Purpose: In a preclinical study using a swine myocardial infarction (MI) model, a delayed enhancement (DE)-multi-detector computed tomography (MDCT) scan was performed using a hybrid system alongside diagnostic invasive coronary angiography (ICA) without the additional use of a contrast agent, and demonstrated an excellent correlation in the infarct area compared with histopathologic specimens. In the present investigation, we evaluated the feasibility and diagnostic accuracy of a myocardial viability assessment by DE-MDCT using a hybrid system comprising ICA and MDCT alongside diagnostic ICA without the additional use of a contrast agent. Materials and Methods: We prospectively enrolled 13 patients (median age: 67 years) with a previous MI (>6 months) scheduled to undergo ICA. All patients underwent cardiac magnetic resonance (CMR) imaging before diagnostic ICA. MDCT viability scans were performed concurrently with diagnostic ICA without the use of additional contrast. The total myocardial scar volume per patient and average transmurality per myocardial segment measured by DE-MDCT were compared with those from DE-CMR. Results: The DE volume measured by MDCT showed an excellent correlation with the volume measured by CMR (r=0.986, p<0.0001). The transmurality per segment by MDCT was well-correlated with CMR (r=0.900, p<0.0001); the diagnostic performance of MDCT in differentiating non-viable from viable myocardium using a 50% transmurality criterion was good with a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 87.5%, 99.5%, 87.5%, 99.5%, and 99.1%, respectively. Conclusion The feasibility of the DE-MDCT viability assessment acquired simultaneously with conventional ICA was proven in patients with chronic MI using DE-CMR as the reference standard.

Radiofrequency ablation (RFA) is a minimally invasive local therapy for hepatocellular carcinoma (HCC). Even though RFA is considered to be a safe treatment modality, a variety of complications have been reported. Recently, we encountered a case of refractory fistula between a liver abscess and the gallbladder after RFA. A 64-year-old woman diagnosed with HCC associated with chronic hepatitis B was treated by RFA. After RFA, she experienced abdominal pain, and abdominal computed tomography (CT) revealed a liver abscess complicated by a previous treatment of HCC, she was treated with intravenous antibiotics and percutaneous abscess drainage. Follow-up abdominal CT revealed a fistula between the liver abscess and gallbladder, which was successfully treated with percutaneous transcatheter n-butyl-2-cyanoacrylate (NBCA) embolization. We herein report the rare case of a refractory fistula between a liver abscess and the gallbladder after RFA in a patient treated with NBCA embolization.
Abdominal Pain ; Abscess ; Anti-Bacterial Agents ; Carcinoma, Hepatocellular ; Catheter Ablation ; Drainage ; Enbucrilate ; Female ; Fistula ; Follow-Up Studies ; Gallbladder ; Hepatitis B, Chronic ; Humans ; Liver Abscess ; Middle Aged ; Tomography, X-Ray Computed

BACKGROUND: Gated myocardial perfusion SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls, ejection fraction as well as myocardial perfusion. Many studies suggested that there was a decrease of left ventricular ejection fraction (LVEF) at post-stress compared with that at rest gated myocardial perfusion SPECT (stunning). The objective of this retrospective study is to evaluate the clinical significance of the decrease of LVEF at post-stress gated myocardial perfusion SPECT by correlating with coronary angiographic finding. METHODS: Authors selected 41 patients who underwent exercise electrocardiography and gated myocardial perfusion SPECT between May, 2001 and May, 2002. The patients underwent coronary angiography within 6 months. The patients were divided into two groups, 16 patients in whom post-stress LVEF was >or=5% lower than rest (stunning group) and 25 patients in whom LVEF was not >or=5% lower than rest (non-stunning group). RESULTS: The number of patients with hyperlipidemia was higher in stunning group than in non-stunning group (50% vs 4%, p=0.001). The number of patients with angiographic stenoses >90% was significantly higher in stunning group than in non-stunning group (75% vs 28%, p=0.04). The number of patients with multi-vessel disease was also significantly higher in stunning group than in non-stunning group (75% vs 36%, p=0.015). CONCLUSION: The patients who had a decreased LVEF after stress (stunning) showed more severe coronary artery stenosis. This finding suggests that stunning may be an important additional indicator of underlying myocardial ischemia.
Constriction, Pathologic ; Coronary Angiography ; Coronary Artery Disease ; Coronary Stenosis ; Electrocardiography ; Humans ; Hyperlipidemias ; Myocardial Ischemia ; Myocardial Stunning ; Perfusion* ; Retrospective Studies ; Stroke Volume* ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Syncope is a sudden and brief loss of consciousness associated with a loss of postural tone, from which recovery is spontaneous. The most frequently identified causes of syncope are neurocardiogenic, cardiac, cerebrovascular and side effects of drugs. However, in many cases, it is not easy to make a diagnosis of syncope. The prevalence rate of syncope also is variable according to the nature of the study. We investigated the prevalence rate, characteristics and triggering factors of syncope in young medical students. METHODS: We contacted 400 medical students of Kyungpook National University, Daegu, Korea, and a questionnaire on the prevalence, triggering factors, and recurrence rate of syncope was handed out. The data from 379 medical student (male 168, female 211, mean age 22.3 years) were included for further analysis. RESULTS: Fifty-eight students (15.3%) experienced syncope and female students reported higher prevalence rate than male students (20.4 versus 8.9%, p=0.002). Among 58 students with syncopal history, 22 students (male 2, female 20) experienced recurrent syncope. The students who experienced recurrent syncope were younger at first syncope than those without recurrent syncope (15.0 versus 17.3 years, p=0.039). The triggering factors of syncope were prolonged standing, warm environment, immediate standing, tiredness, emotional upset, menstruation, and so on. CONCLUSION: The prevalence rate of syncope was 15% in medical student with mean age of 22.3 years. As the syncope in female and early onset syncope showed higher rate of recurrence, more attention may prevent recurrent syncope in these cases.
Daegu ; Diagnosis ; Female ; Gyeongsangbuk-do ; Hand ; Humans ; Korea ; Male ; Menstruation ; Prevalence* ; Recurrence ; Students, Medical* ; Syncope* ; Unconsciousness ; Surveys and Questionnaires

Bleeding from anastomotic site in operation for aorta has been troublesome, because it has influence on postoperative morbidity and mortality. Therefore, hemostasis is very important. We describe a simple and effective method for achieving hemostasis of the anastomotic site in aortic surgery. By wrapping around anastomotic site with remnant artificial vascular graft, we have acquired good results.
Aorta ; Hemorrhage ; Hemostasis* ; Mortality ; Transplants*

BACKGROUND: An antioxidant, probucol, prevents endothelial dysfunction and low density lipoprotein oxidation and also inhibits the secretion of interleukin-1 by macrophages. These effects of probucol may result in decreased production of matrix metalloproteinases by smooth muscle cells and thus modify remodeling of the extracellular matrix. METHODS AND MATERIALS: We analyzed clinical events at 1 month and 6 months in 337 patients with 363 coronary arterial lesions after coronary stenting at Chonnam National University Hospital between January 1998 and May 1999. The patients were assigned to following four modalities: 500 mg of tilcipidine daily (Group I), 200 mg of cilostazol daily (Group II), 500 mg of probucol in addition to 500 mg of ticlipidine daily (Group III), and 500 mg of probucol in addition to 200 mg of cilostazol daily (Group IV). All patients received aspirin. RESULTS: Group I comprised of 149 (104 M, 45 F, 62+/-10 years), Group II 96 (73 M, 23 F, 60+/-10 years), Group III 50 (32 M, 18 F, 61+/-10 years), and Group IV 42 (32 M, 10 F, 62+/-10 years) patients. Clinical diagnosis was not different among four groups. Major adverse cardiac events, including myocardial infarction, cardiac death, and repeated intervention, at 1 month were 7 (4.7%) in Group I, 2 (2.1%) in Group II, 0 (0%) in Group III, 2 patients (4.8%) in Group IV, and those at 6 months were 29 (19.5%) in Group I, 17 (17.7%) in Group II, 9 (18.0%) in Group III, and 6 patients (14.3%) in Group IV. CONCLUSIONS: Probucol combined with aspirin and cilostazol has a tendency reducing the major cardiac events compared with aspirin and ticlopidine or cilostazol after stenting.
Aspirin ; Death ; Diagnosis ; Extracellular Matrix ; Humans ; Interleukin-1 ; Jeollanam-do ; Lipoproteins ; Macrophages ; Matrix Metalloproteinases ; Myocardial Infarction ; Myocytes, Smooth Muscle ; Probucol* ; Stents* ; Ticlopidine

No abstract available.
Adult* ; Cytarabine* ; Cytosine* ; Humans ; Leukemia* ; Mitoxantrone*

No abstract available.
Drug Therapy, Combination* ; Lymphoma, Non-Hodgkin*