Coronary arteriovenous fistulas (CAVF) are rare malformations of the coronary circulation. They are seen in approximately 0.1% to 0.2% of all patients undergoing selective coronary angiography. We experienced a 58-years old male patient with bilateral coronary AV fistulas whoes diagnosis was confirmed by selective coronary angiography.
Arteriovenous Fistula* ; Coronary Angiography ; Coronary Circulation ; Diagnosis ; Fistula ; Humans ; Male ; Middle Aged

To evaluate the effect of allergic parameters, such as serum IgE, eosinophil, and skin test on the bronchial hyperresponsiveness (BHR) in patients with chronic airflow obstruction, we performed methacholine bronchial provocation test, pulmonary function test, skin prick test, and measured blood eosinophil counts and serum IgE level from seventy-nine patients who showed persistent fixed airflow obstruction, less than 75% of predicted value in FEV~ and FEV1/FVC, despite of conventional treatment without steroid therapy for more than 3 months. The results were as follows 1) There were 53 patients with BHR and 26 patients without BHR. There were no statistically significant differences in sex, age, and smoking duration between positive BHR group and negative BHR group (p>0.05). 2) There was no statistically significant difference in absolute and predicted value of FVC(p>0.05). But there were significantly lower absolute, predicted value of FEV1 and FEV1/FVC% in positive group compared with negative group (p<0.05). 3) There was somewhat higher trend of serum IgE level in positive group. Skin test was not significantly different between two groups (p > 0.05 ). 4) Blood eosinophil count was significantly higher in positive group than in negative group(p<0.05). Conclusion of this study is that increased bronchial responsiveness in patients with chronic airflow obstruction is inversely related to the level of pulmonary function and significantly associated with blood eosinophilia.
Bronchial Provocation Tests ; Eosinophilia ; Eosinophils ; Humans ; Immunoglobulin E ; Methacholine Chloride ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Function Tests ; Skin ; Skin Tests ; Smoke ; Smoking

Renal infarction usually occurs in patients with atrial fibrillation, valvular heart disease, trauma, renal artery stenosis, atherosclerosis and coagulopathy. However it may occur rarely in patients without such underlying disease. We report on 3 patients who developed renal infarction and had no underlying disease. In two cases, renal artery thrombosis occured. And in the other case, renal artery dissection occured. All patients of the renal infarction experienced severe flank pain. And increased serum LDH, ALT and ALP was noted. The differential diagnosis of renal artery dissection and renal artery thrombosis was established by renal artery angiography. In two patients with renal artery thrombosis, anticoagulation therapy was performed. In the other patient with renal artery dissection, only conservative therapy was performed. All 3 patients of renal infarction preserved normal renal function. but developed hypertension. Two patients were given anti-hypertensive agents. In the other patient, hypertension was normalized spontaneously.
Adult* ; Angiography ; Antihypertensive Agents ; Atherosclerosis ; Atrial Fibrillation ; Diagnosis, Differential ; Flank Pain ; Heart Valve Diseases ; Humans ; Hypertension ; Infarction* ; Renal Artery ; Renal Artery Obstruction ; Thrombosis

PURPOSE: To compare the diagnostic efficacy of fast spin-echo (FSE) T2-weighted MR imaging with and without fat suppression. MATERIALS AND METHODS: Twelve patients (7 men and 5 women; mean age, 48 years) with pathologically proven cancer of the tongue were included in this study. In all of these, FSE T2-weighted MR images with and without fat suppression were obtained in the same imaging planes before surgery or biopsy. Two radiologists visually compared the images thus obtained in terms of detection, extent, and conspicuity of the tumor, and the contrast-to-noise ratio (CNR) of each tumor was also calculated. RESULTS: In all patients, both imaging modalities were equal in terms of tumor detection. In 4 of 12(33%), the extent of the tumor was greater with fat suppression, while in eight (67%), it was almost the same both with and without. In ten patients (83%), the tumor was more conspicuous with fat suppression, and percentage CNRs were significantly higher with fat suppression than without (180 +/-70% and 113 +/-61%, respectively; p = 0.02). CONCLUSION: For the evaluation of patients with tongue cancer, fat-suppressed FSE T2-weighted MR imaging is superior to its conventional equivalent.
Biopsy ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Tongue Neoplasms* ; Tongue*

PURPOSE: To compare the diagnostic efficacy of fast spin-echo (FSE) T2-weighted MR imaging with and without fat suppression. MATERIALS AND METHODS: Twelve patients (7 men and 5 women; mean age, 48 years) with pathologically proven cancer of the tongue were included in this study. In all of these, FSE T2-weighted MR images with and without fat suppression were obtained in the same imaging planes before surgery or biopsy. Two radiologists visually compared the images thus obtained in terms of detection, extent, and conspicuity of the tumor, and the contrast-to-noise ratio (CNR) of each tumor was also calculated. RESULTS: In all patients, both imaging modalities were equal in terms of tumor detection. In 4 of 12(33%), the extent of the tumor was greater with fat suppression, while in eight (67%), it was almost the same both with and without. In ten patients (83%), the tumor was more conspicuous with fat suppression, and percentage CNRs were significantly higher with fat suppression than without (180 +/-70% and 113 +/-61%, respectively; p = 0.02). CONCLUSION: For the evaluation of patients with tongue cancer, fat-suppressed FSE T2-weighted MR imaging is superior to its conventional equivalent.
Biopsy ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Tongue Neoplasms* ; Tongue*

An understanding of the knowledges, attitudes and perceptions of different populations is key for public health policy makers. Here, a survey was performed on knowledge, attitudes, and perceptions about malaria diagnosis, prevention, control, and treatment. The 407 survey participants included both uninfected inhabitants and patients from 2 cities (Gimpo- and Paju-si) of Northern Gyeonggi-do, known as high-risk areas for vivax malaria. We used community-based study design and non-probability sampling method using the primary data. Association between variables were tested using χ2-tests. In general, the information on malaria reported by the participants in this study was unsystematic and included inaccurate details. The knowledge of malaria symptoms, identified as headache, chills and fever, was high, but the surveyed community lacks knowledge of the specific medications used for malaria treatment, with a large number of respondents having no knowledge of any form of medication. Survey questions with high correct answer rates included questions about easy treatment of malaria in Korea, the high daytime activity of malaria-borne mosquitoes, and the infection risk posed by outdoor activities. However, a large portion of the respondents was unable to provide simple medical and biological information about the disease. This study aimed to comprehensively evaluate the knowledge, attitude, and practical behavior of the surveyed community with respect to malaria and the implications reported here could be applicable to other malaria endemic areas in Korea.

The circumsporozoite protein (CSP) of Plasmodium spp. is a diagnostic antigen and useful biomarker for monitoring short-term/seasonal changes to malaria transmission. Using P. vivax CSP antibody ELISA, epidemiological characteristics were analyzed in the residents of Ganghwa, Cheorwon, Paju, and Goseong from 2017 to 2018. In Ganghwa and Cheorwon, 1.6% and 1.2% of residents, respectively, were PvCSP-antibody-positive in 2018, which indicates a decrease of 0.4% in the positive rate compared to 2017. The annual parasite incidence (API) in Ganghwa and Cheorwon was 24.9 and 10.5 in 2017 and 20.3 and 10.7 in 2018, respectively. Although the changes were not significant, the API in Ganghwa decreased slightly by 4.5 in 2018 compared to the previous year. In Paju and Goseong, 3.9% and 2.0% of residents were positive for the PvCSP antibody. The API in Paju was 13.1 in 2017 and 16.0 in 2018, although no malaria patients were reported for the 2 years. Therefore, the results suggest that PvCSP is a useful antigen for confirming initial malaria infection. Additionally, considering that the antibody is relatively transient, it can be employed for sero-epidemiological studies to determine the extent of malaria transmission in the current year.

The circumsporozoite protein (CSP) of Plasmodium spp. is a diagnostic antigen and useful biomarker for monitoring short-term/seasonal changes to malaria transmission. Using P. vivax CSP antibody ELISA, epidemiological characteristics were analyzed in the residents of Ganghwa, Cheorwon, Paju, and Goseong from 2017 to 2018. In Ganghwa and Cheorwon, 1.6% and 1.2% of residents, respectively, were PvCSP-antibody-positive in 2018, which indicates a decrease of 0.4% in the positive rate compared to 2017. The annual parasite incidence (API) in Ganghwa and Cheorwon was 24.9 and 10.5 in 2017 and 20.3 and 10.7 in 2018, respectively. Although the changes were not significant, the API in Ganghwa decreased slightly by 4.5 in 2018 compared to the previous year. In Paju and Goseong, 3.9% and 2.0% of residents were positive for the PvCSP antibody. The API in Paju was 13.1 in 2017 and 16.0 in 2018, although no malaria patients were reported for the 2 years. Therefore, the results suggest that PvCSP is a useful antigen for confirming initial malaria infection. Additionally, considering that the antibody is relatively transient, it can be employed for sero-epidemiological studies to determine the extent of malaria transmission in the current year.

Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan–Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712–1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

BACKGROUND: Spontaneous pneumothoraces(SP) are divided into primary spontaneous pneumothoraces(PSP) which develop in healthy individuals without underlying pulmonary disorders and secondary spontaneous pneumothoraces(SSP) which occur in those who have underlying disorders such as tuberculosis or chronic obstructive lung diseases. Yet there is no established standard therapeutic approach to this disorder, i.e., from the spectrum of noninvasive treatment such as clinical observation with or without oxygen therapy, to aggressively invasive thoracoscopic bullectomy or open thoracotomy. Although chest tube thoracostomy has been most widely used, the patients should overcome pain in the initiation of tube insertion or during indwelling it potential infection and subcutaneous emphysema. Thus smaller-caliber tube has been challenged for the treatment of pneumothorax. Previously, we studied the therapeutic efficacy of 8 French catheter for spontaneous pneumothorax. But there has been few data for effectiveness of small-caliber catheterization in comparison with that of chest tube. In this study, we intended to observe the long-term effectiveness of 8 French catheter for the treatment of spontaneous pneumothoraces in comparison with that of chest tube thoracostomy. METHODS: From January, 1990 to January, 1996, sixty two patients with spontaneous pneumothoraces treated at Chung-Ang University Hospital were reviewed retrospectively. The patients were sub-divided into a group treated with 8 French catheter(n=23) and the other one with chest tube insertion(n=39). The clinical data were reviewed(age, sex, underlying pulmonary disorders, past history of pneumothorax, size of pneumothorax, follow-up period). And therapeutic effect of two groups was compared by treatment duration(duration of indwelling catheter or tube), treatment-associated complications and recurrence rate. RESULTS: The follow-up period(median) of 8 French catheter group and chest tube group was 28 and 22 months, which had no statistical significance. Their was no statistically significant difference of clinical characteristics between two groups with SP, PSP, SSP. The indwelling time of 8 French catheter group was 6.2+/-3.8 days, which was significantly shorter than that of chest tube group in SP, 9.1+/-7.5 days(p=0.047). In comparison of treatment-related complication in PSP, 8 French catheter group as 6.25% of complication showed lower tendency than the other group as 23.8% (p= 0.041 ; one-tailed, p=0.053 ; two-tailed). The recurrence rate in each group of SP was 17.4%, 10.3%, which did not show any statistically significant difference. CONCLUSION: Treatment with 8 French catheter resulted in shorter indwelling time in sponteous pneumothorax, and lower incidence of treatment-related complication in primary spontaneous pneumothorax. And the recurrence rate in each of treatment group showed no statistically significant difference. So, we can recommend the 8 French small-caliber catheter for the initial therapy for spontaneous pneumothorax for the replacement of conventional chest tube thoracostomy. But further prospective study with more subjects of spontaneous pneumothorax will be needed for the evaluation of effectiveness of 8 French cateter.
Catheterization ; Catheters* ; Catheters, Indwelling ; Chest Tubes ; Follow-Up Studies* ; Humans ; Incidence ; Lung Diseases, Obstructive ; Oxygen ; Pneumothorax* ; Recurrence ; Retrospective Studies ; Subcutaneous Emphysema ; Thoracostomy ; Thoracotomy ; Tuberculosis