Fetal echocardiography is used by means of decleration of fetal cardiac anaztomy, to estabilish the diagnosis of congenital heart disease in utero. We attemped fetal echocardiography to ninty three pregnant women after intra uterine period 24 weeks, and estimated cardiac circumference, cardiac axis, pulmonary atery root diameter, arortic root diameter, diameter of inferior vena cava, diameter of superior ve studied how these estimates associate with following gestational na cava, and fractional shortening of ventricles. We ages. Cardiac axis was on the average 37.28 degree and cardiac apex was located in anterior left side of chest area. Aortic root diameter was 0.227 GA-0.043mm (GA=gestational age) at systolic phase, 0.203 GA+0.421mm at diastolic phase. Pulmonaly root diameter was 0.271 GA-0.029mm at systolic phase, 0.251 GA-0.067mm at diastolic phase. Thoracic aorta diameter was 0.195 GA+0.109mm at systolic phase, 0.198 GA+0.794mm at diastolic phase. Fractional shortening was 0.24 (1 Standard Deviation=0.11) in right ventricle, 0.23(1 SD=0.154) at left ventricle, and so ratio of right and left ventricle was 1.04(1 SD=0.51). Once normal fetal cardiac anatomy is understood, structural defects and/or alternation of function can be evaluated antenatally.
Aorta, Thoracic ; Axis, Cervical Vertebra ; Diagnosis ; Echocardiography* ; Female ; Heart Defects, Congenital ; Heart Ventricles ; Humans ; Pregnant Women ; Thorax ; Vena Cava, Inferior

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

The purpose of this study is to evaluate the efficacy of the balloon bronchoplasty in the treatment of the tuberculous bronchostenosis. Balloon bronchoplasty was performed in thirteen patients with stenosis of the left main bronchus (two with combined left upper and lower lobar bronchostenosis) using a inflatable balloon catheter under a fluoroscopic guide. We analysed the changes in the changes in the severity of dyspnea and wheezing, serial FEV1/FVC as a parameter of the airflow obstruction, and bronchial diameter and lung volume on chest radiographs. The extent of pulmonary tuberculosis was correlated with the improvement of FEV1/FVC. There was an improvement of dyspnea in 69%(9/13), decrease of wheezing in 69%(9/13), significant increase of FEV1/FVC in 18% (2/11). The increase of the bronchial diameter and lung volume were seen in 84%(11/13) and 53% (7/13), respectively. The significant increase of FEVI/FVC was seen in 28% (2/7) of the patients with lung involvement of tuberculosis less than one third of left upper lobe, whereas there was no increase in those of more than one third. There was no complication except transient leukocytosis, fever and blood-tinged sputum. In conclusion, balloon bronchoplasty is effective in the treatment of medically intractable tuberculous bronchostenosis, and can be considered as an initial method of treatment.
Bronchi ; Catheters ; Constriction, Pathologic ; Dyspnea ; Fever ; Humans ; Leukocytosis ; Lung ; Methods ; Radiography, Thoracic ; Respiratory Sounds ; Sputum ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.
Carcinoma, Merkel Cell* ; Lymph Nodes* ; Lymphoscintigraphy* ; Neoplasm Metastasis*

PURPOSE: A acinar cell carcinoma of the pancreas is a rare malignancy arising from exocrine cells and comprising about 0.2 to 1% of all pancreatic cancers. Acinar cell carcinomas are usually seen in elderly patients and show a poor prognosis due to frequent metastasis. So far, we have not found any report of a clinical analysis of acinar cell carcinomas in Korean. METHODS: The records of 5 patients of Dong-A University Hospital and 5 patients already reported on in other literature in Korea were reviewed. The clinical and radiohistologic characteristics, treatment and prognosis were analyzed. RESULTS: The patients consisted of 8 males and 2 female. The patients ranged in age from 25 to 68 years (mean, 49.3 years). Presenting symptoms were nonspecific, and jaundice was infrequent. The symptoms from increased serum lipase levels were present in 2 (20.0%) of the patients. The tumor was frequently located on the tail (6 cases, 60.0%) of the pancreas. The histologic finding showed an acinar arrangement of the tumor cells with a minute central lumen. Ultrastructurely, the tumor cells had a few zymogen granules. The mean size of the tumors was 7.5 cm. We found that 1 case among the 10 cases had an elevated CA19-9 level among 10 cases and no one had an elevated AFP or CEA level among our 5 cases. A radical resection was performed in 7 cases, and the mean survival was 44.0 months. The mean survival of the 10 cases was 35.4 months. CONCLUSION: An acinar cell carcinoma is a rare type of pan creatic cancer and has a more favorable prognosis than a pancreatic ductal carcinoma. The clinical outcome and the radiohistologic characteristics were similar to those in other foreign literature, but the age, the tumor locations and the tumor marker (AFP or CEA) of the patients in this study were different from those of Caucasians.
Acinar Cells* ; Aged ; Carcinoma, Acinar Cell* ; Carcinoma, Pancreatic Ductal ; Female ; Humans ; Jaundice ; Korea* ; Lipase ; Male ; Neoplasm Metastasis ; Pancreas* ; Pancreatic Neoplasms ; Prognosis ; Secretory Vesicles

No abstract available.
Hydroxyurea ; Hyperpigmentation*

No abstract available.
Pulmonary Embolism*

PURPOSE: A laparoscopy-assisted gastrectomy with lymph node dissection for gastric cancer is considered technically more complicated than the open method. To evaluate the short-term surgical validity, the surgical outcome of the laparoscopy-assisted distal gastrectomy (LADG) with extraperigastric lymph node dissection was compared with that of the conventional open distal gastrectomy (CODG) in patients with early gastric cancer. METHODS: One hundred and forty-seven patients with early gastric cancer received a radical distal gastrectomy during 2002 and 2003, where a LADG was performed on 71 patients. The clinicopathological characteristics, postoperative outcomes and courses, and the postoperative morbidities and mortalities were compared between the two groups. Data were retrieved from the stomach cancer database at Dong-A University Medical center. RESULTS: Baseline characteristics, including gender, age, body mass index (BMI), American Society of Anesthesiology (ASA) class, tumor size, T stage, and lymph node metastasis, were similar between the two groups. No significant differences were found between these groups in terms of the number of retrieved lymph nodes with respect to D1+(D1+no. 7) and D1+beta (D1+no. 7, 8a, and 9) lymphadenectomies. In the LADG group, the wound size was smaller (P <0.0001), but the operation time was longer (P=0.0001) than in the CODG group. The perioperative recovery was faster in the LADG than in the CODG group, as reflected by the shorter hospital stay (P=0.0176) and less additional analgesics (P=0.0370). The serum albumin level in the LADG was higher (P=0.0002) on day 7 than that in the CODG group, and the leukocyte count in the LADG lower (P=0.0445) on day 1 than that in the CODG gruop. There were no significant differences in the postoperative morbidities and mortalities between the two groups. CONCLUSIONS: Our data confirmed that a LADG with an extraperigastric (no. 7, 8, and 9) lymph node dissection was a feasible and acceptable surgical technique for early gastric cancer. From a surgical point of view, a LADG with an extraperigastric lymph node dissection is suggested to be a preferred surgical option for patients with early gastric cancer. Its oncological validity awaits larger and prospective multicenterd trials.
Academic Medical Centers ; Analgesics ; Anesthesiology ; Body Mass Index ; Gastrectomy* ; Humans ; Length of Stay ; Leukocyte Count ; Lymph Node Excision* ; Lymph Nodes* ; Mortality ; Neoplasm Metastasis ; Serum Albumin ; Stomach Neoplasms* ; Wounds and Injuries

Adalimumab (Humira(TM)) is the first fully humanized monoclonal TNF-alpha antibody that antagonizes the effects of TNF-alpha. Its use has been found in the treatment of various rheumatologic disorders, namely rheumatoid arthritis, Crohn's disease, and ankylosing spondylitis, as well as for various skin conditions such as psoriasis. As the use of this particular biologic agent is becoming more widespread, cutaneous adverse effects of the drug is now being reported at a steady rate. The authors herein report a case of 32 year-old female who presented with multiple psoriasiform eruptions on her trunk, back and lower extremities. She had a four-year history of ankylosing spondylitis, for which she was started on subcutaneous adalimumab injection monthly, three and a half years prior to her initial visit.
Antibodies, Monoclonal, Humanized ; Arthritis, Rheumatoid ; Crohn Disease ; Dermatitis ; Female ; Humans ; Lower Extremity ; Psoriasis ; Skin ; Spondylitis, Ankylosing ; Tumor Necrosis Factor-alpha ; Adalimumab

Primary liver tumors are uncommon in childhood, with a relative frequency of 3% of childhood tumors. Seventy three cases of pediatric primary liver tumors which were operated on at single institution between 1986 and 2002 were reviewed. There were 37 cases of hepatoblastoma, 11 hepatocellular carcinomas, 6 undifferentiated (embryonal) sarcomas, and 1 mixed germ-cell tumor in malignancies. Benign tumors constitute only 24.6% of liver tumors, including 7 hemangioendotheliomas, 5 mesenchymal hamartomas, 3 congenital cysts, and one each with focal nodular hyperplasia and hemangioma. The common presenting clinical features were abdominal mass or abdominal distension. Anatomical hepatic resections were carried out in 38 cases, and non anatomical resections in 34 cases. One patient died of a direct result of hepatic resection(1.4%), and complication rate was 16.4%.
Carcinoma, Hepatocellular ; Child* ; Focal Nodular Hyperplasia ; Hamartoma ; Hemangioendothelioma ; Hemangioma ; Hepatoblastoma ; Humans ; Liver ; Sarcoma