The aim of this study was to quantitatively estimate the effect of hypertension upon the left ventricle, using the systolic time intervals. The subjects for this study consist of 72 hospitalized hypertensive patients including 38 males and 34 females. The measurements of the systolic time intervals were obtained from simultaneous high speed recording(100mm/sec) of an electrocardiographic lead best displaying the onset of left ventricular depolarization, a carotid pulse tracing, and a phonocardiogram best displaying the initial high frequency vibrations of the aortic valve closure sound. All data were corrected for heart rate and sex using the regression equations of Weissleretal. The results were follows: 1) As the diastolic blood pressure increased, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 2) As the electrocardiographic findings related to hypertension became severe shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 3) As the hypertensive retinopathy became severe, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. It was suggested that the measurement of the systolic time intervals are useful in assessing the effects of hypertension upon the left ventricular function and in detecting early recognition of cardiac dysfunction in hypertension, even though not necessarily associated with overt heart failure.
Aortic Valve ; Blood Pressure ; Electrocardiography ; Female ; Heart Failure ; Heart Rate ; Heart Ventricles ; Humans ; Hypertension ; Hypertensive Retinopathy ; Male ; Systole* ; Ventricular Function, Left ; Vibration

No abstract available.
Fanconi Anemia*

Kawasaki disease is described by fever lasting five days or more, bilateral conjunctival injection, changes of lips and oral cavity, polymorphous exanthema, acute non-purulent cervical lymphadenopathy, and changes of extremities. Atypical Kawasaki disease is defined as fewer than 4 of 6 criteria described above including coronary artery abnormalities. Especially, atypical clinical manifestations of Kawasaki disease appear in infants younger than 6 months old of age. Thus we recommend echocardiography in early infancy who has prolonged fever in order to diagnose atypical Kawasaki disease and treat early. We have experienced three cases of atypical Kawasaki disease with coronary aneurysm who were admitted because of fever and revealed coronary aneurysm on echocardiography.
Coronary Aneurysm* ; Coronary Vessels ; Echocardiography ; Exanthema ; Extremities ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome*

No abstract available.
Ichthyosis, Lamellar*

BACKGROUND/AIMS: Some factors like stent wires, balloon dilatation and use of guide wires seems to increase perforation after self-expandable metal stent (SEMS) placement, but few studies mentioned about the relationship between angulation of malignant stricture and perforation. The present study aimed to confirm that more angular positioning of stents increases perforation. METHODS: This study was conducted with retrospectively evaluation at Digestive Disease Center, CHA Bundang Medical Center, CHA University. Between January 2002 and August 2011, SEMS was inserted in 130 patients with malignant colorectal obstruction. We studied the difference in the angle of stenosis between perforation and non-perforation groups using fluorography images. RESULTS: SEMS insertion was performed in 130 cases of obstruction due to colon cancer. Perforation occurred in eight patients (6.2%) of them. Thirteen cases were excluded from the analysis due to poor fluoroscopic images. Among the eight patients with perforation, the mean stenosis angle was 109.9degrees compared to 153.1degrees in the nonperforation group, indicating that the angle was more acute in the perforation group (p=0.016). CONCLUSIONS: This study shows that more angular positioning of stent increases bowel perforation after SEMS placement for malignant colorectal obstruction.
Colonic Neoplasms ; Constriction, Pathologic ; Dilatation ; Humans ; Intestinal Perforation ; Retrospective Studies ; Stents

PURPOSE: Minimally invasive management of small renal tumors has become more common. We compared the results of partial nephrectomy by video-assisted minilaparotomy surgery (VAMS), open, and laparoscopic techniques. MATERIALS AND METHODS: We retrospectively compared clinicopathological, oncological, and functional outcomes in 271 patients who underwent partial nephrectomy for renal tumors at one institution from 1993 to 2007; including 138 by VAMS, 102 by open, and 31 by laparoscopic technique. RESULTS: Mean follow-up was 47.7+/-29.1 months. No statistically significant differences in the three groups were found in tumor size, tumor location, estimated blood loss, complication rate, preoperative glomerular filtration rate (GFR), and GFR at last follow-up. Ischemic time was shorter in the open (26.9 min) and VAMS (29.3 min) groups than in the laparoscopic group (31.0 min, p=0.021). Time to normal diet and hospital stay were shorter in the VAMS (1.8 days and 5.4 days) and laparoscopic (1.8 days and 4.7 days) groups than in the open group (2.4 days and 7.3 days, p=0.036 and p<0.001, respectively). Of 180 patients with cancer, positive surgical margins occurred in 2 of 82 patients (2.4%) in the VAMS group, none of 75 patients in the open group, and 3 of 23 patients (13.0%) in the laparoscopic group (p=0.084). In the VAMS, open, and laparoscopic groups, 5-year disease-free survival was 94.8%, 95.8%, and 90.3% (p=0.485), and 5-year cancer-specific survival was 96.3%, 98.6%, and 100%, respectively (p=0.452). CONCLUSION: Partial nephrectomy using VAMS technique provides surgical, oncologic, and functional outcomes similar to open and laparoscopic techniques.
Adult ; Aged ; Carcinoma, Renal Cell/mortality/*surgery ; Female ; Humans ; Kidney Neoplasms/mortality/*surgery ; Laparoscopy/instrumentation/*methods ; Laparotomy/instrumentation/*methods ; Male ; Middle Aged ; Nephrectomy/instrumentation/*methods ; Retrospective Studies ; Treatment Outcome ; Video-Assisted Surgery/instrumentation/*methods

PURPOSE: The aim of this study was to analyze various clinical characteristics of ischemic colitis according to its location. METHODS: The medical records of 92 cases of gastrointestinal ischemic colitis (IC) diagnosed at Bundang CHA Hospital from 1995 to 2008 were reviewed and analyzed retrospectively. The patients were diagnosed by using colonoscopic biopsies or laparotomy findings. The patients were divided into two groups, right and left, according to the main involvement area of the IC at the embryologic boundary line of the distal transverse colon, and the two groups were compared as to clinical characteristics and co-morbid diseases. RESULTS: Left IC was present in 59 patients (64.1%) and right IC in 33 patients (35.9%). No differences between the two groups in terms of clinical characteristics, cardiovascular disease and diabetes mellitus were observed. However, in 16 cases with renal failure, 10 patient had right IC and 6 patients had left IC, and this difference had statistical significance (P = 0.014). Among the 16, the 11 patients requiring hemodialysis included 8 with right IC (24.2%) and 3 with left IC (5.1%; P = 0.009). Among the 19 cases of severe IC requiring surgical treatment or involving mortality, irrespective of surgery, 11 patients showed right IC and 8 patients showed left IC (P = 0.024). CONCLUSION: Right-side ischemic colitis was significantly associated with renal failure and disease severity, so patients with right-side colon ischemia should be more carefully observed and managed.
Biopsy ; Cardiovascular Diseases ; Colitis, Ischemic ; Colon ; Colon, Transverse ; Diabetes Mellitus ; Humans ; Ischemia ; Laparotomy ; Medical Records ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies

Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal proliferation of Langerhans cells. The temporal bone is frequently involved in pediatric LCH cases, but there have been few reports of adult LCH with temporal bone involvement. We present a case of adult onset LCH affecting the temporal bone. The diagnosis was made by biopsy, based on histopathologic findings of Langerhans cells. Diagnostic and therapeutic considerations of LCH involving the temporal bone are discussed.
Adult ; Biopsy ; Ear Canal ; Histiocytosis, Langerhans-Cell ; Humans ; Langerhans Cells ; Rare Diseases ; Temporal Bone

The vesicoureteral reflux (VUR) is frequently found among the patients with urinary tract infection (UIT) and some patients with VUR progress to reflux nephropathy. The presence of scarring at UIT is an important determinant in the selection of those at risk of progressive damage. 99m Technetium dimercaptosuccinic acid (99m Tc-DMSA) is a renal scanning agent provides a good quality of renal image as a result of preferential cortical accumulation. 99m Tc-DMSA scan and VCUG were performed in 133 patients diagnosed UTI at pediatric department of Kyung Hee University, College of Medicine from May, 1990 to May, 1992 The results were as follows: 1) VUR was seen in 27 children among 133 patients with UTI. The incidence was 20.3%. Under 1 year of age, male to female ratio was higher incidence of VUR. 2) Incidence of renal scarring was higher in patients with VUR than those of without VUR. 3) Grading of VUR in relation to age, the older the age, the lower the grade. 4) There is no correlation between renal scarring and grades of VUR. 5) In distribution of renal scarring, it was found to have tendency to develop at upper polar area, there was diffuse and multiple in patients with VUR. In conclusion the incidence of renal scarring was related to the age of onset, duration of UTI and the severity of the VUR and 99mTc-DMSA scan is mandatory in patient with UTI even without VUR in order to detect early phase of renal scarring.
Age of Onset ; Child ; Cicatrix* ; Female ; Humans ; Incidence ; Male ; Succimer ; Technetium ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux

A 29-year-old male patient was admitted due to subacute onset of right chest pain. He had no history of trauma, chest surgery or other medical disease. Chest roentgenogram showed an expansile, radiolucent lesion on the posterior segment of right seventh rib. Computed tomogram of the chest also showed lytic expansile mass with septation. He took an en-bloc resection of the involved rib. Pathologically there were multiple cystic spaces, filled with blood and collagenofibrous tissue proliferation and locally areas of new bone formation and giant cells of osteoclastic type, which was compatible with aneurysmal bone cyst. We report a case of aneurysmal bone cyst of the rib with a brief review of literature.
Adult ; Aneurysm ; Bone Cysts ; Chest Pain ; Giant Cells ; Humans ; Male ; Osteoclasts ; Osteogenesis ; Ribs* ; Thorax