Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

Pseudotumor cerebri is a condition of obscure etiology characterized by headache, papilledema and raised intracranial pressure in the absence of a space-occupying lesion. We have experienced a case of pseudotumor cerebral complicated by acute frontal sinusitis associated with mild intracranial meningeal inflammation. We have checked the intracranial pressure through serial lumbar puncture before and after medication and conservative management. Symptom were resolved gradually upon lowering the intracranial pressure by serial lumbar puncture and conservative management. So we report a case with brief review of the literature.
Frontal Sinus* ; Frontal Sinusitis* ; Headache ; Inflammation ; Intracranial Pressure ; Papilledema ; Pseudotumor Cerebri* ; Spinal Puncture

OBJECTIVES: The purpose of this study was to evaluation the effect of administration of postpartumtonic agent(MMQ) on postpartum anemia during puerperal period, obesity control and uterine involution. SUBJECTS AND METHODS: From June 2002 to November 2002, twenty women who underwent spontaneous vaginal delivery at department of obstetrics and gynecology, college of medicine, Pochon CHA University ghopital were included in this study. All women were randomly assigned to receive postpartum tonic agent(MMQ, Albiomed Co.Ltd) or placebo two times a day after each meal for four weeks. They were assessed obesity test(BMI), hematologic examination(CBC, reticulocyte count), liver function test(AST/ALT) and ultrasound test at first day and 28th days after delivery. RESULTS: There was no statistically significant difference between the two group in demographic characteristics. No statistically significant difference were found in this study between the two group in hemoglobin, hematocrit, BMI and the size of uterus. There was no adverse effect to the tested drug. CONCLUSION: There was no significant difference in efficacy and safety between MMQ and placebo in the effect of postpartum anemia, obesity control and reduction of recovery perod. The following limitations have to be considered; Iron supplement, variable diet, seaweed ingestion, consumption of herb and small sample ize. Therefore, a extensive prospective study with control of these variables should be required.
Administration, Oral* ; Anemia* ; Diet ; Eating ; Female ; Gynecology ; Hematocrit ; Humans ; Iron ; Liver ; Meals ; Obesity* ; Obstetrics ; Postpartum Period* ; Reticulocytes ; Seaweed ; Ultrasonography ; Uterus

PURPOSE: This study was designed to optimize the flip angle (FA) and scan timing of the hepatobiliary phase (HBP) using the 3D T1-weighted, gradient-echo (GRE) imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique on gadoxetic acid-enhanced 3T liver MR imaging. MATERIALS AND METHODS: Sixty-two patients who underwent gadoxetic acid-enhanced 3T liver MR imaging were included in this study. Four 3D T1-weighted GRE imaging studies using the CAIPIRINHA technique and FAs of 9° and 13° were acquired during HBP at 15 and 20 min after intravenous injection of gadoxetic acid. Two abdominal radiologists, who were blinded to the FA and the timing of image acquisition, assessed the sharpness of liver edge, hepatic vessel clarity, lesion conspicuity, artifact severity, and overall image quality using a five-point scale. Quantitative analysis was performed by another radiologist to estimate the relative liver enhancement (RLE) and the signal-to-noise ratio (SNR). Statistical analyses were performed using the Wilcoxon signed rank test and one-way analysis of variance. RESULTS: The scores of the HBP with an FA of 13° during the same delayed time were significantly higher than those of the HBP with an FA of 9° in all the assessment items (P < 0.01). In terms of the delay time, images at the same FA obtained with a 20-min-HBP showed better quality than those obtained with a 15-min-HBP. There was no significant difference in qualitative scores between the 20-min-HBP and the 15-min-HBP images in the non-liver cirrhosis (LC) group except for the hepatic vessel clarity score with 9° FA. In the quantitative analysis, a statistically significant difference was found in the degree of RLE in the four HBP images (P = 0.012). However, in the subgroup analysis, no significant difference in RLE was found in the four HBP images in either the LC or the non-LC groups. The SNR did not differ significantly in the four HBP images. In the subgroup analysis, 20-min-HBP imaging with a 13° FA showed the highest SNR value in the LC-group, whereas 15-min-HBP imaging with a 13° FA showed the best value of SNR in the non-LC group. CONCLUSION: The use of a moderately high FA improves the image quality and lesion conspicuity on 3D, T1-weighted GRE imaging using the CAIPIRINHA technique on gadoxetic acid, 3T liver MR imaging. In patients with normal liver function, the 15-min-HBP with a 13° FA represents a feasible option without a significant decrease in image quality.
Acceleration ; Artifacts ; Breath Holding ; Contrast Media ; Fibrosis ; Gadolinium DTPA ; Humans ; Injections, Intravenous ; Liver ; Magnetic Resonance Imaging ; Signal-To-Noise Ratio

BACKGROUND: The function of the p53 protein is known to regulate cell proliferation by inhibiting cells entering S phase, so DNA damaged cell proliferation is inhibited by apoptosis. p21 is a cyclin dependent kinase inhibitor induced by wild type p53, not mutant p53. Thus p21 is thought to mediate the signal of p53 induced by DNA damaged agents to arrest the cell cycle in G1 phase. p53 and p21 are expressed in many malignant tumors, and its role in oncogenesis, tumor progression and prognosis are important. OBJECTIVE: The purpose of this study was to analyze immunohistochemical expression of mutant p53 and p21 protein in melanocytic lesions. METHOD: 11 cases of intradermal nevus, 7 cases of junctional nevus and 6 cases of malignant melanoma were immunohistochemically stained with p53 and p21 monoclonal antibodies. RESULTS: 1. In intradermal nevus, the p53 was negative in 100% and the p21 was negative in 98%. These findings suggest that the composing cells of intradermal nevus is completely mature cell. 2. The positive rates of p53 and p21 in junctional nevus were 43% and 43%, respectively. The positive rates of p53 and p21 in malignant melanoma were 82% and 67%, respectively. CONCLUSION: If the expression of p21 is induced by p53 independent pathway, the cell cycle can be arrested in G1 phase, so the tumor cell proliferation is inhibited. But if the expressed p21 is mutated as p53, it means that the natural function of p21 disappears. More research is necessary about the nature of p21 which is expressed with mutant p53.
Antibodies, Monoclonal ; Apoptosis ; Carcinogenesis ; Cell Cycle ; Cell Proliferation ; Cyclins ; DNA ; G1 Phase ; Melanoma* ; Nevus* ; Nevus, Intradermal* ; Phosphotransferases ; Prognosis ; S Phase

The prognosis of primary hepatocellular carcinoma is very poor, and a curative resection is capable only in few selected patients. Most patients die from tumor recurrence. The rate of intrahepatic recurrence of hepatocellular carcinoma is much higher than extrahepatic recurrence or metastasis. The most common site of extrahepatic metastasis is lung, and followed by lymph nodes, bone and adrenal gland. Common sites of node metastasis are celiac lymph nodes and hepatoduodenal lymph nodes, however paraaortic lymph node metastasis is very rare. Here, we report an experience of solitary paraaortic lymph node metastasis from hepatocellular carcinoma which was misdiagnosed as primary retroperitoneal tumor by preoperative imaging studies.
Adrenal Glands ; Carcinoma, Hepatocellular* ; Humans ; Lung ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Recurrence ; Retroperitoneal Neoplasms

The five-year survival rate of patients after curative resection of hepatocellular carcinoma (HCC) has been reported to be 30 to 50 %, however the actual survival rate may be different. We analyzed the actual 5-year survival rate and prognostic factors after curative resection of HCC. Retrospective analysis was performed on 63 HCC patients who underwent curative resection from 1998 to 1999. A total of 63 cases were reviewed, consisting of 53 men and 10 women, with a median age of 49 years. These cases included all four pathologic T stages (pT stage) and had the following representation: stage 1 (1 case), stage 2 (17 cases), stage 3 (38 cases), and stage 4 (7 cases). In our study, the actual 5-year survival rate was 57.0% and the median survival time was 60 months. In addition, the patients in our study had an actual 5-year disease-free survival rate of 50.2% and a median disease-free survival time of 46 months. Thirty-one patients had recurrences, with a majority occurring within one year (65%). These patients with early recurrences had a poor actual 5-year survival rate of 5%. A univariate analysis showed that the prognostic factors influencing survival rate were the presence of satellite nodules, increased pT stage, HCC recurrence, and the time to recurrence (within one year). Interestingly, microvascular invasion made a difference in survival rate but was not statistically significant (p = 0.08). Furthermore, factors influencing the disease free survival rate include the presence of satellite nodules, microvascular invasion, and pT stage. Multivariate analysis identified pT stage as the only statistically related factor in determining the disease-free survival rate. The most important prognostic factor of HCC is recurrence. Moreover, the major risk factor for recurrence is an advanced pT stage. Therefore, performing prospective studies of postoperative adjuvant therapy is necessary to prevent recurrences after hepatic resection. Furthermore, active preventative treatment and early diagnosis of recurrences should be of the highest priority in the care of high-risk patient groups that have an advanced pT stage.
Survival Rate ; Retrospective Studies ; Middle Aged ; Male ; Liver Neoplasms/*mortality/pathology/*surgery ; Liver/pathology/surgery ; Humans ; *Hepatectomy ; Female ; Carcinoma, Hepatocellular/*mortality/pathology/*surgery ; Aged ; Adult

The falciform ligament is a hepatic suspensory ligament that extends from the umbilicus to the diaphragm, containing the ligamentum teres and a vestigial remnant of the umbilical vein. Among the rarely-occurring pathologies of the falciform ligament, which include ligament cyst, tumor, abnormal vascularization, and congenital ligament defect, a falciform ligament abscess is even more sporadic. Accordingly, the definitive diagnosis of the falciform ligament abscess is rather challenging and may easily be misinterpreted as an infected choledochal cyst or a liver abscess. We present a 25-day-old infant with the falciform ligament abscess, which developed after the umbilical venous catheter insertion and was successfully treated with percutaneous drainage and antibiotic administration.

OBJECTIVE: The purpose of this study was to evaluate the clinical usefulness of CD44v6 in patients with histologically confirmed endometrial cancer. METHODS: Immunohistochemistry was used to determine the expression of CD44v6 in 39 hysterectomy specimens with the diagnosis of endometrial cancer. RESULTS: CD44v6 expression was detected in 8 specimens with no myometrial invasion of endometrial cancer, one specimen with <50% myometrial invasion, and none with >50% myometrial invasion. There was a significant association between CD44v6 expression and no myometrial invasion of endometrial cancer. There was a statistically significant association between CD44v6 expression and lymph node metastasis, lymphovascular involvement. And all cases of CD44v6 expression were FIGO stage I with histological grade 1 or 2. CD44v6 expression was statistically related with estrogen receptor expression. Although statistical significance was not revealed, it was likely that CD44v6 expression was related with progesterone receptor expression with positive predictive value of 6/9 (66.7%). CONCLUSION: Significant relationships between myometrial invasion, lymph node metastasis, lymphovascular involvement, surgical stage and expression of estrogen receptor and CD44v6 expression suggest that CD44v6 expression could be a good prognostic factor. CD44v6 expression may have potential clinical usefulness if this expression is demonstrated in a further study with prehysterectomy sampling specimens containing endometrial cancer.
Diagnosis ; Endometrial Neoplasms* ; Estrogens ; Female ; Humans ; Hysterectomy ; Immunohistochemistry ; Lymph Nodes ; Neoplasm Metastasis ; Receptors, Progesterone

PURPOSE: To compare three, motion-resistant, T1-weighted MR sequences on the hepatobiliary phase for gadoxetic acid-enhanced MR imaging of the liver. MATERIALS AND METHODS: In this retrospective study, 79 patients underwent gadoxetic acid-enhanced, 3T liver MR imaging. Fifty-nine were examined using a standard protocol, and 20 were examined using a motion-resistant protocol. During the hepatocyte-specific phase, three MR sequences were acquired: 1) gradient recalled echo (GRE) with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA); 2) radial GRE with the interleaved angle-bisection scheme (ILAB); and 3) radial GRE with golden-angle scheme (GA). Two readers independently assessed images with motion artifacts, streaking artifacts, liver-edge sharpness, hepatic vessel clarity, lesion conspicuity, and overall image quality, using a 5-point scale. The images were assessed by measurement of liver signal-to-noise ratio (SNR), and tumor-to-liver contrast-to-noise ratio (CNR). The results were compared, using repeated post-hoc, paired t-tests with Bonferroni correction and the Wilcoxon signed rank test with Bonferroni correction. RESULTS: In the qualitative analysis of cooperative patients, the results for CAIPIRINHA had significantly higher ratings for streak artifacts, liver-edge sharpness, hepatic vessel clarity, and overall image quality as compared to, radial GRE, (P < 0.016). In the imaging of uncooperative patients, higher scores were recorded for ILAB and GA with respect to all of the qualitative assessments, except for streak artifact, compared with CAIPIRINHA (P < 0.016). However, no significant differences were found between ILAB and GA. For quantitative analysis in uncooperative patients, the mean liver SNR and lesion-to-liver CNR with radial GRE were significantly higher than those of CAIPIRINHA (P < 0.016). CONCLUSION: In uncooperative patients, the use of the radial GRE sequence can improve the image quality compared to GRE imaging with CAIPIRINHA, despite the data acquisition methods used. The GRE imaging with CAIPIRINHA is applicable for patients without breath-holding difficulties.
Acceleration ; Artifacts ; Humans ; Liver* ; Magnetic Resonance Imaging* ; Retrospective Studies ; Signal-To-Noise Ratio