1.The prevalence and associated risk factors of renal artery stenosis in patients undergoing cardiac catheterization.
Hyun Yong SONG ; Jae Ha HWANG ; Hyunjin NOH ; Sug Kyun SHIN ; Dong Hoon CHOI ; Won Hum SHIM ; Ho Yung LEE ; Seung Yun CHO ; Dae Suk HAN ; Kyu Hun CHOI
Yonsei Medical Journal 2000;41(2):219-225
Renal artery stenosis may be a cause of hypertension and a potential contributor to progressive renal insufficiency. However, the prevalence of renal artery disease in a general population is poorly defined. The purposes of this study were to evaluate the prevalence of angiographically-determined renal artery narrowing in a patient population undergoing routine cardiac catheterization, and to identify the risk factors for renal artery stenosis. After left ventriculography, abdominal aortography was performed to screen for the presence of renal artery stenosis. A total of 427 patients (274 males, 153 females) were studied and the mean age was 59 years. Renal artery narrowing was identified in 10.5% of patients. Significant (> or = 50% diameter narrowing) renal artery stenosis was found in 24 patients (5.6%) and insignificant stenosis was found in 21 patients (4.9%). Significant unilateral stenosis was present in 4.2% of patients and bilateral stenosis was present in 1.4%. The stem of the renal artery was a more common site of stenosis in 62.2% of patients than in the ostium (37.8%), but the severity of stenosis was not significantly different according to the site of stenosis. By univariate and multivariate logistic regression analysis, the association of clinical variables with renal artery stenosis was assessed. Multivariable predictors included age, hypertension and peripheral vascular disease (p < 0.05). The variables such as sex, smoking history, hyperlipidemia, renal insufficiency, as well as the presence of obesity, severity of coronary heart disease and D.M., were not associated. In conclusion, the prevalence of angiographically-determined renal artery narrowing in a patient population undergoing cardiac catheterization is 10.5%. Old age, hypertension and evidence of peripheral vascular disease represent the predictors of renal artery stenosis.
Adult
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Aged
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Female
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Heart Catheterization*
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Human
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Hypertension/etiology
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Male
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Middle Age
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Multivariate Analysis
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Prevalence
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Renal Artery Obstruction/etiology
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Renal Artery Obstruction/epidemiology*
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Risk Factors
2.A Case of Lower Gastrointestinal Bleeding with Ileal Ulceration in Scrub Typhus.
Su Jung BAIK ; Ki Nam SHIM ; Min Jung KANG ; Hyun Joo SONG ; Kum Hei RYU ; Hye Jung YEOM ; Tae Hum KIM ; Sung Ae JUNG ; Kwon YOO ; Il Hwan MOON ; Kyu Won CHUNG
Korean Journal of Gastrointestinal Endoscopy 2007;34(1):56-59
Scrub typhus, an acute febrile illness caused by Orientia tsutsugamushi-induced vasculitis, is common in Korea, Asia and Pacific Islands. Endoscopic mucosal lesions or mucosal damages have rarely been reported in Scrub typhus. However, four cases of upper gastrointestinal bleeding, controlled by hemoclipping, in Tsutsugamushi-infected patients have been reported in Korea; although, no case of lower gastrointestinal bleeding in Scrub typhus has been reported. We experienced massive hematochezia in a 77-year-old female patient with Scrub typhus. Special studies, including upper gastroduodenoscopy, colonoscopy, abdominal CT scan, and SMA angiography were performed, but the focus of the bleeding could not be found. An RBC scan showed suspicious small bowel bleeding, but a capsule endoscopy could not reveal the focus of the bleeding focus; however, a colonoscopy showed active bleeding at the terminal ileum, with multiple ileal ulcerations. After conservative therapy, the patient's condition was stable and the hematochezia disappeared.
Aged
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Angiography
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Asia
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Capsule Endoscopy
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Colonoscopy
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Female
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Gastrointestinal Hemorrhage
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Hemorrhage*
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Humans
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Ileum
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Korea
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Pacific Islands
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Scrub Typhus*
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Tomography, X-Ray Computed
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Ulcer*
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Vasculitis