Transarterial chemoembolization is often the first-line treatment for multiple hepatocellular carcinomas. However, hepatic arterial infusion chemotherapy is a treatment option for hepatocellular carcinoma refractory to multiple sessions of transarterial chemoembolization. Hepatic arterial infusion chemotherapy requires implantation of an appropriate port into the hepatic artery. However, it may be impossible to implant a port due to hepatic artery variation. We report a case of hepatocellular carcinoma refractory to transarterial chemoembolization and hepatic artery variation treated successfully with hepatic arterial infusion chemotherapy and radiofrequency ablation with complete response after implantation of ports in both liver lobes.

No abstract available.
Hormone Replacement Therapy ; Humans ; Incheon* ; Osteoporosis* ; Physicians, Primary Care* ; Primary Health Care*

Angiokeratoma circumscriptum is present at birth or early childhood and is an uncommon dermatosis characterized by papules and small nodules that may coalesce to form plaques. Histopathologically, there are varying degrees of hyperkeratosis, papillomatosis, and irregular acanthosis. In the papillary dermis, greatly dilated capillaries are observed, The acanthotic epidermis encircles the vascular spaces(blood cysts) where, occasionally, organized thrombi may be found. The use of pulsed-dye lasers to treat cutaneous vascular lesions is based on the theory of selective photothermolysis. We report a case of an angiokeratoma circumscriptum in an 48-year-old woman for whom the flashlamp pulsed tunable dye laser proved to be a highly successful means of treatment.
Angiokeratoma* ; Capillaries ; Dermis ; Epidermis ; Female ; Humans ; Lasers, Dye* ; Middle Aged ; Papilloma ; Parturition ; Skin Diseases

We report a case of arteriovenous fistula involving the external ear in a 27- year-old male patient, who presented with pruritic erythematous scaly patch with multiple pulsating nodules on the thickened and hypertrophied left auricle.The blood flow, measured by laser Doppler velocimetry, was increased markedly on the affected site comparing with the other (710.33mV vs 8.4mV, 663.33mV vs 107. 33mV). We suggest that macrotia must be considered as the one of the clinical manifestations of cutaneous arteriovenous fistula.
Arteriovenous Fistula* ; Ear, External ; Humans ; Laser-Doppler Flowmetry ; Male

Currently, various tyrosine kinase inhibitors and immune checkpoint inhibitors have been suggested in the treatment guidelines for advanced hepatocellular carcinoma (HCC). However, sorafenib was the only systemic drug approved 10 years ago. In 2010, a woman diagnosed with HCC rupture and multiple lung metastases visited our hospital. At the time of visiting our hospital, she had undergone transarterial chemoembolization at another hospital to control bleeding due to HCC rupture. We treated her with hepatic arterial infusion chemotherapy and sorafenib combination therapy to increase the control of intrahepatic tumors in consideration of the modest efficacy of sorafenib. The intrahepatic tumor was almost controlled. Metastasectomy was performed to control lung oligometastasis. Subsequently, additional muscle metastasis was confirmed, and metastasectomy was performed. Although this is a very rare case, it shows that a multidisciplinary approach can improve the prognosis of patients with HCC.

No abstract available.
Ascites* ; Female ; Ovary*

PURPOSE: The purpose of the experiment with the rabbit was to evaluate the effect of human amniotic membrane transplantation in the extraocular muscle surgery area after the operation. METHODS: Five millimeters resection of both superior rectus muscles was performed in eight rabbits. The left eye was served as a control, and the right eye was covered with human amniotic membrane at the site where the operation was performed. Each rabbit was graded according to the degree of adhesion. A histological comparison was done after enucleation. RESULTS: At one week after the operation, it was discovered that the inflammation of the human amniotic membrane transplantation site was suppressed, but at two weeks the human amniotic membrane transplantation site was significantly inflamed. However, the inflammation decreased at six weeks. CONCLUSIONS: This study shows that strabismus surgery with transplantation of human amniotic membrane may reduce postoperative inflammation and adhesion in strabismus surgery after one week. However, after two weeks the inflammation will increase and produce more postoperative adhesion. After six weeks there was no significant inflammation in comparison to the control group.
Amnion* ; Humans ; Inflammation ; Muscles ; Rabbits* ; Strabismus* ; Tissue Adhesions*

A 51-year-old Korean woman presented with a non-tender, well-demarcated, reddish, edematous patch on the right anterior chest where a previous mastectomy and radiation therapy had been performed. She had been diagnosed as having infiltrating ductal carcinoma of the right breast about 1 year ago. Histopathological findings of the skin lesions were consistent with inflammatory metastatic carcinoma of the breast. Inflammatory carcinoma or carcinoma erysipeloides is a well-established entity most frequently associated with carcinoma of the breast. It is characterized by dermal lymphatic invasion by malignancy and clinically should be distinguished from erysipelas or cellulitis. We describe a case of inflammatory metastatic carcinoma derived from an infiltrating ductal carcinoma of the breast which can be clinically confused with radiation dermatitis.
Breast* ; Carcinoma, Ductal ; Cellulitis ; Dermatitis ; Erysipelas ; Erysipeloid ; Female ; Humans ; Mastectomy ; Middle Aged ; Skin ; Thorax

OBJECTIVES: The aims of this study were to estimate the antihypertensive medication adherence in people with a disability and a history of taking antihypertensive medication, and to identify the factors affecting medication adherence. METHODS: The National Health Insurance claims data were linked with the National Disability Registry. People with a disability, who received a prescription of antihypertensives, were identified from a total of 85,098 cases. Cumulative medication adherence (CMA) was used as an indicator of medication adherence. A CMA > 80% was defined as appropriate medication adherence. Multiple logistic regression analysis was used to identify the factors affecting medication adherence. RESULTS: The average CMA in a total of 85,098 patients was 79.5%. The appropriate adherence (CMA > or =80%) rate was 54.5% and 20.5% of patients had a CMA < 50%. Multiple logistic regression analysis revealed that the probability of appropriate adherence decreased with decreasing number of prescription days per visit, increasing number of providers, the patients' residential area moving from urban to rural areas, and when patients have an internal organ disability, auditory impairment, mobility impairment. CONCLUSIONS: The adherence to antihypertensive medication in people with a disability is influenced by various socio-economic, clinical and regional factors. In particular, the disabled who have locomotive and communication disabilities and internal organ impairments have a higher probability of under-adherence to antihypertensive medication adherence in Korea.
Adult ; Aged ; Antihypertensive Agents/*administration & dosage ; Comorbidity ; Disabled Persons/*statistics & numerical data ; Drug Utilization ; Female ; Health Services Accessibility ; Humans ; Insurance Claim Review ; Korea/epidemiology ; Logistic Models ; Male ; Middle Aged ; National Health Programs ; Patient Compliance/*statistics & numerical data ; Residence Characteristics ; Socioeconomic Factors

OBJECTIVE: To compare physiological cost index of the two manual wheel chair propulsion methods: pushing the handrim forward and reversely, and to find out whether the reverse propulsion method will help prevention of the carpal tunnel syndrome in manual wheelchair users. METHOD: The subjects were thirty healthy men in their twenties. All of them performed two manual wheelchair propulsion methods for two days, foreward propulsion on the first day and reverse propulsion the next day. Duration of the wheelchair propulsion was ten minutes. Electromyography (EMG) of wrist extensor groups, biceps brachii, pectoralis major, trapezius, and triceps brachii, and heart rates were recorded. The EMG activity of each individual was transformed to root mean square (RMS), EMG activity appearance time (%), and EMG activity continuance time (%). RESULTS: EMG activity of the wrist extensors in reverse propulsion of the wheelchair was less active compared to forward propulsion. In reverse propulsion method, energy efficiency was not significantly increased, but RMS of wrist extensor groups was significantly reduced. Contractions of trapezius and biceps brachii muscles appeared in earlier phase of propulsion. CONCLUSION: We concluded that reverse propulsion of the wheelchair will be more effective method of wheelchair propulsion compared to forward propulsion in preventing carpal tunnel syndrome in long-term wheelchair users. The reverse propulsion method in this study uses wrist extensor less, which can reduce the wrist extension movement during wheelchair propulsion. It can possibly contribute on the prevention of carpal tunnel syndrome in long-term wheelchair users.
Carpal Tunnel Syndrome ; Electromyography ; Heart Rate ; Humans ; Male ; Muscles ; Superficial Back Muscles ; Upper Extremity* ; Wheelchairs* ; Wrist