A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the traumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the posttraumatic tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.
Dilatation ; Dyspnea ; Edema ; Emergencies ; Humans ; Middle Aged ; Motor Vehicles ; Rupture ; Tricuspid Valve ; Tricuspid Valve Insufficiency

No abstract available.
Biliary Atresia*

Computerized Tomography is now well established and important noninvasive method of diagnosting mediastinal mass lesions because of its superior imaging of their size, location and internal composition. Authors analyzed and present CT findings of 30 surgically proven mediastinal tumors and cysts that were studied and treated at the Yeungnam University Hospital during recent 6 years. The most common tumor was thymoma (9 cases), and teratoma (6 cases), lymphoma (6 cases), bronchogenic cyst (4 cases), neurogenic tumor (4 cases), pericardial cyst (1 case) were next in order of frequency. There were 5 cases of thymoma showing homogenous solid density mass, 2 cases were malignant thymoma and myasthenia gravis was present in 2 cases. A case of thymolipoma and a case of thymic carcinoma were included. All teratomas were cystic masses but pathognomonic fat, and calcified density were seen only in 4 cases. 5 cases were located in anterior mediastinum and 1 case was in posterior mediastinum. Lymphoma (3 Hodgkin's and 3 non-Hodgkin's) appeared as irregular lobulated mass in anterior mediastinum. Neurogenic tumor (2 ganglioneuroma and 2 neurilemmoma) appeared as homogenous density mass located in posterior mediastinum. Among the 4 bronchogenic cysts, 2 were located in retrotracheal area, 1 was located in subcarinal and 1 was in parathoracic area. One case of pericardial cyst was oval shaped cystic mass located in left pericardiac border.
Bronchogenic Cyst ; Ganglioneuroma ; Lymphoma ; Mediastinal Cyst ; Mediastinum ; Methods ; Myasthenia Gravis ; Teratoma ; Thymoma

Inflammatory myofibroblastic tumor (IMT) is a space occupying lesion which is composed of myofibroblasts, plasma cells, and lymphocytes. IMT of the maxillary sinus is rare and its etiology is unknown. We present a case of inflammatory myofibroblastic tumor occurring in the right maxillary sinus of a 57-year-old woman. Radiologically, this tumor was interpreted as malignant neoplasm. On histologic examination, bundles of spindle cells were admixed with inflammatory cells including mature plasma cells and lymphocytes. On the basis of the immunohistochemical findings and ultrastructural features, we recognized that the intervening spindle cells were myofibroblasts. We discussed etiology and prognostic factors of this tumor.
Female ; Humans ; Lymphocytes ; Maxillary Sinus* ; Middle Aged ; Myofibroblasts* ; Plasma Cells

Background : It has been suggested that thrombospondin (TSP) is a p53-dependent negative regulator of tumor angiogenesis. TSP expression and localization in hepatocellular carcinomas (HCCs) and its association with overexpression of p53 protein were investigated. Methods : TSP-1 and -2 expressions were examined in 40 HCC specimens by immunohistochemical staining and in 4 HCC cell lines by Western blotting. In addition, p53 protein expression and microvessel density (MVD) were correlated with the TSP expression. Results : Strong immu- nopositivity for TSP-1 was observed in fibroblasts, vascular endothelial cells, and some vas- cular smooth muscle cells of the stroma in 18 cases (45%), and in tumor cells in 3 cases (7.5%) of 40 cases of HCC. Immunoreactivity for TSP-2 was observed in only the sinusoidal lining cells of the tumor in 15 cases (46%), and in tumor cells in 2 cases (6%) of 32 cases of HCC. TSP-1 expression was inversely correlated with MVD (p=0.028), but TSP-2 expression did not show any correlation with MVD. Although p53 was overexpressed in 17 cases, there was no significant correlation between TSP and p53 expressions. None of the HCC cell lines expressed TSP-1 or -2. Conclusions : These findings indicate that TSP-1 is mainly derived from nonparenchymal cells, and may decrease tumor angiogenesis in HCC.
Angiogenesis Inhibitors ; Blotting, Western ; Carcinoma, Hepatocellular* ; Cell Line ; Endothelial Cells ; Fibroblasts ; Microvessels ; Myocytes, Smooth Muscle ; Thrombospondin 1 ; Thrombospondins

A case of Wegener's Granulomatosis of 35 year old Korean male having 38 months duration with typical clinical symptoms and coular manifestations had been treated and observed in our clinic form April to November 21, 1958. The diagnosis was confirmed by the histopathological studies on biopsy specimen and by postmortem examination. The ultimate cause of the death in this case was thought to be massive cerebral hemorrhages as a result of systemic involvement of necrotizing angitis which is one of the characteristic features of this disease. Uremia and hypertension were not observed in this case to the end of the course. There is no report dealing with Wegener's Granulomatosis in Korean literatures to the best of our knowledge at this moment.
Adult ; Autopsy ; Biopsy ; Cerebral Hemorrhage ; Diagnosis ; Humans ; Hypertension ; Male ; Uremia ; Wegener Granulomatosis*

No abstract available.
Thymus Neoplasms*

No abstract available.
Lipoma* ; Neck*

A 50 year old male patient was admitted due to fever and left upper-quadrant abdominal pain. He had a history of previous treatment for pulmonary TB and splenectomy due to aplastic anemia. A large peritoneal abscess with connection to a chronic left side tuberculous empyema thoracis was diagnosed on admission. Chest CT also revealed a soft tissue lesion on the left anterior chest wall. Staged drainage of the peritoneal lesion followed by left side pleuropneumonectomy with chest wall resection was performed. The pathologic studies showed a high grade sarcoma of the chest wall.
Abdominal Pain ; Abscess ; Anemia, Aplastic ; Drainage ; Empyema ; Empyema, Tuberculous ; Fever ; Humans ; Male ; Sarcoma ; Splenectomy ; Thoracic Wall ; Thorax

PURPOSE: Osteoporosis and growth failure have been known one of the serious side effects of corticosteroid therapy especially in children. This study was designed to evaluate the effect of long-term administration of steroids on bone mineral density(BMD) in children with nephrotic syndrome and its relationship to cumulative steroid dose, the duration of therapy and sex. Meathods : The BMD of the spine and arm were measured by dual energy x-ray absorptiometry in 24 children with biopsy-proven minimal change nephrotic syndrome who have been revealed steroid dependent and/or frequent relapse in its clinical course and in age- and sex-matched healthy controls. The mean duration of steroid therapy was 37+/-29.8 months and the mean cumulative steroid doses was 12.8+/-7.7g/m2. RESULTS: 1) The BMD at arm was 0.57+/-0.06g/cm2 in patient group and 0.59+/- 0.06g/cm2 in control group. The BMD at spine was 0.68+/-0.1g/cm2 in patient group and 0.76+/-0.1g/ cm2 in control group. Compared with control group significant decrease in BMD was detected in patient group at arm(p=0.011) and spine(p<0.01). The bone loss at spine and arm was -10.6+/-7.44% and -3.7+/-5.5%, respectively. The bone loss was more prominant at spine(p<0.01). 2) Bone loss at arm was significantly correlated to the total cumulative dose of steroid(Y=-0.0029-0.294X, r=-0.4148, p=0.0434), but was not correlated to the duration of steroid(Y=-2.15-0.04X, r=0.1396, p=0.4619). At spine, there were no significant correlation between bone loss and the cumulative steroid doses(Y=-8.47-0.178X, r=-0.19397, p=0.363) and the duration of steroid therapy (Y=-9.75-0.025X, r=0.09081, p=0.6332). CONCLUSIONS: The long-term use of steroid can induce significant bone loss at the both site of arm and spine. To minimize the extent of corticosteroid-induced bone loss, BMD measurement using dual energy x-ray absorptiometry in children with nephrotic syndrome would be helpful.
Absorptiometry, Photon ; Arm ; Bone Density* ; Child* ; Humans ; Nephrosis, Lipoid* ; Nephrotic Syndrome ; Osteoporosis ; Recurrence ; Spine ; Steroids