There are many kinds of treatments for hepatocellular carcinoma (HCC) such as surgical resection, liver transplantation, chemotherapy, interventional therapy [TACE, ethanol embolization, Immuno -chemoembolization, I131 -lipiodol embolization], thermal therapy, cryotherapy, and radiation therapy. Generally spontaneous remission is not common in HCC, however underlying mechanism of spontaneous remission is uncertain. We report a case of complete remission after one time TACE in ruptured HCC with review of literature about the effect of TACE and spontaneous remission. We conclude that arterial embolization is an effective alternative to surgery for hepatic hemostasis in patients with spontaneous rupture of hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Cryotherapy ; Drug Therapy ; Ethanol ; Hemostasis ; Humans ; Liver Transplantation ; Remission, Spontaneous ; Rupture, Spontaneous

The purpose of the study is to develop a Web-based health information service system for the disabled. To identify users' information needs, we conducted an online and offline survey of the disabled and their caregivers as well as welfare institutes' staff. Based on the user's information needs, a Web-site was developed. The Web-site was evaluated by users for their satisfaction with the Web-site and by experts for the quality of the site. Content of the Web-site includes information on rehabilitation, welfare, and diseases causing the disability, definition and classification of disability, prevention from disability, management of the disabled, and disability related policies. Besides this information, FAQ on the disabled, statistics, links to the disabled institutes and Web sites, risk factor appraisal tool, and aiding tools for the disabled are added. The Web site is a subsystem of the Healthguide. Users rated efficiency, convenience, and design of the site highly in their satisfaction rating. Staff at welfare institutes rated design, efficiency, and relevance of the site highly in their satisfaction rating. Experts rated easiness, reliability, clearness and appropriateness of the site highly in their site evaluation. It is expected that this Web-based health information service system for the disabled will contribute to the disabled's health promotion as well as provide a community for the disabled related researchers, professionals and experts to share information on the disabled's health.
Academies and Institutes ; Caregivers ; Classification ; Health Promotion ; Humans ; Information Services ; Information Systems ; Internet ; Rehabilitation ; Risk Factors

Hypereosinophilic syndrome is characterized by prolonged eosinophilia of blood and tissue without an identifiable underlying cause and multiorgan system dysfunction by eosinophil-related tissue damage to variable organs: liver, heart, lung, kidney, gastrointestinal tract, skin, nerve. Some case of hypereosinophilic syndrome with hepatic and gastrointestinal involvement have been reported, but not much. We are reporting a case of hypereosinophilic syndrome with hepatic and gastrointestinal involvement in 56-year-old man who presented general weakness and epigastric discomfort. In abdominal US, CT and MRI, intrahepatic multifocal ill-defined lesions were detected. The patient was treated with prednisolone for 16 weeks and recovered from eosinophilia and gastric involvement. A gastric biopsy was taken to confirm recovery. Also, the ill-defined lesions in US and CT disappeared after treatment.
Biopsy ; Eosinophilia ; Gastrointestinal Tract ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Kidney ; Liver ; Lung ; Magnetic Resonance Imaging ; Middle Aged ; Prednisolone ; Skin

A glomus tumor of the stomach is a rare submucosal lesion that was first described by De Busscher in 1948. Submucosal tumors of the stomach are mostly leiomyoma, leiomyosarcoma, and malignant lymphoma. It is difficult to diagnose this kind of tumor preoperatively. We present a patient with a gastric glomus tumor which showed the characteristic endoscopic ultrasonographic (EUS) finding. Our case was also diagnosed by pathology after surgery. The major EUS findings in the present case are circumscribed low echoic mass in the forth submucosal layer and an internal heterogenous echo mixed with high echoic spots. The EUS seems to be useful in distinguishing between glomus tumor and other submucosal tumors.
Endosonography* ; Glomus Tumor* ; Humans ; Leiomyoma ; Leiomyosarcoma ; Lymphoma ; Pathology ; Stomach*

There are many various complications associated with coronary artery stenting, in cluding thrombotic and hemorrhagic complications, in-stent restenosis, side branch occlusion, stent embolization. The retention of equipment components is the uncommon, unexpected and often problematic situations that can arise requiring ingenuity, skill, and creativity. We reports on a patient in whom an sleeve marker ring of a stent balloon catheter retained within the lumen of the coronary artery following coronary stenting. The sleeve marker ring was extracted by dilatation and withdrawal of balloon catheter which readvanced over a guidewire positioned in the center of ring.
Catheters ; Coronary Vessels* ; Creativity ; Dilatation ; Humans ; Stents*

OBJECTIVES: The stress response involves the activation of the hypothalamic-pituitary-adrenal(HPA) axis and the sympathetic nervous system. Corticosteroids have been clearly demonstrated to cause anti-inflammatory and/or immnosuppressive effects in man including granulocytosis in part by decreasing migration into tissue, especially damaged tissues(myocardium), and circulating relative lymphocytopenia. To test whether automated measurements of the the increased serum cortisol-induced hematologic changes in the leukocyte differential significance or not in the initial differential diagnosis of acute myocardial infarction in acute chest pain syndromes. METHODS: 101 consecutive patients with myocardial infarction or myocardial ischemia presenting to the emergency room of Seoul Adventist Hospital with acute chest pain from January 1993 to August 1995(Retrospective group) and from December 1995 to March patients compatible with exclusion criteria in myocardial infarction were excluded. We measured automated leukocyte differential and serial CK-MB level in both groups, and the intial serum cortisol levels in prospective infarction group. RESULTS: 1) Total leukocyte and granulocyte counts were increased in acute myocardial infarction(p<0.01). 2) In acute myocardial infarction group, lymphocyte counts were slightly increased(p<0.05), but relative lymphocytes percentage more significantly decreased(p<0.01). 3) Serum cortisol levels are significantly raised early in the course of the acute myocardial infarction and prior to the elevation of the specific cardiac enzymes on the basis of analytic results of prospective infarction group. 4) Cortisol-induced changes in leukocyte differential were noted with time passes into reverse approximately 4 days later in our study. 5) The leukocyte differential does not shows significant changes in the retrospective myocardial ischemia group, so we arrive in careful conclusion that serum cortisol level seems does not increase. 6) No sexual differences were noted in leukocyte differential. CONCLUSIONS: The serum cortisol level and cortisol-induced leukocyte differential are helpful for initial differential diagnosis of acute myocardial infarction in acute chest pain sysdrome.
Adrenal Cortex Hormones ; Axis, Cervical Vertebra ; Chest Pain* ; Diagnosis, Differential* ; Emergency Service, Hospital ; Granulocytes ; Humans ; Hydrocortisone* ; Infarction ; Leukocytes* ; Lymphocyte Count ; Lymphocytes ; Lymphopenia ; Myocardial Infarction ; Myocardial Ischemia ; Prospective Studies ; Retrospective Studies ; Seoul ; Sympathetic Nervous System ; Thorax*

The Eisenmenger syndrome is characterized by severe irreversible pulmonary hypertension and right-to-left shunting of blood through the pulmonary-systemic communication. The resultant right-to-left shunt leads to clinical cyanosis and secondary manifestations of chronic hypoxemia. Clinical features include dyspnea on exertion, fatigue, palpitation, hemoptysis, syncope, chest pain and predisposition to brain abscess and cerebrovascular accident. Brain abscess is a serious complication of cyanotic congenital heart disease and major cause of death. We report a patient with Eisenmenger syndrome in whom the presence of right-to-left shunt and paradoxical embolism appears to be critical for the development of brain abscess.
Anoxia ; Brain Abscess* ; Brain* ; Cause of Death ; Chest Pain ; Cyanosis ; Dyspnea ; Eisenmenger Complex* ; Embolism, Paradoxical ; Fatigue ; Heart Defects, Congenital ; Hemoptysis ; Humans ; Hypertension, Pulmonary ; Stroke ; Syncope

Finite Element Analysis

OBJECTIVE: To investigate a suitable animal model for studies of male osteoporosis. Osteoporosis has a particularly high incidence in postmenopausal women, resulting in a substantial amount of research with respect to this disease in women. However, research on osteoporosis in men is still lacking. METHODS: Twenty 10-week-old male Sprague Dawley rats were used in this study, including 4 rats used to establish a baseline bone mineral density (BMD). The other 16 rats were divided into two groups: a sham surgery group (n=8), which underwent a sham operation, and an orchiectomized rat group (OCX) (n=8), which underwent bilateral OCX at 10 weeks of age. Bone mineral density was measured in 4 rats from both the sham surgery group and the OCX group 8 weeks after the surgery, while BMD in the remainder of the rats was measured 10 weeks post-surgery. RESULTS: Femoral BMD at 8 weeks post-surgery was found to be significantly lower in the OCX group compared to the sham group; a finding that was also similar 10 weeks post-surgery. CONCLUSION: 8 weeks after undergoing orchiectomy performed via a scrotal, white rats are a suitable model for studies of male osteoporosis.
Animals ; Bone Density* ; Female ; Femur ; Humans ; Incidence ; Male ; Models, Animal ; Multiple Endocrine Neoplasia Type 1 ; Orchiectomy* ; Osteoporosis ; Rats* ; Rats, Sprague-Dawley

BACKGROUND: Chronic kidney disease is a common complication after liver transplantation. In this study, we analyzed the results of kidney biopsy in liver transplantation recipients with renal impairment. METHODS: Between 1999 and 2012, 544 liver transplants were performed at our hospital. We retrospectively analyzed the clinical and histological data of 10 liver transplantation recipients referred for kidney biopsy. RESULTS: The biopsies were performed at a median of 24.5 months (range, 3-73 months) after liver transplantation. The serum creatinine level was 1.81+/-0.5mg/dL at the time of kidney biopsy. There were no immediate complications. The most common diagnosis was glomerulonephritis (GN), such as immunoglobulin A nephropathy (n=4), mesangial proliferative GN(n=1), focal proliferative GN (n=1), and membranous GN (n=1). Typical calcineurin inhibitor (CNI)-induced nephrotoxicity was detected in three cases (30%).Chronic tissue changes such as glomerulosclerosis, interstitial fibrosis, and tubular atrophy were present in 90%, 80%,and 80% of cases, respectively, and mesangial proliferation was detected in 40%of cases. We began treatment for renal impairment based on the result of kidney biopsy; for example, angiotensin-receptor blockers or steroids were prescribed for GN, and the CNI dose was reduced for CNI nephrotoxicity. As a result, eight of 10 patients showed improvement in glomerular filtration rate, but two progressed to end-stage renal disease. CONCLUSION: Kidney biopsy is a safe and effective method for determining the cause of renal impairment after liver transplantation. Management of patients based on the result of kidney biopsy may improve renal outcomes.
Atrophy ; Biopsy* ; Calcineurin ; Creatinine ; Diagnosis ; Fibrosis ; Glomerular Filtration Rate ; Glomerulonephritis ; Glomerulonephritis, IGA ; Humans ; Kidney Failure, Chronic ; Kidney* ; Liver Transplantation ; Liver* ; Methods ; Renal Insufficiency, Chronic ; Retrospective Studies ; Steroids ; Transplantation*