No abstract available.
Arthritis, Infectious* ; Hip Joint* ; Hip*

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

PURPOSE: Drug resistance is one of the major obstacles to treatment of cancer. Multidrug resistance (MDR) caused by overexpression of p-glycoprotein (Pgp) in cancer cell membrane is a well-known mechanism of drug resistance in in vitro system and was reported to be a significant mechanism of resistance in non-Hodgkins lymphoma (NHL). Verapamil, a calcium channel blocker, is proven in vitro to overcome the MDR caused by Pgp. We performed a phase II trial of verapamil in patients with NHL refractory to EPOCH regimen (etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin) to overcome the MDR caused by Pgp. MATERIALS AND METHODS: Verapamil was administered via intravenous route from 1 hour before to 12 hour after the 96-hour infusion of etoposide, doxorubicin, and vincristine which were known to be substrates of Pgp in EPOCH regimen. The dose of verapamil was 0.15 mg/Kg in bolus and 0.2 mg/Kg/hr in infusion at the beginning and escalated by 0.05 mg/Kg/hr every 24 hours if there was no dose-limiting toxicities such as 2nd or 3rd degree AV block, hypotension, or congestive heart failure. Plasma verapamil concentrations were measured every 24 hour by gas chromatography. Mdrl expression level in tumor tissues was measured by RT-PCR. RESULTS: From Feb. to Nov. 1994, 14 patients were treated with this protocoL However, poor tolerability and no response in these patients led to early closure of the study at this 1st stage of patient accrual according to Gehans method. Among 14 patients, 12 experienced 2nd or 3rd degree AV block and/or hypotension and required temporary cessation of infusion and reduction of verapamil dose. However, there was no congestive heart failure or treatment-related death. The peak concentrations of verapamil were 0.29-1.94 pM (mean 0.93 pM) and mean concentrations during the 4-day infusion were 0.22-1.21 pM (mean 0.6 pM). Mdrl expression levels measured in 6 patients were 0.99-14.43 U (median 4.39). CONCLUSION: These results suggest that verapamil in this dose and schedule was neither tolerable nor effective for the reversal of drug resistance in NHL patients.
Appointments and Schedules ; Atrioventricular Block ; Calcium Channels ; Cell Membrane ; Chromatography, Gas ; Cyclophosphamide ; Doxorubicin ; Drug Resistance* ; Drug Resistance, Multiple ; Etoposide ; Heart Failure ; Hodgkin Disease* ; Humans ; Hypotension ; Lymphoma, Non-Hodgkin ; P-Glycoprotein ; Plasma ; Prednisolone ; Verapamil* ; Vincristine

BACKGROUND: The advantages of mitral valve reconstruction have been well established and so mitral valve reconstruction is now considered as the procedure of choice to correct mitral vlave disease. This is the report of intermediate-term results of 38 cases that performed mitral valve reconstruction for valve insufficiency(the total number of mitral valve reconstruction were 49 cases, but 11 cases that performed mitral valve replacement due to incomplete reconstruction were excluded). MATERIAL AND METHOD: From March 1991 to March 2001, 38 patients underwent mitral vlave repair due to mitral valve regurgitation with or without stenosis. Mean age was 47.6+/-14.7 years(range 15 to 70 years) : 11 were men and 27 were women. The causes of mitral valve regurgitation were degenerative in 14, rheumatic in 21, infective in 2 and the other was congenital. RESULT: According to the Carpentier's pathologic classification of mitral valve regurgitation, 3 were type I, 16 were type II and 19 were type III. Surgical procedures were annuloplasty 15, commissurotomy 19, leaflet resection and annular plication 9, chordae shortening 11, chordae transfer 5, new chordae formation 2, papillary muscle splitting 2 and vegetectomy 2. These procedures were combined in most patients. There were 2 early death and the causes of death were respiratory failure, renal failure and sepsis. There was no late death. Valve replacement was done in 6 patients after repair due to valve insufficiency or stenosis 3 weeks, 1,3,51,69,84months later respectively. These patients have been followed up from 1 to 116 months(mean 43.0 months). The mean functional class(NYHA) was 2.36 pre-operatively and improved to 1.70. CONCLUSION: In most cases of mitral valve regurgitation, mitral valve reconstruction when technically feasible is effective operation that can achieve stable functional results and low surgical and late mortality.
Cause of Death ; Classification ; Constriction, Pathologic ; Female ; Humans ; Male ; Mitral Valve Insufficiency* ; Mitral Valve* ; Mortality ; Papillary Muscles ; Renal Insufficiency ; Respiratory Insufficiency ; Sepsis

Polyarteritis nodosa (PAN) is a multi systemic disease, occasionally described as limited forms of the disease. Localized form of PAN is usually associated with better prognosis. We describe unusual two cases of patients who has suffered from sudden onset of low extremity pain by localized forms of polyarteritis nodosa. Magnetic resonance imaging of the lower legs showed abnormal signal intensity of the suspected muscle. Acute necrotizing arteritis with myopathy has been revealed by muscle biopsy. The symptom of the patient has been improved soon after corticosteroid administration. Muscle biopsy of symptomatic muscles or MRI-directed biopsies can be useful to diagnose this case as PAN with localized myopathies.
Biopsy ; Extremities ; Humans ; Leg ; Magnetic Resonance Imaging ; Muscles ; Muscular Diseases ; Polyarteritis Nodosa* ; Prognosis

PURPOSE: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. METHODS: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. RESULTS: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were −1.7±0.5 mm in the SL group and −1.8±0.4 mm in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. CONCLUSIONS: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.
Alveolar Process* ; Bone Regeneration ; Collagen* ; Cone-Beam Computed Tomography ; Dental Implants ; Humans ; Membranes* ; Miners ; Molar ; Pilot Projects ; Prospective Studies ; Tooth ; Tooth Extraction ; Transplants ; Vertical Dimension

OBJECTIVE: The aim of this study was to describe and evaluate the clinical data and short-term treatment response in patients with obsessive-compulsive disorder (OCD) based on an outpatient setting. METHODS: A group of patients with OCD underwent mean 12-weeks treatment with selective serotonin reuptake inhibitors. The patients were divided into two groups according to treatment response, defined as a reduction of the Yale-Brown Obsessive Compulsive Scale total score >35% and CGI of 1 or 2. RESULTS: 1) Among the 249 patients, 24.1% had checking type and 23.7% washing type. Among these two types, 31.9% had mood disorder, 15.0% had anxiety disorder and 24.5% personality disorder as co-morbidity. One hundred fourteen patients (45.8%) responded to the treatment and 135 (54.2%) did not. The responders decreased Y-BOCS scores from 27.9+/-7.2 at baseline to 21.3+/-6.4 and 19.3+/-3.8 at post-treatment 8 and 12 weeks, respectively (repeated measure ANOVA, p=0.039). There were no differences among the treatment responses to serotonin reuptake inhibitors. CONCLUSION: About half of the OCD patients showed a response to pharmacological treatment using SSRI in the outpatient clinic setting for 12 weeks. Long-term and contrast studies of OCD may elucidate further clinical aspects of this disorder in the future.
Ambulatory Care Facilities ; Anxiety Disorders ; Comorbidity ; Humans ; Mood Disorders ; Obsessive-Compulsive Disorder* ; Outpatients ; Personality Disorders ; Serotonin Uptake Inhibitors

No abstract available.
Cyclophosphamide* ; Drug Therapy, Combination* ; Hodgkin Disease* ; Procarbazine* ; Vincristine*

BACKGROUNDS/AIMS: To compare surgical results and survival of two groups of patients, age > or =70 vs. age <70, who underwent pancreaticoduodenectomy and to identify the safety of this procedure for elderly patients for the treatment of distal common bile duct (CBD) cancer. METHODS: Between January 2003 and December 2009, 55 patients who underwent pancreaticoduodenectomy for the treatment of distal CBD cancer at Keimyung University Dong San Medical Center were enrolled in our study. RESULTS: Of 55 patients, 28 were male and 27 female. Nineteen were over 70 years old (older group) and 36 were below 70 years (younger group). The mean ages of the two groups of patients were 73.5 years and 60.5 years respectively. Although patients of the older group had significantly more comorbid diseases, perioperative results including operation time, amount of intraoperative bleeding, duration of postoperative hospital stay and postoperative complications were not significantly different. A higher level (more than 5 mg/dl) of preoperative initial bilirubin showed significant correlations with operative morbidity by univariate analysis, and age was not an independent risk factor of operative morbidity. Overall 5 year survival of older and younger groups were 45.9% and 39.5% respectively (p=0.671) and disease-free 5-year survival were 31.7% and 31.1%, respectively (p=0.942). CONCLUSIONS: Surgical outcomes of elderly patients were similar to those of younger patients, despite a higher incidence of comorbid disease. This results shows that pancreaticoduodenectomy can be applied safely to elderly patients.
Aged ; Bile ; Bile Duct Neoplasms ; Bile Ducts ; Bilirubin ; Common Bile Duct ; Female ; Hemorrhage ; Humans ; Incidence ; Length of Stay ; Male ; Pancreaticoduodenectomy ; Postoperative Complications ; Risk Factors

Renal graft recipients with hepatitis B virus(HBV) infection are at increased risk of fatal outcome, when 1they have serological evidence of active viral replication, such as HBV-DNA and/or HBeAg. Some patients have been treated successfully with interferon. But the major drawback of this therapy is acute rejection. Lamivudine is a potent inhibitor of hepatitis B virus replication. The aim of this study was to determine the efficacy and safety of lamivudine therapy in HBsAg positive renal recipients with active viral replication. Of the 20 HBsAg positive renal transplants, 12 patients with positive HBV-DNA, determined by hybridization method, were given lamivudine. The doses of lamivudine ranged from 37.5 to 150mg/day according to the graft function of patients. Alanine aminotransferase(ALT), aspartate aminotransferase (AST), HBsAg, HBeAg, anti-HBe, HBV-DNA and creatinine were regularly monitored. Lamivudine was well tolerated without significant side effect. Viral replication was effectively suppressed, as evidenced by negative conversion of serum HBV-DNA in 11 of 12 patients and reduction in HBV-DNA titer in 1 patient. In 3 patients who stopped lamivudine due to economic reason, HBV-DNA promptly increased to high titer, but decreased to undetectable level after retrial of medication. In 2 patients with initial negative conversion of HBV-DNA and under continued medication, HBV-DNA reappeared at 7 and 16 months respectively after initiation of lamivudine, with deterioration of hepatic function in 1 patient. These patients with lamivudine-resistant mutant continued medication with persistent low titer of HBV-DNA and without further aggravation of hepatic dysfunction. Lamivudine seems to inhibit HBV replication effectively in HBV-infected renal recipients and seems to be helpful in delaying the progression of liver disease. However, the optimal duration of treatment and long term efficacy and safety remain to be determined.
Alanine ; Aspartate Aminotransferases ; Creatinine ; Fatal Outcome ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Interferons ; Kidney Transplantation* ; Lamivudine* ; Liver Diseases ; Transplants