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.
Aortic Coarctation*

The clinical triad of relapsing iritis, ulcers of the mouth and genitalia was first described in 1939 by Hulusi Behcet. This entity, originally confined to the above triad of symptoms appears to be systemic disease manifested by skin lesion, thrombophlebitis, neurologic, cardiovascular or visceral symptoms. The vascular involvement in Behcet's syndrome has been reported since Mischima first described a case in 1961, four types of vascular lesion are freuqnetly observed most commonly on the inferior or superior vena cava. Treatments consist of anticoagulation and administering oral steroids. We report a case of SVC obstruction in 36 years old female patient with Behcet's syndrome.
Adult ; Behcet Syndrome* ; Female ; Genitalia ; Humans ; Iritis ; Mouth ; Skin ; Steroids ; Thrombophlebitis ; Ulcer ; Vena Cava, Superior

Williams syndrome(Williams-Beuren Syndrome, Williams elfin facies syndrome) is a rare syndrome and this is the first case in Korea. We experienced a case of Williams syndrome who was a 11 year old male child. He showed a characteristic facial appearance of this syndrome. A systolic thrill was palpable over the upper sternal borders and in the suprasternal notch. A Grade 3 (on the basis of 6) ejection systolic murmur was heard maximally over the right and left upper sternal borders and radiated over the entire precordium and into the neck. No manifestations of congestive cardiac failure were present. Pectus excavatum and inguinal hernia were observed. he also had mental retardation (IQ=66). Diagnosis was established by angiocardiography, and also aided by EKG and phonocardiography. A brief review of the literatures was done.
Angiocardiography ; Aortic Stenosis, Supravalvular* ; Child ; Diagnosis ; Electrocardiography ; Estrogens, Conjugated (USP) ; Facies ; Funnel Chest ; Heart Failure ; Hernia, Inguinal ; Humans ; Intellectual Disability ; Korea ; Male ; Neck ; Phonocardiography ; Systolic Murmurs ; Williams Syndrome

Clinical problem occuring in the early post operative period after cardiopulmonary bypass may ne related to the altered function of capillary bed which was affected by activation of complement system. This is so called post perfusion syndrome. We selected 20 patients with confirmed congenital heart disease by cariac catheterization. We studied the changes in the C3 , immunolglobulins, total protein, and WBC count while performing open heart surgery. The results were as followed. 1. C3 level was lowest during cardiopulmonary bypass and returned to the normal level after 8 days. 2. Each immunoglobulin level decreased just after cardiopulmonary bypass, especially the IgG level, and immunoglobulins slowly returned to the normal range after 8 days. 3. Serum total protein level and electrophoretic fractions were comperatively reduced as much as immunoglobulin levels. 4. WBC count was lower just before cardiopulmonary bypass than baseline.
Capillaries ; Cardiopulmonary Bypass* ; Catheterization ; Catheters ; Complement System Proteins* ; Heart Defects, Congenital ; Humans ; Immunoglobulin G ; Immunoglobulins ; Oxygenators ; Perfusion ; Reference Values ; Thoracic Surgery

The extension of HCC with tumor thrombus through the hepatic veins into the right atrium can cause sudden death due to heart failure and pulmonary embolism, even though the primary tumor may be relatively localized. We report a case of hepatic resection and tumor thrombectomy of hepatocellular carcinoma with tumor thrombus extending into right atrium using cardiopulmonary bypass and total hepatic vascular exclusion. A 65-year-old man, with a diagnosis of left liver mass, visited Yeungnam University Hospital. The patient had no noticeable edema in the lower extremities, but had dyspnea on exertion. Laboratory studies revealed a platelet count of 162 K/uL, total bilirubin of 1 mg/dL, albumin of 4.1 g/dL and a prothrombin time of 14.7 second. In addition, the retention of indocyanine green at 15 min was 13.5 %. The patient was anti-HCV was positive and his levels of alpha-fetoprotein and PIVKA-2 were 6.45 ng/mL and 582 mIU/mL, respectively. An abdominal CT scan, hepatic angiogram and echocardiogram showed a 4 cm sized HCC in the left lobe and a 4 to 5 cm sized tumor thrombus extending into the right atrium through the left and middle hepatic veins. No distant metastasis was detected in other studies. Total operative time, total duration of cardiopulmonary bypass and cardioplegic time were 13 hours, and 55 and 24 minutes, respectively. The total hepatic vascular exclusion time was 18 minutes. Unfortunately, the patients died 2 months later due to ARDS without being discharged from hospital.
Aged ; alpha-Fetoproteins ; Bilirubin ; Carcinoma, Hepatocellular* ; Cardiopulmonary Bypass* ; Death, Sudden ; Diagnosis ; Dyspnea ; Edema ; Heart Atria* ; Heart Failure ; Hepatic Veins ; Humans ; Indocyanine Green ; Liver ; Lower Extremity ; Neoplasm Metastasis ; Operative Time ; Platelet Count ; Prothrombin Time ; Pulmonary Embolism ; Thrombectomy* ; Thrombosis* ; Tomography, X-Ray Computed

Achalasia is a rare motor disorder of the esophageal smooth muscle in which the lower esophageal sphincter dose not relax properly with swallowing, and the normal peristalsis of the esophageal body is replaced by abnormal contractions. Achalasia has been described as party of several distinct multisystem syndromes suggesting a generalized neuromuscular disorder as the mode of origin. An 11-year-old female was admitted because of paresthesia on the trunk and both legs for 5 days. She had suffered from chest discomfort, dysphagia, postprandial vomiting, and weight loss for 6 months. She was diagnosed as having achalasia by means of the esophagography and esophageal manometry. Her chest discomfort, dysphagia and vomiting much improved after the endoscopic balloon dilatation. The authors present an 11-year-old female with achalasia complained of paresthesia and sucessfully managed by the balloon dilatation.
Child ; Deglutition ; Deglutition Disorders ; Dilatation ; Esophageal Achalasia* ; Esophageal Sphincter, Lower ; Female ; Humans ; Leg ; Manometry ; Muscle, Smooth ; Neurologic Manifestations* ; Paresthesia ; Peristalsis ; Thorax ; Vomiting ; Weight Loss

Carcinoid tumors of ampulla of Vater are rare and slow growing neoplasms that are composed of variable numbers of cells that contain endocrine secretory granules in their cytoplasm, which can be identified by immunohistochemistry, and electron microscopy. Symptoms of Carcinoid tumors of ampulla of Vater are jaundice, hemorrhage, abdominal discomfort, duodenal obstruction or carcinoid syndrome. The incidence of Carcinoid tumors of ampulla of Vater is 1% of all gastrointestinal carcinoid tumors in Western countries. We report a case of no recurrence for 53 months after pylorus preserving pancreaticoduodenectomy for carcinoid tumor of ampulla of Vater
Ampulla of Vater* ; Carcinoid Tumor* ; Cytoplasm ; Duodenal Obstruction ; Hemorrhage ; Immunohistochemistry ; Incidence ; Jaundice ; Microscopy, Electron ; Pancreaticoduodenectomy ; Pylorus ; Recurrence ; Secretory Vesicles

Twelve patients with ventricular septal defect with pulmonary hypertension underwent lung biopsy to assess pulmonary obstructive vascular disease at the time of open heart surgery. According to the Heath and Edwards classification in grading of Pulmonary obstructive vasculr disease, there are eleven cases in grade 1 and one case in grade 3. Thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic resistance ratio. In tolazoline test performed in 4 cases, one patients who had pulmonary obstructive vascular disease, had no change of pulmonary vascular resistance to systemic vascular resistance after intravenous injection of tolazoline during cardiac catheterization, but Rp/Rs of three cases was decreased significantly.
Arterial Pressure ; Arteries ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Classification ; Heart Septal Defects, Ventricular* ; Humans ; Hypertension, Pulmonary* ; Injections, Intravenous ; Lung ; Pulmonary Artery* ; Thoracic Surgery ; Tolazoline ; Vascular Diseases ; Vascular Resistance

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*