A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

Causative bacterias of keratitis due to mishandling of contact lenses are mainly Gram negative rods, and large percentage of them are Pseudomonas. We experienced 6 cases of culture-proven Pseudomonas keratitis due to mishandling of soft contact lenses and wetting solution can be cultured. They are lack of education as how handle the contact lenses safely. And they did not done disinfection of the soft contact lens cases. To prevent contact lens related keratitis, we think it is very important for users to know its possible complication and how to use it and disinfect it safely.
Bacteria ; Contact Lenses ; Contact Lenses, Hydrophilic* ; Disinfection ; Education ; Keratitis* ; Pseudomonas*

A 40-year-old man attended our hospital with presenting symptoms of an acutely swollen, tender testicle and bulging mass on the inguinal area. Considered it as urgent conditions no demonstrating blood flow to the involved testicle on Color Doppler ultrasonography, we underwent scrotal exploration right away. On operative finding the right testis was so enlarged and engorged secondarily to the irreversible ischemic damage, but torsion of spermatic cord was not found. Another inguinal approach revealed herniated mass protruding from internal inguinal ring and compressing the spermatic cord. For further evaluation abdominal ultrasonography and CT scan was done and huge mass occupying right lower quadrant of abdomen and pelvic cavity was noted. The resected tumor through surgical exploration was proved to be a retroperitoneal liposarcoma pathologically. Herein we report an uncommon case of testicular infarct, mimicking torsion of spermatic cord that is a urological emergency, caused by herniated retroperitoneal mass. So the present report suggest that, when adult men attend with symptoms of acutely swollen painful testicle, we pay a more careful attention to patient,s physical findings and recommend further diagnostic evaluation.
Abdomen ; Adult ; Emergencies ; Humans ; Inguinal Canal* ; Liposarcoma* ; Male ; Spermatic Cord ; Testis ; Tomography, X-Ray Computed ; Ultrasonography ; Ultrasonography, Doppler, Color

Ganglioneruroblastoma and neuroblastoma are among commonest types of childhood malignancy and a number of unique paraneoplastic syndromes have associated with both localized and disseminated neuroblastoma. The coincidence of neuroblastoma and myoclonic encephalopathy or other paraneoplastic syndromes occurs relatively rare, and therefore, failure to recognize this association could result in delays in both diagnosis and treatment, and the result could prove to be unfortunately fatal. The mechanism which underlies the remote damaging effect of neural crest tumor, especially neuroblastoma, on the nervous system resulting in myoclonic encephalopathy is by no means clear. In addition the nature and the extent of the pathologic lesion are inconsistent. We experienced a case of myoclonic encephalopathy associated with an occult mediastinal ganglioneuroblastoma in a 22-month-old girl who was hospitalized for inability to walk without support and tilting of the head to the left side. She became increasingly ataxic, and during the hospitalization myoclonic jerks of upper extremities and head along with chaotic, rapidly flickering, multidirectional spontaneous eye movements, were noted. Laboratory data included normal complete blood count, urinalysis, BUN and creatinine, electrolytes and bone marrow. Chest X-ray and chest CT revealed a relatively well marginated right posterior mediastinal mass. In a 24 hours urine excretion test, VMA and catecholamines were increased. Over the next 2 weeks, a surgical exploration revealed a right posterior mediastinal mass. Microscopically the mass proved to be a ganglioneuroblastoma, extending to right innominate artery and right axillary lymph nodes. Within 2 weeks after the surgery, radiotherapy (2,400 rads) and chemotherapy (CTX, DTIC, VCR) were started, but corticosteroid was not used. She has been free of tumor and abnormal neurological systemic symptoms and signs for 1 1/2 year since the completion of chemotherapy. In the 3 1/2 years follow-up period, her neurologic symptoms has completely resolved by the completion of 2 years chemotherapy. We report a case of mycoclonic encephalopathy associated with hidden ganglioneuroblastoma in 22-month-old girl.
Blood Cell Count ; Bone Marrow ; Brachiocephalic Trunk ; Catecholamines ; Creatinine ; Dacarbazine ; Diagnosis ; Drug Therapy ; Electrolytes ; Epilepsies, Myoclonic* ; Eye Movements ; Female ; Follow-Up Studies ; Ganglioneuroblastoma* ; Head ; Hospitalization ; Humans ; Infant ; Lymph Nodes ; Myoclonus ; Nervous System ; Neural Crest ; Neuroblastoma ; Neurologic Manifestations ; Paraneoplastic Syndromes* ; Radiotherapy ; Thorax ; Tomography, X-Ray Computed ; Upper Extremity ; Urinalysis

Candida albicans keratitis was established in rabbits by intrastromal injection of a suspension containing 1.2 X 10(4) spores. After a 48-hour incubation period, the animals were treated with oral ketoconazole(10mg/kg daily) alone and in combination with topical ketoconazole(2% solution ten times a day) for 2 weeks. Clinical scores were significantly lower in both treated groups than in the control group. But there was no significant difference between the two treated groups.
Animals ; Candida albicans* ; Candida* ; Keratitis* ; Ketoconazole* ; Rabbits* ; Spores

The goal of fracture treatment is to restore the patient to pre-injury function level. But the outcome assessment after orthopedic interventions has usually focused on physician-defined parameters of technical success, such as fracture union, alignment and range of motion rather than patient function and quality of life. However, the correlation among improvements in these parameters and functional status, psychosocial well being is inconsistent and weak in the elderly. Therefore authors assessed the functional status after surgical intervention of hip fractures in the elderly with functional recovery score(FRS). Independence in basic activities of daily living, in instrumental activities of daily living, in mobility, freedom from pain and intact memory were assessed in 133 hip fractures in the elderly. The hip fractures in the elderly resulted in 24.8% loss of function after the first year. The older the age, the more the loss of function after surgery of hip fractures. The more functional loss was observed in female patients and in patients with poor postoperative radiological results, but statistically insignificant (P>0.05). The more functional loss was observed in patients with underlying medical disease preoperatively and it was statistically significant (P<0.05). We recommend the evaluation of functional status in the elderly after hip fractures.
Activities of Daily Living ; Aged* ; Female ; Freedom ; Hip Fractures* ; Hip* ; Humans ; Memory ; Orthopedics ; Quality of Life ; Range of Motion, Articular

Exercise-induced anaphylaxis can be associated with ingestion of a specific food. We experienced a case of exercise-induced anaphylaxis followed by ingestion of parsely. A 22- year old female patient was presented with angioedema of the face and chest tightness induced by running after ingestion of parsley within 15 minutes. She had suffered from allergic rhinitis. She had positive reactions to mugwort pollen and parsely extract on skin prick test in a dose dependent manner. Although the oral provocation test with parsely could not induce bronchoconstriction, we could diagnosed as parsely dependent exercise induced anaphylaxis based upon skin prick test and history.
Anaphylaxis ; Angioedema ; Artemisia ; Bronchoconstriction ; Eating ; Female ; Humans ; Petroselinum ; Pollen ; Rhinitis ; Running ; Skin ; Thorax

No abstract available.
Tracheoesophageal Fistula*

STUDY DESIGN: A retrospective study. OBJECTIVES: Using computed tomography, it is to measure pedicle size of lower cervical spine in Koreas to find ideal insertion point and angle in fixating pedicular screws. SUMMARY OF LITERATURE REVIEW: Although techniques in pedicular screw fixation and pedicle's anatomical shape in foreign populations have been well documented and studied, no anatomical study on lower cervical pedicle in Korean population has been reported. MATERIALS AND METHODS: A total of 180 patients with computed tomography taken at our institution were selected for the study. Width, total length, and length of pedicle, insertion point and angle, and safe insertion angles were measured on axial view. On sagittal view, height of pedicle, insertion point and angle, and safe insertion angles were determined. RESULTS: Mean height of study subject was 164.2cm. Mean width of pedicle was 5.5mm, mean height 7.2mm, mean total length 31.2mm, and mean length 14.8mm. Mean insertion point from 3rd to 7th cervical spines was medially 3.3mm from lateral mass and downward 4.7mm from margin of upper facet. Mean insertion angles from 3rd to 7th cervical spines were 41.6degrees axially and 6.4degrees sagittally. Calculated safe insertion angles were 8degrees on medial and lateral sides and 14degrees on superior and inferior sides. CONCLUSIONS: Using computed tomography images, ideal insertion point and angle were measured for pedicular screw insertion, but, due to individual variation, preoperative measurement of insertion point and angle on computed tomography is necessary.
Humans ; Korea ; Retrospective Studies ; Spine