No abstract available.
Humans ; Retreatment* ; Tuberculosis, Pulmonary*

Mucoepidermoid carcinoma of lung are rare carcinoma arising from the submucosal glands tissue of the proximal tracheobronchial tree. The carcinoma can be divided into low grade and high grade varienties. The most important factors in the prognosis include histological grading and the ability to achieve a complete surgical resection. We experienced a case of high grade mucoepidermoid carcinoma in pulmonary tuberculosis patient of 67 years old male who has been suffered from left chest pain for several weeks. He was not treated and died seventeen months later.
Carcinoma, Mucoepidermoid* ; Chest Pain ; Humans ; Lung ; Male ; Prognosis ; Trees ; Tuberculosis, Pulmonary*

No abstract available.
Humans

The nineteen patients(20 eyes) of traumatic optic neuropathy were investigated to evaluate the effectiveness of high dose corticosteroid for the visual improvernent in the early treatment of this disease. The relationships between the affected region and visual improvement, the interval to treatment and final visual acuity, the initial visual acuity and final visual acuity were studied. 250mg of methylprednisolone was administered intravenously every 6 hours followed by tapering using oral prednisone. The optic canal decompression was performed in five patients suspected swelling of optic nerve or optic canal fracture revealed by orbital CT. It is difficult to know the relationships between the affected region and visual improvement, the interval to treatment and final visual acuity. The vision was improved in nine of eleven patients who had an initial visual acuity of above light perception, but in the two of nine patients who had an initial visual acuity of no light perception. The two of five patients treated with a combina tion of high dose corticosteroid and optic canal decompression showed improved visual function. In initial treatment of traumatic optic neuropathy, high dose corticosteroid was effective and combined optic canal decompression was helpful, if indicated.
Decompression ; Humans ; Methylprednisolone ; Optic Nerve ; Optic Nerve Injuries* ; Orbit ; Prednisone ; Visual Acuity

Purpose: The diagnostic usefulness of fetal echocardiography in congenital heart disease is well known. One of the indications for fetal echocardiography is presence of extracardiac anomalies and such coexistent congenital heart disease may have important implications for obstetric and neonatal management. MATERIALS AND METHODS: 496 women with singleton pegnancies with amgenital anomalies that underwent penatal care and follow-up in Severance Hospital for 5 years from 1991 to 1995 were evaluated for the incidence of congenital heart disease. RESULTS: The incidence of congenital heart disease in fetuses with the associated extracardiac anomalies were as follows; central nervous system 6.9%(11/160), gastro-intestinal system 10.7%(8/75), genito-urinary sysem 4.7%(4/85), others 5.6%(4/72). Thirty-one of eighty-ane fetuses with congenital heart disease were found to have the associated extracardidac anomalies and ten of them chenoscenal abnormalities. CONCLUSION: We recommend that fetuses with congenital extracardiac anomalies sbould be checked for the presence of congenital heart disease and chmmosomal abnormalities, if needed.
Central Nervous System ; Echocardiography ; Female ; Fetus ; Follow-Up Studies ; Heart Defects, Congenital* ; Humans ; Incidence

OBJECTIVES: To assess the relationship between ST segment elevation during exercise testing and coronary artery disease. METHODS: Treadmill exercise electrocardiography and coronary angiography were performed in 137 patients with angina with no Q waves. The J point elevation of > 0.03mV(0.3mm) measured from baseline, the elevation of ST segment at 80msec. from J point(ST80) measured larger in lead V1than in aV1, or both the elevation of ST segment at J point and at ST80 developed earlier than or concomitantly with ST depression were considered as abnormal responses. RESULTS: 1) There was no clinical significance of ST elevation in lead aV1. 2) Exercise-induced ST elevation in lead V1occurred in 29 of 137 patients with angina. 3) Abnormal St elevation in V1was detected in 26 of 86 patients with coronary artery disease, for a specificity of 98%. The patients with left anterior descending coronary artery or left main coronary artery stenosis were observed in 3 of 5(60%) patients with single-vessel disease, in 7 of 9(79%) with two-vessel disease, and in 9 of 10(90%) with three-vessel disease. 4) The standard ST depression yielded a specificity of 55% in the patients with isolated or predominant ST depression in inferior leads(II. III, and aVF) and of 81% in the patients with isolated or predominat ST depressin in precordial leads(p<0.001). 5) Abnormal exercise-induced ST elevation in V1was detected in 13 of 39(33%) patients with isolated or predominat ST depression in inferior leads and yielded a specificity of 94% for coronary artery disease. CONCLUSION: Abnormal ST segment elevation in V1may increase the specificity in isolated or predominat ST segment depression in inferior leads and may predict left anterior descending or left main coronary artery disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Stenosis ; Coronary Vessels* ; Depression ; Electrocardiography ; Exercise Test* ; Hexamethonium ; Humans ; Sensitivity and Specificity

From May, 1975 to August, 1986, we experienced 21 patients with ruptured aneurysm of the sinus of Valsalva. 1) Their ages ranged from 15 to 52 years with a mean age of 26.7 years, and 14 patients were male and 7 patients were female. Among 18 cases of which aneurysms occurred on the right sinus of Valsalva, 15 cases (83%) ruptured into the right ventricle, 1 case (6%) ruptured into the right atrium and 2 cases (11%) ruptured into the pulmonary artery. All 3 cases of which aneurysms occurred on the noncoronary sinus ruptured into the right atrium. 2) Clinical symptoms consisted of dyspnea (95%), palpitation (81%), chest pain (43%), orthopnea (33%), cough (14%), hemoptysis (5%), oliguria (5%), and fever (5%). In all patients continuous heart murmur was audible. Hepatomegaly (48%), pulmonary basal rale (14%), and pretibial pitting edema (19%) were also observed. 3) In all patients diagnosis was made with cardiac catheterization and angiography, and confirmed by operation excetpt one case. 4) Among 20 patients who had been performed corrective surgery, ventricular septal defect was observed in 16 patients (85%), aortic insufficiency in 5 patients (25%), pulmonary infundibular stenosis in 1 patient (5%), patent foramen ovale in 1 patient (5%), and tricuspid insufficiency in 1 patient (5%). Ventricular septal defect was observed in all 16 patients whose aneurysms of the right coronary sinus of Valsalva ruptured into the right ventricle and the pulmonary artery. 5) All patients survived operation, and no postoperative complication was found except 1 patient to whom reoperation was performed because of postoperative aortic insufficiency and detachment of the patch closure for ventricular septal defect. There was symptomatic improvement in all patients.
Aneurysm ; Aneurysm, Ruptured* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Coronary Sinus ; Cough ; Diagnosis ; Dyspnea ; Edema ; Female ; Fever ; Foramen Ovale, Patent ; Heart Atria ; Heart Murmurs ; Heart Septal Defects, Ventricular ; Heart Ventricles ; Hemoptysis ; Hepatomegaly ; Humans ; Male ; Oliguria ; Postoperative Complications ; Pulmonary Artery ; Pulmonary Subvalvular Stenosis ; Reoperation ; Respiratory Sounds ; Sinus of Valsalva*

BACKGROUND: The serious problems in retreatment of pulmonary tuberculosis are a significant proportion of drug resistance. Preferably retreatment should contain the drugs which has never used before, so drug retreatment is limited in selection. A new antibacterial substance, ofloxacin(OFX) is the activity against mycobacterium tuberculosis and it has been used in the treatment of pulmonary tuberculosis. The present report concerns the result of retreatment of pulmonary tuberculosis patients containing OFX treated at National Kongju Tuberculosis Hospital. METHOD: A retrospective study was made through the regular follow up of 92 smear positive cases, who were treated by four drugs regimen between Mar 1991 and June 1994 at National Kongju Tuberculosis Hospital. Four drugs were, namely prothionamide, cycloserine, ofloxacin and streptomycin(kanamycin or tuberactinomycin). The duration of follow up was over one year. RESULTS: 1) Out of 92 cases with positive sputum AFB smear, 67(73%) achieved the negative conversion. 2) Considering the negative sputum conversion in all the groups, the vast majority(85%) of sputum conversion occurred within the first 4 months. 3) The roentgenological improvement occurred in 49 percent on the whole and when the extent of disease was minimal, moderately, far advanced pulmonary tuberculosis, sputum AFB smear negative response to retreatment was 100%, 93%, 68%, respectively. 4) When the duration of patient's illness was less than 1 year, 1 to 3 years, 3 to 5 years and more than 5 years, sputum AFB smear negative response to retreatment was 87%, 76%, 65% and 55%, respectively. 5) Adverse reaction to prothionamide, with complaints of gastrointestinal troubles was common and hepatic dysfunction without jaundice was observed in 7 percent, convulsion in 1 percent, that to cycloserine occurred renal dysfunction & psycosis & convulsion, 2%, 1%, 1%, respectively. Tinnitus with KM occurred in 1% and dirrhea with OFX in 4%. CONCLUSION: The duration of patient's illness was shorter, sputum AFB smear negative response rate was better. Radiologic responses were not remarkable, but extent of disease by national tuberculosis association was smaller, the result of retreatment was better. Adverse reaction of the secondary antituberculosis agent was mainly observed gastrointestinal troubles, as regard to tolerance to the secondary drugs the role of the physician is of very important value and toxic effects can be overcome by the strong confidence.
Chungcheongnam-do ; Cycloserine* ; Drug Resistance ; Follow-Up Studies ; Hospitals, Chronic Disease ; Humans ; Jaundice ; Mycobacterium tuberculosis ; Ofloxacin* ; Prothionamide* ; Retreatment* ; Retrospective Studies ; Seizures ; Sputum ; Streptomycin* ; Tinnitus ; Tuberculosis ; Tuberculosis, Pulmonary*

Although, with regard to diagnosis, history, physical examination, laboratory data, and electrocardiogram (ECG) are helpful, it can be difficult to distinguish between pericarditis, myopericarditis, and myocardial infarction. Typically, the ECG pattern evolves similarly in acute pericarditis and myopericarditis and includes diffuse ST elevation and PR depression, and then diffuse T wave inversion. Nevertheless, atypical ECG features are seen occasionally in both, especially in myopericarditis. They are characterized by localized ST elevation (inferolateral or anterolateral) and T wave inversion before ST segment normalization. This makes it difficult to distinguish acute myopericarditis from acute myocardial infarction. We report the case of a 27-year-old man with acute myopericarditis with localized ST elevation mimicking acute myocardial infarction.
Adult ; Depression ; Electrocardiography ; Humans ; Myocardial Infarction ; Myocarditis ; Pericarditis ; Physical Examination

Percutaneous balloon valvuloplasty (PBV) was done in 7 adults of pulmonary valvular stenosis, which was diagnosed with catheterization and cine-angiography of rigtht heart, in Seoul National University Hospital from Jan. 1986 to Dec. 1986. The results were as follows : 1) Among the seven cases six were male and the range of age was from 19 to 40 years. Atrial septal defects associated in 2 cases were not significant clinically. 2) The peak systolic gradient from right ventricle to pulmonary artery before the procedure was below 50 mmhg in 1 cases, 50 to 100 mmHg in 1 case, and above 100 mmHg in 5 cases. 3) Before PBV the mean systolic pressure of right ventricle was 121+/-42 mmHg and the peak systolic gradient was 106+/-41 mmHg. After PBV those were 58+/-30 mmHg and 40+/-31 mmHg, revealing significant improvement. 4) Balloon catheter (Medi-tech, 9F) was used in all cases. single balloon of 20 mm outer diameter was applied in 2 cases and double balloons of various sizes were applied in 5 cases in which single balloon showed inadequate dilatation. It is suggested that percutaneous balloon valvuloplasty is safe and effective alternative to surgical valvotomy of pulmonary valvular stenosis in adults.
Adult* ; Balloon Valvuloplasty* ; Blood Pressure ; Catheterization ; Catheters ; Constriction, Pathologic* ; Dilatation ; Heart ; Heart Septal Defects, Atrial ; Heart Ventricles ; Humans ; Male ; Pulmonary Artery ; Seoul