Juxtaductal coarctation is usually distal to the origin of the left subclavian artery, occasionally the orifice of the subclavian artery is involved in the coarctation and partially obstructed. An anomalous origin of the right subclavian artery from the descending aorta below the coarcted segment is also occasionally encountered. Reversed vertebral artery flow to a subclavian artery arising at or below a coarctation may produce the subclavian steal syndrome. Rarely both subclavian arteries arise beyond the coarctation. These abnormal subclavian arteries are important in clinical diagnosis and treatment. We report a case of Turner syndrome with coarctation, which present as juxtaductal type and the left subclavian artery from the descending aorta below the coarcted segment with reversed vertebral artery flow to a subclavian artery producing the subclavian steal syndrome. Resecton of coarctation segment and end-to-end anastomosis was successfully performed after transfer of left subclavian artery to distal segment of descending aorta.
Aorta, Thoracic* ; Aortic Coarctation ; Diagnosis ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Turner Syndrome* ; Vertebral Artery

We tried to correlate brain CT findings with clinical state at admission and outcome at discharge in 42 selected cases from 94 adult patients under the diagnosis of tuberculous meningitis at Seoul National University Hospital during last four years from 1981. Their clinical state at admission and outcome at discharge were classified into three groups by severity of symptoms, respectively. The final outcome of them were well correlated with their clinical states at admission. Observed abnormal brain CT findings in this series were hydrocephalus (74%), dirthy cisternal enhancement (52%), infraction (38%), periventricular low density (36%), and tuberculoma (19%). The poorer the clinical state at admission and outcome at discharge, the more frequent the abnormal brain CT findings, especially of periventricular low density and infraction. But periventricular low density without infarction seemed to affect more deleterious effect on clinical state at admission than on final outcome.
Adult ; Brain* ; Diagnosis ; Humans ; Hydrocephalus ; Infarction ; Seoul ; Tuberculoma ; Tuberculosis, Meningeal*

BACKGROUND: The coagulation and fibrinolytic activities increase in the setting of acute myocardial infarction (AMI) and has been shown to increase further after the administration of thrombolytic agents. The reocclusion rate was slightly higher in patients with recombinant tissue type plasminogen activator (rt-PA) than urokinase (UK). However, there are few studies on serial changes in coagulation and fibrinolytic activities during the thrombolytic therapy. METHODS: Twenty five AMI patients who visited Yongdong Severance Hospital from August 1996 to August 1997 were recruited. They were randomized two groups either double bolus UK or accelerated rt-PA. Plasma levels of fibrinogen, thrombin-antithrombin III complex (TAT), plasmin-alpha2 plasmin inhibitor complex (PIC), activities of protein C and protein S were checked before and 3, 12, 24hrs and 7days after the thrombolytic therapy. RESULTS: Plasma level of fibrinogen was decreased 3 and 12hrs after the initiation of thrombolytic therapy in both groups (p<0.05) however, the fibrinogen level in UK treated group (59.9+/-33.5 mg/dl) was decreased than rt-PA treated group (198.2+/-64.3 mg/dl) at 3hrs after thrombolytic therapy (p<0.05). Activities of protein C and protein S were increased at 3hrs after thrombolytic therapy in both groups and no difference was noticed between UK and rt-PA group. Concentrations of TAT and PIC were increased in both groups even before the thrombolytic therapy was initiated. The increment of TAT level was larger in rt-PA group (21.7+/-16.1, 8.9+/-5.4 ng/mL) compared with UK group (15.0+/-17.9, 4.6+/-1.9 ng/mL) at 3 and 12 hrs after thrombolytic therapy (p<0.05). PIC level was significantly increased at 3 and 12 hrs after the treatment in both groups and no difference was noted between UK and rt-PA group. CONCLUSION: Both coagulation and fibrinolytic activities, activated already before thrombolytic therapy, were further aug-mented after thrombolytic therapy in AMI patients. The increment of fibrinolytic activity showed no significant difference between UK and rt-PA treated group. However the coagulation activity in rt-PA treated group was increased more than UK treated group.
Antifibrinolytic Agents ; Fibrinogen ; Fibrinolytic Agents ; Humans ; Myocardial Infarction* ; Plasma ; Protein C ; Protein S ; Thrombolytic Therapy ; Tissue Plasminogen Activator* ; Urokinase-Type Plasminogen Activator*

BACKGROUND: The coagulation and fibrinolytic activities increase in the setting of acute myocardial infarction (AMI) and has been shown to increase further after the administration of thrombolytic agents. The reocclusion rate was slightly higher in patients with recombinant tissue type plasminogen activator (rt-PA) than urokinase (UK). However, there are few studies on serial changes in coagulation and fibrinolytic activities during the thrombolytic therapy. METHODS: Twenty five AMI patients who visited Yongdong Severance Hospital from August 1996 to August 1997 were recruited. They were randomized two groups either double bolus UK or accelerated rt-PA. Plasma levels of fibrinogen, thrombin-antithrombin III complex (TAT), plasmin-alpha2 plasmin inhibitor complex (PIC), activities of protein C and protein S were checked before and 3, 12, 24hrs and 7days after the thrombolytic therapy. RESULTS: Plasma level of fibrinogen was decreased 3 and 12hrs after the initiation of thrombolytic therapy in both groups (p<0.05) however, the fibrinogen level in UK treated group (59.9+/-33.5 mg/dl) was decreased than rt-PA treated group (198.2+/-64.3 mg/dl) at 3hrs after thrombolytic therapy (p<0.05). Activities of protein C and protein S were increased at 3hrs after thrombolytic therapy in both groups and no difference was noticed between UK and rt-PA group. Concentrations of TAT and PIC were increased in both groups even before the thrombolytic therapy was initiated. The increment of TAT level was larger in rt-PA group (21.7+/-16.1, 8.9+/-5.4 ng/mL) compared with UK group (15.0+/-17.9, 4.6+/-1.9 ng/mL) at 3 and 12 hrs after thrombolytic therapy (p<0.05). PIC level was significantly increased at 3 and 12 hrs after the treatment in both groups and no difference was noted between UK and rt-PA group. CONCLUSION: Both coagulation and fibrinolytic activities, activated already before thrombolytic therapy, were further aug-mented after thrombolytic therapy in AMI patients. The increment of fibrinolytic activity showed no significant difference between UK and rt-PA treated group. However the coagulation activity in rt-PA treated group was increased more than UK treated group.
Antifibrinolytic Agents ; Fibrinogen ; Fibrinolytic Agents ; Humans ; Myocardial Infarction* ; Plasma ; Protein C ; Protein S ; Thrombolytic Therapy ; Tissue Plasminogen Activator* ; Urokinase-Type Plasminogen Activator*

No abstract available.

Unilateral nevoid telangiectasia is a rare but clinica.lly distinct dermatosis first deacribed by Zeisler in 1922. It had been also called as linear telangiectasia or unilateral telangiectasia. Wilkin suggested the term unilateral dermatomal superficial telangiectasia, in 1977. There are some reports of congenital unilateral nevoid telangiectasia but it usually occurs in women during the puberty and the third decade. Clinically it is characterized by superficial telangiectatic lesions distributed along the dermatomes uniIaterally and usually on the upper part of the body. It was reported that unilateral nevoid telangiectasia was related with elevated serum estrogen level in the many cases. We present two patients, 23-year and 25-year-old male soldiers, whose leaions were consistent with unilateral nevoid telangiectasia elinically and histopathologically.
Adolescent ; Adult ; Estrogens ; Female ; Humans ; Male ; Military Personnel ; Puberty ; Skin Diseases ; Telangiectasis*

No abstract available.
Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells*

Frey syndrome is characterized by sweating and flushing on the auriculotemporal region in respense to gustatory stimuli following surgery, trauma or irfection of the parotid areas. A 22-year-old man had received a surgery for sclerosis and hypertrophy of the left mandible. Two months after operation gustatory sweating occurred, whenever he eats, on the malar area without any detectable flushing or sensory impairment. Sweating starts in 30 seconds during food intake and is clearly visible with naked eyes within 2 minutes. This syndrome is encountered uncommonly to the dermatologic practitioners but more cases might be discovered if more attention could be given to this condition.
Acitretin* ; Administration, Oral ; Eating ; Etretinate* ; Flushing ; Humans ; Hyperkeratosis, Epidermolytic ; Hypertrophy ; Ichthyosiform Erythroderma, Congenital ; Ichthyosis* ; Mandible ; Nevus ; Porcupines* ; Sclerosis ; Sweat ; Sweating ; Sweating, Gustatory* ; Young Adult

PURPOSE: To evaluate the findings of carotid ultrasonography performed on patients with retinal vascular disease and to determine the risk of cardiovascular disease and association of retinal vascular disease and cardiovascular disease. METHODS: From December 2009 to May 2012, patients diagnosed with central retinal artery occlusion (CRAO, n = 18), central retinal vein occlusion (CRVO, n = 23), and branch retinal vein occlusion (BRVO, n = 68) underwent carotid ultrasonography. We evaluated the intima-media thickness (IMT) of the common carotid artery (CCA) and the internal carotid artery (ICA), stenosis and the number of plaques, and then compared these results with those of a healthy control group (n = 221). RESULTS: The mean CCA-IMT and ICA-IMT were significantly higher in the CRAO and BRVO groups compared with the control group. On the contralateral side, CCA-IMT was increased in the CRAO, BRVO, and CRVO groups and ICA-IMT was increased in the CRAO and BRVO groups compared with the control group. Contralateral CCA stenosis was higher in the CRVO group (9.1%) and ipsilateral ICA stenosis in CRAO group (21.7%) was significantly higher than that of the control group. Plaque was observed better in all groups compared with the control group. The proportion of patients risk for cardiovascular disease, i.e. those who had IMT thickenesses more than 1.0 mm, was higher in the CRAO and BRVO groups compared with the control group. CONCLUSIONS: The carotid ultrasound findings of patients with retinal vascular diseases showed increased IMT and plaque. The group of patient at risk for cardiovascular disease, which was defined with carotid artery IMT, was higher in patients with retinal vascular disease. Therefore, in patients with retinal vascular disease, carotid artery ultrasonography and the overall management and treatment of cardiovascular disease are necessary.
Cardiovascular Diseases ; Carotid Arteries ; Carotid Artery, Common ; Carotid Artery, Internal ; Constriction, Pathologic ; Ultrasonography ; Humans ; Retinal Artery Occlusion ; Retinal Vein ; Retinal Vein Occlusion ; Retinaldehyde* ; Ultrasonography* ; Vascular Diseases*

BACKGROUND: The visceral fat obesity is known to be associated with coronary artery disease. We investigated the relation between visceral fat obesity and the severity of coronary artery disease by angiography. METHODS: The coronary artery disease (CAD) group included 54 angina patients (43 men and 11 women) with angiographically demonstrated coronary artery disease. The control group included angiographically normal 28 controls (15 men and 13 women). The subjects with hypertension, non-insulin dependent diabetes mellitus (NIDDM) and taking any medication known to affect the insulin sensitivity were excluded. We measured the visceral fat area, abdominal subcutaneous fat area, thigh muscle area and the thigh fat area with computed tomography (CT) in both groups. We measured the plasma lipid profile, fasting plasma insulin and glucose level in both groups. RESULTS: There were no differences in the age, sex ratio and body mass index (BMI) between both groups. Total cholesterol and triglyceride increased in CAD group significantly (p<0.05, p<0.001). The HDL cholesterol decreased in CAD group. But there was no statistical significance (p=0.056). The fasting insulin increased in CAD group significantly (p<0.001). There were significant differences between CAD group and the control group in the visceral fat area (117.8+/-34.4 cm2vs. 85.5+/-17.6 cm2, p<0.001), thigh fat area (50.0+/-22.3 cm2vs. 65.8+/-12.9 cm2, p<0.001), visceral fat to abdominal subcutaneous fat area ratio (VS ratio:0.81+/-0.31 vs. 0.51+/-0.15, p<0.001) and the visceral fat to thigh fat area ratio (VSFTF ratio:2.72+/-1.24 vs. 1.34+/-0.35, p<0.001). In the male subgroup (CAD:43, control:15), triglyceride and fasting insulin increased in CAD group significantly (p<0.001). The visceral fat area, VS ratio, and VSFTF ratio increased in CAD group significantly (P<0.001) The thigh fat area decreased in CAD group significantly (P<0.001). In the female subgroup (CAD:11, control:13), fasting insulin and visceral fat area increased in CAD group significantly (p<0.001, p<0.05). Multiple logistic regression analysis revealed that VSFTF ratio, fasting insulin and the HDL cholesterol were independent associated factors of coronary artery disease. In comparison with normal control, one-vessel disease and multi-vessel disease (two vessel and three vessel), there were significant differences between groups in fasting insulin, triglyceride, visceral fat area, thigh fat area, VS ratio, VSFTF ratio. In Turkey's HSD Post Hoc test, however, there were no significant differences between one-vessel disease and multi-vessel disease. CONCLUSION: We observed significant increases in the visceral fat area, VS ratio and VSFTF ratio and decrease in thigh fat area in angiographically demonstrated CAD group compared with age, BMI matched angiographically normal control. But we did not observed any relation between the visceral fat area and the severity of coronary disease by angiography.
Angiography ; Body Mass Index ; Cholesterol ; Cholesterol, HDL ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Diabetes Mellitus ; Fasting ; Female ; Glucose ; Humans ; Hypertension ; Insulin ; Insulin Resistance ; Intra-Abdominal Fat* ; Logistic Models ; Male ; Obesity* ; Plasma ; Sex Ratio ; Subcutaneous Fat, Abdominal ; Thigh ; Triglycerides