PURPOSE: To measure the muscle length of the gastrocnemius and soleus during gait in CP patients with an equinus deformity before and after surgery. MATERIALS AND METHODS: Twelve CP patients with an equinus deformity (17 limbs) were examined by gait analysis preoperatively and postoperatively. The patient group was further classified into the TAL and Strayer group according to the surgical technique. The mean age and mean follow-up periods were 14.3 years (5-25 years) and 15.3 months (12.5-18.5 months), respectively. The muscle length of the Gastrocnemius and Soleus was measured during gait using the SIMM program linked to a gait analysis system. RESULTS: The ankle ROM, knee ROM, maximal muscle length and peak-to-peak excursion during gait improved after surgery. There was a significant difference between the preoperative and postoperative measurements (p<0.05), but no difference between the postoperative and control groups (p>0.05). The muscle length of the soleus was elongated during gait after the Strayer procedure. CONCLUSION: Patients with an equinus deformity had a contracted triceps muscle, which was elongated after surgery. These changes were quantified by a comparison of the preoperative and postoperative measurements.
Animals ; Ankle ; Cerebral Palsy ; Contracts ; Equinus Deformity ; Follow-Up Studies ; Gait ; Humans ; Knee ; Muscle, Skeletal ; Muscles

The patency of graft vessels and their effects on the native coronary circulation were studied by evaluation of 78 graft sites in 35 patients who underwent selective bypass graft angiography among 152 CABG cases at a mean follow-up 12.6 month. The result were as follows ; 1) The overall graft patency rate was 70.5% : 73.8% for left anterior descending artery, 68.4% for left circumflex arterty, 64.7% for right coronary artery. 2) The patency rate of internal mammary artery was 77.8%. 3) In twenty eight patients who underwent native coronary angiography, twelve pateints showed progression of coronary artery disease in grafted vessel and two patients showed progression of coronary artery disease in non-grafted vessel. 4) The treadmill test was performed before and after coronary artery bypass graft in thirteen patients. Among 13 patients, nine patinets showed improved exercise tolerance. 5) The percutaneous transluminal coronary angioplasty were successfully performed for dilating three cases of stenotic vein graft and two cases of left main lesions after CABG and one case of stenotic left internal mammary artery graft.
Angiography ; Angioplasty, Balloon, Coronary ; Arteries ; Coronary Angiography ; Coronary Artery Bypass* ; Coronary Artery Disease ; Coronary Circulation ; Coronary Vessels* ; Exercise Test ; Exercise Tolerance ; Follow-Up Studies ; Humans ; Mammary Arteries ; Transplants ; Veins

BACKGROUND: The early coronary reperfusion with tissue type plasminogen activator(t-PA) influenced on the short term mortality and long term mobidity in acute myocardial infarction. The attention for thrombolysis with t-PA has been focused in identifying the optimal t-PA regimen and on the possibility of achieving effective and safe thrombolysis with a bolus of t-PA. Experimental data demonstrates that rapid t-PA infusion resulted in improved thrombolysis with minimal fibrinogenolysis and without excessive bleeding than prolonged infusion. METHODS: Consecutive patients presenting up to 6 hour from the onset of symptoms were recruited for the study. Aspirin(200mg daily) should be given immediately, 100mg t-PA was administered as two intravenous bolus injections of 50mg t-PA each given 30 minute apart, and followed by 5,000 unit heparin IV bolus with continuous infusion for 5 days. Angiography was performed at 60 and 90min after the first bolus and between 12-24 hour after study entry. After 7-10 days of myocardial infacrtion, coronary angiograms were performed in all patients who had been taken ddouble bolus t-PA. RESULTS: At 60min, angiography revealed infarct-related coronary artery patency of TIMI flow grade 3 in 15(88%) of 17 patients. At 90min, infarct-related coronary artery patency of TIMI flow grade 3 was achieved in 16(94%) of 17 patients. Bleeding episodes were mostly minor(6 of 33 patients, 18%), and hemorrhagic stroke was developed in 1 patients(1/33, 3.0%). Three patients(9.0%) died in hospitalization probably due to ventricular rupture. CONCLUSION: The administration of 100mg of double bolus t-PA in acute myocardial infarcion results in remarkably high early TIMI flow grade 3 on infarct-related coronary artery patency rates(88% and 94% at 60 and 90min, respectively). The bolus injection of t-PA may be simple and effective strategy in the treatment of acute myocardial infarction. However, large numbers of prospective study would be required.
Angiography ; Coronary Vessels ; Hemorrhage ; Heparin ; Hospitalization ; Humans ; Mortality ; Myocardial Infarction* ; Myocardial Reperfusion ; Plasminogen ; Rupture ; Stroke ; Tissue Plasminogen Activator*

Data on the clinical outcomes in deferred coronary lesions according to functional severity have been limited. This study evaluated the clinical outcomes of deferred lesions according to fractional flow reserve (FFR) grade using Korean FFR registry data. Among 1,294 patients and 1,628 lesions in Korean FFR registry, 665 patients with 781 deferred lesions were included in this study. All participants were consecutively categorized into 4 groups according to FFR; group 1: ≥ 0.96 (n = 56), group 2: 0.86–0.95 (n = 330), group 3: 0.81–0.85 (n = 170), and group 4: ≤ 0.80 (n = 99). Primary endpoint was major adverse cardiac events (MACE), a composite of all-cause death, myocardial infarction, and target vessel revascularization. The median follow-up period was 2.1 years. During follow-up, the incidence of MACE in groups 1–4 was 1.8%, 7.6%, 8.8%, and 13.1%, respectively. Compared to group 1, the cumulative rate by Kaplan-Meier analysis of MACE was not different for groups 2 and 3. However, group 4 had higher cumulative rate of MACE compared to group 1 (log-rank P = 0.013). In the multivariate Cox hazard models, only FFR (hazard ratio [HR], 0.95; P = 0.005) was independently associated with MACE among all participants. In contrast, previous history of percutaneous coronary intervention (HR, 2.37; P = 0.023) and diagnosis of acute coronary syndrome (ACS) (HR, 2.35; P = 0.015), but not FFR, were independent predictors for MACE in subjects with non-ischemic (FFR ≥ 0.81) deferred coronary lesions. Compared to subjects with ischemic deferred lesions, clinical outcomes in subjects with non-ischemic deferred lesions according to functional severity are favorable. However, longer-term follow-up may be necessary.
Acute Coronary Syndrome ; Coronary Artery Disease ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Kaplan-Meier Estimate ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Prognosis ; Proportional Hazards Models