BACKGROUND AND OBJECTIVES: Primary intervention by stent implantation during acute myocardial infarction is a novel strategy to provide better myocardial perfusion compared to thrombolysis or baloon angioplasty. We aimed to assess the reperfusion achieved by primary stenting, employing TIMI frame count for more objective and quantitative measurement. MATERIALS AND METHOD: Measurements for number of frames required to opacify standardized angiographic landmark branch(TIMI frame count) were determined for the coronary arteries of 77 normal controls and 65 patients with acute myocardial infarction who underwent primary stenting within 12 hours of symptom onset. RESULTS: In normal subjects, TIMI frame count for left anterior descending artery(LAD) was 1.3 times of mean count of right coronary artery(RCA) and left circumflex artery(LCx), and significant less than that of TIMI study(22.3+/-4.9 vs 36.2+/-2.6, p<0.05). TIMI frame count for RCA and LCx was similar to results of TIMI study. In infarct related arteries(IRA), corrected TIMI frame count(CTFC) after primary stenting was similar to those of normal control. Frame counts of RCA was larger compared to that of normal control, but statistically insignificant(23.0+/-7.5 vs 17.6+/-3.5, p>0.05). There was no difference of CTFC of non-infarct related arteries between patients and normal controls. CONCLUSION: The TIMI frame count of LAD artery in normal Korean subjects was significantly less than that of American counterpart. In patients with acute myocardial infarction, primary stenting appeared to provide improved coronary flow similar to that observed in normal subjects, as measured by TIMI frame counting.
Angioplasty ; Arteries ; Coronary Vessels ; Humans ; Myocardial Infarction* ; Perfusion ; Reperfusion ; Stents*

No abstract available.
Kidney Transplantation*

The linear scratching wound was made gently on the corneal epithelium of rabbit with 21 gauge needle under an operating microscope. Impression cytology was performed at 30 minutes, 1, 2, 3 and 4 hour and 1, 2, 3 and 4 day after 0.5% tetracaine drops under an operating microscope. The filter paper was stained with hematoxylin and eosin. At 30 minute post-scratching, a few polymorphonuclear leukocytes appeared on the scratched cornea at 3 eyes (30%). At 3 and 4 hour, numerous polymorphonuclear leukocytes with corneal epithelial cells appeared on the scratched conea. By 3 day, no inflammatory cells were shown on the filter paper in all eyes. These findings suggest that the polymorphonuclear leukocytes could infiltrate on the corneal lesion at 30 minute post-scratching and the inflammatory cells might act even on the minute corneal lesion such as corneal erosion.
Cornea ; Eosine Yellowish-(YS) ; Epithelial Cells ; Epithelium, Corneal ; Hematoxylin ; Needles ; Neutrophils* ; Tetracaine ; Wounds and Injuries*

Familial hemophagocytic lymphohistiocytosis (FHL) is a rare disease characterized by fever, hepatosplenomegaly, cytopenia and non-malignant lymphohistiocytic infiltration with hemophagocytosis in reticulendothelial organs. We experienced three cases of FHL in identical male twins and their younger brother who presented with fever and severe hepatosplenomegaly. Cytopenia, elevated serum transaminase and low serum albumin levels, hypertriglyceridemia were common laboratory findings of them. One of them showed markedly decreased phytohemagglutinin induced lymphocyte proliferation and reversed CD4/CD8 ratio (0.52) in flowcytometric lymphocyte subset analysis. Aspirate of bone marrow revealed typical features consistent with FHL in two of them. In spite of recent therapeutic approaches, none of them survived.
Bone Marrow ; Fever ; Humans ; Hypertriglyceridemia ; Lymphocyte Subsets ; Lymphocytes ; Lymphohistiocytosis, Hemophagocytic* ; Male ; Rare Diseases ; Serum Albumin ; Siblings

Amniotic fluid embolism (AFE) is a rare peripartum complication with a mortality rate of 61 to 86%. The main clinical manifestations include shock, acute pulmonary edema, neurologic signs, and coagulopathies. Most diagnosis of AFE is made on the postmortem examination of the maternal pulmonary vasculature, but antemortem confirmation of amniotic fluid material by aspiration of pulmonary blood is rare. We report the first case in Korea who survived from amniotic fluid embolism confirmed by the identification of amniotic fluid debris in pulmonary artery blood. Serial echocardiographic changes of left ventricle systolic dysfunction are also described with a brief review of literatures.
Amniotic Fluid* ; Autopsy ; Diagnosis ; Echocardiography ; Embolism, Amniotic Fluid* ; Female ; Heart Ventricles* ; Korea ; Mortality ; Neurologic Manifestations ; Peripartum Period ; Pregnancy ; Pulmonary Artery ; Pulmonary Edema ; Shock

PURPOSE: To evaluate the effect of modified simple excision for epicanthal folds. METHODS: Eight patients with the epicanthal folds were treated using a modified simple excision method from June to December 2005. After medial traction of the epicanthal fold to expose the medial canthus, parabola-shaped marking was done near mucocutaneous junction. Under local anesthesia, incision of skin, dissection of subcutaneous tissue and excision of subcutaneous fibrous tissue and orbicularis oculi muscle were done. After marking the medial canthus on the skin, a wedge-shaped excision of the extra skin was done. Fixation sutures to the medial canthal tendon and skin sutures were then performed. RESULTS: Eight participants were evaluated (four males and four females) with a mean age of 16.71+/-8.34 years. The mean follow-up period was 42.86+/-5.80 days. After the operation, the skin scar was not visible due to its deep position, and no complication, such as damage to the lacrimal canaliculus or sac, was observed. CONCLUSIONS: Modified simple excision for epicanthal folds is an effective method that does not leave a visible scar.
Anesthesia, Local ; Cicatrix ; Follow-Up Studies ; Humans ; Male ; Skin ; Subcutaneous Tissue ; Sutures ; Tendons ; Traction

PURPOSE: To differentiate complex obstruction from the nasal cavity floor when performing probing in congenital nasolacrimal obstruction. METHODS: Twenty-five eyes of 23 patients with congenital nasolacrimal duct obstruction were treated by probing from January to December 2003. We measured the length between the medial canthus and nasal ala and between the punctum and nasal floor after positioning the probe in the nasal cavity and compared the two lengths. RESULTS: There were 15 males and 10 females. Their mean age was 11.48+/-4.32 months. The mean length between the lower punctum and nasal floor was 3.28+/-0.34 cm, and the mean length between the medial canthus and nasal ala was 2.82+/-0.26 cm. The length between the punctum and nasal floor was longer than that between the medial canthus and nasal ala (p<0.01). There was a positive relationship between two lengths (r=0.805, p<0.01). CONCLUSIONS: Measuring the length between the medial canthus and nasal ala before probing in patients with congenital nasolacrimal obstruction is helpful to distinguish the nasal floor from complex nasolacrimal obstruction when a hard stop is encountered.
Female ; Humans ; Infant ; Male ; Nasal Cavity ; Nasolacrimal Duct*

No abstract available.
Biopsy, Fine-Needle* ; Breast Neoplasms* ; Breast* ; Diagnosis*

We report the clinical features and the course of traumatic corneal endothelial rings by trauma. Fourteen eyes (of fourteen patients) with traumatic endothelial rings (twelve cases of BB shot injury), were enrolled in this study. With median follow-up interval of 50 weeks, initial and final best corrected visual acuity, presence of combined injuries such as gross hyphema, and time of disappearance of traumatic endothelial rings were recorded. And specular microscopic examination was performed. The duration of existence of traumatic endothelial rings was mean 4.6 days. On the specular microscopic examination, the count of corneal endothelial cells in the injured eye decreased by mean 16.8% (ranged from 1 to 56%) than that in the opposite unjnjured eye. The duration of existence of traumatic endothelial rings was 3.5 days in the group without combined angle recession and was 6.1 days in the group with combined angle recession. We suggest that the possibility of traumatic corneal endothelial rings and resultant endothelial cell loss and their clinical potential should be always kept in mind in ocular trauma, particularly BB shot injury.
Adolescent ; Adult ; Aged ; Child ; Cornea/*injuries ; Endothelium, Corneal/*pathology ; Eye Injuries/*pathology ; Human ; Male ; Retrospective Studies ; Wounds, Gunshot/pathology

PURPOSE: To evaluate the results and complications of the punctal plug insertion through lacrimal fistula. METHODS: Four patients diagnosed with congenital lacrimal fistula had a punctual plug inserted through the lacrimal fistula without anesthesia from January to May 2005. RESULTS: Mean follow-up period was 6.8 months. In two pediatric patients whose mean age was 5.0 years, the fistula was not associated with nasolacrimal duct. In two adult patients, it was associated nasolacrimal duct obstruction, whose mean age was 49.0 years. In all cases epiphora improved. There was a puncal plug prolapse in one case and no other complications. CONCLUSIONS: Punctal plug insertion is considered a simple and useful technique for lacrimal fistula without congenital nasolacrimal obstruction in children especially whose parents refuse general anesthesia. Punctal plug insertion can be useful to reduce scarring in adult patients that receive endoscopic dacryocystorhinostomy with nasolacrimal obstruction.
Adult ; Anesthesia ; Anesthesia, General ; Child ; Cicatrix ; Dacryocystorhinostomy ; Fistula* ; Follow-Up Studies ; Humans ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct ; Parents ; Prolapse