Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu disease is an autosomal dominant disorder characterized by repeated episodes of bleeding. Multiple telangiectases consisting of thin-walled, dilated vascular channels with arteriovenous communication may involve, for example, mucocutaneous tissue, the gastrointestinal tract, and the liver, lung, and brain. We report the imaging findings of two cases of HHT involving arteriovenous malformation of both the lungs and liver, a rare condition. Chest radiography revealed a round mass, while helical CT showed a feeding artery and draining vein with arteriovenous malformation in the lung. Color Doppler sonography revealed an enlarged and tortuous hepatic artery with high systolic velocity. CT demonstrated an enlarged hepatic artery, arteriovenous shunt, and early draining hepatic vein in the liver. Celiac angiography showed arteriovenous malformation.
Angiography ; Arteries ; Arteriovenous Malformations* ; Brain ; Gastrointestinal Tract ; Hemorrhage ; Hepatic Artery ; Hepatic Veins ; Liver* ; Lung* ; Radiography ; Telangiectasia, Hereditary Hemorrhagic* ; Telangiectasis ; Thorax ; Tomography, Spiral Computed ; Veins

PURPOSE: This study was performed to verify the effect of Tai Chi exercise on patients with rheumatoid arthritis particularly their level of pain, fatigue, sense of balance and daily life performance (ADL). METHOD: It employed a non-equivalent control group pre- and post-test design. The research instruments used in this study were pain, fatigue, sense of balance and ADL. Thirty-two patients in the experimental group carried out 50 minutes of Tai Chi exercise for 12 weeks, and 29 patients in the control group did not. Before and after the experiment, both groups were tested for pain, fatigue, sense of balance and ADL. Collected data were processed using the SPSS/WIN 10.0 program analyzed by the frequency, percentage, X2-test, and t-test. RESULTS: Pain and fatigue significantly decreased in the experimental group. However the improvement in ADL of the rheumatoid arthritis patients was not statistically significant but their sense of balance was enhanced significantly. CONCLUSION: Tai Chi exercise is an effective nursing intervention that can be used for rheumatoid arthritis patients.
Activities of Daily Living ; Arthritis, Rheumatoid/*rehabilitation ; Fatigue/*rehabilitation ; Female ; Humans ; Male ; Middle Aged ; Pain/*rehabilitation ; Postural Balance ; *Tai Ji

Lipoma is one of the unusual benign breast neoplasms and usually manifests at fatty breast of women at the age of 40 to 60. We experienced a case of large breast lipoma nearly replacing the whole left breast parenchymal tissue with mammographic finding of well-defined radiolucent mass, sonographic finding of hyperechoic mass with disorganized echopattern and computerized tomographic finding of very low attenuation mass, characteristic to adipose tissue, in a young woman of her dense breast.
Adipose Tissue ; Breast Neoplasms ; Breast* ; Female ; Humans ; Lipoma* ; Ultrasonography

OBJECTIVE: To determine the incidence of embryo retention (ER) in the transfer catheter following embryo transfer (ET) in blastocyst transfer and investigate whether retransferring retained embryos has an impact on reproductive outcomes in patients undergoing in vitro fertilization-ET. METHODS: We retrospectively analyzed the records of 1,131 blastocyst transfers, which comprised 223 single blastocyst transfer (SBT) and 908 double blastocyst transfer (DBT) cycles. Each SBT and DBT group was classified depending on whether ET was performed without retained embryos in the catheter during the first attempt (without-ER group) or whether any retained embryos were found following ET (ER group) for the purpose of comparing reproductive outcomes in a homogenous population. RESULTS: The overall incidence of finding retained embryos was 2.8% (32/1,131). There were no retained embryos in SBT cycles. In DBT cycles, implantation rates (30.0% vs. 26.6%), positive β-hCG rates (57.2% vs. 56.2%), clinical pregnancy rates (45.3% vs. 46.9%), and live birth rates (38.9% vs. 43.8%) were not significantly different between the without-ER and ER groups. There were no significant differences in the mean birth weight (g) 2,928.4±631.8 vs. 2,948.7±497.8 and the mean gestational age at birth (269.3±17.2 days vs. 264.2±25.7 days). A total of nine cases of congenital birth defects were found in this study population. Eight were observed in the without-ER group and one in the ER group. CONCLUSION: Our results suggest that retransfer of retained embryos does not have any adverse impact on reproductive outcomes in blastocyst transfer cycles. Furthermore, our results support finding that SBT might be advantageous for decreasing the incidence of retained embryos in catheters.
Birth Weight ; Blastocyst* ; Catheters ; Congenital Abnormalities ; Embryo Transfer* ; Embryonic Structures* ; Fertilization in Vitro ; Gestational Age ; Humans ; In Vitro Techniques ; Incidence ; Live Birth ; Parturition ; Pregnancy Rate ; Retrospective Studies

BACKGROUND: Biodegradable microspheres are a useful method of drug delivery because they are both injectable and biodegradable. Previous work in our group has characterized implantable preparations of local anesthetics in pellets for prolonged regional anesthesia. In this paper we evaluated injectable suspensions of lidocaine-polymer microspheres for extended period of percutaneous sciatic nerve blockade in rats. METHODS: Microspheres were prepared using poly (lactide-co-glycolide) loaded with 50 wt% lidocaine by a solvent evaporation method. In vitro release rate of lidocaine from microspheres was determined by high performance liquid chromatography (HPLC). Percutaneous blockade of the rat sciatic nerve was performed, and sensory blockade of the nerve was assessed using an analgesiometer. RESULTS: Lidocaine was released in a controlled manner in vitro. In general 60% of the drug released in the first day, 80% in two days. Sciatic nerve blockade duration ranged from 8 to 12 hours. Incorporation of dexamethasone 0.05 wt% into the microspheres resulted in significant prolongation of block. CONCLUSION: Prolonged percutaneous blockade of peripheral nerve is achieved using biodegradable polymeric lidocaine microspheres.
Anesthesia, Conduction* ; Anesthetics, Local ; Animals ; Chromatography, Liquid ; Dexamethasone ; Lidocaine* ; Microspheres* ; Peripheral Nerves ; Polymers* ; Rats ; Sciatic Nerve ; Suspensions

Pigmented villonodular synovitis(PVNS) is a synovial lesion of joints or tendon sheaths, characterized by villous and nodular overgrowth of the synovial membrane. It commonly occurs in synovial joints of the appendicular skeleton, particularly those of the knee and hip, but rarely affecting those of the spine. We report a case of PVNS of the lumbar spine mimicking epidural mass.
Hip ; Joints ; Knee ; Skeleton ; Spine* ; Synovial Membrane ; Synovitis ; Synovitis, Pigmented Villonodular* ; Tendons

PURPOSE: This study was to developed to create a CD-ROM and an educational program for the prevention of sexual harassment and violence and to contribute to the perception and add to the coping of the victims of sexual harassment and violence as well as the child, parents, and teachers. METHOD: The study's methods were literature reviews, surveys, and assessments of the negotiation process for educational needs of sexual harassed and abused children. RESULT: The sexual harassment and violence prevention program will contain four subjects : 1) sexual development of a preschool child, 2) characteristics of sexual harassment and violence of a preschool child, 3) safe sex, early detection of sexual violence syndrome, and coping strategies. The CD-RON was composed from three sites. The first was a child site, the second was a parent/teacher site, and the third was a game site for evaluations. The child site consisted of 10 possible scenarios of sexual harassment and violence that a child could experience. The parent/teacher site consisted of knowledge and information for prevention and coping strategies for sexual harassment and violence. At the end of each situation question and answer sections that were used for formative evaluation. Also, the game site could be a summative evaluation. CONCLUSION: The effects of this program and the CD-ROM were based of the promotion of reverence for humanity and gender equality for preschool childen. Eventually, children, parents, and teachers will have prevention and coping ability that will reduce the occurrence of sexual harassment and violence in Korea.
CD-ROM* ; Child ; Child, Preschool* ; Humans ; Korea ; Negotiating ; Parents ; Safe Sex ; Sex Offenses* ; Sexual Development ; Sexual Harassment* ; Violence

PURPOSE: To assess the efficacy of ancillary CT findings other than the obstructive lesion per se for the differential diagnosis of extrahepatic biliary obstruction. MATERIALS AND METHODS:CT findings of 49 patients with extrahepatic bile duct obstruction(22 benign and 27 malignant lesions) were assessed with emphasis on the patterns of ductal dilatation, contrast enhancement, and diffuse thickening of the extrahepatic ductal wall. Degree of central and peripheral intrahepratic ductal dilatation was graded by comparing with the adjacent portal radicles and hepatic parenchymal thickeness. RESULTS: Diffuse circumferential thickening and contrast enhancement of the extrahepatic ductal wall were more frequent in benign cases, but only thickening was statistically significant(p < 0.01). Peripheral intrahepatic ducts were more severely dilated by malignant causes(p < 0.01). With the same degrees of extrahepatic and central ductal dilatations, peripheral intrahepatic ducts were more severely dilated in malignant than in benign cases. CONCLUSION: These results may help to interpret the CT findings of extrahepatic biliary obstruction, particularly when the cause of biliary obstruction is uncertain.
Bile Ducts, Extrahepatic ; Diagnosis, Differential ; Dilatation* ; Humans

BACKGROUND: It is controversial that an electrocardiography (EEG) is valuable in evaluation of patients with headache. The purpose of this study was to determine whether EEG brain mapping can be a useful indicator for evaluating the analgesic efficacy of treatment on the patient with an occipital headache. METHODS: We did an EEG on 20 patients with occipital headaches at the peri-laser application period. The laser was radiated for 3 minutes a third of the total distance from the external occipital protuberance to the mastoid process on the superior nuchal line. An EEG was taKen before laser radiation as control use, and at 10, 30 and 60 minutes after laser radiation by 32 channel electrodes (international 10 20 system). The EEG mapping was red for the high electric potential and blue for the low electric potential. RESULTS: Compared with control group, the alpha wave increased significantly in parieto-occipital and occipital region at 60 minutes after laser radiation (P < 0.05). DarK red color was increased especially in occipital region at 60 minutes after laser radiation, compared with EEG mapping before laser radiation. Good and Fair improvements were observed in 55% of the patients with occipital headaches. CONCLUSIONS: We conclude that EEG can be a valuable indicator in the evaluation of analgesic efficacy of treatment in the patients suffering from occipital headaches. Pain scores were assessed by the patient with the visual analogue scale (VAS).
Brain Mapping ; Electrocardiography ; Electrodes ; Electroencephalography* ; Headache* ; Humans ; Mastoid

Subungual squamous cell earcinoma is an uncommon disease. Diagnosis of this condition is often delayed because of a resemblance to a variety of benign inflammatory conditions such as onychomycosis, chronic paronychia, eczema, and verruca vulgaris. The importance of an early skin biopsy for a chronic nonhealing subungual lesion is stressed. We present a case of subungual squamous cell carcinoma iri a 75-year-old man who had a 3-year history of intermittent swelling, erythema, and tenderness on the left 5th toe. The patient complained of a tender whitish verrucous 1.5cm-sized mass which had been present for a few months. A Histopathological study revealed invasive, well differentiated squamous cell carcinoma.
Aged ; Biopsy ; Carcinoma, Squamous Cell* ; Diagnosis ; Eczema ; Erythema ; Humans ; Onychomycosis ; Paronychia ; Skin ; Toes ; Warts