Takayasu's arteritis is an arteritis of undetermined etiology, which affects the aorta, proximal portion of its major branches, and causes narrowing, occlusion, or aneurismal dilatation of vessel. Authors report 2 cases of Takayasu's arteritis with brief review of the literature.
Aorta ; Arteritis ; Dilatation ; Takayasu Arteritis*

The Di(a+b-) phenotype is extremely rare among Caucaclans and mostly confined to mongoloids. The incidences of Di antigen among Koreans were reported to be 6.1 to 14.5%, with an average of 9.6%; it can be calculated that the frequency of Di(a+b-) is 0.25% on the average. Authors report the first case of hemolytic disease of the newborn due to anti-Dib in Korea. The Diego phenotypes of the mother, baby and father were Di(a+b-), Di(a+b+) and Di (a-b+), respectively. The mother's serum and eluate from infant's erythrocytes contained anti-DP antibody active in the antiglobulin phase. After transfusions of Di-negative red cells from the mother and mother's relative, the patient was recovered from anemia and jaundice.
Anemia ; Erythrocytes ; Fathers ; Humans ; Incidence ; Infant, Newborn* ; Jaundice ; Korea ; Mothers ; Phenotype

No abstract available.

-D- is a very rare haplotype which determines D without C, c, E or e and exalted D activity. The extremely rare homozygote propositi(-D-/-D-) are usually ascertained through their immune antibodies which react with red cells of all common Rh phenotypes. Authors experienced a woman with -D- phenotype for the first time in Korea. She had a history of abortion and intrauterine fetal death. She delivered a baby with severe hemolytic disease of the newborn at the third pregnancy. In spite of intensive medical interventions, the baby died of hydrops fetalis. An immune antibody to high incidence Rh antigen, namely anti-Hro, was demonstrated in the woman's serum. Family study revealed that all of the family had -D- gene complex and one of her sisters also was -D-homozygote. The sister also had anti-Hro in the serum.
Antibodies ; Female ; Fetal Death ; Haplotypes ; Homozygote ; Humans ; Hydrops Fetalis ; Incidence ; Infant, Newborn* ; Korea ; Phenotype* ; Pregnancy ; Siblings

BACKGROUND: Quyyumi et al described circadian variation of ischemic eletrocardio-graphic changes and heart rate in patients with and without significant coronary disease in 1985. Rocco et al also described circadian variation of transient myocaldial ischemia in patients with coronary artery disease. They also noted an increse in ischemic eletrocardiographic abnormalities in the morning hours.In recent years the important of circadian variation of cardiovascular phenomena has generated a great deal of interest. Such phonomena include the occurrence of ischemia in patients with both chronic stable angina and variant angina, myocaldial infarction, sudden cardiac death, ventricular arrhythmia and platelet aggregability. METHOD: To examine whether a significant circadain variation of transient myocardial ischemia exists and to better understand the character of such variation, 35 patients with againa pectoris(15 patients treated with nitrate and/or caclcum channel blocker and 20 patients without treatment) underwent 24 hours ambulatory monitoring of ischemic ST segment changes during daily life. RESULT: Only 21% of the episodes of ST depression were accompanied by chest pain. While 79% were asymptomatic. A significant circadian increase in ischemic activity was found with 44% of episodes and 40% of total ischemic time in not treated group, and 52% of episodes and 56% of total ischemic time in treated group, occuring between 6 A.M. to 12 P.M.(P<0.05 respectively) When the distribution of ischemic episodes was corrected for the variable time of waking, the peak ischemic activity was occuring in the 1st and 2nd hours after rising. There were no significant differences in heart rate at onset and heart rate at 1 min before onset. CONCLUSION: Is summary, transient myocardial ischemia in the absence of pain was more common and there were a significant circadian variation of transient myocardial ischemia with peak activity in the morning. In addition most of transient myocardial were not preceded by a rise in heart rate.
Angina, Stable ; Arrhythmias, Cardiac ; Blood Platelets ; Chest Pain ; Coronary Artery Disease ; Coronary Disease ; Death, Sudden, Cardiac ; Depression ; Heart Rate ; Humans ; Infarction ; Ischemia ; Monitoring, Ambulatory ; Myocardial Ischemia*

5 cases of lead poisoning were investigated clinically. Of the 5 patients, 4 were male and 1 was female. The causes of lead poisoning in 3 cases were ingestion of herb drug pills and in 2 cases were occupational poisoning. Chief complain at admission in 4 cases were ill defined colicky abdominal pain and constipation. Only 1 case complained of dizziness and palpitation without gastrointestinal symptom. On peripheral blood, normocytic normochromic anemia (mean Hgb 9.2 gm/dl), reticulocytosis (mean 4.7%) and basophilic stippling were found in 100% of patients. Bone marrow aspiration was done in 4 cases. Erythroid hyperplasia and basophilic stippling were found in all 4 cases. Mean M:E ratio was 0.7:1. The lead concentration in serum was increased in 4 cases (80%) of patients. Lead concentration, delta aminolevulinic acid concentration in 24 hours collected urine were increased in 5 patients (100%).
Abdominal Pain ; Aminolevulinic Acid ; Anemia ; Basophils ; Bone Marrow ; Constipation ; Dizziness ; Eating ; Female ; Humans ; Hyperplasia ; Lead Poisoning* ; Male ; Poisoning ; Reticulocytosis

Nonsurgical endoscopic or percutaneous dilatation and insertion of an endoprosthesis is the treatment of choice in the majority of patiens with incurabie malignant biliary obsturction. But these palliative treatment of extrahepatic cholestasis with an endoscopic or percutaneous biliary endoprosthesis is limited by clogging. One of the factors thought to be of importance is the diameter of the stent. So in order to avoid being limited by the size of the instrumentation channel of the endoscope, expandable stents have been developed. Wallstent is braided in the form of a tubular mesh from surgical grade stainless alloy. This prosthesis is geometrically stable, pliable and self expanding. Its elastic properties are such that its diameter can be substantially reduced by moderate elongation. The stent is constrainded on a small diameter delivery catheter(total outside diameter: 9 French). During the implantation procedure the final position of the partially released endoprosthesis can be adjusted by gradual removal of the delivery catheter. If full expansion to 30 French occurs, the stent will be shortened by approximately 30% to their normal length range between 34-102mm. Now in this article we report a new method for endoscopic retrograde placement of biliary Wallstent in a patient with obsturctive jaundice due to periampullary choangiocacrcinoma.
Alloys ; Catheters ; Cholestasis, Extrahepatic ; Dilatation ; Endoscopes ; Humans ; Jaundice ; Palliative Care ; Prostheses and Implants ; Stents

Dissecting aortic aneurysm is relatively rare in those under 40 years of age without high risk factors. After dissecting aortic aneurysm is occurred, the coronary artery is rarely perfused by false lumen. We present a thirty two-year-old man who showed Debakey type 1 dissecting aortic aneurysm with right coronary artery perfused by false lumen of ascending aorta and with congestive heart failure due to aortic insufficiency without discernible risk factor. Medical and surgical treatment (Modified Bentall's operation) were successfully performed. The pathologic report showed combined cystic medial necrosis. Now he is well tolerated and stable only with anticoagulation during follow up 18 months.
Aorta* ; Aortic Aneurysm* ; Coronary Vessels* ; Follow-Up Studies ; Heart Failure ; Necrosis ; Risk Factors

PURPOSE: The proportion of interventional catheterization in congenital heart disease is being increased in Korea, especially in Sejong Heart Institute, so we performed statistical analysis on the cardiac catheterization cases. METHODS: Total 233 cases of congenital heart disease confirmed by cardiac catheterization at the Sejong Heart Institute between Jaunary 1995 and June 1995 were analyzed retrospectively. RESULTS: 1) The distribution of age has become more younger than that of previous reports that is, the proportion of the infant less than 1 year old was 34.8%. 2) The proportion of male sex was equal to that of female. TOF and TGA were observed predominantly in male patients, and PDA and UVH revealed female preponderance. 3) The relative frequencies of each individual congenital heart disease in order of frequency were as follows; TOF 37.3%, PDA 13.3%, VSD 8.2% and UVH 7.7%. 4) Among the 145 (62%) cases of hemodynamic study pre-operation and post-operation cases were 85 and 60 cases, respectively. The cases of interventional catheterization were 84 (36%), and those of endomyocardial biopsy were 4 (2%). 5) The frequencies of each interventional catheterization of 84 cases in order of frequency were as follows: defect closure 28 cases, balloon valvuloplasty 20 cases, balloon angioplasty 17 cases, coil embolization 15 cases, and balloon atrial septostomy 4 cases. 6) There were 2 cases of mortality associated with cardiac catheterization. CONCLUSIONS: The proportion of interventional catheterization in congenital heart disease is being increased in the Sejong Heart Institute, and this trend will spread to the other cardiac center in Korea.
Angioplasty, Balloon ; Balloon Valvuloplasty ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Catheterization* ; Catheters* ; Embolization, Therapeutic ; Female ; Heart ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Infant ; Korea ; Male ; Mortality ; Retrospective Studies

BACKGROUND: The stability of A-V junctional rhythm is the most important clinical interest in the patients with the complete heart block with narrow QRS complex. The QRS morphology, the basal heart rate & the reponse of subsidiary pacemaker to drugs may be helpful to assess the stability. But it can not be assessed exactly. The recording of the His-bundle was thought to be a means of predicting the clinical course of the patients and the necessity of the artificial pacemaker insertion;also it can assess the A-V block site. But it is invasive study cannot assessed exactly the stability of subsidiary pacemaker. To investigate the characteristics of subsidiary pacemaker, we studied the responses of the artificial pacemaker to ventricular overdrive suppression and the drugs by used the artificial pacemaker in the patient with the complete heart block with the narrow QRS complex, which can be accepted as "stabli" in general. METHOD: There was total of 11 patients diagnosed with the complete AV block with the narrow QRS complex(the escape junctional rhythm was less than 0.10sec) at the Yeungnam University Hospital from May 1988 to June 1989. To investigate the ventricular overdrive suppression of subsidiary pacemaker, the response of the subsidiary pacemaker after IV administatin of drugs (atropine, isoproterenol, lidocaine) and the junctional recovery time were measured. RESULTS: Thtee patterns were obtained in the overdrive suppression test (fig.1). The recovery time of the subsidiary pacemaker was 364.5+/-212.15% of the basal R-R interval. Among seven of the eight patients who showed syncoped, the JRTmax were 3 times higher than the basal R-R interval. In one of eight, CJRT which represent the absolute time, was prolonged to 560 msec. In one case, we examined overdrive suppression test serially was which shows gradual decrement of junctional recovery time, and normal sinus rhythm was recovered at the 14th after the development of complete heart block. After VOS, the junctional recovery time of the subsidiary pacemaker was 364.5+/-212.1% of basal R-R interval in complete heart block group. After injection of atropine, the decrement of R-R interval was 5.51+/-3.88% of basal R-R interval. After injection of isoproterenol, the decrement of R-R interval was 32.76+/-8.09% of basal R-R interval. Marked increase of the basal heart rate was observed. After injection of lidocaine, the increment of R-R interval was 1.72+/-1.82% of basal R-R inteval. CONCLUSION: The results suggest that measurement of the junctional recovery time following overdrive suppression is useful for evaluation of stability of subsidiary pacemaker. And also the subsidiary pacemaker shows the better response to sympathomimetic agent than to parasympathetic blocker.
Atrioventricular Block ; Atropine ; Heart Block ; Heart Rate ; Humans ; Isoproterenol ; Lidocaine ; Pacemaker, Artificial ; United Nations