Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

Although some employees working for Seoul Metropolitan Subway Cooperation are working at the noisy workplaces, they has been excluded from Special Periodic Health Examination Program. And some workers complained of hearing loss or tinnitus. So, this study was carried out to investigate the prevalence rate of Noise Induced Hearing Loss of employees(10,792) working for Seoul Metropolitan Subway Cooperation. The number of subjects were total 10,792 with 10,355 men and 437 women. A questionnaire survey, otological examination, Rinne test, pure tone audiometric tests were performed and through the first and second screening audiometric examination, 605 workers were selected after excluding employees with past otologic problems, recent exposure to high level noise, and under medications. and the results were as follow; 1. Among 10,792 workers, 4 workers(0.037%) diagnosed as NIHL and 601 workers(5.56%) as early NIHL. As workers grew older, the prevalence rate of NIHL and early NIHL became more rising. 2. The prevalence rate of NIHL and early NIHL was different between work site. After age adjustment, The prevalence rate of NIHL and early NIHL was 23.74% in Train repairmen{80dB(A)}, 3.1% in Station staffs{below 70dB(A)}, 2.53% in Train crew{below 70dB(A)}, 2.1% in Office workers. 3. The perception rate of necessities of ear plug in NIHL and early NIHL was below 55% and wearing rate of ear plug in NIHL and early NIHL was 1.1% In conclusion, some employees who was under working environment in Seoul Metropolitan Subway Cooperation should be monitored to prevent hearing impairment and would be needed health education.
Ear ; Female ; Health Education ; Hearing Loss* ; Hearing* ; Humans ; Male ; Mass Screening ; Noise* ; Prevalence ; Railroads* ; Seoul* ; Tinnitus ; Workplace ; Surveys and Questionnaires

The exact incidence of esophagitis in gastroesophageal reflux disease (GERD) remains poorly understood in Korea. To determine incidence of esophagitis in GERD, from August 1988 to July 1993, endoscopy, esophageal manometry with Bernstein test, and ambulatory 24 hour esophageal pH monitoring were carried out in a group of 349 patients with symptoms of heartburn or noncardiac chest pain. Based on these studies, 151(40%) patients had some degree of GERD and pstients were categorized as having: pathologic reflux, 98 patients; symptomatic reflux, 42 patients; and sensitive mucosal reflux, 11 patients. Among 151 patients with GERD, 27 patients(18%) had some degree of esophagitis. In conclusion, 40% of patients with symptoms suggestive of GERD have GERD. GERD is divided into subgroups; pathologic reflux, symptomatic reflux, and mucosal sensitive reflux. Less than 20% of GERD have esophagitis or esophageal mucosal injury and these low incidence of mucosal injury in Korean may be due to increased esophageal mucosal resistance.
Chest Pain ; Endoscopy ; Esophageal pH Monitoring ; Esophagitis* ; Esophagitis, Peptic ; Gastroesophageal Reflux* ; Heartburn ; Humans ; Incidence* ; Korea ; Manometry

PURPOSE: The purpose of this study was to evaluate the spectrum of MR characteristics of cystic acoustic neurinomas and to correlate with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed the MR findings of 12 patients with cystic acoustic neurinomas. The signal intensity and enhancement pattern of the cystic components as well as the location relative to the tumors were analyzed. RESULTS: A total of 30 cysts were found in 15 acoustic neurinomas;28 were intratumoral cysts and the remaining two were extratumoral cysts. The signal intensity of all 28 intratumoral cysts was higher than that of CSF on Tl-weighted images, and isointense to CSF on T2-weighted images, while the signal intensity of the two extratumoral cysts was same as CSF on both Tl-weighted and T2-weighted images. Rim enhancement was seen in 27 of 28 intratumoral cysts but in none of the two extratumoral cysts. CONCLUSION: We concluded that intratumoral cyst was due to tumoral necrosis, hemorrhage or degenerative change and extratumoral cyst due to secondary arachnoid cyst formation.
Acoustics* ; Arachnoid ; Hemorrhage ; Humans ; Necrosis ; Neuroma, Acoustic* ; Retrospective Studies

This study was performed to investigate the effect of kimchi intake on free radical and oxidative substance production in young adults and the elderly. Daily kimchi intake by people in their twenties (n = 93, 20 to 29 years old) and over sixty-five (n = 143, over 65 years old) in M city were surveyed and blood was drawn to analyze the free radicals in their plasma. The average amount of kimchi intake by the subjects was 115.8 +/- 91.7 g. The amount of kimchi intake of those in their twenties (106.1 +/- 80.6 g) was significantly lower than that of those over sixty-five (125.5 +/- 102.9 g, p<0.05). Concentrations of total free radicals and OH radicals were 27 and 33% greater respectively, in those over sixty-five than in those in their twenties, indicating that more free radicals were produced by the older group. The concentration of GSH was not signiacantly different in the two groups, but that of GSSG in the over sixty-five age group was 53% greater than in the twenties group, which resulted in a 35% reduction in GSH/GSSG in the elderly group. TBARS concentration in the over sixty-five group was 26% greater than that of the twenties group. In order to see the effect of kimchi intake on free radical production, subjects in same age group were divided into two sub groups-the mean over and the mean under groups-according to the average amount of kimchi intake, which was 115.8 g. The total free radicals, the OH radicals, the GSH, the GSSG, and the GSH/GSSG in the twenties group were not significantly different in the two kimchi intake groups. However, those in the over sixty-five group were significantly different. The concentration of total free radicals and OH radicals of the mean over group were 21 and 26% lower respectively, than those of the mean ova. group (p<0.05). The GSH and GSH/GSSG of the mean ova. groups were higher by 8 and 12%, respectively. The correlation coefficient between the kimchi intake and the total free radicals was -0.1862 (p<0.05) and that for GSH/GSSG was 0.1861 (p<0.05). In conclusion, the production of free radicals and oxidative substances increased with age, and kimchi seemed to retard this phenomena.
Aged* ; Free Radicals ; Glutathione ; Glutathione Disulfide ; Humans ; Ovum ; Plasma ; Thiobarbituric Acid Reactive Substances ; Young Adult*

Toxoplasma gondii is an obligate intracellular protozoan parasite, which invades a wide range of hosts including humans. The exact mechanisms involved in its invasion are not fully understood. This study focused on the roles of Ca2+ in host cell invasion and in T. gondii replication. We examined the invasion and replication of T. gondii pretreated with several calcium modulators, the conoid extrusion of tachyzoites. Calmodulin localization in T. gondii were observed using the immunogold method, and Ca2+ levels in tachyzoites by confocal microscopy. In light microscopic observation, tachyzoites co-treated with A23187 and EGTA showed that host cell invasion and intracellular replication were decreased. The invasion of tachyzoites was slightly inhibited by the Ca2+ channel blockers, bepridil and verapamil, and by the calmodulin antagonist, calmidazolium. We observed that calcium saline containing A23187 induced the extrusion of tachyzoite conoid. By immunoelectron microscopy, gold particles bound to anti-calmodulin or anti-actin mAb, were found to be localized on the anterior portion of tachyzoites. Remarkably reduced intracellular Ca2+ was observed in tachyzoites treated with BAPTA/AM by confocal microscopy. These results suggest that host cell invasion and the intracellular replication of T. gondii tachyzoites are inhibited by the calcium ionophore, A23187, and by the extracellular calcium chelator, EGTA.
Animals ; Calcium/*physiology ; Calcium Channel Blockers/pharmacology ; Calmodulin/antagonists & inhibitors ; Chelating Agents/pharmacology ; Hela Cells ; Host-Parasite Relations ; Humans ; Ionophores/pharmacology ; Research Support, Non-U.S. Gov't ; Toxoplasma/drug effects/pathogenicity/*physiology

A 3-year-old boy presented to our emergency department with a 3-week history of pain in the bilateral hip and abdomen that had persisted through antibiotic therapy based on diagnosis of acute osteomyelitis. At presentation, he had fever, anemia, and increased concentration of lactate dehydrogenase. After the identification of a left adrenal mass indicating neuroblastoma on computed tomography scan, he was admitted to the hospital by a pediatric oncologist. Subsequently, positron emission tomography and bone scintigraphy showed disseminated metastasis to the bone and bone marrow, and neuroblastoma was pathologically confirmed. This case highlights the importance of differential diagnosis of non-traumatic hip pain in toddlers considering the protean manifestations of neuroblastoma.
Abdomen* ; Anemia ; Bone Marrow ; Child ; Child, Preschool* ; Diagnosis ; Diagnosis, Differential ; Emergencies ; Emergency Service, Hospital ; Fever ; Hip* ; Humans ; L-Lactate Dehydrogenase ; Male* ; Neoplasm Metastasis ; Neuroblastoma* ; Osteomyelitis ; Positron-Emission Tomography ; Radionuclide Imaging

For the purpose of correction of high myopia, we had implanted Worst-Fechner Biconcave Lens (Ophtec B.V., Groningen, Holland) in the 10 phakic eyes which were more myopic than -8.0 D. We examined postoperative visual acuity and complications. Postoperative uncorrected visual acuity was from 0.3 to 1.0. Cataract, glaucoma, chronic iridocyclitis and macular edema or retinal detachment did not occur and during the iris fluorescein angiography of 4 eyes there was no leakage of dye at the fixation site of iris by haptic of the lens. But all patients complained of glare. In the 3 eyes which were followed up for 12 months, corneal endothelial cell loss occurred continuously and the endothelial cell loss was 17.2% at the central cornea and 19.5% at the paracentral cornea. Therefore, long term follow up is necessary.
Cataract ; Cornea ; Corneal Endothelial Cell Loss ; Endothelial Cells ; Fluorescein Angiography ; Follow-Up Studies ; Glare ; Glaucoma ; Humans ; Iridocyclitis ; Iris ; Macular Edema ; Myopia* ; Retinal Detachment ; Visual Acuity

The pancreatobiliary ductal system is one of the most frequent areas of anatomic variations. Rcently despite the improvement in diagnosis and management of pancreatobiliary lesion, a lack of s more through knowledge and understanding of these variations is undoubtedly reaponsible for many problems of medical and surgical management. Especially, drainage of the common bile duct and the pancreatic duct at sites other than the second portion of the duodenum is an anotomical curiosity. We report two cases of anomalous termination of the common bile duct and the pancreatic duct into the duodenal bulb diagnosed by ERCP and Gastroscopy.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct* ; Diagnosis ; Drainage ; Duodenum ; Exploratory Behavior ; Gastroscopy ; Pancreatic Ducts*

We report a case of cardiac arrest in a 71 year old male during the Valsalva maneuver that had been performed immediately after completing a pneumonectomy. The patient had a subclinical atrial septal defect (1.08 cm sized) and he previously undergone a left upper lobectomy of the lung without complications 11 months earlier. He underwent a left completion pneumonectomy due to recurrent lung cancer. After surgery a Valsalva maneuver was performed with 35 cmH2O to relocate the mediastinum. During this procedure, the patient experienced a cardiac arrest and was resuscitated with difficulty. It is believed that the cardiac arrest was due to pulmonary hypertension, right ventricular failure and right to left shunt caused by several factors, such as the pneumonectomy, subclinical atrial septal defect (1.08 cm sized), and Valsalva maneuver. In addition, the hypovolemia caused by fluid restriction and the epidural injection of local anesthetics might have contributed to this incident. Although it is a rare complication, it is suggested that subclinical ASD can cause severe hypoxemia, dyspnea even cardiac arrest after pneumonectomy. In order to avoid these complications, ASD should be treated with percutaneous closure or surgical intervention. If these are not possible, care must be taken when anesthetizing the patient, and anything that can increase the pulmonary vascular resistance and right to left shunt should be avoided.
Anesthetics, Local ; Anoxia ; Dyspnea ; Heart Arrest ; Heart Septal Defects, Atrial ; Humans ; Hypertension, Pulmonary ; Hypovolemia ; Injections, Epidural ; Lung ; Lung Neoplasms ; Male ; Mediastinum ; Pneumonectomy ; Valsalva Maneuver ; Vascular Resistance