A 32-yr-old male patient with recurrent pneumothorax associated with bronchial atresia of the subsegmental branch of the posterior segmental bronchus of the right upper lobe was successfully treated with right upper lobectomy. Before surgery, the bronchial atresia with pneumothorax was suspected on the chest radiograph and CT scans, which showed the findings of bronchocele with localized hyperinflation of the right upper lobe. The examination of surgical specimen from the resected right upper lobe suggests that the cause of the recurrent pneumothorax was the rupture of the subpleural bullae in the hyperinflated lung segment distal to the atretic bronchus.
Adult ; Bronchi/*abnormalities/pathology ; Bronchial Diseases/*diagnosis ; Human ; Male ; Pneumothorax/*diagnosis ; Respiratory System Abnormalities/*pathology ; Tomography, X-Ray Computed

BACKGROUND: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. MATERIAL AND METHOD: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4:1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. RESULT: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346+/-597 mL in dilutedplegia (mean+/-standard deviation, and 28+/-9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21+/-4% in dilutedplegia and 24+/-3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250+/-810 mL, 1689+/-548 mL) than in microplegia (959+/-410 mL, 1481+/-784 mL; p<0.05). CONCLUSION: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.
Blood Transfusion ; Body Temperature ; Cardiopulmonary Bypass ; Constriction ; Coronary Circulation ; Erythrocytes ; Heart Arrest, Induced* ; Hematocrit ; Hemofiltration ; Hospital Mortality ; Humans ; Myocardial Infarction ; Oxygen ; Oxygenators ; Potassium* ; Stroke Volume ; Transplants

PURPOSE: To investigate the correlation between pulmonary vascular dilatation on high-resolution computed tomography (HRCT) and expression of endothelial nitric oxide synthase (eNOS) after common bile duct ligation (CBDL) in the rabbit as a model of hepatopulmonary syndrome. MATERIALS AND METHODS: CBDL was done in 11 rabbits (2 weeks after CBDL, n = 5; 3 weeks after CBDL, n = 6). Four rabbits were done by abdominal incision with peritoneal suture only as a control group. HRCT scans were performed in the both groups. We evaluated peripheral pulmonary vascular dilatation in the upper and lower lobe. Tissue samples were immediately obtained from both upper and lower lobes of the lung and the liver after sacrifice. Dilatation of peripheral pulmonary vessel was correlated with the expression of endothelial nitric oxide synthase (eNOS) determined by Western blot. We also compared the degree of pulmonary vascular dilatation between the groups with administration of L-arginine (n = 5) and without administration of L-arginine (n = 6) after CBDL. RESULTS: Two weeks after CBDL, pulmonary vascular dilatation on HRCT was seen in three rabbits (60%) and the increase of eNOS expression was shown in two rabbits (40%) in the lower lobe. Three weeks after CBDL, pulmonary vascular dilatation on HRCT was seen in four rabbits (66.7%) and five rabbits (83.3%) each upper and lower lobe, respectively. Expression of eNOS was coincidently increased. The pulmonary vascular dilatation was noted more frequently in the lower lobe than in the upper lobe. Pulmonary vascular dilatation on HRCT was highly correlated with increase of expression of eNOS in the upper (r = 1.00, p = .0001) and lower lobe (r = .83, p = .0015). In contrast, control group of four rabbits developed neither pulmonary vascular dilatation on HRCT nor increase of eNOS expression. The grade of pulmonary vascular dilatation in the group with L-arginine administration was higher than that without administration of L-arginine (p < .05). CONCLUSION: Pulmonary vascular dilatation on HRCT is significantly correlated with increase of eNOS expression in a rabbit lung after CBDL. These results suggest that NO, derived from pulmonary eNOS, contributes to pulmonary vascular dilatation in a rabbit model of hepatopulmonary syndrome. Index words : Lung, CT Lung, effect of drugs on Lung, vascular disease
Arginine ; Blotting, Western ; Common Bile Duct ; Dilatation* ; Hepatopulmonary Syndrome* ; Ligation ; Liver ; Lung ; Nitric Oxide Synthase Type III ; Rabbits ; Sutures ; Vascular Diseases

PURPOSE: At present, a human epidermal growth factor receptor 2 (HER2)-based concept of tumor biology has been established, and trastuzumab (Herceptin(R); Genentech/Roche, San Francisco, CA, USA), a monoclonal humanized antibody directed against HER2, is a pivotal agent for the management of HER2 positive (HER2+) metastatic breast cancer. It is also known that HER2 has a predictive value in gastric cancer; however, its association with the prognosis of this disease remains uncertain. The purpose of this study was to evaluate both the relationship between HER2 overexpression in the tumors of gastric cancer patients, and the prognosis of these patients who have had curative resection. MATERIALS AND METHODS: A total of 139 consecutive patients with gastric cancer who underwent surgery at the Kosin University Gospel Hospital between October 2011 and March 2012 were included in this retrospective study. All tumor samples were examined for HER2 expression by immunohistochemistry. A retrospective review of the medical records was conducted to determine the correlation between the presence of HER2 overexpression and clinicopathological factors. RESULTS: The HER2+ rate was 15.1%. HER2 overexpression was associated with histological grade (P=0.044) and Lauren classification (P=0.036). There was no significant difference in the 2-year overall survival between HER2+ and HER2- patients (P=0.396). Multivariate analysis showed that HER2 was not an independent prognostic factor. CONCLUSIONS: HER2 overexpression in tumors was associated with histological grade and Lauren classification in gastric cancer patients with curative resection. However, HER2 was not an independent prognostic factor for gastric cancer in our study.
Biology ; Breast Neoplasms ; Classification ; Humans ; Immunohistochemistry ; Medical Records ; Multivariate Analysis ; Prognosis ; Receptor, Epidermal Growth Factor ; Retrospective Studies ; Stomach Neoplasms* ; Trastuzumab

The synchronous primary lung cancer is very rare cancer, proportion of synchronous lung cancer is about 1~2% of total lung cancer, When pathologic type is same, preoperative diagnosis is very difficult and it may be misdiagnosed as lung to lung metastasis. We have experienced synchronous primary lung cancer of heterogenous squamous cell carcinoma.
Carcinoma, Squamous Cell* ; Diagnosis ; Lung Neoplasms* ; Lung* ; Neoplasm Metastasis

BACKGROUND AND OBJECTIVES: The local delivery of drugs to the arterial wall represents a strategy for the treatment of fibroproliferative vascular disease. Paclitaxel has been shown to inhibit vascular smooth muscle cell proliferation and migration, which contribute to neointimal formation. This study tested whether the perivascular delivery of paclitaxel can prevent neointimal formation in a rat carotid artery injury model. MATERIALS AND METHODS: The ability of locally-administered paclitaxel to prevent the neointimal hyperplastic response was tested by incorporating 10 microgram paclitaxel into 40% F-127 pluronic gel, which was then applied to the adventitial surface of the rat carotid artery immediately following balloon injury. Fourteen days after angioplasty, the neointimal growth was compared between paclitaxel- (n=12) and pluronic gel only treated (control group, n=11) rats. RESULTS: The paclitaxel-treated group showed significant neointimal formation reductions compared to the control group (0.10+/-0.05 versus 0.21+/-0.05 mm2, p<0.05). The perivascular application of paclitaxel produced a highly localized pattern of neointimal growth inhibition in the arterial cross-section. Although 10 microgram paclitaxel showed no significant cytotoxicity, 20 microgram paclitaxel (n=3) demonstrated cytotoxicity, with medial cell drop out in the region of application. CONCLUSION: We have demonstrated that the local extravascular application of 40% F-127 pluronic gel containing paclitaxel provides an effective mechanism for inhibiting the proliferative response to vascular injury in the rat. The cellular response to paclitaxel is highly focal. Locally sustained delivery of paclitaxel, as little as 10 microgram, was effective in preventing neointimal growth, without destroying medial wall smooth muscle cells.
Angioplasty ; Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Cell Proliferation ; Hyperplasia* ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Paclitaxel* ; Rats* ; Vascular Diseases ; Vascular System Injuries

BACKGROUND AND OBJECTIVES: The roles of angiotensin II (Ang II) in the regulation of heart function under normal and pathological conditions have been well documented, with its biological actions mainly mediated via the Ang II type 1A receptor (AT(1A)R). Since the inhibition of the renin-angiotensin system can prevent or regress left ventricular hypertrophy (LVH) with hypertension, AT(1A)R-mediated signaling is considered one of the important transcriptional pathways in the development of cardiac hypertrophy. SUBJECTS AND METHODS: To address whether AT(1A)R-mediated signaling plays an important role in the development of pressure overload-induced LVH and fibrosis, the physiological, biochemical, hemodynamic and histopathological parameters were evaluated before and after transverse aortic constriction (TAC) in wild-type (WT) and AT(1A)R knockout (KO) mice. RESULTS: Although the LV systolic pressure (83.2+/-10.0 mmHg, n=5) of the KO mice was lower than that (90.0+/-5.0 mmHg, n=7) of the WT mice, there was no difference in the increase in the LV systolic pressure between the WT and KO mice (WT, 42.0 mmHg; KO, 41.8 mmHg). Also, there was no difference between the baseline LV-to-body weight (LVW/BW) ratio between the two groups (WT, 3.10+/-0.21 mg/g; KO 3.04+/-0.21 mg/g). Two weeks after TAC, the degree of increase in the LVW/BW ratio was markedly increased in both the WT (4.17+/-0.28 mg/g, n=9) and KO mice (4.16+/-0.43 mg/g, n=8), which were almost identical (WT, 34.5%; KO, 36.8%). There were no significant differences in the LV end-diastolic pressure, LV+dP/dt(max), and heart rate between the two groups. The ERK44/42 and p38-MAPK activities in the LV were markedly increased by TAC in both groups, but that of JNK was not. Interstitial and perivascular fibrosis developed in both groups following TAC. However, the degree of increased fibrosis was significantly attenuated in the KO mice. CONCLUSION: These results suggest AT(1A)R-mediated signaling is not indispensable for the development of pressure overload-induced LVH, and provides new insights into the development of novel therapeutic strategies for cardiac hypertrophy.
Angiotensin II* ; Angiotensins* ; Animals ; Blood Pressure ; Cardiomegaly ; Constriction ; Fibrosis* ; Heart ; Heart Rate ; Hemodynamics ; Hypertension ; Hypertrophy, Left Ventricular* ; Mice ; Renin-Angiotensin System

Adenoid cystic carcinoma is a very slowly growing and directly invasive cancer. The treatment of choice is complete surgical resection but if major complications associated with remaining carcinoma occur, aggressive conservative treatment to prevent complication is able to gain long term survival even though remaining carcinoma metastases to other organs. We experienced a case of surgical treatment of uncontrollable fever that caused by multiple lung abscesses due to obstruction of left main bronchus with adenoid cystic carcinoma. The post operative course was uneventful for 4 months to now.
Adenoids* ; Bronchi ; Carcinoma, Adenoid Cystic* ; Fever ; Lung Abscess* ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis

Adenoid cystic carcinoma is a very slowly growing and directly invasive cancer. The treatment of choice is complete surgical resection but if major complications associated with remaining carcinoma occur, aggressive conservative treatment to prevent complication is able to gain long term survival even though remaining carcinoma metastases to other organs. We experienced a case of surgical treatment of uncontrollable fever that caused by multiple lung abscesses due to obstruction of left main bronchus with adenoid cystic carcinoma. The post operative course was uneventful for 4 months to now.
Adenoids* ; Bronchi ; Carcinoma, Adenoid Cystic* ; Fever ; Lung Abscess* ; Lung Neoplasms ; Lung* ; Neoplasm Metastasis

OBJECTIVE: The aim of this study was to evaluate the temperament and character profiles of the patients with posttraumatic stress disorder(PTSD) after burn injury. METHODS: The study subjects consisted of 23 PTSD patients after burn injury, 24 patients not being diagnosed as PTSD after burn injury(non-PTSD) and 53 healthy controls. The assessment of PTSD was performed using clinician administered PTSD scale. All participants were instructed to complete the Temperament and Character Inventory(TCI), the Beck Depression Inventory and the State and Trait Anxiety Inventory of Spielberger. RESULTS: The PTSD group after burn injury, compared with the non-PTSD group and the normal controls, had the higher novelty seeking and harm avoidance scores. But there were no differences in other dimensions in the TCI among the three groups. CONCLUSION: The results of this study suggest that the PTSD group after burn injury showed the specific properties of temperament and character compared with the non-PTSD group and the normal group.
Anxiety ; Burns* ; Depression ; Humans ; Stress Disorders, Post-Traumatic* ; Temperament*