We experience coronary artery aneurysm and coronary artery stenosis in an adult as complications of Kawasaki disease. The patient suffered from ischemic heart disease due to coronary artery aneurysm and stenosis, We carried out PTCA and stenting at stenotic coronary artery successfully. A brief review of related literature was made.
Adult* ; Aneurysm ; Angioplasty, Balloon, Coronary* ; Constriction, Pathologic ; Coronary Aneurysm* ; Coronary Stenosis* ; Coronary Vessels* ; Humans ; Mucocutaneous Lymph Node Syndrome* ; Myocardial Ischemia ; Stents

BACKGROUND AND OBJECTIVES: The effective management of tinnitus should start with an accurate diagnosis, but no concensus has been developed in Korea concerning how to measure the features of tinnitus. This study surveyed otologists in the training hospitals and hospitals specialized in otologic care in Korea to identify the current status in the assessment of patients with tinnitus. SUBJECTS AND METHOD: The questionnaire on the assessment of tinnitus was sent by email to otologists in training and to specialized hospitals specializing in otologics in Korea. The questionnaire included inquiry about various types of tests conducted, such as the audiologic test, tinnitus test, blood test, radiologic test, and the methods of history taking and physical examination for somatic tinnitus. RESULTS: Regarding the audiologic assessment of tinnitus, all the otologist were using pure tone audiometry, 97% speech audiometry, and 87% tinnitus test. For the psychophysical measure of tinnitus, both loudness and pitch matching were conducted by all the otologists. The performance rate of blood test were 38.5%, and the most preferred radiologic test in pulsatile tinnitus was temporal bone computed tomography (59%). Finally, the rate of investigation including the history taking and physical examination of somatic tinnitus was between 74-84%. CONCLUSION: Our results showed that although the tests perfermed by otologists varied, the essential tests for assessing tinnitus were commonly practiced. We analyzed the current status of tinnitus assessment and supplemented guidlines to help measure tinnitus. Further concensus on tinnitus diagnosis is needed, particularly about the standadized and unified principles.
Audiometry ; Audiometry, Speech ; Diagnosis ; Electronic Mail ; Hematologic Tests ; Humans ; Korea ; Physical Examination ; Surveys and Questionnaires ; Temporal Bone ; Tinnitus*

Clinical experiences of pulmonary artery aneurysm are distinctly rare and current knowledge is mainly derived from autopsy findings. Pulmonary artery aneurysms are associated with congenital heart disease, most frequently patient ductus arteriosus, followed in decreasing order by ventricular septal defect, atrial septal defect. In the remaining cases, such aneurysms are associated mainly with secondary acquired lesions, such as Behcet's disease, bacterial endocarditis, syphilis, tuberculosis, atherosclerosis, vasculitis, hypertension, trauma. Angiography was the gold standard for diagnosing pulmonary artery aneurysms, but MRI imaging has been potentially useful diagnostic modality in demonstrating aneurysm and other fine pathologic processes with high resolution. Surgery was main, but there are no firm guidelines for optimal treatment of pulmonary artery aneurysm. We experienced a case of pulmonary artery aneurysm with pulmonary hypertension in a 58 year-old female and observed for 2 years. The aneurysmal size was 5.19 cm initially and inreased to 5.5cm for two years, accompanying by pulmonary hypertension. We report this case of pulmonary artery aneurysm with a brief review of literature.
Aneurysm* ; Angiography ; Atherosclerosis ; Autopsy ; Ductus Arteriosus ; Endocarditis, Bacterial ; Female ; Heart Defects, Congenital ; Heart Septal Defects, Atrial ; Heart Septal Defects, Ventricular ; Humans ; Hypertension ; Hypertension, Pulmonary* ; Magnetic Resonance Imaging ; Middle Aged ; Pathologic Processes ; Pulmonary Artery* ; Syphilis ; Tuberculosis ; Vasculitis

A case of traumatic carotid-cavernous fistula treated by using Debrun's latex detachable balloon catheter is reported. The patient was a 28 year old man, who had complaints of headache, proptosis and chemosis of left eye 3 weeks after motor vehicle accident. The cerebral angiography showed direct fistula between intracavernous portion of internal carotid artery and cavernous sinus as high flow type. Following complete radiologic and neurologic examination, the fistulous opening was successfully occluded by Debrun's latex detachable balloon. Immediately after occlusion of the fistula the clinical symptoms were markedly improved.
Adult ; Carotid Artery, Internal ; Catheters ; Cavernous Sinus ; Cerebral Angiography ; Exophthalmos ; Fistula* ; Headache ; Humans ; Latex* ; Motor Vehicles ; Neurologic Examination

The authors present a case of occipital chondroid chordoma in a 12 year-old boy who presented with occipital mass amd mild tenderness but no neurologic symptoms or signs. On plain skull X-rays, there was an irregular calcific mass at the left occipital area. The CT scan revealed irregular extracranial calcific mass with intracranial extradural lentiform low density lesion at the left occipital area. Also, the occipital bone was thickened. Angiography showed hypervascular mass feeded by occipital artery of left ECA.
Angiography ; Arteries ; Child ; Chordoma* ; Humans ; Male ; Neurologic Manifestations ; Occipital Bone ; Skull ; Tomography, X-Ray Computed

OBJECTIVE: This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. MATERIALS AND METHODS: We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. RESULTS: Sixteen patients received thrombectomy. The mean age was 67.8 +/- 11 years and the mean NIHSS score was 12.3 +/- 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. CONCLUSION: Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
Basilar Artery ; Cerebral Infarction ; Endovascular Procedures ; Humans ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Suction ; Thrombectomy ; Thrombosis

OBJECTIVE: This study was conducted to assess the efficacy and safety of endovascular mechanical thrombectomy (EMT) for patients diagnosed with basilar artery (BA) occlusion. MATERIALS AND METHODS: We retrospectively analyzed clinical and imaging data of 16 patients diagnosed with BA occlusion who were treated with endovascular intervention from July 2012 to February 2013. Direct suction using the Penumbra system and thrombus retrieval by the Solitaire stent were the main endovascular techniques used to restore BA flow. The outcomes were evaluated based on rate of angiographic recanalization, rate of improvement of National Institutes of Health Stroke Scale (NIHSS) score, rate of modified Rankin Scale (mRS) at discharge and after 3 months, and rate of cerebral hemorrhagic complications. Successful recanalization was defined as achieving Thrombolysis In Cerebral Infarction (TICI) of II or III. RESULTS: Sixteen patients received thrombectomy. The mean age was 67.8 +/- 11 years and the mean NIHSS score was 12.3 +/- 8.2. Eight patients treated within 6 hours of symptom onset were grouped as A and the other 8 patients treated beyond 6 hours (range, 6-120) were grouped as B. Successful recanalization was met in six patients (75%) for group A and 7 (87.5%) for group B. Favorable outcome occurred in 4 patients (50%) for group A and 5 (62.5%) for group B. CONCLUSION: Our study supports the effectiveness and safety of endovascular mechanical thrombectomy in treating BA occlusion even 6 hours after symptom onset.
Basilar Artery ; Cerebral Infarction ; Endovascular Procedures ; Humans ; National Institutes of Health (U.S.) ; Retrospective Studies ; Stents ; Stroke ; Suction ; Thrombectomy ; Thrombosis

OBJECTIVE: Chronic subdural hematoma (cSDH) is a common disorder that is readily surgically treated but has high recurrence rate. This is a preliminary report to evaluate the effectiveness of a newly designed catheter compared with the conventional one in treating cSDH. METHODS: We conducted a retrospective study of 111 patients with unilateral chronic subdural hematoma treated by burr hole craniostomy with closed-system drainage from November 2009 to September 2012. Group A was defined as patients treated with an external ventricular drainage (EVD) catheter and B as patients treated with the new catheter. We measured changes of thickness of hematoma and midline shifting in brain computed tomography (CT), amount of drainage and recurrence rate in both groups. RESULTS: Group A consisted of 54 and B of 57 cases. The mean duration for total removal of hematoma was 42.6+/-13.9 hours in group A and 30.3+/-11.9 hours in group B (p<0.05). The mean amount of drainage counted per six hours cumulatively differed significantly between groups. The result (p<0.05) showed that the newly designed catheter effectively removed the hematoma. The total recurrence rate in group A was 11% and 3.5% in group B. CONCLUSION: The study showed that the newly designed catheter effectively removed the hematoma in less time than the conventional one. This helps re-expand the brain block CSF from flowing into the subdural space and decrease the recurrence rate.
Brain ; Catheters* ; Drainage* ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans ; Recurrence ; Retrospective Studies ; Subdural Space

IL-28RA is one of the important candidate genes for complex trait of genetic diseases, but there is no published information of the genetic variation in this gene. We scanned the seven exons and their boundary introns sequence of IL-28RA including the promoter regions to analyze genetic variation sites, and identified eighteen single nucleotide polymorphisms (SNPs) and two variation sites. We chose seven SNPs (g.-1193 A>C, g.-30 C>T, g.17654 C>T, g.27798 A>G, g.31265 C>T, g.31911 C>T and g.32349 G>A) of them for large sample size genotyping, and assessed the association of genotype and allele frequencies of these SNPs between allergic rhinitis patients and non-allergic rhinitis controls. We also compared the genotype frequencies between Korean controls and Han Chinese control or Korean Chinese control. We investigated the frequencies of haplotype constructed by these SNPs between allergic rhinitis patients and non-allergic rhinitis controls. Our results suggested that the g.32349 G>A polymorphism of IL-28RA might be associated with susceptibility to allergic rhinitis (P=0.032), but seems to have no relationship with serum total IgE levels. The haplotype frequencies by these SNPs also show significant association between controls and allergic rhinitis patients.
Variation (Genetics) ; Rhinitis, Allergic, Seasonal/blood/*genetics ; Rhinitis, Allergic, Perennial/blood/*genetics ; Receptors, Cytokine/*genetics ; Promoter Regions (Genetics)/genetics ; Polymorphism, Single Nucleotide/*genetics ; Male ; Immunoglobulin E/blood ; Humans ; Haplotypes ; Genotype ; Genetic Predisposition to Disease/genetics ; Gene Frequency ; Female ; Exons/genetics ; Case-Control Studies ; Alleles ; Adult

Replacement lipomatosis of the kidney is a rare disorder in which a massive fatty tissue proliferation occurs within the renal sinus, hilum and perirenal region. Clinical symptoms includes flank pain, hematuria, fever usually associated with urinary tract infection and renal stone. But deep vein thrombosis due to mass effect has not been reported to be associated with replacement lipomatosis of kidney. A 37-year-old male was referred for the initiation of hemodialysis due to chronic rejection of allograft kidney. Collateral superficial veins were observed on his anterior abdominal wall and firm mass was palpable in the right lower quadrant abdomen. Abdominal-pelvis computed tomography revealed huge fatty mass originated from allograft kidney and non-visualization of inferior vena cava with lower density thrombus at both the common femoral veins. We report a rare case of replacement lipomatosis of the kidney complicated by deep vein thrombosis after renal transplantation.
Abdomen ; Abdominal Wall ; Adipose Tissue ; Adult ; Femoral Vein ; Fever ; Flank Pain ; Hematuria ; Humans ; Kidney ; Kidney Transplantation ; Lipomatosis ; Male ; Rejection (Psychology) ; Renal Dialysis ; Thrombosis ; Transplantation, Homologous ; Urinary Tract Infections ; Veins ; Vena Cava, Inferior ; Venous Thrombosis