Benign tumors of the esophagus occur rarely as compared with the incidence of carcinomas. Among the benign tumors of the esophagus such as leiomyoma, lipoma, hemangioma, papilioma. polyp, cystetc. leiomyoma is the most common, although less than 10 percents of leiomyomas of the gastrointestinal tract are found in the esophagus. Most of leiomyomas of the esophagus present as solitary lesions but multiple tumors occur in about 4 percents of cases. Leiomyomas of the esophagus are diagnosed by thorough clinical evaluation, esophagogram and upper gastrofiberscopic examination but histological confirmation requires surgical or necropsy specimens. Occasionally gastrofiberscopic polypectomized specimens are used. We report one case of multiple leiomyomas of the esophagus located in between 25 cm and 40 cm distance from the incisor in a 38-year-old man who complained of vague substernal discomfort for about 10 years. Gastrofiberscopic polypectomized specimen was used for preoperative histological confirmation. The pathologic examination of the specimen showed leiomyoma of the esophagus.
Adult ; Esophagus* ; Gastrointestinal Tract ; Hemangioma ; Humans ; Incidence ; Incisor ; Leiomyoma* ; Lipoma ; Polyps

Numerous reports have documented cardiac arrhythmias in animals and man during halothane anesthesia, Cardiac arrhythmia may occur regularly with halothane anesthesia, being related to several factors; fright, overdoasge of atropine, surgical stimvlation in light anesthesia, hypercapnia and intravenous injection of epinephrine. The authors experienced a case of severe cardiac arrhythmia induced by fialothane anesthesia and treated by change of anesthetic agent to ether.
Anesthesia* ; Animals ; Arrhythmias, Cardiac* ; Atropine ; Epinephrine ; Ether ; Halothane* ; Hypercapnia ; Injections, Intravenous

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductalpapillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.
Breast Neoplasms ; Breast* ; Busan ; Carcinoma, Papillary ; Coloring Agents ; Cyclin D1 ; Cyclins* ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Papilloma ; Pathology ; Recurrence ; Survival Rate

PURPOSE: It is difficult at times to differentiate between a papillary carcinoma and benign papilloma of the breast, and papillomas can undergo malignant transformation. The authors investigated the expression of cyclin D1 and MIB-1 to assess the diagnostic value of these markers in distinguishing papillary carcinomas from papillomas of the breast, and in determining the clinical relevance of these markers as prognostic predictors. METHODS: The medical records of 38 patients treated for benign and malignant papillary lesions of the breast at Inje University Pusan Paik Hospital between January 1992 and December 1997 were reviewed. Immunohistochemical stains for cyclin D1 and MIB-1 were performed in 30 cases of papilloma and eight cases of papillary carcinoma of the breast. The authors performed a statistical analysis of the relationship between cyclin D1 and MIB-1 with respect to the size of tumors, pathologic lymph nodes, and postsurgical residual lesions, and the recurrence and survival rates. RESULTS: Breast cancer or ADH was associated with six cases (15.79%) of papillary lesions of the breast. The incidence of postsurgical residual lesions and their recurrence were 2.63% and 2.63% in all the patients with papillary lesions of the breast. The labeling index of cyclin D1 was significantly higher in the eight papillary carcinomas (36.7+/-27.0) than in the 30 papillomas (3.5+/-4.2) (P=0.001). There was a statistically significant difference betweenn the MIB-1 labeling index of the eight papillary carcinomas (4.9+/-5.9) and that of the 30 papillomas (0.4+/-1.4) (P=0.0225). The cyclin D1 and MIB-1 expressions of the single intraductal papillomas and multiple papillomas were not different. In addition, there was no statistically significant difference of cyclin D1 and MIB-1 in the eight papillary carcinomas with respect to the associated pathologies, size, positive lymph nodes, recurrence or survival. CONCLUSION: These results suggest that cyclin D1 and MIB-1 might be useful markers for distinguishing papillary carcinomas from papillomas of the breast.
Breast Neoplasms ; Breast* ; Busan ; Carcinoma, Papillary ; Coloring Agents ; Cyclin D1 ; Cyclins* ; Humans ; Incidence ; Lymph Nodes ; Medical Records ; Papilloma ; Papilloma, Intraductal ; Pathology ; Recurrence ; Survival Rate

Hyperthyroidism is a well known cause of atrial fibrillation. It is also known that control of hyperthyroidism can usually curb thyrotoxic atrial fibrillation and restore sinus rhythm. In this study, 282 patients with hyperthyroidism were investigated to quantify the incidence of atrial fibrillation, and to identify the vulnerable groups. In addition, we compared two groups of subjects with atrial fibrillation-one group with hyperthyroidism and the other group without
Aged ; Atrial Fibrillation ; Female ; Follow-Up Studies ; Heart Diseases ; Humans ; Hyperthyroidism ; Incidence ; Male ; Sex Ratio ; Thyroid Gland

OBJECTIVES: The aim of this study was to compare the 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm between postmenopausal Korean women with and without type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: We used data from the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. The measurements of anthropometric parameters and bone mass were obtained using dual energy X-ray absorptiometry (DXA) (Discovery-W, Hologic Inc., USA). Data was available for a total of 1,594 postmenopausal women (1,498 without T2DM and 96 with T2DM) aged 40 to 90 years old. The FRAX(R) 10-year probability was computed using the algorithm available online at http://www.shef.ac.uk/ FRAX (South Korea version). To compare the 10-year probability of osteoporotic fracture between the groups with and without adjustment for age and weight, a general linear model was used. RESULTS: Mean 10-year probabilities of fracture were similar between groups for major fractures [diabetic 9.0 (8.0, 10.0, 95% CI) versus non-diabetic 8.1 (7.8, 8.4, 95% CI), P=0.087] and hip fractures [diabetic 3.6 (2.8, 4.3, 95% CI) versus non-diabetic 2.9 (2.7, 3.1, 95% CI), P=0.099]. After adjustment for confounding factors (age and weight), there was also no significant difference between the diabetic and non-diabetic group [major osteoporotic fracture: 8.4 versus 8.1, P=0.563; hip fracture: 3.2 versus 2.9, P=0.320]. CONCLUSIONS: FRAX did not reflect higher major osteoporotic and hip fracture risk in Korean T2DM patients. T2DM might be considered for inclusion in future iterations of FRAX.
Absorptiometry, Photon ; Bone Density ; Diabetes Mellitus, Type 2 ; Female ; Hip ; Hip Fractures ; Humans ; Korea ; Linear Models ; Nutrition Surveys ; Osteoporotic Fractures

Adefovir dipivoxil is used antiviral agent in the treatment of chronic hepatitis B virus infection. This drug is recommended for patients infected with lamivudine-refractory hepatitis B. Many studies of low-dose adefovir have shown little evidence of renal tubular dysfunction. However, hypophosphatemic osteomalacia has recently been reported in patients treated with adefovir. We report three cases of low dose adefovir-induced hypophosphatemic osteomalacia with fractures. All three patients had been receiving adefovir due to lamivudine-refractory hepatitis B, presented multiple bone pain. The laboratory tests revealed hypophosphatemia and phosphaturia. Bone scintigraphy showed increased uptake in multiple lesions. They were diagnosed as adefovir induced hypophophatemic osteomalacia. Changing the antiviral agent and administration of calcitriol and phosphates improved hypophosphatemia and clinical symptoms. Patients with hepatitis B virus treated with adefovir should be monitored with the serum phosphate levels and presenting symptoms of diffuse bone pain, clinicians need to suspect this infrequent complication.
Calcitriol ; Hepatitis B ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis, Chronic ; Humans ; Hypophosphatemia ; Hypophosphatemia, Familial ; Osteomalacia ; Phosphates ; Radionuclide Imaging

Purpose: To report a case of acute bilateral corneal edema after inhalation of spray paint.Case summary: A 47-year-old male presented with blurred vision in both eyes 12 hours after inhalation of spray paint. He had no history of ocular surgery or chronic ocular disease. The corrected visual acuity was 20/100 in the right eye and 20/40 in the left eye. An ocular examination revealed diffuse bullous changes in the epithelium and mild stromal edema in the cornea of both eyes. At one week after treatment with topical hypertonic solutions and corticosteroids, the visual acuity had improved to 20/20 and slit-lamp examination showed clear corneas without edema. Conclusions Inhalation of a chemical substance can lead to acute bilateral corneal edema, even without direct contact, but the lesion may resolve rapidly.

Purpose: To evaluate the accuracy of intraocular pressure (IOP) measurements obtained by a rebound and non-contact tonometer in eyes with a therapeutic contact lens (CL) after vitrectomy. Methods: In 60 eyes of 60 patients who underwent vitrectomy for vitreoretinal disease, IOP was measured using a rebound tonometer (iCare ic200®; IOPRT) and non-contact computerized air puff tonometer (CT-80, IOPNCT), before and after wearing a CL (Purevision2®, +0.0 diopter). The mean IOP of three consecutive measurements were analyzed, and a comparative analysis with IOP measured by a Goldman applanation tonometer (IOPGAT) was performed. Results: The mean IOPRT without and with the CL was 12.55 ± 5.43 and 13.12 ± 5.13 mmHg, respectively, showing a statistically significant difference (p = 0.02) and strong positive correlation (r = 0.90, p < 0.001). The mean IOPNCT with and without the CL was 12.18 ± 3.24 and 12.17 ± 3.14 mmHg, showing no statistically significant difference (p = 0.17). The consistency with IOPGAT (12.57 ± 5.22 mmHg) was highest in IOPRT without the CL, followed by IOPRT with the CL, IOPNCT without the CL, and IOPNCT with the CL (intraclass correlation coefficients = 0.955, 0.945, 0.856, and 0.850, respectively). In addition, the rebound tonometer successfully measured IOP, regardless of whether the CL was worn; however, the non-contact tonometer failed to measure IOP in seven eyes without the CL and nine with the CL. No difference was observed according to intraocular tamponade type. Conclusions A rebound tonometer can be used as an alternative IOL measuring method in eyes for which it is difficult to use a Goldman applanation tonometer due to the postoperative presence of a therapeutic CL.

BACKGROUND: Outpatient surgery has recently grown at a substantial rate. The development and use of short acting anesthetic and analgesic agents have played a major role in the growth of outpatient surgery. This study was designed to evaluate the intraoperative hemodynamic responses and recovery characteristics, using propofol or isoflurane to maintain the anesthesia. METHODS: A total number of 30, ASA physical status I-II patients scheduled for outpatient surgery, all of whom were to undergo excision of breast mass. The patients were randomly allocated to receive either total intravenous anesthesia with propofol, or inhalation anesthesia with isoflurane after induction of anesthesia with propofol. All patients were ventilated via a laryngeal mask airway (LMA) using a mixture of oxygen and air so that the FiO2 would be 0.4. RESULTS: There were no significant differences in hemodynamic changes during anesthesia in recovery time, or in complications between the two groups. CONCLUSIONS: We conclude that both methods provide reasonably rapid and reliable recovery from anesthesia and are equally acceptable to the patients.
Ambulatory Surgical Procedures* ; Analgesics ; Anesthesia* ; Anesthesia, Inhalation ; Anesthesia, Intravenous ; Breast ; Hemodynamics ; Humans ; Isoflurane ; Laryngeal Masks ; Outpatients* ; Oxygen ; Propofol*