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1.
Maxillofacial Plastic and Reconstructive Surgery ; : 41-2018.
Artigo em Inglês | WPRIM | ID: wpr-918428

RESUMO

BACKGROUND@#S: The purpose of this study is to discuss the total joint reconstruction surgery for a patient with recurrent ankylosis in bilateral temporomandibular joints (TMJs) using three-dimensional (3D) virtual surgical planning, computer-aided manufacturing (CAD/CAM)-fabricated surgical guides, and stock TMJ prostheses.CASE PRESENTATION: A 66-year-old female patient, who had a history of multiple TMJ surgeries, complained of severe difficulty in eating and trismus. The 3D virtual surgery was performed with a virtual surgery software (FACEGIDE, MegaGen implant, Daegu, South Korea). After confirmation of the location of the upper margin for resection of the root of the zygoma and the lower margin for resection of the ankylosed condyle, and the position of the fossa and condyle components of stock TMJ prosthesis (Biomet, Jacksonville, FL, USA), the surgical guides were fabricated with CAD/CAM technology. Under general anesthesia, osteotomy and placement of the stock TMJ prosthesis (Biomet) were carried out according to the surgical planning. At 2 months after the operation, the patient was able to open her mouth up to 30 mm without complication.@*CONCLUSION@#For a patient who has recurrent ankylosis in bilateral TMJs, total joint reconstruction surgery using 3D virtual surgical planning, CAD/CAM-fabricated surgical guides, and stock TMJ prostheses may be an effective surgical treatment option.

2.
The Korean Journal of Gastroenterology ; : 34-39, 2008.
Artigo em Coreano | WPRIM | ID: wpr-182645

RESUMO

BACKGROUND/AIMS: Intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms are included in mucin-producing pancreatic tumors. The reports about IPMN are not uncommon but those about the mucinous cystic neoplasms are relatively few. The aims of this study were to define the natural history of resected mucinous cystic neoplasms of the pancreas and to identify the findings which suggest malignancy. METHODS: The authors retrospectively evaluated the clinical outcomes of 41 patients with mucinous cystic neoplasms who were surgically resected at Asan Medical Center between 1995 and 2004. RESULTS: Women (n=33) were more frequently affected than men (n=8). Thirty three patients (80.6%) had adenoma, 1 (2.4%) borderline malignancy, 1 (2.4%) carcinoma in situ, and 6 (14.6%) invasive mucinous cystadenocarcinoma. The most frequent symptom was abdominal pain (39%). About half of the enrolled patients were asymptomatic. Unilocular type (79%) was more frequent than the multilocular type (21%) on gross morphology. The tumor size of invasive mucinous cystic neopolasms was larger than that of non-invasive mucinous cystic neoplalsms (p=0.01). Abdominal pain was more frequent in invasive mucinous cystic neoplasms (p=0.026). On gross morphology, mural nodules were detected in 4 of 6 patients with invasive mucinous cystic neoplasms. However, they were not detected in any patients with non-invasive mucinous cystic neoplasms. Recurrence developed in none of the 35 patients with non-invasive mucinous cystic neoplasms, however 2 of the 6 patients with invasive mucinous cystic neoplasms died within 5 years. CONCLUSIONS: Clinical predictors of invasive mucinous cystic neoplasms are suggested to be tumor size and abdominal pain. The prognosis of the non-invasive mucinous cystic neoplasms is excellent when curative resection is performed.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma Mucinoso/diagnóstico , Carcinoma Ductal Pancreático/diagnóstico , Cistadenocarcinoma Mucinoso/diagnóstico , Diagnóstico Diferencial , Invasividade Neoplásica , Neoplasias Pancreáticas/diagnóstico , Estudos Retrospectivos , Análise de Sobrevida
3.
Korean Journal of Gastrointestinal Endoscopy ; : 109-115, 2006.
Artigo em Coreano | WPRIM | ID: wpr-104782

RESUMO

BACKGROUND/AIMS: A macrocystic variant of a serous cystadenoma (M-SCA) is usually indistinguishable from a mucinous cystadenoma (MCA) as a result of their morphologic similarity on conventional imaging studies. However, a MCA requires a resection due to its malignant potential. The aim of this study was to determine the EUS morphological characteristics of a M-SCA to determine if they could be used to help differentiate it from MCA. METHODS: The clinical and EUS morphologic characteristics were examined in 31 consecutive patients with M-SCA and MCA who underwent surgery. RESULTS: Resected specimens were available from 11 M-SCAs and 20 MCAs. Significant differences were observed with regard to the age and location within the pancreas. On EUS, most of the M-SCA contained microcysts (82%) compared with only 15% of MCA cases, and a lobulated configuration of the cyst was observed more frequently in the M-SCA cases than in the MCA (91% vs. 25%). The combination of microcysts and the lobulated configuration of the cysts had a 100% specificity and positive predictive value for differentiating M-SCA from MCA. CONCLUSIONS: M-SCA tends to occur at a relatively younger age than MCA, and is located mainly in the head of the pancreas. Although there is considerable morphological similarity between M-SCA and MCA on the conventional imaging modalities, the morphological characteristics obtained from EUS including microcysts with a lobulated configuration may help to make a distinction between M-SCA and MCA.


Assuntos
Humanos , Cistadenoma Mucinoso , Cistadenoma Seroso , Cabeça , Mucinas , Pâncreas , Sensibilidade e Especificidade
4.
Korean Journal of Gastrointestinal Endoscopy ; : 302-306, 2006.
Artigo em Coreano | WPRIM | ID: wpr-185110

RESUMO

Endoscopic drainage of pancreatic pseudocysts is the initial treatment of choice for symptomatic pancreatic pseudocysts and nonresolving pseudocysts. Recently, endoscopic ultrasound (EUS) has been used as a guide for transmural entry and the safer drainage of pancreatic pseudocysts. We report a case of therapeutic linear array EUS-guided pseudocyst drainage without the use of fluoroscopy in a patient with portal hypertension.


Assuntos
Humanos , Drenagem , Fluoroscopia , Hipertensão Portal , Pseudocisto Pancreático , Ultrassonografia
5.
The Korean Journal of Gastroenterology ; : 440-448, 2006.
Artigo em Coreano | WPRIM | ID: wpr-151319

RESUMO

BACKGROUND/AIMS: Autoimmune chronic pancreatitis (AIP) is a clinically attractive entity because of its dramatic response to steroid therapy. But the long-term results after steroid therapy have not been reported yet in Korea. The purpose of this study was to assess the long-term results and prognosis after steroid therapy in patients with AIP. METHODS: We retrospectively analyzed the clinical, radiologic, and laboratory features and evaluated clinical outcomes in 19 patients with AIP who have been treated with oral corticosteroid. All patients were initially treated with prednisolone (30-40 mg/d) for 1 or 2 months. After the confirmation of clinical improvement in radiologic imaging and laboratory findings, the daily dose of prednisolone was then gradually tapered by 5-10 mg per month to the maintenance dose (2.5-7.5 mg/d). RESULTS: All the patients showed normalization or marked improvement in symptoms, laboratory and imaging findings after steroid therapy. There were 4 cases (21%) of recurrence during the mean follow-up period of 27 months. All the patients with recurrence responded to oral steroid again. Among the 10 patients with diabetes mellitus, seven patients were able to stop or reduce the medication for diabetes after completion of steroid therapy. The biliary stents were additionally inserted in 10 patients who showed distal common bile duct stricture and obstructive jaundice. The accompanying autoimmune diseases were also improved with oral corticosteroid. CONCLUSIONS: Steroid therapy is very effective for AIP and is also effective in the cases of recurrence. A definitive protocol of steroid therapy for AIP should be established in the future.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Administração Oral , Doenças Autoimunes/tratamento farmacológico , Glucocorticoides/administração & dosagem , Pancreatite Crônica/tratamento farmacológico , Prednisolona/administração & dosagem , Recidiva
6.
Korean Journal of Gastrointestinal Endoscopy ; : 155-160, 2005.
Artigo em Coreano | WPRIM | ID: wpr-175720

RESUMO

BACKGROUND/AIMS: Endoscopic pancreatic sphincterotomy (EPST) has been performed more frequently in recent years. However, it is less widely practiced than biliary sphincterotomy due to lack of firm scientific data regarding its indication and safety. The aims of this study are to evaluate EPST with regard to indications, complications, and safety. METHODS: We retrospectively reviewed and analyzed the results of EPST performed in three hundred thirty nine patients from January 2000 to April 2004.RESULTS: Complications occurred in 37 patients (10.7%) which included pancreatitis, hemorrhage, perforation, cholangitis, sepsis, and stenosis of sphincterotomy site. They were successfully managed by medical treatment. No mortalities were reported. CONCLUSIONS: EPST is a relatively safe procedure in various pancreatic diseases. Incidence of long-term complications awaits further investigations. EPST enlarges our endotherapeutic armamentarium and deserves additional evaluation.


Assuntos
Humanos , Colangite , Constrição Patológica , Hemorragia , Incidência , Mortalidade , Pancreatopatias , Pancreatite , Estudos Retrospectivos , Sepse
7.
Korean Journal of Pediatric Hematology-Oncology ; : 125-130, 2005.
Artigo em Coreano | WPRIM | ID: wpr-220859

RESUMO

Pheochromacytoma, although occasionally present with adrenal cortical hyperfunction, is rarely associated with nonfunctioning adrenal cortical tumor. To our knowledge, eight cases of phemchromocytoma associated with adrenocortical adenoma have been reported in the literature, including a case in a Korean adult female. An adrenal mass is considered an incidentaloma when there is no history or physical findings suggesting an adrenal functional disorder or tumor. The majority of adrenal masses are nonfunctioning adrenocortical adenomas. In our case, left adrenal mass was found incidentally by ultrasonography after birth, done because of mother's oligohydroamnios. Abdomial CT study revealed an adrenal tumor, and a surgical resection was performed. The specimen showed a coincident pheochromocytoma and adrenocortical adenoma. The patient seems to be the first case of coexistence of nonfunctioning pheochromocytoma and adrenocortical adenoma in one adrenal tumor. We report this case with the review of literatures.


Assuntos
Adulto , Feminino , Humanos , Lactente , Adenoma Adrenocortical , Parto , Feocromocitoma , Ultrassonografia
8.
The Korean Journal of Gastroenterology ; : 463-470, 2005.
Artigo em Coreano | WPRIM | ID: wpr-199897

RESUMO

BACKGROUND/AIMS: Bile duct injury is the most serious complication of cholecystectomy. The aim of this study was to evaluate the outcome of endoscopic treatment in bile duct injury after cholecystectomy. METHODS: We reviewed the results of endoscopic treatments in the patients diagnosed as bile duct injury after cholecystectomy on cholangiographic examinations, retrospectively. Endoscopic treatment included insertion of nasobiliary drainage catheter or plastic stent after endoscopic sphicterotomy. RESULTS: A total of twenty-two patients (9 male, 13 female; median age of 59 years) with bile duct injury were included. Endoscopic treatment was successfully performed in 12 of 13 patients with bile leak only. In patients with both bile leak and stricture, endoscopic treatment was successful in 2 of 3 patients. In 6 patients with complete obstruction of bile duct, endoscopic treatment failed and surgical approach was needed. In our series, transpapillary endoscopic treatment was not successful when proximal bile duct above the injured site was not visualized by endoscopic retrograde cholangiopancreatography (ERCP) and surgery was performed in all cases. Overall success rate of endoscopic treatment in 22 patients with bile duct injury was 64% (14/22). There was no complication associated with endoscopic treatment. CONCLUSIONS: ERCP is useful for the treatment of bile leakage after cholecystectomy and can be used for the treatment prior to surgery. Surgical intervention is needed in case of endoscopic treatment failure.


Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Biliares/lesões , Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia/efeitos adversos , Endoscopia do Sistema Digestório , Resumo em Inglês , Resultado do Tratamento
9.
The Korean Journal of Gastroenterology ; : 396-403, 2005.
Artigo em Coreano | WPRIM | ID: wpr-165586

RESUMO

BACKGROUND/AIMS: Treatment of pancreatic duct stones by extracorporeal shockwave lithotripsy (ESWL) serves as a nonsurgical treatment modality in patients with stones that are located in upstream of the strictures or in patients with impacted stones. We present the results of ESWL in endoscopically unretrievable pancreatic duct stones in the past 2 years. METHODS: Between January 2002 and December 2003, 58 patients with chronic pancreatitis were treated by ESWL for pancreatic duct stones. ESWL was performed with an electrohydraulic lithotripter ultrasound focusing system. RESULTS: The mean number of shockwave treatments was 2.5, and the patients received 4,578 (1,527-10,155) shockwave discharges with a mean energy of 15.8 kV. Fragmentations of the stones were achieved in 54 patients (93.2%), and complete clearance of the stones were noticed in 27 patients (46.6%). Fragmentation of stones equal or less than 3 mm in diameter was associated with successful removal of stones (p<0.05). Complete relief of pain occurred in 32 patients (55.2%). The procedures were well tolerated and no patient had significant complications such as acute pancreatitis. CONCLUSIONS: ESWL is an effective and a safe procedure for endoscopically unretrievable main pancreatic duct stones. ESWL combined with endoscopic therapy can increase the success rate of nonsurgical removal of pancreatic duct stones in patients with chronic pancreatitis.


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cálculos/terapia , Resumo em Inglês , Litotripsia , Pancreatopatias/terapia , Ductos Pancreáticos , Pancreatite Crônica/complicações
10.
Journal of the Korean Academy of Rehabilitation Medicine ; : 449-455, 2002.
Artigo em Coreano | WPRIM | ID: wpr-723211

RESUMO

OBJECTIVE: To classify the findings of magnetic resonance imaging of the lumbar interspinous ligaments in relation to the lumbar disc herniation, disc degeneration, and lordosis. METHOD: The subjects were 45 herniated intervertebral disc(HIVD) patients and 35 normal subjects on MRI finding. The magnetic resonance features of the interspinous ligament were classified into five categories according to their signal intensities: type 1A (low intensity on T1- and T2- weighted images without hypertrophy of spinal process); type 1B (same signal pattern as in type 1A with hypertrophy of spinal process); type 2 (low intensity on T1- and high intensity on T2-weighted images); type 3 (high intensity on T1-weighted images); type 4 (others). RESULTS: The most common type in both HIVD patients and normal subjects was type 3. The mean age and disc degeneration grade of the type 1B ligaments were significantly higher. Lordosis of type 1B of L5-S1 interspinous ligament was increased with significant difference. CONCLUSION: The classification of the MRI findings of interspinous types didn't show statistical difference between HIVD patients and normal subjects, but was helpful in assessing the degree of the degeneration of the intervertebral disc and age.


Assuntos
Animais , Humanos , Classificação , Hipertrofia , Degeneração do Disco Intervertebral , Disco Intervertebral , Ligamentos , Lordose , Imageamento por Ressonância Magnética
11.
Journal of the Korean Academy of Family Medicine ; : 417-429, 2002.
Artigo em Coreano | WPRIM | ID: wpr-228241

RESUMO

No abstract available.


Assuntos
Aromaterapia , Atenção Primária à Saúde
12.
Korean Circulation Journal ; : 781-790, 2002.
Artigo em Coreano | WPRIM | ID: wpr-184254

RESUMO

BACKGROUND AND OBJECTIVES: Assessment of the regional left ventricular function provides valuable diagnostic and prognostic information of patients with coronary artery disease. The aim of the study was to analyze the agreement between wall motion scores, derived by gated single photon emission computed tomography (SPECT) and echocardiography (Echo) in myocardial infarction patients with a perfusion defect. SUBJECTS AND METHODS: We studied the regional wall motion in 81 patients with an acute myocardial infarction, who underwent adenosine stress gated SPECT and Echo. Echo was performed in all the patients immediately prior to, or following, gated SPECT. The regional wall motion was evaluated by both modalities, and scored using a 16-segment model with a 4-point scoring system: 1=normal, 2=mild and moderate hypokinesia, 3=severe hypokinesia, 4=akinesia or dyskinesia. RESULTS: There was a high agreement in the left ventricular regional wall motion scores between the gated SPECT and the Echo of 84.2% of segments (1091/1296 segments, k=0.76, p<0.0001). The agreement in the regional wall motion scores between the two modalities decreased significantly along the longitudinal axis of the left ventricle from 92.9% (301/324, k=0.89, p<0.0001) at the apex, 84.6% (411/486, k=0.77, p<0.0001) at the mid point, to 77.9% (379/486, k=0.65, p<0.0001) at the basal segments (p<0.0001). Also, the agreement based on the degree of myocardial perfusion was 86.6% for segments with normal, or mild hypoperfusion, and 82.6% with moderate to severe hypoperfusion (p=0.072). CONCLUSION: The gated SPECT had a good agreement with the Echo for the assessment of the left ventricular regional wall motion in patients with an acute myocardial infarction. These results support the clinical use of gated SPECT.


Assuntos
Humanos , Adenosina , Vértebra Cervical Áxis , Doença da Artéria Coronariana , Discinesias , Ecocardiografia , Ventrículos do Coração , Hipocinesia , Infarto do Miocárdio , Perfusão , Tomografia Computadorizada de Emissão de Fóton Único , Função Ventricular Esquerda
13.
Korean Journal of Medicine ; : 59-63, 2001.
Artigo em Coreano | WPRIM | ID: wpr-105797

RESUMO

Hepatitis B virus infection is known to be associated with various types of glomerulonephritis (GN), including membranous GN, membranoproliferative GN, and mesangial proliferative GN. Although there has been considerable experiences with interferon in clinical trials during the past decade, acute renal failure as a complication of interferon treatment has rarely been reported. We report a case in which acute renal failure with proteinuria was associated with interferon-alpha treatment. A 33-year-old man with chronic hepatitis B presented with diarrhea and RUQ pain. Two weeks after INF-alpha treatment, Oliguria and proteinuria suddenly occurred, although the hepatic function was improved. With discontinuation of interferon treatment and ultrafiltration, his renal function was improved.


Assuntos
Adulto , Humanos , Injúria Renal Aguda , Diarreia , Glomerulonefrite , Vírus da Hepatite B , Hepatite B Crônica , Hepatite Crônica , Interferon-alfa , Interferons , Oligúria , Proteinúria , Ultrafiltração
14.
Korean Journal of Medicine ; : 20-29, 2000.
Artigo em Coreano | WPRIM | ID: wpr-73543

RESUMO

BACKGROUND: The aims of our study was to explore the effectiveness of 1 year treatment of lamivudine in Korean patients with chronic liver disease caused by chronic infection of HBV. METHODS: Thirty patients with chronic infection of HBV were included in this study who were diagnosed at Hanyang University Hospital from January 1998 to August 1999. They received 150mg of lamivudine per oral once daily for 1 year with follow-up of liver function test, serum HBV-bDNA and serologic markers for hepatitis B virus every two months. RESULTS: The mean values of ALT, AST, and GGT decreased significantly after 6 months treatment, but after 10-12 months treatment, 6 out of 30 cases(20%) tended to flare-up or return to pretreatment state. Nevertheless, their levels revealed no statistically significant changes after 12 months. No case show disappearance of HBsAg. HBeAg seroconversion occurred in 10 among 27 patients(37%). The mean of HBV-bDNA decreased from 1,776.0 pg/mL(2.5-17,000) to 10.8 pg/mL (2.5-67) after 6 months, but tended to rise to 317.9 pg/mL(2.5-5,900) after 12 months. After 10-12 months treatment, 11 cases out of 30 showed breakthrough or incomplete suppression of HBV DNA replication. Stepwise-logistic regression analysis proved the high baseline ALT was the only predictable factor for loss of HBeAg by lamivudine with an odds ratio of 1.0518(95% confidence interval: 1.0052-1.1007)(p=0.0291). CONCLUSION: Treatment of lamivudine showed improvement in normalization of ALT and reduction of HBV-bDNA after 6months. But after 10-12 months treatment, one third cases of them tended to flare-up or return to pretreatment state. And the group with high baseline ALT is not only suitable for indication of lamivudine therapy but also predictable factor of disappearance of HBeAg after 12months treatment with lamivudine.


Assuntos
Humanos , DNA , Replicação do DNA , Seguimentos , Antígenos E da Hepatite B , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B , Hepatite B , Hepatite B Crônica , Vírus de Hepatite , Hepatite , Lamivudina , Hepatopatias , Testes de Função Hepática , Razão de Chances , Estudos Prospectivos
15.
The Korean Journal of Hepatology ; : 311-320, 2000.
Artigo em Coreano | WPRIM | ID: wpr-125025

RESUMO

PURPOSE: There have been studies concerning prognostic factors in patients with hepatocellular carcinoma (HCC) undergoing transcatheter arterial chemoembolization (TACE) but they reported different prognostic factors from each other. The aim of this study is to determine which prognostic factors contribute to long-term survival after TACE of hepatocellular carcinoma. MATERIAL AND METHOD: Two hundred and forty-one patients with HCC who had been treated by TACE were analyzed retrospectively. TACE was accomplished by hepatic arterial infusion of a suspension of lipodol and anticancer drugs (Mitomycin-C and Adriamycin), either alone or followed by gelfoam embolization. RESULTS: Male to female ratio was 4.7:1. Mean survival was 13.98 months. Maximum survival was 101 months. The overall cumulative survival rates at the end of the first and second years were, respectively, 41.54% and 20.06%. According to univariate analysis (log-rank scale test), variables significantly associated with survival were: sex, liver cirrhosis, Child-Pugh classification, gross type of the tumor, location of the tumor, size of the tumor, TNM stage, metastasis, portal vein thrombosis, arterioportal shunt, ascites, AFP, protein, albumin, alkaline phosphatase, AST, AST/ALT ratio, total bilirubin, and sodium. Multivariate analysis (Cox proportional hazard model) for the significant variables in a univarariate analysis revealed that the gross type of the tumor, portal vein thrombosis, and Child-Pugh classification were statistically significant independent prognostic factors. CONCLUSION: The prognosis of patients with HCC treated with TACE was affected favorably by the nodular type tumor, the patent main and the first-order portal vein, and the good liver function (Child-Pugh class A).


Assuntos
Feminino , Humanos , Masculino , Fosfatase Alcalina , Ascite , Bilirrubina , Carcinoma Hepatocelular , Classificação , Epidemiologia , Esponja de Gelatina Absorvível , Fígado , Cirrose Hepática , Análise Multivariada , Metástase Neoplásica , Veia Porta , Prognóstico , Estudos Retrospectivos , Sódio , Taxa de Sobrevida , Trombose Venosa
16.
The Korean Journal of Hepatology ; : 322-331, 1999.
Artigo em Coreano | WPRIM | ID: wpr-212653

RESUMO

BACKGROUND/AIMS: As a tumor marker, alpha-etoprotein is widely used. Diagnositic cut-ff value is known as 400 ng/mL in sera. This study is aimed to determine the clinical features of hepatocellular carcinoma (HCC) with reference to serum AFP levels in Korean patients. METHODS: From May 1990 to March 1998, 367 patients diagnosed as HCC, hospitalized and followed-p at Hanyang University Hospital, have been retrospectively analyzed with special reference on serum AFP level at time of diagnosis. The differences in clinical, hematological, and radiological features of HCC, as well as the survival rate in the two groups have been compared. Group 1 (N=182) was defined as an AFP level lower than 400 ng/mL, group 2 (N=185) was defined as an AFP level greater than 400 ng/mL. Comparisons were made by student's t test or chi-quare test. Survival rate was calculated from the time of diagnosis by Kaplan-eier method. Survival curves were also compared using log-ank test. P values less than 0.05 were considered significant. RESULTS: The patients with serum AFP levels above 400 ng/mL showed (1) a lower mean age; (2) a higher level of AST; (3) a higher level of AST/ALT ratio; (4) a high incidence of liver cirrhosis; (5) a high incidence of portal vein thrombosis; (6) a high incidence of positive HBsAg; (7) a low incidence of anti-CV; (8) a low incidence of small HCC but high incidence of large HCC; (9) a high incidence of more advanced TNM stage; (10) a low incidence of single nodular type and high incidence of diffuse type. CONCLUSIONS: Depending on the value of AFP, HCC has some clinical features. In hepatocellular carcinoma, high levels of AFP represent young age, HBV infection more than HCV infection and advanced disease state.


Assuntos
Humanos , Carcinoma Hepatocelular , Diagnóstico , Antígenos de Superfície da Hepatite B , Incidência , Cirrose Hepática , Estudos Retrospectivos , Taxa de Sobrevida , Trombose Venosa
17.
Journal of the Korean Radiological Society ; : 813-817, 1999.
Artigo em Coreano | WPRIM | ID: wpr-140275

RESUMO

PURPOSE: To evaluate the difference in radiologic features of rhabdoid tumor of the kidney (RTK) in children according to the location of the tumor within the kidney. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of pathologically confirmed RTK in seven children (5 boys and 2 girls; age range, 6 months to 4 years 8 months; median, 18 months). All subjects underwent abdominal CT. We analyzed tumor location, size, and margin; renal hilar involvement, subcapsular hematoma, calcification, necrosis, and lymphadenopathy. RTK was classified according to the location of the tumor within the kidney: A tumor that mainly located in the central portion of the kidney with or without peripheral extension was described as type I, while one located at the periphery was type II. Imaging findings between the two types were compared. RESULTS: Tumor size varied from 3 cm to 12 cm. Tumor outlines were ill-defined in four cases but relatively well-defined in three. Four tumors (57 %) were type I. Hilar involvement was found in all four and a small subcapsular hematoma in one. Three tumors (43%) were type II, and in all three, large crescent-shaped subcapsular hematomas were found. CONCLUSION: Centrally located RTK showed hilar involvement with a small subcapsular hematoma, while in cases of peripherally located RTK, a large subcapsular hematoma was present. These findings may be helpful for the differential diagnosis of other pediatric renal tumors.


Assuntos
Criança , Feminino , Humanos , Diagnóstico Diferencial , Hematoma , Rim , Doenças Linfáticas , Necrose , Estudos Retrospectivos , Tumor Rabdoide , Tomografia Computadorizada por Raios X
18.
Journal of the Korean Radiological Society ; : 813-817, 1999.
Artigo em Coreano | WPRIM | ID: wpr-140274

RESUMO

PURPOSE: To evaluate the difference in radiologic features of rhabdoid tumor of the kidney (RTK) in children according to the location of the tumor within the kidney. MATERIALS AND METHODS: We retrospectively reviewed the radiologic findings of pathologically confirmed RTK in seven children (5 boys and 2 girls; age range, 6 months to 4 years 8 months; median, 18 months). All subjects underwent abdominal CT. We analyzed tumor location, size, and margin; renal hilar involvement, subcapsular hematoma, calcification, necrosis, and lymphadenopathy. RTK was classified according to the location of the tumor within the kidney: A tumor that mainly located in the central portion of the kidney with or without peripheral extension was described as type I, while one located at the periphery was type II. Imaging findings between the two types were compared. RESULTS: Tumor size varied from 3 cm to 12 cm. Tumor outlines were ill-defined in four cases but relatively well-defined in three. Four tumors (57 %) were type I. Hilar involvement was found in all four and a small subcapsular hematoma in one. Three tumors (43%) were type II, and in all three, large crescent-shaped subcapsular hematomas were found. CONCLUSION: Centrally located RTK showed hilar involvement with a small subcapsular hematoma, while in cases of peripherally located RTK, a large subcapsular hematoma was present. These findings may be helpful for the differential diagnosis of other pediatric renal tumors.


Assuntos
Criança , Feminino , Humanos , Diagnóstico Diferencial , Hematoma , Rim , Doenças Linfáticas , Necrose , Estudos Retrospectivos , Tumor Rabdoide , Tomografia Computadorizada por Raios X
19.
The Korean Journal of Hepatology ; : 46-58, 1998.
Artigo em Coreano | WPRIM | ID: wpr-56512

RESUMO

BACKGROUND/AIMS: Hepatocarcinogenesis of microscopically altered foci could be shown to be progressed into a trabecular pattern of hepatocellular carcinoma. And it is reported that down-regulation of TGF beta II receptor and up-regulation of TGF alpha and c-myc reveal the progression of diethylnitrosamine-induced foci into liver cell cancer. Up-regulation of TGF beta II receptor, however, causes apoptosis of foci. To determine characteristic morphology and growth kinetics of putatively precancerous y glutamyl transpeptidase (GGT) positive foci and hyperplastic nodules, a stereological quantification was attempted in the Peraino's neonatal rat model initiated by diethylnitrosamine and promoted by phenobarbital. MATERIALS/METHODS: Fifteen Sprague-Dawley rats were I.p. injected with 0.15 pmole/g of body weight of diethylnitrosamine mixed in corn oil at one day after birth. From weaning at 4 weeks of life, the rats were continuously fed 0.035% phenobarbital in drinking water and sacrified 5 rats at each time point of 8 weeks, 16 weeks, and 32 weeks. Teklad standard diet was fed after weaning. The livers obtained were fixed in freshly prepared, cold ethanol-acetic acid (99:1 vo1%). For the GGT histochemical staining, Rutenberg's method was modified, and counterstained with H & E or toluidine blue. For the stereological analysis GGT positive foci and nodules were traced in 200 consecutive tissue sections and quantified the 3 dimensional volumes by computer assisted planimetry. Either spheroidal or non-spheroidal morphology was determined by parabola 2nd degree equation ' y=ax+bx+c (sphere a=-P,). RESULTS: Thirty nine (55.71%) out of 70 representative lesions were nonspheroidal. Especially at 8 weeks, the 28 out of 40 GGT positive foci were irregular, nonspheroidal shape. Later times, however, GGT positive foci and reprogrammed nodular lesions were become spheroidal. Lilliefors probabilities test for spheroidal frequency was statistically significant (p<0.05). CONCLUSION: Stereologically non-spheroidal characteristics of the early GGT positive foci limit growth kinetic estimation by 3 dimensional volume quantitation but permit in later times in spheroidal, GGT positive foci and reprogrammed nodules showing fade-out of GGT activity. In other words, GGT positive foci may be clonally selected for growing into hyperplastic nodules and hepatocellular carcinoma or regressed by apoptosis.


Assuntos
Animais , Ratos , Apoptose , Peso Corporal , Carcinoma Hepatocelular , Óleo de Milho , Dieta , Dietilnitrosamina , Regulação para Baixo , Água Potável , gama-Glutamiltransferase , Cinética , Fígado , Modelos Animais , Parto , Fenobarbital , Ratos Sprague-Dawley , Cloreto de Tolônio , Regulação para Cima , Desmame
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