This study was designed to determine if topical cardiac hypothermia is a necessary adjunct to intraoperative myocardial protection. In this study, 105 patients ranging in age from 22 to 74 years were included. Myocardial temperature was measured at the ventricular septum. All patients received cold blood cardioplegia without topical cooling. In most of the patients(90%) the myocardial temperature was dropped to 10-15degrees C without topical cooling. In Group A, myocardial temperature was dropped rapidly to 10-15degrees C with, 1,000ml or less cardioplegic solution. In Group B, the amount of cardioplegic solution required for lowering myocardial temperature to 10-15degrees C was 1,000-2,000ml. In Group C, myocardial temperature was not dropped below 18degrees C or cardioplegic solution over 2,000ml was required for lowering myocardial temperatur. Eight patients(8/61, 8%) in group A, 12 patients(12/35, 34%) in group B and 8 patients(8/9. 89%) in group C had Complete obstructive lesions in at least one of major branches of coronary artery(p=0.001). Myocardial perfusion score was different among the groups(8.27+/-2.27 in group A, 9.98+/-2.21 in group B, 10.30+/-2.49 in group C, p<0.002). These data suggest that routine topical hypothermia may be unnecessary if myocardial temperature of less than 15degrees C could be attained with cold blood cardioplegia, especially in case of myocardial perfusion score below 10.
Cardioplegic Solutions* ; Heart Arrest, Induced ; Humans ; Hypothermia ; Perfusion ; Ventricular Septum

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

BACKGROUND AND OBJECTIVES: The goal of this study was to examine the safety and feasibility of a primary (direct) stenting in acute myocardial infarction (AMI). In the treatment of AMI, Percutaneous transluminal coronary angioplasty (PTCA) has documented superior reperfusion rate and improved clinical outcomes than thrombolytic therapy. However, there are several limitations of PTCA, such as recurrent ischemia in 10 to 15%, reinfarction in 3 to 5% and restenosis in 30 to 50% of patients. There are several reports that, compared with PTCA, the implantation of coronary stent has been shown to reduce angiographic restenosis and improve late clinical outcomes. But in general, stenting has been contraindicated in thrombus containing lesion due to the risk of subacute thrombosis. With advance in technique and the recognition of the importance of adequate platelet inhibition, the incidence of subacute thrombosis has fallen in patients with acute coronary syndrome and thrombus laden lesion. Methods and Results: In our study, primary stenting was performed in 42 patients of AMI. There are 6 cases (22.5%) target lesion restenosis during the follow up coronary angiography (150+/-86day) and no in-hospital death. Three cases (7.1%) of them require revascularization including two re-PCTA and a coronary artery bypass graft for the recurrent ischemic symptoms. There were no reinfarction and death after discharge. Six-months event free survival reate was 85.7%. CONCLUSION: Primary stenting is safe and feasible in the majority of patients with AMI and results in excellent mid-term outcomes compared with PTCA.
Acute Coronary Syndrome ; Angioplasty, Balloon, Coronary ; Blood Platelets ; Coronary Angiography ; Coronary Artery Bypass ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Transplants

Bicuspid ; Crowding ; Humans ; Incisor ; Malocclusion ; Orthognathic Surgery ; Orthopedics ; Osteotomy ; Palatal Expansion Technique ; Recurrence ; Temporomandibular Joint ; Temporomandibular Joint Disorders

No abstract available.

No abstract available.
Candida albicans* ; Candida*

Zonisamide was administered to 20 patients with refractory epileptic seizures. The mean duration of the administration was 6 months, and the mean dosage was 7.2 mg/kg/day. The efficacy of zonisamide was rated remarkable in 15% of the cases, improvement in 40%, and no change in 45%. The response rates of zonisamide were 62.5% for myoclonic seizures, 50% for tonic-clonic seizures, 80% for atonic seizures and 33.3% for atypical absence seizures. There was no correlation between the clinical response and dose or serum concentration of the drug. The adverse effects were observed in 35% of the cases which were drowsiness, dizziness, ataxia, nausea, and vomiting. In all cases, however, the administration of zonisamide could be continued.
Ataxia ; Child* ; Dizziness ; Epilepsy* ; Epilepsy, Absence ; Humans ; Nausea ; Seizures ; Sleep Stages ; Vomiting

No abstract available.
Pregnancy*