Biliary papillomatosis is a rare disease with a high risk of recurrence and malignant transformation. Therapeutic options include partial hepatectomy, Whipple's procedure and liver transplantation. If there is no surgical option left due to several reasons, local palliative procedures such as biliary stenting and drainage for the treatment of cholestasis are considered, but tumor growth cannot be influenced. Photodynamic therapy might be a new additional, palliative option for patients with biliary papillomatosis who are not eligible for surgery. Benign biliary stricture is a rare complication of photodynamic therapy. We report here a case of a 63-year-old male who developed benign biliary stricture after photodynamic therapy using the photosensitizer photofrin.
Cholestasis ; Constriction, Pathologic ; Dihematoporphyrin Ether ; Drainage ; Hepatectomy ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Papilloma ; Photochemotherapy ; Rare Diseases ; Recurrence ; Stents

OBJECTIVE: We evaluated the clinical value of whole body FDG-PET to detect recurrent cervix cancer in patients with elevated serum SCC antigen levels but negative conventional imaging techniques such as CT and MRI after primary treatment for uterine cervix cancer. METHODS: Between August 1998 and January 2004, PET scans were performed on 41 patients in whom recurrent cervix cancers were suspected because serum SCC antigen levels were reelevated after primary treatment, but there were no abnormal CT or MRI findings. Recurrence was defined by monitoring serum SCC antigen levels or imaging findings of CT/MR. A value of 1.5 ng/mL was taken as the upper limit of normal of SCC antigen level. RESULTS: Positive PET findings were noted in 27 out of 41 patients, including 10 patients with distant lesions only, 8 patients with local lesions only, one patient with both local and distant lesions, 1 patient with both local lesion and paraaortic lymph node, 4 patients with both paraaortic lymph nodes and distant lesions, and 3 patients with paraaortic lymph nodes only. In detecting recurrent cervix cancer, the sensitivity, specificity, and accuracy of PET were 84.4%, 100%, and 87.8%, respectively. 27 of 41 patients were predicted as recurrence by PET scanning. CONCLUSION: Whole body FDG-PET scan is useful diagnostic tool to locate recurrent cervix cancer in patients with clinically suspected recurrence but negative conventional imaging techniques.
Cervix Uteri* ; Female ; Humans ; Lymph Nodes ; Magnetic Resonance Imaging ; Positron-Emission Tomography ; Recurrence ; Sensitivity and Specificity ; Uterine Cervical Neoplasms

BACKGROUND: Although adding rituximab to the chemotherapy regimen of cyclophosphamide, vincristine, doxorubicin, and prednisone (R-CHOP) has improved clinical outcomes of patients with diffuse large B-cell lymphoma (DLBCL), several recent studies have shown that the effect of rituximab is dominantly in the non-germinal center (non-GC) subtype compared to the germinal center (GC) subtype. Natural killer (NK) cell count, a surrogate marker of immune status, is associated with clinical outcomes in DLBCL patients in the rituximab era. We investigated whether the impact of NK cells on clinical outcomes differed according to the immunophenotype of DLBCL. METHODS: This study analyzed 72 DLBCL patients treated with R-CHOP between January 2010 and January 2014. RESULTS: Low NK cell counts (<100/microL) were associated with poor progression-free survival (PFS) and overall survival (OS) compared to high NK cell counts. In multivariate analysis, low NK cell count was an independent prognostic factor for PFS and OS. However, survival did not significantly differ between the GC and non-GC subtypes. We examined the clinical influence of NK cells according to the immunophenotype and found that low NK cell counts were significantly associated with poor PFS and OS in non-GC cases, but not in GC cases. CONCLUSION: Low NK cell counts at diagnosis are associated with poor clinical outcomes in DLBCL patients treated with R-CHOP therapy. However, the impact is significant only in non-GC subtype DLBCL, not in the GC subtype.
Biomarkers ; Cell Count ; Cyclophosphamide ; Diagnosis ; Disease-Free Survival ; Doxorubicin ; Drug Therapy ; Germinal Center ; Humans ; Killer Cells, Natural* ; Lymphoma, B-Cell* ; Multivariate Analysis ; Prednisone ; Vincristine ; Rituximab

BACKGROUND: Hyaluronic acid (HA) is a carbohydrate, occurring naturally throughout the human body. With linear polysaccharide structure, it is (HA) found in soft connective tissues, cartilage and joinfluids. Hyaluronic acid filler is used for treatment of depth of the fold or volume of filler needed and performed for wrinkle improvement and cosmetic. We did property of matter for the Perfectha(R) fillers. OBJECTIVE: Our purpose is to describe and comment on our experiences with two kinds of Perfectha(R) fillers. METHODS: We obtained image of the shape of fillers using a folliscope, VC98 and particle size using the Scanning electron microscope (SEM). We tested to make sure that affinity both fillers with water. We mixed the fillers and distilled water. We the PARKER ink added to the mixture. Viscosity and elasticity were measured using a rheometer. RESULTS: The test revealed that a particle sized Perfectha(R) derm deep is bigger than a Perfectha(R) derm. We were confirmed as hydrophile. While Perfectha(R) derm deep filler has high viscosity and elasticity, Perfectha(R) derm filler has high viscosity only, not elasticity. CONCLUSION: Two kinds of Perfectha(R) fillers act as space filler by binding to water and thus keeping the skin wrinkle-free.
Cartilage ; Connective Tissue ; Elasticity ; Human Body ; Hyaluronic Acid ; Ink ; Particle Size ; Skin ; Viscosity ; Water

The potential role of topical valproate (VPA) in hair regrowth has been recently suggested. However, safety reports of VPA as a topical formulation are lacking. Therefore, in the present study, we investigated whether VPA causes skin irritation in humans. We first performed a cell viability test and showed that VPA did not exhibit toxicity toward HaCaT keratinocytes, fibroblasts, and RBL-3H mast cells. We then performed clinical patch test and skin irritation test through transdermal drug delivery with the help of microneedle rollers. No significant findings were obtained in the clinical patch test. In the skin irritation test, only 1 patient showed erythema at 1 hr, but the irritation reaction faded away within a few hours. Erythema and edema were not observed at 24 hr. We concluded that VPA has minimal potential to elicit skin irritation. Therefore, we consider that VPA can safely be applied to human skin.
Cell Survival ; Edema ; Erythema ; Fibroblasts ; Hair ; Humans ; Keratinocytes ; Mast Cells ; Patch Tests ; Skin ; Valproic Acid

BACKGROUND: Hyaluronic acid (HA) is a mucopolysaccharide that occurs naturally throughout the human body, where it attaches to collagen and elastin to form cartilage, and also helps maintain the strength and flexibility of the cartilage that cushions joints. A decline in HA synthesis may lead to a variety of symptoms, ranging from joint discomfort, to wrinkles. Cross-linked HA is a viscoelastic solid that resists in vivo degradation by hyaluronidase for much longer than endogenous HA, and which is also a key ingredient in various cosmetics. OBJECTIVE: To describe our experience with three kinds of Elravie(R) fillers. METHODS: We obtained images of filler shape using a folliscope. Scanning electron microscopy (SEM) was used to compare particle sizes. Hydrophilic filler is a hydroxyl, and for this reason, we mixed the filler with water. Next, PARKER ink was added to the mixture, and viscosity and elasticity were measured using a rheometer. RESULTS: Among the tested fillers, particle size was largest in the Restylane(R) SubQ. Elravie(R) ultra volume filler was greater in volume than Elravie(R) deep line, and Elravie(R) light fillers. We confirmed Elravie(R) fillers to be hydrophilic. Elravie(R) ultra volume filler was found to have the highest viscosity and elasticity, whilst Elravie(R) light filler had the lowest. CONCLUSION: All three kinds of Elravie(R) fillers were found to be suitable for human cosmetic use.
Cartilage ; Collagen ; Elasticity ; Elastin ; Human Body ; Humans ; Hyaluronic Acid ; Hyaluronoglucosaminidase ; Ink ; Joints ; Microscopy, Electron, Scanning ; Particle Size ; Pliability ; Viscosity ; Water

Purpose: This study investigated the effects of open kinetic chain (OKC) exercise for the gastrocnemius (GCM) and tibialis anterior (TA) muscles on static and dynamic balance and muscle strength. Methods: We recruited 21 healthy participants, dividing them into 3 groups (GCM, TA, and non-exercise). Each group contains 7 participants. Two exercise groups (GCM and TA) performed OKC exercise with elastic bands twice per week for 4 weeks, while non-exercise group did nothing. We obtained the data for static and dynamic balance and muscle strength before and after the intervention. We used the Kruskal–Wallis test to compare and analyze the pre–post-intervention differences among the groups. Results: For static balance, the stability index of the TA group was the lowest for the dynamic platform (p < 0.05). The dynamic balance of the TA group increased for the anterior and posteromedial directions (p < 0.05). The peak torque increased in the TA group for dorsiflexion (D/F) movement and in the GCM group for plantar flexion movement compared with the other groups, except for the left direction during D/F (p < 0.05). Conclusion OKC exercises with elastic bands were effective for selectively increasing muscle strength. It is clinically thought that strength training for TA muscles will be effective among the muscles of the ankle.

BACKGROUND: As cardiac disorders, especially coronary artery disease is increasing in end-stage renal disease patients, the indications for coronary artery bypass surgery are increasing now. They have high risks for postoperative morbidity and mortality after coronary artery bypass surgery. MATERIAL AND METHOD: Between March of 1996 and May of 2000, medical records of 25 patients with end-stage renal disease who underwent coronary artery bypass surgery at Asan medical center were reviewed retrospectively. We reviewed the short-term results of preoperative risk factors, preoperative renal function, perative methods, operation results, hospital course, postoperative morbidity and mortality. RESULT: Preoperative creatinine clearance was 12.68+/-5 ml/min and serum creatinine level was 6.18+/-3 mg/dL(range 1.7-14. 4). Preoperatively, 11 patients(44%) received dialysis and the others(14 patients, 56%) were not supported by dialysis due to adequate urine output. Of the non-dialysis patients(14 cases), 8 patients were newly supported by dialysis, perioperatively. Of the preoperative hemodialysis patients(9 cases), two patients changed dialysis method postoperatively to peritoneal dialysis. Operative mortality occured in 2 patients(8%) and the causes of death were sepsis from aspiration pneumonia and mediastinitis, and postoperative bleeding and mediastinitis, respectively. Postoperative complications were developed in 14 patients(56%). There were 2 cases(8%) late mortalities and the cause of death was catheter-induced peritonitis. The actuarial survival rates in hospital survivals at 4 years was 82+/-13%. CONCLUSION: The coronary artery bypass surgery of end-stage renal disease patients were performed with acceptable mortality(8%). However , because the morbidity and mortality from morbidity were very frequent, perioperative prevention of infectious complications and careful patient management are very important.
Cause of Death ; Chungcheongnam-do ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Creatinine ; Dialysis ; Hemorrhage ; Humans ; Kidney Failure, Chronic* ; Mediastinitis ; Medical Records ; Mortality ; Peritoneal Dialysis ; Peritonitis ; Pneumonia, Aspiration ; Postoperative Complications ; Renal Dialysis ; Retrospective Studies ; Risk Factors ; Sepsis ; Survival Rate

We evaluated the incidence, clinical characteristics, and prognostic impact of calreticulin (CALR) mutations in essential thrombocythemia (ET) and primary myelofibrosis (PMF) patients. In all, 48 ET and 14 PMF patients were enrolled, and the presence of CALR mutations was analyzed by direct sequencing. Patients were classified into three subgroups according to Janus kinase 2 (JAK2) V617F and CALR mutation status, and their clinical features and prognosis were compared. CALR mutations were detected in 15 (24.2%) patients, and the incidence increased to 50.0% in 30 JAK2 V617F mutation-negative cases. These included 11 patients with three known mutations (c.1092_1143del [seven cases], c.1154_1155insTTGTC [three cases], and c.1102_1135del [one case]) and 4 patients with novel mutations. ET patients carrying CALR mutation were younger, had lower white blood cell counts, and experienced less thrombosis during follow-up than those carrying JAK2 V617F mutation, while both patient groups showed similar clinical features and prognosis. In ET patients without JAK2 V617F mutation, CALR mutation did not significantly affect clinical manifestation and prognosis. In conclusion, CALR mutation analysis could be a useful diagnostic tool for ET and PMF in 50% of the cases without JAK2 V617F mutations. The prognostic impact of CALR mutations needs further investigation.
Adult ; Aged ; Calreticulin/*genetics ; DNA Mutational Analysis ; Exons ; Female ; Genotype ; Humans ; INDEL Mutation ; Janus Kinase 2/genetics ; Male ; Middle Aged ; Primary Myelofibrosis/diagnosis/epidemiology/*genetics ; Prognosis ; Republic of Korea ; Tertiary Care Centers ; Thrombocythemia, Essential/diagnosis/epidemiology/*genetics ; Young Adult

BACKGROUND: Bortezomib has significant activity in treating multiple myeloma (MM). The risk of herpes zoster (HZ) has been reported to increase significantly with bortezomib treatment, but the predisposing factors for HZ are not clear. This study is a retrospective analysis of the relevant risk factors for HZ in Korean MM patients treated with bortezomib. METHODS: Sixty-six patients with refractory or relapsed MM who underwent chemotherapy with bortezomib were included in the study. Prophylactic antiviral drugs were not used for treatment. The following parameters were reviewed: age, gender, stage and type of MM, extent of previous treatment, history of HZ, duration from the time of diagnosis to the time of bortezomib treatment initiation, and absolute lymphocyte counts (ALC) at the time of bortezomib treatment initiation. RESULTS: The incidence of HZ was 16.7%. There were no intergroup differences between the HZ-positive and the HZ-negative groups with regard to a history of HZ, number of previous treatments, and exposure to steroids before bortezomib treatment. The median duration from the time of MM diagnosis to the time of bortezomib treatment initiation in the HZ-positive group was significantly shorter than that in the HZ-negative group. The median ALC at the time of bortezomib initiation in the HZ-positive group was significantly lower than that in the HZ-negative group. CONCLUSION: Bortezomib itself might act as a risk factor for HZ by inhibiting cell-mediated immunity, and patients with low ALC at the time of bortezomib treatment initiation were at greater risk of HZ during bortezomib treatment.
Antiviral Agents ; Boronic Acids ; Herpes Zoster ; Humans ; Immunity, Cellular ; Incidence ; Lymphocyte Count ; Multiple Myeloma ; Protease Inhibitors ; Pyrazines ; Retrospective Studies ; Risk Factors ; Steroids ; Bortezomib