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

Purpose: There are a variety of techniques for treating chronic prostatitis. Regardless of the presence of infections, antibiotics were arbitrarily prescribed for 4-12 weeks, but there seemed to be ongoing debate of their effectiveness and side effects. Uro-vaxom(R) is known as an effective treatment for urinary tract infection due to its initiation the urothelial immune system activity. This study was performed to investigate for the possibility of Uro-vaxom(R) as a drug for use in non-inflammatory chronic prostatitis. Materials and Methods: 95 patients, diagnosed as chronic pelvic pain syndrome (CPPS) (National Institutes of Health (NIH)-category IIIB), were divided into three groups: group A, 35 patients were given levofloxacin 100mg TID and Uro-vaxom(R) 60mg OD for the first 4 weeks, followed by only Uro-vaxom(R) 60mg OD for the next 8 weeks; group B, 30 patients were given only Uro-vaxom(R) 60mg OD before breakfast for 12 weeks; group C, the patients were treated with levofloxacin 100mg TID for 4 weeks. All the patients were reevaluated 4 weeks and 12 weeks later. Results: The initial diagnostic stati, the NIH-Chronic Prostatitis Symptom Index (CPSI) were 25.1+/-2.7, 24.4+/-3.2 and 24.7+/-2.2 for groups A, B and C, respectively. In groups A and B, the NIH-CPSI after 12 weeks were 13.5 2.3 and 13.9+/-2.7, respectively, and showed noticeable improvements (p<0.05). In group C, the NIH-CPSI was 15.7+/-3.4, which was less improved compared to groups A and B (p>0.05). No patients experienced any adverse symptoms due to Uro-vaxom(R) intake. Conclusions: Uro-vaxom(R) could be appointed as an alternative method for the treatment of chronic prostatitis.
Academies and Institutes ; Anti-Bacterial Agents ; Breakfast ; Humans ; Immune System ; Levofloxacin ; Pelvic Pain* ; Prostatitis ; Urinary Tract Infections ; Urinary Tract*

PURPOSE: Many techniques have evolved to treat benign prostatic hyperplasia (BPH). These techniques attempt to achieve the clinical benefits of transurethral resection of the prostate, while trying to decrease the morbidity associated with this procedure. Visual laser ablation of the prostate (VLAP) has also been used as an effective treatment modality of BPH. The objective of this paper was to evaluate the long term effect of VLAP for patients with symptomatic BPH. MATERIALS AND METHODS: 85 patients with BPH underwent an initial operation, where a VLAP was performed with a neodymium:YAG laser. 65 patients, 6 months after the operation, and 25, 6 years after the operation, were available for follow-up studies. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured over time. RESULTS: 6 months after the operation significant improvement was seen in the prostatic size, maximal flow rate and post-void residual volume. However, no significant statistical improvement in these parameters was noticed in the subsequent 6 year follow-up (p>0.05). Comparisons of the mean AUA scores, before the operation, and 6 months (p<0.05) and 6 years (p>0.05) after, showed significant differences for the different times. With regard to the quality of life due to the urinary symptoms, 87.7% of patients 6 months, and 72.7% 6 years after the operation felt more than mildly satisfied. CONCLUSIONS: There have been numerous reports on the efficacy of VLAP, which show its many advantages, such as low morbidity, high simplicity and good short-term effect. However, according to this study, the long-term therapeutic effect of VLAP was poor, but its exact role for the treatment of BPH remains to be determined.
Follow-Up Studies* ; Humans ; Laser Therapy* ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Transurethral Resection of Prostate

PURPOSE: Many techniques have evolved to treat benign prostatic hyperplasia (BPH). These techniques attempt to achieve the clinical benefits of transurethral resection of the prostate, while trying to decrease the morbidity associated with this procedure. Visual laser ablation of the prostate (VLAP) has also been used as an effective treatment modality of BPH. The objective of this paper was to evaluate the long term effect of VLAP for patients with symptomatic BPH. MATERIALS AND METHODS: 85 patients with BPH underwent an initial operation, where a VLAP was performed with a neodymium:YAG laser. 65 patients, 6 months after the operation, and 25, 6 years after the operation, were available for follow-up studies. Voiding outcomes, including peak urinary flow rates, residual urine volumes and American Urological Association (AUA) symptom scores, were measured over time. RESULTS: 6 months after the operation significant improvement was seen in the prostatic size, maximal flow rate and post-void residual volume. However, no significant statistical improvement in these parameters was noticed in the subsequent 6 year follow-up (p>0.05). Comparisons of the mean AUA scores, before the operation, and 6 months (p<0.05) and 6 years (p>0.05) after, showed significant differences for the different times. With regard to the quality of life due to the urinary symptoms, 87.7% of patients 6 months, and 72.7% 6 years after the operation felt more than mildly satisfied. CONCLUSIONS: There have been numerous reports on the efficacy of VLAP, which show its many advantages, such as low morbidity, high simplicity and good short-term effect. However, according to this study, the long-term therapeutic effect of VLAP was poor, but its exact role for the treatment of BPH remains to be determined.
Follow-Up Studies* ; Humans ; Laser Therapy* ; Prostate* ; Prostatic Hyperplasia ; Quality of Life ; Residual Volume ; Transurethral Resection of Prostate

No abstract available.
Breast Neoplasms* ; Breast*

Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.
Female ; Humans

Adenoid cystic carcinoma of the esophagus is a rare tumor and has been considered to be counterpart of the salivery gland. The patient we experienced was a 60-year-old female who had a tumor in the lower third of the esophagus. The tumor was located in the submucosa and showed histologic features similar to those of the salivary gland. Electron micrsopic examination revealed ductal structures invested by basal lamina, and clusters of basaloid cells with tonofilaments and desmosomes. No myoepithelial cells were identified. Immunohistochemical studies for S-100 protein, cytokeratin and vimentin were performed. A few cells showed positive reaction to the S-100 protein. These findings suggest that the esophageal adenoid cystic carcinoma arises from the duct of submucosal gland.
Female ; Humans

Pick's disease is a rare neurodegenerative disorder presenting cortical type of dementia. Pick's disease shows unique clinical and pathological features, that are due to a degeneration of fronto-temporal lobes of the cerebrum. The authors experienced a case of Pick's disease in a 58-year-old male patient who had dementia symptoms for five years. The patient showed compulsive behavior since five years ago. Memory decline started from four years ago and progressed. Brain CT disclosed lobar atrophy of the cerebral gyri in frontal and temporal lobes. He died of septicemia associated with aspiration pneumonia. At autopsy, both cerebral hemispheres showed marked encephalomalacia. The gyral atrophy was moderately severe in prefrontal and anterior temporal lobes. Coronal section disclosed moderate dilatation of the lateral ventricles. Microscopically, there were marked neuronal loss in prefrontal and anterior temporal cortices. Also noted were Pick's cells and Pick's body in occasional pyramidal cells preserved.
Atrophy ; Autopsy* ; Brain ; Cerebrum ; Compulsive Behavior ; Dementia ; Dilatation ; Encephalomalacia ; Humans ; Lateral Ventricles ; Male ; Memory ; Middle Aged ; Neurodegenerative Diseases ; Neurons ; Pick Disease of the Brain* ; Pneumonia, Aspiration ; Pyramidal Cells ; Sepsis ; Temporal Lobe

BACKGROUND: Following several decades of decline, the incidence of tuberculosis has recently begun to increase in many countries and the control of this disease has been impeded by the emergence of multi-drug resistant tuberculosis (MDR-TB). The development of rapid diagnostic methods and effective new drugs are needed to control MDR-TB. One of the new drugs for MDR-TB is rifabutin (RBU) which has been known to be effective in some patients with MDR-TB. A few reports showed that some types of mutaitions of the rpoB gene, which were known to be present in 96-98% of rifampicin-resistant M. tuberculosis, were associated with the rifampicin-resistant but RBU-susceptible phenotype. This study was performed to investigate the correlation between RBU susceptibility and the patterns of rpoB gene mutations in Korean MDR-TB. METHODS: Sixty-five clinical isolates of multi-drug resistant Mycobacterium tuberculosis, gathered from patients two visited the Asan Medical Center from July 1997 to June 1999, were investigated. Clinical responses to rifabutin-containing regimen were evaluated. An RBU susceptibility test and sequencing analysis of rpoB gene were performed, and the result were analyzed to confirm which mutations correlated with RBU-susceptible MDR-TB. RESULTS: Fifty-three of 56 (95%) clinical isolates of MDR-TB had 60 mutations of the rpoB gene. The most frequent mutations were found at codon 531 (43%), and two mutations were combined in seven clinical isolates. Five of 53 (10%) clinical isolates showed the RBU-susceptible phenotype, and in them the characteristic patterns of point mutations were found at codon 509, 516, and 526. CONCLUSION: The frequency and pattern of mutations of the rpoB gene of Korean MDR-Tb isolates were similar to those in western countries, where the prevalence of tuberculosis is low, but some show RBU-susceptible phenotypes. RBU-susceptible MDR-TB isolates showed the characteristic pattern of mutations of the rpoB gene which could be used to rapidly diagnose RBU susceptibility.
Chungcheongnam-do ; Codon ; Humans ; Incidence ; Mycobacterium tuberculosis* ; Mycobacterium* ; Phenotype ; Point Mutation ; Prevalence ; Rifabutin* ; Tuberculosis ; Tuberculosis, Multidrug-Resistant

Background/Aims: Vascular disease is an established risk factor for stroke in patients with atrial fibrillation (AF), which is included in CHA2DS2-VASc score. However, the role of carotid atherosclerosis remains to be determined. Methods: Three hundred-ten patients with AF who underwent carotid sonography were enrolled. Results: During a median follow-up of 31 months, 18 events (5.8%) of stroke were identified. Patients with stroke had higher carotid intima-media thickness (CIMT) (1.16 ± 0.33 mm vs. 0.98 ± 0.25 mm, p = 0.017). CIMT was significantly increased according to the CHA2DS2-VASc score (p < 0.001) and it was correlated with left ventricular mass index and early diastolic mitral annular velocity (e’), a ratio of early transmitral flow velocity to e’ (E/e’) and pulmonary artery systolic pressure (all p < 0.05). Cox regression using multivariate models showed that carotid plaque was associated with the risk of stroke (hazard ratio, 3.748; 95% confidence interval [CI], 1.107 to 12.688; p = 0.034). C-statistics increased from 0.648 (95% CI, 0.538 to 0.757) to 0.716 (95% CI, 0.628 to 0.804) in the CHA2DS2-VASc score model after the addition of CIMT and carotid plaque as a vascular component (p = 0.013). Conclusions Increased CIMT and presence of carotid plaque are associated with a high risk of ischemic stroke, and CIMT is related to myocardial remodeling and diastolic dysfunction, suggesting that carotid atherosclerosis can improve risk prediction of stroke in patients with AF, when included under vascular disease in the CHA2DS2-VASc scoring system.