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KMID : 0378019620050040111
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New Medical Journal
1962 Volume.5 No. 4 p.111 ~ p.119
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Pulseless Disease
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ÍîìÙûÇ/Kong, In Ho
ï÷ñØ/õËܼÙò/ì°Ò»Ð³/ê÷٤Ш/ì°á¡âª/ÑÑé¸ìé/Chung Choon/Choi, Byung Moo/Lee, Yung-Kyoon/Lyu, Myung Kyu/Lee, Sung Soo/Kim, Yong Il
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Abstract
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A 25 year old Korean woman was admitted with chief complaints of non-palpable radial pulse and cerebral vascular insufficiency.
One year prior to admission she suffered from headache, dizziness, syncopal attacks, and visual disturbance. At that time she was told her radial pulse on both sides were not palpable.
Pertinent physical findings were bilateral cataracts. A-V anastomosis of retinal vessels, non-palpable pulses on both upper¢¥ extremities and common carotid arteries.
Chest and abdomen were negative. Albuminuria was noted. Retrograde aortography to visualize the major branches of aortic arch failed because of inability to insert Amplatz catheter beyond the upper margin of 2nd vertebra.
A Nylon bifurcation bypass graft was inserted between ascending aorta and bilateral carotid arteries under general hypothermia (30C). Patient expired 2 nd post-operative day without gaining consciousness post-operatively.
On autopsy, important pathologic processes were observed in the vascular system. All arteries arising from the aortic arch were al-most occluded with organized and recanalized thrombi, being associated with severe atherosclerosis and also with arteritic changes, including lymphocytic infiltration in the adventitia and junction between media and adventitia, and intimal and adventitial thickening. Giant cells were not observed through all layers of the thrombotic vessels. The aorta showed marked atherosclerosis and calcification in all segments, and coarctation of lumbar segment 7cm proximal to bifurcation of common iliac arteries. The heart revealed findings of the arteriosclerotic cardiovascular disease. Multiple recent cerebral infarcts measuring 1.5 X 1.5 cm to 2.5 X 3.0 cm were observed in the bilateral lower temporal and parietal regions of the cerebral cortices. The weight of the right and left lungs were 470 gm and 430 gm respectively, and moderate acute bronchopneumonia was observed in the lower lobes of both lungs. There was moderate degree of diffuse fibrous obliteration of bilateral pleural cavities. There were moderate generalized passive congestion and edema of viscera, especially in lungs, liver, spleen and brain.
This is believed to be the first autopsy case with clinical symptoms of pulseless disease reported in the Korean literature.
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