BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

A 44-year-old woman underwent surgery for an asymptomatic primary tumor of the heart located in the right atrium. The tumor was detected incidentally during follow-up computed tomography for a resected breast cancer. The mass, lying along the lower portion of the right atrial septum, was homogenous and cystic in nature, as detected by transthoracic and transesophageal echocardiography. Complete resection was performed via a median sternotomy under cardiopulmonary bypass. The postoperative course was uneventful. However, the histological result was surprising: the mass was a cardiac lymphangioma.
Adult ; Breast Neoplasms/complications/pathology ; Cysts/etiology/pathology ; Echocardiography, Transesophageal ; Female ; Heart Atria ; Heart Neoplasms/complications/*diagnosis/surgery ; Humans ; Lymphangioma/complications/*diagnosis/surgery ; Myocardium/*pathology ; Tomography, X-Ray Computed

A pseudocyst, one of the most prominent and definitive signs of pancreatitis, can also be cause by pancreatic carcinoma. However, a pancreas carcinoma and pancreatitis are sometimes indistinguishable. Reports of a pancreatic carcinoma coexisting with pancreatitis and a pseudocyst are rare. We have experienced a case of a pancreatic carcinoma, which was misdiagnosed as chronic pancreatitis with a pseudocyst. A 31-year-old man complaining of an epigastric pain visited our hospital. Ultrasonography (US) and computed tomography (CT) revealed two cystic lesions, about 8 and 2 cm in diameter, splenic vein thrombosis and diffuse inflammatory changes in the pancreatic body and tail. The value of the tumor marker, CA19-9, was 132 U/ml. Chronic pancreatitis with pseudocyst was suspected, and a cystogastostomy and splenectomy performed. A histological examination revealed a pancreatic pseudocyst. The patient was readmitted 7 months later due to abdominal pain. The serum CA19-9 level was 544 U/ml. The CT revealed severe diffuse inflammatory changes in the pancreatic body and tail. Percutaneous CT- guided fine-needle aspiration revealed a pancreatic adenocarcinoma. The differentiation between the pseudocyst of pancreatitis and the secondary cyst caused by a pancreatic carcinoma is important but is difficult or impossible in some cases. The CT features of pseudocysts secondary to a pancreatic carcinoma are identical to those of pseudocysts in pancreatitis. Even in retrospect, our case was difficult to differentiate from pancreatitis with pseudocysts. Our results indicate that whenever pancreatic cysts are encountered in patients with unusual presentation, further examinations, including percutaneous aspiration biopsies, should be performed to exclude malignancy.
Abdominal Pain ; Adenocarcinoma ; Adult ; Biopsy, Fine-Needle ; Biopsy, Needle ; Humans ; Pancreas ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pancreatitis ; Pancreatitis, Chronic* ; Splenectomy ; Splenic Vein ; Thrombosis ; Ultrasonography

BACKGROUND: The purpose of this study is to analyze the types of complications, the incidences of complications, and preoperative and postoperative risk factors affecting the incidence of the complication. MATERIAL AND METHOD: Between August 1990 and August 1997 in Asan Medical Center, 42 patients(24 men and 18 women) underwent surgical resection for pulmonary aspergilloma. The mean age was 46.6+/-11.5 years(range 29 to 69 years). Hemoptysis(90%) was the most common presentation. Pulmonary tuberculosis was the most common predisposing cause(81%). The associated diseases were bronchiectasis(n=11), active puolmonary tuberculosis(n=9), diabetes mellitus(n=8), lung carcinoid(n=1), and acute myeloblastic leukemia(n=1). Lobectomy was done in 32 cases(76%), segmentectomy or wedge resection in 4, pneumonectomy in 2, and lobectomy combined with segmentectomy in 4. RESULT: Operative mortality was 2%. The most common postoperative complication was persistent air leakage(n=6). The variables such as age, sex, pulmonary function test, amount and duration of hemoptysis, associated diseases(diabetes mellitus, active pulmonary tuberculosis), mode of preoperative management(steroid, antifungal agent, bronchial arterial embolization), and modes of operative procedures were statistically insignificant. The radiologic extent of infiltration to normal lung parenchyme was statistically significant(p=0.04). CONCLUSION: We conclude that the extent of the infiltration to normal lung parenchyme in preoperative radiologic studies should be carefully evaluated to reduce the postoperative complications in surgery for pulmonary aspergilloma.
Chungcheongnam-do ; Granulocyte Precursor Cells ; Hemoptysis ; Humans ; Incidence ; Lung ; Male ; Mastectomy, Segmental ; Mortality ; Pneumonectomy ; Postoperative Complications ; Respiratory Function Tests ; Risk Factors* ; Surgical Procedures, Operative ; Tuberculosis, Pulmonary