Feasibility of Transradial Coronary Angiography Using a Single Judkins Left Catheter

BACKGROUND AND OBJECTIVES: Transradial coronary angiography and intervention are getting more popularity throughout the world because of lower incidence of puncture site complications and the patients have displayed early ambulation. However, radial arterial spasms and possible endothelial injury due to the small size of radial artery are troublesome. To overcome this problem, we investigated the usefulness of performing transradial coronary angiography using a single Judkins left catheter (JL). SUBJECTS AND METHODS: A total of 268 patients who underwent right transradial coronary angiography from June 2003 to December 2003 were enrolled for this prospective study. The Judkins Left 3.5(JL3.5), the Multipurpose (MP) and Amplatz Left (AL2 for males, AL1 for females) were assigned to be used in patients with a randomized protocol. The technical/angiographic success rate, procedural/fluoroscopic time and the frequency of stiffwire usage were assessed. RESULTS: Technical success was accomplished in 87 (96.7%) of the patients with a single JL3.5, in 90 (97.8%) of the patients with the MP and in 83 (96.5%) of the patients with the AL catheter. Successful angiography success was achieved in 77 (85.6%) of the patients using the JL3.5, in 71 (77.2%) of the patients using the MP and in 66 patients (76.7%) using the AL. The technical success rate (p=0.270) and the angiographic success rate (p= 0.162) showed no significant difference among the three catheters. The procedural time was 8.1+/-4.0 min in the JL3.5 group, 8.1+/-3.7 min in the MP group and 7.3+/-3.4 min in the AL group, respectively (p=0.431). Also, the fluoroscopic time was not different among the three groups. CONCLUSION: The JL3.5 catheter is an excellent tool for both coronary imaging and it is equally successful as compared with the MP and AL catheters. Therefore, the JL3.5 may be considered as the initial catheter that can be used, including for those difficult cases having tortuous vasculature of the subclavian artery and the ascending aorta, during transradial coronary angiography.

A case of the overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis / 대한내과학회지

Primary biliary cirrhosis and autoimmune hepatitis are the two main immune-mediated liver diseases. They are generally differentiated easily on the basis of clinical, biochemical, serological, and histological findings. Occasionally, the normally distinctive features overlap and classification of a given patient's chronic liver disease is difficult. Series of such patients with Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome were reported. We report a case of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome proven by clinicopathology. The patient showed hepatitic features including easy fatigability, icteric sclera. Markers of hepatitis B and C virus were absent. The liver biopsy showed chronic hepatitis with piecemeal necrosis, infiltration of inflammatory cell surrounding bile duct. The clinical data of high titers of antinuclear antibodies and antimitochondral antibodies, elevated serum IgM, suggest mixed features of primary biliary cirrhosis-autoimmune hepatitis. The patient as given only ursodeoxycholic acid (600 mg/day), then was observed follow-up regularly.

A Case of Strongyloidiasis Associated with Intestinal obstruction in a Patient with Alcoholic Liver Disease / 감염과화학요법

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.

A Case of Strongyloidiasis Associated with Intestinal obstruction in a Patient with Alcoholic Liver Disease / 감염과화학요법

Human is infected by third stage filariform larvae of Strongyloides stercoralis which is a soil-transmitted nematode. Rhabditiform larvae passed in feces can transform into infectious filariform larvae either directly or after a free living phase of development. Most infected patients may be asymptomatic or have mild cutaneous symptoms or induces non-specific complaints such as moderate abdominal pain, nausea and diarrhea. However, in immunocompromised hosts, the parasite is augmented by autoinfection, resulting in hyperinfection and can disseminate widely and can be fatal. We report a case of strongyloidiasis associated with intestinal obstruction in a patient with alcoholic liver disease.