No abstract available.
Thyroid Gland*

Cardiac resynchronization therapy is effective in selected patients with symptomatic left ventricular dysfunction. Coronary sinus dissection is a relatively uncommon, but much feared, complication that may occur during placement of the left ventricular pacing lead. A 68-year-old man was transferred to our hospital for treatment of severe heart failure. He developed coronary sinus dissection after balloon dilatation during the procedure for cardiac resynchronization therapy. Nevertheless, we successfully placed the left ventricular pacing lead in the coronary vein. We present the case with a review of the literature.
Aged ; Cardiac Resynchronization Therapy ; Coronary Sinus ; Coronary Vessels ; Dilatation ; Heart Failure ; Humans ; Ventricular Dysfunction, Left

No abstract available.
Humans ; Inpatients*

Right transradial coronary catheterization is very popular and performed by many clinicians with few complications. An aberrant right subclavian artery (arteria lusoria) arising from the descending thoracic aorta is an uncommon congenital variant. Here, we present the case of a patient with an aberrant right subclavian artery dissection after right transradial coronary catheterization, which is a rare complication. We diagnosed the complication by chest CT, which showed the dissection of the aberrant right subclavian artery. Dissection of an aberrant right subclavian artery is a rare complication of right transradial coronary angiograph.
Aneurysm ; Angiography ; Aorta, Thoracic ; Cardiovascular Abnormalities ; Catheterization ; Catheters ; Deglutition Disorders ; Humans ; Subclavian Artery ; Thorax

The authors present the case of basilar artery bifurcation area aneurysm showing the growth of sac. A 46-year-old man was admitted for evaluation of fluctuating dysarthria. He had a history of lacunar infarction 3 years ago. The cerebral angiogram, taken at that time, showed a small aneurysm on basilar artery bifurcation area. Surgical intervention was not performed because of its small size. Brain MRI, taken for evaluation of dysarthria, showed large signal void at the basilar artery bifurcation area and following cerebral angiogram revealed the growth of previous aneurysm in its size. This observation suggests that careful follow-up examination should be performed for incidental small sized aneurysm.
Aneurysm* ; Basilar Artery* ; Brain ; Dysarthria ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Stroke, Lacunar

OBJECTIVE: The aim of this study is to evaluate of the significance of intraoperative electrophysiologic monitoring and follow up electrophysiologic study at seven days after microvascular decompression(MVD) for hemifacial spasm(HFS). METHODS: Thirty nine patients with hemifacial spasm were included in this study and were treated with MVD of the facial nerve from Jun 1990 to May 2001. The patients were divided into a monitoring group and a non-monitoring group. We compared the surgical outcomes, operation related complications between two groups. The abnormal muscle response(AMR) of preoperative electromyographic recording appeared on the mentalis muscle during stimulation of the zygomatic branch of the facial nerve was compared with those of changed during operation, immediately after operation and at postoperative 7th day(POD 7). The relationship between degree of AMR disappearance and surgical outcome was analyzed. RESULTS: There was no difference in surgical outcomes but significant difference in the incidence of operation-related complications between two groups. The results of electrophysiologic study at POD 7 were significantly correlated with surgical outcome in the monitoring group. CONCLUSION: The electrophysiologic study is helpful for identifying the offenders, determining the adequacy of vascular decompression and decrease of operation-related complications. The clinical and electrophysiologic status of HFS after MVD has continuously changed, and therefore the results of eletrophysiologic study at POD 7 are useful for predicting the surgical outcome.
Criminals ; Decompression ; Electromyography* ; Facial Nerve ; Follow-Up Studies* ; Hemifacial Spasm* ; Humans ; Incidence ; Microvascular Decompression Surgery*

In the field of the experimental lung transplantation, we analyzed the CT findings of acute rejection, infection in the left single allotransplanted lung of adult mongrel dogs, and the CT findings were compared with the histological findings obtained by the lung biopsy. Twenty two adult mongrel dogs were divided into two groups(Donor and recipient group). Donor lungs were flushed with LPDG(low potassium dextran glucose) solution(n=4) or modified Euro-collins solution(n=7) and preserved over 20 hours with 10degrees C(1 case preservation for 4hours). After left single lung transplantation, the chest X-ray and sequential computed tomogram were performed with concomitant hemodynamic study and arterial blood gas analysis on immediate postoperative period, postoperative 3rd day and postoperative 7th day. Two of eleven transplanted lungs had acute rejection which was represented as moderate infiltration at immediate or 1st postoperative day but became extensive infiltration at postoperative 3rd day on CT. There were showed one case of bronchopleural fistula, six cases of pneumonia and two cases of pulmonary infarction. In one rejection cases, the opacity of transplanted lung was improved by injection of methylprednisolone 500mg daily during 3 days. We concluded that CT was a useful noninvasive evaluation parameter after lung trans- plantation and the serial CT scan enabled early detection of acute rejection.
Adult ; Allografts* ; Animals ; Biopsy ; Blood Gas Analysis ; Dextrans ; Dogs* ; Fistula ; Hemodynamics ; Humans ; Lung Transplantation* ; Lung* ; Methylprednisolone ; Pneumonia ; Postoperative Period ; Potassium ; Pulmonary Infarction ; Thorax ; Tissue Donors ; Tomography, X-Ray Computed

We retrospectively analyzed 54 patients with esophageal cancer treated surgically between 1992 and 1996. They composed of 51(94.4%)men, 3(5.6%)women, and the age ranged from 42 to 78, the mean was 58.7+/-8.37. Symptoms were varied with dysphagia(72.2%), epigastric discomfort(16.6%), chest pain (5.6%), and so on(5.6%). Transthoracic esophagectomy(TTE) with esophagogastrostomy was done in 36 case, TTE with esophagocologastrostomy in 4 case, and transhiatal esophagectomy(THE) with esophagogastrostomy in 14 case. The operative mortality was 12.9%(7/54); 6 underwent TTE with esophagogastrostomy, and 1 underwent TTE with esophagocologastrostomy. Postoperative complications were of anastomotic leakage in 7 case, wound infection in 10 case, anastomotic stricture in 9 case, vocal cord paralysis in 2 case, bronchial tearing in 1 case, and pneumothorax in 3 case. Locations of esophageal cancer were upper thoracic esophagus in 4 case, middle thoracic esophagus in 34 case and lower thoracic esophagus in 16 case. Histological types were adenocarcinoma in 1 case and squamous cell carcinoma in 53 case. During the follow-up period, 25 cases died. Cumulative survival rate was 52.7% in 1 year, 45.5% in 2 year, 45.5% in 3 year, 45.5% in 4 year, 45.5% in 5 year.
Adenocarcinoma ; Anastomotic Leak ; Carcinoma, Squamous Cell ; Chest Pain ; Constriction, Pathologic ; Esophageal Neoplasms* ; Esophagus ; Follow-Up Studies ; Humans ; Mortality ; Pneumothorax ; Postoperative Complications ; Retrospective Studies ; Survival Rate ; Vocal Cord Paralysis ; Wound Infection

OBJECTIVE: This study is designed to evaluate the therapeutic effects and prognostic factors for barbituate coma therapy(BCT)in severe and refractory vasospasm following subarachnoid hemorrhage. METHODS: Barbiturate coma therapy was used in 18 patients with severe and refractory vasospasm in spite of "3-H therapy" and intra-arterial papaverine infusion. The authors analyzed the clinical parameters including Glasgow Coma Scale(GCS), electroenceplographic finding, and brain computerized tomography(CT) scan findings in relation to outcome at discharge. RESULTS: Among 18 patients, burst suppression pattern could be obtained in 17. In cases with good outcome, the duration elapsed from coma to drowsiness after BCT was 14.09+/-5.82 days and GCS score at this time was significant in the prediction of final outcome(p<0.05). Patients with ideal burst suppression pattern attainable more than 24 to 48 hours showed good outcome in 81.8%(p<0.05). The group that showed focal low density in the brain CT scan taken before BCT fared better prognosis compared with that of multifocal or diffuse low density(p<0.05), and patients with resolution of perimesencephalic cistern effacement on follow-up brain CT scan taken 48 hours after BCT showed better prognosis(p<0.05). Overall, 72.2% showed improvement of GCS score by 2 or more, and good outcome was noted in 50%. CONCLUSION: The barbiturate coma therapy seems to have a beneficial therapeutic effect on severe and refractory vasospasm and can be considered as a useful therapeutic modality.
Brain ; Coma* ; Follow-Up Studies ; Humans ; Papaverine ; Prognosis ; Sleep Stages ; Subarachnoid Hemorrhage* ; Tomography, X-Ray Computed

We report the case of a 47-year-old female who developed idiopathic eosinophilia-myalgia syndrome following complete remission of non-Hodgkin's lymphoma. She had been diagnosed extranodal marginal zone B cell lymphoma of nasal cavity and treated with CHOP chemotherapy and radiotherapy. She complained fever, myalgia and the complete blood count showed markedly elevated eosinophil count. Non-Hodgkin's lymphoma was confirmed in complete remission state by PNS CT, nasal septum biopsy and bone marrow biopsy. The patient showed eosinophilia in peripheral blood, myositis in electromyography and muscle biopsy consistent with eosinophilia-myalgia syndrome. The symptoms were improved and the eosinophilia count was decreased after prednisolone medication. We report a case of idiopathic eosinophilia-myalgia syndrome with a review of the literature.
Biopsy ; Blood Cell Count ; Bone Marrow ; Drug Therapy ; Electromyography ; Eosinophilia ; Eosinophilia-Myalgia Syndrome* ; Eosinophils ; Female ; Fever ; Humans ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin ; Middle Aged ; Myalgia ; Myositis ; Nasal Cavity ; Nasal Septum ; Prednisolone ; Radiotherapy