PURPOSE: To make the guideline for diagnosis and treatment policy of various hepatocytic nodular lesions detected during the imaging diagnosis of cirrhotic liver and to get our own data about hepatocellular carcinoma based on Korean patients. MATERIALS AND METHODS: We retrospectively reviewed 40 confirmed hepatocellular carcinomas foilwed up with CT more than once without any treatment. Total numbers of follow-up were 50. First, we input the data of initial and follow-up diameter visible on CT images and follow-up interval of each mass to the computer, and got the mean growth rate curve and growth curve of hepatocelluiar carcinoma using a program of Quattro-pro, one of the spreadsheet. And then the doubling time was also calculated using Schwarz's formula. RESULTS: According to the growth rate curve, the tumor under 3 cm in diameter showed relatively show growing pattern but the one above 3 cm in diameter showed rapid growing pattern. Mean growth curve also showed rapid turning point around 3 cm. Overall mean doubling time was 82 days(mean +/- SD = 82.3 +/- 56.2): 119 days in the tumors smaller than 30 mm in diameter, 69 days larger than 30 mm in diameter. CONCLUSION: Hepatocellular carcinoma'is relatively slowly growing tumor and shows rapid increase of its growth rate when it is larger than 30 mm in diameter as a turning point. We think that this fact could make an important role to determine the treatment policy of various hepatocytic nodular lesions suspecting hepatocellular carcinoma.
Carcinoma, Hepatocellular* ; Diagnosis ; Follow-Up Studies* ; Humans ; Liver ; Retrospective Studies

No abstract available.
DNA* ; Nucleic Acid Hybridization*

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

PURPOSE: To evaluate intrahepatic nodular lesions detected on CTAP but not on conventional contrast CT in regard to its relationship with satellite nodules or borderline malignancies. MATERIALS AND METHODS: From June 1991 to March 1994, CTAP was undertaken in 132 cases with confirmed hepatocellular carcinoma(HCC), of which 35 cases having 82 lesions were suitable for analysis(excluding the cases which had no follow-up studies, showed segmental abnormal portal perfusion, no additional lesions and, or inumerable lesions). The CTAP findings were compared with those on artery dominant imaging studies (angiography, DSA, bolus dynamic CT, arterial CT, Lipiodol CT) taken during the same period(to confirm the presence of lesions) and the findings on follow-up imaging studies(to assess the developemerit of malignancy). RESULTS: Arterial vascularity was identified in 35 of 82 lesions(42.7%) on arterial dominant imaging studies. Developement into malignancy was identified on follow-up imaging studies in 25 of remained 47 lesions(53.2%). CONCLUSION: The total positive predictive value of nodules on CTAP was 73.2%(35+25/82), but the predictive value for HCC by follow-up only was 53.2%. Given'the difficulties in detecting intranodular arterial flow and the short follow-up duration in many patients, the actual positive value might be higher.
Arteries ; Ethiodized Oil ; Follow-Up Studies ; Humans ; Perfusion

Filiform polyposis(FP), an unusual form of inflammatory polyposis, has been recently designated to a lesion characterized by multiple, long slender, finger-like projections of mucosa and submucosa of the gastrointestinal tract. We present 5 cases of FP, of which two were associated with irritable bowel syndrome, two with advanced colon carcinoma, and one with active ileotyphlitis(Behcet's disease). The polyps ranged from 1.0 cm to 3 cm; they were either isolated or aggregated, and their numbers were up to 100. The common microscopic feature was filiform polyps which consisted of central submucosal core covered by intact or minimally inflamed intestinal mucosa, comparable with that in reparative processes and formation of inflammatory(redundant) pseudopolyps. We conclude that awareness of FP in non-inflammatory bowel disease may promote the endoscopists to search its underlying disease and prevent unnecessary surgical procedure. Behcets enterocolitis in the ileocecal junction seems an additional preceding disorder of a localized form of FP.
Colon ; Enterocolitis ; Gastrointestinal Tract ; Intestinal Mucosa ; Irritable Bowel Syndrome ; Mucous Membrane ; Polyps

Pathological proliferation of Brgnners gland is rare, and its wide range of morphologieal variations have led to confusing the terminology with considerable lack of agreement. Six cases of duodenal nodular lesions which consisted of pathological proliferation of Brunners glands were examined by light microscopy. Polypectomy was made in two cases, and the remaining 4 cases were examined with endoscopic biopsy materials. Two polypectomy specimens, 2 cm and 3 cm each in great diameters, consisted of protruded ovoid mass with broad and short stalks. Microacopically, all of 6 cases revealed thin strands of fibrous connective tissue which separated the normal-looking Brunners glands in lobules. Individual lobules were composed of groups of acini formed by cuboidal cells admixed with occasional endocrine cells. Presence of glandular and ductal configuration of the Brunners gland aside from thick, randomly arranged bundles of smooth muscle were featured without distinct relation to interlobular septa. Also, one polypectomy case disclosed the nests of fat cells interspersed with the glandular acini. One mucosal biopsy case contained not only the smooth muscle bands but also the intimate mixture of both acini and ducts. We conclude that some of heterogeneous composition of duodenal nodular proliferation of Brunners gland is indicative of a hamartomatous growth.
Adipocytes ; Biopsy ; Brunner Glands ; Connective Tissue ; Duodenum ; Endocrine Cells ; Hamartoma* ; Microscopy ; Muscle, Smooth ; Pathology

No abstract available.
Femoral Neck Fractures* ; Femur Neck*

The results of cementless total knee arthroplasty(TKA) have improved steadly during the past decade due to development of design, fixation and surgical technique. We analyzed the results of 45 total knee arthroplasties performed with Anatomic Modular Knee(AMK) prosthesis at the department of Orthopedic Surgery, Yonsei University College of Medicine between June 1989 and December 1991 and compared their results of rheumatoid arthritis(RA) and osteoarthritis(OA) patients. The follow up ranged from 2 years to 4 years and 2 months (average 2 years and 8 months). Using the Hospital for Special Surgery(H.S.S.) rating system and Knee Society(K.S.) clinical rating system, we found that the clinical results were similar for RA group(Average; H.S.S. 86.1, K.S. 81.2/74.4) and OA group(Average; H.S.S. 88, K.S. 87.8/77.1) even though the preoperative knee score was lower in RA group(Average;H.S.S.42.8) than OA group(Average;H.S.S. 57.7). The average age of RA patients was 14 years younger than that of OA patients. The improvement of range of motin and preoperative flexion contracture after TKA was remarkable in RA group. The radiologic evaluation based on Knee Society roentgenographic evaluation system revealed proper alignment of all component and no definite radiologic loosening except 1 case in which postoperative deep infection had occurred. On the basis of this prospective clinical and radiologic review, we concluded that uncemented implantation of AMK prosthsis both in RA and OA patients was encouraging.
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Orthopedics ; Osteoarthritis ; Prospective Studies ; Prostheses and Implants

No abstract available.
Radiosurgery*

A study was performed to investigate a relationship between the status of T lymphocyte subsets in the peripheral blood and the pathogenesis of erythema nodosum leprosum (ENL) reactions. T lymphocyte subsets, B lymphocytes and serum immnnoglobulin levels were explored in 40 leprosy patients (10 tuberculoid (TT), 17 lepromatous (LL), and 13 lepromatous with ENL). In patients with LL, suppressor cells increased and helper cell diminished, resulting in a decrease in the helper/suppressor (Th/Ts) ratio to 0.86 + 0.20, as compared with controls (1. 77 + 0.41). But in ENL patients, there was a significant diminution of suppressor cells and an increase of helper cells, resulting in an increase in Th/Ts ratio to 2.08 + 0.30. Four weeks after treatment of ENL, Th/Ts ratio decreased to l.18+ 0.31 again. The mean percentages of B cells and serum immunoglobulin levels in with LL. and ENL increased significantly compared with controls. Only IgG increased in patients with ENL compared with patients with LL. The results in patiients with TT did not differ significantly from those of controls. The findings suggest that cell-mediated immune responses, imbalance in T lymphocyte subsets, may play a role in the pathogenesis of ENL, either directly or by inducing an antibody critical to the formation of the immune complex
Antigen-Antibody Complex ; B-Lymphocytes ; Erythema Nodosum* ; Erythema* ; Humans ; Immunoglobulin G ; Immunoglobulins ; Leprosy ; T-Lymphocyte Subsets* ; T-Lymphocytes, Helper-Inducer