Isolated and severe left main coronary ostial stenosis is a rare case. In the majority of these patients ostial stenosis was associated with any of the conditions known to involve the coronary ostia. These conditions include syphilitic aortitis, Takayasu's aortitis, familial hypercholesterolemia, and aortic valve disease. A 34-year young female patient was presented with exertional and stabbing anterior chest pain. There was no history of syphilis, diabetes mellitus, hypertension, hyperlipidemia and smoking. Coronary angiogram showed isolated left main coronary ostial stenosis. Transesophageal echocardiography(TEE) showed acute angle takeoff of the left main coronary artery. She underwent surgical angioplasty of coronary ostia with a patch of autologous pericardium. After angioplasty, TEE showed dilatation of left main coronary ostium and her clinical symptom improved.
Angioplasty ; Aortic Valve ; Aortitis ; Chest Pain ; Constriction, Pathologic* ; Coronary Vessels ; Diabetes Mellitus ; Dilatation ; Female ; Humans ; Hyperlipidemias ; Hyperlipoproteinemia Type II ; Hypertension ; Pericardium ; Smoke ; Smoking ; Syphilis ; Syphilis, Cardiovascular

Between March 1963, and December 1994, fifty-three patients with a ruptured aneurysm of sinus of Vasalva(RSV) were operated. The RSV originated from the right coronary sinus in 43 patients(81%), from the non coronary sinus in 7 patients(13%), and from combined sinuses in 2 patients. The RSV from the right coronary sinus mainly drained to the right ventricle(81.4%), and the RSV from the non coronary sinus mainly drained to the right atrium(71.4%). Recently, we are using patch to repair the RSV through a double approach. During the operation, concomitant procedures were performed; 32 Patch repairs of VSD, 14 aoric valvuloplasty, 10 aortic valve replacement, 2 tricuspid valvuloplasty, and one Bentall's procedure. During the follow up period between 1 and 31 years(mean 8 years, 94% follow up), there were 2 late deaths and 14 late complications. Actuarial 10-year survival rate was 95%, and 10-year actuarial freedom from late event was 53 %. Factor analysis revealed that the combined SBE is a risk factor of late event. Actuarial freedom from failure of aortic valvuloplasty was 55% at 9 years. Although surgical repair of RSV achieved excellent long term survival, aortic regurgitation and endocarditis revealed significant risk factor in long-term results. Therefore, more attention should be required in patients of RSV associated with aortic regurgitation or endocarditis.
Aneurysm, Ruptured* ; Aortic Valve ; Aortic Valve Insufficiency ; Coronary Sinus ; Endocarditis ; Follow-Up Studies ; Freedom ; Humans ; Risk Factors ; Sinus of Valsalva ; Survival Rate

OBJECTIVES: To determine the health behavior practices and needs for health promotion in shift work pattern in subway workers. METHODS: Among 789 male subway workers divided into four groups, 191 day time workers, 187 station service men (3 groups, 2 turns), 204 rolling stock inspectors (3 groups, 2 turns) and 207 train operators (8 groups, 5 turns), we surveyed the health behavior and needs for health promotion by questionnaire. RESULTS: For obesity, blood pressure and total cholesterol, day time workers had the highest levels, while train operators had higher diseases of the liver and stomach than others. The station service men had the highest smoking rate and daily smoking amount. More than 80% of the respondents consumed alcohol, and the drinking amount was highest among the day time workers and the 8/5 shift train operators. Eighty-two percent of the station service men had irregular eating habits and 17.7% did not have any breakfast. In health promotion activities, exercise and restriction of one's favorite(smoking or drinking) were most preferred in the four groups of respondents. The priority of needs and participation for health promotion program was exercise programs, followed by stress management, cancer prevention program, weight control program, anti-smoking campaign, high blood pressure control program, and abstinence/moderation in drinking. CONCLUSION: As the health behavior practices differed relative to shift work patterns, it was suggested that a comprehensive health promotion program according to shift work pattern should be planned and implemented among subway workers.
Blood Pressure ; Breakfast ; Cholesterol ; Data Collection ; Drinking ; Eating ; Health Behavior* ; Health Promotion* ; Humans ; Hypertension ; Liver ; Male ; Obesity ; Questionnaires ; Railroads* ; Smoke ; Smoking ; Stomach

No abstract available.

No abstract available.
Female ; Ovary*

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

No abstract available.
Leukemia, Myelomonocytic, Acute* ; Skin*

No abstract available.
DNA* ; Immunophenotyping*

BACKGROUND AND OBJECTIVES: To evaluate the feasibility and the short- and mid-term follow-up outcomes of endovascular stent-graft implantation in patients with Stanford type B aortic dissection. SUBJECTS AND METHODS: Twenty-eight patients with Stanford type B aortic dissection were evaluated. An aortogram was performed immediately after the procedure and a follow-up computed tomography (CT) scan was performed within one week, between 3 and 6 months, and annually thereafter. Clinical status was also evaluated at the same time. RESULTS: Endovascular stent-graft implantation at the target site was successful in 27 patients (96.4%). There were primary endoleaks in 6 patients and one case of procedure failure owing to migration of the stent-graft; and no procedure-related mortality. The number of patients with early complications requiring treatment was 2 (2/27, 4%). Fourteen patients experienced postimplantation syndrome (14/27, 52%). The average follow-up period was 22.1+/-17.5 months. Complete resolution or thrombosis of the false lumen was achieved in 14 patients and partial thrombosis was achieved in 10 patients. Operative treatments were required in three patients due to a progressing dissection or new dissection. There were no deaths and no instances of aneurysm or aortic rupture during the follow-up period. CONCLUSION: Endovascular stent-graft implantation for Stanford type B aortic dissection is a feasible, safe, and effective treatment modality. All patients who underwent surgery had a persisting leak. Therefore, regular evaluation of the aortic dissection and management of endoleaks were crucial for a favorable outcome in endovascular stent-graft implantation for a Stanford type B aortic dissection.
Aneurysm ; Aortic Rupture ; Endoleak ; Follow-Up Studies ; Humans ; Mortality ; Thrombosis

To understand the clinical results of aortic root replacement with either inclusion or open technique, we analysed 53 patients who underwent replacement of the aortic root with composite graft between October,1980, and May, 1995. Annuloaortic ectasia was the most common indication for operation(29 patients), follwed by aortic dissection(22 patients). Among 53 patients, 19(35%) had Marfan syndrome. Three patients died during hospitalization (Mortality: 5.5%). The follow up was possible in 48 patients(Follow-up rate; 94%,mean duration;37 months). The actuarial survival rate at 24 months was 95% in open technique group, and 87% in inclusion technique group. Late complications developed in 10 patients. Dissecting aneurysm in the remaining aorta was noted in 3 patients with inclusion technique, and a pseudoaneurysm from coronary artery anastomosis site developed in a patient with inclusion technique. In conclusion, there was no statistical differences in survival for 24 months between inclusion technique and open technique group. But late problems in the remaining aorta or death from unknown cause occurred with moderate frequency ; careful follow-up after aortic root replacement thought to be important for long term survival.
Aneurysm, Dissecting ; Aneurysm, False ; Aorta ; Coronary Vessels ; Dilatation, Pathologic ; Follow-Up Studies ; Hospitalization ; Humans ; Marfan Syndrome ; Survival Rate ; Transplants