Aspergillosis refers to an infection with any species from the genus Aspergillus. Pleural aspergillosis is an uncommon disease with less than 30 cases having been reported in the literature since 1958. The etiologic factors for this aspergillosis are preexisting pulmonary tuberculosis, bronchopleural fistula, pleural drainage, and a lung resection. Surgical removal of the aspergillus-infected pleura is the main treatment for managing this disease. We have experienced two cases of pleural aspergillosis as a complication of a preexisting chronic empyema. The chest radiographs showed a pyopneumothorax with cavitation and the chest computed tomographic scans revealed a loculated pyopneumothorax with cavity formation suggesting a bronchopleural fistula. A grossly purulent fluid was extracted by thoracentesis, and Aspergillus fumigatus was grown from a fungus culture of the fluid. A decortication, wedge resection with a pleurectomy and a pleuropneumonectomy were performed. The postoperative course was satisfactory and the patients have been in good condition up to now. Pleural aspergillosis is a very rare and potentially life-threatening disease. However, good result without significant complication were obtained by treatment with systemic antifungal agents and surgical removal.
Antifungal Agents ; Aspergillosis* ; Aspergillus ; Aspergillus fumigatus ; Drainage ; Empyema ; Fistula ; Fungi ; Humans ; Lung ; Pleura ; Radiography, Thoracic ; Thorax ; Tuberculosis, Pulmonary

BACKGROUND: Angiogenesis plays a critical role in human tumor growth and metastasis. Microvessel count, as a measure of tumor angiogenesis, has been significantly correlated with invasive and metastatic patterns in breast, prostate and cutaneous carcinomas. Materials and METHODS: Fifty patients with curatively resected non-small cell lung cancer were evaluated. Tumor tissues embedded in paraffin block were stained by anti CD 31 (PECAM, platelet endothelial cellular adhesion molecule) using immunohistochemical method to assess microvessel count. Microvessels were counted in the most active areas of neovascularization(microscopy, 200×). RESULTS: 1) Mean microvessel count was 47.1 ± 17.7(per 200×field) in total 50 cases. 2) Mean microvessel count of adenocarcinoma (54.4±19.9) was significantly higher than that of squamous cancer(43.9±16.2)(p<0.05), but there were no relationship between microvessel count and TNM stages. 3) Median survival time, 2-year and 5-year survival rates of the low microvascular group(microvessel count<45, 22cases) were 61 months, 80% and 40%, respectively, and those of the high microvascular group(microvessel count ≥ 45, 28 cases) were 46 months, 75% and 12%, respectively. As results, prognosis of low microvascular group is statistically significantly superior to that of the high microvascular group(p=0.0162, Kaplan-Meier, log-rank). CONCLUSION: Angiogenesis assessed by microvessel count can be used as one of the significant prognostic factors in non-small cell lung cancer.
Adenocarcinoma ; Blood Platelets ; Breast ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis ; Prostate ; Survival Rate

Tuberculosis is a common chronic infectious disease, although the spleen is an uncommon organ to harbor tubercle bacilli. Immunocompromised subjects are primarily prone to miliary tuberculosis and in them the spleen is invaded by Mycobacterium tuberculosis. Spleen tuberculosis is manifested commonly as a miliary form. The basic pathology is granulomatous inflammation. The CT finding of splenic tuberculosis are multiple, well-defined, roung or ovoid, low-density masses. Lymphadenopathy in the abdomen and mediastinum and pleural effusion can be found. We report two cases with tuberculosis of the spleen proved by computed tomography and histologic identification. One paitient did not improve following antituberculous medication, so splenectomy was performed. The other patient has been treated with antituberculous medication.
Abdomen ; Communicable Diseases ; Humans ; Inflammation ; Lymphatic Diseases ; Mediastinum ; Mycobacterium tuberculosis ; Pathology ; Pleural Effusion ; Spleen* ; Splenectomy ; Tuberculosis* ; Tuberculosis, Miliary ; Tuberculosis, Splenic

BACKGROUND: Angiogenesis is an essential component of tumor growth and metastasis, and the vascular endothelial growth factor (VEGF) is one of the most important angiogenic factors. Several solid tumors produce substantial amounts of VEGF, which stimulates proliferation and the migration of ednothelial cells, therby inducing neovasculization by a paracrine mechanism. To evaluate the prognostic roles of angiogenesis and VEGF expression in patients with non-small cell lung cancer, the relationship between VEGF expression in tumor tissues, the clinicopathologic features and the overall survival rate were analysed. METHODS: Sixty-nine resected primary non-small cell lung cancer specimens were evaluated. The pareffinembedded tumor tissues were stained by anti-VEGF polyclonal antibodies using an immunohistochemical method to assess VEGF expression. RESULTS: In Forty-one patients (59%), the VEGF antigen was expressed weakly in their tumor tissue, whereas in twenty-eight patients (41%) the VEGF antigen was expressed strongly. The median survival time of the weak VEGF expression group was 24 months, and that of the strong VEGF expression group was 19 months. The three year-survival rates were 35%, 33%, respectively. The survival difference between both groups was not statistically significnat. CONCLUSION: Although results were not statistically significant, the strong expression group tended to poorer prognosis than weak expression group.
Angiogenesis Inducing Agents ; Antibodies ; Carcinoma, Non-Small-Cell Lung* ; Humans ; Neoplasm Metastasis ; Prognosis ; Survival Rate ; Vascular Endothelial Growth Factor A

During ten years from Mar. 1973 to Feb. 1982, 2410 amputations of limbs have been experienced in Korea Veterans Hospital. 240 painful neuromas, which developed in 203 amputated limbs of 191 patients were treated with four different methods 1) Stretching and simple transection, 2) Transection and ligation, 3) Ligation and absolute alcohol injection and 4) Implantation into bone. After following up for average 5 years and 7 months, the following results were obtained. 1. The painful neuroma occured in 191 (7.9%) out of 2410 amputees. 2. The painful neuroma developed averege 2 years and 9 months after the first amputation. 3. After transection and ligation of the nerves, the painful neuroma recurred in 19.2% of the cases. The average interval taken to recur was 2 years and 6 months. 5. After ligation and absolute alcohol injection into the nerves, the painful neuroma recurred in 14.8% of the cases. The average interval taken to recur was 2 years and 6 months. 6. After implantation of the nerve into the bone, the painful neuroma recurred in 5.7% of the cases. The average interval taken to recur was 2 years and 2 months. 7. The best results were obtained after implantation of the nerves into the bone.
Amputation ; Amputees ; Ethanol ; Extremities ; Hospitals, Veterans ; Humans ; Korea ; Ligation ; Neuroma

BACKGROUND/AIMS: The endoscopic injection therapy with hypertonic saline-epinephrine(HSE) and absolute ethanol are the most widely and easily used procedure in the management of patients with bleeding peptic ulcers. We performed a prospective, randomized trial to compare the hemostatic efficacy between HSE and absolute ethanol injection therapy. METHODS: During the period of 1993 to 1996, 60 patients who were identified as active bleeding or visible vessel were enrolled for this trial. The 60 patients were randomly divided into two groups(HSE group, 30 cases: ethhnol group, 30 cases). We performed endoscopic injection therapy with 3% saline and 1:10,000 epinephrine solution in HSE group, and with 99.5% absolute ethanol in ethanol group. The two groups were matched for sex, age, site of bleeding, endoscopic findings, initial hemoglobin, and concomitant illness at randomization. RESULTS: Bleeding was initially controlled in 21(70%) of the HSE group and in 29(96.7%) of the ethanol group(p < 0.05). Rebleeding occurred in 4(19%) of the HSE group and in 2(6.9%) of the ethanol group(p < 0.1). The ethanl group achieved a better hemostatic effect for spurting hemorrhage(3/13 vs 9/10, p < 0.05). The emergent operations were undergone in 10(33.3%) and 2(6.7%) for HSE group and ethanol group respectively(p < 0.01). The stay in hospital were less than in ethanol group(mean 9.5 vs 16.3, p < 0.01). The death were noticed in 6 cases(20%) in HSE group and 1 case(3.3%) in ethanol group(p < 0.05). CONCLUSIONS: This study shows that absolute ethanol injection is more efficaceous and better satisfactory method in peptic ulcer bleeding.
Epinephrine ; Ethanol* ; Hemorrhage* ; Humans ; Peptic Ulcer* ; Prospective Studies ; Random Allocation

Tracheal perforation during intubation of the neonate is a rare event but may have contributed to lethal complication. We have had experience with a case of tracheal perforation which probably resulted from the trauma of too vigorous an attempt at orotracheal intubation for cardiopulmonary resuscitation of a newborn infant delivered by C-section.
Cardiopulmonary Resuscitation ; Humans ; Infant, Newborn* ; Intubation*

Intramural pregnancy is an unusual ectopic gestation located within the uterine wall, completely surrounded by myometrium and separate from the uterine cavity, fallopian tube, or round ligament. It is known to be difficult to diagnose, and associated with a high rate of uterine rupture. We report a case of intramural pregnancy in which early diagnosis was made and successful treatment was done by dilatation and curettage. Diagnostic laparoscopy confirmed the absence of uterine rupture during the procedure. Therefore, conservation of fertility can be possible with early diagnosis of intramural pregnancy. To our knowledge, this is the first case report of intramural pregnancy following IVF-ET in Korea.
Animals ; Dilatation and Curettage ; Early Diagnosis ; Embryo Transfer* ; Embryonic Structures* ; Fallopian Tubes ; Female ; Fertility ; Fertilization in Vitro* ; Korea ; Laparoscopy ; Mice ; Myometrium ; Pregnancy* ; Round Ligaments ; Uterine Rupture

PURPOSE: To further improve the advantages of minimally invasive surgery, single port laparoscopic techniques continue to be developed. We report our initial experience with single port laparoscopic appendectomy (SPLA) in children and compare its outcomes to those of conventional laparoscopic appendectomy (CLA). METHODS: Clinical data were prospectively collected for SPLA cases performed at Chung-Ang University Hospital by a single surgeon between March 2011 and December 2011, including operative time, perioperative complications, conversion rate, and length of hospital stay. Each case of SPLA was performed using conventional laparoscopic instruments through Glove port placed into the single umbilical incision. To compare outcomes, a retrospective review was performed for those patients who underwent CLA between March 2010 and December 2010. RESULTS: Thirty-one patients underwent SPLA and 114 patients underwent CLA. Mean age (10.5 years vs. 11.1 years, P = 0.43), weight (48.2 kg vs. 42.9 kg, P = 0.27), and operation time (41.8 minutes vs. 37.9 minutes, P = 0.190) were comparable between both groups. Mean hospital stay was longer for CLA group (2.6 days vs. 3.7 days, P = 0.013). There was no conversion to conventional laparoscopic surgery in SPLA group. In CLA group, there were nine complications (7.9%) with 3 cases of postoperative ileuses and 6 cases wound problems. There was one complication (3.2%) of umbilical surgical site infection in SPLA group (P = 0.325). CONCLUSION: The results of this study demonstrated that SPLA using conventional laparoscopic instruments is technically feasible and safe in children. SPLA using conventional laparoscopic instruments might be popularized by eliminating the need for specially designed instruments.
Appendectomy* ; Child* ; Humans ; Ileus ; Laparoscopy ; Length of Stay ; Operative Time ; Pediatrics ; Prospective Studies ; Retrospective Studies ; Surgical Procedures, Minimally Invasive ; Wounds and Injuries

PURPOSE : Increasing evidences have indicated the critical role of HO-1 in cytoprotection and more diverse biological functions. HO-1 has been reported to stimulate tumor cell growth and proliferation. And several tumors, including renal cell carcinoma, prostate tumor, hepatoma, and sarcoma, express a high level of HO-1. Indeed, inhibition of HO-1 by using specific HO inhibitors demonstrated in vivo antitumor activity. However, the precise mechanism of HO-1 induction and signals in lung cancer is not clearly known yet. We aimed to analyze the role of HO-1, characterize the mechanism of HO-1 induction, the role of Nrf2 in the induction, and investigated whether inhibition of HO-1 may induce apoptosis in lung cancer cells. MATERIALS AND METHODS : Western blot and immunostaining analyses were performed to ascertain whether HO-1, Nrf2, and NFkB were expressed or not in various lung cancer cell lines. Apoptosis by HO-1 inhibition through siRNA transfection was measured by flow cytometric analysis and Western blot. And the expression of HO-1 by siRNA of Nrf2 and NFkB was examined by ARE-driven luciferase activity and Western blot. RESULTS : We demonstrated that HO-1 was expressed highly in A549 cells than other lung cancer cells. And A549 cells were transfected by HO-1 small interfering RNA (siRNA) induced apoptosis. Nrf2 siRNA, next, resulted in a decrease of HO-1 expression. However, NFkB siRNA had no influence on the expression of HO-1. CONCLUSION : Increasing HO-1 expression in A549 cells may be resulted from the transcriptional activation of Nrf2, and inhibition of Nrf2-HO-1 pathway induces apoptosis. Therefore it provides new important insights into the possible molecular mechanism of the antitumor therapy
Apoptosis* ; Blotting, Western ; Carcinoma, Hepatocellular ; Carcinoma, Renal Cell ; Cell Line ; Cytoprotection ; Heme Oxygenase-1* ; Heme* ; Luciferases ; Lung Neoplasms* ; Lung* ; Prostate ; RNA, Small Interfering ; Sarcoma ; Transcriptional Activation* ; Transfection