No abstract available.
Angiography ; Catheters* ; Coronary Vessels* ; Spasm*

No abstract available.
Pulmonary Embolism ; Vertebroplasty

Crohn's disease is a rare inflammatory bowel disease requiring a differential diagnosis with intestinal tuberculosis in Korea. There have been several problems in the diagnosis of Crohn's disease due to the much higher incidcnce of intestinal tuberculosis and the clinical similarities between the two diseases. Therefore, in many cases, treatment involveed anti-Tb drugs based upon empirical diagnosis, This study presents a case of Crohn's disease treated with anti-Tb drugs for about 9 months after intestinal tuberculosis was misdiagnosed.
Crohn Disease* ; Diagnosis ; Diagnosis, Differential ; Inflammatory Bowel Diseases ; Korea ; Tuberculosis*

The goal of periodontal treatment is predictable periodontal regeneration. But until now, many products including GTR materials and growth factors are beyond of complete regeneration. BMP can induce ectopic bone formation when implanted into sites such as rat muscle and can greatly enhance healing of bony defects when applied exogenously. BMP can promote periodontal regeneration by their ability to stimulate new bone and new cementum formation. But little is known about optimal conditions required for the application. Root conditioning is used for bioactive root change so altered root surface provides a substrate that promotes chemotaxis, migration and attachment of peridontal cells encouraging connective attachment to the denuded root surface. The aim of this study is to investigate whether the acid conditioning change effect of rhBMP-2 on human periodontal ligament cell and osteoblast cell line. 288 periodontally involved root dentin slices are divided into 6 groups, each 48, 1)control, 2)treated with BMP, 3)treated with citric acid 4)treated with citric acid+BMP 5)treated with tetracycline 6)treated with TC+BMP. Each group was devided half, so 12 root dentin slices were seeded with periodontal ligament cells and 12 were seeded with osteoblasts. At day 2 and 7, cell number, protein assay, ALP activity was measured. To investigate morphology of cultured cells, SEM was employed. Statistical analysis was performed with SPSS 8.0 either t-test or ANOVA test. The results are ; Protein assay and cell number was slightly decreased in CA+BMP group compared to CA group but it was not statistically significant and ALP activity was much more increased in CA+BMP group compared to CA group so there was no statistically significance between BMP and CA+BMP group and statistically significant compared to control group. Cell number and protein assay was slightly increased in TC group and ALP activity was much less than BMP group and CA group. Cell number and protein and ALP activity was not much increased in TC+BMP group. TC group and TC+BMP group showed cell morphology change in SEM. This results suggested that application of root surface with citric acid before BMP treatment might give better result in periodontal regeneration.
Animals ; Cell Count ; Cell Line ; Cells, Cultured ; Chemotaxis ; Citric Acid* ; Dental Cementum ; Dentin ; Fibroblasts* ; Humans* ; Intercellular Signaling Peptides and Proteins ; Osteoblasts* ; Osteogenesis ; Periodontal Ligament* ; Rats ; Regeneration ; Tetracycline*

The role of neuropeptides in the central nervous system (CNS) has received increasing attention. Numerous peptide molecules are found in the mammalian CNS and many of them are thought to act as either neurotransmitters or neuromodulators. The neuropeptides found in high concentration in the hypothalamus include vasopressin (VP), vasoactive intestinal polypeptide, somatostatin, and oxytocin. The main approches to assess the involvement of neuropeptides can be focused on functions affecting the aging of the brain. Morphological aging of the CNS has been characterized by degenerative changes of fiber connections and cell loss, although degeneration does not always occur to the same extent throughout various parts of the brain and, moreover, varies for different cell types. Despite of many studies in VP containing neurons , there exist discrepancies in results about the changes of aged rat brain. The aim of the present study is, therefore, to investigative possible changes in the number and morphology of VPimmunoreactive neurons with aging in each area of the hypothalmus of the aged rats. As a result, the number of VP-immunoreactive neurons was decreased in hypothalamus nucleus of aged group. Especially, in VP-immunoreactive neurons of hypothalamus, the size of neuronal cell body and nuclei in aged group is larger than in young group and the fiber density of immunoreactivity neurons of median eminance (ME) in aged group is stronger than in young group. But, the total number of VP-immunoreactive neurons in the suprachiasmatic nucleus (SCN) of the aged group is larger than in the young group. These studies indicate the involvement of VP-immunoreactive neurons in aging process of hypothalamus, and aging process may affect the synthesis of VP in the neurons of hypothalamic nuclei. Whereas, in VP expression, aging process induces an enlargement of the cell size of surviving neurons to compensate.
Aging ; Animals ; Brain ; Cell Size ; Central Nervous System ; Hypothalamus* ; Neurons* ; Neuropeptides ; Neurotransmitter Agents ; Oxytocin ; Paraventricular Hypothalamic Nucleus ; Rats* ; Somatostatin ; Suprachiasmatic Nucleus ; Supraoptic Nucleus ; Vasoactive Intestinal Peptide ; Vasopressins

A right atrial and inferior vena caval thrombus in a structurally normal heart is a very rare condition. We report a case of such a thrombus in a 66-year-old woman. She was admitted to our hospital with recent onset dyspnea. Based on echocardiography, we suspected that she had myxoma. We performed an excision of a mass, which was found, by pathologic examination, to be an organized mural thrombus.
Aged ; Dyspnea ; Echocardiography ; Female ; Heart ; Heart Atria ; Humans ; Myxoma ; Thrombosis ; Vena Cava, Inferior

The purpose of this study was to evaluate newly fabricated tricalcium phosphate(TCP)/chitosan microgranuls as bone substitutes. TCP/chitosan microgranules were fabricated by dropping TCP-chitosan suspension into the NaOH/ethanol solution. The size of microgranules could be controllable via airflow rate. PDGF-BB was loaded into the fabricated granules via freeze-drying methods(300 ng/20 mg). To evaluate cell proliferation, cultured osteoblasts cell lines(MC3T3-E1) was dropped on the BioOss(R), chitosan microgranules, TCP/chitosan microgranules and cultured for 1, 7, 14, and 28 days. Scanning electron microscopic observation was done after 7 days of culture and light microscopic examination was done after 28 days of culture. PDGF-BB release from the microgranules was tested. Rabbit calvarial defects(8 mm in diameter) were formed and chitosan, TCP/chitosan, PDGF-TCP/chitosan microgranules, and BioGran(R) were grafted to test the ability of new bone formation. At SEM view, the size of prepared microgranules was 250-1000 um and TCP powders were observed at the surface of TCP/chitosan microgranules. TCP powders gave roughness to the granules and this might help the attachment of osteoblasts. The pores formed between microgranules might be able to allow new bone ingrowth and vascularization. There were no significant differences in cell number among BioOss(R) and two microgranules at 28 day. Light and scanning electron microscopic examination showed that seeded osteoblastic cells were well attached to TCP/chitosan microgranules and proliferated in a multi-layer. PDGF-BB released from TCP/chitosan microgranules was at therapeutic concentration for at least 1 week. In rabbit calvarial defect models, PDGF-TCP/chitosan microgranules grafted sites showed thicker bone trabeculae pattern and faster bone maturation than others. These results suggested that the TCP/chitosan microgranules showed the potential as bone substitutes.
Bone Substitutes ; Cell Count ; Cell Proliferation ; Chitosan* ; Osteoblasts ; Osteogenesis* ; Powders ; Transplants

This study compared the short-term(4 months) clinical results of regenerative therapy with bioabsorbable membranes(BioMesh(R)) and bone allograft for the treatment of periodontal(intrabony and furcation) defects in smokers and non-smokers.(16 smokers) 32 subjects with 92 defects participated in the study(46 in smokers and 46 in non-smokers). This study also evaluated a bioresorbable barrier with and without decalcified freezedried bone allograft(DFDBA). The 92 periodontal defects were randomly treated with either the resorbable barrier alone or resorbable barrier in combination with DFDBA following thorough defect debridement and root preparation with tetracycline. Each patient received both types of treatment modalities. Clinical examinations(probing depth, gingival recession, clinical attachment level, plaque index and gingival index) were carried out immediately before and 4 months after surgery. Significant(p<0.001) gains in mean attachment level were observed for both smokers(2.93mm) and nonsmokers(3.30mm) but there were not significant difference between two groups. Similarly, significant reductions in mean probing depthshowed for smokers(4.52mm) and non-smokers(4.26mm). However, when comparing gingival recession, smokers were found to exhibit significantly poorer treatment results(1.59mm vs 0.96mm, p<0.05). Using the split-mouth-design, no statistically significant difference between the two modalities could be detected with regard to pocket depth reduction, gingival recession, or attachment gain. These results illustrate that the attachment gain is better in the non-smoker and the best in the non-smoker with the combination therapy of resorbable barrier and DFDBA than with resorbable barrier alone but smoking had no significant effect on clinical treatment outcome, even though smokers show more significant gingival recession. In addition, both treatments, either resorbable barrier plus DFDBA or resorbable barrier alone, promoted significant resolution of periodontal defects but the addition of DFDBA with a bioabsorbable membrane appears to add no extra benefit to the only membrane treatment.
Allografts ; Debridement ; Gingival Recession ; Guided Tissue Regeneration ; Humans ; Membranes* ; Smoke* ; Smoking* ; Tetracycline ; Treatment Outcome

BACKGROUND AND OBJECTIVES: Cilostazol is an antiplatelet drug with antiproliferative properties when administered after coronary bare metal stent implantation. However, its effect on clinical and angiographic outcomes after sirolimus-eluting stent (SES) implantation in native coronary arteries has not been established. SUBJECTS AND METHODS: Two hundred patients who had undergone successful SES implantation were randomly assigned to receive, in addition to aspirin, 75 mg clopidogrel daily or 100 mg cilostazol twice daily after one month of triple oral therapy (aspirin, clopidogrel, and cilostazol). The medications were continued until the follow-up coronary angiography, which was performed after six months. RESULTS: There were no significant differences in the minimal luminal diameters before and immediately after the coronary intervention, and at the follow-up angiography. The late loss of minimal luminal diameter was 0.26+/-0.40 mm in the cilostazol group and 0.28+/-0.41 mm in the clopidogrel group (p=0.773). Other quantitative coronary angiography variables were also similar in the two groups. Restenosis, determined by quantitative coronary angiography at six months and defined as > or =30% narrowing, occurred in 11.4% of the clopidogrel group and 8.7% of the cilostazol group (p=0.478). However, in-stent restenosis was focal (100% vs 23.1% in the clopidogrel group, p<0.001), and shorter in the cilostazol group (6.26+/-2.42 vs 14.5+/-6.55 mm, p=0.001). CONCLUSION: Cilostazol was not inferior to clopidogrel in terms of clinical anti-coagulation effect, and had an antiproliferative effect in native coronary arteries after SES implantation.
Angiography ; Aspirin ; Coronary Angiography ; Coronary Restenosis ; Coronary Vessels* ; Drug-Eluting Stents* ; Follow-Up Studies ; Humans ; Phenobarbital ; Sirolimus ; Stents

BACKGROUND/AIMS: Impaired responsiveness to clopidogrel is common in patients with type 2 diabetes mellitus (DM). The aim of this study was to evaluate the clinical application of a point-of-care assay to detect impaired responsiveness to clopidogrel after coronary stent implantation in patients with type 2 DM. METHODS: We measured P2Y12 reaction units (PRU) with the VerifyNow point-of-care assay in 544 consecutive patients undergoing dual or triple (i.e., dual plus cilostazol) anti-platelet therapy after coronary stent implantation. High platelet reactivity (HPR) was defined as a PRU value > or = 240. RESULTS: The mean PRU values were 233.5 +/- 83.2 and 190.3 +/- 85.5 in patients undergoing dual or triple anti-platelet therapy, respectively (p < 0.001). Patients with DM manifested higher post treatment PRU values (238.3 +/- 82.4 vs. 210.8 +/- 86.8, p = 0.001) and a higher frequency of HPR (44.8% vs. 31.0%, p = 0.003) as compared to patients without DM. We also found that higher PRU values and a higher frequency of HPR were present in patients with DM who were undergoing both triple and dual anti-platelet therapy. However, the higher post-treatment PRU values observed in patients with DM decreased with triple anti-platelet therapy (219.4 +/- 82.5 vs. 247.9 +/- 81.1, p = 0.044). CONCLUSIONS: A point-of-care assay can detect elevated platelet reactivity and impaired responsiveness to clopidogrel in patients with type 2 DM. The addition of cilostazol to dual anti-platelet therapy may decrease post-treatment PRU values in patients with type 2 DM.
Aged ; Angioplasty, Balloon, Coronary/adverse effects/*instrumentation ; Aspirin/administration & dosage ; Chi-Square Distribution ; Coronary Disease/blood/*therapy ; Diabetes Mellitus, Type 2/*blood ; Drug Therapy, Combination ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Platelet Activation/*drug effects ; Platelet Aggregation Inhibitors/*administration & dosage/adverse effects ; *Platelet Function Tests ; *Point-of-Care Systems ; Predictive Value of Tests ; Purinergic P2Y Receptor Antagonists/*administration & dosage/adverse effects ; Registries ; Republic of Korea ; Risk Assessment ; Risk Factors ; *Stents ; Tetrazoles/*administration & dosage/adverse effects ; Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives ; Treatment Outcome