Bilateral coronary artery fistula is very uncommon congenital anomaly which occupy small percentage of all congenital coronary artery fistula. About 20% of the cases associated with additional congenital heart disease. And it may cause congestive heart failure, especially severely in neonate. We experienced a case of neonate who was 1 day-old-male with bilateral coronary artery-right ventricular fistula associated with atrial septal defect and congestive heart failure. The Patient was admitted because dyspnea, cyanosis since birth. 2D ecgicardiogram and cardiac catheterization revealed that a fistulous communicating ; forming a large aneurysm, was noted from bilateral coronary artery emptied into the right ventricle, and there was oxygen step-up in right ventricle.
Aneurysm ; Cardiac Catheterization ; Cardiac Catheters ; Coronary Vessels ; Cyanosis ; Dyspnea ; Fistula* ; Heart Defects, Congenital ; Heart Failure ; Heart Septal Defects, Atrial* ; Heart Ventricles ; Humans ; Infant, Newborn* ; Oxygen ; Parturition

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Hydrops fetalis is diagnosed when abnormal fluid collections are manifest in two or more fetal compartments, including abdominal ascites, pleural effusions, pericardial effusions, skin edema, polyhydroamniosis and placental edema. Although fetal hydrops was hystorically most commonly associated with Rh blood group isoimmunization, the availability of Rh immunoglobulin has increased the proportion of fetuses affected due to nonimmune etiologies. We have experienced a case of nonimmune hydrops fetalis at 32 weeks of gestation in a 27-year-old woman and reported that with brief review of related literatures.
Adult ; Ascites ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Immunoglobulins ; Pericardial Effusion ; Pleural Effusion ; Pregnancy ; Skin

OBJECTIVE: To evaluate the efficacy of prenatal multiplex PCR with chorionic villi, in the case of family history of DMD due to exon deletion. METHODS: DNA was extracted when cells' size are 1x 106 on T- flask surface area reach to 25 cm2 after 2 weeks from sex confirmation. Average DNA concentration was 50-100 ng and multiplex PCR test was performed from DNA extraction. RESULT: PCR was done for 17 exons devided into 4 groups. Seventeen exons were all amplified with their right size. CONCLUSIONS: This method is DNA analysis for prenatal diagnosis of DMD with chorionic villi in the family of DMD. This is useful when preimplantation genetic diagnosis is not available.
Chorion* ; Chorionic Villi* ; DNA ; Exons ; Humans ; Multiplex Polymerase Chain Reaction* ; Muscular Dystrophy, Duchenne* ; Polymerase Chain Reaction ; Preimplantation Diagnosis ; Prenatal Diagnosis*

Injuries from sea urchins are induced by from penetration of the calcareous spines into the skin. Apart from the transient episode of excruciating pain, there is usually no residual disability. Complications arise, however, when spines are embedded over bony prominences, or within joints. Two cases are reported with injury and protracted disability of fingers resulting from contact with the purple sea urchin, Anthocidaris crassispina, a common echinoderm inhabitant of the Korean east coast. After a latent period of several months in both cases, Case 1 presented as caseating granulomas in the synovium and case 2 exhibited as the usual soft tissue nonsynovial foreign body and noncaseating granulomas. There appears to be a paucity of published data regarding the effects of puncture wounds caused by the spines of this animal. The granulomas have appeared after a latent interval of several months in a proportion of the sufferers, suggests a delayed hyperserisitivity reaction similar to that produced by Mycobacterium species.
Animals ; Anthocidaris ; Bites and Stings* ; Fingers ; Foreign Bodies ; Granuloma ; Hand* ; Hypersensitivity, Delayed ; Inflammation* ; Joints ; Mycobacterium ; Punctures ; Sea Urchins* ; Skin ; Spine ; Strongylocentrotus purpuratus ; Synovial Membrane ; Wounds and Injuries

Brucellosis is zoonotic disease of worldwide distribution and still remains endemic in some developing countries. The main pathogenic species worldwide are B. abortus, responsible for bovine brucellosis, B. melitensis. The B. abortus is most common in Korea. Each Brucella spp. has a preferred natural host that serves as a reservoir of infection. The incubation period varies between 5 and 60 days, and Brucella infection may be asymptomatic or symptomatic. The majority of patients complained of fever (undulating fever), sweats, malaise, anorexia, and arthralgia. The diagnosis of brucellosis requires the isolation of Brucella from blood or body tissues, or the combination of suggestive clinical presentation and positive serology. There were first patients in 2002, thereafter 16 patients in 2003, and 47 patients in 2004, the human brucellosis are increasing more gradually in Korea. Brucellosis is an occupational risk for farmers, veterinarians, and abattoir workers. The main sources of Brucella are infected animals or their products, such as milk, blood, carcasses, and abortion products. Routes of transmission of the infection to humans include direct contact with infected animals and their secretions through cuts and abrasions in the skin, by way of infected aerosols inhaled or via the ingestion of unpasteurized dairy products. A combination of doxycycline and streptomycin has been used widely in brucellosis. Prevention of brucellosis in human still depends on the eradication or control of the disease in animal hosts, the exercise of hygienic precautions to limit exposure to infection through occupational activities and the effective heating of dairy products, and other potentially contaminated foods. Also, physicians and veterinarians must be concerned about specific environments and clinical patterns of brucellosis.
Abattoirs ; Aerosols ; Animals ; Anorexia ; Arthralgia ; Brucella ; Brucellosis* ; Brucellosis, Bovine ; Cattle ; Dairy Products ; Developing Countries ; Diagnosis ; Doxycycline ; Eating ; Fever ; Heating ; Hot Temperature ; Humans ; Korea ; Milk ; Skin ; Streptomycin ; Sweat ; Veterinarians ; Zoonoses

Human anthrax has been a zoonotic disease affecting those who have close contact with animals or animal products contaminated with the spore-forming bacterium Bacillus anthracis. Now the incidence of anthrax in herbivores and human are rare, but it remains an important health problem in Korea because anthrax is seen as one of the most likely biological weapon. The B. anthracis forms a spore, which is resistant to drought, heat and numerous disinfectants, and the spore can remain viable and infective in the environment for decades. There are three major forms of human disease depending on how infection is contracted, cutaneous, inhalation and ingestion. Inhalational anthrax is the most common form, but the events in the Korea show that gastrointestinal anthrax is the most common. Several cases of anthrax have been reported in Korea. In recent years, 2 cases of bovine anthrax and 5 cases of human anthrax occurred in Changnyeong-gun, 2000, but it haven't occurred any more so far. The most useful microbiological test remains the standard blood culture. Confirmatory diagnostic tests such as polymerase chain reaction can also be used and may help in early diagnosis. Prompt clinical suspicion and rapid administration of effective antimicrobials are essential for treatment of anthrax. Ciprofloxacin or doxycycline should be used for initial intravenous therapy until antimicrobial susceptibility results are known. The best measure to eliminate human anthrax is control in domestic animals by effective surveillance and by immunization of animals in endemic areas. Also, the government must establish countplan for knowledge and rational policies in dealing with potential bioterrorism attacks.
Animals ; Animals, Domestic ; Anthrax* ; Bacillus anthracis ; Biological Warfare Agents ; Bioterrorism ; Ciprofloxacin ; Diagnostic Tests, Routine ; Disinfectants ; Doxycycline ; Droughts ; Early Diagnosis ; Eating ; Herbivory ; Hot Temperature ; Humans ; Immunization ; Incidence ; Inhalation ; Korea ; Polymerase Chain Reaction ; Spores ; Zoonoses

OBJECTIVE: To assess the feasibility and clinical efficacy of laparoscopic myomectomy (LM). METHODS: We analyzed retrospectively the data for 110 LM preformed at Kangbuk Samsung Hospital between July 2003 and July 2006. We reviewed their clinical charts and the operative and anesthetic records, and analyzed data on the patients' age, parity, previous operative history, preoperative indication, the diameter of the largest myoma, operating time, number of the removed myoma, hospital stay, change of the hemoglobin concentration from preoperative to postoperative day 1, concomitant procedures, histopathological reports, and complications. RESULTS: The mean age of the patients was 35.7+/-5.8 years, the mean parity was 0.8+/-0.9, and 26 (23%) patients had a previous operative history. The most common operative indication was a palpable abdominal mass (46 patients, 41.9%), followed by chronic pelvic pain (32 patients, 29.0%), abnormal uterine bleeding (24 patients, 21.8%), urinary frequency (7 patients, 6.4%), and infertility (1 patient, 0.9%). The mean operating time was 82.9+/-30.8 minutes, and the mean diameter of the largest myoma was 7.1+/-2.3 cm. The heaviest of the removed myoma weighed 795 gm. The mean change of the hemoglobin concentration was 2.2+/-1.1 g/dL, and the mean hospital stay was 3.5+/-1.4 days. Postoperatively, transfusions were done 10% (11 cases) of patients, and 2 cases of paralytic ileus and a case of subcutaneous emphysema were noted. Conversion rate to laparotomy was 0.9% (1 case). CONCLUSION: LM for various sized myomas can be performed successfully and effectively by decreasing laparoconversion, if the surgical team and the laparoscopic surgeon are experienced and enhanced equipment is available.
Female ; Humans ; Infertility ; Intestinal Pseudo-Obstruction ; Laparotomy ; Length of Stay ; Myoma* ; Parity ; Pelvic Pain ; Retrospective Studies ; Subcutaneous Emphysema ; Uterine Hemorrhage

OBJECTIVE: To evaluate feasibility and efficacy of laparoscopic management for borderline ovarian tumors. METHODS: From May 2005 to October 2007 in our institution, laparoscopic treatments were performed for 16 patients for borderline ovarian tumors. Through clinical records, the patients' age, parity, operating time, tumor diameter, length of hospital stay, change in hemoglobin level, intraoperative and postoperative complications, and recurrence were analyzed. RESULTS: The median age of the patients was 38 years (27-72 years), the median parity was 1 (0-3), and 6 patients were nulliparous., Eight patients were performed conservative surgery, and radical surgery was performed in the remainder. The median operating time was 90 minutes (50-305 minutes), the median hospital stay was 5 days (4-16 days), the median change of the hemoglobin level was 1.5 g/dL (0.2-4.5 g/dL), and the median diameter of the tumors was 8.5 cm. FIGO stage was Ia for 9 patients, Ib for 2, Ic for 4, and IIIc for the last one. Histopathological results showed mucinous tumor for 8 patients, serous tumor for 6, and mixed type and endometrioid tumor for each remaining. Laparoscopic pelvic and paraaortic lymphadenectomy were performed 4 patients. There was no upstaging by intraoperative cystic rupture. Neither laparoconversion nor intraoperative complication was noted. The median duration of follow-up was 20 months (3-53 months) and none showed recurrence. One of 8 patients who were treated conservatively obtained a baby by vaginal delivery in 32th postoperative month. CONCLUSION: This preliminary analysis demonstrated patients with borderline ovarian tumor can feasibly and efficiently undergo laparoscopic management.
Female ; Follow-Up Studies ; Hemoglobins ; Humans ; Intraoperative Complications ; Laparoscopy ; Length of Stay ; Lymph Node Excision ; Mucins ; Parity ; Postoperative Complications ; Recurrence ; Rupture ; Surgical Procedures, Operative