We report a case with an isolated single coronary artery originating from the ascending aorta, which to our knowledge has never been described before. A 51-year-old man presented for evaluation of atypical chest pain, suffering from a short resting chest pain for 3 days. However, serial electrocardiogram showed no change during chest pain. Cardiac enzymes such as CK-MB, Troponin-I, and myoglobin were within normal limit. Aortography and coronary angiography revealed a single coronary artery originating from the postero-lateral wall of the ascending aorta above the left coronary siuns. However, this anomaly was not of clinical significance based on the atypical nature of the chest pain, negative exercise echocardiography and an absence of obstruction of the coronary artery.
Aorta* ; Aortography ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessel Anomalies ; Coronary Vessels* ; Echocardiography ; Electrocardiography ; Humans ; Middle Aged ; Myoglobin ; Troponin I

PURPOSE: Tumor size and multiplicity are known to be important prognostic factors in non-muscle-invasive bladder cancer (NMIBC). However, evaluation of accurate tumor size is subjective and difficult. Furthermore, there are limitations to the objectification of tumor volume in the case of multiple lesions. In this study, we investigated the relation between resection weight after transurethral resection of bladder tumor (TURBT) and the prognosis of NMIBC. MATERIALS AND METHODS: This was a retrospective analysis of 406 patients diagnosed with pTa or pT1 bladder tumors after TURBT between September 1999 and May 2010. The patient's age, sex, underlying diseases, cancer stage, grade, multiplicity, tumor size, lymphovascular invasion, and resection weight were analyzed in relation to cancer progression and recurrence. The resection weight was weighted after formaldehyde fixation. RESULTS: The mean follow-up time was 76.9 months (range, 12 to 167 months) in 406 patients diagnosed as having NMIBC. Mean resection weight was 4.5 g (range, 0.1 to 35.0 g). The cancer recurred in 99 patients (24.4%), and disease progression was noted in 30 patients (7.4%). Resection weight was categorized as greater than or less than 2 g by use of receiver operator characteristic curves. Cancer grade (p=0.022) and multiplicity (p=0.043) were significantly related to cancer recurrence in the analysis with Cox's multivariate proportional hazard model. Cancer grade (p=0.001) and resection weight (p=0.018) were related to disease progression. CONCLUSIONS: Resection weight after TURBT was significantly related to progression of NMIBC. Resection weight was an independent factor of progression. Further management should be considered if the resection weight exceeds 2 g.
Disease Progression ; Follow-Up Studies ; Formaldehyde ; Humans ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Tumor Burden ; Urinary Bladder ; Urinary Bladder Neoplasms

PURPOSE: Tumor size and multiplicity are known to be important prognostic factors in non-muscle-invasive bladder cancer (NMIBC). However, evaluation of accurate tumor size is subjective and difficult. Furthermore, there are limitations to the objectification of tumor volume in the case of multiple lesions. In this study, we investigated the relation between resection weight after transurethral resection of bladder tumor (TURBT) and the prognosis of NMIBC. MATERIALS AND METHODS: This was a retrospective analysis of 406 patients diagnosed with pTa or pT1 bladder tumors after TURBT between September 1999 and May 2010. The patient's age, sex, underlying diseases, cancer stage, grade, multiplicity, tumor size, lymphovascular invasion, and resection weight were analyzed in relation to cancer progression and recurrence. The resection weight was weighted after formaldehyde fixation. RESULTS: The mean follow-up time was 76.9 months (range, 12 to 167 months) in 406 patients diagnosed as having NMIBC. Mean resection weight was 4.5 g (range, 0.1 to 35.0 g). The cancer recurred in 99 patients (24.4%), and disease progression was noted in 30 patients (7.4%). Resection weight was categorized as greater than or less than 2 g by use of receiver operator characteristic curves. Cancer grade (p=0.022) and multiplicity (p=0.043) were significantly related to cancer recurrence in the analysis with Cox's multivariate proportional hazard model. Cancer grade (p=0.001) and resection weight (p=0.018) were related to disease progression. CONCLUSIONS: Resection weight after TURBT was significantly related to progression of NMIBC. Resection weight was an independent factor of progression. Further management should be considered if the resection weight exceeds 2 g.
Disease Progression ; Follow-Up Studies ; Formaldehyde ; Humans ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Recurrence ; Retrospective Studies ; Tumor Burden ; Urinary Bladder ; Urinary Bladder Neoplasms

The hypotensive effect of diltiazem hydrochloride(Herben(R)) was investigated with 32 cases of essential hypertension. Diltiazem, 90-180mg per day, was administer ed in divided doses to each of the subjects for 6 week and the blood pressure lowering effect was assessed, as remarkably effective when the lowering of blood pressure was, 20mmHg or more of systolic pressure and 10mmHg or more of diastolic pressure; as satisfactorily effective when 20mmH or more of systolic pressure or 10mmHg or more of diastolic pressure was lowered; as fairly effective when 10-19mmHg of systolic pressure and 5-9mmHg of diastolic pressure. 1. With above mentioned criteria, diltiazem was remarkably, satisfactorily and fairly effective in 11(37%), 13(43%) and 1(3%) of 30 patients, respectively, while the drug was ineffective in 5(17%). 2. Diltiazem was effective in lowering of both systolic and diastolic blood pressure, and was effective as a sole agent of as an agent of combination therapy. 3. With diltiazem treatment, the depressed ST segment was conversed to isoelectric line in all of 10 cases which showed ST depression before diltiazem treatment and the elevated ST segment was conversed to isoelectric line in 1 of 2 cases. all of 4 cases with flat T wave and 10 of 12 cases with inverted T wave showed conversion to upright T waves after diltiazem treatment. 4. Undesirable side effects was observed in 2 cases out of 32 cases(6%); 1 case of erythema multiforme-like skin eruption and 1 case of the clinical aggravation of congestive heart failure, in whom the diltiazem administration was discontinued.
Blood Pressure ; Depression ; Diltiazem* ; Erythema ; Heart Failure ; Humans ; Hypertension* ; Skin

In patient with Zollinger-Ellison syndrome, it is difficult to localize gastrinoma because the tumor is frequently small and multiple. However, accurate localization of the tumor is important for the treatment. Among various imaging modalities, somatostatin receptor scintigraphy (SRS) has been recognized to be the most sensitive tool for the detection of neuroendocrine tumors such as gastrinomas based on the presence of high-affinity binding sites for somatostatin. Recently, we experienced a case of Zollinger-Ellison syndrome caused by gastrinomas which was localized by SRS. This is the first case report of gastrinoma detected by SRS in Korea. SRS can facilitate tumor detection in patient with Zollinger-Ellison syndrome and should be considered as the first-line diagnostic method in the early course of the disease.
Binding Sites ; Gastrinoma* ; Humans ; Korea ; Neuroendocrine Tumors ; Radionuclide Imaging ; Receptors, Somatostatin ; Somatostatin ; Zollinger-Ellison Syndrome*

PURPOSE: A conventional thyroidectomy requires a wide transverse incision on the anterior neck, which can cause significant scaring. We developed an endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure in order to produce better cosmetic results. We reports the clinical analysis of endoscopic thyroid lobectomy and compare the result with those from a conventional thyroid lobectomy. METHOD: From July 2003 and December 2004, 55 consecutive patients with benign thyroid nodules, who underwent endoscopic thyroid lobectomy, and 51 consecutive patients with benign thyroid nodules, who underwent a conventional thyroid lobectomy, were retrospectively reviewed. The preoperative diagnosis of the thyroid nodules was performed using high-resolution ultrasonography and fine- needle aspiration cytology. The clinical results of endoscopic thyroid lobectomy were analyzed and compared with those from a conventional thyroid lobectomy. RESULTS: There were no significant differences between the two groups in terms of the patients' gender, size of tumor, preoperative diagnosis (follicular tumor/adenomatous nodule), postoperative diagnosis (cancer/benign), level of postoperative discomfort, length of hospital stay. The patients who underwent endoscopic thyroidectomy were significantly younger than those underwent conventional thryoidectomy (37.4+/-10.3 years vs. 48.8+/-13.0 years; P<0.001). The operation time for the endoscopic group was significantly longer than that for the conventional group (171.9+/-35.6 min vs. 92.5+/-26.5 min; P<0.001). The length of closed drainage in the endoscopic group was longer than that in the conventional group (2.8+/-0.8 days vs. 1.4+/-1.3 days; P<0.001). However, these factors did not affect the length of the hospital stay, and the number of intraoperative complications. CONCLUSION: Endoscopic thyroid lobectomy using the breast approach and a low carbon dioxide pressure has cosmetic benefits and is a feasible and safe procedure.
Breast ; Carbon Dioxide ; Diagnosis ; Drainage ; Humans ; Intraoperative Complications ; Length of Stay ; Neck ; Needles ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule ; Thyroidectomy ; Ultrasonography

PURPOSE: In early 1980s, vasectomy was performed in more than 10 thousand men of reproductive age annually without cost as a South Korean government policy of birth control, but because the policy has been converted to encouraging childbirth since July 2004, vasovasostomy is now covered by national health insurance. We investigated the effect of national health insurance coverage of vasovasostomy. MATERIALS AND METHODS: From August 1997 to June 2009, a total of 117 patients who underwent vasovasostomy were enrolled in this study. We divided the patients into two groups. The 63 patients undergoing the procedure before national health insurance coverage were included in group A, and the other 54 patients, who underwent the procedure after insurance coverage began, were classified into group B. The two groups were compared according to age, spouse's age, time since vasectomy, number of children at the time of vasectomy, occupation, educational attainment, religion, and the reason for vasovasostomy. RESULTS: The average number of cases of vasovasostomy was almost 3 times higher after insurance coverage was introduced, at 2.3 cases per month. The average spouse's age was significantly higher in group B than group A (35.2+/-4.8 vs. 32.2+/-3.5, p=0.012). Time since vasectomy was shorter in group B than group A (5.7+/-4.7 years vs. 8.9+/-5.0 years, p=0.001). Number of children at the time of vasectomy showed no significant difference between group A and group B, at 1.7+/-0.7 and 1.6+/-0.8 respectively. Cross tabulation analysis of occupation, educational status, religion, and the reason for vasovasostomy showed no significant difference. The patency rate was significantly higher in group A than group B (87.3% vs. 90.7%, p=0.012), but there was no significant difference in pregnancy rate. CONCLUSIONS: A significant increase was seen in patency rate, but not in pregnancy rate, after insurance coverage. However, further follow up will show us that a rise in the patency rate promises positive effects on the rise of pregnancy rate. We suggest that insurance coverage for vasovasostomy has encouraged an increase in births.
Child ; Contraception ; Educational Status ; Humans ; Insurance Coverage ; Insurance, Health ; Male ; National Health Programs ; Occupations ; Parturition ; Pregnancy ; Pregnancy Rate ; Vasectomy ; Vasovasostomy

PURPOSE: Infantile colic is one of the most commonly encountered problems, characterized by excessive crying in apparently healthy young infants within the first 3 months of life. It is commonly assumed that the infant with colic has distress and possible pain. In recent investigations, it has been found that sucrose has an analgesic effect in newborn infants. The purpose of this study is to examine if sugar solution as sucrose also has an analgesic effect on infant colic. METHODS: This prospective randomized, double-blind placebo controlled study examined healthy term infants aged 4 to 12 weeks with colic. A total of 40 infants were randomly assigned into two groups who visited Daedong Hospital from June 1999 to June 2001. Each group received sugar solution or sterile water. All data from parental diaries and interviews were recorded and analysed blindly. RESULTS: The daily crying time and the colic improvement score were significantly better in sugar solution group as compared with the control(P=0.019, 0.045). No significant differences were noted between groups regarding the number of night wakenings(P=0.173). CONCLUSION: We conclude that sugar solution has an analgesic effect on infantile colic.
Colic* ; Crying ; Humans ; Infant ; Infant, Newborn ; Parents ; Prospective Studies ; Sucrose ; Water

BACKGROUND/AIMS: Serum HBV DNA levels are correlated with hepatic histologic activity in chronic HBV infection based on HBeAg. Liver injury may persist, even though HBV DNA are not detected by hybridization assay. This study was to investigate whether serum HBV DNA levels determined by more sensitive quantitative method are correlated with histologic activities in chronic HBV infections. METHODS: This study included 66 chronic HBV infected patients. HBV DNA level was quantified by Cobas Amplicor HBV Monitor(TM). RESULTS: Serum HBV DNA levels in HBeAg-positive patients were significantly higher than HBeAg-negative patients. In HBeAg-positive patients, serum HBV DNA levels showed a significant negative correlation with portal-periportal activity and fibrosis (r=-0.451, -0.446 respectively). AST levels were correlated with lobular, portal-periportal activity and fibrosis (r=0.432, 0.365, 0.301 respectively), whereas ALT levels were related to lobular activity (r=0.294). Elevated AST levels predicted lobular activity, portal-periportal activity, and fibrosis with moderate to severe degree (OR 1.733, 95% CI 1.083-2.775; OR 1.518, 95% 1.028-2.243, p=0.336; OR 17.897, 95% CI 1.517-211.208, p=0.022, respectively). CONCLUSIONS: In HBeAg-positive patients, serum HBV DNA level correlates inversely with histologic activity. On the other hands AST level correlates with histologic activity and the stage of moderate or severe degree.
Adolescent ; Adult ; Child ; Child, Preschool ; DNA, Viral/*blood ; Female ; Hepatitis B e Antigens/analysis ; Hepatitis B virus/genetics/*isolation & purification ; Hepatitis B, Chronic/pathology/*virology ; Humans ; Liver/*pathology ; Male ; Middle Aged

Acute pancreatitis caused by primary hyperparathyroidism-induced hypercalcemia is a rare condition, as acute pancreatitis is typically associated with a decrease in serum calcium levels. If hypercalcemia is present in a patient with acute pancreatitis, the possibility of hyperparathyroidism should be considered, and parathyroid hormone levels should be evaluated and the parathyroid gland imaged. We present a case of a 48-year-old male with acute recurrent pancreatitis caused by hyperparathyroidism. Initially, the acute pancreatitis improved after conservative therapy. However, the patient relapsed 1 month later. The patient had hypercalcemia and was diagnosed with parathyroid adenoma. He underwent surgical resection of the parathyroid adenoma and recovered. After 24 months of the treatment, there was no recurrence of the hypercalcemia or pancreatitis.
Calcium ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Male ; Middle Aged ; Pancreatitis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms ; Recurrence