Purpose: We describe the use of optical coherence tomography angiography (OCTA) to investigate the relationship between thyroid-stimulating hormone receptor autoantibody (TSHR Ab) levels and retinal vessel and choroid changes in patients with thyroid eye disease (TED). Methods: We enrolled 23 TED patients with abnormal TSHR Ab levels (>1.5 IU/L; all right eyes). Sex, visual acuity, intraocular pressure and TSHR Ab level were recorded at baseline and after 1 month. We used OCTA to determine the size of the superficial and deep foveal avascular zones (sFAZ and dFAZ, respectively), as well as the 1-mm foveal and 3-mm parafoveal superficial capillary plexus density (sCPD) and choroidal thickness (CT), at baseline and after 1 month later. Results: The mean age of the 23 patients was 43.30 ± 16.16 years and 18 were female (78%). The mean baseline TSHR Ab level was 11.47 ± 11.22 IU/L. The TSHR Ab level showed non-significant correlations with sFAZ and dFAZ size, and with the 1-mm foveal sCPD; the correlation coefficients were 0.173, 0.073, and 0.266, respectively (p = 0.465, p = 0.759, and p = 0.224, respectively). The 3-mm parafoveal sCPD and CT showed non-significant correlations with the TSHR Ab level; the correlation coefficients were -0.185 and -0.16 (p = 0.421, p = 0.487). Conclusions In TED patients, changes in TSHR Ab level over 1 month do not affect retinal blood flow or CT, but show a non-significant positive association with the 1-mm foveal sCPD.

Purpose: We describe the use of optical coherence tomography angiography (OCTA) to investigate the relationship between thyroid-stimulating hormone receptor autoantibody (TSHR Ab) levels and retinal vessel and choroid changes in patients with thyroid eye disease (TED). Methods: We enrolled 23 TED patients with abnormal TSHR Ab levels (>1.5 IU/L; all right eyes). Sex, visual acuity, intraocular pressure and TSHR Ab level were recorded at baseline and after 1 month. We used OCTA to determine the size of the superficial and deep foveal avascular zones (sFAZ and dFAZ, respectively), as well as the 1-mm foveal and 3-mm parafoveal superficial capillary plexus density (sCPD) and choroidal thickness (CT), at baseline and after 1 month later. Results: The mean age of the 23 patients was 43.30 ± 16.16 years and 18 were female (78%). The mean baseline TSHR Ab level was 11.47 ± 11.22 IU/L. The TSHR Ab level showed non-significant correlations with sFAZ and dFAZ size, and with the 1-mm foveal sCPD; the correlation coefficients were 0.173, 0.073, and 0.266, respectively (p = 0.465, p = 0.759, and p = 0.224, respectively). The 3-mm parafoveal sCPD and CT showed non-significant correlations with the TSHR Ab level; the correlation coefficients were -0.185 and -0.16 (p = 0.421, p = 0.487). Conclusions In TED patients, changes in TSHR Ab level over 1 month do not affect retinal blood flow or CT, but show a non-significant positive association with the 1-mm foveal sCPD.

A 56-year-old man presented with sudden onset of congestive heart failure (New York Heart Association class III to IV) after mild stress and developed various cardiovascular manifestations. At first visit, cardiac enzyme elevation, regional left ventricular (LV) wall motion abnormality and pulmonary edema were evident. However, coronary angiography was normal. LV function was totally recovered at discharge, suspicious of fulminant myocarditis. During the hospital stay, acute non-obstructive stroke without neurologic sequelae occurred. After 3 years, he re-admitted because ventricular tachycardia and severe LV systolic dysfunction (ejection fraction, 15%) were developed. After 3 days of applying percutaneous cardiopulmonary bypass system, the patient was completely recovered. Suspicious of pheochromocytoma, we checked 24-hour urine catecholamines and metanephrines and abdomen computed tomography, which revealed pheochromocytoma. The patient underwent laparoscopic adrenalectomy.
Abdomen ; Adrenalectomy ; Cardiomyopathies ; Cardiopulmonary Bypass ; Catecholamines ; Coronary Angiography ; Heart ; Heart Failure ; Humans ; Length of Stay ; Middle Aged ; Myocarditis ; Pheochromocytoma* ; Pulmonary Edema ; Stroke ; Tachycardia, Ventricular

BACKGROUND: Candida species are not only the leading cause of nosocomial fungal infections but also the important cause of infections in the immunocompromised hosts. Epidemiologic study of nosocomial candidiasis has been difficult because of the lack of a reliable typing system. We performed molecular epidemiologic study by using RFA and Southem hybridization for typing of candida isolates from patiients. METHODS: A total of 27 candida isolates from 19 immunocompromised patients were studied. Morphotyping and biotyping were done by germ tube test and API 20C system, respectively. Candidial chromosomal DNA was extracted, digested with EcoRI, HindalII and RFA was done. Southem hybridization of chromosomal DNA was also done with digoxigen-labelled Candial albicans-specific DNA probe. RESULTS: The time-period of development of oral candidiasis after admission was 5-14 days (mean: 8 days). C.albicans was the most common species (19), followed by C tropiadis (2), C glabn#zta (2), C.paratropicalis (2), and C parapsilosis (1). The subtypes of Candida species by RFA of chromosomal DNA were C. albieans, 12 types , C tropicalis, 2 types, C glabrata, 2 types ; C.parapsilasis, 1 type ; C. paratropicalis, 1 type. For 7 (87.5%) of 8 patients, RFA pattern of one isolate was identical to that of the other isolates. CONCLUSION: RFA of candidial chromosomal DNA results were obtainable within days. RFA showed high reproducibility, typeability and good discrimination power between isolates, provided a robust system that may be used rapidly to identify outbreaks of nosocomial candidiasis.
Candida ; Candidiasis* ; Candidiasis, Oral ; Cross Infection ; Discrimination (Psychology) ; Disease Outbreaks ; DNA ; Epidemiologic Studies* ; Epidemiology ; Humans ; Immunocompromised Host

A clinical study was done on 16 cases of constrictive pericarditis admitted to National Medical Center, from january, 1970 to October, 1982, were reviewed, conclusion as follows: 1) The patients with constrictive pericarditis generally revealed clinical features of right heart failure but low incidence of its characteristic features. 2) Hemodynamic and echocardiographic examinations were much helpful in confirmation of clinical diagnosis. 3) pericardiectomy was highly succesful in achievement of clinical improvement.
Diagnosis ; Echocardiography ; Heart Failure ; Hemodynamics* ; Humans ; Incidence ; Pericardiectomy ; Pericarditis, Constrictive*

No abstract available.
Aortic Valve Insufficiency ; Transcatheter Aortic Valve Replacement

BACKGROUND AND OBJECTIVES: Recent studies have shown that transradial coronary intervention (TRI) is feasible for percutaneous revascularization of chronic total occlusion (CTO). We investigated the feasibility and safety of using a 5-French catheter (5F) TRI for CTO and we compared it with that of using a 6F catheter TRI. SUBJECTS AND METHODS: One hundred fifteen patients (117 lesions) who underwent TRI for CTO (TIMI 0 or 1 for more than 2 months) were prospectively registered in this study from April 2002 to July 2004 (54 patients for the 5F and 61 patients for the 6F). The clinical, angiographic and procedural characteristics were evaluated and compared between the 2 groups. RESULTS: No major difference was noted for the clinical characteristics between the 2 groups. Coronary angiography showed a shorter occlusion length (5F: 8.8+/-7.6 mm, 6F: 14.7+/-12.7, p=0.008) and a higher incidence of the tapered type of entry morphology (5F: 74%, 6F: 56%, p=0.042) in the 5F group. A deep-seating technique was used more often in the 5F group (5F: 83%, 6F: 51%, p<0.001). The procedural success rate was similar between the 2 groups (5F: 82%, 6F: 86%, p<0.54). The most common cause of procedural failure for both groups was failure to pass the guidewire. The occlusion duration, lesion length and lesion angulation were the statistically significant predictors of procedural failure. No major procedural or local complication was noted. Minor hematoma occurred in 2 patients and no radial artery occlusion was noted. CONCLUSION: A 5F catheter TRI may be feasible and safe to use for a selected group of CTO lesions.
Angioplasty, Balloon, Coronary ; Catheters ; Coronary Angiography ; Hematoma ; Humans ; Incidence ; Prospective Studies ; Radial Artery