Carcinoma of the parathyroid gland is rare, comprising only 0.1% to 5% of all patients with primary hyperparathyroidism. It presents with severe hypercalcemia, bone disease, palpable neck mass, renal involvement and etc. Since the initial operation offers the best chance for cure, preoperative localization and intraoperative recognition of parathyroid cancer are essential. Recently parathyroid imaging has been described with 99mTc-sestamibi as an alternative to 201Tl. This newer agent has many physical and dosirnetric advantages and represents higher detection sensitivity than 201Tl-99mTc subtraction scan. We experienced a 41-year-old man presenting with recurrent hyperparathyroidism in spite of 2 previous operations. In preoperative localization, there was no abnormal uptake in 201Tl-99mTc subtraction scan but 99mTc-sestamibi scan revealed metastatic foci on right cervical area. He was successfully treated with modified radical neck dissection.
Adult ; Bone Diseases ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neck ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms* ; Technetium Tc 99m Sestamibi*

Insulinoma is a functional endocrine tumor arising from the beta cells of islets of Langerhans of pancreas. The only effective treatment of insulinoma was surgical removal of the tumor. Recently, laparoscopic surgery for islet cell tumors of the pancreas is introduced. Laparoscopic enucleation or resection of benign islet tumors results in a shorter hospital recovery and is a good alternative to open surgery We report a case of insulinoma that was treated sucessfully by laparoscopic enucleation.
Adenoma, Islet Cell ; Insulinoma* ; Islets of Langerhans ; Laparoscopy ; Pancreas

Total anomalous pulmonary venous confluence(TAPC), a rare cyanotic congenital anomaly of the heart especially in adult, is now diagnosed by echocardiography instead of cardiac catheterization with high sensitivity and specificity. The key points are identification of pulmonary veins, pulmonary venous confluence draining anomalously to the heart. RVDVO on M-mode, abnormal echo free space posterior to left atrium on 2D-echo are basic characteristics of TAPVC. Peak velocity and flow profile measurement on the doppler provide additional informations : obstruction and anomalous vessels. A case of 23 year old male with supracardiac type TAPVC diagnosed by echocardiography was corrected successfully by surgery.
Adult* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Heart ; Heart Atria ; Humans ; Male ; Pulmonary Veins ; Sensitivity and Specificity ; Young Adult

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

Eikenella corrodens is a slow growing, facultatively anaerobic gram-negative rod that is part of the normal flora of the oral cavity and upper respiratory tracts. In most patients with E. corrodens infections, host defenses are compromised due to surgery, or chronic debilitating illness such as malignancies, or immunosuppressive therapy. This organism causes abscesses and infections that are at times fatal. We experienced a case of E. corrodens isolated from liver abscess in an immunocompetent patient. A 50-year-old man who is a dentist, was hospitalized because of fever and myalgia of 10 days' duration. Abdominal ultrasonography showed non-septated, 3.8x4.6 cm sized abscess in the segment 6/7 of the liver. E. corrodens was isolated from aspiration of liver abscess. This organism was presumably acquired from his patient's oral cavity during dental procedure. We hope that increased awareness to E. corrodens will raise the index of suspicion, and contribute to optimal management of these infections, minimizing the significant morbidity associated with this organism.
Abscess ; Bites, Human* ; Dentists ; Eikenella corrodens* ; Eikenella* ; Fever ; Hope ; Humans ; Humans* ; Liver Abscess* ; Liver* ; Middle Aged ; Mouth ; Myalgia ; Respiratory System ; Ultrasonography

Red Liriope platyphylla (RLP) produced by steaming process has been reported to enhance the secretion of insulin and nerve growth factor (NGF). However, there has been no report on the toxicity of RLP in the specific organs of mice. To investigate the toxic effect of RLP, we tried to observe a significant alteration on body weight, food/water intake, organ weight, liver pathology and kidney pathology in female ICR mice received 12.5, 25.0 and 50.0 mg/kg body weight/day of RLP via gavage for 10 days. Out of seven organs including brain, heart, lung, liver, kidney, spleen and ovary, two organs (heart and lung) showed significantly decreased weights in the medium dosage RLP-treated group, whereas weights of other organs were maintained at constant levels in all dosage groups. In the liver toxicity analysis, no significant increase of alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate amino-transferase (AST) were detected in any RLP-treated group compared to vehicle-treated group. The specific pathological changes induced by most of toxic compounds were not observed in the liver in microscopic examination. Furthermore, in the kidney toxicological analysis, a significant enhancement of the blood urea nitrogen (BUN) concentration was detected in the high dosage RLP-treated group compared to the vehicle-treated group. However, the serum creatinine (CA) concentration on the serum biochemistry as well as the pathological changes in microscopic examination were not significantly different between the vehicle- and RLP-treated groups. Therefore, these results suggest that RLP does not induce any specific toxicity in liver or kidney tissues of mice, although the BUN level slightly increased in 50.0 mg/kg of RLP-treated group.
Alanine Transaminase ; Alkaline Phosphatase ; Animals ; Aspartic Acid ; Biochemistry ; Blood Urea Nitrogen ; Body Weight ; Brain ; Creatinine ; Female ; Heart ; Humans ; Insulin ; Kidney ; Liver ; Lung ; Mice ; Mice, Inbred ICR ; Nerve Growth Factor ; Organ Size ; Ovary ; Spleen ; Steam ; Weights and Measures

PURPOSE: The optimal interval at which to repeat prostate-specific antigen (PSA) measurement is controversial. We evaluated the probability of the serum PSA value increasing above specific cutoff values (4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml) on annual follow-up visits in men with a lower baseline PSA than each cutoff value. MATERIALS AND METHODS: Between 2002 and 2006, a total of 14,459 men aged 40 to 79 years who underwent serum PSA determinations at least twice during health examinations at 11 medical centers were enrolled in this study. To reduce probable bias, we excluded men with pyuria, those with a baseline or follow-up PSA level of 10.0 ng/ml or more, and those with a history of medication with 5 alpha-reductase inhibitors. Serum PSA underwent logarithmic conversion to work out the normal distribution. The cumulative rate of freedom from increase in PSA above 4.0 ng/ml, 3.0 ng/ml, and 2.5 ng/ml was estimated with the Kaplan-Meier method according to baseline PSA range and age. The significance level was 1%. RESULTS: The rate of increase in PSA was lower in men who had a baseline PSA value in the low range and whose age was in the 40s or 50s. However, the cumulative rate of freedom from increase in PSA decreased as the PSA cutoff value was lowered. The optimal screening interval for men in their 40s and 50s whose baseline serum PSA level was 1.0 ng/ml or lower was 3 years when the significance level for PSA rising above 4.0 ng/ml was 1%. It was 2 years and 1 year, respectively, when the cutoff value was lowered to 3.0 ng/ml or 2.5 ng/ml. An annual PSA screening interval was recommended in men older than their 60s. CONCLUSIONS: The PSA test interval should be individualized according to baseline PSA, age, and PSA cutoff value.
Aged ; Bias (Epidemiology) ; Cholestenone 5 alpha-Reductase ; Follow-Up Studies ; Freedom ; Humans ; Male ; Mass Screening ; Prostate-Specific Antigen ; Pyuria