Surgical endarterectomy has been shown to be superior to medical treatment in the management of severe carotid stenosis. Endarterectomy, although effective, does have limitations, and percutaneous transluminal angioplasty with stent may offer an alternative modality of treatment. We report on a patient with severe coronary disease that femoral arterial cannulation was not possible due to aorto-femoral shunt operation and absent pulse. The transradial approach was used for aortography, bilateral carotid angiography and successful elective stent deployment in the left internal carotid artery. The transradial approach might be useful alternative in case of problems with femoral approach.
Angiography ; Angioplasty* ; Aortography ; Carotid Arteries* ; Carotid Artery, Internal ; Carotid Stenosis* ; Catheterization ; Coronary Disease ; Endarterectomy ; Humans ; Stents*

OBJECTIVES: We aimed to explore the relationship among fatigue and perceived stress, depressive mood in the working population. We also examined associations with demographic and life style factors and investigated the effect of individual coping skills on these associations. METHODS: Fatigue Severity Scale(FSS), Perceived Stress Scale(PSS), Brief Encounter Psychosocial Instrument - Korean version(BEPSI-K), Beck Depression Inventory(BDI), Stress Coping Skill Questionnaire were administered to 621 civil servants. All of above and other demographic factors are self-administered questionnaire survey and this study is cross sectional. RESULTS: Mean FSS score was 3.04 which was lower than 3.22, the severity cut off score. FSS, PSS, BEPSI-K, BDI were all higher in female. Subjects with active coping skills showed relatively low fatigue, perceived stress, depressive mood than those with passive coping skills. Logistic regression analyses indicated that the PSS, BDI, BEPSI-K in working population increase the risk of fatigue and regular exercise lowers the risk. CONCLUSIONS: Adults who were afflicted by stress, experienced depressive mood or were physically inactive were at much higher risk of feeling fatigue. Since no other large data sets are available for fatigue, the results from this study could serve a very useful purpose, to furnish a basis for comparison with future research results based on more complete data.
Adaptation, Psychological ; Adult ; Dataset ; Demography ; Depression ; Fatigue* ; Female ; Humans ; Life Style ; Logistic Models ; Questionnaires

Coronary stent embolization is a rare event but may result in clinically relevant cardiac ischemia or peripheral embolization during the procedure. We report a case of systemic embolizations of two coil stents during the primary PTCA in acute myocardial infarction, who were treated successfully with a double wire helix technique and a gooseneck snare. Although in our experience this rare complication did not produce any clinical complications, care should be taken to prevent this possibility, especially in patients with significant vessel tortuosity, calcification, total occlusion, or mild stenosis proximal to the target lesion.
Constriction, Pathologic ; Humans ; Iliac Artery* ; Ischemia ; Myocardial Infarction ; SNARE Proteins ; Stents*

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy ; Risk Factors*

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy ; Risk Factors*

BACKGROUND: Neointimal hyperplasia, as the most important mechanism of restenosis after intracoronary artery stenting, its severity is closely correlated with the degree of local inflammatory reaction initiated by vasular injury during stenting procedure. So, we proceeded this study to determine whether inflammatory markers such as CD11b/CD18 (Mac-1) adehsion molecules of neutrophils, sICAM-1 (soluble intercellular adhesion molecule-1), ESR, and CRP increase or not in the peripheral circulation after coronary artery stenting, and whether there is any association between these findings and the degree of later restenosis. METHOD: 32 patients (chronic stable angina 4, unstable angina 17, acute myocardial infarction 11) underwent single vessel coronary artery stenting were enrolled in our study. Blood samples were obtained from peripheral vein just before coronary artery stenting and 48 hours thereafter. The degrees of CD11b/CD18 expression on the surface of neutrophils were analyzed by flow cytometry with monoclonal antibodies, and sICAM-1 by ELISA method. At each times, ESR and CRP were also measured. Follow-up coronary artery angiography was performed with QCA analysis at least 6 months later. We compared the each 48 hours values with the baseline (just before procedure) values. Percentage increments (as a ratio 48 hours values to baseline) of CD11b/CD18 expression, sICAM-1, ESR, and CRP levels were also compared with the results of follow-up QCA analysis. RESULTS: Restenosis (diameter stenosis > or = 50%) occurred in 6 patients (19%) at follow up angiography. 48 hours values of CD11b/CD18 expression, sICAM-1, ESR, and CRP were significantly elevated from the baseline values (each p values, CD11b : < 0.0001, CD18 : 0.01, sICAM-1 : < 0.0001, ESR : 0.005, and CRP : 0.001). The percentage increments of CD11b/CD18 expression were more elevated in restenosis group than nonrestenosis group (CD11b : 341+/-215%/74+/-95%, CD18 : 84+/-60%/17+/-37%, each p < 0.001, 0.001). There was some positive correlation between the percentage increments in the expression of CD11b and the late loss index at the follow up angiography (r=.43, p<0.05). CONCLUSIONS: Through this study, we found that the activation of neutrophils was occurred, and that sICAM-1 level was increased after coronary artery stenting in the peripheral blood. There was some correlations between the degree of CD11b expression on the surface of neutrophils and the severity of late lumen loss of inserted stents. The measurements of increased neutrophil adhesion molecules of CD11b/CD18 levels at 48hrs after coronary stenting may have a value as the predictor of subsequent late restenosis.
Angina, Stable ; Angina, Unstable ; Angiography ; Antibodies, Monoclonal ; Arteries ; Constriction, Pathologic ; Coronary Vessels* ; Enzyme-Linked Immunosorbent Assay ; Flow Cytometry ; Follow-Up Studies ; Humans ; Hyperplasia ; Myocardial Infarction ; Neutrophils* ; Stents* ; Veins

Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.
Biliary Tract ; Choledocholithiasis ; Needles ; Pancreas ; Sphincterotomy, Endoscopic* ; Urinary Bladder

OBJECTIVES: The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. METHODS: We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. RESULTS: 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory≥16), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. CONCLUSIONS: Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.
Anxiety ; Cross-Sectional Studies ; Depression* ; Female ; Health Behavior ; Health Promotion ; Humans ; Menopause ; Prevalence ; Prospective Studies ; Psychology ; Quality of Life* ; World Health Organization

PURPOSE: To evaluate the radiologic features of fibrothecoma of the ovary, which is a rare solid tumor originating from the ovarian sex cord-stroma. MATERIALS AND METHODS: The radiologic findings of 29 patients with pathologically-proven fibrothecoma of the ovary were retrospectively evaluated for bilaterality, size, shape, margin, echogenecity, CT attenuation, signal intensity on magnetic resonance imaging, calcification, and amount of ascites. RESULTS: All fibrothecomas were unilateral, and had well defined margins. The diameter of the mass was 4-18(mean, 9.6)cms. Elghteen of 29 tumors were round or oval with a smooth margin, and eleven were lobulated. The internal architecture of the tumor was purely solid in 21 patients, predominantly solid in six, and pre-dominantly cystic in two. A broad spectrum of sonographic features was apparent, including a homogeneously hypoechoic mass (with posterior shadowing in four cases, and without posterior shadowing in ten), a homoge-neously hyperechoic mass in seven cases, an anechoic mass with septatations in two, and a mixed echoic mass in six. On precontrast CT scans, the mass was isodense to the uterine myometrium in eight of nine cases, while on postcontrast scans the lesion was slightly hypodense to the myometrium in seven cases and isodense in one. On T1-weighted MR images, nine of ten cases showed a relatively homogeneous low signal intensity, while on T2-weighted images, signal intensity was homogeneously low in two patients and predominantly low with focal high intensity in seven of the other eight. On gadolinium-enhanced T1-weighted images, most tu-mors showed slight heterogeneous enhancement. Calcifications were present in two cases, and in two others there was a large amount of ascites. CONCLUSION: The characteristic finding of ovarian fibrothecomas is a well-defined, oval or lobulated homoge-neously solid mass, which on CT scans enhances less than uterine myometrium and demonstrates a predomi-nantly low signal intensity on both T1- and T2-weighted images. However, a predominantly solid mass with cystic components or a predominantly cystic mass may also be presented.
Animals ; Ascites ; Female ; Humans ; Magnetic Resonance Imaging ; Mice ; Myometrium ; Ovary ; Retrospective Studies ; Shadowing (Histology) ; Tomography, X-Ray Computed ; Ultrasonography

Meningiomas arise from meningothelial cells that line the arachnoid membrane. So most meningiomas are dural-based lesion. But meningiomas without dural-attachment do occur and are less common. We report our experience of intraparenchymal sylvian fissure menigioma. A 21-year-old female presented with a one-month history of headache that was associated with long-term intermittent partial seizure. CT revealed about 4.5x4.3x5.5cm sized calcified mass with enhancement in right temporal lobe. On MR imaging, the lesion was observed in the right temporal lobe that was low-signal intensity on T2WI and iso-signal intensity on T1WI with well enhancement. Operation was performed via right orbitocranial approach. The internal surface of dura was intact. Tumor was totally removed except the capsule of tumor adhered to main trunk of middle cerebral artery. The histopathology showed meningioma, psammomatous type. Intraparenchymal meningioma should be considered in the differential diagnosis of intraaxial lesions in patients of any age group.
Arachnoid ; Diagnosis, Differential ; Female ; Headache ; Humans ; Magnetic Resonance Imaging ; Membranes ; Meningioma* ; Middle Cerebral Artery ; Seizures ; Temporal Lobe ; Young Adult