ABSTRACT
The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.
ABSTRACT
The radial artery is generally the preferred access route in coronary angiography and coronary intervention. However, small size, spasm, and anatomical variations concerning the radial artery are major limitations of transradial coronary intervention (TRI). We describe a successful case involving a patient with coronary artery disease who underwent TRI via a well-developed radial recurrent artery branch from the radioulnar alpha loop using a sheathless guiding catheter.
Subject(s)
Humans , Arteries , Catheters , Coronary Angiography , Coronary Artery Disease , Percutaneous Coronary Intervention , Radial Artery , SpasmABSTRACT
BACKGROUND/AIMS: Adenosine deaminase (ADA) is a valuable biochemical marker for pericardial effusion (PE) and may be useful for diagnosing tuberculous pericarditis (TPE) in patients with PE. However, no definite cut-off or borderline values for ADA currently exist to distinguish TPE from other PE etiologies. In this study, we identified other useful parameters and characterized their relationship with ADA as a method for diagnosing TPE. METHODS: From June 2004 to November 2011, 42 patients underwent pericardiocentesis due to moderate or severe PE, as confirmed by echocardiography or chest computed tomography (CT). Patients were subdivided into TPE and non-TPE (NTPE) groups. We analyzed ADA (p) (the pericardial ADA) and %Lymph (p)/Glucose (p) (the ratio between the percentage of lymphocytes and glucose levels in PE). RESULTS: We defined the cut-off value of ADA (p) as 48.5 IU/L, and that of %Lymph (p)/Glucose (p) as 0.678%.dL/mg. In a multivariate logistic regression analysis, an odds ratio (OR) of 44.24 and a 95% confidence interval (CI) of 2.85-686.97 were observed in patients with an ADA (p) > or = 48.5 IU/L (p = 0.023). An OR of 20.39 and a 95% CI of 1.06-392.93 were observed in patients with a %Lymph (p)/Glucose (p) > or = 0.678%.dL/mg (p = 0.046). The combination of ADA (p) and %Lymph (p)/Glucose (p) had a higher positive predictive value (PPV, 80.0%) and specificity (Sp, 93.8%) than either ADA (p) (PPV, 47.4%; Sp, 68.8%) or %Lymph (p)/Glucose (p) (PPV, 69.2%; Sp, 87.5%) alone. CONCLUSIONS: %Lymph (p)/Glucose (p) is a useful parameter for distinguishing TPE from other pericardial diseases if combined with an ADA (p) > or = 48.5 IU/L.
Subject(s)
Humans , Adenosine Deaminase , Biomarkers , Echocardiography , Glucose , Logistic Models , Lymphocytes , Odds Ratio , Pericardial Effusion , Pericardiocentesis , Pericarditis, Tuberculous , Sensitivity and Specificity , ThoraxABSTRACT
Whether the metabolic syndrome (MetS) has prognostic value for coronary artery disease (CAD) beyond its individual components is controversial. We compared the relationship between the number of MetS components and CAD severity as assessed by angiography in non-diabetic and diabetic subjects. We consecutively enrolled 527 patients who underwent their first coronary angiography. Patients were divided into four groups according to the number of MetS components: 0/1, 2, 3, and 4/5. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between the MetS score and angiographic CAD severity or clinical presentation was compared between non-diabetic and diabetic subjects. Individuals with the MetS (n = 327) had a higher prevalence of CAD (60% vs 32%, P < 0.001), multi-vessel disease (34% vs 16%, P < 0.001), and acute coronary syndromes (49% vs 26%, P < 0.001) than those without the MetS. In the non-diabetic group, atherosclerosis score increased with the MetS score (1.0 +/- 2.1, 2.0 +/- 2.9, 2.8 +/- 2.9, and 3.6 +/- 3.9, P < 0.001) whereas there was no significant difference in the diabetic group (0.5 +/- 1.0, 5.2 +/- 4.7, 4.2 +/- 2.9, and 4.4 +/- 3.5, P = 0.102). The MetS score is related to CAD severity in non-diabetic patients but the association between the MetS score and angiographic CAD severity may be obscured in the presence of diabetes.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Coronary Angiography , Coronary Artery Disease/complications , Diabetes Mellitus, Type 2/complications , Metabolic Syndrome/complications , Odds Ratio , Prognosis , Republic of Korea , Risk Factors , Severity of Illness IndexABSTRACT
Ovarian malignancy can rarely present as a colonic mass and simulate colon cancer. Mullerian anomalies are congenital anatomic abnormalities of the female internal genitalia, of which a unicornuate uterus is a rare subtype. Several cases of gynecologic malignancies arising in Mullerian anomalies have been described. However, an ectopic ovarian malignancy in conjunction with a unicornuate uterus has never been reported. We report a case of ectopic ovarian mixed epithelial tumor, a very rare subtype of ovarian epithelial tumor, which presented as a colonic mass simulating colon cancer in a woman with a unicornuate uterus.
Subject(s)
Female , Humans , Colon , Colonic Neoplasms , Genitalia , Mullerian Ducts , Ovary , UterusABSTRACT
Ovarian malignancy can rarely present as a colonic mass and simulate colon cancer. Mullerian anomalies are congenital anatomic abnormalities of the female internal genitalia, of which a unicornuate uterus is a rare subtype. Several cases of gynecologic malignancies arising in Mullerian anomalies have been described. However, an ectopic ovarian malignancy in conjunction with a unicornuate uterus has never been reported. We report a case of ectopic ovarian mixed epithelial tumor, a very rare subtype of ovarian epithelial tumor, which presented as a colonic mass simulating colon cancer in a woman with a unicornuate uterus.
Subject(s)
Female , Humans , Colon , Colonic Neoplasms , Genitalia , Mullerian Ducts , Ovary , UterusABSTRACT
BACKGROUND: Catheter-related bloodstream infections (CR-BSIs) are common, costly, and potentially lethal. The purpose of this study was to ascertain the effect of maximal sterile barrier on CR-BSIs in intensive care units. METHODS: We monitored CR-BSIs in intensive care units of Sunlin Hospital in Pohang, before (September 2005 to May 2006) and after (June to December 2006) implementation of maximal sterile barrier. CR-BSIs were identified by using the definition of Centers for Disease Control and Prevention. RESULTS: During the intervention period, the proportion of conducting maximal sterile barrier was 84%. In the pre-intervention period, 10 episodes of CR-BSIs were recorded out of a total of 1,749 catheter-days, compared to 1 episode of CR-BSI out of a total of 1,277 catheter-days in the post-intervention period. The rate of CR-BSIs was significantly reduced from 5.72 to 0.57 per 1,000 catheter-days (P=0.03). CONCLUSION: Implementation of maximal sterile barrier resulted in a significant reduction in CR-BSIs.