No abstract available.
Aneurysm* ; Cerebral Infarction* ; Foramen Ovale, Patent*

No abstract available.
Cor Triatriatum*

BACKGROUND: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer MATERIAL AND METHOD: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. RESULT: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) CONCLUSION: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.
Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Mortality ; Neoplasm Staging ; Pathology ; Radiotherapy ; Retrospective Studies ; Survival Rate

BACKGROUND: Color Doppler echocardiography is sensitive in detecting mitral regurgitation and useful in quantitating its severity. The presence of an eccentric regurgitant jet suggests that regurgitation is caused by prolapsing or flail leaflet of mitral valve. Until recently the direction of regurgitant jet in mitral valve prolapse has been examined in a single(parasternal short axis view) or orthogonal plane using color Doppler echocardiography, and few in the apical rotation method of a transducer. The purpose of this study was to clarify the usefullness of the apical rotation method of a transducer in detection of the direction of mitral regurgitant jet and diagnosis of the sites of mitral valve prolapse. METHODS: Twenty four patients(8 men and 16 women, mean age:47.3+/-18.8 years) with mitral valve prolapse with eccentric regurgitant jet were examined by two-dimensional and color Doppler echocardiograply using conventional parasternal long and short axis views, and four apical longitudinal planes(four chamber, vertical, two chamber and transverse views) obtained by the apical retation method of a transducer. RESULTS: Thirty one regurgitant jets were detected in twenty four patients, eighteen patients had anterior, nine patints posterior, and three patients bi-leaflet(anterior and posterior) prolapse. In eighteen patients with anterior leaflet prolapse, ten had medial, eight had middle, three had lateral, and three had two portions(two, medial and middle; one, middle and lateral) prolapse. In nine patients with posterior leaflet prolapse, five had medial, three had middle, two had lateral, and one had two(medial and middle) scallop prolapse. CONCLUSION: Color Doppler echocardiography by the apical rotation method of transducer is useful in assessment of the site of prolapse in patients with mitral valve prolapse with eccentric regurgitation.
Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Echocardiography, Doppler, Color ; Female ; Humans ; Male ; Mitral Valve Insufficiency ; Mitral Valve Prolapse* ; Mitral Valve* ; Pectinidae ; Prolapse* ; Transducers*

A diagnosis of gout is often straightforward because gout has well known clinical presentations, laboratory analyses, and radiologic features. On the other hand, gout can mimic other diseases by showing a range of atypical clinical manifestations. This paper reports a 35-year-old male with no prior history of gout who developed tophaceous gout at his previously repaired Achilles tendon 11 years after surgery. He was initially misdiagnosed with cellulitis because of his atypical clinical features. This case is presented with a review of the relevant literature.

BACKGROUND: Mitral valve prolapse(MVP) is now recognized as noe of the most common cardiovascular disorders, particularly in young women with a slender body habitus. However, there is little clinical information about young men with mitral valve prolapse. The purpose of this study was to evaluate the physical and echocardiographic characteristics of young men about 20 years old with mitral valve prolapse. METHOD: Twenty young men with mitral valve prolapse(MVP graoup, mean age ; 19.9±2.4 years) and twenty healthy volunteers(control group, mean age ; 19.9±3.2 years) were examined using physical examination, chest X-ray, computed thoracic tomography and two dimensional and Doppler echocardiography. RESULTS: Compared with control group, MVP group had a smaller chest circumference(p < 0.001), a larger height-arm span difference(p < 0.01), smaller anteroposterior chest diameters(by chest X-ray ; p < 0.001 and computed tomography ; p < 0.01) and smaller anteroposterior/transverse chest diameter ratio(chet X-ray ; p < 0.01 and computed tomography ; p < 0.05). In MVP group, mitral regurgitation was noted 15 men(75%), those had posteriorly directed jets suggesting anterior mitral leaflet anomalies. CONCLUSION: Healthy young men having mitral valve prolapse had narrow chest and slender physical characteristics and anterior mitral leaflet abnormalities.
Clinical Study ; Echocardiography ; Echocardiography, Doppler ; Female ; Humans ; Male ; Methods ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Mitral Valve ; Physical Examination ; Thorax

Bafckground: Thr role and indication of surgery in the treatment of small cell lung cancer (SCLC) is currently limited and unsettled. MATERIAL AND METHOD: We analyzed the surgical results of 9 patients with SCLC at Yosei Medical Center from January 1990 to December 1996. There were 8 males and 1 female, and their mean age was 57.2 years (range; 35-76). Preoperatively SCLC was confirmed in 5, but the other 4 cases were diagnosed as undifferentiated squamous cell carcinoma. All patients underwent pulmoinary resection (lobectomy;5, lobectomy, segmentectomy and en-bloc resection of rib;1, bilobectomy; 2, pneumonectomy;1) and mediastinal lymph node dissection. RESULTS: There were no operative mortality with two complications (postoperative bleeding;1, arrhythmia;1). All cases were diagnosed as SCLC histologically and their TNM staging were confirmed as follows: T1N0M0;1, T2N0M0;4, T3N0M0;1, T3N1M0;1, T2N2M0; 1, T4N0M0;1. All patients had received postoperative chemotherapy, and radiotherapy was combined in 4 patients. During follow up period (range 1-63 months; mean 33.0months), there was only one metastasis to pelvic bone among 8 patients without lymph node metastasis, and all patients were alive. On the other hand, among 3 patients who had regional and/or mediastinal lymph node metastasis or T4 lesion, all patients had recurrences (local;2, brain;1), and 2 patients died. CONCLUSION: We suggest that the use of TNM staging is beneficial, and surgical resection should be recommended in the patients with early staged SCLC as an important treatment modality.
Carcinoma, Squamous Cell ; Drug Therapy ; Female ; Follow-Up Studies ; Hand ; Humans ; Lymph Node Excision ; Lymph Nodes ; Male ; Mastectomy, Segmental ; Mortality ; Neoplasm Metastasis ; Neoplasm Staging ; Pelvic Bones ; Radiotherapy ; Recurrence ; Small Cell Lung Carcinoma*

BACKGROUND: Many institutes are interested in lung metastatectomy than before because of the improved long term survival, low mortality, and low morbidity after lung metastatectomy. However, prognostic factors affecting long term survival are controversial. We attempt to analyze the prognostic factors affecting retrospectively by comparing the results of lung metastasectomy. MATERIAL AND METHOD: Between Jan. 1990 and Dec. 1997, 74 operations were taken in 63 patients with pulmonary metastases in various primary sites. We analyzed the postoperative long term survival according to sex, cell type, laterality, disease free interval(DFI), operation, the number of metastases, and the size of the largest metastasis. RESULT: There were 27 male and 36 female patients. Sex did not appeared to affect survival time(p=0.849). The primary tumor was carcinoma in 32, sarcoma in 28, and others in 3. Cell type, considering carcinoma and sarcoma, did not relate to survival time(p=0.071). DFI had no influence on the outcome(p=0.902). The type of operative procedure had no influence on the outcome(p=0.556). The laterality of metastases, 47 unilateral(74.6%) and 16 bilateral(25.4%), had no influence on the outcome(p=0.843). The number of metastases excised(one, two or three, four or more) did not appear to affect survival(p=0.263). The size of largest metastasis(<=10mm, 11mm-30mm, and >30mm) did not appear to affect survival(p=0.751). Previous factors were evaluated in both the carcinoma and sarcoma patients respectively. DFI was the only significant prognostic factor in metastatic lung sarcoma(p=0.0026). CONCLUSION: Survival was not related to sex, cell type, laterality, DFI, operative procedure, number of metastases, nor the size of the largest metastasis. DFI was related to the survival time in sarcoma group but further study is needed.
Academies and Institutes ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Male ; Metastasectomy ; Mortality ; Neoplasm Metastasis ; Retrospective Studies ; Sarcoma ; Surgical Procedures, Operative

BACKGROUND: Surgical resection is the standad therapy for the stage I lung cancer. We analysed the risk facturs of stage I lung cancer patent and tryed to establish more effective and aggressive treatment modality. MATERIALS AND METHODS: A detailed analysis was undertaken to evaluate the surgical results and to define the risk factors associated with the recurrence and the survival time in 146 consecutive patients with stage I lung cancer who were diagnosed, and resected at Yonsei Medical Center from January 1990 to December 1996. RESULTS: There were 115 males and 31 females. Their ages ranged from 27 to 79 years (mean age:58.9+/-9.3 years). The histologic types were squamous carcinoma in 72 cases (49.3%) and adenocarcinoma in 45 cases (30.8%). A pulmonary resection and mediastinal lymph node dissection were done in all cases. A lobectomy was performed in 96 cases (65.7%) and a pneumonectomy in 48 cases (32.9%). There were 5 operative mortalities (3.4%) and complications occured in 24 cases (16.5%). The overall 5-year survival was 64.1%, and survival time did not depend on the type of operation or histologic type. Significant predictors of decreased survival were visceral pleural invasion (p=0.0079), T2 lesion (p=0.0462), and tumor size (> or =5 cm) in adenocarcinoma (p=0.0472). The overall incidence of recurrence was 33.3% (47 cases; local or regional 6.4%, distant 26.9%). Almost all recurrences (44cases) occurred in T2 lesions. The distant organs that failed were the contralateral lung in 13 patients, the brain in 12, the bone in 10, and other organs in 3. CONCLUSIONS: even in stage I lung cancer, we suggest that postoperative adjuvant therapy is recommended in patients with poor prognostic factors such as visceral pleural invasion, T2 lesions, and a tumor size (> or =5 cm) in the adenocarcinoma.
Adenocarcinoma ; Brain ; Carcinoma, Squamous Cell ; Female ; Humans ; Incidence ; Lung Neoplasms* ; Lung* ; Lymph Node Excision ; Male ; Mortality ; Pneumonectomy ; Recurrence ; Risk Factors

BACKGROUND: The prognosis for young patients generally considered to be poor. The purpose of this study was to determined whether the clinical characteristics and the survival rate in young lung cancer patients after surgical treatment differs from that in older patients. MATERIAL AND METHOD: Of 526 patients, 28(5.3%) were 30 to 40 years old. We studied the clinical characteristics and prognosis of 28 patients aged 40 years or less(Group 1), in whom primary lung cancer was diagnosed and operated between 1990 and 1997, and compared them with those 498 patients aged more than 40 years(Group 2). RESULT: The differences in sex ratio that were higher for women in Group 1, but there was no significant difference (p=0.297). The percentages for smokers and symptoms in Group 1 were significantly less than in Group 2.(p=0.049, p=0.008). Adenocarcinoma was significantly more common (p=0.018) and squamous cell diagnosed was diagnosed as stage IIIb or stage IV in 9 patients(32.1%), while 12.0% of the patients older than 40 years of age had either stage IIIb or stage IV(p=0.002). The 5-year survival rate was 41.3% in Group 1 ; 37.7% in Group 2, and the median survival time was 24.3 months in Group 1 ; 27.0 months is Group 2. There were no significant difference in survival between two age groups(p=0.808). CONCLUSIONS: Younger patients have more adenocarcinoma, however have less squamous cell carcinoma, less symptoms and less smoking history. Although younger patients tended to have more advanced disease and less complete resection rate, the recurrence and the long term survival in these patients did not differ that of older patients.
Adenocarcinoma ; Adult ; Carcinoma, Squamous Cell ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Prognosis ; Recurrence ; Sex Ratio ; Smoke ; Smoking ; Survival Rate