The coronary arteries are also subject to congenital anomalies of both minor and major consequence. Hemodynamically significant primary anomalies of the coronary arteries are those which alter myocardial perfusion. There are four major types : coronary artery fistula, origin of the left voronary artery from the pulmonary artery, congenital coronary stenosis or atresia and origin of the left or right coronary artery from the opposite sinus of Valsalva with subsequent passage of the vessel between the aorta and right ventricular infundibulum. Minor anomlies are the variation of the origin of the coronary arteries from the aorta with normal distal circulation. We can see more coronary anomalies associated with congenital cardiac anomalies, probably representing a circulatory response to the primary intracardiac defect. We present a total of 76 cases of congenital coronary anomalies, reviewing 3946 cases of angiocardiography or selective coronary arteriography, performed during last 8 years at Sejong General Hospital.
Angiocardiography ; Angiography ; Aorta ; Arteries ; Coronary Stenosis ; Coronary Vessels* ; Fistula ; Hospitals, General ; Perfusion ; Pulmonary Artery ; Sinus of Valsalva

OBJECTIVE: To investigate the regional differences of skin blood flow and to evaluate the effects of foot temperature on the severity of neuropathic pain and to predict the development of plantar foot ulceration by measuring of the temperature variations on the plantar surface of feet in the diabetic patients. METHOD: We measured the temperature variations on plantar surface of the feet in controls (n=18) and diabetic patients with(n=20) or without(n=23) polyneuropathy. The surface temperature from the 3rd metatarsal head(MTH), greater toe(GT), heel, medial and lateral longitudinal arch(LA) was measured by Digital Infrared Thermographic Imaging(DITI). RESULTS: The mean foot temperature of diabetic patients with polyneuropathy was significantly increased compared to controls or diabetic patients without polyneuropathy(p<0.001). The surface temperature readings of the GT, medial LA and the 3rd MTH tended to be increased in controls and patients with polyneuropathy. The mean plantar surface temperature was significantly increased according to the duration of diabetes mellitus(DM)(p<0.05). CONCLUSION: The results suggest that DITI provides a diagnostic modality in the prediction of neuropathic foot and increased risks of foot ulcer development in the diabetic patients.
Diabetic Neuropathies ; Foot Ulcer* ; Foot* ; Heel ; Humans ; Metatarsal Bones ; Neuralgia ; Polyneuropathies ; Reading ; Skin

OBJECTIVES: To determine if agricultural work is related to radiological flattening of lumbar lordosis, and to identify the relationship between of back pain and flat back in selected Korean farmers. METHODS: Between June 2006 and July 2008, 414 farmers, 155 (37.4%) males and 259 (62.6%) females participated in this study. We collected data on hazardous agricultural work postures and other factors from interviews, surveys, and x-ray views of lateral lumbar. The operational definition of a flat back was below -1 SD of lordotic angle, with a normal distribution between L1 and S1 level. Logistic regression analysis was conducted to evaluate the relationship between flat back and hazardous working posture ratio, sex, the severity of back pain. RESULTS: Mean lordotic angle was 42.9+/-15.7degrees. Flat back had a higher prevalence in the females (24.7%) than the males (5.8%). The odds ratio of flat back risk is 3.30 (95% CI: 1.46~7.46) in the females compared to the males, 1.31 (95% CI: 0.61~2.79), 4.11 (95% CI: 1.77~9.55) in the group of hazardous working posture ratio compared to the low risk group, 2.78 (95% CI: 1.27~6.07), 5.74 (95% CI: 2.27~14.49) in the group of L4-L5 disc space narrowing compared to normal group, 3.06 (95% CI: 1.27~7.31), 5.45 (95% CI: 1.70~17.46) in the group of lumbar spine compression fracture compared to no fracture. Odds ratio of severe back pain is 2.29 (95% CI: 1.12~4.72) in the group of flat back compared to normal group. CONCLUSIONS: Hazardous agricultural working postures, such as 'low- lifting, pulling, pushing work and high- squatting posture work' are associated with flat back. Low back pain is significantly associated with flat back group in female farmers.
Agriculture ; Animals ; Back Pain ; Female ; Fractures, Compression ; Humans ; Korea ; Lifting ; Logistic Models ; Lordosis ; Low Back Pain ; Male ; Odds Ratio ; Posture ; Prevalence ; Sex Ratio ; Spine

OBJECTIVES: The objectives of this study are to identify the relationship between the Korean occupational stress scale (KOSS) and emotional labor, and to study the association between emotional labor and musculoskeletal symptoms, absence or early leave due to physical problems among civil affairs officials. METHODS: 391 public workers who provide social insurance service were analyzed. A structured self-reported questionnaire was used to assess sociodemographics, job stress, emotional labor, musculoskeletal symptoms and the experience of absence or early leave due to physical problems. For a comprehensive understanding of the relationship among these factors, multiple logistic regression analysis was used. RESULTS: The Pearson coefficient was 0.409 between the job demand of KOSS and the emotional labor score. The odds ratio of musculoskeletal symptoms is 2.32(95% CI: 1.17~4.61), 2.48(95% CI: 1.15~5.33) in the groups of moderate and, high emotional labor score, respectively, compared to the low score group. On the other hand, the odds ratio of the experience of absence or early leave due to physical problems is 2.43(95% CI: 1.24~4.76) and, 3.08(95% CI: 1.44~6.57) in the same groups. CONCLUSIONS: Emotional labor acts as a factor of job demand of KOSS, and has an effect on musculoskeletal symptoms and absence or early leave among civil affairs officials.
Absenteeism ; Hand ; Logistic Models ; Musculoskeletal Diseases ; Odds Ratio ; Questionnaires ; Social Security ; Stress, Psychological

BACKGROUND: AG60 is a complex of acriflavine and guanosine. Our previous study revealed that AG60 had not only in vitro antitumor activities in several human cancer cell lines, but also strong antitumor effects in animal experiments using p388 or S180 cells-implanted mice. METHODS: Antitumor effects of AG60 were compared with those of Adriamycin, acriflavine, guanosine or control group. Body weight, tumor weight change, and survival time were measured in Ehrlich carcinoma cells implanted ICR mice. RESULTS: Body weights in AG60, acriflavine, or Adriamycin treated groups were significantly lower than those in control group during 30 day observation period(p<0.05). The percent tumor growth inhibition of AG60, Adriamycin, acriflavine, or guanosine two weeks after last treatment was respectively 86% (T/C%=14), 83% (T/C%=17), 68%(T/C%=32), 41% (T/C%=59). According to above data, tumor growth inhibition in AG60 treated group was significantly stronger than that in control, acriflavine or guanosine treated group(p<0.01), but there was no significant difference between AG60 and Adriamycin treated group. Mean survival time in control, AG60, Adriamycin, acriflavine, or guanosine treated group was respectively 33+/-3.9 days, 68+/-4.2 days, 54+/-5.8 days, 36+/-3.8 days, 50+/-8.1 days. CONCLUSIONS: The anti-tumor effect of AG60 against Ehrlich tumor was significantly stronger than that of control, acriflavine or guanosine, and comparable with Adriamycin. Mean survival time in AG60 treated group was significantly longer than that in control, acrifavine, guanosine or Adriamysin treated group.
Acriflavine ; Animal Experimentation ; Animals ; Body Weight ; Cell Line ; Doxorubicin ; Guanosine ; Humans ; Mice ; Mice, Inbred ICR ; Survival Rate ; Tumor Burden

Oxcarbazepine (OXC) is generally assumed to be safe with regard to the risk for adverse hematopoietic effects. Recently, pancytopenia and leukopenia associated with the treatment of OXC have been reported. However, that serious adverse effect has never been reported in Korea. We describe a case of 47-year-old woman with temporal lobe epilepsy who developed reversible leukopenia following OXC monotherapy. She stopped to take OXC and WBC count was normalized completely.
Carbamazepine ; Epilepsy, Temporal Lobe ; Female ; Humans ; Korea ; Leukopenia ; Pancytopenia

Peroperative localization of pheochromocytoma is the very crucial step for the successful removal of tumors. Computed tomography(CT) and magnetic resonance(MR) imaging have been commonly used for tumor localization, but in some cases of pheochromocytoma, such as extraadrenal location or distant metastasis of malignant tumor, their localization is somewhat difficult. Recently ^131 I-metaiodobenzylguanidine(MIBG) scintigraphy has been developed and increasingly used for the localization of pheochromocytoma and reported to be more sensitive and specific than CT or MR imaging in the cases of extraadrenal tumor location.We report a case of multiple extraadrenal pheochromocytoma in which ^131 I-MIBG scintigraphy clearly localized two intraabdominal and one bladder tumors, after failure of localization with conventional CT and MR imaging.
Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pheochromocytoma ; Radionuclide Imaging ; Urinary Bladder Neoplasms

Endoscopic retrograde cholangiopancreatography (ERCP) is a safe procedure with life-threatening complications rarely occurring after the procedure. There are several reports of complications with ERCP, including bleeding, perforation, pancreatitis, cholangitis and cholecystitis. In our case, an umbilical hernia was strangulated after therapeutic ERCP had been performed in a patient with acute pancreatitis by a biliary stone, which required a surgical resection. To the best of our knowledge, this is the first report of such a case in Korea. This case highlights the need for close and careful observations for the early detection of possible complications after ERCP.
Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystitis ; Hemorrhage ; Hernia, Umbilical* ; Humans ; Korea ; Pancreatitis*

Endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly performed endoscopic procedure for the diagnosis and treatment of pancreatobiliary disease. ERCP is a relatively safe procedure. However, there are chances of potentially severe complications such as pancreatitis, hemorrhage, infection and perforation. Duodenal perforation is an uncommon, but serious complication of ERCP, and this has occurred in 0.3 to 1.1% of most of the previous series. There are various clinical course and treatments depending on the cause of perforation. However, the development of pneumothorax in patients undergoing ERCP is rare. There are no reports of tension pneumothorax complicating ERCP in Korea. We experienced a case of tension pneumothorax with complicating duodenal microperforation following ERCP, and the patient (a 77 year old female with suspicious dysfunction of the sphincter of Oddi) was treated with conservative treatment.
Aged ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Hemorrhage ; Humans ; Korea ; Pancreatitis ; Pneumothorax*

BACKGROUND/AIMS: Intraductal papillary mucinous neoplasms of the pancreas (IPMNs) are consisted of two types; branch-duct type and main-duct type. Branch-duct type is more common and follows a better course than main-duct type. However, the natural history of branch-duct type IPMN has not been exactly verified yet. The aim of this study was to investigate the natural course of branch-duct type IPMN. METHODS: The medical records of 45 patients with branch-duct type IPMN diagnosed by pancreatogram were reviewed retrospectively. The mean age was 62.9+/-8.3 years old and the mean follow-up duration was 27.4+/-18.9 months. Demographic, clinical and radiologic characteristics were evaluated. The histological findings of specimens resected during the follow-up period were also analyzed. RESULTS: Ten (22.2%) out of 45 patients showed enlargement of the cysts during follow-up. Initial size of the cyst in patients with cyst enlargement were smaller than in patients without it in univariate analysis (p<0.01). Cysts less than 1.0 cm were significantly associated with cyst enlargement with odds ratio of 4.48 in multivariate analysis. Ten patients underwent surgical resection and pathologic examination revealed one carcinoma in situ and one invasive adenocarcinoma. The presence of mural nodule was associated with malignant change of IPMNs (p=0.02). None of unresected cases showed metastasis or disease-related death. CONCLUSIONS: Natural history of branch-duct type IPMNs is generally good. The occurrence of mural nodule is associated with the malignant change of the cyst but not the speed of size increment.
Adenocarcinoma, Mucinous/*pathology/surgery ; Aged ; Carcinoma, Pancreatic Ductal/*pathology/surgery ; Carcinoma, Papillary/*pathology/surgery ; Disease Progression ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; Neoplasm Staging ; Pancreatic Neoplasms/*pathology/surgery ; Prognosis ; Retrospective Studies