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: The goal of this study was the early diagnosis of ABCB11 spectrum liver disorders, especially those focused on benign recurrent intrahepatic cholestasis and progressive familial intrahepatic cholestasis. METHODS: Fifty patients presenting neonatal cholestasis were evaluated to identify underlying etiologies. Genetic analysis was performed on patients suspected to have syndromic diseases or ABCB11 spectrum liver disorders. Two families with proven ABCB11 spectrum liver disorders were subjected to genetic analyses to confirm the diagnosis and were provided genetic counseling. Whole exome sequencing and Sanger sequencing were performed on the patients and the family members. RESULTS: Idiopathic or viral hepatitis was diagnosed in 34%, metabolic disease in 20%, total parenteral nutrition induced cholestasis in 16%, extrahepatic biliary atresia in 14%, genetic disease in 10%, neonatal lupus in 2%, congenital syphilis in 2%, and choledochal cyst in 2% of the patients. The patient with progressive familial intrahepatic cholestasis had novel heterozygous mutations of ABCB11 c.11C>G (p.Ser4*) and c.1543A>G (p.Asn515Asp). The patient with benign recurrent intrahepatic cholestasis had homozygous mutations of ABCB11 c.1331T>C (p.Val444Ala) and heterozygous, c.3084A>G (p.Ala1028Ala). Genetic confirmation of ABCB11 spectrum liver disorder led to early liver transplantation in the progressive familial intrahepatic cholestasis patient. In addition, the atypically severe benign recurrent intrahepatic cholestasis patient was able to avoid unnecessary liver transplantation after genetic analysis. CONCLUSION: ABCB11 spectrum liver disorders can be clinically indistinguishable as they share similar characteristics related to acute episodes. A comprehensive genetic analysis will facilitate optimal diagnosis and treatment.
Biliary Atresia ; Choledochal Cyst ; Cholestasis ; Cholestasis, Intrahepatic ; Diagnosis ; Early Diagnosis* ; Exome ; Genetic Counseling ; Hepatitis ; High-Throughput Nucleotide Sequencing ; Humans ; Hyperbilirubinemia ; Jaundice ; Liver Transplantation ; Liver* ; Metabolic Diseases ; Parenteral Nutrition, Total ; Syphilis, Congenital

PURPOSE: To evaluate the significance of T2-weighted MR imaging(T2WI) in the diagnosis of pituitarymicroadenoma. MATERIAL AND METHODS: We retrospectively evaluated the MR imaging findings of 30 cases of pituitarymicroadenoma. Diagnosis was made on the basis of surgery, serum hormonal level, and the presence of mass lesion onMR (T1WI and T2WI), and conventional as well as dynamic contrast enhanced T1WI images were obtained. In each MRsequence, signal intensity and detectability of the tumor were evaluated. We also determined whether diagnosis waspossible on both T1WI and T2WI. In eight cases, histopathologic findings (cellularity, fibrosis, and cysticchange) were correlated with T2 signal intensity of the tumor. RESULTS: T2WI, T1WI, and dynamic and conventionalenhanced T1WI detected the tumor in 21 cases (70%), 21 cases (70%), 28 cases (93.3%), and 22 cases (73.3%),respectively. On T2WI, pituitary microadenomas showed a high signal in 18 cases (60%), an iso-signal in nine(30%), and a low signal in three (10%) compared with normal pituitary gland. In 20 cases (66.7%), diagnosis ofpituitary microadenoma was possible on both T1WI and T2WI, but in one case, the tumor was detected only on T2WI.Three cases with fibrosis, as seen on histopathologic examination showed an iso or low signal on T2WI. CONCLUSION: T2WI is useful in the diagnosis of pituitary microadenoma Decreased signal intensity on T2WI may suggestfibrosis.
Diagnosis* ; Fibrosis ; Magnetic Resonance Imaging ; Pituitary Gland ; Retrospective Studies

The sparsity of publication concerning CT findings of tuberculous arthritis prompted authors to retrospectively evaluate 12 patients with tuberculous arthritis for characteristic CT findings. In each patient, the diagnosis of tuberculous arthritis was confirmed by surgery or biopsy. The CT examinations were evaluated by two radiologists retrospectively. Involved joints were the hip joint in seven patients, the sacroiliac joint in three parients, and the shoulder and ankle joint in one patients each. CT features included subchondral bony erosion(12 patients), soft tissue mass in the joint space(nine), widenining of the joint space(eight), ipsilateral muscle atrophy(eight), thickening of the joint capsule(seven), intra-articular effusion(six), soft tissue abscess(five),and bony sclerosis(four). In seven patients with the duration of symptoms less than 1 year, thickening of joint capsule and intra-articular effusion were the predominent findings, while bony sclerosis, gross bone destruction, and soft tissue mass in joint space were seen in five patients with the duration of symptoms longer than 1 year. Our results indicate that CT is useful in the diagnosis of tuberculous arthritis by demonstrating characteristic pathologic changes of the joint space, soft tissue abnormality and bony involvement.
Ankle Joint ; Arthritis* ; Biopsy ; Diagnosis ; Hip Joint ; Humans ; Joint Capsule ; Joints ; Publications ; Retrospective Studies ; Sacroiliac Joint ; Sclerosis ; Shoulder

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