No abstract available.
Cholesterol, HDL* ; Coronary Artery Disease* ; Coronary Vessels* ; Fibrinogen*

BACKGROUND: Neointimal ingrowth rather than stent recoil has thought to be important for coronary arterial in-stent restenosis. Intuitively cell migration and extracellular matrix (ECM) formation seems to be important in the pathogenesis of stent restenosis. Therefore, with specific aim of identifying molecules implicated in cell migration and extracellular matrix formation, histopathologic analysis on atherectomized coronary arterial in-stent restenotic tissue was performed. METHODS: In the present study we analyzed 29 atherectomized coronary arterial in-stent restenotic tissue specimens (LAD 14, LCX 5, RCA 10) retrieved (5.7+/-5.4 months after stent deployment) from 25 patients (age 59+/-13, M/F:18/70) in whom restenosis complicated previous revascularization with Palmaz-Schatz stent. Histopathologic analysis was performed after immunostaining. Antibodies against TGF- 1, hyaluronan synthase (HAS) 1, MMP1, MMP9, urokinase type plasminogen activator, PDGF receptor were used for immunostaining. RESULTS: Myxoid tissue characterized by stellate-shaped cells embedded in a loose ECM was present in 20 out of 29 specimens, and tends to decrease over time after stenting. Foci of cell poor area (48-320 cells/mm2) in a microscopic field was present in 17 out of 29 specimens, and tends to increase over time after stenting (13/16 in <4 mo vs. 4/13 in > or =4 mo, p<0.01). Various proportions of specimens show positive stained cells with respect to each antibodies: TGF 1 in 16 out of 20:HAS1 in 10 out of 13:MMP1 in 8 out of 16:MMP9 in 4 out of 13:PDGF receptor in 12 out of 17 specimens. Abundant cells labled with certain antibodies (TGF 1, uPA, PDGF receptor) were frequently found in myxoid tissue. CONCLUSIONS: Myxoid tissue, frequently found in stent restenotic tissue, may be a biologically active tissue in terms of cell migration and of ECM formation. ECM accumulation tends to increase over time after stenting and may be important in pathogenesis of coronary arterial stent restenosis.
Antibodies ; Cell Movement* ; Extracellular Matrix* ; Humans* ; Hyaluronic Acid ; Receptors, Platelet-Derived Growth Factor ; Stents* ; Urokinase-Type Plasminogen Activator

BACKGROUND AND OBJECTIVES: Neointimal ingrowth rather than stent recoil is thought to be important for coronary in-stent restenosis. However only limited pathologic data are available to adress the mechanisms of in-stent restenosis. With the specific aim of measuring cell replication and of assessing cellularity and extracellular matrix (ECM) composition, we analyzed atherectomized coronary arterial in-stent restenotic specimens. METHODS AND RESULTS: In the present study, we analyzed 29 atherectomized coronary arterial in-stent restenotic tissue samples (14 LAD, 10 RCA, and 5 LCX) retrieved from 25 patients (m/f:18/7: age 59+/-13 yr) at 0.5-23 (mean 5.7) months after deployment of Palmaz-Schatz stent. Histopathological analysis of cellular components and ECM was performed using H & E, modified Movat pentachrome, and immunocytochemical staining. Cellular proliferation rate, as estimated by use of antibodies to Ki-67 nuclear antigen showed low proliferation rate with the range of 0-4%, and no positive cells were found in 62% of cases. Myxoid tissue having ECM enriched with versican and hyaluronan was found in 69% of cases, and decreased over time after stenting. Foci of cell poor area were found in 57% of cases, and could be classified into as: (1) containing collagen-rich ECM and (2) containing a proteoglycan-rich ECM. Versican, biglycan, perlecan, and hyaluronan were identified with varying individual distributions in the proteoglycan rich area. Specimens with foci of cell poor area tended to increase over time after stenting (31% in & 4 mo vs. 81% in > or =4 mo after stenting, p<0.01). alpha-smooth muscle actin staining identified the majority of cells as smooth muscle cells (SMC) and occasional macrophages (< or =12 cells per section) were detected by CD68 antibody. CONCLUSIONS: These data suggest that enhanced ECM accumulation rather than cell proliferation may be important mechanisms for stent restenosis. Angioplasty of stent restenosis may therefore fail due to transient compression of this hygroscopic matrix.
Actins ; Angioplasty ; Antibodies ; Biglycan ; Cell Proliferation ; Extracellular Matrix ; Humans* ; Hyaluronic Acid ; Macrophages ; Myocytes, Smooth Muscle ; Proteoglycans ; Stents* ; Versicans

No abstract available.

Renal artery embolization was induced experimentally in rabbits and microvascular changs were studiedangiographically, microangiographically and histopathologically. The results were as follows; 1. The mainmicroangiographic findings of renal artery embolization were arterial occlusion and collateral vessels arecharacterized by spiralling, dilatation, irregular lumen with abrupt caliber change, disoriented course andincreased number. 2. Collateral vessel formation was demonstrated in all cases of renal artery embolization bymicroangiography. 3. Recanalization of embolized vessels was better visualized by renal angiography thanmicorangiography. It was considered that microangiography is a valuable method for the observation ofmicrovascular changes in renal artery embolization and other renal diseases.
Angiography ; Dilatation ; Methods ; Rabbits ; Renal Artery

The early weight bearing in treatment for tibial fractures was reporded first by Gurd(1940) and in recent by Weissman(1966), Sarmiento(1967), and Brown(1969). 1. One hundred and fifty cases of fractures of the tibia treated at the Orthopedic Department f the 17 th Army Hospital during period of January 1968 to June 1970 were subjected to analysis. Of three groups, first group was applied functional below the knee cast after mannual reduction and started weight bearing on the 5 th weeks from injury, second group was treated with same method as first group except the reduction was achievd surgically, and third group was applied toe-to-groin cast after manipulation with no weight bearing until union. 2. Casting method; The toe-to-groin cast was applied on the day of injury after manipulation and functional below the knee cast was applied tightly after swelling was subsided. Supporting the leg on the table, we could obtain satisfactory alignment in all cases. Especial firm molding over the medial flare of the tibia, Patellar tendon and popliteal space was the most important step in applying this type of the cast. Finally rubber walking heel was held in place throught the tibial axis. 3. Traffic accident was the most common cause of the fractures in this series and it was 78 cases out of 150. 4. The average healing time of the first group was 15.7 weeks, of second group was 19.4 weeks, and of third group was 23.5 weeks. 5. The open and/or comminuted fractures would delay healing time, and prolonged convalescent period. 6. Though slight shortening and angulation was observed in the early weight bearing groups, the final function was excellent.
Accidents, Traffic ; Fractures, Comminuted ; Fungi ; Heel ; Hospitals, Military ; Knee ; Leg ; Methods ; Orthopedics ; Patellar Ligament ; Rubber ; Tibia ; Tibial Fractures ; Walking ; Weight-Bearing

Surgery is the treatment of choice for recurrent dislocation of the patella and many proposed operations can conveniently be grouped into three headings: transposition medially of the quadriceps pull mechanism (Hauser), installment of medial checkrein, either proximal or distal to the patella (Campbell) and patellectomy (West and Sotto Hall). Two cases of the dislocation observed in the young men are reported here, in which the authors performed an operation consisting of Hauser method and in addition the medial checkrein utilizing semitendinosus tendon. The results were successful in both cases, with complete restoration of the knee function.
Dislocations ; Head ; Humans ; Knee ; Male ; Methods ; Patella ; Tendons

We have treated three cases of bone abscesses, two in proximal tibia and one in os calcis, by radical excision and filling the remaining bone cavity with autogenous iliac bone graft. We have observed them postoperatively for one to six years. They have not shown any sign of recurrence and they are carrying out their normal daily activity without any restriction. Eventhough it is against the basic fundamental of surgery to lay bone grafts in an infected area, our treatment was successful. We believe that this was resulted from the administration of the broad spectrum antibiotics, complete excision of the diseased tissue, gentle handling of the tissue at the surgery, and relatively perfect postoperative care. When the remaining bone cavity after the surgery of the osteomyeIitis can not filled by the usual method such as muscle pedicle graft, especially in the proximal metaphyseo-epiphyseaI region of the tibia, fresh cancellous bone graft immediately after the radical excision, and primary closure of the operative wound may be tried. It seems that this method brings rapid and permanent heaIing of the chronic osteomyelitis. Thus the patient can leave hospital earlier, pays Iess expense, and returns to his work earlier.
Abscess ; Anti-Bacterial Agents ; Humans ; Methods ; Osteomyelitis ; Postoperative Care ; Recurrence ; Tibia ; Transplants ; Wounds and Injuries

BACKGROUND AND OBJECTIVES: As previously reported, unstable angina is usually related to characteristic coronary artery lesion's morphology analyzed by coronary angiogram. This takes the form of an eccentrically placed convex stenosis with a narrow neck due to one or more overhanging edges or irregular, scalloped borders, or both. Although most studies were done for lesions with high degree stenosis(>50%), recent studies emphasized the role of vulnerability of plaque in acute coronary syndrome and even mild degree stenotic lesions may progress rapidly to evoke acute coronary syndrome. Therefore in this study, we analyzed the morphological characteristics of coronary artery lesions with mild degree stenosis as well as severe stenosis. MATERIALS AND METHODS: We conducted a retrospective study of 96 patients with angina pectoris (42 of stable patients and 54 of unstable patients) who underwent coronary angiography. Each lesions with 25% or greater diameter stenosis were categorized into simple and complex lesion(convex intraluminal obstruction with a narrow neck or irregular borders, diffuse irregularities, ulceration, thrombus). Calcification of coronary artery, extents of lesions were analyzed and stenosis grade and location were categorized by AHA classification. RESULTS: There were no significant differences between the stable angina and unstable angina in risk factors and vessel involvement, numbers of lesions, calcification and total obstruction. In morphologic analysis, complex lesions were more frequent in unstable angina than stable angina (49% vs 33%, p<0.05). The mean of percent diameter stenosis was not signigicantly different between two groups, but severe stenotic lesions with 90% or more stenosis were more frequent in unstable angina (34% vs 22%, p<0.05). Locations of involved vessels were similar between the angina groups. Complex lesions were distributed more frequent in RCA and simple lesions were more in LAD and LCX (p<0.05). CONCLUSIONS: The lesions with both complex morphology and severe degree stenosis are closely implicated in unstable angina.
Acute Coronary Syndrome ; Angina Pectoris ; Angina, Stable ; Angina, Unstable* ; Classification ; Constriction, Pathologic ; Coronary Angiography ; Coronary Vessels* ; Humans ; Neck ; Pectinidae ; Retrospective Studies ; Risk Factors ; Ulcer

PURPOSE: To describe the radiological differences between tuberculous(TBB) and non-tuberculous bronchiectasis(NTBB). MATERIALS AND METHODS: Chest radiographs(n=62), bronchograms(n=18), and CT scans(n=52) of 37 patients with TBB and 25 patients with NTBB were reviewed retrospectively. Diagnostic basis for TBB were positive sputum AFB with or without history of anti-tuberculous chemotherapy(n=35), and radiological findings of pulmonary tuberculosis (n=2). Four of NTBB had a history of severe respiratory tract infection in childhood. RESULTS: Air-fluid levels on chest radiographs were seen in 2% of TBB, and 20% of NTBB. On bronchograms, all patients with TBB had combined focal bronchostenosis, whereas patients with NTBB had tubular(50%), cystic(17%), or mixed(33%) pattern of dilatation without stenosis. On CT scans, focal emphysema was seen in 86% of the patients with TBB, and 38% of the patients with NTBB. Peribronchiolar infiltration were seen in 78% and 44% of patients with TBB and NTBB, retrospectively. CONCLUSION: Basic radiological difference between TBB and NTBB was that the former had coexistent sten.
Bronchiectasis* ; Constriction, Pathologic ; Dilatation ; Humans ; Pulmonary Emphysema ; Radiography, Thoracic ; Respiratory Tract Infections ; Retrospective Studies ; Sputum ; Thorax ; Tomography, X-Ray Computed ; Tuberculosis, Pulmonary