Since the introduction of percutaneous balloon angioplasty by Gruentzig in 1979, percutaneous coronary intervention (PCI) has become the main treatment modality for the management of coronary heart disease. More than 1,000,000 PCI procedures are performed annually worldwide. With the advent of new therapeutic technologies, the indications for PCI have markedly expanded. Nowadays, improvements in balloon technology, popular use of coronary stent, and the proper administration of antiplatelet agents including GPIIbIIIa inhibitors have influenced the acute procedural outcomes. This technological and procedural advance in PCI has resulted in angiographic success rates of 96 to 99%, with Q-wave MI rates of 1 to 3%, emergency coronary bypass surgery rates of 0.2 to 3%, and unadjusted in-hospital mortality rates of 0.5~1.4%. However, despite the marked improvements in the acute outcome of PCI, long-term results including the restenosis rate are less impressive. The restenosis rate following balloon angioplasty reaches 30~40%, and is higher in certain clinical and angiographic subsets. The recent introduction of intracoronary stent and brachytherapy (intracoronary lesional ionizing radiation therapy) has a favorable impact on the restenosis precess including elastic recoil and intimal hyperplasia. Intracoronary stents decreased elastic recoil and remodeling and intracoronary radiation reduced intimal hyperplasia. Several randomized clinical trials to assess the efficacy of stents and intracoronary brachytherapy are ongoing with impressive results. In 2001, a breakthrough has been made in the prevention and the treatment of restenosis with the advent of a drug-eluting stent. Balloon-expandable stents coated with rapamycin or paclitaxol showed nearly 0% restenosis rate at 6-month follow-up. We might expect to solve restenosis completely in a very near future.
Angioplasty, Balloon ; Brachytherapy ; Coronary Disease ; Drug-Eluting Stents ; Emergencies ; Follow-Up Studies ; Hospital Mortality ; Hyperplasia ; Percutaneous Coronary Intervention* ; Platelet Aggregation Inhibitors ; Radiation, Ionizing ; Sirolimus ; Stents

No abstract available.
Diagnosis*

Aplasia cutis congenita is a rare disease presenting in the newborn infant as localized areas of skin defect. Its association with a number of congenital malformations is well documented. I observed a newborn infant with typical aplasia cutis congenita. The skin defect of my case was found on the posterior fontanelle without any congenital malformation. Diagnosis was made by history, clinical and histopathological findings.
Cranial Fontanelles ; Diagnosis ; Ectodermal Dysplasia* ; Humans ; Infant, Newborn ; Rare Diseases ; Skin

Porokeratosis plantaris palmaris et disseminata is a rare variant of porokeratosis. A 37-year-old patient has been affected for about 2 years by mildly discornforting numerous, 1-3mm sized, keratotic lesions of the trunk and limbs, especially on the palms and soles. Histopathologically the diagnosis of porokeratosis was established by demonstration of a cornoid larnella. The family tree of the patient is compatible with autosomal dominant inheritance. The patient has been treated with topical 5-fluorouracil with little auccess.
Adult ; Diagnosis ; Extremities ; Fluorouracil ; Humans ; Pedigree ; Porokeratosis* ; Wills

The hemolytic uremic syndrome consists of microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia following a prodromal illness of gastroenteritis or upper respiratory infection. Sometimes, the syndrome can present in a dramatic fashion with severe abdominal pain and signs of intestinal obstruction, suggesting an intussusception or acute surgical crisis. A 2-year-old girl with a 3-day history of several episodes of bloody-mucoid diarrhea and severe abdominal pain was admitted under suspicion of intussusception. Her symptoms started 4 days after eating a pork and X-ray revealed the distended small bowel without a large bowel gas pattern. Colitis without perforation was found by abdominal ultrasonogram and sigmoidoscope. Unfortunately, she became pallor, puffy, and oliguric 7 days later. Clues to the diagnosis of hemolytic uremic syndrome in the early stages of the acute illness were oliguria, abnormal peripheral blood smear, anemia despite dehydration, and proteinuria. The onset is usually preceded by symptoms of gastroenteritis, such as fever, vomiting, abdominal pain, and bloody diarrhea. This is followed in 5 to 10 days by a sudden onset of pallor, irritability, weakness, lethargy, and oliguria. The majority of patients recover normal renal function with aggressive management of the acute renal failure. Careful medical management of the hematologic and renal manifestations, in conjunction with early and frequent peritoneal dialysis, offers the best chance of recovery from the acute phase. The present patient was recovered by apropriate fluid and electrolyte management, transfusions of packed RBCs, fresh frozen plasma, and early application of peritoneal dialysis.
Abdominal Pain ; Acute Kidney Injury ; Anemia ; Anemia, Hemolytic ; Child, Preschool ; Colitis* ; Dehydration ; Diagnosis ; Diarrhea ; Eating ; Female ; Fever ; Gastroenteritis ; Hemolytic-Uremic Syndrome* ; Humans ; Intestinal Obstruction ; Intussusception ; Lethargy ; Oliguria ; Pallor ; Peritoneal Dialysis ; Plasma ; Proteinuria ; Red Meat ; Sigmoidoscopes ; Thrombocytopenia ; Ultrasonography ; Vomiting

Gram negative folliculitis is a well-known complication of acne in patients treated with long-term broad-apectrurn oral antihiotics, This report presents the case of a 18-year-old boy who developed gram negative folliculitis during the treatment of acne vulgaris. This patient has superficial pustules, 1-Rmm in diameter with aene lesions such as comedones, papules, puatules in face. Diagnosis was made by the past medical history, skin lesions and bacteriological study.
Acne Vulgaris ; Adolescent ; Diagnosis ; Folliculitis* ; Humans ; Male ; Pseudomonas* ; Skin

No abstract available.
Problem-Based Learning*

A case of eruptive vellus hair cysts (EVHC) is reported in a patient having paoriasis. The patient, 30-year-old man, has the hyperpigmented umbilicated papules with psoriatic plaques. The histopathologic findings confirm the diagnosis of EVHC, Some lesions of EVHC regressed spontaneously after one month. This is, to my knowledge, the first report of EVHC associated with psoriasis in the Korean literature.
Adult ; Diagnosis ; Hair* ; Humans ; Psoriasis*

We made a mistake in our recently published article.

Extracapsular cataract extraction with posterior chamber intraocular lens in 24 eyes of 24 diabetics. With and without diabetic retinopathy, were followed up postoperatively for an average of 14 months to determine the incidence of diabetic retinopathy, the final visual acuity and factors predictive of progression of retinopathy and final visual acuity. Overall, retinopathy progressed in 52% of operated-on eyes. Cataract extraction was highly associated with progression of diabetic retinopathy. Women had a significantly increased risk of progression of retinopathy in the operated-on eye compared to men. Visual acuity improved in 22 of 24 orerated-on eyes : however, only 11 eyes achieved a visual acuity of 0.5 or better and only 7 eyes achieved a visual acuity of 0.7 or better. Patients treated with oral hypoglycemic agents had a worse visual prognosis than those treated with insulin. The prognosis of patients with diabetic retinopathy about to undergo cataract surgery, even extracapsular cataract extraction with placement of a posterior chamber lens, is guarded.
Cataract Extraction ; Cataract* ; Clinical Study* ; Diabetic Retinopathy* ; Female ; Humans ; Hypoglycemic Agents ; Incidence ; Insulin ; Lenses, Intraocular ; Male ; Prognosis ; Visual Acuity