Intracranial tumor with extracranial metastasis has been seldom reported. A 28 year-old-male was admitted to Presbyterian Hospital in Daegu on May 9, 1977. Who was diagnosed to have a medulloblastoma in the right cerebellar hemisphere with metastases to the right axillary lymphnode and head of pancreas by pathological reports. In generally medulloblastoma with extracranial metastasis occurs very rarely in the cerebellar hemisphere, and especially in adulthood. Distant metastasis of the intracranial tumor is discussed with review of the literatures.
Daegu ; Head ; Medulloblastoma* ; Neoplasm Metastasis ; Pancreas ; Protestantism

A clinical observation was done in 72 patients with renal cell carcinoma admitted to Department of Urology, St. Mary's Hospital, Catholic University Medical College from Jan. 1980 to Jun. 1988 retrospectively. There were 52 men and 20 women, giving a ratio of 2.6 to 1, with the highest incidence in the sixth to seventh decades (66%). The most common symptom and sign were hematuria, flank pain and palpable mass in orders, but classic symptom triad of renal cell carcinoma was present in only 11% of the patients. Symptoms secondary to metastasis were only initial presentations in more than half of the patients with stage IV disease, initially 11% (12 pts.) of all the patients with renal cell carcinoma. CT scan showed a high diagnostic accuracy (78%) as compared to pathologic examination. So recently angiography is not done routinely. In one patient, tumor was not detected by CT scan, but by ultrasonography and angiography. Liver scan is not indicated unless there are 2 or more abnormal values among liver function test including alkaline phosphatase, GOT and GPT. Bone metastasis is not correlated with the elevation of alkaline phosphatase and bone scan is indicated only when bone pain and/or gait disturbance are present. Radical nephrectomy is the choice of treatment and adjunctive therapy including. irradiation, chemotherapy, hormone therapy and immunotherapy were not effective. The majority of distant metastasis (86%) occurred within the first 2 years following nephrectomy and metastatic sites were lung, lymph nodes, liver and bone in orders. Of the 72 patients, it was possible for 36 patients to follow up more than 3 years. Patients with stage 1 disease showed 90%. (9/10) 3 year survival and there were no significant differences in 3 year survival between stage II (50%) and stage III (44%) disease. No patients with stage IV disease survived more than 3 years.
Alkaline Phosphatase ; Angiography ; Carcinoma, Renal Cell* ; Drug Therapy ; Female ; Flank Pain ; Follow-Up Studies ; Gait ; Hematuria ; Humans ; Immunotherapy ; Incidence ; Liver ; Liver Function Tests ; Lung ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography ; Urology

urothelial tumors of the upper urinary tract are relatively uncommon, mostly malignant. 25 patients with urothelial tumor of upper urinary tract seen at St. Mary`s hospital from Jan. 1975 to Dec. 1986 are reviewed retrospectively. The average age was 57.3 years, approximately half of them being more than 60 years old. Gross Hematuria was the most prevalent sign and cytologic examination of the urine has proved not to be diagnostic. The most common findings of excretory urography and retrograde urography were non- visualization of the kidney and filling defect. CT can help to evaluate the extent of disease by determining the invasion or metastasis to surrounding tissues or retroperitoneal node. All 25 patients were surgically explored, 23 patients underwent nephroureterectomy and 6 of them was also done lymphadenectomy, distal ureterectomy with ureteral reimplantation was done in 1 patient and simple nephrectomy was done under the misdiagnosis of renal tuberculosis in 1 patient. There were close relations between histological grade and pathologic grade. Of the 25 patients, stage A and grade II were the most common, each of them were 11 and 16 cases. The over-all 2 year survival rate of 13 patients followed up was seventy percent.
Diagnostic Errors ; Hematuria ; Humans ; Kidney ; Lymph Node Excision ; Middle Aged ; Neoplasm Metastasis ; Nephrectomy ; Prognosis ; Replantation ; Retrospective Studies ; Survival Rate ; Tuberculosis, Renal ; Ureter ; Urinary Tract* ; Urography

No abstract available.
Osteotomy*

No abstract available.
Calcinosis* ; Humans ; Infant, Newborn*

No abstract available.
Acromioclavicular Joint* ; Classification* ; Dislocations*

OBJECTIVES: At present, the overall incidence of lung cancer is increasing, causing the age-adjusted lung cancer death rate to double every 15 years. Surgical resection of the tumor offers the best prospect of long-term survival in patients with lung cancer. Accurate prediction of postoperative ventilatory function should be helpful in determining in which patients the risk of surgery are acceptable. Exercise pulmonary function test has been widely applied to objective measure of work capacity, and can be extremely helpful for investigating exertional dyspnea. But no attempt is made to assess the contribution of the lung to be resected to performance, and it has been advocated as an additional predictor of postoperative complications. The present investigation was designed to evaluate the factors such as FEV1, FVC, VEmax, Vo2max, anaerobic threshold, heart rate reserve, breathing reserve and the corelation between FEV1 and VO2max at 4 weeks and 6months after resection in patients with lung cancer. METHODS: The eighteen of patients with lung cancer who considered surgically resectable underwent progre ssively incremental exercise test to symptom-limited stage before opera-tion, and also have done at surgical resection after 4 weeks, and 6 momths. Measurements were made of metabolic, cardiorespiratory, blood gases and symptoms during exercise test. RESULTS: 1) There were significant decreases in FEV1, FVC, VO2max, VE max in 4 weeks after operation and were more decreased in FEV1, FVC, VE max with significance, but fall in VO2max without significance in 6 month after operation. 2) There was a significant corre lation between the decrease of FEV1 and that of VO2max in 6 month after operation . Conclusions This result suggests that change of FEV1 is a relatively useful predictor of change in exercise performance after lung resection in 6 month after operation.
Anaerobic Threshold ; Dyspnea ; Exercise Test ; Follow-Up Studies* ; Gases ; Heart Rate ; Humans ; Incidence ; Lung Neoplasms ; Lung* ; Mortality ; Postoperative Complications ; Respiration ; Respiratory Function Tests*

We report a case of premature constriction of the fetal ductus arteriosus following maternal ingestion of a cyclooxygenase-2 (COX-2) inhibitor at 37 weeks' gestation. Fetal sonography at 38+2 weeks' gestation revealed tricuspid regurgitation, absent transpulmonary valve flow, right heart enlargement, and pericardial effusion. An immediate delivery resulted in a good postnatal outcome with dramatic improvement in the clinical and echocardiographic findings. Maternal exposure to Non-steroidal anti-inflammatory drugs (NSAIDs), especially late in gestation, can cause premature constriction of the ductus arteriosus, heart failure, and fetal death. Therefore, the use of NSAIDs late in gestation should be considered in limited cases with close fetal heart monitoring.
Anti-Inflammatory Agents, Non-Steroidal ; Cardiomegaly ; Constriction ; Cyclooxygenase 2 ; Ductus Arteriosus ; Eating ; Female ; Fetal Death ; Fetal Heart ; Heart ; Heart Failure ; Maternal Exposure ; Pericardial Effusion ; Pregnancy ; Sulfonamides ; Tricuspid Valve Insufficiency

PURPOSE: Premature narrowing of the foramen ovale is rare but serious clinical entity. Prenatal narrowing or obstruction of the foramen ovale shows symptoms such as right heart failure, fetal hydrops, triscupid regurgitation, left heart obstructive disease, and supraventricular tachycardia. This study aimed to assess the prenatal diagnosis and postnatal clinical course of restrictive foramen ovale in utero in otherwise normal heart. METHODS: The subjects were five patients diagnosed with restrictive foramen ovale in utero from January 2001 to June 2005 at Chungnam National University Hospital. The diagnostic criteria was defined when the maximum diameter in a 4-chamber view is less than 2.5 mm and there is a continuous doppler velocity at the foramen ovale of more than 0.6m/s. RESULTS: At the time of diagnosis of restrictive foramen ovale, gestation age was 34~37 wks, and chief complaints were fetal arrhythmia(2 cases), pericardial effusion, Ebstein anomaly and subaortic stenosis. Two cases which were diagnosed fetal hydrops and supraventricular tachycardia delivered by emergent cesarian section. Five cases were found to have right heart dilatation on echocardiogram after birth, but right heart dilatation became normalized at day 7 after birth and the clinical courses were not eventful. CONCLUSION: Identifying an obstructed foramen ovale in the fetus warrants the further search for additional cardiac and extracardiac anomalies, which may alter the prognosis. Delivery should be induced if possible in cases of foramen ovale obstruction with signs of cardiac decompensation.
Chungcheongnam-do ; Constriction, Pathologic ; Diagnosis ; Dilatation ; Ebstein Anomaly ; Fetal Heart ; Fetus ; Foramen Ovale* ; Heart Failure ; Heart* ; Humans ; Hydrops Fetalis ; Parturition ; Pericardial Effusion ; Pregnancy ; Prenatal Diagnosis* ; Prognosis ; Tachycardia, Supraventricular ; Ultrasonography, Prenatal

PURPOSE: To evaluate the MR findings of extra-abdominal fibromatosis and the role of MRI in primary diagnosis MATERIALS AND METHODS: Fifteen cases in of histologically proven extra-abdominal fibromatosis in 13 patients were retrospectively reviewed. T1-weighted and T2-weighted images were obtained in axial, coronal and sagittal planes. Gd-enhancement was performed in 14 cases, and dynamic enhancement studies in two. All lesions were evaluated for mass shape and margin definition. RESULTS: Among the 15 cases, tumors of the buttock accounted for five, and tumor of the thigh for two. In eight cases tumors were intermuscular and in six cases were intramuscular. In ten cases (67 %) the mass extended along the long axis of the body and in 14 of 15 cases (93%) focal infiltration of adjacent structures was visible. The signal intensity of the lesion was in all cases inhomogeneous on both T1 and T2 weighted images. As seen on Gd-DTPA enhanced scans, the masses were inhomogeneously enhanced. In all cases MRI revealed star-shaped linear strands or a band-like low signal area in the mass. These features were not enhanced and were arranged along the long axis of the mass. CONCLUSION: MR findings of extra-abdominal fibromatosis were relatively characteristic and helpful for primary diagnosis of the condition.
Axis, Cervical Vertebra ; Buttocks ; Diagnosis ; Fibroma* ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Thigh