No abstract available.
Animals ; Antibodies, Neutralizing* ; Immunization* ; Mice*

BACKGROUND: This study proposed a desirable direction for the future development of the Korean Journal of Family Medicine (KJFM) by comparing with the overseas SCI journals, Family Medicine (FM) and The Journal of Family Practice (JFP) based on the statistical viewpoints. METHODS: All of the original articles published in KJFM from January 1981 to June 2011, FM from January 1998 to June 2011, and JFP from January 1978 to June 2011, were reviewed and compared in terms of content, data size, research design, and statistical method. RESULTS: Of 3,226 total original articles, KJFM published 1,549, FM 322, and JFP 1,355, respectively. Both JFP and KJFM mainly focused on biomedical topics (67.2% and 61.7%), while FM focused on education (55.9%). Most of the studies in three journals used the data size of between 100 to 300 cases. The most frequently used research design was cross-sectional, FM 66.8%, JFP 58.4%, and KJFM 72.4%, respectively. The statistical methods in KJFM were gradually diversified. CONCLUSION: The quality of the original articles in KJFM has been improved over the years, but still has conducted based on the relatively weak research designs. Under the circumstances that the higher ranked SCI journals demand the prospective design and large size of data, and most researchers in Korea could not use the large scaled prospective data, we need to collaborate to accumulate the small sized data sets and try to make a registry. More refined statistical method such as a propensity score matching analysis for retrospective data could be an alternative.
Family Practice ; Humans ; Korea ; Propensity Score ; Research Design

PURPOSE: To assess the clinical and pathologic features of each type of intrahepatic cholangiocarcinoma,which is divided into three types according to gross appearance, and to determine the efficacy of CT in detectingthis tumor. MATERIALS AND METHODS: The pathologic and CT features of 53 surgically proven cases of intrahepaticcholangio-carcinoma were reviewed. On the basis of their gross appearance, the tumors were divided into threetypes, as follows: mass forming (n=33), periductal infiltrating (n=6), and intraductal growth type (n=14). CTscans were analyzed for sensitivity of detection and correlation between a tumors appearance and itshistopathology. RESULTS: The most common histopathologic feature of mass forming and periductal infiltrating typewas tubu-lar adenocarcinoma, while in the intraductal growth type, papillary adenocarcinoma (100%) was common.With regard to pattern of tumor spread, intrahepatic and lymph node metastasis were more common in the massforming and periductal infiltrating type than in the intraductal growth type. CT findings including intra-hepaticmass, ductal wall thickening or intraductal mass associated with segmental dilatation of intrahepataic bile ducts,corresponded with these morphologic types. CONCLUSION: This classification according to gross appearance is ofconsiderable value when interpreting the pathologic features of intrahepatic cholangiocarcinoma. CT seems to be auseful modality for the detection of tumors and may be consistent with their gross morphologic findings.
Adenocarcinoma ; Adenocarcinoma, Papillary ; Bile ; Cholangiocarcinoma* ; Classification ; Dilatation ; Lymph Nodes ; Neoplasm Metastasis

PURPOSE: To describe the CT and ERCP findings of mass-forming chronic pancreatitis. MATERIALS AND METHODS: CT and ERCP features were assessed in 13 patients suffering from mass-forming chronic pancreatitis. Diagnosis was on the basis of surgery (n=5), percutaneous needle biopsy (n=3), and clinical follow-up (n=5). Contrast-enhanced CT was available for all patients: five underwent dynamic study and ERCP was performed in 12. On CT and ERCP, both groups were evaluated with regard to the presence and degree of pancreatic ductal dilatation (greater or less than 50 % of total gland width), double duct sign, enhancement pattern, pancreatic parenchymal calcification (site and distribution pattern), mass identification, the direction of infiltration, pancreatic parenchymal atrophy, configuration at the site of obstruction in the pancreatic and common bile duct, lymphadenopathy, vascular encasement, and vascular engorgement or increased collateral vessels in the peripancreatic space. RESULTS: Seven of 13 patients had suffered chronic alcoholism. Serum CA19-9 levels were normal in all patients except one. Common CT and ERCP findings of mass-forming chronic pancreatitis included pancreatic duct dilatation (92.3%), double duct sign(69.2%), inhomogeneous enhancement of the mass (69.2%), and the presence of calcification (61.5%). Patterns of pancreatic duct dilation were irregular in five patients (38.4%) and smooth in three (23.1 %).In all patients, duct dilatation was less than 50 % of total gland width. Enhancement patterns of the pancreatic mass were inhomogeneous (69.2%), a nonenhancing low attenuation mass (15.3%), and homogeneous enhancement (15.3 %). Configuration at the site of obstruction in the pancreatic duct was abrupt termination in two patients (15.4 %) and smooth termination in two (15.4 %). The common bile duct teminated abruptly in three patients (23.1%), and in four (30.8 %) smooth narrowing was abserved. CONCLUSION: Common findings of mass-forming chronic pancreatitis were duct dilatation of less than 50 % of total gland width, double duct sign, inhomogeneous enhancement of the mass, and the presence of calcification. These were combined with observation of clinical findings such as chronic alcoholism and CA19-9 levels, which are useful indicators for differentiating mass-forming chronic pancreatitis from pancreatic cancer.
Alcoholism ; Atrophy ; Biopsy, Needle ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Dilatation ; Follow-Up Studies ; Humans ; Lymphatic Diseases ; Pancreas ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis, Chronic* ; Tomography, X-Ray Computed

This single center cohort study aimed to test the hypothesis that use of a cryopreserved arterial allograft could avoid the maturation or healing process of a new vascular access and to evaluate the patency of this technique compared with that of vascular access using a prosthetic graft. Between April 2012 and March 2013, 20 patients underwent an upper arm vascular access using a cryopreserved arterial allograft for failed or failing vascular accesses and 53 using a prosthetic graft were included in this study. The mean duration of catheter dependence, calculated as the time interval from upper arm access placement to removal of the tunneled central catheter after successful cannulation of the access, was significantly longer for accesses using a prosthetic graft than a cryopreserved arterial allograft (34.4 ± 11.39 days vs. 4.9 ± 8.5 days, P < 0.001). In the allograft group, use of vascular access started within 7 days in 16 patients (80%), as soon as from the day of surgery in 10 patients. Primary (unassisted; P = 0.314) and cumulative (assisted; P = 0.673) access survivals were similar in the two groups. There were no postoperative complications related to the use of a cryopreserved iliac arterial allograft except for one patient who experienced wound hematoma. In conclusion, upper arm vascular access using a cryopreserved arterial allograft may permit immediate hemodialysis without the maturation or healing process, resulting in access survival comparable to that of an access using a prosthetic graft.
Adult ; Arteries/*transplantation ; Blood Vessel Prosthesis ; Cohort Studies ; *Cryopreservation ; Female ; Hematoma/diagnosis ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Renal Dialysis ; Transplantation, Homologous ; Vascular Access Devices ; Veins/pathology

This single center cohort study aimed to test the hypothesis that use of a cryopreserved arterial allograft could avoid the maturation or healing process of a new vascular access and to evaluate the patency of this technique compared with that of vascular access using a prosthetic graft. Between April 2012 and March 2013, 20 patients underwent an upper arm vascular access using a cryopreserved arterial allograft for failed or failing vascular accesses and 53 using a prosthetic graft were included in this study. The mean duration of catheter dependence, calculated as the time interval from upper arm access placement to removal of the tunneled central catheter after successful cannulation of the access, was significantly longer for accesses using a prosthetic graft than a cryopreserved arterial allograft (34.4 ± 11.39 days vs. 4.9 ± 8.5 days, P < 0.001). In the allograft group, use of vascular access started within 7 days in 16 patients (80%), as soon as from the day of surgery in 10 patients. Primary (unassisted; P = 0.314) and cumulative (assisted; P = 0.673) access survivals were similar in the two groups. There were no postoperative complications related to the use of a cryopreserved iliac arterial allograft except for one patient who experienced wound hematoma. In conclusion, upper arm vascular access using a cryopreserved arterial allograft may permit immediate hemodialysis without the maturation or healing process, resulting in access survival comparable to that of an access using a prosthetic graft.
Adult ; Arteries/*transplantation ; Blood Vessel Prosthesis ; Cohort Studies ; *Cryopreservation ; Female ; Hematoma/diagnosis ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/therapy ; Male ; Middle Aged ; Renal Dialysis ; Transplantation, Homologous ; Vascular Access Devices ; Veins/pathology

Sagittal synostosis with related functional aspects of elevated ICP, hydrocephalus, mental retardation and visual abnormalities, or with multiple suture synostosis, surgical correction is imperative. But, craniofacial surgery may impose a threat to an infant or small child. The blood volume in these patients is small and a minor hemorrhage may induce proportionately greater blood loss, resulting in a greater stress to the patient's system. Mortality resulting from craniofacial surgery is uncommon, mostly from operative hemorrhage and infections. Releasing the stenosis and reshaping the cranial vault is the primary operative goal. Authors sought to minimize surgical stress on the child and attain control of cranial vault reshaping by gradual distraction osteogenesis in treating children with sagittal suture synostosis. Three sagittal synostosis patients, aged from 11 months to 3 years old were treated. One of the patients had multiple suture synostosis. Patient follow-up ranged from 3 months to 3 years. Biparietal bone flap was elevated and external distraction devices were inserted. Distraction rate varied from 0.5 to 1mm/day, without a latency period. After a consolidation period of 2-3weeks, the devices were removed. Functional aspects of ICP and mental retardation subsided post surgery. Radiological follow-up showed cessation of enhancement of bone deposition at the frontal and occipital sutures. Excellent aesthetic results were accounted for in all three of the patients. Application of distraction osteogenesis in correcting sagittal craniosynostosis is very effective; surgical stress on the patients is minimal and controlled cranial vault reshaping is possible.
Blood Volume ; Child ; Child, Preschool ; Constriction, Pathologic ; Craniosynostoses* ; Follow-Up Studies ; Hemorrhage ; Humans ; Hydrocephalus ; Infant ; Intellectual Disability ; Latency Period (Psychology) ; Mortality ; Osteogenesis, Distraction* ; Sutures ; Synostosis

Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages.
Adolescent ; Bone Density ; Child ; Femoral Neck Fractures* ; Femur Neck* ; Femur* ; Humans ; Marfan Syndrome* ; Osteoporosis

Chylous ascites is extravasation of lymphatic fluid and retention in the peritoneal cavity due to traurna or obstruction of the lymphatic system. Chylous ascites is very rare complication of Continuous Ambulatory Peritoneal Dialysis (CAPD) and is associated with trauma to the lymphatics during catheter insertion in the early stage of CAPD and repeated mild trauma to the lyrnphatics during longterm dialysis. Chylous ascites in the CAPD is suspected when the drained peritoneal fluid is milky white and confirmed by demonstration of the specific components of chyle, such as elevated triglyceride and low cholesterol than plasma and should be differentiated from pseudochyle and bacterial peritonitis. We report a case of chylous ascites in a patient undergoing CAPD at 2 months later of initiation of CAPD, which was not improved by conservative management. So CAPD catheter was removed and renal replacement therapy was changed to hemodialysis.
Ascitic Fluid ; Catheters ; Cholesterol ; Chyle ; Chylous Ascites* ; Dialysis ; Humans ; Lymphatic System ; Peritoneal Cavity ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis ; Plasma ; Renal Dialysis ; Renal Replacement Therapy ; Triglycerides

Enteric fistulae result from gastrointestinal perforations in which communication is established between the site of perforation and another hollow viscus, potential space, or skin surface. Certain types of enteric fistulae are difficult to demonstrate by conventional radiographic methods, and CT is unique in its ability to demonstrate the extent and nature of extraluminal changes. The purpose of this study is to illustrate the CT findings of enteric fistulae occurring in a variety of abdominal and pelvic organs.
Fistula* ; Skin