No abstract available.
Coronary Disease* ; Secondary Prevention*

No abstract available.
Endothelium* ; Hemostasis* ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Inflammation*

A 62-year-old farmer was admitted to our department because of second degree chemical burns of both buttocks ten days following accidental contact with Gramoxone, a weed killer. He was treated with oral antibiotics and cold compresses and discharged after the burned area were reepithelialized. Laboratory findings were within normal limits for three weeks. Although lung fibrosis, hepatic and renal failure can be caused by repeated absorption of paraquat (Gramoxone) through injuried skin, systemic absorption through normal skin has not been reported. During the four month follow up period there were no systemic problems nor recurrence of skin lesions. We report herein a case of chemical burns induced by Gramoxone, which is probably an occupational dermatosis of farmers handling weed killers.
Absorption ; Anti-Bacterial Agents ; Burns ; Burns, Chemical* ; Buttocks ; Fibrosis ; Follow-Up Studies ; Humans ; Lung ; Middle Aged ; Paraquat ; Recurrence ; Renal Insufficiency ; Skin ; Skin Diseases

Backgound: The placement of stents in coronary arteries has been shown to reduce acute closure and restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the subacute stent thrombosis and hemorrhagic complications associated with the anticoagulant regimen. It's known that the complete stent deployment with high pressure inflation and new antiplatelet agents are effective in reduction of subacute thrombosis and hemorrhage. So we evaluated initial results (success and complication rate) after high pressure-stent deployment with new anticoagulation protocol. METHODS: One hundred and ninety one patients with 201 lesions were treated with 231 stents of various types. The high pressure balloon inflation and antiplatelets agents were used in all cases. Final high pressure balloon inflation guided by IVUS were performed in 23 consecutive cases with incomplete stent deployment according to angiographic findings. RESULTS: 1) The indications of stenting (n=210) were De novo in 124 (59%), bailout procedure in 57 (27%), suboptimal result after PTCA in 19 (8%), and restenosis after PTCA in 14 (6%). The location of lesions were LAD in 101, RCA in 67, circumflex in 28, ramus intermedius in 3, and LMT artery in 2 lesions. Angiographic morphologic characteristics were type A in 2, type B in 158 (B1: 57, B2: 101), and type C in 22 lesions. 2) The angiographic and clinical success rate was 96% (192/201) and 92% (186/201) respectively. 3) In angiographic analysis, the baseline average reference vessel dirmeter was 3.33+/-0.35 mm. Baseline minimum lumen diameter (MLD) was 0.58+/-0.29 mm, with baseline percent diameter stenosis of 82.86+/-8.64%. The final stent diameter was 3.37+/-0.29 mm, with mean final percent stenosis of 0.63+/-8.25. The mean MLD after stenting was significantly increased (p<0.001). The mean MLD within stent increased 14%, from 2.91+/-0.39 mm at the nominal balloon inflation (inflation pressure=7 atm) to 3.37+/-0.29 mm at high pressure balloon inflation (inflation pressure <0A65B>12atm) (p<0.001). The length of lesions in GR I (cook), GR II, and Micro II stents were significantly longer than ones in PS, Cordis, Wiktor, Nir (p<0.001). 4) In intravascular ultrasound analysis, the mean lumen CSA at the tightest point within stent increased 11%, from 8.4+/-2.4 mm2 at the intial intravascular ultrasound to 9.4+/-2.1 mm2 at the final intravascular ultrasound (p<0.001). 5) The procedural and postprocedural complications were 2 acute closures associated with AMI and emergent CABG, 1 subacute closure which was revascularized by bail out stenting, 5 major hemorrhage requiring transfusion associated with 1 CVA and 2 metabolic acidosis induced by acute renal failure, and 5 death. CONCLUSION: The high pressure stent deployment procedure and new anticoagulation protocol associating tidopidine and aspirin without coumadin or prolonged heparin infusion allow us to obtain an acceptably low subacute thrombosis or bleeding complication rate. These results are encouraging and allow a wide use of coronary stenting.
Acidosis ; Acute Kidney Injury ; Angioplasty, Balloon ; Arteries ; Aspirin ; Constriction, Pathologic ; Coronary Vessels* ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Platelet Aggregation Inhibitors* ; Stents* ; Thrombosis ; Ultrasonography ; Warfarin

Obesity has been implicated as a significant risk factor for multiple medical condition including hypertention, glucose intolerance, hyperlipidemia, hyperinsulinemia and fatty liver. Furthermore, obesity in childhood is believed to be a reliable predictor of a similar condition in adulthood. During the recent years, there has been a rapid rise in the incidence of childhood obesity in Korea due to increased dietary intake rich in caloric content. This study was undertaken to investigate the epidemiology and potential health complications of obesity observed in elmentary school students. A total of 3,103 children (1630 boys and 1,473 girls), ages ranging from 6 to 12, were studied with personal interview, physical examination, and laboratory evaluation. The results were as follows: 1) The prevalence of obesity was 13.44% with approximately equal distribution among boys (14.42%) and girls (12.36%). 2) The prevalence of childhood obesity in Seoul was significantly higher (18.62%) than that in Suwon (7.85%) and in Hongchon (6.02%). 3) A higher incidence of hypertension was dectected in obese subjects and this was more obvious in girls. 4) Hyperlipidemia and elevated Atherogenic Index were more frequently observed in obese group. 5) although fasting blood glucose levels were similar in both groups. AST and ALT abnormalities were much more prevalent in obese group. It is concluded that hypertension and other metabolic abnormalities are much more frequently observed in obese children and that our effects should be focused on the earliest dection, prevention and management of childhood obesity.
Blood Glucose ; Child* ; Epidemiology ; Fasting ; Fatty Liver ; Female ; Glucose Intolerance ; Gyeonggi-do ; Humans ; Hyperinsulinism ; Hyperlipidemias ; Hypertension ; Incidence ; Korea ; Obesity* ; Pediatric Obesity ; Physical Examination ; Prevalence ; Risk Factors ; Seoul

Autogenous costal cartilage graft has been commonly used for reconstruction of auricular deformity. However, the risk of complication and discomfort at the donor site, as well as distortion of the graft due to morphological change in the cartilage have been serious drawbacks to this procedure. Previous studies examining the chondrogenic potential of perichondrium have suggested that perichondrium may be used as graft for cartilage reconstruction. When a perichondrial flap or a free perichondrium was used as graft, new cartilage formed appositional to the grafted perichondrium. However, the neocartilage was often irregular in shape and varied considerably in quantity. In this study, the feasibility of controlling the shape and the mass of neocartilage was investigated using coral, a porous biomaterial, as a template. A coral a template was wrapped with perichondrial flap from the ears of New Zealand white rabbits and placed into a subcutaneous pocket in the rabbits and placed into a subcutaneous pocket in the rabbit's back by incision. A total of 12 animals were used. Formation of new cartilage was later evaluated by gross and histological examination of the perichondrial flap and the coral template. New cartilage was formed in 11 animals. Immature chondrocytes were visible by 3 weeks after the surgery, and by 8 weeks the immature chondrocytes had formed a cartilage. New cartilage was formed only on the surface of the coral template. These results indicated that the shape and the mass of new cartilage may be controlled by using coral template. Therefore, the desired shape of cartilage may be achieved using a coral template of corresponding shape, and this may help in correcting subtle auricular contour defect and in correcting other structural defects that also require new cartilage formation.
Animals ; Anthozoa* ; Cartilage ; Chondrocytes ; Congenital Abnormalities ; Ear ; Humans ; Rabbits ; Tissue Donors ; Transplants

BACKGROUND: Dopamine is an inotropic agent that is often selected for continuous infusion. For hemodynamic stability, the rate of infusion is controlled in the range of 5-15 µg/kg/min. This study aimed to compare the time intervals from the administration of dopamine to the onset of its hemodynamic effects when dopamine was administered through three different peripheral veins (the cephalic vein [CV], the great saphenous vein [GSV], and the external jugular vein [EJV]). METHODS: Patients in group 1, group 2, and group 3 received dopamine infusions in the CV, GSV, and EJV, respectively. A noninvasive continuous cardiac output monitor (NICCOMO™, Medis, Ilmenau, Germany) was used to assess cardiac output (CO) and systemic vascular resistance (SVR). Six minutes after intubation, baseline heart rate (HR), systolic blood pressure (BP), diastolic BP, mean arterial pressure (MAP), CO, and SVR values were recorded and dopamine infusion was initiated at a dose of 10 µg/kg/min. Hemodynamic changes at 0, 4, 8, 12, and 15 minutes postinfusion were recorded. RESULTS: No statistically significant differences were observed among the three groups with respect to the rate of hemodynamic change. In all groups, systolic BP, diastolic BP, MAP, and SVR tended to increase after decreasing for the first 4 minutes; in contrast, HR and CO decreased until 8 minutes, after which they tended to reach a plateau. CONCLUSIONS: For patients under general anesthesia receiving dopamine at 10 µg/kg/min, there were no clinical differences in the effect of dopamine administered through three different peripheral veins.
Anesthesia, General ; Arterial Pressure ; Blood Pressure ; Cardiac Output ; Dopamine* ; Heart Rate ; Hemodynamics* ; Humans ; Intubation ; Jugular Veins ; Saphenous Vein ; Vascular Resistance ; Veins*

No abstract available.
Alprostadil* ; Ductus Arteriosus ; Heart Defects, Congenital* ; Humans ; Infant, Newborn*

BACKGROUND AND OBJECTIVES: Protein kinase C (PKC) has been known to play a central role in mediating ischemic preconditioning. The isoform of the PKC changes during the development of the heart in rats. Therefore, the protective effects of PKC activation may vary between neonatal and adult hearts. MATERIALS AND METHODS: To test this hypothesis, primary cultures of neonatal and adult rat ventricular myocytes (NRVM and ARVM, respectively) were subjected to ischemic condition, which consisted of a deoxygenated air supply and glucose deprivation in the media. The survival was evaluated by counting trypan blue excluding cells. The effect of PKC activation was analyzed by the addition of a PKC agonist (12-o-tetradecanoylphorbol 13-acetate, TPA), or an antagonist (staurosporin) to cultured myocytes. RESULTS: Under ischemic condition, ARVMs were more susceptible than NRVM. The survival of the ARVMs were 63.1+/-8.3%, 42.8+/-6.1%, 10.1+/-5.8% after 3, 6, 12 hours of ischemia, respectively, while those of the NRVMs were 68.9+/-6.4%, 60.3+/-7.3%, 34.3+/-7.5%, and 8.2+/-6.6% after 6, 12, 24, 36 hours of ischemia, respectively (p=0.031). However, the activation of the PKC following the addition of 100 nM TPA to the media significantly enhanced the survival of the ARVM, from 38.5+/-8.3% to 62.1+/-7.3%, after 6 hours of ischemia, which was similar to that of the controls (65.4+/-6.2%). In contrast, the activation of the PKC by the addition of TPA did not change the survival of the NRVM, from 31.8+/-5.8% to 28.5+/-7.3%, after less than 24 hours of ischemia. CONCLUSION: These findings demonstrate that the protective effect of PKC activation in adult hearts differs from that in neonatal hearts, indicating that PKC isoform variance between two tissues may affect the biologic consequence of its activation.
Adult* ; Animals ; Glucose ; Heart* ; Humans ; Ischemia ; Ischemic Preconditioning ; Muscle Cells ; Myocardium ; Myocytes, Cardiac* ; Negotiating ; Protein Kinase C ; Rats* ; Trypan Blue

Diabetes is one of the most prevalent chronic conditions and is expected to affect nearly 800 million people worldwide by 2045. Diabetes entails many complications; diabetic foot is among the most notorious complications. It requires complex long-term treatments and often has a high rate of relapse. Diabetic foot significantly threatens patient quality of life and imposes a considerable economic burden on both patients and healthcare systems. Therefore, prevention of diabetic foot is essential. It is important to identify patients at-risk of diabetic foot through regular check-ups and assessments. At-risk diabetic foot patients should be educated about foot self-care, appropriate footwear, and pre-ulcerative signs. Once pre-ulcerative lesions are found, swift intervention by trained professionals is necessary. Multidisciplinary collaboration in education of diabetic patients about diabetic foot is recommended and should consistently support patients in managing foot self-care.