Hepatoma is one of the most common malignant disease among cancers that occur in Korea. Recently, according ta developing imaging diagnostic technology and non surgical treatment the hepatoma is easily detected in early diagnosis and appropriate treatment. From this point of view, the histologic pattern of hepatoma is markedly important. This is the first reported case of sclerosing hepatocellular carcinoma, which is characterized by intense fibrosis, in which the tubular neoplastic structures are embedded. The incidence of sclerosing hepatocellular carcinoma is very rare. Therefore the rare histologic pattern of hepatoma might be introduced by many studies and reports. We recently experienced a case of sclerosing hepatocellular carcinoma.
Carcinoma, Hepatocellular ; Early Diagnosis ; Fibrosis ; Incidence ; Korea

The concept of cellular reprogramming was developed to generate induced neural precursor cells (iNPCs)/dopaminergic (iDA) neurons using diverse approaches. Here, we investigated the effects of various nanoscale scaffolds (fiber, dot, and line) on iNPC/iDA differentiation by direct reprogramming. The generation and maturation of iDA neurons (microtubule-associated protein 2-positive and tyrosine hydroxylase-positive) and iNPCs (NESTIN-positive and SOX2-positive) increased on fiber and dot scaffolds as compared to that of the flat (control) scaffold. This study demonstrates that nanotopographical environments are suitable for direct differentiation methods and may improve the differentiation efficiency.
Cellular Reprogramming ; Nanofibers ; Neurons ; Tyrosine

OBJECTIVE: Intracranial ruptured vertebral artery dissecting aneurysms (VADAns) are associated with high morbidity and mortality when left untreated due to the high likelihood of rebleeding. The present study aimed to establish an endovascular therapeutic strategy that focuses specifically on the angioarchitecture of ruptured VADAns. METHODS: Twenty-three patients with ruptured VADAn received endovascular treatment (EVT) over 7 years. The patient group included 14 women (60.9%) and 9 men (39.1%) between the ages of 39 and 72 years (mean age 54.2 years). Clinical data and radiologic findings were retrospectively analyzed. RESULTS: Four patients had aneurysms on the dominant vertebral artery. Fourteen (61%) aneurysms were located distal to the posterior inferior cerebellar artery (PICA). Six (26%) patients had an extracranial origin of the PICA on the ruptured VA, and 2 patients (9%) had bilateral VADAns. Eighteen patients (78%) were treated with internal coil trapping. Two patients (9%) required an adjunctive bypass procedure. Seven patients (30%) required stent-supported endovascular procedures. Two patients experienced intra-procedural rupture during EVT, one of which was associated with a focal medullary infarction. Two patients (9%) exhibited recanalization of the VADAn during follow-up, which required additional coiling. No recurrent hemorrhage was observed during the follow-up period. CONCLUSION: EVT of ruptured VADAns based on angioarchitecture is a feasible and effective armamentarium to prevent fatal hemorrhage recurrence with an acceptable low risk of procedural complications. Clinical outcomes depend mainly on the pre-procedural clinical state of the patient. Radiologic follow-up is necessary to prevent hemorrhage recurrence after EVT.
Aneurysm ; Aneurysm, Dissecting* ; Arteries ; Endovascular Procedures ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Infarction ; Male ; Mortality ; Pica ; Recurrence ; Retrospective Studies ; Rupture ; Subarachnoid Hemorrhage* ; Vertebral Artery*

No abstract available.
Carcinoma, Renal Cell* ; Melena*

BACKGROUND: The purpose of this study was to report outcomes of congenital hallux varus deformity after surgical treatment. METHODS: We evaluated ten feet of eight patients with a congenital hallux varus deformity, including four feet combined with a longitudinal epiphyseal bracket (LEB). There were seven male patients and one female patient with a mean age of 33 months (range, 7 to 103 months) at the time of surgery. Two patients were bilaterally involved. The mean duration of follow-up was 5.9 years (range, 2.3 to 13.8 years). Clinical outcomes were assessed according to the criteria of Phelps and Grogan. Surgical procedures included the Farmer procedure, the McElvenny procedure or an osteotomy at the first metatarsal or proximal phalanx. RESULTS: The clinical results were excellent in two feet, good in six and poor in two feet. The LEB was associated with hallux varus in four feet and were treated by osteotomy alone or in conjunction with soft tissue procedure. CONCLUSIONS: Congenital hallux varus was successfully corrected by surgery with overall favorable outcome. Preoperatively, a LEB should be considered as a possible cause of the deformity in order to prevent recurrent or residual varus after surgery.
Child ; Child, Preschool ; Female ; Foot Deformities, Congenital/radiography/*surgery ; Hallux Varus/radiography/*surgery ; Humans ; Infant ; Male ; Osteotomy

Traumatic dislocation of the peroneus longus tendon is an often unrecognized injury which has been reported to occur most commonly during sports activity. Most acute cases with early detection can be treated by simple repair of the tendon or retinaculum using one of several procedures available. Accurate treatment through a comprehensive evaluation of the ankle injury prevents suboptimal and sometimes unrecorrectable outcomes. The authors experienced concomitantly the peroneus longus tendon dislocation associated with a trimalleolar fracture of the ankle. We report this case a brief review of the literature.
Animals ; Ankle ; Ankle Injuries ; Dislocations ; Sports ; Tendons

It is well known that autotransfusion can reduce or eliminate the use of homologous transfusion and can overcome the side effects of homologous transfusion. Also, many studies have been reported that autotransfusion showed better postoperative courses than homologous transfusion. We have reported the concept and benefit of autotransfusion in spinal surgery. So we would also compare the autotransfusion and homologous transfusion in total hip replacement arthroplasty, and would find out the effect of autotransfusion. From March 1993 to February 1995, autotransfusion group(38 hips) and homologous transfusion group(30 hips) were compared and eight patients(8 hips) who required homologous blood among autotransfusion group were excluded in comparison. The results were as follows: 1. Total transfusion amounts were 1013±174cc in autotransfusion group and 1088±601cc in homologous transfusion group. There were no statistically significed difference between both groups. 2. Total amounts and duration of postoperative drainage were significantly less in autotransfusion group, especially in the cases of postoperative autotransfusion with Orth-evac. 3. There was no difference of preoperative hemoglobin level in both groups, but the level was recovered more promptly in autotransfusion group. 4. In autotransfusion group, 3 hips(10%) showed fever and chilling sensation. Among them, 2 hips were transfused postoperatively with Orth-evac. In homologous transfusion group, 8 hips(27%) experienced one or more than one of transfusion side effects. 5. Homologous blood was also required in eight patients of autotransfusion group. Four patients of them were hypertensive and one was revision case. In conclusion, we think we can expect better postoperative recovery and also reduce or eliminate homologous transfusion with autotransfusion. But, hematologically and physiologically, further study will be necessary.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Blood Transfusion, Autologous ; Drainage ; Fever ; Hip ; Humans ; Sensation

BACKGROUND: Mobilized peripheral blood stem cells (PBSCs) are now used increasingly in patients with hematologic and solid tumors to reconstitute hematopoiesis after dose-intensive chemotherapy. We evaluated the efficacy of large-volume leukapheresis (LVL) and compared the ability of Fenwal CS3000 Plus and Cobe Spectra to collect mononuclear cells (MNCs) for PBSCT. METHODS: Twenty liters of whole blood per LVL were processed in 22 patients with acute leukemia and lymphoma. LVL were performed in rapid recovery phase (white cells >3x109/L, or CD34+ cells > 1% of white cells) after chemotherapy followed by granulocyte-colony stimulating factor. The end point of LVL was mononuclear cells (MNCs) >8x108/kg, or CD34+ cells > 6x106/kg. A-35 collection chamber was used in Fenwal CS3000 Plus and whole blood flow was set at 85mL/min, whole blood to anticoagulant ratio 11~13:1, interface offset 150. MNC procedure was used in Cobe Spectra, whole blood flow was 90~100mL/min, whole blood to anticoagulant ratio 24:1 with heparin to anticoagulant and product bags, collection rate 1mL/min, and hematocrit 2~3%. RESULTS: Total 53 LVL (35 with Fenwal CS3000 Plus and 18 with Cobe Spectra) were performed on 22 patients. An average of 2.4 LVL per patient (range 1~4) were performed. With Fenwal CS3000 Plus, post-LVL values of hematocrit, platelets and MNCs were reduced by 12.4%, 53.1%, and 33.0% and with Cobe Spectra, 9.2%, 36.1%, and 39.6%, respectively. Mean collection volume of Fenwal CS3000 Plus and Cobe Spectra were 135.7mL and 175.2mL per LVL, respectively. There was no statistical significant difference in the yields of LVL between Fenwal CS3000 Plus (3.4+/-1.9x108/kg MNCs, 7.2+/-11.2x106/kg CD34+ cells) and Spectra (4.7+/-2.1x108/kg MNCs, 7.4+/-9.6x106/kg CD34+ cells). The yields of LVL were correlated well with patients' pre-MNC counts in both cell separators. Mean percentages of MNC were 95.4% with Fenwal CS3000 Plus and 74.0% with Cobe Spectra (P<0.001) and collection efficiencies were 53.6+/-18.8% and 57.3+/-27.8%, respectively (P> 0.05). LVL product with Cobe Spectra contained less red cells (10.5+/-2.7mL) than Fenwal CS3000 Plus (34.1+/-10.8mL) (P<0.001). Platelet contamination was not different for Fenwal CS3000 Plus (2.3+/-2.1x1011) and Cobe Spectra (3.1+/-1.0x1011). CONCLUSION: LVL could be conveniently used for PBSC collection with good collection efficiency and safety without serious citrate toxicities. LVL products with Fenwal CS3000 Plus showed less collection volume and granulocyte contamination. The products with Cobe Spectra showed less red cell contamination and less decrease in patients' platelet counts.
Blood Platelets ; Citric Acid ; Drug Therapy ; Granulocytes ; Hematocrit ; Hematopoiesis ; Heparin ; Humans ; Leukapheresis* ; Leukemia ; Lymphoma ; Platelet Count ; Stem Cells*

PURPOSE: There has been a renewal of interest in Macrophage migration inhibitory factor (MIF), especially correlation in pathogenesis of sepsis by many infectious diseases and in regulation of host inflammatory and immune response. We developed immunoradiometric assay (IRMA) to determine serum human MIF concentration. MATERIALS AND METHODS: The IRMA system utilizes solid phase bound monoclonal anti-recombinant human MIF (rhMIF) antibody as a capture antibody, biotinylated polyclonal anti-rhMIF antibody as a detector antibody. We applied with rhMIF that concentration of standard solutions increased from 0 ng/ml to 100 ng/ml. We used 125I-streptavidin (SA) as radiotracer to determination of rhMIF concentration. Streptavidin was labeled with 125I by Chloramine-T method and 125I-SA was purified by ultracentrifugation. 125I-SA stability was evaluated by ITLC analysis at 4 degrees C and room temperatures until 60days. To validate IRMA system for MIF, we experimented intra-assay and inter-assay coefficients of variation, recovery test and dilution test. RESULTS: Radiolabeling yield of 125I-SA was 87% and purified 125I-SA retained above 99% radiochemical purity. 125I-SA showed above 93% stability in 4 degrees C until 60days that it is good for immunoradiometric assay as radiotracer. Plotted standard dose response curve showed that increased concentration of rhMIF linearly correlated (R2=0.99) with bound radioactivity of 125I-SA. The highest intra- and inter-assay coefficients of variation were 5.5% and 7.6%, respectively. The average of recovery of MIF in samples was 102%. In dilution test, linear response curves were obtained (R2=0.97). CONCLUSION: Radioimmunoassay using 125I-SA as radiotracer thought to be useful for the determination of serum MIF concentration, and further, its data will be used to evaluate the correlation between clinical significance and serum MIF concentration in patients with various inflammatory diseases.
Communicable Diseases ; Humans ; Immunoradiometric Assay ; Macrophages* ; Radioactivity ; Radioimmunoassay* ; Sepsis ; Streptavidin ; Ultracentrifugation

Background/Aims: Veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is one of the most fatal complications of hematopoietic cell transplantation (HCT), and defibrotide is the only curative drug. We conducted this study to confirm the survival rate of VOD/SOS patients diagnosed in Korea and assess the efficacy of defibrotide. Methods: Patients diagnosed with VOD/SOS after allogenic HCT between 2003 and 2020 were enrolled. We investigated day +100 survival rates and associated risk factors in patients who satisfied the modified Seattle criteria within 50 days of HCT. Results: A total of 110 patients satisfied the modified Seattle criteria, of which 65.5% satisfied the Baltimore criteria. Thirty-seven patients were treated with defibrotide. The day +100 survival rate of the 110 patients was 65.3%. The survival rates in patients who did not meet the Baltimore criteria and in those who did were 86.8% and 53.7%, respectively (p = 0.001). The day +100 survival rate of patients treated with defibrotide was 50.5%. Among the patients receiving defibrotide, those whose creatinine levels were more than 1.2 times the baseline had a significantly lower survival rate at 26.7% (p = 0.014). On multivariate regression analysis, the hazard ratio of satisfaction of the Baltimore criteria was 4.54 (95% confidence interval [CI], 1.69 to 12.21; p = 0.003). In patients treated with defibrotide, the hazard ratio was 8.70 (95% CI, 2.26 to 33.45; p = 0.002), when creatinine was more than 1.2 times the baseline on administration. Conclusions The day +100 survival rate was significantly lower when the Baltimore criteria were satisfied, and when there was an increase in creatinine at the time of defibrotide administration.