No abstract available.
Heart Septal Defects, Atrial

A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
Bile Duct Obstruction, Extrahepatic/*etiology/pathology ; Biopsy ; Carcinoma, Hepatocellular/*complications/pathology/surgery ; Case Report ; Common Bile Duct/pathology ; Female ; Hemobilia/*complications ; Human ; Liver Cirrhosis/diagnosis ; Liver Neoplasms ; Middle Age

A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
Bile Duct Obstruction, Extrahepatic/*etiology/pathology ; Biopsy ; Carcinoma, Hepatocellular/*complications/pathology/surgery ; Case Report ; Common Bile Duct/pathology ; Female ; Hemobilia/*complications ; Human ; Liver Cirrhosis/diagnosis ; Liver Neoplasms ; Middle Age

PURPOSE: Paradoxical embolism due to the presence of patent foramen ovale(PFO) is a well-established possible mechanism of ischemic stroke of unknown origin, and the closure of PFO seems to be a kind of most effective method of the prevention of stroke recurrence. We report the initial and intermediate-term result of transcatheter closure of PFO associated with paradoxical embolism leading to cryptogenic transient ischemic attack or cerebrovascular accident using the Amplatzer(R) PFO Occluder. METHODS: From January 2003 through May 2005, 10 patients with PFO(4 male, 6 female) with history of at least 1 cryptogenic transient ischemic attack or cerebrovascular accident underwent percutaneous transcatheter closure of PFO using Amplatzer(R) occluder assisted by transesophageal echocardiography(TEE). All procedure were performed under general anesthesia and assisted by TEE. RESULTS: In all patients, the implantation procedure was successful and no significant complication was observed(in one case, peri-interventional ST-segment elevation observed). During the follow-up period of mean 13.1 months(range, 1-28 months), no recurrence of neurologic episode were observed and there was no residual shunt through PFO. CONCLUSION: We were able to implant the device without significant complication in all our patients and close PFO effectively. No recurrence of neurologic episode were observed. We conclude that in this initial and intermediate-term follow up, the transcatheter closure of PFO associated with paradoxical embolism using the Amplatzer(R) PFO Occluder is a safe and effective method in prevention of stroke recurrence and there is no significant adverse effect until now. And this procedure may be the treatment choice in patients with the high risk of recurrence ischemic attack. However, in this study, the number of patients included[5 patients(50%) had multiple thromboembolic events] is small and follow-up period is not long. So, we need more clinical cases and long-term clinical follow-up.
Anesthesia, General ; Embolism, Paradoxical* ; Follow-Up Studies ; Foramen Ovale, Patent* ; Humans ; Ischemic Attack, Transient ; Male ; Recurrence ; Stroke

Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.
Cardiac Catheterization ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Heart Defects, Congenital

Patent ductus arteriosus (PDA) is a common congenital heart defect. All PDAs, regardless of size or degree of symptoms, require occlusion. Transcatheter PDA occlusion features fewer complications than trans-thoracic closure. It is also more cost-effective and has an excellent occlusion rate. Therefore, transcatheter PDA occlusion is accepted as the standard treatment option for PDA. However, tubular-type PDAs are difficult to close with ordinary detachable coils or the Amplatzer Duct Occluder; thus, these lesions remain a challenge for transcatheter closure. We attempted to occlude a tubular-type PDA by using an oversized Amplatzer Vascular Plug, which allowed intraluminal packing of the ductus. By using this treatment method, PDA occlusion was achieved safely with an excellent final outcome. We suggest that this approach may be a good option for transcatheter closure of a tubular-type PDA.
Cardiac Catheterization ; Ductus Arteriosus ; Ductus Arteriosus, Patent ; Heart Defects, Congenital

PURPOSE: The cardiopulmonary exercise test (CPET) is an important clinical tool for evaluating exercise capacity and is frequently used to evaluate chronic conditions including congenital heart disease. However, data on the normal CPET values for Korean children and adolescents are lacking. The aim of this study was to provide reference data for CPET variables in children and adolescents. METHODS: From August 2006 to April 2009, 76 healthy children and adolescents underwent the CPET performed using the modified Bruce protocol. Here, we performed a medical record review to obtain data regarding patient' demographics, medical history, and clinical status. RESULTS: The peak oxygen uptake (VO2Peak) and metabolic equivalent (METMax) were higher in boys than girls. The respiratory minute volume (VE)/CO2 production (VCO2) slope did not significantly differ between boys and girls. The cardiopulmonary exercise test data did not significantly differ between the boys and girls in younger age group (age, 10 to 14 years). However, in older age group (age, 15 to 19 years), the boys had higher VO2Peak and METMax values and lower VE/VCO2 values than the girls. CONCLUSION: This study provides reference data for CPET variables in case of children and adolescents and will make it easier to use the CPET for clinical decision-making.
Adolescent ; Bacterial Toxins ; Child ; Demography ; Exercise Test ; Heart Diseases ; Humans ; Medical Records ; Metabolic Equivalent ; Oxygen

A 7-year-old girl was admitted to the emergency department with a 2-week history of fever and general weakness. She had been diagnosed with tetralogy of Fallot and received surgical repair. Pulmonary prosthetic valve replacement was performed in January 2014 because of severe pulmonary regurgitation and moderate right ventricle dilatation. Echocardiography revealed suspicious vegetation around the prosthetic pulmonary valve. Neisseria cinerea was confirmed in blood culture. We diagnosed with bacterial infective endocarditis, and administered empirical intravenous antibiotics for endocarditis. However, the fever and general weakness continued, with mild muscle aches and coughing. Thus, we performed a chest radiography and pneumonia workup. Therefore, she was diagnosed with mycoplasma pneumonia and given oral clarithromycin twice daily for 2 weeks. She was successfully treated with antibiotics for 46 days. We report the first case of infective endocarditis caused by N. cinerea in Korea.
Anti-Bacterial Agents ; Child* ; Clarithromycin ; Cough ; Dilatation ; Echocardiography ; Emergency Service, Hospital ; Endocarditis* ; Female* ; Fever ; Heart Ventricles ; Humans ; Korea ; Neisseria cinerea* ; Neisseria* ; Pneumonia ; Pneumonia, Mycoplasma ; Pulmonary Valve Insufficiency ; Pulmonary Valve* ; Radiography ; Tetralogy of Fallot ; Thorax