No abstract available.

Cardiovascular symptoms presenting in a patient with dengue fever may post a diagnostic dilemma. We describe a case of dengue myocarditis mimicking an acute myocardial infarction in a 56-year-old woman.

The isolated coronary ostial stenosis is a lesion of the aortic wall that encroaches on the orifice of the left main coronary artery, atherosclerosis is belived to be a common cause and premenopausal female patients are most commonly affected. Stenosis of the left coronary ostium is a critical lesion which requires urgent myocardial revascularization including a surgical intervention because this lesion jeopardizes such a large volume of left ventricular myocardium. We report the case of a patient in whom percutaneous transluminal coronary angioplasty (PTCA) was performed successfully for the stenotic lesion of distal anastomotic site after surgical ostioplasty with autologous pericardium.
Angioplasty, Balloon, Coronary ; Atherosclerosis ; Constriction, Pathologic* ; Coronary Vessels ; Female ; Humans ; Myocardial Revascularization ; Myocardium ; Pericardium*

Objective To study the feasibility and safety of transradial approach for coronary interventions Methods Coronary intervention was tried to be performed via transradial approach in 116 patients with coronary heart disease (96 males, 20 females, mean age 57 44?9 40 years) Results Transradial puncture failed in 5 cases and coronary interventions were performed via transfemoral approach instead Coronary intervention failed in 2 cases although transradial puncture succeeded Both transradial puncture and coronary intervention succeeded in the rest 109 cases One hundred and thirty five narrowed coronary arteries were dilated (69 LAD, 26 LCX, 39 RCA, 1 venous graft) One hundred and forty eight coronary lesions, including 15 type A, 106 type B and 27 type C lesions were treated One hundred and ten stents were implanted in 105 coronary arteries of 98 patients Rotablator was performed in one case and intracoronary ultrasound detected for another Changing guiding catheter was necessary for 25 cases during the procedure Transfusion was needed due to puncture site bleeding in one case Big hematoma was found in two cases Perforation of a branch of brachial artery happened in another case No surgery repair needed Conclusion Coronary intervention via transradial approach was feasible, but the radial artery puncture was somewhat difficult, and guiding catheter support is poor to some extent One must be cautious about vascular damages near the puncture site

No abstract available.
Aneurysm

Liver function tests before treatment showed abnormalities of liver function tests during treatment, while 15(68. 2%) of 22 patients who had abnormal liver function tests before treatment showed abnormalities during treatment. In 12 of the 25 patients who showed abnormalities of liver function tests during treatment with allopurinol, allopurinol was stopped and all patients showed improvement of liver function tests. In remaining 13 patients, 10 patients were improved and other 2 patients showed only mild abnormalities of liver function tests despite of continuing allopurinol and 1 patient was lost during follow-up. CONCLUSION: Abnormalities of liver function tests were common during treatment with allopurinol. Most patiensts who had mild abnormalities of liver functions tests during treatment with allopurinol were improved regardless of continuing allopurinol.
Allopurinol* ; Follow-Up Studies ; Gout* ; Humans ; Liver Function Tests* ; Liver*

The relationship of stress perception and frequency of stressors with serum total Ig E level was investigated in 54 outpatients with bronchial asthma. The GARS (global assessment of recent stress) scale and SRRS (social readjustment rating scale) were used to measure the degree of stress perception and frequency of stressors during a one-year period Total serum Ig E was measured by the PRIST method. 56% of the patients were found to have psychosomatic disorders, but there was no significant difference in stress perception and frequency of stressors between psychosomatic and non-psychosomatic groups. A considerable number of patients (63%) rated their symptoms as severe, but no significant correlation was found between severity of symptoms and stress perception. Severity of stress perception and frequency of stressors did not correlate with serum total Ig E level. Multiple regression analysis revealed that female patients were significantly higher in stress perception than male ones, and that chronicity of illness was more likely to increase stress perception. Extrinsic asthmatics had significantly more negative stressors than intrinsic ones. In conclusion, serum Ig E is considered a stable indicator of allergy not influenced by stress. It was also indicated that patients with bronchial asthma were more likely to perceive physical symptoms than psychological stress.
Adolescent ; Adult ; Asthma/*blood/*psychology ; Female ; Human ; Immunoglobulin E/*blood ; Male ; Middle Age ; Stress/*blood ; Support, Non-U.S. Gov'

No abstract available.
Hyperbilirubinemia, Neonatal*

No abstract available.
Allografts* ; Dendritic Cells*

BACKGROUND: Many physicians hesitate to discuss do-not-resuscitate (DNR) orders with patients or family members in critical situations. In the intensive care unit (ICU), delayed DNR decisions could cause unintentional cardiopulmonary resuscitation, patient distress, and substantial cost. We investigated whether the timing of DNR designation affects patient outcome in the medical ICU. METHODS: We enrolled retrospective patients with written DNR orders in a medical ICU (13 bed) from June 1, 2014 to May 31, 2015. The patients were divided into two groups: early DNR patients for whom DNR orders were implemented within 48 h of ICU admission, and late DNR patients for whom DNR orders were implemented more than 48 h after ICU admission. RESULTS: Herein, 354 patients were admitted to the medical ICU and among them, 80 (22.6%) patients had requested DNR orders. Of these patients, 37 (46.3%) had designated DNR orders within 48 hours of ICU admission and 43 (53.7%) patients had designated DNR orders more than 48 hours after ICU admission. Compared with early DNR patients, late DNR patients tended to withhold or withdraw life-sustaining management (18.9% vs. 37.2%, p = 0.072). DNR consent forms were signed by family members instead of the patients. Septic shock was the most common cause of medical ICU admission in both the early and late DNR patients (54.1% vs. 37.2%, p = 0.131). There was no difference in in-hospital mortality (83.8% vs. 81.4%, p = 0.779). Late DNR patients had longer ICU stays than early DNR patients (7.4 ± 8.1 vs. 19.7 ± 19.2, p < 0.001). CONCLUSIONS: Clinical outcomes are not influenced by the time of DNR designation in the medical ICU. The late DNR group is associated with a longer length of ICU stay and a tendency of withholding or withdrawing life-sustaining treatment. However, further studies are needed to clarify the guideline for end-of-life care in critically ill patients.
Advance Directives ; Cardiopulmonary Resuscitation ; Consent Forms ; Critical Illness* ; Hospital Mortality ; Humans ; Intensive Care Units ; Resuscitation Orders* ; Retrospective Studies ; Shock, Septic