Aneurysm of the pulmonary artery is a rate entity. A neonate was seen with cyanosis and tachypnea. There was a grade 4/6 systolic murmur along the left sternal border. The chest X-ray showed a round mass shadow in the left parahilar region. Echocardiogram showed large Ventricular Septal Defect and mild Pulmonary Stenosis. The cardiac angiogram showed giant aneurysm of pulmonary artery. Surgical intervention was advised. However, the patient was discharged against operative plan. And the patient died two weeks later.
Aneurysm* ; Cyanosis ; Heart Septal Defects, Ventricular* ; Humans ; Infant, Newborn ; Pulmonary Artery ; Pulmonary Valve Stenosis* ; Systolic Murmurs ; Tachypnea ; Thorax

No abstract available.
Child* ; Humans ; Parotid Gland*

Schwannomas are neurogenic tumors that arise from Schwann cells of the neural sheath. They are most often benign and solitary. Ancient schwannoma is a rare variant of schwannoma with a typical characteristics of a slow growing benign tumor. A case of ancient schwannoma which originated from the lingual nerve has not been reported in the literature yet. The clinical and histological aspects of this tumor are discussed and the literature regarding this rare entity is reviewed.
Lingual Nerve* ; Neurilemmoma* ; Schwann Cells

BACKGROUND: CYFRA 21-1 is a tumor marker which measures a fragment of cytokeratin 19 expressed by epithelial cells in bronchus. It is known that cytokeratin 19 is abundant in squamous epithelial cell cancer of the lung. However, if the incidence of elevated serum CYFRA 21-1 level in patients with benign lung diseases or pulmonary tuberculosis with severe parenchymal damage is high the specificity of CYFRA 21-1 could be decreased. The purpose of this study is to investigate the changes of serum CYFRA 21-1 according to the degree of parenchymal damage and the usefulness of CYFRA 21-1 for diagnosing possibly combined lung cancer in patients with pulmonary tuberculosis. METHOD: We studied the changes of serum CYFRA 21-1 according to the sputum AFB stain, radiologic manifestation and history of treatment in 81 patients with pulmonary tuberculosis, and 20 healthy persons, 25 patients with lung cancer, as a control group. CYFRA 21-1 concentration in serum was quantified by the immunoradiometry assay(Centocor (R)) RESULT: The results were as follow; Serum CYFRA 21-1 level was significantly lower in patients with pulmonary tuberculosis(1.54+/-1.19ng/mL, p<0.01) as compared to patients with lung cancer( 12.25+/-15.97ng/mL), and was slightly higher than the level in heathy persons(0.90+/-0.49ng/mL) but there was no significant difference. Serum CYFRA 21-1 level was below the cut-off value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis but it was above the cut-off value in 64 percent of patients with lung cancer. Serum CYFRA 21-1 level was significantly higher in the initial treatment group(1.91+/-1.55ng/mL, p<0.05) as compared to the treatment failure group (0.92+/-0.30ng/mL). According to the sputum AFB smear, serum CYFRA 21-1 level in patients with negative result was slightly higher than the level in patients with positive result but there was no significant difference. According to the radiologic manifestation, serum CYFRA 21-1 level was significantly higher in patients with infiltrative lesion (2.15+/-1.63ng/mL, p<0.01) as compared to patients with destructive lesion (1.04+/-0.54ng/mL). As the size of cavity or destructive lesion was larger, the level was significantly lower(p<0.05). CONCLUSION: As serum CYFRA 21-1 level was significantly higher in the initial treatment group and patients with infiltrative lesion, it suppose to be closely related with the degree of parenchymal damage of the lung of the pulmonary tuberculosis. However CYFRA 21-1 could be useful method for diagnosing lung cancer even in patients with pulmonary tuberculosis combined with lung cancer because of the fact that it was below the cutoff value of 3.3ng/mL in 95 percent of patients with pulmonary tuberculosis.
Bronchi ; Epithelial Cells ; Humans ; Incidence ; Keratin-19 ; Lung ; Lung Diseases ; Lung Neoplasms ; Sensitivity and Specificity* ; Sputum ; Treatment Failure ; Tuberculosis ; Tuberculosis, Pulmonary*

In order to investigate electrolyte changes in serum and urine diuretic therapy, we studied 98 patients with hypertension not optimally controlled by previous treatment. After we divied the patients into three gorups in randomized trial, group A were given Amiloride 10mg/day, group B were given Dihydrochlorothiazide 50mg/day, group C were given Amiloride 5mg/day combined with Dihydrochlorothiazide 25mg/day for 7 days. Blood pressure and electrolyte changes in serum and urine after diuretic theraphy for 7 days were as follows. 1) Serum sodium concentrations were not significantly changed in all three groups(P>0.05). 2) Serum potassium concentrations were increased in group A and C (P<0.05), but there were no significant changes in group B(P<0.05). 3) Urinary sodium exceretions were increased in all three groups(P<0.05). 4) Urinary potassium excretion were decreased in group A and C (P<0.05), but there were increased in group B (P<0.05). 5) Blood pressure were decreased in all three groups(P<0.05).
Amiloride ; Blood Pressure ; Diuretics* ; Electrolytes* ; Humans ; Hydrochlorothiazide ; Hypertension* ; Potassium ; Sodium

Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

OBJECTIVES: In HFRS, there is a varying degree of disseminated intravascular coagulation which was evident in the early phase of the illness. It is believed also that DIC would be the consequence, at least in part, of functional changes of endothelium resulting in kinin activation and clinical syndrome. This study investigated the role of adhesion molecule in the pathogenesis of Hantaan virus-related disease. METHODS: The expression of ICAM-1 antigen on the cell membrane of human umbilical vein endothelial cells was assessed by immunohistochemistry, and ICAM-1 mRNA in the endothelial cells was assessed by in situ hybridization after Hantaan virus infection (2.6 x 10(4) PFU/mL) with the time course. RESULTS: In immunohistochemistry, the number of ICAM-1 positive cells increased with time during the 12 or 24 hours after infection. 5 to 10% of HUVECs had been positive after 12-24 hours and the number of positive cells decreased abruptly after 24 hours. Hantaan antigen had been noticed after 12 hours focally on the HUVECs but continued to proliferate into day 7 post-infection when most of HUVECs were infected by Hantaan virus. In situ hybridization showed identical patterns of ICAM-1 mRNA expression after Hantaan virus infection. CONCLUSION: It implies that the Hantaan virus infection on HUVECs would express more ICAM-1 on their surface and implicated in the pathogenesis of early clinical syndrome of HFRS.
Cell Line ; Endothelium, Vascular/virology ; Endothelium, Vascular/immunology ; Gene Expression ; Hantaan Virus/pathogenicity* ; Hemorrhagic Fever with Renal Syndrome/immunology* ; Hemorrhagic Fever with Renal Syndrome/genetics ; Hemorrhagic Fever with Renal Syndrome/etiology ; Human ; Immunohistochemistry ; In Situ Hybridization ; Intercellular Adhesion Molecule-1/metabolism* ; Intercellular Adhesion Molecule-1/genetics* ; RNA, Messenger/metabolism ; RNA, Messenger/genetics

Several methods for the management of intractable pain for various conditions including malignant disorders, herpes zoster, and low back pain and/or sciatica in 80 patients were described and analyzed. Neurolytric blocks of celiac plexus were given to the patients suffering from intra-abdominal pain from malignant origin or chronic pancreatitis. Herpes zoster was treated mainly by chemical sympathectomy via paravertebral route and occassionaly corticosteroid was administered epidurally with the local anesthetic, bupivacaine. All the patients with low back pain and/or sciatica were given epidural corticosteroid one to three times. Other peripheral were blocks and regional corticosteroid therpy were given to the rest of the patients. Fair to excellent result was obtained in 71% of the patients but the response was poor in the remaining 28% of the patients. It seems that the earlier the patients were referred to the pain clinic, the better the results were.
Bupivacaine ; Celiac Plexus ; Herpes Zoster ; Humans ; Low Back Pain ; Pain Clinics ; Pain, Intractable ; Pancreatitis, Chronic ; Sciatica ; Sympathectomy, Chemical

BACKGROUND: The Nuss procedure is a recently developed technique for minimally invasive repair of pectus excavatum using a metal bar. Although its technical simplicity and cosmetic advantages are remarkable, applications have been limited to children with standard pectus excavatum. We report a single center experience of the technique that has been evolving in order to correct asymmetric pectus configurations and adult patients. MATERIAL AND METHOD: Between August 1999 and June 2002, 322 consecutive patients underwent repair by the Nuss technique and its modifications. Among them, 71 (22%) were adults. For the precise correction, morphology of the pectus was classified as symmetric and asymmetric types. Asymmetric type was subdivided into eccentric and unbalanced types. In repair, differently shaped bars were applied to individual types of pectus to achieve symmetric correction. RESULT: Symmetric type was 57.5% (185/322) and asymmetric type was 42.5% (137/322). Eccentric, unbalanced, and combined types were 71, 47 and 19, respectively. Major modifications were bar shaping and fixation. In asymmetric group, different shapes of asymmetric bars were applied (n=125, 38.8%). For adult patients, double bar or compound bar technique was used (n=51, 15.8%). To prevent bar rotation, multipoint wire fixations to ribs were used. Major postoperative complications were pneumothorax (n=24, 7.5%) and bar displacement (n=11, 3.4%). 42 patient had bar removal 2 years after the initial procedure. CONCLUSION: The Nuss procedure is safe and effective.Modifications of the techniques in accordance with precise morphological classification enabled the correction of all variety of pectus excavatum including asymmetric types and adult patients.
Adult ; Child ; Classification ; Funnel Chest* ; Humans ; Pneumothorax ; Postoperative Complications ; Ribs

BACKGROUND: The objective of this study was to explore whether individual variations in the concentration of growth factors (GFs) influence the biologic effects of platelet-rich plasma (PRP) on human mesenchymal stem cells (HMSCs). METHODS: The concentrations of 7 representative GFs in activated PRP (aPRP) were measured using ELISA. The effects of PRP on the proliferation and alkaline phosphatase (ALP) activity of HMSCs were examined using several concentrations of aPRP from 3 donors; the relationships between the GF levels and these biologic effects were then evaluated using 10% aPRP from 5 subgroups derived from 39 total donors. HMSCs were cultured in DMEM with the addition of aPRP for 4 or 12 days; then, DNA content and ALP activity were measured. RESULTS: The quantity of DNA increased significantly at a 10% concentration of aPRP, but the ALP activity was suppressed at this concentration of aPRP. The GF concentrations varied among donors, and 5 subgroups of characteristic GF release patterns were identified via cluster analysis. DNA levels differed significantly between groups and tended to be higher in groups with higher concentrations of transforming growth factor-beta1 (TGF-beta1) and platelet-derived growth factors (PDGFs). DNA quantity was positively correlated with TGF-beta1 concentration, and was negatively correlated with donor age. ALP activity was negatively correlated with PDGF-BB concentration. CONCLUSIONS: The varying GF concentrations may result in different biologic effects; thus, individual differences in GF levels should be considered for reliable interpretation of the biologic functions and standardized application of PRP.
Alkaline Phosphatase/metabolism ; Blood Donors ; Cell Differentiation ; Cells, Cultured ; Culture Media/chemistry ; DNA/analysis ; Humans ; Intercellular Signaling Peptides and Proteins/*pharmacology ; Mesenchymal Stem Cells/*cytology/drug effects ; Platelet-Derived Growth Factor/pharmacology ; Platelet-Rich Plasma/*metabolism ; Transforming Growth Factor beta1/pharmacology