1.A Case of Persistent Left SVC Associated with Tricuspid Regurgitation.
Jin Whee SON ; Chung Seok LEE ; Sae Whan HAN ; Seong Woo LEE ; Sung Koo KIM ; Young Joo KWON
Korean Circulation Journal 1993;23(4):609-613
A persistent left superior vena cava is the most common anomaly of the superior caval system. Usually the persistent left superior vena cava is connected with the right atrium via the coronary sinus, resulting in no physiologic derangement : however in 7 to 8 percents of the patietns with a persistent left superior vena cava, the anomalous vessel communicates with the left atrim. In the absence of obstruction to the flow from the left atrium to the left ventricle. this anatomic situation usually results in right to left shunting of varying degress. We recently experienced a case of persistent left superior vena cava in a 52-year-old female who complained of chest discomfort, epigastric pain and dyspnea(NYHA functional class II). Cine-angiography showed that the contrast passed from the left SVC through the dilated coronary sinus into right atrium. And right sided SVC was not seen. The patient was treated with conservative measures and discharged with improved condition.
Coronary Sinus
;
Female
;
Heart Atria
;
Heart Ventricles
;
Humans
;
Middle Aged
;
Thorax
;
Tricuspid Valve Insufficiency*
;
Vena Cava, Superior
2.Comparison of the Activities of NF-kappa B and I kappa B alpha in Patients with Rheumatoid Arthritis and Osteoarthritis.
Nan Kyung HA ; Soon Young KWON ; Hae Seok KOH ; Jong Min SOHN ; Jin Young KIM ; Sae Cheol OH ; Yun Hack SHIN ; Chang Whan HAN
Journal of Korean Orthopaedic Research Society 2004;7(2):125-132
PURPOSE: The nuclear factor-kappa B (NF-kappa B) has been known to regulate the inflammatory and immune process by transcription of inflammatory intermediates. The purpose of the present study is to show the difference in activity of NF-kappa B and its inhibitory factor-I kappa B alpha in patients with rheumatoid arthritis, osteoarthritis and normal control subjects. MATERIALS AND METHODS: Synovial membrane samples were obtained at the time of orthopedic surgery from the knees of 7 patients with RA and 7 patients with OA. Two control samples were obtained from an amputee with no history of arthritis. We designed the primer of the subunit p65 of NF-kappa B and I kappa B alpha, measured the activity of them by RT-PCR, and analyzed the expression of NF-kappa B by immunohistochemical staining. RESULTS: From the results of RT-PCR, the expression levels of NF-kappa B was found to be higher in synovial tissues obtained from patients with RA than from synovial tissue obtained from patients with OA, and the least from the control group. The expression levels of I kappa B alpha were not different statistically among the three groups. Immunohistochemical staining for the NF-kappa B was dominant in synovial tissue from patients with RA. The result of immunohistochemical staining was similar to the results of RT-PCR for NF-kappa B. The localization of the staining was predominantly nuclear. CONCLUSION: In this study, activity of NF-kappa B of rheumatoid arthritis was higher than the other group, but expressions of I kappa B alpha were no different between the diseases. Further studies about specific inhibitors of NF-kappa B will benefit the development of rheumatoid arthritis regimens with greater efficacy.
Amputees
;
Arthritis
;
Arthritis, Rheumatoid*
;
Humans
;
I-kappa B Proteins*
;
Knee
;
NF-kappa B*
;
Orthopedics
;
Osteoarthritis*
;
Synovial Membrane
3.Early and late clinical outcomes after primary stenting of the unprotected left main coronary artery stenosis in the setting of acute myocardial infarction.
Myung Zoon YI ; Seung Whan LEE ; Sae Hwan LEE ; Chang Bum PARK ; Sung Du KIM ; Song Yi HAN ; Young Hak KIM ; Cheol Whan LEE ; Myeong Ki HONG ; Jae Joong KIM ; Seong Wook PARK ; Seung Jung PARK
Korean Journal of Medicine 2004;67(3):249-254
BACKGROUND: Acute left main coronary artery occlusion is a dramatic condition with very high mortality. The study was aimed to evaluate the effect of primary stenting in patients with left main coronary artery disease in the setting of acute myocardial infarction. METHODS: Between June 1997 and April 2002, primary stenting for left main coronary artery disease was performed in eighteen patients with acute myocardial infarction. We evaluated clinical outcomes and prognostic determinants in this clinical setting. RESULTS: Mean ages of patients were 59 +/- 12 years. Fourteen patients had cardiogenic shock on admission. Angiographic success (TIMI flow >or= 2 and diameter stenosis < 30% after stenting) was achieved in 17 patients (94%). In-hospital death occurred in 8 patients (44%). Two patients (11%) received emergent bypass surgery because of hemodynamic instability after primary stenting. On univariate analysis, good pre-intervention TIMI flow (grade >or= 2) was identified as a good prognostic determinant of in-hospital survival. During mean follow-up of 39 +/- 22 months, there was no late death and 1 patient received bypass surgery. Probability of freedom from death at 3-year was 56 +/- 12%. CONCLUSION: Primary stenting is a valuable therapeutic strategy for left main coronary disease in the setting of acute myocardial infarction, and it might save the life especially in patients with good pre-intervention TIMI flow (grade >or= 2). Long-term clinical outcome of patients surviving to hospital discharge is favorable.
Constriction, Pathologic
;
Coronary Artery Disease
;
Coronary Disease
;
Coronary Stenosis*
;
Coronary Vessels*
;
Follow-Up Studies
;
Freedom
;
Hemodynamics
;
Humans
;
Mortality
;
Myocardial Infarction*
;
Shock, Cardiogenic
;
Stents*
4.The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer.
Soo Kyung AHN ; Wonshik HAN ; Hyeong Gon MOON ; Jong Han YU ; Eunyoung KO ; Jin Hye BAE ; Jun Won MIN ; Tae You KIM ; Seock Ah IM ; Do Youn OH ; Sae Won HAN ; Sung Whan HA ; Eui Kyu CHIE ; Seung Keun OH ; Yeo Kyu YOUN ; Sung Won KIM ; Ki Tae HWANG ; Dong Young NOH
Journal of Breast Cancer 2010;13(1):90-95
PURPOSE: The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. METHODS: We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. RESULTS: Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). CONCLUSION: Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.
Antibodies, Monoclonal, Humanized
;
Breast
;
Breast Neoplasms
;
Estrogens
;
Humans
;
Multivariate Analysis
;
Neoplasm Metastasis
;
Trastuzumab
5.The Impact of Primary Tumor Resection on the Survival of Patients with Stage IV Breast Cancer.
Soo Kyung AHN ; Wonshik HAN ; Hyeong Gon MOON ; Jong Han YU ; Eunyoung KO ; Jin Hye BAE ; Jun Won MIN ; Tae You KIM ; Seock Ah IM ; Do Youn OH ; Sae Won HAN ; Sung Whan HA ; Eui Kyu CHIE ; Seung Keun OH ; Yeo Kyu YOUN ; Sung Won KIM ; Ki Tae HWANG ; Dong Young NOH
Journal of Breast Cancer 2010;13(1):90-95
PURPOSE: The main treatment for stage IV breast cancer is currently systemic therapy. Surgical resection of the primary tumor is usually done for treating the tumor-related complications. Recent studies have suggested that surgery may improve the long-term survival of stage IV breast cancer patients. We evaluated the impact of the primary surgical resection site on the survival of stage IV breast cancer patients. METHODS: We reviewed the records of the stage IV breast cancer patients who were treated at Seoul University Hospital between April 1992 and December 2007. The tumor and clinical characteristics, the type of treatments and the overall survival were compared between the surgically versus nonsurgically treated patients. RESULTS: Of the 198 identified patients, 110 (55.8%) received surgical excision of their primary tumor and 88 (44.2%) did not. The mean survival was 67 months vs. 42 months for the surgically treated patients vs. the patients without surgery, respectively (p=0.0287). On a multivariate analysis with using the Cox model and after adjusting for the estrogen receptor status, visceral metastases, the number of metastatic sites and trastuzumab treatment, surgery was an independent factor for improved survival (hazard ratio, 0.55; 95% confidence interval, 0.31-0.97; p=0.041). CONCLUSION: Surgical resection of the primary tumor in stage IV breast cancer patients was independently associated with improved survival. Randomized prospective trials are needed to firmly recommend surgical resection of the primary tumor in stage IV breast cancer patients.
Antibodies, Monoclonal, Humanized
;
Breast
;
Breast Neoplasms
;
Estrogens
;
Humans
;
Multivariate Analysis
;
Neoplasm Metastasis
;
Trastuzumab
6.A New Isolated Mediastinal Lymph Node or Small Pulmonary Nodule Arising during Breast Cancer Surveillance Following Curative Surgery: Clinical Factors That Differentiate Malignant from Benign Lesions.
Tae Yong KIM ; Kyung Hun LEE ; Sae Won HAN ; Do Youn OH ; Seock Ah IM ; Tae You KIM ; Wonshik HAN ; Kyubo KIM ; Eui Kyu CHIE ; In Ae PARK ; Young Tae KIM ; Dong Young NOH ; Sung Whan HA ; Yung Jue BANG
Cancer Research and Treatment 2014;46(3):280-287
PURPOSE: A newly isolated mediastinal lymph node (LN) or a small pulmonary nodule, which appears during breast cancer surveillance, may pose a diagnostic dilemma with regard to malignancy. We conducted this study to determine which clinical factors were useful for the differentiation of malignant lesions from benign lesions under these circumstances. MATERIALS AND METHODS: We enrolled breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule that arose during surveillance, and whose lesions were pathologically confirmed. Tissue diagnosis was made by mediastinoscopy, video-assisted thoracic surgery or thoracotomy. RESULTS: A total of 43 patients were enrolled (mediastinal LN, 13 patients; pulmonary nodule, 30 patients). Eighteen patients (41.9%) were pathologically confirmed to have a benign lesion (benign group), and 25 patients (58.1%) were confirmed to have malignant lesion (malignant group). Between the two groups, the initial tumor size (p=0.096) and N stage (p=0.749) were similar. Hormone receptor negativity was more prevalent in the malignant group (59.1% vs. 40.9%, p=0.048). The mean lesion size was larger in the malignant group than in the benign group (20.8 mm vs. 14.4 mm, p=0.024). Metastatic lesions had a significantly higher value of maximal standardized uptake (mSUV) than that of benign lesions (6.4 vs. 3.4, p=0.021). CONCLUSION: Hormone receptor status, lesion size, and mSUV on positron emission tomography are helpful in the differentiation of malignant lesions from benign lesions in breast cancer patients who were presented with a new isolated mediastinal LN or small pulmonary nodule during surveillance.
Breast Neoplasms*
;
Diagnosis
;
Humans
;
Lymph Nodes*
;
Mediastinoscopy
;
Neoplasm Metastasis
;
Positron-Emission Tomography
;
Thoracic Surgery, Video-Assisted
;
Thoracotomy
7.Concurrent Chemoradiotherapy Versus Chemotherapy Alone for Unresectable Locally Advanced Pancreatic Cancer: A Retrospective Cohort Study.
Younak CHOI ; Do Youn OH ; Kyubo KIM ; Eui Kyu CHIE ; Tae Yong KIM ; Kyung Hun LEE ; Sae Won HAN ; Seock Ah IM ; Tae You KIM ; Sung Whan HA ; Yung Jue BANG
Cancer Research and Treatment 2016;48(3):1045-1055
PURPOSE: The optimal treatment strategy for locally advanced pancreatic cancer (LAPC), particularly the role of concurrent chemoradiotherapy (CCRT), remains debatable. We compared the clinical outcomes of CCRT and palliative chemotherapy alone (CA) in patients with unresectable LAPC. MATERIALS AND METHODS: Patients with LAPC who were consecutively treated between 2003 and 2010 were included. Resectability was evaluated according to National Comprehensive Cancer Network ver. 1.2012. The clinical outcomes for each treatment group (CCRT vs. CA) were evaluated retrospectively. RESULTS: Sixty-three patients (58.9%) and 44 patients (41.1%) were treated with CCRT and CA, respectively. The CCRT cohort included patients who were treated with CCRT with or without chemotherapy backbone (CCRT alone, induction chemotherapy-CCRT, CCRT-maintenance chemotherapy, and induction-CCRT-maintenance chemotherapy). Median progression-free survival (PFS) and overall survival (OS) of all patients were 7.2 months and 13.1 months. PFS of the CCRT and CA groups was 9.0 months and 4.4 months, respectively (p=0.020). OS of the CCRT and CA groups was 15.4 months and 9.3 months, respectively (p=0.011). In multivariate analysis, the adjusted hazard ratio of CCRT was 0.536 (p=0.003) for OS and 0.667 (p=0.078) for PFS. Although the pattern of failure was similar in the CCRT and CA groups, the times to both local and distant failure were significantly longer in the CCRT group. CONCLUSION: In patients with unresectable LAPC, those who underwent CCRT during their entire treatment courses had longer OS than patients treated with chemotherapy alone.
Chemoradiotherapy*
;
Cohort Studies*
;
Disease-Free Survival
;
Drug Therapy*
;
Humans
;
Multivariate Analysis
;
Pancreatic Neoplasms*
;
Prognosis
;
Retrospective Studies*
8.The Results of Extracardiac Fontan Operation in the Patients with Heterotaxy Syndrome.
Hong Gook LIM ; Soo Jin KIM ; Chang Ha LEE ; Woong Han KIM ; Seong Wook HWANG ; Cheul LEE ; Sam Sae OH ; Man Jong BAEK ; Chan Young NA ; Jae Hyun KIM ; Hong Joo SEO ; Sung Chol JUNG ; Chong Whan KIM ; Jun Seok KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2005;38(8):529-537
BACKGROUND: Historically the Fontan operation in patients with single ventricle and heterotaxy syndrome has been associated with high mortality because of systemic or pulmonary anomalous venous drainage, incompetent common atrioventricular valve, right ventricle type univentricular heart, and arrhythmia. MATERIAL AND METHOD: A retrospective review of 62 patients (age: 54.79+/-33.97 months) with heterotaxy syndrome who underwent a extracardiac Fontan operation between 1996 and 2005 was performed. Twenty one patients had left atrial isomerism, and 41 had right isomerism. The Fontan procedure was staged in all but 2 patients, and a fenestration was less placed in left isomerism. RESULT: Left isomerism was associated more with interrupted inferior vena cava and pulmonary arteriovenous fistula, and right isomerism was associated more with anomalous pulmonary venous drainage, common atrioventricular valve and morphologic right ventricle. There were 3 hospital deaths (4.8%), and 3 late deaths (5.2%) with a follow-up duration of 48.8+/-31.0 months. Eight-year survivals were 90.5+/-6.4% in left isomerism and 88.6+/-5.4% in right isomerism (p=0.94). At 8 years, freedom from reoperation was 73.9+/-11.3% in left isomerism, and 82.3+/-6.7% in right isomerism (p=0.87). Atrioventricular valve regurgitation progressed after Fontan operation in heterotaxy syndrome, and reoperation for pulmonary arteriovenous fistula and permanent pacemaker implantation for sinus node dysfunction were required more in left isomerism. CONCLUSION: The extracardiac Fontan operation can now be performed in patients with heterotaxy syndrome with excellent survival. However, morbidity in terms of postoperative atrioventricular valve regurgitation, arrhythmia, and pulmonary arteriovenous fistula remains significant.
Arrhythmias, Cardiac
;
Arteriovenous Fistula
;
Drainage
;
Follow-Up Studies
;
Fontan Procedure*
;
Freedom
;
Heart
;
Heart Defects, Congenital
;
Heart Ventricles
;
Heterotaxy Syndrome*
;
Humans
;
Isomerism
;
Mortality
;
Reoperation
;
Retrospective Studies
;
Sick Sinus Syndrome
;
Vena Cava, Inferior
9.A Case of Melioidosis Presenting as Migrating Pulmonary Infiltration: The First Case in Korea.
Sei Won LEE ; Jongyoun YI ; Sae Ik JOO ; Young Ae KANG ; Young Soon YOON ; Jae Joon YIM ; Chul Gyu YOO ; Sung Koo HAN ; Young Soo SHIM ; Eui Chong KIM ; Young Whan KIM
Journal of Korean Medical Science 2005;20(1):139-142
Melioidosis is an infection of the Gram-negative bacterium Burkholderia pseudomallei. While it is known as an important cause of sepsis or chronic abscessforming disease in Southeast Asia and northern Australia, no case has yet been reported in Korea. A 50-yr-old man visited our hospital for intermittent fever associated with dry cough and sputum. Roentgenographic examination showed migrating pulmonary infiltration. Symptoms and chest radiograph and computed tomography (CT) image findings did not improve despite use of fluoroquinolone antibiotics. Gram-negative bacteria were isolated on bronchoscopic washing culture and were identified as B. pseudomallei on DNA sequencing of 16S ribosomal RNA with 100% homology. Treatment for melioidosis was commenced with high dose ceftazidime, and the patient's fever, cough, and sputum were improved and the lesion on chest radiograph and CT almost disappeared.
Anti-Bacterial Agents/pharmacology
;
Burkholderia pseudomallei/metabolism
;
Ceftazidime/pharmacology
;
Diagnosis, Differential
;
Fluoroquinolones/pharmacology
;
Humans
;
Korea
;
Lung/*microbiology
;
Lung Diseases/diagnosis/*microbiology
;
Male
;
Melioidosis/diagnosis/*pathology
;
Middle Aged
;
RNA, Ribosomal, 16S/chemistry
;
Sepsis
;
Sequence Analysis, DNA
;
Temperature
;
Time Factors
;
Tomography, X-Ray Computed
10.Pacemaker Lead Endocarditis Combined with Rupture of Sinus Valsalva after Redo Aortic Valve Replacement.
Man Jong BAEK ; Chan Young NA ; Sam Sae OH ; Woong Han KIM ; Sung Wook WHANG ; Cheol LEE ; Chang Hyun KANG ; Yunhee CHANG ; Won Min JO ; Jae Hyun KIM ; Hong Ju SEO ; Chong Whan KIM
The Korean Journal of Thoracic and Cardiovascular Surgery 2003;36(10):780-783
Pacemaker lead-related infective endocarditis is an uncommon, but serious complication. We report a case of a 45-year-old man who had symptom of intermittent high fever and rupture of sinus Valsalva that developed after a redo aortic valve replacement and transvenous permanent pacemaker implantation. Positive blood cultures of streptococcus viridans and transesophageal echocardiography showing a large mobile vegetation on pacemaker lead and tricuspid valve lead to the diagnosis of pacemaker lead-related infective endocarditis. Initial antibiotic therapy followed by surgical extraction of the pacemaker lead and wide debridement of infective tissues including multiple vegetations was required. Postoperative antibiotic therapy was continued for 4 weeks. The postoperative course has been uneventful. The patient is totally asymptomatic and is doing well up to now.
Aortic Valve*
;
Debridement
;
Diagnosis
;
Echocardiography, Transesophageal
;
Endocarditis*
;
Fever
;
Humans
;
Middle Aged
;
Rupture*
;
Tricuspid Valve
;
Viridans Streptococci