No abstract available.
Cause of Death* ; Humans ; Kidney Failure, Chronic* ; Renal Dialysis* ; Survival Rate*

No abstract available.
Frontal Sinus*

No abstract available.
Colorectal Neoplasms* ; Humans* ; Oncogenes* ; Point Mutation* ; Polymerase Chain Reaction*

Primary intimal sarcoma of the pulmonary artery is a rare disease and there has been no report of any case originating from the pulmonary valve. Recently we experienced a 62 year-old female patient who had a primary intimal sarcoma of the pulmonary valve with distal metastasis. She was brought to medical attention due to exertional dyspnea facial edema productive coughing and general weakness for 1 month. Chest CT and echocardi-ography suggest an acute pulmonary thromboembolism or tumor. Exploration showed a large polypoid mass arising from the pulmonary leaflets and multiple masses on distal pulmonary arteries. We replaced the pulmonary valve and reconstructed the pulmonary artery. She received radiotherapy 1 month postoperatively and now 4 months after surgery she has begun receiving chemotherapy.
Cough ; Drug Therapy ; Dyspnea ; Edema ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Pulmonary Artery ; Pulmonary Embolism ; Pulmonary Valve* ; Radiotherapy ; Rare Diseases ; Sarcoma* ; Tomography, X-Ray Computed

No abstract available.
Hemorrhage*

No abstract available.
Hemorrhage*

PURPOSE: To determine the usefulness of microbubble contrast enhanced power Doppler ultrasonography (PDUS)for the detection of residual tumor in hepatocellular carcinomas (HCCs) treated by transcatheter arterialchemoembolization (TACE). MATERIALS AND METHODS: Fourteen nodular HCCs (size range: 1 - 7.3 cm, mean: 3.5) intwelve patients treated by TACE, and on the basis of follow-up liver CT, thought to have a residual tumor, wereincluded in this study. Between July 1997 and April 1998, PDUS examinations were performed with a 2-4 MHz convextransducer before and after intravenous injection of a microbubble contrast agent (Levovist(, Schering AG, Berlin,Germany). Real-time power Doppler ultrasonographic images were recorded on videotape and representative imageswere color-printed. Tumor vascularity was analyzed on real-time images with regard to its presence or absence, andchanges, and two observers reached a consensus. The results were compared with those of other diagnostic tests(three-phase helical CT, conventional angiography, percutaneous biopsy, and/or surgical pathology). RESULTS: Contrast-enhanced PDUS revealed intratumoral vascularity in ten of 14 tumors, none of which showed vascularity onunenhanced PDUS. In the remaining four tumors, both unenhanced and enhanced PDUS showed intratumoral tumorvascularity, which in all cases was more pronounced on enhanced than on unenhanced PDUS. Other diagnostic testsrevealed residual tumors in eleven lesions. CONCLUSION: Microbubble contrast-enhanced PDUS was more sensitivethan non-enhanced PDUS in depicting vascularity within a residual tumor and could be a useful method for thedetection of residual tumor in HCCs treated by TACE.
Angiography ; Biopsy ; Carcinoma, Hepatocellular* ; Consensus ; Follow-Up Studies ; Humans ; Injections, Intravenous ; Liver ; Microbubbles ; Neoplasm, Residual ; Tomography, Spiral Computed ; Ultrasonography, Doppler* ; Videotape Recording

PURPOSE: To assess the effectiveness of subsegmental transcatheter arterial chemoembolization(TAE) forhepatocellular carcinomas(HCCs) on the basis of tumor necrosis rate. MATERIAL AND METHODS: Between May 1996 andMarch 1998, ten patients with single HCC after subsegmental TAE underwent surgical resection. Subsegmental TAE wasperformed by injecting a mixture of lipiodol and adriamycin followed by gelatin sponge particles into the distalbranches of the subsegmental arteries. Tumor size and the extent of necrosis were analyzed in ten resectedlesions, and in all patients, complications after subsegmental TAE were assessed. RESULTS: The size of resectedtumors ranged from 1 to 5,5cm. On histological examination, complete necrosis was seen in 6 to 10 resected lesionsand 95% necrosis in three. In the remaining lesion, 85% necrosis had occured. Complete necrosis was noted in 4 of6 small HCCs(less than 3cm in diameter), while in the remaining two the extent of necrosis was 95%. Nocomplications were observed. CONCLUSION: For the treatment of HCC, subsegmental TAE is safe and effective.Curative therapy must, however, involve follow-up and repeated TAE.
Arteries ; Carcinoma, Hepatocellular* ; Doxorubicin ; Ethiodized Oil ; Follow-Up Studies ; Gelatin ; Humans ; Liver Neoplasms ; Necrosis ; Porifera

The search for alternative epicardial energy sources in the treatment of nonvalvular atrial fibrillation (AF) is a relatively new aspect of the evolving spectrum of Maze operations. We tested the hypothesis that epicardial microwave ablation produces identical results to those of the standard cryosurgical Maze. Fourteen consecutive patients with chronic AF underwent on-pump epicardial Maze procedures after routine cardiac surgery. The results were compared with those of 14 control patients selected from our Maze database of 280 patients. There were no differences in age, sex, cardiothoracic ratio, duration of AF, pump time, intensive care unit or hospital stays. The aortic cross clamp time with epicardial microwave was, however, shortened from 110 to 65 minutes (p=0.011). The recurrence rate of AF after discharge showed no significant difference between the two groups (14% vs. 15%, p=0.841). Epicardial microwave ablation might be a valuable alternative to the conventional cryosurgical Maze procedure, especially for those patients without associated mitral valve disease.
Age Distribution ; Atrial Fibrillation/*epidemiology/*therapy ; Chronic Disease ; Cryosurgery/*statistics and numerical data ; Female ; Humans ; Korea/epidemiology ; Male ; Microwaves/*therapeutic use ; *Pericardium ; Prognosis ; Recurrence/prevention and control ; Risk Assessment/methods ; Risk Factors ; Sex Distribution ; Treatment Outcome

BACKGROUND: The present study was undertaken to assess the effectiveness of surgical repair as a method of treatment for rheumatic mitral regurgitation by comparing the results of mitral valvuloplasty(MVP) in rheumatic mitral regurgitation and degenerative mitral regurgitation. MATERIAL AND METHOD: Among the 184 MVP patients between January 1995 to December 1998, 49 Rheumatic mirtal regurgiation patients(Group I) and 72 degenerative mirtal regurgitation(Group II) patients were studied. The mean age in group I was 36.3+/-14.6(16-74) and in group II, 52.5+/-13.4(14-77) years. The total follow up duration was 72.2patient years for group I and 77.2 patient years for group II. The Echocardiography was performed preoperatively, at 6months and 1 year postoperatively, and then yearly thereafter in both groups. RESULT: Preoperatively, there were no hemodynamic differences between the two groups. The preoperative mitral regurgitation was 3.9+/-0.4 in group I and 3.9+/-0.3 in group II, but on follow up, both groups showed decrease of grade of regurgitation to 0.9+/-0.9 in group I and 0.8+/-0.7 in group II. The mitral valve area or the mean transmitral pressure gradient was not significantly different between the two groups. There was neither early nor late mortality in either group and the reoperation rate in group I was 1.4% per patient year and 2.6% per patient year in group II. The rate of thromboembolism in group I was 2.8% per patient year and 1.3% per patient year in group II. There was one bacterial endocarditis in group I. Statistical analysis of the data between the two groups failed to reveal any significant differences. CONCLUSION: Although the results of a long term follow up will be required, the current intermedite term study showed that repair was a viable option in the treatment of rheumatic mitral regurgitation.
Echocardiography ; Endocarditis, Bacterial ; Follow-Up Studies ; Hemodynamics ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mortality ; Reoperation ; Rheumatic Heart Disease ; Thromboembolism