No abstract available.
Diagnosis* ; Ductus Arteriosus, Patent* ; Echocardiography, Doppler, Pulsed* ; Sensitivity and Specificity*

Systemic arteriovenous (AV) fistulas are a rare but well-recognized cause of hyperkinetic circulation that, if undetected, may lead to congestive heart failure. We experienced a very rare case of acquired arteriovenous fistula. A 61-year-old female patient presented with congestive heart failure symptoms after percutaneous pinning for right sternoclavicular joint dislocation. We surgically obliterated the fistula between aorta and innominate vein and performed tricuspid annuloplasty for severe tricupid insufficiency simultaneously. She was discharged with complete relief of her symptoms and has been well during 2 years and 6 months follow up.
Aorta ; Arteriovenous Fistula* ; Brachiocephalic Veins ; Dislocations ; Female ; Fistula ; Follow-Up Studies ; Heart Failure ; Humans ; Joints* ; Middle Aged ; Sternoclavicular Joint ; Tricuspid Valve

No abstract available.

Asbestos exposure may cause asbestosis, pleural plaques and benign pleural disease, and may give a predisposition to malignant mesothelioma in occupationally exposed workers. This case report describes a 50-year-old man, dying from histologically confirmed, diffuse, malignant mesothelioma after asbestos exposure. As a young man, he had been exposed at the workplace to crocidolite for 2 years, but he had no other known history of occupational or environmental asbestos exposure. The patient presented with chest pain and general weakness. Computed tomography showed bilateral irregular pleural thickening along both lower lateral chest walls and a low attenuating mass in the anterior portion of the left lobe. Pathological examinations revealed that it was an epithelial type with tubulopapillary structures and it tested immunohistochemically positive for antibodies against cytokeratin, calretinin and vimentin. The patient was started on chemotherapy but he died to the disease at ten months after the first onset of the symptoms. Mesothelioma is a rare neoplasm in the general population. Nevertheless, the importance of close medical surveillance of the high-risk population is emphasized, because of increased asbestos exposure.
Antibodies ; Asbestos ; Asbestos, Crocidolite* ; Asbestosis ; Calbindin 2 ; Chest Pain ; Drug Therapy ; Humans ; Keratins ; Mesothelioma* ; Middle Aged ; Occupations ; Pleural Diseases ; Thorax ; Vimentin

PURPOSE: Traumatic telecanthus can result from naso-ethmoid-orbital fractures. Repair of the medial canthal tendon(MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. METHODS: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. RESULTS: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. CONCLUSION: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.
Asian Continental Ancestry Group ; Corneal Ulcer ; Craniofacial Abnormalities ; Dacryocystitis ; Dietary Sucrose ; Eye ; Eyelashes ; Humans ; Mandrillus ; Nose ; Orbit ; Skin ; Traction ; Canaliculitis

PURPOSE: Blow out fracture can present tenderness, swelling, enophthalmos, extraoccular muscle limitation, paresthesia, diplopia according to severity of injury, so reconstruction of blow out fracture is important. Orbital soft tissue should be in orbit and defected orbital wall should be corrected by autologus tissue or alloplastic implants. Every implants have their merits and faults, every implants are used various. This study was designed to compare the sequelae of blow-out fracture repair using the alloplastic implants: micro-titanium mesh(Micro Dynamic titanium mesh(R) , Leibinger, Germany), porous polyethylene (Medpor(R) , Porex, USA), absorbable mesh plate(Biosorb FX(R) . Bionx Implants Ltd, Finland). METHODS: Between January 2006 and April 2008, 52 patients were included in a retrospective study analysing the outcome of corrected inferior orbital wall fracture with various kind of implants. Implants were inserted through subciliary incision. Twenty patients were operated with micro-titanium mesh, fourteen patients with porous polyethylene and eighteen patients with absorbable mesh plate. In comparative category, enophthalmos, diplopia, range of motion of extraoccular muscle, inferior orbital nerve injury were more on frequently statistically in patients. RESULTS: Fourteen of 18 patients underwent surgical repair to improve diplopia, 11 of 17 patients to improve parasthesia, 11 of 15 patients to improve enophthalmos, 8 of 9 patients to improve extraoccular muscle limitation. Duration of follow-up time ranged from 6 months to 12 months(mean, 7.4 months). There was no statistic difference of sequelae between micro titanium mesh and porous polyethylene and absorbable mesh plate in blowout fracture, inferior wall. CONCLUSION: There is no difference of sequelae between micro-titanium mesh, porous polyethylene and absorbable mesh plate in blow-out fracture, inferior wall. The other factors such as defect size, location, surgeon's technique, may influence the outcome of blow-out fracture repair.
Diplopia ; Enophthalmos ; Follow-Up Studies ; Humans ; Muscles ; Orbit ; Orbital Fractures ; Paresthesia ; Polyethylene ; Range of Motion, Articular ; Retrospective Studies ; Titanium

Herniation of the stomach through the esophageal hiatus into the posterior mediastinum is a commom affliction of humans. The incidence of hiatal hernia is difficult to determine because of the absence of symptoms in a large number of patients. Hiatal hernias are classified into two major types; type I sliding hiatal hernia and type II paraesophageal hiatal hernia. Sliding hernia is common, but paraesophageal hernia(PEH) is rare. Most PEH is demonstrated in elderly women. PEH in infancy is really rare. PEH is a true hernia, so it is a potentially life-threatening condition because of the risk of volvulus, incarceration, strangulation, and perforation. PEH is itself the indication for surgery. We experienced congenital PEH in two infants. One case was nearly asymptomatic, found incidentally by plain chest X-ray taken for pneumonia in a 12 month old female infant. She had no vomiting or reflux, but history of frequent feeding of small amount and often gurgling noise in her right chest. She had type IV PEH including herniation of the transverse colon. Another case was presented because of vomiting, and was diagnosed by ultrasonography initially in a 48 day old male infant. He had intrathoracic stomach, type III PEH with idiopathic hypertrophic pyloric stenosis and gastroesophageal reflux.
Aged ; Colon, Transverse ; Female ; Gastroesophageal Reflux ; Hernia ; Hernia, Hiatal* ; Humans ; Incidence ; Infant ; Intestinal Volvulus ; Male ; Mediastinum ; Noise ; Pneumonia ; Pyloric Stenosis, Hypertrophic ; Stomach ; Thorax ; Ultrasonography ; Vomiting

PURPOSE: For blowout fracture of the medial orbital wall, the goals of treatment are complete reduction of the herniated soft tissue and anatomic reconstruction of the wall without surgical complications. Surgeons frequently worry about damage to the optic nerve from the dissection, when the part over the posterior ethmoidal foramen was fractured. The authors performed small incision and inlay grafting for reconstruction of medial orbital wall fracture. METHODS: Between January 2007 and April 2008, 15 out of 32 patients were included in an analysing the outcome of corrected medial orbital wall fracture. In 15 patients of posterior comminuted fracture of medial orbital wall, insertion of porous polyethylene(Medpor(R) channel implant, Porex, USA) to ethmoidal sinus was performed in multiple layer, through the transconjunctival approach (inlay grafting). RESULTS: In all cases, the orbital bone volume was reconstructed in its normal anatomical position. The associated ocular problems disappeared except for mild enophthalmos in 2 patients and there were no surgical complications associated with inlay grafting. CONCLUSION: The advantage of inlay grafting include anatomical reconstruction of the orbital wall; the avoidance of optic nerve injury; the simplicity of the procedure; and consequently, the absence of surgery-related complications. This technique is presented as one of the preferred treatments for posterior comminuted fracture of medial orbital wall.
Enophthalmos ; Fractures, Comminuted ; Humans ; Imidazoles ; Inlays ; Nitro Compounds ; Optic Nerve ; Orbit ; Transplants

BACKGROUND AND OBJECTIVES: The transradial approach for coronary intervention has a lower incidence of access site complications and can increase patient comfort after percutaneus tansluminal coronary angioplasty(PTCA). The purpose of this study is to compare procedural success and complication rates of percutaneous transradial coronary stenting which was performed by four operators in two hospitals with those using transfemoral approach. MATERIALS AND METHOD: From September 1998 to July 1999, one hundred seventy five consecutive patients(201 lesions) treated with coronary stent implantation were enrolled for this study : 84 patients underwent transradial coronary stenting(Radial Group), and 91 patients transfemoral coronary stenting(Femoral Group). RESULTS: Seven patients who failed coronary cannulation via radial artery were crossed over to the Femoral Group. The measurements of the radial artery were not done. Patient demographics were similar in both groups. Procedural success was similar in both group(95.2% in Radial Group vs. 97.8% in Femoral Group, p=S). All transradial coronary stenting were possible using conventional guiding catheters which are used in transfemoral intervention. Local vascular complication rates showed a trend toward a reduction in the Radial Group(2.4% vs. 8.8%, p=.06). CONCLUSION: This study showed the similarity in the safety and efficacy of transradial coronary stenting compared to those of transfemoral approach.
Catheterization ; Catheters ; Demography ; Humans ; Incidence ; Radial Artery ; Stents*

Many studies have led to the notion that essential hypertension in adults is the result of a process that starts early in life: investigation of blood pressure(BP) in children and adolescents can therefore contribute to knowledge of the etiology of the condition. a A unique longitudinal study on BP in Korea, known as Kangwha Children's Blood Pressure(KCBP) Study was initiated in 1986 to investigate changes in BP in children. This study is a part of the KCBP study. The purposes of this study are to show changes in BP and to determine factors affecting to BP level and change in Korean adolescents during age period 12 to 16 years. A total of 710 students(335 males, 375 females) who were in the first grade at junior high school(12 years old) in 1992 in Kangwha County, Korea have been followed to measure BP and related factors(anthropometric, serologic and dietary factors) annually up to 1996. A total of 562 students(242 males, 320 females) completed all five annual examinations. The main results are as follows: 1. For males, mean systolic diastolic BP at age 12 and 16 years old were 108.7 mmHg & 118.1 mmHg(systolic), and 69.5 mmHg & 73.4 mmHg(diastolic), respectively. BP level was the highest when students were at 15 years old. For females, mean systolic and diastolic BP at age 12 and 16 years were 114.4 mmHg & 113.5 mmHg(systolic) and 75.2 mmHg & 72.1 mmHg(diastolic), respectively. BP level reached the highest point when they were 13-14 years old. 2. Anthropometric variables(height, weight and body mass index etc) increased consitantly during the study period for males. However, the rate of increase was decreased for females after age 15 years. Serum total cholesterol decreased and triglyceride increased according to age for males, but they did not show any significant trend for females. Total fat intake increased at age 16 years compared with that at age 14 years. Composition of carbohydrate, protein and fat among total energy intake was 65:15:20 at age 14 and 16 years. 3. Most of anthropometric measures, especially, height, body mass index(BMI) and triceps skinfold thickness, showed a significant correlation with BP level in both sexes. When BMI was adjusted, serum total cholesterol showed a significant negative correlation with systolic BP at age 12 years in males, but at age 14 years the direction of correlation changed to positive. In females serum total cholesterol was negatively correlated with diastolic BP at age 15 and 16 years. Triglyceride and creatine showed positive correlation with systolic and diastolic BP in males, but they did not show any correlation in females. There was no consistent findings between nutrient intake and BP level. However, protein intake correlated positively with diastolic BP level in males. 4. Blood pressure change was positively associated with changes in BMI and serum total cholesterol in both sexes. Change in creatine was associated with BP change positively in males and negatively in females. Students whose sodium intake was high showed higher systolic and diastolic BP in males, and students whose total fat intake was high maintained lower level of BP in females. The major determinants on BP change was BMI in both sexes.
Adolescent* ; Adult ; Blood Pressure* ; Body Height ; Body Mass Index ; Child ; Cholesterol ; Creatine ; Energy Intake ; Female ; Humans ; Hypertension ; Korea ; Longitudinal Studies ; Male ; Skinfold Thickness ; Sodium ; Triglycerides