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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

BACKGROUND: Adaptive remodeling of the wall of diseased arterial segments occurs to compensate for the accumulation of atherosclerotic plaque. Histopathologic studies and intraoperative high-frequency epicardial coronary ultrasound imaging as well as intracoronary ultrasound imaging have shown that human coronary arteries enlarge in parallel with the formation of atherosclerotic plaque. Therefore, the lumen area is preserved until the progressive accumulation of plaque exceeds the compensatory mechanisms of the vessel. In 1995, however, Pastercamp et al. reported that arterial wall constriction (shrinkage) or inadequate enlargement may be a different mechanism associated with the development of severe arterial lumen narrowing in addition to plaque proliferation. The aim of this study is to examine what extent of de novo native coronary arterial stenosis is accompanied by compensatory enlargement and to find the predictors of inadequate remodeling with intravascualr ultrasound. METHODS: Fifty eight patients were enrolled from February 1997 through October 1997. Patients who had the lesion of more than 50% stenosis of minimal luminal diameter in coronary angiography were indicated. The lesion which was located in the ostium or was very tortuous or angulated was excluded. The lesion which had the history of balloon angioplasty or stent insertion was also excluded. We used 20 MHz endosonic intravascular ultrasound catheter. We measured EEM area (External Elastic Membrane area), lumen area and plaque plus media area and analysed plaque characteristics. RESULTS: 1) Fifty-eight consecutive patients (43 men, 15 women; mean age 55.4 years, range 33 to 78) who had not undergone previous catheter intervention were studied with a single intravascular ultrasound system. 2) Among 58 patients, 20 patients (35%) had acute myocardial infarction, 30 patients (52%) unstable angina, 6 patients (10%) stable angina and 2 patients (3%) old myocardial infarction. Lesions were located at the left anterior descending arteries in 29 patients (50%), right coronary arteries in 21 patients (36%) and left circumflex coronary artery in 8 patients (14%). 3) Compensatory enlargement was observed in 19 (32%) of 58 lesions and inadequate compensatory enlargement in 39 (68%). 4) EEM and plaque areas at lesion site of compensatory enlargement group were significantly larger than those of inadequate enlargement group (p<0.05). 5) Risk factors for coronary arterial disease including diabetes mellitus, hypertension, hypercholesterolemia (serum cholesterol<0A65B>240 mg/dl), smokings and plaque characteristics were not statistically related with inadequate enlargement. Although there was no statistical significance, there was a tendency of inadequate enlargement in patients with diabetes mellitus and calcified plaque. 6) The only predictor of inadequate remodeling was the postmenopausal female (p<0.05). CONCLUSION: Adaptive compensatory coronary arterial remodeling was occured less frequently in patients with acute coronary syndromes than in patients with stable angina. The only statistically significant predictor of adaptive compensatory coronary arterial remodeling was postmenopausal women. Inadequate compensatory coronary arterial remodeling was occured more frequently in patients with diabetes mellitus or calcified plaque but without statistical significance.
Acute Coronary Syndrome ; Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Catheters ; Constriction ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Diabetes Mellitus ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Membranes ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Risk Factors ; Smoke ; Stents ; Ultrasonics* ; Ultrasonography

Congential bile duct cysts, the so called "choledochal cysts" occur at all levels of the biliary tree and may be of saccular, diverticular, or fusiform configuration. There are 6 types of choledochal cysts proposed by todani et al based on roentgenologic and operative findings. This disease is usually diagnosed at the childhood or early adult life and predilection for orientals. Clinical manifestations are usually jaundice, right upper quadrant abdominal pain and abdominal mass. Here we are reporting a case of choledochal cyst, type IV-A diagnosed by abdominal ultrasonogram. 99mTc-DISIDA hepatobiliary scan and endoscopic retrograde cholangiopancreatogram.
Abdominal Pain ; Adult ; Biliary Tract ; Choledochal Cyst* ; Humans ; Jaundice ; Technetium Tc 99m Disofenin ; Ultrasonography

Authors report a case with recurrent epigastric pain who revesled to have chronic pancreatitis due to impaction of Ascaris lumbricoides into the pancreatic duct. She was a 41-year-old female who favored raw meat. ERCP revealed a living round worm in the pancreatic duct which was also showed by ultrasonegraphy and computed tomography. She underwent distal pancreatectomy and developed glucose intolerance but was well controlled.
Adult ; Ascaris lumbricoides* ; Ascaris* ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Glucose Intolerance ; Humans ; Meat ; Pancreatectomy ; Pancreatic Ducts* ; Pancreatitis, Chronic*

Authors came acoss a case of Behcet's syndrome involving cecum. The patient was a 33-year-old female. Her chief complaint was right lower quadrant pain, Colonoscopy revealed several ulcerations the base of which was covered by thick whitish coat, They were surrounded by mulitiple nodular masses. Endoscopic biopsy showed noaspecific ulceration. The patient had a history of aphthous ulceration of mouth and external genitalia. So she was diagnosed to have Behcets syndrome. She underwent right hemicolectomy with tetminal ilectomy. We report this case with literiature review.
Adult ; Behcet Syndrome* ; Biopsy ; Cecum* ; Colonoscopy ; Female ; Genitalia ; Humans ; Mouth ; Stomatitis, Aphthous ; Ulcer

OBJECTIVES: This study was to define the clinical characteristics and formulate the management strategies of the patients with infectious cerebral aneurysms. METHODS: During the past 30 years, among 2,830 patients who were treated with intracranial aneurysms, 11 patients had infectious cerebral aneurysms. The authors reviewed the database and the imaging studies as sources for identification and analysis. RESULTS: Nine patients had ruptured lesions: Five patients presented with subarachnoid hemorrhage (SAH) and 4 patients presented with intracerebral hemorrhage (ICH). Two patients were Hunt and Hess Grade I, 1 Grade II, 2 Grade III, 3 Grade IV, and 1 Grade V. Seven aneurysms were located at middle cerebral artery, 2 at anterior cerebral artery, 1 at internal carotid artery, and 1 at posterior circulation. Ten aneurysms were small ((8 mm). Seven aneurysms were fusiform, and the remaining 4 aneurysms were saccular. Five of the 11 patients (44.4%) had multiple aneurysms. All patient were treated by microsurgery. The obliteration methods of the aneurysms were trapping in 7 patients, and neck clipping in 4 patients. Nine patients showed favorable outcome (good : 7, fair : 2) and 2 patients showed unfavorable outcome (poor : 1, dead : 1). CONCLUSION: Infectious cerebral aneurysms had high frequency of ICH, fusiform-shape, multiple aneurysms, and initial poor clinical grade. Surgery was necessary for ruptured lesion and unruptured lesions which size was increased at follow up angiography. The ultimate management outcome was satisfactory. Co-work with cardiologist and cardiovascular surgeon is necessary.
Aneurysm ; Angiography ; Anterior Cerebral Artery ; Carotid Artery, Internal ; Cerebral Hemorrhage ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Microsurgery ; Middle Cerebral Artery ; Neck ; Subarachnoid Hemorrhage