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The coronary arteries are also subject to congenital anomalies of both minor and major consequence. Hemodynamically significant primary anomalies of the coronary arteries are those which alter myocardial perfusion. There are four major types : coronary artery fistula, origin of the left voronary artery from the pulmonary artery, congenital coronary stenosis or atresia and origin of the left or right coronary artery from the opposite sinus of Valsalva with subsequent passage of the vessel between the aorta and right ventricular infundibulum. Minor anomlies are the variation of the origin of the coronary arteries from the aorta with normal distal circulation. We can see more coronary anomalies associated with congenital cardiac anomalies, probably representing a circulatory response to the primary intracardiac defect. We present a total of 76 cases of congenital coronary anomalies, reviewing 3946 cases of angiocardiography or selective coronary arteriography, performed during last 8 years at Sejong General Hospital.
Angiocardiography ; Angiography ; Aorta ; Arteries ; Coronary Stenosis ; Coronary Vessels* ; Fistula ; Hospitals, General ; Perfusion ; Pulmonary Artery ; Sinus of Valsalva

PURPOSE: The purpose of study was to evaluate the reliability of transrectal ultrasonography (TRUS) in the prostate volume measurement. MATERIALS AND METHODS: Forty-one patients underwent two TRUS examinations during two independent sessions to measure the three-dimensional diameters and volume of the prostate. The difference between the two TRUS examinations was evaluated, and the reliability of TRUS was assessed using the intraclass correlation coefficient (ICC), coefficient of variation (CV), and Bland and Altman plot. RESULTS: The patients were divided into two subgroups by two observers those with the mean prostate volume same or greater than 30 ml (group A) and those with the mean prostate volume less than 30 ml (group B). A prostate volume difference greater than 5 ml and 10 ml between the two TRUS examinations was more frequently included in the group A than in the group B (43% and 33%, 5% and 0%, respectively) (p < 0.05). ICC and CV showed poor reliability for measuring the prostate height, length and volume in the group A (ICC for width, height, length and volume < 0.75, CV for volume =12.97%). CONCLUSION: Prostate volume measurement by TRUS may be unreliable in large prostates with unreliable measurement of the height and length being the primary limiting cause.
Humans ; Prostate

PURPOSE: Leigh syndrome is a kind of mitochondrial disease with a pathological production of lactate and variable clinical manifestations. Recently biochemical assay of the mitochondrial enzyme activity and MRS are becoming a powerful tool for the definitive antemorterm diagnosis of this disease. The aim of this study was designed to determine the usefulness of biochemical enzyme assay and MRS in Leigh syndrome. METHODS: A clinical study of 8 cases of pediatric patients were diagnosed as Leigh syndrome on the basis of clinical manifestations and MRI features at the department of pediatrics, Ulsan university hospital, from July, 1992 to June, 1997. Biochemical enzyme assay of the cultured skin fibroblasts was consulted to hospital for sick children, Toronto, Canada. Cerebral lactates were detected on MRS were analysed in relation to the MRI findings and lactate levels in the CSF. RESULTS: 1) Age at diagnosis ranged from 7 months to 8.9 years; seven were boys and one was girl. 2) Main clinical symptoms were as follows in the order of frequency; seizure(75%), ophthalmoplegia(50%), hemiplegia(50%), hypotonia(50%), respiratory difficulty(50%), developmental delay(38%), consciousness change(38%), mental retardation( 25%). 3) Anatomical locations of the focal lesions detected on the initial MRI were as follows in the order of frequency; putamen(75%), caudate nuclei(63%), medulla oblongata (18,50%), substantia nigra(38%), thalamus(38%). 4) Biochemical enzyme assay revealed deficiency of NADH cytochrome c reductase (complex I) and deficiency of cytochrome c oxidase(complex N) respectively in 2 patients who had markedly elevated serum and CSF lactate levels and lactate/pyruvate ratio. 5) Cerebral lactates were detected by MRS from 6 lesions of 1 week-4 months old in 6 patients who had normal or mildly elevated serum and CSF lactate levels and lactate/pyruvate ratio. CONCLUSION: MRS detected the brain parenchymal lactate non-invasively from the acute or subacute lesions. Therefore, combined evaluation by MRS and biochemical enzyme assay will provide an important information for the diagnosis and estimation of disease activity in pediatric patients who are suspected to have Leigh syndrome.
Brain ; Canada ; Child ; Consciousness ; Cytochromes c ; Diagnosis ; Enzyme Assays* ; Female ; Fibroblasts ; Humans ; Lactates ; Lactic Acid ; Leigh Disease* ; Magnetic Resonance Imaging ; Medulla Oblongata ; Mitochondrial Diseases ; NADH Dehydrogenase ; Pediatrics ; Skin ; Ulsan

BACKGROUND: This is to evaluate the noisy environment, and to improve the hearing conservation program by analyzing the status of hearing loss and risk factors which cause hearing loss of Airlines pilots. METHODS: We reviewed Audiometric, Medical and Flying records of total 92 pilots under 55 years old . These subjects selected after excluding pilots with history of ear disease and ototoxic drug administration. The significance of the factors was analyzed by ANOVA and Regression test. RESULT: The mean age of pilots was 39.96 years old and the mean flight time was 5665.39 hours. The noise levels by aircrafts were mean 76.9dB and maximum 144.4dB in B737, mean 78.5dB and maximum 143.2dB in B747. The noise levels by headset were mean 72.1dB and maximum 144.1dB. The mean hearing threshold level was different with age groups. The older in age, the higher in the mean hearing threshold level at high frequency and left ear. It was increased the mean hearing threshold level (dB) at high frequency (4,000 Hz) by total flight time The effect on hearing threshold level at high frequency in left ear was statistically significant in total flight time (p=0.032). CONCLUSION: The noise level of aircrafts could cause noise-induced hearing loss in some pilots. Age and total flight time are within the range of possibility of hearing loss. The result of this study ascertained the possibility of hearing loss due to monaural-headsets on the left ear at 4,000 Hz. It is recommended that an effective hearing conservation program should be provided for the headset-wearing communication pilots.
Aircraft ; Diptera ; Ear ; Ear Diseases ; Hearing Loss ; Hearing Loss, Noise-Induced ; Hearing* ; Humans ; Middle Aged ; Noise ; Risk Factors

Collecting duct carcinoma is an unusual variant of renal cell carcinoma, which is originated from the collecting tubules of the kidney. The typical histological appearance is that of a papillary adenocarcinoma with infiltrating tubules and desmoplastic reaction. And there is mainly tubulo-papillary. structure in histologic examination. We report a case of collecting duct carcinoma of kidney in a 47 years old female, which was managed by radical nephrectomy.
Adenocarcinoma, Papillary ; Carcinoma, Renal Cell* ; Female ; Humans ; Kidney ; Middle Aged ; Nephrectomy

The clinical review was done on 15 cases with the foreign body in the upper gastrointestinal tract who visited and underwent endoscopic removal of foreign body at department of lnternal Medicine of Chonnam University Hospital and Namkwang Hospital from June 1982 to August 1987. The results are as follows: 1) The age distribution varied from 32 yeara to 83 years of age, being most prevalent at 6th decade, The ratio between male and femaie was 4:1, more prevelant in male. 2} Among 15 eases, 8 cases were lodged in the esophagus and 7 cases in the stomach. The foreign bodies in the esophagus were meat, pressure-through package, food materials and bone in order of frequency and those in the stomach were bezoar, persimmon seed, brown seaweed, tooth brush and suture materials. 3) Cambined diseases of upper gastrointetinal passage disturbance were 1 case of esophageal cancer and 3 cases of gastric outlet obstruction caueed by duodenal ulcers and gastric malignancy. Other combined diseases were schizophrenia, chronic alcoholism, diabetes mellitus and gastrie polyp. 4) Complications by foreign body were retropharyngeal abscess and phlegmonous esophagitis with esophageal ulcer.
Age Distribution ; Alcoholism ; Bezoars ; Cellulitis ; Diabetes Mellitus ; Diospyros ; Duodenal Ulcer ; Esophageal Neoplasms ; Esophagitis ; Esophagus ; Foreign Bodies* ; Gastric Outlet Obstruction ; Humans ; Jeollanam-do ; Male ; Meat ; Polyps ; Retropharyngeal Abscess ; Schizophrenia ; Seaweed ; Stomach ; Sutures ; Tooth ; Ulcer ; Upper Gastrointestinal Tract*

The effects of oxygenation of differential independent lung ventilation using HFJV (High Frequency Jet Ventilation) and CPAP (Continuous Positive Airway Pressure) on PaO2 and Qs/Qt were studied during one lung anesthesia in 11 mongrel dogs in left semilateral position with pentobarbital anesthesia. The dogs were divided into two groups. In group A(N = 7), following the conventional two lung ventilation, one lung ventilation, HFJV, one lung ventilation, cpap 5 cmH2O, and CPAP 10 cmH20 were applied sequentially. In group B(N =4), following the conventional two lung ventilation the above applications were reversed. In group A PaO2 revealed a similar increase among a two lung ventilation, CPAP 5 cmH2O, CPAP 10 cmH2O and HFJV. Intrapulmonary shunt showed the similar decrease among two lung ventilation, HFJV and CPAP 10cmH2O, but CPAP 5 cmH2O was higher than CPAP 10cmH2O. Although there were no statistically significant differences in PaO2 and shunt among each step in group B, HFJV showed a greate increase in PaO2, and shunt than one lung ventilation, CPAP 5 cmH 20) 20, and CPAP 10 cmH2O. In conclusion, HFJV proved to be more effective than CPAP 5 cmH2O in increasing PaO2 and decreasing shunt in differential independent lung ventilation. Both CPAP and JFJV should be applied in the deflation phase of the nondependent lung to cause an effective increase in PaO2. HFFV proved to be more effective than CPAP in recruiting the small airway closure.
Anesthesia ; Animals ; Continuous Positive Airway Pressure ; Dogs ; Lung* ; One-Lung Ventilation ; Oxygen ; Pentobarbital ; Ventilation*

Studies were made to ascertain the relationship between arterial and end-tidal carbon dioxide tension in 19 patients during caesarean section under general anesthesia(Group 2). 27 nonpregnant patients scheduled for abdominal hysterectomy were also performed as a control group(Group I). 15 and 30 minutes after the induction of anesthesia in group I, and just before uterine incision, 15 minutes following induction in group 2, arterial blood was sampled for PaCO analysis and PETCO2(end-tidal CO2 tension) determined at the same time. In group 1, there was a statistically significant differences between PaCO2 and PETCO2 but in group 2, no differences between them were shown. The highly significant correlations between PaCO2 and PETCO2 in both groups were found. On the basis of the above results, we recommend that non-invasive measurement of PETCO2 can be used reliably in stead of measuring PaO2 to evaluate the ventilatory status during anesthesia in patients for caesarean section.
Anesthesia ; Anesthesia, General* ; Capnography ; Carbon Dioxide* ; Carbon* ; Cesarean Section* ; Female ; Humans ; Hysterectomy ; Pregnancy

Studies were made to ascertain the relationship between arterial and end-tidal carbon dioxide tension in 19 patients during caesarean section under general anesthesia(Group 2). 27 nonpregnant patients scheduled for abdominal hysterectomy were also performed as a control group(Group I). 15 and 30 minutes after the induction of anesthesia in group I, and just before uterine incision, 15 minutes following induction in group 2, arterial blood was sampled for PaCO analysis and PETCO2(end-tidal CO2 tension) determined at the same time. In group 1, there was a statistically significant differences between PaCO2 and PETCO2 but in group 2, no differences between them were shown. The highly significant correlations between PaCO2 and PETCO2 in both groups were found. On the basis of the above results, we recommend that non-invasive measurement of PETCO2 can be used reliably in stead of measuring PaO2 to evaluate the ventilatory status during anesthesia in patients for caesarean section.
Anesthesia ; Anesthesia, General* ; Capnography ; Carbon Dioxide* ; Carbon* ; Cesarean Section* ; Female ; Humans ; Hysterectomy ; Pregnancy