No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

No abstract available.

PURPOSE: To evaluate the relationship between factors of metabolic syndrome(MS) to prostate volume and lower urinary tract symptom in men over sixties. MATERIALS AND METHODS: A total of 624 male subjects aged 60 to 90 years were enrolled. Prostate volume, urinary flow rate, voided volume, post void residual urine volume, voiding symptoms and MS-related parameters were investigated. Patients were divided into two groups; those with MS (n=223) and those without(n=401). Prostate volume, urodynamic factors and voiding symptoms were compared based upon MS categories. RESULTS: The MS and control group showed no significant differences with respect to age(74.8+/-5.6 vs. 74.0+/-5.4, respectively, p=0.083) and prostate specific antigen levels(1.8+/-1.5 vs. 1.7+/-1.5, respectively, p=0.248). However, the MS group had significantly greater waist circumference, blood pressure, fasting blood sugar level, hypertriglyceridemia and lower high density lipoprotein(HDL) cholesterol than the control group(p<0.05). Patients with MS showed significantly larger total prostate volume(p=0.008) and transitional zone volume(p=0.012). There were no differences between two groups respect to maximum flow rate, voided volume and residual volume (p>0.05). There was a significant relationship between prostate volume and obesity(p=0.016), however other MS factors such as low HDL, hypertension, non-insulin dependent diabetes mellitus and hypertriglyceridemia were not associated with prostate volume(p>0.05).CONCLUSIONS: Metabolic syndrome is associated with prostate volume related factors, but not to voiding dysfunction in Korean men over sixties. Among subcategories of MS, obesity is the most strongly related factor to prostate volume.
Aged ; Blood Glucose ; Blood Pressure ; Cholesterol ; Diabetes Mellitus ; Fasting ; Humans ; Hypertension ; Hypertriglyceridemia ; Male ; Metabolic Syndrome X ; Obesity ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Residual Volume ; Urinary Tract ; Urination Disorders ; Urodynamics ; Waist Circumference

Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, vomiting, confusion, and seizure. In addition, PRES is associated with reversible bilateral cortical and subcortical edema on occipital lobe or parieto-occipital lobe. Eclampsia is a rare condition to pregnant and puerperal women and one of common causes of the PRES. The clinical and radiologic manifestations can be resolved without irreversible complication by early diagnosis and appropriate treatment. The authors report a case of eclamptic encephalopathy associated with PRES, in which an 18-year-old woman had clinical manifestations of visual disturbance, headache, and tonic-clonic seizure at 34 hours after vaginal delivery. High signal intensities are seen in both parieto-occipital lobes and left basal ganglia on fluid attenuated inversion recovery (FLAIR) images and T2 weighted images performed at emergency room. But no significant signal change in both parieto-occipital lobes on diffusion weighted images (DWI). Because seizure was repeated, then anticonvulsant was administered at intensive care unit. On the second day, the clinical manifestations were resolved as blood pressure was normalized. The FLAIR imaging and DWI sequences can play an important role in the diagnosis of PRES.
Adolescent ; Basal Ganglia ; Blood Pressure ; Diagnosis ; Diffusion ; Early Diagnosis ; Eclampsia ; Edema ; Emergency Service, Hospital ; Female ; Headache ; Humans ; Intensive Care Units ; Occipital Lobe ; Posterior Leukoencephalopathy Syndrome* ; Pregnancy ; Seizures ; Vomiting

The conventional surgical treatment of isolated critical stenosis of the left main coronary artery restores a less physiologic perfusion of the myocardium, leads to occlusion of the left coronary ostium, and consumes an appreciable length of bypass material. From June 1994 to February 1996, eleven patients, three male and eight female, underwent patch angioplasty and additional bypass graft to left anterior descending artery (10 internal mammary artery, 1 saphenous vein) in isolated critical left main coronary artery stenosis. Their ages ranged from 34 to 62 years, mean 44 years. All had 60% to 90% stenosis of the left main coronary artery and Class III angina. The angiogram showed nine osteal lesion and three main stem stenosis. The operation was performed with conventional cardiopulmonary bypass and cold blood cardioplegia. We approached anteriorly and used bovine pericardium as onlay patch in all patients. There were one leg wound dehiscence, but no operative deaths and infarctions. All patients are free of symptoms after a mean follow-up of 15.5 months. Angiographic restudy at an average 14.4 months was obtained in five patients and showed widely patent left main coronary artery with excellent runoff. But additional graft to left anterior descending coronary artery were stenosed in two patients and showed diminutive flow in others. Our preliminary results suggest that angioplasty of the left main coronary artery can be carried out with low operative risks. But additional bypass graft to left anterior descending coronary artery may be unnecessary. The technique appears to be a promising alternative to conventional coronary artery bypass grafting in isolated left main coronary artery stenosis.
Angioplasty* ; Arteries ; Cardiopulmonary Bypass ; Constriction, Pathologic ; Coronary Artery Bypass ; Coronary Stenosis* ; Coronary Vessels* ; Female ; Follow-Up Studies ; Heart Arrest, Induced ; Humans ; Infarction ; Inlays ; Leg ; Male ; Mammary Arteries ; Myocardium ; Perfusion ; Pericardium ; Transplants ; Wounds and Injuries

No abstract available.
Arrhythmias, Cardiac* ; Heart* ; Thoracic Surgery*

BACKGROUND: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular (LV) function after surgical revascularization. MATERIALS AND METHODS: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography (DSE) (dobutamine: baseline, 5, 10, 20microgram/kg/min) before coronary artery bypass grafting (CABG) and underwent echocardiography at least 2 months after CABG. RESULTS: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8 (50%) of 16 patients in DSE. Among them, 6 patients (75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients (38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments (74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments (23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.
Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Vessels* ; Dobutamine* ; Echocardiography ; Echocardiography, Stress* ; Humans ; Male ; Mortality ; Myocardial Ischemia ; Myocardium* ; Sensitivity and Specificity

BACKGROUND: Since 1992, we developed the technique for video endoscopic sympathectomy to treat palmar hyperhidrosis. It was soon proven to be a simple and effective therapy for essential hyperhidrosis. Compensatory hyperhidrosis, however, is the main cause of patient dissatisfaction after video-assisted thoracoscopic sympathectomy. According to many authors, initial satisfaction rate was high(94-98%), but it was declined with time (66%) due to mainly to embarrassing side effects. MATERIAL AND METHOD: From January 1992 to February 1998, the thoracoscopic T2 sympathicotomy, T2 sympathectomy and T2-4 sympathectomy were performed in 315 patients suffering from Essential hyperhidrosis in the Department of Thoracic and Cardiovascular Surgery in the Respiratory Center of Yongdong Severance Hospital Seoul, Korea. Eighty-nine patients underwent T2 sympathicotomy, and Eighty-eight patients underwent division T2 sympathectomy. RESULT: All of the treated patients obtained satisfactory alleviation of essential hyperhidrosis. The global rate of compensatory sweating were ; 64.0% in T2 sympathicotomy, 73.8% in T2 sympathectomy and 87.8% in T2-4 sympathectomy. The rate of embarrassing or disabling compensatory sweating was significantly higher in T2 sympathicotomy 15.7%(14/89) and in T2 sympathectomy 32.8%(28/88) than in T2-4 sympathectomy 58.0%(80/138) with significancy in statistic analysis(p<0.05). Video- assisted thoracoscopic sympathectomy is an effective minimally invasive and effective procedure. CONCLUSION: We suggest that the incidence and degree of compensatory hyperhidrosis was closely related to the extent of thoracic sympathectomy.
Humans ; Hyperhidrosis* ; Incidence ; Korea ; Respiratory Center ; Seoul ; Sweat ; Sweating ; Sympathectomy*

The present study was done to determine the efficacy and safety of varicose vein removal using a minimally invasive, powered vein-extracting device with cutaneous transillumination and tumescent anesthesia techniques and then compared this to a retrospective group of conventional phlebectomy operations. There were 133 limbs in 104 patients(72 women, 32 men) treated with the use of the vein extractor aided by transcutaneous illumination. The hydrodissection was performed with TrivexTM Irrigated Illuminator(Smith and Nephew ) system using normal saline after the 2~3mm sized skin incision. Varicose clusters were extracted by the use of TrivexTM Resector(Smith and Nephew ) system under transillumination. After the varisoce vein extraction, the operation area was compressed with surgical pad for bleeding control. The complication rate was 3.84%. The mean number of incisions was 3.24 and mean operative time per limb was 65.9 minutes. The mean hospitalization was 1.86 days. The varicose vein extraction using transilluminated powered phlebectomy(TIPP) is a safe, efficacious and cosmetically satisfactory method. The procedure decreases the operating time and the number of incisions repuired to remove varicose clusters. Further evaluation and long term follow up will be necessary to determine the recurrence rate and long term complications.
Anesthesia ; Extremities ; Female ; Follow-Up Studies ; Hemorrhage ; Hospitalization ; Humans ; Lighting ; Operative Time ; Recurrence ; Retrospective Studies ; Skin ; Transillumination ; Varicose Veins* ; Veins

Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.
Frontal Bone* ; Hemangioma, Cavernous* ; Orbit* ; Transplants