Primary Undifferentiated Pleomorphic Sarcoma of the Left Atrium that Presented as Acute Pulmonary Edema

A 37-year-old woman was admitted to Dong-A University Hospital for rapidly progressive congestive heart failure. Transthoracic echocardiography demonstrated a large mass with a stalk that appeared to be a myxoma on the posterior wall of the left atrium. However, the histological diagnosis was undifferentiated pleomorphic sarcoma. We report a case of primary undifferentiated pleomorphic sarcoma of the left atrium with acute pulmonary edema caused by mitral inflow obstruction.

Prevalence and predictors of tortuous radial artery in patients undergoing transradialcoronary angiography / 대한내과학회지

BACKGROUND: It is well known that the presence of a tortuous radial artery, in patients undergoing transradial coronary angiography (CAG), may cause undesirable results such as access failure and arterial dissection. Thus, our aim was to investigate the prevalence and predictors of the presence of a tortuous radial artery in patients undergoing transradial CAG. METHODS: We prospectively investigated the tortuosity of the radial artery in 158 consecutive patients. The tortuosity of the radial artery was determined by radial angiography. A tortuous radial artery was defined as one with a maximal angulation of more than 45 degrees. To determine the predictors of a tortuous artery, we examined clinical and intra-procedural characteristics. RESULTS: A right radial angiography was easily performed in 154 patients (97.5%) without any complications. A tortuous radial artery was identified in 34 patients (22%). On the univariate analysis, advanced age, female gender, short stature, underweight, hypertension, and absence of progression of the mini-guide wire were significantly associated with the presence of a tortuous radial artery. Significant independent predictors of a tortuous radial artery by multivariate analysis were: advanced age, absence of progression of the mini-guide wire and hypertension. CONCLUSIONS: These data showed that the presence of a tortuous radial artery could be predicted by advanced age, absence of progression of the mini-guide wire and a history of hypertension. Thus, identification of a tortuous radial artery prior to coronary angiography may be helpful for a safe transradial CAG in patients at high risk for a tortuous radial artery.

Comparison of Colonoscopy and Virtual Colonoscopy for the Detection of Colorectal Polyps / 대한소화기내시경학회지

BACKGROUND/AIMS: Virtual colonoscopy using abdominal spiral computed tomography scanning allows total colonic evaluation with minimal invasiveness. We compared the performance of virtual colonoscopy and colonoscopy for the detection of colorectal polyps. METHODS: We performed colonoscopy before the virtual colonoscopy. Virtual colonoscopy was performed immediately before the colonoscopic polypectomy in 24 adults (16 men and 8 women: mean age, 59 years). RESULTS: A total of 48 polyps were found by colonoscopy. Virtual colonoscopy identified 20 of 28 polyps that were 10 mm or more in diameter (71%), 3 of 4 that were 6 to 9 mm (75%), and 9 of 16 that were 5 mm or smaller (56%). Overall sensitivity of virtual colonoscopy for colorectal polyps was 67%. CONCLUSIONS: Our result of virtual colonoscopy showed lower sensitivity for detection of significant colorectal lesions than previously reported studies. Further large group study may be needed to determine the usefulness of virtual colonoscopy.

A Case of Cerebral Air Embolism Occurred after CT-guided Transthoracic Needle Biopsy / 결핵및호흡기질환

CT-guided transthoracic needle biopsy is a common procedure for the evaluation of pulmonary and mediastinal lesions. The most frequent complications include pneumothorax, hemorrhage, and hemoptysis. Air embolism especially cerebral embolism is rare but potentially fatal complication after this procedure. Here, we report a case of cerebral air embolism occurred after CT-guided transthoracic needle biopsy for the peripheral lung mass.

Study on the therapeutic efficacy and complications of radio-frequency ablation according to the diameter and location of hepatocellular carcinoma / 대한내과학회지

BACKGROUND: Induction of coagulation necrosis by using thermal energy sources such as radio-frequency (RF), microwaves and lasers has recently been as a new, minimally invasive technique for percutaneous tumor ablation. RF ablation is considerd effective and safe for the local control of small HCCs. The aim of this study is to evaluate the therapeutic efficacy and complications according to the diameter and location of the HCC. METHODS: Between May 1999 and December 2000, one hundred fifty patients underwent RF thermal ablation in Dong-A university hospital. Among them, forty nine patients were enrolled in this study who have no history of prior other treatment including hepatic resection, TAE, PEI, and chemotherapy, also who have follow-up CT performed at least six months after ablation. The patients devided into two groups, who have small HCC (3 cm in diameter), the mean follow-up duration was 10.8 months and local recurrence rate was 51.0%+/-12.4. In small HCC group (