The encapsulated hepatocellular (HCC) is a pathologic subtype of HCC. It is a well defined tumor that tends to grow slowly, and has a better prognosis than any other gross forms of HCC. Twenty surgically resected HCC were evaluated retropectively to correlate the thickness of pseudocapsules in pathology with those in computed tomography and ultrasound. At a histologic examination, pseudocapsules of seven cases were composed of two layers, an inner compact fibrous zone and outer loose fibrous zone interlaced with compressed liver parenchyma containing small vessels and newly formed bile ducts. Sonographic thickness and pathologic measurements of pseudocapsule relatively well correlated, but the former slightly overestimated the thickness of pathologic pseudocapsule (r=0.825, y=2.56x-1.23, P<0.05). On the other hand, thickness in CT and pathologic measurement did not correlate well. Thirteen cases showed one layer of pseudocapsule in which two cases were composed of thin layer of compact fibrosis and eleven cases composed of loose fibrosis. There were poor correlations in this group between thickness of pseudocapsules in pathology and those in images. Image overtly overestimated the thickness of the pseudocapsules in pathology. In conclusion, radiologic pseudocapsule of HCC may represent the compressed liver parenchyma as well as the fibrous pseudocapsule.
Bile Ducts ; Carcinoma, Hepatocellular* ; Fibrosis ; Hand ; Liver ; Pathology ; Prognosis ; Ultrasonography

The encapsulated hepatocellular (HCC) is a pathologic subtype of HCC. It is a well defined tumor that tends to grow slowly, and has a better prognosis than any other gross forms of HCC. Twenty surgically resected HCC were evaluated retropectively to correlate the thickness of pseudocapsules in pathology with those in computed tomography and ultrasound. At a histologic examination, pseudocapsules of seven cases were composed of two layers, an inner compact fibrous zone and outer loose fibrous zone interlaced with compressed liver parenchyma containing small vessels and newly formed bile ducts. Sonographic thickness and pathologic measurements of pseudocapsule relatively well correlated, but the former slightly overestimated the thickness of pathologic pseudocapsule (r=0.825, y=2.56x-1.23, P<0.05). On the other hand, thickness in CT and pathologic measurement did not correlate well. Thirteen cases showed one layer of pseudocapsule in which two cases were composed of thin layer of compact fibrosis and eleven cases composed of loose fibrosis. There were poor correlations in this group between thickness of pseudocapsules in pathology and those in images. Image overtly overestimated the thickness of the pseudocapsules in pathology. In conclusion, radiologic pseudocapsule of HCC may represent the compressed liver parenchyma as well as the fibrous pseudocapsule.
Bile Ducts ; Carcinoma, Hepatocellular* ; Fibrosis ; Hand ; Liver ; Pathology ; Prognosis ; Ultrasonography

BACKGROUND: In this study, we assessed the 50% effective concentration (EC50) of sevoflurane for reducing a rocuronium-induced reaction, based on the Dixon's up-and-down method. We also assessed the 50 and 95% effective end-tidal concentration of sevoflurane (ETsev), based on the probit regression curve of the probability of nonwithdrawal reaction. METHODS: We conducted a prospective, double-blind study in 23 males and 24 females. After using 2.5% thiopental sodium (4 mg/kg), anesthesia was induced in the patients. The patients then inhaled sevoflurane with 5 vol% in 6 L/min of oxygen. When the target ETsev was achieved, a nurse injected the intubating dose of rocuronium (0.6 mg/kg) for 5-10 s under the free flow of intravenous fluid. After the nurse evaluated the response, the nurse recorded the maximum heart rate during 30 s and the mean arterial pressure after rocuronium injection. RESULTS: Based on Dixon's up-and-down method, the EC50 of sevoflurane was 2.5 alpha 0.5 vol% in males and 2.5 alpha 0.3 vol% in females. The probit regression curve of the probability of nonwithdrawal reaction showed that in males the 50% effective ETsev was 2.4 vol% (95% confidence interval [CI], 1.5-3.1 vol%) and the 95% effective ETsev was 3.5 vol% (95% CI, 2.9-11.0 vol%); in females, the 50% effective ETsev was 2.4 vol% (95% CI, 2.1-2.7 vol%) and the 95% effective ETsev was 3.0 vol% (95% CI, 2.7-4.5 vol%). CONCLUSIONS: The inhalation of sevoflurane during the induction period may provide a simple and reliable means of reducing rocuronium-induced reactions without adverse hemodynamic changes. There was no significant difference between males and females.
Adult* ; Anesthesia ; Arterial Pressure ; Double-Blind Method ; Female ; Heart Rate ; Hemodynamics ; Humans ; Inhalation ; Male ; Oxygen ; Prospective Studies ; Thiopental

BACKGROUND: A "difficult airway" can be simulated with an extrication collar, which restricts cervical motion and mouth opening. The purpose of this study is to compare the efficacy of the GlideScope and the McGrath in difficult airway simulation. METHODS: Patients were randomized using computer-generated numbers and were placed into the GlideScope group or the McGrath group. The total intubation time was defined as the time measured from when the anesthesiologist picks up the device to the time at which three successive end-tidal CO2 values are acquired after intubation. RESULTS: There was no significant difference in total intubation time between the two groups (73.0 ± 25.3 sec vs. 72.3 ± 20.9 sec, P = 0.92). The success rates of the first intubation attempt did not differ between the two groups (82.8% vs. 83.3%, P = 0.95). CONCLUSIONS: Our results suggest that there are no significant differences in the intubations with GlideScope and McGrath using vascular forceps and tube exchangers in difficult intubation scenarios.
Airway Management ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopes ; Mouth ; Surgical Instruments*

No abstract available.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular*

PURPOSE: Bystander cardiopulmonary resuscitation (CPR) and dissemination of its training are essential to improve the survival outcomes of sudden cardiac death. The purpose of this study was to investigate the tri-temporal trend analysis of the national CPR capacity variables and preparedness in a community. METHODS: This nationwide population-based study used structured questionnaire by a telephone survey for CPR in 2007 (n=1,029), in 2011 (n=1,000), and in 2015 (n=1,000). We used stratified cluster sampling to assess the impact of age, gender, and geographic regions. The contents in the questionnaire consisted of CPR awareness, self-efficacy for bystander CPR, prior training status, and willingness of public CPR training. RESULTS: The proportion of CPR awareness and its recent training experience (<2 years) increased from 89.0% and 14.6%, respectively, in 2007 to 88.5% and 18.7% in 2011, and finally to 94.8% and 30.6% in 2015 (both p for trend<0.001). More than 95% of respondents had agreed to mandatory CPR training acquiring a driver's license or CPR education in school. The awareness of Good Samaritan Law was increased from 20.5% in 2011 to 28.7% in 2015; however, the overall values were lower than the other CPR-related awareness and preparedness. CONCLUSION: In Korea, the trends of national CPR capacity index have been increasing during the past decade. However, the public awareness of the Good Samaritan Law was still low. We suggest that promoting the Good Samaritan Law should be the next step in preparing public CPR training in the future.
Cardiopulmonary Resuscitation* ; Death, Sudden, Cardiac ; Education ; Health Services Needs and Demand ; Humans ; Jurisprudence ; Korea ; Licensure ; Surveys and Questionnaires ; Telephone

OBJECTIVES: To develop and test the validity and reliability of a brief self-completed questionnaire (Service Satisfaction Scale: SSS) for routinely assessing the quality of service in psychiatric ward inpatients. METHODS: A 30-item multidimensional questionnaire was developed by several steps of face validity and content validity. The questionnaire was administered to inpatients (n=348) discharged from psychiatric hospitals, general hospitals, and university hospitals. Construct validity was supported by performing principal component analysis. Reliability was estimated by calculating internal consistency of Cronbach's alpha. RESULTS: Factor analysis yielded five factors comprising staff attitude, treatment quality, ward environment, access/cost, and ward rule, which account for 63.04% of the common variance. The internal consistency of the scale was high (Cronbach's alpha=0.95). The concurrent validity was supported by the significant correlation of each of five factors with item that measured overall satisfaction of SSS. Patients with neurosis (anxiety disorder, somatoform disorder, obsessive compulsive disorder) and mood disorders were significantly satisfied than those with psychosis and alcoholic disorders. Patients who admitted voluntarily were more significantly satisfied than those who admitted involuntarily. Sociodemographic variables such as age, gender, marital status, monthly income, education level, employment status and religion were not significantly different at the total scores of SSS. Similarly, clinical characteristics such as age of onset, duration of illness, lengths of hospital stay and number of previous hospitalization did not associate significantly with the total scores of SSS. Patients discharged from university hospitals were significantly more satisfied than those of the general and psychiatric hospitals. CONCLUSION: SSS performed well in the validity and reliability, indicating that it can be a useful tool for measuring satisfaction of psychiatric inpatients in Korea.
Age of Onset ; Alcoholics ; Attitude of Health Personnel ; Education ; Employment ; Hospitalization ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Humans ; Inpatients* ; Korea ; Length of Stay ; Marital Status ; Mood Disorders ; Patient Satisfaction ; Principal Component Analysis ; Psychotic Disorders ; Surveys and Questionnaires ; Reproducibility of Results ; Somatoform Disorders

Pediatric liver transplantation is the standard of care for treatment of liver failure in children. The aim of this study was to identify the characteristics of pediatric liver transplantation in centers located in Korea and determine factors that influence outcomes. This retrospective study was performed using data from between 1988 and 2010 and included all recipients 18 yr old and younger who underwent pediatric liver transplantation in Korea during that period. Our data sources were hospital medical records and the outcome measure was overall patient survival. Univariate and multivariate statistical analyses were undertaken using the Cox proportional hazards model. Five hundred and thirty-four pediatric liver transplantations were performed in 502 children. Median age and average pediatric end-stage liver disease (PELD) score were 20 months and 18 point, respectively. Biliary atresia (57.7%, 308/534) was the most common cause of liver disease. Eighty-two (15.3%) were deceased donor liver transplantations and 454 (84.7%) were living donor liver transplantations. Retransplantation was performed in 32 cases (6%). Overall, 1-, 5-, and 10-yr patient survival rates were 87.8%, 82.2%, and 78.1%, respectively. In multivariate analysis, independent significant predictors of poor patient survival were chronic rejection and retransplantation. This study presents the epidemiologic data for nearly all pediatric liver transplantation in Korea and shows that the independent prognostic factors in patient survival are chronic rejection and retransplantation.
Adolescent ; Biliary Atresia/epidemiology ; Child ; Child, Preschool ; End Stage Liver Disease/epidemiology/mortality/*therapy ; Female ; Graft Survival ; Humans ; Infant ; *Liver Transplantation ; Male ; Prognosis ; Proportional Hazards Models ; Republic of Korea ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate ; Treatment Outcome

Depression is common in the patients with rheumatoid arthritis (RA). Estimates of the prevalence of depression in the patients with RA have ranged from 14 to 46%, depending on the criteria used and the patient subgroups studied. Our objectives were to show how frequently depression occur among patients with RA, to compare depression in RA and osteoarthritis (OA) patients, and to identify the disease and sociodemographic variables with which depression are associated. Subjects included in this study were 119 RA patients, and 140 OA patients. The Korean version of the Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depression. The Korean health assessment questionnaire (KHAQ) was used to assess physical function in patients with RA. The associations of sociodemographic variables, disability, severity and other variables with CES-D score were evaluated by multiple regression analysis. RESULTS: When CES-D cut-off score of 25 was used, 54 (50.9%) of 106 RA patients, and 32(23.5%) of 122 OA patients had scores suggestive of depression, and the difference was still significant after adjusting age, sex, disease duration, pain scale and fatigue scale (p<0.05). RA patients had higher mean scores on CES-D than OA patients after adjusting above variables, too (p<0.05). The bivariate analysis showed that age, sex, education level, fatigue scale, pain scale, KHAQ-disability score, WBC, ESR were significantly associated with CES-D scores in RA patients; and the duration of disease, pain scale and fatigue scale were associated with those in OA patients (p<0.05). By stepwise selection in multiple logistic regression model, the age, pain scale and KHAQ-disability score were selected as significant independent variables in RA patients. In OA patients, the duration of disease and pain scale were selected as significant independent variables. CONCLUSION: RA patients are significantly more depressed than OA patients, and the associated factors with depression are patient? age, pain scale and KHAQ disability score in RA.
Arthritis, Rheumatoid* ; Depression* ; Education ; Fatigue ; Humans ; Logistic Models ; Osteoarthritis ; Prevalence ; Surveys and Questionnaires

It has been suggested that hyperuricemia and possibly gout are associated with the metabolic syndrome, but there have been no direct studies. This study was undertaken to obtain the prevalence of the metabolic syndrome in patients with gout and to compare it with those from the general population studies. This was a 4-institutional case-historical control study composed of 168 patients with gout. We assessed the prevalence of metabolic syndrome according to the ATP III criteria and compared the prevalence with that of the historical controls. To elucidate the factors in gout that were associated with metabolic syndrome, a multivariate analysis was done. The age-adjusted prevalence of metabolic syndrome in gout patients was 43.6%, which was significantly higher than that of the Korean control population (5.2%) from the previous studies. Patients with gout had more components of metabolic syndrome than did the controls. Body mass index (BMI, OR=1.357 (95%CI 1.111-1.657)) and high density lipoprotein (HDL, OR=0.774 (95%CI 0.705-0.850)) were the variables most significantly associated with the occurrence of metabolic syndrome in gout, but alcohol consumption did not show such associations. Gout is associated with the metabolic syndrome, and furthermore, obesity and dyslipidemia were the factors most associated with the syndrome in these patients.
Adult ; Aged ; Body Mass Index ; Case-Control Studies ; Gout/*complications ; Humans ; Korea/epidemiology ; Lipoproteins, HDL/blood ; Male ; Metabolic Syndrome X/*complications/epidemiology/etiology ; Middle Aged ; Multivariate Analysis ; Risk Factors