No abstract available.
Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Thyroid Gland*

No abstract available.
Humans ; Kidney Failure, Chronic* ; Kidney Transplantation* ; Thyroid Gland*

No abstract available.
Hip Joint* ; Hip* ; Prostheses and Implants*

No abstract available.
Head* ; Knee* ; Necrosis*

PURPOSE: To evaluate abnormal neurosonographic (NSG) findings of thalami and basal ganglia in full term babies with hypoxic-ischemic encephalopathy and to correlate the findings with follow-up studies and prognosis. METHODS: We evaluated 13 full term babies with abnormal NSG findings of thalarni and basal ganglia. NSG was performed within 7 days after clinical abnormalities. Follow-up NSG was done in 11 cases; CT scan in 4 and MRI in 7. We classified NSG findings as diffuse, unilateral, and focal types according to increased echogenicity and evaluated prognosis based on follow-up studies and neurological sequelae. RESULTS: Nine cases of diffuse type had diffuse echogenic changes of bilateral thalami and basal ganglia, slit-like lateral ventricles suggesting cerebral edema, and increased parenchymal echogenicity. In diffuse type, follow-up studies showed more prominent echogencities and ventricular dilatations and cerebromalacia. One case of unilateral type caused by thromboembolism had unilateral echogenicity of right thalamus and basal ganglia with increased echogenicity of the ipsilateral cerebral hemisphere and compression of the lateral ventricle, suggesting cerebral infarction. Follow-up study showed unilateral cystic cerebromalacia. Three cases of focal type had a localized echogenic area in thalamus with lacunar infarction, which decreased in size during follow-up. Among nine cases of diffuse type, one died within 2 days, two were discharged against medical advice, and six had severe neurologic sequelae. One case of unilateral type had a moderate degree of neurologic sequelae. All 3 cases of focal type had normal development. CONCLUSION: Pattems of abnormal echogenicity in thalami and basal ganglia in fullterm infants with hypoxic-ischemic encephalopathy are correlated with the outcome and may be helpful for treatment planning.
Basal Ganglia* ; Brain ; Brain Edema ; Brain Ischemia* ; Cerebral Infarction ; Cerebrum ; Dilatation ; Encephalomalacia ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; Infant* ; Lateral Ventricles ; Magnetic Resonance Imaging ; Prognosis* ; Stroke, Lacunar ; Thalamus* ; Thromboembolism ; Tomography, X-Ray Computed

We report a case of polycythemia vera combined with coagulation disorder. The patient was 54 years old man who complained of continuous bleeding after incision of skin abscess 20days ago. Laboratory tests were revealed prolonged aPTT and slightly prolonged PT. Coagulation factor, I, VIII, IX, XI and fibrinogen decreased, however FDP did not increased. It appears that patient with polycythemia vera have chronic activation of coagulation system, probably initiated by activation of factor XII. Platelet aggregation test to ADP, collagen, epinephrine was also revealed poor response.
Abscess ; Adenosine Diphosphate ; Blood Coagulation Factors ; Collagen ; Epinephrine ; Factor XII ; Fibrinogen ; Hemorrhage ; Humans ; Platelet Aggregation ; Polycythemia Vera* ; Polycythemia* ; Skin

BACKGROUND: The most important acute complication of percutaneous transluminal coronary angioplasty (PTCA) is abrupt closure by dissection and thrombus, which account for the majority of deaths and emergency coronary artery bypass procedures associated with PTCA. We sought to determine the relationship between clinical, angiographic characteristics and abrupt thrombotic closure related to coronary intervention. METHODS: One hundred thirty two patients (61.6+/-8.0 year, 98 male) underwent PTCA or stenting under the diagnosis of acute myocardial infarction were analyzed at Chonnam University Hospital between Jan '97 and Jun '98. Patients were divided into two groups, one, 14 patients (Group A, 61.7+/-8.0 year, 9 male), who developed thrombotic occlusion, and the other, 118 patients (Group B, 61.5+/-8.0 year, 89 male) who did not develop abrupt closure related to the coronary intervention. RESULT: There were no significant differences in age, sex, risk factors, activated partial thromboplastin time, fibrinogen, erythrocyte sedimentation rate, C-reactive protein, location of lesion, branch involvement, lesion severity, AHA/ACC morphology between two groups. The incidence of intra-coronary thrombus was greater in Group A than in Group B (44% vs. 2%, p=0.025). Acute thrombotic occlusion related to the coronary interventions developed more frequently in the lesions within two days after the symptomatic onset (55% vs. 19%, p=0.035) and in the right coronary artery (RCA) lesions (55% vs. 24%, p=0.041). CONCLUSION: Predictors of abrupt thrombotic occlusion during coronary intervention in patients with acute myocardial infarction are intracoronary thrombus, earlier intervenion within 2 days after onset of aucte myocardial infarction and RCA lesion.
Angioplasty, Balloon, Coronary ; Blood Sedimentation ; C-Reactive Protein ; Coronary Artery Bypass ; Coronary Vessels ; Diagnosis ; Emergencies ; Fibrinogen ; Humans ; Incidence ; Jeollanam-do ; Myocardial Infarction* ; Partial Thromboplastin Time ; Risk Factors ; Stents ; Thrombosis

BACKGROUND AND OBJECTIVES: One of the major limitations in coronary intervention is restenosis. This study was aimed to identify clinical, angiographic and procedural factors, which may be related to the second restenosis (SR). MATERIALS AND METHOD: We studied 101 patients who underwent more than two follow-up coronary angiograms after two coronary interventions between Jan 1996 and Dec 1998 in Chonnam University Hospital (out of 4092 total coronary interventions in 3030 patients during the same period). The patients were divided into two groups according to the evidence of second restenosis (SR). Fifty two patients (Group A: 56.6+/-9.9 year, M: F=44:8) who had SR, and the other 49 patients (Group B: 53.8+/-8.5 year, M: F=44: 5) were analyzed. Clinical features, angiographic characteristics, coronary interventional procedures, and other risk factors were compared between two groups by univariate analysis and multivariate stepwise logistic regression analysis for the predictive factors of second restenosis. RESULTS: 1) The clinical variables of age, sex, clinical diagnosis, and risk factors were not different between two groups. 2) The lesion types severer than B2 by AHA/ACC classification were associated with SR (p<0.05). 3) Recurrent angina as an indication for follow up angiography was associated with SR (p<0.01). CONCLUSION: The predictive factors associated with SR were patient's subjective symptom and lesion severer than type B2 according to AHA/ACC classification.
Angiography ; Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Jeollanam-do ; Logistic Models ; Risk Factors*

Congenital coronary arteriovenous fistulas represent abnormal communication between coronary arteries and any cardiac chambers, pulmonary artery, coronary sinus, superior vena cava or pulmonary vein. A 60 year-old male patient presented with severe effort-induced chest pain radiating to left arm. Resting electrocardiogram was normal and anterior ischemia was demonstrated on stress myocardial SPECT. Coronary angiogram reve-aled very long and tortuous coronary arteriovenous fistulas originated from the left circumflex and right coronary artery, which drained into intercostal arteries. Proximal segment of left anterior descending artery stenosed about 50%. Both coronary artery fistulas were ligated and left internal mammary artery was grafted into left anterior descending artery. After surgical correction he has no cardiovascular events on 7-month clinical follow-up.
Arm ; Arteries ; Arteriovenous Fistula* ; Chest Pain ; Coronary Sinus ; Coronary Vessels ; Electrocardiography ; Fistula ; Follow-Up Studies ; Humans ; Ischemia ; Male ; Mammary Arteries ; Middle Aged ; Pulmonary Artery ; Pulmonary Veins ; Tomography, Emission-Computed, Single-Photon ; Transplants ; Vena Cava, Superior

Pacemaker Runaway is a rare, but potentially lethal complication after pacemaker implantation. Pacemaker runaway was one of the common manifestations of malfunctioning pacemaker at the time of fixed rate pacemaker, but has been less common after the demand type pacemaker had replaced the fixed rate model. The early recognition of runaway pacemaker is very important because runaway pacemaker can cause bradyarrhythmia, ventricular tachycardia-fibrillation and asystole resulting in syncope or death. We report a clinical experience of runaway pacemaker in 68 year-old woman, who received permanent pacemaker implantation(fixed rate 72/min, VVI, Micropulse 22U, Edwards system) due to sick sinus syndrome eight years ago. She complained of sudden chest tightness and dyspnea 10 days prior to admission. On physical examination, increased jugular venous pressure, rapid heart beats, basal rales on both lung fields and three finger-breath tender hepatomegaly. Electrocardiogram showed a rapid pacemaker rhythm of 140 beats per minute. So, the malfunctioning pacemaker was removed and replaced with a new programmable demand type pacemaker(VVI, OPTIMA-MP, Telectronics) in the same pocket under the diagnosis of pacemaker runaway. Her subject symptoms were relieved and electrocardiogram showed a regular pacemaker rhythm of 71 BPM. She was discharged ten days after pacemaker replacement.
Aged ; Bradycardia ; Child ; Diagnosis ; Dyspnea ; Electrocardiography ; Female ; Heart ; Heart Arrest ; Hepatomegaly ; Homeless Youth* ; Humans ; Lung ; Physical Examination ; Respiratory Sounds ; Sick Sinus Syndrome ; Syncope ; Thorax ; Venous Pressure