PURPOSE: This study was designed to evaluate usefulness of intravenous digital subtraction angiography (IV-DSA) in detection of peripheral arterial obstructive disease(PAOD) and in follow-up of percutaneous transluminal angioplasty(PTA). MATERIALS AND METHODS: 35 Patients who had clinical symptoms and signs of compromised lower extremity perfusion, was screened with IV-DSA and then performed confirmative conventional angiography. We obtained sensitivity, specificity and accuracy of IV-DSA by comparing the findings of IV-DSA with those of conventional angiography. 21 patients who had been performed successful PTA, were foliowed-up with IV-DSA in 3, 6, 12months. We studied patency rate and factors that influenced restenosis. RESULTS: The sensitivity, specificity and accuracy of IV-DSA were 100%, 97%, 97% in lilac artery, 92%, 96%, 93% in femoropopliteal artery, 85%, 75%, 70% in proximal tibioperoneal artery retrospectively. IV-DSA follow up after PTA showed patency rate of 67% in first 3month, 67% in 2nd 3month, 60% in next 6month. Longer length and more irregular surface of the stenotic site, and higher incidence of run-off of vessel and of residual stenosis in the patients with restenosis were noted. CONCLUSION: High sensitivity, specificity and accuracy of IV-DSA in evaluating PAOD suggest that IV-DSA is useful in screening, planning therapy and following up after PTA.
Angiography ; Angiography, Digital Subtraction ; Arterial Occlusive Diseases* ; Arteries ; Constriction, Pathologic ; Follow-Up Studies ; Humans ; Incidence ; Lower Extremity ; Mass Screening ; Perfusion ; Retrospective Studies ; Sensitivity and Specificity

No abstract available.
Barium* ; Enema* ; Intussusception* ; Ultrasonography* ; Water*

No abstract available.
Balloon Valvuloplasty* ; Pulmonary Valve Stenosis* ; Pulmonary Valve*

No abstract available.
Scimitar Syndrome*

Successful percutaneous transluminal angioplasty (PTA) of an internal mammary artery graft was performed in a 40 year old male patient who had recurrent angina soon after bypass surgery. Coronary angiography showed total occlusion of proximal portion of the left anterior descending artery and normal right coronary artery. Angiography of the left internal mammary artery graft revealed a tight stenosis (90% diameter narrowing) in the mammary artery at its insection into the left anterior descending artery.Angiography after the angioplasty demonstrated a widely patent graft (residual stenosis 10%) and translesional pressure gradient was 10 mmHg.
Adult ; Angiography ; Angioplasty* ; Arteries ; Constriction, Pathologic* ; Coronary Angiography ; Coronary Vessels ; Humans ; Insects ; Male ; Mammary Arteries* ; Transplants*

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

From May, 1978 through Oct., 1979 the effect of Coenzyme Q10 was evaluated on 10 patients with chronic heart failure. The subjects selected for this study consisted of 7 patients with cardiomyopathy and 3 patients with valvular heart disease admitted to Severance Hospital, Yonsei University College of Medicine, All these patients had symptoms and signs of congestive heart failure which was stable for at least one month before starting Coenzyme Q10. Coenzyme Q10 was administered 30mg daily for eight weeks, one hour before meal and in combination with digitalis and/or diuretics. The drug effects were determined by measuring the cardio-thoracic ratio by chest X-ray, the sum of 'S' wave in V1 and 'R' wave in V5 in electrocardiogram, and PEP/LVET (pre-ejection period/left ventricular ejection time) by simultaneous tracings of carotid pulse and phonocardiogram every two weeks during medication. The cardio-thoracic ratio was improved in 4 of 10 cases, the sum of RV+SV5 was decreased in all 5 cases who showed voltages above 40mm before medication, and PEP/LVET ratio was decresed in 4 of 10 cases. The difference of average values before and after medication were not statistically significant(p<0.05) in all 3 parameters when examined by t-test. During treatment, there was improvement, if any, from two weeks after medication and no significant side effects were noted throughout the study period.
Cardiomyopathies ; Digitalis ; Diuretics ; Electrocardiography ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Heart Valve Diseases ; Humans ; Meals ; Thorax

PURPOSE: Colonoscopy is a safe and commonly used method for the screening of colon cancer, but sometimes major complications, such as, colonic perforation or hemorrhage occur during the procedure. The aim of this study was to compare the surgical outcomes of laparoscopic and open surgery for colon perforation after colonoscopy. METHODS: A retrospective review of patient records was performed on 25 patients with iatrogenic colon perforation during colonoscopy during the 7-year period from January 2005 to June 2012. Demographic data, operative procedures, operation times, postoperative complications, hospital course, and morbidities in the laparoscopic surgery group (LG) and open surgery group (OG) were compared. RESULTS: Seventeen of the 25 patients underwent laparoscopic surgery (68%) and 8 patients open surgery (32%). The most common surgical methods were primary repair in the LG, and Hartmann's operation in the OG. Average time to first flatus was 2.9 days in the LG and 4.5 days in the OG, and average times to first meals were 4.5 days and 5 days, respectively. Mean hospital stays were 10.8 days in the LG and 17 days in the OG. After surgery, complications occurred in two patients in the LG, but no complication occurred in the OG. CONCLUSION: Laparoscopic repair for iatrogenic colonic perforation during colonoscopy seems to be useful and safe surgical method in early period after perforation. However, open surgery is also needed for the delayed cases after perforation.
Colon* ; Colonic Neoplasms ; Colonoscopy* ; Flatulence ; Hemorrhage ; Humans ; Intestinal Perforation ; Laparoscopy ; Length of Stay ; Mass Screening ; Meals ; Postoperative Complications ; Retrospective Studies ; Surgical Procedures, Operative

To determine factors involved in left ventricular aneurysm formation after transmural anterior myocardial infarction, 74 patients with a first myocardial infarction who underwent cardiac catheterization within 6 weeks of infarction were evaluated.Patients were divided into four groups depending on the status of the left anterioe descending artery(LAD) and the presence Group I(n=15);aneurysm with occluded LAD, Group II(n=16);no aneusrysm and occluded LAD, Group III(n=18);aneusrysm and patent LAD, and Group IV(n=25);no aneusrsm with patent LAD. Neither age, sex nor risk factors for coronary disease correlated with aneusrysm formation,but the duration of chest pain in patients with previous angina was significantly longer in group II(no aneusrysm with occluded LAD) compared with other groups(P<0.01). Single vessel disease was more commom in Group I and III(aneusrysm) compared with II and IV(no aneusrysm)(P<0.06). Collateral blood supply was more frequently observed in Group I and II(occluded LAD) compared with Group III and IV(patent LAD)(P<0.01) and was slightly less in Group I(aneusrysm) compared with Group II(no aneusrym)(P<0.07). Delta area decreasing rate of the left ventricle was significantly lower in Group I and III(aneusrysm)compared with Group II and IV(no aneusrysm)(P<0.01). Single vessel disease in assocition with poor collateral circulation tends to be a determinant of left ventricular aneusrysm formation after anterior myocardial infarction.
Aneurysm* ; Cardiac Catheterization ; Cardiac Catheters ; Chest Pain ; Collateral Circulation ; Coronary Disease ; Heart Ventricles ; Humans ; Infarction ; Myocardial Infarction* ; Risk Factors

With the recent increase of coronary artery disease in Korea, coronary arteriography israpidly gaining importance as a diagnostic procedure in the management of ischemic heart disease in this country. In order to delineate normal angiographic anatomy of the coronary arteries in Korean adults, the author reviewed 63 normal or near normal coronary angiograms out of 113 consecutive cases done at the cardiac laboratory of Yonsei University Severance Hospital from February, 1976 through September, 1982 and obtained the following results. 1) The diameter of the main stems of the left and the right coronary arteries measured 2.7-6.3mm(mean, 4.0mm) and 2.1-6.0mm(mean, 3.6mm) respectively, and the length of the left main stem measured 0-23mm(mean, 9.3mm). 2) The conus branch was visualized to originate from the proximal right coronary artery in 50 cases(79.4%), and in the other 13(20.6%) in whom the conus branch was not visualized, it was assumed to have a separate ostium directly from the aortic root. 3) The sinus node artery originated from the right coronary artery in 35 cases(55.5%) and from the left circumflex 20(31.7%). The remaining 8 cases(12.7%) appeared to have dual blood supply. 4) The artery to the A-V node arose from the proximal part of the posterior descending artery as a branch of the right coronary artery in 59 cases(93.7%) and of the left circumflex in only 4(6.3%), and the pattern of the A-V node blood supply coincided with the dominancy(crossing the crux of the heart and giving rise to the posterior descending artery) of the right or the left circumflex arteries. 5) In 33 cases(52.4%), both of the arteries to the SA and the AV nodes arose from the right coronary, and in 19(30.2%), the SA node artery came from the right, whereas the AV node artery originated from the left circumflex. 6) The number of ramifications(furcation) of the main left coronary artery was two in 53 cases(83.1%), three in 9(14.3%), and four in 1(1.6%). 7) The number of diagnoal branches of the left anterior descending artery was one in 34 cases(54%), two in 28(44.4%) and 3 in 1(1.6%).
Adult* ; Angiography ; Arteries ; Atrioventricular Node ; Conus Snail ; Coronary Angiography* ; Coronary Artery Disease ; Coronary Vessels* ; Heart ; Humans ; Korea ; Myocardial Ischemia