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Cardiac Malignant Mesenchymoma - Two Cases Report - (심장의 악성 간엽세포종 - 2례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.750-754
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    • 2002
  • Primary cardiac tumors are rare and about 20~25% of primary cardiac tumors are malignant. Moreover, primary malignant mesenchymoma of the heart is extremely rare. Recently, we have experienced two cases of cardiac malignant mesenchymoma. In the first case, malignant mesenchymoma which was originated from the posterior wall of the left atrium obstructing the mitral orifice was revealed pathologically in a 61-year-old woman with mitral regurgitation. The mass, which was 2.7$\times$3.7cm in size on the posterior wall of left atrium, was extended to the posteromedial commissure and annulus of the mitral valve. The mass was resected partially without excision of the left atrial free wall. She was discharged after 30 days without any problems and she received chemotherapy and followed up for 19months. The second case was a 4$\times$5cm in size, friable, yellow-whitish multilobulated mass in the left atrium which was originated from the left lower pulmonary vein. Multiple minor tumor nodules were found in the wall of the left atrium and the posterior leaflet of mitral valve. Partial mass excision and mitral valve replacement were performed.

Descending Thoracic Aorto-bifemoral Artery Bypass Grafting in a Leriche's Syndrome (Leriche's 증후군에서 흉부하행대동맥-양측 대퇴동맥 우회술)

  • Chung, Jae Ho;Son, Ho Sung;Yi, Eun Jue;Son, Kuk Hui;Kang, Moon Chul;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.104-106
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    • 2009
  • Extra-anatomic graft bypass is frequently performed instead of standard infrarenal aorto-iliac reconstruction in patients with Leriche syndrome in whom the thrombus extends to the level of the renal arteries. However, many different surgical options are still being attempted due to the unsatisfying long-term graft patency. We performed a descending thoracic aorto-bifemoral bypass graft with 14 and 14-7-7 mm artificial vessels through a posterolateral thoracotomy, a median laparotomy, and a longitudinal inguinal incision in a 48-year-old male who suffered from claudication with Leriche syndrome. After surgery, the patient recovered well and was discharged. The patient walked well without any symptoms during the 6 month follow-up period in the outpatient department. We have concluded that descending thoracic aorto-bifemoral bypass grafting could be considered as an alternative method for patients with Leriche syndrome in whom standard infrarenal aorto-iliac reconstruction is unsuitable.

Ruptured Sinus of a Valsalva Aneurysm into the Left Ventricle with the Rupture Site Communicating with the Left Coronary Sinus and the Left Noncoronary Sinus (좌관상동맥동과 비관상동맥동이 좌심실로 파열된 발살바동 동맥류)

  • Lee, Hongkyu;Kim, Gun-Jik;Lee, Jong-Tae
    • Journal of Chest Surgery
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    • v.42 no.1
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    • pp.96-99
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    • 2009
  • We report here on a case of a ruptured sinus of a valsalva aneurysm into the left ventricle with the rupture site communicating with both the left coronary sinus and the noncoronary sinus in a 37-year-old male who presented with symptoms of congestive heart failure. Echocardiography showed a sac-like structure around the sinus of valsalva, an enlarged left ventricle (LV) and severe aortic regurgitation, which all suggested a ruptured sinus of a valsalva aneurysm or an aortic-left ventricular tunnel. The operative findings revealed that both the left coronary sinus and the noncoronary sinus had an opening into the left ventricle. The proximal opening into the LV was closed with bovine pericardium and the aortic root was replaced with a composite graft (a 21 mm St. Jude Epic Supra tissue valve and a 24 mm Hemashild graft) by the modified Bentall procedure. The patient was discharged on the 15th postoperative day, and he was regularly followed up for 2 months. We report on this case due to its rarity and to describe the surgical repair techniques.

Complementarity between SDQ-SR and MMPI-A in Assessing Adolescents with Internalizing Disorder : A Preliminary Study (내재화장애 청소년의 평가에서 자기보고용 강점난점척도와 MMPI-A의 상호보완성 : 예비연구)

  • Shin, Kyo Jung;Ahn, Joung Sook;Lim, Jee Young;Lee, Jin Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.1
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    • pp.9-18
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    • 2018
  • Objectives : The aims of this study were to investigate the psychopathology in adolescents with internalizing disorder using the self-report version of Strengths and Difficulties Questionnaire (SDQ-SR) and the Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A), and to explore the complementarity between these two inventories for diagnostic assessment. Methods : Ninety-one patients aged 13-17 were divided into two groups by clinical diagnosis, 44 with internalizing disorder and 47 comparison group with other disorders. The data of SDQ-SR and MMPI-A completed by them were analyzed for the ability to predict internalizing disorder. Results : The logistic regression analysis revealed that diagnostic predictability increased by 2.27 times with every 1 point of SDQ-SR emotional symptom score increment. Comparison of ROC curves for internalizing disorders showed that the SE and SP of SDQ-SR emotional symptom with score over 4 was 88.94 and 78.72, respectively. For A-anx of MMPI-A with score over 56, SE and SP was 77.27 and 74.47, respectively. However, combination of these scales could not enhance the predictability of diagnostic classification more than that of SDQ-SR emotional symptom alone. Conclusions : Emotional symptom scale of SDQ-SR and A-anx, A-aln, A and INTR of MMPI-A should be important subscales for diagnosing the internalizing disorder of adolescents, however, which needs to be examined further with a larger sample size including normal control group.

The Relationship of Stress Perception and Psychopathology with Intensity of Tinnitus in Patients with Tinnitus (이명환자들에서 스트레스지각 및 정신병리와 이명강도 간의 관계)

  • Koh, Kyung-Bong;Kim, Hee-Nam;Lee, Ho-Ki;An, Suk-Kyoon
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.151-157
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    • 1997
  • The relationship of stress and psychopathology with subjective or objective tinnitus intensity was investigated in 43 patients with tinnitus. Global assessment of recent stress scale, Beck depression inventory and symptom checklist-90-revision were used to measure stress perception and psychopathology. Subjective tinnitus intensity was assessed by subjective tinnitus severity inventory, whereas objective tinnitus intensity was assessed by tinnitogram. Scores of perceived stress related to interpersonal relationship and sickness or min had significantly positive correlation with subjective tinnitus intensity. In psychopathology, scores of somatization, interpersonal sensitivity, depression, anxiety, phobia, paranoid ideation, psychoticism had significantly positive correlation with subjective tinnitus intensity. However, stress perception and psychopathology did not significantly correlate with objective tinnitus intensity. These findings suggest that tinnitus may be associated with stress perception and multiple psychopathology including anxiety and depression. Thus, it is emphasized that Psychosocial intervention as well as effective consultation-liasion activity is needed for evaluation and treatment of patients with tinnitus.

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Usefulness of Ultrasonography in Diagnosis of Baker's Cyst (베이커 낭종에 대한 초음파 검사의 진단적 유용성)

  • Kim, Jung-Man;Ra, Ki-Hang;Nam, Ho-Jin;Park, Bum-Yong;Choi, Seung-Kyun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.1-7
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    • 2010
  • Purpose: The goal of this study is to assess the usefulness of ultrasonography in diagnosis of Baker's cyst. Materials and Methods: 42 cases of popliteal mass in 41 patients were reviewed between August 2006 and April 2009. All patients were evaluated with both MR imaging and ultrasonography. We investigated the comparison of a morphology, location, septation, and communication of mass between MR imaging and ultrasonography. Results: On ultrasonography, 40 Baker's cysts and 2 lipomas were detected, and all cysts were located at the medial side. 11 simple septated masses and 3 multiple cysts were detected, and 26 simple communicated cysts were suspected. On MR imaging, 40 Baker's cysts and 2 lipomas were detected, and all cysts were located at the medial side. 13 simple septated masses and 3 multiple cysts were detected, and 15 simple communicated cysts were suspected. Conclusion: Ultrasonography didn't give the definite information of Baker's cyst about communication with joint, but ultrasonography was a cost-effective useful tool for evaluation of a morphology, location and differential diagnosis of the Baker's cyst.

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Thoracoscopic Sympathectomy in Hyperhidrosis (비디오 흉강경을 이용한 다한증 수술의 임상적 고찰)

  • 김동원;배철영;신원선;好돼?;이신영
    • Journal of Chest Surgery
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    • v.31 no.12
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    • pp.1212-1216
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    • 1998
  • Background: Recently thoracoscopic surgery is widely applied in thoracic surgical field and hyperhidrosis is one of the most frequently operated diseases. Material and Method: From June 1997 to February 1998, 30 patients with hyperhidrosis underwent bilateral thoracic sympathectomy under thoracoscopy at Inje University Sanggye Paik Hospital. There were 10 males and 20 females whose mean age was 22.42±6.84 years ranging from 17 to 51. All patients underwent bilateral thoracic sympathectomy under semi-sitting position and two 5 mm sized trocars were inserted. Result: Mean operation time was 52.32±11.72 minutes and the mean elevation of palmar temperature after sympathectomy was 2.17±0.47℃. Eighteen patients(60%) complained compensatory hyperhidrosis. All patients except one were able to discharge at the operation day or postoperative one day. There were no recurrence during follow up from 2 to 8 months(mean 5.30±2.17 months). Conclusion: Thoracoscopic sympathectomy is simple and effective technique in hyperhidrosis and widely applied indication will be necessary. We conclude that further discussion should be made about the resection area and method to get maximal effect and minimal side effect.

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Psychological Analysis of Recurrent aphthous ulcer Patients with SCL-90-R (SCL-90-R을 이용한 재발성 아프타성 구내궤양 환자의 심리학적 분석)

  • Ko, Myung-Yun;Kim, Chang-Yong;Jeon, Hye-Mi;Ok, Soo-Min;Ahn, Young-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.19-25
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    • 2012
  • Personality characteristics of recurrent aphthous ulcer patients was analyzed psychologically by means of the SCL-90-R. The patients, 20 recurrent aphthous ulcer(RAU) patients, 33 oral lichen planus patients who visited Department of Oral Medicine, in Pusan National University Dental Hospital from 2010 to 2011. 59 control were collected from students of School of Dentistry, in Pusan National University. The obtained results were as follows. 1. Mean values of T-scores on 9 basic scales in RAU patients group, oral lichen planus patients group and control group were within normal range. 2. The T-score of SOM in RAU patients group were significantly higher than that in the control group. 3. The T-score of SOM, DEP, HOS in RAU female patients group were remarkably higher than that in the female control group. 4. The T-score of HOS in RAU patients group were significantly higher than that in the oral lichen planus patients group.

Clinical Efficacy of Individual Cognitive Behavioral Therapy for Patients with Primary or Secondary Insomnia (일차성 및 이차성 불면증 환자에서의 개별 인지행동치료의 임상적 효능)

  • Shin, Youn-Mi;Cha, Bo-Seok;Lim, Chae-Mi;Shin, Hong-Beom
    • Sleep Medicine and Psychophysiology
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    • v.17 no.1
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    • pp.34-40
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    • 2010
  • Objectives: This study aimed to evaluate the clinical efficacy of individual cognitive behavioral therapy (CBT) for Patients with Primary or Secondary Insomnia. Methods: Participants were recruited from a primary care sleep clinic from January 2008 to June 2009. The study sample included 64 outpatients with primary insomnia (n=30) and secondary insomnia (n=34) according to the criteria of DSM-IV. Participants completed sleep diaries, Dysfunctional Beliefs and Attitudes about Sleep Scale-16 (DBAS), State-Trait Anxiety Inventory (STAI) before CBT and shortly after completion of CBT. CBT was provided in 7 weekly, 40-50-minute individual therapy sessions. Results: Both groups of patients with primary and secondary insomnia showed significant improvement in the DBAS and sleep parameters including sleep onset latency, total sleep time, and sleep efficiency. Repeated-measures ANOVA of the DBAS and sleep parameters showed no significant group-by-time interactions between patients with primary and secondary insomnia, suggesting the efficacy of CBT for patients with secondary insomnia was equivalent to that of CBT for patients with primary insomnia. Conclusion: This study suggests that CBT is effective for the management of primary and secondary insomnia in a primary care setting.

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Video-assisted Thoracoscopy in the Treatment of Multi Loculated Pleural Effusion and Empyema (다방성 흉막수 및 노흉 환자에서 비디오 흉강경의 치료)

  • 김영진
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.160-165
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    • 2004
  • Successful treatment of multi-loculated pleural effusion or thoracic empyema requires effective drainage and definitive diagnosis of causative organism. The purpose of this study was to assess the efficacy of the video-assisted thoracoscopic surgery in the management of thoracic empyema or multi-loculated pleural effusion after chest tube drainage treatment had failed. Material and Method: Between April 2000 and July 2002, 20 patients with thoracic empyema or multi-loculated pleural effusion that failed to chest tube drainage or other procedures who underwent an operation. All patients were assessed by chest-computed tomogram and underwent video assisted thoracoscopic drainage, debridement, biopsy and irrigation of pleural cavity. Result: In 18 cases (90%), underwent successful video-assisted thoracoscopic surgery. In 2 cases, decortications by mini-thoracotomy were necessary. The ratio of sex was 4 : 1 (16 male: 4 female), mean age was 48.9 years old (range, 17∼72 years), mean duration of postoperative chest tube placement was 8.2 days (range, 4∼22 days), mean postoperative hospital stay was 15.2 days (range, 7∼33 days). Causative disease was tuberculosis, pneumonia, trauma and metastatic breast cancer, There were no major postoperative complications. Symptoms improved in all patients and were discharged with OPD follow up. Conclusion: In an early organizing phase of empyema or multi loculated pleural effusion, video-assisted thoracoscopic drainage and debridement are safe and suitable treatment.