Primary pericardial tumors are rare than those originating within the myocardium or endocardium and, moreover, primary benign pericardial tumors are much rare in occurrence. Fine(1986) was able to collect only 43 cases of lipoma. Most cases are diagnosed only at autopsy. One fourth of the cardiac lipoma arise subepicardially, where they suggest the presence of pericardial effusion with compression or displacement of the heart. A case of primary intrapericardial lipoma simulating pericardial effusion is presented. This tumor originated in left anterior aspect of pericardium. The tumor was measured 30x30x5cm in size and 2,200mg in weight. Total excision of the mass was accomplished by posterior lateral thoracotomy incision, resulting in complete cure. This is the first case of primary benign lipoma of the pericardium in literatures in our knowledge.
Autopsy ; Endocardium ; Heart ; Lipoma* ; Myocardium ; Pericardial Effusion* ; Pericardium ; Thoracotomy

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis was administered to 34 patients with primary hypertlipidemia, 20 mg once daily with the evening meal. Patients experienced mean total and LDL cholesterol reductions of 30.9% and 34.0% respectively. HDL cholesterol level was significantly increased by 15.4% and plasma triglyceride level was decreased by 11.2%. maximal hypocholesterolemic effects were evident at 8 weeks, after which the effects were stable. Adverse effects were noted in 2 patients who had mild gastrointestinal symptoms, that subsided after discontinuing the drug. We concluded that lovastatin is a well tolerated and effective agent for the treatment of primary hyperlipidemia.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Humans ; Hyperlipidemias* ; Lovastatin ; Meals ; Plasma* ; Triglycerides

We have examined the regenerative capabilities of the human scalp hair follicle after grafting the lower half of the follicle. Twenty-eight of 32 intact whole-hair follicles isolated from the human scalp regenerated hairs when grafted onto the forehead of the same person. Seven of the 15 lower-half follicles regenerated complete hair follicles 8 months after grafting showed that the lower-half follicle implant reconstituted the complete hair follicle. The sebaceous gland was not regenerated, but there was an outgrowth in the sebaceous gland regPark ion. Some grafts formed epithelial cysts. Two years after grafting, the histological examination of the regenerated follicle from the lower-half implant showed that the sebaceous gland was completely regenerated. While an intact follicle shows prominent naked shaft outgPark Park Parkrowth, the sheath grows concomitantly with the shaft in lower-half follicles in culture. If grafted lower-half follicles were located too deep, the regrown sheath could not reach the epidermal layer. In this situation, the formation of an epidermal cyst was likely.
Epidermal Cyst ; Forehead ; Hair Follicle* ; Hair* ; Humans ; Scalp ; Sebaceous Glands ; Transplants*

BACKGROUND: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2x2 anchor with 4x4 suture stands). METHODS: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. RESULTS: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. CONCLUSIONS: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.
Arthroscopy ; Atrophy ; Classification ; Humans ; Magnetic Resonance Imaging ; Muscular Atrophy ; Rotator Cuff* ; Shoulder ; Suture Anchors ; Sutures ; Tears* ; Tendons

No abstract available.
Neuroectodermal Tumor, Melanotic

Since Mikulicz's description of symptomless hypertrophy of the salivary gland and lacrimal gland, the term, Mikulicz syndrome, has been used to describe enlargement of the salivary gland with or without lacrimal gland involvement occurring in leukemia, lymphosarcoma, sarcoidosis, tuberculosis syphilis, etc. However, there are still a tremendous amount of confusion in the application of the term, Mikulicz syndrome. In Korea, there has been no reported case of Mikulicz syndrome to date. Internationally, it is also extremely rare to spot a reported case of the disease originating primarily from submandibular glands. We would like to report a case in which a 56 year old female patient was reported to have the disease ; she was diagnosed initially as benign lymphoepithelial lesion (BLL) by submandibular biopsy, but later confirmed by lacrimal gland biopsy to have mucosa associated lymphoid tissue (MALT).
Biopsy ; Female ; Humans ; Hypertrophy ; Korea ; Lacrimal Apparatus ; Leukemia ; Lymphoid Tissue ; Lymphoma, B-Cell, Marginal Zone* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Mucous Membrane ; Salivary Glands ; Sarcoidosis ; Submandibular Gland ; Syphilis ; Tuberculosis

BACKGROUND: Thoracic epidural analgesia is the mainstay of postoperative pain control after thoracotomy. Usually the epidural catheter is blindly inserted and secured without confirming the tip position. The purpose of this study was to determine the influence of epidural approach angle on the position of the thoracic epidural catheter tip. METHODS: 129 patients scheduled for thoracotomy were enrolled. Patients were randomized into two groups: narrow angle group and wide angle group. The epidural needle was inserted at the skin of T8-9 level in both groups. In the narrow angle group the epidural space was approached at T7-8, whereas in the wide angle group the epidural space was approached at T6-7. After epidural space confirmation, a B-D nylon multi-hole epidural catheter was threaded 8cm into the epidural space. The epidural catheter tip position was assessed using a small amount of radiocontrast dye under fluoroscopy. RESULTS: The mean (95% confidence interval) position of the catheter tip was the mid-body of T5 (T5-6 - T5 upper body) in the narrow angle group and T3-4 (mid-body of T4-T3 lower body) in the wide angle group (P = 0.037). CONCLUSIONS: When approaching the thoracic epidural space by a wide angle, we can place the epidural catheters at a higher level because of a straighter threading.
Analgesia ; Analgesia, Epidural ; Catheterization* ; Catheters* ; Epidural Space ; Fluoroscopy ; Humans ; Needles ; Nylons ; Pain, Postoperative ; Skin ; Thoracic Surgery ; Thoracotomy

The omentum is unique in that it is the body tissue developed for the resolution of local inflammatory processes because of combination of its blood supply and abundant lymphatic drainage. Thus, the use of omentum is well established for the more complex reconstruction of the urinary tract. We managed 3 cases of multiple severe renal injury using omentum and results were favorable.
Drainage ; Omentum* ; Urinary Tract

BACKGROUND: Asthmatic patients frequently suffer cold-weather-associated respiratory symptoms. The sensitivity, specificity, accuracy and diagnostic value of isocapnic hyperventilation of cold air(IHCA) using a multistep method was investigated in patients suspected to have asthma. METHOD: One hundred and 29 adult patients who had an IHCA performed between july 1999 and December 2000, had an methacholine bronchoprovocation test because of a clinical suspicion of asthma. RESULTS: According to strict criteria, 50 were defined as asthmatics and 79 as symptomatic nonashmatics. There were no differences in age, sex and smoking state between the asthmatic and symptomatic nonasthmatic groups. There was a significant decrease in the percentage reduction in the forced expiratory volume in 1 second(FEV1) after the IHCA between the asthmatics(-10.0±6.8%) and the symptomatic nonasthmatics(-2.3±2.5%). The factors associated with a reactivity to IHCA were FEV1/FVC, FEF25-75/FVC and FEV1(% of predicted). The accuracy was highest using a 7% fall in FEV1; the sensitivity was 76% and the specificity 96%. CONCLUSION: IHCA is a specific, although not a sensitive, test for diagnosing asthma in adult patients. Furthermore, the diagnostic cut-off value of the different methods of IHCA need to be determined.
Adult* ; Asthma* ; Forced Expiratory Volume ; Humans ; Hyperventilation* ; Methacholine Chloride ; Sensitivity and Specificity ; Smoke ; Smoking

A 9-year-old boy showed orofacial dyskinesia and psychic symptoms shortly after open heart surgery with deep hypothemia and cardiopulmonary bypass for congenital cyanotic heart disease. The choreothetosis progressed to be generalized and accompanied by mental deterioration. This involuntary movement partially responded only to repetitive administration of sedatives. After 3 month the patient expired with sudden development of ventricular tachycardia and cardiogenic shock.
Cardiopulmonary Bypass* ; Child ; Dyskinesias ; Heart Diseases ; Humans ; Hypnotics and Sedatives ; Hypothermia* ; Male ; Movement Disorders ; Shock, Cardiogenic ; Tachycardia, Ventricular ; Thoracic Surgery