Serous cystadenomas of the pancreas account for approximately a third of pancreatic cystic neoplasms. Their coexistence with a second tumor is extremely rare. We now report a case of a serous microcystic adenoma combined with an intraductal papillary mucinous tumor of the pancreas in a 69-year-old man. Abdominal computed tomography scans demonstrated an incidental cystic mass in the body with cystic dilatation of the duct in the head of the pancreas. Central pancreatectomy with pancreatico-jejunostomy, and cyst excision of the pancreatic head were performed. Histologic examination demonstrated a serous microcystic cystadenoma in the body coexisting with an intraductal papillary mucinous adenoma in the head of the pancreas. This case study highlights the importance of careful intra-operative and pathologic examination for synchronous pancreatic tumors.
Adenoma ; Aged ; Cystadenoma ; Cystadenoma, Serous ; Dilatation ; Head ; Humans ; Mucins ; Pancreas ; Pancreatectomy ; Pancreatic Cyst

BACKGROUND: In the Republic of Korea, there had been no reports about indigenous malaria cases since 1984 until a vivax malaria case was detected in 1993. Thereafter fram 1993 to 1996, 486 malaria cases were reported. Most of the patients were soldiers in the northern militarized zone. However, since 1997, several patients with malaria were detected in Kang Hwa where there had previously been no report of malaria cases. It is our intent to report the 16 cases diagrnosed in Kang Hwa Community Hospital from January 1, 1997 to August 10, 1998. METHODS: Medical records of the malaria cases from January 1, 1997, to August 10, 1998 in Kang Hwa Community Haspital were reviewed. All of the patients had no histories of traveling abroad, drug abuse or blood transfusion. They were all civilians. Laboratory studies including blood cell count, routine chemistry and platelet-associated IgG(PAIgG) and abdominal sanography were taken. RESULTS: All of the patients were diagnosed with malaria by blood smears. Common symptams were fever(100%), headache(94%), rigors(81%), myaJgia(56%), nausea or vomiting(44%), alternate day fever (25%), left flank pain(19%), diarrhea(13%), and abdominal pain(13%). Splenomegaly was detected in 92% of cases by sonography. Laboratory findings included leukopenia(37.5%), anemia(37.5%) and thrombocytopenia(81.3%). Platelet-associated IgG was elevated in 1 of 5 thrombocytopenic patients who had had the laboratory study performed. All recovered withaut complications. CONCLUSIONS: Cases of indigenous malaria have been progressively increasing in the Republic of Korea. Fortunately, patients responded well to treatment, but continued interest will be required in the future.
Blood Cell Count ; Blood Transfusion ; Chemistry ; Fever ; Hospitals, Community ; Humans ; Immunoglobulin G ; Malaria ; Malaria, Vivax ; Medical Records ; Military Personnel ; Nausea ; Republic of Korea ; Splenomegaly ; Substance-Related Disorders ; Thrombocytopenia

Ciliated hepatic foregut cyst (CHFC) is a rare benign lesion consisting of ciliated pseudostratified columnar epithelium, loose subepithelial connective tissue, a smooth muscle layer, and an outer fibrous capsule. We encountered a patient with retroperitoneal and posterior mediastinal neurilemmoma and additional CHFC mimicking metastasis. Abdominal CT examination demonstrated that the posterior mediastinal and retroperitoneal lesions were lobulated, well-defined tumors with a neural foraminal extension that were pathologically confirmed as neurilemmomas. Unenhanced CT indicated that the additional lesion was a slightly hypodense mass relative to surrounding parenchyma at the medial segment of the left lobe of the liver, and after the IV ad-ministration of contrast material, the lesion did not show enhancement.
Connective Tissue ; Epithelium ; Humans ; Liver ; Muscle, Smooth ; Neoplasm Metastasis* ; Neurilemmoma ; Tomography, X-Ray Computed

PURPOSE: It is to examine clinical manifestations, early biochemical indicators, and risk factors for non-oliguric hyperkalemia (NOHK) in extremely low birth weight infants (ELBWI). MATERIALS AND METHODS: We collected clinical and biochemical data from 75 ELBWI admitted to Ajou University Hospital between Jan. 2008 and Jun. 2011 by reviewing medical records retrospectively. NOHK was defined as serum potassium > or =7 mmol/L during the first 72 hours of life with urine output > or =1 mL/kg/h. RESULTS: NOHK developed in 26.7% (20/75) of ELBWI. Among NOHK developed in ELBWI, 85% (17/20) developed within postnatal (PN) 48 hours, 5% (1/20) experienced cardiac arrhythmia and 20% (4/20) of NOHK infants expired within PN 72 hours. There were statistically significant differences in gestational age, use of antenatal steroid, and serum phosphorous level at PN 24 hours, and serum sodium, calcium, and urea levels at PN 72 hours between NOHK and non-NOHK groups (p-value <0.050). However, there were no statistical differences in the rate of intraventricular hemorrhage, arrhythmia, mortality occurred, methods of fluid therapy, supplementation of amino acid and calcium, frequencies of umbilical artery catheterization and urine output between the two groups. CONCLUSION: NOHK is not a rare complication in ELBWI. It occurs more frequently in ELBWI with younger gestational age and who didn't use antenatal steroid. Furthermore, electrolyte imbalance such as hypernatremia, hypocalcemia and hyperphosphatemia occurred more often in NOHK group within PN 72 hours. Therefore, more use of antenatal steroid and careful control by monitoring electrolyte imbalance should be considered in order to prevent NOHK in ELBWI.
Gestational Age ; Humans ; Hyperkalemia/diagnosis/drug therapy/*epidemiology ; *Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases/diagnosis/drug therapy/*epidemiology ; Republic of Korea ; Risk Factors

BACKGROUND: To provide some fundamental physiological basis for the physical training of pilots to improve orthostatic intolerance, cardiorespiratory responses to the symptom-limited maximal exercise loading were studied in pilots and non-pilots, and the results were compared. METHOD: Cardiorespiratory reponses to the symptom-limited maximal exercise loading by Bruce protocol was studied in 11 pilots and 11 matched controls (non-pilots). RESULTS: Comparisons of various data at maximal exercise in the pilots with those in the controls revealed that RR, VE/M2, VE/VO2, VE/VCO2, VT/VC and VE/MVV as well as HR, VO2, O2 pulse and AT showed no significant difference. CONCLUSION: The fact that the aerobic power in the pilots is not superior to that in the controls seems to emphasisze the necessity of aerobic endurance training along with muscular strength training to improve orthostatic tolerance of pilots flying modern high-performance aircrafts.
Aircraft ; Diptera ; Orthostatic Intolerance ; Resistance Training

Use of oral hypoglycemic agents during pregnant women with type 2 diabetes is controversial due to safety issues. Recently, randomized controlled trials support short-term safety of glyburide and metformin for the treatment of gestational diabetes mellitus. However, long-term safety data are not available. Moreover, use of oral hypoglycemic agents, except for metformin and glyburide, during pregnancy were limited to a few case reports. We report the case of a pregnant woman with type 2 diabetes unintentionally exposed to metformin and voglibose in addition to lercanidipine and bisoprolol during fetal organogenesis. The patient was continuously exposed to oral agents because we were not aware of her pregnancy until 22 weeks of gestation. After pregnancy was confirmed, we replaced oral hypoglycemic agents with insulin and discontinue betablockers. Delivery occurred without maternal or fetal complications.
Bisoprolol ; Diabetes, Gestational ; Female ; Glyburide ; Humans ; Hypoglycemic Agents ; Insulin ; Metformin* ; Organogenesis ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy* ; Pregnant Women*

Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia because of hypersecretion of renin. We present a case of a 29-year-old female patient with reninoma and concomitant variant angina. The patient had uncontrolled hypertension and elevated plasma renin activity and aldosterone levels. Imaging studies revealed a mass in the left kidney, which was further confirmed as a renin-producing lesion via selective venous catheterization. During the evaluation, the patient had acute-onset chest pain that was diagnosed as variant angina after a provocation test. After partial nephrectomy, the plasma renin activity and plasma aldosterone levels decreased and blood pressure normalized. We report a case of reninoma with variant angina.
Adult ; Aldosterone ; Angina, Unstable ; Blood Pressure ; Catheterization ; Catheters ; Chest Pain ; Female ; Humans ; Hypertension ; Hypokalemia ; Kidney ; Kidney Neoplasms ; Nephrectomy ; Plasma ; Renin

BACKGROUND: Thoracic sympathectomy for hyperhidrosis has been recognized as an effective treatment using thoracoscopic devices and operative techniques, but the satisfaction has decreased due to a compensatory hyperhidrosis. Therefore, the postoperative results and compensatory hyperhidrosis were analyzed. We also measured the temperature differences in the hand and foot during the preoperative and postoperative periods and measured the blood flow of upper and lower extremities. MATERIAL AND METHOD: From December 1995 to July 1998, total of 47 patients with hyperhidrosis underwent sympathectomy via VATS at the Department of Thoracic and Cardiovascular Surgery, Kangnam St. Mary's Hospital. The patients were evaluated for preoperative and postoperative temperature changes on the finger and toe, and preoperative and postoperative blood flows were measured by the Doppler examination on the digital artery, radial artery and dorsalis pedis artery. RESULT: There were no operative deaths but some complications existed: 7 pneumothorax, 3 recurrence and 1 Honor syndrome. Ninety-five percent of the patients also had compensatory sweating especially in the trunk. There were 5 patients who regretted recurring the operation because of the compensatory sweating. Sweating decreased in 46% of the sole hyperhidrosis patients. The temperature difference between preoperation and postoperation was 1degree C on the right hand side and 1.9degree C on the left hand side(p<0.05). There was no significant temperature difference on the sole. Blood flow increased significantly in the palm, but no difference in the sole. CONCLUSION: In conclusion, thoracic sympathectomy for hyperhidrosis is a safe and effective treatment but satisfaction has been decreased by the compensatory sweating; therefore, it is important to thoroughly explain the compensatory sweating prior to surgery. Improvement of the plantar hyperhidrosis is not due to a physiological change, but to a psychological stability.
Arteries ; Fingers ; Foot ; Hand ; Humans ; Hyperhidrosis* ; Lower Extremity* ; Pneumothorax ; Postoperative Period ; Radial Artery ; Recurrence ; Regional Blood Flow ; Sweat* ; Sweating* ; Sympathectomy ; Thoracic Surgery, Video-Assisted ; Toes

This study surveyed and measured the level and structure of cancer deaths and their trends over time for offering the fundamental data of the cancer prevention and control in Pusan city in the future. Authors conducted the study of descriptive epidemiology using materials derived from the computerized data of total 3,722 certified cancer deaths in Pusan city from January 1 to December 31, 1993 registered on the National Statistical Office, the Republic of Korea. The obtained results were as follows: 1. According to the total registered cases of deaths(16,331 cases) in Pusan city during 1993, cancer(3,722 cases) and cerebrovascular disease(2,718 cases) were the first and second cause of deaths as 23.1% and 16.9%, respectively. These pattern showed the change between cancer(14.7%) and cerebrovascular disease(18.5%) in order of frequency in comparison to 1982. Also, the total number of cancer deaths was increased in comparison to 1982. The rate of death certification by physicians was 87.1% of all registered deaths, which was increased to 6.8% in comparison to 1982(80.3%). 2. Crude death rate and cancer specific death rate was 4.06 per 1,000 populations and 93.8 per 100,000 populations(male:117.8, female:70.0), respectively. The former was similar to that of 1982, but the latter was increased to 1.6 times as that of 1982. 3. Age-adjusted cancer specific death rate by standardization with whole country population was 111.9(male:141.5, female:106.7) per 100,000 populations, higher than not age-adjusted cancer specific death rate(93.8), and the sex difference was statistically significant with male predominance(p<0.05). 4. Cancer specific death rate by age was generally increased with age and most of cancer deaths(male:91.8%, female:88.5%) occurred since 40 years old. 5. The major cancer(cancer specific death rate per 100,000 populations) in male was liver(30.6) followed by stomach(25.6), lung(21.9), and GB and EHBD(5.7), in female stomach(15.7), liver(9.9), lung(7.3), and uterus(6.9). The relative frequency of the leading three cancer among total cancer deaths marked 66.3% in male and 47.1% in female, and decreased in comparison to 1982(male:72.2%, female:54.5%). 6. The total ratio of male to female cancer specific death rate showed 1.68 to 1 with male predominance. And the ratio was above 2.0 in larynx, oral cavity & pharynx, esophagus, liver, lung, bladder cancer and the ratio was 1.0~1.9 in stomach, pancreas, gall bladder and EHBD, brain, rectum and anus cancer, leukemia, but the ratio was reversed in thyroid and colon cancer. In conclusion, cancer was the first cause of deaths. The proportion of lung cancer was increased, that of stomach & uterine cancer was decreased relatively, and liver cancer was constantly higher proportion. In the future, it is necessary to conduct the further investigations on the cancer risk factors considering areal specificity.
Adult ; Anus Neoplasms ; Brain ; Busan* ; Cause of Death ; Certification ; Colonic Neoplasms ; Epidemiologic Studies* ; Epidemiology ; Esophagus ; Female ; Humans ; Larynx ; Leukemia ; Liver ; Liver Neoplasms ; Lung ; Lung Neoplasms ; Male ; Mortality ; Mouth ; Pancreas ; Pharynx ; Rectum ; Republic of Korea ; Risk Factors ; Sensitivity and Specificity ; Sex Characteristics ; Stomach ; Thyroid Gland ; Urinary Bladder ; Urinary Bladder Neoplasms ; Uterine Neoplasms

BACKGROUND: Although IL-12 has been widely accepted to play a central role in the control of pathogen infection, the use of recombinant IL-12 (rIL-12) as a vaccine adjuvant has been known to be ineffective because of its rapid clearance in the body. METHODS: To investigate the effect of sustained release of IL-12 in vivo in the peptide and protein vaccination models, rIL-12 was encapsulated into poly (DL-lactic-co-glycolic acid) (PLGA). RESULTS: We found that codelivery of IL-12-encapsulated microspheres (IL-12EM) could dramatically increase not only antibody responses, but also antigen-specific CD4(+) and CD8(+) T cell responses. Enhanced immune responses were shown to be correlated with protective immunity against influenza and respiratory syncytial virus (RSV) virus challenge. Interestingly, the enhancement of CD8(+) T cell response was not detectable when CD4(+) T cell knockout mice were subjected to vaccination, indicating that the enhancement of the CD8(+) T cell response by IL-12EM is dependent on CD4(+) T cell "help". CONCLUSION: Thus, IL-12EM could be applied as an adjuvant of protein and peptide vaccines to enhance protective immunity against virus infection.
Animals ; Antibody Formation ; Influenza, Human ; Interleukin-12 ; Mice ; Mice, Knockout ; Microspheres* ; Respiratory Syncytial Viruses ; Vaccination* ; Vaccines, Subunit