Takayasu's arteritis is a chronic inflammatory disease of unknown etiology involving the aorta, major branches of aorta, and pulmonary arteries and leads either stenosis and occlusion of the involved artery or aneurysm formation or both. The clinical course and prognosis are variable according to two major prognostic factors, ie, complications and the pattern of the past clinical course, as well as by ESR. Though the aggressive medical and surgical treatment are required for patients with a major complication and a progressive course, surgical reconstruction entails a high incidence of suture line complications including stenosis or dilatation. Moreover all the vascular lesions are amenable for vascular surgery. Initial reports revealed excellent results of percutaneous transluminal angioplasty (PTA) in patients with Takayasu's arteritis. However the suboptimal results and restenosis have been the main limitations of the PTA. Stenting has some benefits for early elastic recoil of the fibrotic vessels and restenosis as in other large vessels in Takayasu's arteritis or atherosclerosis. We report early and long-term results of two cases of carotid stenting in patients with symptomatic carotid stenosis and Takayasu's arteritis, which revealed variable angiographic results according to clinical courses and recommend that stenting in Takayasu's arteritis may be another treatment modality in inactive Takayasu's arteritis.
Aneurysm ; Angioplasty ; Aorta ; Arteries ; Atherosclerosis ; Carotid Arteries* ; Carotid Stenosis ; Constriction, Pathologic ; Dilatation ; Follow-Up Studies* ; Humans ; Incidence ; Prognosis ; Pulmonary Artery ; Stents* ; Sutures ; Takayasu Arteritis

Dermatomyositis(DM) is the classic example of an inflammatory disease that has both cutaneous and systemic manifestations. An association with pregnancy is very uncommon. Glickman described the first case of DM associated with pregnancy in 1958. Since then a few reports of DM cases associated with pregnancy were published. This is the report of a female patient who had a previously established diagnosis of DM, and then became pregnant during the remission stage of DM. The DM recurred in 33 week of gestation. Because a Pregnancy it involves alterations in the immune responses of the patients, it may lead to a recrudescence or aggrevation of DM. The pregnancy should be considered a high risk for a recrudescence and aggrevation of DM. Careful monitoring of DM patients and with pregnancy should be warranted.
Dermatomyositis* ; Diagnosis ; Female ; Humans ; Pregnancy* ; Recurrence

The purpose of this study is to measure the skin epidural distance(SED) of L3-4 interspace and to correlate SED with the individual constitutional data of patients such as body-weight, height, abdominal circumference and body mass index(BMI; kg/m2). In this study we examined 120 patients (45 men and 75 women) who had no pathological abnormality in L3-4 interspace such as herniated disc, spondylolisthesis and spinal stenosis in MRI study, although majority of patients had pathology below this level. The SED was measured under fluoroscopic guide with loss of resistance technique, and we also measured individual constitutional data of patients. Pearson's correlation analysis of the data showed that there were no correlations of statistical significance between SED and the height, abdominal circumference of the patient (p>0.01). But there were statistically significant correlations between SED and body-weight as well as BMI (p<0.0001). Linear regression analysis of these data showed significant correlations between SED and body weight(male r(2)=0.49, p<0.0001, y=0.37x18.1; female r(2)=0.31, p<0.0001, y=0.18x30.8), BMI(male r(2)=0.52, p<0.0001, y=0.89x23.1; female r(2)=0.35, p<0.0001, y=0.41x31.6).
Epidural Space* ; Female ; Humans ; Intervertebral Disc Displacement ; Linear Models ; Magnetic Resonance Imaging ; Male ; Pathology ; Sagittal Abdominal Diameter ; Skin* ; Spinal Stenosis ; Spondylolisthesis

OBJECTIVE: To evaluate the effects of intra-articular injection of shoulder and subscapularis motor point block on painful hemiplegic shoulder. METHOD: Thirty painful hemiplegic shoulder of recent onset stroke were divided randomly into three groups, i.e. group I: range of motion (ROM) exercise only, group II: intra-articular injection with ROM exercise, group III: subscapularis motor point block with ROM exercise. The intra-articular injection of shoulder was done with 20 ml of normal saline, 5 ml of 1% lidocaine, and 40 mg of triamcinolone. The subscapularis motor point block was done with 5 ml of 5% phenol under electromyographic guide. The ROM in external rotation and simple X-ray of shoulder in full abduction were checked in three groups at pre-treatment and post-treatment 3 week, and the glenohumeral abduction and scapulohumeral rhythm were obtained from the shoulder X-ray. RESULTS: There were significant (p<0.05) improvements of glenohumeral abduction, external rotation, and scapulohumeral rhythm of shoulder in group II and III, but improvement of only glenohumeral abduction was significant in group I. Angular increment of glenohumeral abduction and external rotation was most significant in group III compared with other two groups. CONCLUSION: These results suggest that the intra-articular injection of shoulder and subscapularis motor point block are potentially useful techniques in the prevention and management of the painful hemiplegic shoulder.
Injections, Intra-Articular* ; Lidocaine ; Phenol ; Range of Motion, Articular ; Shoulder* ; Stroke ; Triamcinolone

BACKGROUND: Coronary sinus catheterization is important in electrophysiological studies. However the mor-phologic feature of the coronary sinus and its significance in patients with supraventricular tachycardia (SVT) have not been determined. During diagnostic electrophysiological studies, coronary sinus catheterization was easier in patients with atrioventricular nodal reentry tachycardia (AVNRT) than in patients with atrioventricular reentry tachycardia (AVRT). Therefore, we studied coronary sinus morphology in patients with SVT and compared AVNRT and AVRT patients. METHODS: The size and shape of the coronary sinus were measured in 13 patients who underwent retrograde coronary sinus venogram during electrophysiologic study between May and June 1996. The diagnosis was 7 cases of AVNRT, 2 of Wolff-Parkinson-White syndrome and 4 of concealed bypass tracts (mean age, 40 years : male vs female, 1 : 1.2). RESULTS: The mean coronary sinus ostial diameter was 10.4+/-2.0 mm:for AVNRT, it was 11.4+/-2.2 mm, and for AVRT it was 9.3+/-1.0 mm in left anterior oblique projection (p=0.031). The mean coronary sinus-to-spine angle was 82.6+/-17.4degrees : AVNRT 95.4+/-24.4degrees and AVRT 67.7+/-15.2degrees in anterior posterior projection (p=0.035). CONCLUSION: The coronary sinus ostial diameter of AVNRT patients was significantly larger than that of AVRT patients. This finding may have important implications for arrythmia pathogenesis in such patients.
Arrhythmias, Cardiac ; Catheterization ; Catheters ; Coronary Sinus* ; Diagnosis ; Female ; Humans ; Male ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry ; Tachycardia, Supraventricular* ; Wolff-Parkinson-White Syndrome

Cystic hygroma, a cystic subtype of lymphangioma, is relatively rare tumor of lymphatic origin. The lesion is a benign, painless, soft, compressible malformation of the lymphatic system. They can arise anywhere along the lymphatic system, however they are usually located in the head and neck regions and in most cases appear by the age of 2 years. The cases in the adult is rarely occurred and a few cases are described in the literature. Surgical excision remains the treatment of choice. But complete extirpation of these lesion is often impossible, because the tumor tends to spread along vital structures. Therefore recurrence rates are accordingly high. This is a case report about 19 year old male patient with cystic hygroma on right retromandibular area. We obtained the successful, functional and esthetic result by surgical excision of the mass. Therefore, we report the case with a review of literatures.
Adult ; Head ; Humans ; Lymphangioma ; Lymphangioma, Cystic ; Lymphatic System ; Male ; Neck ; Recurrence

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.
Adult ; Catheters ; Disinfectants ; Extracorporeal Membrane Oxygenation ; Female ; Fibrosis ; Humans ; Humidifiers* ; Inhalation ; Inhalation Exposure ; Intensive Care Units ; Korea ; Lung Injury* ; Lung Transplantation* ; Lung* ; Oxygen Inhalation Therapy ; Respiration, Artificial ; Survivors

BACKGROUND: The diagnosis of malaria has been usually made using microscopic examination of Wright stained thin blood films in Korean army. This method is labor-intensive, time consuming and requires the microscopic expertise. Therefore, the alternative techniques, rapid diagnostic test, have been sought for use in Korean army. We performed a comparison of the OptiMAL test with GENEDIA Malaria (P. vivax) Ab Rapid I, II to assess its sensitivity and specificity of Plasmodium vivax malaria. METHODS: Blood specimen were collected from 51 patients who were presented and initially diagnosed for P. vivax by the microscopy of blood smears and from 30 control patients without malaria infection at the Capital Armed Forces General Hospital (CAFGH) between October 2000 and February 2001. Among the 51 patients, we also collected 24 samples from 24 patients at 2 or 3 days after therapy. The OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid I, II were performed according to the manufacturer's instructions on all samples respectively. RESULTS: Compared with the blood film, sensitivities and specificities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II were 94.1~100% (29/29), 80.4~83.3%, 96.1~96.7% respectively. One case was interpreted as 'undetermined' by OptiMAL test. In 24 patients during therapy, the sensitivities of the OptiMAL test, GENEDIA Malaria (P. vivax) Ab Rapid I and GENEDIA Malaria (P. vivax) Ab Rapid II on 8 specimens with mean 120/microliter parasitemia and 16 specimens with negative parasitemia were 75~43.8%, 87.5~81.3%, 100~100% respectively. CONCLUSION: Our data demonstrated that the sensitivity and specificity of the GENEDIA Malaria (P. vivax) Ab Rapid I were not satisfactory, but the sensitivity and specificity of the OptiMAL test and GENEDIA Malaria (P. vivax) Ab Rapid II were relatively high and useful diagnostic tests for diagnosis of P. vivax in areas like the militaries where laboratory facilities are poor or non-existent.
Arm ; Diagnosis* ; Diagnostic Tests, Routine ; Hospitals, General ; Humans ; Malaria* ; Malaria, Vivax ; Microscopy ; Military Personnel* ; Parasitemia ; Plasmodium vivax* ; Plasmodium* ; Sensitivity and Specificity

PURPOSE: In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred. METHODS: Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging. RESULTS: The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively. CONCLUSION: CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.
Colonic Neoplasms ; Colorectal Neoplasms* ; Humans ; Neoplasm Staging ; Positron-Emission Tomography ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

The IRB approval number should be corrected.