Spontaneous coronary artery dissection is a rarely identified entity whose exact incidence, etiology, pathogenesis, medium-term evolution and optimal treatment have not yet been firmly estabilished. The cause of spontaneous disection remains unclear but theories of etiology include a medial eosinophilic angiitis, pregnancy induced degeneration of collagen and rupture of the vasovasoum. Most paients die suddenly, but a clinical spectrum is seen including and unstable angina, myocardial infarction and cardiogenic shock. We experienced 4 cases with spontaneous coronary artery dissection found angiographically which caused myocardial infarction and unstable angina. Our patients were treated medically.
Angina, Unstable ; Collagen ; Coronary Vessels ; Eosinophils ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Ischemia* ; Pregnancy ; Rupture ; Shock, Cardiogenic ; Vasculitis

BACKGROUND: Intrathecal baclofen has an analgesic effect. However, the analgesic effect and neurotoxicity of epidural baclofen has not been reported. METHODS: Twenty rabbits, weighing 2.5-3.0 kg, were randomly assigned to three groups; five rabbits receiving 0.9% saline (S), five rabbits receiving 0.1 mg morphine (M), ten rabbits receiving 0.5% baclofen (B). An epidural catheter was inserted at the L(6-7) interspace, and 0.6 ml of saline, morphine or baclofen was injected. Motor and sensory deficits were measured. After two weeks, a spinal cord segment 3 cm on each side of the catheter tip was removed for histological examination. RESULTS: In the M and B groups, no rabbits showed any response of the hindlimbs to the pinch toe test. On light microscopy findings, no inflammation of the meninges or degenerative myelopathy was observed in the S or M groups. In the B group, one rabbit showed local myelopathy of the white matter, and degenerative myelopathy of white and grey matter in the area adjacent to the epidural catheter. However, these changes are focal and minimal, and thought to be ischemic changes due to vascular damage caused by catheterization. Electron microscopy findings showed no morphologic difference between the S and B groups. CONCLUSIONS: Epidural 0.5% baclofen produced antinociceptive effect with slight motor weakness. No definite neurotoxicity was observed after a single epidural injection of 0.5% baclofen in the rabbit.
Animals ; Baclofen* ; Catheterization ; Catheters ; Hindlimb ; Inflammation ; Injections, Epidural ; Meninges ; Microscopy ; Microscopy, Electron ; Morphine ; Rabbits ; Spinal Cord ; Spinal Cord Diseases ; Toes

Of all forms of ectopic gestation, the possibility of fertility catastrophe is highest with a cervical pregnancy. Though rare, it is a potentially life-threatening condition. In the past it was diagnosed late, after there was profuse hemorrhage from the cervix and it usually required hysterectomy. With ultrasound, diagnosis can be made earlier and conservative management attempted in order to preserve the reproductive potential. Methotrexate has been used both systemically and intra-amniotically to treat cervical ectopic gestation conservatively.
Cervix Uteri ; Diagnosis ; Female ; Fertility ; Hemorrhage ; Hysterectomy ; Methotrexate ; Pregnancy* ; Ultrasonography

No abstract available.

Progressive supranuclear palsy (PSP) is a kind of chronic neurodegenerative diseases, the main clinical characteristics of which are loss of voluntary control of vertical gaze, particularly downgaze, dysarthria. Diffuse body rigidity with dystonic extension of the peck, and dementia In its earlier stages, PSP can be misdiagnosed as Parkinson's disease because of lack of awareness of the disease and symptoms and signs may not be diagnostic until the disease is advanced. About 4% of all patients with parkinson's disease turn out eventually to have progressive supranuclear palsy. We report the three cases of PSP with MRI brain scan.
Brain ; Dementia ; Dysarthria ; Humans ; Magnetic Resonance Imaging ; Neurodegenerative Diseases ; Parkinson Disease ; Supranuclear Palsy, Progressive*

To investigate the discriminative values of different lipid and lipoproteins in the presence and severity of coronary artery disease(CAD), liporotein profiles and other risk factors were measured in 333 patients age 30-69 years who were admitted at Severance Hospital from January 1980 to Agust 1986. The extent of atherosclerosis was quantified by a coronary atheosclerosis score(CAS) based on number and severity of lesions in eight proximal segments of the follows; 1) In age 30-49 and 50-69 groups, there were no significant differences of age, hypertension, smoking, diabetes, obesity to compare with control groups. 2) In age 30-49 group, the extent of CAD was more severe in male patients(1.7+/-0.7 vessel disease) than female(1.3+/-0.6 vessel disease)(P<0.05). But, no significant difference was showed between male(2.0+/-0.9 vessel disease) in age 50-69 group. CAS was significantly increased in male patients(6.1+/-3.7)to compare with female(3.7+/-2.6) in age 30-49 group(P<0.01). But, there was no difference in age 50-69 group. However, stronger liner correlations were demonstrated between the age and CAS in male patients(r=0.227, P<0.005) and in female patients(r=0.317, p<0.05). 3) Total cholesterol(TC), triglyceride(TG), HDL/c, HDL-TC and HDL-C/LDL-C were significantly associated with the presence of CAD in age 30-69 male patients; HoweverTC and LDL-C had disciriminatory value only for age 50-69 female patients. 4)The concentration of TC, LDL/C, HDL-C/TC and HDL_C/LDL-C showed a strong correlation with CAS in male patients, TC and LDL-C in female patents. But, HDL-C had no significant correlation with CAS on both groups. Above data suggest that TC, TG and HDL-C are the significants markers in man and TC and LDL-C on female for presence of CAD. The concentration of TC and LDL-C are related to the severity of CAD in both sexes. Further studies of lipoproteins and risk factors with large population are needed.
Adult* ; Atherosclerosis ; Coronary Artery Disease* ; Coronary Vessels* ; Female ; Humans ; Hypertension ; Lipoproteins* ; Male ; Obesity ; Risk Factors ; Smoke ; Smoking

Rhabdomyolysis is a syndrome that causes various complications due to the release of substances from muscle cells, often associated with preceding infectious diseases. We report the case of a 7-year-old Korean boy with recent severe acute respiratory syndrome coronavirus 2 infection, presenting with fever, chills, and generalized body aches, diagnosed as rhabdomyolysis. Additionally, we conducted a systematic review with the aim of delineating the disease spectrum, treatment, and outcomes. We identified seven reports that met the inclusion criteria. Among the cases, 5 had fever, with creatine kinase levels ranging from 3,717 and 274,664 IU/L. Two individuals received treatment in intensive care unit, 2 underwent renal replacement therapy, and 1 case has deceased. For children with coronavirus disease 2019 infection and muscle pain, a thorough examination of urine color and an assessment of muscle enzymes through blood tests can help diagnose and treat rhabdomyolysis, a condition that might otherwise be overlooked.

Rhabdomyolysis is a syndrome that causes various complications due to the release of substances from muscle cells, often associated with preceding infectious diseases. We report the case of a 7-year-old Korean boy with recent severe acute respiratory syndrome coronavirus 2 infection, presenting with fever, chills, and generalized body aches, diagnosed as rhabdomyolysis. Additionally, we conducted a systematic review with the aim of delineating the disease spectrum, treatment, and outcomes. We identified seven reports that met the inclusion criteria. Among the cases, 5 had fever, with creatine kinase levels ranging from 3,717 and 274,664 IU/L. Two individuals received treatment in intensive care unit, 2 underwent renal replacement therapy, and 1 case has deceased. For children with coronavirus disease 2019 infection and muscle pain, a thorough examination of urine color and an assessment of muscle enzymes through blood tests can help diagnose and treat rhabdomyolysis, a condition that might otherwise be overlooked.

Rhabdomyolysis is a syndrome that causes various complications due to the release of substances from muscle cells, often associated with preceding infectious diseases. We report the case of a 7-year-old Korean boy with recent severe acute respiratory syndrome coronavirus 2 infection, presenting with fever, chills, and generalized body aches, diagnosed as rhabdomyolysis. Additionally, we conducted a systematic review with the aim of delineating the disease spectrum, treatment, and outcomes. We identified seven reports that met the inclusion criteria. Among the cases, 5 had fever, with creatine kinase levels ranging from 3,717 and 274,664 IU/L. Two individuals received treatment in intensive care unit, 2 underwent renal replacement therapy, and 1 case has deceased. For children with coronavirus disease 2019 infection and muscle pain, a thorough examination of urine color and an assessment of muscle enzymes through blood tests can help diagnose and treat rhabdomyolysis, a condition that might otherwise be overlooked.

Compared with iron dextran, iron chondroitin sulfate(ICS) is much cheaper and has better bioavailability. To evaluate the efficacy and safety of ICS in maintenance HD patients, i.v. ICS was given to 37 HD patients [20 M, 17 F, median age 51 years, median duration of HD 21 months] whose ferritin(Fer)< 100microgram/L or transferrin saturation(TFS) <20% [Group I , 12 M, 10 F] or Hb<9.0g/dL in spite of increased rHuEPO dose, Fer>or=100microgram/L and TFS>or=20% [Group II, 8 M, 7 F]. The patients had taken oral iron [227+/-73mg/day(mean+/-SD)] before this study. All patients received 120mg i.v. ICS weekly for 1 month. Then, ICS dosage was adjusted to 40-120mg/week depending on Hb, Fer and TFS in the following 3 months. Hb, Fer, TFS, rHuEPO dose and side effects were monitored monthly. The results were as follows : 1) I.v. iron therapy produced a significant rise in Hb(8.3+/-0.9g/dL to 9.7+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(95+/-50U/kg/wk to 69+/-28U/kg/wk; P<0.05), a significant increase in serum ferritin levels(162+/-149microgram/L to 472+/-255microgram/L; P<0.01) and TFS(24+/-13% to 41+/-18%; P<0.05). 2) In group 1, i.v. iron therapy produced a significant rise in Hb(8.5+/-1.1g/dL to 9.9+/-0.9g/dL; P< 0.01), a significant reduction in rHuEPO dose(87+/-45U/kg/wk to 69+/-27U/kg/wk; P<0.05), increased serum ferritin levels(90+/-48microgram/L to 379+/-186microgram/L; P<0.01) and TFS(18+/-9% to 36+/-16%; P<0.05). 3) In group 2, i.v. iron therapy produced a significant rise in Hb(8.1+/-0.6g/dL to 9.3+/-0.9g/dL; P<0.01), a significant reduction in rHuEPO dose(108+/-55U/kg/ wk to 69+/-31U/kg/wk; P<0.05) and increased serum ferritin levels(274+/-185microgram/L to 602+/-287microgram/L; P< 0.01) with a tendency of increase in TFS(35+/-13% to 41+/-18%; P=0.06). 4) No significant side effect was observed. 5) An annual cost reduction of 221 US dollars per patient was expected. In conclusion, ICS is an effective and safe intravenous iron preparation in HD patients.
Anemia ; Biological Availability ; Chondroitin ; Dextrans ; Erythropoietin ; Ferritins ; Humans* ; Iron* ; Kidney Failure, Chronic ; Transferrin