No abstract available.
Gallbladder* ; Lithotripsy*

No abstract available.
Coronary Aneurysm* ; Mucocutaneous Lymph Node Syndrome*

The improved survival rate of premature infants requiring intensive care, shows an increased risk for nosocomial infections such as disseminated fungal infection. Renal candidasis usually occurs secondary to systemic disease, and can Iead to obstructive uropathy by fungus ball. A male neonate was born in week 28 of the gestational period. His birth weight was 1200gm. He required mechanical ventilation and surfactant for respiratory distress syndrome, umbilical artery and vein catheterization, percutaneous central veneous catheterization(PCVC) for parenteral nutrition, steroid, aminophylline and broad spectrum anibiotics. Hypertension developed on the 29th hospital day, but was not controlled by diuretics and antihypertensive drugs. on the 40th hospital day, he had abdominal distension, anuria, and azotemia. A Renal ultrasonogram showed that the ureteropelvic junction of the left kidney was completely obstructed with fungus balls. A percutaneous nephrostorny tube, made in a pigtail shape by hand, was inserted under fluoroscopy guidance, and the obstruction of the pelvis was resolved by wire manipulation. Parenteral amphotericin B and oral flucytocine were started, and the left renal pelvis was directly drained and irrigated by percutaneous nephrostomy tube. Candida albicans(C. albicuns) was cultured from urine and a percutaneous central venous catheter tip. His general condition improved, and follow up urine culture revealed no fungus. On follow-up renal ultrasonogram, renal cortex echogenicity and fungus ball had disappeared except for mild left renal calyectasis and pelvic thickening. This report describes a case of obstructive uropathy by fungus ball in systemic candidiasis of prematurity, and reviews the related literature.
Aminophylline ; Amphotericin B ; Antihypertensive Agents ; Anuria ; Azotemia ; Birth Weight ; Candida ; Candidiasis ; Catheterization ; Catheters ; Central Venous Catheters ; Cross Infection ; Diuretics ; Fluoroscopy ; Follow-Up Studies ; Fungi ; Hand ; Humans ; Hypertension ; Infant, Newborn ; Infant, Premature ; Critical Care ; Kidney ; Kidney Pelvis ; Male ; Nephrostomy, Percutaneous* ; Parenteral Nutrition ; Pelvis ; Respiration, Artificial ; Survival Rate ; Ultrasonography ; Umbilical Arteries ; Veins

The pancreatic pseudocyst as a sequela of pancreatitis or pancreatic trauma can occur at any site in the abdomen. Its detection seems to be increasing with modern imaging tools such as abdominal ultrasound or abdominal CT scanning. But recently, we experienced a case of a pseudocyst due to a ruptured pancreatic pseudocyst which was misdiagnosed as a simple hepatic cyst by abdominal ultrasonography or abdominal CT scan. A 12-year-old male presented with recurrent epigastric pain during the past 4 years. On the abdominal ultrasound and abdominal CT scan, there was an 8x7.5 cm sized sharply defined thin-walled cyst in the left lobe of the liver. First, percutaneous (cather) drainage guided by ultrasonography was done. An exploratory laparotomy was performed because of signs of hemoperitoneum. A 8x7.5 cm sized cyst was found at the left subhepatic space, which communicated with another smaller cystic lesion in the pancreatic head. Microscopic finding of the cyst showed infiltration of inflammatory cells and granulation tissue without ephithelial lined cells which is compatible to a pseudocyst. So we report this case with a review of literatures.
Abdomen ; Child ; Diagnostic Errors* ; Drainage ; Granulation Tissue ; Head ; Hemoperitoneum ; Humans ; Laparotomy ; Liver ; Male ; Pancreatic Pseudocyst* ; Pancreatitis ; Tomography, X-Ray Computed ; Ultrasonography

The implatnation of malignant cells along the needle tract is an extremely rare complication after a percutaneous fine-needle aspiration biopsy(FNAB). However, it is very serious and may result in a change in the prognosis of lung cancer, especially in the curable early stage(T1-2,N0,M0). Recently, we experienced two cases of such complications. A 43 years old female underwent a fine needle aspiration biopsy and a right middle lobectomy with adjuvant chemotherapy due to an adenocarcinoma(T2N0M0). Two years later, a new tumor developed at the site of the needle aspiration biopsy. It had the same pathological findings as the previous lung cancer. Therefore, it was concluded to be an implantation metastasis, and she was treated successfully by a right pneumonectomy and a resection of the chest wall mall with adjuvant radiotherapy. In another case, a 62 years old man was diagnosed with squamous cell lung cancer by a fine needle aspiration biopsy and underwent a right upper lobectomy(T2N0M0) with adjuvant chemotherapy. eight months later, a protruding chest wall mass developed at the aspiration site. It showed the same pathological findings as the previous lung cancer. Consequently, a total excision of the mass with adjuvant radiotherapy was done. Two years after the second operation, although the right lung was intace a metachronous squamous cell lung cancer was found at the left lower lobe. The two patients were still alive 15 and 37 months after thenresection of the chest wall mass, respectively.
Biopsy ; Biopsy, Fine-Needle* ; Biopsy, Needle ; Chemotherapy, Adjuvant ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Needles ; Neoplasm Metastasis* ; Pneumonectomy ; Prognosis ; Radiotherapy, Adjuvant ; Thoracic Wall* ; Thorax*

An anomalous left coronary artery from the pulmonary artery(Bland-White-Garland syndrome) is a rare congenital malformation and sometimes fatal. It is caused by an abberant endothelial budding from or an anomalous division of the truncus arteriosus. Echocardiography (transthoracic and transesophageal) and angiographical imaging are essential for the diagnosis of this anomaly. Corrective Surgery is recommended due to its fatal natural course. A case was diagnosed in a 45-year-old man who presented with intermittent palpitation. This patient was successfully treated with closure of anomalous left coronary artery orifice combined with right saphenous vein graft anastomosis.
Bland White Garland Syndrome ; Coronary Vessels* ; Diagnosis ; Echocardiography ; Humans ; Middle Aged ; Pulmonary Artery* ; Saphenous Vein ; Transplants ; Truncus Arteriosus

A patient, 59 years old male, with paroxysmal AV reentrant tachycardia utilizing a concealed left lateral accessory pathway with long VA conduction time is presented. During tachycardia P waves were negative in leads I, aVL, and V6 and positive in leads aVR and V1. The R-P/P-R ratio was 1.6. Radiofrequency catheter ablation was successful to interrupt the VA conduction through the accessory pathway.
Catheter Ablation ; Humans ; Male ; Middle Aged ; Tachycardia*

The occurrence of an abdominal wall hematoma caused by abdominal paracentesis in patients with liver cirrhosis is rare. This paper presents a case of an abdominal wall hematoma caused by abdominal paracentesis in a 67-year-old woman with liver cirrhosis with a review of the relevant literature. Two days prior, the patient underwent abdominal paracentesis for symptom relief for refractory ascites at a local clinic. Upon admission, a physical examination revealed purpuric patches with swelling and mild tenderness in the left lower quadrant of the abdominal wall. Abdominal computed tomography revealed advanced liver cirrhosis with splenomegaly, tortuous dilatation of the para-umbilical vein, a large volume of ascites, and a large acute hematoma at the left lower quadrant of the abdominal wall. An external iliac artery angiogram showed the extravasation of contrast media from the left deep circumflex iliac artery. Embolization of the target arterial branches using N-butyl-2-cyanoacrylate was then performed, and the bleeding was stopped. The final diagnosis was an abdominal wall hematoma from the left deep circumflex iliac artery after abdominal paracentesis in a patient with liver cirrhosis.

BACKGROUD: Primary care physicians (PCPs) and ariental medical dactors (OMDs), as primary healthcare providers, could directly affect patients use of complementary and alternative medidne(CAM). This study was carried out to compare the practice experience with, the knowledge about, and the attitudes taward CAM between PCPs and OMDs in Korea. METHODS: A total of 502 PCPs and 500 OMDs in urban area of Karea were selected by the proportionate quota and systematic sampling methood. Face-to-face interviews were done with structured questionnaire. RESULTS: The rate af practice experience with and referral rate af CAM were reported 13.7% and 38.6% in PCPs, 76.8% and 85.4%. in OMDs respectively. OMDs evaluated the efficacy of each CAM higher than PCPs. Both doctors had wide variatians of knowledge in how to practice each CAM. However more than half OMDs knew how to practice chiropracic, taping therapy, aromatherapy, and iridology respectively, about 30% of PCPs high colic/enema and chiropractic. PCPs had mcire negative attitudes toward CAM and the advertisement of the other professional medidne (korean traditional medicine) than OMDs. OMDs more strongly supported the natural healing process, health-disease continuum, and psychological effect on health, and opposed Descares view on human body than PCPs. CONCLUSIONS: This study showed OMDs had more experience with, knowledge about, positive attitudes toward and supportive health concepts to CAM than PCPs. CAM practice would be diffused with chiropractic, taping therapy, aromatherapy, and iridolagy in OMDs; high colic/enema and chiropractic in PCPs.
Aromatherapy ; Chiropractic ; Complementary Therapies* ; Human Body ; Humans ; Korea ; Medicine, East Asian Traditional ; Medicine, Korean Traditional* ; Physicians, Primary Care ; Primary Health Care ; Referral and Consultation ; Surveys and Questionnaires

BACKGROUND: Hypertension is an important as well as common disease in primary practice, so family physicians should concern about it. It is well known that if hypertension were well controlled, it could lower cardiovascular complications. However, there are few studies on the impact of hypertension affecting the quality of life. Therefore, we carried out this study to compare the quality of life in the hypertensive patients by whether it is well controlled or not. METHODS: The authors surveyed the quality of life using the questionnaire named as CMC Health Survey Version 1.0 for the hypertensive patients. The subjects had no complications and no other diseases, and aged 40 or more, and visited doctors at the Department of Family Medicine, Kyung Hee University Hospital or the Department of Internal Medicine, Sungmin Hospital from May 1 to Aug 31, 1998. We categorized the subjects into the two groups of the well controlled group(SBP<140 mmHg and DBP<90 mmHg) and the uncotrolled group(SBP> or = 140 mmHg or DBP> or = 90 mmHg) and compared the quality of life and lifestyle. RESULTS: The total number of subjects was 119, that of well controlled group was 69, and that of the uncontrolled group was 50. Mean systolic and diastolic blood pressure was 133.1+/-7.5 mmHg and 85.3+/-5.2 mmHg in the well controlled group, 159.2+/-7.4 mmHg and 100.2+/-5.5 mmHg in the uncontrolled group. The comparison of the distribution of age, sex, education, occupation, and monthly income between the two groups showed no difference. The comparision of the lifestyle between two groups by Alameda 7 questionnaire showed no difference ,too. As for the comparison of quality of life between two groups, the well controlled group had significantly higher scores in the domain of physical function, social function, general health, vitality(above P<0.01), emotional function, role limitation, and health perception(above P<0.05) than uncontrolled group. However, the scores of the domain of change in health, satisfaction, bodily pain were not significantly different between two groups. After covariated by obesity, the comparion of quality of life between two groups showed similar results. CONCLUSION: We confirmed that the well controlled group had better quality of life than the uncontrolled group. So family physicians should consider the quality of life when they consult the patients with hypertension.
Blood Pressure ; Education ; Health Surveys ; Humans ; Hypertension* ; Internal Medicine ; Life Style ; Obesity ; Occupations ; Physicians, Family ; Quality of Life* ; Surveys and Questionnaires