The benign teratoma is usually slow growing tumor, but we expirienced a case of primary huge mediastinal benign teratoma that had grown very rapidly, maximally during 3 years. The 14-year-old female patient was admitted to our hospital because of abnormal chest X-ray that showed 10x10cm sized well definded mass with multiple calcificactions. but the mass was not present in chest X-ray perfomed on 3 years prior to admission. Under the diagnosis of teratoma, complete surgical resection was done by the left thoracotomy. The result of pathology was benign teratoma.
Adolescent ; Diagnosis ; Female ; Humans ; Mediastinal Neoplasms ; Pathology ; Teratoma* ; Thoracotomy ; Thorax

Carcinosarcoma of the esophagus have an interesting pathologic feature of admixture of carcinomatous and sarcomatous lesion and accounts for 0.5~1.5% of all esophageal neoplasm. Generally, it has been reported that these have better prognosis than the squamous cell carcinoma. We have experienced two cases of carcinosarcoma occurring at the mid-esophagus. In both two cases, Ivor Lewis operation was performed and lymph node metastasis was absent. The pathologic diagnosis was confirmed as carcinosarcoma. Postoperative course was uneventful and the patients have been followed up for 3 months and 3 years, respectively, without any problems. We report these cases with a brief review of the literatures.
Carcinoma, Squamous Cell ; Carcinosarcoma* ; Diagnosis ; Esophageal Neoplasms ; Esophagus* ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis

BACKGROUND: An increasing number of elderly are referred for open heart surgeries(OHS). These patients are assumed to have significantly increased morbidity and mortality because of compromised functional reserves in their vital organs. We reviewed the results of OHS patients who were 70 years old or older. MATERIAL AND METHOD: Thirty six consecutive septuagenarians underwent OHS from 1995 to 1997. Operations were coronary artery bypass grafting(CABG) in 26 including 3 left main surgical angioplasty, valve replacement in 7, MVR+CABG in 2, and ASD closure+TAP in 1. Statistical tests were carried out to compare survivor group with nonsurvivor group in respect to risk factors including NYHA functional class, LVEF, emergent operation, IABP support, CPB/ACC time, ventilator time cardiac index, ICU stay and hospital stay for operative mortality. RESULT: Operative mortality rate and postoperative complication were 16%(6/36) and 50%(18/36). One-year and 3-year actuarial survival rates were 76%. Nine patients(25%) had major complications including third-degree A-V block(2), respiratory failure(1), stroke(3), renal failure requiring dialysis(3) and postoperative hemorrhage(2). The causes of death were pneumonia(1), bleeding(1), acute renal failure(1), low cardiac output(1), third-degree A-V block(1), and ventricular tachycardia(1). The univariate analysis of mortality shows that NYHA class IV, LVEF<40%, lesser values for C.I, and longer time for ventilatory support were associated with the risk factors(p value=0.03, 0.001, 0.007, and 0.014). The emergent operation, CPB/ACC time, IABP support, ICU stay and hospital stay were not significant. CONCLUSION: We conclude that cardiac operation can be performed in septuagenarians with acceptable outcomes when done in patients with normal to moderately depressed left ventricular function and adequate functional reserves in their vital organs.
Age Factors ; Aged ; Angioplasty ; Cause of Death ; Coronary Artery Bypass ; Heart* ; Humans ; Length of Stay ; Mortality ; Postoperative Complications ; Renal Insufficiency ; Risk Factors ; Survival Rate ; Survivors ; Ventilators, Mechanical ; Ventricular Function, Left

Primary leiomyosarcoma is an extremely rare tumor. We exprienced a case of 46-year-old man with a mass located in the left upper lobe bronchus which was discovered on a chest CT. Cytology of the sputum and bronchoscopic biopses did not reveal any malignant cells. The patient underwent a left sleeve upper lobectomy. The tumor was growing from the left upper lobe bronchus and had partially destroyed the lung parenchyme. The pathologic feature of the tumor was composed of fascicular arrayed cellular spindle cells with blunt-ended nuclei revealed mild to moderate pleomorphism and frequent mitoses (15/10HPF). The immunohistochemical staining was revealed positive reaction for antibody to smooth muscle actin and desmin. We conclude that the tumor is leiomyosarcoma of the lung and then report with a review of the literatures.
Actins ; Bronchi ; Desmin ; Humans ; Leiomyosarcoma* ; Lung* ; Middle Aged ; Mitosis ; Muscle, Smooth ; Sputum ; Subclavian Artery ; Thoracic Outlet Syndrome ; Tomography, X-Ray Computed

Epithelial-myoepithelial carcinoma is a rate low-grade malignant salivary neoplasm that usually occurs in the parotid gland but can also arise in minor salivary glands. We report a case of a primary epithelial-myoepithelial carcinoma of the lung neoplasm. The patient was 48-year-old women who presented with dry cough of 1 month duration. A right middle lobe endobronchial lesion was identified bronchoscopically. The bilobectomy of RML & RLL was performed, the pathologic result was epithelial-myoepithelial carcinoma.
Cough ; Female ; Humans ; Lung Neoplasms ; Lung* ; Middle Aged ; Parotid Gland ; Salivary Glands, Minor

OBJECTIVE: Several tests can be used to screen for alcohol dependence (AD), a prevalent disease with a heterogeneous etiology. As some patients with AD have a strong familial tendency in this regard, a family history of alcohol use disorders can affect the outcomes of screening tests and diagnostic evaluations for AD. In this study, we evaluated associations between a family history of alcohol use disorders and evaluations using the Cut down, Annoyed, Guilty, Eye-opener (CAGE) test, Alcohol Use Disorder Identification Test (AUDIT), and Diagnostic and Statistical Manual of Mental Disorders-fourth edition (DSM-IV) diagnostic criteria among patients with AD. METHODS: We recruited 487 male patients with AD from eight hospitals in Korea. Patients were evaluated using the CAGE, AUDIT, and DSM-IV diagnostic criteria. Patients with and without family histories were compared in terms of these assessment tools. RESULTS: Drinking initiation, uncontrollable drinking, and problem drinking occurred earlier and CAGE "annoyed" scores were higher in patients with a family history. Alcohol problems before the age of 25 years, frequency of spontaneous or compulsive alcohol-seeking behavior, and frequencies of psychological dependence and guilt related to alcohol use were also higher. CONCLUSION: Earlier drinking problems, higher scores on specific items of the CAGE, and AUDIT, and meeting more diagnostic criteria indicate more dependent, harmful drinking by patients with AD who have a family history of this condition. Clinicians should consider patients' family history of alcohol use disorders when screening for AD to identify the correct diagnosis and develop appropriate treatment plans for these patients.
Alcoholism ; Diagnostic and Statistical Manual of Mental Disorders ; Drinking ; Guilt ; Humans ; Korea ; Male ; Mass Screening

BACKGROUND: Intertrochanteric fractures of the femur are the most common type of fracture, and are an increasing occurrence due to the aging of the population. The objectives of our study are to predict the fate of intertrochanteric fractures treated with intramedullary hip nails by assessing the postoperative fracture stability utilizing the newly developed scoring system, and to help rehabilitate these patients. METHODS: Eighty-two patients with intertrochanteric fractures that were treated with intramedullary hip nails between December, 2004 and January, 2011 were subjected to this study. The patients who could be followed for a minimum of one year postoperatively were enrolled. The immediate postoperative conditions were determined by radiograms: reduction status (3 parameters/4 points: contact accuracy of posteromedial cortex, severity of angulation, and distraction), fixation status (3 parameters/3 points: tip-apex distance, location of tip of the lag screw, entry point of the intramedullary nail), and fracture type (1 parameter/1 point: stable or unstable type by the Kyle's classification). Postoperative reduction loss and fixation failure were checked by radiograms taken at a minimum 3 months postoperative. RESULTS: Reduction loss and fixation failure were observed in 14 consecutive patients (17%). The fixation failure rate was 100% (2 patients) in score 1, 60% (3 out of the 5 patients) in score 2, 39% (3 out of the 8 patients) in score 3, and 50% (4 out of the 8 patients) in score 4 groups. There were fixation failures only in 1 out of 13 patients with score 5, and in 1 out of 18 patients with score 6. There was no fixation failure in 17 patients with score 7 and 11 patients with score 8. CONCLUSIONS: Maintenance of the fracture reduction by the stable fixation in the patient scores over 5 could be predicted by the postoperative radiograms.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Early Ambulation ; Female ; Femur/surgery ; Fracture Fixation, Intramedullary ; Health Status Indicators ; Hip Fractures/classification/rehabilitation/*surgery ; Humans ; Male ; Middle Aged ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Treatment Outcome

Rupture of the bronchus following endotracheal intubation with a double-lumen tube is extremely rare in all complications of endotracheal intubation. We experienced a case of left main bronchial rupture following endotracheal intubation. This 58-year old female patient was diagnosed of well-differentiated adenocarcinoma of right lower lobe, stage II B, preoperatively. She was intubated with Robertshaw double-lumen tube (35 Fr.) for Rt. lower lobectomy. Intraoperatively, Lt. main bronchial rupture was suspected because of pneumomediastinum and ventilation insufficiency and immediately repaired with monofilament absorbable sutures (PDS) through left thoracotomy. Postoperative course was uneventful.
Adenocarcinoma ; Bronchi ; Female ; Humans ; Intubation* ; Intubation, Intratracheal ; Mediastinal Emphysema ; Middle Aged ; Rupture* ; Sutures ; Thoracotomy ; Ventilation

No abstract available.
Cell Proliferation* ; Female ; Humans ; Trophoblasts*

PURPOSE: To evaluate the MR findings of gestational trophoblastic tumor(GTT) in correlation with pathological results. MATERIALS AND METHODS: Nine patients who confirmed the diagnosis (four choriocarcinomas and five invasive moles) constituted the basis of our study. Pathologic specimens were taken from the tumors corresponding to the regions of interest on MR images. The MR images were analyzed in respect of the morphology and signal intensity of the tumors, uterine and adnexal vascularity, and the adnexal lesion. RESULTS: The MR findings of four choriocarcinomas were well-defined, hemorrhagic masses with central necrosis;the masses were hyperintense on Tl-weighted images. In contrast, the five invasive moles showed irregular and permeative masses with densely enhanced solid components and tiny cystic lesions. The trophoblastic proliferation, coagulation necrosis, and molar villi had variable signal intensities on Tl-and T2-weighted images. CONCLUSION: Our results suggest that MR imaging is a promising tool for noninvasive morphologic analysis of GTTS.
Choriocarcinoma ; Diagnosis ; Female ; Humans ; Hydatidiform Mole, Invasive ; Magnetic Resonance Imaging* ; Molar ; Necrosis ; Pregnancy ; Trophoblastic Neoplasms* ; Trophoblasts*