No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Ifosfamide* ; Paclitaxel*

Unilateral absence of a pulmonary artery is an uncommon anomaly, which presents as an isolated lesion or in combination with other congenital heart disease such as TOF or PD^. We encountered three cases of isolated unilateral absence of a pulmonary artery;one was left pulmonary artery agenesis with right sided aortic arch and the others were right pulmonary artery agenesis with left sided aortic arch. Plain chest radiograph showed considerable loss of unilateal lung volume and lack of ipsilateral hilar shadow. Pulmonary angiogram which was done in two cases, revealed proximal interruption of a pulmonary artery. Chest CT was done in only one case, on which right pulmonary artery was absent and was replaced by adipose tissue. CT with its clean demonstration pulmonary artery without any evidence of aquired obstruction of a pulmonary artery by pulmonary embolism or tumor invasion, maybe a valuable method for evaluaton of the unilateral absence of a pulmonary artery.
Adipose Tissue ; Aorta, Thoracic ; Heart Defects, Congenital ; Lung ; Pulmonary Artery* ; Pulmonary Embolism ; Radiography, Thoracic ; Tomography, X-Ray Computed

The Kallmanns syndrome is the most common form of isolated hypogonadotropic hypogonadism in which anosmia or hyposmia resulting from agenesis of hypoplasia of the olfactory lobes is associated with LHRH deficiency, This syndrome is genetically heterogeneous and can be trans-mitted as an X-linked, autosomal dominant or autosomal recessive trait. The hypogonadotropic hypogonadism results in absent or incomplete pubertal development and may be associated with anosmia or hyposmia, mid-line defect(color blindness, cleft-lip or
Blindness ; Cryptorchidism ; Epiphyses ; Femur Neck ; Gonadotropin-Releasing Hormone ; Growth Plate ; Head ; Humans ; Hypogonadism ; Kallmann Syndrome ; Male ; Olfaction Disorders ; Olfactory Cortex ; Slipped Capital Femoral Epiphyses

Purpose: Vessel wall imaging (VWI) for carotid plaque is better for detecting unstable carotid plaque such as intraplaque hemorrhage (IPH), lipid-rich necrotic core (LRNC), and thin/ruptured fibrous cap. However, the role of VWI before carotid artery stenting (CAS) is unclear. Thus, this study aimed to determine the findings of symptomatic carotid stenosis before CAS on angiography and carotid VWI and to evaluate the imaging findings associated with post-procedural clinical events after CAS. Materials and Methods: This retrospective study included 173 consecutive patients who underwent carotid VWI, CAS, and post-procedural diffusion-weighted imaging (DWI) after CAS. Findings of unstable plaque on carotid VWI and unstable findings on angiography were analyzed. We also analyzed the incidence of post-procedural clinical events, any stroke, myocardial infarction (MI), and death within 30 days of CAS. Results: Of 173 patients, 101 (58.4%) had initial ischemic symptoms and positive findings on DWI. Symptomatic patients were significantly higher in patients with IPH than in patients without IPH (62.4% vs. 45.8%, P=0.031). Degree of stenosis, thrombus of the stenotic lesion, flow delay of internal carotid artery, and flow arrest by filter thrombus had significantly higher prevalence in the symptomatic group. Twenty patients (11.6%) had post-procedural clinical events such as any stroke, clinical symptoms, and/or MI. Hyperlipidemia and intraluminal thrombus on angiography were identified as significant factors influencing post-procedural events after CAS. Conclusion An intraluminal thrombus on angiography was identified as a significant factor influencing post-procedural clinical events after CAS.

BACKGROUND: Systemic hypertension produces varying degree of LVH which is associated with increased cardiovascular morbidiity. Previous studies have documented regression of LVH with various antihypertensives including calcium channel blockers, except diuretics and vasodilators. Recently echocadiographic assessment of the change of left ventricular mass(LVM) after antihyertensive therapy have been reported to offer prognostic cardiovascular information. The aim of this echocardiographic study is determining the influence of nicardipine, a calcium channel blocker, on the change of LVM in patients with essential hypertenison. METHODS: Left ventricular mass(LVM) and left ventricular mass index(LVMI) were measured by M-mode echocardiography in 15 patients with essential hypertension. Nicardipine, a calcium channel blocker, was administered for 6 months and two echocardiographies were done before and after administering, respectively. RESULTS: In the 15 patients treated for 6 months, systolic and diastolic pressure remained very significantly decreased compared with pressure before before therapy(135+/-15mmHg vs 168+/-26mmHg, and 86+/-7mmHg vs 105+/-16mmHg, both p<0.01). Concomitantly both LVM and LVMI decreased significantly(209+/-49g vs 235+/-71g, and 116+/-6g/m2 vs 131+/-38g/m2,both p<0.05). And no change was noted in left ventricular cavity size, demonstration that LVM reduction was due to regression of hypertrophy. CONCLUSION: This study showed that nicardipine produced a significant decrease in blood pressure, LVM, and LVMI over the 6 months period. And large and longterm controlled studies are needed for the clarification of the association between nicardipine and regression of LVH in hypertensive patients.
Antihypertensive Agents ; Blood Pressure ; Calcium Channel Blockers ; Calcium Channels ; Diuretics ; Echocardiography ; Humans ; Hypertension ; Hypertrophy ; Nicardipine* ; Vasodilator Agents

No abstract available.
Posterior Leukoencephalopathy Syndrome ; Visual Fields

In order to determine the electrophysiologic properties of aberrant ventricular conduction we analyzed the electrophysiologic studies done for various reasons in SNUH(1983.3 -1987.8). All patients did not have underlying heart disease and were in sinus rhythm with normal PR intervals & no intraventricular conduction delay at the time of study. The patients of preexcitation syndrome were excluded. Only aberrant ventricular conduction induced by premature atrial stimulation at the high right atrium or(HRA) during sinus rhythm or HRA pacing was analyzed. 1) Aberrant ventricular conuction was induced by premature atrial extrastimulation in 34 subjects of 156 cases reviewed(21.8%). The patients were 16 to 70 years old(sixteen males and eighteen females). 2) The longest atrial coupling(A1S2) interval resulting in aberrant ventricular conduction approximated 45%(600-280) of the basic cycle length(450-1550 msec). 3) As a prerequisite for aberrant ventricular conduction, the functional refractory period(FRP) of the AV node should be less than the relative refractory period(RRP) of the His Purkinje System and the most important determinant of aberrant ventricular conduction by atrial extreastimulation was resultant H1H2 interval, which should be between RRP and effective refractory period(ERP) of HPS. 4) There was good linear correlation between the basic cycle length(BCL) and RRP of the HPS(RRP=0.247xBCL+247.048, r=0.885, p-value<0.001). 5) 155 different configurations of aberrant ventricular conduction were recorded during atrial extrastimulation till atrial ERP. The pattern frequencies were as follows : left anterior hemiblock, 6(3.9%) ; right bundle brach block, 92(59.4%) ; left bundle branch block, 28(18.0%) ; left anterior hemiblock combined with right bundle branch block, 14(9.0%) ; left posterior hemiblock combined with right bundle branch block, 9(5.8%) ; unclassified intraventricular conduction disturbances, 6(3.9%). 6) As the atrial coupling intervals were further shortened, aberrant conduction persisted up to the point of atrial ERP at 19/41 BCL's(46.3%). Other patterns of atrioventricular conduction were as follows : atrio-His block, 7(17.1%) ; His-ventricular block, 6(14.6%) ; normal conduction due to prolonged A2H2, 9(22.0%). But there was no statistical significance between the pattern of A-V conduction and the longest S2H2 & H2V2 intervals during VAB (p-value=0.235>0.050). In conclusion, atrial extrastimulation which is routinely done during clinical EPS is an effective method to induce aberrant ventricular conduction and to study the electrophysiologic characteristics of atrioventricular conduction. Further study with recording of bundle branch electrogram, after infusion of cardioactive drugs and pacing of HRA at fixed rate should be done to determine the electrophysiologic properties of VAB more completely.
Atrioventricular Node ; Bundle-Branch Block ; Heart Atria ; Heart Diseases ; Humans ; Male ; Pre-Excitation Syndromes

BACKGROUND: Because of the high complication rate of anatomical reconstruction after periacetabular resection, the strategy of resection alone has been revisited. However, in terms of complications and functional outcome, whether resection hip arthroplasty (RHA) shows a superior result to that of pelvic ring reconstruction remains controversial. METHODS: We compared 24 RHAs and 16 pasteurized autograft-prosthesis composite (PPC) reconstructions regarding the complication rates, operative time, blood loss, and functional outcome. RESULTS: Compared to 16 PPC hips, 24 RHA hips showed lower major and minor complication rates (p < 0.001), shorter surgical time (p < 0.001), and superior Musculoskeletal Tumor Society scores (p < 0.001). Of the 24 RHA hips, bony neo-acetabulum was identified in 7 on computed tomography and partial neo-acetabulum in 9; the remaining 8 had no bony acetabular structure. The average time to bony neo-acetabulum formation was 7 months (range, 4 to 13 months). CONCLUSIONS: RHA for periacetabular tumors can be an excellent alternative to anatomical reconstruction. It offers short surgical time, low complication rates, and functional results comparable to those of other reconstruction methods. However, this procedure is indicated for patients who can accept some limb shortening, and a tumor should be confined to the periacetabular area.
Acetabulum ; Arthroplasty* ; Extremities ; Hip* ; Humans ; Operative Time ; Treatment Outcome

PURPOSE: The purpose of this study was to evaluate the accuracy of each method of counting ribs on chest CT and to propose a new method: the anterior approach with using the sternocostal joints. MATERIALS AND METHODS: CT scans of 38 rib lesions of 27 patients were analyzed (fracture: 25, metastasis: 11, benign bone disease: 2). Each lesion was independently counted by three radiologists with using three different methods for counting ribs: the sternoclavicular approach, the xiphisternal approach and the modified sternomanubrial approach. The rib lesions were divided into three parts for evaluation of each method according to the location of the lesion as follows: the upper part (between the first and fourth thoracic vertebra), the middle part (between the fifth and eighth) and the lower part (between the ninth and twelfth). RESULTS: The most accurate method was a modified sternomanubrial approach (99.1%). The accuracies of a xiphisternal approach and a sternoclavicular approach were 95.6% and 88.6%, respectively. A modified sternomanubrial approach showed the highest accuracies in all three parts (100%, 100% and 97.9%, respectively). CONCLUSION: We propose a new method for counting ribs, the modified sternomanubrial approach, which was more accurate than the known methods in any parts of the bony thorax, and it may be an easier and quicker method than the others in clinical practice.
Bone Diseases ; Humans ; Neoplasm Metastasis ; Ribs* ; Sternocostal Joints ; Thorax* ; Tomography, X-Ray Computed*

Aneurysms of the posterior inferior cerebellar artery (PICA) are rarely encountered. In particular, due to frequent anatomic complexity and the presence of nearby critical structures, PICA origin aneurysms are difficult to treat. However, recent reports of anecdotal cases using advanced endovascular instruments and skills have made the results of endovascular treatment rather outstanding. PICA preservation is the key to a successful endovascular treatment, based on the premise that a PICA origin aneurysm is well occluded. To secure PICA flow, stenting into the PICA would be the best method, however, it is nearly impossible technically via the ipsilateral vertebral artery (VA) if the PICA arose at an acute angle from the sac. In such a case, a bilateral approach for stent-assisted coiling can be a creative method for achievement of two goals of both aneurysm occlusion and PICA preservation: ipsilateral approach for coil delivery and contralateral cross-over approach for stent delivery via a retrograde smooth path into the PICA.
Achievement ; Aneurysm ; Arteries ; Intracranial Aneurysm ; Pica ; Stents ; Vertebral Artery