BACKGROUND: The surgical indications of stage IV non-small cell lung cancer(NSCLC) are extremely limited with its controversial results. We analyzed the surgical results and survival in selected patients with resectable stage IV NSCLC. MATERIAL AND METHOD: We reviewed the medical records of 21 patients who underwent operation for stage IV NSCLC from Jan. 1992 to Sep. 1999. RESULT: The mean age of patients was 55.6 years(range: 35 to 78). Sixteen were men and 5 were women. Tissue types were squamous cell carcinoma in 10(45.5%), adenocarcinoma in 9(40.9%), large cell carcinoma in 1 and carcinosarcoma in 1. Distant metastatic lesions were ipsilateral other lobe of lung in 18, brain in 2 and adrenal gland in 1. Pneumonectomy was performed in 16 patients, bilobectomy in 3, and lobectomy in 2 who underwent previous operatin for brain metastasis. Mean follow-up duration was 21.2+/-17.7 months. During follow-up period, 13 patients died. Three-and 5-year survival of patients were 38.0% and 19.0%, the median survival time was 19.1+/-7.8 months. In the group with ipsilateral pulonary metastasis(PM, n=18), 3- and 5-year survival of patients with N0 and N1(n=9) disease were 64.8% and 32.4%, median survival time was 55.3+/-27.2 months. Three-year survival of patients with N2(n=9) disease was 11.1%, median survival time was 10.6+/-0.3 months. The survival of N0 and N1 disease group was significantly better than that of N2 disease group(p=0.042). Also the disease free survival of N0 and N1 was significantly better than that of N2 disease in overall group(53.3 months vs 12.1 months, p=0.036) and ipsilateral PM group(63.4 months vs 8.8 months, p=0.001). CONCLUSIONS: We suggest that surgical treatment is worthful modality in well selected patients with stage IV NHSCLC especially with ipsilateral PM and N0 or N1 disease. Nevertheless our study indicate questions that will need to be experienced further in larger studies.
Adenocarcinoma ; Adrenal Glands ; Brain ; Carcinoma, Large Cell ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Carcinosarcoma ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung ; Lung Neoplasms ; Male ; Medical Records ; Neoplasm Metastasis ; Neoplasm Staging ; Pneumonectomy

BACKGROUND: Bronchial anthracofibrosis (BAF) is a dark black or brown pigmentation of multiple large bronchi associated with a fibrotic stenosis or obliteration that is incidentally found during a diagnostic bronchoscopy. Some reporters have suggested endobronchial tuberculosis or tuberculous lymphadenitis as a possible cause of BAF. However, some BAF patients do not have any medical history of tuberculosis. The aim of this study was to elucidate the clinical features of simple BAF patients, which were not associated with tuberculosis. METHODS: We reviewed the patients' charts retrospectively and interviewed all BAF patients who were followed up for 1 year or more. Among the 114 BAF patients, 43 patents (38 %) had no associated tuberculosis, cancer and pneumoconiosis. The clinical characteristics, radiological findings and associated pulmonary diseases of these patients were evaluated. RESULTS: Most patients were non-smokers, old aged, housewifes who resided in a farming village. The common respiratory symptoms were dyspnea, cough and hemoptysis. The predominant X-ray findings were a multiple bronchial wall thickening(89%), bronchial narrowing or atelectasis (76%) and a mediastinal lymph node enlargement with/without calcification (78%). Pulmonary function test usually showed mild obstructive ventilatory abnormalities but no patient showed a restrictive ventilatory pattern and the patients were frequently affected with chronic bronchitis(51%), post-obstructive pneumonia(40%) and chronic asthma(4%). CONCLUSION: Because BAF is frequently associated with chronic bronchitis and obstructive pneumonia as well as tuberculosis, a careful clinical evaluation and accurate differential diagnosis is more essential than empirical anti-tuberculous medication.
Diagnosis, Differential ; Pneumoconiosis

BACKGROUND: The right gastroepiploic artery(RGEA) has been use in coronary artery bypass grafting from 1987. The RGEA is the most useful arterial conduit in coronary artery bypass grafting(CABG) followed by the internal mammary artery, MATERIALS AND METHOD: From Septermber 1998 to February 1999 the RGEA was used for coronary artery bypass grafting in 11 patients 10 males and 1 female. Postoperative angiography was performed in all of the patients before discharge RESULT: Early patent rate of the RGEA was 100%. The flow competition of the REGA graft was seen in 4 patients(36.4%) The flow pattern war RGEA dependent type in the inner diameter of the recipient coronary artery 1.5 mm the inner diameter of the RGEA 2.5 mm and the rtio of inner diameter of the RGEA and the recipient coronary artery 1(p<0.05) CONCLUSION: Early results of CABG with RGEA was satisfactory. However the RGEA graft has a tendency of flow competition in relation to the inner diameter of graft. Preoperative angiographic evaluation for RGEA and meticulous operative technique are required for a good surgical results.
Angiography ; Coronary Artery Bypass ; Coronary Vessels ; Female ; Gastroepiploic Artery* ; Humans ; Male ; Mammary Arteries ; Transplants*

Mediastinal hemangioma is a rare tumor and only few cases have been reported in the literatures. We have experienced one case of cavernous hemangioma occuring at the superior vena cana. The patient was a thrity-five year old female with no specific symtoms except palpable cystic mass in the right cervical area. A routine chest radiography showed an upper mediastinal mass. Computed Tomography showed about 4x5 cm sized cystic mass communicating to the superior vena cava 2 cm above of the veno-atrial junction. After the evaluation, surgical excision was performed and the pathologic diagnosis was confirmed to cavernous hemangioma. Postoperative course was uneventful and the patient has been followed up without any problems.
Diagnosis ; Female ; Hemangioma ; Hemangioma, Cavernous* ; Humans ; Mediastinal Neoplasms ; Radiography ; Thorax ; Vena Cava, Superior

BACKGROUND: Left ventricular hypertrophy (LVH) is a critical and an independent factor for mortality of patients with end-stage renal disease, and numerous risk factors for LVH have been discussed in previous studies. In present study, we intended to clarify the factors that affect the progression of LVH in patients with their first continuous ambulatory peritoneal dialysis (CAPD) and to analyse the influences of these risk factors on severity of LVH. METHODS: This retrospective study enrolled the patients who performed echocardiography both before and in period between 24 to 30 months after CAPD. We estimated the change of LVH by the calculated difference of left ventricular mass index (LVMI) on echocardiography. We analyzed the factors that influence the change of LVMI such as age, sex, baseline renal disease, body mass index, blood pressure, hematocrit, calcium, phosphate, intact parathyroid hormone (i-PTH), serum albumin and peritoneal transport status on peritoneal equilibration test (PET). RESULTS: The causes of renal disease of the patients (male : female=10 : 16, mean age 55.74+/-12.0 years) were as follows : 13 cases (50.0%) of diabetic nephropathy, 11 cases (47.4%) of chronic glomerulonephritis, 1 case (3.8%) of hypertensive nephrosclerosis, and 1 case (3.8%) of unknown cause. Mean duration of follow-up was 25.5+/-2.1 months. As a result, the difference of LVMI positively correlated with mean systolic blood pressure (p=0.001, r=0.598) and mean diastolic blood pressure (p<0.001, r=0.718), difference of pulse pressure (p<0.001, r=0.893), and maximal i-PTH level (p=0.041, r=0.404). On the other hand, the difference of LVMI showed negative correlation with mean hematocrit (p=0.031, r=-0.421). In multiple linear regression analysis, the mean diastolic blood pressure and the difference of pulse pressure appeared to be the independent risk factors for the difference of LVMI (R2=0.923). CONCLUSION: The factors necessary to restrict the progression of LVH after initiation of CAPD are strict blood pressure control, correction of anemia, optimal treatment of secondary hyperparathyroidism. These corrections could secure the amelioration of LVH.
Anemia ; Blood Pressure ; Body Mass Index ; Calcium ; Diabetic Nephropathies ; Echocardiography ; Follow-Up Studies ; Glomerulonephritis ; Hand ; Hematocrit ; Humans ; Hyperparathyroidism, Secondary ; Hypertrophy, Left Ventricular* ; Kidney Failure, Chronic ; Linear Models ; Mortality ; Nephrosclerosis ; Parathyroid Hormone ; Peritoneal Dialysis, Continuous Ambulatory* ; Retrospective Studies ; Risk Factors* ; Serum Albumin

BACKGROUND/AIMS: The purpose of this study was to compare changes in primary percutaneous coronary artery intervention (PCI) outcomes after starting the government-directed Busan-Ulsan Regional Cardiocerebrovascular Center Project. METHODS: Patients with ST segment elevation myocardial infarction (STEMI) who visited the Busan-Ulsan Regional Cardiocerebrovascular Center from 1 June 2009 to 30 May 2011 were selected. Their medical records were retrospectively reviewed. Clinical and survival outcomes before and after starting the project were compared. RESULTS: A total of 122 patients (mean age, 63 +/- 13 years; male, 74%) with STEMI were selected for analysis. There were no significant differences in patients' baseline characteristics. After starting the Busan-Ulsan Regional Cardiocerebrovascular Center Project, the door-to-balloon time decreased from 72 +/- 30 to 59 +/- 22 minutes (p = 0.011). The door-to-balloon time when the PCI team did not stay in the hospital also decreased from 80 +/- 30 to 62 +/- 12 minutes (p = 0.005). However, there was no significant change in the total ischemic time (339 +/- 293 vs. 304 +/- 287 minutes, p = 0.514), survival discharge rate (94% vs. 93%, p = 1.000), or 1-year survival rate (89% vs. 91%, p = 0.996). CONCLUSIONS: After starting the government-directed Busan-Ulsan Regional Cardiocerebrovascular Center Project, the door-to-balloon time was significantly reduced. However, the total ischemic time and short-term survival remained unchanged.
Coronary Vessels ; Humans ; Male ; Medical Records ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Retrospective Studies ; Survival Rate

Ancient DNA analyses are widely used for evolutionary and phylogenetic study of mankind in anthropology and archeology. However, the DNA extraction from particularly poorly preserved ancient human samples is often unsuccessful in these analyses. In the present study, to improve the success rate of ancient DNA analysis, we introduced a high grade ancient DNA purification method using ion-exchange columns. We compared the success rate of ancient DNA analysis of this new method with that of the two methods that have been used for ancient DNA extraction, GENECLEAN(R) kit (Qbiogene) and Qiaquick column (Qiagen). Twelve ancient bone samples from Korea and Mongolia that are about 500 to 5,000 years old by an archeological estimation were used. As the DNA analysis methods, polymerase chain reaction (PCR) methods for the amplification of a mitochondrial DNA HV1 segment, a male sex determination marker DNA and M175 marker DNA that is used for the determination of O haplogroup of Y chromosome that is reportedly a common one in modern Korean people. The method developed in this study remarkably increased the success rate of DNA analysis compared with the other two methods. Using the GENECLEAN(R) kit, only two samples were amplifiable for the mitochondrial DNA, no samples for the male sex determination marker and M175 marker DNAs. Using the Qiaquick columns, nine samples were amplifiable for mitochondirial DNA, nine samples for male sex determination marker and six samples for M175 marker. The developed method allowed for the amplification of mitochondrial DNA from all samples, male sex determination marker from eight samples and M175 marker from eight samples. The results demonstrate that ion-exchange columns can be useful for the improved ancient DNA extraction in anthropology and archeology.
Anthropology ; Archaeology ; DNA* ; DNA, Mitochondrial ; Humans ; Korea ; Male ; Mongolia ; Polymerase Chain Reaction* ; Y Chromosome

The follow-up of patients after performing potentially curative resection for colon cancer is important, yet the ideal surveillance strategy has not been defined. Periodic clinical examinations, laboratory tests, radiographic imaging, colonoscopy and carcinoembryonic antigen (CEA) testing have been utilized for surveillance, and the serial CEA measurement is the most cost-effective test for identifying the recurrence of disease. However, this test also indicates the development of secondary gastrointestinal malignancy such as gastric cancer or duodenal cancer. We report here on a case of metachronous duodenal adenocarcinoma that was revealed by the serial measurement of the serum CEA after we performed curative resection for colon cancer.
Adenocarcinoma* ; Carcinoembryonic Antigen ; Colon* ; Colonic Neoplasms* ; Colonoscopy ; Duodenal Neoplasms ; Follow-Up Studies ; Humans ; Recurrence ; Stomach Neoplasms