A Case of Pulmonary Artery Sling

Pulmonary artery sling is a rare vascular anomaly in which the left pulmonary artery arises from the right pulmonary artery and then traverses between the esophagus and the trachea toward the hilum of the left lung. Despite the availability of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of tracheobronchial trees. We experienced a 8 month old female infant who was admitted because of recurrent pneumonia and expiratory wheezing. She was diagnosed as pulmonary sling by esophagography, echocardiography, computed tomography. We report this with a brief review and related literature.

Usefulness of Urodynamic Study in Diabetic Cystopathy / 대한비뇨기과학회지

Sixty diabetic cystopathy patients (symptomatic DCP, 4.9%) among 1236 patients of diabetes mellitus (DM) from May, 1995 to June, 1996 were analyzed to ascertain the usefulness of urodynamic study in the diagnosis of DCP. The mean age was 58 (24--80) years and mean duration of DM was 9 (1~30) years. 36 (60%) patients had diabetic neuropathy, 31 (52%) had diabetic retinopathy and 4 (7%) had diabetic nephropathy. DM was managed by insulin pump (DIABECARETM, 52%) and subcutaneous insulin injection (42%). In residual urine and voiding diaries, residual urine volume more than 40ml was 83%, voiding interval less than 2 or more than 5 hours was 67% and voiding amount less than 200ml or more than 400ml was 48%. According to urodynamic findings, patients were classified as detrusor areflexia (63%), impaired detrusor contractility (18%), detrusor instability (15%) and normal detrusor contraction (3%). There were no significant differences of age, semm-HbA1C, treatment method and duration of diabetes mellitus among above groups. Mean duration of DM in irritative symptom group (32%), combined symptom group (23%) and obstructive symptom group (45%) were 2 years, 8 years and 15 years respectively (p<0.001). The shape of the cystometrographic curve was not influenced by the rate of bladder filling (40ml/min versus 100ml/min). In conclusion, because DCP is marked by insidious onset and progression with minimal symptoms, DCP can be early diagnosed using urodynamic study especially in patients with voiding symptoms and 1ong.DM duration.