Focal nodular hyperplasia is a benign hepatic tumor mainly composed of nodules of hepatocytes and Kupffer cells separated by fibrous septa. In general, it is difficult to differentiate focal nodular hyperplasia and hepatocellular carcinoma on ultrasonography, conventional CT(computerized tomography), and angiography. But IV bolus CT is of particular value in the diagnosis of focal nodular hyperplasia because it can divide enhanced CT into early and late phase and can characterize tumor vascularity and analyze any intratumoral elements. In our case, it was seen as a hypoechoic mass lesion on ultrasonograpl'hy and hyperdense mass lesion on early-phase IV bolus CF and isodense mass, lesion on late-phase IV bolus CT. On angiography, hypertrophy of the feeding artery and tumor staining were well visualized. The patient underwent operation and the mass was pathologically confirmed to a focal nodular hyperplasia. We report the first case of focal nodular hyperplasia on IV bolus CT in Korea.
Angiography ; Arteries ; Carcinoma, Hepatocellular ; Diagnosis ; Focal Nodular Hyperplasia ; Hepatocytes ; Humans ; Hypertrophy ; Korea ; Kupffer Cells ; Liver* ; Ultrasonography

Open discectomy is one of usual treatment for herniated intervertebral disc. We may expect the reduction of height of intervertebral disc due to decreased volume by partial resection of herniated disc. But the effect of decreased height of intervertebral disc space to posterior joint and spinal canal has not been identified, and the correlation between the amount of reduced height and the changes of range of motion has been undetermined. Thus, we analyzed radiologic changes of disc height and segmental motion by the flexion-extension view in 20 patients who had undergone discetomy for prolapsed intervertebral disc from June 1989 to January 1991 who could be followed up for 3 years or more. As a result, lumbar discetomy associates with 1) significant decrement of disc height (average 14%), 2) decreased disc motion of involved segment without hypermobility (average 34%), 3) hypermobility of adjacent segment, 4) and posterior facet overriding consistent with recurred low back pain.
Diskectomy ; Humans ; Intervertebral Disc ; Intervertebral Disc Displacement ; Joints ; Low Back Pain ; Range of Motion, Articular ; Spinal Canal

PURPOSE: To compare photon thunderbird with deep match (technique 1) with 3-field technique with electron inguinal boost (technique 2) in acute skin toxicity, toxicity-related treatment breaks and patterns of failure in elective inguinal radiation therapy (RT) for curative chemoradiation in anal cancer. MATERIALS AND METHODS: Seventeen patients treated between January 2008 and September 2010 without evidence of inguinal and distant metastasis were retrospectively reviewed. In 9 patients with technique 1, dose to inguinal and whole pelvis area was 41.4 to 45 Gy and total dose was 59.4 Gy. In 8 patients with technique 2, doses to inguinal, whole pelvis, gross tumor were 36 to 41.4 Gy, 36 to 41.4 Gy, and 45 to 54 Gy, respectively. The median follow-up period was 27.6 and 14.8 months in group technique 1 and 2, respectively. RESULTS: The incidences of grade 3 radiation dermatitis were 56% (5 patients) and 50% (4 patients), dose ranges grade 3 dermatitis appeared were 41.4 to 50.4 Gy and 45 to 54 Gy in group technique 1 and 2, respectively (p = 0.819). The areas affected by grade 3 dermatitis in 2 groups were as follow: perianal and perineal areas in 40% and 25%, perianal and inguinal areas in 0% and 50%, and perianal area only in 60% and 25%, respectively (p = 0.196). No inguinal failure has been observed. CONCLUSION: Photon thunderbird with deep match technique and 3-field technique with electron inguinal boost showed similar incidence of radiation dermatitis. However, photon thunderbird with deep match seems to increase the possibility of severe perineal dermatitis.
Anus Neoplasms ; Chemoradiotherapy ; Dermatitis ; Electrons ; Follow-Up Studies ; Humans ; Incidence ; Neoplasm Metastasis ; Pelvis ; Retrospective Studies ; Skin

CT findings and comparison between clinical and CT staging were reviewed in 45 consecutive patients withbiopsy proven carcinoma of the cervix. CT was done for staging of primary untreted cercial cancer in 36 patientsand for diagnosis of recurrent cervical cancer or follow-up study 14 times in 9 patients . The results are asfollows; 1. As comparing with clinical staging in 36 cases, CT agreed with clinical stage in 19 cases (52.8%),upstaged in 10 cases(27.8%) and downstaged inn 7 cases (19.4%). 2. The main upstaged CT findings are detection ofunsuspected bladder or rectal invasion and paraaortic lymph node metastasis. Inadequate delineation ofintravaginal tumor was the leading causes of understage of CT than clinical one. 3. CT detected all 10 cases ofthe hydronephrosis shown by IVP and detected unsuspected bladder invasion in 3 cases. 4. CT was valuable in thediagnosis of recurrent tumor and follow-up study after treatment. 5. CT offeres distinct advantages over clinicalstaging and can be integrated into the present FIGO classification of uterine cervix carcinoma. CT can served asan initial radiological staging work-up of primary of recurrent cervical carcinoma.
Cervix Uteri ; Chungcheongnam-do ; Classification ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis ; Lymph Nodes ; Neoplasm Metastasis ; Urinary Bladder ; Uterine Cervical Neoplasms

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

No abstract available.
Gastric Outlet Obstruction*

Forry-two symptomatic hands of 29 patients with carpal tunnel syndrome operated during the period from Marth 1986 to December 1993 were analized in clinical aspect. Among 29 patients, 3(10.3%) were male and 26(89.7%)were female. The syndrome occured on the right side in 10(34.5%) patients, on the left in 6(20.7%) patients, and on both in 13(44.8%) patients. The causes of the syndrome were idiopathic(90.5%), trauma(7.1%), mass(2.4%). Paresthesia(57.1%) was the most common chief complanit, followed by numbness(35.7%), pain(21.4%), weakness(9.5%). Thenar muscie atrophy occured in 84.8%, positive Tinel sign in 83.3% and positive Phalen sign in 90.0%. Delay of motor conduction velocity of median nerve was noted in all cases and delay of sensory nerve conduction velocity in all cases. Denervation finding such as fibrillation or sharp waves were seen in all cases. The carpal tunnel release was performed in all cases, and 31 cases were treated by carpal tunnel tunnel release with internal neurolysis. 35 cases(83.3%) were excellent or good results. The cases were long duration were poorer results. No significant difference was found between the results in cases treated by carpal tunnel release alone and those in cases treated by carpal tunnel release with internal neurolysis of median nerve.
Atrophy ; Bryophyta ; Carpal Tunnel Syndrome ; Denervation ; Female ; Hand ; Humans ; Male ; Median Nerve ; Neural Conduction

Authors performed Ilizarov treatment for 9 cases of severse knee flexion contracture. The causes of knee flexion contracture were 2 cases of rheumatoid arthritis, 2 cases of malunion of tibia and femur, 2 cases of infection sequelae, and 3 cases of hemophilic arthritis. The preoperative flexion contracture was av. 65.6 degrees(40-90 degrees). We started the correction at postoperative av. 3.88th day(2-12th day) after postoperative pain was controlled. After the deformity was corrected, the frame was left in place for av. 16.6 days(6-42 days). But in 2 cases of malunion of tibia and femur and 1 case of infection sequela, angular deformity and leg length discrepancy were managed after the correction of knee flexion contracture. The postcorrection flexion contracture was av. 2.6 degrees(0-10 degrees). The correction rate was av. 1.71 degrees/day(0.57-4.16 degrees/day) and the duration for correction was av. 51.1 days(12-85 days). After the follow-up period of av. 7.6 months from removal of Ilizarov, flexion contracture was av. 10.0 degrees(0-25 degrees). We conclude that the severe flexion contracture of the knee can be treated successfully with the Ilizarov correction. Limb shortening and neurovascular injuries can be avoided or minimized with the Ilizarov correction for flexion contracture of the knee as apposed to the other method. The recurrence of the flexion contracture of the knee may be prevented with the sufficient maintenance period.
Arthritis ; Arthritis, Rheumatoid ; Congenital Abnormalities ; Contracture ; Extremities ; Femur ; Follow-Up Studies ; Knee ; Leg ; Methods ; Pain, Postoperative ; Recurrence ; Tibia

No abstract available.

BACKGROUND: Prospective studies suggest that C-reactive protein (CRP) is a novel and indepen-dent risk factor of coronary heart disease. High-sensitivity methods for CRP (hs-CRP) measurement are needed for this purpose. In this study, we evaluated the performance of Cobas Integra 700 (Roche Diagnostics, Basel, Switzerland) and aimed to establish the distribution of serum CRP concentrations in healthy Koreans with the hs-CRP method. METHODS: The subjects of this study were 853 males (age; 45.9 +/- 9.8 years) and 546 females (age; 45.7 +/- 10.8 years) who visited the Health Promotion Center of the Asan Medical Center for routine health checks. Hs-CRP was measured with the Cobas Integra 700. The within-day precision, the between-day precision, the degree of correlation, the linearity, and the detection limit of hs-CRP were also analyzed with the Cobas Integra 700. RESULTS: The within-day coefficients of variation (CVs) were 0% and 1.3%. The between-day CVs were 4.0% and 3.0%. The percentage of relative nonlinearity was 0.78%. The correlation coefficient of the Cobas Integra 700 with the Behring Nephelometer was 0.994. The lower detection limit was 0.064 mg/L and the functional detection limit was 0.472 mg/L. The geometric mean concentration of CRP in Koreans was 0.69 mg/L. The mean CRP of the male population was 0.79 mg/L, which was higher than that of Korean females (0.54 mg/L) (P<0.0001). There was a significant trend to higher CRP values with increasing age (P<0.05). CONCLUSIONS: The linearity, the precision, the correlation, the detection limit of the Cobas Integra 700 were satisfactory. The age and sex-specific guidelines for hs-CRP would make the early intervention for coronary heart disease possible.
C-Reactive Protein* ; Chungcheongnam-do ; Coronary Disease ; Early Intervention (Education) ; Female ; Health Promotion ; Humans ; Limit of Detection ; Male ; Risk Factors