Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

Chondroblastoma is a rare primary bone tumor which originates from cartilage, and represents approximate 1% af all bone tumor. The chondroblastoma arises most frequently from the epiphysis of the long bones with the humerus being the commonest site. It afflicts usually the young under 25 years with greater incidence in male. As there is no cartilage cell on craniofacial bone which is mainly fromed by intramembranous ossification, the chondroblastoma on the craniofacial bone is extremely rare. But the chondroblastoma recurred frequently in craniofacial bone when the mass is excised incompletely or curretted and, as the tumor has the outstanding ability of local invasiveness, it destructs the adjacent bone. In addition, it is difficult to diagnose differentially from sarcoma or giant cell tumor histopathologically. Due to the entities described above, it is necessary to remove the entire tumor mass as complete as possible, to treat with radiation pre or postoperatively for preventing from recurrence, and to observe for a long time. The chondroblastoma on temporal bone is rare and is difficult to diagnose and treat successfully. So we'd like to present a case of chondroblastoma which was originated from temporal side of TMJ with literatural review.
Cartilage ; Chondroblastoma ; Epiphyses ; Giant Cell Tumors ; Humans ; Humerus ; Incidence ; Male ; Recurrence ; Sarcoma ; Temporal Bone ; Temporomandibular Joint*

To determine factors involved in left ventricular aneurysm formation after transmural anterior myocardial infarction, 74 patients with a first myocardial infarction who underwent cardiac catheterization within 6 weeks of infarction were evaluated.Patients were divided into four groups depending on the status of the left anterioe descending artery(LAD) and the presence Group I(n=15);aneurysm with occluded LAD, Group II(n=16);no aneusrysm and occluded LAD, Group III(n=18);aneusrysm and patent LAD, and Group IV(n=25);no aneusrsm with patent LAD. Neither age, sex nor risk factors for coronary disease correlated with aneusrysm formation,but the duration of chest pain in patients with previous angina was significantly longer in group II(no aneusrysm with occluded LAD) compared with other groups(P<0.01). Single vessel disease was more commom in Group I and III(aneusrysm) compared with II and IV(no aneusrysm)(P<0.06). Collateral blood supply was more frequently observed in Group I and II(occluded LAD) compared with Group III and IV(patent LAD)(P<0.01) and was slightly less in Group I(aneusrysm) compared with Group II(no aneusrym)(P<0.07). Delta area decreasing rate of the left ventricle was significantly lower in Group I and III(aneusrysm)compared with Group II and IV(no aneusrysm)(P<0.01). Single vessel disease in assocition with poor collateral circulation tends to be a determinant of left ventricular aneusrysm formation after anterior myocardial infarction.
Aneurysm* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Collateral Circulation ; Coronary Disease ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction* ; Risk Factors

No abstract available.
Hyponatremia* ; Hypopituitarism*

Pigmented lesions of palmar and plantar skin may cause diagnostic problems, because some features of benign lesions in these sites may raise the suspicion of melanoma if considered alone. Transepidermal elimlnation is a mechanism by which a substance is eliminated through the epidermis, and it is apt to be confused with a feature of melanoma that tumor cells are located at all layers of the epidermis. We report a case of transepidermal elimination of nevus cells in acral letiginous nevus which needs a differential dignosis of melanoma.
Epidermis ; Melanoma ; Nevus* ; Skin

No abstract available.
Acetazolamide* ; Aneurysm* ; Brain* ; Humans ; Perfusion* ; Subarachnoid Hemorrhage* ; Tomography, Emission-Computed, Single-Photon*

Transscleral and transpupillary diode lasers are methods of cyclophotocoagulation used to lower intraocular pressure by reducing aqueous humor production through ciliary ablation. When compared with the neodymium[Nd]-YAG, the diode laser has characteristics of lower transmission rate through the sclera and more absorption by pigment or melanin in the ciliary body, therefore the transpupillary method might be more effective in Asians who have greater ciliary body pigmentation than caucasian. We compared the efficacy of diode laser transpupillary and transscleral cyclophotocoagulation on lowering of the intraocular pressure in Asian patients. We performed transpupillary[group 2, n=9]and transscleral [group 1, n=21]diode laser cyclophotocoagulation in medically uncontrolled glaucoma patients. Preoperative mean intraocular pressures were 35.0 +/-13.1 millimeters of mercury[group 1]and 31.8 +/-9.8 millimeters of mercury[group 2], respectively. Postoperative mean pressure were 23.0 +/-14.8 millimeters of mercury[group 1]and 24.8 +/-9.9 millimeters of mercury [group 2], respectively. The intraocular pressure decreased in both groups[p=0.002 group 1, p=0.025 group 2]with statistical significance. Complications were phthisis, bullous keratopathy[group 1]and corneal edema[group 2]. Both transscleral and transpupillary diode laser cyclophoto-coagulation may be performed safely to decrease intraocular pressure. Retrospective studies and long term follow up are further needed to determine the safety of laser cyclophotocoagulation.
Absorption ; Aqueous Humor ; Asian Continental Ancestry Group ; Ciliary Body ; Follow-Up Studies ; Glaucoma ; Humans ; Intraocular Pressure ; Lasers, Semiconductor* ; Melanins ; Pigmentation ; Retrospective Studies ; Sclera

PURPOSE: To estimate the incidence and risk of significant renal injury quantitatively in the admitted patients with abdominal trauma. MATERIALS AND METHODS: From January 1992 to July 1997, 511 patients who admitted to departments of urology and general surgery due to major abdominal trauma with and without renal injury were included in this study. The risk of renal injury was defined as the percentage of square of Abbreviated Injury Scale of kidney in the Injury Severity Score(ISS) per each patient. The patients were classified to 5 groups according to the causes of trauma as traffic accident, falls, assault, other blunt and stab Injury, then compared the incidence and risk of renal injury each other. RESULTS: The overall incidence of significant renal injury was 14.9%, and the incidence according to the causes was 27.0%,20.8%, 16.1%, 14.3% and 10.7% in falls, assault, stab injury, other blunt and traffic accident, respectively. The overall risk of significant renal injury estimated by ISS was 15.7% and the risk according to the causes was 26.7%,24.9%, 11.9%,9.9% and 4.9% in assault, falls, traffic accident, other blunt and stab injury, respectively Mean ISS in the patients with renal injury was markedly higher than that of the patients without renal injury(27.5 vs 13.6)(p < 0.01). CONCLUSIONS: Our study shows that both the incidence and risk of significant renal injury in the admitted patients with abdominal trauma can be expected in the probability of 15% or so, and according to the causes, those in the traumatized patients by the assault and falls mark high.
Abbreviated Injury Scale ; Accidents, Traffic ; Humans ; Incidence* ; Injury Severity Score ; Kidney ; Urology

Malignant hyperthermia is a well-recognized syndrome of uncertain etiology. The confusing facts are: the variety and different nature of the triggering agents, the variation in time of onset of rigidity and fever coupled with a variation in response to succinylcholine, the lack of family history in some patients, and its occurence in some who have had previously normal general anesthetics. A case is a 23 year old relatively healthy male patient in whom subtotal gastrectomy was performed under N2O-O2-ether and gallamine anesthesia with induction after pentothal sodium and succinylcholine. This was complicated by an abrupt, high rise in body temperature, muscle rigidity, flushing with peripheral cyanosis, disseminated intravascular coagulation and hyperpnea 40 minutes after induction. He died 3 hours after cessation of anesthesia without effective response to any active antipyretic therapy. The etiologic factors, incidence, clinical feature, prevention, treatment and prognosis of malignant hyperthermia are discussed.
Anesthesia* ; Anesthetics, General ; Body Temperature ; Cyanosis ; Disseminated Intravascular Coagulation ; Fever ; Flushing ; Gallamine Triethiodide ; Gastrectomy ; Humans ; Incidence ; Male ; Malignant Hyperthermia* ; Muscle Rigidity ; Prognosis ; Sodium ; Succinylcholine ; Thiopental

Epidural nerve block is the most widely practiced procedure in the pain clinic. Accidental dural puncture during epidural nerve block also has been associated with postdural puncture headache and total spinal anesthesia. Especially, total spinal anesthesia is the most serious complication of epidural nerve block and can lead to a life threatening conditions. We have experienced two cases in whom total spinal anesthesia occurred during epidural nerve block for neck and lower back pain control. Immediately after epidural nerve block, the patients became unresponsive and apneic with loss of muscle tone in all extremity. We performed resuscitations and about 3 hours later the patients recovered completely without any complication.
Anesthesia, Spinal* ; Extremities ; Humans ; Low Back Pain ; Neck ; Nerve Block* ; Pain Clinics ; Post-Dural Puncture Headache ; Punctures ; Resuscitation