Kasabach-Merritt phenomenon does not occur with common hemangioma, rather it is associated with the more aggressive Kaposiform hemangioendothelioma and rarely with other vascular neoplasm. We report the case of an adult who was diagnosed as Kaposiform hemangioendothelioma complicated by Kasabach-Memtt phenomenon. This is the first report in Korea of an adult with Kasabach-Merritt phenomenon who has osteolytic changes of femur, pelvic bone, and lumbar spine.
Adult* ; Femur ; Hemangioendothelioma* ; Hemangioma ; Humans ; Kasabach-Merritt Syndrome ; Korea ; Pelvic Bones ; Spine ; Vascular Neoplasms

Long-term dialysis is undertaken infrequently in patients with hemophilia and chronic renal failure, and there are no definite guidelines for the treatment of end-stage renal disease in hemophiliacs. We report a case of peritoneal dialysis in a hemophiliac with diabetic chronic renal failure. A 46-year-old man with severe hemophilia was admitted to our hospital for decreased visual acuity and the management of uremia. After vitrectomy, he was started on hemodialysis to treat his uremic bleeding diathesis. To avoid bleeding through a vascular access site, peritoneal dialysis therapy for long-term treatment was proposed. A surgical peritoneal catheter was introduced with simultaneous factor VIII administration. In the seven subsequent months, no episodes of intraperitoneal or retroperitoneal hemorrhage have been observed. Continuous ambulatory peritoneal dialysis may be a relatively safe dialysis modality without danger of bleeding in hemophiliacs.
Catheters ; Dialysis ; Disease Susceptibility ; Factor VIII ; Hemophilia A ; Hemorrhage ; Humans ; Kidney Failure, Chronic ; Middle Aged ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Uremia ; Visual Acuity ; Vitrectomy

BACKGROUND AND OBJECTIVES: The elderly is the fast growing segment of the population in Korea. Elderly patients undergoing coronary revascularization are considered a high-risk group. Few data exist that relate the results of stenting in treating coronary artery disease in the elderly population. This study sought to compare the short- and long-term outcomes of elderly patients undergoing coronary artery stenting with those of younger patients. METHODS: All elderly patients 70 years of age who underwent coronary artery stenting between January 1997 and July 1999 (n = 106) at our centers were compared to the patients <70 who underwent coronary artery stenting during the same time period (n = 597). METHODS: Elderly patients presented with lower ejection fraction (52.9% vs. 57.4%, p = 0.001), more unstable angina (47% vs. 31%, p = 0.003), and more multivessel disease (67% vs. 51%, p = 0.005) than younger patients. Major in-hospital complications including death (0.9% vs. 0.5%, p = NS), procedural acute Q-wave myocardial infarction (0.9% vs. 0.3%, p = NS), and emergency CABG (0% vs. 0.3%, p = NS) did not differ between two groups. And also vascular complication rate was similar between two groups(1.9% vs. 1.0%, p = NS). Angiographic follow-up, obtained in both groups, demonstrated similar restenosis rates (26.5% vs. 24.9%, p = NS). Long-term clinical follow-up at 12 months showed major adverse cardiac events including death, acute myocardial infarction, and repeat revascularization were significantly higher in elderly patients than in younger patients (18.3% vs. 12.6%, p = 0.04). CONCLUSIONS: Elderly patients with higher risk factors who underwent coronary artery stenting had similar rates of in-hospital procedural complications and similar rates of 6 months angiographic restenosis, compared to younger patients. Overall rates of major adverse cardiac events in the elderly population at 12 months postcoronary artery stenting were significantly higher than those of younger patients.
Aged* ; Angina, Unstable ; Arteries ; Coronary Artery Disease ; Coronary Vessels* ; Emergencies ; Follow-Up Studies* ; Humans ; Korea ; Myocardial Infarction ; Risk Factors ; Stents*