PURPOSE: Computed tomographic(CT), ultrasonographic(US) findings of solid and papillary epithelial neoplasm of the pancreas were correlated with pathologic findings for the better understanding of this disease entity. METHODS AND MATERIALS: A retrospective review of CT and US of 14 cases of solid and papillary epithelial neoplasm of the pancreas was carried out in terms of the margin, internal architecture, caicification and septation, and this was correlated with gross pathologic findings. RESULTS: CT and US findings were well defined round masses consisting of both solid and cystic components. Five cases were cystic, four cases were solid and five cases were mixed. Cystic portion of the tumor represented variable degree of hemorrhagic necrosis. Six cases contained foci of calcification, which were linear, marginal and amorphous. Marginal calcification interfered US examination of the mass in three cases. Internal septurn was demonstrated in four cases on CT, one case on US and three cases on gross specimen. CONCLUSIONS: Our results indicate that calcification and internal septurn were considered as a part of radiologic findings in solid and papillary epithelial neoplasm of the pancreas.
Necrosis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. MATERIALS AND METHODS: First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. RESULTS: Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. CONCLUSION: Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.
Humans ; Voice Disorders* ; Voice*

Limb-shaking transient ischemic attack is a rare disease, associated with the steno-occlusion of the internal carotid artery. It is caused by hemodynamic dysfunction in the anterior circulation. It is difficult to observe patients directly in clinical settings since they visit the hospital after symptoms have subsided which usually last less than 5 minutes. Here we report a atient who developed right arm dominant myoclonus related to left internal carotid artery occlusion along with a recorded video.

Limb-shaking transient ischemic attack is a rare disease, associated with the steno-occlusion of the internal carotid artery. It is caused by hemodynamic dysfunction in the anterior circulation. It is difficult to observe patients directly in clinical settings since they visit the hospital after symptoms have subsided which usually last less than 5 minutes. Here we report a atient who developed right arm dominant myoclonus related to left internal carotid artery occlusion along with a recorded video.

Persons with disabilities use more health care services due to ill health and face higher health care expenses and burden. This study explored the incidence of catastrophic health expenditures of households with persons with disabilities compared to that of those without such persons. We used the Korean Health Panel (KHP) dataset for the years 2010 and 2011. The final sample was 5,610 households; 800 (14.3%) of these were households with a person with a disability and 4,810 (85.7%) were households without such a person. Households with a person with a disability faced higher catastrophic health expenditures, spending about 1.2 to 1.4 times more of their annual living expenditures for out-of-pocket medical expenses, compared to households without persons with disabilities. Households having low economic status and members with chronic disease were more likely to face catastrophic health expenditures, while those receiving public assistance were less likely. Exemption or reduction of out-of-pocket payments in the National Health Insurance and additional financial support are needed so that the people with disabilities can use medical services without suffering financial crisis.
Aged ; Databases, Factual ; Delivery of Health Care/*economics ; Disabled Persons ; Health Expenditures/*statistics & numerical data ; Humans ; Middle Aged ; National Health Programs ; Odds Ratio ; Republic of Korea

No abstract available.
Humans

PURPOSE: To compare ADC mapping with trace mapping in normal and infarct areas of the brains of strokepatients. MATERIALS AND METHODS: Eighteen patients diagnosed on the basis of clinical and brain MRI examinationsas suffering from brain infarction were included in this study (hyperacute-1, acute-4, subacute-12, chronic-1).Diffusion weighted images of three orthogonal directions of a patient's brain were obtained by means of a singleshot EPI pulse sequence, using a diffusion gradient with four serial b-factors. Three ADC maps were thenreconstructed by post-image processing and were summed pixel by pixel to yield a trace map. ROIs were selected inthe normal areas of white matter, gray matter and CSF of one hemisphere, and other ROIs of the same size wereselected at the same site of the contralateral hemisphere. ADC and trace values were measured and right/leftratios of ADC and trace values were calculated. Using these values, we then compared the ADC map with the tracemap, and compared the degree of anisotropic diffusion between white matter, gray matter and CSF. Except for three,whose infarct lesions were small and lay over white and gray matter, patients were divided into two groups. Thosewith infarct in the white matter (n=10)were assigned to one group, and those with in-farct in the gray matter(n=5) to the other. ROIs were selected in the infarct area and other ROIs of the same size were selected at thesame site of the contralateral hemisphere. ADC and trace values were measured and infarct/contralateral ratioswere calculated. We then compared ADC ratio with trace ratio in white matter and gray matter infarct. RESULTS: Innormal white matter, the Dxx ratio was 0.980 +/-0.098, the Dyy ratio 1.019 +/-0.086, the Dzz ratio 0.999 +/-0.111,and the trace ratio 0.995 +/-0.031. In normal gray matter, the Dxx ratio was 1.001 +/-0 . 0 5 8 , the Dyy ratio0.996 +/-0.063, Dzz ratio 1.005 +/-0.070, and the trace ratio 1.001 +/-0.028. In CSF, the Dxx ratio was 1.002+/-0.064, the Dyy ratio 1.023 +/-0.055, the Dzz ratio 0.999 +/-0.060 and the trace ratio 1.007 +/-0 . 0 2 1. Becausethe standard deviation of trace ratios (<0.05) is less than that of ADC ratios (>0.05), the trace ratio is moreaccurate representative value. The standard deviation of white matter is greater than that of gray matter or CSF(p<0.05), the degree of anisotropic diffusion in white matter is therefore more severe than in gray matter andCSF. The difference between the ADC ratios and trace ratio is greater in an infarct involving white matter than inone involving gray matter (p<0.05). CONCLUSION: Because a trace map overcomes the anisotropic diffusions of ADCmaps, the former offers better post-image processing. The deviation of ADC ratios owing to the direction ofdiffusion gradient is greater in white matter than in gray matter, and the trace map is thus superior forevaluation of an infarct involving white matter.
Brain Infarction ; Brain* ; Diffusion ; Humans ; Magnetic Resonance Imaging

BACKGROUND: Philadelphia(Ph) chromosome is found in about 95 percent of chronic myelogenous leukemia(CML) patients. Ph chromosome results from a reciprocal translocation between the long arms of chromosomes 9 and 22, and the fusion gene, BCR-ABL contribute to oncogenesis. Three to five years after first diagnosis, CML progresses to the blast crisis, and is accompanied by secondary cytogenetic changes in about 85% of cases. In this study, we investigated the incidence of ABL deletion of derivative 9 chromosome in CML and evaluated the association between this deletion and progression to the blast crisis by interphase fluorescence in situ hybridization(FISH). METHOD: The subjects included in this study were a consecutive series of 58 patients who were diagnosed as CML at Seoul National University Hospital between January 1997 and April 2000. On 90 archival bone marrow aspirate samples from these 58 CML patients, interphase FISH was performed with a commercially available probe. RESULTS: The ABL deletion of derivative 9 chromosome was detected in 17(29.3%) of 58 patients with CML. Eighteen of 58 patients progressed to blast crisis in this period. ABL deletion was found in 7 of 18 patients with blast crisis, and not in 11 remainders. The mean duration from the diagnosis to blast crisis was 37.1 months in 7 patients with the ABL deletion, while the mean duration was 74.2 months in 11 patients without the ABL deletion. The mean duration from the diagnosis to blast crisis in patients with ABL deletion was significantly shorter than in patients without ABL deletion(P=0.043). CONCLUSIONS: We found that 29.3% of patients with CML had the ABL deletion on derivative 9 chromosome. In these patients, the time taken for evolution to blast crisis was significantly shorter than that of the patients without ABL deletion.
Arm ; Blast Crisis* ; Bone Marrow ; Carcinogenesis ; Cytogenetics ; Diagnosis ; Fluorescence* ; Humans ; Hydrogen-Ion Concentration ; In Situ Hybridization* ; Incidence* ; Interphase* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive* ; Philadelphia Chromosome ; Seoul

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

BACKGROUND: JC virus (JCV) is a polyomavirus that commonly infects humans and can cause progressive multifocal leukoencephalopathy in immunocompromised patients. Recently, many reports have documented detection of JCV in gastrointestinal tract cancers. We investigated the presence of JCV in gastric adenocarcinoma, adenoma, and non-neoplastic gastric mucosa. METHODS: We selected paraffin-embedded tissue from endoscopic mucosal resections performed from January 2007 to September 2008. DNA was extracted from the paraffin-embedded specimens of 30 adenocarcinomas, 20 adenomas of the stomach, and 20 non-neoplastic gastric mucosa. Polymerase chain reaction amplifications were performed using gene-specific primers to detect the JCV gene sequences, and immunohistochemical staining was performed to detect the T-antigen (T-Ag) protein. RESULTS: The T-Ag sequence was detected in nine of 30 gastric cancers (30%), two of 20 adenomas (10%), and eight of 20 non-neoplastic gastric mucosa specimens (40%). T-Ag protein expression was found in five of 30 gastric cancers (16.7%) and one of 20 non-neoplastic gastric mucosa specimens (5%), whereas no expression was observed in any of the adenomas. CONCLUSIONS: Although we could not detect a correlation between JCV and gastric cancer, we demonstrated the presence of JCV T-Ag expression in human gastric cancers. These findings suggest a possible role for JCV in gastric carcinogenesis.
Adenocarcinoma ; Adenoma ; Antigens, Viral, Tumor ; DNA ; Gastric Mucosa ; Gastrointestinal Neoplasms ; Humans ; Immunocompromised Host ; JC Virus ; Leukoencephalopathy, Progressive Multifocal ; Polymerase Chain Reaction ; Polyomavirus ; Stomach ; Stomach Neoplasms