BACKGROUND AND OBJECTIVES: To avoid the risk of developing contrast-induced nephropathy (CIN), it has been suggested that patients be subjected to a minimal necessary dose of contrast medium (CM-dose). However, often it is not easy to determine such a dose. This study assessed the usefulness of the ratio of CM-dose to estimated glomerular filtration rate (eGFR) in predicting the risks of CIN and sought to determine the safe level of CM-dose/eGFR in patients undergoing non-emergent percutaneous coronary intervention (PCI). SUBJECTS AND METHODS: We enrolled a total of 226 patients and calculated the ratio of CM-dose using grams of iodine (g-I) to eGFR, thus expressing it as g-I/eGFR. Among the CIN patients, those with ne-phropathy requiring dialysis (NRD) were also evaluated. RESULTS: Overall, there were 16 cases (7.1%) of CIN. On univariate and multivariate regression analysis, g-I/eGFR alone was found to be an independent predictor for CIN (hazard ratio=10.73, p<0.001). In an receiver operating characteristic analysis, fair discrimination for CIN was found at a g-I/eGFR level of 1.42 (C statics=0.867), and at this value, the sensitivity and specificity were 81.3% and 80%, respectively. Of patients (n=51) with g-I/eGFR > or =1.42, 23.6% (13/51) and 7.8% (4/51) developed, while those with g-I/eGFR <1.42 (n=171) had a lower incidences of CIN (1.8%, 2/171, p<0.001) and NRD (0%, 0/171, p<0.001). CONCLUSION: It can be concluded that a g-I/eGFR <1.42 is a simple, useful indicator for determining the safe CM-dose based on the pre-PCI eGFR values. Furthermore, g-I/eGFR might have a close relationship with the development of NRD as well as CIN.
Acute Kidney Injury ; Angiography ; Contrast Media ; Dialysis ; Discrimination (Psychology) ; Glomerular Filtration Rate ; Humans ; Incidence ; Iodine ; Percutaneous Coronary Intervention ; ROC Curve ; Sensitivity and Specificity

Intravascular ultrasound (IVUS) is a useful diagnostic method that provides valuable information in addition to angiography regarding the coronary vessel lumen, dimensions, plaque burden, and characteristics. The major use of IVUS in coronary intervention is to guide interventional strategies and assess optimal stent deployment. Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased. However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased. Thus, optimization of stent deployment under IVUS guidance may be clinically important. In this review, we focus on the potential role of IVUS in stent optimization during percutaneous coronary intervention and its clinical benefits.
Angioplasty, Balloon, Coronary/adverse effects/*instrumentation/mortality ; Coronary Artery Disease/mortality/*therapy/*ultrasonography ; Coronary Restenosis/etiology ; Drug-Eluting Stents ; Evidence-Based Medicine ; Humans ; Myocardial Infarction/etiology ; Prosthesis Design ; *Stents ; Thrombosis/etiology ; Treatment Outcome ; *Ultrasonography, Interventional

Cholesterol granuloma is thought to arise as the consequence of obstruction of the air cell system. Once the ventilation is blocked, negative pressure builds with mucosal hemorrhage and blood extravasation into the air cell system. And the catabolism of blood releases cholesterol, hemosiderin, lipids and fibrin. It is the foreign body reaction of these products that leads to cholesterol granuloma and cholesterol granuloma cyst formation. The cholesterol granuloma and cholesterol granuloma cyst may develop in any portion of the pneumatic system of the temporal bone and small lesions are commonly encountered in the middle ear and mastoid air cells. But, huge cholesterol granuloma cyst is a unusual lesion and cholesterol granuloma cyst with extensive temporal bone destruction and intracranial extension has been rarely reported. Recently we experienced a case of huge cholesterol granuloma cyst with intracranial extension in a 38-year-old female, and report this case with review of literatures.
Adult ; Cholesterol* ; Ear, Middle ; Female ; Fibrin ; Foreign-Body Reaction ; Granuloma* ; Hemorrhage ; Hemosiderin ; Humans ; Mastoid ; Metabolism ; Temporal Bone* ; Ventilation

PURPOSE: This study was conducted to determine the correlation of anemia and conjunctival vasculature on slit lamp biomicroscopy. METHODS: Through random sampling, 118 subjects who were either inpatients or outpatients in the hematology department were selected for examination. Palpebral conjunctival hue (PCH) and bulbar conjunctival blood column (BCBC) were observed by a single physician to whom the diagnosis and hemoglobin level of the patient were strictly masked. Three different threshold levels were defined for anemia : <10 mg/dl, <11 mg/dl, and <12 mg/dl. RESULTS: Mean hemoglobin concentration was 10.39+/-2.9 mg/dl. Sensitivity of the BCBC and PCH for anemia was 86% and 41%, respectively. Specificity of BCBC improved with increasing hemoglobin threshold level for anemia. BCBC was significantly associated only with anemia of hemoglobin <12 mg/dl (p<0.02). PCH was significantly associated only with anemia of <11 mg/dl (p<0.05). BCBC showed a significant association with anemia: sensitivity was higher and specificity was slightly less than PCH. CONCLUSIONS: It was not easy to detect moderate anemia solely on slit lamp biomicroscopic findings unless hemoglobin concentration was given. In conclusion, BCBC was useful in detecting moderate anemia than PCH.
Anemia* ; Diagnosis ; Hematology ; Humans ; Inpatients ; Masks ; Outpatients ; Sensitivity and Specificity

PURPOSE: To evaluate the functional and cosmetic results of trichiasis treatment between the argon laser epilation(Group A) and tarsotomy(Group B). METHODS: Twenty-seven patients with diffuse lower lid trichiasis, whose post-treatment follow-up periods were longer than 3 months, were reviewed retrospectively. Functionally, 14 of 16 patients(89.6%) in group A were satisfied, whereas 9 of 11 patients(84.0%) were in group B. And cosmetically, 10 of 16 patients(62.9%) in group A were satisfied, whereas 8 of 11 patients(79.0%) were in group B. The functional results were similar between the two groups(p>0.05), but the cosmetic results were better in group B than in group A(p<0.05) CONCLUSIONS: The inferior tarsotomy appears to be an effective surgical procedure in patients with diffuse lower lid trichiasis.
Argon ; Follow-Up Studies ; Humans ; Retrospective Studies ; Trichiasis*

OBJECTIVES: Congenital muscular torticollis, a common disorder that refers to the shortening of the sternocleidomastoid in infants, is sensitive to correction through physical therapy when treated early. If physical therapy is unsuccessful, surgery is required. In this study, we developed a support vector regression model for congenital muscular torticollis to investigate the prognosis of the physical therapy treatent in infants. METHODS: Fifty-nine infants with congenital muscular torticollis received physical therapy until the degree of neck tilt was less than 5degrees. After treatment, the mass diameter was reevaluated. Based on the data, a support vector regression model was applied to predict the prognoses. RESULTS: 10-, 20-, and 50-fold cross-tabulation analyses for the proposed model were conducted based on support vector regression and conventional multi-regression method based on least squares. The proposed methodbased on support vector regression was robust and enabled the effective analysis of even a small amount of data containing outliers. CONCLUSIONS: The developed support vector regression model is an effective prognostic tool for infants with congenital muscular torticollis who receive physical therapy.
Humans ; Infant ; Least-Squares Analysis ; Neck ; Prognosis ; Torticollis

No abstract available.

Balanced complex chromosomal rearrangements involving three or more chromosomes are often detected in phenotypically normal female patients with an adverse obstetric history. Here, we report a 32-yr-old phenotypically normal female with a history of multiple in vitro fertilization (IVF) failures and carrying a balanced complex chromosomal rearrangement involving chromosomes 1, 7, and 16. Cytogenetic analysis revealed the following complex karyotype: 46,XX,t(1;7;16)(p32.1;q22;q13). The patient achieved a twin pregnancy after IVF, although no heartbeat was detected during the sixth gestational week checkup. Tissues from intrauterine fetal demise were tested for chromosomal analysis and revealed 46,XX,t(1;7;16)(p32.1;q22;q13)mat and 46,XY,der(1)t(1;16)(p32.1;q13),der(7)t(1;7) (p32.1;q22)mat. This case illustrates the importance of chromosomal analysis in infertile females or infertile females with multiple IVF failures. Therefore, it would be beneficial for patients visiting infertility clinics to undergo cytogenetic screening for complex chromosome rearrangements before further counseling and prenatal investigations.
Abortion, Habitual ; Counseling ; Cytogenetic Analysis ; Cytogenetics ; Female ; Fertilization in Vitro ; Humans ; Infertility ; Lifting ; Mass Screening ; Pregnancy ; Pregnancy, Twin

BACKGROUND/AIMS: The liver function tests (LFTs), such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyltranspeptidase (gamma-GT), have been widely used as screening tests but their low positive predictive value can cause many false positive results. To evaluate the clinical usefulness of these tests, we analyzed the serial LFT results for factory workers, and we compared the risk factors for the groups that were divided according to the serial LFT results. METHODS: From June 2001 to October 2001, 1223 consecutive healthy workers in a single factory were enrolled in our study; a questionnaire, LFT and liver ultrasonography were done for all the subjects. The previous LFT results were collected from the Annual health examination survey. According to the abnormalities on the serial LFT, the participants were classified into three groups (abnormal-in-both, alternating or, normal-in-both) and the risk factors were compared among these groups using multiple logistic regression analysis. RESULTS: The prevalence of LFT abnormality on a single test was 16.8%, but on the serial LFT, only 5% of the study participants showed consistent abnormality. The risk factors for the abnormal-in-both group, compared with the alternating group, were liver ultrasonography abnormality such as a fatty liver (odds ratio, 2.2; P=0.026) and a heavy alcohol intake (more than 210 g/week) (odds ratio, 7.2; P=0.064). HBsAg was not a significant risk factor for any of the three groups. CONCLUSIONS: In factory workers having serial LFT abnormalities, alcoholic liver disease could be the principal cause of abnormal LFT. Even if the HBsAg were positive in patients with abnormal LFT, there is the possibility of another causes for LFT abnormalities such as alcoholic liver disease and non-alcoholic steatosis or steatohepatitis.
Adult ; English Abstract ; Female ; Humans ; Korea ; Liver/*enzymology ; Liver Diseases/*diagnosis ; *Liver Function Tests ; Male ; Middle Aged ; Occupational Health Services ; Risk Factors