The pulmonary cavernous hemangioma is usually from birth and there may be without symptoms until adulthood. Larger or multiple pulmonary angiomata with considerable pulmonary arteriovenous shunts may cause cyanosis, finger clubbing, dyspnea and frequently accompanyingbruit. Recently, we experienced a case of cavernous hemangioma of the lung. A 34-year-old woman was admitted to our hospital for surgical evaluation of a 4 cm solitary, round nodule in the right upper lobe on the chest X-ray and CT scan. She had no symptoms. Laboratory findings are within normal limits except for elevated glucose levels. At surgery, the mass was well encapsulated and easily excised from the peripheral portion of the posterior segment of the right upper lobe. Grossly, it consisted of a 4 cm in diameter, round, soft, sponge-like, hemorrhagic, slightly lobulated mass with a smooth external surface. Microscopically, the mass was composed of vessels, which were thin walled, dilated and filled with blood. The wall of the abnormal vessels was thin and composed of endothelium and fibrous connective tissue with only a little smooth muscle. Immunohistochemically, the wall of the dilated abnormal vessesls showed negative reaction for cytokeratin(low and high) and epithelial membrane antigen but weakly positive reaction for UEA-1 in focal areas.
Adult ; Male ; Female ; Humans ; Hemangioma

BACKGROUND: As a result of exposure to human leukocyte antigen(HLA) by pregnancy, blood transfusion and previous organ transplantation, many patients awaiting renal transplantation can develop HLA antibodies. The level of HLA sensitization is determined by PRA(panel reactive antibody) test using a lymphocyte panel from HLA phenotyped selected donors. In Korea, PRA tests have not been performed routinely for organ transplantations. and there is no available data about HLA sensitization in renal transplantation. METHODS: PRA test was done in 136 sera of chronic renal failure(CRF) patients receiving dialysis (hemodialysis 108, peritoneal dialysis 28) by NIH standard microlymphocytotoxicity method with a frozen lymphocytes panel from 36 HLA-typed donors. PRA positive sera were re-tested after dithiothreitol(DTT) treatment and analyzed for HLA antibody specificities. RESULTS: Thirty five out of 136 sera(25.7%) showed positive PRA values in HLA antibody screening test. The PRA(%) values of the 35 positive sera were distributed into 1-10%(n=8), 10-20%(n=7), 20-50%(n=12) and 50%-100%(n=8). respectively. After DTT treatment, the change of PRA reactivity was divided into three groups. The PRA values of Group A(22 sera: 63%) showed no change, Group B(7 sera: 20%) declined, and Group C(6 sera. 17%) completely disappeared after DTT treatment. The specificities of HLA antibodies were identified in 19 out of 35 sera(54%). The success rate in defining antibody specificities was 0 at PRA values of 1-10% and 70-100%, and high at PRA values of 20-70%. CONCLUSION: We observed that about a quarter of CRF patients have developed HLA antibodies of immunoglobulin class-IgG, mixed IgG and IgM, and IgM HLA antibody in decreasing order of frequency.
Antibodies ; Antibody Specificity ; Blood Transfusion ; Dialysis ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Immunoglobulins ; Isoantibodies* ; Kidney Failure, Chronic* ; Kidney Transplantation ; Korea ; Leukocytes ; Lymphocytes ; Mass Screening ; Organ Transplantation ; Peritoneal Dialysis ; Pregnancy ; Tissue Donors ; Transplants

Actinomycosis, in which the principal causative agent in man is known to Actinomyces israelii, is a chronic, suppurative diseases characterized by extensive fibrosis, multiple abscesses, and formation of sinus tracts that drain suppurative exudates. On the basis of the anatomical sites involved; it can be subclassified into the cervicofacial form, which is the most common form, pulmonary form and abdominal form. Kidneys are rarely affected. Clinically, radiologically, and at operation it is difficult to differentiate the renal actinomycosis from renal tuberculosis and renal carcinoma. The prognosis is excellent after nephrectomy followed by appropriate antibiotic therapy. We presented a case of renal actinomycosis with a brief review of the literatures.
Male ; Humans

The authors report two cases of successful reconstruction in infected nonunion of the femur involving marked shortening by compression and gradual distraction at the nonunion site using Ilizarov external fixator. At first, infection was controlled by radical excision & the administration of systemic antibiotics for four weeks and we also started compression at the nonunion site 3 days after operation. Autogenous iliac bone graft was added to strengthen the site of new bone formation lastly. In this report, the role of the compression seems to provide a good environment for distraction osteogenesis by focal necrosis and triggering inflammation. Compression and gradual distraction may be one of the treatment mordalities for nonunion of a long bone with massive bone loss or shortening, even infected.
Anti-Bacterial Agents ; External Fixators ; Femur* ; Inflammation ; Necrosis ; Osteogenesis ; Osteogenesis, Distraction ; Transplants

A survey of the literature on the treatment of ruptures of deltoid ligament associated with fracture of distal part of fibula is controversial. Some authors advocated surgical repair of the ruptured deltoid ligament based on the theoretical consideration, while others advocated non-operative treatment based on the clinical consideration. We studied the results in forty-five patients who were treated for disruption of the deltoid ligament and a distal fibular fracture. The length of follow-up in our series was twelve to twenty-four months, with an average of fifteen months. When the fibular fracture was adequately reduced and medial clear space was returned to its normal width, the 91 percents both of patients of being treated with repair of deltoid ligament and patients of being treated without repair had a good or excellent results.
Clinical Study ; Fibula ; Follow-Up Studies ; Humans ; Ligaments ; Rupture

OBJECTIVE: In the field of spinal surgery, a few laboratory results or clinical cases about robotic spinal surgery have been reported. In vivo trials and development of related surgical instruments for spinal surgery are required before its clinical application. We investigated the use of the da Vinci(R) Surgical System in spinal surgery at the craniovertebral junction in a human cadaver to demonstrate the efficacy and pitfalls of robotic surgery. METHODS: Dissection of pharyngeal wall to the exposure of C1 and odontoid process was performed with full robotic procedure. Although assistance of another surgeon was necessary for drilling and removal of odontoid process due to the lack of appropriate end-effectors, successful robotic procedures for dural sutures and exposing spinal cord proved its safety and dexterity. RESULTS: Robot-assisted odontoidectomy was successfully performed in a human cadaver using the da Vinci(R) Surgical System with few robotic arm collisions and minimal soft tissue damages. Da Vinci(R) Surgical System manifested more dexterous movement than human hands in the deep and narrow oral cavity. Furthermore, sutures with robotic procedure in the oral cavity demonstrated the advantage over conventional procedure. CONCLUSION: Presenting cadaveric study proved the probability of robot-assisted transoral approach. However, the development of robotic instruments specific to spinal surgery must first precede its clinical application.
Arm ; Cadaver ; Hand ; Humans ; Imidazoles ; Mandrillus ; Mouth ; Nitro Compounds ; Odontoid Process ; Robotics ; Spinal Cord ; Surgical Instruments ; Sutures

Multiple biliary papillomatosis involves an epithelial field change of the intrahepatic and extrahepatic portions of the biliary tree. Pathologically it is benign, occasionally with dysplasia, but the clinical behavior is regarded as having a low-grade malignant potential. Such malignancy is rare but the prognosis is poor if it is impossible to remove the tumor completely. Here, we report one case of multiple biliary papillomatosis in the biliary tree.
Biliary Tract ; Papilloma* ; Prognosis

No abstract available.
Aspirin* ; gamma-Globulins* ; Mucocutaneous Lymph Node Syndrome*

Wegener's granulomatosis is characterized by necrotizing granulomatosis lesion of the respiratory tract, glomerulonephritis and frequently vasculitis involving other organs. The basic pathophysiologic mechanism of Wegener's granulomatosis is not defined yet. However, it may be suspected an autoimmune disease. We experienced a case of Wegener's granulomatosis which are associated with acute renal failure and pneumothorax. The patient suffered from hemoptysis, fever and cough. Despite antibiotic therapy, symtoms did not improved and multiple varying sized nodules were aggravated on chest roentogenogram and serum creatinine elevated 3.4mg/dl. After diagnosis using video associated thoracoscopic surgery, the patient was treated with cyclophsphamide, glucocorticoid and sulfamethoxasole-trimethoprime. With the combination therapy, the patient felt completely well and chest roentogenogram showed lungs were improved and serum creatinine was normal. The patient was readmitted because of right pleuritic pain and dyspnea 15 day after discharge. The patient was developed a right pneumothorax. The lung was easily expanded by intercostal tube drainage with a one way valve. The patient has been treated as an out- patient with immunosuppressive agents continously.
Acute Kidney Injury* ; Autoimmune Diseases ; Cough ; Creatinine ; Diagnosis ; Drainage ; Dyspnea ; Fever ; Glomerulonephritis ; Hemoptysis ; Humans ; Immunosuppressive Agents ; Lung ; Pneumothorax* ; Respiratory System ; Thoracoscopy ; Thorax ; Vasculitis ; Wegener Granulomatosis*

Echocardiography was done on 51 cases with various cardiovascular disease and on 23 cases of normal control subjects from April, 1981 to March, 1982 in the Department of internal medicine, Eul Ji General Hospital, Seoul, Korea. The results obtained were as follows: 1. The left ventricular mass estimated by the measurements made with standard convention was 261+/-8gm in patient group and 126+/-6gm in control group. With penn convention, the left ventricular mass of the patients group was 297+/-11gm and that of control group was 127+/-6gm. The differences between both conventions were significant statistically. 2. In measurements made with standard convention, those who showed increased left ventricular posterior wall thickness were 37 cases(73%) and those who showed increased left ventricular internal dimension were 15 cases(29%). On the other hand, number of cases who showed increased left ventricular mass were 45 cases(88%) and this results suggested estimation of left ventricular mass seems to be more useful method in the diagnosis of left ventricular hypertrophy than simple measurements of left ventricular posterior wall thickness of left ventricular internal dimension. 3. The correlation coefficient between left ventricular mass and maximum voltage of electrocardiography, left ventricular posterior wall thickness left ventricularinternal dimension was 0.70, 0.74 0.51 respectively in standard method and 0.82, 0.76, 0.44 respectively in penn convention. Left ventricular mass was correlated fairly closely with the maximum voltage of electrocardiography and left ventricular posterior wall thickeness, less closely with the left ventricular internal dimension.
Cardiovascular Diseases ; Diagnosis* ; Echocardiography* ; Electrocardiography ; Hand ; Hospitals, General ; Humans ; Hypertrophy, Left Ventricular* ; Internal Medicine ; Korea ; Seoul