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Biomedical subjects

H Y Yune

Publications and source records attributed to H Y Yune.

At least 37 records · Page 2Linked to original sources
PubMed1983

Unilateral hypersecretion of aldosterone associated with adrenal hyperplasia as a cause of primary aldosteronism.

In 3 patients with longstanding hypertension and spontaneous or diuretic-induced hypokalemia, the diagnosis of primary aldosteronism was established by the dual criteria of non-suppressible plasma aldosterone level and suppressed plasma renin activity. Preoperative studies of the etiology for the hyperaldosteronism using the postural plasma aldosterone test and adrenal venous steroid measurements gave conflicting results. On the basis of the differential adrenal venous steroid content, which suggested an unilateral adrenal source for the aldosterone hypersecretion, presumed to be adrenal adenoma, each patient was operated upon. In each case the excised adrenal revealed adenomatous or macronodular hyperplasia. Reinvestigation of the patients 3 to 12 months after the adrenalectomy showed that the dynamics of the renin-aldosterone axis was now restored to the normal state even though the patients remained hypertensive. These findings indicate that unilateral hypersecretion of aldosterone associated with adrenal hyperplasia can occur in some patients with primary aldosteronism simulating that due to an aldosteronoma. Such observations also raise questions about the pathogenesis of the adrenal hyperplasia and seem to add further complexity to the evaluation of patients with hyperaldosteronism.

Adrenal Cortex↗
PubMed1983

Klippel-Feil syndrome and associated ear deformities.

The Klippel-Feil syndrome is characterized by a short, thick neck with restricted head mobility and a low occipital hairline. The head appears to rest directly on the thorax and the trapezius muscles flare out on either side of the neck, producing a pterygium-like effect. Cervical roentgenograms demonstrate fusion of some or even all of the vertebral bodies into bony blocks. Ear deformities occur in approximately one-third of the Klippel-Feil patient population. We report five cases of Klippel-Feil syndrome and describe their otologic and roentgenographic features. Although no single characteristic otologic or audiologic problem is identified, a proclivity for major malformations of involved ears is demonstrated. Early audiometric and otologic evaluation is indicated when the diagnosis of Klippel-Feil syndrome is made.

Adolescent↗
PubMed1982

Contrast extravasation through Dacron grafts: a sequela of low-dose streptokinase therapy.

Local transcatheter administration of low-dose streptokinase for the treatment of thrombosed Dacron grafts was performed in four patients. Angiography after the infusion revealed extravasation of contrast material through the interstices of the graft. In each case the graft material was knitted Dacron, Surgically placed 1 month to 6 years before infusion with streptokinase. The fibrinolytic activity of streptokinase is likely responsible for lysis of the fibrin in the interstices of the graft with resultant extravasation of contrast material.

Aged↗
PubMed1982

Renal tumor infarction with absolute ethanol.

Sixteen renal tumors were infarcted with intraarterial absolute ethanol. Renal tumor infarction was performed for one of three indications: for palliation of symptoms in patients with metastatic disease, as a preoperative measure to reduce blood loss during radical nephrectomy, or as a primary therapy in selected circumstances. In most cases, absolute ethanol was injected into the main renal artery through a balloon occlusion catheter. In all cases, ethanol produced effective infarction of the renal tumor. Only one complication developed, a perinephric abscess that developed several weeks after the infarction. Results indicate that absolute ethanol is a safe and effective agent for the infarction of renal tumors.

Adenocarcinoma↗
PubMed1982

Efficacy of balloon catheter dilatation for lower extremity atherosclerosis.

Since there are few data regarding complications and long-term efficacy of balloon catheter dilatation for advanced lower extremity atherosclerosis, we are reporting our experience with 132 attempted dilatations in 88 patients. Dilatation was attempted on 51 aortoiliac-common femoral lesions, 80 superficial femoral-popliteal lesions and 1 peroneal lesion. Twenty procedures were technically unsuccessful and led to urgent surgery in three patients. Thirty-one complications in the 109 technically successful dilatations led to emergency surgery in only one, but another required closure of an arteriovenous fistula at the site of catheterization. There were three episodes of embolism, but none required operation. In 109 dilatations monitored for 1 month, there was significant hemodynamic improvement in 52 and mild to moderate improvement in 37; 10 had no change; 10 occluded at the site of dilatation. Of the 42 patients observed 6 months or longer, 11 maintained a significant increase, and 15 had mild to moderate improvement; 11 reverted to predilatation levels; 1 had progressive worsening; 4 occluded. Sixteen patients who had significant increases in flow after dilatation and were followed longer than 6 months showed a trend to restenosis as the length of follow-up increased. We conclude that dilatation is a useful adjunctive procedure in treating lower extremity atherosclerosis, that the early results are good, and that the incidence of recurrent stenosis is high. Indications for dilatation and its complications are similar to those for operations. It should not be done without hemodynamic monitoring.

Aged↗
PubMed1981

Percutaneous transluminal dilatation or surgery in the management of renal vascular hypertension?

1. Twelve patients with renal artery stenosis due to fibromuscular disease (FMD) were treated with percutaneous transluminal dilation (PTD) and their results (first year) compared with those for 26 patients treated with attempted renal artery bypass. The cumulative probability of cure at 1 year was 0.67 for PTD and 0.36 for surgery (P = N.S.) in patients with FMD. The cumulative probability of being improved or cured was 0.92 for PTD and 0.88 for surgery. 2. Eighteen patients with renal artery stenosis due to atherosclerosis were treated with PTD and their results compared with those of 28 patients treated by surgery. The cumulative probability of cure at 1 year was 0.11 for PTD and 0.17 for surgery (P = N.S.). The cumulative probability for cure or improvement at 1 year was 0.30 for PTD and 0.88 for surgery (P less than 0.001). 3. We conclude that PTD may be a satisfactory alternative to surgery in fibromuscular disease, but is inferior to surgery in atherosclerotic disease causing renal artery stenosis. 4. A randomized clinical trial is needed to define the role of PTD and surgery in renal artery stenosis.

Adult↗
PubMed1981

Percutaneous transluminal dilatation in the treatment of renal vascular hypertension.

Twenty-six patients with renal vascular hypertension were treated with percutaneous transluminal dilatation. Twenty-one were followed for more than 1 year; 18 underwent repeat angiography. Recurrence of stenosis was shown angiographically in one of six patients with fibromuscular disease and in 12 of 12 patients with atherosclerotic disease. The procedure was more likely to result in cure of hypertension (six of 10) in patients with fibromuscular disease than in patients with atherosclerotic disease (one of 16). Although percutaneous transluminal angioplasty provides the advantages of simplicity, reduced cost, and probably reduced risk, long-term utility of the procedure remains to be established. A prospective randomized trial, establishment of a registry, or both would serve this purpose.

Adolescent↗
PubMed1981

Computed tomography of the temporal bone.

Computerized tomography (CT) is useful in otolaryngology, particularly in those patients with pathology of the posterior fossa and skull base. With the current development and improvement of CT scanners, the more detailed anatomy of the temporal bone can now be evaluated. For interpretation, detailed knowledge of the temporal bone and skull base anatomy is essential. The methodology of CT scanning of the temporal bone is presented along with a detailed description of the anatomy both in the axial and the coronal projections. A review of the current CT literature on the temporal bone is with discussion of the advantages and limitations of this diagnostic tool.

Humans↗
PubMed1981

Trisomy 7 mosaicism and manifestations of Goldenhar syndrome with unilateral radial hypoplasia.

We describe a girl born to a mother who took birth control pills and antihistamines during the first trimester of pregnancy. Congenital abnormalities included plagiocephaly, abnormalities of left ear, facial asymmetry, abnormalities of head hair pattern, cleft lip and palate, bifid tongue, left torticollis, hemivertebrae, left radial hypoplasia and absent thumb, left inguinal hernia, patient ductus arteriosus, narrowing of the thoracic aorta, and hypoplastic right pulmonary artery. The karyotype obtained from peripheral lymphocytes and from fibroblasts from the left side of the body was 46XX whereas fibroblasts from the right side revealed 46XX/47XX+7 mosaicism.

Child↗
PubMed1980

Transluminal balloon dilatation of renal artery stenosis causing hypertension: 18 months' experience.

1. We have treated 25 patients with renovascular hypertension with balloon catheter dilatation. 2. In 17 patients, surgical treatment was thought to be either risky or difficult due to the presence of a serious medical condition or because of the peripheral location of the lesion. 3. Seventeen patients had atherosclerotic lesions, six patients had fibromuscular dysplasia and one patient had neurofibromatosis and one had stricture of an aorto-renal bypass graft. 4. Of the total group, six in the atherosclerotic group, three patients with fibromuscular dysplasia and the one with neurofibromatosis are normotensive without medications. 5. Five patients with atherosclerosis, two patients with fibromuscular dysplasia and the patient with aorto-renal bypass graft are either normotensive or have reasonable control of blood pressure with medication. 6. Four technical and treatment failures and three major medical complications were encountered. Recurrence of stenosis occurred in eight patients but none of these was in the fibromuscular dysplasia group.

Arteriosclerosis↗
PubMed1980

Clinical experience with percutaneous transluminal angioplasty (PTA) of stenotic renal arteries.

During an 18-month period, percutaneous transluminal angioplasty (PTA) was performed in 66 patients who had renal artery stenosis. All of the patients were hypertensive, and 12 were in renal failure. Of 52 patients with renovascular hypertension in whom dilatation was achieved, 23 (44%) are cured and 25 (48%) are improved. Four (8%) did not respond to attempted dilatation. Of the 12 patients in renal failure, two (17%) are now out of failure, seven (58%) are stable, and one (8%) is slowly deteriorating after an initial favorable response. Significant complications were noted in two patients (17%) in this group. While the initial results are promising, a long-term study of this technique is indicated.

Acute Kidney Injury↗
PubMed1979

Diagnosis and localization of pheochromocytoma. Detection by measurement of urinary norepinephrine excretion during sleep, plasma norepinephrine concentration and computerized axial tomography (CT-scan).

The feasibility of differentiating patients with pheochromocytoma from other hypertensive patients by measuring urinary excretion rates of norepinephrine during sleep, a period of physiologic suppression of norepinephrine release, was investigated. The mean excretion rates of norepinephrine in 248 normal subjects and in 109 patients with essential hypertension were 1.03 +/- 0.03 and 1.12 +/- 0.06 (SEM) micrograms/hour, respectively, whereas the lowest excretion rate among the six patients with pheochromocytoma was about seven times higher. Plasma norepinephrine concentration in patients with pheochromocytoma was also consistently above the range observed in both normotensive and hypertensive subjects. CT scan correctly identified the same tumors visualized by selective arteriography. It is suggested that the usefulness of these approaches will provide simpler means of screening and detecting pheochromocytoma.

Adolescent↗