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

BACKGROUND: We evaluated the role and effects of prolotherapy in patients presenting with lower back pain and detected sacral asymlocation, by retrospectively analyzing the results of prolotherapy performed at our institute. METHODS: Twenty-three patients with referred pain in the lower back rather than distinct radiculopathy, were detected to have sacral asymlocation by simple X-ray from May 2004 through July 2005. The patients were treated with prolotherapy and manipulation by the Ongley's method around the lumbosacral junction, iliolumbar ligament, and sacroiliac joint. They were treated for approximately one to two week intervals, and during this period were rechecked by X-ray and evaluated using the visual analogue scale (VAS). RESULTS: A total of 23 patients were included in the study (10 male and 13 female), and the average age was 41 years. The average VAS at the time of visit was 8.5, the average treatment time was 4.7 days, and the average VAS after treatment was 2.1. CONCLUSIONS: Back pain, and associated leg and buttock pain, originate from several causes. In these case analyses, instability around the lumbosacral area and sacral asymlocation might have been important causes of patient back pain and associated buttock and leg pain. We therefore applied prolotherapy as well as manipulation techniques devised by Ongley to these patients, and obtained good results.
Back Pain* ; Buttocks ; Diagnosis* ; Humans ; Leg ; Ligaments ; Low Back Pain ; Male ; Pain, Referred ; Radiculopathy ; Retrospective Studies ; Sacroiliac Joint

Castleman's disease is a rare disorder characterized by tumorous masses that may develop in the lymph node tissue throughout the body. Most common location is mediastinum, but it can also affect retroperitoneum, neck, pelvis, and/or axilla. It may exceptionally affect extranodal sites like striated muscle, thoracic wall, lungs, skull, larynx, and/or vulva. The presentation is varied and diagnosis is difficult. There are two main types of Castleman's disease: hyaline-vascular type and plasma cell type. The hyaline vascular type accounts for approximately 90% of the cases. Most individuals exhibit no symptoms of this form of the disorder or they may develop non-cancerous growths in the lymph nodes. The plasma cell type is often associated with fever, weight loss, skin rash, early destruction of red blood cells, leading to unusually low levels of circulating red blood cells (hemolytic anemia), and/ or abnormally increased amounts of certain immune factors in the blood (hypergammaglobulinemia). We here report a case of Castleman's disease of ileal mesentery in 30-years old female patient. Abdominal mass, 4.7x3.6 cm in size, was completely removed from ileal mesentery without complication, and confirmed histologically mesenteric Castleman's disease of the mixed type.
Adult ; Axilla ; Diagnosis ; Erythrocytes ; Exanthema ; Female ; Fever ; Giant Lymph Node Hyperplasia* ; Humans ; Hyalin ; Immunologic Factors ; Larynx ; Lung ; Lymph Nodes ; Mediastinum ; Mesentery ; Muscle, Striated ; Neck ; Pelvis ; Plasma Cells ; Skull ; Thoracic Wall ; Vulva ; Weight Loss

PURPOSE: The aim of this study was to investigate the anorectal function in patients with progressive systemic sclerosis (PSS), thus to define the clinical role of anorectal manometry in the earlier diagnosis of anorectal involvement of PSS. METHODS: Seventeen consecutive patients (all females) with PSS were evaluated with anorectal manometry by the stationary pullthrough technique using the 8-channel hydraulic capillary infusion system for anorectal function. Functional parameters of the manometry were compared between patients with PSS and 20 normal control subjects, matched for age and sex. RESULTS: The mean resting pressure over the high pressure zone (HPZ) in patients with PSS was significantly lower than that in the control group (70.8 3.4 mmHg vs. 81.5 3.2 mmHg: P=0.046). The HPZ in patients with PSS was also significantly reduced compared with that in the control (1.5 0.1 cm vs. 2.5 0.1 cm: P=0002). The rectoanal inhibitory reflex (RAIR) was detected in only 10 patients (59%) in the PSS group, but was present in all except one (95%) in the control (P=0.022). More interestingly, RAIR in patients with PSS responded at a higher volume of the air insufflated than that in the control (74% vs. 30% at 20 cc, 21% vs. 30% at 30 cc, and 0% vs. 40% at 50 cc, respectively: P=0.031). Other functional parameters, including maximal squeeze pressure, minimal sensory and maximal tolerable volume of the rectum, and rectal compliance were not significantly different between two groups. CONCLUSIONS: Anorectal involvement reflected by the anorectal manometric dysfunction may be rather an earlier event in patients with PSS. An awareness to perform an anorectal manometric study in every case of PSS may be necessary for earlier subclinical detection of anorectal involvement by the disease.
Capillaries ; Compliance ; Diagnosis ; Humans ; Manometry ; Rectum ; Reflex ; Scleroderma, Diffuse*

BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the most common complications after gynecological laparoscopic surgery and it appears more frequently after use of inhalation anesthetics than total intravenous anesthesia (TIVA). Palonosetron was introduced as a new-generation potent antiemetic agent, which may reduce PONV more effectively than previous drugs. The aim of this study was to evaluate whether palonosetron could prevent PONV after gynecological laparoscopic surgery, regardless of the anesthetic technique employed. METHODS: Seventy-three patients scheduled for gynecological laparoscopic surgery were randomly assigned into 3 groups according to the anesthetic agent employed (group 1: inhalation anesthesia with desflurane, group 2: inhalation anesthesia with sevoflurane, group 3: total intravenous anesthesia with propofol and remifentanil). Palonosetron 0.075 mg was administered intravenously before the induction. Opioids were not used for postoperative pain control. The incidences of nausea, vomiting and side effects were recorded from 2 hr upto 48 hr, postoperatively. RESULTS: There were no significant differences in the incidence of PONV, severity of nausea, and the use of rescue antiemetics among the groups, throughout the observation. No differences were observed in the adverse side effects among the groups. CONCLUSIONS: Palonosetron decreased the incidence of PONV after gynecological laparoscopic surgery to a similar level, regardless of the anesthetic technique.
Analgesics, Opioid ; Anesthesia, Inhalation ; Anesthesia, Intravenous* ; Anesthetics, Inhalation ; Antiemetics ; Female ; Gynecologic Surgical Procedures ; Humans ; Incidence ; Laparoscopy* ; Nausea ; Pain, Postoperative ; Postoperative Nausea and Vomiting* ; Propofol ; Vomiting

PURPOSE: The goal of reduction mammaplasty is breast with natural cone shape, minimizing scars, well-placed and sensate nipple-areolar area and maintaining breast physiology. In order to satisfy that goal, variable reduction mammaplasty methods are performed, however, two methods such as vertical reduction method and inverted T-scar method are currently most used. We compared indications and advantages of the two methods and set up useful guidlines. METHODS: For 15 years from 1995 to 2010, we experienced 84 patients(162 breasts). We performed vertical reduction method as Lejour's superior pedicle technique(45 patients) and inverted T-scar method as Goldwyn's inferior dermal flap technique(39 patients). We evaluated the result of the operation comparing patient's age, amount of resected tissue, complications and post-operative scars of the two methods. RESULTS: The mean age was 36 years and the vertical reduction group was 3 years younger than inverted T-scar group. The mean breast tissue resection amount per one breast, inverted T-scar group(712 gm) was lagger than vertical reduction group(395 gm). CONCLUSION: There is no ideal method for reduction mammaplasty until now. However, we suggest that guide line, the vertical reduction method is effective for minimal and moderate macromastia in young and middle aged women and inverted T-scar method is appropriate for severe macromastia with ptosis in elderly women. Recently, all procedures tried shorter and smaller scar on the vertical line as small I, J or L shape scar, and inframammary fold as short inverted T-scar.
Aged ; Breast ; Cicatrix ; Female ; Humans ; Hypertrophy ; Mammaplasty ; Middle Aged

Coronary artery disease(CAD), such as atherosclerosis, myocardial infarction and sudden death has been considered the major cause of death for decades and their incidence and prevalence are still increasing. Numerous studies have been done on the risk factor analysis of CAD. But, they were usually based on the clinical and epidemiologic studies of the living patients. The purpose of this study was to evaluate the risk factors for the cardiovascular diseases in autopsy cases from Korean men. The author analysed 81 cases of heart who underwent legal autopsy from Aug. to Dec. 1998. The author measured percent stenosis of coronary artery, site of stenosis, perimeter of aorta, heart weight, body weight, and height and checked the past history including smoking, drinking and age. The results were as follows: 1) Coronary artery stenosis had a positive correlation with age, perimeter of aorta and smoking, but had no correlation with body weight, height, body mass index, heart weight, and drinking. 2) According to the logistic regression analysis, smoking amount and age were significantly associated with coronary artery stenosis. In conclusion, smoking was the most significant independent variable for coronary artery stenosis of some Korean men.
Aorta ; Arteries ; Atherosclerosis ; Autopsy* ; Body Height ; Body Weight ; Cardiovascular Diseases ; Cause of Death ; Constriction, Pathologic ; Coronary Stenosis* ; Coronary Vessels* ; Death, Sudden ; Drinking ; Epidemiologic Studies ; Heart ; Humans ; Incidence ; Logistic Models ; Male ; Myocardial Infarction ; Prevalence ; Risk Factors ; Smoke* ; Smoking*

The plant Dendropanax morbifera Léveille is effective folk medicines for the treatment of several conditions, such as infectious diseases, skin diseases, and other illnesses. Although the inhibitory effects of D. morbifera on the proliferation and migration of vascular smooth muscle cells (VSMCs) have been shown in our previous study, its effects in vivo remain to be elucidated. In this study, we aimed to investigate the protective effects of the extracts from D. morbifera (EDM) on neointimal hyperplasia of rat carotid artery and explore the underlying mechanisms. We observed that the ratio of intima to media thickness (I/M) was significantly decreased in the EDM-treated groups by ~80% compared to that of the control. The expression of Ki-67 and proliferating cell nuclear antigen was decreased by ~70% in the EDM-treated groups compared to that of the control. In addition, matrix metalloproteinase (MMP)2 and MMP9 significantly reduced in the neointimal layer of the EDM-treated groups. Moreover, the decreased levels of contractile phenotypic markers of VSMCs, such as α-smooth muscle actin, myocardin, and smooth muscle-myosin heavy chain, were successfully restored by EDM treatment. Furthermore, the levels of synthetic phenotypic markers, cellular retinal binding protein 1 and connexin 43 were also restored to normal levels. These results suggest that EDM inhibits vascular neointimal hyperplasia induced by balloon injury in rats via phenotypic modulation of VSMCs. Therefore, EDM may be a potential drug candidate for the prevention of restenosis.

Although ascending aortic aneurysm is a uncommon disease, it has fatal complications such as aortic rupture, dissection, or death. So, experts recommend a preemptive aortic operation. A 77-year-old man with hypertension visited for slow progressive exertional dyspnea and general weakness. Chest X-ray showed deviation of trachea to right, mediastinal widening, cardiomegaly, and bulging of right heart border to right. Transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE) showed marked dilated ascending aorta with wall calcification associated with severe aortic regurgitation and pericardial effusion. Measured diameter of ascending aorta was 12 x 11 cm on Chest Computed Tomography (CT) scan, 8.35 cm on TTE, and 10.2 cm on TEE. Our exam found out the obstructive pneumonia and aortic regurgitation as consequences of complications of huge aneurysm. We report a case of huge ascending aortic aneurysm without any previous aortic operation, aortic complications, trauma, or other etiologic factors.
Aged ; Aneurysm ; Aorta ; Aortic Aneurysm* ; Aortic Rupture ; Aortic Valve Insufficiency ; Cardiomegaly ; Dyspnea ; Heart ; Humans ; Hypertension ; Pericardial Effusion ; Pneumonia ; Thorax ; Trachea

BACKGROUND AND OBJECTIVES: Despite significant improvement in the field of angioplasty, restenosis remains a major obstacle to the long-term success of the procedure. Radiation can effectively inhibit neointimal hyperplasia by causing the arrest of mitosis during cell division and limiting proliferation by reducing the number of regenerating clonal progenitors. Balloon injury could induce the cell adhesion molecule, ICAM-1 and VCAM-1, on SMCs and regenerating endothelial cells (ECs). ICAM-1 and/or VCAM-1 may play a role in the progression of neointimal hyperplasia induced by balloon injury and external radiation may effectively inhibit neointimal hyperplasia by attenuating their expression. The purpose of this study was to examine the effect of external radiation against ICAM-1 and VCAM-1 on neointimal hyperplasia after balloon injury in rat carotid arteries. MATERIAL AND METHODS: A standardized carotid balloon catheter arterial injury was produced in 51 rats and external beam radiation with doses from 5-20 Gy were delivered in 28 rats (radiation treated group) at 24 hours after injury. To investigate the effect of the external radiation on neointimal hyperplasia, the intima area and the intima/medial area of arteries were measured at day 14 after injury. The expressions of ICAM-1 and VCAM-1 at day 2, day 7, and day 10 after injury were studied in control group and radiation treated group by immunohistochemistry. RESULTS: Means of intimal area and intima/medial ratio in radiation treated group were significantly lower than those in control group and significantly reduced with increasing radiation dosage. At day 2 after injury, medial SMCs of injury group extensively expressed ICAM-1, while it was focally expressed with 10 Gy radiation treated group. At day 7 and day 10 after injury, ICAM-1 expression on medial SMCs was attenuated and neointimal ICAM-1 expression was increased. As compared with control group, ICAM-1 expression after radiation was weak and focal just around the internal elastic lamina. At 2 days after injury, medial SMCs moderately expressed VCAM-1, which was weakly and focally expressed with 10 Gy radiation treated group. At day 7 and day 10 after injury, focal expression of VCAM-1 was noted around the internal elastic lamina, but there was no VCAM-1 expression on neointima with radiation. CONCLUSION: External radiation after carotid arterial injury may potentially inhibit SMC proliferation and neointimal hyperplasia, and balloon injury-induced or upregulated expressions of ICAM-1 and VCAM-1 may be attenuated with external radiation.
Angioplasty ; Animals ; Arteries ; Carotid Arteries ; Catheters ; Cell Adhesion* ; Cell Division ; Endothelial Cells ; Hyperplasia* ; Immunohistochemistry ; Intercellular Adhesion Molecule-1* ; Mitosis ; Neointima ; Radiation Dosage ; Rats* ; Vascular Cell Adhesion Molecule-1