No abstract available.
Pierre Robin Syndrome*

No abstract available.

No abstract available.
Atrial Natriuretic Factor* ; Humans* ; Lymph Nodes* ; Polymerase Chain Reaction*

BACKGROUND: Coronary stent is known as an effective treatment in the intimal dissection after angioplasty and the prevention of restenosis. However, in-stent restenosis still remains a major concern in clinical stenting. METHOD: The Microstents were placed in 151 patients from May '96 to Aug '97 and performed follow-up coronary angiograms in 49 (32.5%) patients. To identify the clinical, angiographic and procedure-related variables that predict late restenosis within the stented artery, 49 patients (58+/-8 year:38 M, 11 F) were studied. Indications for stenting were 25 de novo (52.8%), 9 restenotic (18.7%), 8 suboptimal PTCA (16.7%) and 6 bail-out lesions (12.6%). All patients were treated with aspirin and ticlopidine for one month after stenting. The follow-up angiograms were obtained at 5+/-3 months and variables of 13 patients with restenosis were compared with those of 36 patients without restenosis. RESULTS: The in-stent restenosis rate was 26.5%. Univariate logistic regression analysis was used to determine how in-stent restenosis was influenced. Clinical diagnosis, presence of risk factors, lipid profiles, numbers of involved vessels, target arteries, lesion length, lesion types, stent length, maximal inflation pressure, predilation balloon size, reference vascular diameter, minimal luminal diameter, and stent to artery diameter ratio were analyzed. Among these variables, only lesion length before stent implantation was a predictor for in-stent restenosis (19.9+/-11.1 mm vs. 10.9+/-7.3 mm, p=.017). CONCLUSION: Lesion length before Microstent II implantation is the single predictor of late in-stent restenosis.
Angioplasty ; Arteries ; Aspirin ; Diagnosis ; Follow-Up Studies ; Humans ; Inflation, Economic ; Logistic Models ; Phenobarbital ; Risk Factors ; Stents ; Ticlopidine

BACKGROUND: Percutaneous transluminal coronary angioplasty(PTCA) for long coronary lesion is known to be associated with low success rate,suboptimal outcome,high complication and restenosis rates. Here we report the early clinical and angiographic results of long coronary stent implantations for long coronary lesions. METHOD: We analyzed the clinical,angiographic features and early results after stent implantations in 46 patients who were implanted long coronary stent(> or =20mm in length)among 174 stented patients at Chonnam University Hospital from Jan.through Nov.1996. RESULT: 1) Age was 59+/-7(35-78) years,and sex ratio was 2.5:1(33 male:13 female). clinical diagnosis was as follows; 24 patients with unstable angina, 21 with acute myocardial infarction, 1 with stable angina and 6 with old myocardial infarction. Left ventricular ejection fraction by left venriculogram was 58+/-10(27-87)%. 2) Involved numbers of vessel were single in 27 patients, two in 14 patients, and three in 5 patients. Target stented coronary arteries were 28 left anterior descending arteries, 17 rigtt coronory arteries, and 1 left circumflex artery. Morphologic types of target lesions were type C in 26 patients, type B2 in 20, and diameter stenosis(DS) was 76+/-13%, minimal luminal diameter(MLD) 1.0+/-0.3mm, length 21+/-6(10-38)mm. Indications for stent were 28 denovo lesions, 10 restenoses, 5 suboptimal PTCAs and 3 bailout procedures. Twenty six Microstents 2, 15 Wallstents, 4 Freedom stents, and 1 Wictor stent were used. Stent diameter was 3.2+/-0.3(2.5-5.0)mm and length 30+/-3(20-49)mm, stent diameter/reference diameter(RD) ratio 1.0+/-0.1, and stent minus lesion length 9.0+/-3.7mm. 3) Stents were deployed successfully in all 46 patients. No procedure-related death, myocardial infarction, emergency bypass surgery, and laboratory evidences of acute or subacute stent thrombosis were observed. 4) DS was decreased to 3.5+/-7.5%, MLD was increased to 3.2+/-0.3mm(p<0.0001, respectively). Acute gain was 2.2+/-0.4mm(71.8+/-15.6%,p<0.0001). CONCLUSION: We observed high success rate without major complications in long stent implantations for long coronary arterial lesions. Long-term follow-up should be required to prove long coronary stent as a better treatment modality to reduce acute complications and late restenosis.
Angina, Stable ; Angina, Unstable ; Arteries ; Coronary Vessels ; Diagnosis ; Emergencies ; Follow-Up Studies ; Freedom ; Humans ; Jeollanam-do ; Myocardial Infarction ; Phenobarbital ; Sex Ratio ; Stents* ; Stroke Volume ; Thrombosis

OBJECTIVE: To examine whether the presence of high risk-human papilloma virus (HR-HPV) after conization of the cervix was a risk factor for persistence or recurrence of cervical intraepithelial neoplasia (CIN) and whether HR-HPV test could be a guideline for post-therapy surveillance. METHODS: The study retrospectively analyzed data from 243 patients who underwent LLETZ or CKC of the cervix due to CIN. RESULTS: A positive HR-HPV test result which was performed between 3 and 6 months after procedure was a risk factor for persistent or recurrent cytological (p<0.001, odds ratio [OR]=22.51, 95% confidence interval [CI]=9.74-52.02) and pathological (p<0.001, OR=18.28, 95% CI=5.55-60.20) abnormalities. CONCLUSION: HR-HPV positive patients between 3 and 6 months after procedure should undergo frequent and meticulous post-therapy surveillance, while HR-HPV negative patients do not require such high-level surveillance and could undergo routine surveillance.
Cervical Intraepithelial Neoplasia ; Cervix Uteri ; Conization ; Female ; Follow-Up Studies ; Humans ; Odds Ratio ; Papilloma ; Recurrence ; Retrospective Studies ; Risk Factors ; Viruses

BACKGROUND: One of most important mechanisms of coronary stent restenosis is neointimal hyperplasia. Although the process of neointima formation is not fully understood, a special role has been advocated for adherent platelets. Previous studies have shown a clear benefit with combined antiplatelet therapy such as aspirin plus ticlopidine in reducing the rate of thrombotic occlusions of stented vessels. The purpose of this study was to evaluate the effects of duration of antiplatelet regimens on coronary stent restenosis. METHODS: After successful placement of coronary artery stents in 222 patients, we performed follow-up coronary angiograms in 99 patients (42.3%). Forty-six patients were randomly assi-gned to receive aspirin and ticlopidine for four weeks (Group I: 54+/-9 years: M 38, F 8) and 48 patients for 6 months (Group II: 58+/-8 years: M 38, F 10). RESULTS: There were no significant differences in clinical and procedural variables or coronary lesion characteristics before and after stenting. At 6 months after stenting, minimal luminal diameter was 2.16+/-0.93mm in Group I and 2.04+/-1.07mm in Group II (p-0.57). Late lumen loss was 0.80+/-1.07mm in Group I and 0.92+/-1.11mm (p-0.58) in Group II. The stent restenosis rate of Group I at 28.3% and that of Group II at 29.2% were not statistically significant between the two groups (p-0.92). CONCLUSIONS: The therapeutic duration of combined antiplatelet regimen with aspirin and ticlopidine after coronary stent does not affect stent restenosis rate.
Aspirin* ; Coronary Vessels ; Follow-Up Studies ; Humans ; Hyperplasia ; Neointima ; Phenobarbital ; Stents* ; Ticlopidine*

BACKGROUND: Acute or subacute stent thrombosis, bleeding complications and restenosis remain major clinical concerns in coronary stenting despite high pressure inflation and intravascular ultrasound guidance. A new strategy of local heparin delivery may maintain sustained local concentration and limit systemic complications. To observe the feasibility and efficacy of local heparin delivery in stenting, local heparin deliveries were performed in stented patients. METHOD: Heparin was delivered(5,000 Units, 1.0ml/min over 10 min) using the Dispatch Catheter, after predilation of target lesons in 10 patients(4 unstable angina, 6 acute myocardial infarction, mean age 52+/-7 yr) in the left anterior descending artery without systemic heparin loading. After local heparin delivery. Palmaz-Schatz stents were placed using standard methods. APTT and CK were checked at 1hr, 3hrs and 24 hrs after local heparin delivery and stenting. Follow-up coronary angiograms were done at 48 hrs and 6 months after stenting. RESULTS: All patients had no ischemic symptoms or ECG changes during and after local heparin delivery. All APTT and CK values were unchanged at 3 hrs and 24 hrs after local heparin delivery and stenting. Follow-up quantitative coronary angiograms at 48 hrs and 6 months showed all stents patent, with TIMI III distal flow, and without intra-stent thrombus(%diameter stenosis : 79.4+/-4.2% before predilation, 32.9+/-7.7% after predilation, 32.4+/-13.1% after local delivery, 14.2+/-2.3% immediately after stenting, 13.9+/-2.5% at 48 hrs and 21.7+/-8.8% at 6 months after stenting). CONCLUSION: Intracoronary stenting may be performed safely and effectively without systemic heparin therapy by using local heparin prior to stent implantation. Long-term stent patency and lack of coronary events appear favorable.
Angina, Unstable ; Arteries ; Catheters ; Constriction, Pathologic ; Electrocardiography ; Follow-Up Studies ; Hemorrhage ; Heparin* ; Humans ; Inflation, Economic ; Myocardial Infarction ; Stents* ; Thrombosis ; Ultrasonography

In this study, we evaluated accuracy and usefulness of CyberKnife Respiratory Tracking System (SynchronyTM, Accuray, USA) about a moving during stereotactic radiosurgery. For this study, we used moving phantom that can move the target. We also used Respiratory Tracking System called Synchrony of the Cyberknife in order to track the moving target. For treatment planning of the moving target, we obtained an image using 4D-CT. To measure dose distribution and point dose at the moving target, ion chamber (0.62 cc) and gafchromic EBT film were used. We compared dose distribution (80% isodose line of prescription dose) of static target to that of moving target in order to evaluate the accuracy of Respiratory Tracking System. We also measured the point dose at the target. The mean difference of synchronization for TLS (target localization system) and Synchrony were 11.5+/-3.09 mm for desynchronization and 0.14+/-0.08 mm for synchronization. The mean difference between static target plan and moving target plan using 4D CT images was 0.18+/-0.06 mm. And, the accuracy of Respiratory Tracking System was less 1 mm. Estimation of usefulness in Respiratory Tracking System was 17.39+/-0.14 mm for inactivity and 1.37+/-0.11 mm for activity. The mean difference of absolute dose was 0.68+/-0.38% in static target and 1.31+/-0.81% in moving target. As a conclusion, when we treat about the moving target, we consider that it is important to use 4D-CT and the Respiratory Tracking System. In this study, we confirmed the accuracy and usefulness of Respiratory Tracking System in the Cyberknife.
Four-Dimensional Computed Tomography ; Prescriptions ; Radiosurgery ; Track and Field

In this study, we estimated inhomogeneity correction factor in small field. And, we evaluated accuracy of treatment planning and measurement data which applied inhomogeneity correction factor or not. We developed the Inhomogeneity Correction Phantom (ICP) for insertion of inhomogeneity materials. The inhomogeneity materials were 12 types in each different electron density. This phantom is able to adapt the EBT film and 0.125 cc ion chamber for measurement of dose distribution and point dose. We evaluated comparison of planning and measurement data using ICP. When we applied to inhomogeneity correction factor or not, the average difference was 1.63% and 10.05% in each plan and film measurement data. And, the average difference of dose distribution was 10.09% in each measurement film. And the average difference of point dose was 0.43% and 2.09% in each plan and measurement data. In conclusion, if we did not apply the inhomogeneity correction factor in small field, it shows more great difference in measurement data. The planning system using this study shows good result for correction of inhomogeneity materials. In radiosurgery using small field, we should be correct the inhomogeneity correction factor, more exactly.
Electrons ; Radiosurgery