Kawasaki disease is an acute febrile illness frequently developed in infants and children. This disease may involve coronary arteries in 15- 25% of the patients and may progress to coronary aneurysms, ischemic cardiac diseases, and sudden cardiac death. Recently we experienced successful balloon angioplasty followed by coronary stenting in a 15-year old boy with unstable angina and severe coronary arterial occlusive disease secondary to Kawasaki disease. He was diagnosed as unstable angina by 24 hours Holter monitoring, treadmill exercise stress test, echocardiography, and Dipyridamole 99mTc-sestamibi scan. And coronary angiogram revealed severe multiple stenosis and aneurysmal changes due to Kawasaki disease. We successfully performed a percutaneous transluminal coronary angioplasty with stent implantation at left circumflex arterial occlusive lesion.
Adolescent ; Aneurysm ; Angina, Unstable ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Arterial Occlusive Diseases ; Child ; Constriction, Pathologic ; Coronary Aneurysm ; Coronary Stenosis* ; Coronary Vessels* ; Death, Sudden, Cardiac ; Dipyridamole ; Echocardiography ; Electrocardiography, Ambulatory ; Exercise Test ; Heart Diseases ; Humans ; Infant ; Male* ; Mucocutaneous Lymph Node Syndrome* ; Stents* ; Technetium Tc 99m Sestamibi

In planning treatment of tibial condylar fracture, the patient's age and physical condition, associated ligament injury and accurate fracture diagnosis, such as presence and degree of separatiori of split fragment, type of fracture and the severity of comminution must be considered. For accurate diagnosis, many kinds of methods including simple X-ray, arthroscopy, arthrography and tomography can be used. In spite of these procedures, sometimes we cannot know the accurate fracture morphology. The computed tomography(CT) has many advantages over other diagnostic methods. The application of CT in the evaluation of patients with spinal and pelvic fractures has been established, but rarely has its usefulness been noted in tibial condylar fracture. We thought that in assessing tibial condylar fracture, CT is more useful and accurate than conventional radiography. From March 1985 to August 1986, we took 17 patients(18 cases) of tibial condylar CT and were convinced with that it is a good diagnostic method. The results are as follows: l. In 5 cases, we could find a new fracture on CT film, which was impossible to be detected on simple X-ray. 2. In 7 cases, the fracture classification by plain X-rays was changed after CT check-up. 3. We could make the decision of treatment methods easily through more realistic classification and better recognition of split and comminution. 4. Proper approach could be done by understanding the accurate fracture size and localization.
Arthrography ; Arthroscopy ; Classification ; Diagnosis ; Humans ; Ligaments ; Methods ; Radiography

Osteoma is a slow-growing benign tumor composed of mature bone. Osteoma of the nose and paranasal sinuses is usually asymptomatic and most commonly occurs in the frontal sinus, followed by the ethmoidal and maxillary sinus. The occurrence in the sphenoidal sinus and nasal cavity is very rare. We present a case report of a patient with an isolated osteoma in the right nasal cavity presenting with nasal obstruction.
Frontal Sinus ; Humans ; Maxillary Sinus ; Nasal Cavity* ; Nasal Obstruction ; Nose ; Osteoma* ; Paranasal Sinuses

OBJECTIVES: To estimate the weighting for the disability caused by major cancers in Korea using the Delphi method. METHODS: We selected 19 panelists to estimate the disability weighting of major cancers in Korea by using the Delphi method. To select the relevant kinds of cancers, we used National Death Certificate Data produced by the National Statistical Office in 1996. Then the stability of each delphi round was calculated by using the coefficient of variance. RESULTS: The disability weight of major cancers for males was pancreas cancer(0.36), liver cancer(0.35), esophageal cancer(0.30), stomach cancer(0.27), lung cancer(0.26), and colorectal cancer(0.30). The disability weight of major cancers for females was pancreas cancer(0.36), liver cancer(0.34), esophageal cancer(0.29), stomach cancer(0.28), lung cancer(0.26), and colorectal cancer(0.28). CONCLUSION: The results of this study will provide baseline data useful for the measurement of the burden of disease caused by cancers in Korea.
Death Certificates ; Female ; Humans ; Korea* ; Liver ; Lung ; Male ; Pancreas ; Stomach

No abstract available.
Breast* ; Tuberculosis*

Purpose: To compare long-term toxicity incidences, including secondary cancer (SC) with or without total body irradiation (TBI), in Asian patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) using a nationwide database. Methods: We identified 4,554 patients receiving HSCT for leukemic disease from 2009 to 2016 using the healthcare bigdata system of Korea. Incidence rate ratios (IRRs) for SC, cataracts, hypothyroidism, chronic kidney disease (CKD), myocardial infarction, or strokes were compared, and standardized incidence ratios (SIR) of SC was also estimated. Results: TBI was conducted on 1,409 patients (30.9%). No overall survival differences based on TBI were observed. With a median follow-up duration of 58.2 months, 143 patients were diagnosed with subsequent SC (3.4%). Incidence rates per 1,000 person-year were 6.56 (95% confidence interval [CI], 4.8–8.8) and 7.23 (95% CI, 5.9–8.8) in the TBI and no-TBI groups, respectively (p = 0.594). Also, the SIR (95% CI) was not significantly increased by TBI (1.32 [0.86–1.94] vs. 1.39 [1.08–1.77] in the no-TBI group). In the young age group (0–19 years), SIRs were increased in both groups regardless of TBI (8.60 vs. 11.96). The IRRs of cataracts (1.60; 95% CI, 1.3–2.0), CKD (1.85; 95% CI, 1.3–2.6), and hypothyroidism (1.50; 95% CI, 1.1–2.1) were significantly increased after TBI. However, there were no significant differences in the occurrence of myocardial infarction and stroke according to TBI. Conclusions Our results suggest that modern TBI may not additionally increase the risk of SC after allogeneic HSCT, although increased risks of other diseases were noted. Physicians should carefully consider individualized risks and benefits of TBI, with a particular focus by age group.

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers

Acute scrotum is any pathologic condition of the scrotum or intrascrotal contents that requires emergency medical or surgical management. Management of each disease entity is different, but the differential diagnosis is very difficult. So many testes had been lost due to delay of the adequate surgery and unnecessary explorations had been taken under the misdiagnosis. Clinical observations were carried out on 59 patients with acute scrotum admitted to the department of urology, Ewha Womans University Hospital during 10 years from April, 1976 to March, 1986. There were 36 patients with acute epididymitis, 6 spermatic cord torsion and 17 scrotal trauma, the mean age was 32.6 year old in acute epididymitis, 12.8 spermatic cord torsion and 23.5 scrotal trauma. Symptoms and signs showed no significant difference from each disease entity, but Prehn`s sign was somewhat useful to differentiate each one. In half patients with spermatic cord torsion that had arrived to the hospital within 24 hours from onset of symptom, the testes could be saved. Testicular scan with 99mTc-perte- chnetate was performed in 14 patients and the diagnostic accuracy was 93%, 21 patients with acute epididymitis had urinary tract infection and spermatic cord torsion occurred in 2 patients with cryptorchidism.
Cryptorchidism ; Diagnosis, Differential ; Diagnostic Errors ; Emergencies ; Epididymitis ; Female ; Humans ; Male ; Scrotum* ; Spermatic Cord Torsion ; Testis ; Urinary Tract Infections ; Urology

A 42-year-old female diagnosed with tuberous sclerosis was found to have multiple polyps in the fundus of stomach. On histologic examination, the lesions were hamartomatous polyps. In tuberous sclerosis, many lesions occur in multiple organs and there are several reports about the frequent association of hamartomatous polyps of the colon. However, gastric manifestation of tuberous sclerosis has not been established probably due to its asymptomatic nature. This is the first report of multiple gastric hamartomatous polyposis in patient with tuberous sclerosis.
Abdominal Pain/etiology ; Actins/analysis ; Adult ; Case Report ; Cecal Neoplasms/pathology ; Encephalomalacia/etiology ; Female ; Gastric Fundus/pathology ; Gastroscopy ; Hamartoma/genetics+ACo- ; Human ; Hyperplasia ; Nasopharyngeal Neoplasms/pathology ; Neoplasm Proteins/analysis ; Polyps/genetics+ACo- ; Protein Isoforms/analysis ; Stomach Neoplasms/genetics+ACo- ; Tuberous Sclerosis/pathology+ACo- ; Tumor Markers, Biological/analysis

A 42-year-old female diagnosed with tuberous sclerosis was found to have multiple polyps in the fundus of stomach. On histologic examination, the lesions were hamartomatous polyps. In tuberous sclerosis, many lesions occur in multiple organs and there are several reports about the frequent association of hamartomatous polyps of the colon. However, gastric manifestation of tuberous sclerosis has not been established probably due to its asymptomatic nature. This is the first report of multiple gastric hamartomatous polyposis in patient with tuberous sclerosis.
Abdominal Pain/etiology ; Actins/analysis ; Adult ; Case Report ; Cecal Neoplasms/pathology ; Encephalomalacia/etiology ; Female ; Gastric Fundus/pathology ; Gastroscopy ; Hamartoma/genetics+ACo- ; Human ; Hyperplasia ; Nasopharyngeal Neoplasms/pathology ; Neoplasm Proteins/analysis ; Polyps/genetics+ACo- ; Protein Isoforms/analysis ; Stomach Neoplasms/genetics+ACo- ; Tuberous Sclerosis/pathology+ACo- ; Tumor Markers, Biological/analysis