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

We tried to correlate brain CT findings with clinical state at admission and outcome at discharge in 42 selected cases from 94 adult patients under the diagnosis of tuberculous meningitis at Seoul National University Hospital during last four years from 1981. Their clinical state at admission and outcome at discharge were classified into three groups by severity of symptoms, respectively. The final outcome of them were well correlated with their clinical states at admission. Observed abnormal brain CT findings in this series were hydrocephalus (74%), dirthy cisternal enhancement (52%), infraction (38%), periventricular low density (36%), and tuberculoma (19%). The poorer the clinical state at admission and outcome at discharge, the more frequent the abnormal brain CT findings, especially of periventricular low density and infraction. But periventricular low density without infarction seemed to affect more deleterious effect on clinical state at admission than on final outcome.
Adult ; Brain* ; Diagnosis ; Humans ; Hydrocephalus ; Infarction ; Seoul ; Tuberculoma ; Tuberculosis, Meningeal*

No abstract available.
Extremities* ; Oximetry* ; Oxygen*

No abstract available.
Giant Cell Tumor of Bone* ; Giant Cell Tumors* ; Giant Cells*

BACKGROUND: In spite of the successful reperfusion therapy, coronary blood flow in infarcted myocardium was known to decrease for a long time. Abciximab is known to inhibit the final pathway of platelet aggregation and maintenance the large vessel patency. But abciximab may have another important effect beyond the these effect. TIMI frame count method is simple, reproducible, objective and quantitative index of coronary flow. We tried to define the effect of abciximab that used with primary angioplasty on the coronary blood flow using TIMI frame count methods. METHODS: We consecutively studied 30 patients who admitted for acute myocardial infarction without cardiogenic shock from September 1997 to August 1999. We analyzed the changes of corrected TIMI frame count(CTFC) between the baseline(immediate after the angioplasty) and follow-up(post-op 7th day) coronary angiogram and compared the results between the group of primary angioplasty with abciximab(abciximab group, n=1) and the group of primary angioplasty without abciximab(non-abciximab group, n=9). RESULTS: There were no differences between abciximab group and non-abciximab group in baseline characteristics, treatment modalities and angiographic results. According to the results of the comparison of deltaCTFC, changing rate of CTFC, deltavelocity and changing rate of velocity, there were significant improvement of the coronary blood flow in infarct related artery in the abciximab group than non-abciximab group. But there were no differences in the changes of coronary blood flow in non-infarct related artery between two groups. The frequency of major adverse coronary events during follow up periods(mean 6 months) were similar(9.1% and 5.2% each other, p>0.05). CONCLUSIONS: Abciximab used with primary angioplasty in acute myocardial infarction improved the coronary blood flow significantly in infarcted myocardium. This finding may be related that abciximab enhance the perfusion and function of microvasculature in infarcted myocardium.
Angioplasty* ; Arteries ; Coronary Vessels* ; Follow-Up Studies ; Humans ; Microvessels ; Myocardial Infarction* ; Myocardium ; Perfusion ; Platelet Aggregation ; Reperfusion ; Shock, Cardiogenic

We report here on a case of priapism that was associated with the use of tadalafil. A 41 year-old-man visited our urology outpatient department with a relapsed erection he'd experienced for 3 days. He had no contributing factors for the priapism. He had taken tadalafil, which was prescribed at a local medical center 3 days previously. After the development of priapism, he first visited the emergency department of other hospital. Aspiration was done and then the priapism was resolved. Yet the priapism recurred 2 days later, andaspiration and other bedside management failed to resolve it. After his arrival to our department, weimmediately performed a caverno-glandular shunt with 18-gauge needle and we observed bright reddish- color blood. An intracorporal ephedrine injection and saline irrigation were then done. After that, the patient gradually experienced detumescence. The priapism did not recur during the 2 days of the hospitalization period. At the outpatient follow-up of 3 months later, patient almost recovered to his full erectile function and he had normal sexual activity.
Carbolines ; Emergencies ; Ephedrine ; Follow-Up Studies ; Hospitalization ; Humans ; Needles ; Outpatients ; Priapism ; Sexual Behavior ; Urology ; Tadalafil

PURPOSE: To evaluate the radiological and clinical results after open reduction and internal fixation with calcaneal F plate and locking calcaneal plate using lateral extensile approach in the treatment of intra-articular calcaneal fracture. MATERIALS AND METHODS: This study included 34 cases of 33 patients followed up for at least 6 months postoperatively. F plate was applied in 18 cases (Group 1), locking plate was used in 16 cases (Group 2) and compared radiological and clinical results between two groups. RESULTS: Radiollogically, the mean Bohler angle was improved from 5.5degrees preoperatively to 20.1degrees postoperatively and 18.8degrees at the last follow up in group 1 and 8.6degrees preoperatively, 21.4degrees postoperatively and 20.3degrees at last follow up in group 2. Bone union was observed in all cases and 4 cases of screw loosening were noted in Group 1 with extended fracture to anterior process. At the last follow up, both groups showed clinical results in American orthopedic foot and ankle society ankle hindfoot score, 76(77 in Sanders type II and 75 in type III) in group 1 and 72(73 in type II and 70 in type III) in group 2. CONCLUSION: F plate and locking plate showed firm fixation and satisfactory clinical results in the treatment of intra-articular calcaneal fracture. We suggest applying locking plate in cases with extended fracture to anterior process, considering screw loosenings in those who were treated with F plate fixation.
Animals ; Ankle ; Calcaneus ; Follow-Up Studies ; Foot ; Humans ; Intra-Articular Fractures ; Orthopedics

OBJECTIVE: The purpose of this study was to evaluate the incidence of inability to flex proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint in normal Koreans. The opposition palm ratio and thumb index ratio was also of interest. METHOD: Randomly selected eighty nine normal Korean adults of 48 men and 41 women, with ages 20 to 79 years. The finger flexion was measured using the standard flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) screening tests. Thumb index ratio and opposition palm ratio was also assessed additionally. RESULTS: In the sample population, 2 subjects (2.2%) were unable to bilaterally flex their fifth PIP joints independently. Four subjects (4.4%) were unable to flex one or both of their fourth or fifth DIP joints. These results show far less incidence of FDS dysfunction comparing with 52% of FDS dysfunction rate in Americans. The opposition palm ratio in men were 63.6% and in women 69.9%, indicating lower ratio in men. The thumb index ratio was not different statistically between the men and women. CONCLUSION: These data suggest that the different incidences of FDS and FDP dysfunction should be considered in interpretation. The opposition palm ratio and thumb index ratio might be useful in the hand rehabilitation.
Adult* ; Female ; Fingers ; Hand ; Humans ; Incidence ; Joints ; Male ; Mass Screening ; Rehabilitation ; Thumb*

BACKGROUND: In diagnosis or monitor of the airway obstruction in bronchial asthma, the measurement of FEV1 in the standard method because of its reproducibility and accuracy. But the measurement of peak expiratory flow(PEF) by peak flow meter is much simpler and easier than that of FEV1 especially in children. Yet there have been still no data of the predicted normal values of PEF measured by peak flow meter in Korean children. This study was conducted to provide equations to predict the normal value of PEF and correlation between PEF and FEV1 in healthy children. METHOD: PEF was measured by MiniWright peak flow meter, and the forced expiratory volume and the maximum expiratory flow volume curves were measured by Microspiro HI 501(Chest Co.) in 346 healthy children (age:5-16 years, 194 boys and 152 girls) without any respiratory symptoms during 2 weeks before the study. The regression equations for various ventilatory parameters according to age and/or height, and the regression equations of FEV1 by PEF were derived. RESULTS: 1. The regression equation for PEF(L/min) was:12.6×age(year)+3.4×height(cm)-263(R2=0.85) in boys, and 6×age(year)+3.9×height(cm)-293(R2=0.82) in girls. 2. The value of FEFmax(L/sec) derived from the maximum expiratory flow volume curves was multiplied by 60 to compare with PEF(L/min), and PEF was faster by 125 L/min in boys and 118 L/min in girls, respectively. 3. The regression equation for FEV1(ml) by PEF(L/min) was:7×PEF-550(R2=0.82) in boys, and 5.8×PEF-146(R2=0.81) in girls, respectively. CONCLUSION: This study provides regression equations predicting the normal values of PEF by age and/or height in children. And the equations for FEV1, a gold standard of ventilatory function, was predicted by PEF. So, in taking care of children with airway obstruction, PEF measured by the peak flow meter can provide useful information.
Airway Obstruction ; Asthma ; Child* ; Diagnosis ; Female ; Forced Expiratory Volume ; Humans ; Reference Values

No abstract available.
Antibodies* ; Female ; Hepatitis B* ; Hepatitis* ; Humans ; Pregnant Women*