Peripartum cardiomyopahty(PPCM) is an uncommon myocardial disease arising in the last month of pregnancy or within 5 months after delivery, in the absence of obvious cause and without prior evidence of heart disease. The risk of recurrence of PPCM is considered low when left ventricular size and function return to normal. But we experienced a case of peripartum cardiomyopathy recurred in subsequent pregnancy despite the return to normal heart size and function. This case was summarized here with a brief review of the related literatures.
Cardiomyopathies* ; Heart ; Heart Diseases ; Peripartum Period* ; Pregnancy ; Recurrence

PURPOSE: It is very important to evaluate and fix coronoid process fractures because they are a critical element for a stable, effective elbow function. The lateral view of the elbow joint is used for a radiographic evaluation of the coronoid but an understanding of the fracture pattern is often difficult because of overlap of the radial head and obliquity of the fracture line. We developed the coronoid view, which is a new radiograph for an evaluation of the coronoid process fracture, and discuss its advantages for a postoperative follow-up. MATERIALS AND METHODS: The coronoid view was designed for an evaluation of the anteromedial fragment of the coronoid process. After the patient sat on his side, the shoulder was abducted 45degrees and the elbow was flexed 90degrees The X-ray beam was shot perpendicular to the table. Since shoulder was abducted 45degrees the fracture line of the coronoid process can be parallel to the X-ray beam, and the radial head can be cleared. CONCLUSION: The coronoid view can be a good alternative radiograph for an evaluation of a coronoid process fracture because the beam is parallel to the fracture line. The coronoid view can be particularly useful in postoperative patient follow-up where computed tomography is impractical due to metal implants and cost.
Elbow ; Elbow Joint ; Follow-Up Studies ; Head ; Humans ; Shoulder

Two cases of cavernous hemangioma of the cauda equina are presented. Cavernous hemangioma of the cauda equina is rare vascular malformation. This is the fifth and sixth case of cavernous hemangioma of the cauda equina in the literature. These cases are female patients. MRI is more sensitive method than spinal myelography and CT in diagnosis of cavernous hemangioma of the cauda equina. Total removal was possible without immediate post-operative complication.
Cauda Equina* ; Diagnosis ; Female ; Hemangioma, Cavernous* ; Humans ; Magnetic Resonance Imaging ; Myelography ; Vascular Malformations

Bilateral ectopic testes, located in the perineum is a rare disease with no cases reported yet in Korea. We report a case of bilateral perineal ectopic testes in a 7-month-old infant who visited for evaluation of both non palpable testis in scrotum. External genitalia was male in appearance and cystic masses were palpated in both inguinal area. Serum testosterone level was lower than 0.01 ng/mL and suspicious hernial sac-like structures were seen in both inguinal area on pelvic ultrasonography. After 4 weeks of total 12,000IU hCG(human chorionic gonadotropin) therapy in pediatrics, serial follow up was done for 2 months and bilateral palpable masses were identified on deep perineal area, so bilateral orchiopexy was carried out.
Chorion ; Follow-Up Studies ; Genitalia ; Humans ; Infant ; Korea ; Male ; Orchiopexy* ; Pediatrics ; Perineum ; Rare Diseases ; Scrotum ; Testis* ; Testosterone ; Ultrasonography

Holoprosencephaly is a rare malformation complex or development defect including different degrees of incomplete cleavages of the embryonic prosencephalon and varying degrees of the midface defects, resulting from the defect of prechordal mesoderm, migrating forward into the area anterior to the notochord during the third week of fetal development. Early antenatal diagnosis of holoprosencephaly is important to find out its severity, to predict its prognosis, and to determine proper management according to its prognosis and severity. The possibility of early antenatal diagnosis of holoprosencephaly by ultrasound has been suggested, but occasionally missed and rarely confirmed. We present one case of lobar holoprosencephaly, diagnosed postnatally and one case of alobar holoprosencephaly, diagnosed antenatally in our hospitals.
Fetal Development ; Holoprosencephaly* ; Mesoderm ; Notochord ; Prenatal Diagnosis ; Prognosis ; Prosencephalon ; Ultrasonography

Norcardia is an aerobic, gram-positive, AFB positive filamentous organism which is frequently branching. Nocardial infection is usually opportunistic and is found in immunosuppressed patients during transplantation or anti-cancer chemotherapy. With the increasing number of AIDS, nocardial infection have been increasingly recognized as a serious human infection. Among patients on peritoneal dialysis, Nocardia is a rare cause of peritonitis : only one case has been reported in Korea. It is extremely important to make an early and correct diagnosis and treatment with susceptible antibiotics. We report here a case of nocardial peritonitis associated with Continuous Ambulatory Peritoneal Dialysis(CAPD) which was resistant to trimethoprim/sulfamethoxazole and has treated successfully with imipenem and amikacin.
Amikacin ; Anti-Bacterial Agents ; Diagnosis ; Drug Therapy ; Humans ; Imipenem ; Korea ; Nocardia ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis*

Sigmoid colon cancer occasionally attaches to the adjacent viscera. It is estimated that such attachment occurs in 6% to 12% of all patients with colon carcinoma without distant metastases. This study was performed to identify the parameters to distinguish direct tumor invasion to adjacent organs from simple inflammatory adhesion in sigmoid colon cancer and to clarify the difference of survival and recurrence pattern between two groups. METHODS: Between 1989 and 1998, 415 patients underwent resection of sigmoid colon cancer in our clinic. Of these, 46 had tumors adherent to adjacent organs and confirmed as tumor direct invasion or simple inflammatory adhesion by pathologic examination. The mean age of 46 cases was 54.2+/-12.8 (mean+/-SD) years and median follow up was 21 (3~53) months. RESULTS: Among the clinical and pathologic parameters such as symptoms and laboratory findings presenting bowel obstruction, serum CEA levels, preoperative radiological findings, tumor size, differentiation, and stage, there was no specific one that was correlated with direct tumor invasion or inflammatory adhesion. Almost all cases with adhesion to adjacent organ were treated by an en bloc resection including mutivisceral resection. The group with direct invasion had inferior disease free survival rate and overall survival rate comparing with simple inflammatory adhesion group. CONCLUSIONS: In the situation that there was no valuable parameter suggesting direct tumor invasion, en bloc resection or multivisceral resection involving one tumor-free plane may be beneficial to the patients with sigmoid colon cancer adherent to adjacent organ.
Colon ; Colon, Sigmoid* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sigmoid Neoplasms* ; Survival Rate ; Viscera

PURPOSE: Oral UFT is known to be a safe and effective antineoplastic regimen for adjuvant chemotherapy of colorectal cancer. As it sometimes produces upper gastrointestinal symptoms such as anorexia, nausea, vomiting and abdominal pain, medication should be stopped transiently or dosage reduced. UFT-E, an enteric coated granule of UFT was introduced to reduce UGI toxicity. We analyzed the toxicity of UFT and UFT-E prospectively for the purpose of comparison between the two types. METHODS: The toxicity of UFT and UFT-E were evaluated in 83 patients (UFT; 45, UFT-E; 38) with colorectal cancer who underwent curative surgery according to the WHO toxicity criteria. All patients were selected consecutively with patients' approval and by the "Institutional Review Board, Asan Medical Center". RESULTS: The toxicity incidence in UFT-E group was slightly less than that in UFT group without statistical significance. The severity of toxicity seemed to be mild within grade 1 or 2 and most of them toxicity self-limiting. The regimen was completely interrupted in 9 patients (20%) in the UFT group, 3 patients (7.9%) in the UFT-E group due to severe UGI symptoms, prolonged leukopenia, derrangement of liver function and skin rash. CONCLUSIONS: Toxicity rate of UFT-E was not higher than that of UFT. But we cannot prove superiority of UFT-E on UGI toxicity. Oral UFT-E can be administered safely on an outpatient basis without lethal toxicity requiring hospitalization.
Abdominal Pain ; Anorexia ; Chemotherapy, Adjuvant ; Chungcheongnam-do ; Colorectal Neoplasms* ; Exanthema ; Hospitalization ; Humans ; Incidence ; Leukopenia ; Liver ; Nausea ; Outpatients ; Prospective Studies ; Vomiting

Metastases to the liver from carcinoma of the colon and rectum occur as many as 80% of cases. As resection of metastases is proven to enhance survival and to reduce hepatic recurrence, the criteria for selection of patients and surgery type appear to be indispensable. Purpose: The aim of this study was to assess the prognostic factors after hepatic resection for metastatic colorectal cancer and propose the optimal surgical principles for resection of metastatic colorectal cancer. Methods: Sixty-three patients who underwent initial hepatic resection for liver metastases from colorectal cancer between 1989 and 1998 were analyzed regarding clinical and pathologic parameters. Results: Overall 5-year survival rate was 32%. Preoperative serum CEA level and resection margin of metastatic tumors were found to be significant predictors for poor long-term outcome. Resection margin of greater than 5 mm was closely associated with better survival. In multivariate analysis, resection margin alone was an independent prognostic factor. Conclusions: Preoperative serum CEA level and surgical resection margin may affect the outcome for the patients who underwent hepatic resection for metastatic colorectal cancer. Surgical resection margin must be kept enough to avoid re-recurrence or metastasis during hepatic resection for metastatic colorectal cancer.
Colon ; Colorectal Neoplasms* ; Humans ; Liver ; Multivariate Analysis ; Neoplasm Metastasis ; Rectum ; Recurrence ; Survival Rate

PURPOSE: Recent randomized phase III trial by the Breast Cancer International Research Group (BCIRG 001) showed that docetaxel plus doxorubicin and cyclophosphamide (TAC) is superior to fluorouracil plus doxorubicin and cyclophosphamide (FAC) as adjuvant chemotherapy for node-positive operable breast cancer. Unfortunately, TAC was clearly more toxic than FAC not only with respect to neutropenic fever events, but also with respect to many extrahematological side effects. The aim of this study was to evaluate the toxicity and tolerability of Korean patients with breast cancer treated with TAC. METHODS: This study was conducted on 80 patients with breast cancer who underwent primary surgery at the Department of Surgery in Soonchunhyang University (4 affiliated hospitals) from October 2005 to October 2008. The patients received 480 courses consisting of TAC (75/50/500 mg/m2, every 3 weeks for 6 cycles) without prophylactic granulocyte colony-stimulating factor (G-CSF). Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria version 3.0. RESULTS: The main toxicities were hematologic (neutropenia grade 3/4 in 98.8% of patients and 92.3% of cycles; febrile neutropenia in 42.5% of patients and 16.0% of cycles). No cases of septic death occurred. The peak time of occurrence for febrile neutropenia was 7-10 days after receiving chemotherapy (mean duration, 2.05 days). Severe nonhematologic adverse events were as follows: myalgia (30.0%), neurotoxicity (17.5%), fatigue (16.3%), stomatitis (12.5%), and nausea (11.3%). CONCLUSION: An adjuvant TAC regimen without prophylactic G-CSF was tolerable in Korean patients with breast cancer. Although most of the patients developed neutropenia, the nonhematologic toxicities (cardiac toxicity) were tolerable. Further studies on prophylactic G-CSF use to assess the contribution to reduced hematologic toxicities are required in Korean patients with breast cancer.
Breast Neoplasms ; Drug Toxicity