Primary tumors of the heart are rare, three quarter of the tumors are benign, and nearly half of the benign heart tumors are myxomas. Cardiac myxoma usually originate in the left atrium about 75 percent, however, only 3 to 4 percent of myxoma are detected in the left ventricle. We report on a 32 years old woman with left ventricular myxoma who presented with shortness of breath, chest tightness, and general weakness. Acute pulmonary embolism and left ventricular myxoma were found on a perfusion lung scan and echocadiogram. A mass located on septal wall of left ventricle was excised en bloc. The patient recovered uneventfully and careful follow up has be performed periodically.
Adult ; Dyspnea ; Female ; Follow-Up Studies ; Heart ; Heart Atria ; Heart Neoplasms ; Heart Ventricles ; Humans ; Lung ; Myxoma* ; Perfusion ; Pulmonary Embolism* ; Thorax

OBJECTIVE: The purpose of this study is to evaluate the efficacy of ferritin-folate-cyanocobalamin supplementation for prevention of anemia during pregnancy. METHODS: The authors conducted a clinical investigation on 50 pregnant women from 20th to 36th gestational weeks. The cobination of cyanocobalamin coenzyme 500mg, folic coenzyme 800mcg, and ferritin 20mg constituted the supplementation. The parameters examined in first trimester as baseline, before treatment(at 20th weeks), and after treatment(at 36th weeks) were : hemoglobin, hematocrit, ferritin, mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration(MCHC), mean corpuscular volume(MCV), red blood cell count(RDW), folic acid, and vit. BPaired sample t-test was used for comparison. RESULTS: The results indicated a significant increase in the value of hemoglobin(p<0.05) and hematocrit(p<0.01) in comparison to before and after the treatment. The values of serum ferritin, folic acid, vitamin Bwere increased after the treatment compared to those of before the treatment, though there was no statistical significance. The results of MCV, MCH, MCHC, and RDW showed no statistically significant in comparison to before and after the treatment. CONCLUSIONS: These data indicate that supplementing ferritin 20mg-folate 800mcg-cyanocobalamine 500mcg per day from 20th to 36th weeks' gestation can increase values of hemoglobin, hematocrit, and ferritin concentration and can be cosidered as an appropriate method to prevent iron deficient anemia. It also might increase the value of folic acid and vitamin B12, concentration, but further study is stiU needed to determine whether the supplementation of folate and cyanocobalamine in combination with iron can have better eflicacy than iron alone in prevention of iron deficiency anemia.
Anemia* ; Anemia, Iron-Deficiency ; Erythrocyte Indices ; Erythrocytes ; Female ; Ferritins* ; Folic Acid* ; Hematocrit ; Humans ; Iron ; Pregnancy Trimester, First ; Pregnancy* ; Pregnant Women ; Vitamin B 12* ; Vitamins

The aim of this study was to evaluate the efficacy of intravenous immunoglobulin treatment for recurrent spontaneous abortion. Immunologic causes in either alloimmune or autoimmune type have been suggested for more than 80% of these patients. Various immunotherapy including paternal leukocyte transfusion has been used, but there is controversy on its efficacy and side-effects. The proposed immunomodulatory mechanism of intravenous immunoglobulin includes passive transfer of blocking or anti-idiotype antibody, blockade of Fc receptors, enhancement of supressor T-cell function, down regulation of B cell function. In this study, we used intravenous immunoglobulin for the prevention of spontaneous abortion. Five patients with a history of two or more spontaneous abortions were enrolled in this study. Other etiologic factors such as anatomical, chromosomal, hormonal factors were excluded. Three of them were positive for anti-cardiolipin antibody (ACA). When the pregnancy was diagnosed at about five weeks of gestation, 30 g intravenous immunoglobulin was administered and continued up to 28 weeks with three weeks. Ongoing pregnancy beyond 20 weeks was considered successful. Four among five patients (80%) was successful in maintaining pregnancy now ongoing 20, 31, 33, 39 weeks. One patient with ACA positive had abartion due to anembryonic pregnancy. No adverse reaction was observed during the treatment. From these preliminary data, it is suggested that intravenous immunoglobulin treatment may be effective in maintaining pregnancy in patients with unexplained recurrent spontaneous abortion, Further studies are needed to clarify the its immunomodulatory mechanism and establish a more simplified protocol limiting the use at certain critical period of time.
Abortion, Spontaneous* ; Critical Period (Psychology) ; Down-Regulation ; Female ; Humans ; Immunoglobulins* ; Immunotherapy ; Leukocyte Transfusion ; Pregnancy ; Receptors, Fc ; T-Lymphocytes

We present a case of meningeal and brain metastasis of multiple myeloma. A 60-year-old woman who had been diagnosed as multiple myeloma two years ago, was referred to neurosurgery department because of headache and nausea. The magnetic resonance image of the brain showed a large epidural mass and the parenchymal enhancement. The patient received an operation of tumor removal and cranioplasty. A histological diagnosis of metastatic multiple myeloma was made.
Brain ; Diagnosis ; Female ; Headache ; Humans ; Immunoglobulin G* ; Middle Aged ; Multiple Myeloma* ; Nausea ; Neoplasm Metastasis ; Neurosurgery ; Plasmacytoma*

PURPOSE: This study examined the effect of a varus positioned femoral stem after cementless proximal fitting total hip arthroplasty. MATERIALS AND METHODS: A total of 144 hips in 136 patients who underwent cementless total hip arthroplasty, were followed-up. Twenty-one varus positioned hips were compared with 123 neutral positioned hips. The clinical results were analyzed according to the level of thigh pain and the Harris Hip score. The radiological outcome was assessed according to osteolysis, loosening and stem failure. RESULTS: In the varus positioned hips, thigh pain was present in 1 hip, and the average Harris Hip Score was 96 points. None of the implants showed radiological evidence of loosening or impending failure. Localized osteolysis was identified in 1 hip, non-progressive radiolucencies in 2 hips, and cortical hypertrophy in 1 hip. In the neutral positioned hips, thigh pain was present in 6 hips, and the average Harris Hip Score was 97 points. Localized osteolysis was identified in 8 hips, non-progressive radiolucencies in 7 hips, cortical hypertrophy in 9 hips. CONCLUSION: Patients with varus alignment of the stem did not present poorer clinical outcomes than those with neutral alignment of the stem.
Arthroplasty, Replacement, Hip* ; Hip ; Humans ; Hypertrophy ; Osteolysis ; Thigh

PURPOSE: To investigate the epidemiologic and clinical features of uveal melanomas in Korean patients. METHODS: The medical records of 35 patients (35 eyes) with the diagnosis of uveal melanoma between September 2004 and December 2006 were reviewed retrospectively. RESULTS: Of the 35 patients, 22 were males (62.9%) and 13 were females (37.1%), with a mean age at diagnosis of 48.2+/-14.1 years (range, 24-82 years). Decreased visual acuity was the most common symptom in 23 patients (65.7%), while 6 patients (17.1%) were detected without prior symptoms. The shape of the uveal melanoma was dome-shaped in 27 eyes (77.1%) and mushroom-shaped in 8 eyes (22.9%). The mean largest basal diameter of the tumors was 9.0+/-3.3 mm (2.4-19.0 mm), and the mean apical height was 6.2+/-2.6 mm (1.1-13.0 mm). The tumors were classified according to their size; a small melanoma was found in 4 eyes (11.4%), a medium melanoma in 29 eyes (82.9%), and a large melanoma in 2 eyes (5.7%). CONCLUSIONS: Uveal melanomas manifest earlier in Korean patients than in Caucasian patients. At the time of diagnosis, 33 eyes (94.3%) had small or medium melanomas that could be treated.
Eye ; Female ; Humans ; Male ; Medical Records ; Melanoma ; Retrospective Studies ; Uveal Neoplasms ; Visual Acuity

Pseudo-inflammatory tumors are also known as plasma cell granuloma, inflammatory pseudo-tumor and inflammatory myofibroblastic tumor, and these tumors are a group of highly variable proliferations of myofibroblastic cells that are associated with a prominent inflammatory infiltrate. This tumor is known to most commonly occur in the lungs, bladder and gastrointestinal system with only a few cases having been reported in the skin. A previously healthy 26-year-old man presented with a 6-year history of an intermittently pruritic lesion on his back. On the histologic examination, there were spindle cells in fascicles and a mixed inflammatory cellular infiltrate of plasma cells and lymphocytes. A diagnosis of inflammatory fibroblastic tumor was made and the nodule was surgically removed. We report here on an additional case of this rare cutaneous entity, and it is probably the first such report from Korea.
Adult ; Fibroblasts ; Granuloma, Plasma Cell ; Humans ; Korea ; Lung ; Lymphocytes ; Myofibroblasts ; Plasma Cells ; Skin ; Urinary Bladder

Most of intradural tumors are primary tumors and few of them are metastatic tumors. Especially, spinal intradural metastatic tumors which are derived from renal cell carcinoma are rarer. Even though such tumors occur, it accompany with brain metastasis in many cases. And there was no report regarding isolated intradural metastasis, without metastasizing on brain or other central nervous system organs, in domestic.
Brain ; Carcinoma, Renal Cell ; Central Nervous System ; Neoplasm Metastasis

Transnasal endoscopic dacryocystorhinostomy (eDCR) has been performed with relative ubiquity since the introduction of the rigid nasal endoscope, with multiple reports found in the literature. Multiple techniques have been used for lacrimal osteotomy, including standard rongeurs, laser, radiofrequency and microdrill. The ultrasonic bone aspirator (UBA) has been described for a variety of neurosurgical procedures and was initially studied in orbital and lacrimal surgery by Sivak-Callcott et al. We report a 74-year-old female patient who suffered from epiphora and pus-like discharge of the right eye. The bone of the lacrimal sac fossa was thinned and removed using an ultrasonic bone aspirator. The patient had a significant symptom improvement without any complications related to UBA use. We applied an ultrasonic bone aspirator for a patient with lacrimal duct stenosis and report a successful result.
Aged ; Constriction, Pathologic ; Dacryocystorhinostomy* ; Endoscopes ; Female ; Humans ; Lacrimal Apparatus Diseases ; Neurosurgical Procedures ; Orbit ; Osteotomy ; Ultrasonics*

PURPOSE: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, it could lead to skin irritation and medial pain after the surgery. The purpose of this paper was to report our clinical and radiographic results with transarticular fixation of Akin osteotomy for the treatment of patients with hallux valgus after resection of the medial protrusion of base of the proximal phalanx. MATERIALS AND METHODS: Our study is subject to 34 cases of 30 patients who went through proximal phalanx medial corticectomy among patients undergone both hallux valgus surgery and Akin osteotomy at our institution from March 2006 to March 2012. In all cases, we used absorbable suture material through the articular surface for Akin osteotomy after resection of the medial protrusion in proximal phalanx. Radiographs were reviewed to assess the union and displacement of osteotomy site at the time of postoperative 6 months. The clinical results were assessed by using AOFAS score and complication such as skin irritation and pain. RESULTS: AOFAS score was improved from average 44 points(36-58), before operation and average 87 points(74-96), 12 months after operation. In two cases, partial union was suspected in radiological perspective, however, complete union on the osteotomy site was observed in all cases, 12 months after the operation. No patients was dissatisfied with pain, joint discomfort, skin irritation and inflammation from the knot. CONCLUSION: When medial protrusion in the base of proximal phalanx is severe from removing metatarsal bunion during the hallux valgus surgery, We have good results by transarticular fixation of Akin osteotomy using absorbable suture material.
Arthralgia ; Displacement (Psychology) ; Hallux ; Hallux Valgus ; Humans ; Inflammation ; Metatarsal Bones ; Osteotomy ; Skin ; Sutures