Purpose: We report a case of pseudopapilledema combined with idiopathic papilledema in a pediatric patient receiving growth hormone treatment.Case summary: An 11-year-old girl without any underlying disease presented with bilateral transient visual obscurations, a dark-adaptation disorder, and helplessness that developed while she had been on growth hormone therapy for 3 months at a local clinic. Reduced visual acuity (from 20/20 to 20/25) was observed on physical examination and bilateral optic disc edema on fundus examination, growth hormone was immediately discontinued. Four weeks later, fundus examination revealed papilledema of both eyes with mild red-green dyschromatopsia. Recombinant growth hormone-associated idiopathic papilledema combined with pseudopapilledema was suspected. Although growth hormone, had been discontinued, we scheduled further observation of the papilledema. Conclusions Papilledema was observed on fundus examination during growth hormone treatment and four weeks after discontinuation thereof. The symptoms improved, but mild papilledema combined with pseudopapilledema remained.

Purpose: We report a case of pseudopapilledema combined with idiopathic papilledema in a pediatric patient receiving growth hormone treatment.Case summary: An 11-year-old girl without any underlying disease presented with bilateral transient visual obscurations, a dark-adaptation disorder, and helplessness that developed while she had been on growth hormone therapy for 3 months at a local clinic. Reduced visual acuity (from 20/20 to 20/25) was observed on physical examination and bilateral optic disc edema on fundus examination, growth hormone was immediately discontinued. Four weeks later, fundus examination revealed papilledema of both eyes with mild red-green dyschromatopsia. Recombinant growth hormone-associated idiopathic papilledema combined with pseudopapilledema was suspected. Although growth hormone, had been discontinued, we scheduled further observation of the papilledema. Conclusions Papilledema was observed on fundus examination during growth hormone treatment and four weeks after discontinuation thereof. The symptoms improved, but mild papilledema combined with pseudopapilledema remained.

PURPOSE: The purpose of this study was to investigate the effect of hospital case volume on clinical outcomes in patients with nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Data on 1,073 patients with cT1-4N0-3M0 NPC were collected from a multi-institutional retrospective database (KROG 11-06). All patients received definitive radiotherapy (RT) either with three-dimensional-conformal RT (3D-CRT) (n=576) or intensity-modulated RT (IMRT) (n=497). The patients were divided into two groups treated at high volume institution (HVI) (n=750) and low volume institution (LVI) (n=323), defined as patient volume ≥ 10 (median, 13; range, 10 to 18) and < 10 patients per year (median, 3; range, 2 to 6), respectively. Endpoints were overall survival (OS) and loco-regional progression-free survival (LRPFS). RESULTS: At a median follow-up of 56.7 months, the outcomes were significantly better in those treated at HVI than at LVI. For the 614 patients of propensity score-matched cohort, 5-year OS and LRPFS were consistently higher in the HVI group than in the LVI group (OS: 78.4% vs. 62.7%, p < 0.001; LRPFS: 86.2% vs. 65.8%, p < 0.001, respectively). According to RT modality, significant difference in 5-year OS was observed in patients receiving 3D-CRT (78.7% for HVI vs. 58.9% for LVI, p < 0.001) and not in those receiving IMRT (77.3% for HVI vs. 75.5% for LVI, p=0.170). CONCLUSION: A significant relationship was observed between HVI and LVI for the clinical outcomes of patients with NPC. However, the difference in outcome becomes insignificant in the IMRT era, probably due to the standardization of practice by education.
Cohort Studies ; Disease-Free Survival ; Education ; Follow-Up Studies ; Humans ; Nasopharyngeal Neoplasms ; Radiotherapy ; Radiotherapy, Intensity-Modulated ; Retrospective Studies* ; Treatment Outcome

No abstract available.
Nevus, Blue* ; Prurigo*

No abstract available.
Nevus, Blue* ; Prurigo*

PURPOSE: To investigate the patterns of care for patients with nasopharyngeal carcinoma (NPC) in South Korea. MATERIALS AND METHODS: A multi-institutional retrospective study was performed (Korean Radiation Oncology Group [KROG] 11-06) on a total of 1,445 patients from 15 institutions. RESULTS: Of the 1,445 patients, more than half were stages III (39.9%) and IV (35.8%). In addition to patterns of care, we also investigated trends over time with the periods 1988-1993, 1994-2002, and 2003-2011. The frequencies of magnetic resonance imaging and positron emission tomography-computed tomography were markedly increased in the third period compared to previous 2 periods. Concurrent chemoradiation (CCRT) was performed on 894 patients (61.9%), neoadjuvant chemotherapy on 468 patients (32.4%), and adjuvant chemotherapy on 366 patients (25.3%). Of stage II-IV patients, CCRT performed on 78.8% in 2003-2011 compared to 15.0% in 1988-1993. For patients treated with CCRT, cisplatin was the most commonly used agent in 81.3% of patients. Over the periods of time, commonly used radiotherapy (RT) techniques were changed from 2-dimensional RT (1988-1993, 92.5%) to 3-dimensional RT (2003-2011, 35.5%) or intensity-modulated RT (IMRT; 2003-2011, 56.5%). Median RT doses given to primary tumors, high-risk lymphatics, and low-risk lymphatics were 70.0 Gy, 58.1 Gy, and 48.0 Gy, respectively. Adoption of IMRT increased the dose per fraction and escalated total radiation dose. CONCLUSION: Assessment of the patterns of care for NPC patients in South Korea demonstrated that management for NPC including diagnostic imaging, treatment regimen, RT techniques and dose schedule, advanced in accordance with the international guidelines.
Appointments and Schedules ; Chemotherapy, Adjuvant ; Cisplatin ; Diagnostic Imaging ; Drug Therapy ; Electrons ; Humans ; Korea* ; Magnetic Resonance Imaging ; Nasopharyngeal Neoplasms ; Radiation Oncology ; Radiotherapy ; Retrospective Studies

Several postharvest diseases of table grapes (Vitis vinifera) occur during storage, and gray mold rot is a particularly severe disease because the causal agent, Botrytis cinerea, grows at temperatures as low as 0degrees C. Other postharvest diseases, such as those caused by Penicillium spp. and Aspergillus spp., also often lead to deterioration in the quality of table grapes after harvest. The use of plant essential oils such as thymol and linalool, to reduce postharvest diseases in several kinds of fruits, including table grapes and oranges, has received much attention in European countries. However, to the best of our knowledge there has been no report of the use of thymol fumigation to control gray mold in table grapes in Korea. Thymol (30 microg/mL) and linalool (120 microg/mL) significantly inhibited mycelial growth and conidia germination of B. cinerea. The occurrence rate of gray mold rot of B. cinerea and other unknown fungi was significantly reduced by fumigation with 30 microg/mL thymol in several table grape cultivars, such as Campbell early, Muscat Bailey A, Sheridan, and Geobong. In this study, fumigation with 30 microg/mL thymol, had no influence on the sugar content and hardness of grapes, but reduced fungal infection significantly. This suggests that 30 microg/mL thymol could be utilized to reduce deterioration of grapes due to gray mold and other fungal infections during long-term storage.
Aspergillus ; Botrytis ; Citrus sinensis ; Fruit ; Fumigation* ; Fungi ; Germination ; Hardness ; Korea ; Oils, Volatile ; Oman ; Penicillium ; Plants ; Spores, Fungal ; Thymol* ; Vitis*

A 67-year-old male patient was admitted with an abrupt sudden cardiac death. He represented with an extreme electrical storm of 30 times of ventricular fibrillation (VF) episodes on one day. External shocks were performed to terminate VF. Transient J-wave in the inferior-lateral leads and Brugada electrocardiography pattern on the right precordial leads appeared during the electrical storm. And J-wave disappeared after the termination of electrical storm. We report a case of the appearance of J-wave during electrical storm in a patient with Brugada syndrome.
Brugada Syndrome ; Death, Sudden, Cardiac ; Electrocardiography ; Humans ; Male ; Shock ; Ventricular Fibrillation

PURPOSE: To evaluate the extent of pain response and objective response to palliative radiotherapy (RT) for bone metastases from hepatocellular carcinoma according to RT dose. MATERIALS AND METHODS: From January 2007 to June 2010, palliative RT was conducted for 103 patients (223 sites) with bone metastases from hepatocellular carcinoma. Treatment sites were divided into the high RT dose and low RT dose groups by biologically effective dose (BED) of 39 Gy10. Pain responses were evaluated using the numeric rating scale. Pain scores before and after RT were compared and categorized into 'Decreased', 'No change' and 'Increased'. Radiological objective responses were categorized into complete response, partial response, stable disease and progression using modified RECIST (Response Evaluation Criteria In Solid Tumors) criteria; the factors predicting patients' survival were analyzed. RESULTS: The median follow-up period was 6 months (range, 0 to 46 months), and the radiologic responses existed in 67 RT sites (66.3%) and 44 sites (89.8%) in the high and low RT dose group, respectively. A dose-response relationship was found in relation to RT dose (p=0.02). Pain responses were 75% and 65% in the high and low RT dose groups, respectively. However, no statistical difference in pain response was found between the two groups (p=0.24). There were no differences in the toxicity profiles between the high and low RT dose groups. Median survival from the time of bone metastases diagnosis was 11 months (range, 0 to 46 months). The Child-Pugh classification at the time of palliative RT was the only significant predictive factor for patient survival after RT. Median survival time was 14 months under Child-Pugh A and 2 months under Child-Pugh B and C. CONCLUSION: The rate of radiologic objective response was higher in the high RT dose group. Palliative RT with a high dose would provide an improvement in patient quality of life through enhanced tumor response, especially in patients with proper liver function.
Carcinoma, Hepatocellular ; Follow-Up Studies ; Humans ; Liver ; Neoplasm Metastasis ; Quality of Life

PURPOSE: Biliary stones, situated in the proximal sites from the confluence level of the right and left main bile ducts, are considered to be intrahepatic stones. Synonyms include hepatolithiasis and recurrent pyogenic cholangitis. The exact etiology of this condition is unknown, but it causes serious problems, such as obstructive jaundice, cholangitis and liver abscesses and so on. Hepatic resection is the treatment of choice for intrahepatic stones. With improving techniques in hepatobiliary surgery and aggressive surgical treatment, the outcome of intrahepatic stones has improved. The aim of this study was to evaluate the clinical outcomes after a hepatectomy for intrahepatic stones. METHODS: 77 patients underwent hepatic resections due to intrahepatic stones at the Department of Surgery, Kyung-Hee University between January 1996 and December 2002. The surgical outcome and follow-up were analyzed by a retrospective clinical review. RESULTS: The gender ratio of the patients was 1: 1.9 male to female, with a mean age of 54-years. The most common preoperative symptom was RUQ pain (81.8%). Concomitant diseases were common bile duct stones (53.2%), gallstones (23.4%), liver abscesses (7.8%), malignant neoplasms (6.5%) and choledochal cysts (5.2%). Nineteen patients (24.7%) had a history of cholecystectomy and 2 (2.6%) had had a hepatectomy at other hospitals due to intrahepatic stones. The stone locations were the right hemi-liver 18.2%, the left hemi-liver 66.2%, especially the left lateral section 44.2%, and bilaterally 15.6%. The operation methods were as follows; a right hemihepatectomy in 11 patients (14.3%), a posterior sectionectomy in 3 (3.9%), a left hemihepatectomy in 14 (18.2%), a lateral sectionectomy in 42 (54.5%), segmental resections at both lobes in 7 (9.1%) and biliary-enteric bypass in 24 (31.2%). The most common complication was wound infection (26.0%). Two patients had remaining stones and 1 had recurrent stones 4 years later. The morbidity and mortality were 42.9 and 1.3%, respectively. With a mean follow-up period of 49.6 months, 59 patients (76.6%) were free of symptoms. 15 patients (19.5%) had mild to moderate RUQ discomfort or pain, but no detectable stones on radiological studies. 3 patients (3.9%) needed admission for severe symptoms, one due to recurrent stones, but the others had no abnormal findings. CONCLUSION: There was low mortality, despite the high complication rates with hepatic resections for intrahepatic stones. Low rates of remaining stones and recurrence of intrahepatic stones can be achieved.
Bile Ducts ; Bile Ducts, Intrahepatic ; Cholangitis ; Cholecystectomy ; Choledochal Cyst ; Cholelithiasis ; Common Bile Duct ; Female ; Follow-Up Studies ; Gallstones ; Hepatectomy* ; Humans ; Jaundice, Obstructive ; Liver Abscess ; Male ; Mortality ; Recurrence ; Retrospective Studies ; Wound Infection