Electrical injury may lead to a conduction disorder of the heart. We report here on a 36-year-old man, who was treated with a permanent pacemaker, after an electrical injury induced high-degree atrioventricular block and clinical manifestations (dizziness and dyspnea).
Adult ; Atrioventricular Block* ; Electric Injuries ; Heart ; Heart Conduction System ; Humans

OBJECTIVES: We sought to examine the diverse factors associated with aneurysms of the posterior circulation. In addition, the results of conventional craniotomy were compared with those of endovascular treatment. METHODS: One hundred and one patients with posterior circulation aneurysms were selected for study inclusion. The factors that might affect the clinical outcomes were studied , such as the initial Hunt-Hess (H-H) grade, aneurysm location, size of the aneurysm, and therapeutic modalities. In addition, the morbidity and mortality rates were analyzed. The treatment outcomes were evaluated using the Glasgow Outcome Scale (GOS) 6 months after the initial insult. RESULTS: The patient population consisted of 67 women and 34 men, with a mean age of 52 (range 28-81 years). The overall morbidity and mortality rates at 6 months were 13.9% (14/101) and 17.8% (18/101), respectively. Sixty-one operations (60.3%) were performed, and 32 patients were treated with endovascular therapy. Forty-two (85.7%) of the 49 patients that had initial H-H grades of I and II had a better prognosis (GOS more than 4) than those with poor H-H grades (P<0.001). Patients that underwent endovascular treatment had better outcomes than those that had clipping (P=0.032). There was no significant difference in outcome according to the size of the aneurysm, location of the aneurysm, or the age of the patients. CONCLUSIONS: The results of this study showed that the factors affecting the prognosis were the initial HH grade and treatment modality. Considering the very high mortality rate in patients with rebleeding, early management may help improve the prognosis of patients with posterior circulation aneurysms. Endovascular therapy should be considered the primary treatment modality in patients with posterior circulation aneurysms.
Aneurysm ; Craniotomy ; Female ; Glasgow Outcome Scale ; Humans ; Intracranial Aneurysm ; Male ; Prognosis

BACKGROUND AND OBJECTIVES: Increased carotid intima-media thickness (IMT) is known to be associated with adverse cardiovascular events in the patients with risk factors or established atherosclerosis. However, the prognostic importance of carotid IMT is uncertain in the patients who underwent percutaneous coronary intervention (PCI). We sought to evaluate the association of carotid IMT with major adverse cardiovascular events (MACE) and restenosis in the patients who underwent PCI. SUBJECTS AND METHODS: The study population consisted of 308 consecutive patients who underwent PCI, and they were followed up for mean of 30.6+/-13.3 months. Base on the median values of carotid IMT, which was measured in the right common carotid artery at the time of PCI with using high-resolution ultrasound and a semiautomatic method, the subjects were divided into the thick (n=156, 1.003+/-0.14 mm) and thin IMT (n=152, 0.748+/-0.07 mm) groups, and they were followed up for at least 1 year. RESULTS: Patients with thick carotid IMT were older (61+/-9 years vs. 57+/-10 years, respectively, p=0.001), had a higher body mass index (25.0+/-3.0 vs. 23.9+/-4.0, respectively, p=0.017), a history of previous myocardial infarction (20% vs. 9%, respectively, p=0.008), more multivessel disease and more restenosis (34.6% vs. 23.0%, respectively, p=0.025) than those patients with a thin carotid IMT. However other MACEs such as death, myocardial infarction, stroke, heart failure and target lesion revascularization did not show any significant differences between the two groups. Multivariate Cox regression analysis showed that carotid IMT was an independent predictor of restenosis (odds ratio: 1.754, 95% confidence interval: 1.1296 to 2.726, p=0.012). CONCLUSION: An increased carotid IMT is associated with restenosis, but it does not have clinical prognostic importance for the patients who underwent PCI during a mean follow up period of 31 months.
Angioplasty, Balloon, Coronary ; Atherosclerosis ; Body Mass Index ; Carotid Artery, Common ; Carotid Intima-Media Thickness* ; Follow-Up Studies ; Heart Failure ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention* ; Prognosis ; Risk Factors ; Stroke ; Ultrasonography

No abstract available.
Endocarditis* ; Hypertension ; Mitral Valve

No abstract available.
Angiomyolipoma* ; Tuberous Sclerosis*

BACKGROUND AND OBJECTIVES: While the clinical significance of descending thoracic aorta intima-media thickness (DTA-IMT) remains unclear, common carotid IMT (CIMT) is known to be associated with major adverse cardiovascular events (MACE) in patients with atherosclerotic disease. SUBJECTS AND METHODS: A total of 104 patients (mean age, 59 yrs; 69 male) with angiographically proven coronary atherosclerosis underwent transesophageal echocardiography (TEE) for DTA-IMT measurement and carotid scanning for CIMT measurement. The patients were divided into two groups based on the median IMT value, and they were followed up for cardiovascular events and all-cause mortality for a period of 50+/-21 months. RESULTS: Patients having a higher DTA-IMT value (n=44, >2.1 mm) had a higher chance of stroke (6.7% vs. 2.8%, p=0.04), peripheral vascular disease (6.7% vs. 1.9%, p=0.02), and death (2.9% vs. 0%, p=0.04) than those who had lower DTA-IMT values (n=60, < or =2.1 mm). The patients who had higher CIMT values (n=49, >0.089 mm) had a higher chance of peripheral vascular disease (16% vs 2%, p=0.009) than those having lower IMT values (n=55, < or =0.089 mm). However, there was no significant difference between the groups in terms of recurrent chest pain, heart failure, syncope, myocardial infarction or chronic kidney disease during the follow-up period. Multivariate Cox regression analysis revealed that increased DTA-IMT was associated with stroke (OR, 4.29; 95% CI, 1.076-17.181; p=0.039) and peripheral vascular disease (OR, 9.37; 95% CI, 1.571-55.499; p=0.014), whereas increased CIMT was associated with peripheral vascular disease (OR, 14.365; 95% CI, 1.050-196.540; p=0.046). CONCLUSION: This study suggests that descending thoracic aorta IMT is more closely associated with prognosis in patients with coronary atherosclerosis than CIMT.
Aorta ; Aorta, Thoracic* ; Atherosclerosis ; Carotid Arteries ; Chest Pain ; Coronary Artery Disease* ; Echocardiography, Transesophageal ; Follow-Up Studies ; Heart Failure ; Humans ; Mortality ; Myocardial Infarction ; Peripheral Vascular Diseases ; Prognosis ; Renal Insufficiency, Chronic ; Stroke ; Syncope

PURPOSE: To evaluate the validity of the University of California San Francisco Cancer of the Prostate Risk Assessment-S score (CAPRA-S score), a biochemical indicator of recurrent prostate cancer that uses histopathologic data, in Korean prostate cancer patients. MATERIALS AND METHODS: A total of 203 prostate cancer patients who underwent radical prostatectomy between February 1997 and November 2010 were observed for longer than 6 months. The CAPRA-S score of 134 patients for whom records were available for preoperative prostate-specific antigen (PSA), pathologic specimen Gleason score, surgical margin, seminal vesicle invasion, extracapsular extension, and lymph node invasion were calculated. Biochemical recurrence was defined as repetitive measurement of PSA > or =0.2 ng/mL at least 6 months after surgery with at least a 4-week interval. The Cox proportional hazard model and Kaplan-Meier analysis were used for the statistical testing. RESULTS: The CAPRA-S scores were divided into nine groups. The 5-year disease-free survival rate was reduced as the CAPRA-S score increased compared with the group with a CAPRA-S score of 0-1. The CAPRA-S score in this study was more sensitive to biochemical recurrence than was the CAPRA score conducted at this institution (CAPRA-S concordance index, 0.776; CAPRA concordance index, 0.728). CONCLUSIONS: The CAPRA-S score is judged to be a useful tool for predicting the disease-free survival rate of Korean prostate cancer patients and is thought to assist in establishing postoperative management.
California ; Disease-Free Survival ; Goats ; Humans ; Kaplan-Meier Estimate ; Lymph Nodes ; Neoplasm Grading ; Proportional Hazards Models ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; San Francisco ; Seminal Vesicles

PURPOSE: To evaluate the efficacy of transcatheter arterial embolization(TAE) in children with blunt splenicinjury. MATERIALS AND METHODS: The results of transcatheter splenic arterial embolization in nine children whosuffered splenic injury after blunt abdominal trauma were retrospectively studied. This injury was demonstrated byCT, and the findings were evaluated according to the classification of Mirvis et al. ; two patients were grade 3and seven were grade 4. All were carefully observed in intensive care before embolization. TAE was performed if apatient satisfied the following criteria : (1) transfusion and/or fluid replacement required to maintainhemodynamic stability ; or (2) rapid Hb/Hct decrease ; or (3) both. Splenic function was subsequently estimatedaccording to the results of 99mTc-sulfur colloid scintigraphy and/or CT scanning. RESULT: TAE was suscessful inall nine children. Two were embolized with a coil only, three with gelfoam, and four with gelfoam and a coil.Seven were embolized in the main trunk of the splenic artery and others in both the main trunk and its branches.Splenic function was preserved in all nine children, during follow-up, none suffered rebleeding. CONCLUSION: TAEof the splenic artery can be a safe and effective nonsurgical approach to the management of blunt splenic injuryin children, and can preserve splenic function.
Child* ; Classification ; Colloids ; Follow-Up Studies ; Gelatin Sponge, Absorbable ; Humans ; Critical Care ; Radionuclide Imaging ; Retrospective Studies ; Splenic Artery ; Tomography, X-Ray Computed

Schwannomas are relatively common, benign tumors that are thought to arise from the nerve sheath cell. Schwannomas of the C1 root are extremely rare and seldom invade lateral masses because they gradually increase in size and can extend through the wide space behind the lateral mass instead of the intervertebral foramen. We present here an unusual case of a benign schwannoma that aggressively invaded the lateral mass of C-1.
Female ; Humans ; Middle Aged ; Neoplasm Invasiveness ; Neurilemmoma/*pathology ; Spinal Neoplasms/*pathology ; Spinal Nerve Roots/*pathology

BACKGROUND AND OBJECTIVES: Hypercholesterolemia is a key factor in the development of atherosclerosis. We sought to evaluate the relation between hypercholesterolemia and plaque composition in patients with coronary artery disease. SUBJECTS AND METHODS: Study subjects consisted of 323 patients (mean 61.5 years, 226 males) who underwent coronary angiography and virtual histology-intravascular ultrasound examination. Patients were divided into two groups according to total cholesterol level: hypercholesterolemic group (> or =200 mg/dL, n=114) and normocholesterolemic group (<200 mg/dL, n=209). RESULTS: Hypercholesterolemic patients were younger (59.7+/-13.3 years vs. 62.6+/-11.5 years, p=0.036), than normocholesterolemic patients, whereas there were no significant differences in other demographics. Hypercholesterolemic patients had higher corrected necrotic core volume (1.23+/-0.85 mm3/mm vs. 1.02+/-0.80 mm3/mm, p=0.029) as well as percent necrotic core volume (20.5+/-8.5% vs. 18.0+/-9.2%, p=0.016) than normocholesterolemic patients. At the minimal lumen area site, percent necrotic core area (21.4+/-10.5% vs. 18.4+/-11.3%, p=0.019) and necrotic core area (1.63+/-1.09 mm2 vs. 1.40+/-1.20 mm2, p=0.088) were also higher than normocholesterolemic patients. Multivariate linear regression analysis showed that total cholesterol level was an independent factor of percent necrotic core volume in the culprit lesion after being adjusted with age, high density lipoprotein-cholesterol , hypertension, diabetes mellitus, smoking and acute coronary syndrome (beta 0.027, 95% confidence interval 0.02-0.053, p=0.037). CONCLUSION: Hypercholesterolemia was associated with increased necrotic core volume in coronary artery plaque. This study suggests that hypercholesterolemia plays a role in making plaque more complex, which is characterized by a large necrotic core, in coronary artery disease.
Acute Coronary Syndrome ; Atherosclerosis ; Cholesterol ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessels ; Demography ; Diabetes Mellitus ; Humans ; Hypercholesterolemia ; Hypertension ; Linear Models ; Smoking