BACKGROUND AND OBJECTIVES: The relationship of cold pressor, hyperventilation and exercise test responses to circadian patterns and types of angina in vasospastic angina have still not been known. The aim of this study was to identify subgoups of patients who have similar clinical features and provocation test response. MATERIALS AND METHODS: Twenty-one consecutive patients with pure vasospastic angina were studied. Six exercise tests were performed in the early morning, late morning, and late afternoon in consecutive days, and 2 hyperventilation tests and 2 cold pressor tests in the early morning. Circadian distribution and types of angina(at rest, on physical activity or both) were evaluated by clinical history, clinical records and ambulatory ECG recordings during admission and follow-up periods(mean 19+/-9 months). RESULTS: Three patterns of circadian distribution of anginal attacks were identified during all observation periods together(morning and night: MN n=, morning and afternoon or evening: M+/E n=, morning, night and afternoon and/or evening: MN+/E n=1). Exercise test was positive in 36%(40/111) without circadian variation, hyperventilation test in 66%(23/35) and cold pressor test in 6%(2/33). Neither hyperventilation test nor cold pressor test was related to circadian patterns, types or activity of angina, or numbers of spastic artery. But positive exercise test increased significantly in patients with angina on physical activity(43% vs 21%, p<0.05), high activity(57% vs 18%, p<0.01), multivessel spasm(50% vs 27%, p<0.05 ) and circadian patterns of M+/E and MN+/E(29%, 55% vs 4%, p<0.05, p<0.01). All patients with MN had rest angina and single vessel spasm. All 6 patients with M+/E had angina both at rest and on physical activity and 5 single vessel spasm. Eight of 11 patients with MN+/E had angina both at rest and on physical activity and 8 multivessel spasm. CONCLUSION: These findings suggest that hyperventilation test is highly sensitive in vasospastic angina without any relationship to clinical features, but exercise test response is related well to circadian patterns of angina attacks which are associated with characteristic clinical features.
Arteries ; Electrocardiography ; Exercise Test ; Follow-Up Studies ; Humans ; Hyperventilation ; Motor Activity ; Muscle Spasticity ; Spasm

We conducted this cohort analytic study to determine whether women with unexplained elevations of maternal serum hCG at 15-18 weeks' gestation are at increased risk for pregnancy complications and adverse perinatal outcomes. The inclusion criteria were a singleton gestation, a confirmed gestational age, and an hCG level greater than 2.0 multiples of the median (MoM). The exclusion criteria were fetal anomalies, an abnormal karyotype, molar pregnancy, and an MSAFP level greater than 2.5 multiples of the median (MoM). A group of randomly selected women with hCG levels under 2.0 MoM served as controls. Patients with elevated levels of hCG had a significantly higher risk for PIH (17.9% versus 4.5%; P <.05) and preterm delivery (17.9% versus 3.5%; P<, 05) than control. But no significant differences were observed in the incidence of intrauterine growth restriction and low birth weight and in the newborn weight. We suggested that pregnancies with unexplained elevated hCG levels should be regarded as high-risk pregnancies. And these patients require careful monitoring with adequate obstetric management.
Abnormal Karyotype ; Chorionic Gonadotropin* ; Cohort Studies ; Female ; Gestational Age ; Humans* ; Hydatidiform Mole ; Incidence ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome* ; Pregnancy* ; Pregnancy, High-Risk

Kinship testing in forensic casework is largely based on a likelihood ratio (LR) approach with short tandem repeat (STR) markers; however, in order to efficiently identify potential relatives in a specific population, the threshold values for kinship prediction should be determined by analyzing the kinship index distributions of the population in question. In this study, 250,000 DNA profiles were simulated using allele frequencies at 20 autosomal STR loci in Koreans, then the LRs were calculated for true close relatives and unrelated pairs. The LR distributions in related and unrelated pairs under a given relationship were compared in 2 sets of 13 Combined DNA Index System (CODIS) and 20 STR profiles. Using 13 CODIS STRs, true relatives in parent/child and full-sibling relationships were sufficiently discriminated from unrelated pairs with LR thresholds of 1,000 and 100, respectively. However, the CODIS STRs lacked the discriminatory power to differentiate between related and unrelated pairs in uncle/nephew and first cousin relationships due to high false-positive and false-negative rates with a LR threshold of 10. Increasing the number of STR loci to 20 increased discrimination of close relatives, but high false results remained in uncle/nephew and first cousin relationships. The kinship index data from this study will help make decisions on various kinship testing and familial searching in Koreans.
Asian Continental Ancestry Group ; Discrimination (Psychology) ; DNA ; Gene Frequency ; Humans ; Microsatellite Repeats

Purpose: This study assessed the results of surgical treatment for Neer type-II and type-V unstable distal clavicle fractures via hybrid fixation with a locking compression plate and finger trap wire. Materials and Methods: From September 2016 to April 2018, 15 patients treated for Neer type-II and type-V unstable distal clavicle fractures using hybrid fixation were analyzed retrospectively. The clinical results were analyzed based on the radiological healing time, range of motion of the shoulder joint, American Shoulder and Elbow Society (ASES) score, and the University of California at Los Angeles (UCLA) shoulder score. Results: The range of motion of the shoulder joint completely recovered to the normal range within 9.2 weeks on average (6−24 weeks). Furthermore, the follow-up of the clinical trial showed excellent results, including an ASES score of 98.5±2.3 and an UCLA score of 34.2±1.3. In addition, fracture union was successfully achieved in all cases, and was identified during week 15 on average. Conclusion For the treatment of unstable distal clavicle fractures, hybrid fixation is a useful surgical method with excellent clinical outcomes through rapid recovery of the range of motion of the shoulder joint after surgery.

It has been suggested that the frictional force between bracket and arch wire may impede the tooth movement. The present study was aimed to compare and analyze the effect of wire size, type of ligation, and duration of ligation on the magnitude of frictional force between cobalt chromium wire and stainless steel bracket under the artificial saliva. The results were as follows: 1. Type of ligation and size of wire were the main influencing factor on the level of friction. 2. Stainless steel ligature generated higher frictional forces thanelastomeric module. 3. The rectangular wire consistently exhibited more frictional force values than round wires, while there was no significant difference between frictional forces of round wires. 4. In elastic ligature, frictional force decreased with time. 5. Artificial saliva had no significant influence on the frictional force between cobalt chromium wire and bracket.
Chromium ; Cobalt ; Friction* ; Ligation ; Orthodontic Wires* ; Saliva, Artificial* ; Stainless Steel ; Tooth Movement

Catheters ; Diskectomy ; Endoscopes ; Humans ; Printing, Three-Dimensional ; Spine ; Surgical Instruments

The relationship between infective endocarditis and mycotic aneurysm formation appers clear : In about two to ten percent of patients with infective endocarditis harbor septic intracranial aneurysms. But the pathogenesis, natural course and management of these lesions remains controversial. Aggressive medical treatment of the underlying infected cardiac valve or surgical replacement therapy have significantly reduced the morbidity and mortality rates associated with infective endocarditis. Clinical predictors of mycotic aneurysm, especially neurologic prodromes prior to rupture have been ill-defined since most series contain few patients or include patients with infective aneurysms who have no infective endoarditis. Similarly there has been no consensus regarding the indications and timing of cerebral angiography in patients with infective endocarditis. We have experienced a case of cerebral mycotic aneurysm complicated with subarachnoid hemorrhage due to infective endocarditis in a 29 year-old female patient, who admitted to our hospital because of the pain and paralysis of sudden onset in right forearm, which was diagnosed by echocardiography, brain computed tomography and 4-vessel cerebral angiography. The patient died of sudden rupture of mycotic aneurysm in the 7th hospital day despite intensive medical treatment. We report one case of cerebral mycotic aneurysm with a brief of literature.
Adult ; Aneurysm ; Aneurysm, Infected* ; Brain ; Cerebral Angiography ; Consensus ; Echocardiography ; Endocarditis* ; Female ; Forearm ; Heart Valves ; Humans ; Intracranial Aneurysm ; Mortality ; Paralysis ; Rupture ; Subarachnoid Hemorrhage*

PURPOSE: To evaluate the ultrasonographic and CT findings of hepatosplenic tuberculosis MATERIALS AND METHODS: We retrospectively reviewed the ultrasonographic and CT findings of confirmed hepatosplenic tuberculosis in 12patients. Six were men and six were women ; their average age was 41, and most were in their twenties. Lesions ofthe liver and spleen, as well as associated findings such as abdominal tuberculosis and other organ involvement oftuberculosis were analyzed. RESULTS: There were three cases of hepatic tuberculosis, seven of splenictuberculosis, and two of hepatosplenic involvement of tuberculosis. On the basis of the ultrasonographic and CTfindings, hepatosplenic tuberculosis was classified as one of two patterns : miliary or micronodular, ormacronodular. The micronodular type was more common (9/12 cases) being characterized by innumerable micronodules,and with easy coalescence in the liver and spleen in five of the nine cases. The macronodular type of low densitymass was noted in the other three patients. Splenomegaly was noted in 12 cases and hepatomegaly in ten. Pulmonarytuberculosis-including the miliary type(n=5)-was noted in eight patients. Associated abdominal tuberculosis suchas lymphadenopathy with central low density and peripheral rim enhancement (n=6), tuberculous peritonitis(n=3),highly attenuated ascites(n=6), adrenal tuberculosis(n=1), renal tuberculosis(n=1), ovarian abscess(n=1), psoasabscess(n=1), and systemic tuberculosis such as central nervous system tuberculoma(n=2), cervicallymphadenopathy(n=4) and tuberculous spondylitis(n=1) were noted. CONCLUSION: Ultrasonography and CT werevaluable in the detection and diagnosis of hepatosplenic tuberculosis
Central Nervous System ; Diagnosis ; Female ; Hepatomegaly ; Humans ; Liver ; Lymphatic Diseases ; Male ; Retrospective Studies ; Spleen ; Splenomegaly ; Tuberculosis* ; Tuberculosis, Gastrointestinal ; Tuberculosis, Hepatic ; Ultrasonography

Takayasu's arteritis(TA) is a nonspecific areritis of unknown etiology affecting segmentally the aorta and its main branches, which result in stenosis, occlusion or aneurysm of involved arteries. The clinical manifestations present with a variety of symptoms such as headache, dyspnea on exertion, pain and weakness of extremities, pulse deficit, and hypertension according to involves arteries. Usually it can be managed by medical or surgical treatment, and recently by percutaneous transluminal balloon angioplasty. The type III classified by Lupi-Herrena and associates is the most frequent variety of TA. However the case of type III involving both subclavin arteries and both renal arteries has rarely been reported. We experienced a case of TA involving both subcalvian arteries, and both renal arteries presented with paroxysmal hypertension and right flank pain, in which the stenosis of both subclavian arteries were managed by percutaneous transluminal balloon angioplasty and the stenosis and occlusion of both renal arteries were successfully managed by aorto-renal bypass surgery with autogenous right iliac artery and synthetic vessel(Gortex). The patient was discharged uneventfully.
Aneurysm ; Angioplasty, Balloon ; Aorta ; Arteries* ; Constriction, Pathologic* ; Dyspnea ; Extremities ; Flank Pain ; Headache ; Humans ; Hypertension ; Iliac Artery ; Renal Artery* ; Subclavian Artery ; Takayasu Arteritis*

Medial meniscal root tears have been repaired using various methods. Arthroscopic all-inside repair using a suture anchor is one of the popular methods. However, insertion of the suture anchor into the proper position at the posterior root of the medial meniscus is technically difficult. Some methods have been reported to facilitate suture anchor insertion through a high posteromedial portal, a posterior trans-septal portal, or a medial quadriceptal portal. Nevertheless, many surgeons still have difficulty during anchor insertion. We introduce a technical tip for easy suture anchor insertion using a 25° curved guide and a soft suture anchor through a routine posteromedial portal.
Menisci, Tibial ; Surgeons ; Suture Anchors* ; Sutures* ; Tears