PURPOSE: There have been many trials to find a cure for inoperable multiple hepatocellular carcinomas (HCC), but no effective therapy has been found. As the combined therapy of tumor reductive surgery and intraoperative radio-frequency ablation (RFA) is by far the best known effective treatment modality, the effect of a combined resection and intraoperative RFA for multiple HCC was evaluated. METHODS: Between July 1999 and 2004, a retrograde study was conducted on 8 patients who had undergone combined therapy for HCC, with respect to the number of tumors, location, size, postoperative complications and recurrence. RESULTS: The average age of the patients was 51. A Rt. hepatectomy, Lt. Lateral sectionectomy, bi-segmentectomy, segmentectomy and wedge resection were performed. The total number of tumors and resected tumors were 21 and 8, respectively; with an average size of 6.6 cm. Thirteen tumors, with average size of 2 cm, were treated with RFA. Seven postoperative complications were encountered in 2 patients, with 2 operation related complications biloma and ascites. One patient suffered from pleural effusion and a wound complication. One patient went through a RFA-related complication biliary-cutaneous fistula. Four patients suffered a recurrence one at the RFA site, and the rest at the remnant liver. The treatments used for the recurrences were TACE/ TACI, percutaneous Holmium injection and surgical resection. All patients survived, with an average survival and a median disease free survival time of 15 and 11 months, respectively. CONCLUSION: Until now, surgery has been the least favored choice for the treatment of multiple HCC. However, thinking our opinion, the combined therapy of hepatectomy with intraoperative RFA is beneficial. Our group of patients was small, with a short follow up period, without any definite indication; therefore, it will be necessary to conduct continuous follow up, with the collection of appropriate data.
Ascites ; Carcinoma, Hepatocellular* ; Catheter Ablation ; Disease-Free Survival ; Fistula ; Follow-Up Studies ; Hepatectomy ; Holmium ; Humans ; Liver ; Mastectomy, Segmental ; Pleural Effusion ; Postoperative Complications ; Recurrence ; Thinking ; Wounds and Injuries

PURPOSE: Multiple early gastric cancer (MEGC) accounts for between 4.5% and 11.7% of all early gastric cancers (EGC). We investigated the treatment of MEGC from the viewpoint of the clinicopathologic features of the disease. MATERIALS AND METHODS: 2,281 patients with EGC underwent gastric resection at the Department of Surgery, Severance Hospital during the 11 years between January 1994 and December 2004 and we carried out a retrospective analysis of these patients. RESULTS: There were 91 cases of synchronous MEGC (4.0%) according to the diagnostic criteria of Moertel: there were 81 double, 9 triple and 1 quadruple lesions. Of the 102 accessory lesions, 64 (62.7%) were less than 10 mm in diameter and 83 (81.4%) were located in the same region as the main lesion. The most frequent histologic type of main lesion was a well differentiated adenocarcinoma, which was found in 52 cases (57.1%). There were 49 mucosal main lesions and 42 submucosal main lesions. Lymph node metastasis was detected in 6 cases (6.6%): 1 in mucosal lesions and 5 in submucosal main lesions. CONCLUSION: Solitary EGC and MEGC had very similar clinopathological features and a similar prognosis. Therefore, we believe that the general EGC treatment guidelines can be applied for multiple EGC. It is important to evaluate the whole stomach before and during the operation and then after examining the resected specimen.
Adenocarcinoma ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Stomach ; Stomach Neoplasms

Background: This study, examines the applicability of the Lifestyle Evaluation Tool for Patients with Metabolic Syndrome (LET-PMS) questionnaire, originally developed for general population, on psychiatric patients with metabolic syndrome. Methods: The study included 320 patients diagnosed with schizophrenia spectrum disorder (N=190), bipolar spectrum disorder (N=65), and depressive disorder (N=65). They were provided assignments using 36 items from the LETPMS questionnaire and various established scales. The evaluation encompassed psychometric properties of reliability, exploratory factor, and confirmatory factor analysis. Results: We refined the LET-PMS questionnaire by eliminating six items through a reliability test. The resultant questionnaire exhibited six factors. The overall Cronbach’s alpha value was 0.896, with factor-specific reliability coefficients ranging from 0.730 to 0.859. Based on confirmatory factor analysis of the adapted LET-PMS, the root mean square error of approximation was 0.069 (0.05-1.1). Goodness-of-fit and comparative fit indexes were 0.815 and 0.821, respectively. All 30 items met the criteria for suitable configuration. Conclusion The LET-PMS questionnaire demonstrated robust internal consistency and sound structural validity, making it suitable for psychiatric patients with metabolic syndrome.

OBJECTIVE: This study aimed to evaluate the validity and reliability of a Korean version of the Mood Disorder Questionnaire-Adolescent version (K-MDQ-A) as a screening instrument for bipolar disorders in adolescents. METHODS: One hundred two adolescents with bipolar disorders and their parents were recruited from November 2014 to November 2016 at 7 training hospitals. One hundred six controls were recruited from each middle school in two cities of South Korea. The parent version of the original MDQ-A was translated into Korean. The parents of all participants completed the K-MDQ-A. The diagnoses of bipolar disorders were determined based on the Korean version of K-SADS-PL. The test-retest reliability with a 10-month interval was investigated in 33 bipolar adolescents. RESULTS: K-MDQ-A yielded a sensitivity of 0.90 and a specificity of 0.92 when using a cut-off score of endorsement of 5 items, indicating that symptoms occurred in the same time period and caused moderate or serious problems. The internal consistency of the K-MDQ-A was good. The correlations between each item and the total score ranged from 0.40 to 0.76 and were all statistically significant. Factor analysis revealed 3 factors that explained 61.25% of the total variance. The mean total score was significantly higher in bipolar adolescents (7.29) than in controls (1.32). The Pearson correlation coefficient for the total test-retest score was 0.59 (p < 0.001). CONCLUSION: The K-MDQ-A completed by parents showed the excellent validity and reliability and may be a useful screening tool for adolescents with bipolar disorders attending in- and outpatient psychiatric clinics.
Adolescent* ; Bipolar Disorder* ; Diagnosis ; Humans ; Korea ; Mass Screening* ; Mood Disorders* ; Outpatients ; Parents ; Reproducibility of Results* ; Sensitivity and Specificity