Prevalence of the coronary artery anomaly is approximately 1% of the population who undergo coronary angiography. The anomalous origin of the right coronary artery (RCA) as a branch of the left anterior descending artery (LAD) is a very rare variation of single coronary artery. The anatomic variation has no clinical significance. However, some patterns of congenital coronary artery anomalies can cause clinical manifestations of myocardial ischemia, reducing myocardial perfusion. We report on a case of a 78-year-old man who had anomalous RCA arising from the proximal part of the LAD, which probably caused chest pain.

Everolimus is a secondary medication for metastatic renal cell carcinoma when vascular endothelial growth factor inhibitor treatment fails. Everolimus is reported to cause a variety of metabolic complications but complications in the eye are rare. Although serious eye complications have not been reported, secondary complications may result from the metabolic complications. We observed a case in which central retinal vein occlusion occurred, probably caused by metabolic complications following Everolimus treatment of RCC. We report this case.

Respiratory distress resulting from a neuromuscular disorder is often misdiagnosed and not managed properly until development of severe respiratory failure. Amyotrophic lateral sclerosis (ALS) is a rare but archetypical motor neuron disease. Most cases manifest as weakness, muscular atrophy, and progressive paralysis of the limbs. Late stage of the disease is characterized by respiratory failure due to respiratory muscle weakness. In a few cases, 3% of patients, respiratory failure is the initial presentation, preceding other symptoms. We report on a case of ALS accompanied by acute respiratory failure and weaning failure, with a review of the literature.