No abstract available.
Cyclotrons*

BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

BACKGROUND: Cardiogenic shock is the most common cause of in-hospital mortality after acute myocardial infarction. Despite improvement in coronary care, the in-hospital mortality rate of cardiogenic shock is very high in conventional conservative therapy. Recently, it was suggested that coronary angioplasty may reduce the mortality associated with cardiogenic shock. METHOD: Thirteen consecutive patients with cardiogenic shock who underwent coronary angioplasty were studied. Shock was not induced by mechanical complications, arrhythmia, hypovolemia and other reversible cause. We collected and analyzed the clinical, hemodynamic survivor groups. RESULTS: Of 13 patients, 11 had successful reperfusion of the infarct-related coronary artery and 2 had unsuccessful reperfusion. Of 11 patients with successful angioplasty, 8 survived at the time of hospital discharge. All patents with unsuccessful angioplasty died in the hospital. Therefore overall hospital survival rate was 62% and the rate increased to 73% in patients with successful reperfusion. Survivor and non-survivor groups in clinical, hemodynamic and angiographic variables were similar except systolic blood pressure and the presence of successful reperfusion. CONCLUSION: In patients with cardiogenic shock, the patency of infarct-related coronary artery was strongly associated with in-hospital mortality. This findings support aggressive interventional strategy in patient with cardiogenic shock complicating acute myocardial infarction.
Angioplasty ; Angioplasty, Balloon, Coronary* ; Arrhythmias, Cardiac ; Blood Pressure ; Coronary Vessels ; Hemodynamics ; Hospital Mortality ; Humans ; Hypovolemia ; Mortality ; Myocardial Infarction* ; Reperfusion ; Shock ; Shock, Cardiogenic* ; Survival Rate ; Survivors

We report a case of 13 years old male patient. He was diagnosed as glycogen storage disease Ib at 6 month age, and received cadaver donor liver transplantation at 2 years and 4 months. He underwent immunosuppression for 9 years with several immunosuppressants including tacrolimus. Then he visited hospital for gum swelling and showed multiple malignancy suspicious lesions at nasal cavity, maxilla, mandibula, frontal bone, temporal bone, C1 and C2 spines, and several submandibular lymph nodes at radiologic study. Biopsy was done at oral cavity lesion, and histologically diagnosed as diffuse large B-cell lymphoma. The tissue specimen showed positivity in Epstein-Barr virus polymerase chain reaction (PCR). After diagnosis, the patient stopped all immunosuppressive agents and received 9 cycles of CHOP (cyclophosphamide, adriamycin, vincristine and prenisolone) chemotherapy for 8 months, then the patient achieved radiologic remission state, and being well without any signs of recurrence for two years of follow up.
Biopsy ; Cadaver ; Child ; Doxorubicin ; Follow-Up Studies ; Frontal Bone ; Gingiva ; Glycogen Storage Disease ; Glycogen Storage Disease Type I ; Herpesvirus 4, Human ; Humans ; Immunosuppression ; Immunosuppressive Agents ; Liver ; Liver Transplantation ; Lymph Nodes ; Lymphoma ; Lymphoma, B-Cell ; Male ; Maxilla ; Mouth ; Nasal Cavity ; Polymerase Chain Reaction ; Recurrence ; Spine ; Tacrolimus ; Temporal Bone ; Tissue Donors ; Transplants ; Vincristine

Simultaneous occurrence of remote intracerebral hemorrhage (ICH) and intracranial aneurysmal subarachnoid hemorrhage is very rare. We report on a case of concurrent hypertensive ICH at the left thalamus and rupture of an intracranial aneurysm at the bifurcation of the single A2 segment of the anterior cerebral artery in a 64-year-old woman, which was clipped previously, with review of the literature. To our knowledge, this is the first case report demonstrating bleeding of previously clipped aneurysm with simultaneous hypertensive ICH. Hypertensive crisis following ICH seems to have provoked rupture of the residual aneurysm.
Aneurysm ; Anterior Cerebral Artery ; Cerebral Hemorrhage ; Female ; Hemorrhage ; Humans ; Intracranial Aneurysm ; Intracranial Hemorrhage, Hypertensive ; Middle Aged ; Rupture ; Subarachnoid Hemorrhage ; Thalamus

Several suspension biomaterials are available for soft tissue augmentation. Although these gel type implants have been shown to be relatively safe and convenient, their varying degrees of resorption require repeated percutaneous injections. Previous in vivo and in vitro studies have shown that the injection of cultured human adipocytes can produce a sufficient volume effect with extended in vivo stability. This pilot study was undertaken to evaluate the clinical efficacy of this method. Between November 2007 and January 2008, 5 patients were treated with implants of autologous differentiated adipocytes for wrinkle correction and forehead augmentation. The contour changes of the treatment sites were investigated in accordance with the passage of time, as was the occurrence of complications. The degree of patient satisfaction was also evaluated. The injected bioimplants remained in situ. Two weeks after injection, they began to show evidence of a soft tissue augmentation effect. All patients were satisfied with the overall results of this method, and no complications occurred during the follow-up period. The results obtained indicate that differentiated human adipocytes may be successfully injected as living grafts for long-term implants, and that this method is a well tolerated, effective way of performing soft tissue augmentation.
Adipocytes ; Biocompatible Materials ; Follow-Up Studies ; Forehead ; Humans ; Patient Satisfaction ; Pilot Projects ; Skin Aging ; Transplants

This is a report of a 58-year-old female with Cushing syndrome who underwent posterior lumbar fusion and lost both her vision completely. She was diagnosed with posterior ischemic optic neuropathy. Cushingoid features such as buffalo hump and central obesity might have attributed in triggering posterior ischemic optic neuropathy. When laid prone for surgery, perioperative high abdominal pressure causes venous hypertension leading to increase amount of blood loss. To compensate, infusion of large quantities of intravenous fluids is necessary which leads to hemodilution which decreases ocular perfusion pressure. Hypercoagulability of Cushing syndrome is also potentially a risk factor of this condition which increases the incidence of venous thromboembolism. For there is no known effective treatment for posterior ischemic optic neuropathy, means to prevent this complication must be strategically reviewed. When performing long spine surgery on patient who has Cushing syndrome or cushingoid features, caution must be taken to avoid this devastating complication.
Buffaloes ; Cushing Syndrome ; Female ; Hemodilution ; Humans ; Hypertension ; Incidence ; Intraocular Pressure ; Middle Aged ; Obesity, Abdominal ; Optic Neuropathy, Ischemic ; Perfusion ; Risk Factors ; Spinal Fusion ; Spine ; Thrombophilia ; Venous Thromboembolism

BACKGROUND: Reactivation of the polyomavirus and the use of conditioning regimen may be the causes of hemorrhagic cystitis (HC) following hematopoietic stem cell transplantation (HSCT). However, there are only a few reports on the clinical characteristics of viral reactivation in HC following HSCT in Korea, especially in pediatric population.METHODS: 51 patients who received HSCT in Ajou University Hospital from January 2006 to June 2012 were investigated retrospectively. 16 patients were diagnosed with HC following HSCT and were enrolled in this study. Confirmation of polyomavirus was done by polymerase chain reaction (PCR) method.RESULTS: Out of the 16 patients diagnosed with HC following HSCT, there were 5 early type HC patients and 11 late type HC patients. Positive PCR results for the BK virus (BKV) and the JC virus were found on 13 and 5 patients, respectively. 4 patients showed positive results for both viruses. For the late type HC, there were 10 patients with positive PCR results for the BKV. Cyclophosphamide was used in 33 patients, and 13 patients eventually developed HC. There was no statistical significance between the incidence of hematuria and the reactivation of the BKV or the conditioning regimens. Most patients were treated conservatively but 4 patients who showed severe hematuria or poor general condition received intravenous cidofovir. After the infusion of cidofovir, hematuria disappeared on average of 65 days and the BKV was undetectable on average of 53 days.CONCLUSION: In our study, activation of the BKV was common in patients who were diagnosed with HC following HSCT. All patients recovered from HC with conservative management and the BKV became undetectable in the majority of patients who were treated with intravenous cidofovir.
BK Virus ; Cyclophosphamide ; Cystitis ; Cytosine ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Hematuria ; Humans ; Incidence ; JC Virus ; Korea ; Organophosphonates ; Polymerase Chain Reaction ; Polyomavirus ; Retrospective Studies

PURPOSE: In treating diabetic foot ulcers, satisfactory vascularity is an essential prerequisite. To improve vascularity, a bypass graft has long been carried out. Recently, however, percutaneous transluminal angioplasty(PTA) has also been tried since the PTA is less invasive than the bypass graft. However, publication demonstrating the improvement of vascularity after the PTA are lacking. Therefore, this study was designed to show usefulness of the PTA in treating vasculopathy of diabetic foot. MATERIALS: and Methods This study included 30 feet of 24 ischemic diabetic foot patients. Inclusion criteria were diabetes(duration>5years) and a significant lower extremity ischemia, as determined by a transcutaneous oxygen pressure(TcpO2)<30mmHg. The PTA was carried out in 61 arteries. PTA procedure was considered successful, when residual stenosis was less than 30%. The procedure was considered failed when residual stenosis was more than 50%. Residual stenosis between 30% and 50% was considered acceptable. For evaluation of PTA effect, foot TcpO2 and infrared thermography were measured before and 7th day after PTA. RESULTS: Immediately after PTA performed in 61 arteries, 58 and 3 arteries were evaluated as being successful and acceptable, respectively. Before PTA, average foot TcpO2 was 12.6+/-8.8mmHg and its value was increased to 44.2+/-23.9 on 7th day after PTA(p<0.01). Average skin temperature was 31.8+/-1.2degrees C before PTA and it was increased to 33.5+/-1.1degrees C on 7th day after PTA (p<0.01). CONCLUSION: PTA procedure increases tissue oxygenation of ischemic diabetic feet which do not have wound healing potential due to low tissue oxygenation, to the level of possible wound healing. In addition, PTA increases skin temperature of ischemic diabetic feet which can imply an improvement of peripheral circulation.
Angioplasty ; Arteries ; Constriction, Pathologic ; Diabetic Foot ; Foot ; Humans ; Ischemia ; Lower Extremity ; Oxygen ; Publications ; Skin Temperature ; Thermography ; Transplants ; Ulcer ; Wound Healing

Endobrochial tuberculosis which may result in stenosis of the bronchus, is a rare complication of pulmonary tuberculosis in children. We recently treated three children with endobronchial tuberculosis which presented different clinical manifestations and different response to the treatments. Endoscopic examinations revealed bronchial masses, in which biopsy and polymerase chain reaction(PCR) were consistent with endobronchial tuberculosis. We reviewed the presentation and treatment of endobronchial tuberculosis in 3 children.
Biopsy ; Bronchi ; Bronchoscopy* ; Child ; Constriction, Pathologic ; Diagnosis* ; Humans ; Tuberculosis* ; Tuberculosis, Pulmonary