Pulmonary carcinosarcoma(Sarcomatoid carcinoma of the lung) is a rare pulmonary malignancy, which is defined as having an admixtture of both carcinomatous and sarcomatous components. Pulmonary carcinosarcoma occurs most frequentlly in males between 50 and 80 years of age. It predominantly affects the upper lobe and/or the principal bronchi, and is associated with a history of smoking. Here, we report a case of pulmonary carcinosarcoma with a left lobe atelectasis due to an endobronchial mass in a 56-year-old male. After a left pneumonectomy, the pathologic stage was IIb (T3N0M0). Four months later, an abdominal mass was observed and exploratory laparotomy revealed metastases of the pulmonary carcinosarcoma to the pelvic cavity.
Bronchi ; Carcinosarcoma* ; Humans ; Laparotomy ; Male ; Middle Aged ; Neoplasm Metastasis ; Pneumonectomy* ; Pulmonary Atelectasis ; Smoke ; Smoking

Angiomyolipomas (AML) are generally known as benign tumors. The kidney is the most common location of this tumor, and the liver is reported as the second most common site. Occurrence in other tissues is extremely rare. For instance, some cases of AML originating from the nasal cavity have been previously reported. We describe an AML case arising from the nasal cavity of a 56-year-old man. The patient had been complaining of nasal obstruction and foreign body sensation in the nasopharynx and was initially treated with preoperative angio-embolization. AML was then totally removed by endoscopic surgery without complications. He has been asymptomatic and has had no evidence of recurrence for 2 months after surgery.
Angiomyolipoma ; Embolization, Therapeutic ; Endoscopy ; Humans ; Kidney ; Liver ; Middle Aged ; Nasal Cavity ; Nasal Obstruction ; Nasopharynx ; Recurrence

OBJECTIVE: To report the learning curve of percutaneous endoscopic lumbar discectomy (PELD) for a surgeon who had not been previously exposed to this procedure based on the period and detailed technique with a retrospective matched comparative design. METHODS: Of 213 patients with lumbar disc herniation encountered during the reference period, 35 patients who were followed up for 1 year after PELD were enrolled in this study. The patients were categorized by the period and technique of operation : group A, the first 15 cases, who underwent by the 'in-and-out' technique; group B, the next 20 cases, who underwent by the 'in-and-out-and-in' technique. The operation time, failure rate, blood loss, complication rate, re-herniation rate, the Visual Analogue Scale (VAS) for back and leg were checked. The alteration of dural sac cross-sectional area (DSCSA) between the preoperative and the postoperative MRI was checked. RESULTS: Operative time was rapidly reduced in the early phase, and then tapered to a steady state for the 35 cases receiving the PELD. After surgery, VAS scores for the back and leg were decreased significantly in both groups. Complications occurred in 2 patients in group A and 2 patients in group B. Between the two groups, there were significant differences in operative time, improvement of leg VAS, and expansion of DSCSA. CONCLUSION: PELD learning curve seems to be acceptable with sufficient preparation. However, because of their high tendency to delayed operation time, operation failure, and re-herniation, caution should be exercised at the early phase of the procedure.
Diskectomy* ; Humans ; Learning Curve* ; Learning* ; Leg ; Magnetic Resonance Imaging ; Operative Time ; Retrospective Studies*

PURPOSE: The aim of this study was to evaluate the diagnostic value of the MR Imaging findings with provoked discography used as the standard for painful lumbar disc derangement. MATERIALS AND METHODS: Two hundred patients (412 discs), (age range: 21-77 years), with chronic low back pain underwent MRI and provoked discography. We evaluated the MRI T2-WI findings such as disc degeneration, high-Intensity zones and endplate abnormalities. Subsequently, provocative discography was independently performed with using MR imaging, and a painful disc was defined when moderate to severe and concordant pain was provoked. We calculated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the MRI findings with using provoked discography as the standard. RESULTS: 400 discs showed abnormal findings such as disc degeneration, HIZ and endplate abnormalities on the T2-WI images. 12 discs showed normal findings. HIZ or endplate abnormalities were always combined with disc degeneration. The prevalence of each findings were disc degeneration (400 discs: 97.1%), HIZ (111 discs: 26.9%), type I endplate abnormalities (34 discs: 8.3%), type II endplate abnormalities (75 discs: 18.2%), the combined findings of HIZ and type I endplate abnormalities (2 discs: 0.5%) and the combined findings of HIZ and type II endplate abnormalities (7 discs: 1.7%). The disc degeneration showed high sensitivity (99.5%) and low specificity (5.0%), so only the NPV (91.7%) was significant, and not the PPV (47.8%). Each findings of HIZ (sensitivity, 36.5%; specificity, 81.4%; PPV, 63.18%; NPV, 59.5%), type I endplate abnormalities (11.0%, 94.1%, 61.8% and 54.8%, respectively), type II endplate abnormalities (19.8%, 83.2%, 50.7% and 54.3%, respectively), the combined findings of HIZ and type I endplate abnormalities (0.5%, 99.6%, 50.0% and 53.4%, respectively) and the combined findings of HIZ and type II endplate abnormalities (26.0%, 99.1%, 71.4% and 53.8%, respectively) show high specificity, but low sensitivity, so the PPV and NPV were also not significant. CONCLUSION: For diagnosing painful lumbar disc derangement, the MR imaging findings seem to be inadequate as predictive factors when provoked discography was used as the standard.
Humans ; Intervertebral Disc Degeneration ; Low Back Pain* ; Magnetic Resonance Imaging* ; Prevalence ; Sensitivity and Specificity

BACKGROUND AND OBJECTIVES: Intraoperative echocardiography (IOE), mostly done by transesophageal methods, provides an important means of accessing cardiac structure and function during cardiac and noncardiac surgery. The purpose of this study was to determine the role of IOE by identifying the frequency of the use of IOE during cardiac surgery, the rate of second pump operations determined by IOE findings, and the results of the operations. SUBJECTS AND METHODS: Sixty-five patients (93 lesions) underwent cardiac surgery with the concomitant IOE done by a cardiologist in a single institution between March 1997 and October 1998. The data was collected retrospectively by reviewing the hospital records and IOE videotapes. IOE was applied to 18.9% of total cardiac operations, primarily being used in MV surgery (48.4%). A pre-pump IOE was done in 2 cases and the post-pump procedure was done in the remainder. A second pump operation was performed in 4 cases (6.25%) and all of these were found to be successful after immediate re-operation. CONCLUSION: IOE was primarily used in valve operations, particularly in procedures involving the mitral valve. IOE appears to be useful in determining the immediate results following cardiac surgery and may contribute to determining the prognosis of the patient.
Echocardiography ; Echocardiography, Transesophageal* ; Hospital Records ; Humans ; Mitral Valve ; Monitoring, Intraoperative ; Prognosis ; Retrospective Studies ; Thoracic Surgery ; Videotape Recording

Inflammatory pseudotumor is a pathologically benign condition, but it demonstrates a wide range of clinical features ranging from silent small sized tumors to aggressive features mimicking malignancy. Pseudotumors most commonly occur in the orbital area, and the involvement of the middle ear cavity is extremely rare. Several modalities are known for the treatment of pseudotumors, including complete surgical excision, oral steroid therapy, and radiation therapy. We describe a 35-year-old woman with inflammatory pseudotumor involving the middle ear cavity. The patient was treated with canal wall up tympanomastoidectomy and additional treatments with steroid and radiation therapy. However, she showed side effects to high dose steroid treatment and no response to radiation therapy. Therefore, we decided to use methotrexate with low dose steroid. After treatment, symptoms were completely resolved and there was no evidence of recurrence 1 year after maintaining immunosuppressant treatment.
Adult ; Ear, Middle ; Female ; Granuloma, Plasma Cell ; Humans ; Methotrexate ; Orbit ; Recurrence ; Temporal Bone

Aneurysms of sinus of Valsalva often remain undiagnosed until they rupture. A huge, heavily calcified unruptured aneurysm originating from the right sinus of Valsalva was detected incidentally in a 61-year-old man. Chest X-ray showed cardiomegaly and 10 cm sized huge calcified mass lesion around the cardiac shadow. Two-dimensional echocardiogrm revealed pericardial effusion with huge calcified mass compressing right ventricular outflow and color-flow Doppler echocardiogram visualized blood flow from aortic root into aneurysm. Chest CT scan and MRI revealed a large thrombosed aneurysm arising from aortic root measuring 1010cm. After pericardiocentesis cardiac catheterization was performed, which showed elevated right ventricular systolic pressure up to 80 mmHg. Aortic root angiogram revealed huge unruptured calcified aneurysm in the sinus of Valsalva arising from the right coronary sinus. The patient underwent surgical correction for the prevention of aneurysmal rupture and the relief of right ventricular outflow obstruction.
Aneurysm* ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomegaly ; Coronary Sinus ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Pericardial Effusion ; Pericardiocentesis ; Rupture ; Sinus of Valsalva* ; Thorax ; Tomography, X-Ray Computed ; Ventricular Outflow Obstruction

PURPOSE: The prognostic factors of renal cell carcinoma(RCC) are well known. However, the knowledge about the behavior of the nodal and metastatic involvement is still lacking. We analyzed the prognostic factors and survival for patients with various statuses of RCCs. MATERIALS AND METHODS: We conducted a retrospective review of 1,140 patients who had RCC between 1989 and 2005. The patients with multifocal and/or cystic RCCs, bilateral RCCs, RCCs related to ESRD and von Hippel-Lindau disease or the patients who didn't undergo lymph node dissection were excluded. The patients were divided into 4 groups; the TxN0M0(473 patients), TxN1-2M0(31), TxN0M1(47) and TxN1-2M1(21) groups. Univariate and multivariate analysis were performed to identify the prognostic factors(age, the mean tumor size, the pT stage, the histological type, the nuclear grade and the presence of symptoms). The five- year cancer-specific survival(CSS) also was calculated. RESULTS: The five-year CSS for each group was 90.5%, 62.8%, 38.8% and 17.9%, respectively. For the TxN0M0 group, every prognostic factor had a significant impact on survival on univariate analysis. Multivariate analysis subsequently showed that the pT stage, the histological type and the nuclear grade were independent prognostic factors. For the TxN1-2M0 group, the histological type was a significant prognostic factor. Age and the pT stage were independent prognostic factors for the TxN0M1 group and the presence of symptoms was an independent prognostic factor for the TxN1-2M1 group. CONCLUSIONS: The survival was the highest for the TxN0M0 group and it was the lowest for the TxN1-2M1 group. The survival for the TxN1-2M0 group was better than that for the TxN0M1 group. These results obtained by analyzing the prognostic factors and the five-year CSS according to the various nodal and metastatic statuses of RCC patients will provided crucial information to predict clinical progression and the survival outcomes.
Carcinoma, Renal Cell ; Humans ; Kidney Failure, Chronic ; Lymph Node Excision ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Survival Rate ; von Hippel-Lindau Disease

This study surveyed the prevalence of traumatic reticular diseases (TRD) of slaughter cattle in Korea, the typology of the causative foreign bodies and the effects on beef quality and carcass weight. The overall prevalence of TRD in 3,121 slaughter cattle was 5.5%. However, the prevalence was significantly higher in Korea indigenous cattle Hanwoo (5.8%, p < 0.05) and female cattle (20.75%, p < 0.001). The prevalence significantly increased in aged cattle (p < 0.001). Major lesions related to foreign bodies were reticulitis (96%) and peritonitis (86%). Most causative foreign bodies were made of iron including nails, wires, steel rods, screw nails, and syringe needles. Cattle affected with TRD produced significantly lower grade quality of beef compared to normal cattle (p < 0.0001), but TRD did not affect carcass weight. The data will be useful in the management of TRD, with the aim of increasing beef productivity in Korea.
Aged ; Animals ; Cattle ; Efficiency ; Female ; Foreign Bodies ; Humans ; Iron ; Korea ; Nails ; Needles ; Peritonitis ; Prevalence ; Steel ; Syringes

PURPOSE: We investigated the characteristics of the distribution of the serum prostate- specific antigen (PSA) and evaluated the factors influencing the serum PSA levels in healthy men under 50 years old. MATERIALS AND METHODS: A total of 5,701 healthy Korean men under 50 years old who visited the Health Promotion Center at our hospital for a routine health checkup were enrolled into a prospective study. All the men underwent a PSA determination using a Hybritech Tandem-R assay, anthropometric measurements, liver function tests, renal function tests, and other constituents. The risk factors associated with an increase in the serum PSA among these clinical parameters were investigated using univariate and multivariate logistic regression analyses. RESULTS: Almost no change was observed in the median and 95th percentiles serum PSA value in men under 50 years old. Univariate logistic regression analysis indicated that the hematocrit, sodium, potassium, osmolarity, albumin, and globulin levels were the risk factors associated with an increase in the serum PSA. In the multivariate model used, the hematocrit, potassium and albumin levels were found to be independent predictors of an increase in the serum PSA, whereas the sodium, and globulin levels, and the osmolarity had no statistical significance. CONCLUSIONS: Age does not appear to influence the serum PSA levels of healthy Korean men under 50 years old. The results also suggest that the chemical constituents in young adults may exert an influence on the serum PSA levels.
Health Promotion ; Hematocrit ; Humans ; Kidney ; Liver ; Liver Function Tests ; Logistic Models ; Male ; Middle Aged* ; Osmolar Concentration ; Potassium ; Prospective Studies ; Prostate-Specific Antigen* ; Risk Factors ; Sodium ; Young Adult