No abstract available.

No abstract available.
Carcinoma, Hepatocellular* ; Child* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Humans

No abstract available.
Escherichia ; Hemolytic-Uremic Syndrome

A 69-year-old female patient presented with a huge liver mass at another hospital. Computed tomography (CT) revealed a huge, well-demarcated, low-attenuated mass in the right lobe of the liver and multiple nodules in both lungs. The liver mass invaded the colon at the hepatic flexure and infiltrated into the retroperitoneum. Spiral CT revealed a huge tumor thrombus in the right ventricle (RV). The enhancement pattern of the right ventricular mass was identical to that of the liver mass. After ultrasonography-guided needle biopsy of the liver mass, the patient was diagnosed with intrahepatic sarcomatoid cholangiocarcinoma. Although we recommended debulking open-heart surgery for the prevention of sudden death caused by massive pulmonary embolism, the patient and her family opted against surgery due to high operation-related mortality and old age. The patient later died of massive pulmonary embolism at another hospital a few weeks later.
Aged ; Biopsy, Needle ; Cholangiocarcinoma ; Colon ; Death, Sudden ; Female ; Heart Ventricles ; Humans ; Liver ; Lung ; Pulmonary Embolism ; Thrombosis ; Tomography, Spiral Computed

BACKGROUND/AIMS: The aim of this study was to compare the diagnostic capabilities of narrow band imaging (NBI) colonoscopy with and without optical magnification in differentiating neoplastic from nonneoplastic colorectal polyps. METHODS: Between April 2012 and March 2013, 122 patients with colorectal polyps detected by using diagnostic conventional colonoscopy were prospectively enrolled. A total of 236 polyps were evaluated with NBI, in vivo in real time during therapeutic colonoscopy, by one experienced endoscopist. Whether magnification was used or not was determined by randomization. After an in vivo real-time endoscopic prediction of histology, all lesions were endoscopically excised. Surgical pathologic reports were used as the criterion standards. The sensitivity (Sn), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) of identifying neoplastic polyps were calculated. RESULTS: A total of 236 lesions with an average size of 5.6 mm in 122 patients were assessed (159 neoplastic, 77 nonneoplastic). The Sn, Sp, PPV, and NPV in differentiating neoplastic from nonneoplastic lesions with the magnified NBI were 97.5%, 83.3%, 94.0%, and 92.6%, respectively, whereas those of the nonmagnified NBI group were 97.5%, 85.1%, 91.7%, and 95.2%, respectively. CONCLUSIONS: Nonmagnified NBI colonoscopy distinguishes neoplastic from nonneoplastic colorectal polyps as accurately as does magnified NBI colonoscopy.
Colonoscopy ; Humans ; Narrow Band Imaging* ; Polyps* ; Prospective Studies ; Random Allocation ; Sensitivity and Specificity

BACKGROUND/AIMS: Balloon expulsion test (BET) is regarded as a screening tool of dyssynergic defecation (DD). However, some patients with normal BET results may be treated effectively by biofeedback training. This study aims to validate BET as a single screening test. METHODS: Two hundred and thirty-two patients who were diagnosed with functional constipation or irritable bowel syndrome with constipation who underwent anorectal manometry (ARM) and BET at Seoul National University Hospital were enrolled. We evaluated the validity of BET based on ARM and electromyography (EMG) during biofeedback training. RESULTS: If BET ≤ 1 minute was defined as normal, sensitivity and negative predictive value (NPV) of BET in predicting paradoxical contraction based on ARM findings were 71.4% and 13.9%. If BET ≤ 3 minutes was defined as normal, sensitivity and NPV were 35.2% and 6.6%. Specificity and positive predictive value (PPV) of BET ≤ 3 minutes criteria were 84.8% and 93.3%. Same analysis was conducted in 107 patients who underwent EMG during biofeedback training. With 1-minute criteria, sensitivity and NPV of BET were 70.3% and 14.3%. With 3 minutes criteria, sensitivity and NPV of BET was 38.6% and 8.8%. Specificity and positive predictive values were both 100.0%. CONCLUSIONS: Based on either ARM or EMG during biofeedback training, sensitivity was at most 71.4% and NPV was less than 15.0% irrespective of whether BET was within 1minute or within 3 minutes. BET seems to have a limitation as both a screening test for dyssynergic defecation and a simple assessment to rule out the necessity of biofeedback training.
Arm ; Biofeedback, Psychology ; Constipation ; Defecation* ; Electromyography ; Humans ; Irritable Bowel Syndrome ; Manometry ; Mass Screening* ; Sensitivity and Specificity ; Seoul

No abstract available.
Delivery of Health Care* ; Irritable Bowel Syndrome* ; Korea ; National Health Programs*

Acral metastasis to the finger is a very rare phenomenon. We report herein a case of cutaneous acrometastasis to the right 5th finger tip in a 36-year-old woman with metastatic breast cancer. The patient underwent a right modified radical mastectomy for T3N3 invasive ductal carcinoma and received adjuvant chemotherapy and radiotherapy. After 2 years, she developed metastasis to the brain, bones, and lungs. She was found to have a growing tender mass on the tip of right 5th finger. A well-demarcated, soft tissue mass was identified on sonography. Under the clinical impression of a possible benign process, the nodule was surgically removed. The pathologic finding was consistent with metastatic breast cancer. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER2 were all negative, as in the primary tumor. Radiation was given to the finger tip and systemic chemotherapy with capecitabine was tried for systemic metastatic disease.
Adult ; Brain ; Breast ; Breast Neoplasms ; Carcinoma, Ductal ; Chemotherapy, Adjuvant ; Deoxycytidine ; Estrogens ; Female ; Fingers ; Fluorouracil ; Humans ; Lung ; Mastectomy, Modified Radical ; Neoplasm Metastasis ; Receptors, Progesterone ; Capecitabine

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*