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*

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

To assess the value of CT and MR in the detection of local tumor recurrence after hysterectomy, we evaluate CT and MRI findings of the vaginal stump in fifteen patients who underwent hysterectomy for uterine cervical carcinoma (N=14) or endometrial carcinoma (N=1). The presence of stump recurrence was confirmed by needle biopsy in 7 patients and by reoperation in 1 patient. The absence of stump recurrence was diagnosed by needle biopsy in 3 patitients and by clinical follow-up in 4 patients. In eight patients with vaginal stump recurrence, six patients were correctly diagnosed by CT and seven patients by MRI. In remaining seven patients who had no evidence of tumor recurrence, four patients were correctly diagnosed with CT and all the rester patients with MRI. ON the bases of our results, MRI seems to be superior to CT in the evaluation of local tumor recurrence after hysterectomy.
Biopsy, Needle ; Endometrial Neoplasms ; Female ; Follow-Up Studies ; Humans ; Hysterectomy* ; Magnetic Resonance Imaging* ; Recurrence* ; Reoperation

Essential hypertension is an important public health problem in Korea-being common, asymptomatic, easily treatable, and often leading to lethal complication in left untreated. The number of patients with hypertension has been significantly increased, and this factor may be an importnat one responsible for the increase in cardivascular mortality during past 20 years in Korea. As the drug therapy for hypertension needs longer period, it is very important to evaluate the efficacy and the adverse effects. Thirty patients(17 men and 13 womon) with essential hypertension were evaluated in this study. All patients had received oral Isradipine 1.25~2.5mg b.i.d. for 8 weeks. 1) The systolic and diastolic pressure were decreased significantly(166.8+/-9.0mmHg vs 147.3+/-12.0mmHg, p<0.001 and 100.3+/-4.0mmHg vs 90.3+/-6.1mmHg, p<0.001, respectively) 2) Heart rate, body weight, laboratory tests, chest X-ray, ECG studies were not changed significantly. 3) The systolic pressure was lowered by 20mmHg or more in 17 cases(56.7% of total), and the diastolic pressure was lowered by 10mmHg or more in 20 cases(66.7% of total) at 8 weeks after Isradipine administration. 4) The adverse effects of Isradipine were edema in 3(10%), constipation in 2(6.7%), headache in 2(6.7%), and insomnia, dizziness and dry mouth in 1 patient respectively, and none of them discontinued Isradipine administration due to adverse effects. In many patients with essential hypertension there is an effective response to Isradipine, even though there may be some mild adverse effects.
Blood Pressure ; Body Weight ; Constipation ; Dizziness ; Drug Therapy ; Edema ; Electrocardiography ; Headache ; Heart Rate ; Humans ; Hypertension ; Isradipine ; Korea ; Male ; Mortality ; Mouth ; Public Health ; Sleep Initiation and Maintenance Disorders ; Thorax

The elbow joint is the most commonly dislocated-joint in the body except for the shoulder, and in children less then 10 years old, it is the most frequently dislocated articulation. The injury and the treatment are well described in most standard textbooks, but the characteristic findings and follow-up evaluations are not generally recognized. Authors have clinically analyzed 45 cases of traumatic fracture and dislocation of the elbow joint which are treated between January, 1975 and June, 1985 at the Department of Orthopedic Surgery, Wonju Medical College of Yonsei University. The results were as follows; 1. The age incidences were in even distribution except in the old ages where the incidence was low and the male to female ratio was 7: 3. 2. The major cause of the injury of the elbow was fall down (60%). 3. Posterior and posterolateral dislocations were about 60% of all cases. 4. Associated fractures were 35.6% of all the elbow dislocations, of which medial epicondyle fracture had the highest incidence. 5. Complications including ulnar nerve injury (3 cases), median nerve injury(1 case), radial nerve mjury(1 case), rupture of brachial artery(2 cases), recurrent dislocation(1 case) and calcification of ligament(2 cases) were observed. 6. Pure elbow dislocation occurred in 13 cases (28.9%). 7. The average immobilization period for patient with non-operative treatment (45%) and operative treatment(55%) were 7 days and 3 weeks, respectively, and much better results were seen in patients with non-operative treatment than in operative treatment and in shortened immobilization period.
Child ; Clinical Study ; Dislocations ; Elbow Joint ; Elbow ; Female ; Follow-Up Studies ; Gangwon-do ; Humans ; Immobilization ; Incidence ; Male ; Median Nerve ; Orthopedics ; Radial Nerve ; Rupture ; Shoulder ; Ulnar Nerve

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

PURPOSE: To evaluate the specific findings of infiltrating ductal carcinoma from the ductal carcinoma in situ (DCIS) and to differentiate from the atypical ductal hyperplasia(ADH). MATERIALS AND METHODS: Fifty breast lesions in 48 patients including thirty-six breasts of 36 patients with infiltrating ductal carcinoma, fourteen breasts of 12 patients with DCIS, and nine breasts of 7 patients with ADH were examined with FLASH technique using Gd-DTPA. We evaluated the maximal amount, the speed, and the pattern of enhancement after intravenous injection of Gd-DTPA(0.16mmol/kg body weight). Also we evaluated the diagnostic accuracy in the patients with breast cancer. RESULTS: The maximal amount of enhancement were 1,161.84 +/- 394.44 NU in infiltrating ductal carcinoma, 982.11 +/- 458.35 NU in DCIS, and 1,035.94 +/- 305.20 NU in ADH. The speed of enhancement was 827.33 +/- 384.20 NU within the first 1 minute with a sudden increase in signal intensity after injection and a much slighter in- crease thereafter in infiltrating ductal carcinoma. DCIS showed in creasing signal intensity within the first 2 minutes(749.70 +/- 487.36 NU), and ADH showed significant increased enhancement(765.40 +/- 313.61 NU) at 3 minutes after injection of Gd-DTPA. The patterns of enhancement were focal with irregular margins in infiltrating ductal carcinoma and irregular peripheral enhancement in DCIS and ADH. However, absent or extreme delayed enhancement at the central portion of the tumor was more frequently seen in infiltrating ductal carcinoma rather than DCIS or ADH. CONCLUSION: Gd-DTPA enhanced dynamic MRI was valuable in the diagnosis of breast cancer and in differentiating DCIS from ADH. Furthermore, it was effective in analyzing the extension of breast carcinoma, multiplicity, and bilaterality of breast carcinoma.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Diagnosis ; Gadolinium DTPA* ; Humans ; Injections, Intravenous ; Magnetic Resonance Imaging

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

PURPOSE: To assess the usefulness of the ultrasound-guided subclavian vein catheterization in difficult patients. MATERIALS AND METHODS: We tried subclavian vein catheterization in 18 patients in which conventional blind technique failed(N=9) :or was complicated by hemothorax or pneumothorax(N=3) :or was prohibited by respirator care(N=4) and severe thoracic deformity(N=2). Initially, the patency of subclavian vein was evaluated with ultrasonography, and then, the puncture of the subclavian vein was performed under the guidance of ultrasonography. Under the fluoroscopy, the patency of the proximal subclavian vein and the superior vena cava was evaluated after contrast-media injection and a catheter was inserted into the subclavian vein and accurately positioned at the superior vena cava. RESULTS: Successful catheterization was performed in 17 patients. In the remaining one patient, we did not perform catheterization because of bilateral subclavian vein thrombosis detected during the procedure. There were no procedure-related complications. CONCLUSION: Ultrasound-guided subclavian vein catheterization is an easy and safe method even in difficult cases.
Catheterization* ; Catheters* ; Fluoroscopy ; Hemothorax ; Humans ; Punctures ; Subclavian Vein* ; Thrombosis ; Ultrasonography ; Vena Cava, Superior ; Ventilators, Mechanical

This study was carried out to reveal the epidemiologic characteristics of psoriasis in Korea. Seventeen university hospitals were engaged in this study, and the results were as follows : 1. The number of psoriasis patients during the 10 years from January 1977 to March 1987 was 1.05% of all the outpatients; the male to female-ratio was 1.08:1. 2. In the prospective study, the number of psoriasis patients was 2.3% of all the outpatients in 1987, 2.8% of all the outpatients in 1988 and the male to female ratio was 1.26:1. 3. The most prevalent age of onset was 20-29 years ; 81.1% were living in urban areas; and a family history was obtainable in 19.8% with parents holding the highest rank of 7.8%. 4. The most frequent duration of disease activity was under 5 years in 63.3%; the most common age for the worst condition was 20-29 yrs. The most common area size of skin involvement at the peak of the worst condition was less than 10%. 5. The most common initiating skin lesion began on the scalp in 20.2%, on the nail in 17.2%, pruritus in 63.0% with joint symptoms in 10.8%, and Koebner phenomena in 50.6%. 6. Emotional stress was the most common aggravating factor in 34.4%. The method of treatment that attained the best result was the combination therapy of oral medication and a topical agent. The best treatment modality was said to be the application of ointment with p.o.medication by as many as 28.4% of patients who took the leading rank. Photo-chemotherapy, effective with few complications, was not used much as it was not well-known in Korea until after 1980. Most people had an accurate knowledge of psoriasis.
Age of Onset ; Epidemiologic Studies* ; Epidemiology ; Female ; Hospitals, University ; Humans ; Joints ; Korea ; Male ; Methods ; Outpatients ; Parents ; Prospective Studies ; Pruritus ; Psoriasis* ; Scalp ; Skin ; Stress, Psychological