We performed 70 proceudres of transarterial chemoembolization (TAE) through extrahepatic collateral vessels (n=27) or parasitic feeders (n=18) in 45 hepatocellular carcinoma patients. The collaterals developed after interruption of the hapatic artery due to repeated TAE(n=17), surgical ligation(n=7) and primary celiac occlusion (n=3). Radiologic findings suggesting the existence of parasitic or collateral supply for hepatocellular carcinoma were 1) a focal defect of Lipiodol retention on CT or plain film after TAE via the hepatic artery, 2) dilated and tortuous vessels around the mass on angiography, 3) persistent elevation of the level of serum alpha fetoprotein or continuous clinical symptoms in spite of sufficient devascularization of the tumor via the hepatic artery, and 4) radiological findings of direct invasion into adjacent organ. The sites of the catheter placement were the inferior phrenic artery (n=19), omental branches (n=16), periportal collaterals (n=6), pancreaticodenal arcade (n=3), gastroduodenal artery (n=3), internal mammary artery (n=2), intercostal artery (n=2), lateral thoracic artery (n=1), bronchial artery(n=1), and colic branches(n=1). Masses feeded by the inferior phrenic and chest wall collaterals were usually located at the dome area of the liver, and the omental and gastroduodenal collaterals developed in the masses located at the inferior tip of the liver. After TAE via collateral vessels, 37 patients underwent follow-up study. In 18 cases(48%), the tumor favorably responded to TAE. Specific complications of collateral TAE were epigastric soreness (n=10), severe shoulder pain (n=4), and embolization of the spinal artery during embolization through the intercostal artey (n=1). In conclusion, various extrahepatic collaterals are important alternative or additional routes for effective chemoembolization in patients with advanced hepatoma, and early recognition of the parasitic supply and the effort to perform TAE via collaterals is very important for effective management of the patients with the hepatoma.
alpha-Fetoproteins ; Angiography ; Arteries ; Carcinoma, Hepatocellular* ; Catheters ; Colic ; Ethiodized Oil ; Follow-Up Studies ; Hepatic Artery ; Humans ; Liver ; Mammary Arteries ; Shoulder Pain ; Thoracic Arteries ; Thoracic Wall

PURPOSE: To evaluate the frequently of low ahetenuation area in enhanced CT scans of non-Hodgkin lymphoma(NHL) and to find out if there is any pertinent relationship between this and the histopathologic classification. MATERIALS & METHODS: The authors reviewed CT scans in the newly diagnosed 53 patients with NHL. We defined the-low attenuation area as the one with CT attenuation value lower than that of the muscle, surrounding lesion, or other lymph nodes after contrast enhancement. NHL with the low attenuation areas were correlated with the histopathologic findings according to the classification based on the Working Formulation and the frequency of the lesion was evaluated. RESULT: Of the 53 patients, the low attenuation area was found in 13 patients (25%) at CT. The histopathologic classification could be made in 12 patients, among whom one patient was classified as low grade, six as intermediate grade, and five as high-grade. Concerning the specific cell typing, the diffuse large cell type was most common in intermediate-grade NHL seen in five patients and the large cell, immunoblastic type was most common in high-grade NHL seen ih three patients. CONCLUSION: The authors concluded that the low attenution area within lymphoma is not an infrequent finding at CT, and there was no stastistically significant correlation between this finding and the prognostic grading of the Working Formulation.
Classification ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Tomography, X-Ray Computed

We herein report a case of occupational contact urticaria syndrome induced by cefotiam di-hydrochloride in a nurse. She had generalized pruritic wheals accompanied by palpitations and tachypnea during the preparation of cefotiam solution. A scratch patch test with cefotiam di-hydrochloride, a major component of cefotiam ingredient showed multiple erythema and wheals within 5 minutes, accompanied by palpitations and tachypnea. No delayed type reaction was observed. Based on her clinical history and scratch test result, we diagnosed her condition as contact urticaria syndrome caused by cefotiam.
Cefotiam* ; Erythema ; Patch Tests ; Tachypnea ; Urticaria*

Acral persistent papular mucinosis is a subtype of the localized papular mucinosis. Clinically, ivory to flesh-colored papules develop exclusively on the back of the hands, the extensor surface of the wrists, and occasionally the distal forearms. Histologically, mucin accumulates in the upper reticular dermis, typically sparing a subepidermal zone and fibroblasts are not increased in number. On experiencing a case of numerous papules on both hands and forearms of a fifty year-old woman, we present it as acral persistent papular mucinosis.
Dermis ; Female ; Fibroblasts ; Forearm ; Hand ; Humans ; Mucins ; Scleromyxedema* ; Wrist

No abstract available.
Pulmonary Artery* ; Takayasu Arteritis*

Yonsei University College of Medicine, Seoul, Korea Maffucci's syndrome is characterized by dysccondroplasia with hemangiomata. Since Angelo Maffucci (1881) first described this entity, 105 cases and some more were reported in the literature till 1976. We recently observed a patient suffering from this disorder. The patient is 21 year-old girl, who has multiple hemangiomes on her right foot, right buttock, left wrist and enchondromas on both proximal phalanx, distal phalanx of both great toes and proximal, middle phalanx of right second toe. The disease started at age of 11 and these lesions grew rapidly last 3 years. The diagnosis was based on clinical, radiological and histological findings. Because of its rarity, we report it with brief review of literature.
Buttocks ; Chondroma ; Diagnosis ; Female ; Foot ; Humans ; Korea ; Osteochondrodysplasias ; Seoul ; Toes ; Wrist

Purpose: To evaluate the potential advantages of using topical rebamipide 2% to manage dry eye following cataract surgery. Methods: Patients who underwent cataract surgery (phacoemulsification and intraocular lens insertion) were evaluated for dry eye 1 week postoperatively. Randomly selected patients were divided into the rebamipide group, who received 2% rebamipide eye drops, and the control group, who did not receive rebamipide. Various dry eye-related tests, including Schirmer’s test, the tear break-up time (TBUT), ocular surface staining, tear film osmolarity, tear lipid layer thickness, and the ocular surface disease index (OSDI) were performed in both groups 1 week, and 1 and 2 months postoperatively. Results: In the rebamipide group, we observed significant improvement in TBUT, the ocular surface staining score, and OSDI at 2 months postoperatively, as compared to 1 week (p = 0.002, 0.014, and 0.013, respectively). Schirmer’s test, tear film osmolarity, and tear lipid layer thickness remained unchanged in the rebamipide group. Throughout the entire follow-up period, the rebamipide group had a significantly prolonged TBUT (1 month: p = 0.007, 2 months: p = 0.000), and lower ocular surface staining score (1 month: p = 0.000, 2 months: p = 0.000), as compared to the control. Conclusions Following cataract surgery, the use of rebamipide eye drops produced improvements in TBUT, ocular surface staining scores, and OSDI. This suggests that rebamipide offers benefits in managing dry eye that can occur after cataract surgery.

PURPOSE: To evaluate characteristic MR findings of primary cardiac and pericardiac tumors. MATERIALS AND METHODS: There were myxomas (n=7), malignant lymphoma (n=l), lipoma (n=l), and pericardiac mesotheliomas (n=2). We analyzed location, size, shape, signal intensity, contrast enhancement, and associated findings of adjacent structures such as pericardiac and pleural effusion, and mediastinal lymph node enlargement. RESULTS: Locations of the myxomas were left atrium in four cases, left ventricle in one, right atrium in one, and right ventricle in one. Mean diameter was 3.5cm (range, 2-7cm). They were polypoid or Iobulated in shape, and attached to interatrial or interventricular septurn in all cases except in right atrial myxoma which was attached to lateral wall. Their peduncles were demonstrated in three left atrial myxomas. The signal intensities were iso or slightly high on T1-weighted images and high on T2-weighted images. Pleural and pericardial effusions were shown in the three cases. Malignant lymphoma was manifested as large mass in right ventricle infiltrating to right atrium, interventricular septum, right paratracheal and retrocardiac area. It had slightly high intensity in both T1- and T2-weighted images with a strong contrast enhancement and associated with both pericardiac and pleural effusion. Lipoma was polypoid in shape and attached to lateral wall of left ventricle with bright T1 and high T2 signal intensity. Pericardiac mesothelioma was manifested as a pericardiac and atrial mass with diffuse irregular uneven thickening of pericardium which had iso signal on T1- and high T2-weighted images with moderate contrast enhancement. Conculsion: MR imaging is a very useful method in demonstration of the location, extent, tissue characteristics of the mass, and relationship with its adjacent structu res in evaluation of cardiac and pericardiac tumors.
Heart Atria ; Heart Ventricles ; Lipoma ; Lymph Nodes ; Lymphoma ; Magnetic Resonance Imaging* ; Mesothelioma ; Myxoma ; Pericardial Effusion ; Pericardium ; Pleural Effusion

Fewer than 20 cases of adventitial cystic disease of the vein have been reported in the worldwide literature. This small number of reported cases may be due not only to the disease's low incidence, but also to the difficulty in making the proper diagnosis. Many techniques have been used to investigate this disease, but venography has been the traditional diagnostic tool. In this report we present a case of adventitial cystic disease that was well demonstrated by CT venography.
Aged ; Cysts/pathology/*radiography ; Femoral Vein/pathology/*radiography ; Humans ; Male ; Peripheral Vascular Diseases/pathology/*radiography ; *Tomography, X-Ray Computed

Post and core is used to restore endodontically treated teeth, and it is a very important part which supplies retention and support to the prosthesis. But occasionally, caries occurred due to the microleakage at the post and core and tooth interface, the failure of prosthesis has happened. In this study, the microleakage of cast gold post and core, amalgam core, and composite resin core was investigated and compared. The coronal part of the extracted upper anterior teeth were removed and endodontically treated with conventional method. The teeth were divided into three groups. In group 1, cast gold post and core was cemented with resin cement and in group 2, ready-made post was cemented with resin cement and amalgam core was built. In group 3, ready-made post was cemented with resin cement and composite resin core was built. All specimens were thermocycled between 5degrees C and 55degrees C with dwell time of 15 seconds, and immersed in 0.5degrees C aqueous solution of basic fuchsin dye for 24 hours. After embedded in the epoxy resin, the specimens were sectioned longitudinally and observed with stereomicroscope with the magnification of 25. From the findings of this study, the following conclusions were obtained. 1. There was microleakage at the core/tooth interface of all specimens. 2. The microleakage of gold post and core was significantly less than those of the other two groups. 3. There was no significant difference between the microleakage of amalgam core and that of composite resin core.
Equipment and Supplies ; Prostheses and Implants ; Resin Cements ; Rosaniline Dyes ; Tooth*