BACKGROUND AND OBJECTIVES: Percutaneous transluminal septal myocardial ablation (PTSMA) and surgical septal myotomy-myectomy are two treatment options for patients with drug-resistant hypertrophic cardiomyopathy & a left ventricular outflow tract (LVOT) obstruction. The clinical courses, after nonsurgical and surgical septal myotomy-myectomy, are described in 3 patients with hypertrophic cardiomyopathy that continued to be symptomatic following medical management. SUBJECTS AND MEHTODS: 3 patients (2 women, 1 man), with symptomatic drug-refractory obstructive hypertrophic cardiomyopathy, were the subjects of this study. One patient underwent a PTSMA by injection of ethanol into the septal perforator branches of the left anterior descending coronary artery, and 2 a surgical myotomy-myectomy. Examinations of the early and late follow-up echocardiographic results were performed. RESULTS: Both treatment modalities significantly reduced the peak gradient across the LVOT (ablation : 85 to 7.7 mmHg, myectomy : 104 to 10 mmHg), and led to similar improvements in the New York Heart Association class (ablation : NYHA IV to II, myectomy : NYHA III or IV to NYHA I or II). One patient, who underwent a successful PTSMA, showed a temporary right bundle branch block on the ECG for several days following the PTSMA. At the 1-year follow-up, 2 patients were observed to have persistent symptomatic improvements, with no cardiac complications. CONCLUSION: Both a percutaneous septal myocardial ablation and a surgical myotomy-myectomy resulted in similar degrees of significant improvements of the left ventricular outflow tract obstructions, with improvements of the symptoms. Prospective studies are necessary to compare the long-term efficacy of these two treatment modalities.
Bundle-Branch Block ; Cardiac Surgical Procedures ; Cardiomyopathy, Hypertrophic* ; Catheter Ablation ; Coronary Vessels ; Echocardiography ; Electrocardiography ; Ethanol ; Female ; Follow-Up Studies ; Heart ; Humans ; Ventricular Outflow Obstruction*

The skin is a frequently involved organ in graft-versus-host disease(GVHD). Various skin lesions including erythematous eruption, bullae, desquamation, lichenoid, and sclerodermoid lesions have been reported in GVHD, but vitiligo-like lesions were. We present two cases of chronic GVHD presenting multiple hypopigmented patches following allogenic bone marrow transplant(BMT) due to severe aplastic anemia. The histopathologic studies showed focal vacuolar degeneration of basal cells, absence of melanocytes in the epidermis, and perivascular lymphocytic infiltration consisting of T cells in the upper dermis, These cases suggest that vitiligo-like lesions may develop due to marked melanocyte- lymphocyte interaction after BMT.
Anemia, Aplastic ; Bone Marrow ; Dermis ; Epidermis ; Lymphocytes ; Melanocytes ; Skin* ; T-Lymphocytes ; Vitiligo

Serratia marcescens is a gram-negative bacillus of enterobacteriaceae family. The organism is known to cause various types of infection including cellulitis, bacteremia, pneumonia, endocarditis, meningitis, peritonitis, osteomyelitis, and septic arthritis. Cellulitis due to gram-negative organisms is uncommon and usually occurs in immunosuppressed hosts. We present a case of S. marcescens cellulitis in a patient with acute lymphocytic leukemia who had been treated with chemotherapy. Microbial studies with pus identified S. marcescens as a causative organism of cellulitis. The lesion healed completely by antibiotic treatment.
Arthritis, Infectious ; Bacillus ; Bacteremia ; Cellulitis* ; Drug Therapy ; Endocarditis ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Leukemia ; Meningitis ; Osteomyelitis ; Peritonitis ; Pneumonia ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Serratia marcescens* ; Serratia* ; Suppuration

BACKGROUND: The present study is undertaken to acquire normative data of health-related physical fitness(HRPF) of Republic of Korea Air Force(ROKAF) aircrews and to provide norm-referenced standard of HRPF. METHODS: From 15 May 1998 through 14 December 1999, 1284 KAF pilots are checked muscular strength, muscular endurance, flexibility, and body fat percentage. RESULTS: The grip strength was relatively maintained, but flexibility, back strength, and muscular endurance were declined according to promotion and aging. And the incidence of obesity determined by bioelectrical impedence analysis was higher than that assessed on the basis of height and weight. CONCLUSION: It is suggested that many pilots who were normal in BMI have abdominal or visceral obesity. Further studies must be made on the health promotion program for the pilots, on the changes in physical fitness, and on the criterion-referenced standard of HRPF of the pilots.
Adipose Tissue ; Aging ; Hand Strength ; Health Promotion ; Incidence ; Obesity ; Obesity, Abdominal ; Physical Fitness* ; Pliability ; Republic of Korea

No abstract available.
Anesthesia* ; Anesthesia, General* ; Humans

Total intravenous anesthesia(TIVA) is desirable technique for a number of reasons. The first is that it implies all the components of general anesthesia : hypnosis, amnesia, analgesia, and muscle relaxation by combination of several drugs and the lungs are ventilated with oxygen-enriched air. A combination of fentanyl-propofol were used as TIVA for laryngomicrosurgery (LMS) with high frequency jet ventilation(HFJV). 41 patients were studied. Glycopyrrolate was given 1 hour before anesthetic induction. Propofol 2 mg/kg was intravenously administered 1 minute after fentanyl 1.5 ug/kg intravenously injection for induction. Endotracheal intubation was performed after succinylcholine administration with internal diameter 4.0-6.0 mm LASER tube through oral cavity or 8 fr. polyethylene catheter through nasal airway. After then, HFJV was started with frequency 108-120 cycles/minute and driving pressure 2.0-2.5 kg/cm(2). The adequacy of ventilation was evaluated with arterial blood gas analysis. For maintenance a continuous propafol infusion of 10 mg/kg/hour was used for the first 10 minutes, followed by 8 mg/kg/hour for the next 10 minutes and 6 mg/kg/hour, thereafter. Continuous dripping of succinylcholine was used for muscle relaxation. The patients showed relatively stable hemodynamic status during procedure (Fig. 1). Two recovery times were as followed: the interval from cessation of infusion until opening eyes on command(4.90+/-3.41 min), and that until correct response to simple question (5.50+/-3.49 min). There was a correlation between total amount of propofol given to patients and recovery times(P<0.05)(Table 1). Interestingly. a group of patients weighed over 70 kg showed carbon dioxide retension on arterial blood gas analysis(Fig. 2). In conclusion, fentanyl-propofol cobination with muscle relaxant is proper regimen for TIVA in LMS with HFJV. More stable and better recovery are the main reasons. However, carbon dioxide retension should be consider to the patients weighed over 70 kg with the HFJV.
Amnesia ; Analgesia ; Anesthesia, General ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Carbon Dioxide ; Catheters ; Fentanyl ; Glycopyrrolate ; Hemodynamics ; High-Frequency Jet Ventilation* ; Humans ; Hypnosis ; Intubation, Intratracheal ; Lung ; Mouth ; Muscle Relaxation ; Polyethylene ; Propofol ; Succinylcholine ; Ventilation

PURPOSE: To determine the presence of cruciate ligament tears following avulsion injuries involving the ACL and PCL, and to correlate the findings with those of surgery. MATERIALS AND METHODS: Between March 1997 and May 2002, avulsion injury involving the ACL or PCL was diagnosed in 19 patients. Ten of these [8 males and 2 females aged 10-51 (avergae, 27.7) years] were included in this study. We assessed the presence of cruciate ligament tears at MR imaging, correlating the findings with those of surgery. Associated intra-articular injuries, treatment methods and follow-up results were also evaluated. RESULTS: Among Seven patients with ACL avulsion injury, this was assessed at MR imaging as complete tear (n=1), partial tear (n=5), or intact (n=1), while all MR images of PCL avulsion injury (n=3) showed that this was partial tear. All imaging findings corresponded with the surgical findings. In four patients there was associated knee injury involving, respectively, tears of the medial meniscus, lateral meniscus, PCL and MCL, and popliteal ligament. CONCLUSION: Our findings showed that with one exception, patients with avulsion injury of the ACL or PCL had suffered either a partial or complete tear. MR imaging may be useful in the diagnosis of tears of the cruciate ligament which have not been noticed at surgery or arthroscopy in avulsion injuries involving the ACL and PCL.
Arthroscopy ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee Injuries ; Knee* ; Ligaments* ; Magnetic Resonance Imaging* ; Male ; Menisci, Tibial ; Spine*

We identified the early and late prognostic factors of acute myocardial infarction, and evaluated the clinical differences and the prognosis between Q-wave myocardial infarction and non-Q wave myocardial infarction. Total 146 patients who were managed from Jan 1987 to Aug. 1989 at hallym University hospital were evaluated. According to the presence or absence of Q wave on electrocardiogram, the patients were divided into two groups : a Q wave myocardial infarction group(QMI) and a non-Q wave myocardial infarction group (NQMI). Among 146 patients 109 patients(74.7%) had QMI and 37 patients(25.3%) had NQNI. The mean age, male to female ratio and serum cholesterol level were similar in both groups. But peak level of CPK was significantly higher in the QMI group than that in the NQMI group(P<0.01). Left ventricular end-systolic dimension and ratio of left ventricular dimension to wall thickness in the QMI group were significantly higher than that in the NQMI group(P<0.01). There were no significant differences between two groups in the incidences of mortality, postinfarction angina and re-infarction. During the in-hospital period female gender, old age(more than 60 years), Killip class at admission, early reinfarction and a history of hypertension were significant prognostic factors. main causes of death during the in-hospital period were ventricular tachyarrthymia, heart failure and cardiogenic shock. The incidences of mortality, heart failure and post-infarction angina during a mean follow-up period of 14 months (6~30months) were same in the two groups. The late prognostic factors were old age(more than 60 years), Killip class at admission, heart failure occured during follow-up period(P<0.001) and a history of diabetes mellitus(P<0.05). The patients with late postinfarction angina had more dilated left ventricular end-systolic demension(P<0.05) and lower fractional shortening(P<0.01) than those of patients without late postinfraction angina. There were no significant difference in long term survival rate between QMI group and NQMI group. Further prospective study should be performed to clarify the short and long term prognosis in patients with acute myocardial infarction treated by reperfusion.
Cause of Death ; Cholesterol ; Electrocardiography ; Female ; Follow-Up Studies ; Heart Failure ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Myocardial Infarction* ; Prognosis ; Reperfusion ; Shock, Cardiogenic ; Survival Rate

Statement of problem: One of common problems associated with dental implant is the loosening of abutment screws that retain the implants. Purpose: This study was performed to investigate the influence of abutment screw length and repeated tightening on screw loosening in dental implant. Material and method: Forty nine Hexplants (13mm length, 4.3mm diameter, Ti grade IV, Warantec. Co. Ltd. Seongnam, Korea) and cementation type abutments(straight abutment) and abutment screws (0.4mm/pitch) were divided into 7 groups, depending on abutment screw length. Each implant and abutment was tightened to 30Ncm by torque controller(MGT50, MARK-10 Inc., USA) and the removal torque values were measured during 10 consecutive closure/opening trials Results and Conclusion: The results of comparing the removal torque value are as follows: 1. There is no significant difference in the removal torque value between groups in 10 consecutive closure/opening trials(p=0.97). 2. If the fractured abutment screw is engaged in longer than 2.425 thread length, there is no significant difference in the preload between the fractured abutment screw and the new abutment screw when both are equally tightened to 30 Ncm 3. The removal torque value in the 1st trial(24.510 Ncm) was lower than that in the 2nd,3rd,4th,5th,6th,7th trials and the removal torque value in the 2nd trials(25.551 Ncm) was maximum and was decreased in following trials. The removal torque value in the 1st trial was significantly lower than that in the 2nd,3rd,4th trials and was significantly higher than that in the 8th,9th,10th trials(p<0.05). 4. In the 2nd,3rd,4th,5th,6th,7th trials, the abutment screw was mainly influenced by settling effect and the higher preload was obtained. In the 8th,9th,10th trials, the abutment screw was mainly influenced by adhesive wear and the progressively lower preload was obtained.
Adhesives ; Cementation ; Dental Implants* ; Gyeonggi-do ; Torque

BACKGROUND: Tumor angiogenesis is required for tumor growth and metastasis. In this study, we investigated the correlation between the intensity of angiogenesis and stage, nodal status, histologic type, metastasis and survival rate of non-small cell lung cancer. METHOD: Formalin fixed, paraffin embedded surgical specimens of 45 patients who had surgically resected primary non-small cell lung cancers without pre or post perative adjuvant chemotherapy or radiotherapy were examined. The microvessel count(MVC) was demonstrated by immunohistochemical staining for CD31(platelet ednothlial cell adhesion molecule, PECAM). RESULTS: Microvessel counts(MVCs)in stage IIIA and IIIB were higher than in stage I and II(p<0.05). The MVC in patients with lymph node metastasis was higher than that in patients without lymph node metastasis, although the difference was not statistically significant(p>0.05). However, in adenocarcinoma, the MVC in patients with lymph node metastasis was significantly higher than that seen in patients without lymph node metastasis(p<0.05). The MVC in adenocaricinoma was higher than that in squamous cell carcinoma(p<0.05). The difference between the MVCs of adenocarcinoma and squamous cell carcinoma was not statistically significant in stage Iand II or NO stage(p>0.05). However, in stage IIIA and IIIB or N1~3 stage, the MVC in adenocarcinoma was higher than that in squamous cell carcinoma(p<0.05). MVC was more increased when metastasis developed within 12 months. In the same histologic type and stage, the duration of survival time in patients with high MVC was shorter than in patients with low MVC, however the difference was not statistically significant(p>0.05). The survival rate in patients with high MVCs was lower than that in patients with low MVCs(P<0.05). CONCLUSION: In non-small cell lung cancer, MVC correlated relatively well with pathologic stage, nodal status (limited in patients with adenocarcinoma), histologic type, postoperative metastasis and survival rate. However, in the same histologic type and stage, MVC was not significantly related to the duration of survival. Therefore the assessment of the intensity of angiogenesis in non-small cell lung cancer may be helpful in predicting prognosis and in selecting patients for systemic adjuvant therapy of potential metastasis according to the results.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Adhesion ; Chemotherapy, Adjuvant ; Formaldehyde ; Humans ; Lung Neoplasms ; Lymph Nodes ; Microvessels ; Neoplasm Metastasis ; Paraffin ; Prognosis* ; Radiotherapy ; Survival Rate