BACKGROUND: With the recent development in arterial reconstructive procedure such as percutaneous transluminal coronary angioplasty or atherectomy, the incidence of vascular complications involving femoral artery is increasing due to greater use of larger percutaneous instruments(including arterial sheath) and periprocedural anticoagulant therapy. Femoral pseudoaneurysm requires rapid diagnosis and management to prevent limb ischemia, worsening of the arterial injury or repair of the arterial defect. Recently, accurate diagnosis of these injuries can be made nonivasively with duplex sonography and Doppler color flow imaging, and nonsurgical treatment may be possible by using external compression guided by ultrasound even in patients requiring prolonged anticoagulant therapy. METHOD: Three patients, one undergoing coronary angiography and two undergoing percutaneous transluminal coronary angioplasty, developed expansile groin masses at the vascular access sites diagnosed as femoral artery pseudoaneurysm s by Doppler ultrasound. All patients were hypertensives, taking aspirin and two patients who underwent PTCA received intravenous heparin after procedure. After diagnosis of femoral pseudoaneurysm, all patients underwent mechanical(C-clamp) external compression guided by ultrasound for 3 hours. RESULT: Follow up color flow scans were obtained after 24 hours and in one patients, blood flow in the tract was eliminated but persistent blood flow was observed in two patients who underwent PTCA. Before closure of pseudoaneurysm, one patient needed another 6 hours of ultrasound guided compression and the other needed more 12 hours. All patients were discharged without complication or recurrence of pseudoaneurysm. CONCLUSION: These cases suggest that nonsurgical closure of femoral pseudoaneurysms is feasible even in patients requiring prolonged antiplatelet and anticoagulant therapy.
Aneurysm, False* ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherectomy ; Cardiac Catheterization* ; Cardiac Catheters* ; Coronary Angiography ; Diagnosis ; Extremities ; Femoral Artery ; Follow-Up Studies ; Groin ; Heparin ; Humans ; Incidence ; Ischemia ; Recurrence ; Ultrasonography

Primary or isolated chylopericardium of unknown etiology is considered a rare cause of pericardial effusion. Its etiology is obscure but certain communication between the lymphatic system and pericardial sac was suggested. Up to 1991, there was only one case report that successfully showed the direct communication by a lymphangiogram. We report a case of chylopericardium occurring in a nearly asymptomatic 22-year-old man with no apparent history of trauma, infection or mediastinal neoplasm, in which we succeeded in visualizing the communication between the thoracic duct and pericardial sac by lymphangiography and computed tomography of the chest. A review of the previous cases is described also.
Adult ; Case Report ; Chyle/*metabolism ; Human ; Lymphography ; Male ; Pericardial Effusion/*metabolism/radiography ; Radiography, Thoracic ; Tomography, X-Ray Computed

A study was conducted to investigate the blood lead and zinc protoporphyrin(ZPP) concentrations of the underground parking lot workers who exposed to vehicular exhaust aerosols which contained lead. The blood samples were collected from 25 study subjects of underground parking lot and from 33 controls in Taegu, from July to October, 1997. And also the related factors to the blood lead and ZPP concentrations were investigated. Blood lead concentration and ZPP concentration were measured by flameless furnace atomic absorption spectrophotometer (IL.551) and hemetofluorometer, respectively. The mean blood lead concentrations of study subjects and controls were 23.10+/-20.77microgram/dl and 12.99+/-12.71microgram/dl, respectively(p<0.05), and the mean blood ZPP concentrations of study subjects and controls were 40.72+/-9.46microgram/dl and 38.21+/-10.97microgram/dl, respectively. No significant correlations were observed between the blood lead concentration of the study subjects and their job duration and between blood ZPP concentration of the study subjects and their job duration. There were no statistically significant differences in the blood lead concentration and the blood ZPP concentration of smokers and nonsmokers. In multiple regression analysis on blood lead concentration of the study subjects and controls, occupation was a only significant dependent variable. In case of bood ZPP concentration, age was a only significant dependent variable in the study subjects and controls.
Absorption ; Aerosols ; Daegu ; Occupations ; Zinc

OBJECTIVES: Cardiovascular diseases are common causes of diseases and death for workers. With the increasing prevalence of obesity, the social costs for obesity related diseases are a growing burden in Korea. We aimed to investigate the impact of weight change on metabolic syndrome and its components in Korean male workers. METHODS: We analyzed the data from 2,785 male workers obtained during health checkups in 2000 and in 2008. The subjects were classified into 5 groups as Loss (< or = -3.0 kg), Stable (-2.9 to 2.9 kg), Mild gain (3.0 to 5.9 kg), Moderate gain (6.0 to 8.9 kg), and Severe gain (> or = 9.0 kg) group according to the amount of weight change between the 2 health checkups. The mean values of metabolic syndrome components were compared across the 5 weight change groups by ANCOVA. After classifying subjects into 2 groups according to the normality of their body weight at baseline, the odds ratios for metabolic syndrome and its components each weight-change group were computed by multiple logistic regression analyses, using the Stable group as the reference. RESULTS: There was a strong linear relationship between weight gain and a worsening of the components of metabolic syndrome in 2008 (p<0.001). In normal body weight group, the odds ratios for metabolic syndrome significantly increased in the Mild, Moderate, and Severe gain groups (OR 1.83, 2.82, and 7.56, respectively), and increased with weight gain (p<0.001). In subjects who were obese, the odds ratios for metabolic syndrome significantly increased if their amount of weight gain placed them in the Mild or Moderate gain groups(OR 1.75 and 3.97), increased with the increase of weight gain (p<0.001), and decreased in the Loss group(OR 0.51, 95%CI 0.30 to 0.85). CONCLUSIONS: Weight gain in male workers was positively associated with metabolic syndrome through worsening of metabolic syndrome components. On the other hand, weight loss in obese male workers had a protective effect against metabolic syndrome through the improvement of the components of metabolic syndrome.
Body Weight ; Cardiovascular Diseases ; Hand ; Humans ; Ideal Body Weight ; Korea ; Logistic Models ; Male ; Obesity ; Odds Ratio ; Prevalence ; Weight Gain ; Weight Loss

BACKGROUND: We aimed to investigate the association between marital status and metabolic syndrome, and observed how their lifestyle may influence within their relationship. METHODS: We analyzed the data from 12,288 Korean men over 20 years old taking a health checkup in a university hospital in Ulsan from March 2008 to February 2009. The subjects were classified as married, unmarried, separated, widowed, and divorced. The odds ratios for metabolic syndrome in each marital status were calculated after adjusting for age, educational level, and family income. In only married men and divorced men, odds ratios were calculated again after adjusting for alcohol intake, smoking, or exercise added to age, educational level, and family income. RESULTS: After adjustment for age, educational level, and family income, the odds ratio for metabolic syndrome in divorced men was 1.48 (95% confidence internal [CI], 1.03 to 2.12; P = 0.03) compared to married men. However, the odds ratios in divorced men decreased to 1.47 (95% CI, 0.97 to 2.24; P = 0.07) after adjusting for alcohol intake added to age, educational level, and family income, 1.42 (95% CI, 0.99 to 2.04; P = 0.06) after adjusting for smoking added, 1.35 (95% CI, 0.93 to 1.96; P = 0.12) after adjusting for exercise added, and 1.37 (95% CI, 0.89 to 2.12; P = 0.15) after adjusting for alcohol intake, smoking, and exercise added. CONCLUSION: Divorced men were likely to have metabolic syndrome compared to married men and this finding may be mediated by their bad lifestyle.
Divorce ; Humans ; Life Style ; Male ; Marital Status ; Odds Ratio ; Single Person ; Smoke ; Smoking ; Widowhood

BACKGROUND: Progression of coronary artery disease(CAD) is highly unpredictable, and follows a nonlinear course. In previous reports, progression was related to acute myocardial infarction and cardiac death. The present study was designed to assess the characteristics of progression of CAD and to ditermine the predictors for progression. METHODS: The present study included 41 patients(age 55+/-9 years ; male/female=36/5) with CAD who underwent coronary angiography at least twice(interval : mean 26 months), and patients who underwent coronary angioplasty of coronary bypass surgery before the 2nd angiograms were excluded from analysis. The coronary arterial bed was divided into 15 segments according to American Heart Association(AHA) committee report. We measured both % stenosis and minimal diameter of the lesions, and divided the lesions into four Ambrose's morphological categories. Progression was considered to be present if one of the following changes had occurred : increase in % stenosis of lesions by> or =20%, decrease in minimal diameter by> or =0.5mm, or any new occlusion. For the purpose of detecting predictors we investigated clinical history(smoking, hypertension, obesity, and DM), angiographic findings(numbers of diseased vessels and lesions), and biochemical study (total cholesterol, LDL, HDL, triglyceride, uric acid, and albumin). RESULTS: Altogether, 32 patients(78%) showed progression, and regression was present in 11 patients(27%). Six patients had both progressed lesions and regressed lesions. Progression occurred most frequently in segments with stenosis of 1% to 25% at initial arteriogram. Progression occured in increasing order in proximal right coronary artery, mid-LAD, and proximal LAD. There was no significant differences in progression among four Ambrose's morphologic categories. 59(10%) of the analyzable 589 segments had progressed, 19 them upto occlusion, and 7 segments became infarct related artery. In 5(71%) of 7 cases of new myocardial infarction it occurred in segments with< or =75% stenosis at initial arteriogram. The analysis selected two independent predictors for progression: uric acid and numbers of lesions> or =20% stenosis. CONCLUSION: The present study suggests that progression of CAD occurred most frequently in minimally stenotic lesions and that about two thirds of acute myocardial infarction occurred from insignificantly stenotic lesion. Uric acid level and numbers of lesions> or =20% stenosis were selelcted as the independent predictors of coronary disease progression.
Angioplasty ; Arteries ; Cholesterol, LDL ; Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Death ; Heart ; Humans ; Hypertension ; Myocardial Infarction ; Obesity ; Research Report ; Triglycerides ; Uric Acid

BACKGROUND: Metabolic syndrome is a cluster of metabolic abnormalities leading diabetes and cardiovascular diseases. Helicobacter pylori (H. pylori) infection is suggested to be a risk factor of cardiovascular diseases. We aimed to investigate the association between H. pylori infection and metabolic syndrome. METHODS: This study was designed with Korean adults having a health check-up in a university hospital in Ulsan from March 2008 to February 2009. The subjects were 17,448 over 20 years old. The analysis was undertaken according to sex separately. The association of H. pylori seropositivity (IgG) with metabolic syndrome components was investigated by multiple linear regression analysis. The association of H. pylori seropositivity with metabolic syndrome was investigated by multiple logistic regression analysis. RESULTS: H. pylori seropositivity was significantly inversely associated with high density lipoprotein cholesterol in men (Coefficient, -0.02; 95% confidence interval [CI], -0.03 to -0.004; P = 0.01). However, H. pylori seropositivity was not significantly associated with metabolic syndrome in both men and women (OR, 1.01; 95% CI, 0.90 to 1.14; P = 0.81 for men; OR, 0.75; 95% CI, 0.55 to 1.02; P = 0.06 for women). CONCLUSION: H. pylori infection was significantly negatively associated with high density lipoprotein cholesterol in men, but not significantly associated with metabolic syndrome in both men and women.
Adult ; Cardiovascular Diseases ; Cholesterol ; Cholesterol, HDL ; Female ; Helicobacter ; Helicobacter pylori ; Humans ; Linear Models ; Lipoproteins ; Logistic Models ; Male ; Risk Factors

BACKGROUND: Infection with hepatitis B virus (HBV) may be a risk factor for cardiovascular disease. We investigated the relationship between HBV infection and metabolic syndrome. METHODS: We performed a cross-sectional study of 9,474 Korean men and women who were at least 20 years old and who underwent a routine health check-up at Ulsan University Hospital in Ulsan, South Korea between March 2008 and February 2009. The associations of hepatitis B surface antigen (HBsAg) seropositivity with the presence of metabolic syndrome and its components were investigated by logistic regression analysis. Data were analyzed separately for males and females. RESULTS: HBsAg seropositivity was significantly negatively associated with hypertriglyceridemia and metabolic syndrome in men (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.29 to 0.50; P < 0.001 and OR, 0.75; 95% CI, 0.57 to 0.98, P = 0.033). In women, HBsAg seropositivity was also significantly negatively associated with hypertriglyceridemia, but not with metabolic syndrome (OR, 0.40; 95% CI, 0.17 to 0.91; P = 0.029 and OR, 0.80; 95% CI, 0.38 to 1.66, P = 0.545). CONCLUSION: HBV infection was significantly negatively associated with hypertriglyceridemia and metabolic syndrome in men and hypertriglyceridemia in women.
Cardiovascular Diseases ; Cross-Sectional Studies ; Female ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B* ; Hepatitis* ; Humans ; Hypertriglyceridemia ; Korea ; Logistic Models ; Male ; Risk Factors ; Triglycerides ; Ulsan ; Young Adult

PURPOSE: The standard treatment for aortic aneurysms is surgical replacement with a prosthetic graft. Currently there is great interest in endoluminal intervention for treatment of aortic aneurysm. The purpose of this study was to evaluate the safety and effectiveness of endoluminally placed Stent-graft for the treatment of aortic aneurysms. MATERIALS AND METHODS: Transluminal endovascular Stent-graft placements were attempted in 9 patients with infra-renal aortic aneurysms(n=6), thoracic aortic aneurysm(n=l), and aortic dissection(n=2). The endovascular Stent-grafts were custom-designed for each patient and were constructed of self-expandable modified Gianturco Stents covered with polytetrafluroethylene. The Stent-grafts were introduced through a 16-18 french sheath and expanded to 17-30mm in diameter. The endovascular therapy was performed using a common femoral artery cutdown with local anesthesia. RESULTS: The endovascular Stent-graft deployment was achieved in 7 of 9 patients. Two cases failed deployment of the Stent-graft due to lilac artery stenosis and tortousity. There were complete thrombosis of the thoracic and infra-renal aortic aneurysm surround the Stent-graft in 3 patients, and persistent leak with partial thrombosis in 2. Two patients with aortic dissection were successfully treated by obliteration of entry tears. There were no major complication associated with Stent-graft placement. CONCLUSION: These preliminary results show that transluminal endovascular Stent-grafts offer great promise and good results. Further investigation is needed to establish its long-term safety and efficacy.
Anesthesia, Local ; Aortic Aneurysm ; Arteries ; Constriction, Pathologic ; Femoral Artery ; Humans ; Stents ; Thrombosis ; Transplants

A new radiopharmaceutical, technetium-99m hexamethylpropyleneamine oxime(99mTc-HMPAO), has been reported to cross the blood-brain-barrier and to distribute in brain in proportion to regional blood flow. Measurement of cerebral blood flow with single photon emixxion computed tomography(SPECT) was performed using 99mTc-HMPO in 46 patients and clinical analysis was done. Decreased regional cerebral perfusion was observed in 41 cases. Moreover eight cases of them who had normal X-ray C-T scan revealed positive finding on SPECT. We porpose that 99mTc-HMPAO SPECT seems to be a useful diagnostic method for evaluation of ischemic cerebral lesions.
Brain ; Diagnosis* ; Humans ; Perfusion ; Regional Blood Flow ; Technetium Tc 99m Exametazime* ; Tomography, Emission-Computed, Single-Photon*