No abstract available.
Seizures*

From March 1985 to June 1997, 451 patients of spontaneous pneumothorax treated at Kangbuk Samsung Hospital were reviewed retrospectively. Most of the patients were male (male to female ratio, 8.2:1). The mean age of the primary spontaneous pneumothorax (PSP) was 26.8 years, and that of secondary spontaneous pneumothorax (SSP) was 53.1 years. 330 out of 451 patients (73%) were PSP. The causes of the SSP were mostly pulmonary tuberculosis and COPD: 87 patients (72%), and 24 patients (19.2%), respectively. All the patient were treated by one of the following modalities: 1)rest and oxygen therapy in 42 patients, 2) closed thoracostomy in 208 patients, 3) thoracotomy in 156 patients, 4) VATS bullectomy in 45 patients. The mean duration of postoperative chest tube drainage was as following: thoracotomy 8.3 days, VATS bullectomy 4.7 days. For recent 3 consecutive years, VATS bullectomy has become the more frequently applied operative procedure than thoracotomy in the treatment of surgically indicated PSP, from 33% in 1994 to 78% in 1996. With the minimally invasive thoracoscopic surgery being more prevalent, VATS bullectomy will be able to be the 1st choice of treatment not only for the recurrent pneumothoracies but also for the some selected cases of the 1st episode pneumothoracies. To verify this approach as clinically acceptable one in terms of cost-effectiveness, recurrence rate, etc, a large scale of multi-institutional clinical study will be needed in a sooner time.
Chest Tubes ; Drainage ; Female ; Humans ; Male ; Oxygen ; Pneumothorax* ; Pulmonary Disease, Chronic Obstructive ; Recurrence ; Retrospective Studies ; Surgical Procedures, Operative ; Thoracic Surgery, Video-Assisted ; Thoracoscopy ; Thoracostomy ; Thoracotomy ; Tuberculosis, Pulmonary

BACKGROUND: Recently, many cardiac centers have been using aprotinin to reduce operative bleeding in cardiac operations using cardiopulmonary bypass. A variety of reports have confirmed the effectiveness of the drug in cardiac operations. In addition to the operations which could be considered to cause severe operative bleeding such as redo operation, long cardiopulmonary bypass operation and etc, the use of aprotinin is increasing in the field of primary cardiac operations. Varying doses of regimen have been introduced since the first report by Royston et al, and also various opinions on the effectiveness and safeness of the each regimen have been reported. We reviewed our own experience of the full dose aprotinin regimen(Hammersmith regimen) retrospectively. MATERIAL AND METHOD: From October 1994 to February 1998, 40 cases of cardiac operative patients were randomized into two groups: aprotinin group(20 patients) which received a full dose aprotinin regimen and control group(20 patients) which did not receive aprotinin. To evaluate the degree of bleeding decrease, we analysed and compared the amount of postoperative 6 hours and 24 hours bleeding in the each group. To confirm the renal dysfunction, we measured the postoperative creatinine level. RESULT: In the amount of postoperative 6 hours bleeding, a statistically significant bleeding decrease was demonstrated in the aprotinin group compared to the control group(aprotinin group: 186+/-40cc, control group:409+/-69cc, P=0.010). Similar result was observed in the postoperative 24 hours(aprotinin group:317+/-53cc, control group: 671+/-133cc, P=0.024). CONCLUSION: We concluded that full dose regimen of aprotinin can remarkably reduce postoperative bleeding in cardiac operations without significant renal dysfunctions.
Adult* ; Aprotinin* ; Cardiopulmonary Bypass ; Creatinine ; Hemorrhage ; Humans ; Retrospective Studies ; Thoracic Surgery

Since Wands et al. reported for the first time in 1975 the reactivation of the hepatitis B virus in hematologic disease patients who had been receiving chemotherapy, the efficacy of chemotherapy and immunosuppressants has improved. As a result, the frequency of the reactivation of hepatitis B is increasing. Reported herein is a case of a non-Hodgkin lymphoma patient in her 70s who was suspected to have had HBsAg negative/anti-HBs negative occult HBV infection. The patient experienced fulminant hepatitis caused by the reactivation of hepatitis B, and died three months after the R-CHOP regimen was completed. In the HBsAg negative plus HBV DNA-negative case, there were few instances of viral activation of HBV. In this case, antiviral therapy was needed when the patient was confirmed to have become HBV DNA positive through regular monitoring, but its necessity is often overlooked, unlike the preemptive antiviral treatment in the HBsAg positive cases.
DNA ; Drug Therapy* ; Hematologic Diseases ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Virus Activation ; Rituximab

Bartter syndrome is a renal tubular defect in electrolyte transport characterized by hypokalemia, metabolic alkalosis, hyperreninemia, hyperaldosteronism, normal blood pressure, and other clinical symptoms. As a clinical and genetical heterogeneous disorder, this syndrome can be classified into two clinical variants, antenatal Bartter syndrome and classic Bartter syndrome according to the onset age. Nephrocalcinosis is common in antenatal Bartter syndrome, but is rare in classic Bartter syndrome. It can also be classified into five genetic subtypes by the underlying mutant gene, all of which are expressed in the tubular epithelial cells of the thick ascending limb of the loop of Henle. Patients with Bartter syndrome type 1, 2 and 4 present at a younger age than classic Bartter syndrome type 3. We have experienced a case of Bartter syndrome with nephrocalcinosis in a 42-year-old woman diagnosed by biochemical and radiologic studies. We had successful response with potassium chloride and spironolactone.
Adult* ; Age of Onset ; Alkalosis ; Bartter Syndrome* ; Blood Pressure ; Epithelial Cells ; Extremities ; Female ; Humans ; Hyperaldosteronism ; Hypokalemia ; Loop of Henle ; Nephrocalcinosis* ; Potassium Chloride ; Spironolactone

We experienced a case of primary sternal tuberculosis with destroyed midsternum and bony defect. An 22-year-old female was admitted to our hospital two times for severe sternal pain and spontaneous fracture without history of trauma. On hospital admission, chest X-ray and chest CT showed destruction of midsternum and soft tissue swelling. Fine needle aspiration cytology revealed tuberculous osteomyelitis with cold abscess. And the patient was treated with usual anti-tubeculosis medication for preoperative preparation. At operation, we confirmed midsternal destruction with cold abscess and multiple sinus tracts. After removal of diseased sternal segment and cold abscess, we performed sternal reconstruction with autologus iliac bone graft. The pathologic report was compatible with tuberculous osteomyelitis and caseous necrosis.
Abscess ; Biopsy, Fine-Needle ; Female ; Fractures, Spontaneous* ; Humans ; Necrosis ; Osteomyelitis ; Sternum ; Thorax ; Tomography, X-Ray Computed ; Transplants ; Tuberculosis* ; Young Adult

Malignant mesenchymoma is a very rare tumor presented during the embryonic and infant period and malignant mesenchymoma in the adult is extremely rare. Tumor is composed of two or more unrelated mesenchymal derivatives apart from fibrous tissue. These tumors are thought to be originated from embryonic mesenchyme capable of differentiating into any type of connective tissue. A 61 years old man with complaints of cough and copious sputum of onset of two months was admitted after initial examinations, showing a very huge mass over the right upper lobe. Right pneumonectomy with partial rib resection of 3rd, 4th, and 5th ribs was performed due to the initial diagnostic impression of squamous cell carcinoma by the fine needle aspiration biopsy. The operative field presented a mass locating across the interlobal fissure with severe adhesions to the chest wall. Postoperatively, the patient received 5,000 rads of radiotherapy and presently, 6 months later, has shown no signs of recurrence.
Adult* ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Squamous Cell ; Connective Tissue ; Cough ; Humans ; Infant ; Lung Neoplasms ; Lung* ; Mesenchymoma* ; Mesoderm ; Middle Aged ; Pneumonectomy ; Radiotherapy ; Recurrence ; Ribs ; Sputum ; Thoracic Wall

The authors reviewed the chart of 37 patients who had chestnut bur injury to the eye from September 1997 to November 1998.Their ages were ranged from 4 to 69 years old and they 33 men (89.2%)and 4 women (10.8%).They were injured by chestnut bur on cornea (33 eyes), sclera (1 eye), cornea and sclera (2 eyes), cornea and periorbital tissue (2 eyes). Chestnut burs were removed from 28 eyes at Out Patient Department (75.7%)and from 9 eyes with surgical microscope in operating room (24.3%).At OPD, simple removals without leaking were performed in 21 eyes (56.8%)and leaking occurred in 7 eyes (18.9%).Among 7 eyes (18.9%), primary repairs were performed in 2 eyes (5.4%), therapeutic contact lens were worn in 3 eyes (8.1%), chemical tissue glue was used in 1 eye (2.7%) and a pressure patch was used in 1 eye (2.7%). At operating room, simple removals were performed in 3 eyes (8.1%)and leaking occurred in 6 eyes (16.2%).Among 6 eyes (16.2%), primary repairs were performed in 4 eyes (10.8%)and therapeutic contact lens were in 2 As complications, traumatic cataract, iritis, endophthalmitis, cornealulcers and scleral granuloma were developed in 8 eyes (21.6%), 12 eyes (32.4%), 1 eye (2.7%), 1 eye (2.7%)and 3 eyes (8.1%)respectively. In conclusion, the prompt &proper management of chestnut bur injury and the importance of prevention &public information should be stressed.
Adhesives ; Aged ; Cataract ; Cornea ; Endophthalmitis ; Female ; Granuloma ; Humans ; Iritis ; Male ; Operating Rooms ; Sclera

Primary pulmonary meningioma is an extremely rare disease. It is mostly benign and asymptomatic. This tumor shows the same cytohigstologic appearance as brain or spinal cord meninioma. It can be diagnosed as a primary pulmonary meningioma only if there is no evidence of metastasis from the brain or spinal cord meningioma. We experienced a case of primary pulmonary meningioma in a 60-year-old woman who had asymptomatic 2 cm-sized solitary pulmonary tumor in the right lower lobe. It is rather peripherally located. Fine needle aspiration cytology has suggested the possibility of either well-differentiated epithelial malignancy such as papillary adenocarcinoma or mucoepidermoid carcinoma or metastatic carcinoma such as from ductal carcinoma of the breast. Right lower lobectomy was performed. The tumor was bilobated and soild with yellowish color. pathologically it proved to be a primary pulmonary and solid with yellowish color. Pathologically it proved to be a primary pulmonary meningioma because there was no evidance of brain or spinal cord tumor. To the best of our knowledge this is the first case reported in Korea. We report this case with review of the literature.
Adenocarcinoma, Papillary ; Biopsy, Fine-Needle ; Brain ; Breast ; Carcinoma, Ductal ; Carcinoma, Mucoepidermoid ; Female ; Humans ; Korea ; Meningioma* ; Middle Aged ; Neoplasm Metastasis ; Rare Diseases ; Spinal Cord ; Spinal Cord Neoplasms

BACKGROUND: This prospective and cross-sectional study was conducted to assess the risk factors for coronary artery disease in the selected Korean Pateints. METHOD: We analyzed clinical parameters and biochemical parameters in 158 subjects; 98 subjects with significant coronary artery disease as proven by coronary angiography(stable angina pectoris : 55, unstable angina pectoris : 30, post-myocardial infarction angina pectoris : 13) and 58 normal subjects as proven by coronary angiography, from November 1993 to April 1994 in Seoul National University Hospital. RESULTS: 1) Old age, male gender, history of diabetes and smoking, high low density lipoprotein cholesterol level, high lipoprotein (a) level and high fibrinogen level were identified and risk factors for coronary artery disease on simple logistic regression analysis. 2) Lp(a) was positively related to fibrinogen(r=0.23), cholesterol(r=0.23) and low density lipoprotein cholesterol(r=0.28). 3) High fibrinogen level, old age, and male gender were independent risk factors of significant coronary artery disease in the selected Korean Population on multiple stepwise logistic regression analysis. CONCLUSION: High fibrinogen level, old age, and male gender six were independent risk factors of significant coronary artery disease in the selected Korean Population of multiple stepwise logistic regression analysis. These findings could not deny the role of cholesterol in coronary artery disease, but suggested that factors related to thrombosis and fibrinolysis, may play more important role in Korean patients coronary artery disease.
Angina Pectoris ; Angina, Unstable ; Cholesterol ; Cholesterol, LDL ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Cross-Sectional Studies ; Fibrinogen* ; Fibrinolysis ; Humans ; Infarction ; Lipoprotein(a) ; Lipoproteins ; Logistic Models ; Male ; Prospective Studies ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Thrombosis