No abstract available.
Rhabdomyosarcoma, Embryonal*

This study compared the effectiveness two-finger chest compression technique (TFCC) performed using the right vs. left hand and the index-middle vs. middle-ring fingers. Four different finger/hand combinations were tested randomly in 30 healthcare providers performing TFCC (Test 1: the right index-middle fingers; Test 2: the left index-middle fingers; Test 3: the right middle-ring fingers; Test 4: the left middle-ring fingers) using two cross-over trials. The "patient" was a 3-month-old-infant-sized manikin. Each experiment consisted of cardiopulmonary resuscitation (CPR) consisting of 2 minutes of 30:2 compression: ventilation performed by one rescuer on a manikin lying on the floor as if in cardiac arrest. Ventilations were performed using the mouth-to-mouth method. Compression and ventilation data were collected during the tests. The mean compression depth (MCD) was significantly greater in TFCC performed with the index-middle fingers than with the middle-ring fingers regardless of the hand (95% confidence intervals; right hand: 37.8-40.2 vs. 35.2-38.6 mm, P = 0.002; left hand: 36.9-39.2 vs. 35.5-38.1 mm, P = 0.003). A deeper MCD was achieved with the index-middle fingers of the right versus the left hand (P = 0.004). The ratio of sufficiently deep compressions showed the same patterns. There were no significant differences in the other data. The best performance of TFCC in simulated 30:2 compression: ventilation CPR performed by one rescuer on an infant in cardiac arrest lying on the floor was obtained using the index-middle fingers of the right hand. Clinical Trial Registry at the Clinical Research Information Service (KCT0001515).
Adult ; Cardiopulmonary Resuscitation/*methods ; Cross-Over Studies ; Female ; *Fingers ; Hand ; Heart Arrest/*therapy ; Humans ; Infant ; Male ; Manikins ; Models, Cardiovascular ; Thorax/physiology ; Young Adult

PURPOSE: To evaluate mortality and morbidity of very low birth weight (VLBW) infants born in Busan from 1996 to 2001. METHOD: Seven neonatal intensive care units (including 3 university hospitals and 4 general hospitals) in Busan participated for this study. We performed retrospective review of 756 VLBW infants who were born in this area during study period was done to assess their mortality and morbidity. RESULT: The total number of VLBW infant was 756 (incidence: 0.97%, mean gestational age: 29.5 +/- 2.9 wk, mean birth weight: 1165+/-232 g) including 187 extremely low birth weight infants who were less than 1, 000 g birth weight (24.7%). The survival rate was 61.0% (461 of 756). It increased from 56.4% in early period (1996 to 1998) to 65.2% in late period (1999 to 2001) (P<0.01). The incidence of respiratory distress syndrome was 61.5% (466 of 756), patent ductus arteriosus 12.3% (93 of 756), blood culture positive sepsis 10.2% (77 of 756), bronchopulmonary dysplasia 9.3% (70 of 756), severe intracranial hemorrhage 6.5% (49 of 756), necrotizing enterocolitis 4.9% (37 of 756), severe retinopathy of prematurity 3.7 % (28 of 756). The main causes of death were respiratory distress syndrome and sepsis. CONCLUSION: The survival rate of VLBW infant in Busan area during recent 6 years was 61.0%, which is lower than other single unit result of our country, recent Japanese or North American data. We think both modernized facilities in NICU and well-trained medical personnel are needed to improve survival.
Asian Continental Ancestry Group ; Birth Weight ; Bronchopulmonary Dysplasia ; Busan* ; Cause of Death ; Ductus Arteriosus, Patent ; Enterocolitis, Necrotizing ; Gestational Age ; Hospitals, University ; Humans ; Incidence ; Infant* ; Infant, Low Birth Weight ; Infant, Newborn ; Infant, Very Low Birth Weight* ; Intensive Care Units, Neonatal ; Intracranial Hemorrhages ; Mortality* ; Retinopathy of Prematurity ; Retrospective Studies ; Sepsis ; Survival Rate

OBJECTIVE: According to the current guidelines, arterial hyperenhancement for diagnosis of hepatocellular carcinoma (HCC) is determined using the arterial phase only. We investigated the optimal definition of arterial hyperenhancement in patients with HCC using computed tomography (CT) and magnetic resonance imaging (MRI). MATERIALS AND METHODS: The Institutional Review Board approved this retrospective study. The requirement for informed consent was waived. Between January 2011 and September 2013, 147 consecutive patients with surgically proven HCCs with both pre-operative CT and MRI were included. Identification rates of arterial hyperenhancement on CT and magnetic resonance (MR) images using arterial phase only, dual phase (unenhanced and arterial phases), and also subtraction MR images were assessed qualitatively. RESULTS: The identification rates for arterial hyperenhancement on CT were significantly different between arterial phase and dual phase (72.8% vs. 90.5%; p < 0.001), whereas the rates were similar on MRI (91.8% vs. 93.9%; p = 0.257). The identification rate of arterial hyperenhancement in MRI increased to 98.6% using subtraction MR images. CONCLUSION: Visual comparison of arterial and unenhanced phases could be recommended instead of conventional qualitative arterial phase alone assessment to determine arterial hyperenhancement of HCCs, especially when using CT.
Carcinoma, Hepatocellular ; Diagnosis ; Ethics Committees, Research ; Humans ; Informed Consent ; Magnetic Resonance Imaging ; Retrospective Studies

Viral hepatitis is one of major global health challenges with increasing disease burden worldwide. Hepatitis B virus and hepatitis C virus infections are major causes of chronic liver diseases. They can lead to cirrhosis, hepatocellular carcinoma, and death in significant portion of affected people. Transmission of hepatitis B virus can be blocked by vaccination. Progression of hepatitis B virus-related liver diseases can be prevented by long-term viral suppression with effective drugs. Although vaccine for hepatitis C virus is currently unavailable, hepatitis C virus infection can be eradicated by oral direct antiviral agents. To eliminate viral hepatitis, World Health Organization (WHO) has urged countries to develop national goals and targets through reducing 90% of new infections and providing universal access to key treatment services up to 80%. This can lead to 65% reduction of viral hepatitis-related mortality. Here, we discuss some key features of viral hepatitis, strategies to control viral hepatitis suggested by WHO, and current status and strategies for viral hepatitis control in South Korea. To achieve the goal of viral hepatitis elimination by 2030 in South Korea, an independent 'viral hepatitis sector' in Centers for Disease Control & Prevention (CDC) needs to be established to organize and execute comprehensive strategy for the management of viral hepatitis in South Korea.
Antiviral Agents ; Carcinoma, Hepatocellular ; Centers for Disease Control and Prevention (U.S.) ; Fibrosis ; Global Health ; Hepacivirus ; Hepatitis A ; Hepatitis B ; Hepatitis B virus ; Hepatitis C ; Hepatitis* ; Korea* ; Liver Diseases ; Mortality ; Vaccination ; World Health Organization

Gallbladder tuberculosis is an extremely rare disease that is rarely reported in the literature. Arriving at the correct diagnosis of gallbladder tuberculosis is difficult, and it is usually made by histopathologic examination after cholecystectomy. However, due to the low sensitivity of acid-fast stain and culture result, diagnosing gallbladder tuberculosis is still demanding even after tissue acquisition. To overcome this problem, tuberculosis-polymerase chain reaction (TB-PCR) is performed on the resected specimen, which has high sensitivity and specificity. A 70-year-old female who had previously undergone total gastrectomy for advanced gastric cancer was admitted with right upper quadrant pain. Abdominal ultrasonography and computed tomography revealed acute cholecystitis without gallstones or sludge. She underwent cholecystectomy and the histopathologic finding of the specimen showed chronic active cholecystitis without gallstones or sludge. Because she was suspected to have pulmonary tuberculosis, TB-PCR was also performed on the resected gallbladder. TB-PCR showed positive reaction for Mycobacterium tuberculosis and we could diagnose it as gallbladder tuberculosis. Herein, we present a case of gallbladder tuberculosis diagnosed by TB-PCR from resected gallbladder.
Aged ; Antitubercular Agents/therapeutic use ; Cholecystitis, Acute/*diagnosis/surgery/ultrasonography ; DNA, Bacterial/analysis ; Female ; Humans ; Mycobacterium tuberculosis/genetics/isolation & purification ; Polymerase Chain Reaction ; Tomography, X-Ray Computed ; Tuberculosis/*diagnosis/drug therapy/microbiology

Basaloid squamous cell carcinoma is a rare and aggressive variant of squamous cell carcinoma, which mostly occurs in the upper aerodigestive tracts. Basaloid squamous cell carcinoma also typically arises in the anal canal, but is extremely rare in the lower gastrointestinal tract. A 70-year-old man presented with loose stool and intermittent hematochezia 2 months ago. Colonoscopy showed an ulceroinfiltrative mass on the rectosigmoid colon from 16 cm to 18 cm above the anal verge. Conventional colonoscope could not pass through the lesion but it was possible with pediatric colonoscope. Abdominal CT scan showed 1.6 cm sized wall thickening with circumferential luminal narrowing in the rectosigmoid colon and multiple ill-defined low density masses in both lobes of the liver. Therefore, colon cancer with liver metastasis was suspected. However, basaloid cells were noted on histologic examination, and they were weakly positive for synaptophysin on immunohistochemical study. After palliative lower anterior resection, histologic examination of the resected specimen revealed basaloid differentiation with keratin pearls, and tumor cells were positively stained with high molecular weighted cytokeratin (34BE12) and CK 5/6. Thus, the patient was finally diagnosed with basaloid squamous cell carcinoma of rectosigmoid colon with distant metastases.
Aged ; Carcinoma, Squamous Cell/*diagnosis/pathology/surgery ; Colonoscopy ; Colorectal Neoplasms/*diagnosis/pathology/surgery ; Humans ; Immunohistochemistry ; Keratins/metabolism ; Liver Neoplasms/radiography/secondary ; Lung Neoplasms/radionuclide imaging/secondary ; Male ; Positron-Emission Tomography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

A spontaneous subcapsular hematoma of the liver is an unusual clinical phenomenon and is usually associated with trauma, surgery, tumor or pregnancy. We report a case of a recurrent spontaneous subcapsular hematoma of the liver without an identifiable cause. A 52-year-old female presented to the emergency room with acute abdominal pain localized in the right upper quadrant area. Diagnostic workup revealed a subcapsular hematoma in the segment 8 area. The laboratory evaluation was also normal. She was managed conservatively. However, two months later another episode of abdominal pain in the right upper quadrant recurred. Diagnostic workup showed recurrence of a subcapsular hematoma in the segment 6 area. Follow-up evaluation revealed resorption of the previous subcapsular hematomas, as well as a new lesion in the segment 1 area. Herein, we discuss potential causes of this spontaneous subcapsular hematoma of the liver.
Abdominal Pain ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hematoma* ; Humans ; Liver* ; Middle Aged ; Pregnancy ; Recurrence ; Tamoxifen

Background: Liver cirrhosis is advanced stage of hepatic brosis caused by viral hepatitis. Mac-2 binding protein glycosylation isomer (M2BPGi) is a serum marker to diagnose and evaluate hepatic brosis progression. In this study, we evaluated the efficacy of serum M2BPGi to predict chronic hepatitis B (HBV)-mediated cirrhosis by liver biopsy. Methods: M2BPGi cut-off index (COI) was evaluated from 312 patients with chronic HBV-mediated hepatocellular carcinoma and 105 healthy controls. Comparative analysis was performed with conventional hepatic brosis markers such as brosis index based on four factors (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and Fibroscan. Results: Korean Study Group for Pathology of Digestive Diseases classified 165 (52%) patients with histological stage F4 liver cirrhosis. Comparison of cases with stage F4 cirrhosis and stage F3 septal brosis revealed significant difference between M2BPGi, platelet count, APRI, FIB-4, and Fibroscan prediction. M2BPGi 2+ (COI ≥3) was found to be 8% in patients with F4 cirrhosis and 1% in patients with F3 brosis. In multi-regression analysis, M2BPGi showed higher odds ratio than that of other serum markers while M2BPGi 2+ showed comparable odds ratio to Fibroscan F3 and F4 assessment. Conclusions In patients with chronic HBV-mediated hepatocellular carcinoma, M2BPGi was neither comprehensive nor as effective as Fibroscan in assessing liver cirrhosis and brosis progression.

Background/Aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015. Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated. Results: The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 26.3%, 12.7%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (29.5%) was the most commonly performed initial treatment, followed by surgical resection (25.1%), best supportive care (20.2%), and local ablation therapy (10.5%). Overall, 42.4% of patients were treated in accordance with the BCLC guidelines: 61.7% in stage 0/A, 39.0% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 66.5%, 49.0%, and 17.0%, respectively. Conclusions In 2015, approximately 40% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 42.4% of patients; in patients with stage B or C disease, there was relatively low adherence.