The majority of lung cancers associated with hyperamylasemia are adenocarcinomas. Here we report an unusual case of a 54-year-old male patient who complained of dyspnea, anterior chest wall discomfort and facial edema for one month, presenting with a huge mediastinal mass and hyperamylasemia complicated by pericardial effusion Histological evaluation of mediastinal mass revealed small cell carcinoma and pericardium showed nonspecific inflammation with fibrosis. The serum amylase had an electrophoretic mobility similar to that of salivary gland enzyme. There were no evidence of a salivary or pancreatic causes of hyperamylasemia. After chemotherapy, parenchymal lung lesions improved and hyperamylasemia disappeared. For the mannagement of peracardial effusion a pericardial window was forms(i. We concluded that the striking increase in serum amylase was due to the ectopic production of this enzyme by the tumor.
Adenocarcinoma ; Amylases* ; Carcinoma, Small Cell ; Drug Therapy ; Dyspnea ; Edema ; Fibrosis ; Humans ; Hyperamylasemia ; Inflammation ; Lung ; Lung Neoplasms ; Male ; Middle Aged ; Pericardial Effusion ; Pericardium ; Salivary Glands ; Small Cell Lung Carcinoma* ; Strikes, Employee ; Thoracic Wall

Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dissecting aortic aneurysm is occurred, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treatment (Modified Bentall's operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.
Aorta* ; Aortic Aneurysm* ; Coronary Vessels* ; Follow-Up Studies ; Heart Failure ; Necrosis ; Risk Factors

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has been used worldwide since the advent of ESS by Messerklinger and Wigand. There have been many reports concerning the results of ESS on the treatment of chronic paranasal sinusitis, but few reports about the intraoperative complications of ESS in Korea. In this paper, we analyzed the intraoperative complications of ESS in Kyung Hee University Hospital and discussed about early recognition and managements. MATERIALS AND METHOD: We reviewed retrospectively the intraoperative complications of ESS of 1025 patients who underwent the ESS at Kyung Hee University Hospital from January 1998 to January 2001. Dividing the intraoperative complications into major and minor, we describe the managements and results. RESULTS: The rate of total complications was 13.27%. The major complications occurred in 0.78%, with cerebrospinal fluid (CSF) leakage (0.39%) marking the commonest complication. The ratio of minor complications was 12.49%, with the leading one being the periorbital ecchymosis (6.15%). CONCLUSION: ESS is often complicated by anatomical variations and inexperience of operator, and we must prepare for early detection and managements through preoperative survey of anatomical defects and improvement of operative skills.
Cerebrospinal Fluid ; Ecchymosis ; Endoscopy ; Humans ; Intraoperative Complications* ; Korea ; Retrospective Studies ; Sinusitis

Purpose: To compare the thickness of the processed pericardial patch graft for glaucoma implant tube coverage using anterior segment optical coherence tomography (AS-OCT). Methods: Thicknesses of seven samples of two pericardial patch grafts (Tutoplast pericardium, IOP Inc, Costa Mesa, CA, USA; pericardium LYO, DCI Donor Services, Inc., Nashville, TN, USA) were measured using AS-OCT (CASIA2, Tomey Corporation, Nagoya, Japan). The thickness of each sample was measured at the center and eight points with 45-degree angular distance, 2 mm from the center. The thickness was measured using AS-OCT program tools. Results: The median thicknesses were 219 μm for Tutoplast pericardium and 157 μm for pericardium LYO. Tutoplast pericardium was significantly thicker than pericardium LYO (p = 0.001); pericardium LYO had a wider interquartile range within each sample, compared to Tutoplast pericardium (p = 0.017). Conclusions The thickness of the Tutoplast pericardium was greater and less variable than that of the pericardium LYO. These findings should be considered when choosing processed pericardium for coverage of glaucoma implants.

BACKGROUND/OBJECTIVES: This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS: A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS: When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B₆, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B₆, B₁₂, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B₁₂ intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS: When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
Antioxidants* ; Ascorbic Acid ; Atherosclerosis ; Cerebral Arteries ; Classification ; Folic Acid ; Food Habits ; Fruit ; Homocysteine ; Humans ; Intracranial Arteriosclerosis* ; Korea ; Plasma ; Seoul ; Stroke* ; Vegetables ; Vitamin B Complex* ; Vitamins

PURPOSE: To assess the usefulness of Ahmed valve implantation using scleral tunneling. METHODS: Thirty-four eyes of 34 patients with refractory glaucoma who had not responded to medical treatment nor previous glaucoma surgery was given Ahmed valve implantation using scleral tunneling and were enrolled in the study with a minimum follow-up of six months. RESULTS: The mean follow-up period was 7.7 +/- 2.8 months (6~24 months). The mean preoperative IOP was 47.6 +/- 6.9 (25~70) mmHg and the mean postoperative IOP at six months was 18.7 +/- 9.8 (4~31) mmHg. The postoperative success rate was 73.5% and 73.3% at six and eighteen months, respectively, and was not affected by sex, preoperative diagnosis, or preoperative IOP. The postoperative complications were hyphema (4 eyes), choroidal detachment (3 eyes), and immediate hypotony (3 eyes). CONCLUSIONS: Ahmed valve implantation using scleral tunneling is useful, especially when patch graft is not available. The success rate was comparable with other traditional methods such as patch graft and scleral flap.
Choroid ; Diagnosis ; Follow-Up Studies ; Glaucoma ; Humans ; Hyphema ; Postoperative Complications ; Transplants

PURPOSE: We performed this study to assess the suitability of conventional angiography (CA) vs. multi-detector row helical CT angiogram (MD-CTA) as a method of preoperative diagnostic imaging for low extremity arterial surgery. METHODS: From February 2004 to September 2006, 23 patients (4 claudicants, 19 limb-threatening ischemia) were studied with CA and MD-CTA preoperatively. The site and degree of stenotic or occlusive lesions in arterial segments from the renal artery to the dorsalis pedis artery were compared with both methods. We also compared the surgical inflow and outflow site changes in preoperative planning based on CA and MD-CTA and the final outcome. Additional diagnostic value and test-related complications were also analyzed. RESULTS: The median age of patients was 68 years old (range: 43~89 years), with a male to female ratio of 1.3:1. Twenty-three patients had CA after an MD-CTA scan. One hundred fifty lesions were detected in these patients. The total ratio of consistency for occlusion in CA vs. MD-CTA was 69.6%. Three patients received amputation treatment and eleven patients received a bypass operation. The agreement between the preoperative plan based on MD-CTA and the final operation was 100%, even in critical limb ischemia. There were no serious complications related to the tests. CONCLUSION: These findings suggest that MD-CTA is an adequate preoperative imaging study of infrainguinal arterial surgery and may be substituted for conventional angiography without any serious complications.
Amputation ; Angiography ; Arteries ; Diagnostic Imaging ; Extremities ; Female ; Humans ; Ischemia ; Male ; Renal Artery ; Tomography, Spiral Computed

There has been little data on the prevalence of supplement use and the characteristics of the dietary supplement users in the Republic of Korea. This study presents the prevalence and the details of any dietary supplement use and the characteristics of the adults who use dietary supplements in the Republic of Korea. Between May 18 and June 16, 2006, nationwide and population-weighted personal interviews with 6,201 adult aged from 30 to 69 years were conducted and the final sample consisted of 3,000 people with a 49.8% response rate. We examined the prevalence and details of the use of dietary supplements and the characteristics of those who use the dietary supplement among adults. About sixty two percent of adults had taken any dietary supplement during the previous 12-month period in 2006. The most commonly reported dietary supplement was ginseng, followed by multivitamins, glucosamine, probiotics, and vitamin C. Female (versus male), an older age group, a higher family income, those living in metropolitan cities, those with marital experience, those with a higher level of education, and those having medical problems had a greater likelihood of reporting the use of any dietary supplements. The particular relationships differed depending on the type of supplement. The most Korean adults took one more dietary supplement and the dietary supplement users had different demographic and health characteristics compared to those of the nonusers. Research on diet supplements by the medical community is needed in the future.
Adult ; Aged ; Ascorbic Acid ; Complementary Therapies ; Demography ; Diet ; Dietary Supplements ; Female ; Glucosamine ; Humans ; Morinda ; Panax ; Prevalence ; Probiotics ; Republic of Korea

BACKGROUND AND OBJECTIVES: Knowledge of the postnatal growth of ear is decisive in determining the optimal time for ear reconstruction and planning the morphology of an artificial ear. However, basic population studies have not been carried out in Korea and the dynamics of ear growth and the age of maturation have not been clearly determined and established. The aim of this study was to establish the age of ear maturation and to help determine the optimal time of ear reconstruction for Koreans. SUBJECTS AND METHOD: From June 2000 through February 2001, we measured facial length and the 3 lengths of the auricle, i.e., length, width, the distance between the two insertion points of the auricle and facial length in 950 Korean subjects between the ages of 0 to 18. RESULTS: The auricle length reached 90% of its mature size at 14 years and width at 15 years. The distance between the two insertion points of the auricle was not significantly different in this study. CONCLUSION: The length and width of auricle reached 90% of the adult size at the age of 14 and 15, respectively. Therefore, when performing auriculoplasty, consideration should be given for auricle growth up to the age of 15 years.
Adult ; Anthropometry ; Ear ; Ear Cartilage ; Humans ; Korea

Arteries ; Body Height ; Dentofacial Deformities ; Female ; Hemorrhage ; Humans ; Male ; Maxilla ; Osteotomy