Early and longterm prognosis depended on the extents of acute myocardial infarction and residual myocardial function. Many clinical methods have been evaluated to determine their ability to estimate the size of myocardial infarcts. But because of many disadvantages simplified QRS scoring system, used with standard 12-lead EKG, was developed, which is noninvasive, inexpensive and easily releatible. Therefore, the correlation between QRS and peak CK,killip classification were evaluated in 55 patients with initial acute myocardial infarction at the Chung-Ang University, Yong-San and Pil-Dong Hospital during the period from January 1983 to December, 1986. The results were as follows : 1) The average QRS score of the anterior wall infarction is 7.1 and that of the inferior wall infarction is 4.5 and there is a statistical significance(p<0.01). 2) In the acute myocardial infarction, the correlation coefficeient between the QRS score and the killip classification is 0.66(p<0.05). 3) In the acute myocardial infarction, the average QRS score is 6.3 and the correlation coefficient between the leak CK and the QRS score is 0.52(p<0.05). 4) In the anterior wall infarction, the average QRS score is 7.1 and the correlation coefficient between the peak Ck and QRS score is 0.48(p<0.05). 5) In the inferior wall infarction, the average QRS score is a 4.5 and the correlation coefficient between the leak CK and QRS score is 0.79(p<0.05).
Classification ; Electrocardiography ; Humans ; Infarction ; Myocardial Infarction* ; Prognosis

No abstract available.
Plasma* ; Prostate* ; Prostatic Neoplasms* ; Stomach Neoplasms*

PURPOSE: To understand the normal endosonographic anatomy of the perianal spaces, and to evaluate the diagnostic efficacy and limitation of endorectal sonography(EUS), correlative study with MRI, cadaveric sectional image and cadaveric MRI were performed. MATERIALS AND METHODS: EUS images of the normal 6 perianal spaces (pelvirectal, ischiorectal, intersphincteric, subcutaneous, central, submucous space) which were bounded by internal and external anal sphincters, rectal wall and levator ani muscle were correlated with MRI in 10 normal persons, cadaveric sectional images and cadaveric MRI in 2 cadavers. RESULTS: Pelvirectal space located superior to levator ani muscle could be demonstrable only on anterior wall scan but could not be visualized on lateral or posterior wall scan on EUS. Five perianal spaces located inferior to levator ani muscle were well seen on anterior, lateral, and posterior wall EUS. MRI was superior to EUS in the evaluation of pelvirectal and ischiorectal spaces but equal or inferior to EUS in the evaluation of intersphincteric, subcutaneous, central and submucous spaces. CONCLUSION: EUS was valuable in the evaluation of perianal spaces inferior to levator ani muscle but was limited in the evaluation of perianal spaces superior to levator ani muscle.
Anal Canal ; Cadaver* ; Humans ; Magnetic Resonance Imaging*

STUDY DESIGN: A retrospective study OBJECTIVES: We analyzed clinical and radiological results to verify the efficacy of calcium phosphate cement in kyphoplasty for treatment of osteoporotic vertebral fracture. SUMMARY AND LITERATURE REVIEW: Calcium phosphate is a biocompatible alternative to PMMA for vertebral augmentation in painful osteoporotic vertebral fracture as it is osteoconductive, non-exothermic, and injectable. MATERIALS AND METHODS: We analyzed 45 cases treated from April 2005 to August 2006 with a minimum of 1 year follow-up. Preoperative and post operative pain scores (visual analogue scale), ambulatory status, and patient satisfaction were measured. Anterior vertebral height, as well as the status and size of cement were assessed radiologically preoperatively, postoperatively, and at 3 months and 1 year. RESULTS: Pain scores (visual analogue scale) and ambulatory status improved significantly after kyphoplasty and remained unchanged during follow-up. Overall patient satisfaction was 93%. Radiological findings showed that mean vertebral height was significantly higher than preoperative (p<0.05). According to follow-up radiological finding, we divided cases into 4 groups: Group 1, 2; maintained vertebral height with minimal or some cement resorption; Group 3, 4; cement crack resorption and vertebral collapse. Group 1, 2 and Group 3, 4 had 38 patients (84%) and 7 patients(16%) respectively. Revision surgery was needed in 3 cases (antero-posterior surgery in 2 cases of group 4, and decompression in 1 case of extravasation into the neural canal). CONCLUSIONS: Kyphoplasty with calcium phosphate may be a good alternative for treatment of osteoporotic vertebral fracture, but non-union of the vertebral body with a large cleft showed a high risk of premature resorption and collapse of the vertebral body. The presumed advantage over PMMA needs longer follow-up.
Calcium* ; Decompression ; Follow-Up Studies ; Humans ; Kyphoplasty* ; Patient Satisfaction ; Polymethyl Methacrylate ; Retrospective Studies

Inverted papillomas are relatively rare, benign tumors of the sinonasal cavity that generate interest to many clinicians because of their high rate of recurrences, locally invasive character and malignant transformation. The incidence of bilateral occurrence, ranging from 2 to 7%, is extremely rare, and the incidence of synchronous malignancy is also rare too. Here, we report an unusual case of bilateral inverted papilloma with a malignant transformation on one side. We compared the expression of molecules that suggested a relation with malignant transformation in inverted papilloma between each side of the tumors.
Carcinoma, Squamous Cell ; Incidence ; Papilloma, Inverted ; Recurrence

OBJECTIVE: Ovarian cancer represents a relatively chemosensitive solid tumor, with responsiveness to a range of agents. Cisplatin is the mainstay of drug treatment and is one of the most active single agent. However, the overall outcome for patients remains unsatisfactory and the emergence of drug resistance is a major factor in treatment failure. Loss of DNA mismatch repair is a common finding in many types of sporadic cancer as well as in patients with hereditary nonpolyposis colon cancer. Cells that lack DNA mismatch repair are resistant to commonly used chemotherapeutic agents. Selection of cells for resistance to cisplatin, a well-recognized mutagen, could result in mutation in genes involved in DNA mismatch repair. METHODS: This study evaluated the mutation of hMLH1 and hMSH2, and its relation to the Taxol and Topotecan chemosensitivity in the clones from the ovarian cancer cell line 2008 and cisplatin-resistant cell line 2008/ C13*5.25. RESULTS: 1. Cells from 2008 and 2008/C13*5.25 expressed both hMLH1 and hMSH2 when analysed with immunoblotting. 2. Twenty two out of 100 single-cell clones from 2008 and 27 of clones from 2008/C13*5.25 expressed no hMLH1. hMSH2 was expressed in all clones. 3. There was no difference of Taxol chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1-deficient clones were more sensitive to Taxol than the hMLH1-proficient clones(P=0.049), but in 2008 cell lines hMLH1-proficient clones were more sesitive to Taxol(P=0.003). 4. There was no difference in Topotecan chemosensitivity between 2008 and 2008/C13*5.25 cell lines. In the 2008/C13*5.25 cell line, the hMLH1- deficient clones were not more sensitive to Topotecan than the hMLH1-proficient clones. In the 2008 cell lines hMLH1-deficient clones were more sesitive to Topotecan(P=0.001). Overall, hMLH1-deficient clones from both 2008 and 2008/C13*5.25 cell lines were significantly more sensitive to Topotecan(P=0.001). 5. Microsatellite instability was not demonstrated in all 4 types of single-cell clones from 2008 and 2008/C13*5.25 cell lines. CONCLUSIONS: The present results indicate that there is no relation between mutation of mismatch repair gene and cisplatin resistance. But hMLH1-deficient ovarian cancer cells are more sensitive to Taxol or Topotecan in this study. The latter finding mandates the examination to assess the mutation of hMLH1 in tumor cells before treatment or at the time clinical resistance to cisplatin develops in ovarian cancer.
Cell Line* ; Cisplatin ; Clone Cells* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair* ; DNA* ; Drug Resistance ; Humans ; Immunoblotting ; Microsatellite Instability ; Ovarian Neoplasms* ; Paclitaxel* ; Topotecan* ; Treatment Failure

PURPOSE: The status of the axillary nodes in breast carcinoma patients is one of the most significant prognostic factors. Although many trials in order to gain information concerning axillary status, to date there is no satisfactory procedures other than axillary lymph node dissection (ALND) which has many complications. Recently sentinel lymphadenectomy has become accepted as an alternative to ALND. METHODS: Sentinel lymphadenectomy followed by ALND was performed in 157 patients with invasive breast carcinoma between Nov. 1998 and Dec. 2000. The period from Nov. 1998 to May. 1999, which included the first 54 patients was set as a learning period. 99m Tc antimony trisulfide colloid was used in the detection of the sentinel node, with a gamma camera preoperatively and then a gamma probe in the operating room. The dissected sentinel nodes were examined by both frozen section and serial section (SS) with immunohistochemical stains (IHC). RESULTS: The detection rate was 96.8%. The false negative rate was 22.6% for the frozen sections and 4.8% for the permanent sections. The detection rate and the false negative rate had improved after the learning period with statistic significance (P-value<.05). The false negative rate for tumors less than 2 cm was significantly lower than that for tumors greater than 2 cm (P-value=0.000). CONCLUSION: Sentinel lymphadenectomy using 99m Tc antinomy trisulfide colloid showed high detection rate and low false negative rate. The learning period is thought to be necessary for its clinical application. In the future, sentinel lymphadenectomy may replace axillary lymph node dissection in certain subgroups of breast carcinoma patients.
Antimony ; Breast Neoplasms* ; Breast* ; Colloids ; Coloring Agents ; Frozen Sections ; Gamma Cameras ; Humans ; Learning ; Lymph Node Excision* ; Operating Rooms

Pfeiffer syndrome is one of a rare form of craniosynostosis syndrome, showing variable degree of craniosynostosis, midface hypoplasia, broad thumbs and toes and syndactyly. This is transmitted in autosomal dominant pattern and known to be related to mutations in FGFR (Fibroblast Growth Factor Receptor) 1 or FGFR 2. We experience a case of newborn Pfeiffer syndrome type 3 who had multiple facial anomalies, thumbs and great toes anomalies, ankylosis of radius and ulnar and hydrocephalus.
Acrocephalosyndactylia* ; Ankylosis ; Craniosynostoses ; Humans ; Hydrocephalus* ; Infant, Newborn ; Radius ; Syndactyly ; Thumb ; Toes

BACKGROUND: To evaluate the effectiveness of minimally invasive surgery total hip arthroplasty (THA) using the two-incision technique as described by Mears. METHODS: From January 2003 to December 2006, sixty-four patients underwent total hip arthroplasty using the one-incision (group I) and two-incision (group II) technique by one surgeon. There were 34 hips in group I and 30 hips in group II. There was no difference in age, gender, and causes of THA between the two groups. We evaluated the operation time, bleeding amount, incision length, ambulation, hospital stay, and complications between the two groups. RESULTS: There was no difference in the bleeding amount between the two groups. Operation time was longer in the two-incision group than in the one-incision group. Operation time of the two-incision technique could be reduced after 15 cases. Patients started ambulation after surgery earlier in group II than group I, and the hospital stay was shorter in group II than in group I. There was no difference in clinical results between the two groups. There was no difference in component position of the acetabular cup and femoral stem between the two groups. Intraoperative periprosthetic fracture occurred in four cases (13.3%) in group II. CONCLUSIONS: Two-incision THA has the advantage of rapid recovery and shorter hospital stay. However, longer operation time and a high complication rate compared to one-incision are problems that need to be solved in the two-incision technique.
Arthroplasty, Replacement, Hip/*methods ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Surgical Procedures, Minimally Invasive/*methods

Amiodarone is a potent antiarrhythmic agent that is used to treat ventricular arrhythmias and atrial fibrillation. But it has a wide range of adverse effects, including pulmonary toxicity, thyroid dysfunction, liver toxicity, gastrointestinal events, corneal deposits, peripheral neuropathy and so on. Patients treated with amiodarone should be followed regularly to assess ongoing need for amiodarone, efficacy of the drug, appropriateness of dosage, adverse effects, and potential drug interactions. We experienced a case of severe weight loss due to amiodarone-induced multiple toxicity after a long course of a low dose therapy. So we report this unusual case with literature review.
Amiodarone ; Anorexia ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Drug Interactions ; Humans ; Liver Diseases ; Peripheral Nervous System Diseases ; Thyroid Gland ; Thyrotoxicosis ; Weight Loss