We have analyzed utrasonographic finding of 55 cases of hydronephrosis and 34 cases of renal maasses. The results are as follows; 1. 55 cases of hydronephrosis revealed renal enlargement in 55 cases, separation of central echo complex in 27 cases, multiple anechoic areas radiating from the center in 25 cases and dilated renalpelvis in 24 cases. 2. Among the renal masses in 34 cases, simple renal cyst were 15 cases, polycystic kidney in 8 cases, hypernephroma in 8 cases, Wilms' tmor in 2 cases and angiomyolipoma in 1 case. 3. Simple renal cystrevealed single in 14 cases (93%) and well defined anechoic mass with posterior enhancement in all cases. 4. Polycystic kidney revealed bilateral irregular shaped renal enlargement and multiple anechoic cysts throughout the kidney. 2 cases (25%) involved liver. 5. 6 cases (75%) of hypernephroma revealed ill defined modarately echogenicmass without posterior enhancement. 6. All cases of Wilms' tumor revealed well defined large mixed echogenic massin right kidney. 7. Angiomyolipoma revealed bilateral dense echogenic mass with large hemorrhagic cyst in rightkidney. 8. The ultrasonography is useful noninvasive diagnostic modality of evaluation of renal masses and hydronephrosis.
Angiomyolipoma ; Carcinoma, Renal Cell ; Hydronephrosis ; Kidney ; Liver ; Polycystic Kidney Diseases ; Ultrasonography ; Wilms Tumor

BACKGROUND: Contrast-induced nephropathy (CIN) can cause serious adverse effects. To reduce the occurrence of CIN related computed tomography (CT) in emergency patients, we assessed the respective roles of serum creatinine (SCr) alone and estimated glomerular filtration rate (eGFR) as an early predictor for CIN related CT. METHODS: For patients with SCr <1.5 mg/dL who underwent CT in emergency department (ED) between September 2012 and October 2013, we assessed the prevalence of CIN and its adverse effects. The Modification of Diet in Renal Disease Study (MDRD) and Cockcroft-Gault (CG) formula was used for the calculation of eGFR. Practical calculation was performed by electronic medical record (EMR) system for MDRD and internet calculating service for CG. And we investigated the prevalence of CIN in eGFR <60 mL/min/1.73 m2 before CT. RESULTS: A total of 1,555 patients were enrolled. The prevalence of CIN after CT was 4.6% and it showed correlation with renal deterioration, increased in-hospital mortality, and prolonged hospitalization. Despite baseline SCr <1.5 mg/dL, among enrolled patients, 11.3% as MDRD equation and 29.5% as CG formula were <60 mL/min/1.73 m2 and in this condition, the prevalence of CIN was significantly high (odds ratio was 2.87 [1.64-5.02] as MDRD equation and 2.03 [1.26-3.29] as CG formula). CONCLUSION: Just SCr <1.5mg/dL was not appropriate to recognize preexisting renal insufficiency, but eGFR using MDRD equation was useful in predicting the risk of CIN related CT in ED. Using EMR, calculation of eGFR can be easier and more convenient.
Creatinine* ; Diet ; Electronic Health Records ; Emergencies* ; Emergency Service, Hospital* ; Glomerular Filtration Rate ; Hospital Mortality ; Hospitalization ; Humans ; Internet ; Prevalence ; Renal Insufficiency

A device called incisor inclination indicator to control the axial inclinations of the incisors in the diagnostic setup is introduced. It is used to control the retraction of the maxillary and mandibular incisors. In this article, we describe the use of the incisor inclination indicator to prescribe adequate torque into the anterior lingual brackets and evaluate the results of treatment in a bimaxillary dentoalveolar protrusion case that underwent orthodontic treatment with the pretorqued anterior lingual brackets. Retraction of the maxillary and mandibular incisors was achieved with careful control of the axial inclination. It is indicated that the use of the incisor inclination indicator is an effective adjunctive laboratory procedure for anterior torque control during retraction in lingual orthodontic treatment.
Incisor* ; Torque*

This is a case report of double primary malignant cancer occurred aynchronously in the stomach and lymphoid tissue, We report this case with review of literatures about the criteria, age distribution, predisposing factor, inidence, immunity and susceptibility of the primary malignant neoplasms. This case was a 59-year-old man who had Hodgkins disease and tubular adenocarcinoma, of the stomach. The diagnoais was verified histologically, Although multiple primary neoplaas are rare, the possibility of that must be conaidered seriously, And its hereditary predisposition and other predisposing factor muat be researched with enthuaiasm.
Adenocarcinoma ; Age Distribution ; Causality ; Hodgkin Disease ; Humans ; Lymphoid Tissue ; Middle Aged ; Stomach

Erdheim-Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis and is characterized by the diffuse histiocytic infiltration of multiple organs. Retroperitoneal ECD, especially with uterine involvement, is extremely rare. We report about a 73-year-old woman who presented with vaginal spotting for a month and experienced abdominal pain along with pus-like urine. Computed tomography revealed an irregular mass-like lesion in the uterus, possibly a uterine sarcoma, invading the ureter, rectosigmoid, and bladder. A tissue biopsy of the retroperitoneal mass revealed typical morphological and immunohistochemical features of ECD. However, clinical features, especially long bone involvement, did not coincide with ECD, and BRAF V600E gene mutation was not detected. We made a diagnosis of atypical retroperitoneal ECD mimicking uterine sarcoma with multiple organ involvement.

Erdheim-Chester disease (ECD) is a rare type of non-Langerhans cell histiocytosis and is characterized by the diffuse histiocytic infiltration of multiple organs. Retroperitoneal ECD, especially with uterine involvement, is extremely rare. We report about a 73-year-old woman who presented with vaginal spotting for a month and experienced abdominal pain along with pus-like urine. Computed tomography revealed an irregular mass-like lesion in the uterus, possibly a uterine sarcoma, invading the ureter, rectosigmoid, and bladder. A tissue biopsy of the retroperitoneal mass revealed typical morphological and immunohistochemical features of ECD. However, clinical features, especially long bone involvement, did not coincide with ECD, and BRAF V600E gene mutation was not detected. We made a diagnosis of atypical retroperitoneal ECD mimicking uterine sarcoma with multiple organ involvement.

Primary aldosteronism is present in approximately 1% of unselectd hypertensive patients. Adrenal adenoma is a known as one of the surgically curable form of the hypertension. Hypertension is one of the contributing factors for the development of aortic dissection. Cincurrence of aortic dissection in patient with primary aldosteronism is extemely rare. Only one case wasconfirmed by autopsy and reported in the world literature. We report a case of DeBakey type 3 anortic aneursm in a 49-year old hypertensive female patient with primary aldosteronism due to left adrenal adenoma. She underwent left adrenalectomy uneventfully after stabilization of her blood pressure with maximal medical management including nitroprusside, aldactone, enalapril and inderal.
Adenoma ; Adrenalectomy ; Autopsy ; Blood Pressure ; Enalapril ; Female ; Humans ; Hyperaldosteronism ; Hypertension ; Middle Aged ; Nitroprusside ; Propranolol ; Spironolactone

Gangiogliomas are rare tumors, primarily seen in patients under the age of 30 years. They occure least commonly in the spinal cord. We present a 17-year-old girl who harbored an intramedullary conus ganglioglioma.
Adolescent ; Conus Snail* ; Female ; Ganglioglioma* ; Humans ; Spinal Cord

OBJECTIVE: To investigate the status and basic demand of community based stroke-disabled for rehabilitation program development in an urban area. METHOD: The subjects were 46 residencial stroke disabled over 6 months after disease onset. Two teams (composed of one physiatrist and one nurse, respectively) visited patient's home, and evaluated physical and functional status and surveyed for the status and basic demand of community based rehabilitation. RESULTS: Forty two patients (91.3%) received primary medical care after onset of the stroke, and twenty two patients(47.8%) received rehabilitation therapy. The most common reason for not having received rehabilitation therapy was poor economic state. University hospital was the most common place of their rehabilitative management. Mean score of Modified Barthel Index (MBI) was 60.7. Mean score of Craig Handicap Assessment and Reporting Technique (CHART) was 223 and economic self-sufficiency scale presented the lowest score as 6.5+/-4.6. The desire of patients for rehabilitation and welfare service was rehabilitation management and the desire of subjects for the government and society was warrant for livelihood. CONCLUSION: We concluded that rehabilitation program utilizing common resource such as areal university rehabilitation team and facilities of community health center should be developed.
Community Health Centers ; Humans ; Program Development ; Rehabilitation ; Stroke*

BACKGROUND: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. MATERIAL AND METHOD: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of 77.0+/-2.4 years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. RESULT: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was 3.3%. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below 40% were univariate predictors of overall complications. Actuarial probability of survival was 94.9%, 89.8%, and 83.5% at postoperative 1, 3 and 5 years respectively. During the follow-up period 93.3% of patients were in NYHA class I, or II and 91.1% were free from angina. CONCLUSION: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.
Aged ; Arrhythmias, Cardiac ; Cardiac Output, Low ; Chungcheongnam-do ; Coronary Artery Bypass* ; Coronary Vessels* ; Emergencies ; Female ; Follow-Up Studies ; Heart ; Heart Failure ; Heart Ventricles ; Hemodynamics ; Hemorrhage ; Humans ; Male ; Mammary Arteries ; Mortality ; Myocardial Infarction ; Peripheral Vascular Diseases ; Postoperative Complications ; Renal Insufficiency ; Reoperation ; Stroke