No abstract available.
Reference Values*

Transmycardial laser revascularization has made its position as a sole therapy for patients with chronic angina nonamenable to maximal medical therapy, percutaneous transluminal coronary angioplasty, and coronary artery bypass grafting. We report three cases of transmyocardial laser revascularization as a sole therapy for patients with recurrent angina after CABG.
Angioplasty, Balloon, Coronary ; Coronary Artery Bypass ; Humans ; Transmyocardial Laser Revascularization

A 12 years old Korean girl was seen on 10 Oct. 1969 with chief complaint of a large fleshy mass extruded out of the orbit associated with ocular pain of mild degree for several months. Her parents were first noticed that the girl's right eye had a peculiar reflex from the pupillary zone in 2 years of her age. She was advised by a local clinician to correct surgicaIly someday later in her childhood. At the age of four, the pupillary margin of the affected eye had become distorted and they became aware of the eyeball was a little protruded and the grade of protrusion had slowly advanced as she had grown up. About a year ago the patient suffered from sudden attack of severe ocular pain associated with vomiting. Having experienced the recurrences of similar attack several times, she at last in Sept. 1969 met a spontaneous outburst of the extruded mass from which the purulent and bloody contents flowed out. It was to be regretted that the history could not reveal when and how the globe had been disorganized as completely as such that no trace of configuration of the anterior segment could be recognized. Familial and past history were not contributory except measle with good recovery at 2 years of age. On examination, the left eye had good vision and no structural changes, wherease the right side showed a marked extrurusion of fleshy mass out of the lid aperture. The mass had a relatively smooth and congested coverage of the conjunctiva except it had the fistulae through which a small amount of the purulent and bloody discharge flowed out under the digital pressure. It was felt somewhat elastic and movable with a broad base into the orbit. On its surface no trace of the cornea or the other global structures could be found. Physical examinations of the whole body including regional lymphnodes revealed normal X-ray Was of chest, skuIl and optic foramina were normal. On 14 Oct. 1969 under general anesthesia an orbital exentration was undertaken because of either probability of a malignant tumor or a long standing intraocular inflammation. In the way of procedure necrotic contents bursted out by mechanical pressure through the weak point, i.e. the fistulae, and correspondingly the tumorous mass became softened. Confirming no hard mass palpable into the orbit, the operating procedure shifted to do partial exentration. The extirpated mass was subjected to the histological study. Grossly, the dissected area revealed that it contained a well preserved structure of sclera on the one side and completly necrotised material on the other, but it did not contain any remnants of the ordinary global structures such as cornea, iris, lens, vitreous and choroid. The hollowed space partially surrounded by scleral structure was filled with the dark and gelatinous materia. The mass was as a whole rather soft Histological examination showed numerous gland like proliferations composed of poorly differentiated and unpigment columner cells having relatively large nuclei, some of which showed a mitotic figure. These were conceivable to be of an embryonic retina. The lumina of the gland like structures with the various sizes and shapes were filled with a pink staining coagulum and an extremly delicate and regularly arranged fibrillar structure. In some parts the tumor consisted of solid cellular conglomeration with rosett like arrangement and in the other necrotic masses containing tumor cells in all stages of degeneration. For the most part and the surrounding structure of the tumor cells, the picture showed likely to be a diffuse inflammation with an infiltration of polymorphonuclear cells, partly vessels being mostly of capillaries and recent hemorrhages, but the cartilage was not found.
Anesthesia, General ; Capillaries ; Cartilage ; Child ; Choroid ; Conjunctiva ; Cornea ; Estrogens, Conjugated (USP) ; Female ; Fistula ; Gelatin ; Hemorrhage ; Humans ; Inflammation ; Iris ; Orbit ; Parents ; Physical Examination ; Recurrence ; Reflex ; Retina ; Sclera ; Thorax ; Vomiting

Clinical studies on thirteen patients with Behcet's syndrome who had visited during the period from Jan. 1970 to Sep. 1973, to the Department of Dermatology & Ophthahnology, Busan National University Hospital, were made and the following results obtained. 1) The ratio of male vs. female was l. 0: l. 6 with no definite sexual differences. The ages ranged from 17 to 56 years with the peak incidence in third decade of life. 2) The "complete" form consisting of oculo- oro-genital and cutaneous lesions appeared in . 4 patients (30. 8%) and the "incomplet" in 9 patients (69. 2%). 3) Aphthous stomatitis was most predominant, being observed in 12 out of all 13 cases (92.3%), the next was cutaneous manifestations such as erythema nodosum, pyodermas, acneiform & pustular lesions and erythema multiforme in 10 cases (76. 1%) and genital ulcers in 9 cascs (69.2%). Ocular lesions and articular involvements came fourth, each being found in 8 cases (61. 5%). 4) The commonest feature of ocular involvement was relapsing iridocyclitis, being observed in 57. 7% and the disease led to a bilateral loss of vision in 38. 4% 5) Single or combined therapy including corticosteroids and antimicrobials gave transient conservative effects and was of no value to prevent recurrent attacks.
Adrenal Cortex Hormones ; Behcet Syndrome* ; Busan ; Dermatology ; Erythema Multiforme ; Erythema Nodosum ; Female ; Humans ; Incidence ; Iridocyclitis ; Male ; Pyoderma ; Stomatitis, Aphthous ; Ulcer

We evaluated the feasibility and safety of this method by reviewing the early outcome of the patients who underwent coronary artery bypass grafting(CABG) utilizing parallel sequential anastomoses with saphenous vein grafts, comparing with the outcome of the patients revascularized with grafts having only single distal anastomosis. During the one-year period of 1995, a total of 79 patients underwent isolated CABG, among whom 39 patients with sequential vein grafts(sequential group) and 40 patients without sequential grafts(non-sequential group). There was no difference between the two groups in terms of preoperative status, except in the extent of the coronary disease; 87.2% of the sequential group and 45.0% of the non-sequential group had left main and/or triple vessel involvement. 318 distal coronary anastomoses were done; 198 for the sequential group(5.1/patient) and 120 for the non-sequential group(3.0/patient). In the sequential group, the mean durations of cardiopulmonary bypass and aortic clamp per one distal anastomosis were 33.5 and 21.1 minutes, respectively. In the non-sequential group, these were 41.8 and 22.7 minutes. There were two operative deaths, both in the non-sequential group. There was no difference in the incidence of postoperative complications including myocardial infarction. During the follow-up period(2 to 15 months), 8 patients(3 in the sequential and 5 in the non- sequential group) complained of residual or recurrent angina. Comparison of preoperative and postoperative 201Thallium myocardial perfusion scans in 30 patients showed improved or normal perfusion reserve in 83.3% of segments bypassed with sequential grafts and 82.5% of segments bypassed with non-sequential graft(s). These results show that, utilizing parallel sequential anastomoses with saphenous vein grafts, we could achieve satisfactory short-term clinical results in patients with extensive coronary stenoses. So, we conclude that this technique is a safe, technically feasible strategy for CABG, which can achieve the aim of complete myocardial revascularization with a limited length of graft. These results show that, utilizing parallel sequential anastomoses with saphenous vein grafts, we could achieve satisfactory short-term clinical results in patients with extensive coronary stenoses. So, we conclude that this technique is a safe, technically feasible strategy for CABG, which can achieve the aim of complete myocardial revascularization with a limited length of graft.
Cardiopulmonary Bypass ; Coronary Artery Bypass ; Coronary Disease ; Coronary Stenosis ; Follow-Up Studies ; Humans ; Incidence ; Myocardial Infarction ; Myocardial Revascularization* ; Perfusion ; Postoperative Complications ; Saphenous Vein ; Transplants ; Veins

In the preoperative evaluation before coronary artery bypass surgery, review of the coronary arteriogram is the most important step. Expected "normal" lumen diameter at a given coronary anatomic location is a basis for quantative estimation of coronary disease severity that could be more useful than the traditional "percent stenosis". The distribution and number of major coronary artery branches are determinants of number of bypass grafts needed. We reviewed the coronary artery anatomy in 174 adult patients who revealed no coronary pathology in angiographic studies done from September 1994 to June 1996. Quantative analysis was done in all cases by a single person using a Computerized System (Arripro 35(r)). The results were follows; 1) The mean diametre of left main coronary artery was 4.45 mm (range 2.74~6.72). The pattern of branching was bifurcation in 67.24%, trifurcation in 28.74% and quadrifurcation in 4.02% of the patients. 2) The mean diametre of left anterior descending artery was 3.17 mm (range 2.10~5.85), 2.79 (range 1.55~5.59) and 2.17 mm (range 1.37~3.81) in the proximal, mid, and the distal portions, respectively. The number of diagonal branches of left anterior artery was from one to four (mode=2). 3) The mean diametre of proximal and distal left circumflex artery were 3.17mm (range 1.74~4.89) and 2.19 mm (range 1.21~4.46). The number of obtuse marginal branches of left circumflex artery is from one to six (mode 2). 4) The mean diametre of proximal and distal right coronary artery, the posterior descending artery and the largest posterolateral branch were mean 3.51 mm (range 2.07~5.67), 2.09 mm (range 1.42~3.60), 2.09 mm (range 1.02~3.60) and 2.30 mm (range 1.39~4.39). 5) The right coronary artery dominant was 163 cases (93.68%) of the total 174 cases. 6) The large significant acute marginal artery was visualized in more than half of the people.
Adult ; Arteries ; Computer Systems ; Coronary Artery Bypass ; Coronary Disease ; Coronary Vessels ; Humans ; Pathology* ; Single Person ; Transplants

No abstract available.
Age Factors* ; Hematoma, Subdural, Chronic*

No abstract available.
Aneurysm* ; Arteries*

The presnt study was carried out to find out any difference in terms of the rate of rebleeding, mortality and of the occurrence of vasopasm and hydrocephalus between the two groups of patients with subarachnoid hemorrhage : a group of 225 cases which were administered with epsilon aminocaproic acid(EACA) (antifibrinolytic agent) and the other a group of 221 cases without EACA treatment. Both groups were chosen from 476 patients admitted to the Department of Neurosurgery, Kyung-Hee University Medical Center within 7 days after the onset of subarachnoid hemorrhage during a period from January 1982 to December 1987. The clinical observation was done during acute period following subarachnoid hemorrhage. The major findings obtained were as follows : 1) The occurrence of rebleeding was higher within 3 days after the onset of subarachnoid hemorrhage. The rate of rebleeding was 8.4% in treated group whereas the rate was 13.1% in control group. This may suggest that administration of EACA is effective to prevent rebleeding. 2) the occurrence of vasopasm was higher within on the 7th and 8th day after the onset of subarachnoid hemorrhage. The rate of vasospasm was 28.9% in treated group whereas the rate was 12.4% in control group. This means that the rate of occurrence of vasospasm was two times higer in EACA treated group. 3) the rate of occurrence of hydrocephalus was 18.3% in treated group whereas the rate lower in control group(11.6%). 4) Within-two-weeks mortality and within-one-month mortality were 14.7% and 22.2% respectively in treated group whereas the two rates in control group were 15.1% and 24.1% respectively. No significant difference between the two groups was observed. 5) The causes of death in treated group were found to be vasospasm(55.5%) and rebleeding(28.0%) in order, whereas in control group the causes of deaths were rebleeding(40.2%) and vasospasm(21.3%). In other words, the main cause of death was vasospasm in treated and that in control group was rebleeding.
Academic Medical Centers ; Cause of Death ; Humans ; Hydrocephalus ; Mortality ; Neurosurgery ; Subarachnoid Hemorrhage*

This is a report on the clinical outcome and hemodynamic profile of the ATS(R) cardiac valve prosthesis, which is a recently introduced pyrolytic carbon bileaflet prosthesis. We retrospectively reviewed the early outcome of 100 consecutive patients who underwent isolated cardiac valve replacement with the ATS(R) prosthesis from October 1994 through June 1996 at our hospital. All patients were evaluated with Doppler echocardiography before discharge from the hospital. The mean age of the patients was 48.6 years(range: 2 to 74). A total of 124 prosthesis were implanted; 71 mitral, 46 aortic, and 7 tricuspid. The two most frequently used sizes were 27 mm(40.8%) and 29 mm(35.2%) in the mitral position, and 23 mm(30.4%) and 21 mm(28.3%) in the aortic position. There was no early or late death. The total follow-up period was 950 patient-months with 99% follow-up rate. Serious late morbidity occurred in three patients; reoperation in two patients for late rupture of Sinus of Valsava in one and for endocarditis with prosthetic dehiscence in the other, and intracranial hemorrhage due to hypertension in one patient. There has been no thromboembolic complication or structural valve deterioration. In the mitral position, the average values of peak and mean transprosthetic pressure gradients and valve area calculated from pressure half time were 6.9+/-2.8 mmHg, 2.6+/-1.5 mmHg, and 2.7+/-0.8 cm2 respectively. In the aortic position, the peak and mean pressure gradients were 26.4+/-15.9 mmHg and 14.2+/-7.9 mmHg. For the mitral prostheses larger than 25-mm size, there was no significant difference among prosthetic sizes in terms of transprosthetic gradients, whereas there was a significant negative correlation between the prosthesis size and the transprosthetic gradients for the aortic valves. The peak and mean pressure gradients were 52.2+/-17.6 mmHg and 26.9+/-7.4 mmHg across the 19-mm aortic prostheses, and 27.1+/-11.9 mmHg and 13.3+/-6.6 mmHg across the 21-mm size. Above results can lead to the conclusion that the early clinical outcome of the ATS valve prosthesis is quite satisfactory. And the hemodynamic characteristics are comparable, if not better, with other bileaflet prostheses.
Aortic Valve ; Carbon ; Echocardiography* ; Echocardiography, Doppler ; Endocarditis ; Follow-Up Studies ; Heart Valve Prosthesis ; Heart Valves* ; Hemodynamics ; Humans ; Hypertension ; Intracranial Hemorrhages ; Prostheses and Implants* ; Reoperation ; Retrospective Studies ; Rupture