liver male patients with fatty livers. General characteristics, nutritional knowledge, and dietary intakes were obtained from fatty liver male patients aged 20-60yr living in Seoul and Kyunggi province by individual interview and blood samples. The Results were as follows : the mean age of the subjects was 39yrs. Old and over half the subjects were overweight. Although nutritional knowledge, recognition, and accuracy scores were good, these did not affect the subject's health. The average alcohol intake of subjects was 79.8g/day and the drinking duration was 5-40yrs(averge : 17yrs). The subjects drank alcohol over 4tiles/week and preferred Soju. Most side dishes taken with alcohol drinking by the subjects were foods from animal sources. Half of the subjects also drank alcohol the next day for breakfast as a hangover-chaser. The reasons for drinking were due to social relationships and by habit. Vitamin D and folate were lower than the RDA for Koreans, and other nutrient amounts were higher than the RDA. The amounts of aspartate aminotransferase(AST), Alanine amino-transferase(ALT), gamma-glutamyl transpeptidase(gamma-GTP), Triglyceride(TG) for the subjects were higher. In conclusion, fatty liver patients drank excessively and frequently. It seems that heavy alcohol drinking is more prone to overweight or obese people and contributes to fatty livers. Therefore, the subjects need to be taken effectively educated about alcohol-induced liver damage and the importance of a balanced diet for on healthy liver.
Alanine ; Alcohol Drinking ; Animals ; Aspartic Acid ; Breakfast ; Diet ; Drinking ; Fatty Liver* ; Folic Acid ; Gyeonggi-do ; Humans ; Liver ; Male ; Nutritional Status* ; Overweight ; Seoul ; Vitamin D

No abstract available.
Humans ; Living Donors*

No abstract available.
Humans ; Living Donors*

Purpose: This study aims to oncologic outcomes of the watch-and-wait (WW) strategy compared with radical resection (RR). Methods: Patients with rectal cancer who received neoadjuvant chemoradiotherapy (nCRT) and achieved ≤ycT2 between 2008 and 2016 were included. The mean follow-up time was 61 months (range, 0–168 months). Recurrence-free survival (RFS), local recurrence-free survival (LRFS), distant metastasis-free survival (DMFS), and overall survival (OS) were compared. A total of 446 patients were included, and WW was adopted for 34 patients. Results: WW patients were older (P = 0.022) and less advanced initial cT stage (P = 0.004). Ten patients in the WW group (29.4%) experienced local regrowth. Later, distant metastases occurred in 7 of these patients. The 5-year RFS (74.1% vs. 79.5%), DMFS (74.1% vs. 81.6%), and OS (90.4% vs. 87.7%) for the WW and RR groups were not statistically different.However, LRFS in the WW group was significantly lower (65.1% vs. 97.0%, P < 0.001). The initial cT stage was associated with RFS (P = 0.019) and LRFS (P = 0.037). WW was an independent risk factor for LRFS (P < 0.001) and DMFS (P = 0.024).After 1:4 propensity score matching between the WW and RR groups, there was no difference in RFS and OS. However, the 5-year LRFS (67.5% vs. 96.5%) and DMFS (73.2% vs. 86.4%) demonstrated a statistically significant difference between the groups. Conclusion By appointing the WW strategy, oncologic safety was not ensured. The WW strategy must be implemented with caution in patients with ≤ycT2 stage, particularly those with advanced initial cT stage.

BACKGROUND AND OBJECTIVES: Otogenic cerebrospinal fluid (CSF)fistula referrs to the abnormal communication between the CSF and the middle ear space due to defects in the inner ear, and is one of the causes of recurrent meningitis. MATERIALS AND METHODS: We report on five children with congenital otogenic CSF fistula, presented by recurrent meningitis and confirmed by surgical exploration. We also propose diagnostic steps for detecting otogenic fistula in the children based on our experiences and paper review. RESULTS: We used the metrizamide CT in the diagnostic procedure for most cases, although not all. The temporal bone CT was an useful initial diagnostic step for clinically suspicious cases. CONCLUSION: No one test or combination of specific tests were found to accurately predict the presence or absence of CSF fistula. It is thought that the only way to diagnose the CSF fistula is by surgical exploration. If the CSF fistula was suspected, aggressive diagnostic evaluation was needed in order to prevent recurrence.
Cerebrospinal Fluid ; Child* ; Diagnosis* ; Ear, Inner ; Ear, Middle ; Fistula* ; Humans ; Meningitis* ; Metrizamide ; Recurrence ; Temporal Bone

An avulsion fracture of the anterolateral tibial epiphysis or Tillaux fracture is commonly seen in adolescents, reported first by Paul Jules Tillaux in 1892. Adolescent Tillaux fracture occurs during the period when the lateral physis is still open and the anterior-inferior tibiofibular ligament is stronger than the physis, so rarely occurs in adults. An avulsion fracture of the posterior inferior tibiofibular ligament, Volkmann fracture, occurs counterpart of Tillaux fracture. In this study, a tennis player injured during sliding and diagnosed as the rare simultaneous Tillaux-Chaput fracture and Volkmann fracture, is reported with the mechanism of injury, clinical importance of syndesmosis, sprain, and fracture of the ankle joint.

OBJECTIVE: The aim of this study is to investigate the clinical outcomes of surgery and coiling and analyze the predicting factors affecting the clinical outcomes of ruptured posterior inferior cerebellar artery (PICA) aneurysms. METHODS: During the last 15 years, 20 consecutive patients with ruptured PICA aneurysms were treated and these patients were included in this study. The Fisher's exact test was used for the statistical significance of Glasgow Outcome Scale (GOS) according to initial Hunt-Hess (H-H) grade, treatment modalities, and the presence of acute hydrocephalus. RESULTS: Eleven (55%) and nine (45%) patients were treated with surgical clipping and endovascular treatment, respectively. Among 20 patients, thirteen (65.0%) patients had good outcomes (GOS 4 or 5). There was the statistical significance between initial poor H-H grade, the presence of acute hydrocephalus and poor GOS. CONCLUSION: In our study, we suggest that initial H-H grade and the presence of acute hydrocephalus may affect the clinical outcome rather than treatment modalities in the ruptured PICA aneurysms.
Aneurysm ; Arteries ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Pica ; Subarachnoid Hemorrhage ; Surgical Instruments

OBJECTIVE: The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment. METHODS: Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD. RESULTS: Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was 40.9+/-6.9 months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05). CONCLUSION: It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD.
Decompression ; Follow-Up Studies ; Hemifacial Spasm ; Humans ; Microvascular Decompression Surgery ; Prospective Studies