Juxtaductal coarctation is usually distal to the origin of the left subclavian artery, occasionally the orifice of the subclavian artery is involved in the coarctation and partially obstructed. An anomalous origin of the right subclavian artery from the descending aorta below the coarcted segment is also occasionally encountered. Reversed vertebral artery flow to a subclavian artery arising at or below a coarctation may produce the subclavian steal syndrome. Rarely both subclavian arteries arise beyond the coarctation. These abnormal subclavian arteries are important in clinical diagnosis and treatment. We report a case of Turner syndrome with coarctation, which present as juxtaductal type and the left subclavian artery from the descending aorta below the coarcted segment with reversed vertebral artery flow to a subclavian artery producing the subclavian steal syndrome. Resecton of coarctation segment and end-to-end anastomosis was successfully performed after transfer of left subclavian artery to distal segment of descending aorta.
Aorta, Thoracic* ; Aortic Coarctation ; Diagnosis ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Turner Syndrome* ; Vertebral Artery

PURPOSE: The most common complication of Kawasaki disease(KD) is the development of coronary artery aneurysm. Other cardiac complication include myocarditis, pericarditis, mitral or aortic insufficiency, congestive failure, and arrhythmia. These non- coronary cardiac problems have important role on clinical course in acute phase of KD. Extensive researches have been performed about the pathogenesis, natural course and treatment of coronary artery lesion. But the studies about non-coronary cardiac complication have been limited, so we aimed to study the manifestation, incidence, and clinical predictor of carditis. METHODS: The retrospective studies was performed to the 48 KD patients diagnosed in Chungnam National University Hospital from May 1998 to September 2004. The patients were divided into two groups. Patients with carditis(11 patients) and without carditis(37 patients) before receiving the IVGG infusion were analyzed. RESULTS: There were no differences in age and sex between two groups. Patients with long duration of fever and high Harada score had the significant increase in the incidence of carditis before the initial IVGG infusion. No significant differences were not shown between the two groups in terms of WBC count, hemoglobin, hematocrit, platelet count, total protein, AST/ALT, LDH, CPK, troponin I, total cholesterol, and triglyceride before the initiL IVGG infusion. The incidence of carditis was high in patient with high CRP, low albumin, and high cholesterol and triglyceride. CONCLUSION: The possibility of significant carditis should be considered before the infusion of high dose IVIG, which may worse the caridac dysfunction. Some predictors of significant carditis such as long duration of fever, high Harada score, high levels of CRP, and low levels of albumin can be suggested.
Aneurysm ; Arrhythmias, Cardiac ; Child* ; Cholesterol ; Chungcheongnam-do ; Coronary Vessels ; Estrogens, Conjugated (USP) ; Fever ; Hematocrit ; Humans ; Immunoglobulins, Intravenous ; Incidence ; Mucocutaneous Lymph Node Syndrome* ; Myocarditis* ; Pericarditis ; Platelet Count ; Retrospective Studies ; Risk Factors* ; Triglycerides ; Troponin I

OBJECTIVE: The purpose of this study is to evaluate the efficacy and safety of 3-level hybrid surgery (HS), which combines fusion and cervical disc replacement (CDR), compared to 3-level fusionin patient with cervical spondylosis involving 3 levels. METHODS: Patients in the anterior cervical discectomy and fusion (ACDF) group (n=30) underwent 3-level fusion and the HS group (n=19) underwent combined surgery with fusion and CDR. Clinical outcomes were evaluated using the visual analogue scale for the arm, the neck disability index (NDI), Odom criteria and postoperative complications. The cervical range of motion (ROM), fusion rate and adjacent segments degeneration were assessed with radiographs. RESULTS: Significant improvements in arm pain relief and functional outcome were observed in ACDF and HS group. The NDI in the HS group showed better improvement 6 months after surgery than that of the ACDF group. The ACDF group had a lower fusion rate, higher incidence of device related complications and radiological changes in adjacent segments compared with the HS group. The better recovery of cervical ROM was observed in HS group. However, that of the ACDF group was significantly decreased and did not recover. CONCLUSION: The HS group was better than the ACDF group in terms of NDI, cervical ROM, fusion rate, incidence of postoperative complications and adjacent segment degeneration.
Arm ; Arthroplasty ; Diskectomy* ; Humans ; Incidence ; Neck ; Postoperative Complications ; Range of Motion, Articular ; Spondylosis ; Total Disc Replacement*

About 50 cases of Listeria monocytogenes endocarditis were reported in worldwide literature in 1950-1995. Though clinical and laboratory data suggest a similarity with other types of bacterial endocarditis, the prognosis is more unfavorable and the mortality rate is higher. However, there has not been a report in Korean literature. We report a case of 55 year-old male with rapidly progressive native aortic endocarditis caused by L. monocytogenes. He had neither history of underlying cardiac disease nor definitive predisposing factor. He presented mild dyspnes, chest pain and febrile sensation for a week. Echocardiography showed large vegetation in aortic valve and severe aortic regurgitation. L. monocytogenes grew on blood culture. We underwent artificial aortic valve replacement due to rapidly progessive heart failure. A thromboembolism occured at right femoral artery on postoperative 2nd day was removed successfully. He discharged without any sequellae.
Adult* ; Aortic Valve ; Aortic Valve Insufficiency ; Causality ; Chest Pain ; Echocardiography ; Endocarditis* ; Endocarditis, Bacterial ; Femoral Artery ; Heart Diseases ; Heart Failure ; Humans ; Listeria monocytogenes* ; Listeria* ; Male ; Middle Aged ; Mortality ; Prognosis ; Sensation ; Thromboembolism

BACKGROUND: We report here the results of surveys for external quality assessment of blood bank tests performed in 2009. METHODS: Survey specimens were sent three times to 488, 491 and 490 participant institutes, and the response rates for the 1st, 2nd and 3rd trial were 97.7%, 98.0%, and 98.0%, respectively. Test items for the surveys were ABO grouping, Rh (D) typing, crossmatching, direct antiglobulin test, antibody screening and antibody identification test. RESULTS: The average accuracy rates of ABO grouping and Rh typing were 99.6-100% and 98.5-100%, respectively. In crossmatching test, the accuracy rates were 99.3-99.8% for the compatible samples, 92.7-100% for the incompatible samples, and 92.6-93.1% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.5-100% for negative samples and 98.1-98.8% for positive samples. The correctresults were reported by 98.0-100% of the surveyed institutions for antibody screening test and 82.9-100% for antibody identification test. Nineteen institutions gave repeatedly incorrect answers for crossmatching test. Eight institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year. CONCLUSIONS: The overall results of this survey were good, however, it is required that the institutions where the incorrect results were reported should perform corrective actions for quality improvement.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening ; Quality Improvement

We report here the results of surveys for external quality assessment of blood bank tests performed in 2008. Survey specimens were sent three times to 460, 470 and 473 participant institutes, and the response rates for the 1st, 2nd and 3rd trial were 97.6%, 97.7%, and 97.7%, respectively. Test items for the surveys were ABO grouping, Rh (D) typing, crossmatching, direct antiglobulin test, antibody screening and antibody identification test. The average accuracy rates of ABO grouping and Rh typing were 100% and 98.3-100%, respectively. In crossmatching test, the accuracy rates were 97.5-99.7% for the compatible samples, 92.4-99.2% for the incompatible samples, and 88.2-98.9% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.4-99.7% for negative samples and 93.4-99.7% for positive samples. The correct results were reported by 99.6-100% of the surveyed institutions for antibody screening test and 98.2-100% for antibody identification test. Twenty-three institutions gave repeatedly incorrect answers for crossmatching test. Ten institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening

We report here the results of surveys for external quality assessment of blood bank tests performed in 2003. Response rates for the 1st, 2nd and 3rd trial were 93.1%, 91.7%, and 90.1%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.7-100% and 99.7-100%, respectively. In crossmatching test, the accuracy rates were 97.4-100% for the compatible samples, 83.4-100% for the incompatible samples, 87.2-92.4% for the samples which were incompatible in albumin phase, and 83.4-88.8% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 97.9-99.6% for negative samples and 93.8-95.0% for positive samples. The correct results were reported from 95.9-100% of the surveyed institutions for antibody screening test and 98.8-100% for identification test. Forty six institutions gave repeatedly incorrect answers for crossmatching. Nine out of 46 institutions gave incorrect answers for all the test specimens sent out 3 times last year.
Blood Banks* ; Coombs Test ; Korea* ; Mass Screening

We report here the results of surveys for external quality assessment of blood bank tests performed in 2005. Response rates for the 1st, 2nd and 3rd trial were 97.0%, 96.8%, and 97.1% respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.5-100% and 99.7-100% respectively. In crossmatching test, the accuracy rates were 94.3-98.2% for the compatible samples, 88.5-92.9% for the incompatible samples, and 88.5-92.9% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.9-99.3% for negative samples and 89.2-96.9% for positive samples. The correct results were reported by 98.3-100% of the surveyed institutions for antibody screening test and 98.9-100% for identification test. Seventeen institutions gave repeatedly incorrect answers for crossmatching. Thirteen institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Blood Banks* ; Coombs Test ; Korea* ; Mass Screening

We report here the results of surveys for external quality assessment of blood bank tests performed in 2002. Response rates for the 1st, 2nd and 3rd trial were 91.0%, 91.6%, and 91.8%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.4-100% and 97.4-100%, respectively. In crossmatching test, the accuracy rates were 92.5-98.3% for the compatible samples, 73.7-99.7% for the incompatible samples, 88.0% for the samples which were incompatible in albumin phase, and 73.7% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 96.3-98.4% for negative samples and 95.9-97.0% for positive samples. The correct results were reported by 98.6-100% of the surveyed institutions for antibody screening test and 100% for identification test. Forty six institutions gave repeatedly incorrect answers for crossmatching. Nine institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Blood Banks* ; Coombs Test ; Korea* ; Mass Screening

We report here the results of external quality assessment of blood bank tests performed in 2007. Survey specimens were sent three times to 448, 450, and 455 participant institutes, and the response rates were 99.3%, 97.3%, and 98.0%, respectively. Test items for the surveys were ABO grouping, Rh(D) typing, crossmatching, direct antiglobulin test, antibody screening and identification test. The average accuracy rates of ABO grouping and Rh typing were in the range of 99.5-100% and 98.9-100%, respectively. In crossmatching test, the accuracy rates were 96.0-97.1% for the compatible samples, 89.6-92.4% for the incompatible samples, and 89.6-92.4% for the samples which could be detected as incompatible only by antiglobulin method. The accuracy rates of direct antiglobulin test were 98.0-99.7% for negative samples and 96.3-99.0% for positive samples. The correct results were reported by 95.7-100% of the surveyed institutions for antibody screening test and 98.2-100% for identification test. Fifteen institutions gave repeatedly incorrect answers for crossmatching. Five institutions out of them gave incorrect answers for all the test specimens sent out 3 times last year.
Academies and Institutes ; Blood Banks ; Coombs Test ; Korea ; Mass Screening