Preoperative assessment of electrocardiographical(EKG) abnormalities in the patients with subarachnoid hemorrhage(SAH) is importment. Authors analyzed 58 SAH patients who had EKG abnormalities of neurogenic origin. EKG abnormalities consisted of T wave abnormality, arrhythmia, ST segment change, QT prolongation and U wave. Five patients were dead in this study because of brain swelling(3 cases) and cerebral spasm(2 cases). EKG abnormalities were normalized 13 days after aneurysmal SAH. Radioactive nuclear(99mTc-pyrophosphate) scan of myocardial revealed normal findings in the patients with EKG abnormalities of neurogenic origin. It is concluded that life-saving surgical intervention need not be delayed in the patients with EKG abnormalities of neurogenic origin. On the other hand, patients who had cardiac origin EKG abnormalities need a careful and detailed preanesthetic cardiac evaluation.
Aneurysm* ; Arrhythmias, Cardiac ; Brain ; Electrocardiography* ; Hand ; Humans ; Subarachnoid Hemorrhage

PURPOSE: Infrainguinalfemoropopliteal bypass (IFPB) is recommended to peripheral arterial disease (PAD) with a long occlusion of the superficial femoral artery (SFA). The aims of our study were to determine the patency of graft materials, and identify the risk factors of graft failure. METHODS: From January 1995 to April 2011, we had performed 380 IFPBs in 351 patients, including 302 femoro-above the knee (AK) bypasses and 78 femoro-below the knee (BK) bypasses. We compare age, sex, severity of ischemia between polytetra-uoroethylene (PTFE) graft and saphenous vein (SV) graft, and evaluate patency rate rates of the two groups. RESULTS: The primary patency rates at 5 years for SV (n = 76 limbs) and PTFE grafts (n = 226 limbs) in AK were 85.2% and 64.5% (log rank = 0.03), and the secondary patency rates at 5 years for SV and PTFE grafts in AK were 88.2% and 79.0% (log rank = 0.13). The primary patency rates at 5 years for SV (n = 50 limbs) and PTFE grafts (n = 28 limbs) in BK were 63.2% and 40.0% (log rank = 0.08), and the secondary patency rates at 5 years for SV and PTFE grafts in BK were 71.6% and 55.5% (log rank = 0.18). CONCLUSION: There was no statistical significant difference in secondary patency rates between SV and PTFE in IFPB. PTFE grafts as SV grafts can be a good alternative bypass material in IFPB instead of SV grafts.
Femoral Artery ; Humans ; Ischemia ; Knee ; Peripheral Arterial Disease ; Polytetrafluoroethylene ; Risk Factors ; Saphenous Vein* ; Transplants*

PURPOSE: As general population survival has improved in the last few decades, the age of patients participating in renal transplantation also has increased. This study aimed to investigate the impact of donor and recipient age as predictor of long-term graft survival in renal transplantation. METHODS: We analyzed the transplantation outcome in 598 patients, who received renal transplantation from 1978 to 2003 at Hanyang Universitiy. Patients were divided into four groups according to the age at renal transplantation. Group A (donor age> or =50, recipient age> or =50, n=19/3.2%), group B (donor age> or =50, recipient age<50, n=153/25.5%), group C (donor age<50, recipient age> or =50, n=69/11.6%), group D (donor age<50, recipient age<50, n=357/59.8%). Univariate analysis was used to assess the effect of donor and recipient age as predictor factors of graft outcome. We used Kaplan Meier log-rank method for graft survival and P values less than 0.05 were considered significant. RESULTS: In elderly donor group, graft survival was 89.8% at 1 year, 76.4% at 3 years and younger donor group was 92.8 at 1year, 84.0% at 3 years and the differences showed statistic significance (P=0.009). Univariate analysis of age factor showed a significant reduction of graft survival in recipients transplanted with kidneys coming from donors older than 50 years, however recipient age greater than 50 years was not found as an independent risk factor. The incidence of rejection was 24.6% in elderly donor group and 23.5% in younger donor group (P=NS). Among the four groups, the most valuable result was group D and the 1 year and 3 years graft survival were 93.1%, 84.5% respectively but it was not significant statistically (P=0.50). CONCLUSION: This result is important for the design of allocation and transplantation strategies for kidneys procured in elderly donors and recipients.
Age Factors ; Aged ; Graft Survival ; Humans ; Incidence ; Kidney ; Kidney Transplantation ; Risk Factors ; Tissue Donors* ; Transplants

BACKGROUND: Atrial fibrillation is the commonest arrhythmia seen in clinical practice. However, there have been no epidemiologic data on its prevalence in general population of Korea. We performed this study to investigate the prevalence of atrial fibrillation in Korea. METHODS: From March 1, 1999 to July 31, 2000, Kangwon Branch, Korea Association of Health (KAH) parformed electrocardiograms to investigate the health status in the general public in Kangwon Province. We analyzed these data by of chi square(2) test. RESULTS: A total of 45,133 persons participated in the health screening performed by KAH. The number of persons above 40 years old were 13,768, with men and women 6,367 (46.2%) and 7,401 (53.8%)respectively. Prevalence among those above 40 years old was 0.72% and the prevalence among men, 0.96% (61 persons) was significantly higher than that of women, 0.51% (38 persons)(p<0.01). In the group above 60 years old with the prevalence of 1.24%, a similar phenomenon was observed with 1.57% (40 persons) in men and 0.97% (29 persons) in women (p<0.05). CONCLUSION: Prevalence of atrial fibrillation became higher as age increased, specifically in persons older than 40 years.
Adult ; Arrhythmias, Cardiac ; Atrial Fibrillation* ; Electrocardiography ; Female ; Gangwon-do* ; Humans ; Korea ; Male ; Mass Screening ; Middle Aged ; Prevalence*

Serrated adenoma (SA) is a distinct form of colorectal neoplasia and it is defined as a neoplastic lesion composed of a monotonous cell population with atypical nuclei proliferating in serrated glandular architectures. Hyperplastic polyp is considered a benign lesion with no malignant potential. However, SA progressed into frank carcinoma has been demonstrated in an individual case, and 'serrated neoplasia pathway' is suggested by some authors as an alternative to classical adenoma-carcinoma sequence. Distinguishing between hyperplastic polyp and SA is important because of the different management implications and the increased potential for neoplastic progression in the latter, but sometimes it is very difficult. SA is usually small and sessile polypoid lesion. We report a case of SA presenting as large fungating mass similar to colon cancer, diagnosed as hyperplastic polyp initially by colonoscopic biopsy and confirmed as after SA the surgery.
Adenoma* ; Biopsy ; Colon* ; Colonic Neoplasms* ; Polyps

Congenital hemolytic anemia is mainly developed due to intrinsic defects of erythrocytes, but in some cases the cause of hemolytic anemia is unclear. Gilbert's syndrome shows mild, chronic unconjugated hyperbilirubinemia that is due to reduced UDP glucuronosyltransferase (UGT-1A1) activity and this develops because of UGT-1A1 gene mutation. We report here on a case of severe hyperbilirubinemia in a 17-year-old male who was diagnosed with congenital hemolytic anemia of an unknown cause combined with Gilbert's syndrome.
Adolescent ; Anemia, Hemolytic ; Anemia, Hemolytic, Congenital ; Erythrocytes ; Gilbert Disease ; Glucuronosyltransferase ; Humans ; Hyperbilirubinemia ; Male

OBJECTIVE: To investigate the effect of laterally wedged insole on static balance of patients with degenerative osteoarthritic knees. METHOD: Eighteen female patients were diagnosed with medial compartment knee degenerative osteoarthritis (OA) based on symptoms and simple X-rays. Patients were studied while they stood wearing shoes with the 5 degrees or 10 degrees lateral wedged insoles compared with a bare foot. Patients chose a comfortable stance with feet spread apart, slightly turned outwards, and were asked to look straight ahead at a fixed point in a quiet room. Postural sway and weight load asymmetry were recorded while the patients were standing on two adjacent force platforms during a 30 second trial. RESULTS: Postural sway and weight load asymmetry for 30 seconds were not significantly changed by wearing laterally wedged insoles with varying elevations (p>0.05). CONCLUSION: The degree of the postural sway and weight load asymmetry for 30 seconds with the insole were not affected by the tilt of the lateral wedge.
Female ; Foot ; Humans ; Knee* ; Osteoarthritis* ; Osteoarthritis, Knee ; Shoes

Duchenne Muscular Dystrophy (DMD) is an X-linked, recessive disorder characterized by progressive muscular weakness, Gower sign, waddling gait and pseudohypertrophy of the calf muscles. Little is reported about DMD manifestations in females because of its' X-linked, recessive inheritance. The authors described a 12-year-old female with gait disturbance. Her symptoms were diminished muscle power, decreased deep tendon reflexes, Gower sign and pseudohypertrophy of calf muscle. Serum creatinine kinase level was elevated to 1, 674 U/ml. Electromyographic findings were compatible with myopathy. Histopathologic examination of the muscles confirmed the diagnosis of DMD. The result of karyotyping was 45X, but multiplex PCR (Polymerase Chain Reaction) analysis showed normal findings.
Child ; Creatinine ; Diagnosis ; Female* ; Gait ; Humans ; Karyotyping ; Multiplex Polymerase Chain Reaction ; Muscle Weakness ; Muscles ; Muscular Diseases ; Muscular Dystrophy, Duchenne* ; Phosphotransferases ; Reflex, Stretch ; Turner Syndrome* ; Wills

There were many reports of infected pseudoaneurysms of the forearm that are caused by arterial injury or cannulation. However, spontaneous pseudoaneurysm of forearm artery without any history of arterial injury or cannulation is rare. Here, we report the case of an infected pseudoaneurysm in the forearm after infective endocarditis, without arterial injury or cannulation. A 76-year old man had a large, growing, pulsatile mass of the radial artery after experiencing infective endocarditis. We performed an interposition with great saphenous vein graft after removing the aneurysm. This presented case emphasizes the importance of considering pseudoaneurysms in the differential diagnosis and treatment of pain in the extremity and swelling after infective endocarditis.
Aneurysm ; Aneurysm, False ; Aneurysm, Infected ; Arteries ; Catheterization ; Diagnosis, Differential ; Endocarditis ; Extremities ; Forearm ; Radial Artery ; Saphenous Vein ; Transplants

Intradialytic hypotension during dialysis adversely affects a patient's prognosis and increases mortality. We report a case in which intradialytic hypotension that persisted after the administration of midodrine was relieved after the use of fludrocortisone. Administration of 0.2 mg of fludrocortisone occurred 30 minutes before dialysis. We compared 45 sessions of dialysis without fludrocortisone administration and 45 sessions of dialysis with fludrocortisone administration in one patient. The number of times in which systolic blood pressure became lower than 80 mmHg and the number of early terminations of dialysis due to a decrease in systolic blood pressure were higher in the sessions without fludrocortisone administration than in the sessions with fludrocortisone administration (P < 0.05). Fludrocortisone may be helpful for the treatment of intradialytic hypotension that does not respond to midodrine administration.
Blood Pressure ; Dialysis ; Fludrocortisone* ; Humans ; Hypotension* ; Midodrine ; Mortality ; Prognosis ; Renal Dialysis