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: To identify the longterm hemodynamics of various hepatic masses and to determine any differential findings by using postangiographic CT performed with increased amount of contrast media and time than conventional contrast CT. MATERIALS AND METHODS: 50 confirmed masses consisted of 22 hepatocellular carcinoma, 10 cholangiocarcinoma, 9 metastasis, and 9 cavernous hemangioma were included. The changes of the density of internal viable tumor portion relative to surrounding normal liver parenchyma in postangiographic CT from that in conventional CT were classified as 3 patterns; no specific changes, increase, or decrease. RESULTS: in 22 cases of hepatoceilular carcinoma, six cases showed no relative density change, four cases increase, and twelve cases decrease. In ten cases of cholangiocarcinoma, one case showed no change, nine cases increase. In nine cases of metastasis, four cases showed no change, five cases increase. In nine cases of hemangioma, all cases showed increase. CONCLUSION: In postangiographic CT which emphasize the significance of postequilibrium and delayed phase, other hemodynamic changes undetected in angiography could more easily be comprehended. Considering the differing amount of consumed contrast media and time duration, and with reference of other imaging modalities, differential diagnosis of hepatic masses based on longterm hemodynamics could easily be made.
Angiography ; Carcinoma, Hepatocellular ; Cholangiocarcinoma ; Contrast Media ; Diagnosis, Differential ; Hemangioma ; Hemangioma, Cavernous ; Hemodynamics ; Liver ; Neoplasm Metastasis ; Specific Gravity

Acute cavitating pulmonary infection with a mycetoma is sometimes occur in immunocompromised patient. Most mycetoma lesions are due to Aspergillus species, and lesion caused by Candida species is rare. So we report an experienced case that pulmonary and rib infection caused by Candida species-'in -AML patient and complete remission with previous reports.
Aspergillus ; Candida albicans* ; Candida* ; Candidiasis ; Humans ; Immunocompromised Host ; Lung Diseases, Fungal ; Mycetoma* ; Ribs

BACKGROUND: To determine the various sonographic findings in a papillary carcinoma of the thyroid. MATERIALS AND METHODS: 48 patients with a proven papillary carcinoma of the thyroid were involved. The sonographic features analyzed were the size, shape, content, margin, internal echo, and calcification pattern. RESULTS: Common sonographic features of a papillary carcinoma include the hypoechoic texture (94%), an ill defined margin (81%), a solid nodule (100%), irregular shape (48%), and microcalcifications (35%), or no calcifications (42%). The uncommon features included a hyperechoic or mixed echo texture, cystic elements, a well defined margin, and a coarse or peripheral calcifications. CONCLUSION: Ill-defined hypoechoic solid nodule with microcalcification is a characteristic ultrasonographic finding of a thyroid papillary carcinoma.
Carcinoma, Papillary* ; Humans ; Thyroid Gland* ; Thyroid Neoplasms ; Ultrasonography*

Silicone is widely used for medical purposes in breast augmentation and other cosmetic procedures. Illegal injections of silicone in human beings might have adverse effects and one of the serious problems is a silicone embolism. We experienced five cases of unusual respiratory difficulties after an injection of liquid silicone in the breast, vagina, uterus, and hip. They were all young adult females, who were previously healthy. One of them died after the injection. The three remaining patients were admitted because of dyspnea, coughing, chest discomfort and bilateral pulmonary infiltration after the silicone injection. A transbronchial lung biopsy and autopsy disclosed many oil like materials filling the alveolar septal capillaries. Three patients underwent a computed tomogram (CT), which revealed multifocal airspace consolidations at the peripheral and non-dependent portions of both lungs, which is a different finding from other thromboembolisms. Lung scans of the disclosed abnormalities were compatible with silicone induced pulmonary embolism.
Autopsy ; Biopsy ; Breast ; Capillaries ; Cough ; Dyspnea ; Embolism ; Female ; Hip ; Humans ; Lung ; Pulmonary Embolism* ; Respiratory Distress Syndrome, Adult ; Silicones* ; Thorax ; Thromboembolism ; Uterus ; Vagina ; Young Adult

BACKGROUND: Methods to reduce the amount of blood transfusion include perioperative hemodilution, hypotensive anesthesia, the transfusion of previously deposited autologous blood, and intraoperative autotransfusion used the cell saver. The purpose of this study is to evaluate the effect of the use of the cell saver in orthopedic spinal surgery. METHODS: One hundred and one patients for orthopedic spinal surgery were involved in this study and divided into two groups: group 1 (no used cell saver, n=51) and group 2 (used cell saver, n=50). We checked transfusion amounts during operation and the changes of hematocrit after operation. RESULTS: The amount of blood obtained from cell saver apparatus was 1220 +/- 651 ml (mean SD). Hematocrit of the autologous blood from this apparatus was 48.5 +/- 2.5%. Amounts of blood transfusion during operation were 4.1 +/- 0.9 IU (400 ml/IU) in group 1 and 2.5 +/- 0.7 IU in group 2 (p<0.05). The hematocrit was markedly decreased at the postoperative 2 and 3 days in group 2 (p<0.05). CONCLUSIONS: This study suggested that intraoperative salvage technique with cell saver apparatus could decrease the use of bank blood by 40% in orthopedic spinal surgery. However, we should be prepare the blood for the decrease of the hematocrit at the postoperative 2 and 3 days.
Anesthesia ; Blood Transfusion ; Blood Transfusion, Autologous ; Hematocrit ; Hemodilution ; Humans ; Orthopedics*

No abstract available.

The effects of pretreatment of Co-Cr alloy, including two adhesive primers that contain either MDP or MAC-10, and silicoating on the bond. The results obtained as follows : Strength of 4-META/MMA-TBB resin were investigated using FT-IR SEM, and EDAX. in the SEM observation of surface morphologies, the sandblasted specimen exibited a very rough surface, whereas the surfaces of the two groups primed with either MDR or MAC-10 were covered with a layer of primer, and the surface morphology of the silicoated specimen remained almost the same after sandblasting. Before the thermocycling tests, the group treated with MDP demonstrated the highest mean tensile bond strength and the sandblasted group showed the lowest bond strength. After 20,000 themocyling, the mean tensile bond strength of the sandblasted group exhibited a 50% reduction in bond strength, while the other showed a 20~30% reduction. Observation of the metal-resin interface revealed that in all groups the resin permeated the rough surface formed by sandblasting thereby producing a mechnical bond between the metal and the resin, It was also found that thermocycling resulted in a gap formation at the metal-resin interface of the specimens, and the sandblasted group exhibited a larger gap width than the other groups. in fracture mode, all specimens indicated a cohesive fracture within the resin before thermocycling. However, thermocyling produced adhesive failure at the edge of the resin-metal interface in most specimens, The sandblasted group, which exhibited the lowest bond strength after thermocycling, also demonstrated the largest area of adhexive failure.
Adhesives ; Alloys*

We report a case of squamous cell carcinoma arising in porokeratosis of Mibelli in a 32-year-old male who presented with a large, slowly extending, erythematous patch with central ulceration on the left lateral side of the neck. Histopathologic examination of the periphery of the patch and central tumor showed porokeratosis and squamous cell carcinoma, respectively.
Adult ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Male ; Neck ; Porokeratosis* ; Ulcer

We report two cases of proliferating trichilemmal cyst in a 61-ear-old woman and a 44-year-old woman who had a solitary tumor, on the left temporal area of the scalp and right flank, respectively. Histologically, the tumors were localized in the dermis and corisised of multilobulated cysts. The cyst walls were composed of liquamous epithelium showing trichilemmhl keratinization. Some of the cells had clear cytoplasm and were positive on PAS staining. Individiial cell keratinization, mild nuclear atypia were also found in the cyst walls. For the treatment, surgical excision was performed with sufficiert margin.
Adult ; Cytoplasm ; Dermis ; Epithelium ; Female ; Humans ; Scalp