BACKGROUND: Coronary intervention is a well established treatment of ischemic heart diseases. However, acute arterial occlusion and restenosis have remained as the principal limitations of coronary intervention. This study was aimed to analyze the acute and long-term, and the clinical angiographic results of the coronary intervention for restenotic lesions. METHOD: Between March 1996 and July 1997 at Chonnam University Hospital, second interventions were performed in one hundred restenotic coronary lesions of ninety patients (age 58.5+/-9.0 year, M:F = 5:1), i.e. percutaneous transluminal coronary angioplasty (PTCA) or stent implantation for the treatment of restenosis. RESULTS: 1) Initial interventions were PTCA in 75 lesions (Group I) and stent in 25 lesions (Group II). There were no differences in clinical manifestations, angiographic findings and follow-up period between the two groups. 2) The method of the second intervention for the restenotic lesions after PTCA were either PTCA or stent implantation ; in Group I PTCA was performed in 27 (37%) lesions and stent in 46 (63%), In Group II, PTCA was performed in 20 (91%) lesions and stent in 2 (9%) lesions. The overall success rate of the second intervention for the restenotic lesion was 96%. 3) Follow-up angiogram at 5.5+/-2.9 months after the second intervention revealed the second restenosis rates of 44% (8/18) after stent and 50% (7/14) after PTCA. CONCLUSION: Second intervention for restenotic lesion can be performed with high success rate. Second restenosis rate are not different between the PTCA and stent groups.
Angioplasty, Balloon, Coronary ; Follow-Up Studies* ; Humans ; Jeollanam-do ; Myocardial Ischemia ; Stents

The survey methods for confirming the epidemicity and identifying the possible causes of the cancer epidemic can be different from those for infectious diseases. The procedure for confirming whether the outbreak is epidemic or not is quite different. Household survey for identifying cancer cases and residents actually living at the area should be done. Hospital survey for medical record review should be performed to identify all cancer cases among the residents of the outbreak area and confirming the final diagnoses of the cancer cases. Comparing the level of cancer incidence or mortality with other areas can be done by using poison distribution, or calculating SIR (standard Incidence Ratio) from cumulative incidence rates. Case-control study can be conducted to identify the etiologic factors of the cancer epidemic and to establish strategy for preventing further recurrence of the outbreak.
Case-Control Studies ; Communicable Diseases ; Surveys and Questionnaires* ; Diagnosis ; Epidemiology ; Family Characteristics ; Incidence ; Medical Records ; Mortality ; Recurrence

PURPOSE: Clinicopathological features were investigated to clarify the outcome and prognostic indicators for patients with IgA nephropathy in Korean children. METHODS: We reviewed the outcomes of 61 patients in whom IgA nephropathy was diagnosed before the age of 15 years from 1991 to 2005 and followed-up at least for one year. All patients were confirmed by renal biopsy. RESULTS: After mean follow-up of 5.2 years from onset, 24 patients of 61 (39.3%) were in clinical remission at the last examination. Thirty patients (49.2%) had hematuria or mild proteinuria (<1 g/ m2/d), five (8.2%) had severe proteinuria (> or =1 g/m2/d), and two (3.3%) had chronic renal failure. By univariate analysis, initial presentation at onset and Haas classification were less concordant with outcome. Hypertension during follow-up, rather than hypertension at presentation, was significantly correlated with outcomes (P<0.01). Sixty percent of patients who had more than 20% of glomerular sclerosis or crescent progressed to severe proteinuria or chronic renal failure, as compared with 7.1% of those who did not (P<0.01). CONCLUSION: Prognosis of childhood IgA nephropathy had a relatively benign course during a mean follow-up of 5.2 years. Persistent hypertension during follow-up and more than 20% of glomerular sclerosis or crescent were strong predictors of a progressive course of IgA nephropathy. A new histologic classification according to characteristics of childhood IgA nephropathy must be established to assess prognosis. Further efforts should be made to understand the prognosis of IgA nephropathy through long-term follow-up.
Biopsy ; Child ; Classification ; Follow-Up Studies ; Glomerulonephritis ; Glomerulonephritis, IGA* ; Hematuria ; Humans ; Hypertension ; Immunoglobulin A* ; Kidney Failure, Chronic ; Prognosis* ; Proteinuria ; Sclerosis

The position of interventricular septum, which was measured by transitional zone of EKG, was compared with that measured by 2-D echocardiography in 51 patient. 1) The position of interventricular septum measured by 2-D echocardiography was very similar to that measured by transitional zone of EKG. 2) Extensive AMI (Anterior Myocardial Infarction) and LBBB showed moderate differences between two method. 3) RBBB and replaced mitral valve state showed severe differences between two methods. Transitional zone of EKG was helpful to define the position of interventricular septum except extensive AMI, bundle branch block and replaced mitral valve state.
Bundle-Branch Block ; Echocardiography ; Electrocardiography* ; Humans ; Mitral Valve

BACKGROUND: The endovascular stent has been applied clinically in acute arterial occlusions after intimal dissection by angioplasty and in the prevention of restenosis. However, subacute stent thrombosis and restnosis remain major concerns in clinical stenting despite intravscular ultrasound guidance and high pressure inflation. Moreover, anticoagulation before and after stent implantation may be required for long periods and complicated by bleeding. A new strategy may be local drug delivery, which maintains sustained local concentration and may limit systemic complications. To evaluate the efficacy of local Nitric Oxide(NO) donor delivery on acute or subacute stent thrombosis and bleeding complications in patients, local NO donor delivery was performed in stented patients. METHOD: NO donor (2.0mg, Molsidomine) was delivered (1.0ml/min over 10min) using the Dispatch Catheter, after predilation of target lesion in 15 patients (8 angina, 7 myocardial infarction, mean age 5311.5 yr.) without heparin or nitrate infusion after stenting. After local NO donor delivery, Palmaz-Schatz stents were placed with standard methods. APTT and CK were checked at 1 hr, 3 hrs and 24 hrs after local NO donor delivery and STENTING. Follow-up coronary angiograms were done 48 hrs after stenting. RESULT: All patients had no hypotensive effects, no ischemic symptoms or no ECG changes during and after locaL NO donor delivery. ARTT and CK values were not changed at 3 and 24 hrs after local NO donor delivery and stenting. This allowed early arterial sheath removal. Follow-up coronary angiograms at 48 hrs showed all stents patent without stent recoil, with TIMI III flow, and without intra-stent thrombus. No target lesion revascularization and 100% event free survival were obsered for one month's clinical follow-up after NO donor delivery and stenting. Conclusion: Local NO donor delivery prior to stenting prevents acute and subacute stent thrombosis, systmic complications of nitrate, and maintains stent blood flow without stent recoil within the first one month after stenting.
Angioplasty ; Catheters ; Disease-Free Survival ; Electrocardiography ; Follow-Up Studies ; Hemorrhage ; Heparin ; Humans ; Inflation, Economic ; Myocardial Infarction ; Nitric Oxide* ; Stents* ; Thrombosis ; Tissue Donors* ; Ultrasonography

Fifteen cases of the primary duodenal malignancies were radically resected from July 1989 to September 1996. These cases were analysed retrospectively with the literature review. The male to female ratio was 8:7. The mean age was 49 years. Histopatholgically, adenocarcinomas were 10 cases, sarcomas were 4 cases and malignant lymphoma was 1 case. The symptoms and signs were abdominal pain and discomfort, weight loss, nausea and vomiting, jaundice, melena and diarrhea in the order of the frequency. We performed Whipple's operations in 11 cases, regional pancretectomy in 1 case, Whipple's operation with Right hemicolectomy in 2 cases and local resection in 3 cases. There was no operative mortality. The perioperative morbidity was 33%. The post operative complications were abscess in abdomen in 3 cases and wound infections in 2 cases. 1 year and 2 years survival rate were 93.3% and 33.3%. Aggressive and radical treatment with curative intention even in the presence of locally advanced disease, could be performed with acceptable mortality and morbidity and expect a better outcome.
Abdomen ; Abdominal Pain ; Abscess ; Adenocarcinoma ; Diarrhea ; Female ; Humans ; Intention ; Jaundice ; Lymphoma ; Male ; Melena ; Mortality ; Nausea ; Retrospective Studies ; Sarcoma ; Survival Rate ; Vomiting ; Weight Loss ; Wound Infection

Osteoblasts from alveolar bone may have an important role in the bone regeneration for periodontium, but their culture and characterization are not determined yet. The purpose of this study was to investigate the biological characteristics of primary explant cultured osteoblasts(PECO) from alveolar bone. Osteoblasts were isolated and cultured from alveolar socket of extracted tooth in children. To compare the characteristics, osteoblasts and gingival fibroblasts were cultured with DMEM at 37degrees C, 5% CO2, 100% humidity incubator, and human fetal osteoblasts cell line(hFOB1) were cultured with DMEM at 34degrees C, 5%, CO2, 100% humidity incubator. To characterize the isolated bone cells, morphologic change, cell proliferation and differentiation were measured. Morphology of PECO was small round body or cuboidal shape on inverted microscope and was similar with hFOB1. PECO became polygonal shape with stellate and had an amorphous shape at 9th passage in culture. PECO had significantly higher activity than that of gingival fibroblasts and hFOB1 in alkaline phosphatase activity. The expression of osteocalcin and bone sialoprotein in PECO was notably increased when compared with hFOB1 and gingival fibroblasts. These result indicated that PECO from alveolar bone in children has an obvious characteristics of osteoblast, may be applied for the regeneration of bone.
Alkaline Phosphatase ; Bone Regeneration ; Cell Proliferation ; Child ; Fibroblasts ; Humans ; Humidity ; Incubators ; Integrin-Binding Sialoprotein ; Osteoblasts* ; Osteocalcin ; Periodontium ; Population Characteristics* ; Regeneration ; Tooth

OBJECTIVE: This study was designed to compare the vaginal hysterectomy and abdominal hysterectomy for a non-prolapsed, benign uterus in women without vaginal delivery. METHODS: A retrospective study in Hallym-university hospital analysed 182 total hysterectomies in women without vaginal delivery performed from January 2000 to December 2001. Vaginal route was used for 98 (53.8%) patients and 84 (46.2%) had laparotomies. RESULTS: The mean uterine weight was 217 g in vaginal route, 270 g in abdominal route. Mean operation time was 70 minutes in vaginal route, 125 minutes in abdominal route. There was one serious re-operation due to hemorrhge in each group and other complication was not much different at each gruops. The hospital stay was 6.2 days in vaginal route and 8.4 days in abdominal route. CONCLUSION: Vaginal hysterectomy for a non-prolapsed uterus is indicated for women without vaginal delivery and is feasible to performance. Vaginal hyterectomy is less morbidity, shorter hospitalization and faster convalescence. So training in vaginal surgury should allow safe performance of the procedure at most center.
Convalescence ; Female ; Hospitalization ; Humans ; Hysterectomy* ; Hysterectomy, Vaginal* ; Laparotomy ; Length of Stay ; Retrospective Studies ; Uterine Diseases* ; Uterus

The purpose of this study was to evaluate the significance of telomerase activity in gestational trophoblastic disease and the association of telomerase activity in complete hydatidiform mole and subsequent development of persistent gestational trophoblastic tumor. By using the standard telomerase repeat assay, we examined telomerase activity in 2 normal placentas, 31 complete hydatidiform moles, 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). Telomerase activity was detected in 13 of 15 (86.7%) complete hydatidiform mole patients who eventually had chemotherapy for the treatment of persistent gestational trophoblastic tumor. All of the 9 patients with metastatic disease (FIGO Stage III) had telomerase activity in their initial molar tissue. In contrast, telomerase activity was evident in only two of 16 (12.5%) complete hydatidiform mole patients with spontaneous remission. While telomerase activity was not detected in normal placentas, high level of telomerase activity was detected in all of 7 invasive moles, 5 choriocarcinoma tissues and choriocarcinoma cell line (JEG-3). The presence of telomerase activity in a complete hydatidiform mole is associated with the development of persistent gestational trophoblastic tumor, such as invasive mole and choriocarcinoma.
Cell Line ; Choriocarcinoma ; Drug Therapy ; Female ; Gestational Trophoblastic Disease* ; Humans ; Hydatidiform Mole ; Hydatidiform Mole, Invasive ; Molar ; Placenta ; Pregnancy ; Remission, Spontaneous ; Telomerase* ; Telomere ; Trophoblastic Neoplasms

BACKGROUND: Aspirin, one of the antiplatelet agents, improves the survival rate after myocardial infarction. This beneficial effect is known to be obtained in part by the antiarrhythmic action of aspirin. It is not known whether other antiplatelet agents have such effects. This study was performed to compare the effects of aspirin, ticlopidine, and abciximab (platelet glycoprotein IIb/IIIa receptor antagonist) on the ischemia-induced arrhythmias with a rat model of cardiac regional ischemia. METHODS: Experiments were performed in 4 groups of rats. The 4 groups were as follows : control, n=10:aspirin-pretreated, 300 mg/kg po for 1 week:ticlopidine-pretreated, 200 mg/kg po for 1 wk:abciximab-pretreated, 2 mg/kg iv 10-20 minutes before experiment. The electrocardiogram and blood pressure were recorded during 20 minutes. The time to the onset of ST-segment elevation and ventricular tachyarrhythmias, frequency and incidence of ventricular tachyarrhythmias, and death rate were assessed during acute myocardial ischemia induced by ligation of proximal left anterior descending coronary artery in anesthetized rats. RESULTS: Platelet aggregations to ADP were significantly lower in aspirin (42.8%), ticlopidine (43.8%), and abciximab group (34.0%) than in control group (66.4%). The frequencies of sustained ventricular tachycardia (VT) were 6.8+/-3.6 in control, 3.6+/-3.8 aspirin, 4.7+/-3.7 ticlopidine, and 1.4+/-2.5 abciximab group. The frequency of sustained VT in the abciximab group was significantly lower than in control group. The incidences of ventricular arrhythmias for 20 min were 10/10 for VT and 8/10 for ventricular fibrillation (VF) in control group, 7/10 for VT and 3/10 for VF in aspirin group, 10/10 for VT and 3/10 for VF in ticlopidine group, and 5/10 for VT and 4/10 for VF in abciximab group. The incidences of cardiac death during 20 min were 8/10 in control group, 4/10 in aspirin group, 2/10 in ticlopidine group and 5/10 in abciximab group. The incidence of VT in the abciximab group was significantly lower than in control group, incidences of VF in the aspirin and ticlopidine groups were significantly lower than in control group, and death rate in ticlopidine group was significantly lower than in control group. CONCLUSION: The present study suggested that aspirin, ticlopidine, and abciximab could prevent ventricular tachycardia or ventricular fibrillation in a rat model of cardiac regional ischemia and their antiarrhythmic effects improve the survival rate.
Adenosine Diphosphate ; Animals ; Arrhythmias, Cardiac ; Aspirin ; Blood Platelets ; Blood Pressure ; Coronary Vessels ; Death ; Electrocardiography ; Glycoproteins ; Incidence ; Ischemia ; Ligation ; Models, Animal ; Mortality ; Myocardial Infarction ; Myocardial Ischemia* ; Platelet Aggregation Inhibitors* ; Rats* ; Survival Rate ; Tachycardia* ; Tachycardia, Ventricular ; Ticlopidine ; Ventricular Fibrillation