PURPOSE: Percutaneous closure with occluding coils has been recently described as a method of nonsurgical treatment of the small patent ductus arteriosus (PDA). The snare-assisted technique or detachable coil has been newly developed, improving coil delivery and eliminating the incidence of coil embolization. This method is also applicable to residual PDA following surgical ligation or device implantation. The study purpose is to discuss our experience with percutaneous closure of the small patent ductus arteriosus by occluding coils. METHODS: Between February 1995 and September 1996, 41 patients underwent coil occlusion. Thirty-one patients had native PDAs and 10 residual PDAs. Mean age was 5.0 +/- 3.2 years (1.5 to 14.0 years), and mean body weight 18.0 +/- 7.2kg (8.7 to 45kg). Mean ductal diameter was 1.9 +/- 0.6mm (1.0 to 3.5mm). Occlusion was performed by using the snare technique in 34 patients and by using a detachable coil in 6 patients. Follow-up was done at week 1, 3, 6, and a 12-month postprocedure was dont by echocardiography. RESULTS: Of the 41 patients with successful coil implantation, 32 patients (78%) had no residual shunting, 8 trace residual shunting, and 1 small residual shunting shown by angiogram immediately after coil embolization. All the patients except for one were followed up for 6.5 +/- 4.5 months (1 day to 12 months). Complete closure was confirmed in 38 patients (95%) at 6 months after implantation (34/40 at 1 month, 37/40 at 3 months, 38/40 at 6 months). There were no significant complications. CONCLUSION: Percutaneous occlusion of PDA can be safely and effectively performed in patients with small PDA, irrespective of native or residual nature, by using the snare technique or a detachable coil.
Body Weight ; Ductus Arteriosus, Patent* ; Echocardiography ; Embolization, Therapeutic* ; Follow-Up Studies ; Humans ; Incidence ; Ligation ; SNARE Proteins

OBJECTIVE: The presence of the various cytokines in human peritoneal fluid has been evaluated incompletely. Changes in cytokine lefels may be related to activation of peritoneal macrophage and T-lymphocyte, development of endometriosis, and infertility. This study assesses peritoneal fluid levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-alpha) in infertile women with endometriosis and normal women without endometriosis. Design : Prospective and case-control study in university hospital. MATERIALS AND METHODS: Cytokine levels in peritoneal fluid obtained during laparotomy or laparoscopy from 21 patients in infertile patients in infertile patients with endometriosis and 24 controls undergoing laparotomy or laparoscopy with no evidence of pelvic endometriosis were determined by enzymelinked immunosorbent assay. RESULTS: The mean levels of interleukin-6 in infertile patients with endometriosis and controls were 72.7+/-23.7 pg/ml and 18.5+/-9.7 pg/ml respectively (p=0.02). Similarly, the mean levels of interleukin-8 in infertile patients with endometriosis was significantly higher than that of controls (445.0+/-89.6, vs 45.1+/-48.4, p=0.04). The mean concentration of interleukin-10 in infertile patients with endometriosis was significantly lower than that of controls (1.09+/-0.04 vs 2.19+/-0.03, p=0.03). The level of tumor necrosis factor-alpha was not significantly different between the two study groups. CONCLUSIONS: Increased IL-6 and IL-8 and decreased IL-10 levels in the peritoneal fluid may be related to pathogenesis in the endometriosis and infertility, suggesting that partially contribute to the disturbed immune regulation observed in infertili women with endometriosis.
Ascitic Fluid* ; Case-Control Studies ; Cytokines ; Endometriosis* ; Female ; Humans ; Infertility ; Interleukin-10 ; Interleukin-6 ; Interleukin-8 ; Laparoscopy ; Laparotomy ; Macrophages, Peritoneal ; Prospective Studies ; T-Lymphocytes ; Tumor Necrosis Factor-alpha

Actinomycosis is a chronic, progressive, suppurative disease which appears to be difficult to establish a correct preoperative diagnosis. Most of pelvic actinomycosis in women are related to a long time intrauterine device(IUD) inserted state. The causative agent is a branching, gram-positive anaerobic or microaerobic organism, not fungi. Ascending infection of the upper genital tract by actinomycosis may be clinically inapparent. We experienced a case of clinically inapparent tuboovarian actinomycosis in a 47-year-old women with IUD, discovered pathologically after laparotomy.
Actinomycosis* ; Diagnosis ; Female ; Fungi ; Humans ; Intrauterine Devices* ; Laparotomy ; Middle Aged

Although vascular injury after clavicular fracture is a extremely rare, it is a complication which is serious problem. Vascular injury associated with the fracture can be immediate or delayed. We report a case of late-onset brachial artery occlusion caused by subclavian artery stenosis with excessive scar tissue after open reduction and plate fixation for clavicular fracture and include a review of the literature.
Brachial Artery* ; Cicatrix ; Subclavian Artery* ; Subclavian Steal Syndrome* ; Vascular System Injuries

PURPOSE: The proportion of interventional catheterization in congenital heart disease is being increased in Korea, especially in Sejong Heart Institute, so we performed statistical analysis on the cardiac catheterization cases. METHODS: Total 233 cases of congenital heart disease confirmed by cardiac catheterization at the Sejong Heart Institute between Jaunary 1995 and June 1995 were analyzed retrospectively. RESULTS: 1) The distribution of age has become more younger than that of previous reports that is, the proportion of the infant less than 1 year old was 34.8%. 2) The proportion of male sex was equal to that of female. TOF and TGA were observed predominantly in male patients, and PDA and UVH revealed female preponderance. 3) The relative frequencies of each individual congenital heart disease in order of frequency were as follows; TOF 37.3%, PDA 13.3%, VSD 8.2% and UVH 7.7%. 4) Among the 145 (62%) cases of hemodynamic study pre-operation and post-operation cases were 85 and 60 cases, respectively. The cases of interventional catheterization were 84 (36%), and those of endomyocardial biopsy were 4 (2%). 5) The frequencies of each interventional catheterization of 84 cases in order of frequency were as follows: defect closure 28 cases, balloon valvuloplasty 20 cases, balloon angioplasty 17 cases, coil embolization 15 cases, and balloon atrial septostomy 4 cases. 6) There were 2 cases of mortality associated with cardiac catheterization. CONCLUSIONS: The proportion of interventional catheterization in congenital heart disease is being increased in the Sejong Heart Institute, and this trend will spread to the other cardiac center in Korea.
Angioplasty, Balloon ; Balloon Valvuloplasty ; Biopsy ; Cardiac Catheterization ; Cardiac Catheters ; Catheterization* ; Catheters* ; Embolization, Therapeutic ; Female ; Heart ; Heart Defects, Congenital* ; Hemodynamics ; Humans ; Infant ; Korea ; Male ; Mortality ; Retrospective Studies

Clinical features, laboratory and operative findings were reviewed in 10 cases of Ebstein's anomaly admitted to Dong San Hospital, Keimyung University during a 7(1/2)-year period from January 1982 to June 1989. The following results obtained : 1) Exertional dyspnea(90%) and palpitation(30%) were the predominant symptoms, and cyanosis was documented in 2 cases among 10 patients. 2) Chest X-ray showed cardiomegaly in all cases, but cardio-thoracic ratio was above 0.6 in 4 cases. 3) Electrocardiograms showed RBBB in 4 cases, RVH in 2 cases, 1st degree AV block in 4 cases. 4) Echocardiograms and angiograms showed displacement of tricuspid valve in all cases. 5) Interatrial communication via atrial septal defect (5) and patent foramen ovale (5) was present in 10 cases(100%). 6) Operative findings of 5 cases showed abnormalities of septal leaflet in 5(100%), posterior leaflet in 5(100%), and anterior leaflet in 1 case (20%).
Atrioventricular Block ; Cardiomegaly ; Cyanosis ; Ebstein Anomaly* ; Electrocardiography ; Foramen Ovale, Patent ; Heart Septal Defects, Atrial ; Humans ; Thorax ; Tricuspid Valve

OBJECTIVE: A large body of evidence suggests that cyclooxygenase-2(COX-2) is important in tumorigenesis of gastrointestinal cancer. The purpose of this study was to determine whether COX-2 was also expressed in cervical intraepithelial neoplasia(CIN) and invasive cervical carcinoma. METHODS: We studied the expression of COX-2 in normal cervix(n=6), CIN I(n=4), CIN II(n=2), CIN III(n=15), microinvasive carcinoma(n=5) and invasive carcinoma(n=7) by immunohistochemistry. RESULTS: We observed strong COX-2 expression in 16.7% of the normal cervix, 0% of the CIN I and II, 80.0% of CIN III, 60.0% of microinvasive carcinoma and 71.4% of invasive carcinoma. The intensity of immunostaining was stronger in the CIN III and invasive cancer than the normal cervix and CIN I lesions(p<0.01). CONCLUSION: These results suggest that COX-2 may have a role in carcinogenesis of CIN and may be a target for the prevention or treatment of CIN and invasive cervical cancer.
Carcinogenesis ; Cervical Intraepithelial Neoplasia* ; Cervix Uteri ; Cyclooxygenase 2 ; Female ; Gastrointestinal Neoplasms ; Immunohistochemistry ; Prostaglandin-Endoperoxide Synthases* ; Uterine Cervical Neoplasms*

No abstract available.
Periodontal Diseases*

PURPOSE: To evaluate the midterm result of patients who underwent rotational acetabular osteotomy for the treatment of acetabular dysplasia. MATERIALS AND METHODS: The clinical and radiographic outcomes of 36 patients, who underwent rotational acetabular osteotomy between January 1987 and September 1998, were evaluated after a minimum followup of five years. The mean follow-up period was 8.6 years. The clinical evaluation included recording the level of pain, the ambulation status and range of motion according to the d'Aubigne and Postel system. Radiographic analysis included the C-E angle of Wiberg, the acetabular roof obliquity, and arthritis grade of Tonnis. RESULTS: The average Postel score increased from 12.5 points preoperatively to 15.7 points at the final follow up. All the radiologic indices improved after surgery. In five hips (13.1%), there was a progression of arthritis prior to surgery. CONCLUSION: Rotational acetabular osteotomy is a valuable procedure for preventing the progression of early osteoarthritis in patients with a dysplastic hip. However the results were unsatisfactory for hips with more advanced osteoarthritis.
Acetabulum* ; Arthritis ; Follow-Up Studies* ; Hip Joint ; Hip* ; Humans ; Osteoarthritis ; Osteotomy* ; Range of Motion, Articular ; Walking

PURPOSE: To assess the mode of a polyethylene liner failure in total hip replacement using a Harris-Galante II acetabular component. MATERIALS AND METHODS: A retrospective review was performed and 128 consecutive primary total hip arthroplasties were analyzed in 111 patients who had a second-generation Harris-Galante cup. All patients were followed up for a minimum of five years, with a mean follow up of 7.4 years (range, 5 to 12.9 years). A total of 26 cups (20.2%) were revised at the time of the latest follow up. The medical records, radiographs, surgical notes, and retrieved components were analyzed in order to determine the precise causes of the revision. RESULTS: Twenty-two cases (17.3%) were found to have experienced problems with the polyethylene liner. Three types of liner failure were identified; metallosis associated with polyethylene liner wear (14 cases), excessive wear without metallosis necessitating a revision (6 cases), and polyethylene liner dissociation without gross evidence of wear (2 cases). CONCLUSION: This study find that polyethylene liner failure is the main cause of the revision of this component. Early surgical intervention needs to be performed before fatal metal damage occurs in order to avoid metallosis, and severe bone stock damage in cases of excessive polyethylene wear.
Acetabulum* ; Arthroplasty ; Arthroplasty, Replacement, Hip* ; Follow-Up Studies ; Hip ; Humans ; Medical Records ; Polyethylene* ; Retrospective Studies