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*

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

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

PURPOSE: To assess the postoperative CT findings of aortic aneurysms or dissections treared by resection- and-graft replacement or continuous-suture graft-inclusion technique MATERIALS AND METHODS: We reviewed postoperative follow-up CT findings of 14 patients, 19 cases. There were 8 patients(10 cases) of aortic aneurysm and 6 patients(9 cases) of aortic dissecton which involved the thoracic aorta in 9 patients(13 cases) and abdominal aorta in 5 patients(6 cases). The interval of follow-up after operation was from 9 days to 2 year 9 months. On CT scans, we analyzed the appearance of graft materials, differences of CT findings between two surgical techniques, and normal or abnormal postoperative CT findings. RESULTS: Most of grafts appeared as hyperdense ring on precontrast scan, and all of them were not seperated from aortic lumen on postcontrast scan. On CT findings of patients who were operated by continuous-suture graft-inclusion technique, perigraft thrombus was concentrically located with sharp demarcation by native aortic wall and its density was homogeneous, but in cases of those operated by resection-and-graft replacement, perigraft hematoma was eccentrically located with indistinct margin and its density was heterogeneous and native aortic wall could not be delineated. In patients without complication, perigraft thrombus or hematoma(15 cases), perigraft calcification(11 cases), residual intimal flap(6 cases), graft deformity(4 cases), perigraft air(2 cases) and reconstructed vessels(1 case) were noted. And in one patient with complication, perigraft flow was noted with more increased perigraft hemaroma. CONCLUSION: Precise knowledge of the differences of CT findings between two surgical techniques and nor- mal postoperative CT findings is crucial to evaluate the postoperative CT findings in aortic aneurysm and dissection.
Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm* ; Follow-Up Studies ; Hematoma ; Humans ; Thrombosis ; Tomography, X-Ray Computed ; Transplants

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

Constrictive pericarditis represents a rare cause of protein-losing enteropathy in children. Reported is an 11-year-old girl with protein-losing enteropathy (PLE) as the principal manifestations of constrictive pericarditis. After total pericardiectomy, symptoms and signs of PLE disappeared. Doppler echocardiography including tissue Doppler imaging is a useful noninvasive initial diagnostic tool for differential diagnosis of diastolic heart failure.
Child ; Diagnosis, Differential ; Echocardiography, Doppler ; Female ; Heart Failure, Diastolic ; Humans ; Pericardiectomy ; Pericarditis, Constrictive* ; Protein-Losing Enteropathies*