No abstract available.
Aspergillosis* ; Maxillary Sinus*

The modality of treatment for malignant or benign aggressive tumors in the shoulder includes radical or wide removal of the lesion, accompanied by chemotherapy or radiotherapy. With the introduction of chemotherapy, advance in surgical techniques, and improvements in radiographic imaging studies, the shoulder resection with reconstruction or replantation is a limb-sparing surgical option to be considered for bony and soft-tissue tumors in and around the shoulder, but amputation is used still if inevitable. We treated 16 tumors in or around the shoulder from June 1986 to August 1991: thirteen shoulder resections, two shoulder disarticulations, and one forequarter nine patients, reconstructed with a free fibular graft in two or with a allograft and myocutaneous flap in two. Chemotherapy or radiotherapy were followed if indicated. Function of the hand after the operations should be nearly normal. Mean rating for functional results was 69% (range 43-97%) by criteria of Enneking et al. During the follow-up of the mean 4 years and 1 month, a distant metastasis occurred in one case, leading to death and a local recurrence was noted in another one, indicating the forequarter amputation. Our experience indicates that shoulder resection with reconstruction or replantation can to be used for limb salvage in selected patient with tumors in or around the shoulder.
Allografts ; Amputation ; Disarticulation ; Drug Therapy ; Follow-Up Studies ; Hand ; Humans ; Limb Salvage ; Myocutaneous Flap ; Neoplasm Metastasis ; Radiotherapy ; Recurrence ; Replantation ; Shoulder ; Transplants

The coronary artery fistula from right coronary artery to left ventricle is a rare disease among coronary artery anomaly. We experienced three cases of rare coronary fistula and report with literature review. Although symptoms of coronary artery fistula are associated with arteriovenous shunt and coronary steal phenomenon, many cases are asymptomatic. In this report, all patients had no symptom. but incidental murmur was noted (two are continuous, one is diastolic rumbling). The diagnosis was made by transthoracic or transesophageal echocardiogram and selective coronary angiography. Because patients were relatively young and the diameter of dilated coronary artery were huge, we perfomed operation on three patients.
Coronary Angiography ; Coronary Vessels* ; Diagnosis ; Fistula* ; Heart Ventricles* ; Humans ; Rare Diseases

To investigate the human lung development and the distribution of elastic and reticular fibers during the fetal period proper, lung tissues taken from the periphery of the right lower lobes of Korean fetuses (n=49) of both sex were studied. The fetuses were the prodocts of spontaneous or therapeutic abortions and were found to have no associated lesions or anomalies at autopsy. The fetal age were estimated from crown-rump length or foot length. Paraffin sections, cut at 5-7 µm, were stained with routine hematoxylin and eosin for general structure, acid orcein and a1dehyde fuchsin for elastic fiber, and with Gomori's silver technique for reticular fiber, respectively. The lung development during fetal period proper, could be subdivided into three continuous periods according to the relation between airspaces, surrounding mesenchymal tissue, their structural changes and distribution, i.e., an early stage of the formation of conductive airways (pseudoglandular period, before 16th week of gestation), a middle stage of the development of lung parenchyma and new blood vessels (canalicular period, between 16th and 28th week of gestation), and a late stage of transition of respiratory portion to vascular organ (terminal sac stage, after 28th week of gestation). In places, secondary septa of sac or saccule formed by capillaries, capillary connective tissue, elastic and reticular fuel could be identified by the 33rd week of gestation. Elastic fibers could be noted in pleura, subepithelial areas of bronchioles and the wall of blood vessels in the late stage of pseudoglandular period. By the 28th week of gestation, elastic fibers were seen in the wall of small blood vessels or capillaries in the septal wall among the airspaces. And these fibers were observed in the tip of the secondary septa by the 33rd week of gestation but were not still completely developed in the walls of primary or secondary septa. Reticular fibers were already developed and widely distributed in fetal lung by the 10th week of gestation. These fibers were concentrated particular around the subepithelial area of bronchicoles, the airspaces and the blood vessel wall in the canalicular period. By the late stage of terminal sac period, reticular fibers formed a network along the small blood vessels in the septum of airspaces. These results indicate that primitive alveoli might be formed by the late stage of fetal period proper. The fibrous framework could partially formed by collagenous and reticular fibers during the pseudoglandular period, by addition of elastic fiber to the preformed network, and incompletely still finally by the three kinds of connective tissue fiber.
Abortion, Therapeutic ; Autopsy ; Blood Vessels ; Bronchioles ; Capillaries ; Collagen ; Connective Tissue ; Crown-Rump Length ; Elastic Tissue ; Eosine Yellowish-(YS) ; Female ; Fetus ; Foot ; Gestational Age ; Hematoxylin ; Humans ; Lung* ; Paraffin ; Pleura ; Pregnancy ; Reticulin* ; Rosaniline Dyes ; Saccule and Utricle ; Silver

A total of 23 human fetal hearts from 18 to 40 weeks of gestation were provided for histologic and morphometric studies. The fetuses were the products of spontaneous or artificial abortions and were found to have no congential anomalies or associated lesions at autopsy. Maxima thickness of the left anterior, left lateral, left posterior, right anterior, right lateral, right posterior ventricular wall, and of the interventricular septal wall were measured and the left / right wall thickness ratio was calculated. The cross-sectional area of each ventricle parallel to the base of the heart at about 3-5mm below from the origin of the aorta was measured under drawing attachment-equipped light microscope with the application of point counting or cut-and-weigh method. Data were analyzed by the Anderson-ell ABSTAT dBASE ll statistical package program. The ventricular wall consisted of endocardium, myocardium and epicardium. The myocardium showed epithelial character by stratification of barrel-shaped myocardial cells, but the epithelial character progressively changed to as in adult myocardial tissue from the myocardial area close to the epicardium with increasing fetal age. However, any significant histologic difference between the left and the right ventricular wall at the same fetal age was not found. The growth pattern of both ventricular wall, the interventricular septal wall, and of the cross sectional area were linear (p<0.01). However, there was no significant difference in the wall thickness between the left and right ventricle at the same fetal age, and the left / right thickness ratio was nearly constant with increasing fetal age. The cross sectional area was greater in the right than in the left ventricle in the fetuses after 18 weeks of gestation (p<0.01), and there was no significant difference in the morphometric values between point counting and cut-and-weigh method (p>0.1).
Adult ; Aorta ; Autopsy ; Endocardium ; Fetal Heart* ; Fetus ; Gestational Age ; Heart ; Heart Ventricles ; Humans* ; Methods ; Myocardium ; Pericardium ; Pregnancy

BACKGROUND: It has been reported that one or more intermittent reperfusion(s) during ischemia may be beneficial to the myocardium by washing out catabolites that have accumlated during ischemia. We evaluated the effect of four cycles of ichemia (2 minutes) and reperfusion (3 miutes), i.e., preconditioning on sustained ischemia (20 minutes) and reperfusion (60 minutes) using isolated Langendorff-perfused rabbit hearts. METHODS: After a fifty-minutes recovery phase, LVP , dLVP/dt and ECG were simultaneously recorded and ultrastructure of the stunned(or risk) area of the left ventricle was examined with conventional methods. RESULTS: In the preconditioned hearts, functional parameters such as LVPP(peak pressure), LVPP recovery rate and LVEDP(end-diastolic pressure) reached to 99.6+/-4.38mmHg, 98.0+/-4.67% and 14.0+/-2.90mmHg (109.3+/-2.91mmHg, 109.4+/-1.29mmHg and 10.7+/-2.67mmHg for the controls), respectively, after 30 minutes from the onset of reperfusion and maintained as in the controls(p>0.01). In contrast, in the ischemia-reperfusion hearts, LVPP and LVPP recovery rate were significantly reduced(81.6+/-6.83mmHg and 85.7+/-5.30%;p<0.05) and LVEDP elevated(21.2+/-3.00mmHg) but dP/dtmax, heart rate and ECG patterns were not significantly different between the preconditioned and the ischemia-refusion hearts during reperfusion. Furthermore, irreversible myocardial injury was homogeneous(both subendo- and subepicardial) in the ischmia-reperfusion hearts but only focal(subendocardial) in preconditioned hearts. CONCLUSION: These results suggest that preconditioning induced by very short periods of ischemia and reperfusion may enhance recovery of the left ventricular function and delay ultrastructhral changes to a certain extent during reperfusion.
Electrocardiography ; Heart Rate ; Heart Ventricles ; Heart* ; Ischemia ; Myocardium ; Reperfusion ; Ventricular Function, Left

No abstract available.

No abstract available.
Agaricales* ; Morus*

Cardiac lymphangioma is one of the rarest, primary, benign tumor of the heart. We report a case of cardiac lymphangioma, which was diagnosed with CT and MRI in a 50 years old female. Plain chest film showed minimal enlargement and globular shape of the heart. On CT scan, abnormal fluid density mass lesion was noted within pericardial sac. The signal intensity was lower on T1-weighted image and hgher on T2-weighted image than that of the myocardium and located along the left atrioventricuar groove. Several small low signal spots representing hemorrhage were seen within this lesion.
Female ; Heart ; Hemorrhage ; Humans ; Lymphangioma* ; Magnetic Resonance Imaging ; Myocardium ; Thorax ; Tomography, X-Ray Computed

BACKGROUND: It is well known that ischemic preconditioning protects the heart against infarction or arrhythmias from a subsequent ischemic injury. Recent laboratory data indicate that the adenosine during the ischemic period may trigger protection via A1 or A3 adenosine receptor and also protein kinase C(PKC) plays a central role. This study was designed to determine the role of adenosine receptor subtypes and PKC in the preconditioning protection. METHODS: All cat heart groups were subjected to 40min ischemia and 30min reperfusion. The preconditioning protocol consists of 4min ischemia and then 10min of reperfusion 4 times. The effects of ischemic preconditioning, nonselective adenosine receptor blocker(SPT), an A1 specific antagonist(DPCPX) and protein kinase C inhibitor(Polymyxin B), on ischemic preconditioning were determined by infarction size. There were 5 groups : (1) control group (Group 1, n=10)(2) Ischemic preconditioned group(Group 2, n=9)(3) DPCPX pretreatment group(Group 3, n=6)(4) SPT preteatment group(Group 3, n=6)(5) Polymyxin B pretreatment group(Group 5, n=6). SPT and DPCPX were given intravenously 5 min before ischemic preconditioning. Polymyxin B was administered to cats for 30min during ischemic preconditioning period. RESULTS: Ischemic preconditioning only or pretreatment with DPCPX prior to preconditioning demonstrated a significant reduction in infarct size(22.6+/-1.5, 25.4+/-0.9% infarction of the risk zone, respectively, p<0.05) with respect to control, SPT-pretreatment, and polymyxin B-pretreatment groups(44.0+/-1.7, 43.0+/-2.0 and 40.3+/-0.4% infarction of the risk zone, respectively). CONCLUSIONS: Ischemic preconditioning protects heart from subsequent ischemia. Protection was blocked by SPT and protein kinase C inhibitor(polymyxin B), but not by A1 antagonist DPCPX. The cardioprotective effects by ischemic preconditioning in the in vivo cat heart appear to be dependent on A3 adenosine receptors and activation of protein kinase C.
Adenosine* ; Animals ; Arrhythmias, Cardiac ; Cats* ; Heart* ; Infarction ; Ischemia ; Ischemic Preconditioning* ; Polymyxin B ; Polymyxins ; Protein Kinase C* ; Protein Kinases* ; Receptors, Purinergic P1* ; Reperfusion