Diltiazem(Herben(R)) was orally administered in a daily dose of 180mg over 8 weeks to 15 patients with angina pectoris requiring minimum 5 tablets of nitroglycerin per week. The symptom of angina pectoris was scored according to frequency and character of anginal attacks and the number of nitroglycerin tablets used was recorded during the Diltiazem therapy. We noted significant decrease of the score of anginal attack and the number of nitroglycerin tablets used during the course of Diltiazem therapy. No significant change in blood pressure, heart rate and the product of systolic blood pressure and heart rate was noted during the course of Diltiazem therapy. It is possibel that Diltiazem improved ischemic heart disease by slightly decreasing myocardial oxygen demand and increasing blood flow to the ischemic areas by dilatation of coronary arteries and collateral vessels. There was no abnormal change in laboratory findings during the Diltiazem treatment. These findings suggest that Diltiazem(Herben(R)) is a favorable and safe antianginal agent useful for longterm treatment of anginal pectoris.
Angina Pectoris* ; Blood Pressure ; Coronary Vessels ; Dilatation ; Diltiazem ; Heart Rate ; Humans ; Myocardial Ischemia ; Nitroglycerin ; Oxygen ; Tablets

PURPOSE: The purpose of this study was to analyze of the MR findings of the pyogenic osteomyelitis involving the epiphyses of the long bones in childhood. MATERIALS AND METHODS: Eleven childen with pyogenic osteomyelitis involving the epiphyses of the long bones were evaluated by MRI. A diagnosis of pyogenic osteomyelitis was established by biopsy and culture in eight cases and during follow-up after antibiotic treatment in three. We analyzed the involved bone, initial location, pattern, degree of growth plate involvement, degree of epiphyseal involvement, surrounding change and plain radiographic findings. RESULTS: The involved bones were the proximal femur in four cases, distal femur in two, proximal tibia in two, distal tibia in one, distal fibula in one and proximal humerus in one. The initial site of the lesion was the metaphysis in ten cases and epiphysis in one. The lesion pattern was the Brodie's abscess in six cases and osteomyelitis in five. The degree of growth plate involvement was 16-20% in five case and 5% or less in four ; the degree of epiphyseal involvement was 5% or less in four cases, 6-10% in four and 11-15% in two. All cases showed low or intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement. Joint effusion adjacent to the lesion was detected in five cases. Radiographic findings of the involved epiphysis were normal in six cases, but indicated osteolytic lesion in four cases and sclerosis in one. CONCLUSION: Pyogenic osteomyelitis involving the epiphyses of the long bones in childhood usually developed from metaphyseal osteomyelitis and was combined with destruction of the growth plate.
Abscess ; Biopsy ; Diagnosis ; Epiphyses* ; Femur ; Fibula ; Follow-Up Studies ; Growth Plate ; Humerus ; Joints ; Magnetic Resonance Imaging ; Osteomyelitis* ; Sclerosis ; Tibia

PURPOSE: The purpose of this study was to analyze of the MR findings of the pyogenic osteomyelitis involving the epiphyses of the long bones in childhood. MATERIALS AND METHODS: Eleven childen with pyogenic osteomyelitis involving the epiphyses of the long bones were evaluated by MRI. A diagnosis of pyogenic osteomyelitis was established by biopsy and culture in eight cases and during follow-up after antibiotic treatment in three. We analyzed the involved bone, initial location, pattern, degree of growth plate involvement, degree of epiphyseal involvement, surrounding change and plain radiographic findings. RESULTS: The involved bones were the proximal femur in four cases, distal femur in two, proximal tibia in two, distal tibia in one, distal fibula in one and proximal humerus in one. The initial site of the lesion was the metaphysis in ten cases and epiphysis in one. The lesion pattern was the Brodie's abscess in six cases and osteomyelitis in five. The degree of growth plate involvement was 16-20% in five case and 5% or less in four ; the degree of epiphyseal involvement was 5% or less in four cases, 6-10% in four and 11-15% in two. All cases showed low or intermediate signal intensity on T1-weighted images, high signal intensity on T2-weighted images, and contrast enhancement. Joint effusion adjacent to the lesion was detected in five cases. Radiographic findings of the involved epiphysis were normal in six cases, but indicated osteolytic lesion in four cases and sclerosis in one. CONCLUSION: Pyogenic osteomyelitis involving the epiphyses of the long bones in childhood usually developed from metaphyseal osteomyelitis and was combined with destruction of the growth plate.
Abscess ; Biopsy ; Diagnosis ; Epiphyses* ; Femur ; Fibula ; Follow-Up Studies ; Growth Plate ; Humerus ; Joints ; Magnetic Resonance Imaging ; Osteomyelitis* ; Sclerosis ; Tibia

PURPOSE: To investigate the changes occurring in portal hemodynamics in patients with esophageal and gastric varices, according to variceal type, before and after TIPS. MATERIALS AND METHODS: Between January 1994 and June 1999, we evaluated 22 of 44 patients who had undergone TIPS and endoscopy on admission. In these 22, hepatic venous and main portal venous pressure were measured. On the basis of endoscpic findings, the esophageal and gastric varices were classified as one of three types. Changes in portal hemodynamics in relation to the diameter of the portal vein, mean portosystemic gradient before and after TIPS, delta MPSG, and the presence of hepatic encephalopathy and gastrorenal shunt were all evaluated. RESULTS: Endoscopy indicated that there were ten Type-I cases, nine Type-II, and three Type-III. The diameter of the main portal vein was 14.95 +/-1.79 mm in Type I cases, and 13.35 +/-1.59 mm in Type II. Before TIPS, main portal venous pressure was 31.40 +/-6.79 mmHg (Type I) and 22.80 +/-4.26 mmHg (Type II), and the mean portosystemic gradient was 16.10 +/-7.0 mmHg (Type I), and 11.20 +/-5.36 mmHg (Type II). After TIPS, the pressure readings were 25.70 +/-7.60 mmHg (Type I) and 17.80 +/-6.52 mmHg (Type II), while those relating to were 10.80 +/-4.94 mmHg (Type I) and 5.25 +/-3.67 mmHg (Type II). delta MPSG was 6.04 +/-2.98 mmHg (Type I) and 5.91 +/-3.98 mmHg (Type II). Angiography revealed that the gastrorenal shunt was Type I in 10% of cases, Type II in 77%, and Type III in 33%. Hepatic encephalopathy after TIPS occured in three Type-I cases, three-Type- II, and two Type-III. CONCLUSION: The diameter of the main portal vein was significantly smaller, and portal venous pressure and mean portosystemic gradient before and after TIPS significantly lower in patients with dominant gastric varices than in those with dominant esophageal varices (p<0.05). Gastrorenal shunt was more frequent among patients with dominant gastric varices. No difference in the incidence of hepatic encephalopathy after TIPS was noted between those with dominant gastric varices and those with the esophageal variety.
Angiography ; Endoscopy ; Esophageal and Gastric Varices* ; Hemodynamics* ; Hepatic Encephalopathy ; Humans ; Incidence ; Portacaval Shunt, Surgical ; Portal Pressure ; Portal Vein ; Portasystemic Shunt, Surgical* ; Reading

PURPOSE: We wanted to evaluate the safety and effectiveness of superselective transarterial embolization for the management of gastrointestinal bleeding. MATERIALS AND METHODS: We evaluated 97 of 115 patients who had undergone diagnostic angiography and transarterial embolization for gastrointestinal bleeding from February 2001 to July 2004, and they subsequently underwent superselective transarterial embolization. Their ages ranged from 17 to 88 years (mean age: 58.5 years), and 73 were men and 24 were women. The etiologies were a postoperative condition (n=31), ulcer (n=23), Mallory-Weiss syndrome (n=3), trauma (n=3), pseudoaneurysm from pancreatitis (n=3), diverticula (n=2), inflammatory bowel disease (n=2), tumor (n=2), Behcet's disease (n=2), hemobilia (n=1), and unknown origin (n=25). The regions of bleeding were the esophagus (n=3), stomach and duodenum (n=41), small bowel (n=38) and colon (n=15). All the patients underwent superselective transarterial embolization using microcoils, gelfoam or a combination of microcoils and gelfoam. Technical success was defined as devascularization of targeted vascular lesion or the disappearance of extravasation of the contrast media, as noted on the angiography after embolization. Clinical success was defined as the disappearance of clinical symptoms and the reestablishment of normal cardiovascular hemodynamics after transarterial embolization without any operation or endoscopic management. RESULTS: The technical success rate was 100%. The primary clinical success rate was 67% (65 of 97 patients). Of the 32 primary failures, fourteen patients underwent repeat embolization; of these, clinical success was achieved in all the patients and so the secondary clinical success rate was 81% (79 of 97 patients). Of the 18 patients with primary failures, five patients underwent operation, one patient underwent endoscopic management and the others died during the observation period due to disseminated coagulopathy or complications of their underlying diseases. During the follow up period, six patients of the 79 clinically successful patients died due to disseminated coagulopathy or complications of their underlying diseases, and so the total mortality rate was 19% (18 of 97 patients). Postembolization complications such as bowel ischemia or infarction did not occur during the observation period. CONCLUSION: Superselective transarterial embolization is an effective therapy for treating acute gastrointestinal hemorrhage, and it has a high technical rate and clinical success rate, and a low complication rate.
Aneurysm, False ; Angiography ; Colon ; Contrast Media ; Diverticulum ; Duodenum ; Esophagus ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemodynamics ; Hemorrhage* ; Humans ; Infarction ; Inflammatory Bowel Diseases ; Ischemia ; Male ; Mallory-Weiss Syndrome ; Mortality ; Pancreatitis ; Stomach ; Ulcer

BACKGROUND: There has been some reports demonstrating the geographic heterogeneity in frequency of specific cytogenetic aberrations, but little is known about the types, frequency and prognostic value of specific chromosomal abnormalities in Korean adults with acute myelogenous leukemia. To evaluate cytogenetic characteristics of Korean adults with acute myelogenous leukemia, following study was performed. METHODS: Cytogenetic studies using high-resolution banding technique were done on newly diagnosed 38 patients with de nono acute myelogenous leukemia (AML) admitted to Asan medical center from January 1995 to May 1996. RESULTS: 1) Sixteen patients (42.1%) had clonal chromosomal abnormalities. 2) The t (8;21) was detected in 8 patients (21.1%). The t (15;17) was detected in 2 patients. The inv (16), del (11)(q23) and 7q- were detected in 1 patient each. Trisomy 21 as a sole abnormality was detected in 1 patient and complex abnormalities were detected in 2 patients. risomy 8 was not detected. 3) Eight (50%) of the 16 patients with AML-M2 had t (8;21), 2 of the 3 patients with AML-M3 had t (15;17) and 1 patient with AML-M4Eo had inv (16). 4) The median age of patients with chromosomal abnormalities was significantly younger than that of patients with normal karyotype (34 vs. 48 years, P=0.003). Other clinical andlaboratory characteristics were not significantly different between abnormal and normal cytogenetic groups. 5) The complete remission rate of patients with chromosomal abnormalities was lower than that of patients with normal karyotype, but the difference of CR rates was not statistically significant (78.1 vs. 84.2%, P=NS). CONCLUSION: These results suggest that lower incidence of trisomy 8, higher incidence of t (8;21) and stronger association between t (8;21) and AML-M2 than usually described may be the cytogenetic characteristics of acute myelogenous leukemia in Korean adult.
Adult* ; Chromosome Aberrations ; Chungcheongnam-do ; Cytogenetics ; Down Syndrome ; Humans ; Incidence ; Karyotype ; Leukemia, Myeloid, Acute* ; Population Characteristics ; Trisomy