BACKGROUND: Transradial coronary intervention was introduced recently. It has less bleeding and vascular complications and advantage of early ambulation. METHODS: We compared 142 transradial coronary interventions (101 stents, 56 balloon angioplasty and 18 rotablation) with 120 transfemoral interventions in 230 patients from January to August 1998. RESULTS: Overall success rate was not different between two approaches (92% vs 89%), but smaller sized sheath and less amount of contrast agent were required in transradial interventions compared to transfemoral interventions. Conventional guiding catheters which are used in transfemoral approach were used in most cases (94%) of transradial interventions. Judkins left 3.5 (in stead of JL4.0 in femoral approach) and Judkins right 4.0 were the most frequently used guiding catheters in transradial approach. Stent implantation was successfully done in 99 out of 101 lesions (98%) in transradial intervention and 76 out of 78 lesions (97%) in transfemoral intervention. Rotational atherectomy and primary balloon angioplasty or stenting were done successfully in 10 - 20% of the patients in both groups. All procedures were done successfully without any major procedure-related complications (myocardial infarction, death, bypass surgery) or major vascular complications in both groups. During the clinical follow-up of transradial group, punctured arteries showed 10% incidence of radial artery pulse weakness with 3% of pulse loss. CONCLUSION: Transradial approach is useful another feasible route for coronary interventions. The feasibility of primary balloon angioplasty or stenting and rotational atherectomy by transradial approach should be evaluated in the future.
Angioplasty, Balloon ; Arteries ; Atherectomy, Coronary ; Catheters ; Coronary Artery Disease* ; Coronary Vessels* ; Early Ambulation ; Follow-Up Studies ; Hemorrhage ; Humans ; Incidence ; Infarction ; Radial Artery ; Stents

The aim of this study was to quantitatively estimate the effect of hypertension upon the left ventricle, using the systolic time intervals. The subjects for this study consist of 72 hospitalized hypertensive patients including 38 males and 34 females. The measurements of the systolic time intervals were obtained from simultaneous high speed recording(100mm/sec) of an electrocardiographic lead best displaying the onset of left ventricular depolarization, a carotid pulse tracing, and a phonocardiogram best displaying the initial high frequency vibrations of the aortic valve closure sound. All data were corrected for heart rate and sex using the regression equations of Weissleretal. The results were follows: 1) As the diastolic blood pressure increased, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 2) As the electrocardiographic findings related to hypertension became severe shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. 3) As the hypertensive retinopathy became severe, shortening of left ventricular ejection time index and prolongation of preejection period index and PEP/LVET ratio were significant. It was suggested that the measurement of the systolic time intervals are useful in assessing the effects of hypertension upon the left ventricular function and in detecting early recognition of cardiac dysfunction in hypertension, even though not necessarily associated with overt heart failure.
Aortic Valve ; Blood Pressure ; Electrocardiography ; Female ; Heart Failure ; Heart Rate ; Heart Ventricles ; Humans ; Hypertension ; Hypertensive Retinopathy ; Male ; Systole* ; Ventricular Function, Left ; Vibration

BACKGROUND: Carotid artery stenosis is not infrequently associated with coronary artery disease. However, the technique performing selective carotid angiography is not established during right transradial coronary angiography. We investigated the reliability and safety of selective carotid angiography from the right transradial approach. MATERIALS AND METHODS: Following right transradial coronary angiography, selective carotid angio-graphy was performed using a 5 Fr Simmons-2 catheter in 103 patients (59+/-8 years [range, 18-80], 78 males). Ninety five (92%) patients had significant coronary artery disease. Subclavian and innominate arteries were moderately tortuous in 25 (24%) patients and aortic arch was elongated, more vertically oriented in 20 (19%). After forming a loop in ascending (n=65, 63%) or descending (n=38, 37%) aorta, the catheter was withdrawn and rotated counterclockwise to engage its tip in left carotid artery and innominate artery subsequently. After the catheter tip was adjusted at each ostia of carotid arteries, contrast material was delivered. In 63 (61%) patients, the procedures were performed on outpatient basis. RESULTS: Bilateral selective carotid angiography was successfully performed in 101 (98%) patients. In two patients with severely tortuous subclavian artery, the catheter was not engaged selectively in left carotid artery. The image quality of the angiograms performed by manual injection was determined satisfactory. Significant carotid stenosis was found in 17 (17%) patients. There were no complications, including thromboembolism and arterial dissection. CONCLUSION: Selective carotid angiography can be performed reliably and safely using a 5 Fr Simmons catheter from the right transradial approach. This technique is useful for evaluation of isolated or associated carotid artery stenosis from the right transradial approach.
Angiography* ; Aorta ; Aorta, Thoracic ; Brachiocephalic Trunk ; Carotid Arteries ; Carotid Stenosis ; Catheters ; Coronary Angiography ; Coronary Artery Disease ; Humans ; Outpatients ; Radial Artery ; Subclavian Artery ; Thromboembolism

Graft-versus-host disease can develop in immunosuppressed individuals who receive blood product transfusions that contain imrnunocompetent lymphocytes. We report a case of transfusion-associated graft-versus-host disease(TA-GVHD) that developed in a patient with acute lymphocytic leukemia who were undergoing therapy. The groups at risk for development of TA-GVHD, the clinical presentation and course, and methods of diagnosis are summarized. Prevention of TA-CVHD is possible by irradiation of blood products given to patients at risk, but problems remain in determining the groups that warrant such measures. We should be aware of the risk of developing TA-GVHD after routine blood transfusion, especially in areas where the population's HLA types are rather homogeneous.
Blood Transfusion ; Diagnosis ; Graft vs Host Disease ; Humans ; Leukemia* ; Lymphocytes ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Transplants*

A 13-year-old girl developed rice to nut-sized, bluish to slate-gray colored, depressed patches in a zosteriform distribution along the right side of her upper back and arm without any symptoms. Microscopically, the lesions showed a normal-appearing epidermis, dermis, and subcutaneous fat tissue except for a thinning of collagen fibers and widening of intervals between them in the lower dermis. There have been no changes to the skin lesions during the last 2 years.
Adolescent ; Arm ; Collagen ; Dermis ; Epidermis ; Female ; Humans ; Skin ; Subcutaneous Fat

The origin of Paget cells in extramammary Pagets disease is uncertain, however, some ultrastructural surveys revealed differentistion of Paget cells toward sweat gland apparatus. This is supported by recent immunohistochemical studies that Paget cells are irnmunohistochemically shown to react with antikeratin monoclonal antibodies specific to simple epithelia. In this siudy, seven cases of extramammary Pagets disease were immunohistochemically investigated with adenokeratin, carcinoembryonic antigen(CEA), involucrin by peroxidase-antiperoxidase(PAP) techniques. The results were as follow : l. Epidermis, hair follicies and sebaceous glands revealed negative immunoreacativity for adenokeratin in all cases. Sweat glands(6/7), Paget cells(6/7) and underlying adenocarcinoma revealed positive immunoreactivity for adenokeratin. 2. Epidermis, hair follicles and sebaceous glands(6/7) revealed negative immunoreactivity for CEA. Sweat glands, Paget cells and underlying adenocarcinoma revealed positive immunoreactivity for CEA in all cases. 3. Lower epidermis, sweat glands(6/7), Paget cells and underlying adenocarcinorna revealed negative irnmunoreactivity for involucrin. Upper epidermis, hair follicles and sebaceous glands(5/7) revealed positive immunoreactivity far involucrin. Based on these results, Paget cells of extramammary Pagets disease are considered to be derived from the sweat glands.
Adenocarcinoma ; Antibodies, Monoclonal ; Carcinoembryonic Antigen* ; Epidermis ; Hair ; Hair Follicle ; Paget Disease, Extramammary* ; Sebaceous Glands ; Sweat ; Sweat Glands

Kawasaki disease is described by fever lasting five days or more, bilateral conjunctival injection, changes of lips and oral cavity, polymorphous exanthema, acute non-purulent cervical lymphadenopathy, and changes of extremities. Atypical Kawasaki disease is defined as fewer than 4 of 6 criteria described above including coronary artery abnormalities. Especially, atypical clinical manifestations of Kawasaki disease appear in infants younger than 6 months old of age. Thus we recommend echocardiography in early infancy who has prolonged fever in order to diagnose atypical Kawasaki disease and treat early. We have experienced three cases of atypical Kawasaki disease with coronary aneurysm who were admitted because of fever and revealed coronary aneurysm on echocardiography.
Coronary Aneurysm* ; Coronary Vessels ; Echocardiography ; Exanthema ; Extremities ; Fever ; Humans ; Infant ; Lip ; Lymphatic Diseases ; Mouth ; Mucocutaneous Lymph Node Syndrome*

OBJECTIVE: The aim of this study were to compare the effects of EG and PROH on cryopreservation of mouse and human embryos, and to find the optimal protocol for embryo freezing. METHODS: Human embryos derived from fertilized eggs showing 3 pronuclei (PN) and mouse embryos were divided into two groups respectively: dehydrated with 1.5 M EG+0.2 M sucrose or 1.5 M PROH+0.2 M sucrose using the slow freezing method. Moreover mouse embryos were controlled the exposure time of cryoprotectant during dehydration or rehydration steps. RESULTS: The survival rates of human embryos were 79.2% (84/106) in EG group and 77.9% (88/113) in PROH group. In mouse embryos, the survival and development rates up to blastocyst were 70.6% (245/347), 44.1% (123/279) in EG group and 62.1% (198/319), 45.1% (123/279) in PROH group, respectively. However, in EG group, partially damaged embryos after thawing were decreased compared to PROH group. In combination group, when the exposure time during dehydration and rehydration were reduced, the survival and embryonic developments were increased slightly, but not significant. CONCLUSION: Cryopreservation of mouse and human embryos at cleavage stage by using EG or PROH exhibited no statistical difference in the survival rate and/or developmental rate to blastocyst. However, the use of EG for cryopreservation of embryos might reduce the exposure time of the cryoprotectant because of a high permeation of EG and result in lessen its toxic effects.
Animals ; Blastocyst ; Cryopreservation ; Dehydration ; Embryonic Development ; Embryonic Structures ; Ethylene Glycol* ; Female ; Fluid Therapy ; Freezing ; Humans* ; Mice* ; Pregnancy ; Propylene Glycol* ; Sucrose ; Survival Rate ; Zygote

Microvascular endothelial cells were purely isolated from human fetal skin using magnetic particles. The principle of this technique is based on the selective binding of the lectin Ulex europaeus I (UEA I) to the endothelial cell surface via fucose residues. Initially UEA I was covalently bound to tosyl-activated magnetic polydisperse polymer particles (Dynabeads) and then the UEA I-coated beads were collected using a magnetic particle concentrator (MPC). Endothelial cells were isolated by extracting microvascular segments from trypsin-treated fetal skin tissue and were purified by sieving with nylon mesh and by 35% Percoll gradient centrifugation. For further purification, the obtained cells were incubated with UEA I-coated Dynabeads. The endothelial cells bound to the Dynabeads were collected using MPC. This is a simple and reproducible technique for isolating a pure population of microvascular endothelium from the fetal skin.
Cells, Cultured ; Endothelium, Vascular/*cytology ; Factor VIII/analysis ; Female ; Fetus ; Human ; Intercellular Adhesion Molecule-1/analysis ; Pregnancy ; Skin/blood supply ; Support, Non-U.S. Gov't ; Vascular Cell Adhesion Molecule-1/analysis

The vesicoureteral reflux (VUR) is frequently found among the patients with urinary tract infection (UIT) and some patients with VUR progress to reflux nephropathy. The presence of scarring at UIT is an important determinant in the selection of those at risk of progressive damage. 99m Technetium dimercaptosuccinic acid (99m Tc-DMSA) is a renal scanning agent provides a good quality of renal image as a result of preferential cortical accumulation. 99m Tc-DMSA scan and VCUG were performed in 133 patients diagnosed UTI at pediatric department of Kyung Hee University, College of Medicine from May, 1990 to May, 1992 The results were as follows: 1) VUR was seen in 27 children among 133 patients with UTI. The incidence was 20.3%. Under 1 year of age, male to female ratio was higher incidence of VUR. 2) Incidence of renal scarring was higher in patients with VUR than those of without VUR. 3) Grading of VUR in relation to age, the older the age, the lower the grade. 4) There is no correlation between renal scarring and grades of VUR. 5) In distribution of renal scarring, it was found to have tendency to develop at upper polar area, there was diffuse and multiple in patients with VUR. In conclusion the incidence of renal scarring was related to the age of onset, duration of UTI and the severity of the VUR and 99mTc-DMSA scan is mandatory in patient with UTI even without VUR in order to detect early phase of renal scarring.
Age of Onset ; Child ; Cicatrix* ; Female ; Humans ; Incidence ; Male ; Succimer ; Technetium ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract Infections* ; Urinary Tract* ; Vesico-Ureteral Reflux