OBJECTIVE: To test the hypothesis that a safety margin may affect local tumor recurrence (LTR) in subsegmental chemoembolization. MATERIALS AND METHODS: In 101 patients with 128 hepatocellular carcinoma (HCC) nodules (1-3 cm in size and < or = 3 in number), cone-beam CT-assisted subsegmental lipiodol chemoembolization was performed. Immediately thereafter, a non-contrast thin-section CT image was obtained to evaluate the presence or absence of intra-tumoral lipiodol uptake defect and safety margin. The effect of lipiodol uptake defect and safety margin on LTR was evaluated. Univariate and multivariate analyses were performed to indentify determinant factors of LTR. RESULTS: Of the 128 HCC nodules in 101 patients, 49 (38.3%) nodules in 40 patients showed LTR during follow-up period (median, 34.1 months). Cumulative 1- and 2-year LTR rates of nodules with lipiodol uptake defect (n = 27) and those without defect (n = 101) were 58.1% vs. 10.1% and 72.1% vs. 19.5%, respectively (p < 0.001). Among the 101 nodules without a defect, the 1- and 2-year cumulative LTR rates for nodules with complete safety margin (n = 52) and those with incomplete safety margin (n = 49) were 9.8% vs. 12.8% and 18.9% vs. 19.0% (p = 0.912). In multivariate analyses, ascites (p = 0.035), indistinct tumor margin on cone-beam CT (p = 0.039), heterogeneous lipiodol uptake (p = 0.023), and intra-tumoral lipiodol uptake defect (p < 0.001) were determinant factors of higher LTR. CONCLUSION: In lipiodol chemoembolization, the safety margin in completely lipiodolized nodule without defect will not affect LTR in small nodular HCCs.
Adult ; Aged ; Carcinoma, Hepatocellular/radiography/*therapy ; Chemoembolization, Therapeutic ; Cone-Beam Computed Tomography ; Ethiodized Oil/*administration & dosage ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/radiography/*therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local/radiography

OBJECTIVE: In the present study, we evaluate visual outcomes after surgical removal of craniopharyngiomas and analyze the factors that are considered to affect visual outcomes. METHODS: This study includes 30 patients with craniopharyngioma, who underwent surgery in this clinic during the last 10 years. The changes of visual function (visual acuity and field) of the patients were assessed preoperatively and postoperatively, and paired data of this change were compared. Also, the factors that influence on this change were analysed. RESULTS: Among the 21 patients complaining of decreased vision before the operation, 8 patients were improved (38.0%), and 7 patients were worse (33.3%). However, Four out of 9 patients without any preoperative visual symptoms developed worse vision after the operation (44.4%). The average duration of symptom was 17.2 months in the improved group and 23.6 months in the aggravated group. The tumors recurred in only 5 patients after the gross total resection: Four of them showed the aggravation of visual function after surgical removal and 1 had improvement. CONCLUSION: After removal of craniopharyngiomas, the overall rate of vision improvement, no change and aggravation are 26.6%, 36.7% and 36.7%, respectively. Aggravation of postoperative visual function is higher in males, children and patients with a longer duration of symptom and the tumor recurres more frequently in patients who complained of worsened vision after surgical removal.
Child ; Craniopharyngioma* ; Humans ; Male

PURPOSE: To determine whether gadolinium enhancement is helpful in rectal tumor staging determined by MRI and using an endorectal surface coil. MATERIALS AND METHODS: Between January 1995 and July 1996, we studied 17 MRI scans in which the scanning procedure had involved the use of an endorectal coil ; this was a prostate coil in six patients, and a colon coil in eleven. Eight patients were male and nine were female ; they were aged between 39 and 77 (mean, 59) years, and the tumors which had presented were adenocarcinoma (n=15), lymphoma (n=1) and villous adenoma (n=1). Precontrast scanning showing invasion of the rectal wall and perirectal fat were interpreted, and postcontrast T1WI and pathological findings were then compared. Fifteen patients underwent surgical resection but the other two (one adenocarcinoma and one lymphoma) underwent only an endoscopic biopsy. RESULTS: On precontrast scanning with the prostate coil, accurate staging was possible in three cases (one of stage T2, and two of stage T3) ; we overstaged two cases of stage T2 as stage T3. On postcontrast T1WI, however, we additionally understaged one case of stage T3 as stage T2. In a case of adenocarcinoma proven by biopsy, no definite difference was noted between pre- and postenhanced scan. On precontrast scan using a colon coil, accurate staging was possible in six cases (two of stage T1, one of stage T2 and three of stage T3). We overstaged a case of stage T2 as stage T3 and understaged three cases of stage T3 as stage T2. On postcontrast T1WI, however, we accurately diagnosed one additional case of stage T3, not diagnosed on precontrast scan. In one case of bioptically-proven lymphoma, no definite difference was noted between pre- and postenhanced scan. CONCLUSION: In rectal tumor staging, pre- and postenhanced scans are both 60% accurate. In MRI using an endorectal surface coil, gadolinium enhancement is not, therefore significantly helpful.
Adenocarcinoma ; Adenoma, Villous ; Biopsy ; Colon ; Female ; Gadolinium* ; Humans ; Lymphoma ; Magnetic Resonance Imaging* ; Male ; Prostate ; Rectal Neoplasms*

PURPOSE: To assess the relationship between splenic transient inhomogeneous contrast enhancement(CE) on the arterial phase of spiral CT, and splenic volume, and to classify the CE pattern in liver cirrhosis. MATERIALS AND METHODS: We measured the splenic volume of 120 patients, 60 showed inhomogeneous splenic CE on arterial phase,and 60 showed homogeneous splenic CE. CT scans with intrinsic splenic pathology were excluded. Sixteen patients with clinically confirmed liver cirrhosis were included. Splenic volumes of the inhomogeneous and homogeneous CE group were compared. The inhomogeneous group was divided into three grades according to areas of non-enhanced portion (grade I, focal geographic ; grade II, multifocal patchy, grade III, extensive serpentine inhomogeneous CE) , and these were correlated with splenic volume. RESULTS: Among the 60 inhomogeneous CE scans, 23 cases(38.3%) showed splenomegaly (spleen volume>220cm3); in contrast, this applied to only 8 cases (13.3%) of the 60 homogeneous CE scans. Mean splenic volume in the inhomogeneous CE group (226.74+/-129.78cm3) was greater than in the homogeneous CE group (184.56+/-77.44cm3) (p<0.033). A larger splenic volume and extensive inhomogeneous CE(grade III) were noted, and most liver cirrhosis patients(14/16) were grade III. Three such patients who had shown inhomogeneous splenic CE on arterial phase showed inhomogeneous CE even on portal phase. CONCLUSION: Inhomogeneous splenic CE on arterial phase was more common in cases of an enlarged spleen, and more extensive in liver cirrhosis. These findings suggest hemodynamic change of the spleen may be a contributory factor.
Hemodynamics ; Humans ; Liver Cirrhosis ; Pathology ; Spleen* ; Splenomegaly ; Tomography, Spiral Computed* ; Tomography, X-Ray Computed

OBJECTIVES: This study was conducted to determine whether nano-sized carbon black exposure results in greater damage in high fat diet-induced overweight rats than normal weight ones and to identify the possible causes of any differences. METHODS: Two groups of Sprague-Dawley rats allocated by body weight (normal and overweight) were exposed to aerosolized nano-sized carbon black for 6 hours a day, 5 days per week over a 4-week period. Differential cell counts, lactate dehydrogenase (LDH) activities and albumin concentrations were measured in bronchoalveolar lavage (BAL) fluid, and histopathological findings in the lungs were evaluated. Tumor necrosis factor-alpha (TNF-alpha) and interleukin (IL)-6 were measured in BAL fluid and supernatants of lipopolysaccharide(LPS)-stimulated lymphocyte culture. RESULTS: Rats exposed to high concentrations of nano-sized carbon black showed significantly increased (p<0.05) polymorphonuclear leukocyte number and LDH activity in the BAL fluid from both overweight and normal rats. Mild histopathological changes were observed in normal rats irrespective of carbon black concentrations. However, severe histological scores were found in overweight rats (1.75+/-0.46, 2.25+/-0.46, and 2.88+/-0.35 after low, medium, and high concentration exposures). Proinflammatory cytokine levels of TNF-alpha and IL-6 were significantly higher in the supernatant of LPS-stimulated lymphocytes of overweight rats, whereas there was no significant difference in the BAL fluid between normal and overweight rats. CONCLUSIONS: Inflammation and damage to lungs exposed to nano-sized carbon black was more severe in high fat diet-induced overweight rats compared to normal rats.
Animals ; Body Weight ; Bronchoalveolar Lavage ; Carbon* ; Cell Count ; Inflammation ; Inhalation ; Interleukin-6 ; Interleukins ; L-Lactate Dehydrogenase ; Lung* ; Lymphocytes ; Neutrophils ; Obesity ; Overweight* ; Rats* ; Rats, Sprague-Dawley ; Soot* ; Tumor Necrosis Factor-alpha

An inflammation of an epiploic appendage is a relatively rare cause of acute abdominal pain. It can be clinically misdiagnosed as either acute appendicitis or diverticulitis. Judicious interpretation of imaging with ultrasound or computed tomography may lead to an early diagnosis and prevent unnecessary surgical or medical treatment. Conservative treatment of symptoms is usually sufficient. We have experienced a case of epiploic appendagitis treated by conservative management and report this case with the review of the literature.
Abdomen* ; Abdominal Pain ; Appendicitis ; Diverticulitis ; Early Diagnosis ; Inflammation ; Ultrasonography

OBJECTIVES: To identify prevalence of dementia and it's subtypes in patients with Hansen's disease in a sanatorium of Korea. METHODS: The study employs a two-stage design for case identification. One hundred-six patients with Hansen's disease aged 65 and over participated in the study. The Korean Version of the Consortium to Establish a Registry for Alzheimer's disease (CERAD-K) assessment packet was administered to One hundred-two patients with Hansen's disease. Dementia was defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnostic features of dementia. RESULTS: The prevalence was 15.1% in Hansen's sanatorium. The prevalence of Alzheimer's and vascular dementia were 10.4% and 4.7%. The age-adjusted prevalence rate for dementia was 11.9%. The rate of patients with dementia was 12.73% in males and 17.65% in females. CONCLSION: The prevalence of dementia in Hansen's disease sanatorium of Korea appears to be similar with those reported in previous study. Our result suggests that Hansen's disease was unrelated to prevalence of dementia, and also that the dementia is major neuropsychiatric disease in patient with Hansen's disease.
Alzheimer Disease ; Dementia* ; Dementia, Vascular ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Humans ; Korea* ; Leprosy* ; Male ; Prevalence*

Acute renal infarction is a rare disease and it is often difficult to make a clinical diagnosis due to the non-specific clinical presentations and lack of the physicians' awarenesses. We experienced a case of a 72-year-old man who was diagnosed as multiorgan with renal infarction during the bridge therapy of cerebral infarction with atrial fibrillation. Computed tomogram (CT) with intravenous contrast of the abdomen and pelvis revealed left renal infarction with renal artery occlusion, multifocal splenic infarction, and ischemic colitis on rectum and sigmoid colon. The patient was treated with low molecular weight heparin for 10 days, his symptoms were improved and laboratory findings were normalized. Follow-up CT was performed on the 43th day, there were persisted left renal infarction with atrophic change shown and the splenic perfusion was improved.
Abdomen ; Atrial Fibrillation ; Awareness ; Cerebral Infarction ; Colitis, Ischemic ; Colon, Sigmoid ; Follow-Up Studies ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Pelvis ; Perfusion ; Rare Diseases ; Rectum ; Renal Artery ; Splenic Infarction

This study was performed to investigate the effects of a levan diet on the body fat accumulation and serum lipid composition of 29 Korean women over a period of up to 12 weeks (n = 13 for the control group, n = 16 for the levan group). The subjects ate an uncooked diet (6 g) with 400 ml of tap water twice a day. The mean body weight and height measurements of the subjects (levan group) at the outset were 66.0 +/- 8.8 kg and 156.7 +/- 5.3 cm, respectively. The subjects showed a significant reduction in weight, body fat mass, anthropometric measurements and skinfold thickness during the experimental period. The waist hip ratio (WHR) was 0.88 +/- 0.03 at the outset, and fell to 0.82 +/- 0.05 after 4 weeks. The intake of levan was also influenced on the levels of serum Fe, leptin, lipoprotein lipase, HDL-cholesterol, LDL-cholesterol, and triglyceride. The serum glucose levels were within the normal range during the experimental period. The initial serum triglyceride level was 121 mg/dl, but fell to 103 mg/dl after 4 weeks of levan supplementation. The current study demonstrates that a levan diet is effective in controlling weight, body fat, HDL-cholesterol, LDL-cholesterol, and triglyceride levels.
Adipose Tissue* ; Blood Glucose ; Body Weight ; Diet ; Female ; Fructose* ; Humans ; Hyperlipidemias ; Leptin ; Lipoprotein Lipase ; Obesity ; Polymers* ; Reference Values ; Skinfold Thickness ; Triglycerides ; Waist-Hip Ratio ; Water

PURPOSE: To determine the prevalence of dry eye disease (DED) and risk factors among young people based on the Ocular Surface Disease Index (OSDI) questionnaire. METHODS: The authors of the present study distributed the OSDI questionnaire to 263 university students. DED was diagnosed when the OSDI score was greater than 13 points. According to the OSDI score, DED was classified as mild (13-22 points), moderate (23-32 points), or severe (33-100 points). Additionally, the associations between the OSDI score and possible risk factors such as gender, contact lens use and allergic conjunctivitis were studied. RESULTS: Of 263 students, diagnosed DED was present in 133 (50.6%) and severe cases of DED were observed in 49 (18.6%). A high OSDI score was associated with female sex (p < 0.01), a history of allergic conjunctivitis (p = 0.02), contact lens use (p < 0.01), self-awareness of the dry eye symptoms (p < 0.01) and a history of clinically diagnosed DED (p < 0.01). CONCLUSIONS: Prevalence of DED, which has been reported to be high in the elderly, was considered high at 50.6% among young people in the present study. Caution or education regarding DED is necessary for people who have a high OSDI score, particularly females, contact lens wearers and people with allergic conjunctivitis.
Aged ; Conjunctivitis, Allergic ; Eye ; Eye Diseases ; Female ; Humans ; Prevalence ; Surveys and Questionnaires ; Risk Factors ; Young Adult