PURPOSE: Lipiodol CT is a important modality for the diagnosis of hepatocellular carcinoma and compared is usually performed at 2-3 week after Lipiodol injection. Therefore, we assessed and the diagnostic value and merits of immediate CT after chemoembolization from there of 2-3 week delayed Lipiodol CT. MATERIALS AND METHODS: Thirty three cases of chemoembolization which were performed both immediate CT after chemoembolization and 2-3 week delayed Lipiodol CT were reviewed retrospectively. They were divided into four grades according to pattern of lipiodol uptake by three radiologists. The diagnostic value of immediate Lipiiodol CT was compared to delayed Lipiodol CT. RESULTS: Grade 0 was two cases(3.0%) and Grade 1 was seven cases(21.2%). In the cases of Grade 2(23/33, 69.7%) tumor uptake could be dishng wished from parenchymal uptake of Lipiodol by its density and pattern. Tumor uptake showed dense and homogeneous pattern, but parenchymal uptake revealed less dense and hepatoram-like wedge shaped pattern. Lipiodol uptake of tumor in Grade 3(1/24, 3.0%) was equal to that in delayed Lipiodrl CT. Grade 3 and 2(72.7%) of the immediate Lipiodol CT were not inferior to delayed Lipiodol CT in its diagnostic value. CONCLUSION: The immediate Lipiodol CT could make rapid establishment of treatment plan and are expected to be more convenient than delayed CT for the patients.
Carcinoma, Hepatocellular* ; Diagnosis ; Ethiodized Oil ; Humans ; Retrospective Studies

We report distinctive diffusion-weighted magnetic resonance image (DWI) findings in a 65-year-old man with clinically diagnosed Creutzfeldt-Jakob disease (CJD). Four weeks before admission he developed general weakness and febrile sense which were followed by progressive dementia, ataxia, and choreo-athetoid movement of the right hand. T2-weighted magnetic resonance image (MRI) showed subtle high signal intensities only in the left basal ganglia, whereas DWI demonstrated marked hyperintensities in multiple regions including the left basal ganglia and left cerebral cortex. Five weeks after the onset of symptoms, he was noted to have myoclonus and characteristic electroencephalographic changes consisting of periodic triphasic sharp waves. In our patient, high signal changes on the DWI preceded myoclonus and typical EEG findings, a result suggesting that DWI may be useful in the early premortem diagnosis of CJD.
Aged ; Ataxia ; Basal Ganglia ; Cerebral Cortex ; Creutzfeldt-Jakob Syndrome* ; Dementia ; Diagnosis ; Electroencephalography ; Hand ; Humans ; Myoclonus

Although the detection of recurred lesions following curative gastrectomy in patients with gastric cancer has increased as the use of computed tomography (CT) has grown, early or small tumor recurrence can be difficult to identify or correctly diagnose using CT. Therefore, in this study, we retrospectively reviewed cases in which tumor recurrence was missed upon analysis of the follow up CT after gastrectomy. The characteristics of the lesions in various locations of the abdomen and pelvis are illustrated and discussed.
Abdomen ; Follow-Up Studies* ; Gastrectomy ; Humans ; Neoplasm Recurrence, Local ; Pelvis ; Recurrence* ; Retrospective Studies ; Stomach Neoplasms ; Tomography, X-Ray Computed

Transarterial chemoembolization (TACE) is a useful treatment option for hepatocellular carcinoma (HCC). TACE can particularly be used as a treatment for localized HCC, where surgical resection is impossible due to decreased liver function. However, TACE is associated with several complications, including vascular complications, liver failure, non-target embolization, infection, and death. The main risk factor for complications after TACE is decreased liver function. There have been only few reports of brain abscesses after TACE that are difficult to be distinguished from hepatic encephalopathy. Here, we report a rare case of brain abscess caused by Klebsiella pneumoniae that occurred after TACE.

Transarterial chemoembolization (TACE) is a useful treatment option for hepatocellular carcinoma (HCC). TACE can particularly be used as a treatment for localized HCC, where surgical resection is impossible due to decreased liver function. However, TACE is associated with several complications, including vascular complications, liver failure, non-target embolization, infection, and death. The main risk factor for complications after TACE is decreased liver function. There have been only few reports of brain abscesses after TACE that are difficult to be distinguished from hepatic encephalopathy. Here, we report a rare case of brain abscess caused by Klebsiella pneumoniae that occurred after TACE.

Spinal trauma accounts for a large portion of injuries to the spine area, particularly as societies are entering an era of aging populations. Consequently, spine fractures accompanied by osteoporosis are becoming more prevalent. Achieving successful fusion surgery in patients with spine fractures associated with osteoporosis is even more challenging. Pseudarthrosis in the spine does not yield clinically favorable results; however, considerable effort has been made to achieve successful fusion, and the advancement of bone graft substitutes has been particularly crucial in this regard. Autograft bone is considered the best fusion material but is limited in use due to the quantity that can be harvested during surgery and associated complications. Accordingly, various bone graft substitutes are currently being used, although no specific guidelines are available and this mainly depends on the surgeon's choice. Therefore, the purpose of this review, across part I/II, is to summarize bone graft substitutes commonly used in spine surgery for spine fusion in patients with spine trauma and to update the latest knowledge on the role of recombinant human bone morphogenetic protein-2.

BACKGROUND: This study was conducted to find out the relationship between autonomous function and fatigue rating. The subjects were patients with complaints of fatigue who visited the department of family medicine in a general hospital. METHODS: We conducted this study from April to December 2002 in patients complaining of fatigue. The subjects were categorized into low, intermediate, and high fatigue groups. Heart rate variability was measured for five minutes at rest, followed by a five minute mental arithmetic test. We analyzed the relationship between fatigue ratings and autonomous function with SPSS 10.0. RESULTS: There was a statistically significant increase in the mean heart rate variability in the all three groups at rest and with stress. There was a statistically significant increase in LF norm increase in the low and high fatigue groups. HF norm showed a statistically significant decrease in the intermediate and high fatigue group. The variation in LF norms was highest in the low fatigue group and lowest. With the mental arithmetic test, the low fatigue group showed decreased rMSSD, HF and HF norm values compared to the intermediate group. The above values showed decrease in the high fatigue group compared to the low group. CONCLUSIONS: Overactivity of the sympathetic nervous system was observed as fatigue ratings increased. The cadiovascular autonomic response tended to decrease as fatigue ratings increased.
Autonomic Nervous System ; Fatigue* ; Heart Rate ; Hospitals, General ; Humans ; Sympathetic Nervous System

PURPOSE: Piezolith 3000(R) is one of the 3rd generation lithotriptors that uses double layered piezoelectric shock waves for the treatment of urinary stone. We evaluated the safety and effectiveness of the Piezolith 3000(R) lithotriptor and we compared it with the previous Piezolith 2300(R) lithotriptor. MATERIALS AND METHODS: We reviewed the records of 500 patients with urinary calculi who had been treated with extracorporeal shock wave lithotripsy (ESWL) from January 2002 to December 2003, but complete follow up data was available for only 385 cases. The distribution of stones, the success rate and the number of ESWL sessions according to the size and location of the stones, the auxiliary procedures and their complications were analyzed. RESULTS: There were 172 cases with renal stone and 213 cases with ureteral calculi. The success rate, defined as being stone-free or having asymptomatic residual fragments measuring 3mm or less, was 82.0% for the renal stones and 93.0% for the ureteral calculi. The overall success rate for all the calculi was 88.1%. The mean number of sessions was 3.6 for the renal stones and 2.3 for the ureteral calculi. The overall mean number of sessions was 2.8. All the treatments were performed without analgesia or sedation except for one child (5 years old) who was given oral sedation. Any serious complications or side effects such as renal hematoma were not observed. CONCLUSIONS: The Piezolith 3000(R) lithotriptor allows shorter treatment sessions and it has more comfortable positioning tools to focus on the stone. It also has the advantage of being anesthesia free and a lower morbidity rate (e.g. pain). Yet we couldn't find any difference of the success rate between the previous standard piezo-system and the Piezolith 3000 .
Analgesia ; Anesthesia ; Calculi* ; Child ; Follow-Up Studies ; Hematoma ; Humans ; Lithotripsy ; Shock* ; Ureteral Calculi ; Urinary Calculi ; Urinary Tract*

We report two cases of systemic lupus erythematosus (SLE) in myasthenia gravis (MG) patients who had undergone thymectomy. SLE developed in the patients 3 months or 13 yr after thymectomy, and polyarthritis was the main clinical manifestation of SLE. Both patients fulfilled at least four of the revised criteria for the classification of SLE. In this report, we describe two postthymectomy lupus patients and perform a comparative review of previous cases.
Adult ; Female ; Human ; Lupus Erythematosus, Systemic/*diagnosis/etiology ; Myasthenia Gravis/*diagnosis/therapy ; Thymus Gland/*surgery ; Time Factors

A 67-year-old male visited Pusan Veterans Hospital due to general weakness and weight loss for 6 months. Physical examination showed non-tender 4 finger breaths sized splenomegaly and both inguinal and cervical lymphadenopathy. The white blood cell count was 25,300/uL with 91% morphologically mature lymphocytes. Bone marrow aspirate revealed hypercellularity with 74.5% lymphocytes morphologically similar to peripheral lymphocytes. The immunophenotpying study of lymphocytes displayed the phenotype of CD19(+), CD20(+), HLA-DR(+), sIg(+) but CD5(-). We concluded that this patients's diagnosis is CD 5 negative B-cell chronic lymphocytic leukemia.
Aged ; B-Lymphocytes* ; Bone Marrow ; Busan ; Diagnosis ; Fingers ; Hospitals, Veterans ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukocyte Count ; Lymphatic Diseases ; Lymphocytes ; Male ; Phenotype ; Physical Examination ; Splenomegaly ; Weight Loss