We report a case of primary adenocarcinoma of the urethra in 62 years old female. Primary carcinoma of the female urethra is an uncommon malignancy that accounts for less than 0.02 per cent of all cancers occurring in women. Adenocarcinoma is rare in the literature. Whereas squamous cell carcinoma and transitional cell carcinoma, which comprise the majority of urethral malignancies, arise form the squamous or epithelial cells lining the urethra, adenocarcinoma arises form the periurethral glands.
Adenocarcinoma* ; Carcinoma, Squamous Cell ; Carcinoma, Transitional Cell ; Epithelial Cells ; Female* ; Humans ; Middle Aged ; Urethra*

"Dual LAD" was defined as the early bifurcation of the proximal LAD into two vessels : a short LAD which remained in the anterior interventricular sulcus and does not reach the apex, and a long LAD which leaves the anterior interventricular sulcus only to return to the distal sulcus and continue to the apex. Recognition of "Dual LAD" is essential to prevent errors of interpretation of the coronary arteriogram and for planning of optimal surgical therapy. We report 2 cases of "Dual LAD" with the review of the literatures.
Coronary Vessels*

We studied 70 cases of transmural myocardial infarction with first attack to look into the coronary anatomy of the infarct-related artery in the time course of infarction and evaluate the left ventricular wall motion according to patency of the infarct-related artery. The following result were obtained. 1) Among 70 cases with transmural myocardial infarction, 47(67.1%) had anterior infarction and 23 (32.9%) inferior infarction. Mean age of the total cases was 52.1+/-10.6 and M:F ratio was 7.8:1. 2) 28 cases were single vessel disease(40.0%), 19 cases were two vessel disease(27.1%), 18 cases werew three vessel disease(25.8%) and 5 cases had insignificant coronary stenosis (7.3%) with 4 cases of normal coronary artery. 3) The total occlusion rate of the infarct-related artery in 70 cases was 48.6%. The total occlusion rate of the 8 cases catheterized within 1 day was 87.5%, that of the 17 cases from 2nd to 15th day 52.9% that of the 23 cases from 16th day to 2nd month 39.1%, that of the 15 cases from 3rd to 12th month 40.0% and that 7 cases from 2nd and 6th year 42.8%. These results suggest that the natural resolution of the infarct-related artery has almost happened within 2 weeks. 4) The left ventricular ejection fraction was higher and the left ventricular end-diastolic pressure was lower in the group with incomplete occulsion of infarct-related artery than in those with complete occulsion, and left ventricular wall motion was better in the group with incomplete occulsion of the infarct-related artery than in those with complete occulsion.
Arteries* ; Catheters ; Coronary Stenosis ; Coronary Vessels ; Infarction ; Myocardial Infarction* ; Stroke Volume

We report a case of 70-year-old woman who had bilateral coronary arteriovenous fistula(CAVF) and treated with percutaneous transcatheter coil embolization. Enlarged LV and reduced global LV systolic function were demonstrated on transthoracic echocardiography. Coronary angiography revealed a large coronary arteriovenous fistula from the right coronary artery to the main pulmonary artery and a small fistula from the left coronary artery to the main pulmonary artery. Percutaneous transcatheter coil embolization for CAVF from the right coronary artery to the main pulmonary artery was successfully performed with symptomatic improvement.
Aged ; Arteriovenous Fistula* ; Coronary Angiography ; Coronary Vessels ; Echocardiography ; Embolization, Therapeutic* ; Female ; Fistula ; Humans ; Pulmonary Artery

PURPOSE: To evaluate the clinical usefulness of venous filling time (VFT) in proliferative diabetic retinopathy (PDR) and the relation of VFT with PDR complications. METHODS: Retinal circulation time (RCT) such as ART (arm to retinal circulation time), AVP (arteriovenous passage time), and VFT (venous filling time) were obtained by video fluorescein angiogram using SLO (Scanning Laser Ophthalmoscope), after which PRP (panretinal photocoagulation) was performed. We performed two studies on 39 patients, (39 eyes), who had PDR. In the first study, according to the development of complication, patients were classified into 2 groups, stabilized and complicated groups. In the second study, according to the score of the risk factor by DRS (Diabetic Retinopathy Study), patients were classified into 4 groups, A (1 score), B (2 score), C (3 score), and D (4 score) groups. RCTs, especially VFT were analyzed with each group. RESULTS: In the Mann-Whitney test, the Z-values of ART, AVP and VFT were -1.92, -0.49, and -2.59, respectively. There was a significant difference only in VFT(P<0.05). According to the risk factor scores, VFTs were 7.48 +/- 1.36, 7.84 +/- 0.91, 9.15 +/- 1.10, and 10.94 +/- 0.44 sec in A, B, C, and D groups, respectively. In each group, there were significant differences, except between A and B. CONCLUSIONS: VFT was delayed in the complicated group. With increasing risk factor score, VFT was more delayed. We suggest that VFT is a predictable indicator of the progression and development of complication in PDR.
Diabetic Retinopathy* ; Fluorescein ; Humans ; Retinaldehyde ; Risk Factors

Patients with hypertrophic cardiography often complain of chest pain and have electrocardioagrams suggesting myocardial damage or ischemia. Some of three patients have associated coronary arterial atherosclerosis. Transmural myocardial infarction may occur in patients with hypertrophic cardiomyopathy in the absence of significant atherosclerosis of the extramural coronary arteries, about which several pathophysiologic exlpanations were discussed. Presented here, a case of 49-year-old man with hypertrophic cardiomyopathy accompanied with myocardial infarction and angiographically normal coronary arteries is reported. Asymmetric septal hypertrophy, characteristic morphologic abnormality of hypertrophic cardiomyopathy, was progressed to dilated cardiomyopathy after the occurrence myocardial infarction.
Atherosclerosis ; Cardiomyopathy, Dilated ; Cardiomyopathy, Hypertrophic* ; Chest Pain ; Coronary Vessels ; Humans ; Ischemia ; Middle Aged ; Myocardial Infarction*

No abstract available.
Cartilage* ; Fascia* ; Transplants* ; Tympanoplasty*

Renal tubular acidosis is a clinical state of systemic hyperchloremic acidosis resulting from impaired urine acidification. Medullary sponge kidney is a renal parenchymal malformation characterized by cystic dilatation of the collecting ducts. Although medullary sponge kidney is a congenital disease, it is rarely identified in childhood and is usually discovered in adulthood. Medullary sponge kidney patients may have defects in urinary acidification and concentration mechanism. We experienced a case of distal renal tubular acidosis associated with medullary sponge kidney. So, we report a case of distal renal tubular acidosis associated with medullary sponge kidney with a brief review of the related literature.
Acidosis ; Acidosis, Renal Tubular* ; Dilatation ; Humans ; Medullary Sponge Kidney*

OBJECTIVES: Catecholamine metabolism has been thought to be related to the pathophysiology of panic disorder. There are two human COMT alleles, coding for a low activity enzyme, COMT L(L), and a high activity enzyme, COMT H(H), respectively. We examined the distribution of COMT genotypes and the relationship between COMT genetic polymorphism and some clinical characteristics in patients with panic disorder. METHOD: We recruited 51 patients who met the DSM-IV criteria for panic disorder, and 45 normal control subjects who had neither medical nor psychiatric illnesses. Genetic polymorphism of COMT was identified in all subjects using PCR-based restriction fragment length polymorphism(RFLP) analysis. We assessed some clinical variables including treatment responses in panic patients and measured anxiety and depression levels in normal control subjects using Spielberger State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI). RESULT: The frequency of the homozygous LL genotype was higher in panic patients than that in control subjects (19.6% vs. 2.2%). We found that panic disorder was significantly associated with L allele (x2=8.66, p=0.003) and LL genotype(x2=8.45, p=0.015). Panic patients with LL genotype showed poorer treatment response than those with other genotypes (F=4.98, p=0.011). CONCLUSION: These results suggest that LL genotype of the COMT gene may be related to the pathophysiology and clinical courses in some patients with panic disorder.
Alleles ; Anxiety ; Catechol O-Methyltransferase* ; Clinical Coding ; Depression ; Diagnostic and Statistical Manual of Mental Disorders ; Genotype ; Humans ; Metabolism ; Panic Disorder* ; Panic* ; Pilot Projects* ; Polymorphism, Genetic*

The effect of oral nicorandil were evaluated by a 9-day double-blind cross-over protocol on 16 subjects with angina pectoris referred to our cardiology clinic from June '84 through September '85. total daily doses were 15-45mg. The effects were measured by 3 seperate treadmill exercise EKG tests and symptom reviews on each patient. The following results were obtained. 1) The mean age of the patients was 57.4+/-7.2 years. These were 14 male and 2 female patients. 2) Resting heart rate on nicorandil was 73.6+/-14.0 beats/min and 70.5+/-14.0 beats/min in placebo(P<0.05). There were no significant effects of nicorandil on resting blood pressure and heart rate-blood pressure product. 3) Peak exercise heart rate was 126.4+/-22.5 beats/min on nicorandil and 121.8+/-21.4 beats/min on placebo(P<0.05). There were no significant effects of nicorandil on blood pressure after exercise and peak heart rate-blood pressure product(x10(-3)) after nocorandil was 20.2+/-5.0 and 18.9+/-4.6 on placebo(P>0.05). 4) Exercise duration was 485.8+/-107.7 sec on nicorandil and 423.3+/-101.9 sec on placebo(P<0.001). 5) The exercise duration was prolonged in 11 cases(68.7%), showed on change in 2 cases(12.5%), and shortened in 3(18.8%). 6) There were attacks of chest pain during placebo period in 2 cases, but none developed during nicorandil period. 7) Headache was noted in 2 patients, and in one of them, it was so severe as to discontinue nicorandil stydy. No other side effects were noted. In conclusion, additional therapeutic benefit can be obtained by nicorandil in patients with severe angina in spite of conventional antianginal agents already being administered.
Angina Pectoris* ; Blood Pressure ; Cardiology ; Chest Pain ; Cross-Over Studies* ; Electrocardiography ; Female ; Headache ; Heart ; Heart Rate ; Humans ; Male ; Nicorandil*