Journal of Yeungnam Medical Science

Hyun Woo Lee

57 Articles

Vaginal removal of mature cystic teratoma in postmenopausal woman.: Ki Mog Jung, Hyun Woo Lee, Ki Wan Kim, Min Whan Koh; Yeungnam Univ J Med. 2001;18(2):293-296. Published online December 31, 2001; DOI: https://doi.org/10.12701/yujm.2001.18.2.293

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Abstract PDF: Mature cystic teratomas, commonly called dermoid cysts, are the most common benign germ cell tumors of ovary in women of reproductive age. Mature cystic teratoma that constitutes 10-25% of ovarian tumors and 95% of teratoma, is germ cell tumor of the ovary. This occurs frequently in women less than 20 years old, but it can be found upto 10-20% in postmenopausal women. And in women over the age of 50, a mature cystic teratoma is likely to change into malignant form. Traditional surgical methods of mature cystic teratoma treatment include transabdominal cystectomy, oophorectomy, hysterectomy and(or) bilateral salphingooophorectomy. Recently laparoscopic approach replaces transabdominal surgeries in many cases. Vaginal removal of mature cystic teratoma is unique and rare. Compared with laparotomy, transvaginal approach is characterized by shorter hospital stay and lower morbidity rate. Compared with laparoscopic operation, transvaginal approach has advantages of no visible operative scar and lower intra-operative tumor spillage. The decision for surgical methods is related with patients' situations and surgeon's preference. We report 1 case of vaginal removal of mature cystic teratoma as a part of vaginal hysterectomy in old age patient.

The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.: Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.219

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Abstract PDF: BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).

A Clinical study on the Hypercalcemia in Primary Bronchogenic Carcinoma.: Hye Jung Park, Kyeong Cheol Shin, Young Chul Moon, Jin Hong Chung, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):208-218. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.208

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Abstract PDF: BACKGROUND
Lung cancer-associated hypercalcemia is one of the most disabling and life-threatening paraneoplastic desorders. Humoral hypercalcemia is responsible for most lung cancer-associated hypercalcemia. Patients with hypercalcemia are usually in the advenced atage with obvious bulky tumor and carry a poor prognosis. MATERIALS AND METHODS: Total 29 patients satisfied the following criteria: histologically proven primary lung cancer, corrected calcium level> or =10.5 mg/dL, and symptons which could possibly be attributed to hypercalcemia. In this retrospective study, we evalluated the various clinical aspects of hypercalcemia, in relation to cancer stage, histologic cell type, mass size, bone metastasis, performance status, and other possible characteristics RESULTS: Total 29 lung cancer patients with hypercalcemia were studied, and most of them had squamous cell carcinoma in their histologic finding. The incidence of hypercalcemia was significantly higher between 50 and 69 years of age, and in the advancement of cancer stage. Although serum calcium level showed positive correlation with mass size, performance statusm and bone ore frequent in the patients with higher serum calcium level. There were no differences in effectiveness among therapeutic regimens. Hypercalcemia was more frequently in the later stage of disease than during the initial diagnosis of lung cancer. Most of the patients died within 1 month after development of hypercalcemia. CONCLUSION: We concluded that hypercalcemia in lung cancer is related to extremely poor prognosis, and may be one of the causes of drath and should be treated aggressively to prevent sudden deterioration or death.

The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection.: Hak Jun Lee, Hye Jung Park, Chang Jin Shin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1998;15(2):246-253. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.246

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Abstract PDF: Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safty of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had sign and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were : 1) A total 30 patients were enrolled in the trial. Among them 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria in Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggest that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

A Case of Parathyroid Carcinoma with Systemic Calcification.: Heui Sik Kim, Chan Woo Lee, Sang Yiup Nam, Jin Chul Park, Ji Sang Yoon, Jae Chun Lee, Kyu Chang Won, Ihn Ho Cho, Tae Nyun Kim, Hyoung Woo Lee, Myung Soo Hyun, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(2):459-466. Published online December 31, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.2.459

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Abstract PDF

Hyperparathyroidism due to parathyroid cancer is rare. It is difficult to diagnose preoperatively but there should be an increased index of suspicion in those parathyroid Patient with palpable neck masses, profound hypercalcemia(greater than 14mg/dl), made increase of the parathyroid hormone level to greater than twice normal, and significant metabolic complications. In parathyroid cancer, systemic calcinosis is an extremely rare manifestation. The most common metastatic calcification site is lung and the other involved site is stomach, liver, skin and heart. After resection of parathyroid tumor, this systemic calcinosis is self-limiting. We experienced a patient with primary hyperparathyroidsm, presented with metastatic calcification in the lung and stomach disappeared by successful parathyroidectomy.

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A Case of Parathyroid Carcinoma in a Patient with Stage 3 Chronic Kidney Disease
Youn Hee Cho, Moo Yong Park, Soo Jeong Choi, Jin Kuk Kim, Seung Duk Hwang, Jung Mi Park, Jeong Ja Kwak
Korean Journal of Medicine.2012; 83(6): 796. CrossRef

The Clinical Study of Clarithromycin for the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease.: Ki Beom Kim, Chang Jin Shin, Hak Jun Lee, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1997;14(1):94-100. Published online June 30, 1997; DOI: https://doi.org/10.12701/yujm.1997.14.1.94

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Abstract PDF: To evaluate the efficacy and safety of clarithromycin in acute exacerbation of chronic obstructive pulmonary disease, we administered clarithromycin(250mg) twice in a day in 30 patients with acute exacerbation of chronic obstructive pulmonary disease from September to November in 1996. Twenty eight eases of 30 patients were cured(93.4%) and 2 cases(6.7%) show clinical improvement. Three cases were improved within 3 days of treatment and 24 cases were improved between 5 days and 12 days of treatment. There were no significant side effects. These results suggest that clarithromycin will be effective as a first line therapy in patients with acute exacerbation of chronic obstructive pulmonary disease.

Two Cases of Adenoid Cystic Carcinoma of the Left Main Bronchus and Trachea..: Young Bog Cho, Hak Jun Lee, Ki Beom Kim, Jin Hong Jung, Kwan Ho Lee, Hyun Woo Lee, Mi Jin Kim; Yeungnam Univ J Med. 1996;13(2):347-359. Published online December 31, 1996; DOI: https://doi.org/10.12701/yujm.1996.13.2.347

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Abstract PDF: Adenoid cystic carcinoma is an uncommon histologic variant of adenocarcinoma which usuallyy arises from the salivary, lacrimal, or other exocrine glands. Characteristics of adenoid cystic carcinoma are its potential fo extending long distance submucosally and for perineural invasion. It grows slowly and may have a prolongec course before diagnosis and after treatment. Recently, we have experienced 2 cases of adenoid cystic carcinoma arising from main bronchus and trachea. One case was 58 years old female patient. Her symptoms were productive cough with dyspnea. She ha been history of shortness of breath, wheezing and cough during 4 years, which was initially diagnosed a bronchial asthma. The tumor was located on the left main stem bronchus which was obstructed the lumei nearly complete, by CT demonstration.

A Case of Plummer-Vinson Syndrome.: Kyeong Jin Jeon, Byeong Ik Jang, Tae Nyeun Kim, Moon Kwan Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(2):381-387. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.381

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Abstract PDF: Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.

A Case of Idiopathic Hypereosinophihc Syndrome Assoclated with Pulmonary Infiltration.: Hun Mo Ryoo, Young Soo Kweon, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee, Dong Sug Kim, Sam Beom Lee; Yeungnam Univ J Med. 1994;11(2):375-380. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.375

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Abstract PDF: The idiopathic hypereosinophilic syndrome consists of peripheral blood eosinophilia of 1500/mm3 or more without a known cause, plus signs and symptoms of organ eosinophilia. The prognosis of HES without treatment is poor. However, about one third of the patients with this syndrome may respond to corticosteroid thrapy. Morever, the majority of the remainder may have a favorable response to hydroxyurea. We present here a case of hypereosinophilic syndrome without any identifiable causes, involving bone marrow, liver, lungs and cervical lymph node. We tried corticosteroid as a treatment but it showed no response. However the hydroxyurea showed good response.

Isolation of Acid-fast bacilli from Tissues of Extrapulmonay Tuberculosis.: Jin Woo Rho, Hee Jin Choi, Hyeung Il Kim, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee, Sam Beom Lee; Yeungnam Univ J Med. 1994;11(2):240-247. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.240

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Abstract PDF: To evaluate the isolation rate of acid-fast bacilli on Ziehl-Neelsen stain from biopsy specimens of extrapulmonary tuberculosis proven by chronic granulomatous inflammation, 286 cases of extrapulmonary tuberculosis were reviewed and the results are as follows : 1) Mean age was 27.3 years old and lymphatic tuberculosis was more prevalent in the female but others were more common in the male. 2) The most common site of extrapulmonary tuberculosis was pleura (103 cases ; 36%) followed by lymph nodes (87 cases ; 30.4%), gastrointestinal tract (27 cases ; 9.4%), skin and soft tissue (23 cases ; 8.0%), bone (19 cases ; 6.6%), urinary tract (14 cases ; 4.6%), larynx (9 cases ; 3.2%) and breast (5 cases ; 1.8%) in order of frequencies. 3) Of 286 cases, 30.4%, (87 cases) of the biopsy specimens showed acid fast bacilli on microscopy. The isolation rate according to the sites was slightly higher in breast and lymph nodes as 3 of 5 cases (60.0%) and 35 of 87 cases (40.2%) respectively, and followed by 3 of 9 cases (33.3%) in the larynx, 4 of 13 cases (30.8%) in the urinary tract, 5 of 19 cases (26.3%) in the bone, 7 of 27 cases (25.9%) in the gastrointestinal tract, 26 of 103 cases (25.2%) in the pleura, and 4 of 23 cases (17.4%) in the skin and soft tissue, in order of frequencies. 4) The prevalence of extrapulmonary tuberculosis associated with pulmonary tuberculosis on chest X-ray was 85 of 286 cases (29.7%).

Determinants of Successful Percutaneous Transluminal Coronary Angioplasty.: Kyo Won Choi, Jun Young Kweon, Yeung Jin Kim, Tae Il Lee, Dong Gu Shin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Sam Beom Lee; Yeungnam Univ J Med. 1994;11(2):230-239. Published online December 31, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.2.230

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Abstract PDF: In Order to evaluate determinants of successful percutaneous transluminal coronary angioplasty (PTCA), PTCA was performed for 172 coronary arterial lesions in 120 patients(89 male, 31 female) at Yeungnam university hospital from Sep. 1992 to Aug 1993. The corinary artery luminal diameter at the site of the original stenosis was eveluated from end-diastolic frames of identical projections of the preangioplasty and immediate post angioplasty. The coronary luminal and balloon diameters were measured with using of computer measuring system. Overall success rate of 172 attempted lesions was 87.2%. Success rate of female patients was 93.5% and higher than those of male patients. According to the clinical diagnosis, success rate in stable angina was 93.7% and higher than those of post myocardial infarction angina, unstable angina and acute myocardial infarcrion. Success rate of American Heart Association type C lesion was 65.5% and lower those of type A(95.7%), type B (89.%). There was significantly difference in preangioplasty luminal stenosis, elastic recoil and length of lesion between successful PTCA group and failed PTCA group. Success rate of lesion location at a bed >45° and presence of intracoronary thrombus were lower than than those of other angiographic findings. In coclusion, primary angioplasty success was affected by specific angiographic factors, Stenosis severity, thrombus, lesion location at a bend >45°, elastic recoil, and length of lesion were the principle of determinants of coronary angioplasty success rate.

A Case of Amiodarone-induced Interstitial Lung Disease: Byeong Hun Kim, Won Jong Park, Jin Hong Chung, Kwan Ho Lee, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):186-192. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.186

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Abstract PDF: Amiodarone has a potent suppressive effect on supraventricular and ventricular dysrhythmias, so has widely used as a class III antiarrhythmic agent. However, significant side effects were noted in over 50% of patients treated. Pulmonary toxicity represents the most serious adverse reaction limiting the clinical efficacy of this new antidysrhythmic drug. A 66-year-old male had received amiodarone 200 mg/day for 7 months to control high grade ventricular premature contraction and was admitted due to dyspnea on exertion for 1 week. At the time of admission end-inspiratory crepitant rale was heard on auscultation. The roentgenogram of his chest revealed reticular and granular radiopaque densities on both lower lung fields and high resonance CT revealed interstitial fibrosis and pneumonic consolidations on the periphery of the both middle and lower lobes. Trans-bronchoscopic lung biopsy revealed non-specific interstitial fibrosis. The laboratory findings were non-specific. We present a case of amiodarone-induced interstitial pulmonary disease clinically improved by corticosteroid therapy

A Case of Disappearing Symptoms Developed Repetitively in a Complete Atrioventricular Block Patient Implanted Bipolar Permanent Pacemaker After Converting It into Unipolar System.: Jun Young Kweon, Kyo Won Choi, Dong Gu Shin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):181-185. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.181

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Abstract PDF: Pacemaker malfunctions are secondary to alterations of the preset pacing rate, irregular pacing failure of sensing, failure of cardiac capture or depolarization, and various combinations of these events. A 76 years old male patients was admitted due to pacemaker malfunction. 2 years ago, he was diagnosed as complete atrioventricular block. And then bipolar permanent pacemaker was implanted. Since then syncopal attack developed repetitivly. 12 lead ECG and 24 hour holter moniter monitoring, revealed pacing and sensing failure, thus we converted bipolar system into unipolar system. since then syncopal attack did not developed again.

Analysis of Polar Maps of Dipyridamole Stress/Rest Tc-MIBI Myocardial SPECT in 14 Healthy Young Men.: Ihn Ho Cho, Dong Gu Shin, Hyoung Woo Lee, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):146-152. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.146

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Abstract PDF: We performed the same day dipyridamole stress/rest myocardial SPECT in 14 healthy young men, reconstructed the polar maps according to Cedars-Sinal method and quantitated the radioactivity of myocardial wall. We divided the whole myocardium to 9 sectors. The latero-anterior wall contains the highest count. The infero-septal wall contains the lowest count. There isn't any significant differences of radioactivity in each segment between stress and rest polar map. The hemodynamic parameters after dipyridamole injection in the subjects were significantly changed except systolic blood pressure : the heart rate was increased and diastolic blood pressure was decreased. Adverse effects were reported in 85.7%. We suggest that these data can be used to dectect perfusion defect in the coromary artery disease.

Prevalene of Secondary Hypertension in Yeungnam University Hospital.: Jun Young Kweon, Kyo Won Choi, Dong Gu Sin, Hyoung Woo Lee, Kyeung Woo Yu, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):109-114. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.109

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Abstract PDF: We studied the incidence and results of treatment of secondary hypertension in Yeungnam University Hospital. Nineteen hundred fifty patients with hypertension were included from march 1990 to march 1994. We analysed the prevalence of secondary hypertension and results of treatment. The incidence of secondary hypertension in Yeungnam University Hospital was six percent. The most common underlying causes of secondary hypertension was renal parenchymal disease. Patients with three forms of potentially reversible secondary hypertension, namely, renovascular hypertension, endocrine disease, exogenous hormone, were assed to determine whether surgery or withdrawal of the exogenous hormane had led to an improvement in blood pressure control. The incidence of secondary hypertension in Yeungnam University Hospital was low(6%), but some of these are curable. Thus it is very inportant that evaluate the secondary hypertension.

Estimation of Glomerular Filtration Rate(GFR) Using (99m)Tc-DTPA Renal Scan and the Parameters for Renal Function.: Ihn Ho Cho, Hyun Dae Yoon, Kyu Chang Won, Chan Woo Lee, Hyoung Woo Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1994;11(1):101-108. Published online June 30, 1994; DOI: https://doi.org/10.12701/yujm.1994.11.1.101

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Abstract PDF: Many previously described nuclear medicine procedures to assess glomerular filtration rate have some problems because numerous blood sample is to be taken and they don't measure each separate renal function. Gates described isotopic method for the measurement of global and unilateral GFR based on the fractional renal uptake of (99m)Tc-DTPA 2 to 3 minutes after its intravenous injection. We evaluated GFR using (99m)Tc-DTPA in 57 people according to Gates method and compared with creatinine clearance. A good correlation was observed between creatinine clearance and GRF calculated by Gates' formula with an r value of 0.9(P<0.05). And also the relationship between parameters of (99m)Tc-DTPA renal scan images and GFR was taken. They were significantly correlated with GFR calculated by Gates' formula : r value 0.66 between relative intensity of peak renal to peak aortic activity(pK/pA) and GFR, -0.42 between time between aortic and kidney peak(A-K) and GFR and -0.48 between parenchymal renal activity at 25 min compared to peak kidney activity(25K/pK) and GRF. In conclusion, the determination of GFR according to Gates' formula shows good and reproducible of GRF with rapidity and simplicity. And the parameters from the renal scan images can use to estimate the renal function.

Emphysematous pyelonephritis : a case report and review of the literature.: Hyun Dae Yoon, Kyu Chang Won, Chan Woo Lee, In Ho Jo, Hyung Woo Lee, Kyung Woo Yoon, Heun Ju Lee, Hyun Woo Lee, Cheol Kyu Cho; Yeungnam Univ J Med. 1993;10(2):537-543. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.537

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Abstract PDF: Emphysematous pyelonephritis is a necrotizing renal infections characterized by intrarenal and occasional perirenal gas production. Although uncommon (89 cases in the literature), it occurs almost exclusively in diabetic patients (87% of the cases). Prompt and aggressive management is required to sahage these patients. We describe a recent case of a diabetic woman with emphysematous pyelonephritis due to E. Coll, successfully managed with unilateral nephrectomy.

Two cases report of bronchial carcinoid tumors.: Kyo Won Choi, Jeong Ill Suh, Sung Suk Kim, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee, Dong Hyup Lee, Jung Cheul Lee, Sung Sae Han; Yeungnam Univ J Med. 1993;10(2):525-536. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.525

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Abstract PDF: Bronchial carcinoid tumor was a low grade malignant and it was regarded as predictable clinical course and good survivality after surgical resection. But despite of its low grade malignant potentiality, bronchial carcinoid tumor was clearly capable of metastasizing and causing death. We present 2 cases of bronchial carcinoid tumors. One of them was typical carcinoid tumor in 44 year-old female and another was atypical carcinoid tumor in 53 year-old male patient. Currative therapeutic procedure was performed by lobectomy and wedge resection.

Hyperinfection of strongyloides stercoralis.: Kyeong Cheol Shin, Jun Ha Chun, Chan Weon Park, Choong Ki Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1993;10(2):518-524. Published online December 31, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.2.518

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Abstract PDF: Strongylodiasis is universal in distribution but is most abundant in countries with a tropical climate. Although infestation by Strongyloides stercoralis is usually limited to the intestines, dessemination of this helminth in debilitated host can be lead to death with various clinical disorders. characterized by profound malabsorption, diarrhea, electrolyte imbalance, gram negative or opportunistic fungal sepsis, coma and death. Cell-mediated immunity contributing significantly to the control of helminthic infections, may be suppressed by carcinoma, immunosuppressive chemotherapy and use of corticosteroids. Diagnosis of Strongyloidiasis is achieved by an examination of samples of feces, duodenal aspirates and sputum of patients for Strongyloides stercoralis. Treatment of strongyloidiasis is twofold : correction of the immunosuppressive state by withdrawal of immunosuppressive drug, if possible, and vigorous treatment with thiabendazole. Testing for strongyloidiasis is especially recommanded before treating a patients should be monitored for infection by Strongyloides stercoralis and other opportunistic infection. We are reporting a case patient with Strongyloides stercoralis hyperinfection and pulmonary tuberculosis who had been. used corticosteroid for persisting polyarthritis.

A case of free-floating left atrial ball thrombus in mitral stenosis.: Young Jin Kim, Tea Il Lee, Kyo Won Choi, Seung Ho Kang, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Eun Pyo Hong; Yeungnam Univ J Med. 1993;10(1):237-244. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.237

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Abstract PDF: A free-floating ball thrombus in the left atrium is a rare complication of the mitral valvular disease. A 53-year-old man was admitted for pain and paresthesia on both legs. On admission he had auscultatory sign of mitral stenosis and mitral regurgitation, and the roentgenogram of his chest revealed a slight pulmonary ve..ous congestion, enlargement of the pulmonary conus and cardiomegaly. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal. An echocardiographic examination revealed a mitral stenosis and a free-floating ball thrombus in the left atrium. We performed the emergent open heart surgery for removal of the ball thrombus and mitral replacement successfuly with Duromedics 29 mm valve. The size of thrombus was 39 X 32 X 30 mm.

Comparision of signal - averaged electrocardiography (SAECG) determined by flank lead system (FLS) and pyramidal lead system (PLS) in healthy young adults.: Byeong Ik Jang, Seung Ho Kang, Hyeung Il Kim, Dong Gu Sin, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1993;10(1):179-189. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.179

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Abstract PDF: It has recently become possible to record electrical activity originationg from abnormally conducting myocardium from the body surface with high-gain amplification and averaging technique. These signals, which result from delayed ventricular activation(late potentials), have been recorded in patients with documented ventricular tachyarrythmia. Several electrode lead system for detecting ventricular late potential were introduced. Pyramidal electrode lead system(PLS) is useful. Also interpretation of SAECG in the young could be of value in detecting those at risk for episodic ventricular tachycardia, but suffer from a lack of data in normal young people. There was no difference between normal values, determined by FLS and PLS at high pass filtering of 25 Hz and 80 Hz, but significant, difference was found in HFLAD and RMS-40 of 40 Hz (p<0.05). These results will provide a basis for interpretations of SAECG, determined by FLS and PLS in healthy young adults with normal QRS duration. SELECTION OF SUBJECTS: For this study, normal healthy young adult volunteers (age : mean 24 years) were recruited from the medical students at Yeungnam University Hospital, Internal Medicine. Twenty fourths male and seventeenths female subjects were selected. All subjects had normal resting ECGs as judged from both the standard 12 channel lead and echocardiography, and none had a history of cardiovascular disease. All subjects were considered to be in good general physical condition. SIGNAL-AVERAGED ELECTROCARDIOGRAPHY: In order to obtain low noise recordings with a small number of averaging cycles, all subject ware asked to relax completely in the supine position. Silver/silver chloride electrodes were attached after the skin was cleaned with alcohol, to constitute classic flank lead system(FLS) and pyramidal lead system(PLS). Signals were recorded and processed using a commercially available microprocessor-augmented ECG cart(Marquette Electronics, USA) suitable for portable bedside recording.

Clinical observation of the pulmonary aspergilloma.: Hyeung Il Kim, Sung Sook Kim, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1993;10(1):157-165. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.157

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Abstract PDF: The authors conducted a clinical observation of 13 cases of pulmonary aspergilloma at Yeungnam University Hospital from March 1983 to March 1992, and the following results were observed: 1) The male to female ratio was 1 : 1.2, and the age distribution was ranged 30 to 67 years old. 2) All cases were symptomatic : hemoptysis, cough, sputum and dyspnea. Especially, hemoptysis was the presenting compliant in 10 patients (77%) 3) The underlying lung disease were pulmonary tuberculosis in 9, COPD in 5 and bronchiectasis in 2. 3 cases were without underlying disease. 4) According to radiographic appearance, 8 cases had the typical crescent sign and 5 cases were seen nodular lesion. And the lesions of 11 cases were located in both upper lung. 5) 10 cases were treated with surgical resection. Among these cases, 8 cases were alieved and 2 cases, died. And other 3 cases were treated with conservative treatment. We suggest that these findings would be helpful for the diagnosis and treatment of pulmonary aspergilloma and further study might be needed to evaluate the prognosis of pulmonary aspergilloma.

High Frequency Ventilation.: Hyun Woo Lee, Kwan Ho Lee; Yeungnam Univ J Med. 1993;10(1):1-17. Published online June 30, 1993; DOI: https://doi.org/10.12701/yujm.1993.10.1.1

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Abstract PDF: No abstract available.

Gastric mucosal damage by bile acid.: Hyun Hong Cho, Jeong Ill Suh, Keyong Hee Lee, Tae Nyeun Kim, Moon Kwan Chung, Hyun Woo Lee, Won Hee Choi, Chang Heon Yang; Yeungnam Univ J Med. 1992;9(2):342-350. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.342

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Abstract PDF: To investigate the effect of bile acid on gastric mucosa, we performed biologic test using Sprague-Dawley rat. Mixture solution of TDCA 15mM and Hcl of pH 3 was given into stomach to one group and HCl of pH 3 was given into stomach to another group. The significant gastric mucosal change was vasodilation and edema, that was disappeared progressively. These findings suggest the bile acid and damage gastric mucosa.

Clinical observation of aortic dissection.: Byeong Ik Jang, Jin Ho Park, Dong Ku Shin, Yeoung Jo Kim, Bong Sup Shim, Hyun Woo Lee, Su Hyen Kim, Sung Sae Han; Yeungnam Univ J Med. 1992;9(2):334-341. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.334

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Abstract PDF: A clinical review of 34 cases of aortic dissection which were admitted to Yeungnam University hospital between March 1983 and April 1992. The results are as follows: 1. The peak incidence was in 5th, 6th decade and male to female ratio was 1.83:1. 2. The most common cause of aortic dissection was atherosclerosis and hypertension (79%). 3. The most common presenting symptom was pain (73%). but dyspnea, palpable mass, murmur, shock were also observed. 4. Abnormal electrocardiographic finding was myocardial ischemia in 6 cases, arrhythmia in 5 cases, LVH in 5 cases. 5. The X-ray findings showed abnormal aortic contour in 10 cases but normal X-ray finding was observed in 63% of DeBaKey Type III. 6. The most common diagnostic procedure was echocardiogram and abdominal Ultrasonography. 7. The mortality of all cases was 20%, operation mortality was 18% but no death of medically treatment in medical indication.

A case of SIADH in small cell lung cancer.: Kyu Chang Won, Jong Sik Lim, Chan Woo Lee, Hyoung Woo Lee, Choong Ki Lee, Jin Hong Chung, Myoung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):227-234. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.227

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Abstract PDF: The syndrome of inappropriate ADH secretion is a disorder characterized by hyponatremia which results from water retention attributable to ADH release. The hallmark of SIADH is hyponatremia due to water retention, in the presence of urinary osmolality above plasma osmolality. The SIADH was initially described by Schwartz et al (1957). This syndrome, first recognized in patients with bronchogenic carcinoma, has now been observed in a variety of other illnesses. Recently, we encountered a 59 year-old female with small cell lung cancer, also she had SIADH. Thus, we present a case and review the literature on the subject.

Acute megakaryoblastic leukemia.: Young Jin Kim, Tae Nyun Kim, Myung Soo Hyun, Bong Sup Shim, Hyun Woo Lee, Jung Suk Kim; Yeungnam Univ J Med. 1991;8(2):209-216. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.209

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Abstract PDF: Acute megakaryoblastic leukemia is a rare and rapidly fatal disease characterized by proliferation of megakaryocyte series and atypical megakaryocytes in the bone marrow. Acute megakaryoblastic leukemia is suspicious when 1) megakaryocyte in peripheral blood, mixture of large and small mononuclear megakaryoblast in the bone marrow 2) cytoplasmic budding in blast 3) myelofibrosis (dense medullary overgrowth of reticulin fibers) 4) PAS (+), ANAE (+), SBB (−), peroxidase (−) and which is confirmed by platelet peroxidase oxidation on electron microscope or monoclonal antibody. A case of acute megakaryoblastic leukemia was studied morphologically and monoclonal antibody.

Clinical observation of acute drug intoxications.: Jun Ha Chun, Kyung Chul Shin, Jin Hong Chung, Chong Ki Lee, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):164-173. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.164

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Abstract PDF: Clinical observations were made on 349 cases of acute drug intoxication who were visited to emergency room of Yeungnam University Hospital during recent 7 years from January 1984 to December 1990. The following results were obtained. 1) Total number of cases of acute drug intoxication was 349 which was 0.39% of the total patients of the emergency room during the same period. 2) The ratio of male to female was 1.1:1. The age incidence was highest in the third decade (26.7%). The monthly incidence was highest in May. Higher frequency was observed in summer season. 3) The most common drug of the intoxication was pesticides and herbicides (71.9%), the remainders were miscellaneous drugs (11.2%), sedatives (7.7%), rodenticides (6.3%) and unknown drug (3.2%) in orders. 4) The most common cause of drug intoxication was suicide (69.1%) and the others were accident, unknown cause, intention in orders. 5) Main clinical manifestations were the impairment of consciousness, nausea, vomiting and convulsion. Physical examination revealed increased pulses, increased blood pressure, miosis of the pupil and sweating. Above symptoms and signs were more prominent in pesticide intoxication. Leukocytosis, glycosuria and abnormal LFT were common findings in acute intoxications. 6) The complications were developed in 18.3% among 349 cases and the most common complication was respiratory failure, pneumonia, cardiovascular collapse and pulmonary edema in orders. 7) Overall mortality rate was 8.3% of total cases and mortality rate was highest in herbicide intoxication (22.2%).

A clinical study on multiple myeloma.: Hyeong Ki Hwang, Choong Ki Lee, Myung Soo Hyun, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):106-113. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.106

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Abstract PDF: A clinical review of 31 cases of multiple myeloma which were diagnosed by criteria of the SWOG between May 1983 and February 1990 at Yeungnam University Hospital was done. The results were as followings: 1. The peak incidence was in 7th decade and male to female ratio was 1.8:1. 2. The most common presenting symptom at first diagnosis was bone pain (58%), but fever, dyspnea, dizziness and palpable mass were also noted. 3. The distribution of laboratory findings as following diagnostic criteria of Southwest oncology group (SWOG): Plasmacytoma on tissue biopsy was noted 6 cases, bone marrow plasmacytosis with more than 10% plasma cells was 22 cases, monoclonal globulin spike on serum electrophoresis was 24 cases, lytic bone lesions was observed 22 cases. 4. Initial clinical stages were classified as 2 cases in stage I, 3 cases in stage II, 26 cases in stage III (84%). 5. Immunoelectrophoresis revealed the distribution of IgG 64%, light chain 22%, IgA 10%, Kappa to Lambda ratio of 1.1:1. 6. Hematologic & biochemical findings revealed anemia with <8.5% of hemoglobin in 42%, hypercalcemia with <10.6 mg% of serum calcium in 22%, azotemia >2.0 mg% of serum creatinine in 19%. 7. The multiple punched out lesion of bone x-ray examination were noticed skull (65%), rib (42%), L-spine (35%), pelvis (23%), T-spine (19%). The initial skeletal roentgenographic findings showed osteoporosis, osteolytic lesion and fracture in 55%, only osteolytic lesion in 23%, only osteoporosis in 10%. 8. Complications of multiple myeloma, such as 10 cases of renal impairment, 8 cases of infection, 16 cases of compression fracture of spine were observed.

Toxic effect of azalea extract on cardiovascular system.: Jun Ha Chun, Sung Bok Chung, Seung Ho Kang, Yeong Jo Kim, Bong Sub Shim, Hyun Woo Lee, Dong Gu Shin, Jong Min Park; Yeungnam Univ J Med. 1991;8(2):52-62. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.52

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Abstract PDF: The toxic effect of azalea extract, especially on cardiovascular system, in relatively unclear. The purpose of this study is to study the possible underlying mechanism and effect of toxic ingredient of azalea on cardiovascular system. The 71 healthy rabbits were divided into 10 groups: In group as preliminary study; 4 cc of normal saline was administered intravenously (N); 0.7 gm/kg and 1.0 gm/kg of azalea extract was administered respectively in the same route, volume (A1, A2); atropine was administered intravenously (A); after pretreatment with atropine (0.04 mg/kg) to block parasympathetic system, azalea extract was injected like the above groups (AA1, AA2); normal saline, 0.7 gm/kg and 1.0 gm/kg of azalea extract were administered respectively with 0.2 cc (1:1000) epinephrine (E0, E1, E2). We measured the following indices at I minute interval during first 10 minutes and then 10 minute interval during next 30 minutes: RR interval, QTc interval, maximal systolic and diastolic pressure drop with occurring time and presence of significant arrhythmia. The results were as follows: 1. The changes of RR interval, QTc interval were significantly increased in groups by Azalea extract. The blood pressure change was significantly decreased in groups by Azalea extract. There were no significant differences according to dosage of Azalea extract. 2. The changes of RR interval, blood pressure were significant differences between administration of atropine and Azalea extract after pretreatment with atropine, but not in the change of QTc interval. 3. There were no significant differences in the change of RR interval, ATc interval, blood pressure drop according to pretreatment with atropine. 4. The interaction between epinephrine and Azalea extract was not noted by the effect of epinephrine itself. 5. The ST change by 0.7 gm/kg, 1.0 gm/kg of Azalea extract was revealed in 1 case (14.0%), 7 case (100%), respectively. 6. Most of all cases with arrhythmia, ventricular tachycardia, ventricular fibrillation, were noted in the group by epinephrine, except on case by Azalea extract (1.0 gm/kg). It was idioventricular rhythm. In conclusion, azalea extract has negative inotropic and chronotropic effect with arrhythmogenic potential possibly through direct myocardial ischemia or injury but we can't be absolutely exclusive of actions of autonomic nervous system, especially parasympathetic nervous system.

The Role of Free Radicals in Reperfusion Myocardial Injury.: Young Jo Kim, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(2):1-12. Published online December 31, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.2.1

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Abstract PDF: No abstract available.

Hematological reference values in the healthy adults.: Young Jin Kim, Myung Soo Hyun, Hyun Woo Lee; Yeungnam Univ J Med. 1991;8(1):154-165. Published online June 30, 1991; DOI: https://doi.org/10.12701/yujm.1991.8.1.154

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Abstract PDF: To establish the hematological reference values in the healthy adults visited our hospitals, following examination were done on 2823 persons by Coulter Counter Model S-plus II ; white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), hematocrit (Hct), meant corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), platelet, plateletcrit, mean platelet volume (MPV) and platelet distribution width (PDW). The following results are obtained. 1) Male, mean value of WBC; 6,800±2,680 (2SD)/µl Female, mean value of WBC; 5,950±2,380 (2SD)/µl 2) Male, mean value of RBC; 428±60 (2SD)x104/µl Female, mean value of RBC; 415±56 (2SD)x104/µl 3) Male, mean value of Hb; 15.4±1.8 (2SD) g/dL Female, mean value of Hb; 13.0±1.6 (2SD) g/dL 4) Male, mean value of Hct; 45.3±5.0 (2SD)% Female, mean value of Hct; 38.2±4.6 (2SD)% 5) Male, mean value of MCV; 93.8±5.8 (2SD) fL Female, mean value of MCV; 92.2±7.4 (2SD) fL 6) Male, mean value of MCH; 31.8±2.2 (2SD) pg Female, mean value of MCH; 31.4±2.8 (2SD) pg 7) Male, mean value of MCHC; 34.0±1.2 (2SD)% Female, mean value of MCHC; 33.9±1.2 (2SD)% 8) Male, mean value of RDW; 12.7±1.0 (2SD)% Female, mean value of RDW; 12.6±1.4 (2SD)% 9) Male, mean value of Platelet; 242.9±87.8 (2SD) X103/µl Female, mean value of Platelet; 242.2±89.0 (2SD) X103/µl 10) Male, mean value of Plateletcrit; 0.201±0.076 (2SD)% Female, mean value of Plateletcrit; 0.204±0.076 (2SD)% 11) Male, mean value of MPV; 8.20±1.70 (2SD) fl Female, mean value of MPV; 8.36±1.82 (2SD) fl 12) Male, mean value of PDW; 16.1±0.8 (2SD)% Female, mean value of PDW; 16.0±0.8 (2SD)%

The Clinical Review of Superior Vena Cava Syndrome.: Joung Sun Kang, Sam Beom Lee, Choong Ki Lee, Jin Hong Chung, Hyoung Woo Lee, Kwan Ho Lee, Myung Soo Hyun, Hyun Woo Lee, Sei One Shin, Myung Se Kim; Yeungnam Univ J Med. 1990;7(2):151-158. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.151

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Abstract PDF: We reviewed 30 cases of superior vena cava syndrome in adult patients who were seen at the Yeungnam University Hospital from January 1985 to June 1990. The results were as follows: 1. The male-to-female ratio was 6.5:1, and the most patients were in the age group between the sixth and seventh decades. 2. The most common symptoms were dyspnea (87%) and followed by cough (63%), facial swelling (63%) and chest pain (44%) and the physical signs were dilated neck vein (97%), facial edema (93%) and facial flushing (45%) in order of frequency. 3. The simple chest x-ray findings were superior mediastinal widening (90%), right hilar mass (77%) and pleural effusion (31%). 4. Diagnosis was made by history and physical examination (100%), chest C-T scan (100%), simple chest x-ray (97%), bronchoscopy with biopsy (40%) and so on. 5. 21 cases of patients were confirmed by histology: 14 cases (46%) of bronchogenic ca, 4 cases (14%) of lymphoma, 3 cases (10%) of metastatic lung ca. Of bronchogenic ca, small cell ca was 7 cases (23%), squamous cell ca, 5 cases (17%), and unclassified cawas 2 cases (6%). 6. In response of treatment, the clinical improvement was achieved in 18 cases with radiotherapy alone, 1 case with chemotherapy only, and 6 cases with radio-chemotherapy.

Clinical Observations of the Solitary Pulmonary Nodules.: Jin Woo Roh, Byeong Ik Jang, Jong Sun Park, Jin Hong Chung, Hyung Woo Lee, Kwan Ho Lee, Hyun Woo Lee, Jung Cheul Lee, Sung Sae Han; Yeungnam Univ J Med. 1990;7(2):141-149. Published online December 31, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.2.141

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Abstract PDF: The authors conducted a clinical observation of 55 cases of solitary pulmonary nodules at Yeungnam University Hospital from June 1986 to October 1990, and the following results were obtained: 1. The age distribution was ranged from 18 to 77 years, and the male-to female ratio was 1.8:1. 2. Among 55 cases of nodules, 28 cases were benign and 27 cases were malignant nodules, and of malignant nodules, the primary lung cancer was 23 cases and of benign nodules, 18 cases were tuberculoma. 3. 23 cases (41.8%) was asymptomatic and the other 32 cases were symptomatic; chest pain 12 cases, hemoptysis; 8 cases, cough; 8 cases and dyspnea; 4 cases. 4. The non-smoker-to-smoker ratio was 1:1.04, but among 23 smoker over 20 pack years, 14 cases were malignant nodules. 5. According to nodular size, there is no striking differences between benign and malignant nodules except 3-4 cm sized nodules. 6. The lobar distribution of nodules, 35 cases were in the right lung (upper lobe; 14 cases, middle lobe; 11 cases, and lower lobe; 10 cases) and 23 cases were in the left lung (upper lobe; 9 cases, lower lobe; 11 cases), and the malignant nodules were most commonly observed in the right upper lung.

Ventricular premature complexes and associated factors in the early postinfarction period.: Jong Hoa Choi, Myung Soo Hyun, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1990;7(1):61-68. Published online June 30, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.1.61

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Abstract PDF: To assess the role of multiple factors in influencing occurrence of ventricular premature complexes after acute myocardial infarction twenty-four hour Holter electrocardiographic tape recording were made in 40 survivors of an acute myocardial infarction 10 to 20days after attack. Ventricular premature complexes in the early post infarction period were not correlated with left ventricular function, age, sex, smoking, diabetes mellitus, previous angina, and previous myocardial infarction. The occurrence of ventricular premature complexes showed a positive correlation with the occurrence of ST-T change. The occurrence of ventricular premature complexes during sleep hours was compared to the awake state. In 22 patients, the incidence of ventricular premature complexes are excluded from analysis, the 22 of patients, or in 76 percent, sleep was associated with a lowered occurrence of ventricular extrasystoles.

A Clinical and Serologic Study of 21 Cases of Tsutsugamushi Disease Confirmed by Serologic test.: Jong Seon Park, Young Su Kweon, Kwan Ho Lee, Myung Su Hyun, Moon Kwan Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1990;7(1):151-163. Published online June 30, 1990; DOI: https://doi.org/10.12701/yujm.1990.7.1.151

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Abstract PDF: Tsutsugamushi disease is an acute febrile disease caused by Rickettsia tsutsugamushi, and which has been reported with increasing frequency thorough the nation since 1986. We experienced 21 cases of Tsutsugamushi Disease diagnosed with serologic test occurring in Taegu city and Kyungpook province during October-November, 1989. The results of survey are as follow. 1) Of 21 cases, 12 (57%) were males and 9 (43%) were females, and the peak incidence was the 4th decade. 2) The outbreak was in October to November and the peak incidence was in October. 3) The most frequent symptoms were fever and chill (100%), myalgia (95%), headache (90%), Eschar and rash were observed in 18 patients (86%) and the eschar was detected in all over the body, especially thorax (33%) and lower extremity (22%). 4) Laboratory features were SGOT elevation (83%), SGPT elevation (61%), LDH elevation (67%), leukocytosis (38%). 5) Indirect immunofluorescent antibody test was done in 18 patients and the antibody titer was above 1:320 in all patients. 6) The chloramphenicol, tetracycline or doxycycline regimens were very effective and mean duration of defervescence from initiation of therapy was 1.3 days. 7) The complication such as meningitis or shock, was not seen.

A Case of Rotor Syndrome.: Chan Kyu Kang, Joung Sun Kang, Hyoung Woo Lee, Moon Kwan Chung, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(2):257-263. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.257

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Abstract PDF: Rotor syndrome is a rare disease of hereditary hyperbilirubinemia transmitted with autosomal recessive trait. In general, Rotor syndrome shows direct hyperbilirubinemia and there has been several reports since Sons's report in 1966, in Korea. A 34-year-old female was admitted with the chief complaint of intermittent icteric sclera for 24 years. There was no family history of jaundice. Rotor syndrome was diagnosed by oral cholecystogram, BSP retention test, 99mTc-DISIDA scan, liver biopsy and electron microscopy study of liver biopsy specimen. We report this case with brief review of the literature.

Polycythemia vera combined with coagulation disorder: A case report.: Jae Hee Ahn, Du Ha Lee, Hyo Jin Chun, Myung Soo Hyun, Hyun Woo Lee, Chung Sook Kim; Yeungnam Univ J Med. 1989;6(2):247-255. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.247

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Abstract PDF: We report a case of polycythemia vera combined with coagulation disorder. The patient was 54 years old man who complained of continuous bleeding after incision of skin abscess 20days ago. Laboratory tests were revealed prolonged aPTT and slightly prolonged PT. Coagulation factor, I, VIII, IX, XI and fibrinogen decreased, however FDP did not increased. It appears that patient with polycythemia vera have chronic activation of coagulation system, probably initiated by activation of factor XII. Platelet aggregation test to ADP, collagen, epinephrine was also revealed poor response.

A Case of Bradycardia-Dependent Complete Atrioventricular(A-V) Block.: Jae Yik Lee, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(2):241-245. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.241

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Abstract PDF: Induction of A-V block by tachycardia is a well-known phenomenon. But there are few case reports of bradycardia-dependent A-V block. We report a case of bradycardia-dependent A-V block with review of literatures. This patient was a 52-year-old female who complained of dizziness and anterior chest discomfort. Electrocardiographic recording demonstrated complete A-V block. Monitor electrocardiographic recordings during sitting position and after atropine administration demonstrated decrease of degree of block from complete A-V block to first degree A-V block. The occurrence of complete A-V block from bradycardia during supine position suggests a phase 4-dependent block. After a permanent ventricular pacemaker was implanted, the patient recovered and was without symptoms during 12 months follow up.

A Design of High-Frequency Oscillatory Ventilator Using Phase Lock Loop system.: Sang Hag Lee, Dong Gyo Jeong, Joon Ha Lee, Kwan Ho Lee, Young Jo Kim, Jae Chun Chung, Hyun Woo Lee, Suck Kang Lee, Tae Sug Lee; Yeungnam Univ J Med. 1989;6(2):217-222. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.217

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Abstract PDF: In this study, high frequency oscillatory ventilator was designed and constructed. Using designed by phase-lock loop system, in order to accurately and easily treat both the outlet volume and rpm. A system has been designed and is being evaluated using CD4046A PLL IC. We use this PLL IC for the purpose of motor controls. The device consists of PLL system, pumping mechanism, piston, cylinder, and special crank shaft are required. This system characteristics were as follows: 1) Frequency: 20-1800 rpm 2) Outlet air volume: 1-50 cc

Factors influencing arterial CO² tension in cats during high frequency oscillation ventilation.: Jun Young Do, Jae Yick Lee, Kwan Ho Lee, Yeung Jo Kim, Jae Chun Chung, Hyun Woo Lee, Suck Kang Lee; Yeungnam Univ J Med. 1989;6(2):47-55. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.47

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Abstract PDF: High frequency ventilation (HFV) is a new ventilatory technique that uses very small tidal volume (less than the anatomic dead space) and high frequency, and classified 4 distinct types according to frequency and mode of gas delivery. The mechanism of gas transport of high frequency oscillation ventilation (HFOV) is somewhat different to other types of HFV. To evaluate the determinants of PaCO² in HFOV, a study was done with a HFOV on 9 cats, and the results are: 1) PaCO² was not correlated with frequency at the constant stroke volume (6 voltage) and bias flow (6 L/minutes). 2)PaCO² was correlated with stroke volume but not with bias flow under the constant frequency (15 Hz/min) and bias flow (3 to 6 L/min). From above results, the main determinant of PaCO² on artificial ventilation with HFOV was stroke volume, but further study between flow, the site of delivery to the airway and humidification of bias flow and CO² elimination is required in future research.

The Comparison of Histopathology of Cats Received Conventional Mechanical Ventilation and High Frequency Oscillation Ventilation.: Kwan Ho Lee, Young Jo Kim, Jae Chun Chung, Hyun Woo Lee, Hae Joo Nam, Tae Sook Lee; Yeungnam Univ J Med. 1989;6(2):39-46. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.39

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Abstract PDF: The tracheobronchial histopathologic findings in 7 healthy cats used with high frequency oscillation ventilation (HFOV) were compared with those in 6 cats used with conventional mechanical ventilation (CMV). 4-point, 9-variable scoring system was used to evaluate the injury in the trachea, right & left main bronchi and parenchyma. The following results were obtained; 1) The tracheobronchial tree received HFOV had no significant damage compared with CMV (P>0.05). 2) Intraepithelial mucus loss and emphysema were slightly more prominent in CMV groups. As above results; the tracheobronchial histopathologic difference was not prominent between CMV and HFOV groups received with relatively short period, however, the cellular of function and barotrauma may be more prominent in CMV groups. From now on, as causes of tracheobronchial injury in HFV, interaction between humidification and mechanical trauma considers further study.

Clinical evaluation on 5 cases of lead Poisoning.: Jung Mi Lee, Hyung Woo Lee, Myung Soo Hyun, Moon Kwan Chung, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(2):29-38. Published online December 31, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.2.29

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Abstract PDF: 5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were ill defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2 gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M:E ratio was 0.7:1. The lead concentration in serum was increased in 4 cases (80%) of patients. Lead concentration, delta aminolevulinic acid concentration in 24 hours collected urine were increased in 5 patients (100%).

A Case of Acute Intermittent Porphyria: A case report.: Chang Heon Yang, Moon Kwan Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):205-211. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.205

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Abstract PDF: We report a case of acute intermittent porphyria presenting with variable symptoms and signs such as hypertension, polyneuropathy, syndrome of inappropriate secretion of antidiuretic hormone and cerebral infarction. A 47 year-old female patient entered hospital with abdominal pain followed by generalized seizure. She was diagnosed to have acute intermittent porphyria in consequence of Watson-Schwartz test and δ-ALA in 24 hours urine. She was managed with conservative treatment but died of respiratory failure.

Multiple Myeloma Combined with Stomach Cancer: A case report.: Chang Heon Yang, Myung Soo Hyun, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):197-204. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.197

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Abstract PDF: A case of multiple myeloma combined with stomach cancer and related literatures were reviewed. A 67 year-old male patient entered the hospital with dysphagia and weight loss for 3 months. Peripheral blood examination revealed anemia with rouleaux formation. Total protein of the serum was 9.9 g/dl with hyperglobulinemia (albumin 2.7 g/dl, globulin 7.2 g/dl, A/G ratio 0.375). On the electrophoresis and immunoelectrophoresis of the serum, the abnormal protein with the pattern of monoclonal gammopathy (IgG-K type) was shown. There were multiple variable sized osteolytic lesions on skull X-ray and abnormal hot uptakes of rips on bone scan and result of rib biopsy was plasmacytoma. Gastrofiberscopy was performed to search for the cause of upper gastrointestinal bleeding, revealed stomach cancer, and the result of the gastric mucosal biopsy proved to be well-differentiated adenocarcinoma.

A Case of Dissection in Marfan Syndrome with Ascending Aortic Aneurysm.: Bong Young Yoon, Chang Heon Yang, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Han Young Ryu, Tae Eun Jung, Yee Tae Park, Sung Sae Han; Yeungnam Univ J Med. 1989;6(1):179-184. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.179

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Abstract PDF: The Marfan syndrome is a generalized connective tissue disease involving eye, musculoskeletal system, cardiovascular system, and inherited autosomal dominant with various expression type. The cardiovascular complications such as aortic aneurysm, aortic dissection, aortic regurgitation, mitral regurgitation and aortic dissection which usually occurs in previously normal sized aorta are poor prognostic factors. However, the aortic dissection which developed in patient with Marfan syndrome and aortic aneurysm was rare. We experienced one case of dissecting aneurysm in patient diagnosed as previous aortic aneurysm, aortic regurgitation, and Marfan syndrome, receiving successful operation.

Eaton-Lambert Syndrome with Small Cell Lung Cancer: A case report.: Kyeong Hee Lee, Moon Kwan Chung, Myung Soo Hyun, Jae Chun Chung, Hyun Woo Lee, Jung Sang Hah, Yeung Ju Byun; Yeungnam Univ J Med. 1989;6(1):171-178. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.171

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Abstract PDF: Eaton Lambert Syndrome (ELS) is a disorder of neuromuscular transmission. The defect of neuromuscular transmission is due to decrease in the release of acetylcholine quanta from nerve terminal. This syndrome is frequently associated with bronchogenic carcinoma. The diagnosis is established by electromyography, which characteristically shows 1) low amplitude of evoked compound muscle potential to a single supramaximal stimulus on nerve, 2) significant decremental response at low rates of stimulation 3) marked incremental response at high rates of stimulation. Our patient is 52year old man with dyspnea, coughing and muscle weakness of proximal lower limbs. He has small cell lung cancer and associated with ELS, Superior vena cava syndrome and has metastatic lesion on right supraclavicular lymph node confirmed by pathology. Metastatic mass and SVC syndrome are marked improved following chemotherapy and radiotherapy, however follow up EMG finding does not improved. We are here reporting one case which considered compatible for ELS, with a few elementary reviewed literatures.

The Clinical Value of the 24-hour Ambulatory ECG Monitoring in Patients with Chronic Atrial Fibrillation.: Chang Heon Yang, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):99-107. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.99

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Abstract PDF: 24-hour ambulatory ECG monitoring has been examined for the evaluation of heart rate and longest pause in 34 patients with chronic atrial fibrillation (20 patients treated with digoxin and 14 patients without treatment). Following results were obtained: 1. In 34 patients, the mean of average heart rates was 75.7±13.8/minute, fastest heart rates 148.0±32.4/minute, slowest heart rates 48.1±8.4/minute, difference between fastest and slowest heart rates in individual patients 99.9±29.0/minute and longest pauses 2.95±1.06seconds. The longest pauses of more than 4.0 seconds occurred in 4 of the 34 patients and made an exception of comparison groups. 2. In 27 of the 34 patients, ventricular premature contractures were developed and in 11 of 27, mainly occurred less than 100/24 hours and aberrant conduction occurred in all patients. 3. In 20 patients treated with digoxin (0.25 mg/day), the mean of average heart rates was 78.4±13.7/minute, fastest heart rates 152.5±33.1/minute, slowest heart rates 48.9±8.5/minute, difference between fastest and slowest heart rates in individual patients 103.6±31.7/minute and longest pauses 2.55±0.50 seconds. 4. In 10 patients without treatment, the mean of average heart rates was 78.0±10.7/minute, fastest heart rates 154.5±26.8/minute, slowest heart rates 50.6±7.1/minute, difference between fastest and slowest heart rates in individual patients 103.9±22.2/minute and longest pauses 2.66±0.39 seconds. 5. The difference of heart rates and longest pauses between patients with treatment and without treatment were statistically not significant (P>0.05). In summary, authors seemed to consider that 24-hour ambulatory ECG was useful and safe method for clinical evaluation of patients with chronic atrial fibrillation.

Clinical Evaluation of Exudative Pleural Effusion.: Kyeong Soon Kwon, Chang Heon Yang, Kwan Ho Lee, Yeung Hyun Lee, Jae Chun Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1989;6(1):69-80. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.69

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Abstract PDF: From December 1987 to September 1988, clinical evaluation were performed at the Yeungnam University Hospital on 138 patients with exudative pleural effusion comparing with biochemical, bacteriologic, cytologic and pathologic studies. The results were as follows 1. Among these 138 cases, Incidence of tuberculosis was 57.3%, neoplasm 26.8%. High tendency in malignant pleural effusion occurred in elder age. 2. In tuberculosis pleural effusion, the rate of positive smear and culture for acid-fast bacilli in the pleural fluid was 3.7% and positive biopsy for granuloma 75%. 3. In malignant pleural effusion, the rate of positive cytology for cancer cell in the fluid was 42% and positive biopsy 60%. 4. Analysis in tuberculosis and malignancy showed the tendency of high pH, WBC, protein and of low glucose, but there were clinically not significant in differentiating malignant pleural effusion from tuberculous pleural effusion. 5. Among 23 cases in which the pleural tissue findings were chronic nonspecific reaction pathologically, tuberculosis (52.2%), malignancy (26%), and idiopathic (21.8%) eventually in follow up studies.

An Outbreak of Tsutsugamushi Disease in Vicinity of Taegu City and Kyungpook Province in 1988.: Young Su Kweon, Jong Ho Kim, Kwan Ho Lee, Myung Su Hyun, Moon Kwan Chung, Hyun Woo Lee, Myung Weon Shon; Yeungnam Univ J Med. 1989;6(1):31-41. Published online June 30, 1989; DOI: https://doi.org/10.12701/yujm.1989.6.1.31

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Abstract PDF: Since the first cases of tsutsugamushi disease reported in Korea in 1986, many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills (88%), myalgia (65%), headache (54%), nausea and vomiting (31%), and abdominal pain (27%). The eschar was detected on lower part of body in most of cases, and more frequently in male (M:F 100 vs 58%). 4. Patients were treated with tetracyclines (TC) and/or chlorampenicol (CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 case of shock, and all cases were recovered without any sequelae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.

One Case of Insulinoma.: Jae Hee Ahn, Hye Sang Seo, Sung Chul Yoon, Kyung Woo Yoon, Soo Bong Choi, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):205-211. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.205

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Abstract PDF: Insulinoma is a rare tumor, occurring more often in women and in the older age range. Eighty percent of patients have a single benign tumor, usually 2 cm in diameter, located with about equal frequency in body, head or tail of pancreas and amenable to surgical cure. About 10% have multiple tumors. The remaining 10% of patients have metastatic malignant insulinoma. The symptom of insulinoma is characterized by the periodic attack of hypoglycemia of blood sugar level below 50mg%, by fasting or exertion, and rapid relief of symptom by oral or intravenous administration of glucose. Symptom often lead to misdiagnosis as a neurologic or psychiatric disorder. A case described by authors was 44-year old female with the chief complaints of the loss of consciousness, epileptic seizure although she has been treated by anticonvulsants. Serum blood sugar and insulin level during fasting suggested insulinoma but abdominal computed tomography shows no definitive mass in pancreas. Celiac angiography revealed insulinoma. She transferred to the department of General Surgery and was performed enucleation. Microscopic findings shows the islet cell tumor of pancreas. A brief review of the literature was made.

Uptake of 99mTc - DISDA in Primary Hepatocellular Carcinoma and Metastatic Nodule in the Lung.: Jun Young Do, Heon Ju Lee, Soo Bong Choi, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):171-174. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.171

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Abstract PDF: Recently, several reports of extrahepatic hepatocellular carcinoma metastasis demonstrated by technetium-99mTc-IDAs scan have shown that 99mTc-IDAs can be used to detect extrahepatic metastasis in hepatocellular carcinoma. We report here a case of hepatocellular carcinoma with pulmonary nodules that were demonstrated as metastasis in nature by the use of the 99mTc-DISIDA. The findings in this case and several reports reviewed here suggest that the 99mTc-DISIDA scan may be a useful diagnostic agent that can detect the extrahepatic metastasis of hepatocellular carcinoma and stage the disease. But more clinical study in needed to establish the position of 99mTc-DISIDA in the field of diagnosis of extrahepatic hepatocellular carcinoma.

A Clinical Study on the Patients with Pyuria.: Jong Ho Kim, In Ho Cho, Sung Chul Yun, Soo Bong Choi, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):151-160. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.151

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Abstract PDF: To evaluate the features of pyuria related to the bacteriuria, 140subjects were studied from Jan. 1987 to Dec. 1987. They pyuria was frequently developed from the age 30 to 60 years old, and male to female ratio was 1:1.41. The most common disease was urethrocystitis that was shown 42.8%. Common precipitating factors were urethral catheterization (25%) and urinary tract obstruction (11.4%). Through the observation, symptomatic pyuric patients were 66 subjects (47.1%), and the subjects with significant urine culture were 121 subjects (86.4%). In the urine culture, the most common bacteria was E. coli (41.4%), and the next was Pseudomonas (19.3%). A large percentage of E. coli and Pseudomonas was susceptible of amikin. The pyuria due to S. epidermidis and Accinatobacter was well treated. High therapeutic rate was observed in the acute pyelonephritis (71%) and urethrocystitis (67%). In the persistent urinary tract infection, there were relapsing (22 cases) and recurrent urinary tract infection (16 cases).

The Bronchodilatory Effect of Ipratropium Bromide on Bronchial Asthma.: Jae Hee Ahn, Tae Nyeon Kim, Young Hyeun Lee, Jae Chun Chung, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):95-100. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.95

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Abstract PDF: Ipratropium bromide (IP) is a new anticholinergic bronchodilator. To evaluate its effect on bronchial asthma which is still unknown in Korea, a double blind and randomized study was done on all patients of bronchial asthma who visit out-patients clinic of out department from June to September 197 and showed 75 to 100% of FEV1/FVC ratio on prebronchodilator spirometry (pre BD). The selected patients were given 2 puffs of Fenoterol (FE) or Ipratropium inhalator blindly and Spirometry. The repeated results are: 1. In both FE and IP groups, there was a significant bronchodilatory effect on 5 and 60 minutes after administration. 2. One 5 minutes, effect of FE was significantly greater than IP (FVC p<0.05, FEV1 p<0.01). 3. One 60 minutes, effect of IP was slightly less than FE but statistically non-significant. On the basis of above results, we concluded that onset of effect of IP is slower than FE, but its effect is significant and nearly comparable to FE.

Diagnostic Value of the Intradermal Test for the Infection with Clonorchis sinensis.: Jong Ho Kim, Bong Yung Yun, Heon Ju Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1988;5(2):47-52. Published online December 31, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.2.47

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Abstract PDF: The intradermal (ID) test has been widely used in Korea and several reports about the results of the ID test are known. We examined the egg of Clonorchis sinensis (C.s.) by ID test in 443, stool's egg-counting technique in 79 and direct smear (cellophane thick smear technique) in 1204 subjects. The results are as follows: 1. The positive rate of C.s. was 3.8% out of 1304 persons. 2. The sensitivity of ID test was 82.1% out of 39 persons and the specificity was 64.6% out of 404 persons. 3. The false positive of ID test was 35.4% out of 404 persons and, the false negative was 17.9% out of 39 persons. Intradermal test is a rapid, sensitive and useful supplementary diagnostic tool for the detection of Clonorchiasis infection and must be used as screening test with direct smear of stool but cross reaction with other helminth infections and moderate false reaction are the main disadvantages in its practical application.

Graves' disease Associated with Idiopathic Thrombocytopenic Purpura and Iron Deficiency Anemia.: Jong Myung Kim, Sung Chul Yun, Soo Bong Choi, Hyun Woo Lee, Kyeong Dong Kim, Chung Sook Kim, Hei Joo Nam, Won Hee Choi, Tae Sook Lee; Yeungnam Univ J Med. 1988;5(1):173-179. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.173

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Abstract PDF: Since 1931, sporadic reports have appeared noting an apparent association between hyperthyroidism and idiopathic thrombocytopenic purpura. Recent various studies suggested that these two diseases may share a similar immunologic background, but the exact mechanism is still a matter of speculation. This 22-year-old female patient visited this hospital because of general weakness and purpura of legs for 2 months. The laboratory findings were compatible with Graves' disease associated with idiopathic thrombocytopenic purpura. The platelet count was 16000/mm³, hemoglobin was 10.9 g/dl and MCV was 60.1fL. T3 was 490.53 ng/dL, T4 was 24 ug/dL and free T4 was 5.66 ng/dL. Antiplatelet antibody and antimicrosomal antibody were positive. The bone marrow findings were compatible with iron deficiency anemia and idiopathic thrombocytopenic purpura. The thyroid biopsy showed adenomatous goiter. She was administered with propylthiouracil, Beta-blocker, iron and prednisolon. On the 10th hospital day, platelet count was 184000/mm³, hemoglobin was 12.0 gm/dL and MCV was 67.5 fL. On the 20th hospital day, T4 was 10.35 ug/dL and free T4 was 2.30 ng/dL. Therefore she was discharged and followed up.

Chronic Dissecting Aortic Aneurysm with Right Coronary Artery Perfused Solely by False Lumen of Asceading Aorta.: Myeong Gu Go, Jong Myung Kim, Kwan Ho Lee, Young Jo Kim, Bong Sup Shim, Hyun Woo Lee, Mi Soo Hwang; Yeungnam Univ J Med. 1988;5(1):159-166. Published online June 30, 1988; DOI: https://doi.org/10.12701/yujm.1988.5.1.159

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Abstract PDF: Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dissecting aortic aneurysm is occurred, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treatment (Modified Bentall's operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.

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