Erythema induratum and erythema nodosum are both inflammatory disorders of the panniculus. However they are often difficult to distinguish because of clinical variations and similarity of histopathologic features. We investigated the clinical and histopathologic features of 30 cases of erythema induratum and 38 cases of erythema nodosum in order to define discrimination of clinical and histopathologic features. The results show that presence of ulceration is clinically important in differentiating erythema induratum from erythema nodosum. Histopathologic findings which suggest erythema induratum include lobular panniculitis or lobuloseptal panniculitis, necrosis and necrotizing vasculitis while erythema nodosum is characterized by predominantly septal panniculitis without necrosis and necrotizing vasculitis.
Discrimination (Psychology) ; Erythema Induratum* ; Erythema Nodosum* ; Erythema* ; Necrosis ; Panniculitis ; Ulcer ; Vasculitis

OBJECTIVE: We applied a modified pharmacomechanical thrombolysis (PMT) technique to endovascular treatment of thrombosed arteriovenous (AV) grafts without the use of any mechanical thrombectomy devices. The aim of this study was to evaluate the efficacy of the PMT technique in the treatment of thrombosed AV grafts by analyzing the long-term patency. MATERIALS AND METHODS: Eighty-two patients with thrombosed AV grafts were treated with the PMT technique. AV graft surveillance to detect failing/failed access was followed by endovascular treatment. RESULTS: The technical and clinical success rates were 95% and 95%, respectively. The total number of thrombolysis sessions was 279. A post-intervention primary patency rate was 45% and 22% at 12 and 24 months, respectively. The secondary patency rate was 96% and 91% at 12 and 24 months, respectively. No major complications were noticed. CONCLUSION: The modified PMT technique is effective in endovascular treatment of thrombosed AV grafts.
Adult ; Aged ; Aged, 80 and over ; Angiography ; Angioplasty, Balloon ; *Arteriovenous Shunt, Surgical ; Female ; Graft Occlusion, Vascular/*therapy ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Polytetrafluoroethylene ; Proportional Hazards Models ; Radiography, Interventional ; Renal Dialysis ; Retrospective Studies ; Stents ; Thrombolytic Therapy/*methods ; Treatment Outcome ; Vascular Patency

BACKGROUNDS/AIMS: Mesenchymal stem cells (MSCs) have the capacity to differentiate into hepatocytes, The purpose of this study is to investigate the MSCs' differentiation process and therapeutic potentials by comparing isolated MSCs with HGF-treated MSCs in rat's model with thiacetamide (TAA)-induced cirrhosis. METHODS: Male Sprague-Dawley (SD) rats, weighing 100-150 g were used in this study. To induce liver fibrosis, recipient rats were taken with 0.04% thioacetamide (TAA) in the drinking water (400 mg TAA/L) for 8 weeks. The rats underlying liver cirrhosis were divided into 3 groups according to the transplanted materials, compared to normal saline as control (I) and isolated MSCs (II) HGF-treated MSCs. RESULTS: Severe hepatic fibrosis and hepatocyte destruction were detected in the control group. Less hepatic cirrhosis and collagen formation, more hepatocyte regeneration and glycogen storage were detected in isolated MSCs compared to HGF-treated MSCs group, Distribution of red autofluorescence is mainly localized near the sinusoids in isolated MSCs, scattered away the sinusoids in HGF-treated MSCs group. MSCs transdifferentiated into CK-19 postive Oval cells and then to albulmin-producing hepatocytes, HGF treated MSCs differentiated into hepatocyte without the intermediate oval cells phase. HGF treated MSCs became the CK18-positive, MSCs became CD 90-positive. CONCLUSIONS: Significant hepatocyte differentiation occurred in not HGF-treated MSCs but isolated MSCs group unexpectedly. These results suggest that the beneficial effect of MSCs on in rat's model with TAA-induced cirrhosis may occur during early differentiation course of MSCs. Mature hepatocyte itself has a little effect on the accelerated differentiation and functional capacity of hepatic lineage cell-line.
Animals ; Collagen ; Drinking Water ; Fibrosis ; Glycogen ; Hepatocytes ; Humans ; Liver ; Liver Cirrhosis ; Male ; Mesenchymal Stromal Cells ; Rats ; Regeneration ; Thioacetamide ; Transplants

Advanced hepatocellular carcinoma (HCC) has a poor prognosis and few effective therapies. Recently, low-dose antiangiogenic (also called metronomic) chemotherapy has been tested in patients with advanced HCC. Here, we report two patients with advanced HCC who showed a good response after metronomic chemotherapy. The first was a 54-year-old man who was diagnosed with advanced HCC with lung metastasis. After three cycles of metronomic chemotherapy, the size of tumor and pulmonary metastatic lesions had decreased markedly on follow-up computed tomography. The second was a 54-year-old woman who was diagnosed with HCC with portal vein thrombosis. Metronomic therapy was performed. After 9 months, tumor enhancement in the arterial phase had disappeared completely, and the portal vein thrombus was decreased slightly. Metronomic therapy is an interesting treatment option for patients with advanced HCC. More clinical data and studies are needed to confirm this result.
Carcinoma, Hepatocellular ; Female ; Follow-Up Studies ; Hepatic Artery ; Humans ; Lung ; Middle Aged ; Neoplasm Metastasis ; Portal Vein ; Prognosis ; Thrombosis

PURPOSE: We undertook this study to analyze clinical features and surgical outcome of en bloc resections of the right side colon cancer directly invading duodenum and/or pancreatic head. MATERIALS AND METHODS: The records of all patients who underwent en bloc resection of duodenum and/or pancreas for right colon cancers were analyzed retrospectively. From September 1994 to September 2006, 1,016 patients underwent curative right hemicolectomy. Nine patients (0.9%) had en bloc resection of a right side colon cancer with duodenum or pancreatic head invasion. RESULTS: The median operative time was 320 minutes (range, 200-420) and the median blood loss was 700 mL (range, 100-2,000). The mean size of tumor was 6.6 cm (range, 3.2-10.7). The mean preoperative carcinoembryonic antigen (CEA) was 10.6 ng/mL (range, 0.2-50.8). There was no 30 day perioperative mortality. The median disease-free survival was 23.5 months [95% confidence interval (CI) 5.2-41.8] and the median overall survival was 28.1 months (95% CI 9.7-46.5). CONCLUSIONS: In patients with locally advanced right side colon cancer that directly invades the duodenum or pancreas can be safely resected with curative potential with minimum morbidity and mortality. Long term disease free survival can occur in a significant number of patients undergoing curative en bloc resection in this particular subset of patients.
Adult ; Aged ; Camptothecin/analogs & derivatives/pharmacology/therapeutic use ; Chemotherapy, Adjuvant ; Colonic Neoplasms/*complications/drug therapy/mortality/*surgery ; Disease-Free Survival ; Duodenal Neoplasms/drug therapy/mortality/*secondary/surgery ; Duodenum/drug effects/*pathology/surgery ; Female ; Fluorouracil/pharmacology/therapeutic use ; Humans ; Leucovorin/pharmacology/therapeutic use ; Male ; Middle Aged ; Organoplatinum Compounds/pharmacology/therapeutic use ; Pancreas/drug effects/*pathology/surgery ; Pancreatic Neoplasms/drug therapy/mortality/*secondary/surgery ; Retrospective Studies ; Treatment Outcome

Since the entity of postmastectomy lymphangiosarcoma was first reported by Stewart and Traves in 1948, postmastectomy lymphangiosarcoma has become a well recognized, uncommon malignant tumor which occurs in the upper extremity following mastectomy for mammary carcinoma. The postmastectomy lymphangiosarcoma occurred at an average age of 63.9 years and at an average of 10 years and 3 months following mastectomy. The lymphangiosarcoma raised from blood and lymphatic vessel. The histologic appearance has been observed edematous dermis and dilated lymphatics lining with malignant cells. Most authors recommend radical amputation for treatment, either shoulder disarticulation or forequarter amputation. Other modalities of treatment including radiotherapy were considered as ineffective. The present report provides a case of the regression of postmastectomy lymphangiosarcoma with chronic lymphedima by external irradiation. Radiation therapy was used as primary therapy. Total tumor dose of 6500 cgy in 9 weeks was delivered using 6 MV x-ray and 8 MeV electron.
Amputation ; Dermis ; Disarticulation ; Lymphangiosarcoma* ; Lymphatic Vessels ; Lymphedema ; Mastectomy ; Radiotherapy ; Shoulder ; Upper Extremity

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

PURPOSE: To determine computed tomography (CT) criteria for cardiomegaly. MATERIALS AND METHODS: We analyzed posteroanterior chest radiographs and CT scans of 200 patients (M:F=130:70, mean age 49 years old) that were performed on the same day. On plain radiographs, the cardiothoracic ratio (R) was calculated using a standard method. On CT, we measured the maximal cardiac width (D(c)) and the maximal thoracic width of a patient (D(t1)). A second thoracic width was measured at the same scan level of D(c). Thus, two cardiothoracic ratios were derived in one patient-D(c)/D(t1) (R(1)) and D(c)/D(t2) (R(2)). We analyzed the appropriateness of R(1) and R(2) in the diagnosis of cardiomegaly to establish criteria for the use of the cardiothoracic ratio (ROC curve). RESULTS: When cardiomegaly was defined as a value of R that was greater than 0.5, both R(1) and R(2) were useful indicators of cardiomegaly. For a cut-off value of 0.5 for the cardiothoracic ratio for cardiomegaly, the sensitivity of R(1) and R(2) was 84% and 68%, respectively, and the specificity of R(1) and R(2) was 72% and 86%, respectively. CONCLUSION: The cardiothoracic ratio on CT can be easily obtained by measurement of the maximal cardiac width divided by the maximal thoracic width at the same scan level. When the cardiothoracic ratio on CT is over 0.5, the presence of cardiomegaly can be suggested.
Cardiomegaly* ; Diagnosis ; Heart ; Humans ; Radiography, Thoracic ; Sensitivity and Specificity ; Tomography, X-Ray Computed

No abstract available.
Echocardiography, Transesophageal* ; Mitral Valve Insufficiency*

Neuromyelitis optica (NMO) is an idiopathic inflammatory demyelinating disease, characterized by optic neuritis and myelitis. NMO is a very uncommon and serious neurologic manifestation of systemic lupus erythematous (SLE). We report a 28-year-old man with NMO as neuropsychiatric manifestation of SLE. He was diagnosed as lupus nephritis at 16-year-old. He had optic neuritis at three years and seven months ago. Oral prednisolone was tapered off according to the improved eye symptoms. Two months later, he visited rheumatology clinics for urinary disturbance and paresthesia on both feet. A spinal magnetic resonance imaging revealed increased signal intensity in T2-weighted images from second to sixth cervical level and from eleventh to twelfth thoracic level. We diagnosed neuromyelitis optica and treated with intravenous cyclophosphamide therapy monthly for three times. He was discharged without any neurological deficits and has been followed up.
Adolescent ; Adult ; Cyclophosphamide ; Demyelinating Diseases ; Foot ; Humans ; Lupus Nephritis ; Magnetic Resonance Imaging ; Myelitis ; Neurologic Manifestations ; Neuromyelitis Optica* ; Optic Neuritis ; Paresthesia ; Prednisolone ; Rheumatology