We present two cases of cerebral paragonimiasis in a 23-year-old Korean army soldier and in a 18-year-old Korean girl, respectively. The diagnosis was made on the basis of clinical, laboratory and x-ray findings, and was confirmed by the histopathological examination of the excised cyst. P.W. skin test showed positive reaction, whereas C.S. test negative. X-ray study on skull revealed multiple globulated round cystic formations in occipital region. Two months after surgical removal of cysts, visual field were not improved. Pertinent literatures are reviewed.
Adolescent ; Adult ; Blindness* ; Choroid* ; Coloboma* ; Diagnosis ; Female ; Hemianopsia* ; Heredity ; Humans ; Iris* ; Membranes ; Military Personnel ; Optic Nerve* ; Paragonimiasis* ; Skin Tests ; Skull ; Visual Fields ; Young Adult

The pulmonary sarcomatoid carcinoma is a rare malignant tumor, which is composed of an admixture of carcinomatous and sarcomatous components, and accounts for 0.3% of all pulmonary neoplasms. Clinicopathological features are often related to anatomical location: central endobronchial type and peripheral parenchymal type. Noninvasive diagnostic test had a low yield in detection sarcomatoid carcinoma. Metastasis to the regional lymph nodes and to distant organ is common. The prognosis is poor and the median survival is about 15 months. We report two cases of pulmonary sarcomatoid carcinoma with review of literatures.
Diagnostic Tests, Routine ; Lung Neoplasms ; Lung* ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Sarcoma

A case of iridocyclitis due to cysticercus cyst in the anterior chamber and exophthalmos due to in the orbit. A case of iridocycleitis due to cysticercus cyst in the anterior chamber of the left eye, bilateral exophthalmos due to in the orbit and generalized multiple cysticercus cyst in the subcutaneous tissue, brain and the internal organs is reported in a twenty one year old Korean male. To watch characteristic heaving and undulatory movements of the live cysticercus cyst in the anterior chamber of the eye is fascinating. Iridocyclitis was improved fairly after subconjunctival injection of hydrocortisone acetate 5mg and with general treatment for iridocyclitis. Regarding to literature, ocular cysticercosis is known as a very rare case in Korea. A brief review of the related literatures is presented.
Anterior Chamber ; Brain ; Cysticercosis ; Cysticercus* ; Exophthalmos ; Humans ; Hydrocortisone ; Iridocyclitis ; Korea ; Male ; Orbit ; Subcutaneous Tissue

Double outlet right ventricle, a complex of congenital cardiac anomalies in which both great arteries arise wholly or in large part from the morphologic right ventricle presents diverse clinical manifestations according to the morphological characteristics. Eighty cases with DORV were diagnosed and operated at Yonsei Cardiovascular Center from 1988 to 1992. The analysis of the morphological characteristics of this anomaly and comparative study of operative methods and mortality according to the morphological classification led to the following results: 1) The location of VSD varied to be subaortic in 40 cases, subpulmonic in 15, doubly committed in 6 and noncommitted in 19 cases. The great arteries were interrelated in D-malposition in 43 cases and L-malposition in 18 and 26 cases among above mentioned 61 cases revealed the side-by-side relationship. Ten of the cases showed normal position and the rest 9, A-malposition. 2) Pulmonary stenosis was found in 60 cases, and when associated with subpulmonic VSD, occurring less frequently. PDA and ASD secundum were associated in successional order and only 3 cases were verified to carry aortic arch anomalies such as coarctation and interruption, all with subpulmonic VSD. 3) Intraventricular tunnel repair was possible in every case associated with subaortic VSD and the postoperative prognosis was excellent. In comparison, most of the cases associated with other types of VSD in which only palliative surgery or various types of intraventricular repair were performed, the general outcome was poor. But total cavopulmonary connection, one of the physiological corrective methods, showing a better postoperative prognosis is being carefully considered for its broad adoptation in future. In conclusion, double outlet right ventricle, a pathophysiological complex of various anomalies, should be thoroughly evaluated for the morphological characteristics to decide the most appropriate types of operation and for consequent improvement of prognosis.
Aorta, Thoracic ; Arteries ; Classification ; Double Outlet Right Ventricle* ; Heart Ventricles ; Mortality ; Palliative Care ; Prognosis ; Pulmonary Valve Stenosis

BACKGROUND: Mitral valve replacement(MVR) with chordal preservation in patients with mitral vlavular disease has been proven to be beneficial for left ventricular function and for reduction of postoperative complication. MATERIAL AND METHOD: From January 1995 to July 1996, the early postoperative results of mitral valve replacement were compared between 20 patients who underwent chordae resection(classic MVR group) and 10 patients who underwent chordae preservation(preservation MVR group) in the Department of Thoracic and Cardiovascular Surgery, Chunbuk National University Hospital. RESULT: There was no significant difference between the two groups in age, sex, NYHA functional class, cardiothoracic ratio, echocardiographic finding, cardiopulmonary bypass time and aortic cross clamping time. The difference between preoperative and postoperative cardiothoracic ratio after 3 months was not statistically significant. At echocardiographic left ventricular evaluation, ejection fraction and fractional shortening decreased slightly in the preservation group then preoperative value (p=0.47, p=0.12), however, decreased significantly in the classic MVR group(p=0.03, p=0.04), and were statistically significant between the two groups(p=0.03, p=0.02). CONCLUSION: We conclude that MVR with chorda preservation seems to have a beneficial effect on postoperative left ventricular performance in mitral valve disease than the classic MVR.
Cardiopulmonary Bypass ; Constriction ; Echocardiography ; Humans ; Mitral Valve* ; Postoperative Complications ; Ventricular Function, Left

BACKGROUND: A pleural effusion is not a disease entity but a clincial sign of systemic or pleural disease. Although the diagnosis of pleural effusion can often be done by toracentesis and pleural needle biopsy the yeild of positive diagnosis is low.
Biopsy, Needle ; Diagnosis ; Pleural Diseases ; Pleural Effusion* ; Thoracoscopy*

BACKGROUND: The CarboMedics prosthetic heart valve was produced in an attempt to improve the existing valve designs and was especially concerned with easily the implantation and further reduction of turbulence. Precise positioning of the valve in situ was achieved by the abilityof the valve to rotate relative to the sewing ring. Improved monitoring is possible due to increased radiopacity and the dacron sewing ring is coated with carbon to reduce pannus overgrowth. The leaflets have an opening angle of 78 degrees that apparently allows a rapid synchronous closure The aim of this study was to analyze the clinical performance of the CarboMedics valve prostheses(45 mitral 13 aortic and 7 double aortic-mitral valve replacement) were implanted in 65 patients(mean age 48.75+/-9.74 years) RESULT: The operative mortality was 3.1%(2/65) causes of death were low cardiac output syndrome. Total follow up was 1831 patient-months and mean follow up was 29.06+/-10.97 months/patient. No structural failure hemorrhage valve thrombosis and late death have been observed. Embolism occurred at a rate of 0.65%/Patient-year. Actuarial survival and thrombombolism free rate at 36 months were 96.9% and 98.4% respectively. CONCLUSIONS: The CarboMedics valve stands for low valve related complicatons.
Carbon ; Cardiac Output, Low ; Cause of Death ; Embolism ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves* ; Heart* ; Hemorrhage ; Mortality ; Polyethylene Terephthalates ; Thrombosis

No abstract available.
Angina Pectoris* ; Electrocardiography* ; Pheochromocytoma*

PURPOSE: In this research, a definition of overcrowding in emergency department (ED) was proposed, and the actual state of overcrowding in ED was measured by surveys and extensive statistical analysis of data using objective variables. METHODS: The emergency physicians (EP) of 10 arbitrarily selected hospitals were questioned about the definition and cause of overcrowding in ED. The hospitals were divided into two groups (high-feeling and low-feeling) in accordance with the survey results. Admission/discharge records of the patients including arrival/departure date and time, were also collected for the duration of 4 weeks with consideration of seasonal variations, from March 2002 to March 2003. Four parameters, the bed ratio (BR), the provider ratio (PR), the acuity ratio (AR), and the demand value (DV), which were used for the evaluation of overcrowding, were calculated for each hospital. A statistical analysis was carried out to see whether any difference existed in the BR, the PR, the AR and the DV between weekends and weekdays. Also, a similar statistical method was used to analyze the differences between the high-feeling group and the low feeling group. RESULTS: In the survey, 83 physicians were asked to answer the questions. The most preferred answers (>70%) for the definition of overcrowding were "saturation of the beds in the ED for more than 6 hours a day."For the cause of overcrowding, the popular answers were "delay in the consultation and the disposition decision" (74.7%), "use of the ED by non-urgent patients"(74.7%), and "lack of inhospital beds"(65.1%). Among the 10 hospitals, 5 hospitals were categorized the high-feeling group, and the rest fell into the low-feeling group. The average BR and AR were higher in high-feeling group than those of low-feeling group (p<0.01, p<0.01). However, average PR of low-feeling group was higher than that of high-feeling group (p<0.01). Average DV did not exhibit any difference between the two groups (p=0.31). CONCLUSION: The definition of overcrowding in the ED should include not only the lack of beds in the ED but also patient's acuity and the lack of providers. Certain aspects of overcrowding are clearly different between the high-feeling and the low-feeling groups.
Crowding ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Humans ; Seasons ; Tertiary Care Centers*

Central venous catheterization through subclavian vein has been used for central venous pressure monitoring, hyperalimentation, and fluid therapy. Its complications are air embolism, infection, vascular injury, pneumothorax, hemothorax and thrombosis that is the most serious complication. At the department of Thoracic and Cardiovascular surgery Chonbuk University Hospital, authors experienced superior vena cava syndrome due to thrombosis of the superior vena cava, internal jugular (left), subclavian(left), and innominate vein. Patients was a 21 years old female who had central venous catheterization through subclavian vein for hyperalimentation and fluid therapy because of enterocutaneous fistula. Thrombectomy on superior vena cava was performed, and pre and postoperative anticoagulation therapy was given. Symptoms were relieved after operation. From the venography, performed 6 weeks after the operation, restenosis was seen at the thrombectomy site of the superior vena cava. S anticoagulant and conservative treatment were done that symptoms relieved by the development of collateral venous channel.
Brachiocephalic Veins ; Catheterization, Central Venous ; Central Venous Catheters* ; Central Venous Pressure ; Embolism, Air ; Female ; Fluid Therapy ; Hemothorax ; Humans ; Intestinal Fistula ; Jeollabuk-do ; Phlebography ; Pneumothorax ; Subclavian Vein ; Superior Vena Cava Syndrome ; Thrombectomy ; Thrombosis ; Vascular System Injuries ; Vena Cava, Superior* ; Young Adult