No abstract available.
Angiomyoma* ; Vulva*

No abstract available.
Angiomyoma* ; Vulva*

Abnormalities of body fluid and electrolyte balance, acute renal failure, nephrotic syndrome, interstitial nephritis and papillary necrosis are well known disease of wide spectrum of NSAID induced renal side effect. Many different mechanism such as inhibition of prostaglandin pathway, delayed hypersensitivity reaction and direct toxicity are reported to relate to development of disease. Recently, overuse of NSAID has steadily increased the cases of NSAID induced side effects and in some cases permanent damage to kidney has been reported. Authors experienced a 67-year-old male patient who presented with gross hematuria, edema and azotemia and diagnosed as interstitial nephritis accompanying nephrotic syndrome. Kidney biopsy shows the edema and the diffuse infiltration of lymphocytes in the interstitium. The glomerular changes suggest minimal change lesion or focal segmental glomerular sclerosis in early stage. The patient had continuously consumed piroxicam for 6 months and had improved after discontinuation of this drug as well as treatment with steroid but remained renal damage. This case suggest that piroxicam may be an agent that causes interstitial nephritis and nephrotic syndrome. Therefore clinician should use it with caution especially in patients with high risk factors.
Acute Kidney Injury ; Aged ; Azotemia ; Biopsy ; Body Fluids ; Edema ; Hematuria ; Humans ; Hypersensitivity, Delayed ; Kidney ; Lymphocytes ; Male ; Necrosis ; Nephritis, Interstitial* ; Nephrotic Syndrome* ; Piroxicam* ; Risk Factors ; Sclerosis ; Water-Electrolyte Balance

BACKGROUND/AIMS: The aim of this study is to measure the difference of ionized calcium between heparinized whole blood and serum. METHODS: We recruited 107 maintenance hemodialysis (HD) patients from our hospital HD unit. The clinical and laboratory data included ionized calcium in serum and in whole blood (reference, 4.07 to 5.17 mg/dL). RESULTS: The level of ionized calcium in serum was higher than that in whole blood (p < 0.001). Bland-Altman analysis showed that difference for ionized calcium was 0.5027. For the difference, the nonstandardized beta was -0.4389 (p < 0.001) and the intercept was 2.2418 (p < 0.001). There was a significant difference in the distribution of categories of ionized calcium level between two methods (kappa, 0.279; p < 0.001). CONCLUSIONS: This study demonstrates that whole blood ionized calcium is underestimated compared with serum ionized calcium. Positive difference increases as whole blood ionized calcium decreases. Therefore, significant hypocalcemia in whole blood ionized calcium should be verified by serum ionized calcium.
Aged ; Biological Markers/blood ; Calcium/*blood ; Female ; Humans ; Hypercalcemia/blood/*diagnosis/etiology ; Hypocalcemia/blood/*diagnosis/etiology ; Kidney Diseases/blood/complications/diagnosis/*therapy ; Male ; Middle Aged ; Predictive Value of Tests ; *Renal Dialysis/adverse effects ; Reproducibility of Results ; Specimen Handling/*methods

PURPOSE: Early postoperative arrhythmias are a major cause of mortality and morbidity after open heart surgery in the pediatric population. We evaluated the incidence and risk factors of early postoperative arrhythmias after surgery of congenital heart disease. METHODS: From January 2002 to December 2008, we retrospectively reviewed the medical records of the 561 patients who underwent cardiac surgery in Kyungpook National University Hospital. We analyzed patients' age and weight, occurrence and type of arrhythmia, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time, and postoperative electrolyte levels. RESULTS: Arrhythmias occurred in 42 of 578 (7.3%) cases of the pediatric cardiac surgery. The most common types of arrhythmia were junctional ectopic tachycardia (JET) and accelerated idioventricular rhythm (AIVR), which occurred in 17 and 13 cases, respectively. The arterial switch operation (ASO) of transposition of the great arteries (TGA) had the highest incidence of arrhythmia (36.4%). Most cases of cardiac arrhythmia showed good response to management. Patients with early postoperative arrhythmias had significantly lower body weight, younger age, and prolonged CPB and ACC times (P<0.05) than patients without arrhythmia. Although the mean duration of ventilator care and intensive care unit stay were significantly longer (P<0.05), the mortality rate was not significantly different among the 2 groups. CONCLUSION: Early postoperative arrhythmias are a major complication after pediatric cardiac surgery; however, aggressive and immediate management can reduce mortality and morbidity.
Accelerated Idioventricular Rhythm ; Arrhythmias, Cardiac ; Arteries ; Body Weight ; Cardiopulmonary Bypass ; Child ; Heart ; Heart Diseases ; Humans ; Incidence ; Intensive Care Units ; Medical Records ; Retrospective Studies ; Risk Factors ; Tachycardia, Ectopic Junctional ; Thoracic Surgery ; Ventilators, Mechanical

Intravenous leiomyomatosis (IVL) is a rare neoplasm that is characterized by a histologically benigh-looking smooth muscle cell tumor growing within the uterine and the extrauterine venous system. We report here on patient had a uterine and extrauterine leiomyoma that extended into the right atrium through the inferior vena cava. A 19-year old female patient was suffering from dyspnea, swelling of the lower extremity, abdominal pain and abdominal distension. She had total abdominal hysterectomy performed at a private clinic due to uterine leiomyoma 4 months previously. 4 months after the first operation, we again completely excised the recurred intraperitoneal tumor mass. At 6 months after the re-operation, the tumor mass recurred intraperitoneally. A preoperative abdominal CT scan and an echocardiogram revealed multiple tumor masses that were located intraperitoneally and they extended to the right atrium. We performed intraperitoneal tumor excision and removal of the intravenous tumor mass via the right iliac vein by the one-stage approach. At present, the patient has shown a clinically favorable outcome except for local recurrence of tumor mass in the pelvic cavity. The cure of this complex disease emphasizes the need for a planned systemic approach by a multidisciplinary surgical team. We present here an unusual case of intravenous leiomyomatosis that originated from the uterus and it extended to the inferior vena cava and right atrium.
Abdominal Pain ; Dyspnea ; Female ; Heart Atria ; Humans ; Hysterectomy ; Iliac Vein ; Leiomyoma ; Leiomyomatosis* ; Lower Extremity ; Myocytes, Smooth Muscle ; Recurrence ; Tomography, X-Ray Computed ; Uterus ; Vena Cava, Inferior ; Young Adult

No abstract available.
Head Injuries, Penetrating*

The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, < 40), group B (n = 150, 40-45), and group C (n = 186, > 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.
Adult ; Age Factors ; Aged ; Body Fat Distribution ; C-Reactive Protein/analysis ; Creatinine/blood ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Count ; Male ; Middle Aged ; *Nutrition Assessment ; Peritoneal Dialysis/*mortality ; Proportional Hazards Models ; Risk Factors ; Serum Albumin/analysis

The aim of this study was to evaluate the clinical relevance and usefulness of the Onodera's prognostic nutritional index (OPNI) as a prognostic and nutritional indicator in peritoneal dialysis (PD) patients. Patients were divided into 3 groups based on the initial OPNI score: group A (n = 186, < 40), group B (n = 150, 40-45), and group C (n = 186, > 45). Group A was associated with a higher grade according to the Davies risk index than the other groups. Serum creatinine and albumin levels, total lymphocyte count, and fat mass increased with an increase in OPNI. According to the edema index, the correlation coefficient for OPNI was -0.284 and for serum albumin was -0.322. Similarly, according to the C-reactive protein (CRP), the correlation coefficient for OPNI was -0.117 and for serum albumin was -0.169. Multivariate analysis adjusted for age, Davies risk index, CRP, and edema index revealed that the hazard ratios for low OPNI, serum albumin, and CRP were 1.672 (P = 0.003), 1.308 (P = 0.130), and 1.349 (P = 0.083), respectively. Our results demonstrate that the OPNI is a simple method that can be used for predicting the nutritional status and clinical outcome in PD patients.
Adult ; Age Factors ; Aged ; Body Fat Distribution ; C-Reactive Protein/analysis ; Creatinine/blood ; Female ; Humans ; Kaplan-Meier Estimate ; Lymphocyte Count ; Male ; Middle Aged ; *Nutrition Assessment ; Peritoneal Dialysis/*mortality ; Proportional Hazards Models ; Risk Factors ; Serum Albumin/analysis

BACKGROUNDS: The development of a noninvasive, accurate imaging technique for assessing coronary artery bypass graft patency is of major clinical importance because increasing numbers of patients have undergone coronary artery bypass surgery. The electron beam tomography, by virtue of its rapid data acquisition time and good spatial resolution, may be useful in this regard. The purpose of this study is to determine the accuracy of three-dimensional coronary angiography by electron beam tomography (EBT) in the assessment of patency of coronary artery bypass grafts. METHODS: Twenty-five patients who had undergone coronary artery bypass graft surgery were included. All patients underwent EBT and conventional coronary angiography for the evaluation of the status of bypass grafts. Three dimensional reconstruction of the heart and bypass grafts were performed and compared with selective angiography of the bypass grafts. RESULTS: Fifty-seven saphenous vein grafts (SVG) and 22 left internal mammary artery (LIMA) were evaluated for occlusion or patency. The sensitivity and specificity of EBT in the evaluation of LIMA patency were 80%, 82.4%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG patency were 91.7% and 91.1%, respectively. The sensitivity and specificity of EBT in the evaluation of SVG according to the coronary territory were : 1) SVG to left anterior descending artery 100%, 100%:2) SVG to diagonal branch 100%, 100%:3) SVG to left circumflex artery 100%, 88.9%:4) SVG to right coronary artery 75%, 85.7%. CONCLUSION: Three-dimensional coronary angiography by electron beam tomography is a promising, useful and relatively accurate diagnostic technique for the evaluation of graft patency in patients who had undergone coronary artery bypass graft surgery.
Angiography ; Arteries ; Coronary Angiography* ; Coronary Artery Bypass* ; Coronary Vessels* ; Heart ; Humans ; Mammary Arteries ; Saphenous Vein ; Sensitivity and Specificity ; Tomography, X-Ray Computed* ; Transplants ; Virtues