Regional left ventricular dysfunction is common in patients with coronary artery disease and accurate analysis of regional dysfunction is of particular interest. For the quantitative assessment of regional dysfunction, we measured regional ejection fraction by radial sector division method in 19 patients with acute myocardial infarction and 13 normal controls who had multigated blood pool scan. And two independent observer analyzed regional wall motion using 5 point grading system in 18 patients undergoing radionuclide ventricular cineangiography. The results obtained were as follows : 1) Regional wall motion scores for the gated blood pool study agreed completely in 72 of 108 segments (66.7%) and agreed within 1 grade in 88 of 108 segments(81.5%) and agreement rate is lowest in the septal area. 2) Global left ventricular ejection fraction was 63.2+/-4.2% in normal controls, 36.6+/-6.8% in extensive anterior wall infarction group and 52.6+/-9.7% in inferior wall infarction group. The value of extensive anterior wall infarction group was significantly lower than that of inferior wall infarction group(p<0.005). 3) Regional left ventricular ejection fraction by radial sector division method in normal control group were as follows : area 1 ; 56.5+/-6.7%, area 2 : 77.9+/-4.8%, area 3 ;84.3+/-5.5%, area 4 : 76.8+/-6.6%, area 5 ; 84.7+/-7.6%, area 6 ; 85.9+/-11.2%, area 7 ; 75.5+/-12.3%, area 8 ; 74.9+/-14.0%, area 9 ; 75.5+/-8.8%, area 10 ; 54.2+/-11.0%, 11 ; 34.5+/-16.3, area 12 ; 37.1+/-18.0%. 4) Mean regional ejection fraction in 7 patients with anterior wall infarction showed significantly lower values in area 4 to area 8, and in area 2 to area 5 in case of inferior wall infarction group. 5) We thought that regional ejection fraction obtained by radial sector division method is valuable index for the management and evaluation of patients with coronary artery disease.
Cineangiography ; Coronary Artery Disease ; Humans ; Infarction ; Myocardial Infarction* ; Septum of Brain ; Stroke Volume ; Ventricular Dysfunction, Left

A statistical study was done on arrhythmia of the aged who were older than 60 during the period 1963~1972 at Seoul national University Hospital. This study included 6,511 patients among 40,000 total patients. The results were as follows. 1) Arrhythmias were observed among 3,058 patients(46.97%). Sinus irregularitis were the most frequent arrhythmia. 2) Except sinus irregularities premature beat (38.3%), atrial fibrillation (16.1%), bundle branch block (10.5%), atriovenricular block (10.5%), atrioventricular escape beat (5.1%), atrioventricular junctional rhythm (4.9%), wandering pacemaker(4.0%) and paroxysmal tachycardia(2.5%) were frequent arrhythmias. 3) Cardiovascular disease was major underlying disease. In cardiovascular disease group, the incidence of arrhythmia was 51.15% which was three times as high as non-cardiovascular and normal group. 4) Most arrhythmias were more frequently observed among the aged except bundle branch block and ventricular paroxysmal tachycardia. 5) The incidence of arrhythmia was similar among the aged except pre-excitation syndrome which was predisposed to woman. 6) Arrhythmia was most frequently observed in coronary heart disease. 7) Among sinus irregularities, simus bradycardia was more frequent in the aged. 8) There were no significant differences in frequency of arrhythmia between non-cardiovascular disease group patients and normal group.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Bradycardia ; Bundle-Branch Block ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Coronary Disease ; Female ; Humans ; Incidence ; Pre-Excitation Syndromes ; Seoul ; Statistics as Topic* ; Tachycardia, Paroxysmal ; United Nations

OBJECTIVE: Closure of a low transverse cesarean incision with one layer and two layer, we compared operative time, hemostasis, blood loss and postoperative sonohysteroperitoneographic findings. Study design: At our hospital 103 women were randomized to closure of a low transverse cesarean incision with either one continuous layer of a locking No. 1 chromic suture or two continuous of No. 1 chromic suture with the first layer locked between Mar. 1, 1998 and Dec. 31, 1998. After three months later, sonhysteroperitoneography was taken and then we evaluated uterus indirectly. RESULTS: A one layer closure required less operative time, 16 versus 20.8 minutes (p<0.01), less hemoglobin change, 0.44 versus 1.3 (p<0.01) and less suture materials (p<0.01). But postoperative follow up sonohysteroperitoneography, a one layer closure shows slightly thinning of isthmic layer of myometrium, two layer closure shows more adhesional band and both are similar other findings. CONCLUSION: A one layer does not significantly affect the clinical course than traditional two layer closure. So we recommended a one layer closure when its use is anatomically feasible.
Animals ; Female ; Follow-Up Studies ; Hemostasis ; Humans ; Mice ; Myometrium ; Operative Time ; Sutures ; Uterus

PURPOSE: Few epidemiologic studies have investigated aggressive periodontitis in Koreans, but such studies of disease prevalence and other clinical characteristics would be invaluable in providing proper treatment. The aim of this study was to assess the prevalence of aggressive periodontitis and to measure the extent of associated periodontal breakdown. METHODS: The study population consisted of 1,692 patients who visited the Department of Periodontology, Wonkwang Daejeon Dental Hospital from January to December, 2010. Clinical parameters (probing depth, gingival recession, periodontal attachment loss) were measured by a single examiner, and radiographic examination was performed at the baseline. RESULTS: Twenty-eight (1.65%) patients showed clinical features of aggressive periodontitis, of which 27 patients exhibited the generalized form, and 1 exhibited the localized form. There was no significant difference between the percentage of male and female patients. The probing pocket depth of the maxillary first molar was deeper than that of the other teeth and gingival recession was also the most serious at the maxillary first molar. The periodontal attachment loss was the highest at the maxillary first molar. The average number of missing teeth was 1.29 per subject. Loss of the second molar was prominent. CONCLUSIONS: Within the limitations of this study, the periodontal breakdown evaluated by attachment loss was found to be most severe at the first molars of aggressive periodontitis patients. However, further large scale multicenter studies are necessary to access more precise data, including prevalence.
Aggressive Periodontitis ; Epidemiologic Studies ; Female ; Gingival Recession ; Humans ; Male ; Molar ; Periodontal Attachment Loss ; Prevalence ; Tooth

Liquid tissue adheisve, Histoacryl (n-butyl-2-cyanoacrylate) has been used for the treatment of gastric variceal bleeding. The techniques are as follows: 0.5cc Histoacryl mixed with Lipiodol per each injection are used. 3 to 4 injections are usually required for large variceal convolutes under the fluoroscopic visualization after the injection of Histoacryl. Complications of sclerotherapy with Histoacryl are bleeding, perforation, stenosis and embolism depending on the concentration and amount used, as well as the intensity of the treatment. Here we describe a case report developing portal and splenic vein thrombosis as a side effect after Histoacryl injection therapy for the treatment of gastric varix bleeding, A 59-year-old male patient with liver cirrhosis was admitted due to acute gastric varix bleeding. The control of gastrie variceal bleeding was achieved by several injections of 0.7c mixture of 0.5cc histoacryl and 0,8cc Lipiodol. However, simple X-ray and ultrasonography revealed the elements of Histoacryl-lipiodol mixture in the portal and splenic vein.
Constriction, Pathologic ; Embolism ; Enbucrilate* ; Esophageal and Gastric Varices* ; Ethiodized Oil ; Hemorrhage ; Humans ; Liver Cirrhosis ; Male ; Middle Aged ; Sclerotherapy ; Splenic Vein* ; Thrombosis* ; Ultrasonography

Pacemaker twiddler's syndrome is reported as a very rare complication of permanent pacemaker implantation. There was a recent report suggesting that the incidence of pacemaker twiddler's syndrome increase recently presumably as a result of the implantation of thinner and smaller pacemaker system than before. We experienced a case of pacemaker twiddler's syndrome complicated 3 times with the conventional method of implantation or replacement during 14 months after the first implantation(Optims MP 158C and Pacing lead 400, Telectronic)on June 13th 1987. This case was an 18 year-old high school girl who had suffered frequent syncope for 2 years and extertionl dyspnea for 5 years due to congenital complete heart block, of which block site was proved to be AV nodal by His bundle electrogram. Pacemaker twiddler's syndrome developed 3 times;firstly 6 weeks after the first implantation in the right subclavicular fossa, secondly 10 weeks after the replacement of the twisted pacing lead, thirdly 10 months after the change of implantation site to the left subcalvicular fossa with the replacement of the twisted and fractured lead. Finally, the pacemaker generator was anchored to the clavicular periostium and pectoralis fascia at several points by using Dacron pouch.
Adolescent ; Dyspnea ; Electrophysiologic Techniques, Cardiac ; Fascia ; Female ; Heart Block ; Humans ; Incidence ; Polyethylene Terephthalates ; Syncope

PURPOSE: The aim of this study was to evaluate and compare tooth surface characteristics in extracted human molars after cervical enamel projections (CEPs) were removed with the use of three rotating instruments. METHODS: We classified 60 extracted molars due to periodontal lesion with CEPs into grade I, II, or III, according to the Masters and Hoskins' criteria. Each group contained 20 specimens. Three rotating instruments were used to remove the CEPs: a piezoelectric ultrasonic scaler, a periodontal bur, and a diamond bur. Tooth surface characteristics before and after removal of the projections were then evaluated with scanning electron microscopy (SEM). We analyzed the characteristics of the tooth surfaces with respect to roughness and whether the enamel projections had been completely removed. RESULTS: In SEM images, surfaces treated with the diamond bur were smoothest, but this instrument caused considerable harm to tooth structures near the CEPs. The piezoelectric ultrasonic scaler group produced the roughest surface but caused less harm to the tooth structure near the furcation. In general, the surfaces treated with the periodontal bur were smoother than those treated with the ultrasonic scaler, and the periodontal bur did not invade adjacent tooth structures. CONCLUSIONS: For removal of grade II CEPs, the most effective instrument was the diamond bur. However, in removing grade III projections, the diamond bur can destroy both adjacent tooth structures and the periodontal apparatus. In such cases, careful use of the periodontal bur may be an appropriate substitute.
Dental Enamel* ; Dental Instruments ; Furcation Defects ; Humans ; Microscopy, Electron, Scanning ; Molar* ; Root Planing ; Tooth ; Ultrasonics

As the first nationwide Korean prospective multicenter data collection registry, the Korea Acute Myocardial Infarction Registry (KAMIR) launched in November 2005. Through a number of innovative approaches, KAMIR suggested new horizons about acute myocardial infarction (AMI) which contains unique features of Asian patients from baseline characteristics to treatment strategy. Obesity paradox was existed in Korean AMI patients, whereas no gender differences among them. KAMIR score suggested new risk stratifying method with increased convenience and an enhanced accuracy for the prediction of adverse outcomes. Standard loading dose of clopidogrel was enough for Asian AMI patients. Triple antiplatelet therapy with aspirin, clopidogrel and cilostazol could improve clinical outcomes than dual antiplatelet therapy with aspirin and clopidogrel. Statin improved clinical outcomes even in AMI patients with very low LDL-C levels. The rate of percutaneous coronary intervention was higher and door-to-balloon time was shorter than the previous reports. Zotarolimus eluting stents as the 2nd generation drug-eluting stent (DES) was not superior to the 1st generation DES, in contrast to the western AMI studies. KAMIR made a cornerstone in the study of Korean AMI and expected to be new standards of care for AMI with the renewal of KAMIR design to overcome its pitfalls.
Acute Disease ; Drug-Eluting Stents ; Humans ; Myocardial Infarction/*diagnosis/drug therapy ; Platelet Aggregation Inhibitors/therapeutic use ; Registries ; Republic of Korea ; Risk Factors ; Severity of Illness Index ; Sirolimus/analogs & derivatives/therapeutic use

Type 1 Interferons (T1 IFN) play a pivotal role in innate immune responses against viral infection. Recently, this anti-viral cytokines are shown to be induced during bacterial infections via activation of various pattern recognition receptors (PRRs) including Toll-like receptors, RIG-I-like receptors, or NOD-like receptors. Signaling mediators such as MyD88, TRIF, MAVS, STING, or RIP2 of the receptor signaling pathways are also involved in T1 IFN responses depending on the bacterial species and their ligands. However, role of T1 IFN in anti-bacterial immunity is still obscure and its effect on immunological pathogenesis during bacterial infection has been controversial. It has been reported that T1 IFN could provide protective effect on several bacterial infections but it also aggravates pathogenic situation during some intracellular pathogens or secondary bacterial infection after respiratory viral infection. Here, we summarize recent findings how T1 IFN is induced by various bacterial pathogens and discuss the potential effect of T1 IFN responses on immune responses against bacterial infection.
Bacterial Infections* ; Bites and Stings ; Cytokines ; Immunity, Innate ; Interferon Type I* ; Interferons ; Ligands ; Receptors, Pattern Recognition ; Signal Transduction ; Toll-Like Receptors

Chronic infection with Epstein-Barr virus (EBV) without previous immunodeficiency or immuno-suppressive therapy is relatively rare. Severe chronic active EBV (SCAEBV) infection was reported for the first time in 1984 as 'chronic mononucleosis syndrome', and diagnostic criteria were proposed. It is characterized by clinical features including fever, severe hepatosplenomegaly, lymphadenopathy, hematologic features such as anemia and thrombocytopenia, and elevated antibody titers to EBV. We experienced a 21-year-old woman who initially presented with fever and chronic fatigue; however, no definite diagnosis could be made at the time of admission. Three months after the initial admission, there was evidence of only splenomegaly and the patient had persistent, multiple, paraaortic lymphadenopathies in abdominal CT. Diagnostic splenectomy was performed, and SCAEBV infection with T-cell lymphoproliferative disorder was ultimately diagnosed.
Adult ; Chronic Disease ; Diagnosis, Differential ; Epstein-Barr Virus Infections/*complications/*diagnosis ; Female ; Humans ; Lymphoproliferative Disorders/*diagnosis/pathology/virology ; Severity of Illness Index ; Splenectomy ; *T-Lymphocytes ; Tomography, X-Ray Computed