A hemangioma occurred in the bony epiphysis is extremly rare. A 5-year-old boy visited to our hospital with pain and flexion contracture on the right knee. MRI showed some lesions scattered in the epiphysis of the distal femur and the proximal tibia. Biopsy specimen from the distal femoral epiphysis revealed pathologic findings compatible with hemangioma. On 8 years follow-up, the lesion in the distal femoral epiphysis had been cured, and those in the proximal tibial epiphysis were spontaneously disappeared without surgery. The scanogram shows no leg length discrepancy and angular deformity. We reports a rare case of hemangioma occurred in the bony epiphysis with the results of 8 year follow-up with the review of literatures.
Biopsy ; Congenital Abnormalities ; Contracture ; Epiphyses ; Femur ; Follow-Up Studies ; Hemangioma ; Knee ; Leg ; Preschool Child ; Tibia

BACKGROUND: We observed fentanyl known as centrally-acting antitussive agents provoke a cough response in some patients at induction of anesthesia. This may be of clinical importance. METHOD: 121 patients (ASA class I) were assigned randomly to 4 groups. Each group was given different doses of fentanyll Group 1 (n=30); 0.5ug/kg, Group 2 (n=30); 1ug/kg, Group 3 (n=33); 2ug/kg, Group 4 (n=28); 4 g/kgl, within 1 second through a peripheral venous cannula before induction of anesthesia. All patients were observed carefully in order to detect a cough response and any side effects. RESULT: The incidences of FCR (Fentanyl Cough Response) were 0% in Group 1, 10.0% in Group 2, 30.3% in Group 3, and 39.3% in Group 4. The ED50 of FCR was 4.25ug/kg. The mean onset-time from the end of fentanyl administration to the beginning of coughing was 12.5 seconds. FCR was decreased with aging, but not affected by weight, height, or smoking. Other serious side effects were not accompanied. CONCLUSION: Fentanyl can evoke the pulmonary chemoreflex dose-dependently and the ED50 was 4.25 g/kg.
Aging ; Anesthesia ; Antitussive Agents ; Catheters* ; Cough* ; Fentanyl* ; Humans ; Incidence ; Reflex* ; Smoke ; Smoking

The myocardial infarction is usually associated with the coronary artery disease in adults. It is unusual in chilhood and young adult but occasionally associated with coronary vasculitis. Takayasu's arteritis produces a panaortits with thickening of the adventitia and narrowing of aorta. Narrowing of coronary arteries is due to extension into these arteries of the processes of inflammation that occur in aorta. We report here two cases of Takayasu's aortitis causing acute myocardial infarction. Case 1 is a 17-year-old girl presented with the inferior myocardial infarction and the cerebral infarction. Digital subtraction aortography showed a diffuse narrowing of the aorta and the obstruction of both subclavian arteritis, right carotid artery and both femoral arteries. Case 2 is a 19-year-old male patient with anterior myocardial infarction. Coronary cineangiogram showed the beak like appearance of the left main coronay artery.
Adolescent ; Adult ; Adventitia ; Animals ; Aorta ; Aortitis* ; Aortography ; Arteries ; Arteritis ; Beak ; Carotid Arteries ; Cerebral Infarction ; Coronary Artery Disease ; Coronary Vessels ; Female ; Femoral Artery ; Humans ; Inferior Wall Myocardial Infarction ; Inflammation ; Male ; Myocardial Infarction* ; Takayasu Arteritis ; Vasculitis ; Young Adult

Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

Since the use of Charnley hip prosthesis, total hip arthroplasty has been used for the treatment of coxarthrosis. However, aseptic lossening of the acetabular cup component in total hip arthroplasty remains the most common cause of failure and most serious complication. Cementless acetabular cup fixation in total hip arthroplasty is increasingly popular because of the high failure rates of cemented components, particularly in younger and more active patients. We have experienced 62 cases of CLS expansion acetabular cup developed by L. Spontorno, from January 1992 to January 1994. We analysed 41 CLS expansion acetabular cup components in 38 patients performed at the Department of Orthopedic Surgery, Kang Nam General Hospital with minimum follow up lyear(average 17.3 months). The object of this study is to evaluate the radiographic change of the cup inclination, horizontal and vertical migration of the CLS expansion acetabular cup by methods of Engh et al, and Callagham et al. The results were as follows: 1. The initial adequate contact fit were 39 hips and inadequate fit in 2 hips. 2. The initial acetabular inclination between 35 degrees and 55 degrees were 38 hips. 3. Vertical and/or horizontal migration was not occurred, except 2 hips which were complicated by deep infection. 4. Change of acetabular cup inclination than 5 degrees were not occurred. 5. Radiolucent line wider than 2mm was not found. 6. In final follow up of out 41 hips optimal stability was obtained in 39 hips, suboptimal stability was obtained in 2 hips, and definite instability was not found.
Acetabulum ; Arthroplasty, Replacement, Hip ; Follow-Up Studies ; Hip ; Hip Prosthesis ; Hospitals, General ; Humans ; Orthopedics ; Osteoarthritis, Hip

Takaysu arteritis is a systemic disease characterized by stenosis or obstruction of aorta and its branches. Its etiology is unknown but clinical and serologic data suggest autoimmune process. Coronary artery involvement has been uncommon, but potentially fatal complication of Takayasu arteritis. A 41-year old female patients was presented with exertional dyspnea and anterioi chest pain of 2 week duration. Systolic bruit was heard at the both middle portion of internal carotid artery areas. Both radial arteries were palpated well but both femoral, popliteal and doralis pedis arteries were palpated weakly. Aortogram showed complete obstruction of descending thoracic aorta and collateral circulation of internal mammary artery. Coronary angiogram showed 80% stenosis at the middle portion of the right coronary artery. Calcium channel blocker and antiplatelet agent were prescribed. And her clinical symptom improved.
Adult ; Aorta ; Aorta, Thoracic* ; Arteries ; Arteritis* ; Calcium Channels ; Carotid Artery, Internal ; Chest Pain ; Collateral Circulation ; Constriction, Pathologic* ; Coronary Stenosis ; Coronary Vessels* ; Dyspnea ; Female ; Humans ; Mammary Arteries ; Radial Artery ; Takayasu Arteritis

PURPOSE: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. METHODS: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration, sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (> or =150 mEq/L) and nonhypernatremia group, and were compared. RESULTS: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8+/-1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. CONCLUSION: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration.
Hemorrhage ; Humans ; Hypernatremia ; Incidence ; Infant ; Infant, Newborn ; Infant, Very Low Birth Weight ; Intensive Care, Neonatal ; Medical Records ; Parturition ; Retrospective Studies ; Risk Factors ; Sodium ; Weight Loss

Epithelioid hemangioendothelioma(EH) is a rare vascular tumor of low-grade malignancy. It was previously described as intravascular bronchioloalveolar tumor (IVBAT). But electron microscopic study and immunohistochemical staining results have proved endothelial origin. Patients are usually asymptomatic and the tumors are found incidentally on routine chest X-rays. Most patients show a slowly progressive clinical course, even though some patients occasionally die as results of respiratory failure or extrathoracic complications. Confirmative diagnosis is made through thoracoscopic or open-lung biopsy. There is still no effective therapeutic modality for pulmonary EH. We have experienced a 55-year-old woman whose simple chest x-ray film revealed bilateral multiple small nodules. The nodules were histopathologically and immunohistochemically diagnosed as primary epithelioid hemangioendothelioma of the lung. The possibility of metastatic disease was excluded thorough clinical, laboratory and radiological studies. Comparison of radiographic chest film taken 3 years ago showed no significant progression of the pulmonary nodular lesions. Conservative management was instituted and careful 4 months follow-up showed no significant changes.
Biopsy ; Diagnosis ; Female ; Follow-Up Studies ; Hemangioendothelioma, Epithelioid* ; Humans ; Lung ; Middle Aged ; Respiratory Insufficiency ; Thorax ; X-Ray Film

We experienced a case of mitral incompetence due to rupture of anterolateral papillary muscle in a 56-year-old male who complained of abdominal pain and mild dyspnea after being struck by car. Clinical manifestation immediately following injury was minimal, but heart failure progressed rapidly 3 days after injury. Echocardiopraphic evaluation revealed ruptured anterolateral papillary muscle and severe mitral regurgitation on color flow imaging. There was no evidence of coronary artery disease on coronary angiography. Operation revealed that the haed of anterolateral papillary muscle was torn out of its insertion. Mitral valve replacement with mechanical prosthesis was performed on the 50th day after injury.
Abdominal Pain ; Coronary Angiography ; Coronary Artery Disease ; Dyspnea ; Heart Failure ; Humans ; Male ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Prostheses and Implants ; Rupture* ; Thorax*

BACKGROUND: The purpose of this study is to evalute the clinical findings, DeBakey classification, major associated complication, and mortality of aortic dissection. METHOD: A retrospective clinical study was done on 43 cases of aortic dissection who had been admitted to Wonju College of Medicine Hospital from January, 1988 to September, 1994. We classified to DeBakey type, and dissection was considered to be acute if elapsed time from clinical onsets to admission was less than 2 weeks. RESULTS: 1) Aortic dissection was seen a little more frequently in women than men with M : F ratio of approximately 1 : 1.3. The peak incidence was in the fifth, with the range being 30 to 70 years of age. 2) The frequent symptoms were pain in 67.4%, dyspnea in 9.3%, mental deterioration in 9.3%, syncope in 4.7%, and others in 9.3%. Anterior chest pain was most seen in type I, II of DeBakey classification. But, abdominal pain or back pain were mainly seen in type III dissection. 3) Hypertension was the most frequent physical finding in 72.1% and shock in 16.2%, pulse deficit in 23.6%, neurologic manifestation in 14%. 4) The diagnosing of aortic dissection was made by transthoracic echocardiography in 44.2%, transesophageal echocardiography in 23.3%, computed tomography in 65.1%, magnetic resonance imaging in 23.3%, and aortogram in 20.9%. 5) According to the DeBakey classification, type I was found in 23.3%, type II in 16.3%, and type III in 60.5%. 6) According to the age of dissection, acute dissection was found in 72.1%, chronic dissection in 27.9%. 7) Aortic regurgitation was complicated in 16.3%, pericardial effusion in 9.3%, hemothorax in 25.6%, and renal involvement in 14%. Aortic regurgitation, pericardial effusion, and hemothorax were mainly complicated in type I or type II aortic dissection, and renal vascular involvement was complicated in type I or type II dissection. 8) The hospital death rate was 27.9%. Mortality was high in acute dissaction, typeI or type II dissection and complicated dissection. CONCLUSIONS: The incidence of aortic dissection was more predominant in female patients. Most commom intial chief complaints was pain. Hypertension was combined in 72% of the patients. According to the DeBakey type, most common type was type III(60%). Complication of aortic dissection was aortic regurgitation(16%), pericardial effusion(9%), hemothorax(25%), renal arterial involvement(14%). In hospital mortality was 28% and more increased in patients with proximal dissection and combined complication.
Abdominal Pain ; Aortic Valve Insufficiency ; Back Pain ; Chest Pain ; Classification ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Gangwon-do ; Hemothorax ; Hospital Mortality ; Humans ; Hypertension ; Incidence ; Magnetic Resonance Imaging ; Male ; Mortality ; Neurologic Manifestations ; Pericardial Effusion ; Retrospective Studies ; Shock ; Syncope