• Title/Summary/Keyword: Calcification, pathologic

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Evaluation of the Surgical Treatment for Mitral Stenosis (승모판협착증의 외과적 치료에 대한 평가)

  • Sin, Dong-Geun;Kim, Min-Ho;Jo, Jung-Gu;Kim, Gong-Su
    • Journal of Chest Surgery
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    • v.29 no.10
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    • pp.1095-1101
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    • 1996
  • From July 1983 to June 1995, 95 consecutive patients with mitral stenosis were treated surgically in the Department of Thoracic and Cardiovascular Surgery, Chonbuk national University Hospital, mitral valve replacement(MVR) in 62 patients and open mitral commissurotomy(OMC) in 33 patients. Mitral stenosis combined with coronary artery disease, with aortic valve disease, or wish mitral valvular Insufficiency, were excluded from this study. Surgical procedures for mitral stenosis were evaluated, according to complication, reoperation, mor- tality, nd functional change at mid- and long-term postoperative period. Cardiothoracic ratio in the MVR group was greater than the OMC group(0.59 $\pm$0.07 in MVR, 0.53 $\pm$0. 07 in OMC, p<0.05), but other variables(age, sex, MYHA functional classification, EKG finding, echocardiographic finding) did not show significant difference between two groups in the preoperative periods. Even though pathologic valvular lesion(Sellor's pathologic type m: 35 in MVR, 13 in OMC) and valvular calcification(35 in MVR, 11 in OMC) were severe in the MVR group(p=0.001) at intraoperative observation, OMC was possible in 11 patients(23.9%) among 46 patients with valvular calcification and in 13 patients(27.1 %) among 61 patients with Sellor's pathologic type IH . There was no significant difference in early and late mortality, actuarial survival(75% in MVR, 87.6% in OMC at 12 year), but early and late hemorrhagic, thromboembolic complications in the MVR group were greater than in the OMC. Functional changes in NYHA functional classification, EKG lEnding, cardiothoraclc ratio, and echocardiographic finding(EF, LVIDS, LWDd, LAD) did not differ between two groups in mid- and long-term postoperative periods. We conclude that our efforts for preservation of the native valve would be continued, because hemorrhagic and thromboembolic complications in the MVR were greater than in the OMC, and OMC was possible even in patients with severely stenotic and calcified mitral valve, although there was no sis-nificant difference in the functional change, mortality, and survival between the M VR and OMC.

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Development of Calcification-Resistant Bovine Pericardium with $PEO-SO_3$ (I) - An implantation study of bovine pericardium at aorta and pulmonary artery in canine model - ($PEO-SO_3$를 이용한 항석회화 조직첨포의 개발 (I) - 잡견을 이용한 대동맥과 폐동맥 이식 실험연구 -)

  • Kim, Hyoung-Mook;Baek, Man-Jong;Sun, Kyung;Kim, Kwang-Taik;Lee, In-Sung;Kim, Hark-Jei;Lee, Won-Kyu;Park, Ki-Dong
    • Journal of Chest Surgery
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    • v.31 no.10
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    • pp.919-923
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    • 1998
  • Background: Calcific degeneration is unavoidable in either homo- or heterografts implanted in the human body. We have developed a calcification-resistant cardiovascular tissue patch using a novel technique of anticalcification. Materials and methods: Fresh bovine pericardium was harvested at the slaughter house and transfered to the laboratory in Hank's solution. After trimming and fixing the pericardium, it was embedded in 4$^{\circ}C$ 0.65% glutaraldehyde for a week and then washed by phosphate-buffered saline(PBS) of pH 7.4. This prepared pericardium was then stored in 2.5% sulphonated polyethyleneoxide(PEO-SO3) solution for 2 days at room temperature and reversed by 4$^{\circ}C$ NaBH4 solution for 16 hours. To evaluate the calcification-resistance of surface modified bovine pericardium with PEO-SO3, either glutaraldehyde- treated(GA group, n=4) or PEO-SO3-treated pericardial patch(PEO-SO3 group, n=4) was implanted into adult mongrel dog to reconstruct the main pulmonary artery and the descending aorta using a partial clamp technique. After 1 month follow-up, the implanted patches were retrieved to evaluate the pathologic findings and the content of calcium and phosphorous. Results: The PEO-SO3 group showed substantially less retraction and significantly less calcium deposition than the GA group in both aortic(7.10$\pm$1.05 vs. 13.81$\pm$2.33 mg/g of dried tissue) and pulmonary positions(1.55$\pm$0.29 vs. 6.72$\pm$0.70 mg/g)(p<0.01). Phosphorous contents were also less in the PEO-SO3 group than the GA group significantly, 8.11$\pm$1.07 mg/g vs. 19.33$\pm$4.31 mg/g in the aortic and 2.58$\pm$0.40 vs. 12.60$\pm$3.40 mg/g in thepulmonary position(p<0.01). Conclusions: These findings suggest that PEO-SO3 modified bovine pericardium is highly calcification-resistant but further study is needed to evaluate the long-term biological safety and compatibility of the prosthesis.

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The Clinical Study on the Characteristics of Pulmonary Lesions Which Should Be Differentiated from Pulmonary Tuberculosis in Lung Resection Cases (폐절제 예에서 결핵과 구별해야 할 질환의 특성에 관한 임상적 고찰)

  • 정황규;정성운;박서완
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1232-1240
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    • 1996
  • From January 1990 through June 1995, we operated on 121 patients who were suspected for pulmonary tuberculosis without definite final diagnosis. After operation the final pathologic diagnoses were as follows: 68 pulmonary tuberculosis in which 29 were tuberculoma, 23 lung cancer, 16 bronchiectasis, 6 aspergilloma, 2 lung abscess, 2 benign cyst and 4 others. In 121 cases, 81 were male and 40 were female and the peak age incidence was 4th decade in tuberculosis (39.7%) and 6th and 7th decade in lung cancer (69.6%). The diagnoses in 44 cases presented roentgenographically as pulmonary nodules were pulmonary tuberculosis(29 cases) and lung cancer(15 cases). Tuberculous nodules tended to be smaller in size with calcification and satellite lesions compared to carcinomas. Indications for operation were solitary nodules 44 cases (36.4%); destroyed lobe 31(25.6%); hemoptysis 25 (20.7%); cavitary lesion 11(9.1 %); bronchostenosis 3 (2.5%); destroyed lung 5(4.1 %) and destroyed lung with empyema 2(1.7%). We conclude that preoperatively suspected pulmonary tuberculosis should be distinguished from various pulmonary lesions such as carcinoma, bronchiectasis, aspergilloma, lung abscess and benign cyst. For the possibility of carcinoma, pulmonary nodules of size greater than 3cm, non-calcified, non satellite lesion, newly developed nodule even under the anti-tuberculous medication, negative PPD skin test with elevated CEA level are recommended for an early resectional surgery and follow-up and delayed surgery is recommended in cases such as pulmonary nodules less than 3 cm in size with calcification, satellite lesion, positive PPD skin reaction and elevated ESR, CRP, ALP levels.

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PSEUDOHYPOPARATHYROIDISM : CASE REPORT (가성부갑상선 기능저하증 환아의 구강 증상)

  • Kim, Seong-Oh;Hong, Eun-Kyoung;Choi, Hyung-Joon;Lee, Jae-Ho;Son, Heung-Kyu
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.2
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    • pp.262-266
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    • 2004
  • The parathyroid hormone plays a major role in the metabolism of calcium and phosphorus. In hypoparathyroidism the parathyroid glands are atrophied or absent associated with autoantibodies against parathyroid tissue. Pseudohypoparathyroidism is a metabolic disease caused by the disturbance in peripheral action of parathormone, but parathormone level is normal. In general, patients with pseudohypoparathyroidism have short stature, round face, brachydactylia, obesity, mental retardation, cataracts & ectopic calcifications on soft tissues. Dental manifestations are enamel hypoplasia, delayed eruption, blunting of root apex, hypodontia, pulp calcification, thickened lamina dura, excessive caries & malocclusion. In this case, intraoral examination showed enamel hypoplasia on the erupted permanent teeth & hypermobility on the remaining deciduous teeth. From the radiographic view severe dental anomalies were observed on canines and shortening and blunting of root apex was observed on mandibular incisors. Pathologic root resorption was also observed on deciduous teeth.

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Optochiasmatic Cavernous Angioma with Rapid Progression after Biopsy Despite Radiation Therapy

  • Jo, Kwanag-Wook;Kim, Sang-Don;Chung, Eun-Yong;Park, Ik-Seong
    • Journal of Korean Neurosurgical Society
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    • v.49 no.2
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    • pp.120-123
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    • 2011
  • We present a rare case of optochiasmatic cavernous angioma (CA) that progressed despite radiation therapy. A 31-year-old female patient presented with sudden loss of left visual acuity and right homonymous hemianopsia. Magnetic resonance imaging (MRI) revealed a suprasellar mass and findings compatible with a craniopharyngioma or an optic glioma with bleeding. An open biopsy was conducted using the transcranial approach, and histological examination revealed gliosis. During the one-year follow-up period, imaging suggested intratumoral bleeding and the mass continued to grow. We recommended re-operation, but the patient refused due to fear of surgery. Consequently, the patient received fractionated radiation therapy (3,000 cGy) to the parasellar area. Despite the radiotherapy, the mass continued to grow for the following 6 years. The final MRI before definitive treatment revealed a multi lobulated, multistage hematoma with calcification in the parasellar area, extending into the third ventricle and midbrain. The patient ultimately underwent reoperation due to the growth of the tumor. The mass was completely removed with transcranial surgery, and the pathologic findings indicated a cavernous angioma (CA) without evidence of glioma. As shown in our case, patients may suffer intratumoral hemorrhage after biopsy and radiotherapy. This case places the value of biopsy and radiotherapy for a remnant lesion into question. It also shows that reaching the correct diagnosis is critical, and complete surgical removal is the treatment of choice.

TREATMENT AND PATHOLOGIC STUDY OF PLEOMORPHIC ADENOMAS (다형성 선종의 치험 및 병리조직학적 연구)

  • Kim, II-Kyu;Lee, Seong-Jun;Ha, Soo-Yong;Chu, Young-Chae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.2
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    • pp.167-176
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    • 1991
  • This is three case-reports of pleomorphic adenomas arising from one parotid gland and two minor salivary glands treated by total parotidectomy and complete enucleation. We conclude as follows : 1. During the parotidectomy, we tried to preserve the facial nerve by retrograde approach to the trunk from the mandibular branch where it passes over the posterior facial vein. Although the paresis of the lower lip following the operation was seen, it disappeared in about 3 months. 2. Microscopically, the tumor of the first patient (case 1) contained equally myxoid and cellular components and showed well encapsulation. 3. In the second patient (case 2), the tumor revealed large areas of hemorrhage, cystic change, dystrophic calcification and stromal hyalinization, but no definite evidence of carcinoma, therefore we labeled this tumer as "atypical mixed tumor". 4. In the third patient (case 3), the tumor showed principally myxoid component and incomplete capsule, but the tumor was well demarcated.

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A Case of Primary Localized Laryngo-tracheobronchial Amyloidosis (원발성 국한성 후두 기관기관지형 유전분증 1예)

  • Lee, Seok Jeong;Lee, Won Yeon;Jung, Soon Hee;Kwon, Woocheol;Lee, Shun Nyung;Lee, Namseok;Kim, Sang-Ha;Shin, Kye Chul;Yong, Seok Joong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.532-536
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    • 2008
  • We report on a case of a patient with laryngo-tracheobronchial amyloidosis who complained of cough, sputum, and hoarseness. A chest X-ray showed consolidation in the right middle lobe. A chest CT scan showed diffuse, irregular narrowing of the tracheobronchial tree and atelectasis of the right middle lobe, with calcification of bronchial wall. Bronchoscopic findings were multinodular submucosal thickening of the right vocal cord, and yellowish multinodular submucosal thickening from the lower trachea through both main bronchi, as well as the lingular division of the left upper lobe, the right middle lobe, and the right lower lobe. The right middle lobe bronchus was nearly obstructed. The diagnosis of amyloidosis was made by multiple ronchoscopic biopsies on the right vocal cord and both bronchi. Pathologic findings were characteristic apple-green birefringence under polarized microscopy with Congo-red stain. The patient had no evidence of systemic amyloidosis. The patient is under conservative symptomatic treatment.

CLINICAL CHARACTERIZATION OF THE MAXILLARY SINUS ASPERGILLOSIS (상악동 국균증의 임상적 특성)

  • Choi, Hee-Soo;Yoon, Jung-Hoon;Kim, Hyung-Jun;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.3
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    • pp.271-275
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    • 2001
  • Nine cases of maxillary sinus aspergillosis during a period from February of 1992 to June of 2000 were investigated to analyze the clinical, radiologic and pathologic features. Maxillary sinus aspergillosis is rare disease, but it was increasing tendency with overuse antibiotics, steroid hormones, and anticancer agents. Aspergillosis of the maxillary sinus may occur as a chronic disease in an otherwise healthy person. The clinical features of maxillary sinus aspergillosis were similar to the non-fungal, chronic sinusitis. Intrasinus calcification is known to be a characteristic feature of maxillary sinus aspergillosis. It is suggested that excess root filling materials containing zinc oxide in the maxillary sinus could favour the formation of a local, non-invasive maxillary sinus aspergillosis. And this "dental" model of pathogenensis of maxillary sinus aspergillosis is an alternative to the widely accepted concept of spore inhalation and "aero-genic" pathogenensis of maxillary sinus aspergillosis. The radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. Our results of this study indicate that maxillary sinus aspergillosis might occur mainly in healthy individuals rather than debilitating patients. It could efficiently treated with radical surgery alone without the antifungal agents. 4 cases were suspected to be related with teeth extraction and endodontic treatment. There were no recurrence in all cases.

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Diagnostic Value of Preoperative Ultrasonographic Evaluation on Thyroid Cancer (갑상선 암의 판정에 대한 술전 초음파의 의의)

  • Yoon Kil-Hoon;Ryou Kie-Sun;Jung Jin-Young;Jo Jae-Hyun;Kim Myung-Wook;So Euy-Young
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.66-69
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    • 1999
  • Background and Objectives: It is critical to distinguish benign from malignant thyroid nodule and to select a patient for surgery. Even though the U/S study dose not make great contribution to diagnose a malignant thyroid nodule, it is widely used in the evaluation of anatomic feature of thyroid. The authors tried to estimate the efficacy of the U/S study in preoperative diagnosis of malignant thyroid nodule. Materials and Method: At the department of General Surgery of Ajou University, 75 patients who were operated after diagnosis with thyroid nodule by U/S study between July 1996 to June 1997 were retrospectively analyzed. By comparing the U/S impression that implies malignant thyroid nodule to FNAC and post-operative pathologic results ware as follows. Results: 1) Absence of cystic change, presence of internal hypoechogenicity, lobulation, calcification, thick and irregular halo, and nodule more than 4cm in diameter on U/S were considered significant statistically for the diagnosis of malignancy(Chi-square test, p<0.05) 2) Presence of internal hypoechogenicity or thick and irregular halo has the validity in Logistic regression analysis. 3) FNAC was done in 65 case. 19 case were malignant, 11 case were suspicious and 46 patients were benign (sensitivity 52.6%, specificity 87%). 4) The findings of U/S which are hypoechogenic and thick and irregular halo show 82% sensitivity and 97% specificity. In combination with the findings of FNAC that imply benign or suspicious lesions, the sensitivity was 100% and the specificity was 97%. Conclusion: This study suggest that the hypoechogenicity and thick and irregular halo on U/S are important information for the diagnosis of thyroid malignancy which were considered benign or suspicious after FNAC.

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Mediastinal Lipoblastoma - A case report - (종격동 내 지방모세포종 - 1예 보고 -)

  • Oh, Se-Jin;Kang, Chang-Hyun;Kim, Joo-Hyun;Kim, Young-Tae
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.240-243
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    • 2007
  • Mediastinal lipoblastoma is a rare benign tumor originating from embryonic lipid cells and it almost always occurs during infanthood or early childhood. It is a tumor with a good prognosis despite its potential for local invasion and rapid growth. We report here on a three years old girl who was treated for a benign lipoblastoma in the anterior mediastinum. CT scanning showed a fat containing mass without internal calcification or fluid component, and the mass showed a compressive effect on the adjacent structures. The mass was located between the pericardium and right mediastinal pleura and it was removed completely without complication. Pathologic examination revealed a benign lipoblastoma. The patient showed no evidence of recurrence at the time of the report.