To clarity the effect of biliary obliteration on copper metabolism of rat liver and on the hepatic morphology, 0.5% cuppuric sulfate was administered intraperitoneally for 42 days following ligation of the common bile duct (CBD) of Sprague-Dawley rats. The blood copper concentration, the hepatic copper content and the accumulation patterns of copper and copper binding protein in the liver were examined and compared with those of the simple CBD ligation group and the simple copper over loaded group. CBD ligation induced marked proliferation of bile ductular structures which, after expanding the portal tracts, invaded and divided the hepatic lobules. There was, however, no excess fibosis beyond what needed to support the new ductules. The blood copper concentration and the hepatic copper content were increased by copper overload with or without CBD ligation, particularly incases with CBD ligation. Liver cell necrosis did not occur by the overloaded copper alone in rats. The hepatic copper and copper binding protein were accumulated at periportal liver cells in the group of coppe overload after CBD ligatio, whereas they began to appear at perivenular hepatocytes in the simple copper overloaded group. In conclusion, it is suggested that CBD ligation does not induce excess fibrosis or liver cirrhosis in rat as far as during our experimental period, but affect significantly on copper metabolism by intrahepatic redistribution of the copper and the copper binding proteins.
Rats ; Animals

No abstract available.
Nasal Bone*

Fracture dislocation or dislocation of the knee can produce a popliteal artery injury that may be difficult to evaluate clinically. Diagnosis of disruption or thrombosis of the popliteal artery is frequently delayed until the opportunity to salvage the extremity is lost. 22 cases of popliteal artery injury were reviewed from July 1978 to December 1983, associated with severe knee trauma at the Orthopaedic department of Kyung Hee University Hospital, of whom average follow-up for about 52 months. The results obtained were as follows; 1. In all 22 cases, 14 cases (63. 6%) were amputated. The amputation rate was correlated with ischemic time after injury. 2. Resection of all injuried vessels with reconstitution of continuity by the use of an interposed saphenous vein graft is often warrented to avoid tension. 3. All 8 patients, which was managed conservatively, were amputated in all cases(100%). In cases of suspicious popliteal artery injury, early aggressive exploration and obvious microvascular reconstruction should be mandatory. 4. Subperiosteal fibulectomy-fasciotomy should be done routinely immediately after vascular injury. 5. Diagnosis of popliteal artery injury was based on the clinical findings but the capillary filling was not contributary. 6. The use of Doppler flowmeter and emergency arteriography was recognizedtobeanexcellent methods in determination of arterial injury.
Amputation ; Angiography ; Capillaries ; Diagnosis ; Dislocations ; Emergencies ; Extremities ; Flowmeters ; Follow-Up Studies ; Humans ; Knee ; Popliteal Artery ; Saphenous Vein ; Thrombosis ; Transplants ; Vascular System Injuries

BACKGROUND: Although the first coronary Wallstent implantation ushered in a new era in interventional cordiology with the purpose of circumventing the two major limitations of coronary balloon angioplasty, early acute occlusion and late restenosis, the previous investigators have reported a high rate of subacute occlusion after Wallstent implantation. However, recent studies have reported a low incidence rate of subacute closure and restenosis using the newly modified coronary Less Shortening in aortocoronary vein grafts. The present study reports the immediate results of the Less Shortening Wallstent Implantation for 21 diffuse native coronary lesions in 20 patients. METHODS: Twenty patients were enrolled at the Yonsei Univ. Cardiovasular Center of medical College, Yonsei University in Seoul, Korea from March 1996 through May 1996. The specific angiographic criteria for enrollment included at least 75% diameter stenosis, according to the estimate of two investigatior ; a lesion that was 20mm or more in lenght and a vessel diameter of at least 2.5mm. Bail-out procedure was performed in the case of abrupt closure or threatened closure, defined as a dissection and over 50% residual stenosis of the artery. RESULTS: The coronary Less Shortening Wallstents were successfully implanted in the 21 diffuse coronary lesions(more than 20mm in length) of the 20 patients(pts), including 7 pts of acute myocardial infarction, 11 pts of unstable angina, and 2 pts of stable angina. Angiographic results after Less Shortening Wallstent were 3.0+/-0.3mm in minimal luminal diameter(MLD), 6.7+/-10.8% diameter stenosis(DS) comparing with pre-stent implantation MLD and DS, respectively, 0.3+/-0.4mm and 89.9+/-8.4%. During the in-hospital phase, no major cardiac event occurred except 2 cases of transmural myocardial infarction, including one of stent thrombosis and one of side branch occlusion, despite of inclusion of 7 cases of threatened occlusion in the long lesion. The peristent spasms were observed in 11 among 21 lesions, although long term significance of peristent spasm is not defined. The relative risk for peristent spasm were 10 times higher when larger stents(expanded stent diameter/reference artery diameter>1.7) were implanted. There was no peristent spasm when stents of which expanded stent diameter 1.4 times smaller than reference artery size ware used. CONCLUSION: The results of this introductory study suggest that new Less Shortening Wallstent may reduce the requirement of multiple stent in the long lesion and a lower rate of thrombotic occusion in comparison to its prototype. Further large scale long term follow-up study is needed to evaluate the role of new Less Shortening Wallstent.
Angina, Stable ; Angina, Unstable ; Angioplasty, Balloon, Coronary ; Arteries ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease* ; Follow-Up Studies ; Humans ; Incidence ; Korea ; Myocardial Infarction ; Phenobarbital ; Research Personnel ; Seoul ; Spasm ; Stents ; Thrombosis ; Transplants ; Veins

Heart failure is an important public medical problem in the developed countries. Although there are numerous and fascinating medicines given by physicians for the treatment of heart failure, the general 5 year survival rate for advanced heart failure is only about 50%. There are still many theoretical and practical problems to overcome before the application of gene therapy to cardiovascular disease becomes a reality in the future. With our increased knowledge on the development of gene delivery, vector systems, molecular basis of cardiac dysfunction, and the pathogenesis of heart failure at the cell level, gene therapy is emerging as a new therapeutic option for heart failure.
Cardiovascular Diseases ; Developed Countries ; Genetic Therapy* ; Heart Failure* ; Heart* ; Survival Rate

BACKGROUND/AIMS: A moderate dose of statin/ezetimbe combination therapy reduced the LDL-C (low density lipoprotein-cholesterol) in a fashion comparable to high dose statin without increasing the adverse events in patients with primary hypercholesterolemia. Yet there is no data on the effectiveness and safety of statin/ezetimbe combination therapy in patients suffering with acute myocardial infarction (AMI). METHODS: We retrospectively compared the lipid profiles and clinical variables of 82 patients who were admitted to our institution with AMI. These patients were successfully treated with emergent coronary intervention within 12 hours after the chest pain onset and they were prescribed a single statin (statin group) or statin/ezetimibe combination therapy (dual inhibition group) for treating their hyperlipidemia within 72 hours after the admission. We compared the initial lipid profiles, the % reduction of total cholesterol (TC), the LDL-C at 1 and 6 months and the safety profiles between the two therapeutic groups. RESULTS: Although the initial TC and LDL-C levels were significantly higher in the dual inhibition group than the statin group, one month later, the % reduction of the TC was 27.9+/-13.1% and 17.0+/-15.0% (p=0.004) and the % reduction of the LDL-C was 38.5+/-12.5% and 25.1+/-18.9% (p=0.001) in each group, respectively. One patient in the dual inhibition group showed CPK elevation more than 3 times the upper normal limit and ALT elevation more than 2 times of upper normal limit was observed in one patient in the statin group. CONCLUSIONS: Cholesterol dual inhibition therapy is superior to single statin therapy for the aspect of cholesterol reduction and safety in successfully reperfused AMI patients.
Chest Pain ; Cholesterol ; Humans ; Hypercholesterolemia ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Myocardial Infarction ; Retrospective Studies ; Stress, Psychological

PURPOSE: The TNM classification for carcinoma of the colon and the rectum provides more detail than other staging systems. This study was performed to evaluate the effectiveness of AJCC staging system (5th ed., 1997) for the colorectal cancer in predicting prognosis. METHODS: We analyzed a data base of 1,233 colorectal cancer patients (M:F=673:560) who underwent surgery in Asan Medical Center during July 1989-December 1996. Survival analysis was performed between the stages and the subgroups in same stage by using Kaplan-Meier method and log rank test. Borderline subgroup comparison between the stages was performed, also. Significance was assigned to a P value of <0.05. RESULTS: Mean age of the patients was 57 (19-90) years old. Median follow-up period was 42 (6-129) months. The number of patients in each stage were 0: 15, I: 152, II: 390, III: 465, IV: 199. The 5 year overall & disease free survival rates of each stage were 100%, 100% (in stage 0), 96.4%, 93.6% (in stage I), 82.7%, 82.2% (in stage II), 59.9%, 55.3% (in stage III), and 7.3%, 24.9% (in stage IV), respectively (P=0.000). Subgroup analysis in stage I (T1N0 vs. T2N0) and II (T3N0 vs. T4N0) revealed no differences. However, in stage III, N1 (n=246) group showed better survival than N2 (n=219) group (70.3%, 65.5% vs. 49.2%, 44.6%: P=0.000). Borderline survival analysis between stage I and II (T2N0 vs. T3N0) was significantly different (96.6%, 95.7% vs 82.7%, 82.3%: P=0.006). However, between stage II and III (T4N0 vs. T1N1), appropriate analysis was impossible due to small number of cases. CONCLUSIONS: AJCC staging system for colorectal cancer was reliable and effective in predicting prognosis. However, substages are needed in stage III.
Chungcheongnam-do ; Classification ; Colon ; Colorectal Neoplasms* ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Prognosis ; Rectum

No abstract available.
Cardiac Catheterization* ; Cardiac Catheters* ; Child* ; Cineangiography* ; Heart Diseases* ; Heart* ; Humans ; Statistics as Topic*

The effect of Pheniramine(Avil), a histaminergic-1 receptor blocking agent presently employed in treating various allergic diseases on pressor actions of norepinephring(NE) and tyramine (TR) was studied in the rabbit. Pheniramine, when given into a femoral vein with a dose(3mg/kg) enough to block H1-receptor, potentiated markedly the pressor responses of NE and TR. The pressor action of NE augmented by pheniramine was not affected by additional adminstration of debrisoquin (Drenergic neuron blocker) or phenelzine(monoamine oxidase inhibitor) or desipramine(U1-uptake blocker), or while potentiated by additional treatment with chlorisondamine(ganglionic blocker)or reserpine(catecholamine depleter). The hypertensive response of NE to phenelzine or desipramine was reinforced significantly by addition of pheniramine, but the response of NE in rabbits treated with reserpine or chlorisondamine or debrisoquin was not influenced by pheniramine-addition. Elevation of blood pressure to TR potentiated by pheniramine was attenuated significantly by reserpine treatment with chlorisondamine made the significant augmentation of pressor action to TR after pheniramine. Tyramine-induced response of blood pressure after pheniramine, but the response of blood pressure to TR caused by phenelzine or desipramine was enhanced markedly by pheniramine-treatment. From the above experimental results, it is thought that the pressor effect of NE and TR potentiated by pheniramine is similar to that of debrisoquin, i.e. the sensitization of effector cell, and that central action of pheniramine can not ruled out.
Blood Pressure ; Chlorisondamine ; Debrisoquin ; Desipramine ; Femoral Vein ; Neurons ; Norepinephrine* ; Oxidoreductases ; Phenelzine ; Pheniramine ; Rabbits ; Reserpine ; Tyramine*

Tracheopathia osteoplastica (TO) is a rare clinical and pathologic benign condition that causes irregularity, narrowing and rigidity of the trachea and the main bronchi, characterized by multiple submucosal cartilaginous and osseous nodules of various sizes lining the upper respiratory tract. The treatment of TO diagnosed with CT and bronchoscopic biopsy is mostly supportive, and sometimes laser vaporization is used. We experienced a case of TO with severe obstructed airway that was treated by drilling.
Biopsy ; Bronchi ; Laser Therapy ; Respiratory System ; Trachea