No abstract available.
Sternotomy*

OBJECTIVE: The purpose of this study was to determine the usefulness of brainstem evoked potential (BAEP) in the diagnosis of cerebellopontine angle (CPA) tumors. METHOD: Sixteen subjects in which BAEP study was compatible with CPA tumors were retrospectively reviewed and analyzed the results of BAEP, findings of CT and MRI, and clinical signs. RESULT: Thirteen subjects were reviewed and three were lost in follow-up. 1) CPA tumors were confirmed with CT/MRI in 10 subjects and the other 3 patients had other lesions which could be differentiated from CPA tumors clinically. The positive hit rate of BAEP was 76.9% in 13 patients whose findings were compatible with CPA lesion. 2) Of 10 patients with CPA tumor, the tumors were bilateral in 4 patients and unilateral in 6 patients, and the diagnosis of the tumors were vestibular schwannoma in 9 patients and meningioma in 1 patient. 3) The major symptoms of the patients with CPA tumors were hearing loss, tinnitus, dizziness, facial nerve palsy, headache, cerebellar dysfunction, nystagmus, and vertigo. 4) The most common abnormal findings of BAEP in the patients with CPA tumors were increase in the interpeak latency I-III and I-V on the affected side and interpeak latency III-V on the unaffected side. CONCLUSION: The BAEP considering clinical correlation is a useful study as a screening test in the diagnosis of CPA tumors because of its high positive hit rate and cost-effectiveness compared with CT/MRI.
Brain Stem* ; Cerebellar Diseases ; Cerebellopontine Angle* ; Diagnosis* ; Dizziness ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem* ; Facial Nerve ; Follow-Up Studies ; Headache ; Hearing Loss ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Meningioma ; Neuroma, Acoustic* ; Paralysis ; Retrospective Studies ; Tinnitus ; Vertigo

At the Kyung Hee Medical Center all patients receiving general anesthesia in the operating room are monitored continuously with electrocardioscope, Burdick CS-515 Monitor, and recorded by EK4S ECG. Among 50 patients 18 cases (36%) developed a variety of arrhythmias. Seven (14%) were considered serious in nature, such as ventricular extrasystoles. There was an increased incidence of arrhythmias during induction of anesthesia, in old age group and in poor risk patients. Continuous cardiac monitoring is valuable, easy, and practical in virtually all instances during anesthesia and surgery.
Anesthesia ; Anesthesia, General* ; Arrhythmias, Cardiac ; Electrocardiography* ; Humans ; Incidence ; Operating Rooms ; Ventricular Premature Complexes

The effect of a new analeptic, doxapram hydrochloride, on respiration has been studied in ten subjects anesthetized with thiopental or with nitrous oxide-oxygen-halothane. The results are as follows: 1) Respiratory stimulation was more pronounced in the group anesthetized with thiopental than that with nitrous oxide-oxygen-halothane. 2) The stimulatory effect lasted for four minutes. Subjects who received multiple doses of the drug, however, showed a cumulative effect. 3) Most cases showed moderate hypertensive effect and brief electrocardiographic change was observed in one of the ten.
Anesthesia, General* ; Doxapram* ; Electrocardiography ; Respiration* ; Thiopental

Cytologic features of a poorly differentiated "insular" carcinoma of the thyroid are presented. In fine needle aspiration cytology, the aspirates were highly cellular and tumor cells were arranged in loose clusters or singly dispersed on focally necrotic background. Occasional microfollicles were evident. The tumor cells had poorly defined, scanty cytoplasm and most of the nuclei were fairly uniform with coarse chromatin pattern. A few large pleomorphic cells were also noted. The cytologic findings of the present case were correlated well with the histologic findings, which showed typical insular pattern and the presence of uniform cells with occasional pleomorphism.
Biopsy, Fine-Needle* ; Chromatin ; Cytoplasm ; Thyroid Gland*

BACKGROUND: The p53 and retinoblastoma(Rb) tumor suppressor genes are associated with the pathogenesis of several types of human cancer. Substantial. proportion of the primary lung cancers or cell lines have been reported to have the p53 and/or the Rb gene mutations. But so far there is no report on the analysis of the Rb gene polymorphism as one of the genetic susceptibility marker. This study was undertaken to establish the gene frequencies of the polymorphic genotypes of the p53 and Rb genes in Koreans to evaluate the possible involvement of these genotypes as a risk factor of lung cancer. METHODS: In this study 145 controls without previous and present tumor history and 128 lung cancer patients were subjected to analysis The two intragenic polymorphisms of the p53 gene(exon 4/AccII, intron 6/MspI) and one intron 17/XbaI polymorphism of the Rb gene were analysed by the method of polymersae chain react lion-restriction fragment length polymorphisms(PCR-RFLPS). The genotype of the intron 3/16 bp repeat polymorphism of p53 was determined by PCR and direct gel electrophoresis. RESULTS: There were no significant differences in the genotype distributions of the p53 gene between lung cart cert patients and controls. But heterozygotes(Arg/Pro) of the exon 4/AcclII polymorphisms were slightly over-represented than controls, especially in the Kreyberg type I cancer, which was known 13 be associated with smoking. The intron 3/16 bp duplication and the intron 6/MspI polymorphisms were in complete linkage disequilibrium. About 95% of the individuals were homozygotes of the common alleles both in the 16 duplication and MspI polymorphisms, and no differences were deteced in the genotype distributions between lung cancer patients and controls. Overall genotype distributions of the Rb gene polymorphisms between lung cancer patients and controls were not significantly different However, the genotype distributions in the Kreyberg type I cancer were significantly different from those of controls(p=0.0297) or adenocarcinomas(p=0.0008). It was noticeable that 73.4% of the patients with adenocarcinomas were heterozygotes(r1/r2) whereas 39.2% of the Kreyberg type I cancer were heterozygous at this polymorphisms. In the lung cancer patients, significant differences were a]so noted between the high dose smokers and low dose smokers including non-smokers(p=0.0258). The relative risk to Kreyberg type I cancer was significantly reduced in the individuals with the genotype of r1/r2(odds ratio=0.46, 95%C.I.=0.25-0.86, p=0.0124). The combined genotype distribution of the exon 4/AccII of the p53 and the intron 17 Rb gene polymorphisms in Kreyberg type I cancers were significantly different from dose of controls or adenocarcinomas. The highest odds ratio were observed in the individuals with the genotypes of Arg/pro and r2/r2(odds ratio=1.97, 95%C.I.=0.84-4.59) and lowest one was in the patients with Arg/Arg, r1/r2 genotype(odds ratio=0.54, 95%C.I.=0.25-1.14). CONCLUSION: The p53 and the Rb gene polymorphisms modulate the risk of smoking induced lung cancer development in Koreans. However, the exact mechanism of risk modulation by these polymorphism remains to be determined. For more discrete clarification of associations between specific genotypes and lung cancer risk, the evaluations of these polymorphisms in other ethnics and more number of patients will be needed.
Adenocarcinoma ; Alleles ; Cell Line ; Electrophoresis ; Exons ; Gene Frequency ; Genes, p53 ; Genes, Retinoblastoma ; Genes, Tumor Suppressor ; Genetic Predisposition to Disease ; Genotype ; Homozygote ; Humans ; Introns ; Linkage Disequilibrium ; Lung Neoplasms* ; Lung* ; Odds Ratio ; Polymerase Chain Reaction ; Risk Factors ; Smoke ; Smoking

BACKGROUND: Postprimary pulmonary tuberculosis is located mainly in upper lobes. The tuberculous lesion involving the lower lobes usually arises from the upper lobe cavity through endobronchial spread. When tuberculosis is confined to the lower lung field, it often masquerades as pneumonia, lung cancer, bronchiectasis, or lung ahscess. Thus the correct diagnosis may be sometimes delayed for a long time. METHODS: We carried out, retrospectively, a clinical study on 50 patients confirmed with lower lung field tuberculosis who visited the Department of Pulmonary Medicine at Hanyang University Hospital from January 1992 to December 1994. The following results were obtained. RESULTS: Lower lung field tuberculosis without concomitant upper lobe disease occurred in fifty patients representing 6.9% of the total admission with active pulmonary tuberculosis over a period of 3 years. It occurred most frequently in the third decade but age distribution was relatively even. The mean age was 43 years old. Female was more frequently affected than male (male to female ratio 1:1.9). The most common symptom was cough(68%), followed by sputum(52%), fever(38%), and chest discomfort(30%). On chest X-ray of the S0patients, consolidation was the most common finding in 52%, followed by solitary nodule(22%), collapse(16%), cavitary lesion(l0%), in decreasing order. The disease confined to the right side in 25 cases, left side 20 cases, and both sides 5 cases. Endobronchial tuberculosis (1) Endobronchial involvement was proved by bronchoscopic examination in 20 of S0patients. (2) Mean age was 44years old and female was more affected than man (male to female ratio 1 : 3). Sputum AFB stain and Mycobacterium tuberculosis culture were positive only in 50% of cases unlikely upper lobe tuberculosis, additional diagnostic methods were needed. In our study, bronchoscopic examination and percutaneous fine needle aspiration biopsy increased diagnostic yield by 18% and 32%, respectively. The most common associated condition was diabetes mellitus(18%) and others were anemia, anorexia nervosa, stomach cancer, and systemic steroid usage. CONCLUSION: When we find a lower lung field lesion, we should suspect tuberculosis if the patient has diabetes mellitus, anemia, systemic steroid usage, malignancy or other immune suppressed states. Because diagnostic yield of sputum AFB smear & Mycobacterium tuberculosis culture was low, additional diagnostic methods such as bronchoscopy and fine needle aspiration biopsy were needed.
Adult ; Age Distribution ; Anemia ; Anorexia Nervosa ; Biopsy ; Biopsy, Fine-Needle ; Bronchiectasis ; Bronchoscopy ; Diabetes Mellitus ; Diagnosis ; Female ; Humans ; Lung Neoplasms ; Lung* ; Male ; Mycobacterium tuberculosis ; Pneumonia ; Pulmonary Medicine ; Retrospective Studies ; Sputum ; Stomach Neoplasms ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary

Vibrio damsela was isolated from a wound infection of a 71 year-old patient with chronic renal failure. She complained of severe pain, swelling and erythema in her right hand and fingers, which developed after a puncture injury by a crab, Portunus trituberculatus. Her wound infection was improved after pus drainage and antibiotic therapy. This represents the first reported case of wound infection due to V. damsela in Korea.
Aged ; Drainage ; Erythema ; Fingers ; Hand ; Humans ; Kidney Failure, Chronic ; Korea ; Punctures ; Suppuration ; Vibrio* ; Wound Infection* ; Wounds and Injuries*

Mucoepidermoid carcinoma was initially recognized as occurring only in the salivary gland and only later was it appreciated that it occurred in the bronchus and trachea as well. Mucoepidermoid carcinoma of bronchial gland origin is extremely rare, and little is known about their natural history. This carcinoma is derived from the minor salivary gland of the proximal tracheobronchial tree and it is divided into low-grade and high-grade by gross, histologic, and ultrastructural criteria. Also Its clinical and biologic behaviors are closely related with histologic grade of carcinoma. We have experienced a rare case of bronchial mucoepidermoid carcinoma associated with adenocarinoma which obstructed the left main bronchus and was successfully removed by the pneumonectomy.
Adenocarcinoma ; Bronchi ; Carcinoma, Mucoepidermoid* ; Lung ; Natural History ; Pneumonectomy ; Salivary Glands ; Salivary Glands, Minor ; Trachea ; Trees

No abstract available.
Pulmonary Embolism*