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: 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

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*

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

BACKGROUND: The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral vlave disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). MATERIAL AND METHOD: From March 1991 to March 2001, 38 patients underwent mitral vlave repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6+/-14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. RESULT: According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type I, 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1,3,51,69,84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. CONCLUSION: In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.
Cause of Death ; Classification ; Constriction, Pathologic ; Female ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis

OBJECTIVE: Staphylococcus aureus has persisted and is now resurging as an important hospital and community pathogen. Nosocomial infection caused by methicillin-resistant S.aureus(MRSA) is a major problem which may be connected with heavy or prolonged use of antibiotics S.aureus bacteremia caused acute complications, which occasionally resulted in death, and infectious/suppurative complications, which necessitated prolonged antibiotic therapy, sometimes in conjunction with surgery. Therefore, S.aureus bacteremia is a serious medical problem in association with high morbidity and mortality. METHODS: 130 patients with S.aureus bacteremia who were admitted in the Kyung Hee University Hospital from January, 1991 to December, 1994 were analyzed retrospectively. We compared the clinical and laboratory characteristics, and antibiotics resistances between MRSA and MSSA bacteremia and also we evaluated risk factors that contribute to fatal outcome in patients with S.aureus bacteremia. RESULTS: 1) of 130cases, 80 were male and 50 were female. The mean age was 44.5+/-25.1 years. 2) 84(65%) of S.aureus bacteremia were nosocomial and 46(35%) were community-acpuired. The percentage of MRSA stains studied was 55%(71/130) and The percentage of MRSA bacteremia in hospital-acpuired and community-accquired S. aureus bacteremia were 64% (54/84) and 36%(17/46), respectively. Sources of bacteremia were uncertain in 85(65%) with intravascular catheter(20%) and skin wound sites (8%) being the most common sources in remainder(35%) 3) 110(85%) of 130 patients had one or more underlying diseases. Common underlying dieases were cerebrovascular disease(33%), malignancy(17%), Diabetes mellitus(15%), chronic renal failure(8%) and liver cirrhosis(6%). 4) Acute complications occurred in 35 patients and were fatal in 21 5) The risk factors associated with MRSA bacteremia were various severe underlying diseases, vairous invasive procedures, IV catheter-associated infection, hypoalbuminemia, previous use of antibiotics, male sex and old age. 6) The Case fatality rate for patients with S. aureus bacteremia was 18% and those for patients with MRSA and MSSA bactermia were 20% and 12%, respectively. The risk factors that contribute to the increment of mortality rate in patients with S. aureus bacteremia were acute complication, low serum level of total protein, hypoalbuminemia, various invasive procedures and IV catheter-associated infection, 7) In the antibiotic sensitivity test S. aureus was resistant to penicillin in 98.5%, ofloxacin in 73%, cefotaxime in 67%, erythromycin in 58%, aztreonam in 56%, clindamycin in 52%, vancomycin in 0%. 8) In the multiple antibiotic resistance of S. aureus, 43(68%) of MRSA was resistant to more than 10 antibotics, revealing multiply resistant nature of strains, While all but one MSSA was resistant to 1 to 4 antibiotics, one revealing resistance to 8 antibiotics. CONCLUSION: S. aureus bacteremia is a cause of considerable morbidity and mortality in hospitalized patients who especially, exposed to various risk factors. MRSA revealed higher resistance rate to most antibiotics tested and more marked multiply resistant nature than MSSA. But there was no significant difference in case fatality rate between patients with MRSA and MSSA bacteremia.
Anti-Bacterial Agents ; Aztreonam ; Bacteremia* ; Catheter-Related Infections ; Cefotaxime ; Clindamycin ; Coloring Agents ; Cross Infection ; Drug Resistance, Microbial ; Erythromycin ; Fatal Outcome ; Female ; Humans ; Hypoalbuminemia ; Liver ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Ofloxacin ; Penicillins ; Retrospective Studies ; Risk Factors ; Skin ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin ; Wounds and Injuries