Survival after acute myocardial infarction (AMI) is related to the number of diseased vessel, ejection fraction, extent of residual ischemic tissue, presence of ventricular arrhythmia. Because a variety of revascularization modalities are tried in recent years, the natural course after AMI seems to become difficult ot assess. From the experience of 129 cases of coronary angiography in AMI from Jan 1984 to Apr 1987, the factors related to invasive modality were analysed to evaluate the effect on the survival after AMI. The following results are obtained. 1) Single vessel disease and insignificant lesion were present in 60%, and multivessel disease comprised 40% in all group. 2) Patients were followed for a mean of 16.3 months and 2 cases(1.6%) expired suddenly and reinfarction developed in 6 cases(4.7%). 3) After exclusion of 4 cases taken CABG operation, the event free survival of all patients was 0.98, 0.90, 0.78, 0.78, 0.78 in double vessel disease, 0.94, 0.87, 0.87, 0.77, 0.51 in triple vessel disease. The survival was better in single vessel disease compared to multivessel disease (p<0.05), but no difference was present between double and triple vessel disease. 5) Event free survival in group with left ventricular end diastolic pressure(LVEDP) >16mm Hg was better than that of a group with LVEDP <16mm Hg. But no difference was present between group with ejection fraction <40% and group with ejection fraction >40%. From the above results, it can be concluded that the event free survival after mainly uncomplicated AMI in Koreans depends on the number of diseased vessel and LVEDP.
Arrhythmias, Cardiac ; Coronary Angiography ; Disease-Free Survival* ; Humans ; Myocardial Infarction*

A method for exact evaluation of ligament integrity of the knee joint would be of clinical importance from the diagnostic point of view as well as from the desire to introduce objective measurement of stability either pre-and postoperatively, or before and after conservative treatment. Assessment of the posterior cruciate injury has been considered by numerous authors over the past decades. Even stress machine, such as Gonylaxometer, knee ligament arthrometer(KT-l000) and Genucome, have many problems such as soft tissue error, expansiveness and low popularity. Generally, orthopedic surgeons use passive tests, in which the displacing force is applied externally, to evaluate the integrity of the ligaments of the knee. Posterior tibial displacement of knee was measured at quadriceps neutral angle using a specially designed frame which minimized the rotational error to negate the quadriceps pulling effect. Posterior displacement of both sides of knee was measured in 15 patients who had posterior cruciate ligament injury and 40 adults who had normal knee. The following results were obtained. l. In the normal knee, the mean score of posterior tibial displacement was 3.0875mm in left, 2.8125mm in right each other and there was a mean of 1.05mm posterior displacement of tibia compared to the contralateral knee(range: 0–2.5mm). 2. More than 6mm displacement of lateral femoral condyle compared to the uninjured knee suggested posterior cruciate ligament injury. 3. This radiological measurement seems very efficient in detecting the posterior cruciate ligament instability of knee because of its simplicity, inexpensiveness and easy reproducibility with minimal error.
Adult ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Orthopedics ; Posterior Cruciate Ligament ; Surgeons ; Tibia

No Abstract Available.
Fatigue Syndrome, Chronic* ; Fatigue* ; Prevalence*

The authors presented a case of gastroschisis with a pedunculated gallbladder embedded in hepatic tissue. The patient was born after fullterm gestation. Due to extensive abdominal wall defect, she succumbed 3 days after birth. There was a pedunculated mass measuring 2.5x1.5x1.5 cm between the liver and distended stomach without any attachment to the liver. The pedicle of the mass was connected to the common bile duct. Cut surface revealed that the mass was an accessory hepatic lobe encircling the gallbladder. The histologic feature of both accessory liver and gallbladder was markedly altered probably due to vascular obstruction. We could find only a single similar case in literlature. That case was associated with Beckwith syndrome and ours was associated with large atrial spetal defect, large patent ductus arteriosus, accessory spleen as well as gastroschisis. The common feature of abdominal wall defect might be a predisposing factor.

BACKGROUND: Spontaneous echo contrast(SEC) is known to predict the increased incidence of thromboembolism in a variety of heart diseases. Transesophageal echocardiography can be useful for the detection of SEC due to proximity of the probe to the left atrium. We performed this study (1) to evaluate the incidence of SEC in mitral stenosis and its relation to the past history of thromboembolism and (2) to characterize the echocardiographic and hemodynamic indices in patients with SEC compared with those without SEC. METHODS: Transesophageal and thransthoracic echocardiographies were done in 89 patients with mitral stenosis. Biplane probe was used in transesophageal echocardiography. In 47patients cardiac catheterization and angiography were performed. RESULTS: (1) SEC was found in 56 out of 89 patients(63%), and left atrial thrombus was found in 32 patients. (2) Left atrial dimension was larger in patients with SEC than in patients without SEC(57.3%+/-8.4mm vs 49.3+/-6.8mm, p<0.05) and mitrial valve area was smaller in patients with SEC than in patients without SEC(0.85+/-0.27cm2 vs 0.97+/-0.24cm2) (3) Association of SEC to thrombi or previous history of arterial embolism showed a high sensitivity and negative predictive value. CONCLUSION: SEC was an useful finding to predict the increased risk of thromboembolism in patients with mitral stenosis. Patients with SEC had severe mitral stenosis than patients without SEC.
Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography ; Echocardiography, Transesophageal* ; Embolism ; Heart Atria ; Heart Diseases ; Hemodynamics ; Humans ; Incidence ; Mitral Valve Stenosis ; Thromboembolism ; Thrombosis

No Abstract Available.
Depression* ; Primary Health Care*

No Abstract Available.
Depression* ; Primary Health Care*

Intracavernous (IC) injection therapy of vasoactive agents is now being widely choser as the first armamentarium for the treatment of male erectile dysfunction, nevertheless, has a troublesome problems due to the drug delivery vehicle with needle. Therefore, the less invasive route of drug administration has been needed. We investigated the efficacy and safety of intraurethral (IU) instillation of lyposomal prostaglandin E1 on the induction of penile erection. Thirty patients with male erectile dysfunction were enrolled in a prospective study. Overall, 73.3% of cases were responded with 33.3% of full erection and 40% of partial erection after IU instillation. IU self-instillation at home was more effective than at clinic on the induction of penile erection. It is somewhat effective in cases of diabetogenic, psychogenic, neurogenic and mild vasculogenic erectile dysfunction but much less effective in severe vasculogenic and cavernosal disease. Interval of onset and duration of erection were delayed and shortened in IU instillation rather than IC injection. Side effect were mild and transient urethral pain with the most frequent incidence and followed by transient hypotension in less. In conclusion, intraurethral instillation of lyposomal prostaglandin E1 can be selected as one of therapeutic modality to restore the penile erection for some limited patients with erectile dysfunction to want to select a less invasive treatment lternative.
Alprostadil* ; Erectile Dysfunction ; Humans ; Hypotension ; Incidence ; Male ; Needles ; Penile Erection* ; Prospective Studies

The recorded cases of ileovesical fistula are surprisingly few. However, when encountered, they present an interesting problem which commands the attention of urologist. Ileovesical fistula due to malignant lymphoma is a rare disease and usually first manifested by a long period of urinary symptom. We report a case of ileovesical fistula due to malignant lymphoma, diffuse, poorly differentiated, lymphocytic type, in sixty-four-year-old male patient with the brief review of literature.
Fistula* ; Humans ; Lymphoma* ; Male ; Rare Diseases

Management of bladder tumors depends upon early detection and adequate follow-up. Urine Cytology plays an increasingly important and prominent role in the multidisciplinary approach to this problem. Herein we review our experience with urine cytology in the diagnosis and follow-up of bladder cancer at Department of Urology, College of Medicine, Yonsei University from 1981 to 1985. 1. A total of 478 cytologic evaluations were performed in the 198 patients. 2. The overall incidence of positive cytology was 49.2%. 3. The incidence of positive cytology in the presence of biopsy proven bladder tumor was 71.1%. 4.The incidence of positive cytology after TUR followed by adriamycin instillation was 72.2% at diagnosis, 41.7% after 3 months, 31.0% after 6 months, 33.3% after 9 months and 36.8% after 12 months. 5. The Number of cases with negative cytology after TUR and adriamycin instillation was 11 cases after 3 months, 7 cases after 6 months, 2 cases after 9 months and 1 case after 12 months. 6. Of the 5 patients having recurred tumor, there was 4 patients who constantly class IV, and 1 patient who had conversion from class I or II to class IV.
Biopsy ; Diagnosis ; Doxorubicin ; Follow-Up Studies ; Humans ; Incidence ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urology