Two cases of acute digitalis poisoning were presented. The first patient was 20-year-old male with asymptomatic ventricular septal defect (maladie de Roger) who attempted suicide by ingestion of degitalis leaf about 6.0 g (60 tablets). He developed severe epigastric pain and vomiting one hour after ingestion. Syncopal attack was developed once for a few minutes and recovered. Electrocardiogram revealed 2:1 A-V block. By conservative management he was recovered. The second patient was 2-year-old, healthy baby who ingested digoxin about 2.5 mg(10 tablets) by accident. He developed severe vomiting and electrocardiogram revealed 1degrees, 2degreesand 3degrees A-V block in series. He was recovered by conservative management without sequele.
Child, Preschool ; Digitalis* ; Digoxin ; Eating ; Electrocardiography ; Heart Septal Defects, Ventricular ; Humans ; Male ; Poisoning* ; Suicide, Attempted ; Vomiting ; Young Adult

BACKGROUND: It is well known that a lacunar infarction has characteristic clinical features and a relatively good prognosis. However, the significance of lesions in the parent artery of patients with lacunar syndrome as regard to the prognosis remains unsettled. METHODS: Using the data of consecutive patients with their first ischemic stroke and were followed longer than 1 year, were divided the patients by their clinical features and the results of the work-up was as follows; (1) mismatching [MM] group; lacunar syndrome and the presence of parent arterial lesion, (2) large artery artherosclerosis [LAD]; non-lacunar syndrome and the presence of parent arterial lesion, (3) no determined etiology [NE]; non-lacunar syndrome without parent arterial lesion, and (4) small artery disease [SAD]; lacunar syndrome without parent arterial lesion. Patients with a potential source of embolism were excluded from this study. The prognosis and recurrence rate of patients with the MM group were compared with those of other groups. RESULTS: A total of 176 patients were included; 56 LAD, 62 SAD, 22 MM and 36 NE groups. An unstable hospital course was more frequently found in LAD than in the other groups. The recurrence rate of the MM group (23%) was significantly higher than that of SAD (2%), but was similar to that of patients with non-lacunar syndrome (LAD 16%, NE 28%). CONCLUSIONS: Among patients with lacunar syndrome, the prognosis of those with parent arterial lesions was different from those without lesions. Therefore, a systematic work up of the stroke mechanism may be important in patients with lacunar syndrome.
Arteries ; Embolism ; Humans ; Parents* ; Prognosis ; Recurrence ; Stroke ; Stroke, Lacunar*

Accelerated atherosclerosis is not only a frequent complication but also the most common cause of death in patients with chronic renal failure (CRF). Although mechanisms are unclear, disorder of lipid metabolism may be a major factor. Since apolipo-protein (apo) E is known to play a major regulatory role in lipid metabolism, we evaluated apo E genotype in 72 male patients with CRF and compared with that in 194 rnale normal controls. In addition, we measured plasma lipid and apolipoprotein concentrations and evaluated them according to apo E genotype in patients and controls. Apo E genotype was determined with the INNO-LiPA Apo E kit (Innogenetics, Belgium), which is based on reverse hybridization. The results are as follows ; 1) The distribution of the three major apo E alleles in patients with CRF ( e 2: 6.2%, e 3: 80.6%, e 4: 13.2%) was not different from that in controls ( e 2: 4.1%, e 3: 87.6%, e 4: 8.3%). 2) In patients with CRF, total cholesterol, lowdensity lipoprotein (LDL) and high-density lipoprotein (HDL) levels were significantly lower and the triglyceride and lipoprotein (a) levels were significantly higher than those in controls. 3) In controls, E 4/3 group had significantly lower levels of HDL than E 3/3 and E 3/2 groups. In patients with CRF, E 4/3 group had significantly higher levels of total cholesterol and apo B lipoprotein than E3/2 group. In conclusion, although there was no significant difference in the apo E genotype frequencies between male patients with CRF and controls, apo E polymorphism may play an important role in the determination of individual differences in plasma lipids in male patients with CRF.
Alleles ; Apolipoproteins B ; Apolipoproteins E ; Apolipoproteins* ; Atherosclerosis ; Cause of Death ; Cholesterol ; Genotype ; Humans ; Individuality ; Kidney Failure, Chronic* ; Lipid Metabolism ; Lipoprotein(a) ; Lipoproteins ; Male* ; Plasma* ; Triglycerides

BACKGROUND: The relative importance of embolic mechanisms as opposed to hemodynamic factor in the pathogenesis of ischemic strokes associated with atherosclerotic middle cerebral artery (MCA) or internal carotid artery (ICA) disease remains unresolved. We conducted the present study to identify the differences of clinicoradiological patterns between MCA or ICA diseases. METHODS: We defined atherosclerotic disease of MCA or ICA as > 50% stenotic lesions or ulcerative plaques. We divided the patients into groups of MCA and ICA diseases, and analyzed clinical, laboratory, and neuroradiological data. RESULTS: Among the 620 consecutive patients with acute ischemic strokes, 84 (12.9%) patients met the criteria for atherosclerotic MCA or ICA disease: 54 patients with MCA disease and 30 patients with ICA disease. The mean age was younger in patients with MCA than ICA disease (p=0.003). MCA disease clinically more frequently presented with lacunar syndrome (p=0.001). ICA disease more frequently presented with total anterior circulation infarct and had higher initial NIHSS scores than MCA disease (p=0.004 and 0.003, respectively). While whole MCA territorial infarcts were common in ICA disease, deep perforator infarcts were more significantly caused by MCA disease (p< 0.05). MR topographic patterns showed difference between MCA and ICA diseases according to the degree of stenosis (p< 0.05). Cortical dots were significantly accompanied by superficial perforator infarcts than internal borderzone infarcts (p=0.017). CONCLUSIONS: Our present study suggests that clinical and neuroradiological representations might be different between MCA and ICA diseases, which might reflect difference of underlying pathogenesis.
Carotid Artery, Internal* ; Constriction, Pathologic ; Hemodynamics ; Humans ; Infarction ; Middle Cerebral Artery* ; Stroke ; Stroke, Lacunar ; Ulcer

BACKGROUND: The relative importance of embolic mechanisms as opposed to hemodynamic factor in the pathogenesis of ischemic strokes associated with atherosclerotic middle cerebral artery (MCA) or internal carotid artery (ICA) disease remains unresolved. We conducted the present study to identify the differences of clinicoradiological patterns between MCA or ICA diseases. METHODS: We defined atherosclerotic disease of MCA or ICA as > 50% stenotic lesions or ulcerative plaques. We divided the patients into groups of MCA and ICA diseases, and analyzed clinical, laboratory, and neuroradiological data. RESULTS: Among the 620 consecutive patients with acute ischemic strokes, 84 (12.9%) patients met the criteria for atherosclerotic MCA or ICA disease: 54 patients with MCA disease and 30 patients with ICA disease. The mean age was younger in patients with MCA than ICA disease (p=0.003). MCA disease clinically more frequently presented with lacunar syndrome (p=0.001). ICA disease more frequently presented with total anterior circulation infarct and had higher initial NIHSS scores than MCA disease (p=0.004 and 0.003, respectively). While whole MCA territorial infarcts were common in ICA disease, deep perforator infarcts were more significantly caused by MCA disease (p< 0.05). MR topographic patterns showed difference between MCA and ICA diseases according to the degree of stenosis (p< 0.05). Cortical dots were significantly accompanied by superficial perforator infarcts than internal borderzone infarcts (p=0.017). CONCLUSIONS: Our present study suggests that clinical and neuroradiological representations might be different between MCA and ICA diseases, which might reflect difference of underlying pathogenesis.
Carotid Artery, Internal* ; Constriction, Pathologic ; Hemodynamics ; Humans ; Infarction ; Middle Cerebral Artery* ; Stroke ; Stroke, Lacunar ; Ulcer

Von Meyenburg complexes (VMC) have many synonyms such as bile duct hamartomas and biliary hamartoma. These rare benign disorders are considered as congenital diseases caused by malformed differentiation of ductal plate. The diagnosis of VMC by common radiologic modality such as ultrasound and computed tomography was nearly impossible until the emergence of cholangiopancreatography by magnetic resonance imaging (MRCP) and the pathologic examination was the only way to confirm the diagnosis of VMC. But MRCP is now considered as most accurate noninvasive method for diagnosis of VMC. We report a histologically proven case of VMC associated with calculous cholecystitis, cerebral aneurysm and renal cortical cyst. To our knowledge, no comparable case has been reported and this would be the only second reported case of VMC, which was diagnosed by MRCP.
Bile Ducts ; Cholecystitis* ; Diagnosis ; Hamartoma ; Intracranial Aneurysm* ; Magnetic Resonance Imaging ; Ultrasonography

PURPOSE: To analysis of the clinical aspects of axillofemoral (AXFBG) and aortofemoral bypass (AOFBG) for aortoiliac occlusive disease. METHODS: Between June 1996 and May 2001, 23 patients underwent AXFBG or AOFBG for lower extremity ischemia caused by aortoiliac occlusive disease at Samsung Medical Center. The decision to perform AXFBG or AOFBG was based on an assessment of surgical risk and the patient's preference. We retrospectively analyzed the preoperative clinical status, risk factors and distal runoff scores affecting the patency rate as well as the clinical outcome following surgery. RESULTS: We performed 10 AXFBGs and 13 AOFBGs. The mean age was 67.8 years in AXFBG patients and 57.4 years in AOFBG patients. Limb salvage as an indication for surgery included 8 (80%) cases with AXFBG, as compared to 13(100%) cases with AOFBG. The mean follow-up period was 20.7 months in AXFBG and 21.8 months in AOFBG. The clinical improvement following surgery was statistically higher with AOFBG. The one-year and 2-year primary patency rates in AXFBG were 100% and 82% retrospectively. All of the grafts of AOFBG were patent during this follow-up period. CONCLUSION: The clinical improvement was higher with AOFBG as compared to AXFBG. However AXFBG is a safe practice in high-risk patients.
Follow-Up Studies ; Humans ; Ischemia ; Limb Salvage ; Lower Extremity ; Retrospective Studies ; Risk Factors ; Transplants

Rhabdomyolysis is an uncommon complication in a vascular surgery. Recently we experienced two cases of rhabdomyolysis after aortic surgery. The first one underwent an elective surgery for AAA but the 2nd case performed an emergency surgery because of ruptured AAA. Both patients recovered from rhabdomyolysis by conservative medical treatment without any major complications such as acute renal failure.
Acute Kidney Injury ; Aneurysm ; Aorta ; Emergencies ; Humans ; Rhabdomyolysis*

Acetabular fractures can be treated with variable method. In this study, acetabular posterior wall fracture was treated with arthroscopic reduction and fixation using cannulated screw. The patient recovered immediately and had a satisfactory outcome. In some case of acetabular fracture could be good indication with additional advantages of joint debridement and loose body removal. So, we report our case with technical note.
Acetabulum* ; Debridement ; Humans ; Joints ; Methods

No abstract available.
Postural Orthostatic Tachycardia Syndrome* ; Syncope