No abstract available.
Animals ; Colon* ; Colonic Neoplasms* ; Oncogenes* ; Point Mutation* ; Rats*

This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.7%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow ; the routine CBC was 75.0%, the liver function test was 72.7%, and the computer tomogram was 15.4%.
Daegu* ; Diagnosis* ; Electrocardiography ; Humans ; Internal Medicine ; Liver Function Tests ; Medical Records ; Neurosurgery ; Orthopedics ; Outpatients ; Surveys and Questionnaires ; Tertiary Care Centers* ; Thyroid Function Tests ; Ultrasonography ; Urinalysis

Iliac vein compression syndrome is a rare clinical condition in which left common iliac vein is anatomically compressed between right common iliac artery and the fifth lumbar vertebrae or pelvic brim. Patients usually have marked edema of the left leg. Although the actual incidence is unknown, this syndrome most affects women in the second to fourth decade of life. We report 4 cases of iliac compression syndrome treated by surgical intervention during the last fifteen-year period. Among them, two women have suffered from chronic intermittent swelling and pain of left leg, and two men had acute or subacute symptoms. The fibrous web in the entrance of left iliac vein into vena cava existed in one case. Including this one, two were treated by transposition of iliac artery or vein with thrombectomy. One was decompressed the arterial compression by mobilization or adhesiolysis of the surrounding vessles with thrombectomy. To the last one in which the distal common iliac vein was compressed by tortous dilated left internal iliac artery, transsection and ligation of the internal iliac artery was performed. All patients have experienced improved left leg condition after operation. except the last one in which suffered from thrombosis of left popliteal vein after the iliac decompression.
Decompression ; Edema ; Female ; Humans ; Iliac Artery ; Iliac Vein ; Incidence ; Leg ; Ligation ; Lumbar Vertebrae ; Male ; May-Thurner Syndrome ; Popliteal Vein ; Thrombectomy ; Thrombosis ; Veins

We Reviewed 10 hypertensive children with pheochromocytoma retrospectively and the following results were obtained. 1) Out of 10 patients, 7 were male and 3 female. Age ranged from 5.5 years to 13.8 years and their median age was 9.9 years. 2) They complained of sweating, lethargy, headache. or chest pain and so on. Hypertension were noticed in all patients. Heart murmurs were detected in 7 patients and hypertensive retinopathy in 70%. 3) The three cases arised at extraadrenal gland and bilaterality was seen in 3 patients. In the view of diagnosis, abdominal sonography, computerized tomography and urine VMA test revealed the sensitivity of 100%. But MIBG scan showed 60% in sensitivity. 4) Waiting for operation, their hypertension were controlled by adrenergic blockers or calcium channel blockers. They received tumorectomy successfully except one who was in hypertensive state after operation and followed up through OPD. In conclusion high suspicion for the existence of pheochromocytoma from the clinical manifestations should be entertained in any pediatric patients and biochemical and imaging studies were mandatory. Furthermore, for the accurate localization of tumors, several imaging studies should be collaborated.
3-Iodobenzylguanidine ; Adrenergic Antagonists ; Calcium Channel Blockers ; Chest Pain ; Child* ; Diagnosis ; Female ; Headache ; Heart Murmurs ; Humans ; Hypertension ; Hypertensive Retinopathy ; Lethargy ; Male ; Pheochromocytoma* ; Retrospective Studies ; Sweat ; Sweating

PURPOSE: In the initiation and progression of the atherosclerosis many factors are related each other. The individual variations also complicate the prediction of the atherosclerotic process. The purpose of this study was to investigate the morphologic changes by angiography in iliac arterial segments of the patients who had received bypass operation for the infrainguinal atherosclerotic occlusive disease of the lower extremities. METHODS: Forty-five common iliac artery (CIAs) and forty-two external iliac arteries (EIAs) in twenty nine male patients who underwent angiography for graft failure of lower extremity bypass surgery was included in this retrospective study, and their clinical chart and angiographic findings of iliac arteries were reviewed. Acute arterial occlusive cases were excluded from this study. The mean interval from the previous bypass surgery was 38.9 months (from 6 to 96 months) and the patient ages ranged from 34 to 81 years (average age 59 years). It was considered as change, that is disease progression, when luminal narrowing of iliac artery was more than 25% compared to the previous angiography at bypass surgery. RESULTS: Of 45, fifteen CIAs (33.3%) showed change. In 3 patients, the change was bilateral; in 4, ipsilateral to the failed graft limb; and in 5, contralateral. Considering EIAs, 13 of 42 (31.0%) were changed. In 1 patient, the change was bilateral; in 6, ipsilateral to the failed graft limb; and in 5, contralateral. Therefore the side of the changed iliac arteries had no statistical significance in relation to the side of limb at which graft failure occurred (P<0.05). There was no significant correlation between age or interval between bypass operation and repeat angiography and the progression of atherosclerosis of iliac arteries. CONCLUSION: The progression of atherosclerosis is not dominated in iliac arteries ipsilateral to the side in which bypass surgery was performed and graft failure occurred. In iliac artery, the short-term progression of atherosclerosis observed by angiography may vary among individuals independently withage, interval between operation and repeat angiography, and the hemodynamic change of the infrainguinal arteries.
Angiography ; Arteries ; Atherosclerosis ; Disease Progression ; Extremities ; Hemodynamics ; Humans ; Iliac Artery* ; Lower Extremity* ; Male ; Phenobarbital ; Retrospective Studies ; Transplants

Superior mesenteric artery syndrome (SMAS) is a rare disease and is seldom seen in patients with abdominal aortic aneurysms. We experienced a SMAS as a result of an enlarged abdominal aortic aneurysm in a 52 year-old female patient who had undergone renal transplant in the right iliac position 8 years previously. The abdominal aortic aneurysm was successfully resected without an extracorporeal bypass during crossclamping, and postoperatively the patient's symptoms were improved and her renal function was well preserved.
Aortic Aneurysm, Abdominal* ; Female ; Humans ; Kidney Transplantation ; Mesenteric Artery, Superior* ; Middle Aged ; Rare Diseases ; Superior Mesenteric Artery Syndrome* ; Transplantation*

OBJECTIVES: Generally, it seemed that the therapeutic result in diabetic patients was changed by compliance. This study was conducted on the basis of assumption that the therapeutic result in diabetic patients could control according to compliance. This study was conducted to analyze the related factors in association with compliance to drug, diet and exercise therapy. METHODS: 224 diabetic patients in Kyungpook National University Hospital were selected through the interviews and HbA1c values from 1 Jan. to 28 Feb. 1997. The drug compliance was tested by regularity of drug administration, the diet compliance was tested by restriction of food, exactly allocation, balance of nutrient, measuring food and the exercise compliance was tested by regularity of exercise per day. We assessed compliance by percentage, X2-test and generalized logit regression model(method:enter). RESULTS: The significant variable was the satisfaction to medical personnels in drug, the knowledge to disease in diet, the participation of the diabetic education in exercise therapy and the satisfaction to medical personnels in HbA1c. Using the generalized logit model(method : enter) in compliance change, the significant variables were the satisfaction to medical personnels and the complication in drug; the significant variables were the age at the first diagnosis, the family history, the concern of health, the knowledge of disease, the self-exertion for therapy and the complication in diet; the only significant variable was the gender in exercise therapy. CONCLUSIONS: The degree of glycemic control in diabetic patients was influenced by compliance. In order to improve patient's compliance, we must foster the knowledge on the diseases, lead participation for diabetic education. Because the satisfaction to medical personnels was the important variables, we must build up good relationship between doctors and patients.
Compliance* ; Diabetes Mellitus ; Diagnosis ; Diet ; Education ; Exercise Therapy ; Gyeongsangbuk-do ; Humans

No abstract available.

The early diagnosis of abdominal aortic aneurysms are difficult, especially when they are not clinically evident. Because of the generalized nature of atherosclerosis, there is reason to believe that there is a high incidence of aneurysms of the abdominal aorta in patients with peripheral vascular disease. But the screening test for hidden abdominal aortic aneurysms in patients with peripheral arterial disease has not been used for routine manner. So we retrospectively reviewed the 9 patients who had asymptomatic abdominal aortic aneurysms with symptomatic peripheral arterial disease during the last four and half-year period: among them three aneurysms were screened preoperatively by physical examination with their diameter more than 5 cm and 6 aneurysms were found intraoperatively with their mean diameter of 3.8 cm. The ages ranged from 66 through 84 years with the mean age 73 years. There were 7 men and 2 women. The sites of the peripheral occlusive disease is as follows: femoral artery only in 1, iliac artery only in 2, both iliac and femoral arteries in 5, and from iliac artery through tibial artery with thrombus formation in 1. We suggest that ultrasonographic screening for the presence of hidden abdominal aortic aneurysm preoperatively in patients with lower extremity occlusive arterial disease is needed, especially when the ages of patients is older than 65 years and the site of arterial disease include iliac segment.
Aneurysm ; Aorta, Abdominal ; Aortic Aneurysm, Abdominal* ; Atherosclerosis ; Early Diagnosis ; Female ; Femoral Artery ; Humans ; Iliac Artery ; Incidence ; Lower Extremity ; Male ; Mass Screening ; Peripheral Arterial Disease* ; Peripheral Vascular Diseases ; Physical Examination ; Retrospective Studies ; Thrombosis ; Tibial Arteries

PURPOSE: To evaluate the role of repetitive vascular surgery in below-knee amputation for critical lower-limb ischemia. METHODS: The data of the 39 below-knee amputee despite receiving one more vascular surgery for critical limb ischemia from Jaunary 1990 through October 1995 were retrospectively reviewed. A total of 102 surgical operation was included. RESULTS: The mean age was 46 years old ranged from 21 through 78 and the forth decade was the most prevalent group by proportion of 33% (13 cases). The frequency of Buerger's disease is 20, and that of atherosclerotic occlusion (ASO), ASO with diabetes, and diabetic arteriopathy (DA) were 11, 4, 3, respectively. The number of operative procedures before amputation and the total mean duration (TMD: days) from initial operation to final amputation for femoral, popliteal and tibial occlusion were 45/485, 26/921 and 13/1725, respectively. Those for Buerger's disease, ASO, ASO with diabetes and DA were 42/960, 25/865, 9.1027, and 7/251 respectively. The proportions of duration between initial vascular procedure and second one in the TMD for the patients of tibial occlusion and ASO with diabetes revealed 95.0% and 98.4%. Smoking revealed shortened the duration until amputation in cases of popliteal artery involvement. CONCLUSION: The frequency of below-knee amputation due to critical limb ischemia is high in Buerger's disease and in the age of fourth decade. Patients of the tibial artery involvement and ASO with diabetes may not have benifits from repetitive operative procedures after initial vascular surgery in postponing the below-knee amputation. More study is needed with incresed number of cases.
Amputation* ; Amputees ; Extremities ; Humans ; Ischemia* ; Lower Extremity* ; Middle Aged ; Popliteal Artery ; Retrospective Studies* ; Smoke ; Smoking ; Surgical Procedures, Operative ; Thromboangiitis Obliterans ; Tibial Arteries