An intrathyroid thyroglossal duct cyst (TGDC) presented as an anterior neck mass in a 62-year-old male without history of prior thyroid disease or infection. This cyst was clinically indistinguishable from a thyroid nodule. In addition to that, fine needle aspiration cytology revealed normal–looking squamous cells. Diagnosis, work-up, management approach, and treatment of intrathyroid TGDC are discussed as well as distinguishing features between intrathyrod TGDC with tract and without tract. This is the very rare case of intrathyroid TGDC in Korean population and the possibility of intrathyroid TGDC should remain in the differential diagnosis of thyroid nodule.
Biopsy, Fine-Needle ; Diagnosis ; Diagnosis, Differential ; Epithelial Cells ; Humans ; Male ; Middle Aged ; Neck ; Thyroglossal Cyst ; Thyroid Diseases ; Thyroid Gland ; Thyroid Nodule

BACKGROUND AND OBJECTIVES: Patients with tonsil and adenoid hypertrophy are increasing, and cases of tonsillectomy & adenoidectomy also are steadily on the rise. However, the awareness of patients visiting outpatient is much lower. This study was performed to understand the cognitive level of general public associated with tonsil and adenoid hypertrophy and to suggest the needs of educational program and promotion. SUBJECTS AND METHOD: Prospective survey using structured questionnaire was conducted for 100 parents of patients before the age of 10 who were scheduled to undergo tonsillectomy & adenoidectomy. RESULTS: The total percentage of correct answers in questions related to the awareness level of tonsil and adenoid hypertrophy was 51.7%. In particular, the lowest awareness level corresponded to questions regarding post-operative complications and notes. More detailed information regarding post-operative course and notes was required of 47% of the subjects. CONCLUSION: The survey results indicate poor public awareness about tonsil and adenoid hypertrophy, suggesting more efforts on the behalf of Korean Society of Otorhinolaryngology-Head and Neck Surgery.
Adenoidectomy ; Adenoids* ; Humans ; Hypertrophy* ; Neck ; Outpatients ; Palatine Tonsil* ; Parents* ; Prospective Studies ; Surveys and Questionnaires ; Tonsillectomy

OBJECTIVES: The purpose of this study is to evaluate and compare the maternal and neonatal complications of the overt diabetes with that of gestational diabetes. METHOD : The medical records of 65 pregnant patients complicated by diabetes mellitus at Eulji medical center from January, 2001 to December, 2002 were reviewed retrospectively. Thirteen patients of them were diagnosed as a overt diabetes and the others were diagnosed as a gestational diabetes. RESULTS: Maternal complications were that preeclampsia in 15.4% and preterm labor in 15.4% in overt diabetes patients and preeclampsia in 9.6%, fourth degree laceration in 1.9%, preterm labor in 3.8%, placenta abruption in 1.9%, cardiomyopathy in 1.9% and polyhydroamnios in 1.9% in gestational diabetes patients. Neonatal complications were that hypoglycemia in 38.5% and respiratory distress syndrome in 15.4% in overt diabetes patients and hypoglycemia in 25%, hyperbilirubinemia in 9.6% and shoulder dystocia in 1.9% in gestational diabetes patients. There were no statistic differences in maternal and neonatal complications in two groups when management had done. And in gestational diabetes group, maternal and neonatal complications were significantly higher in no management group than management group regardless of management types. CONCLUSION: If early detection and management were done in overt and gestational diabetes, there were no difference in maternal and neonatal complications. Regardless of types of diabetes, early detection and management were important.
Cardiomyopathies ; Diabetes Mellitus ; Diabetes, Gestational* ; Dystocia ; Female ; Humans ; Hyperbilirubinemia ; Hypoglycemia ; Lacerations ; Medical Records ; Obstetric Labor, Premature ; Placenta ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Shoulder

OBJECTIVE: The purpose of this study was to analyze the inclination, pertinence and influential factor in emergent cesarean section according to the assortment and analysis of the indication of emergent cesarean section. METHODS: The retrospective study was performed with the review of 360 emergent cesarean section cases from January 2003 to December 2003. RESULTS: The indication of cesarean section was followed by the order of progress failure (47.5%), previous cesarean section (19.2%), and fetal distress (15.8%). The improper operation of emergent cesarean section was done in fetal distress (28.1%), progress failure (8.6%), and induction failure (16.7%). The absence of acceleration with prolonged bradycardia was the most common (50.0%) type of fetal distress. The emergent cesarean section were done more commonly on Tuesday and Friday during weekdays and it was the peak time in a whole day of cesarean section from 11 o'clock to 12 o'clock and 16 o'clock to 17 o'clock. CONCLUSION: It was proved that twenty six (7.2%) cases of emergent cesarean section were done improperly. Now, work through the non-medical factors are considered more important to reduce improper section rate.
Acceleration ; Bradycardia ; Cesarean Section* ; Female ; Fetal Distress ; Pregnancy ; Retrospective Studies

BACKGROUND: The prevalence of ischemic heart diseases (IHD) has increased remarkably during the past 10 years in Korea. Because only few reports on risk factors of IHD in Korean women exist, the aim of this study was to determine the clinical characteristics (including risk factors) of IHD in Korean women. METHODS: Fifty-six female patients and 122 (out of 655) of male patients with significant coronary artery stenosis were included in this study. There were 12 cases of angina pectoris and 35 cases of myocardial infarction in the 56 female patients. There were 54 cases of angina pectoris and 68 cases of myocardial infarction in the 122 male patients. Age and sexdistributions, risk factors of atherosclerosis, and coronary angiographic findings were compared between the female and male patients. RESULTS: The female patients were older than the male patients (63+/-8 years vs. 58+/-4 years, p<0.01). The proportion of patients older than 60 was higher in women than men (70% vs. 48%, p<0.01). The number of risk factors was 1.17 in women and 1.27 in men, and the proportion of patients with multiple risk factors (> or = 2) was greater in men than in women (43% vs. 25%, p<0.05). Hypertension was more prevalent (66% vs. 11%, p<0.001) and smoking was less (65% vs. 11%, p<0.001) in women than men. After age adjustment, hypertension was more frequent in women, and smoking was more in men (p=0.001). On coronary angiograms there were no difference in the morphology of coronary artery stenosis, the distribution of culprit vessels, and the number of vessels involved between women and men, In terms of therapeutic modalities, there were no differences between women and men in our study. CONCLUSIONS: In Koean women with IHD, hypertension is more common and smoking is less common. However, coronary artery lesion morphology and distribution are comparable between women and men.
Angina Pectoris ; Atherosclerosis ; Coronary Stenosis ; Coronary Vessels ; Female ; Humans ; Hypertension ; Korea* ; Male ; Myocardial Infarction ; Myocardial Ischemia* ; Prevalence ; Risk Factors ; Smoke ; Smoking

A solid and papillary epithelial neoplasm of the pancreas is a very rare and low-grade type of malignancy, although an increasing number of cases have been reported in recent years. Patients with a solid and papillary epithelial neoplasm of the pancreas have a good prognosis and may be cured if the disease is diagnosed before metastasis and diffuse local invasion. A 23-year-old female who had a 4-year history of recurrent abdominal pain, was admitted due to lower abdominal pain. Incidentally a calcified, 6 4 cm sized ovoid mass was found in the right upper quadrant, from a simple abdominal X-ray. An ERCP, abdominal sonography, and CT were performed, as well as a pylorus preserving pancreatoduodenectomy. Gross pathologic examination revealed a well encapsulated mass with cystic degeneration and hemorrhagic necrosis. Microscopically, the tumor had papillary fronds with a fibrovascular connective tissue core. There was focal infiltration of tumor cells into the duodenal wall and heterotropic pancreatic tissue in the submucosa. Immunohistochemistry revealed positivity for neuron-specific enolase. The patient maintained a healthy status for one year since the operation.
Abdominal Pain ; Cholangiopancreatography, Endoscopic Retrograde ; Connective Tissue ; Duodenum* ; Female ; Humans ; Immunohistochemistry ; Necrosis ; Neoplasm Metastasis ; Neoplasms, Glandular and Epithelial* ; Pancreas* ; Pancreaticoduodenectomy ; Phosphopyruvate Hydratase ; Prognosis ; Pylorus ; Young Adult

BACKGROUND: Inotropic agents have been shown to improve cardiac function in patients with congestive heart failure. The purpose of the present study is to evaluate the short-term efficacy and safety of denopamine(Cardopamin(R)), and orally available beta-stimulant, in patients with chronic congestive heart failure. SUBJECTS AND METHODS: Twenty-four patients(54.1+/-10.9 years, male:female=1.4:1) with chronic congestive heart failure whose functional classes were equal or greater than New York Heart Association(NYHA) Class II were enrolled in this study after informed consents were obtained. Upon completion of baseline evaluation, denopamine(Cardopamin(R)) was administered orally, startion with 15 mg per day and increased to 30 mg per day according to the clinical response of each patient. Blood pressure, heart rate, electrocardiographic(EKG) findings, AST, BUN, and creatinine were also followed up at 4 weeks' interval. The clinical effects and side effects at 4 weeks' interbal and echocardiographic examination at baseline and 8 weeks after trentment were evaluated. RESULTS: Mean dosage of denopamine(Cardopamin(R)) was 22.9+/-5.3mg per day. The clinical symptoms of 18(75%) of 24 patients were improved. The echocardiographic follow-up revealed a significant decrease in left vetricular(LV) end-Systolic dimemsion(fron 4.8+/-0.2mm to 4.5+/-0.1mm. p<0.005) and LV end-systolic volume(from 92.0+/-8.5ml to 80.3+/-4.5ml, p<0.005). However, there was no significant interval change in LV end-diastolic dimension, LV end-diastolic volume, ejection fraction, and fractional shortening. Blood pressure, heart rate, EKG findings, AST, BUN, and creatinine were not changed significantly during treatment. CONCLUSION: Above results suggest that short-term therapy of denopamine(Cardopamin(R)) may improve clinical symptom with no side effect in patients with chronic congestive heart failure, but the long-term efficacy remains to be determined with a randomized long-term follow up study.
Blood Pressure ; Creatinine ; Echocardiography* ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Follow-Up Studies ; Heart ; Heart Failure* ; Heart Rate ; Humans

BACKGROUND: Coronary stent is known as an effective treatment in the intimal dissection after angioplasty and the prevention of restenosis. However, in-stent restenosis still remains a major concern in clinical stenting. METHOD: The Microstents were placed in 151 patients from May '96 to Aug '97 and performed follow-up coronary angiograms in 49 (32.5%) patients. To identify the clinical, angiographic and procedure-related variables that predict late restenosis within the stented artery, 49 patients (58+/-8 year:38 M, 11 F) were studied. Indications for stenting were 25 de novo (52.8%), 9 restenotic (18.7%), 8 suboptimal PTCA (16.7%) and 6 bail-out lesions (12.6%). All patients were treated with aspirin and ticlopidine for one month after stenting. The follow-up angiograms were obtained at 5+/-3 months and variables of 13 patients with restenosis were compared with those of 36 patients without restenosis. RESULTS: The in-stent restenosis rate was 26.5%. Univariate logistic regression analysis was used to determine how in-stent restenosis was influenced. Clinical diagnosis, presence of risk factors, lipid profiles, numbers of involved vessels, target arteries, lesion length, lesion types, stent length, maximal inflation pressure, predilation balloon size, reference vascular diameter, minimal luminal diameter, and stent to artery diameter ratio were analyzed. Among these variables, only lesion length before stent implantation was a predictor for in-stent restenosis (19.9+/-11.1 mm vs. 10.9+/-7.3 mm, p=.017). CONCLUSION: Lesion length before Microstent II implantation is the single predictor of late in-stent restenosis.
Angioplasty ; Arteries ; Aspirin ; Diagnosis ; Follow-Up Studies ; Humans ; Inflation, Economic ; Logistic Models ; Phenobarbital ; Risk Factors ; Stents ; Ticlopidine

OBJECTIVES: The treadmill exercise eletrocardiography(ECG) is the most commonly used non-invasive method in the evaluation of patients with chest pain. But the accuracy of treadmill exercise ECG in detecting the coronary artery disease(CAD) is still controversial. To improve the accuracy of the treadmill exercise test, exercise treadmill score(ETS) based on exercise duration, degree of ST deviation, and treadmill anginal index during treadmill exercise ECG has been used. METHODS: The authors calculated ETS by simple equation(total exercise duration-5 X maximal ST-segment deviation during or after exercise-4 X treadmill angina index) and analyzed coronary angiograms of 173 patients(mean age '55.5 +/- 8.7, male: female=2.7: 1) who underwent treadmill exercise ECG and coronary angiography in Chonnam University Hospital from January, 1990 through March, 1993. RESULTS: 1) The studied subjects were subdivided into 3groups according to ETS. Group A(high risk, ETSETS>or=11) 71cases(mean age 60.2 +/- 7.4, male: female=3.3:1), group C(low risk, ETS>5) 87cases(mean age 54.8 +/- 9.2, male-female =2.5:1). Clinical diagnoses of the studiedsubjects were 63stable angina, 61unstable angina, 3acute myocardial infarction, and 46 old myocardial infarction. On coronary angiographic findings, 61patients had single vessel disesase, 23patients had two vessel disease and 13patients had three vessel disease. 2) The sensitivity of the treadmill exercise ECG in diagnosing coronary artery disease was 88% and the specificity was 46%. 3) One hundred percent of group A patients had CAD and 54% of them had multivessel disease, 75% of group B had CAD and 27% of them had multivessel disease, and 33% of group C had CAD and 10% of them had multivessel disease. 4) There were no significant differences in the siite of stenotic lesion and degree of stenosis according to ETS in the patients with single vessel disease. 5) There were no significant differences in left ventricular ejection fraction and left ventricular end-diastolic pressure among three groups. CONCLUSION: Exercise treadmill score is useful in predicting the presence and severity of CAD and that low ETS less than -11 may be an indicator of multivessel coronary disease.
Chest Pain ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Diagnosis ; Electrocardiography ; Exercise Test ; Female ; Humans ; Jeollanam-do ; Male ; Myocardial Infarction ; Sensitivity and Specificity ; Stroke Volume

BACKGROUND: One of most important mechanisms of coronary stent restenosis is neointimal hyperplasia. Although the process of neointima formation is not fully understood, a special role has been advocated for adherent platelets. Previous studies have shown a clear benefit with combined antiplatelet therapy such as aspirin plus ticlopidine in reducing the rate of thrombotic occlusions of stented vessels. The purpose of this study was to evaluate the effects of duration of antiplatelet regimens on coronary stent restenosis. METHODS: After successful placement of coronary artery stents in 222 patients, we performed follow-up coronary angiograms in 99 patients (42.3%). Forty-six patients were randomly assi-gned to receive aspirin and ticlopidine for four weeks (Group I: 54+/-9 years: M 38, F 8) and 48 patients for 6 months (Group II: 58+/-8 years: M 38, F 10). RESULTS: There were no significant differences in clinical and procedural variables or coronary lesion characteristics before and after stenting. At 6 months after stenting, minimal luminal diameter was 2.16+/-0.93mm in Group I and 2.04+/-1.07mm in Group II (p-0.57). Late lumen loss was 0.80+/-1.07mm in Group I and 0.92+/-1.11mm (p-0.58) in Group II. The stent restenosis rate of Group I at 28.3% and that of Group II at 29.2% were not statistically significant between the two groups (p-0.92). CONCLUSIONS: The therapeutic duration of combined antiplatelet regimen with aspirin and ticlopidine after coronary stent does not affect stent restenosis rate.
Aspirin* ; Coronary Vessels ; Follow-Up Studies ; Humans ; Hyperplasia ; Neointima ; Phenobarbital ; Stents* ; Ticlopidine*