Primary malignant neoplasms of the heart are very rare disorders, which are found at less 1/1000 necropsies. These malignancies are almost exclusively sarcomas and histologically assume a wide veriety of morphological subtypes, angiosarcomas, rhabdomysarcomas, and fibrosarcomas(or MFH) being the most frequent. We experienced a case in which left atrial myxoma was suspected by 2-D echocardigraphy and the histologic diagnosis of promary MFH was confirmed by operation. A 45-year old woman with primary MFH arising from posterior wall of left atrium, interatrial septum and mitral annulus is presented with a brief view of the literatures. The patient was admitted to our hospital on March 1988, because of exertional dyspnea and intermittent palpitation resction of the masses. To date, more than thirteen months after surgery, the patient is alive and well in state of NYHA class II.
Diagnosis ; Dyspnea ; Female ; Heart ; Heart Atria* ; Hemangiosarcoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Middle Aged ; Myxoma ; Sarcoma

Perforated appendicitis with an abscess formation is known to be the most common cause of tender mass in right lower abdomen. The differential diagnosis of a tender mass in right lower abdomen, however, is broad and includesvarious intraabdominal and intrapelvic lesions in origin. Preoperative accurate diagnosis is essential in order toavoid unnecessary surgery or complications resulting from delayed surgery. The purpose of this pictorial essay isto illustrate examples of various causes and methods to differentiate them with ultrasonography and CT.
Abdomen* ; Abscess ; Appendicitis ; Diagnosis ; Diagnosis, Differential ; Ultrasonography ; Unnecessary Procedures

PURPOSE: To evaluate the value of helical CT in patients with endoscopically and pathologically proven early gastric cancer. MATERIALS AND METHODS: Helical CT scans(5-mm section thickness, 5-mm/sec table speed) were obtained in 45 patients with pathologically proven early gastric cancer. CT findings were retrospectively reviewed by two independent radiologists without surgical or pathologic information. Detection rate, depth of invasion, and lymph node staging were evaluated. RESULTS: The overall detection rate was 52% ; there was no significant difference in the rates between observer A(55%) and B(49%). The detection rate was higher in the anterior bodywall(100%) and antrum(63%) than in the posterior body wall(42%) and antrum(53%). The detection rate of the depressed type(63%) was higher than that of the elevated type(38%). Submucosal stripe was seen in 45% of mucosallesions and in 32% of submucosal lesions, though the stripe was not a reliable indicator for depth of invasion.Lymph node metastasis was detected in only one of eight patients. None was found to have distant metastasis. CONCLUSION: Helical CT is of little help in the evaluation of endoscopically evident early gastric cancer and the routine use of helical CT is not recommended in early gastric cancer.
Humans ; Neoplasm Metastasis ; Retrospective Studies ; Stomach Neoplasms* ; Tomography, Spiral Computed*

BACKGROUND: The incidence of candidemia in paediatric patients has increased over the last decade. We analysed the clinical characteristics of pediatric patients with candidemia over a 3-year period in Chonnam National University Hospital. METHODS: The medical records of 28 patients with candidemia diagnosed between 1996 and 1998 were retrospectively reviewed. Clinical characteristics including underlying illness, risk factors, therapy and outcome were assessed in relation to causing Candida species. RESULTS: The causing agents were mainly non-C. albicans species (24/28 cases, 81.5%). Underlying illnesses of patients were malignancy (n=12), surgical diseases (n=4), prematurity (n=2), and other medical illnesses of (n=10). Studies on clinical status at positive culture revealed antibiotic exposure (28/28, 100%), placement of central venous catheter (CVC, 16/28, 57.1%), use of total parenteral nutrition (15/28, 53.6%), and chemotherapy (14/28, 50%). Twenty patients were treated with amphotericin B and/or fluconazole and 15 patients'CVCs were removed. Overall mortality due to candidemia was 25%(7/28). CONCLUSIONS: These data show that most of pediatric candidemia cases are caused by non-C. albicans species and associated with a relatively lower mortality rate
Amphotericin B ; Candida ; Candidemia* ; Central Venous Catheters ; Drug Therapy ; Fluconazole ; Humans ; Incidence ; Jeollanam-do ; Medical Records ; Mortality ; Parenteral Nutrition, Total ; Retrospective Studies ; Risk Factors

PURPOSE: The purpose of this study was to identify the effects of an education program on safety perception, safety control, autonomy and accountability in clinical nurses. Precedent cases related to patient safety were used in the education program. METHODS: A quasi-experimental design with pretest and posttest measures was used. Participants in the study, 72 nurses in the experimental group, 71 nurses in the control group, were enrolled for 3 months. The education program was composed of the 20 precedent cases related to patient safety from home and foreign countries. RESULTS: The major findings of this study were as follows: Safety perception (p=.000), Safety control (p=.000), attitude toward autonomy (p=.000), and attitude toward accountability (p=.000) improved after the education program. CONCLUSION: The findings from this study indicate that an education program using precedent cases is an efficient method to improve behavior and change attitudes towards protecting patients' safety and preventing malpractice claims against nurses.
Humans ; Malpractice ; Patient Safety ; Social Responsibility

BACKGROUND: We reviewed the guidelines for the transfusion of red cells, platelets, and fresh frozen plasma (FFP) of the Korean Society of Blood Transfusion and modified the previous guidelines for transfusions at our hospital. We evaluated the appropriateness of the current hospital transfusions with these algorithms based on these guidelines. METHODS: The medical records of 266 transfusion episodes of patients receiving transfusions of red cells (144), platelets (61), and FFP (61), were reviewed retrospectively at Ewha Womans University Mokdong Hospital during 2002. RESULTS: Inappropriateness rates for transfusion episodes were 2.8% for red cells, 4.9% for platelets, and 44.3% for FFP. 144 red cell transfusions comprised 73 episodes (50.7%) in acute blood loss and 71 (49.3%) in chronic anemia. Among them, 2 episodes in each condition were assessed as inappropriate, respectively. 61 platelet transfusions comprised 32 episodes (52.5%) for a prophylaxis in marrow failure and 13 (21.3%) for active bleeding and 6 (9.8%) for acute disseminated intravascular coagulation (DIC) and 10 (16.4%) for others. Among them, 3 episodes for clinical bleeding were assessed as inappropriate. Out of 61 FFP transfusions, 34 episodes (56%) (16 liver disease with complications, 11 acute DIC, and 7 others) were assessed as appropriate and 27 episodes (44%) (8 liver diseases without complications, 10 surgical procedures and 9 others) were assessed as inappropriate. CONCLUSIONS: We modified our previous guidelines for transfusions according to the transfusion guidelines proposed by the Korean Society of Blood Transfusions. These guidelines could be easily applied to evaluate the appropriateness of transfusions performed at our hospital and to specify the cases of inappropriate transfusions.
Anemia ; Blood Transfusion ; Bone Marrow ; Dacarbazine ; Disseminated Intravascular Coagulation ; Female ; Hemorrhage ; Humans ; Liver Diseases ; Medical Records ; Plasma* ; Platelet Transfusion ; Retrospective Studies

BACKGROUND: Biomarkers for cancer have several potential clinical uses, including the following: early cancer detection, monitoring for recurrence prognostication, and risk stratification. However, no biomarker has been shown to have adequate sensitivity and specificity. Many investigators have tried to validate biomarkers for the early detection and recurrence of lung cancer. To evaluate plasma G-CSF as such a biomarker, protein levels were measured and were found to correlate with the clinicopathological features of primary lung tumors. METHODS: Between December 2006 and May 2008, 100 patients with histologically-validated primary lung cancer were enrolled into this study. To serve as controls, 127 healthy volunteers were enrolled into this study. Plasma G-CSF levels were measured in lung cancer patients using the sandwich ELISA system (R & D inc.) prior to treatment. RESULTS: The mean plasma G-CSF levels were 12.2+/-0.3 pg/mL and 46.0+/-3.8 pg/mL (mean+/-SE) in the normal and in the cancer groups, respectively. In addition, plasma G-CSF levels were higher in patients with early lung cancer than in healthy volunteers (p<.001). Plasma G-CSF levels were higher in patients who were under 65 years old or smokers. Within the cancer group, plasma G-CSF levels were higher in patients with non small cell lung cancer than in patients with small cell lung cancer (p<.05). Overall, plasma G-CSF levels were shown to increase dependent upon the type of lung cancer diagnsosed. In the order from highest to lowest, the levels of plasma G-CSF tended to decrease in the following order: large cell carcinoma, squamous cell carcinoma, adenocarcinoma, and bronchioloalveolar carcinoma. Plasma G-CSF levels tended to be higher in patients with advanced TNM stage than in localized TNM stage (I, II Adenocarcinoma ; Adenocarcinoma, Bronchiolo-Alveolar ; Adrenal Glands ; Biomarkers ; Carcinoma, Large Cell ; Carcinoma, Squamous Cell ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor ; Humans ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Plasma ; Recurrence ; Research Personnel ; Small Cell Lung Carcinoma

BACKGROUND: Most lung cancer patients receive systemic chemotherapy at an advanced stage disease. Cisplatin-based chemotherapy is the main regimen for treating advanced lung cancer. Recently, autophagy has become an important mechanism of cellular adaptation under starvation or cell oxidative stress. The purpose of this study was to determine whether or not autophagy can occurred in cisplatin-treated lung cancer cells. METHODS: H460 cells were incubated with RPMI 1640 and treated in 5 micrometer or 20 micrometer cisplatin concentrations at specific time intervals. Cells surviving cisplatin treatment were measured and compared using an MTT cell viability assay to cells that underwent apoptosis with autophagy by nuclear staining, apoptotic or autophagic related proteins, and autophagic vacuoles. The development of acidic vascular organelles was using acridine orange staining and fluorescent expression of GFP-LC3 protein in its transfected cells was observed to evaluate autophagy. RESULTS: Lung cancer cells treated with 5 micrometer cisplatin-treated were less sensitive to cell death than 20 micrometer cisplatin-treated cells in a time-dependent manner. Nuclear fragmentation at 5 micrometer was not detected, even though it was discovered at 20 micrometer. Poly (ADP-ribose) polymerase cleavages were not detected in 5 micrometer within 24 hours. Massive vacuolization in the cytoplasm of 5 micrometer treated cells were observed. Acridine orange stain-positive cells was increased according in time-dependence manner. The autophagosome-incorporated LC3 II protein expression was increased in 5 micrometer treated cells, but was not detected in 20 micrometer treated cells. The expression of GFP-LC3 were increased in 5 micrometer treated cells in a time-dependent manner. CONCLUSION: The induction of autophagy occurred in 5 micrometer dose of cisplatin-treated lung cancer cells.
Acridine Orange ; Apoptosis ; Autophagy ; Cell Death ; Cell Survival ; Cisplatin ; Cytoplasm ; Humans ; Lung ; Lung Neoplasms ; Organelles ; Oxidative Stress ; Proteins ; Starvation ; Vacuoles

BACKGROUND: Most lung cancer patients receive systemic chemotherapy at an advanced stage disease. Cisplatin-based chemotherapy is the main regimen for treating advanced lung cancer. Recently, autophagy has become an important mechanism of cellular adaptation under starvation or cell oxidative stress. The purpose of this study was to determine whether or not autophagy can occurred in cisplatin-treated lung cancer cells. METHODS: H460 cells were incubated with RPMI 1640 and treated in 5 micrometer or 20 micrometer cisplatin concentrations at specific time intervals. Cells surviving cisplatin treatment were measured and compared using an MTT cell viability assay to cells that underwent apoptosis with autophagy by nuclear staining, apoptotic or autophagic related proteins, and autophagic vacuoles. The development of acidic vascular organelles was using acridine orange staining and fluorescent expression of GFP-LC3 protein in its transfected cells was observed to evaluate autophagy. RESULTS: Lung cancer cells treated with 5 micrometer cisplatin-treated were less sensitive to cell death than 20 micrometer cisplatin-treated cells in a time-dependent manner. Nuclear fragmentation at 5 micrometer was not detected, even though it was discovered at 20 micrometer. Poly (ADP-ribose) polymerase cleavages were not detected in 5 micrometer within 24 hours. Massive vacuolization in the cytoplasm of 5 micrometer treated cells were observed. Acridine orange stain-positive cells was increased according in time-dependence manner. The autophagosome-incorporated LC3 II protein expression was increased in 5 micrometer treated cells, but was not detected in 20 micrometer treated cells. The expression of GFP-LC3 were increased in 5 micrometer treated cells in a time-dependent manner. CONCLUSION: The induction of autophagy occurred in 5 micrometer dose of cisplatin-treated lung cancer cells.
Acridine Orange ; Apoptosis ; Autophagy ; Cell Death ; Cell Survival ; Cisplatin ; Cytoplasm ; Humans ; Lung ; Lung Neoplasms ; Organelles ; Oxidative Stress ; Proteins ; Starvation ; Vacuoles

BACKGROUND: Autophagy is an important adaptive mechanism in normal development and in response to changing environmental stimuli in cancer. Previous papers have reported that different types of cancer underwent autophagy to obtain amino acids as energy source of dying cells in nutrient-deprived conditions. However, whether or not autophagy in the process of lung cancer causes death or survival is controversial. Therefore in this study, we investigated whether nutrient deprivation induces autophagy in human H460 lung cancer cells. METHODS: H460, lung cancer cells were incubated in RPMI 1640 medium, and the starved media, which are BME and RPMI media without serum, including 2-deoxyl-D-glucose according to time dependence. To evaluate the viability and find out the mechanism of cell death under nutrient-deprived conditions, the MTT assay and flow cytometry were done and analyzed the apoptotic and autophagic related proteins. It is also measured the development of acidic vascular organelles by acridine orange. RESULTS: The nutrient-deprived cancer cell is relatively sensitive to cell death rather than normal nutrition. Massive cytoplasmic vacuolization was seen under nutrient-deprived conditions. Autophagic vacuoles were visible at approximately 12 h and as time ran out, vacuoles became larger and denser with the increasing number of vacuoles. In addition, the proportion of acridine orange stain-positive cells increased according to time dependence. Localization of GFP-LC3 in cytoplasm and expression of LC-3II and Beclin 1 were increased according to time dependence on nutrient-deprived cells. CONCLUSION: Nutrient deprivation induces cell death through autophagy in H460 lung cancer cells.
Acridine Orange ; Amino Acids ; Autophagy ; Cell Death ; Cytoplasm ; Flow Cytometry ; Humans ; Lung Neoplasms ; Malnutrition ; Organelles ; Proteins ; Vacuoles