PURPOSE: To obtain the useful information about tumor behavior of hepatocellular carcinoma by analyzing the recurrence pattern after curative resection. MATERIALS AND METHODS: Forty-two patients who underwent curative resection of hepatocellular carcinoma were analyzed. Based on the firstly detected radiologic recurrence, we classified recurrence patterns into three types, type I;marginal recurrence, type II;intrahepatic nodular(multiple, single) and type III;extrahepatic. We also analyzed its duration of recurrence after curative resection. RESULTS: Eighteen patients showed no radiologic recurrence during follow-up period(mean 19.2 months). Twenty-four patients showed radiologic recurrence at 29 sites and its mean duration was 11.0 months. Recurrence patterns were seven cases in type I, 14 cases in type II(multiple 11, single three), eight cases in type III including two omental, two extrahepatic lymph node, two brain, one spine, and one intracranial metastasis. Among the extrahepatic recurrences, five cases showed only distant metastasis without hepatic recurrence. Mean duration of recurrence according to the site was 16.0 months in type I, 12.6 months in type II, 12.3 months in type III. Among 20 patients with single site recurrence, type 11(9.0 months) was earlier than type 1(10.3 months). CONCLUSION: lntrahepatic recurrence is more common than extrahepatic recurrence. Intrahepatic nodular, especially multinodular recurrence, is more common than marginal recurrence. Intrahepatic recurrence has tendency to develope earlier metastain earlier than marginal recurrence.
Brain ; Carcinoma, Hepatocellular* ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Recurrence* ; Spine

PURPOSE: This study aimed to explore how prevalent the community-related methicillin-resistant Staphylococcus aureus (CA-MRSA) was in children with muscular-skeletal infections. METHODS: We retrospectively reviewed the medical records of patients of 18 years or under who were diagnosed with suppurative arthritis or osteomyelitis and S. aureus from September 2000 through August 2012 at the CHA Bundang Medical center. RESULTS: Thirty-one cases of suppurative arthritis or osteomyelitis were identified. The patients were between 17 days old and 18 years old with an average age of 7. Eleven cases (33.5%) of suppurative arthritis and 16 cases (51.6%) of osteomyelitis were observed. Five cases were accompanied by the two diseases. Methicillin sensitive S. aureus (MSSA) was isolated in 25 cases (80.6%) and methicillin resistant S. aureus (MRSA) was isolated in 6 cases (19.4%). Multidrug resistant strains were not observed. MRSA was not found from 2000 through 2005. All patients were treated with antibiotics and the duration of antibiotics treatment was 26.4+/-12.7 days. Vancomycin was used as the initial antibiotic treatment in 4 cases (12.9%) and vancomycin was used as the definitive antibiotics in the 10 cases (32.3%). CONCLUSIONS: The result of this study showed that methicillin resistance rate of S. aureus from muscular-skeletal infections was concentrated in the latter half of the 12 year period.
Anti-Bacterial Agents ; Arthritis, Infectious ; Child ; Humans ; Medical Records ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Retrospective Studies ; Vancomycin

No abstract available.
Fontan Procedure*

PURPOSE: The purpose of this study is to investigate the clinical manifestations and antibiotic resistance of salmonellosis in children. METHODS: We reviewed medical records and investigated the clinical characteristics of culture-proven childhood salmonellosis from January 2000 through December 2011 at the CHA Bundang Medical center. RESULTS: We assessed 53 patients. The median age was 3-years-old (minimum 12 days, maximum 18-years-old) and the number of male patients was 33 (62.3%). It occurred most frequently in the summer (39%) and in 2001 (11 cases) however there was no case in 2009 and 2010. Salmonella typhi was isolated in 3 cases with septicemia. Antibiotic resistance to ampicillin was most frequently presented (30.2%) and 63.6% in serogroup B. No antibiotics resistance strains were cultured in patients with positive Salmonella typhi. Admitted patients from 2000 to 2011 were divided into 2 groups; group 1 from 2000 to 2005 and group 2 from 2006 to 2011. 40 cases belonged to group 1 and 13 cases were in the group 2. Group 2 showed more resistance to ampicillin than group 1 but without any statistical significance(25% vs. 38.5%, P=0.349). In group 1, the most common serotype was group D and in group 2, the most common serotype were group C and D. CONCLUSION: Salmonellosis in children was frequently occurred from 2000 to 2003 but decreased after 2004. There was no difference in clinical manifestations, serotypes and antibiotic resistances between the years.
Ampicillin ; Anti-Bacterial Agents ; Child ; Drug Resistance, Microbial ; Humans ; Male ; Medical Records ; Salmonella Infections ; Salmonella typhi ; Sepsis

BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax

No abstract available.
Ectoderm* ; Ectodermal Dysplasia* ; Prosthodontics*

Gall bladder wall varices are unusual manifestations of protal hypertention. Authors report 4 cases of gall bladder wall varices which were easily detected in IV bolus CT. All of our cases showed main portal vein obstruction but preserved intrahepatic portal flows with development of cavernous transformation. We could easily identify tortous and tubular structures with strong contrast enhancement in the gall bladder wall, compatible with gall bladder wall varices, at the early phase of IV bolus CT. Comparing with Doppler sonography, IV bolus CT is an easy and useful method for detection of gall bladder wall varices even in case of no prior information for portal vein abnormality.
Diagnosis* ; Methods ; Portal Vein ; Urinary Bladder* ; Varicose Veins

Higher cognitive functions refer to the highest level of human intellectual functioning, including formation, reasoning, and executive functions. The executive functions can be conceptualized as having four components ; volition, planning, purposive action, and effective performance. Because higher cognitive functions represent the most advanced stages of intellectual development, they are often highly susceptible to the effects of brain injuries and mental disorders. The ability to perform effectively within the environment is determined in large part by an individual's adequacy in performing such higher-order function. Especially executive functions are necessary for appropriate, socially responsible, and effectively sell-serving adult conduct. Therefore, an assessment of the psychiatric patient's performance in these areas will provide useful diagnostic information, as well as information concerning social and vocational prognosis.
Adult ; Brain Injuries ; Executive Function ; Humans ; Mental Disorders ; Prognosis ; Volition

STUDY DESIGN: The treatment of a stable fracture around thoracolumbarjunction is a controversial subject. OBJECTIVES: To evaluate the result from long term follow-up of the stable spinal fracture around thoracolumbar junction according to the operation, osteoporosis and in situ extension bar, respectively. SUMMARY OF BACKGROUND DATA: The thoracolumbar junction is a transitional zone in which the kyphotic angle of thoracic spine is continued to the lordotic angle of lumbar splne. So it is prone to be injured biomechanically, and the stability of the spine around thoracolumbar junction is not determined yet. METHODS: We studied retrospectively 105 cases of the stable fracture around thoracolumbar junction from January 1985 to December 1995. The criteria of the stability were a compression fracture by Denis F., a bursting fracture without involvement of posterior column, a neural enchroachment of bony fragment below 30%, fracture without subluxation or dislocation in spinal junction. RESULTS: The most common cause was traffic accident and, the first lumbar vertebrate was common site. Below 30% of initial compression, the progression was not exceded 5% in operative group. But in nonoperative group, anterior compression was more progressed than initial compression over 5%. The degree of anterior compression was affected by osteoporosis and in situ extension bar just after injury. CONCLUSIONS: We suggest an anterior compression abode 30% in spinal body of thoracolumbar junction for an additional operative indication. The prognosis may be affected by osteoporosis and in situ extension bar.
Accidents, Traffic ; Dislocations ; Follow-Up Studies* ; Fractures, Compression ; Osteoporosis ; Prognosis ; Retrospective Studies ; Spinal Fractures ; Spine ; Vertebrates

No abstract available.
Dental Implantation* ; Dental Implants* ; Osseointegration*