Percutaneous coronary angioplasty is well established therapeutic modality in the management of coronary artery disease. However, the high restenosis rate of 30 to 50% limits its usefulness. The principal mechanism of restenosis, ntimalhyperplasia, is the proliferative response of vessel wall to injury, which consists largely of smooth muscle cells. A large body of animal investigations and a limited number of clinical studies have established the ability of ionizing radiation to reduce neointimal proliferation and restenosis rate significantly. Human studies have been reported that intravascular radiation after first restenosis inhibits a second restenosis. Encouraged by these reports, we are also conducting a double blind, placebo-controlled, randomized trial to evaluate this new therapeutic modality in patients with coronary artery stenosis. The objective of our trial is to determine the safety and efficacy of catheter-based solutional beta emitting radioisotope system in preventing restenosis after angioplasty. This review describes the vascular brachytherapy systems and isotopes that have been utilized in the initial clinical trials performed in this area of post PTCA coronary restenosis. The results of many worldwide ongoing clinical trials will determine whether this new technology will change the future practice of vascular intervention.
Angioplasty* ; Animals ; Brachytherapy ; Coronary Artery Disease ; Coronary Restenosis ; Coronary Stenosis ; Humans ; Isotopes ; Myocytes, Smooth Muscle ; Radiation, Ionizing

A muscular calf is esthetically unappealing in Asian women. Treatment by liposuction alone has poroven to be difficult due to a small amount of fat. We established a new method of transecting half of the gastrocnemius tendon in order to improve the contour of the calf. Thirty-five patients were operated on during the past 3 years. The medial or lateral half of the gastrocnemius tendon was cut using an endoscopic-guided 3M AGEE blade through a 1cm-sized incision. The portion of the muscle above the site of the transection was elevated from the underlying soleus muscles. We checked the calf circumference and evaluated the clinical results at 6 months postoperatively. An average 10% reduction in calf circumfernce was measured, showing a significant esthetic improvement. There were no significant changes in gait analysis or in the Cybex test. There were no specific complications related to the procedure. Through our clinical experience in 35 cases, we were able to prove that tenotomy is a effective, simple and easy method without severe morbidity.
Asian Continental Ancestry Group ; Female ; Gait ; Humans ; Lipectomy ; Muscles ; Tendons ; Tenotomy*

BACKGROUND: In recent years, lymphocyte subset analysis in peripheral blood is widely performed using erythrocytes-lysed whole blood and two color immunofluorescence/flow cytometry method. Use of fresh blood drawn within 6 hours of staining is recommended, and some patients have to revisit the hospital for blood collection. We tested whether 24 hours-refrigerated/stored whose blood can be used for lymphocyte subset analysis. METHODS: Twenty consecutive blood samples from patients (including nine HIV positive patients) collected in EDTA-vacutainer were tested: 1) on the day of sampling using fresh blood kept at room temperature for up to 6 hours until staining (as recommended by the manufacturer) and 2) on the following day using the same tube of blood refrigerated for 24 hours after the first staining. Two colon immunofluorescenc staining was done using Simultest(TM) IMK-Lymphocyte kit (Beckon Dickinson, U.S.A.) and flow cytometric analysis was performed using FACScan and SimulSET(TM) software (Becton Dickinson, U.S.A.). Results of alive kinds of Lymphocyte subsets (CD3+, CDl9+, CD3+CD4+CD3+CD8+, CD3-CDl6+ and/or CD56+) on day 1 and day 2 were compared by pained-t test and Wilcoxon signed rank test. RESULTS: There was no significant change of values for all of the lymphocyte subsets except CD3+CD8+suppressor/cytotoxic (S/C) T cells. There was a slight but statistically significant change in S/C T cells (39.9%-->41.8%: 1.9%, p=0.008) after 24 hours of refrigeration, and this change was observed mainly in HIV-positive patient group. However, there was no significant change in the absolute count of helper/inducer T cells or CD4/CD8 ratio, and the change of S/C T cells in these patients was not considered to be of clinical significance. CONCLUSIONS: The difference in the values of lymphocyte subsets between fresh blood and 24 hours-refrigerated blood was negligible and it is concluded that 24 hours-stored blood samples can be used for lymphocyte subset analysis for clinical purposes.
Colon ; HIV ; Humans ; Lymphocyte Subsets* ; Lymphocytes* ; Refrigeration ; T-Lymphocytes

No abstract available.
Fallopian Tubes* ; Female ; Pregnancy*

From May, 1985 to July, 1986, 500 cases of intraocular lenses were implanted, and all 500 cases had been followed up for more than 2 months. The results were as follows: 1. In the 500 cases of intraocular lens implantation, the number of patients were 318 men and 115 women. Patient's age was largely distributed to fifth decade in men and fourth decade in women. 2. IOL power ranged from +13.5D to +23.0D in PCL and ranged from +12.5D to +20.0D in ACL. The most frequently used IOL poeer was +19.5D in PCL and +18.0D in ACL. 3. Postoperative corrective vision with IOL was improved up to 0.8 or better in 446 cases(89.2%). 4. During operation, some complications were developed and those were posterior capsular rupture in 19 cases(3.8%), hyphema in 15 cases(3.0%), Descemet's membrane stripping in 2 cases(0.4%), and corneal edema in 1 case(0.2%). More frequently developed postoperative complications were clinical cystoid macular edema in 26 cases(5.2%), secondary glaucoma in 18 cases(3.6%), and distorted pupil in 13 cases(2.6%). 5. Postoperative corrective vision lower than 0.4 was observed in 22 cases(4.4 %), and the causes were diabetic retinopathy, cystoid macular edema, vitreous opacity, congenital cataract, phacoanaphylactic uveitis, endophthalmitis, amblyopia, optic nerve atrophy, corneal opacity, glaucoma, hypertensive retinopathy, and others.
Amblyopia ; Atrophy ; Cataract ; Corneal Edema ; Corneal Opacity ; Descemet Membrane ; Diabetic Retinopathy ; Endophthalmitis ; Female ; Glaucoma ; Humans ; Hypertensive Retinopathy ; Hyphema ; Lens Implantation, Intraocular ; Lenses, Intraocular* ; Macular Edema ; Male ; Optic Nerve ; Postoperative Complications ; Pupil ; Rupture ; Uveitis

BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Dipyridamole ; Humans ; Interviews as Topic ; Medical Records ; Multivariate Analysis ; Myocardial Infarction ; Perfusion ; Prognosis ; Proportional Hazards Models ; Smoke ; Smoking ; Tomography, Emission-Computed, Single-Photon*

No abstract available.
Echocardiography* ; Heart Defects, Congenital* ; Hypertension*

PURPOSE: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). MATERIALS AND METHODS: One hundred fifty patients (M:F=83:67, age 48.6+/-11.2 yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive ( 200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. RESULTS: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were 45+/-27 dpm in grade 0, 707+/-584 dpm in grade 1, 1558+/-584 dpm in grade 2, 1851+/-604 dpm in grade 3, and 2719+/-892 dpm in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. CONCLUSION: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.
Azure Stains ; Biopsy ; Breath Tests* ; Diagnosis ; Eating ; Helicobacter pylori* ; Helicobacter* ; Humans ; Scintillation Counting ; Sensitivity and Specificity ; Urea* ; Urease

The thirty eight newborn infants with periventricular leukomalacia who were admitted to the neonatal intensive care unit of Gil General Hospital from March 1, 1988 to June 30, 1991, were investigated for ultrasonographic findings, risk factors and neurological outcome. The results were as follows: 1) There were 38 cases of PVL including 21 echogenic flarings and 17 cystic PVL's. 2) Mean birth weight was 2,250 gm and mean gestational age was 35 week. 3) Mean detection timing was 4th day in echogenic flarings and 18th day in cystic PVL's. 4) PVL's were located in the parietal region in 1 case and fronto-parieto-occipital in 3 cases. 5) Mean cyst size was 6 mm. 6) Multiple logistic regression analysis for the risk factors of PVL showed that low birth weight, apnea and seizure were the most significant contributing factors (p<0.05). 7) In the follow-up study of cystic PVL's, 7 cases showed improvement, 7 cases developed into multicystic encephalomalacia and 3 cases developed into atrophy. 8) Neurodevelopmental outcome of cystic PVL's showed nomal; 6.2%, minor neurodevelopmental defect; 43.8%, major neurodevelopmental defect; 31.2% and death; 18.8%. 9) Neurosonographic predictability for neurodevelopemental sequelae by cystic PVL's showed sensitivity; 63.6%%, specificity; 98.0%, positive predictive value; 92.8% and accuracy; 88.2%. 10) Major neurodevelopmental defect was more frequent, cyst size being larger and location being more extensive (p<0.05).
Apnea ; Atrophy ; Birth Weight ; Encephalomalacia ; Follow-Up Studies ; Gestational Age ; Hospitals, General ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Intensive Care, Neonatal ; Leukomalacia, Periventricular* ; Logistic Models ; Rabeprazole ; Risk Factors* ; Seizures ; Sensitivity and Specificity

DiGeorge syndrome, a developmental defect of the third and fourth pharyngeal pouches, is characterized by aplasia or hypoplasia of the thymus and parathyroid glands and by conotruncal cardiac malformation. This syndrome is usually associated with deletion of long arm in chromosome 22 (22q11-). We experienced a case of partial DiGeorge syndrome in a 2-month-old male who had hospitalized because of recurrent hypocalcemic tetany and tetralogy of Fallot. Immunologic studies revealed the decreased percentage of T lymphocyte and increased percentage of B lymphocyte. Chromosomal study with high resolution banding, showed 46, XY, 22q13 deletion. We report a case of partial Digeorge syndrome with a brief review of literatures.
Arm ; Chromosomes, Human, Pair 22 ; DiGeorge Syndrome* ; Humans ; Infant ; Lymphocytes ; Male ; Parathyroid Glands ; Tetany ; Tetralogy of Fallot ; Thymus Gland