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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*

PURPOSE: To analyze the clinical characteristics of visual symptoms, aspects of headache, and ophthalmologic features in children diagnosed with migraine. METHODS: The medical records of 31 Korean children who had been diagnosed with migraine by pediatric neurologists were retrospectively reviewed and visual symptoms and ophthalmologic examinations were evaluated. RESULTS: The mean age of the 31 patients was 10.8 years (range, 5-17 years). The mean age of onset of headache was 9 years (range, 4-15 years). Nineteen patients (61.3%) had the associated visual aura. Visual symptoms of the 19 patients included blurred vision, unilateral vision loss, flickering lights, scotoma, and visual hallucination in descending order. However, there was no specific abnormality observed on thorough ophthalmologic examinations. CONCLUSIONS: Most of the children diagnosed with migraine did not show any ophthalmologic problems. Careful ophthalmologic examination with an understanding of migraine should be performed and reassurance to patients may be beneficial.
Age of Onset ; Child ; Epilepsy ; Hallucinations ; Headache ; Humans ; Light ; Medical Records ; Migraine Disorders ; Retrospective Studies ; Scotoma ; Vision, Ocular

In dermatomyositis, involvement of the skeletal muscles of upper esophagus has been reported in many literatures. However, a number of published reports have suggested that motility disturbances of distal esophagus may also be a cause of dysphagia in dermatomyositis and dysphagia in these cases are mainly caused by crico-pharyngeal obstruction or hypomotility of esophagus. The nutcracker esophagus is the one of common esophageal hypermotility disorders causing dysphagia which is characterized manometrically by high pressure in distal esophagus. Recently, we experienced a patient with dermatomyositis who had complained of dysphagia and was diagnosed as having nutcracker esophagus by mannometry. The association of nutcracker esophagus and dermatomyositis has not been reported in the literature. Moreover, the mechanism of nutcracker esophagus differs with that of esophageal involvement in dermatomyositis. Thereby, we report a patient with dermatomyositis who had nutcracker esophagus in the course of her disease.
Deglutition Disorders ; Dermatomyositis* ; Esophageal Motility Disorders* ; Esophagus ; Glycogen Storage Disease Type VI ; Humans ; Manometry ; Muscle, Skeletal

PURPOSE: The pathogenesis of lower urinary tract symptoms (LUTS) is uncertain. We investigated the potential role of inflammation in the development of LUTS, with the use of high-sensitivity C-reactive protein (hsCRP) as an inflammatory marker, in a population-based study of aging men in Korea. MATERIALS AND METHODS: Our study used a multistage stratified design to recruit a random sample of 1,510 men aged 45 years or older in Chuncheon, Korea, in 2003. Men with urologic or neurologic diseases that could cause voiding dysfunction were excluded. Also, men with medical conditions that could affect inflammation, such as infection or the use of nonsteroidal anti-inflammatory drugs, were excluded. LUTS were defined according to the International Prostate Symptom Score (IPSS). Various potential confounding factors were included in the analyses. RESULTS: A total of 330 subjects were included in the final analyses. There were 155 (47.0%) with an IPSS<8 and 175 (53%) with an IPSS> or =8. The mean age of all subjects was 69.2+/-8.4 years. The mean hsCRP level of all subjects was 2.30+/-3.27 (median, 1.19) mg/l. The hsCRP levels in subjects with an IPSS> or =8 differed significantly from those in subjects with an IPSS<8. Also, IPSS, storage symptom, voiding symptom, and quality of life (QoL) scores increased as hsCRP levels increased, respectively. The hsCRP level remained an independent risk factor of LUTS (IPSS> or =8, storage symptom score> or =4, incomplete voiding, intermittency, and QoL) after adjustment for variable possible confounding factors. CONCLUSIONS: Our results suggest that inflammatory processes may play an important role in the pathogenesis of LUTS and that hsCRP levels may indicate the severity of LUTS in aging men.
Aged ; Aging ; C-Reactive Protein ; Humans ; Inflammation ; Korea ; Lower Urinary Tract Symptoms ; Male ; Prostate ; Quality of Life ; Risk Factors