We studied the incidence of spontaneous infarct related artery recanalization and it's effect on LV function in 120 patients with acute myocardial infarction by angiography within 1 month after onset of acute MI between Nov. 1983 to Sep. 1988. The total occlusion rate of the infarct related artery in 34 cases catheterized from 1st day to 7th day was 55.8%, that of 33 cases from 8th day to 14th day 51.5%, that of 32 cases from 15th day to 21th day 40.7% and that of 21 cases from 21th day to 30th day was 47.7%. These results suggest that spontaneous recanalization of infarct related artery has mainly occurred within 24 hours after acute MI. LV ejection fraction among those patients who showed spontaneous recanalization(n=59) was not significantly superior to those with persistent occlusion of the infarct related artery. Both anterior and inferior MI patients showed no difference in LV function as regard to whether they showed recanalization or persistent occlusion. Although early spontaneous reperfusion of the infarct related artery is not uncommon in acute MI, LV function was not influnced by the spontaneous recanalization at least until 1 month after MI.
Angiography ; Arteries ; Catheters ; Humans ; Incidence ; Myocardial Infarction* ; Reperfusion ; Ventricular Function, Left*

No abstract available.
Classification* ; Female ; Hydatidiform Mole* ; Pregnancy

Advances in microneurosurgical treatment of arterial aneurysm have led to increased interest being focused on aneurysm situated within the posterior cerebral fossa. Despite this, reports of neurosurgical intervention in such cases are still rare and there is no report about the distal posterior cerebral artery aneurysm in Korea. An aneurysm of the posterior cerebral artery has been referred to as a "distinct rarity", making up about 0.26 to 2.7% of all cerebral aneurysms. Especially, the incidence of the distal posterior cerebral artery aneurysm is quite rare and most of them are saccular in shape and single in number. The authors report a case of P4 segment aneurysm of left posterior cerebral artery, successfully treated by clipping cross neck and reviewed the literature, and discussed their anatomy, clinical feature, location, and variable operative methods.
Aneurysm ; Incidence ; Intracranial Aneurysm* ; Korea ; Neck ; Posterior Cerebral Artery*

PURPOSE: To evaluate the MRI findings of acute facial nerve paralysis in Bell's palsy and herpes zosteroticus, and to correlate these with the clinical findings. MATERIALS AND METHODS: We retrospectively reviewed theMRI findings in six cases of Bell's palsy(BP) and two of herpes zoster oticus(HZO), and compared them with thefindings for 30 normal facial nerves. This nerve was considered abnormal when its signal intensity was greaterthan that of brain parenchyma or the contralateral normal side on Gd-enhanced T1-weighted axial and coronal MRimages. We analysed the location and degree of contrast enhancement, interval change, and clinical progression incorrelation with House-Brackmann(HB) grade and electroneuronography(ENoG) findings. RESULTS: Fifteen of 30 normalfacial nerves(50%) seen on Gd-enhanced MRI were mildly enhanced in the geniculate ganglion, the proximal tympanic,and the proximal mastoid segment of the facial nerve. No enhancement of the internal auditory canal(IAC) orlabyrinthine segment of the facial nerve was noted, however. In BP and HZO, Gd-enhanced MR images revealed fair tomarked enhancement for more than two segments from the internal auditory canal to the mastoid segment of thefacial nerve. During follow-up MRI, enhancement of the facial nerve varied in location and signal intensity,though gradually decreased in intensity approximately eight weeks after the onset of facial nerve palsy. Nocorrelation between clinical HB grade, ENoG, and follow up MRI findings was noted. CONCLUSION: Except in theinternal auditory canal and labyrinthine segment, normal facial neve may show mild and relatively symmetricalenhancement. In BP and HZO, the facial nerve showed diffuse enhancement from the IAC to the mastoid segment.
Bell Palsy* ; Brain ; Facial Nerve ; Follow-Up Studies ; Geniculate Ganglion ; Herpes Zoster Oticus* ; Herpes Zoster* ; Magnetic Resonance Imaging* ; Mastoid ; Paralysis ; Retrospective Studies

Bone marrow necrosis is infrequently diagnosed during life, and its presence often signifies a poor prognosis. It has been associated with a variety of disease, including acute and chronic leukemia, carcinoma, malignant lymph oma, infection and sickle cell disease. About 5-26% of acute myeloid leukemia has been reported to express lymphoid differentiation markers, of which CD7 is ex pressed very early during T-cell ontogeny. A 46-year-old male complaining severe bone pain had pancytopenia, leukoerythroblastosis and bone marrow necrosis. Peripheral blood immature cells expressed CD7 as well as myeloid markers such as CD13 and CD33 on immunophenotypic studies. We report a case of CD7 positive acute myeloid leu kemia associated with bone marrow necrosis, confirmed by bone marrow biopsy and immunophenotypic study.
Anemia, Sickle Cell ; Antigens, Differentiation ; Biopsy ; Bone Marrow* ; Humans ; Leukemia ; Leukemia, Myeloid, Acute* ; Male ; Middle Aged ; Necrosis* ; Pancytopenia ; Prognosis ; T-Lymphocytes

To evaluate the change in valvular morphology and occurence and severity of mitral regurgitation produced by PMV, 45 patients(33 women and 12 men,mean age 38+/-10 years) were studied using two-dimensional(2-D) and Doppler echocaediography before and 1-2 days after this procedure. Mitral valve area after PMV increased in all patients, from 0.9+/-0.2 to 1.8+/-0.4cm2(P<0.0001). In valve area estimation, the correlation between Gorlin`s method and 2-Dechocardiography was better(r=0.61, p<0.0001) than that between Gorlin`s method and Doppler pressure halftime(r=0.38, P<0.01) before valvuloplasty, but after the procedure Gorlin`s and 2-D image valve area correlated less well(r=0.33, P<0.05) than Gorlin`s-Doppler pressure halftime correlation(r=0.46, P<0.002). Before PMV, 37 patients had no mitral regurgutation, 7 had grade 1 and 1 had grade 2 mitral regurgutation. After PMV, new mitral regurgutation occurred in 14 patients, increased in severity in 5 patients and so mitral regurgutation newly developed or increased in severity in 19(42%) patients. There were no differences between the patients with and those without an increase in mitral regurgutation after PMV, in age, sex, caediac rhythm, initial mitral valve area, increase in mitral valve area and fluoroscopic calcification. However, morphologic characteristics especially mobility(P<0.01) and thickening(P<0.05) of mitral leaflets were better pressured, and EBDA/BSA(effective balloon dilating area/body surface area) was significantly smaller(P<0.02) in patients without an increase in mitral regurgutation. Thus, an increase in mitral regurgutation after PMV might be related to the features of valve morphology especially and thickand EBDA/BSA.
Female ; Humans ; Mitral Valve ; Mitral Valve Insufficiency* ; Mitral Valve Stenosis

Cervical rib is a normal asymptomatic congenital bone abnormality that occurs in 0.4% of the population; 70% of these cases are bilateral. Cervical ribs are found incidentally on routine radiographs, though sometimes patients complain of a hard or pulsatile neck mass in the supraclavicular area. Although most of these ribs produce no symptoms and need no therapy, a few cases are symptomatic and require treatment. Furthermore, a cervical rib can displace the great vessels superiorly and may cause iatrogenic hemorrhage during neck surgery. Thus, otorhinolaryngologists should be aware of the diagnosis and management of this condition in patients with a neck mass. Here, we report three cases of cervical rib and include a review of literature.
Cervical Rib ; Hemorrhage ; Humans ; Neck ; Ribs ; Thoracic Outlet Syndrome

BACKGROUND: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. METHODS: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. RESULTS: Type 2 diabetic group (mean age 64.5+/-8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0+/-10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT, 1.26+/-0.62 mm vs. 1.03+/-0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30+/-0.70 mm vs. 1.17+/-0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09+/-0.32 mm vs. 0.96+/-0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19+/-0.47 mm vs. 1.01+/-0.32 mm, respectively, p=0.01). CONCLUSION: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.
Carotid Arteries ; Carotid Intima-Media Thickness ; Coronary Angiography ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Humans ; Hypertension

BACKGROUND AND OBJECTIVES: Conservation of the normal atrial size and architecture by preventing the structural atrial remodeling that's due to atrial fibrillation (AF) seems to be of prime importance for the management of AF patients. We attempted to assess the relevance of performing strain echocardiography for quantitatively assessing the left atrial (LA) status in AF patients. SUBJECTS AND METHODS: Tissue Doppler strain and 2-dimensional strain imaging were performed in 15 patients with chronic AF, in 15 patients with paroxysmal AF and in 15 healthy age-matched controls with using a GE vivid 7 dimension apparatus. The LA diameter, LA volume index and mitral inflow parameters were measured by standard echocardiography. Longitudinal peak strain and the strain rate were obtained from 2 different areas of the basal left atrial free wall and also the inter-atrial septum in the apical 4 chamber view with using the tissue Doppler strain. The mean peak systolic rate (Sm-SR), the peak early diastolic rate (Em-SR) and the peak late diastolic strain rate (Am-SR) were measured at the inter-atrial septum in the apical 4 chamber view with using the 2-dimensional strain imaging. RESULTS: The peak strain/rate, the Sm-SR and the Em-SR were significantly reduced in the AF group as compared with the normal controls, and they were especially reduced in the chronic AF group. There were no significant differences for the LA size and A wave velocity between the paroxysmal AF group and the normal group; however, the peak systolic strain/rate, the Em-SR and the Am-SR were significantly lower in the paroxysmal AF group than in the normal controls. CONCLUSION: The lower values of atrial Sm-SR, Em-SR and Am-SR revealed that active contraction and passive stretching of the LA wall may be impaired in some patients suffering with paroxysmal AF even before LA enlargement occurs, and this is possibly because of reduced atrial compliance. Our results indicated that strain echocardiography enabled quantitatively precise assessment of the LA contractile function and it can provide clinically useful information concerning the early reversible atrial functional changes in patients suffering with AF, and especially in the paroxysmal AF patients.
Atrial Fibrillation* ; Atrial Remodeling ; Compliance ; Echocardiography ; Humans ; Muscle Stretching Exercises

Tracheopathia osteoplastica is a rare disease of unknown cause and characterized by cartilaginous or bony projection into the tracheobronchial lumen, usually not involved posterior membranous portion of tracheobronchial tree. In the past, most of the cases were diagnosed incidentally at autopsy. But after the introduction of bronchoscopy and computed tomography, antemortem diagnosis was reported. Because of initial presenting symptoms were indolent and non-specific, misdiagnosis was reported frequently and correct diagnosis was delayed usually. We report two cases of tracheopathia osteoplastica diagnosed by fiberoptic bronchoscopic biopsy.
Autopsy ; Biopsy ; Bronchoscopy ; Diagnosis ; Diagnostic Errors ; Rare Diseases