OBJECTIVE: During the follow-up period of extrahepatic malignancy, one may encounter a solitary hepatic metastasis on CT scan which may be difficult to differentiate from hepatic abscess in an ambiguous clinical setting. It was our intention to copmare the radiological similarities and differences between two disease entities from which differentiation can be attempted. MATERIALS AND METHODS: Thirty-six cases of solitary heaptic meastesis and 23 cases of liver abscess were included in this study. Two radiologists interpreted the CT without knowledge of the clinical informations. CT pattern was categorized and the frequency of various findings were compared between the two groups. CT findings of the mass were analysed in misinterpreted cases. RESULTS: Without the clinical informations, the diagnostic accuracy of the mass was 72-76% without pattern analysis. Homogeneous masses were seen in both groups, but all masses larger than 4cm were metastases. In heterogeneous masses, metatases more frequently accompanied high attenuation in central or peripheral portion of the mass and showed thick intermediate zone, Irregular trabecular pattern or septations were more frequently observed in abscesses. Biliary dilatation or stone, pleural effusion, air in mass or biliary tree were more frequently seen in abscesses. The false diagnosis was encountered most frequently when the mass possessed any of the followings; homogeneous attenuation, mosaic pattern in the mass with inhomogeneous attenuation and thin intermediate attenuation area. CONCLUSION: Pattern analysis of the various CT character will be helpful to differentiate hepatic abscess and solitary hepatic metastasis in the equivocal clinical settings. However, similar pattern can be seen in both entities ;in this cases, corrdination of CT pattern and secondary findings is needed for better differentiation.
Abscess ; Biliary Tract ; Diagnosis ; Dilatation ; Follow-Up Studies ; Intention ; Liver Abscess* ; Neoplasm Metastasis ; Pleural Effusion ; Tomography, X-Ray Computed

Pigmented villonodular synovitis is a benign proliferative disorder affecting the synovium. In 1941, Jaffe assembled under the common term of pigmented villonodular synovitis dissimilar lesions described by different names, that issuch as giant cell tumors of synovial tendon sheaths, actual pigmented villonodular synovitis, and villonodular bursitis. (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, or diffuse, usually arising in the vicinity of large joints.) Involvement of the temporomandibular joint is very rare. (We report a rare case of pigmented villonodular synovitis of the temporomandibular joint that invaded the mandibular condyle. A 34-year-old man had a large left preauricular (parotid) mass for two years that he had focal facial nerve paralysis, temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. At surgical exploration, a tumor was found to be severely adhered sion to the facial nerve and involving the temporomandibular joint. Histologically, Tthe resected specimen histologically was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.) The appearance was typical of the family of lesions that includes pigmented villonodular synovitis, bursitis, and tenosynovitis . rewritten as follows: (Giant cell tumors of tendon sheaths, which may be localized, most often occurring in fingers, flexor tendons or interphalangeal joints, and spread to other parts after arising in the vicinity of large joints.) rewritten as follows: (A 34-year-old man had a large left preauricular (parotid) mass for two years and showed focal facial nerve paralysis in the temporal and zygomatic branches. The clinical appearance suggested a parotid tumor. Surgical exploration revealed a tumor that was severely connected to the facial nerve involving the temporomandibular joint. Histologically, the resected specimen was a proliferative lesion composed of epithelioid histiocytes, spindle cells, and multinucleated giant cells.)
Adult ; Bursitis ; Facial Nerve ; Fingers ; Giant Cell Tumors ; Histiocytes ; Humans ; Joints ; Mandibular Condyle ; Paralysis ; Synovial Membrane ; Synovitis, Pigmented Villonodular* ; Temporomandibular Joint* ; Tendons ; Tenosynovitis

OBJECTIVE: Poor head and neck support during sleep can exacerbate the neck pain. Based on the ideal sleep posture and pillow suggested by Cyriax, we designed a new cervical pillow and compared the degree of pain reduction, quality of sleep and pillow satisfaction with a low hospital pillow and a high pillow. METHOD: The newly designed pillow has a built-in pressure-adjustable air bag in the cervical area and provides normal cervical lordotic curve in supine position and maintains cervical and thoracic vertebrae to form a horizontal line in side-lying position. Thiry-four patients with cervical pain used low hospital pillows for the first week of 3-week randomized crossover design study. They were subsequently randomly assigned to use each of the other two pillows for 1-week period. Outcomes were measured using visual analog scale, sleep questionnaire and a pillow satisfaction scale. RESULT: Compared with the other 2 types of pillows, subjects using the newly designed pillow showed much reduced pain intensity, increased duration of sleep and sleep quality and better pillow satisfaction. CONCLUSION: We designed a cervical pillow with built-in pressure adjustable air bag and it can significantly reduce pain intensity and improve quality of sleep in patients with cervical pain.
Air Bags ; Cross-Over Studies ; Head ; Humans ; Neck ; Neck Pain ; Posture ; Surveys and Questionnaires ; Supine Position ; Thoracic Vertebrae ; Visual Analog Scale

BACKGROUND AND OBJECTIVES: Parathyroid gland tumor is a relatively rare disease in Korea. The purpose of our study is to assess the clinical features, diagnostic tools and therapeutic results. MATERIALS AND METHOD: Seven patients with parathyroid gland tumor were analyzed retrospectively. They were diagnosed and received surgical therapy in our hospital from 1995 to 1999. The patients were all female with mean age of 45.3 years (in the range of 21-64 years old). We used ultrasonography, computed tomography, magnetic resonance imaging, parathyroid scan and 18F-FDG positron emission tomograph (PET) to identify the location of parathyroid gland neoplasm. RESULTS: All patients received proper surgical management. Three patients were diagnosed as parathyroid carcinoma, three as parathyroid adenoma and one patient as cavernous hemangioma. Two patients were found as recurrent tumor, Parathyroid carcinoma recurred in one patient, and parathyroid hyperplasia occurred in patient who was previously diagnosed as parathyroid adenoma. CONCLUSION: The results would he a useful guideline for better diagnostic strategies, proper surgical management and follow-up study for recurrence in the parathyroid gland tumor.
Electrons ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Hemangioma, Cavernous ; Humans ; Hyperplasia ; Korea ; Magnetic Resonance Imaging ; Parathyroid Glands* ; Parathyroid Neoplasms ; Rare Diseases ; Recurrence ; Retrospective Studies ; Ultrasonography

BACKGROUND AND ackground and Objectives: Smoking has been reported as an important risk factor of laryngeal cancer. Cytochrome P450 1A1 (CYP1A1) and glutathione S-transferase P1 (GSTP1) are genes that encode enzymes which are involved in the metabolism of carcinogens in cigarette smoke. In this study, we statistically tested the significances of smoking and genotypes of CYP1A1 and GSTP1 as risk factors of laryngeal cancer. MATERIALS AND METHOD: In this case-control study, 84 pathologically proven laryngeal cancer patients and 168 age- and sex-matched controls were included as the study subjects. Information on smoking habit was collected using a self-administered questionnaire, and CYP1A1 and GSTP1 genotypes were analyzed using PCR-RFLP method. Chi-square test, Student's t-test and conditional logistic analysis were used to test statistical significance. RESULTS: Smoking was turned out to be a significant risk factor of laryngeal cancer both in univariate and multivariate analyses. The CYP1A1 Ile/Ile genotype was significant in the univariate test, but the statistical significance disappeared in the multivariate conditional logistic model including smoking. The odds ratio (95% confidence interval) of GSTP1 A/A genotype for laryngeal cancer was 0.71 (0.38, 1.33), which was not statistically significant. CONCLUSION: Smoking is the most potent risk factor among the three factors, and the genotypes of CYP1A1 and GSTP1 would not be major risk factors for laryngeal cancer in Koreans.
Carcinogens ; Case-Control Studies ; Cytochrome P-450 CYP1A1* ; Cytochrome P-450 Enzyme System ; Genotype ; Glutathione Transferase ; Humans ; Laryngeal Neoplasms* ; Logistic Models ; Metabolism ; Multivariate Analysis ; Odds Ratio ; Polymorphism, Genetic* ; Surveys and Questionnaires ; Risk Factors ; Smoke ; Smoking ; Tobacco Products

BACKGROUND AND OBJECTIVES: Although it is well known that mitral valve repair provides a better postoperative outcome than valve replacement for mitral valve prolapse with mitral regurgitation, there haven't been much studied the nature of remnant regurgitation and the change of heart function and structure by remnant regurgitation after mitral valve repair surgery. We tried to research for it. METHODS AND RESULTS: Retrospective analysis of echocardiographic data and medical records was done in patients who underwent repair surgery for mitral valve prolapse with significant mitral regurgitation at the Keimyung University Dong-san Medical Center from February 1996 to February 2000. Patients who underwent echocardiography before and after the surgery were selected for the analysis. Of patients who underwent mitral valve repair surgery for mitral valve prolapse with mitral regurgitation during that period, 30 patients (male 15, female 15) were included in this study. The average age of them was 44.30+/-14.30 year old. After surgery, heart chamber size was decreased significantly in all patients (e. g. LVDd 6.25+/-1.06 cm vs. 5.14+/-0.62 cm, LV mass 272.46+/-107.36 gm vs. 197.30+/-75.16 gm). Remnant mitral regurgitation after repair surgery was found in 22 patients (73.3%). Remnant mitral regurgitation above trivial flow was found in 10 patients. Such case as involving ant. leaflet was found in 5 patients (16.7%), as involving post. leaflet, in 2 patients (6.7%), as involving both leaflet, in 3 patients (10%) among 10 ones. Eccentric flow among remnant regurgitation, was observed in 2 patients who underwent repair surgery for ant. leaflet, 1 patient who underwent repair surgery for both leaflet. CONCLUSION: Mitral valve repair surgery reduce the left ventricular chamber size and left ventricular mass. Postoperatively, patients who involve ant. leaflet were much remnant regurgitation above trivial flow more than others.
Ants ; Echocardiography ; Female ; Heart ; Humans ; Medical Records ; Mitral Valve Insufficiency* ; Mitral Valve Prolapse* ; Mitral Valve* ; Retrospective Studies ; Thoracic Surgery

BACKGROUND: To avoid the adverse effects of cardiopulmonary bypass and to overcome late vein graft failure, we routinely performed off-pump total arterial coronary revascularization. MATERIAL AND METHOD: From July 2000 to August 2001, 104 consecutive patients underwent first elective off-pump total arterial coronary revascularization. Both internal mammary, radial and gastroepiploic arteries were used. Sequential and composite grafts were used to achieve complete revascularization. Perioperative adverse events and postoperative angiograms were analyzed. RESULT: A total of 252 arterial conduits were used with an average of 2.47 grafts per patient. A total of 326 distal anastomosis were performed with a mean of 3.13 distal anastomosis per patient. Cross over to on-pump occurred in seven patients (6.7%). Of these 4 were due to unstable hemodynamics during lateral or posterior wall stabilization as a result of cardiomegaly and 3 were due to uncontrolled bleeding during dissection of diffusely dimunitive deeply placed intramyocardial coronary arteries. There were no opeartive deaths. Two cases of perioperative myocardial infarction and transient neurologic complications occurred, respectively. Of the 312 distal anastomoses, 308 (98.7%) were compatible with Fitz-Gibbon A or B patency grading. CONCLUSION: Off-pump total arterial coronary revascularization was technically feasible in most elective cases with satisfactory early results. However, on-pump coronary bypass surgery should be considered in difficult circumstances, such as cardiomegaly or unfavorable anatomy of the target coronary artery.
Cardiomegaly ; Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Vessels ; Gastroepiploic Artery ; Hemodynamics ; Hemorrhage ; Humans ; Myocardial Infarction ; Transplants ; Veins

The spleen is one of the largest organ in the reticuloendothelial system and plays an important role in theac-tivation of immune response. It is the organ most commonly injured after blunt abdominal trauma, and malig-nantlesions such as lymphoma, or these due to metastasis, occur not infrequently. Even so, it is ignored even inabdominal ultrasonography. Some benign splenic lesions, however can cause severe symptoms and result in high mortality, and their accurate diagnosis is therefore essential. This study describes the imaging findings andhistopathologic features of various nontraumatic benign splenic lesions.
Diagnosis ; Lymphoma ; Mononuclear Phagocyte System ; Mortality ; Neoplasm Metastasis ; Spleen ; Ultrasonography

Mushrooms collected from Deogyu mountain, Korea, in 2011, were identified as four classes, four orders, 13 families, 22 genera, and 33 species. In particular, agaricales was most abundant and comprised more than 70%. Their antioxidant activities were estimated using three different bioassay methods, the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonate) (ABTS) radical scavenging assay, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging assay, and reducing power assay. As a result, the methanol extracts of Stereum ostrea, Laetiporus sulphureus var. miniatus, and Tyromyces sambuceus exhibited potent antioxidant activity in all bioassays tested.
Agaricales ; Biological Assay ; Biphenyl Compounds ; Humans ; Korea ; Methanol ; Ostrea ; Picrates

BACKGROUND AND OBJECTIVES: Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized. SUBJECTS AND METHODS: We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients. RESULTS: Among 14871 patients, 159 (61+/-12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9+/-12.4 years). Group II had 81 patients (61.6+/-12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE. CONCLUSION: Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.
Blood Pressure ; Demography ; Emergencies ; Follow-Up Studies ; Humans ; Korea ; Myocardial Infarction ; Odds Ratio ; Prehypertension ; Prognosis