The adrenal gland is the second most common site of metastasis from a hepatocellular carcinoma (HCC). Radiofrequency ablation (RFA) for these tumors has been reported to be a potentially effective alternative to an adrenalectomy, especially for inoperable patients. However, for intermediate or large adrenal tumors, combination therapy of transarterial chemoembolization (TACE) and RFA can be attempted as it may reduce the heat sink effect. A 74-year-old patient presented with abdominal discomfort. Abdominal CT images revealed a 5.0 cm sized right adrenal mass. A percutaneous biopsy of the adrenal mass revealed a metastatic hepatocellular carcinoma. TACE was performed on the adrenal mass. However, a one-month follow-up CT image revealed a residual viable tumor. RFA was performed for the adrenal tumor six weeks after the TACE. No procedure-related major complications were noted. The serum alpha-fetoprotein level had also been normalized after the treatment, and 10-month follow-up CT images showed no definite evidence of viable adrenal tumor.
Adrenal Glands ; Adrenalectomy ; Aged ; alpha-Fetoproteins ; Biopsy ; Carcinoma, Hepatocellular* ; Catheter Ablation* ; Follow-Up Studies ; Hot Temperature ; Humans ; Neoplasm Metastasis ; Tomography, X-Ray Computed

No abstract available.
Chylothorax*

To evaluate the effects on the restoration of proprioception, we compared joint position sense (JPS) after meniscal allograft transplantation. Nine patients who underwent meniscal allograft transplantation between March 2008 and January 2010 were evaluated at preoperation and 6 months post-operation. International Knee Documentation Committee (IKDC) subjective score and Lysholm score were evaluated. The peak torque of the isokinetic flexor and extensor strength test was performed using Biodex system III. Passive JPS was assessed to evaluate proprioceptive function. In the results, IKDC subjective score and Lysholm score were improved (p=0.05). The flexor and extensor power decreased, however there was no statistically significant difference. In the assessment of JPS, there was improvement from 6.56degrees and 4.11degrees to 4.89degrees and 1.89degrees, however, this was not statistically significant. Although, proprioception was improved in JPS at 6 months after meniscus transplantation, it did not show statistic significance. Therefore, future studies using combined methods will be needed to evaluate proprioceptive function after meniscal allograft transplantation.
Humans ; Joints ; Knee ; Proprioception ; Torque ; Transplantation, Homologous ; Transplants

Eight cases of chondroblastoma were studied by analyzing the clinical and pathologic findings. The age of eight cases ranged from 17 to 38 years old(median age, 22.7 years old). The tumors developed in the femur (3 cases), patella (2 cases), tibia( 1 case), fibula (1 case), and ulna (1 case). The mean diameter of tumors was 4.0 cm (range, 1.5 to 8.0 cm). Grossly, tumors showed grayish brown solid area with foci of secondary aneurysmal bone cyst. Histologically, the tumor cells were round or polygonal in shape with nuclear groove. And there were chondroid differentiation(7 cases), mitosis(3 cases), calcific deposits(3 cases), secondary aneurysmal bone cyst(4 cases), hemosiderin deposits(4 cases), necrosis(3 cases), vascular invasion(1 caes) and foamy histiocytes and cholesterol cleft(1 cases). All cases showed no metastasis to lymph node and distant organ. Seven cases (87.5 %) were immunoreactive for S-100 protein. None were immunoreactive for cytokeratin.
Aneurysm ; Bone Cysts ; Cholesterol ; Chondroblastoma* ; Femur ; Fibula ; Hemosiderin ; Histiocytes ; Keratins ; Lymph Nodes ; Neoplasm Metastasis ; Patella ; S100 Proteins ; Ulna

Dilated cardiomyopathy, which mostly has an idiopathic etiology or is caused by genetic inheritance or infection, can cause irreversible congestive heart failure. Hypocalcemia is a rare etiology of reversible dilated cardiomyopathy. Here we report the case of a two-month-old girl with congestive heart failure who was diagnosed as having dilated cardiomyopathy secondary to hypocalcemia. After calcium and vitamin D replacement therapy, the patient showed a rapid reduction in hypocalcemic tetany and a rapid recovery of left ventricular function. The cause of the hypocalcemia was vitamin D deficient rickets. She was exclusively breast-fed as an infant, and her mother had a vitamin D deficiency and was diagnosed with osteomalacia.
Calcium ; Cardiomyopathy, Dilated ; Heart Failure ; Humans ; Hypocalcemia ; Infant ; Mothers ; Osteomalacia ; Rickets ; Tetany ; Ventricular Function, Left ; Vitamin D ; Vitamin D Deficiency ; Vitamins ; Wills

Congenital lipoid adrenal hyperplasia (CLAH) is a rare autosomal recessive disorder characterized by the marked accumulation of lipids and cholesterol in the adrenal cortex, and the failure of adrenal steroids to synthesise. We report the ultrasound (US), computed tomographic (CT), and magnetic resonance (MR) imaging findings in a four-day- old female neonate with CLAH.
Adrenal Cortex ; Cholesterol ; Female ; Humans ; Hyperplasia* ; Infant, Newborn ; Steroids ; Ultrasonography

No abstract available.
Arthritis* ; Hip* ; Humans ; Infant* ; Infant, Newborn*

In many countries, vaccines are used for the prevention of foot-and-mouth disease (FMD). However, because there is no protection against FMD immediately after vaccination, research and development on antiviral agents is being conducted to induce protection until immunological competence is produced. This study tested whether well-known chemicals used as RNA virus treatment agents had inhibitory effects on FMD viruses (FMDVs) and demonstrated that ribavirin showed antiviral effects against FMDV in vitro/in vivo. In addition, it was observed that combining the administration of the antiviral agents orally and complementary therapy with vaccines synergistically enhanced antiviral activity and preserved the survival rate and body weight in the experimental animals. Antiviral agents mixed with an adjuvant were inoculated intramuscularly along with the vaccines, thereby inhibiting virus replication after injection and verifying that it was possible to induce early protection against viral infection prior to immunity being achieved through the vaccine. Finally, pigs treated with antiviral agents and vaccines showed no clinical signs and had low virus excretion. Based on these results, it is expected that this combined approach could be a therapeutic and preventive treatment for early protection against FMD.
Animals ; Antiviral Agents ; Body Weight ; Foot-and-Mouth Disease ; Immunocompetence ; Ribavirin ; RNA Viruses ; Survival Rate ; Swine ; Vaccination ; Vaccines ; Virus Replication

PURPOSE: S. pneumoniae is one of major pathogens of community-acquired respiratory infections. The rate of antibiotic resistance to this organism has increased, and resistance to multiple antimicrobial agents in a single strain of S. pneumoniae may compromise the efficacy of empiric antimicrobial treatment commonly used for respiratory infections. We did this study to find out the penicillin resistant distributions and oral antibiotics susceptibility patterns against S. pneumoniae, isolated from pediatric patients with community-acquired respiratory infections in Korea. METHODS: One hundred fifty six pneumococcal isolates obtained from pediatric patients with community-acquired respiratory infections such as acute otitis media(AOM), sinusitis and pneumonia between May 2000 to June 2003. And MICs of penicillin and oral antibiotics(amoxicillin, amoxicillin- clavulanate, cefaclor) were performed by broth microdilution methods according to the NCCLS(2003a). RESULTS: Seventy eight percent of the isolates were resistant to penicillin. The isolates, collected from AOM patients showed the highest penicillin resistance(92.7%). The resistant rates of amoxicillin (16.7%) and amoxicillin-clavulanate(9.6%), based on susceptibility breakpoints established by the NCCLS, were markedly lower than these of penicillin. But, the resistant rate of cefaclor was very high, above 95%. CONCLUSION: We concluded that pneumococci isolated from study cases may be one of the world's highest penicillin resistant rates. But, amoxicillin and amoxicillin-clavulanate can be used as a first- line antibiotics. Finally, we hope that a continuous surveillance study to monitor resistant patterns of pneumococcal respiratory infections will be needed for the standard guidelines of empiric antibiotic treatment.
Amoxicillin ; Anti-Bacterial Agents* ; Anti-Infective Agents ; Cefaclor ; Clavulanic Acid ; Community-Acquired Infections ; Drug Resistance, Microbial ; Hope ; Humans ; Korea* ; Otitis ; Penicillin Resistance ; Penicillins* ; Pneumonia ; Respiratory Tract Infections* ; Sinusitis ; Streptococcus pneumoniae* ; Streptococcus*

The histological distinction between benign and malignant phyllodes tumors (PT) is often difficult and arbitrary. We analyzed clinical, histological features and expressions of Ki-67 and p53 using immunohistochemistry and estimate its significance in assessing the grade of malignancy and in predicting the clinical behavior of these tumors on 20 cases of PT of the breast (11 benign, 3 low-grade malignancy and 6 high-grade malignancy). Statistically significant differences between benign, low-grade malignant, and high-grade malignant PT by size of tumor, cellular atypism, stromal cellularity, margin of tumor, and number of mitotic figures. The mean labeling index (LI) of Ki-67 in high-grade malignant PT (9.6+/-9.6) was three-fold higher than that in benign PT (2.7+/-2.2), but this difference was not statistically significant (P=0.074). None of the benign PT were positive for p53, whereas 2 of 3 low-grade malignant and 3 of 6 high-grade malignant PT were positive for p53. Statistically significant differences in the pattern of p53 expression existed among the benign, low-grade malignant, and high-grade malignant lesions (P=0.018). Ki-67 LI and p53 expression were associated with numbers of mitotic figure, but were not associated with metastasis (P=0.546 and 0.216). Increased p53 immunoreactivity is present in high-grade and low-grade malignant PTs in contrast to benign PTs, and malignant PT had a higher Ki-67 LI than benign PT. Thus, p53 and Ki-67 expression may assist in distinguishing benign from malignant PT in diagnostically difficult cases.
Breast* ; Immunohistochemistry ; Neoplasm Metastasis ; Phyllodes Tumor* ; Prognosis