Lipomas of the heart are benign neoplasms and have rarely been described. Due to the fact that they normally cause no symptoms, diagnosis is often purely accidental. Because of the rarity of these tumors, it seems worthwhile to present an example studied at autopsy. It was associated with the sudden death of a 15-year-old boy. The tumor arose from the wall of the left ventricle and occupied the pericardial cavity, measuring 13x7x6 cm in size. The tumor was whitish-yellow, translucent, and soft. Microscopically, the tumor was composed of mature adipose tissue which extended between muscle fibers. This current case, the giant cardiac lipoma is believed to produce disturbances of the conduction system and distrubances of cardiac filling.

We describe an ovarian mucinous cystadenocarcinoma with a sarcoma-like mural nodule. In the literature, rare cases of ovarian mucinous tumors have been described which contain foci of undifferentiated carcinoma, sarcoma, and sarcoma-like nodules. The distinction between these lesions is important because of poorer prognosis of true sarcoma and anaplastic carcinoma than sarcoma-like mural nodules. This case shows different results of immunohistochemical stain for anaplastic carcinoma.

The purpose of this study was to investigate the morphologic changes of the bile canaliculi and its associated structures of the liver induced by common bile duct ligation(CBDL) in the rat. The canalicular surface and lateral surface of the dry-fractured hepatocytes was studied with scanning electron microscopy at 1~6 weeks post ligation. The first week after CBDL, the bile canaliculi were dilated. The microvilli were increased in number and the lumens contained granular materials After 2 weeks or more, the bile canaliculi were dilated to a variable degree, and with irregularity, measuring from 1.5 to 5 micrometer in diameter, and in the advanced stage, the canaliculi showed blunting and the disappearance of microvilli. Some canaliculi had sprouting side branches. At 4~6 weeks post-ligation, the lateral surface of the hepatocytes also showed some irregularity and a tortuous appearance, and numerous small sized microvillous projections were formed. The tubular structures of the proliferated SER distributed adjacent to the lateral surface of the hepatocytes, and the direct connection of a tubular structure and the cytoplasmic membrane was observed. These results suggest that the deformity and loss of microvilli of bile canaliculi reflect the disturbance of bile secretion from the hepatocytes. And prolonged obstruction of bile flow may result in bile excretion via the lateral surface of hepatocytes.
Rats ; Animals

Since the behavior of malignant cells can be predicted by their histologic appearance, various attempts have been made to develop a uniform grading system for prostatic cancer. The system employed at the University of Texas M.D. Anderson Hospital(MDAH system) is based simply on assessment of percentage of gland formation in the tumor. Herein, using the modified MDAH system, histologic grading and prognosis were retrospectively reviewed in 35 patients with prostatic adenocarcinoma managed at Chonnam University Hospital between l997 and 1984. The following results were obtained. 1. The average age of all the patients was 70.1 years, with a range of 25 to 85 years. 2. In 35 patients, the modified MDAH system identified 6 patients (l7%) as Grade 1, 15(43%) as Grade 2-3, and 14 (40%) as Grade 4. There were a 83% 3-year survival for Grade 1 patients, a 69% 3-year survival for Grade 2-3 patients, and a 17% 3-year survival for Grade 4 patients. 3. Of 15 patients with clinical stage D, 2 had Grade 1, 6 had Grade 2-3, and 7 had Grade 4.There were a 100 % 3-year survival for Grade 1 patients, a 50% 3-year survival for Grade 2-3patients, and a 14% 3-year survival for Grade 4 patients.
Adenocarcinoma ; Humans ; Jeollanam-do ; Prognosis* ; Prostatic Neoplasms ; Retrospective Studies ; Texas

A 38-year-old man, with recurrent oral ulcers for 10 years, was admitted because of recent aggravation of odynophagia and sore throat. About 4 years earlier, he had been performed abdominal surgery for intestinal perforation. Gastrofiberscopic examination showed small round ulcers at hypiopharynx and 6cm sized longitudinal linear ulcer at mid esophagus. Biopsy specimens at mid-esophagus showed chronic inflammation. Besides oral ulcer, he had perianal ulcers and skin rashes. He was managed with steroid, colchicine and sulfasalazine under the diagnosis of esophageal involvement in Behcet's disease. After 3 months from discharge, esophagogram and gastrofiberscopic examination showed some improved appearance, but symptoms recurred for steroid tapering. He has been followed in much improved status for 8 months after discharge.
Adult ; Biopsy ; Colchicine ; Diagnosis ; Esophagus ; Exanthema ; Humans ; Inflammation ; Intestinal Perforation ; Oral Ulcer ; Pharyngitis ; Sulfasalazine ; Ulcer*

PURPOSE: To compare foveal shapes in Koreans according to age and gender using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 230 eyes of 115 healthy adults. The subjects were divided into three groups: group 1 (20-39 years of age), group 2 (40-59 years of age) and group 3 (60-79 years of age). Using spectralis OCT, we measured central foveal thickness (CFT), regional maximal retinal thickness (MRT), pit diameter and pit depth and compared the differences between the groups. RESULTS: The MRT of the superior, inferior and nasal sides in group 1 was higher than in groups 2 and 3 (p < 0.05). No significant difference was observed in the MRT of the temporal side. Regarding differences based on age, no significant differences in CFT, pit diameter and pit depth were observed. Regarding differences in gender, the temporal regional MRT of males in group 3 was significantly lower than in group 1 and the pit depth of males in group 1 was significantly higher than in groups 2 and 3. Therefore, differences were observed according to gender. CONCLUSIONS: In the present study, differences in foveal shape were found according to age and gender which should be considered when foveal diseases are evaluated.
Adult ; Humans ; Male ; Retinaldehyde ; Tomography, Optical Coherence*

Spontaneous fistula formation between the kidney and the colon is uncommon. The underlying cause is usually a pyonephrotic kidney which becomes adherent to a portion of the colon and then ruptures spontaneously, thus creating a fistula. Herein we present a case of renocolonic fistula which occurred in a 36-year old man with review of the literature.
Adult ; Colon ; Fistula* ; Humans ; Kidney ; Rupture

No abstract available.
Pancytopenia*

BACKGROUND: Weaning from mechanical ventilation is difficult in the intensive care unit (ICU). Many controversial questions remain unanswered concerning the predictors of weaning failure. This study investigates patient characteristics and delayed weaning after lung transplantation. METHODS: This study retrospectively reviewed the medical records of 17 lung transplantation patients from October 2012 to December 2013. Patients able to be weaned from mechanical ventilation within 8 days after surgery were assigned to an early group (n = 9), and the rest of the patients were assigned to the delayed group (n=8). Patients' intraoperative and postoperative characteristics were collected and analyzed, and conventional weaning predictors, including rapid shallow breathing index (RSBI), were also assessed. RESULTS: The results of the early group showed a significantly shorter ICU stay in addition to a shorter hospitalization overall. Notably, the early group had a higher body mass index (BMI) than the delayed group (20.7 vs. 16.9, p = 0.004). In addition, reopening occurred more frequently in the delayed group (1/9 vs. 5/8, p = 0.05). During spontaneous breathing trials, tidal volume (TV) and arterial oxygen tension were significantly higher in the early group compared to the delayed weaning group, but differences in RSBI and respiratory rate (RR) between groups were not statistically significant. CONCLUSIONS: Low BMI might be associated with delayed ventilator weaning in lung transplantation patients. In addition, instead of the traditional weaning predictors of RSBI and RR, TV might be a better predictor for ventilator weaning after lung transplantation.
Body Mass Index* ; Hospitalization ; Humans ; Intensive Care Units ; Lung Transplantation* ; Medical Records ; Oxygen ; Respiration ; Respiration, Artificial ; Respiratory Rate ; Retrospective Studies ; Tidal Volume ; Ventilator Weaning* ; Weaning

BACKGROUND: The dysfunction of multiple organs is found to be caused by reactive oxygen species as a major modulator of microvascular injury after hemorrhagic shock. Hemorrhagic shock, one of many causes inducing acute lung injury, is associated with increase in alveolocapillary permeability and characterized by edema, neutrophil infiltration, and hemorrhage in the interstitial and alveolar space. Aggressive and rapid fluid resuscitation potentially might increased the risk of pulmonary dysfunction by the interstitial edema. Therefore, in order to improve the pulmonary dysfunction induced by hemorrhagic shock, the present study was attempted to investigate how to reduce the inflammatory responses and edema in lung. MATERIAL AND METHOD: Male Sprague-Dawley rats, weight 300 to 350 gm were anesthetized with ketamine (7 mg/kg) intramuscular. Hemorrhagic Shock (HS) was induced by withdrawal of 3 mL/100 g over 10 min. through right jugular vein. Mean arterial pressure was then maintained at 35~40 mmHg by further blood withdrawal. At 60 min. after HS, the shed blood and Ringer's solution or 5% albumin was infused to restore mean carotid arterial pressure over 80 mmHg. Rats were divided into three groups according to rectal temperature level (37 degrees C [normothermia] vs 33degrees C [mild hypothermia]) and resuscitation fluid (lactate Ringer's solution vs 5% albumin solution). Group I consisted of rats with the normothermia and lactate Ringer's solution infusion. Group II consisted of rats with the systemic hypothermia and lactate Ringer's solution infusion. Group III consisted of rats with the systemic hypothermia and 5% albumin solution infusion. Hemodynamic parameters (heart rate, mean carotid arterial pressure), metabolism, and pulmonary tissue damage were observed for 4 hours. RESULT: In all experimental groups including 6 rats in group I, totally 26 rats were alive in 3rd stage. However, bleeding volume of group I in first stage was 3.2+/-0.5 mL/100 g less than those of group II (3.9+/-0.8 mL/100 g) and group III (4.1+/-0.7 mL/100 g). Fluid volume infused in 2nd stage was 28.6+/-6.0 mL (group I), 20.6+/-4.0 mL (group II) and 14.7+/-2.7 mL (group III), retrospectively in which there was statistically a significance between all groups (p <0.05). Plasma potassium level was markedly elevated in comparison with other groups (II and III), whereas glucose level was obviously reduced in 2nd stage of group I. Level of interleukine-8 in group I was obviously higher than that of group II or III (p <0.05). They were 1,834+/-437 pg/mL (group I), 1,006+/-532 pg/mL (group II), and 764+/-302 pg/mL (group III), retrospectively. In histologic score, the score of group III (1.6+/-0.6) was significantly lower than that of group I (2.8+/-1.2)(p <0.05). CONCLUSION: In pressure-controlled hemorrhagic shock model, it is suggested that hypothermia might inhibit the direct damage of ischemic tissue through reduction of basic metabolic rate in shock state compared to normothermia. It seems that hypothermia should be benefit to recovery pulmonary function by reducing replaced fluid volume, inhibiting anti-inflammatory agent (IL-8) and leukocyte infiltration in state of ischemia-reperfusion injury. However, it is considered that other changes in pulmonary damage and inflammatory responses might induce by not only kinds of fluid solutions but also hypothermia, and that the detailed evaluation should be study.
Acute Lung Injury ; Animals ; Arterial Pressure ; Edema ; Fluid Therapy* ; Glucose ; Hemodynamics ; Hemorrhage ; Humans ; Hypothermia* ; Jugular Veins ; Ketamine ; Lactic Acid ; Leukocytes ; Lung* ; Male ; Metabolism ; Neutrophil Infiltration ; Permeability ; Plasma ; Potassium ; Rats* ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; Reperfusion ; Reperfusion Injury ; Resuscitation ; Retrospective Studies ; Shock ; Shock, Hemorrhagic*