Pleuropulmonary bastoma (PPB) is a rare intrathoracic malignant neoplasm in children, differ from pulmonary blastoma in adults. PPB is usually aggressive and has wide-metastases at the time of diagnosis. The therapeutic modality of PPB is extensive surgical resection with neoadjuvant or adjuvant chemotherapy. We report a case of a cystic pleuropulmonary blastoma treated with surgical resection and adjuvant chemotherapy.
Adult ; Chemotherapy, Adjuvant ; Child ; Diagnosis ; Humans ; Lung Neoplasms ; Lung* ; Pathology ; Pulmonary Blastoma

OBJECTIVE: To determine whether hysterectomy by the vaginal route is safe and feasible in patients with previous pelvic operation. METHODS: A retrospective study of the records of Hallym University Hospistal patients who underwent vaginal hysterectomy performed by the senior author. Between January 1990 and January 1997, 212 patients who had previous pelvic operation were studied with special reference to operative difficulties, previous operation type, intraoperative complications, surgical time, hospital stay. RESULTS: 1. Patients characteristics was that ; The average age was 44.5+/-6.6 years old, the average parity was 2.3 , the average stay of hospitalization was 7.5+/-0.89 days, the frequency of Morcellation was in 24.5%, the average surgical time including associated procedure was 82+/-16.2 minutes, the average uterine weight was 164+/-85.1gm. 2. The most common previous pelvic operation was cesarean section(95 cases). 3. The most common indication was uterine myoma(51.9%). 4. Surgical technique used to gain access to the pouch of Douglas was done anteriorly; 52 patients of previous cesarean section(24.5%) and 112 patients of others operation(52.8%) were easily opened by blunt dissection, 43 patients of previous cesarean section(20.3%) and 5 patients of others operation(2.4%) were required sharp dissection. posterioly ; 190 patients(89.6%) were easily opened by blunt dissection, 22 patients(10.4%) were required sharp dissection. 5. Significant complications were bladder injury(1 case) , postoperative transfusion due to bleeding(6 cases). No cases of postoperative laparotomy was done and other minor compications were fever(15 cases), bladder retention(11 cases), others. CONCLUSIONS: It was possible to perform vaginal hysterectomy safely in patients with previous pelvic operation. Vaginal hysterectomy remains the method of choice for removal of the uterus of the previous pelvic operations in the absence of other contraindications.
Cesarean Section ; Female ; Hospitalization ; Humans ; Hysterectomy ; Hysterectomy, Vaginal* ; Intraoperative Complications ; Laparotomy ; Length of Stay ; Operative Time ; Parity ; Pregnancy ; Retrospective Studies ; Urinary Bladder ; Uterus

malignant melanoma of the lung is extremely rare. A 46-year-old lady was admitted with two month history of dry cough and blood-tinged sputum. Chest CT showed 4.5x5.0 cm sized mass at the right lower lobe. Repeated bronchoscopic and percutaneous biopsies showed no definite diagnosis. Preoperative evaluations revealed no systemic metastais. Primary So, we tried the surgical approach. Right lower lobectomy and lymph node dissection was done. The mass and lymph node were confirmed as primary malignant melanoma. The patient presented with right hemiparesis 40 days after operation. Brain MRI showed 1.5x2.0 cm sized mass lesion on the left parietal lobe. Mass excision was done. However, she expired 8 months later.
Biopsy ; Brain ; Cough ; Diagnosis ; Humans ; Lung Neoplasms ; Lung* ; Lymph Node Excision ; Lymph Nodes ; Magnetic Resonance Imaging ; Melanoma* ; Middle Aged ; Paresis ; Parietal Lobe ; Sputum ; Tomography, X-Ray Computed

BACKGROUND: Traumatic diaphragmatic rupture is not common, but it requires swiftly performing an emergency operation. This study was conducted to evaluate the prognostic factors for mortality after surgically treating traumatic diaphragmatic rupture. MATERIAL AND METHOD: From Jan 2001 to Dec. 2008, we experienced 37 cases of multiple traumas with diaphragmatic injuries that were confirmed by surgical procedures. We evaluated various factors, including the type of injury, the associated injuries, the preoperative vital signs, the ISS, the time until surgery and the rupture size. RESULT: There were 30 patients with blunt trauma and 7 patients with penetrating trauma. Thirty-four patients had associated injuries and the mean ISS was 20.8. Postoperative complications occurred in 11 patients and hospital mortalities occurred in 6 patients. The prognostic factors that had an influence on the postoperative mortalities were the preoperative intubation state, the patient who exhibited hypotension and a high ISS. CONCLUSION: Traumatic diaphragmatic rupture is just one part of multiple traumas. The postoperative mortalities might depend on not only on the diaphragmatic rupture itself, but also on the severity of the associated injuries.
Diaphragm ; Emergencies ; Hospital Mortality ; Humans ; Hypotension ; Intubation ; Multiple Trauma ; Postoperative Complications ; Prognosis ; Rupture ; Vital Signs

Pulmonary mucormycosis is very rare but has a devastating opportunistic fungal infection in immunocompromised hosts. The infection usually occurs in patients with hematologic malignancy, chronic renal failure, diabetes mellitus, or in solid organ transplant recipients. We experienced a case of pulmonary mucormycosis associated with renal cadeveric allograft recipient who had uncontrolled diabetes mellitus. The patient was successfully treated by surgical resection with Amphotericin B therapy.
Allografts ; Amphotericin B ; Diabetes Mellitus ; Hematologic Neoplasms ; Humans ; Immunocompromised Host ; Kidney Failure, Chronic ; Mucormycosis* ; Transplants

BACKGROUND: This study was designed to evaluate the FDG uptake ratio of mediastinal node and primary tumors using integrated PET/CT imaging combined with Glut-1 expression of the primary tumor in order to predict the N2 status more accurately in NSCLC patients. MATERIAL AND METHOD: Patients who underwent integrated PET/CT scanning with a detectable mSUV for both primary tumors and mediastinal lymph nodes were eligible for this study. The FDG uptake ratio between the mediastinal node and the primary tumor was calculated. RESULT: The average mSUV of primary tumors and mediastinal nodes were, respectively, 7.4+/-2.2 and 4.2+/-2.2 in N2-positive patients and 7.6+/-3.7 and 2.8+/-6.9 in N2-negative patients. The mean FDG uptake ratio of mediastinal node to primary tumor were 0.58+/-0.23 for malignant N2 lymph nodes and 0.45+/-0.20 for benign lymph nodes (p<0.05). Models which combined Glut-1 expression with an FDG ratio have better diagnostic power than models that use the FDG uptake ratio alone. CONCLUSION: In some patients with a previous history of pulmonary tuberculosis or other inflammatory lung diseases, an FDG uptake ratio combined with Glut-1 expression may be useful in diagnosing mediastinal node metastasis more exactly.
Carcinoma, Non-Small-Cell Lung ; Humans ; Lung Diseases ; Lung Neoplasms ; Lymph Nodes ; Neoplasm Metastasis ; Tuberculosis, Pulmonary

BACKGROUND: Complete surgical resection is the most effective treatment for stage IB non-small cell lung cancer (NSCLC). Recurrence accounts for the disappointing survival rates after resection. There has been renewed interest in adjuvant therapy after complete resection. Appropriate selection of effective adjuvant therapy will depend on the prognostic factors for recurrence. MATERIAL AND METHOD: The study included 114 patients with completely resected stage IB NSCLC. The variables selected for the study were gender, age, the type of resection, cell type, the degree of differentiation, the tumor size and the presence of visceral pleura invasion. The Kaplan-Meier method was used to estimate the survival and disease-free survival rate. The results were compared using the log rank test. Multivariate analysis was performed by Cox's proportional hazard model. Two-sided p-valves <0.05 were considered to be statistically significant. RESULT: The 3-year overall survival and the disease-free survival rates were 87.0% and 79.4%, respectively. The degree of differentiation showed a significant influence on disease-free survival according to the univariate analysis. According to the multivariate analysis, a poor grade of differentiation was a significant poor prognostic factor. CONCLUSION: These results demonstrate that poor differentiation may be a poor prognostic factor for patients with completely resected IB NSCLC. Therefore, the patients with a poor grade of differentiation may require adjuvant therapies.
Carcinoma, Non-Small-Cell Lung* ; Disease-Free Survival ; Humans ; Lung ; Multivariate Analysis ; Neoplasm Staging ; Pleura ; Proportional Hazards Models ; Recurrence* ; Risk Factors* ; Survival Rate

Hemangiopericytoma is a rare vascular tumor derived from the pericyte and usually occures in the lower extremities and the retroperitoneum. Complete excision is treatment of choice. Regular follow up is strongly recommended due to its potential malignancy which is recurrence and metastasis. We experienced surgical excision of metastatic pulmonary hemangiopericytoma from retroperitoneal hemangiopericytoma completely excised 10 years ago.
Hemangiopericytoma* ; Lower Extremity ; Lung Neoplasms ; Neoplasm Metastasis ; Pericytes ; Recurrence

Herein we report a rare case of primary esophageal malignant melanoma in a 56-year-old gentleman who presented with a 2-month dysphagea. Esophagoscopy reveals a polypoid tumor and a total thoracic esophagectomy was performed through a right thoracotomy and esophageal replacement with stomach. The tumor was proven to be a primary esophageal malignant melanoma by histological and immunohistochemical studies. The pathologic stage was IIa. He received no postoperative adjuvant therapy. He died of liver metastasis at 8 months postoperatively.
Esophageal Neoplasms ; Esophagectomy ; Esophagoscopy ; Humans ; Liver ; Melanoma* ; Middle Aged ; Neoplasm Metastasis ; Stomach ; Thoracotomy

The Marcus ankle arthrodesis was carried out in 16 patients at department of orthopaedic surgery of Korea Veterans Hospital from January 1989 to December 1993. All of patients were reviewed and evaluated with subjective and functional rating scales according to the Mazur scoring system. The average follow up was 23 months, ranging from 12 months to 60 months. The Marcus ankle arthrodesis involves a chevron osteotomy, tibial onlay graft medially, internal fixation with staples and screws. According to the Mazur score, the results were 6 cases of Excellent, 7 cases of Good. The average Mazur score was 75.1. There were 4 cases of complication, a non-union, a superficial wound infection, a bursitis, and a tendon injury. In summary the Marcus ankle arthrodesis by chevron osteotomy seems to be a good procedure, which gives solid bony union with short duration, relief of pain, normal looking ankle configuration without leg length discrepancy and good function with few complications.
Ankle ; Arthrodesis ; Bursitis ; Follow-Up Studies ; Hospitals, Veterans ; Humans ; Inlays ; Korea ; Leg ; Osteotomy ; Tendon Injuries ; Transplants ; Weights and Measures ; Wound Infection