PURPOSE: To evaluate the frequently of low ahetenuation area in enhanced CT scans of non-Hodgkin lymphoma(NHL) and to find out if there is any pertinent relationship between this and the histopathologic classification. MATERIALS & METHODS: The authors reviewed CT scans in the newly diagnosed 53 patients with NHL. We defined the-low attenuation area as the one with CT attenuation value lower than that of the muscle, surrounding lesion, or other lymph nodes after contrast enhancement. NHL with the low attenuation areas were correlated with the histopathologic findings according to the classification based on the Working Formulation and the frequency of the lesion was evaluated. RESULT: Of the 53 patients, the low attenuation area was found in 13 patients (25%) at CT. The histopathologic classification could be made in 12 patients, among whom one patient was classified as low grade, six as intermediate grade, and five as high-grade. Concerning the specific cell typing, the diffuse large cell type was most common in intermediate-grade NHL seen in five patients and the large cell, immunoblastic type was most common in high-grade NHL seen ih three patients. CONCLUSION: The authors concluded that the low attenution area within lymphoma is not an infrequent finding at CT, and there was no stastistically significant correlation between this finding and the prognostic grading of the Working Formulation.
Classification ; Humans ; Lymph Nodes ; Lymphoma ; Lymphoma, Non-Hodgkin* ; Tomography, X-Ray Computed

Churg-Strauss syndrome (CSS) or allergic granulomatosis angiitis is a rare primary vasculitic disease. CSS can be diagnosed by the presence of any four or more of the six criteria, which include asthma, eosinophilia greater than 10%, paranasal sinusitis, pulmonary infiltration, histological proof of vasculitis and mono- or poly-neuropathy. We report here on a 45-year-old male who developed erythematous macules, papules and hemorrhagic vesicles on both right extremities along with a tingling sensation and sacral pain. He has been suffering from recurrent allergic rhinitis and bronchial asthma for 6 months. The laboratory findings showed severe eosinophilia (22.3%), hyper-IgE and positivity for p-ANCA. On the histological examination of the hemorrhagic vesicle on the right lower leg, leukocytoclsatic vasulitis and many neutrophils and eosinophils around the cutaneous vessels were observed in the dermis.
Antibodies, Antineutrophil Cytoplasmic ; Asthma ; Churg-Strauss Syndrome ; Dermis ; Eosinophilia ; Eosinophils ; Extremities ; Humans ; Leg ; Male ; Middle Aged ; Neutrophils ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sensation ; Sinusitis ; Stress, Psychological ; Vasculitis

No abstract available.
Hemorrhage*

BACKGROUND: Intracoronary stent implantation is a promising modality for establishing the blood flow of complex coronary arterial stenosis. However, previous studies have demonstrated that the angiographically visible thrombus is a high risk factor for possibility of stent thrombosis. So many investigators avoided stent implantation traditionally for thrombus containing lesion because of the potency of thrombogenecity of stent. But recently, advanced rapidly growing technique for stenting and powerful antithrombotic regimens make stent thrombosis rare. Stent implantantion has already been showed a acceptable method for bailout procedure of thrombotic occlusion in patients with angioplasty for acute myocardial infarction and also effective in intimal dissection, suboptimal results and arterial recoil. Accordingly, we investigated the effectiveness of stent implantation in the presence of intracoronary thrombus. METHODS: Eighteen patients(AMI 14, Unstable angina 4) underwent PTCA & stent implantation on culprit arterial lesion in all successfully. The stent group was comprised of Palmatz-Schatz stent 10, Cordis 2, Cook 5 and Jo-Med stent 1. Stent implanted to the lesion of remained thrombus visualization on coronary angiography after PTCA. RESULTS: No major complications were developed during hospitalization in all 18 patients. In all patients no stent thrombosis have occurred within 2 weeks after stent implantation. But one patients have showed intracoronary stent thrombus persistently, so we used intracoronary urokinase infusion for 36 hours but there was no visible thrombus after modified anticoagulation and antithrombotic regimen CONCLUSIONS: We harvested good preliminary results of intracoronary stent implantation in the setting of thrombus containing lesion.
Angina, Unstable ; Angioplasty ; Constriction, Pathologic ; Coronary Angiography ; Hospitalization ; Humans ; Myocardial Infarction ; Research Personnel ; Risk Factors ; Stents* ; Thrombosis* ; Urokinase-Type Plasminogen Activator

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

PURPOSE: Tuberculosis (TB) is mainly caused by Mycobacterium tuberculosis, which is a pathogenic mycobacterial species grouped under Mycobacterium tuberculosis complex (MTBC) with four other pathogenic mycobacterial species. The mycobacteria not included in MTBC are known as nontuberculous mycobacteria (NTM), and cause several pulmonary diseases including pneumonia. Currently, NTM occurrences in TB-suspected respiratory specimens have increased, due to which, precise detection of MTBC and NTM is considered critical for the diagnosis and vaccination of TB. Among the various methods available, real-time PCR is frequently adopted for MTBC/NTM detection due to its rapidness, accuracy, and ease of handling. In this study, we evaluated a new real-time PCR kit for analytical and clinical performance on sputum, bronchial washing, and culture specimens. MATERIALS AND METHODS: For assessing its analytical performance, limit of detection (LOD), reactivity, and repeatability test were performed using DNA samples. To evaluate clinical performance, 612 samples were collected and clinically tested at a tertiary hospital. RESULTS: LOD was confirmed as 0.584 copies/µL for MTBC and 47.836 copies/µL for NTM by probit analysis (95% positive). For the reactivity test, all intended strains were detected and, in the repeatability test, stable and steady results were confirmed with coefficient of variation ranging from 0.36 to 1.59. For the clinical test, sensitivity and specificity were 98.6%–100% and 98.8%–100% for MTBC and NTM, respectively. CONCLUSION: The results proved the usefulness of the kit in TB diagnosis. Furthermore, it could be adopted for the assessment of vaccine efficacy.
BCG Vaccine ; Diagnosis ; DNA ; Limit of Detection ; Lung Diseases ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Pneumonia ; Real-Time Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sputum ; Tertiary Care Centers ; Tuberculosis ; Vaccination*

BACKGROUND: Diastolic dysfuction can be assessed by Doppler echocardiography of mitral inflow. Multiple factors including atrioventricular (AV) delay affect the mitral inflow Doppler indexes. This study was designed to assess the changes of mitral inflow patterns after successful radiofrequency catheter ablation (RFCA) of accessory pathway associated with a short AV interval during pre-excitation in patients with WPW syndrome. METHOD: Echocardiogram, ECG and BP were recorded before and after RFCA for treatment of accessory pathway in 15 patients with WPW syndrome (mean age : 39.7+/-14.6). Doppler indexes including E wave velocity and its velocity time integral (EVTI) ,A wave velocity and its VTI (AVTI), deceleration time (DT), isovolumic relaxation time (IVRT), atrial filling fraction (AFF)and total mitral inflow VTI were measured. RESULTS: 1) PR interval prolonged 94+/-18msec to 174+/-34msec (p<0.001) without significant increment of heart rate and blood pressure after successful RFCA. 2) E/A ratio decreased from 1.29+/-0.58 to 1.1+/-0.53 (<0.001) but E wave velocity, DT and IVRT were not changed significantly after RFCA. 3) A wave velocity and AFF was 55.8+/-17.4msec and 0.35+/-0.08 and increased to 61.8+/-19.9msec and 0.42+/-0.1, respectively after RFCA (p<0.05). 4) Total mitral inflow VTI was 13.6+/-3.5cm and 14.9+/-3.6cm before and after RFCA, respectively (p<0.05) CONCLUSION: These results suggested that normalization of the PR interval after RFCA in patients with WPW syndrome had beneficial hemodynamic effects on the stroke volume by changing mitral inflow Doppler indexes. Therefore, the effect of AV delay is an another parameter to consider when evaluating Doppler indexes of LV filling.
Blood Pressure ; Catheter Ablation ; Deceleration ; Echocardiography, Doppler ; Electrocardiography ; Heart Rate ; Hemodynamics ; Humans ; Relaxation ; Stroke Volume ; Wolff-Parkinson-White Syndrome*

Acute esophageal necrosis is uncommon in the literature. Its etiology is unknown, although cardiovascular disease, hemodynamic compromise, gastric outlet obstruction, alcohol ingestion, hypoxemia, hypercoagulable state, infection, and trauma have all been suggested as possible causes. A 67-year-old female underwent a coronary angiography (CAG) for evaluation of chest pain. CAG findings showed coronary three-vessel disease. We planned percutaneous coronary intervention (PCI). Coronary arterial dissection during the PCI led to sudden hypotension. Six hours after the index procedure, the patient experienced a large amount of hematemesis. Emergency gastrofibroscopy was performed and showed mucosal necrosis with a huge adherent blood clot in the esophagus. After conservative treatment for 3 months, the esophageal lesion was completely improved. She was diagnosed with acute esophageal necrosis. We report herein a case of acute esophageal necrosis occurring in a patient undergoing percutaneous coronary intervention.
Acute Disease ; Aged ; Coronary Angiography ; Coronary Stenosis/diagnosis/physiopathology/*therapy ; Esophageal Diseases/diagnosis/drug therapy/*etiology ; Esophagoscopy ; Esophagus/drug effects/*pathology ; Female ; Hemodynamics ; Humans ; Necrosis ; Percutaneous Coronary Intervention/*adverse effects ; Predictive Value of Tests ; Proton Pump Inhibitors/therapeutic use ; Risk Factors ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional ; Wound Healing

BACKGROUND: Serum eosinophil cationic protein(ECP) level has been proposed as a indirect marker of eosinophilic inflammation of the airway in bronchial asthma. OBJECTIVE: To evaluate serum ECP against indirect clinical markers of disease, we compared bronchial obstruction, bronchial hyperresponsiveness and peripheral blood eosinophil counts, total IgE with serum ECP levels in patients with bronchial asthma and normal controls. METHOD: Fourty-two patients with bronchial asthma and twenty-six normal controls were enrolled. Measurement were made by spirometry, inhalation challenge with methacholine, peripheral blood eosinophil counts, total IgE and FEIA(fluoroenzymatic immunoassay) of serum ECP RESULT: Serum ECP levels were significantly higher in asthmatic patients than normal controls(p<0.0,5). Serum ECP levels were correlated with peripheral blood eosinophil counts(p<0.01, r=0.544) and bronchial hyperresponsiveness(PC,)(p<0.01, r=-0.456) in patients with bronchial asthma. Serum ECP levels were correlated with degree of bronchial obstruction(FEV, % to predicted value, FEV1/FVC%) in total subjects, but not in asthmatic patients. CONCLUSION: Serum ECP level may be used as indicator of disease activity in bronchial asthma and be helpful in differentiation between normal person and asthmatic patients on simple serological method. Further studies on the changes of serum ECP levels according to disease course and therapeutic responses are needed.
Asthma* ; Biomarkers ; Eosinophil Cationic Protein* ; Eosinophils ; Humans ; Immunoglobulin E ; Inflammation ; Inhalation ; Methacholine Chloride ; Spirometry

Nerve palsy after total knee arthroplasty is a rare complication and this is usually associated with local nerve compression or severe deformity of the knee. In many cases, the cause of nerve palsy was unknown and this is rarely associated with vascular complication. We report here on a case of the patient who had nerve palsy and delayed arterial occlusion after total knee arthroplasty.
Arthroplasty ; Congenital Abnormalities ; Humans ; Knee ; Paralysis