The majority of ptients with ischemic heart disease such as angina pectoris and myocardial infarction have coronary atherosclerosis as a underlying cause. However, in unusual conditions such as variant angina, aortic valvular heart disease, hypertrophic cardiomyopathy, vasculitis, hypercoagulable states, coronary atherosclerosis is not the cause. Polycythemia vesa is a myeloproliferative disease characterized by infrequent thromboembolic complications such as ischemic heart disease. We report a case of polycythemia vera presenting with angina pectoris without coronary artery stenosis with the review of the literature.
Angina Pectoris* ; Cardiomyopathy, Hypertrophic ; Coronary Artery Disease ; Coronary Stenosis* ; Coronary Vessels* ; Heart Valve Diseases ; Myocardial Infarction ; Myocardial Ischemia ; Polycythemia Vera* ; Polycythemia* ; Vasculitis

Brain death results in adverse pathophysiologic effects in many brain-dead donors with cardiovascular instability. We experienced a brain-dead donor with continuous renal replacement therapy (CRRT) who was in a severe metabolic, electrolyte derangement and poor pulmonary function. The thirty-nine-year-old male patient with subarachnoid hemorrhage and intraventricular hemorrhage was admitted into the intensive care unit (ICU). After sudden cardiac arrest, he went into a coma state and was referred to as a potential organ donor. When he was transferred, his vital sign was unstable even under the high dose of inotropics and vasopressors. Even with aggressive treatment, the level of blood sugar was 454 mg/dl, serum K+ 7.1 mEq/L, lactate 5.33 mmol/L and PaO2/FiO2 60.3. We decided to start CRRT with the mode of continuous venovenous hemodiafiltration (CVVHDF). After 12 hours of CRRT, vital sign was maintained well without vasopressors, and blood sugar, serum potassium and lactate levels returned to 195 of PaO2/FiO2. Therefore, he was able to donate his two kidneys and his liver.
Blood Glucose ; Brain ; Brain Death ; Coma ; Death, Sudden, Cardiac ; Hemodiafiltration ; Hemorrhage ; Humans ; Intensive Care Units ; Kidney ; Lactic Acid ; Liver ; Male ; Potassium ; Renal Replacement Therapy ; Subarachnoid Hemorrhage ; Tissue Donors ; Vital Signs

Segmental testicular infarction is a rare cause of acute scrotum. Its etiology is not well defined and it can be clinically confused with a testicular tumor. Imaging studies play an important role in the preoperative diagnosis, with a Color doppler ultrasonography as the investigation of choice although magnetic resonance imaging (MRI) can be useful in doubtful cases. We report a case of segmental testicular infarction treated with partial orchiectomy seen in a 58-year-old man with right scrotal pain.
Humans ; Infarction ; Magnetic Resonance Imaging ; Middle Aged ; Orchiectomy ; Scrotum ; Testis ; Ultrasonography, Doppler, Color

The calyceal diverticulum is a cystic cavity lined by a transitional epithelium, is encased within the renal substance, and is situated peripheral to a minor calyx, to which it is connected by a narrow channel. Both congenital and acquired factors have been suggested to explain the formation of a calyceal diverticulum. We experienced a case of a huge calyceal diverticulum that was newly developed after a renal injury.
Diverticulum ; Epithelium ; Kidney

PURPOSE: The best option for varicocele treatment is controversial. We evaluate our experience using laparoscopic varicocelectomy & inguinal varicocelectomy, and then compared the two methods. We started this study to find the best treatment for varicocele patients. MATERIALS AND METHODS: Between July 2002 and July 2008, 168 cases (Group I) were treated with laparoscopic varicocelectomy and 157 cases (Group II) were treated with the inguinal approach. We assessed the two methods according to operative time, hospital stay, recurrence rate, complication rate, and cost effectiveness. RESULTS: The mean operative time was 30.2+/-10.9 min for laparoscopic varicocelectomy and 62.6+/-13.3 min for inguinal varicocelectomy (p<0.05). The recurrence rate was 2% for laparoscopic varicocelectomy and 8% for inguinal varicocelectomy (p>0.05). The complication rate was 10.7% for laparoscopic varicocelectomy and 12.7% for inguinal varicocelectomy (p>0.05). The cost of laparoscopic varicocelectomy was 401,870 won, but inguinal varicocelectomy was 256,480 won (p<0.05). CONCLUSIONS: The laparoscopic varicocelectomy required a shorter operative time but no superior outcomes compared to inguinal varicocelectomy. The laparoscopic approach cannot be replaced with the routine open approach but it is thought to be worth consideration in selective cases.
Laparoscopy ; Length of Stay ; Operative Time ; Recurrence ; Varicocele

BACKGROUND: THe Korean Society for Nosocomial Infection Control (KOSNIC) orfanized the Korean Nosocomial Infections Surveillance System (KONIS) to establish a nationwide database of Nosocomial infection (NI) rate in the intensive care units (ICUs) of Korean hospitals. This report is a summary of the data from July through September 2006. METHODS: The KONIS performed a prospective sruveillance for nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 76 ICUs in 44 hospitals. NI rates were calculated as the numbers of infections per 1,000 patient-days or device-days. RESULTS: A total of 846 nosocomial infections were fOlllld during the study period: 407 UTIs (397 cases were urinary catheter-associated), 204 BSIs (182 were central line-associated), and 235 PNEUs (161 were ventilator-associated). The rate of urinary catheter-associated UTIs was 4.61 cases per 1,000 device-days and urinary catheter utilization ratio was 0.83. The rate of central line-associated BSIs was 3.16 and the utilization ratio was 0.55. The rate of ventilator-associated PNEUs was 3.80 and the utilization ratio was 0.41. Although the ventilator utilization ratio was lower in the hospitals with 400-699 beds than in the hospitals with more than 900 beds, the rate of ventilator-associated pneumonia was higher in the smaller hospitals than in the larger ones. The rates of all three device-associated infections were the highest in the neurosurgical ICUs and the rates were the lowest in the surgical ICUs. CONCLUSION: This study may contribute to the development of effective strategies for NI control according to the size of hospital and the type of ICUs.
Cross Infection* ; Intensive Care Units ; Pneumonia ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical