No abstract available.
Mitral Valve* ; Rupture*

Supravalvular aortic stenosis is an uncommon, congenital narrowing of the ascending aorta which originates just distal to the level of the ostium of the coronary artery. We conducted a successful surgical treatment in a 39 year- old female patient with a congenital supravalvular aortic stenosis and aortic regurgitation who did not show signs of William's syndrome. After we performed an inverted Y-shaped aortotomy toward the noncoronary sinus and right coronary sinus, pantaloon shaped prosthetic patch(Vascutek, Ino, USA) was used to repair the narrowing sinotubular junction. The aortic valve was replaced concommittently using Sorin Bicarbon 19mm. Her postoperative course was uneventful. The patient discharged at 9th postoperative day in good health.
Aorta ; Aortic Stenosis, Supravalvular* ; Aortic Valve ; Aortic Valve Insufficiency* ; Coronary Sinus ; Coronary Vessels ; Female ; Humans

Native valve endocarditis (NVE) without preexisting structural valve or congenital cardiac malformation especially in pediatric group is rare. A case of isolated tricuspid valve endocarditis in a 7-year-old child without any cardiac malformation is described. This child had suffered from fever and productive cough for 3 weeks. Blood culture grew Staphylococcus aureus. Fever was not controlled even with proper antibiotic treatment. Transthoracic echocardiogram and lung perfusion scan revealed a large vegetation on the tricuspid valve with multiple embolism Surgical procedures included vegetectomy partial cusps resection and pericardial patch valvuloplasty. Th patient was in NYHA class I during follow up.
Child ; Cough ; Embolism ; Endocarditis* ; Endocarditis, Bacterial ; Fever ; Follow-Up Studies ; Humans ; Lung ; Perfusion ; Staphylococcus aureus ; Tricuspid Valve*

A 4-day-old patient with Down syndrome (DS) visited out patient department (OPD) because of jaundice and VSD. Peripheral blood smear showed 21% of myeloblast. After 4 weeks of observation, WBC count was 55,100/mm3 (blast 90%). BM aspirate showed AML (M7) and treatment was started with low dose Ara-C (20 mg/m2 for 21 days). After remission, maintenance therapy was done with low dose Ara-C (16 mg/m2 for 21 days), 6-TG (40 mg/m2 for 21 days) and low dose IL-2 (0.5 106U/m2 for 21 days) alternatively for 2 years. The patient remained in complete remission and VSD was corrected at 9 months of age. This case shows that remission can be achieved with low dose Ara-C and it can be maintained thereafter with low dose Ara-C, 6-TG and IL-2. Low dose IL-2 has the advantage of selectively activating immune cells with high affinity receptors, low treatment related morbidity, good compliance which can be injected at OPD. As the patients with DS have defect in IL-2 secretion, IL-2 may have an beneficial effects on treating AML in DS.
Compliance ; Cytarabine ; Down Syndrome* ; Drug Therapy* ; Granulocyte Precursor Cells ; Humans ; Interleukin-2* ; Jaundice ; Leukemia, Myeloid, Acute*

Percutaneous suture closure device is known as relatively safe and convenient tool, which can decrease not only bed rest period of patient but also time consuming effort of manual compression of doctor after femoral artery puncture. However [C1], there are also some reports on complication of its use. We report a 62-year-old male patient who had femoral artery endarteritis [0] with pseudoaneurysm as a complication of percutaneous suture closure device after percutaneous coronary angiography [C2]. He was treated successfully by appropriate antibiotics and vessel reconstruction using autologous saphenous vein patch.
Aneurysm, False ; Angioplasty, Balloon, Coronary ; Anti-Bacterial Agents ; Bed Rest ; Coronary Angiography ; Endarteritis* ; Femoral Artery ; Humans ; Male ; Middle Aged ; Punctures ; Saphenous Vein ; Sutures*

Castleman's disease was first described in 1956 in a group of patients with localized mediastinal lymph node enlargement characterized by hyperplasia of lymphoid follicles and marked capillary proliferation with endothelial hyperplasia. They have been divided into 2 histologic types: the hyaline-vascular type, which was more common and usually asymptomatic, was characterized by small hyaline-vascular follicles and interfollicular capillary proliferation; the plasma-cell type was characterized by large follicles with intervening sheets of plasma cells. Systemic manifestations, such as fever, anemia and hyperglobulinemia, were frequently associated with the plasma cell type. Localized lesions have behaved in a benign fashion, and complete surgical excision has been curative. But recent years, reports have described a multicentric variety with severe systemic manifestations, exorable clinical course and poor outcome. Although Castleman's disease has been described at all ages, the disease is rare in childhood. This paper describes a case of plasma cell type Castleman's disease in a 12-year-old boy and review of the literature. We conclude that the Castleman's disease must be considered in childhood lymphadenopathy and the clinicians should be mindful of the malignant potential of the disease and their possible multicentricity. Appropriate treatment plan, close follow-up and periodic surveillance are necessary.
Anemia ; Capillaries ; Child ; Fever ; Follow-Up Studies ; Giant Lymph Node Hyperplasia* ; Humans ; Hyperplasia ; Lymph Nodes ; Lymphatic Diseases ; Male ; Plasma Cells* ; Plasma*

Innominate artery injury by blunt chest trauma is rarely reported. This report describes a 40-year-old male who had innominate artery dissection and pseudoaneurysm caused by blunt chest trauma and was treated successfully by ascending aorta to innominate artery bypass graft. The patient recovered without any complications and was discharged one week after the operation.
Adult ; Aneurysm, False ; Aorta ; Brachiocephalic Trunk* ; Humans ; Male ; Thorax* ; Transplants

The familial occurrence of intracranial aneurysms, defined as the presence of one or more aneurysms in two or more blood relatives, is well established and is relatively rare. The pattern of inheritance in these families is not usually known. The authors report one case of familial intracranial aneurysm, without specific genetic disorder, occurring during a recent six-month period in three of five siblings. Two of these were females, aged 36 and 39, and the other was a 40-year-old male. Two of these patients had ruptured aneurysms, but in the other, the aneurysm was unruptured. All were treated successfully by clipping of the aneurysmal neck, without any neurological deficits. The authors describe their experience of a rare familial intracranial aneurysm, occurring in the absence of a specific genetic disorder, and review the literature concerning this type of aneurysm.
Adult ; Aneurysm ; Aneurysm, Ruptured ; Female ; Humans ; Intracranial Aneurysm* ; Male ; Neck ; Siblings ; Subarachnoid Hemorrhage ; Wills

Lymphangioma(or cystic hygroma) of the chest wall is rare case. We experienced one such case in a 16-year-old girl who complained of a large recurrent mass on her right upper post erolateral chest wall which had developed several years ago. The diagnosis was made following a physical examination, chest magnetic resonance imaging(MRI), and radio isotope (RI) lymphangiogrphy and was confirmed by a histopathological examination. We performed total excision of the lesion followed by a repeated sclerosing therapy with intralesional injection of Vibramycin.
Adolescent ; Diagnosis ; Doxycycline ; Female ; Humans ; Injections, Intralesional ; Lymphangioma* ; Physical Examination ; Thoracic Wall* ; Thorax*

BACKGROUND: Patients who are considered for major pulmonary resection are generally evaluated by spirometry and clinical assessment to predict morbidity and mortality. Despite this, none has yet proved to be a convenient and reliable estimate of risk. MATERIAL AND METHOD: A retrospective analysis was performed in 167 patients who were diagnosed for lung cancer, bronchiectasis, pulmonary tuberculosis, and other benign pulmonary disease, and who underwent major lung resections. The relationship of 25 preoperative or postoperative variables to 19 postoperative events were classified into categories as operative mortality, pulmonary or cardiovascular morbidity, and other morbidity was assessed. Logistic regression analysis and x2 analysis were used to identify the relationship of the operative risk factors to the grouped postoperative complications. RESULT: The best single predictor of complications was the percent predicted postoperative diffusing capacity (pulmonary morbidity, p<0.009; cardiovascular morbidity, p<0.003: overall morbidity, p<0.004). CONCLUSION: The diffusing capacity of the lung for carbon monoxide was an important predictor of postoperative complications than the spirometry, and it usually should be a part of the evaluation of patients being considered for pulmonary resection.
Bronchiectasis ; Carbon Monoxide ; Humans ; Logistic Models ; Lung ; Lung Diseases ; Lung Neoplasms ; Mortality* ; Postoperative Complications ; Retrospective Studies ; Risk Factors* ; Spirometry ; Tuberculosis, Pulmonary