BACKGROUND AND OBJECTIVES: The goal of this study was to examine the safety and feasibility of a primary (direct) stenting in acute myocardial infarction (AMI). In the treatment of AMI, Percutaneous transluminal coronary angioplasty (PTCA) has documented superior reperfusion rate and improved clinical outcomes than thrombolytic therapy. However, there are several limitations of PTCA, such as recurrent ischemia in 10 to 15%, reinfarction in 3 to 5% and restenosis in 30 to 50% of patients. There are several reports that, compared with PTCA, the implantation of coronary stent has been shown to reduce angiographic restenosis and improve late clinical outcomes. But in general, stenting has been contraindicated in thrombus containing lesion due to the risk of subacute thrombosis. With advance in technique and the recognition of the importance of adequate platelet inhibition, the incidence of subacute thrombosis has fallen in patients with acute coronary syndrome and thrombus laden lesion. Methods and Results: In our study, primary stenting was performed in 42 patients of AMI. There are 6 cases (22.5%) target lesion restenosis during the follow up coronary angiography (150+/-86day) and no in-hospital death. Three cases (7.1%) of them require revascularization including two re-PCTA and a coronary artery bypass graft for the recurrent ischemic symptoms. There were no reinfarction and death after discharge. Six-months event free survival reate was 85.7%. CONCLUSION: Primary stenting is safe and feasible in the majority of patients with AMI and results in excellent mid-term outcomes compared with PTCA.
Acute Coronary Syndrome ; Angioplasty, Balloon, Coronary ; Blood Platelets ; Coronary Angiography ; Coronary Artery Bypass ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Ischemia ; Myocardial Infarction* ; Reperfusion ; Stents* ; Thrombolytic Therapy ; Thrombosis ; Transplants

A 36-year-old woman was presented with extensive anterior wall myocardial infarction. We tried to perform direct coronary angiography for the purpose of primary stenting. However, coronary angiogram revealed normal coronary arteries without intracoronary thrombi. We continued further evaluations to find out the cause of normal coronary myocardial infarction. The findings of severe hypertensive retinopathy and concentric left ventricular hypertrophy suggested that she had secondary hypertension. The detailed history, laboratory and radiological findings revealed the pheochromocytoma. The tumor was successfully removed by operation.
Adult ; Anterior Wall Myocardial Infarction ; Coronary Angiography ; Coronary Vessels ; Female ; Humans ; Hypertension ; Hypertensive Retinopathy ; Hypertrophy, Left Ventricular ; Myocardial Infarction* ; Pheochromocytoma* ; Stents

BACKGROUNG AND OBJECTIVES: Diabetes mellitus is a significant risk factor for adverse outcome after PTCA, which is associated with an increased late mortality and target lesion revascularization (TLR) rates. The beneficial role of coronary stenting on the clinical and angiographic outcomes of diabetic patients is not clearly defined. The aim of this study was to evaluate the early and mid-term outcomes in diabetic patients undergoing elective stenting of native coronary lesions compared with those in non-diabetic patients. MATERIALS AND METHODS: Between July 1997 and June 1998, coronary stenting was performed on 46 lesions in 38 diabetic patients and 126 lesions in 117 non-diabetic patients. Follow-up angiography at mean day of 189+/-45 was performed in 58.7% (91 patients) and analysed by quantitative coronary angiography (QCA). RESULTS: There was a higher incidence of multi-vessel disease in diabetic patients than non-diabetic patients but not statistically significant (71.1% vs 51.3%, p=0.106). There were no differences in major procedural complications and in-hospital events (myocardial infarction, angina and death) in diabetics and non-diabetics. During the follow-up, the incidence of target lesion revascularizton (TLR) and cardiac event free survival did not differ between two groups. CONCLUSION: Coronary stenting in diabetics resulted in a low rate of immediate procedural com-plications and early major adverse cardiac event (MACE), similar to non-diabetics. There were no differences in the mid-term clinical and angiographic outcomes in diabetics and non-diabetics.
Angiography ; Coronary Angiography ; Diabetes Mellitus ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Incidence ; Infarction ; Mortality ; Risk Factors ; Stents*

BACKGROUNG AND OBJECTIVES: It was reported that low molecular weight heparin (LMWH) was more effective than unfractionated heparin in patients with acute coronary syndrome. Recent studies have shown that the pathophysiology of restenosis in stented lesions was different from those of nonstented lesions. Treatment strategies designed to limit cellular proliferation that were ineffective in nonstented lesions may be efficacious in reducing in-stent restenosis. This study was aimed to compare the clinical and angiographic results of LMWH (nadroparin) after coronary stenting with those of conventional ticlopidine regimen. MATERIALS AND METHODS: Patients were eligible for inclusion if they had angina and/or objective evidence of myocardial ischemia, and a significant (>50%) stenosis that was documented on a recent coronary angiogram. After stenting, prospective randomized comparison study was performed. Patients were randomly assigned to either nadroparin (200 IU/kg, sc, bid) or ticlopidine (250 mg bid) plus aspirin (200 mg qd) treatment groups. Repeat coronary angiography (KERN=*)was performed at 236+/-90days after stenting, and quantitative coronary angiographic analysis (QCA) was done. RESULTS: Intracoronary stent implantation was performed in eighty five lesions in eighty one patients (ticlopidine:40, nadroparin:41). There was no significant difference in any baseline clinical/angiographic variables between the two treatment groups. There were no subacute stent thrombosis, infarction and death in both groups. Six-month event-free survival was 36 (90%) in the ticlopidine group and 35 (85.4%) in the nadroparin group. Follow-up quantitative angiographic data such as late loss (1.35+/-0.70 vs 1.32+/-0.69), loss index (0.53+/-0.70 vs 0.56+/-0.23) and restenosis rate (36% vs 25.8%) were not different between ticlopidine and nadroparin groups. CONCLUSION: Effects of nadroparin were not different from those with ticlopidine therapy in the prevention of restenosis and subacute stent thorombosis after coronary stenting. Clinical outcomes between two strategies were similar. Low molecular weight heparin may be an alternative to ticlopidine in patients that ticlopidine cannot be administered because of severe adverse effects.
Acute Coronary Syndrome ; Aspirin ; Cell Proliferation ; Constriction, Pathologic ; Coronary Angiography ; Disease-Free Survival ; Follow-Up Studies ; Heparin ; Heparin, Low-Molecular-Weight ; Humans ; Infarction ; Myocardial Ischemia ; Nadroparin* ; Prospective Studies ; Stents* ; Thrombosis ; Ticlopidine*

Darier's disease is a well-known genodermatosis characterized by recurrent waxy, hyperkeratotic papules usually occurring over the seborrheic area. The major histopathological changes are characteristic acantholysis and dyskeratosis which are diagnostic of the disease with typical clinical features. There are less common variants including the hypertrophic, vesicobullous and linear type. However, comedonal lesions are very rare. We report an unusual case of Darier's disease, which showed prominent comedonal papules and plaques over the face, scalp and upper trunk with the typical findings of Darier's disease.
Acantholysis ; Darier Disease* ; Scalp

Actinic reticuloid as a manifestation of chronic actinic dermatitis (CAD) is a rare dermatosis whose clinical and histologic features resemble other types of pseudolymphomas including mycosis fungoides and Jessner's lymphocytic infiltration, and it is regarded as an eventual stage of various photodermatoses like photosensitive eczema or persistent light reaction or chronic photoallergic contact dermatitis and so on. Phototests in the patients with actinic reticuloid usually reveal hypersensitivity to UVB, UVA, and sometimes to visible light. We present a case of actinic reticuloid in a 65-year-old male, whose skin lesions developed as erythematous lichenified infiltrating plaques on the face at first, and then spread themselves onto the upper trunk later. Histologically those skin lesions showed the aggregation of atypical lymphocytes and photobiologically the results of phototests revealed photosensitivity to UVB and UVA.
Actins* ; Aged ; Dermatitis, Photoallergic ; Eczema ; Humans ; Hypersensitivity ; Light ; Lymphocytes ; Male ; Mycosis Fungoides ; Photosensitivity Disorders ; Pseudolymphoma ; Skin ; Skin Diseases

No abstract available.
Ankle*

Short umbilical cord syndrome, also known as the limb-body wall malformation complex and the body stalk anomaly, is a poorly defined sporadic group of congenital anomaly charaterized by a complex set of disruptive abnormalities having in common the failured closure of the ventral body wall. This disorder is charaterized by a short or absent umbilical cord and disruption of the lateral body wall, spine, limbs, face, and cranium, isolated or in combination. Recently, we present a case of short umbilical cord syndrome which found in a term baby, so we report a case of short umbilical cord syndrome with brief review of literature.
Extremities ; Skull ; Spine ; Umbilical Cord*

No abstract available.
Child* ; Gastritis* ; Humans

Intra- and extrahepatic bile duct can be invaded by hepatocellular carcinoma (HCC). This is infrequent in HCC, but it can directly affect the clinical manifestation and prognosis. We present eight cases of HCCs with emphasis on the incidence and features of bile duct invassion on computed tomography (CT). Over a period of 22 months, abdominal CT was performed in 186 with HCC patients. Out of these, five cases of bile duct invasion by HCC were confirmed in our hospital and three in other hospitals. The eight cases were evaluated for the type, size and location. CT features of intraductal mass and ductal dilatation were evaluated. The incidence of bile duct invasion in HCC was 2.6%. Infiltrative type of HCC was seen in seven cases and six of these had mass 5-11 cm in size. The characteristic CT findings of bile duct invasion in HCC are mass in common hepatic duct with bulging contour(8/80, multiple intraductal masses in the intrahepatic ducts (5/8), and diffuse dilatation of intrahepatic ducts (7/8).
Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Carcinoma, Hepatocellular* ; Dilatation ; Hepatic Duct, Common ; Humans ; Incidence ; Prognosis ; Tomography, X-Ray Computed