BACKGROUND & OBJECTIVES: The aim of this study was to investigate the efficacy & safety of a new HMG-CoA reductase inhibitor, atorvastatin, to improve serum lipid profiles in patients with primary hypercholesterolemia. MATERIALS AND METHODS: Three hundred and six patients from 21 hospitals, all with total cholesterol level over 240 mg/dl and triglyceride level below 400 mg/dl were enrolled in the study. Following diet therapy for 2 weeks, atorvastatin 10 mg was taken for 6 weeks if the total cholesterol level remained higher than 240 mg/dl. The percent change of total cholesterol, triglyceride, LDL-cholesterol and HDL-cholesterol from baseline to 6 weeks of treatment were evaluated. Patients were monitored for safety through careful history talking, physical examination, serum sampling for liver and muscle enzyme. RESULTS: 1) The study was completed in a total of 166 patients. The mean age of patients the was 58 1/2 years and the percent of male and female patients was 37%, 37% and 63%, respectively. 2) The baseline mean values of total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol following diet therapy for 2 weeks were 280+/-34 mg/dl, 172+/-77 mg/dl, 190+/-35 mg/dl, 56+/-13 mg/dl, respectively. 3) After 6 weeks treatment, the level of total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol were 195+/-34 mg/d, 150+/-67 mg/dl, 110+/-33 mg/dl, 55+/-12 mg/dl, respectively, and the rates of change were -30%, -7%, -42%, -0.2%, respectively. 4) The level of LDL-cholesterol at the end of treatment was below 100 mg/dl in 44%, 100-130 mg/dl in 33%, 130-160 mg/dl in 14%, over 160 mg/dl in 9% of patients. 5) 77% of total patients achieved the target goal of LDL cholesterol (below 130 mg/dl) according to the NCEP guideline. 6) The reduction rate of LDL-cholesterol was different among the patients. At the end of treatment, the patients with initial LDL-cholesterol below 100 mg/dl achieved a higher reduction rate (52%) as compared with those patient's inithal LDL-cholesterol level were higher. 7) There are was only 1 patient (0.6%) who showed 3 times a three-fold increase of liver enzyme and no patient showed an increase of creatine kinase. CONCLUSION: Atorvastatin is effective and safe in improving the lipid profiles in of patients with hypercholesterolemia without serious side effects. (Korean Circulation J 2001;31 (4):434-441)
Cholesterol ; Cholesterol, LDL ; Creatine Kinase ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia* ; Liver ; Male ; Oxidoreductases ; Physical Examination ; Triglycerides ; Atorvastatin Calcium

Atypical adenomatous hyperplasia (AAH) is regarded as a precancerous lesion in the multistep process for carcinogenesis of pulmonary adenocarcinoma. AAH is found in up to 25% of the lung tissue adjacent to cancer, particularly adenocarcinoma and also in 2-4% of autopsy cases. Until now, its main clinical significance is that some tumor recurrences are the lesions that have progressed from undetected AAH or they are newly developed cancers arising from AAH during the follow-up after the resection of adenocarcinoma. We present here the case of a 58-year-old woman having a large main adenocarcinoma with multiple small AAHs that mimicked lung-to-lung metastasis. AAH should be considered in the differential diagnosis of multiple small nodules during the preoperative evaluation and also during the follow-up of lung cancer patients.
Adenocarcinoma ; Autopsy ; Carcinogenesis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Hyperplasia* ; Lung Neoplasms ; Lung* ; Middle Aged ; Neoplasm Metastasis* ; Recurrence

No abstract available.
Lung Neoplasms* ; Lung*

Four hundred and fifty patients of cerebrovascular accident who underwent computerized tomographic scanning during the 45 months, from January 1978 to October 1981, at department of internal medicine, Kyung Hee University Hospital, were studied and following results were obtained. 1. In Korea, intracerebral hematoma(48.2%) is more common than cerebral infarction(27.6%). 2. 87.3% of intracerebral hemorrhage were comfirmed while 61.5% of cerebral infarction were identified by brain CT. 3. Cerebrovascular accidents are definitely developing in 6th decade(40.6%) and male is more often affected. 4. hypertension is the most common underlying disease(72.3%) of cerebral hemorrhage, 52.4% of cerebral infarction. 5. hematoma occurs most frequently in basal ganglia(40.6%) and cerebral infarction occurs most frequently in global area(48.4%). 6. Changes of consciousness level were observed in 54.2% of the cases of mild degree hematoma. Mortality was 6.2% in mild degree hematoma and 88.2% in severe degree hematoma. 7. In 26.2% of cerebral hematoma, inital CSF findings were normal in spite of the evidence of cerebral hematoma confirmed by CT scanning.
Brain* ; Cerebral Hemorrhage ; Cerebral Infarction ; Classification* ; Consciousness ; Hematoma ; Humans ; Hypertension ; Internal Medicine ; Korea ; Male ; Mortality ; Stroke* ; Tomography, X-Ray Computed

Congenital long QT syndrome (LQTS) is a disease characterized by prolongation of ventricle repolarization and by the occurrence, usually during emotional or physical stress, of life-threatening arrhythmias that lead to sudden death in most symptomatic and untreated patients. Two variants have been initially identified:the original Jervell and Lange-Nielsen syndrome of congenital deafness and autosomal recessive inheritance, and the more frequent Romano-Ward syndrome of autosomal dominant inheritance. Evidence also shows that approximately 25 to 30% of the cases are sporadic with syncope and a prolonged QT interval but without showing evidence for familial involvement. Familial and sporadic cases have been grouped under the definition of congenital long QT syndrome. We experienced a case of congenital long QT syndrome in a 13-year-old female girl. She had episodes of recurrent syncope and QT interval prolongation(QTc=0.46sec) in electrocardiogram(ECG). The ECG of her mother showed QT interval prologation(QTc=0.46sec). After applying atenolol, the QT interval returned to normal range and syncope has not occurred. We report a case of congenital long QT syndrome with a brief review of related literatures.
Adolescent ; Arrhythmias, Cardiac ; Atenolol ; Deafness ; Death, Sudden ; Electrocardiography ; Female ; Humans ; Jervell-Lange Nielsen Syndrome ; Long QT Syndrome* ; Mothers ; Reference Values ; Romano-Ward Syndrome ; Syncope* ; Wills

Hirayama disease usually selectively involves lower cervical myotomes (C8, T1). Thus, patients usually manifest with atrophy and weakness of small hand muscle. Predominant isolated involvement of proximal arm is rarely reported in Hirayama disease. Here, we report a case of Hirayama disease who had focal weakness and wasting, mainly confined to right biceps brachii muscle, with prominent shifting of dural sac in C4-5 segment by dynamic flexion magnetic resonance imaging (dfMRI), which may explain this unusual distribution of the disease.
Amyotrophy, monomelic

BACKGROUND: The cardiac troponin I (cTnI), one of the subunits of the troponin regulatory complex, binds to actin and inhibits interactions between actin and myosin. cTnI is highly sensitive and specific marker for myocardial injury and is useful in diagnosis and detection of reperfusion in acute myocardial infarction (AMI). In this study, we measured the serum concentration of cTnI according to serial time after chest pain in patients with AMI and compared serum concentration of cTnI with CK-MB and echocardiographic data to evaluate the significance of measuring serum concentration of cTnI in AMI. SUBJECTS AND METHODS: The study was carried out on 16 patients with first attack of AMI within 6 hours of chest pain. All patients were performed thrombolytic therapy and reperfusion was confirmed by coronary angiography. Blood samples for measuring of CK-MB and cTnI were collected at 4-h intervals during the first 24 h, 12-h intervals until 48 h, and 24-h intervals until fourth days after hospitalization. Echocardiography were performed before thrombolytic therapy in all patients. RESULTS: 1) The mean age of subjects was 63.6+/-11.5 years (range:44 - 84 years) and 11 patients were men and 5 patients were women. The site of infarction was anterior in 11 patients and inferior in 5 patients. 2) The peak concentrations of CK-MB and cTnI were reached from 4-h to 12-h after admission in all patients (7.3+/-2.6-h, and 9.0+/-3.1-h, respectively), but there was no significant difference in peak time. 3) Serum concentration of CK-MB was normalized at 72-h after admission, but cTnI was remained in increased state until 96-h after admission. The numbers of the patients with above cutoff value of CK-MB and cTnI at different time after admission were significantly different after 72-h (p<0.05). 4) The peak cTnI and sigma cTnI level were significantly correlated with peak CK-MB and sigma CK-MB level, respectively (r 2 =0.7955, p<0.0001 and r 2 =0.6378, p=0.0002, respectively). 5) The ejection fraction was not correlated with peak cTnI concentration (r 2 =0.0948, p=0.2461) and sigma cTnI (r 2 =0.1867, p=0.0946). 6) The wall motion score index was not correlated with peak cTnI concentration (r 2 =0.2135, p=0.0716), but significantly correlated with sigma cTnI (r 2 =0.2540, p=0.0465). CONCLUSION: The serum concentration of cTnI was useful in late diagnosis of AMI and cTnI release in patients with AMI was correlated with myocardial infarct size.
Actins ; Chest Pain ; Coronary Angiography ; Delayed Diagnosis ; Diagnosis ; Echocardiography ; Female ; Hospitalization ; Humans ; Infarction ; Male ; Myocardial Infarction* ; Myosins ; Reperfusion ; Thrombolytic Therapy ; Troponin I* ; Troponin*

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

BACKGROUND: Single pass lead VDD pacing preserves atrioventricular synchrony with a single lead system which incorporates floating atrial electrodes. The objectives of this study were to measure whether different body postures and physical activities cause significant changes of the atrial electrogram amplitudes and to evaluate the effectiveness of its atrial sensing, ventricular sensing and pacing. METHOD: Prospective study was done in 7 patients with high degree AV block and normal sinus node function in whom a single lead VDD pacing system was implanted. The P wave amplitude was been measured in different condition during follow-up period. RESULTS: 1) During follow-up period, the P wave amplitude showed variation with changes in posture and respiration, but there was no consistent increase or decrease in amplitude. The lowest P wave amplitude was above the minimal atrial sensing value of 0.2 mV. 2) The percentage of atrial synchronous ventricular pacing recorded in Holter ECG and during Treadmill exercise test was more than 99%. 3) Atrial oversensing or VA cross sensing were not observed in any of the patients. CONCLUSIONS: Despite floating atrial electrode, the single pass lead VDD pacing maintains reliable atrial sensing and ventricular pacing in different body position and physical activity, so it may offer an excellent alternative in patients with high grade AV block and intact sinus node function.
Atrioventricular Block ; Electrocardiography ; Electrodes ; Electrophysiologic Techniques, Cardiac ; Exercise Test ; Follow-Up Studies ; Humans ; Motor Activity* ; Posture ; Prospective Studies ; Respiration ; Sinoatrial Node

OBJECTIVES: This study evaluated implant success rate, survival rate, marginal bone resorption of implants, and material resorption of sinus bone graft in cases wherein tapered body implants were installed. MATERIALS AND METHODS: From September 2003 to January 2006, 20 patients from Seoul National University Bundong Hospital, with a mean age of 54.7 years, were considered. The mean follow-up period was 19 months. This study covered 50 implants; 14 implants were placed in the maxillary premolar area, and 36 in the maxillary molar area; 24 sinuses were included. RESULTS: The success rate was 92%, and the survival rate was 96.0%. The mean amount of sinus augmentation was 12.35+/-3.27 mm. The bone graft resorption rate one year after surgery was 0.97+/-0.84 mm; that for the immediate implantation group was 0.91+/-0.86 mm, and that for the delayed implantation group was 1.16+/-0.77 mm. However, the difference was not statistically significant. The mean marginal bone resorption one year after restoration was 0.17+/-0.27 mm (immediate group: 0.12+/-0.23 mm; delayed group 0.40+/-0.33 mm); statistically significant difference was observed between the two groups. CONCLUSION: Tapered body implant can be available in the maxillary posterior edentulous ridge which sinus bone graft is necessary.
Bicuspid ; Bone Resorption ; Follow-Up Studies ; Humans ; Molar ; Retrospective Studies ; Survival Rate ; Transplants