No abstract available.
Child* ; Humans ; Rheumatic Heart Disease*

OBJECTIVES: The purpose of this study is to garner useful information through a comparative analysis of health behaviors and health states between the young-old and old-old elderly in a rural Korean area. METHODS: We define the young-old elderly as those 65 to 74 years of age, and the old-old as those over 70. The survey was administered in October and November of 2009 at senior citizen centers in Sangju City, Kyongsangbuk-do, South Korea. The number of subjects surveyed approximated the demographics of the aged population of the administrative district of centers of 24 eup, myeon, and dong. RESULTS: Compared with the young-old elderly, the old-old were vulnerable to population sociological characteristics. While there were many cases of contraction of diseases, only a small percentage of old-old elderly were engaged in regular exercise. In addition, the old-old elderly lagged behind the young-old in terms of physical activity, mental and oral health, hearing, and vision. CONCLUSIONS: The vulnerability of the old-old elderly in terms of physical and mental health needs to be acknowledged as various characteristics of the elderly that appears according an age group. A variety of disease prevention and health promotion programs that focus on the health behavior and status of the young-old and old-old elderly need to be developed and put into practice.
Aged ; Contracts ; Demography ; Health Behavior ; Health Promotion ; Hearing ; Humans ; Mental Health ; Motor Activity ; Oral Health ; Republic of Korea

No abstract available.
Cystitis*

Serrated polyposis syndrome (SPS) can transform to malignant lesions through the sessile serrated pathway and traditional serrated pathway. These pathways may cause rapid neoplastic progression compared to the adenoma-carcinoma sequence, which may cause interval colorectal cancer. The authors experienced a case of SPS with a synchronous colon adenocarcinoma that was treated with an endoscopic mucosal resection. In pathology reviews, other parts of the adenocarcinoma showed sessile serrated adenoma. Therefore, patients with SPS have a potential for malignant transformation, highlighting the need for strict colonoscopy surveillance starting at the time of SPS diagnosis.

Many patients regard tonsillectomy as a minor operation because it is performed frequently. Although tonsillectomy is considered a relatively safe surgical procedure, numerous complications have been described. The common complications are hemorrhage, infection, and following anesthesia, aspiration, cardiac arrhythmia, and laryngeal trauma. Cervicofacial emphysema and pneumomediastinum are rarely observed sequelae of surgical intervention in the upper aerodigestive tract. Although these complications resolve spontaneously in most cases, a few cases result in tension pneumothorax and other life-threatening conditions. Symptoms include chest pain, neck pain, dyspnea and odynophagia. Treatment involves frequent assessment of the airway and extent of the emphysema. The authors of the present study report of a patient who developed pneumomediastinum shortly after an adenotonsillectomy as well as a review of the related literature.
Anesthesia ; Arrhythmias, Cardiac ; Chest Pain ; Dyspnea ; Emphysema ; Hemorrhage ; Humans ; Mediastinal Emphysema ; Neck Pain ; Pneumothorax ; Subcutaneous Emphysema ; Tonsillectomy

BACKGROUND: Adaptive remodeling of the wall of diseased arterial segments occurs to compensate for the accumulation of atherosclerotic plaque. Histopathologic studies and intraoperative high-frequency epicardial coronary ultrasound imaging as well as intracoronary ultrasound imaging have shown that human coronary arteries enlarge in parallel with the formation of atherosclerotic plaque. Therefore, the lumen area is preserved until the progressive accumulation of plaque exceeds the compensatory mechanisms of the vessel. In 1995, however, Pastercamp et al. reported that arterial wall constriction (shrinkage) or inadequate enlargement may be a different mechanism associated with the development of severe arterial lumen narrowing in addition to plaque proliferation. The aim of this study is to examine what extent of de novo native coronary arterial stenosis is accompanied by compensatory enlargement and to find the predictors of inadequate remodeling with intravascualr ultrasound. METHODS: Fifty eight patients were enrolled from February 1997 through October 1997. Patients who had the lesion of more than 50% stenosis of minimal luminal diameter in coronary angiography were indicated. The lesion which was located in the ostium or was very tortuous or angulated was excluded. The lesion which had the history of balloon angioplasty or stent insertion was also excluded. We used 20 MHz endosonic intravascular ultrasound catheter. We measured EEM area (External Elastic Membrane area), lumen area and plaque plus media area and analysed plaque characteristics. RESULTS: 1) Fifty-eight consecutive patients (43 men, 15 women; mean age 55.4 years, range 33 to 78) who had not undergone previous catheter intervention were studied with a single intravascular ultrasound system. 2) Among 58 patients, 20 patients (35%) had acute myocardial infarction, 30 patients (52%) unstable angina, 6 patients (10%) stable angina and 2 patients (3%) old myocardial infarction. Lesions were located at the left anterior descending arteries in 29 patients (50%), right coronary arteries in 21 patients (36%) and left circumflex coronary artery in 8 patients (14%). 3) Compensatory enlargement was observed in 19 (32%) of 58 lesions and inadequate compensatory enlargement in 39 (68%). 4) EEM and plaque areas at lesion site of compensatory enlargement group were significantly larger than those of inadequate enlargement group (p<0.05). 5) Risk factors for coronary arterial disease including diabetes mellitus, hypertension, hypercholesterolemia (serum cholesterol<0A65B>240 mg/dl), smokings and plaque characteristics were not statistically related with inadequate enlargement. Although there was no statistical significance, there was a tendency of inadequate enlargement in patients with diabetes mellitus and calcified plaque. 6) The only predictor of inadequate remodeling was the postmenopausal female (p<0.05). CONCLUSION: Adaptive compensatory coronary arterial remodeling was occured less frequently in patients with acute coronary syndromes than in patients with stable angina. The only statistically significant predictor of adaptive compensatory coronary arterial remodeling was postmenopausal women. Inadequate compensatory coronary arterial remodeling was occured more frequently in patients with diabetes mellitus or calcified plaque but without statistical significance.
Acute Coronary Syndrome ; Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon ; Arteries ; Catheters ; Constriction ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels ; Diabetes Mellitus ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Male ; Membranes ; Myocardial Infarction ; Phenobarbital ; Plaque, Atherosclerotic ; Risk Factors ; Smoke ; Stents ; Ultrasonics* ; Ultrasonography

Introduction: Thromboelastography (TEG) provides an overall assessment of the platelet-coagulation protein cascade interaction. The information generated from the TEG is rapidly obtained and made useful to guide replacement therapy. The purpose of this study was to evaluate the efficacy of the TEG as its guided blood replacement therapy and pharmacological therapy during liver transplantation. METHODS: This study was carried out in 13 consecutive patients who were subjected to TEG-guided replacement therapy during liver transplantation. A prepared mixture of blood products used for continuous replacement therapy was a fluid composed of red blood cells(2 units), fresh frozen plasma (2 units), and normal saline(500 ml). The pharmacological therapy was performed by comparing TEG of untreated blood and blood treated with antifibrinolytic and heparin neutralizing agent. Based on the findings of TEG, platelet concentrates were given. The TEG samples were obtained at various intervals. Additional TEG tracing was obtained as needed to see the effect of therapeutic intervention. RESULTS: In all patients the reaction time was kept in an acceptable range in the preanhepatic stage by administration of the mixture of blood products. Heparin-induced anticoagulation was observed in 3 cases in the anhepatic stage and in 11 cases upon reperfusion. Fibrinolysis was seen in all but one patients: 8% in the preanhepatic stage, 41% in the anhepatic stage, 69% at reperfusion, and 2% in the postanhepatic stage. Early and aggressive treatment with epsilon-aminocaproic acid effectively inhibited fibrinolysis without complications. Ten patients needed platelet transfusion in the postanhepatic stage with significant improvement in the TEG. CONCLUSIONS: The results of this study suggest that TEG monitoring and TEG-guided replacement and pharmacological therapy are clinically effective in maintaining blood coagulability.
Aminocaproic Acid ; Blood Platelets ; Fibrinolysis ; Heparin ; Humans ; Liver Transplantation* ; Liver* ; Plasma ; Platelet Transfusion ; Reaction Time ; Reperfusion ; Thrombelastography ; Transplantation

The widespread application of coronary angiography and poen heart surgery have resulted in more frequent detection of patients with coronary artery anomaly. In 0.6 to 1.2 percent of individials, the coronary arteries arise aberrantly from the aorta. Anomalous origin of the left coronary artery from the fight coronary sinus with subsequent coursing between the aorta and pulmonary artery is a rare and sometimes fatal coronary amonaly. This anomaly has been reported in young and healthy men who died suddenly during or immediately forllowing vigorous physical exercise. The exact mechanism of sudden death is unclear. It is believed to be related to either extrinsic compression of the left coronary artery or distorsion of the vessel orifice, with resultant global ischemia and ventricular fibrllation. A 13-years old healthy boy, who was completely asymptomatic until he had sudden chest pain after running, arrived at hospital with typical clinical picture of acute myocardial infarction. The electrocardiography taken on admission demonstrated pathologic Q wave changes on lead I, aVL, V2, V3 and V4. Cardiac enzymes were elevated. The selective coronary angiography demonstrated that left coronary artery arose from the right coronary sinus. The anomalous left coronary artery passed posterioly around aortic root to reach its normal position in the interventricular groove. We report the patient with anomalous origined left coronary artery which causes the acute myocardial infarction.
Adolescent ; Aorta ; Chest Pain ; Coronary Angiography ; Coronary Sinus* ; Coronary Vessels* ; Death, Sudden ; Electrocardiography ; Exercise ; Humans ; Ischemia ; Male ; Myocardial Infarction* ; Pulmonary Artery ; Running ; Thoracic Surgery

No abstract available.

No abstract available.