No abstract available.

No abstract available.
Extracorporeal Circulation* ; Heart* ; Potassium* ; Thoracic Surgery*

No abstract available.
Immunosuppression* ; Prognosis* ; Transplantation*

Vascular surgeons encounter a myriad of complications during the management of patients. The complications that occur associated with vascular surgery are often life threatening. Vascular surgeons have played a pioneering role in the development and introduction of new vascular and endovascular techniques, and some of the techniques changed the therapeutic options available for patients with vascular disease. Especially, with the development of endovascular surgery, there has been substantial change in the management of most vascular diseases and their complications. The best way to manage complications is to prevent them from occurring by careful planning, appropriate patient selection, extensive operator experience, and the correct use of appropriate devices. Successful operation outcomes depend on avoiding complications, as well as recognizing and promptly managing complications when they occur. This article reviews various local complications and their management in the field of vascular and endovascular surgery.
Endovascular Procedures ; Humans ; Patient Selection ; Vascular Diseases

BACKGROUND: Exercise testing is an importnat diagnostic and prognostic procedure in the assessment of patients with ischemic heart disease. But standard ST-segment depression criteria was not high enough to estimate coronary srtery disease. Recently, the heart rate adjustment of ST segment depression, ST segment/heart rate slope and index, have been proposed as a more accurate criteria for diagnosing significant coronary artery disease. The objective of this study was to compare the discriminating power of proposed ST segment/heart rate slope and index with that of a standard method of assessing exercise-induced ST segment depression for estimating coronary artery disease. METHODS: Sixty nine patients with ischemic heart disease were studied with exercise treadmill testing and coronary angiography. Computer-measured ST-segment amplitudes were obtained and analysis of the heart rate-adjusted ST segment depression(ST/HR slope and big up tri, Delta ST/HR index) was done. The sensitivity, specificity, and extent of coronary artery disease on each criteria were compared. RESULTS: 1) The sensitivity of big up tri, Delta ST/HR index partition of 1.6uV/beats/min was slightly higher(83%) and the specificity of ST/HR slope partition of 2.4uV/beats/min was higher(87%) than the standard exercise electrocardiographic criteria. 2) Early onset of ischemic ST-segment depression, profound ST-segment depression(> or =2mm), and downsloping ST-segment were associated with more extensive coronary artery disease. 3) On ST/HR slope, no CAD was 1.7+/-0.26uV/beats/min, one vessel disease was 2.6+/-0.34 uV/beats/min, two vessel disease was 2.7+/-1.36uV/beats/min, one vessel disease was 2.8+/-0.35uV/beats/min, and on big up tri, Delta ST/HR index, no CAD was 1.8+/-0.38uV/beats/min, one vessel disease was 2.8+/-1.36uV/beats/min, two vessel disease 3.4+/-1.44uV/beats/min, and three vessel disease was 3.7+/-2.95uV/beats/min. The increment of ST/HR slope and big up tri, Delta ST/HR index were associated with the coronary artery disease and its severity, but the correlations were not high enough. CONCLUSION: The heart rate adjustment of ST segment depression was not high enough for improved detection of coronary artery disease, compared with standard ST-segment depression criteria. But these indexes can be improved the clinical usefulness of the treadmill exercise test for coronary aretry disease.
Coronary Angiography ; Coronary Artery Disease* ; Coronary Vessels* ; Depression* ; Electrocardiography ; Exercise Test ; Heart Rate* ; Heart* ; Humans ; Myocardial Ischemia* ; Sensitivity and Specificity

No abstract available.
Carcinoma, Basal Cell* ; Dermoscopy*

BACKGROUND: Rubella is a viral infection of childhood. Its clinical manifestations are not serious, but rubella infection in early pregnancy can result. in congenital rubella syndrome. In Korea, there have been several rubella outbreaks in 1996. We performed an epidemiological study about a rubella outbreak in middle and high school students in an isolated small town. METHODS: This study was carried out from March 22, 1996 to April 29, 1996. The target populations were middle and high school students(middle school-1,369, high school-966 students) in Namseonri. They were given a questionnaire containing sociodemographic characteristics, past vaccination history and rubella-like symptoms. We selected 70 clinically diagnosed patients and 233 students with rubella-like symptoms from the questionnaires. Through IgM and IgG ELISA we analyzed the serum of selected students. All of the middle and high school students except those with clinical rubella were vaccinated on March 27. RESULTS: 1) The number of IgM positive students was 65 among 303 selected students. 58 students among the IgM positive group were diagnosed clinically, and 7 patients and subclincal infection. 2) Male patients were more predominant than female, especially in high school(M : F, 2 : 1 in middle school, 7 : 1 in high school). 3) Positive rates of IgG gradually increased by grade from 58.3% to 92.9% (1st grade of middle school to 3rd grade of high school). 4) IgG titer of the booster vaccinees(2nd and 3rd tirade female, high school) was significantly higher than younger female students(p<.05). 5) After mass vaccination, 3 more patients caught rubella in high school during 1 month follow-up. CONCLUSIONS: Among 2335 students, IgM positive patients were 65 with incidence rate of 2.8%. Mass vaccination of the studentg an effective preventive method in a rubella outbreak.
Disease Outbreaks ; Enzyme-Linked Immunosorbent Assay ; Epidemiologic Studies* ; Female ; Follow-Up Studies ; Health Services Needs and Demand ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Korea ; Male ; Mass Vaccination ; Pregnancy ; Rubella Syndrome, Congenital ; Rubella* ; Vaccination ; Surveys and Questionnaires

BACKGROUND: The gastroepiploic artery is not only an alternative graft but also may be considered an important primary graft for coronary revascularization. However, the long-term patency of the gastroepiploic arterial graft is yet to be determined and the incidence of perioperative spasm and long-term patency of a coronary graft may be affected by the properties of the graft response to certain vasoactive substances. The reactivity of the gastroepiploic artery to vasoactive substances has not been studied extensively and the results of the studies are contradictory. MATERIAL AND METHOD: This study was designed to test the reactivity of human gastroepiploic artery to four constrictors and four relaxants. The middle sections of the human gastroepiploic arteries were collected from the patients undergoing gastrectomy and the arterial rings with intact endothelium were suspended in organ baths for isometric tension recording. RESULT: Epinephrine, norepinephrine, and potassium chloride induced the maximum constriction to higher forces (7.0+/-1.1g, 6.6+/-0.9g, and 6.5+/-1.1g) than 5-hydroxytryptamine did (3.8+/-1.7g, p<0.05). Nitroprusside and histamine induced almost full relaxation in the gastroepiploic arteries preconstricted with norepinephrine. There was no significant difference between two relaxants regarding maximum relaxation force. Acetylcholine induced the maximum relaxation to weaker force when compared with nitroprusside and histamine (p<0.05), and isoproterenol was the weakest of the relaxants (p<0.05 compared with acetylcholine). CONCLUSION: The gastroepiploic artery has a strong capacity of endothelium-dependent relaxation which could have an important influence on long-term patency. The gastroepiploic artery exhibits a potent contractility to catecholamines and the enhanced contractility may facilitate vasospasm in the presence of high circulating levels of catecholamines. Nitroprusside, a potent relaxant in gastroepiploic artery, might be beneficial for the treatment of gastroepiploic arterial graft spasm. The gastroepiploic arterial graft with intact endothelium may respond weakly to beta-adrenoceptor agonist and 5-hydroxytryptamine.
Acetylcholine ; Baths ; Catecholamines ; Constriction ; Endothelium ; Epinephrine ; Gastrectomy ; Gastroepiploic Artery* ; Histamine ; Humans* ; Incidence ; Isoproterenol ; Nitroprusside ; Norepinephrine ; Potassium Chloride ; Relaxation ; Serotonin ; Spasm ; Transplants

No abstract available.
Hypertension*

No abstract available.