To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

In this report, we describe the case of a SARS-CoV-2 infection (COVID-19) in an infant with mild fever and diarrhea in the absence of respiratory distress. A 45-day-old male infant with COVID-19 was transferred to our pediatric department. He had mild fever and diarrhea at admission. Positive-to-negative nasal swab conversion occurred on the 21st day from the onset of symptoms. However, stool swab positivity persisted during the 6-week admission period and for 7 weeks during follow-up at an outpatient clinic after discharge. Negative conversion in a stool specimen occurred on the 142nd day from the onset of symptoms. This case highlights the potential of fecal virus shedding as an important feature of viral transmission in infants and young children.

No abstract available.
Lymphatic Diseases*

Twenty-one patients undergoing aortic valve replacement for pure aoritic regurgitation were studied retrospectively to evaluate the left ventricular function and internal dimension change before, 1-6 weeks(early postoperative) and 2-36 months after(late postoperative) aortic valve replacement by serial echocardiography. Postoperatively, NYHA function class improved remarkably (from 3.3+/-0.6 to 1.4+/-0.7). Early postoperatively, left ventricular end-diastolic dimension (EDD), left ventricular end-systolic dimension(ESD), left ventricular fractional shortenting(FS) significantly decreased in all patients(7.6+/-1.2cm vs 5.8+/-1.5cm P<0.001, 5.5+/-1.3cm vs 4.7+/-1.3cm P<0.001, 39+/-12% vs20+/-8% P<0.001 respectively). Interventricular septum thickness(IVS) and posterior wall thickness (PW) were slightly thickened before(1.4+/-0.3cm, 1.3+/-0.3cm respectively) and in the early postoperative period (1.3+/-0.4cm, 1.3+/-0.3cm respectively) without significant interval change. Late postoperatively, EDD and ESD decreased significantly (7.8+/-1.2cm vs 5.1+/-0.8cm P<0.01, 5.1+/-1.1cm vs 3.4+/-0.8cm P<0.001. respectively), and FS increased significantly (25+/-9% vs 34+/-9%, P<0.05). Among 3 patients of so called high risk group mentioned by Henry(22,33), ESD and FS improved to normal range in 2 patients, and ESD decreased to 4.4cm and FS increased to 33% in the other one. EDD and ESD decreased significantly in both group I(preoperative ESD<5.5cm) and group II(preoperative ESD<5.5cm), without no decrement difference between two groups, and there was a significant difference of FS decrement between group I and group II at early postoperative period. Preoperative ESD correlated highly with the early postoperative EDD(r=0.89) and ESD(r=0.87) with statistical significance, and moderately high with late postoperative EDD(r=0.45), ESD(r=0.50) and FS(r=0.42) without statistical signiticance. We concluded that there was significant improvement in left ventricular function in pure aortic regurgitation patients postoperatively. Preoperative left ventricular and systolic dimension above 5.5cm and fractional shortenting below 25% are not so reliabel index of poor postoperative prognosis.
Aortic Valve Insufficiency* ; Aortic Valve* ; Echocardiography* ; Humans ; Postoperative Period ; Prognosis ; Reference Values ; Retrospective Studies ; Ventricular Function, Left

Surgical revascularization is very effective for the relief of chest pain, improvement of exercise tolerance and ventricular performance in certain ischemic heart diseases. Bypass graft angiography and native coronary angiography after coronary artery bypass graft(CABG) were required for the evaluation of graft patency, progression of the native coronary artery disease and to predict the prognosis of the patients after CABG. The cases included in this study involved 15 patients who underwent selective bypass graft angiography among 102 CABG cases. Thirty eight sites were bypassed by saphenous vein and two sites by internal mammary artery. The results were as follows: 1) The overall patency rate of the saphenous vein bypass graft was 76.3% and the two sites of the internal mammary artery bypass graft were both patent. 2) The patency rate of direct anastomosis was 86.2% and of sequential anastomosis, 44.4%. 3) In eight patients who underwent native coronary angiography, five patients showed progression of grafted coronary artery disease. Among them, two patients had accompanying progression of coronary artery disease in non-grafted vessels. 4) Follow up treadmill test performed in six patients showed improvement of exercise tolerance in all patients. 5) There was some increase in the ejection fraction of the left ventricle after CABG in six patients who received follow up left ventriculography.
Angiography* ; Chest Pain ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Heart Ventricles ; Humans ; Mammary Arteries ; Myocardial Ischemia ; Prognosis ; Saphenous Vein ; Transplants*

BACKGROUND: It is well known that atrial fibrillation is common cardiac arrythmia in old age and poses a definitive risk factor of cerebral infarction. Therefore, effective treatment of atrial fibrillation is very important in the prevention of cerebral infarction. However, oral anticoagulant medication for the prevention of embolic ischemic stroke may be dangerous due to cerebral hemorrhage side effects. METHODS: This is a controlled case study designed to identify the risk factors in a large numbers of stroke and atrial fibrillation patients and to assess those patients with atrial fibrillation as a high risk group for cerebral infarction. All patient discharged from Chonnam National University Hospital were identified over a 42 month period who met our case standards of atrial fibrillation and ischemic stroke (n=62), and compared them with the control groups who were discharged with atrial fibrillation without stroke(n=68). We excluded the atrial fibrillation due to valvular heart disease, ischemic heart disease and congestive heart failure during the selection of subjects. RESULTS: Subjects and the controls were characteristically similar with common past medical histories of diabets, smoking, and hyperlipidemia. Sex, familial history, left ventricular hypertrophy in 2D-echocardiogram were also similar in both groups, however differences did exist. Subjects were significantly older than controls(68.9 : 63.9, p<0.001) and more likely to have a history of hypertension(56.5% : 23.5%, p<0.001) and left atrial enlargement(>40mm)(52.6% : 29.0%, p<0.001). Each of these 3 factors were assinged a measure of 1 point as a risk score, ischemic embolic stroke was found in 4 out of 28 patients(14.3%) with a risk score of 0, in 16 out of 39 patients(41.0%) with a risk score of 1, in 29 out of 41 patients(70.7%) with a risk score of 2, in 8 out of 11 patients(72.7%) with a risk score of 3. CONCLUSIONS: Based on the above results, a subject having more than two risk factors should be regarded as a high risk group for cerebral infarction and the long term anticoagulant therapy for the prevention of stroke may also be necessary even though some complications are present.
Arrhythmias, Cardiac ; Atrial Fibrillation* ; Cerebral Hemorrhage ; Cerebral Infarction* ; Heart Failure ; Heart Valve Diseases ; Humans ; Hyperlipidemias ; Hypertension ; Hypertrophy, Left Ventricular ; Jeollanam-do ; Myocardial Ischemia ; Patient Selection ; Risk Factors* ; Smoke ; Smoking ; Stroke

Renal Infarction is a rare disease and in 90% of patients with renal infarction, underlying cardiac disease is presented. Most often this includes valvular heart disease, cardiac arrhythmias, rheumatic heart disease with fibrillation, or subacute bacterial endocarditis. The correct clinical diagnosis and appropriate treatment of renal infarction are often delayed. Three cases of renal infarction were presented with review of literature.
Arrhythmias, Cardiac ; Diagnosis ; Endocarditis, Subacute Bacterial ; Heart Diseases ; Heart Valve Diseases ; Humans ; Infarction* ; Rare Diseases ; Rheumatic Heart Disease

A case of a 39-year-old woman with corrected transposition of the great vessels without significant intracardiac anomaly or coronary disease is reported. The clinical diagnosis of coronary arterial disese was supported in this patient by electrocardiographic changes of probable old anteroseptal myocardial infarction. Coronary arteriographic study showed the morphologic left coronary artery supplied the right-sided ventricle, and the right coronary artery supplied the left-sided ventricle, and the right coronary artery supplied the left-sided ventricle. Although the condition is theoretically compatible with a normal life span, few patient with this lesion survive past 40 years of age because of the subsequent heart block or functioning as a systemic ventricle.
Adult* ; Anterior Wall Myocardial Infarction ; Coronary Angiography* ; Coronary Disease ; Coronary Vessels ; Diagnosis ; Electrocardiography ; Female ; Heart Block ; Humans

We investigated the overall survival rate after pulmonary metastasectomy in the bone and soft tissue sarcoma and the available prognostic factors related with the survival rate after pulmonary metastasectomy. Between 1986 and 1995, 9 patients (median age 32) with bone and soft tissue sarcoma with pulmonary metastasis were managed in the Catholic University of Korea. Until the final follow-up in May 1996, 6 patients have died of disease and their mean survival period was 28 months (9- 58months). The actual 5-year survival rate by Kaplan-Meier method was 33%. Prognostic factors such as tumor free interval, number of metastatic lesion, postoperative chemotherapy and histologic grade were analyzed. Three patients who had the tumor free interval over 3 years were alive (mean survival period: 52.6 months), whereas six patients who had the tumor free interval less than 3 years were dead (mean survival period: 19 months). Out of four patients with low grade tumor, three patients were alive with average 39.2 months survival period, whereas five patients with high grade tumor were all dead with average 19.2 months survival period. These results suggested that pulmonary metastasectomy in bone and soft tissue sarcoma may prolong the survival rate. The long tumor free interval, histological low grade and soft tissue sarcoma may influenced on prolonged survival rate. However, number of metastatic lesion or postoperative chemotherapy has not influenced on the survival rate.
Drug Therapy ; Follow-Up Studies ; Humans ; Korea ; Metastasectomy* ; Neoplasm Metastasis ; Sarcoma* ; Survival Rate*