No abstract available.
Anemia*

BACKGROUND: Echocardiographically detected left ventricular(LV) hypertrophy is a risk factor for cardiovascular morbidity and mortality. A better understanding of the determinants of LV mass may aid in strategies directed toward the promary and secondary prevention of LV hypertrophy and its consequences. Previous studies have reported that male gender, arterial blood pressure(BP), obesity, age, aortic valvular stenosis, dietary sodium, endocrine factors, and physical activity are positively correlated with LV mass. Of these determinants male gender, hypertension, and obesity are well known but age and blood pressure in healthy adults are controversial. To assess the determinants of LV mass, the relation of 2-dimensional(2D) echocardiographically determined LV mass to body mass inedx(BMI), age, sex, casual BP, and 24 hour ambulatory blood pressure(ABP : systolic, diastolic, and mean BP of 24 hour, day-time, and night-time) was examined in healthy adults. METHODS: The study population consisted of 200 healthy adults who were normotensive, nonobese, and had no evidence of cardiovascular disease(range in age from 20 to 69 years, five decades, 20 men and 20 women per each decade). LV mass was derived from area length method measurements obtained by 2D echocardiography and corrected for height. ABP monitoring was performend over 24 hour(divided into day-time(6am-10pm) and night-time(10pm-6am)periods) with 30 minute inervals. RESULTS: 1) BMI was significantly and independently related to LV mass corrected for height (p<0.001, partial R2=0.31 in men and 0.43 in women). An increase of BMI by 1 kg/m2increased LV mass corrected for height by 1.9g/m in men and 2.0g/m in women. 2) Age was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.15 in men and 0.17 in women). The increments of Lv mass corrected for height per decade were 2.1 g/m in men and 3.4 g/m in women. 3) Gender was significantly and independently related to LV mass corrected for height(p<0.001, partial R2=0.12), which was greater in men than in women by 6.34g/m. 4) Casual Bp and 24 hour ABP were not significantly associated with LV mass corrected for height in total population and women, and 24 hour systolic BP was significantly related to LV mass corrected for height only in men(p<0.001) with weak partial R2(0.05). CONCLUSION: BMI, age, and male gender were statistically significant and independent correlates of LV mass corrected for height(p<0.001). Maintenance of ideal body weight and normal BP, weight reduction in obese persons and BP control inhypertensive patients may contribute to the primary and secondary prevention of LV hypertrophy and its sequalae.
Adult* ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory* ; Constriction, Pathologic ; Echocardiography* ; Female ; Humans ; Hypertension ; Hypertrophy ; Ideal Body Weight ; Male ; Mortality ; Motor Activity ; Obesity ; Risk Factors ; Secondary Prevention ; Sodium, Dietary ; Weight Loss

PURPOSE: The role of local excision in treating rectal cancer patients continues to be controversial. The aim of this study was to evaluate the long-term oncological results of local excision for early rectal adenocarcinomas and review the outcomes of salvage therapy on rectal cancer patients. MATERIALS AND METHODS: Between March 1992 and September 2005, 35 consecutive patients with early-stage primary rectal adenocarcinomas were treated by local excision with curative intent. The mean tumor distance from the anal verge was 5 cm (range, 1-10 cm). RESULTS: The median follow-up was 66 months (range, 17-161 months). Pathological examination revealed 23 cases of T1 and 12 cases of T2. Recurrence had developed in 10 patients (6 local recurrences, 4 systemic recurrences). Purely extrapelvic recurrence was observed in only two (5.7%) patients. Of the eight recurrent patients with surgical salvage, five survived with no evidence of disease at the time of this analysis. The 5-year local recurrence-free and disease-free survival rates were 79.6% and 67.9%, respectively. CONCLUSION: Local excision alone of early-staged rectal adenocarcinomas, even in the ideal candidate, is followed by a relatively higher local recurrence rate than previously reported and may not be a valid modality. Either the use of adjuvant therapy with local excision, even in patients with T1 lesions or the use of preoperative therapy followed by local excision has good promise.
Adenocarcinoma/*pathology/surgery ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology/*pathology/surgery ; Rectal Neoplasms/*pathology/surgery ; Retrospective Studies ; Risk Factors ; Salvage Therapy ; Time Factors ; Treatment Outcome

Allopurinol is one of the causative drugs that induce fixed drug eruption (FDE). The lymphocyte transformation test (LTT) is a safe and reliable diagnostic procedure for drug allergy, but is reported to be rarely positive in patients with FDE. In the current case, we performed an LTT and successfully confirmed allopurinol as the offending drug. This case report suggests that an LTT should be an optional diagnostic tool for FDE or delayed reaction due to allopurinol.
Allopurinol ; Drug Eruptions ; Drug Hypersensitivity ; Humans ; Lymphocyte Activation ; Lymphocytes

BACKGROUND: The etiologies of ischemic cerebrovascular diseases are various-thrombosis or artery to artery embolism, cardiogenic embolism and lipohyalinosis. In the past embolic cerebral infarct was thought to occur uncommonly. But these days substantial portion of patients have been found to have potential embolic sources by transesophageal echo cardiography and carotid duplex doppler. As transesophageal echocardiography has a high yield for identification of potential sources of cardiac embolism in patients with ischemic cerbrovascular diseases, its use has been increasing. In Korea an increasing number of patients with ischemic cerebrovascular diseases have been examined by transesophageal echocardiography since 1990. But in all the previous studies transesophageal echocardiographic evaluation has been confined to the patients with high probability of embolic cerebral infarct. All kinds of ischemic cerebrovascular diseases patients have never been examined by transesophageal echocardiography and carotid duplex doppler and the prevalence of potential embolic sources in Korean ischemic cerebrovascular disease patients is not known. The aim of this study was to evaluate the prevalence of potential cardiovascular embolic sources by transesophageal echocardiography and carotid duplex doppler in unselected patients with ischemic cerebrovascular diseases. METHODS: We evaluated all kinds of ischemic cerebrovascular diseases patients admitted from 1994. 9. 1. until 1995 9. 31. to the Departments of Neurology and Internal Medicine of Kangnam General Hospital. We evaluated them by transesophageal echocardiography, carotid doppler, brain CT(or brain MRI). A significant carotid stenosis was defined as a duplex scandetected lesion producing at least 50% vessel narrowing. The following echocardiographic findings were defined prospectively as potential cardiac sources of embolism : atrial appendage or left atrial cavity thrombus, spontaneous echocardiographic contrast, atrial septal aneurysm, interatrial shunt, ventricular aneurysm, ventricular thrombus, myxomatous mitral valve and protruding atherosclerotic plaque in the ascending aorta or transverse aortic arch. RESULTS: Of 64 patients admitted during the study period, 30 were excluded(Three patients were critically ill, and twenty seven patients refused diagnostic work-up.). Thorough diagnostic work-up was performed in 34 patients. Transesophageal echocardiographic positive findings were present in six patients(17.6%). Of them four(4/34, 11.7%) had spontaneous echo contrast, two(2/34, 5.8%) had left atrial thrombi, one(1/34, 2.9%) had ascending aorta atheroma. Eleven patients(11/34, 32.3%) had abnormalities in carotid doppler study. Five patients(5/34, 14.7%) had abnormalities both in transesophageal echocardiography and carotid doppler study. CONCLUSIONS: The results suggest that among ischemic cerebrovascular diseases patients substantial portion of patients have potential embolic sources. The prevalence of potential embolic sources in Korea may be higher than previously expected. Because the relative small number of the patients studied make it difficult to generalize the results, further studies with a large number of patients are needed.
Aneurysm ; Aorta ; Aorta, Thoracic ; Arteries ; Atrial Appendage ; Brain ; Carotid Stenosis ; Critical Illness ; Echocardiography ; Echocardiography, Transesophageal ; Embolism ; Hospitals, General ; Humans ; Internal Medicine ; Korea ; Mitral Valve ; Neurology ; Plaque, Atherosclerotic ; Prevalence ; Prospective Studies ; Thrombosis

A 69-year-old man was admitted to our hospital for deep vein thrombosis, and he had experienced two episodes of left leg swelling: one happened after an 11 hour-air trip from Europe in June 2007, and the other developed 3 days after an operation for a herniated lumbar disc in July 2007. We treated him for a deep vein thrombosis of the deep femoral vein after admission. However, we arrived at the final diagnosis of angioleiomyosarcoma after the operation for the tentative diagnosis of deep vein thrombosis. We removed the firmly engorged deep femoral vein on the second operation. We report here on a case of angioleiomyosarcoma that arose from the deep femoral vein.
Aged ; Europe ; Femoral Vein ; Humans ; Leg ; Leiomyosarcoma ; Thrombosis ; Venous Thrombosis

BACKGROUND: We compared the analgesic effects of an intravenous infusion of remifentanil with local lidocaine injection during endovenous laser treatments (EVLT) for varicose veins. MATERIAL AND METHOD: In order to compare the efficacy of analgesia between the lidocaine group (n=15) and the remifentanil group (n=15), we measure the pain intensity of the patients, with using the visual analogue scale, during EVLT and at the first week, the second week, the third week and the fourth week after EVLT. RESULT: The remifentanil group showed significantly less pain intensity during EVLT (p<0.01), but there were no differences of pain intensity between the two groups from the first week to the fourth week after EVLT (p>0.3). CONCLUSION: The result showed that the intravenous infusion of remifentanil during EVLT can be a good option to reduce pain during EVLT for treating varicose veins.
Analgesia ; Anesthesia, Local ; Humans ; Infusions, Intravenous ; Laser Therapy ; Lidocaine ; Piperidines ; Varicose Veins ; Veins

With recognition of the biomechanical role of the meniscus, such as load distribution and joint stability in the knee joint, there has been a shift in the treatment of meniscal tears from open total meniscectomy to preservation of the meniscal functions as much as possible with symptomatic relief. Recently, technical development of meniscal surgery, with advanced arthroscopic equipment and instruments, enables biological reconstruction of load bearing functions in the meniscus deficient knee through allograft tissue transplantation as well as repair of torn menisci. Meniscal allograft transplantation (MAT) has been considered as one of the few viable treatment options for the young meniscectomized knees based on various animal experiments and clinical studies. Still, there is insufficient evidence for the long-term chondroprotective effect of human MAT. Some long-term follow-up studies showed that the technique resulted in graft degeneration, deformation, and tear, and structural changes in the remodeling process in early MAT cases, disrupting functional restoration of the original meniscus. Nevertheless, advanced outcomes are documented in some recent studies. The purpose of this article is to review the mid- and long-term follow-up results of MAT and to improve understanding of MAT with evaluation methods of meniscal transplants using magnetic resonance imaging or second-look arthroscopy.
Animal Experimentation ; Arthroscopy ; Follow-Up Studies ; Humans ; Joints ; Knee ; Knee Joint ; Magnetic Resonance Imaging ; Tissue Transplantation ; Transplantation, Homologous ; Transplants ; Weight-Bearing

BACKGROUND: While aspirin sensitivity has been known to be common among patients with severe asthma, its frequency among asthmatics with mild to moderate severity remains to be learned. OBJECTIVES: To elucidate the frequency of aspirin sensitivity and its clinical characteristics among asthma patients with mild to moderate severity. MATERIAL AND METHODS: A total of 96 asthmatics with mild to moderate severity were enrolled. They underwent lysine-aspirin and methacholine bronchial provocation tests, and gave their induced sputum after the lysine-aspirin challenge. RESULTS: FEV1 declined greater than 20% compared with baseline FEV1 in 11 of 96 patients on the lysine-aspirin challenge. The frequency of aspirin sensitivity was higher among patients with enhanced bronchial hyperresponsiveness to methacholine (PC20 < 1 mg/ml) than among those without it (27.3% vs. 6.8%). The frequency was also higher in those with induced sputum eosinophil count higher than 3% than among those without it (38.9% vs. 0%). However, it was not associated with other risk factors such as age, sex, atopy, nasal polyps, and rhinosinusitis. CONCLUSION: More than 10% of mild to moderate asthmatics have aspirin sensitivity even though they have experienced no history of aspirin sensitivity which may be related with bronchial hyperresponsiveness to methacholine and eosinophil activation.
Aspirin* ; Asthma ; Asthma, Aspirin-Induced ; Bronchial Provocation Tests ; Eosinophils ; Humans ; Methacholine Chloride ; Nasal Polyps ; Prevalence* ; Risk Factors ; Sputum

As the use of chemotherapeutic agents increased rapidly in recent years, more patients are under the potential risk of chemotherapy related adverse reactions. Multiple regular exposures to the same drug by chemotherapy protocol may increase the risk of sensitization to a chemotherapeutic agent, which can result in hypersensitivity reactions. Once severe hypersensitivity reactions occur, causative drugs should be avoided. However, a substitute with equal efficacy is not always available. When there is no effective alternative, desensitization is a safe tool for maintenance of chemotherapeutic agents causing hypersensitivity reaction. In this review, we introduce the latest knowledge about desensitization protocol for chemotherapeutic agents which are frequently used recently.
Antineoplastic Agents ; Desensitization, Immunologic ; Drug Hypersensitivity ; Drug Therapy* ; Humans ; Hypersensitivity*