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*

OBJECTIVE: bjective: By identifying the unknown substance responsible for binding with nebulin SH3 domain within the sarcomeric Z-line, we tried to find out Z-line structure which plays an important role on muscle contraction and maintenance of muscle funtion. METHOD: First, the bait plasmid was made by binding the DNA binding domain of Gal4 protein of yeast and the SH3 domain. Second, library plasmid was made by binding activation domain and human skeletal cDNA library. Then, the base sequence of the clone, produced by combining the two proteins expressed by transgenically converted plasmid in yeast, was analyzed. RESULT: We screened out six true positive clones and analyzed the base sequence of the two of six clones. We identified them to be alpha-actinin2. CONCLUSION: We can theorize that Neublin SH3 domain and alpha-actinin2 plays a vital role for the integration of Z-line. Thus, this is an important data in further studying muscle functions, mechanisms, and muscular disease as well.
Base Sequence ; Clone Cells ; DNA ; Gene Library ; Humans* ; Muscle Contraction ; Muscular Diseases ; Plasmids ; src Homology Domains* ; Yeasts

No abstract available.
Esophageal Perforation*

No abstract available.
Thoracotomy*

PURPOSE: The therapeutic effectiveness of callosotomy in controlling medically intractable epilepsy has been discussed since first case reported. Nevertheless, patient selection, type of seizures and epileptic syndromes are now better determined. We reviewed the outcome of corpus callosotomy in 20 pediatric patients and tried to identify factors associated with good outcome. METHODS: The medical records of all pediatric patients who underwent corpus callosotomy at Asan medical center between 1996 and 2000 were retrospectively analyzed. RESULTS: At the time of last follow-up, four patients(20%) became seizure free, fifteen patients(75%) had significant improvement in seizure control, and two patients(10%) remained unchanged. No significant association was found between seizure outcome and age at operation, or duration of seizure, intracranial pathology, or extent of callosal section. Drop attacks are most likely to be benefited by callosotomy in view of the frequency of seizure. This was followed by generalized tonic-clonic and myoclonic seizures. Complex partial seizures had the worst response. CONCLUSIONS: Corpus callosotomy is valuable for controlling medically intractable generalized seizures in appropriate patients. Overall, drop attacks were one of the most frequent seizure pattern and they were also most likely to be benefited from corpus callosotomy. Though most patients do not become seizure-free after corpus callosotomy, worthwhile palliation of an otherwise intractable illness can be achieved. An analysis of prognostic factors should lead to better selection of patients for surgery.
Child* ; Chungcheongnam-do ; Epilepsy* ; Follow-Up Studies ; Humans ; Medical Records ; Pathology ; Patient Selection ; Retrospective Studies ; Seizures* ; Syncope

PURPOSE: The aim of this study was to determine the effects of patterned human periodontal ligament stem cell (hPDLSC) sheets fabricated using a thermoresponsive substratum. METHODS: In this study, we fabricated patterned hPDLSC sheets using nanotopographical cues to modulate the alignment of the cell sheet. RESULTS: The hPDLSCs showed rapid monolayer formation on various surface pattern widths. Compared to cell sheets grown on flat surfaces, there were no significant differences in cell attachment and growth on the nanopatterned substratum. However, the patterned hPDLSC sheets showed higher periodontal ligamentogenesis-related gene expression in early stages than the unpatterned cell sheets. CONCLUSIONS: This experiment confirmed that patterned cell sheets provide flexibility in designing hPDLSC sheets, and that these stem cell sheets may be candidates for application in periodontal regenerative therapy.
Cues ; Extracellular Matrix ; Gene Expression ; Humans* ; Periodontal Ligament* ; Pliability ; Regeneration ; Stem Cells* ; Tissue Engineering

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.
Biopsy ; Breast Neoplasms* ; Breast* ; Decompression ; Disease Progression ; Drug Therapy* ; Electrons ; Fibrosis ; Humans ; Hypertension, Portal ; Liver* ; Neoplasm Metastasis* ; Prognosis

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.
Biopsy ; Breast Neoplasms* ; Breast* ; Decompression ; Disease Progression ; Drug Therapy* ; Electrons ; Fibrosis ; Humans ; Hypertension, Portal ; Liver* ; Neoplasm Metastasis* ; Prognosis

PURPOSE: Emergency department (ED) overcrowding results in loss in timely, effective medical care, as well as in social and economical efficiency. This paper proposes a new overcrowding index to reduce and to prevent these losses. METHODS: We investigated the real-time situation of the emergency department in a major Korean hospital, compared to existing indices and to extracted factors to develop a new, customized overcrowding index based on the flow of patients, a reflection of emergency room conditions. We developed 3 indices, FFOI (Front Flow Overcrowding Index), BFOI (Back Flow Overcrowding Index), and TFOI (Total Flow Overcrowding Index). Each index was applied to test the period from 10 September 2007 to 16September 2007. We extracted values of each index at 3- hour intervals and estimated how they reflected the overcrowding situation compared with basic overcrowdingindices. We used the correlation coefficient and Kullback- Leiblur (KL) distance as the basis for measurement. RESULTS: Existing indices are emergency department work index (EDWIN), national emergency department overcrowding scale (NEDOCS), and real-time emergency analysis of demand indicator (READI) work score (WS). EDWIN and READI did not reflect accurately the overcrowding situation. Some factors extracted from NEDOCS and WS were not suited to the emergency department. We solved these problems by develop in new indices. CONCLUSION: In conclusion, the new indices are more effective and descriptive than the existing indices with respect to correlation to crowdedness in the emergency department. In the future, the new, customized overcrowding index will become more descriptive if the necessary data is gathered in real time and more effectively verified by the medical staffs and patients.
Crowding ; Emergencies ; Emergency Medical Services ; Humans ; Medical Staff

Lymphocytic hypophysitis, a rare inflammatory disorder in the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse lymphocytic infiltration in the pituitary gland. We report a case of lymphocytic hypophysitis in a 38-year-old woman presenting with aggravating headache and sudden visual loss during pregnancy, which was misdiagnosed as pituitary adenoma before neurosurgery. Magnetic resonance imaging, with enhancement, showed an expanding 2.5x2.0x1.7 cm sized sellar mass. The patient underwent transsphenoidal surgery with a preoperative diagnosis of pituitary macroadenoma. A histological examination revealed diffuse lymphocytes and fibrosis of adenohypophysis with atrophy, which are characteristic of lymphocytic hypophysitis. We report a case of lymphocytic hypophysitis occurred during pregnancy with a brief review of literatures.
Adult ; Atrophy ; Diagnosis ; Female ; Fibrosis ; Headache ; Humans ; Lymphocytes ; Magnetic Resonance Imaging ; Neurosurgery ; Pituitary Gland ; Pituitary Gland, Anterior ; Pituitary Neoplasms ; Pregnancy*