We have experienced an unusual case of hemorrhagic renal cyst in the rt. kidney at 58 years old woman. The Rt. kidney was enlarged, and showed a few subcapsular ischemic areas The color of kidney was dark brown. As the cyst at lower pole of rt. kidney was dissected, hemorrhagic fluid visualized in the cystic cavity. The final pathologic finding was renal cyst associated with malignant change and renal cell carcinoma at another renal parenchyma. Herein, hemorrhagic renal cyst, a rare clinical entity, was reported with review of literatures.
Carcinoma, Renal Cell ; Female ; Humans ; Kidney ; Middle Aged

No abstract available.
Heart Valve Prosthesis* ; Heart Valves*

No abstract available.
Diaphragmatic Eventration* ; Humans ; Infant, Newborn*

Incidence of non-contiguous multiple spine fracture was increased from 3.2%~4.5% at 1960th and 70th to 5.7% ~23.8% at 80th and 90th. But there is no reports in Korea which has high incidence of traffic and industrial accidents. In 345 consecutive patients with acute spine fracture, we found that 43 patients (12.5%) had multiple non-contiguous spine fractures. At the 43 patients studies 37 (87.4%) sustained fractures at 2 levels while 6 had more than 3 levels of injury, 26 were injured by fall from heights, 27 (62.8%) had 2.33 associated injuries on an average, and 12 (27.9%) had a neurologic deficit. There are five patterns account for 26 (50%) of the total number of patients. In 19 patients (44.2%), there was a mean 29.3 days delay (from 3 to 233 days) in diagnosis of the minor lesions. In 19 delay diagnosed minor lesions, it confirmed by bone scan in 12 patinets(63.6%). Two patients died within 24 hours after accident, and 41 patients (41 major and 50 minor fractures) were treated in our hospital. Among them, 21 (51.2%) needed modification of treatment by the presence of non-con- tiguous multiple spine fractures. According to above findings, the physician must be aware of the possible noncontiguous multiple spine fractures when examine and treat the patients with spine fracture.
Accidents, Occupational ; Diagnosis ; Humans ; Incidence ; Korea ; Neurologic Manifestations ; Spine

No abstract available.
Tetralogy of Fallot*

Interleukin-6 (IL-6) and its receptor are presumed to play important roles in the developing nervous system. However, little is known about their potential role(s) in the developing kidney. To investigate this, we have studied the expression of IL-6 and its receptor (IL-6R) in the developing rat kidney. Kidneys from 16- (F16), 18- and 20-day-old (F20) fetuses, 1- (P1), 3- (P3), 7- (P7) and 14-day-old (P14) pups, and adult rats were extracted. Renal expressions of IL-6 and its receptors were examined by immunohistochemistry and in situ hybridization respectively. Il-6 protein already appeared in F16. The early stage of renal development before birth, IL-6 showed strong immunoreactivity in the ureteric bud, metanephric mesenchymal cells (MMC) and developing glomerulus. The expression pattern of IL-6 in nephrogenic zone are very similar even after birth. In matured nephron after birth, IL-6 immunoreactivities were detected in distal tubules strongly, and collecting ducts moderately and thick ascending limb weekly. IL-6R hybridization signals have also already appeared in 16-day old fetal kidney. Before birth, IL-6R mRNAs were expressed in ureteric bud, MMC and developing glomerulus. In the matured nephron after birth, IL-6R mRNA was expressed in the thick ascending limb, distal tubules, collecting ducts and S3 segment of proximal tubule. These results suggest that IL-6 and its receptor may be involved in regulation of nephron formation in nephrogenic zone of rat, and play a role in distal nephron including collecting duct after birth.
Adult ; Animals ; Extremities ; Fetus ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Interleukin-6* ; Kidney* ; Nephrons ; Nervous System ; Parturition ; Rats* ; RNA, Messenger ; Ureter

OBJECTIVE: Metabolic syndrome (MS) is associated with increased left ventricular (LV) mass and diastolic dysfunction. This study uses relatively load-independent Doppler tissue echocardiography to examine whether MS is associated with decreased longitudinal contractile reserve during dynamic exercise. METHODS: A total of 112 patients with relatively well-controlled, treated hypertension who complained of exertional dyspnea were enrolled (average age, 56.7+/-10.5 years). Fifty-six were non-diabetic patients with MS (group 1), and 56 were age-sex matched hypertensive patients without MS (group 2). Exercise stress echo was performed using a symptom-limited, multistage, supine bicycle exercise test. Multiple Doppler parameters were obtained at baseline, at each stage of exercise. RESULTS: There was no significant difference between the two groups in terms of age, gender, and hemodynamic variables. E/E', an index of LV filling pressure, was significantly higher in the MS group at rest and during exercise. The longitudinal contractile reserve, the change in S' (longitudinal tissue velocity) from baseline to peak exercise, was significantly lower in the MS group (2.00+/-1.65 vs. 2.90+/-1.66, P=0.015). Multiple regression analysis showed independent association of MS with longitudinal contractile reserve when controlled for confounding factors, such as LV mass index, gender, blood pressure, and age (beta=-0.235, P=0.035). CONCLUSION: Longitudinal contractile reserve was reduced in MS patients compared to others, although both groups demonstrated similar longitudinal contractile function at rest. We present the first demonstration that metabolic syndrome is independently associated with LV systolic dysfunction during exercise in hypertensive patients.
Blood Pressure ; Dyspnea ; Echocardiography ; Exercise Test ; Hemodynamics ; Humans ; Hypertension

No abstract available.
Tuberculosis, Pulmonary*

BACKGROUND: Although medical students' clinical competence should be assessed systematically and objectively, written exams or faculty's subjective methods were used in the past. We assessed the clinical competence of the family medicine clerkship students using the OSCE and evaluated the reliability and the validity of the OSCE. The purpose of this study was to find the logistic problems and the feasibility of the OSCE to an entire clerkship evaluation. METHODS: Twenty six volunteers took part in the OSCE. Ten, 5-minute long stations, were divided into 4 areas: 3 for history taking, 3 for physical exam, 3 for technical skill, and 1 for interview skill areas. RESULTS: Eleven students were examined on first session and 15 students on second session 4 weeks later. The mean OSCE score was 65.5 5.63. The reliability of the total stations was 0.615. The total OSCE score was not different by the sessions, but there was a significant difference in the two stations where the examiners had been changed. There were statistically significant correlations between the total OSCE score and the two previous written exams (r=0.56, 0.54, P<0.01). There was no significant logistic problem and the examinees showed positive responses to the OSCE. CONCLUSION: The OSCE was a useful tool for assessing the clinical competence of family medicine clerkship students. The reliability of the OSCE was moderate and in order to extend the OSCE to an entire clerkship evaluation, we need further study to acquire a higher reliability and validity.
Clinical Competence* ; Humans ; Reproducibility of Results ; Volunteers

Lung hernia is defined as a protrusion of lung parenchyma beyond the confines of the musculoskeletal thorax. To date, less than 300 cases have been reported in the literature. The patients were 37 and 57-year-old men who had traumatic rib fractures in the past, whose chief complaint was a painless soft bulging mass increased in size during expiration or coughing and diminished during inspiration or quiet breathing. The primary repair was performed without any postoperative recurrance. We report two cases of acquired herniation of lung first time in Korea with a brief review of literature.
Cough ; Hernia ; Humans ; Korea ; Lung* ; Male ; Middle Aged ; Respiration ; Rib Fractures ; Thorax