Primary malignant neoplasms of the heart are very rare disorders, which are found at less 1/1000 necropsies. These malignancies are almost exclusively sarcomas and histologically assume a wide veriety of morphological subtypes, angiosarcomas, rhabdomysarcomas, and fibrosarcomas(or MFH) being the most frequent. We experienced a case in which left atrial myxoma was suspected by 2-D echocardigraphy and the histologic diagnosis of promary MFH was confirmed by operation. A 45-year old woman with primary MFH arising from posterior wall of left atrium, interatrial septum and mitral annulus is presented with a brief view of the literatures. The patient was admitted to our hospital on March 1988, because of exertional dyspnea and intermittent palpitation resction of the masses. To date, more than thirteen months after surgery, the patient is alive and well in state of NYHA class II.
Diagnosis ; Dyspnea ; Female ; Heart ; Heart Atria* ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Myxoma ; Sarcoma

Endothelial cells were isolated from the aortic intima of Sprague-Dawley species, rat. These cells and each cancer cell line (HeLa, Hep G2, A549, L929 and NIH/3T3 cells) were co-cultivated in alpha-MEM with 3 micrometer or 30 micrometer nocodazole. To investigate the influences induced by nocodazole, the morphological changes were observed under inverted microscope and transmission electron microscope, the amounts of fibronectin produced by vascular endothelial cells and cancer cell lines and the activities of nitric oxide synthetase synthesized mainly by endothelial cells were analyzed in the aspects associated with fine structural changes. The vascular endothelial cells of control group at the 1st, 2nd and 3rd days extended the cell processes, which contacted with cells from all cell lines investigated, but the endothelial cells of nocodazole-treated groups didn't possess the processes. All cell lines in nocodazole-treated groups had a large number of micronucleated cells, but endothelial cells didn't show micronuclei. Compared with control group, the endothelial cells of nocodazole-treated groups at the 1st, 2nd and 3rd days showed the decrease of amounts of fibronectin because of the increase of heterochromatin area. The amounts of fibronectin increased in all cell lines of nocodazole-treated groups at the 2nd and 3rd days whereas the nuclear folding or the dilatation/numerical increase of rough endoplasmic reticulum didn't appear. The activities of nitric oxide synthetase heightened in endothelial cells of nocodazole-treated groups, and therefore the considerable changes in fine structures such as vesicles, lysosomes, liposomes, pyknosis and cell lysis occurred even though the extent of changes differed among the cell lines. Taken together, the materials such as fibronectin or nitric oxide synthetase produced by endothelial cells directly or indirectly acted on cancer cells, and the amounts of fibronectin and the vesicles, lysosomes, liposomes and cell lysis seemed to be much more increased or enforced. Therefore, co-culture system seemed to work better for the investigation of actions of nocodazole and the role of endothelial cells in cancer cells research. Also, the co-culture system was closer to the in vivo state and more favorable in studies for proliferation or metastasis of cancer cells.
Animals ; Cell Line* ; Coculture Techniques ; Endoplasmic Reticulum, Rough ; Endothelial Cells* ; Fibronectins ; Heterochromatin ; Liposomes ; Lysosomes ; Neoplasm Metastasis ; Nitric Oxide Synthase ; Nocodazole* ; Rats ; Rats, Sprague-Dawley

BACKGROUND: Vascular lesions can be diagnosed by biopsy, simple x-ray, ultrasound, CT, MRI, venography and MR angiography. These diagnostic tools can identify the detailed structure and abnormalities in the peri-lesional area of vascular lesions. Color Doppler ultrasound (CDU) can demonstrate the hemodynamic features, distribution of veins and arteries, shunts and structures of vascular lesions. Authors have tried to categorize vascular lesions with CDU and also applied this to the selection of treatment methods. MATERIALS AND METHODS: Forty-seven vascular lesions were evaluated by means of CDU. All patients underwent a complete clinical evaluation as well as peak systolic velocity (PSV), peak diastolic velocity (PDV), resistive index (RI) of feeding arteries. In particular, we evaluated the hemodynamic features and structures of vascular lesions. We categorized the vascular lesions and then treated them with systemic steroid, compression, SPTL1 Dye laser, steroid intralesional injection and sclerotherapy. We evaluated the clinical improvement and objective effects of treatments by CDU. RESULTS: There were 37 hemangiomas and 10 vascular malformations. Vascular lesions were classified by the hemodynamic features and structures: category Ia (infantile hemangioma, regressed infantile hemangioma), Ib (RICH), Ic (deep hemangioma, mixed hemangioma), II (arteriovenous malformation), III (venous malformation, verrucous hemangioma). The clinical improvement after treatment was associated with the decrease of PSV and RI values. The clinical improvement above 50% resolution of the lesion showed 70.9% in category Ia, 50% in Ib, 66.6% in Ic, 83.3% in II and 50% in III. CONCLUSIONS: The analysis of hemodynamic feature and structures by CDU can be helpful in the study of vascular lesions. These processes suggest CDU be a useful modality in differential diagnosis of vascular lesions and a more advantageous tool in the decision of treatment policy than the conventional modalities. And it is also useful for the evaluation of treatment effects.
Angiography ; Arteries ; Biopsy ; Diagnosis, Differential ; Hemangioma ; Hemodynamics ; Humans ; Injections, Intralesional ; Lasers, Dye ; Magnetic Resonance Imaging ; Phlebography ; Sclerotherapy ; Ultrasonography* ; Vascular Malformations ; Veins

Canalicular occlusion with silicone plug was carried out in 11 patient, 21 eyes with dry eye syndrome and the effect and safety of the procedure were evaulated. Artificial tears were discontinued or frequency of instillation was reduced in 66.6% of eyes after occlusion of canaliculi. There were no stastiscally significant differences in the mean value of B.U.T. and Schirmer test pre-and post-canalicular occlusion. There were no cases of postoperative epophora, allergic reaction and infection.
Dry Eye Syndromes ; Humans ; Hypersensitivity ; Ophthalmic Solutions ; Silicones

We experienced a complication of brachial plexus palsy secondary to operative position during thoracoscopic thoracic sympathectomies. His general health was excellent and no previous histories vulnerable to peripheral nerve systems were observed. The thoracic sympathectomies were done under general anesthesia. The patient was placed left lateral position with his right arm abduced 150o on padded arm board. An operation was lasted 2 hours and 30 minutes at this position because of severe right apical lung adhesion. The controlateral side was performed same procedure and lasted 20 minutes. After the patient recovered from the anesthesia, the patient had a complete paralysis of right arm. There was also slightly diminished sensation to pinprick on the arm and hand. Neurologic examination and EMG study revealed brachial plexus palsy. Nerve blocks and physiotherapy were performed to treat brachial plexus injuries. His motor functions were improved day by day and he was discharged with a complete range of motion against gravity on 14th. postoperation day. However, there were loss of muscle powers against some resistances and tingling sensations of fingertips. Two months later, he was recovered completely and there was no residual disabilities.
Anesthesia ; Anesthesia, General ; Arm ; Brachial Plexus* ; Gravitation ; Hand ; Humans ; Lung ; Nerve Block ; Neurologic Examination ; Paralysis* ; Peripheral Nerves ; Range of Motion, Articular ; Sensation ; Sympathectomy*

PURPOSE: Neuroendocrine differentiation and expression of drug resistance may affect the response to chemotherapy and the prognosis of advanced non-small cell lung cancer. We conducted retrospective study to evaluate the possibilities of neuroendocrine differentiation and drug resistance markers being used as prognostic factors in patients with non-small cell lung cancer. MATERIAL AND METHOD: Immunohistochemical staining of NSE, PgP and GST-pai with polyclonal antibodies in pathologic specimens of 47 patients with non-small cell lung cancer were done. The relationship between the expression of the markers and the response to cisplatin-based chemotherapy and the overall survival were assessed. RESULTS: NSE staining was positive in 17% and there was no difference between adenocarcinoma and squamous cell carcinoma. NSE positive patients showed increased response rate (63% vs 26%, p=0.049) and prolonged response duration (15.8mo vs 4.5mo, p=0.0007). But there was no difference in overall survival between NSE positive and negative groups. The PgP positive rate was 17% and GST-pai positive rate was 47%. No correlations were found among the expression of drug resistance, the sensitivity to chemotherapy and overall survival. CONCLUSION: Patients with non-small cell lung cancer with positive NSE showed increased response rate to chemotherapy and prolonged response duration but overall survival was not related to NSE expression. Expression of PgP and GST- were not important in predicting the prognosis in non-small cell lung cancer.
Adenocarcinoma ; Antibodies ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Drug Resistance ; Drug Therapy ; Drug Therapy, Combination* ; Glutathione Transferase* ; Glutathione* ; Humans ; Neurons* ; P-Glycoprotein* ; Phosphopyruvate Hydratase* ; Prognosis ; Retrospective Studies

When recovery of specific reflexes after acute spinal cord injury are delayed or absent, we should consider an acute local complication or other factors that influence reflex function. We observed three spinal cord injury cases with a long-standing delayed plantar reflex and no evolution of Babinski sign despite enough recovery time had passed for the flexor spasm and all deep tendon reflexes of the lower extremities. In these cases we confirmed common peroneal nerve neuropathy at the fibular head by the nerve conduction study and electromyography. Long-standing delayed plantar reflex without evolution of Babinski sign, beyond expected recovery period, would be considered as a sign of local complication such as common peroneal nerve injury.
Electromyography ; Head ; Lower Extremity ; Neural Conduction ; Peroneal Nerve ; Reflex* ; Reflex, Babinski ; Reflex, Stretch ; Spasm ; Spinal Cord Injuries* ; Spinal Cord*

No abstract available.
Acromegaly* ; Osteoarthropathy, Primary Hypertrophic*

OBJECTIVE: To investigate the current status and the basic information of cumulative traumatic disorder among workers. METHOD: The subjects were 198 workers, consisted of 100 shipspublisher workers, 155 telephone operators and 43 light workers. Workers were surveyed with a standardized self- administered questionnaire and examed by the occupational medicine doctors and physiatrists for the cumulative traumatic disorders. Laboratory tests, nerve conduction studies and X-rays of the C-spine and shoulders were performed in all subjects. RESULT AND CONCLUSION: Myofascial pain syndrome was the most frequent problem in the shipspublisher and telephone operators. As a result of the multiple logistic regression analysis, cycle time, palm pinch, lumbar and neck flexion were the significant variables accounting for the musculoskeletal symptoms.
Logistic Models ; Myofascial Pain Syndromes ; Neck ; Neural Conduction ; Occupational Medicine ; Prevalence* ; Surveys and Questionnaires ; Shoulder ; Telephone

PURPOSE: To evaluate the enhancement patterns of nodular and massive hepatocellular carcinoma (HCC), with or without portal vein thrombosis, on three-phase spiral CT. MATERIALS AND METHODS: Contrast enhancement patterns in 61 patients with HCC were retrospectively analysed. Three-phase spiral CT images of the hepatic arterial dominant phase, portal dominant phase, and delayed phase were obtained 30, 60-70, and 360 seconds after the injection of contrast material was initiated. Tumors were divided into grossly nodular and massive type and enhancement patterns of HCC, with and without portal vein thrombosis, were compared. These patterns were divided into three groups, as follows: High/High/Low; High/Low/Low; Low/Low/Low. HCC with portal vein thrombosis was found in 21 of 61 cases ; this carcinoma without portal vein thrombosis was found in 40 cases. The nodular type accounted for 39 cases, and the massive type for 22. RESULTS: In 21 cases of HCC with portal vein thrombosis, the most common enhancement pattern was L/L/L, and was seen in 13 cases (62%); H/L/L was seen in eight (38%), but H/H/L was not seen. In 40 cases of HCC without portal vein thrombosis, the most common enhancement pattern was H/L/L, seen in 25 cases (63%) ; this was followed by L/L/L (11 cases ; 27%), and H/H/L (4 cases ; 10%). In the arterial dominant phase, among cases of HCC with portal vein thrombosis, low attenuation was more common (13/21) than high (8/21);among cases of HCC without portal vein thrombosis, high attenuation was more common (29/40) than low (11/40). Among 39 nodular-type cases, HCC with portal vein thrombosis was found in six (H/H/L and L/L/L: three each), and HCCwithout portal vein thrombosis was seen in 33 (H/L/L: 22; L/L/L: 7; H/H/L; 4). Among 22 cases of the massive type, HCC with portal vein thrombosis accounted for 15 (L/L/L: 10, H/L/L: 5), and seven cases without portal vein thrombosis were seen (L/L/L: 4 ; H/L/L : 3). CONCLUSION: On Three-phase spiral CT, HCC showed different enhancing patterns according tumor type and the presence of portal vein thrombosis.
Carcinoma, Hepatocellular* ; Humans ; Retrospective Studies ; Tomography, Spiral Computed* ; Venous Thrombosis