Kawasaki disease is an acute febrile illness frequently developed in infants and children. This disease may involve coronary arteries in 15- 25% of the patients and may progress to coronary aneurysms, ischemic cardiac diseases, and sudden cardiac death. Recently we experienced successful balloon angioplasty followed by coronary stenting in a 15-year old boy with unstable angina and severe coronary arterial occlusive disease secondary to Kawasaki disease. He was diagnosed as unstable angina by 24 hours Holter monitoring, treadmill exercise stress test, echocardiography, and Dipyridamole 99mTc-sestamibi scan. And coronary angiogram revealed severe multiple stenosis and aneurysmal changes due to Kawasaki disease. We successfully performed a percutaneous transluminal coronary angioplasty with stent implantation at left circumflex arterial occlusive lesion.
Adolescent ; Aneurysm ; Angina, Unstable ; Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Arterial Occlusive Diseases ; Child ; Constriction, Pathologic ; Coronary Aneurysm ; Coronary Stenosis* ; Coronary Vessels* ; Death, Sudden, Cardiac ; Dipyridamole ; Echocardiography ; Electrocardiography, Ambulatory ; Exercise Test ; Heart Diseases ; Humans ; Infant ; Male* ; Mucocutaneous Lymph Node Syndrome* ; Stents* ; Technetium Tc 99m Sestamibi

BACKGROUND: Angina with normal coronary angiogram has been called syndrome X or microvasclar angina. Pathophysiologic mechanisms for chest pain in this group of patients are not known exactly. This study was performed to compare the insulin level of the patients with syndrome X with that of the healthy asymptomatic volunteers. METHODS: The syndrome X group was consisted of 18 patients(11 men and 7 women). All patients had typical chest pain and positive exercise test with a completely normal coronary andgiogram. Patients with hypertension, diabetes mellitus, and there taking any drug known to affect the insulin secretion were excluded. The control group was consisted of 38 healthy subjects(25 men and 11 women) who were not taking any medications. We measured the plasma glucose insulin and C-peptide concentration during oral glucose tolerance test in both groups. RESULTS: Fasting plasma glucose was normal in all patients in both groups. There were no significant differences in plasma glucose level, during the oral grucose tolerance test. There were no significant differences between control and wyndrome X group in the fasting plasma insulin concentration(5.1+/-2.4 vs 5.9+/-2.7 microg/ml, p>0.05). However, the insulin levels at 60min(47.6+/-20.0 vs 84.0+/-68.0 microg/ml) and 120 min(31.4+/-18.2 vs 92.9+/-83.8 microg/ml)were significantly higher in the syndrome X group(p<0.05). THere were no significant differences in the C-peptide concentrations at fasting, 60 min and 120 min after oral glucose tolerance test between control and syndrome X group(p>0.05). CONCLUSION: As shown in above results, there were significant differences in insulin concentrations, but nor in C-peptide concentrations between control and syndrome X group. Thus it can be suggested that the increased dinsulin level in these patients is resulted from the altered insulin action to the target tissues, not from the pancreatic overproduction of insulin. We suggest that this hyperinsulinemia resulted from the insulin resistance play a possible role in the abnormality of microvascular circulation as a mechanism of Syndrome X.
Blood Glucose ; C-Peptide ; Chest Pain* ; Diabetes Mellitus ; Exercise Test ; Fasting ; Glucose Tolerance Test ; Humans ; Hyperinsulinism* ; Hypertension ; Insulin ; Insulin Resistance ; Male ; Plasma ; Thorax* ; Volunteers

No abstract available.
Herpes Simplex* ; Immunocompromised Host* ; Immunosuppression ; Simplexvirus*

No abstract available.
Porokeratosis*

No abstract available.
Carcinoma, Basal Cell ; Facial Dermatoses* ; Keratosis, Actinic ; Skin*

No abstract available.
Humans ; Myocardial Infarction*

The circulatory system is closely related to the inter-relationship between the anatomy of the heart and blood vessels, and the fluid dynamic properties of blood. The physical properties of blood, which affect blood flow, are called hemorheologic factors. Hemorheologic factors, such as blood viscosity and erythrocyte aggregation, are influenced mainly by hematocrit. A higher hematocrit level results in an increase in blood viscosity, erythrocyte aggregation, which impedes the circulation itself, and tissue oxygenation. An excess of serum ferritin causes injury to vascular endothelial cells and erythrocytes via oxygen free radicals. In addition, an excess of blood can aggravatee the adverse effects of the hemorheologic parameters and induce atherogenesis, microcirculatory disturbances, and major cardiovascular events. A preventive and therapeutic approach with a phlebotomy or blood donation has been stimulated by the knowledge that blood loss, such as regular donations, is associated with significant decreases in key hemorheologic variables, including blood viscosity, erythrocyte aggregation, hematocrit, and fibrinogen. Major cardiovascular events have been improved in regular blood donors by improving blood flow and microcirculation by decreasing the level of oxidative stress, improving the hemorheologic parameters, and reducing the serum ferritin level. Confirmation of the positive preventive and therapeutic effects of blood donations on cardiovascular disease by a well-designed and well-controlled Cohort study may be good news to patients with cardiovascular disease or at risk of these diseases, as well as patients who require a transfusion.
Atherosclerosis ; Blood Donors* ; Blood Vessels ; Blood Viscosity ; Cardiovascular Diseases ; Cohort Studies ; Endothelial Cells ; Erythrocyte Aggregation ; Erythrocytes ; Ferritins ; Fibrinogen ; Free Radicals ; Heart ; Hematocrit ; Humans ; Hydrodynamics ; Microcirculation ; Oxidative Stress ; Oxygen ; Phlebotomy ; Therapeutic Uses

No abstract available.
Pregnancy*

Symptoms of deep cerebral vein thrombosis (DCVT) are variable and nonspecific. Radiologic findings are essential for the diagnoses. In the majority of cases of deep internal cerebral venous thrombosis, the thalamus is affected bilaterally, and venous hypertension by thrombosis causes parenchymal edema or venous infarction and may sometimes cause venous hemorrhage. Intravenous injections of mannitol can be administered or decompressive craniectomy can be performed for reduction of intracranial pressure. The objectives of antithrombotic treatment in DCVT include recanalization of the sinus or vein, and prevention of propagation of the thrombus. Herein, the authors report DCVT which was successfully treated by low molecular weight heparin.
Brain Edema ; Cerebral Infarction ; Cerebral Veins ; Decompressive Craniectomy ; Edema ; Hemorrhage ; Heparin, Low-Molecular-Weight ; Hypertension ; Infarction ; Injections, Intravenous ; Intracranial Pressure ; Intracranial Thrombosis ; Mannitol ; Thalamus ; Thrombosis ; Veins ; Venous Thrombosis

Intramural hematoma(IMH) and penetrating aortic ulcer have been increasingly recognized as causes of acute aortic pathology in addition to aortic dissection. The presence of the intimal tear and a flap traversing the aortic lumen is considered to be a most reliable differential point of aortic dissection and IMH. Transesophageal echocardiography(TEE) has become a valuable modality for the diagnosis, prognosis and management of acute aortic syndrome with the unique advantages of portability and the ability to obtain high-resolution real time images. Endovascular Stent-graft placement over the primary entry tear may be an alternative to open surgery because it can close the intimal tear, which leads to thrombosis of the false lumen, excluding flow through the intimal tear and redirecting aortic flow exclusively into the true lumen. We report 88 year-old male with aortic dissection in descending thoracic aorta, successfully treated with endovascular Stent-graft implantation, which was mimicking intramural hematoma by its appearance and subclinical intimal tear diagnosed exclusively by TEE against other imaging studies.
Aged, 80 and over ; Aorta, Thoracic* ; Diagnosis ; Hematoma* ; Humans ; Male ; Pathology ; Prognosis ; Thrombosis ; Ulcer