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

PURPOSE: To assess the spectral alteration of phosphorus metabolities in patients with liver cirrhosis andcompare energy metabolites with clinical grades using 31P MR spectra localized by two-dimensional chemical shiftimaging. MATERIALS AND METHODS: In 15 normal (control) subjects and 12 patients with liver cirrhosis, 31P MRspectroscopy was undertaken. Patients were divided into two groups, namely 'mild cirrhosis' (Child A, n=5) and'severe cirrhosis' (Child B and C, n=7) according to disease severity, as assessed by Child-Hugh's classification.In vivo 31P MR spectroscopy was performed on a 1.5-T system (Magnetom Vision; Erlangen, Germany), using a surfacecoil. Peak areas of phosphomonoester (PME), inorganic phosphate (Pi), phosphodiester (PDE), and gamma-, alpha- andbeta-ATP were defined. Peak areas of phosphorous metabolites in the spectra were expressed as values of PME/beta-ATP,PDE/beta-ATP, PME/ATP, and PME/PDE. RESULTS: The values of PME/beta-ATP, PDE/beta-ATP, PME/ATP, and PME/PDE betweencontrol subjects and patients with liver cirrhosis were significantly different. With impaired hepaticdysfunction, PME increased as PDE decreased. In patients with severe cirrhosis, the values of PME/(-ATP andPME/ATP were significantly higher than those of patients with mild cirrhosis. CONCLUSION: In patients with livercirrhosis, peak areas of PME, were significantly higher, and this might reflect the severity of hepaticdysfunction. PME/(-ATP and PME/ATP valves appear predict the severity of cirrhosis.
Fibrosis ; Humans ; Liver Cirrhosis* ; Liver* ; Magnetic Resonance Spectroscopy* ; Phosphorus*

Brown tumor refers to a change of skeletones that develops as a complication of hyperparathyroidism. As osteoclast is activated to stimulate reabsorption and fibrosis of bone, it causes a cystic change of the bone. Parathyroid carcinoma is being reported as a tumor that induces primary hyperparathyroidism. It causes excessive secretion of the parathyroid hormone and increases the blood parathyroid hormone and calcium. Bone deformation due to brown tumor is known to be naturally recovered through the treatment for hyperparathyroidism. However, there is no clearly defined treatment for lesions that can induce pathological fractures developing in lower extremities. We experienced a case where brown tumor developed in the proximal femur of a 57-year-old female patient due to parathyroid carcinoma. In this case, spontaneous fracture occurred without any trauma, and it was cured by performing intramedullary nailing fixation and parathyroidectomy. We report the treatment results along with a literature review.
Calcium ; Female ; Femur* ; Fibrosis ; Fracture Fixation, Intramedullary ; Fractures, Spontaneous* ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Lower Extremity ; Middle Aged ; Osteitis Fibrosa Cystica ; Osteoclasts ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Skeleton

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans

PURPOSE: To assess the value of the bolus-tagging method for improving the image quality of contrast-enhanced MR abdominal angiography, and to evaluate the relationship between peak arterial enhancement time and patients' age, weight and heart rate. MATERIALS AND METHODS: Contrast-enhanced 3D FISP abdominal MR angiography was performed in 81 patients during a four-month period. The bolus-tagging method was used in a study group comprising 33 patients, and to this end, 1 ml of Gd-DTPA (gadolinium-diethylenetriamine penta-acetic acid) was administered. thirty sequential images (1 image/sec) were then obtained using turbo-FLASH sequencing. After determining peak arterial enhancement time from the time-to-signal intensity curve, optimal scan delay time can be calculated according to the formula used in our patient series. The 48 patients in whom the bolus-tagging method was not used comprised the control group ; in the study group scanning commenced at the optimal scan delay time (and at 10 seconds in the control group) after the administration of 0.2 mM/kg Gd-DTPA using an automatic power injector. Using a three-point scale we evaluated and compared between the two groups the success with which arterial images were obtained. In addition, vascular visibility -an indication of the quality of arteries and veins-was determined using a four-point scale. In the study group, the relationship between peak arterial enhancement time and patients' age, weight heart rate was also assessed. RESULTS: Pure arterial images were successfully obtained in 32 patients (97%) in the study group and in 40 (83%) in the control group. This difference was not statistically significant (p>.05). With regard to vascular visibility, diagnostic arterial images were seen in 30 patients (91%) in the study group and in 33 patients (69%) in the control group; arterial visibility was significantly better in the study group (p=.0197). On the other hand, the diagnostic venous images were seen in 31 patients (94%) in the study group and in 36 (75%) in the control group; there was no significant difference between the two groups (p=.2367). Peak arterial enhancement time increased significantly with age (r=.443, p=.0098); no correlation,however was seen between peak arterial enhancement time and weight (p>.05) or heart rate (p>.05). CONCLUSION: Used with contrast-enhanced 3-D FISP MR abdominal angiography, the bolus-tagging method provides better arterial visibility. Peak arterial enhancement time increased significantly with age.
Angiography* ; Arteries ; Gadolinium ; Gadolinium DTPA ; Hand ; Heart Rate ; Humans