Aneurysms of peripheral pulmonary arteries are uncommon. It may appear as a coinlesion in a plain chest film. In general, a popular and effective method for pathologic diagnosis of solitary lung lesion is needle aspiration biopsy, a technique which is safe in most instances. Also, ultrasonograhic or fluoroscopic methods are needed for the evaluation of this lesion. If pulmonary artery aneurysm is untreated, the prognosis of this disease is poor. Sixty percents of the patients with pulmonary artery aneurysm died following rupture of the aneurysm. Surgical correction is the preferred treatment. We are reporting a case of pulmonary aneurysm with the review of literature.
Aneurysm* ; Biopsy, Needle ; Diagnosis ; Humans ; Lung ; Needles ; Prognosis ; Pulmonary Artery* ; Rupture ; Thorax ; Tuberculosis

There are controversies in operative management of unstable fracture of fracture-dislocation of the spine. Posterior Stabilization is a good method and there are many benefits, such as the safety method, less complication, easiness to acquire more accurate reduction and more rigid fixation than other methods. Among 141 spinal injury patients who were admitted to this hospital from March, 1980 to November, 1985, twenty two cases of spine fracture and fractuar dislocation who were treated with surgical measures were evaluated and analysed. Our surgical measures were posterior wiring and fusion in cervical spine (7 cases), Harrington instrumentation with or without posterior fusion in thoracolumber spine (12 cases), and others (3 cases). Brief summary of the results is as follows: l. Eighty-six percent of angular deformity was corrected after posterior wiring and posterior fusion and 75%, after Harrington instrumentation, 73%, after Harrington instrumentation and posterior fusion. 2. Eighty four percent of displacement was corrected after posterior wiring and posterior fusion and 65%, after Harrington instrumentation, 71%, after Harrington instrumentation and posterior fusion. 3. Improvement of the neurologic status related to interval between injury and operation was 28% within 24 hours, 11% within a week. 4. No significant differences in the recovery of the neurologic signs were found according tothemethod of surgical treatments. 5. Except for the patients who were seriously compromised or required anterior decompression, immediate posterior stabilization is valuable to provide the better reduction, rigid fixation, promotion of recovery of neural function and early ambulation.
Clinical Study ; Congenital Abnormalities ; Decompression ; Dislocations ; Early Ambulation ; Humans ; Methods ; Neurologic Manifestations ; Spinal Injuries ; Spine

Cardio-renal syndrome (CRS) is a frequent and life-threatening syndrome. It is a disorder of the heart and kidneys in which acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in the other organ. Acute kidney injury (AKI) is strongly associated with increased morbidity and mortality in patients with CRS. Early detection of renal dysfunction is not possible using the traditional marker, serum creatinine, and therefore efforts to explore possible biomarkers for early detection of AKI are being made. Apart from predicting AKI, several biomarker studies also identified predictors for poor prognosis such as the need for renal replacement therapy (RRT) or death. It is possible that biomarkers can become risk factors in an improvement of clinical outcomes of CRS. Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in patients with renal dysfunction and the treatment for this disease can be modified based on cardiac biomarkers. In addition to natriuretic peptides, which are established cardiac markers, several new biomarkers have been identified and may play important roles in CRS. In this review, we will briefly summarize the literature on novel renal and cardiac biomarkers and discuss their potential roles in the clinical outcome of CRS.
Acute Kidney Injury ; Cardio-Renal Syndrome ; Cardiovascular Diseases ; Creatinine ; Heart ; Heart Failure ; Humans ; Kidney ; Natriuretic Peptides ; Prognosis ; Renal Replacement Therapy ; Risk Factors ; Biomarkers

We experienced 3 cases of manometry-induced colon perforation. A 75-year-old man (case 1) underwent anorectal manometry (ARM) 3 years after radiotherapy for prostate cancer and a laparoscopic intersphincteric resection for rectal cancer. A 70-year-old man (case 2) underwent ARM 3 months after conventional neoadjuvant chemoradiotherapy and a laparoscopic low anterior resection for rectal cancer. A 78-year-old man (case 3) underwent ARM 2 months after a laparoscopic intersphincteric resection for rectal cancer. In all cases, a colon perforation with fecal peritonitis occurred. All were treated successfully using prompt and active operations and were discharged without any complications. ARM with a balloon, as a measure of rectal compliance, should be performed 2 months or longer after surgery. If a perforation occurs, prompt and active surgical intervention is necessary due to the high possibility of extensive fecal peritonitis.
Aged ; Arm ; Chemoradiotherapy ; Colon ; Compliance ; Humans ; Manometry* ; Peritonitis ; Prostatic Neoplasms ; Radiotherapy ; Rectal Neoplasms

No abstract available.
Echocardiography* ; Mass Screening*

Malignant deciduoid mesothelioma is a rare malignant neoplasm occurring in the peritoneum of young women. We report a case of malignant deciduoid mesothelioma that occurred in the omentum of a 47-year-old woman. The patient had never exposed to asbestos and had no history of cesarean section. The lesions were multiple infiltrative nodules affected the peritoneal cavity, omentum, and surface of the uterus with both ovaries. Microscopically, the nodules were composed of mesothelial cells similar to decidual cells
Asbestos ; Cesarean Section ; Female ; Humans ; Mesothelioma* ; Middle Aged ; Omentum ; Ovary ; Peritoneal Cavity ; Peritoneum ; Pregnancy ; Uterus

Since the first report on infective endocarditis by Rokitansky in 1985, this subject has been extensively dealt with in the world literature. Nowadays by use of echocardiography, there has been a high discovery rate of vegetation, and thus made it a valuable tool in diagnosis, treatment, and the evaluation of the patient. However in Korea, there have been only a few case reports and even fewer studies on infective endocarditis. This study is a clinical analysis of 87 infective endocarditis cases, which were admitted and treated at the department of Pediatrics and Internal medicine, diagnosed as infective endocarditis, during the period from january 1975 through February 1984. 1) The mean age was 24.8 years and male to female ratio was 1.49:1. 2) Annual incidence showed no increment during the period and it was 1:2500. 3) Underlying heart diseases consisted of rheumatic heart disease(52.3%), congenital heart disease(39.7%), no underlying heart disease(8%), previous infective endocarditis(4.6%), and prosthetic valve endocarditis(3.4%). 4) Frequent clinical manifestations on admission were high fever, heart murmur, congestive heart failure and frequent laboratory findings were positive blood culture results, anemia, positive C-reactive protein, and hematuria. 5) Blood culture was positive in 75.9% and the most common infecting organism was alpha-streptococcus, which represented 42.4% of total positive cases. S. aureus and S. epidermidis were next common and these three organisms consisted of 71.2% Culture positivity was not significantly related to the type and incidence of complications. 6) Antibiotics sensitivity of the major isolated organisms were performed. Alpha-streptococcus was sensitive to almost all antibiotics except Tetracycline. Group D-streptococcus was sensitive to Chloramphenicol and Cephalosporin. S. aureus and S. epidermidis showed same results, which showd sensitivity to Chloramphenicol, Cephalosporin and Methicillin and resistence to penicillin. 7) Echocardiography was performed in 55 cases and showed vegetation in 58.2%. Complications related to the echocardiographic identification of the vegetations showed difference only in the mortality rate, which was greater by 3 times in the positive cases than in the negative. 8) Peripheral embolizations occurred in 29.9% of cases, and by far the mostcommon site was the brain, where 63% of the embolism was localized. 9) Sufficient duration of hospitalization(4-6 weeks) and judicious antibiotics administration was done in 43.7%. The initial response to therapy was noted in 48.5% of total febrile cases. 10) The mortality rate of the cases was 13.8% of the patients died. However, as many patients were discharged against advice because of socio-economic factors, precise therapeutic results of these cases could not be obtained.
Anemia ; Anti-Bacterial Agents ; Brain ; C-Reactive Protein ; Chloramphenicol ; Diagnosis ; Echocardiography ; Embolism ; Endocarditis* ; Female ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Murmurs ; Hematuria ; Humans ; Incidence ; Internal Medicine ; Korea ; Male ; Methicillin ; Mortality ; Pediatrics ; Penicillins ; Tetracycline

BACKGROUND AND OBJECTIVES: Recently, the result of total correction in tetralogy of Fallot(TOF) is improved dramatically. But, residual anatomical changes of right ventricular outflow tract(RVOT) and pulmonary artery junctional stenosis result in bad prognosis. Therefore we sought to analyze risk factors for pulmonary artery junctional stenosis after correction of TOF. METHODS: From 1991 to 1998, 146 patients underwent the follow-up catheterizations after total correction of TOF in our institution and were analysed risk factors for pulmonary artery junctional stenosis. Of this patients group [age on operation 20.119.8 months, follow-up duration after operation 13.95.0 months, male(64%)], 20 cases(13.7%) had a PDA and 26 cases(17.8%) had a systemic-to-pulmonary shunt operation before total correction of TOF. RESULTS: 1) Residual PS is correlated significantly with post-operative RVP/LVP(r=.776, p<0.01) and post-operative RVEDP(r=.196, p<0.05). 2) Post-operative RVP/LVP and residual PS increased significantly in grade II of residual PI than grade III~IV. 3) The left pulmonary artery junctional stenosis(LPAJS) was observed in 31 cases, this group decreased significantly in pre-operative LPA diameter(p<0.01), increased in post-operative RVP/LVP(p<0.01), and increased in post-operative RPA diameter(p<0.01), decreased in post-operative LPA diameter(p<0.01) and was more severe in post-operative PI(p<0.01) than the other group respectively. 4) Of the patients group which went patch enlargement of RVOT to LPA junction, the pressure gradient on LPA junction increased significantly in PDA and false aneurysmal change. 5) Factors significantly associated with pulmonary artery junctional stenosis were patch enlargement of RVOT to LPA junction, aneurysmal change of RVOT, PDA, systemic-to-pulmonary shunt and pre-operative LPAJS. 6) LPAJS(P, mmHg) =5.43 +16.24*[false aneurysmal change of RVOT] +14.13*[RVOT patch enlargement to LPA] +16.89*PDA. CONCLUSION: Several factors significantly associated with pulmonary artery junctional stenosis influenced each other. And the LPAJS led to secondary changes (volume overload of RV, increasing diameter of RPA, et. al) therefore more active diagnosis and treatment after total correction is recommended.
Aneurysm ; Aneurysm, False ; Catheterization ; Catheters ; Constriction, Pathologic* ; Diagnosis ; Follow-Up Studies ; Humans ; Prognosis ; Pulmonary Artery* ; Risk Factors* ; Tetralogy of Fallot*

BACKGROUND: In Korean traditional medicine, human beings are classified into 4 groups accordance with the characteristics of physical constitution, named; Taeum, Taeyang, Soum, and Soyang. Most of Korean traditional doctors believe that the back ground of pathophysiology is differ among each group in many diseases. HLA is the most polymorphic gene and related with human immune response. It has been used for determination of individual identification, genetic diversity and a study of disease association in different ethnic group. It has well known that the most human inflammatory disease which thought to have some autoimmune basis are in some way promoted by genes of the HLA region. The purpose of this study is to observe the distribution of HLA-DR genotypes in 4 types of physical constitution in Korean traditional medicine. METHODS: Three hundred and ten Korean subjects(Soyang : 58cases, Soum :142cases, Taeum : 92cases, Taeyang : 18cases) were enrolled for this study. Genomic DNAs extracted by phenol/chroloform were amplified with allele specific primers and determined by 2% agarose gel electrophoresis with ethidium bromide staining for analysis of HLA-DR polymorphism. RESULTS: The genotype frequency of HLA-DR in a total or 310 Koreans was DR1 ; 7.2%, DR 2; 10.5%, DR 3;1.7%, DR 4; 19.9%, DR 5; 11.9%, DR 6;19.9%, DR 7; 7.0%, DR 8; 10.6%, DR 9; 8.7%, DR10;1.9%. There was no significant diffrence of HLA-DR genotype distribution among four physical constitution groups classified by Korean traditional medicine. CONCLUSION: Our results suggest that the classification of physical constitution in Korean traditional medicine is not related to HLA-DR genotypes.
Alleles ; Classification ; Constitution and Bylaws* ; DNA ; Electrophoresis, Agar Gel ; Ethidium ; Ethnic Groups ; Genetic Variation ; Genotype ; HLA-DR Antigens* ; Humans ; Medicine, Korean Traditional*

BACKGROUND AND OBJECTIVES: Arterial grafts have a better long-term patency rate than saphenous vein (SV) when used in off-pump coronary artery bypass surgery (OPCAB). However, arterial grafts in elderly patients are often diseased. We sought to compare the early outcomes achieved by using the two different types of composite grafts. SUBJECTS AND METHODS: We conducted a randomized trial to compare radial artery (RA) and SV composite grafts based on the in situ left internal mammary artery in 60 elderly (>70 years old) patients, who were scheduled to undergo OPCAB. Clinical outcomes and 1-year postoperative CT angiography results were compared. The quality of the conduit was evaluated by employing vascular ultrasonography, optical coherence tomography (OCT), and histologic examination. RESULTS: No differences in immediate postoperative morbidity and mortality were observed between the two groups. Early postoperative CT angiography revealed a SV patency rate of 100%, which was not different from that of RA composite grafts (99.1%). CT angiography after a year showed an overall patency rate of 96.3%. The overall patency rate of the SV group at 1 year was 94.7%, which was similar to that of the RA group (97.4%). Also, there was no difference in overall survival rate between the two groups. Vascular ultrasonographic images showed strong correlations between OCT and histopathology. CONCLUSION: Our analysis of early outcomes revealed that the SV could be used as an alternative composite graft to the RA in elderly patients. Vascular ultrasonography is an accurate, real-time, and reproducible method for assessing the quality of the RA conduit.
Aged ; Angiography ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Humans ; Mammary Arteries ; Radial Artery ; Saphenous Vein ; Survival Rate ; Tomography, Optical Coherence ; Transplants