Transcatheter hepatic arterial embolization (THAE) is one of the treatment modalities that can be applied to hepatocellular carcinomas (HCC) and metastatic tumors of the liver. Complications such as cholecystitis and gallbladder necrosis, are common with THAE, but liver and peripheral bile duct necrosis are rare, and intrahepatic stones with main bile duct necrosis have never been reported. To prevent intrahepatic spread during operative manupulation and to decrease the vascularity and size of the tumor, we performed a THAE on a huge-sized HCC five times before performing the hepatectomy. We succesfully undertook a right lobectomy after the THAE with lipiodol, gelform, and adriamycin. However, severe bile duct stricture and intrahepatic stones were confirmed during the operation.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Cholecystitis ; Constriction, Pathologic* ; Doxorubicin ; Ethiodized Oil ; Gallbladder ; Hepatectomy ; Liver ; Necrosis

Purpose: This study aimed to prepare basic data for the development of a nursing intervention program to improve nursing performance by identifying the factors affecting nursing performance in an integrated nursing care service ward. Methods: Participants were 166 nurses who had worked for more than six months in the integrated nursing care service wards of three general hospitals located in B city. Data were collected from July 15 to August 30, 2022 using structured questionnaires and analyzed by T-test, ANOVA, Scheffé test, Pearson's correlation coefficients and multiple linear regression using the IBM SPSS/WIN 25.0 statistical program. Results: Factors affecting the nursing performance of participants were age (β=.58, p<.001), positive psychological capital (β=.41, p<.001), and social support (β=.28, p<.001). The total explanatory power of these variables for nursing performance was 55.8%. Conclusion The results of this study suggest the need for programs that improve psychological capital and social support while considering nurse’s age to enhance their performance in nursing integrated service wards.

A 53-year-old male patient presented with quadriparesis during pulmonological hospitalization for the treatment of S. aureus associated necrotizing pneumonia. He was diagnosed with the aquaporin-4 (AQP4) positive longitudinally extensive transverse myelitis from pons to T3 level. Despite the administration of intravenous methylprednisolone and plasma exchange with appropriate antibiotics, the patient's neurological condition deteriorated and he died. Our case implies that an S. aureus associated necrotizing pneumonia can trigger an AQP4 positive neuromyelitis optica spectrum disorder and contribute to the devastating course.
Anti-Bacterial Agents ; Aquaporin 4 ; Hospitalization ; Humans ; Male ; Methylprednisolone ; Middle Aged ; Myelitis, Transverse ; Neuromyelitis Optica ; Plasma Exchange ; Pneumonia ; Pons ; Quadriplegia

As jaws of children differ from those of adults in the aspects of architectural and mechanical properties, site, form and treatment modality of pediatric fractured jaws are somewhat different from those of adults. This study takes stastics of 33 pediatric patients with mandibular fractures (55 fracture sites) who were admitted to the department of oral and maxillofacial surgery. Kyung-hee university from May 1986 to March 1995, aged up to 15years with primary or mixed dentition, by age, cause, site and treatment modality. The results are as follows. 1. The mandibular fracture has sexual predilection for male, 0 to 3 years group. 2. The main cause of mandibular fracture is falling from various position, followed by traffic accident. 3. The highest incidence of fracture site is symphysis and/or condyle area. 4. Circumferential wiring is widely used for pediatric mandibular fracture.
Accidents, Traffic ; Adult ; Child ; Dentition, Mixed ; Humans ; Incidence ; Jaw ; Male ; Mandibular Fractures* ; Surgery, Oral

Despite advancement in diagnosis and progress in the management of intracranial pressure, infection remains a common complication following severe head injury. This following study attempts to better define the cell mediated immunity that decreased immediately following severe head injury. Twenty-five patients admitted with severe head injury(mean Glasgow Coma Scale, 5.32) were studied at the emergency rooms. The control group consisted of 25 mildly head-injured patients requiring hospital observation. Phenotyping of peripheral blood lymphocytes(PBL), determined by flow cytometry using monoclonal antibodies to lymphocytes subpopulation and HLA-DR receptors, was performed immediately following head injury. When severely head-injured patients were compared with controls, it was observed that the total T-cell counts(p<0.01) were markedly decreased, whereas the NK cell counts(p<0.01) were found to be increased. Infection rate of the study group was 44% and the majority of infections occur within the first 10 days after sever head injury. The results of this study suggests that severely head-injured patients had a decreased T-cell population and subpopulation in lines with higher infection rate.
Antibodies, Monoclonal ; Craniocerebral Trauma ; Diagnosis ; Emergency Service, Hospital ; Flow Cytometry* ; Glasgow Coma Scale ; Head* ; HLA-DR Antigens ; Humans ; Immunity, Cellular ; Intracranial Pressure ; Killer Cells, Natural ; Lymphocytes* ; T-Lymphocytes

PURPOSE: To report a case of cancer-associated nummular loss of the retinal pigment epithelium. METHODS: A 47-year-old man with a history of hepatocellular carcinoma presented with three weeks of bilateral visual loss. His best-corrected visual acuity was 20/40 in each eye. He had multiple round confluent grayish-brown patches at the level of retinal pigment epithelium, and no pigmented choroidal lesions. Fluorescein angiography showed circular areas of transmission defect and indocyanine green angiography showed early hyperfluorescence, corresponding with the multiple round confluent patches. CONCLUSIONS: We report a case of visual paraneoplastic syndrome which showed nummular loss of the pigment epithelial cells which distinguishes the clinical component of BDUMP syndrome.
Carcinoma, Hepatocellular/*pathology ; Diagnosis, Differential ; Fatal Outcome ; Fluorescein Angiography ; Fundus Oculi ; Humans ; Liver Neoplasms/*pathology ; Male ; Middle Aged ; Paraneoplastic Syndromes/*diagnosis ; Pigment Epithelium of Eye/*pathology ; Retinal Diseases/*diagnosis ; Tomography, Optical Coherence

We describe the imaging features of two cases of biliary ascariasis. Ultrasonography and CT showed no specific abnormal findings, but MR cholangiography clearly demonstrated an intraductal linear filling defect that led to the correct diagnosis. MR cholangiography is thus a useful technique for the diagnosis of biliary ascariasis.
Adult ; Animal ; Ascariasis/*diagnosis ; *Ascaris lumbricoides ; *Bile Ducts, Intrahepatic ; Biliary Tract Diseases/*diagnosis/*parasitology ; Common Bile Duct Diseases/*diagnosis/*parasitology ; Female ; Human ; *Magnetic Resonance Imaging

PURPOSE: To evaluate the change of intraocular pressure (IOP) after first and second injection of intravitreal triamcinolone acetonide for the treatment of macular edema and the factors that influence these changes. METHODS: A prospective, non-comparative study was performed in 41 eyes at Kangnam Sacred Heart Hospital from October 2003 to November 2005. All of the patients received injection of intravitreal triamcinolone acetonide (4 mg) twice. The IOPs before and after triamcinolone injection were measured with non-contact tonometer and Goldmann applanation tonometer. RESULTS: Mean IOP after the first and second injections were elevated from the day after injection and peaked after 3 months. Younger age (p=0.042), male (p=0.050) and the history of IOP elevation after first injection (p=0.004) were a statistically significant predictive factor for IOP elevation after second injection. Younger age (p=0.000) and male (p=0.010) were a significant predictive factor for IOP elevation after first and second injection. CONCLUSIONS: Clinicians should consider checking IOP especially for the patients who with the history of IOP elevation after first injection, male and relatively younger age.
Heart ; Humans ; Intraocular Pressure* ; Macular Edema ; Male ; Prospective Studies ; Triamcinolone Acetonide* ; Triamcinolone*

PURPOSE: To evaluate a scoring system based on ultrasonographic findings as a means of distinguishing between benign and malignant solid breast masses. MATERIALS AND METHODS: Histopathologically confirmed benign (n=102) and malignant (n=73) breast masses which ultrasonographic findings of histopathologic masses were reviewed for shape, border, internal echo, boundary echo, posterior echo, lateral echo, and ratio of transverse to anteroposterior diameter. There were statistically significant (p < 0.001 ; chi-square test) differences in each feature for benign and malignant lesions. The findings suggesting benignancy, equivocality, and malignancy of the masses were scored as 0, 1, and 2 respectively. The scores for all features were summed for each lesion. An ROC curve was obtained. RESULTS: When the score was 6, five benign and seven malignant cases were found. Scores of 0 and 1 indicated benign masses and a score above 11, malignancy. The turning point was a score of 6, so a score above 7 suggests malignancy. CONCLUSION: A ultrasonographic scoring system can be used to characterise breast masses. A score of a mass above 7 suggests probable malignancy and a score below 5 suggests benignancy.
Breast* ; ROC Curve ; Ultrasonography*

PURPOSE: To evaluate the functional and anatomic outcomes of photodynamic therapy (PDT) for choroidal neovascularization (CNV) in patients with angioid streaks. METHODS: The authors retrospectively evaluated 6 consecutive patients (6 eyes) with CNV secondary to angioid streaks. All patients were treated with standard PDT with verteporfin protocol. Standardized protocol refraction, visual acuity testing, ophthalmologic examination, color photographs, fluorescein angiograms and indocyanin angiograms were used to evaluate the results of PDT with verteporfin. Main outcome measures were visual acuity and CNV size. RESULTS: Their mean age was 61.3+/-5.50 years (range, 53-68 years). Follow-up time ranged from 12 to 38 months with mean of 20.5+/-10.91 months. The mean visual acuity at baseline was 20/100 (range 20/25-20/500), and the mean visual acuity at the last examination was 20/320(range 20/125-counting finger). The mean greatest linear dimension (GLD) at baseline was 2400+/-766.81 micrometer, and the mean GLD at the last examination was 3483+/-444.59 micrometer. CONCLUSIONS: PDT for CNV associated with angioid streaks seemed to slow down but not prevent the progression of the disease and associated visual loss.
Aged ; Angioid Streaks/*complications/*drug therapy ; Choroidal Neovascularization/*complications/*drug therapy ; Female ; Humans ; Male ; Middle Aged ; *Photochemotherapy ; Photosensitizing Agents/*therapeutic use ; Porphyrins/*therapeutic use ; Retrospective Studies