BACKGROUND: We performed this study to evaluate the long-term clinical prognosis, the effects of anti-anginal medicines on angina, and the factors on recurrence of angina in patients with angina and insignificant coronary artery stenosis (CAS). METHODS: The study population was consisted of 372 patients with angina and normal or minimal (less than 50 % stenosed) CAS out of 2475 consecutive patients who were performed coronary angiogram for 3.5 years. We reviewed the medical record of the study population. RESULTS: Myocardial infarction was developed in 2 cases (0.5%), recurrence of angina 59 cases (16%), and no death during mean 19 months follow-up period out of 372 patients. Patients with normal coronary artery (n=66) were younger (mean 54 yrs vs 59 yrs, p<0.001), had less incidence of diabetes (5% vs 13%, p<0.01), hypertension (19% vs 29%, p<0.05), recurrent angina (15% vs 18%, not significant), and myocardial infarction (0.4% vs 0.9%, not significant) than patients with minimal lesion (n=06). Anti-anginal medicine did not show benefits in relieving recurrent angina. Furthermore, in case of taking nitrates in patients with normal coronary artery, there was more frequent recurrence of angina (23% vs 13%, p<0.01) than not taking nitrates. There were no affecting factors to the recurrent angina among age, sex, ischemic changes on electrocardiogram, smoking, hypertension, diabetes, and hyperlipidemia. CONCLUSION: The long-term clinical outcomes in patients with insignificant CAS were good. Although there were no definite factors for recurrence of chest pain, administration of nitrates may cause more frequent angina in patients with normal coronary angiography.
Chest Pain ; Coronary Angiography ; Coronary Stenosis* ; Coronary Vessels* ; Electrocardiography ; Follow-Up Studies ; Humans ; Hyperlipidemias ; Hypertension ; Incidence ; Medical Records ; Myocardial Infarction ; Nitrates ; Prognosis ; Recurrence ; Smoke ; Smoking

Spontaneous perforation of bile duct in adults is very rare, with less than 30 cases described in the literature to date. We repoit a case of a 65-year-old man who presented with severe colicky abdominal pain and fever, just like symptoms of peritonitis. ERCP provided a preoperative noninvasive confirmation of the diagnosis of the rupture of right intrahepatic duct. The patient was performed T-tube choledochotomy and drainage of retroperitoneal bile collection. The etiolgy, diagnosis, and treatment of spontaneous perforation of bile duct is discussed.
Abdominal Pain ; Adult ; Aged ; Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis* ; Drainage ; Fever ; Humans ; Peritonitis ; Rupture

No abstract available.
Colon, Descending* ; Leiomyosarcoma*

To evaluate the character, management and clinical results of the posterior capsular rupture during cataract surgery, we retrospectively studied the cataract surgeries that were performed between May 1989 and Decemeber 1991. We discovered 64 eyes in which the posterior capsule was torn. The overall incidence of this complication was 4.4%. Our chart review of these surgical procedure revealed that the tear occurred most frequently during the nucleus removal(44%), occured more frequently at the periphery than the center and the extent was mostly below one-third of the whole posterior capsular surface(75%). We performed vitrectomy(58%) and peripheral iridectomy(14%). Posterior capsular lenses were implallted in 56 cases. The predicted power of lens calculated with SRK-II fomula and manufacturer's A-constant was approximately 0.46 diopter less than actual postoperative refraction. Final visual acuity of 20/40 or better was achieved in 73% of the 64 cases. Our results revealed that when properly managed, a torn posterior capsule is compatible with an excellent visual outcome.
Cataract* ; Incidence ; Retrospective Studies ; Rupture* ; Visual Acuity

BACKGROUND AND OBJECTIVES: There is little clinical data on the results of using Sirolimus-Eluting Stent (SES) for treating In-Stent Restenosis (ISR). We performed this study to evaluate the clinical outcomes for implanting SES for treating ISR in a real world hospital environment. SUBJECTS AND METHODS: A total of 30 patients with 32 ISRs (males: 73.3%, mean age: 60.2) (focal lesions: 21.9%, diffuse intra-stent lesions: 34.4%, proliferative lesions: 21.9%, total occlusions: 21.9%) were treated with SES after balloon predilation was performed. We evaluated the clinical results and the performed coronary angiography after 6 months. RESULTS: All the procedures were successful. The mean SES diameter and length were 3.0+/-0.3 mm and 27.1+/-5.5 mm, respectively, and the mean acute gain was 2.42+/-0.38 mm. No in-hospital major adverse cardiac events (MACE) were observed. Twenty five patients with 27 lesions (84.4%) underwent coronary angiography at their 6 month follow-up. The late loss and loss index were 0.41+/-0.56 mm and 0.18+/-0.22, respectively. The binary restenosis rate was 7.4% (2/27 lesions). The rate of target lesion revascularization was 3.7% (1/27 lesion). The incidence of MACE at 6 months was 3.3% (1/30 patient). CONCLUSION: Treating ISR with SES is a safe and effective procedure for reducing ISR without the occurrence of acute or sub-acute thrombosis.
Coronary Angiography* ; Coronary Artery Disease ; Coronary Restenosis ; Follow-Up Studies ; Humans ; Incidence ; Stents* ; Thrombosis

Traumatic ventricular septal defect secondary to nonpenetrating chest trauma is very rare. We present one case of nonpenetrating traumatic ventricular septal defect with the review of the literatures.
Heart Septal Defects, Ventricular* ; Thorax*

PURPOSE: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostie usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary Iymph node metastasis. MATERIALS AND METHODS: This study included 30S patients who underwent scintimammography for palpable breast masses or abnormal radiologic findings. Tc-99m MIRI scintirnammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or F.4AB and compared with the results of Tc-99m MIBI scintimammography. RESULTS: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one (2,44+/-0.97 vs 1.94+/-0.78, p=0.01). Delayed L/N had no significant difference between malignant an Breast Diseases ; Breast Neoplasms* ; Breast* ; Diagnosis ; Humans ; Injections, Intravenous ; Lymph Nodes ; Neoplasm Metastasis ; Sensitivity and Specificity

PURPOSE: The aim of this study was to investigate the diagnostic role of 99mTc-Tetrofosmin in detection of breast cancer and compared with that of 99mTc-MIBI. MATERAL AND METHODS: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. RESULTS: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of 99mTc-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of 99mTc-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of 99mTc-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both 99mTc-MIBI and 99mTc-Tetrofosmin scintimammographies and its size was 0.5cm. CONCLUSION: 99mTc-Tetrofosmin and 99mTc-MIBI were non-invasive and useful in detection of breast cancer and 99mTc-Tetrofosmin was comparable to the 99mTc-MIBI in detection of primary breast cancer.
Breast Diseases ; Breast Neoplasms* ; Breast* ; Humans ; Injections, Intravenous ; Radiopharmaceuticals ; Sensitivity and Specificity

No abstract available in English.
Enterocolitis, Pseudomembranous

No abstract available.