Neuroblastoma is a malignant tumor of primordial neural crest origin. It usually develops along the sympathetic nervous system, such as the adrenal glands or paramedian sympathetic chain and metastasizes to the liver most frequently. However, a primary hepatic neuroblastoma has not been reported yet. Here, we report a case of 29-year-old woman who presented with a solitary hepatic mass. Grossly, the mass was large, creamy, rubbery firm, and showed focal hemorrhage and central cavitation. Microscopically, the tumor cells were arranged in small nests of spindle to ovoid cells with abundant neuropil. The neuroblastic nature of the tumor was confirmed by immunohistochemistry and electron microscopy. No extrahepatic mass was found, despite a thorough systemic survey such as chest and abdominopelvic computed tomography (CT) scans and a whole body positron emission tomography-CT study. To the best of our knowledge, this is the first report of a bona fide primary hepatic neuroblastoma.
Adrenal Glands ; Adult ; Electrons ; Female ; Hemorrhage ; Humans ; Immunohistochemistry ; Liver ; Liver Neoplasms ; Microscopy, Electron ; Neural Crest ; Neuroblastoma ; Neuropil ; Sympathetic Nervous System ; Thorax

BACKGROUND: Biodegradable microneedle technology is a recently developed method to deliver medical and pharmaceutical medications into the skin, and is expected to yield better treatment results than topical application methods. OBJECTIVE: To evaluate the efficacy of hyaluronic acid (HA)-based microneedle patches and epidermal growth factor (EGF)-containing microneedle patches on periorbital wrinkle improvement. METHODS: A 20-week randomized, double-blind study was performed. Twenty-five Korean patients with periorbital wrinkles and a wrinkle severity rating scale (WSRS) score above 2 were enrolled into the study. The patients completed the study using the two different types of patches on each side of the designated periorbital wrinkles area every other day for 8 weeks. Patients were requested for an additional 12-week follow up. Wrinkle improvements were assessed by WSRS score, subjective patient satisfaction score, and imaging analysis using the visiometer, corneometer, cutometer, and mexameter, respectively (Courage&Khazaka, Cologne, Germany). RESULTS: Both the HA-based microneedle patch and EGF-containing HA-based microneedle patch had positive effects on WSRS score, patient satisfaction levels, and corneometer result with statistically significant differences. No significant side effects were noticed. CONCLUSION: With respect to efficacy, no statistical difference between the two groups were noted, indicating that the anti-wrinkle effects of the microneedle patch may solely be due to the HA rather than the EGF.
Double-Blind Method ; Epidermal Growth Factor ; Follow-Up Studies ; Humans ; Hyaluronic Acid ; Patient Satisfaction ; Skin

No abstract available.
Pyoderma ; Pyoderma Gangrenosum

Background/Aims: Patients with more than 10 cumulative polyps might involve a greater genetic risk of colorectal neoplasia development. However, few studies have investigated the risk factors of polyposis recurrence and development of advanced neoplasms among patients with non-hereditary colorectal polyposis. Methods: This study included patients (n=855) with 10 or more cumulative polyps diagnosed at Severance Hospital from January 2012 to September 2021. Patients with known genetic mutations related to polyposis, known hereditary polyposis syndromes, insufficient information, total colectomy, and less than 3 years of follow-up were excluded. Finally, 169 patients were included for analysis. We collected clinical data, including colonoscopy surveillance results, and performed Cox regression analyses of risk factors for polyposis recurrence and advanced neoplasm development. Results: The 169 patients were predominantly male (84.02%), with a mean age of 64.19±9.92 years. The mean number of adenomas on index colonoscopy was 15.33±8.47. Multivariable analysis revealed history of cancer except colon cancer (hazard ratio [HR], 2.23; 95% confidence interval [CI], 1.23–4.01), current smoking (HR, 2.39; 95% CI, 1.17–4.87), and detection of many polyps (≥15) on index colonoscopy (HR, 2.05; 95% CI, 1.21–3.50) were significant risk factors for recurrence of polyposis. We found no statistically significant risk factors for advanced neoplasm development during surveillance among our cohort. Conclusions The presence of many polyps (≥15) on index colonoscopy, history of cancer except colon cancer, and current smoking state were significant risk factors for polyposis recurrence among patients with non-hereditary colorectal polyposis.

Primary hepatic mixed germ cell tumor (GCT) is very rare, and less than 10 cases have been reported. We report a case of mixed GCT composed of a choriocarcinoma and yolk sac tumor, which occurred in the liver of a 40-year-old woman. A large mass was detected by computed tomography solely in the liver. Serum β-human chorionic gonadotropin (hCG) was highly elevated, otherwise, other serum tumor markers were slightly elevated or within normal limits. For hepatic choriocarcinoma, neoadjuvant chemotherapy was administered, followed by right lobectomy. Histologic features of the resected tumor revealed characteristic choriocarcinoma features with diffuse positivity for hCG in the syncytiotrophoblasts and diffuse positivity for α-fetoprotein and Sal-like protein 4 in the yolk sac tumor components. Primary malignant GCT in the liver is associated with a poor prognosis and requires specific treatment. Therefore, GCT should be considered during a differential diagnosis of a rapidly growing mass in the liver.

Primary hepatic mixed germ cell tumor (GCT) is very rare, and less than 10 cases have been reported. We report a case of mixed GCT composed of a choriocarcinoma and yolk sac tumor, which occurred in the liver of a 40-year-old woman. A large mass was detected by computed tomography solely in the liver. Serum β-human chorionic gonadotropin (hCG) was highly elevated, otherwise, other serum tumor markers were slightly elevated or within normal limits. For hepatic choriocarcinoma, neoadjuvant chemotherapy was administered, followed by right lobectomy. Histologic features of the resected tumor revealed characteristic choriocarcinoma features with diffuse positivity for hCG in the syncytiotrophoblasts and diffuse positivity for α-fetoprotein and Sal-like protein 4 in the yolk sac tumor components. Primary malignant GCT in the liver is associated with a poor prognosis and requires specific treatment. Therefore, GCT should be considered during a differential diagnosis of a rapidly growing mass in the liver.

Background: Transfusion appropriateness is extremely important due to the growing concerns about the decrease in the supply of blood products and the increase in demand. Considerable time and effort are required to effectively collect and analyze large volumes of data. Therefore, we aimed to develop a transfusion appropriateness management program using the Tableau visual analytics platform, which allows intuitive visualization through various visualization options and interactive features and can quickly process large volumes of data. Methods: Using the transfusion prescription history and blood management and distribution history, we created a data mart comprising patient information, hospitalization history, inpatient/outpatient prescriptions, test results, records, and surgical information. Based on this we developed visualization analysis content for monitoring transfusion appropriateness.We automated the periodic aggregation of the data mart into an analysis database and connected it to Tableau. Results: We developed Transfusion Appropriateness Management (TAM), a program for managing transfusion appropriateness linked to Tableau, after analyzing transfusion-related data and metadata extracted from the Daejeon Eulji Medical Center's order communication system/electronic medical record (OCS/EMR) system. Detailed filters were applied to allow users to intuitively view the desired data according to their criteria. Data were visualized in various forms, such as bar graphs, heat maps, and box plots based on filtering criteria. Conclusion The development of the Transfusion Appropriateness Management program at the Daejeon Eulji Medical Center is expected to effectively reduce inappropriate transfusions in clinical settings and enhance patient safety within the hospital by swiftly and conveniently visualizing vast amounts of data.

Background: Transfusion appropriateness is extremely important due to the growing concerns about the decrease in the supply of blood products and the increase in demand. Considerable time and effort are required to effectively collect and analyze large volumes of data. Therefore, we aimed to develop a transfusion appropriateness management program using the Tableau visual analytics platform, which allows intuitive visualization through various visualization options and interactive features and can quickly process large volumes of data. Methods: Using the transfusion prescription history and blood management and distribution history, we created a data mart comprising patient information, hospitalization history, inpatient/outpatient prescriptions, test results, records, and surgical information. Based on this we developed visualization analysis content for monitoring transfusion appropriateness.We automated the periodic aggregation of the data mart into an analysis database and connected it to Tableau. Results: We developed Transfusion Appropriateness Management (TAM), a program for managing transfusion appropriateness linked to Tableau, after analyzing transfusion-related data and metadata extracted from the Daejeon Eulji Medical Center's order communication system/electronic medical record (OCS/EMR) system. Detailed filters were applied to allow users to intuitively view the desired data according to their criteria. Data were visualized in various forms, such as bar graphs, heat maps, and box plots based on filtering criteria. Conclusion The development of the Transfusion Appropriateness Management program at the Daejeon Eulji Medical Center is expected to effectively reduce inappropriate transfusions in clinical settings and enhance patient safety within the hospital by swiftly and conveniently visualizing vast amounts of data.

Background: Transfusion appropriateness is extremely important due to the growing concerns about the decrease in the supply of blood products and the increase in demand. Considerable time and effort are required to effectively collect and analyze large volumes of data. Therefore, we aimed to develop a transfusion appropriateness management program using the Tableau visual analytics platform, which allows intuitive visualization through various visualization options and interactive features and can quickly process large volumes of data. Methods: Using the transfusion prescription history and blood management and distribution history, we created a data mart comprising patient information, hospitalization history, inpatient/outpatient prescriptions, test results, records, and surgical information. Based on this we developed visualization analysis content for monitoring transfusion appropriateness.We automated the periodic aggregation of the data mart into an analysis database and connected it to Tableau. Results: We developed Transfusion Appropriateness Management (TAM), a program for managing transfusion appropriateness linked to Tableau, after analyzing transfusion-related data and metadata extracted from the Daejeon Eulji Medical Center's order communication system/electronic medical record (OCS/EMR) system. Detailed filters were applied to allow users to intuitively view the desired data according to their criteria. Data were visualized in various forms, such as bar graphs, heat maps, and box plots based on filtering criteria. Conclusion The development of the Transfusion Appropriateness Management program at the Daejeon Eulji Medical Center is expected to effectively reduce inappropriate transfusions in clinical settings and enhance patient safety within the hospital by swiftly and conveniently visualizing vast amounts of data.