Variant angina is characterized by repeated attack at rest associated with ST-segment elevation on ECG and caused by the spasm of coronary artery. But, the pathogenesis of spasm is not well known. A 44-year old man was transferred for the management of intramural hematoma at descending thoracic aorta and uncontrolled hypertension. We started to control hypertension with nitroprusside, propranolol, amlodipine, and doxazocin. At 4th hospital day, severe chest pain, dizziness, and diaphoresis were developed, and ECG showed not only ST-segment elevation on lead II, III, aVF but also 2 degree AV block(Mobitz type II). CK-MB revealed 52.3 ng/dl. When coronary angiography performed emergently, it showed total occlusion of right coronary artery (RCA) and diffuse minimal narrowing of left anterior descending coronary artery (LAD). After nitroglycerin was infused via right coronary catheter, the RCA was opened completely, and reperfusion arrhythmia was developed. Medication were changed to nifedipine, diltiazem, nicorandil, isosorbide mononitrate and he had no more chest pain.
Adult ; Amlodipine ; Aorta, Thoracic ; Arrhythmias, Cardiac ; Catheters ; Chest Pain ; Coronary Angiography ; Coronary Vessels ; Diltiazem ; Dizziness ; Electrocardiography ; Hematoma* ; Humans ; Hypertension ; Isosorbide ; Myocardial Infarction* ; Nicorandil ; Nifedipine ; Nitroglycerin ; Nitroprusside ; Propranolol ; Reperfusion ; Spasm

This is a clinical study of 129 cases of colorectal cancer who were treated in the department of surgery, Inchon Christian Hospital from January 1989 to December 1996. The results were as follows; 1) The peak age incidence was 7th decade and the ratio between male and female was 1.87 : 1 2) The most frequent site of the tumor was the rectum(59.7%). 3) In the right and left colon cancer the most frequent symptom was abdominal pain and in the rectal cancer the most frequent symptom was bloody stool. 4) The duration of symptoms prior to admission was within 3months(58%). 5) The diagnostic methods were digital examination, sigmoidoscopy colonofiberscopy, barium enema and abdominal CT scanning. 6) The most frequently performed operation was Abdominoperineal resection(27%). 7) The staging of tumors was performed according to modified Dukes' classification and Dukes C was most frequent(55.1%). 8) The most common histopathologic type was adenocarcinoma(98%). 9) The most common macroscopic finding was ulcerative pattern. 10) The most common distant metastatic site was pelvic organ(12%). 11) The most common post-operative complication was wound infection(10.1%). 12) The 5year survival rate was analyzed by Kaplan-Meier's method : the overall 5year survival rate was 60.7%.
Abdominal Pain ; Barium ; Classification ; Colonic Neoplasms ; Colorectal Neoplasms* ; Enema ; Female ; Humans ; Incheon ; Incidence ; Male ; Rectal Neoplasms ; Sigmoidoscopy ; Survival Rate ; Tomography, X-Ray Computed ; Ulcer ; Wounds and Injuries

Cerebral aneurysms associated with arteriovenous malformation (AVM) have been reported with a variable incidence, averaged 10% of total AVM cases. It has been AVM. We report four cases of the intracranial aneurysm associated with AVM. Three cases of aneurysm were located in distal portion of feeding artery, and one case was proximal on major feeding artery. And bleeding resulted from rupture of aneurysm. Three of them located in the posterior circulation. Removal of aneurysm and AVM was successfully accomplished in 3 cases.
Aneurysm ; Arteries ; Arteriovenous Malformations* ; Hemorrhage ; Incidence ; Intracranial Aneurysm ; Rupture

Tuberculosis can involve any part of the body and there are case reports of tuberculosis coexisting with malignancy in most body organs. However, cases of intestinal tuberculosis associated with colon cancer have rarely reported. Inflammatory bowel diseases can progress to malignant diseases due to mucosal dysplastic change. Similarly, intestinal tuberculosis can cause chronic inflammation, but the exact relationship between intestinal tuberculosis and colon cancer is currently obscure. A 71-year-old woman visited our hospital because of abrupt right lower abdominal pain that progressed to rebound tenderness and abdominal rigidity. Abdominal computed tomography showed a polypoid mass in the cecum and a distended terminal ileum. Right hemicolectomy was performed and the surgical specimen revealed extremely well differentiated adenocarcinoma combined with intestinal tuberculosis and bowel perforation in the cecum. We report here on a rare case of colon cancer coexisting with colonic tuberculosis and this presented as bowel perforation. We also include a review of the relevant literature.
Abdominal Pain ; Adenocarcinoma ; Aged ; Cecum ; Colon ; Colonic Neoplasms ; Female ; Humans ; Ileum ; Inflammation ; Inflammatory Bowel Diseases ; Tuberculosis

No abstract available.
Myoclonus* ; Spinal Nerve Roots*

Charcot-Marie-Tooth disease (CMTD) is a hereditary neuropathy with slow progression, whereas Guillain-Barre syndrome is an acute acquired neuropathy of immunopathogenesis. A 17 year-old girl with hammertoes and pes cavus developed an acute quadriparesis. The duplication of PMP-22 exons in 17p12-p11.2 was confirmed by genetic study. After Intravenous ingection of immunoglobulin, she recovered to normal activity within one month with improvement of nerve conduction study. We should be concerned with the possibility of Guillain-Barre syndrome if there is rapidly progressive exacerbation on CMTD.
Adolescent ; Charcot-Marie-Tooth Disease* ; Exons ; Female ; Foot Deformities ; Guillain-Barre Syndrome* ; Humans ; Immunoglobulins ; Neural Conduction ; Quadriplegia

The incidence of thymolipoma or thynuc cyst is very rare among the tumors of thymic origin, which are usually benign or invasive thymoma. Thymic tumor has been found among 10 to 15% of the patients with myasthenia gravis(MG). However the patients with thymolipoma or thynuc cyst rarely manifestated as MG. Moreover the case of MG with thymolipoma and thymic cyst is extremely rare ; Only one case has been reported hitherto. We hereby report a 41-year-old woman presenting as ocular MG with thymolipoma and thymic cyst. She complained diplopia, ptosis and headache, which had begun 3 months prior to admission and have been fluctuating thereafter. Ocular MG was confirmed by positive Tensilon and Jolly test. Her chest CT showed an enlarged thymus which turned out to be thymolipoma with thymic cyst on the pathologic examination. Although rare, thymolipoma and/or thymic cyst should be considered in the differential diagnosis of thymic tumor in MG.
Adult ; Diagnosis, Differential ; Diplopia ; Edrophonium ; Female ; Headache ; Humans ; Incidence ; Mediastinal Cyst* ; Myasthenia Gravis* ; Thymoma ; Thymus Gland ; Thymus Neoplasms ; Tomography, X-Ray Computed

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

PURPOSE: This study was conducted to investigate the relationship between serum total testosterone levels and scores on the Aging Male's Symptom (AMS) scale and the International Index of Erectile Function (IIEF) in men with erectile dysfunction with testosterone deficiency syndrome (TDS). MATERIALS AND METHODS: From January 2005 to July 2008, 134 patients who complained of sexual dysfunction such as erectile dysfunction or decreased libido as the main symptoms of TDS with serum total testosterone levels less than 3.5 ng/ml were evaluated by independent t-test and linear regression analysis, respectively. Patients with treated hypogonadism within 6 months, with a history of taking a PDE5 inhibitor or an antidepressant for a depressive disorder, or who had metabolic syndrome were excluded from this study. RESULTS: The AMS scale and its 3 subdomain scores were not significantly correlated with the total testosterone level. By contrast, the total IIEF score and the score of each IIEF domain except sexual desire showed a weakly significantly positive correlation with serum total testosterone. CONCLUSIONS: In TDS patients with erectile dysfunction, there was a low relationship between serum total testosterone levels and the AMS scale and a weakly positive correlation between total testosterone levels and all IIEF domains except sexual desire. There was a low relationship between the AMS scale, the sexual desire domain score of the IIEF, and total testosterone. We should understand these limitations when evaluating patients with erectile dysfunction with TDS. New scales should be developed for the evaluation of erectile dysfunction in these patients.
Aging ; Depressive Disorder ; Erectile Dysfunction ; Humans ; Hypogonadism ; Libido ; Linear Models ; Male ; Sorbitol ; Testosterone ; Tyramine ; Weights and Measures

PURPOSE: Although the measles-mumps-rubella vaccination covers most children against mumps in Korea, the development of mumps has been reported. However, the clinical manifestations of mumps orchitis in postpubertal vaccinated patients have never been investigated. Herein we report the clinical features of mumps orchitis in postpubertal vaccinated patients. MATERIALS AND METHODS: This study included a total of 62 postpubertal males who developed acute mumps orchitis from 2005 to 2010. The clinical manifestations such as the incubation period, febrile duration, and the mean duration of orchitis were retrospectively investigated. The laboratory and sonographic findings were also reviewed and compared with the features of previously reported cases of unvaccinated postpubertal mumps orchitis. RESULTS: The mean age of the 62 patients was 17.56 years (range, 15 to 29 years). All patients were serologically confirmed with acute mumps infection (positive immunoglobulin [Ig] M and negative or positive IgG). The mean incubation period was 5.39 days (range, 0 to 23 days), with a febrile duration of 1.8 days (range, 0.5 to 3 days), and a mean duration of orchitis of 4.96 days (range, 0 to 17 days). Sonography revealed unilateral orchitis in 58 patients (93.6%) and bilateral orchitis in only 6 (6.4%). CONCLUSIONS: In our study, mumps orchitis in postpubertal vaccinated patients showed a relatively shorter febrile duration. In addition, less scrotal swelling and a lower incidence of bilaterality were found upon physical examination and ultrasonography. In the future, additional long-term follow-up is needed to determine the features of mumps orchitis in postpubertal vaccinated males, and an additional booster vaccination should be considered.
Child ; Follow-Up Studies ; Humans ; Immunoglobulins ; Incidence ; Korea ; Male ; Mumps ; Orchitis ; Physical Examination ; Retrospective Studies ; Vaccination ; Young Adult